Challenges In The Home Care Industry By: Robert Rivera
10 Aug

Challenges In The Home Care Industry By: Robert Rivera

The senior population is growing. We face multiple challenges. These challenges are not only affecting the home care industry They are also affecting the seniors in need of assistance as well as their family members. One of the challenges is the shortage of Health Care workers, the lack of proper training and sometimes the lack of commitment from these workers. To alleviate these challenges the spokesperson for Ideal Home Care, CapenterLaborde said the CEO of the company founded a training school called Ideal School of Allied HealthCare.

At Ideal school individuals are not only trained to become nursing assistants, pharmacy technicians, EKG & Phlebotomy technicians but there is a focus on training individuals to become home health aides. They are trained by qualified, licensed registered nurses. In fact, the CEO of Ideal Home Care is also a registered nurse. She devotes her time to trainpeople to become Home Health Aides. She presses five qualities that are necessary when caring for the sick & vulnerable population. These qualities are reliability, punctuality, dependability, compassion and caring. Her goal is twofold after training individuals who have successfully completed the home health aide training they are hired by Ideal Home Care. Ideal School also refers the home health aide graduates to other homecare agencies in the community. These agencies have called to say that they have received higher satisfactions when they receive graduates of ISAHC with their own clients and it’s because they were well trained by Ideal School Instructors.

What to Do When an Aging Loved One Dies
10 Aug

What to Do When an Aging Loved One Dies

If and when my parent passes away (which will likely take place in my own home), I wouldn’t know what to do. Most people don’t know what to do. The process itself is overwhelming to think about. Take a deep breathe, the next few moments maybe may be a little hectic.

Things to consider just after passing

When your aging loved one dies, note the general time of death. You don’t necessarily need to call someone right away unless the circumstances of the death were unusual or if your loved one is an organ donor. Organs need to be transferred as quickly as possible. If you are not sure if they are an organ donor, you can check their driver’s license or any advanced health care directive (living will or health care proxy) they may have available. You may even consider calling the nearest hospital to speak with an organ donor coordinator who can help you through the process.

If your loved one is not an organ donor and you want to spend some time with the newly departed and say goodbye, then is the perfect time to do so. Within the first hour of death, you can also wash and dress the body if you’d like to do so. You can also close their eyes and mouth if they are open. Sometimes the mouth may reopen. If that happens, place a rolled towel underneath the chin in order to keep it shut.

Inviting relatives and loved ones to come say their final good-byes can be done as well. It is generally best to keep these types of invites to a select few as you may be overwhelmed, emotionally drained or even in a panic. Adding additional people’s emotions to your own may make matters worse. Funerals, viewings, and family gathering may be the more appropriate time to invite relatives to visit the deceased.

Calling a local funeral home is your next step (if other arrangements haven’t already been made). It may be many hours before they come. When they arrive they will have questions for you. They will transport your loved on a gurney from the place of death to their vehicle, then drive to the funeral home/mortuary.

Things you will need to think about during the upcoming days

The death of a loved one is not an easy thing to experience. Finalizing their final affairs can be just as difficult. Take time now to understand the items below so you will be prepared to assist your loved one with their final wishes and needs.

Funeral Arrangements

Considering the departed wishes and what you’re able to afford. Reach out to a funeral service and meet with the funeral director. They can assist in any decisions that need to be made including embalming or cremation, closed or open casket, burial site, headstone, etc.

Close Friends, Extended Family

You’ll want to contact the departed’s close friends and extended family and maybe a few of your own. They can help with moral support. This also gives them time to take time off to grieve and time off to attend the funeral.

Religious Leader

Notify the departed’s church leader or clergy. These individuals can help you and your family during the coming days.


Securing the departed’s home and vehicle is important. If the person lives in a rent home/facility, you’ll want to notify the property manager.


Does the departed have pets? If so, making arrangements for them will be necessary.

Post Funeral Gathering

Gathering those together who cared for the departed is a great way to share experiences and help each other through the grieving process. Enlist family and friends to help with this gathering.


Some funeral home may offer this as a service, or you may want to write one yourself. Check with the local newspaper on rates, deadlines, and submission guidelines.

After the Funeral

Death Certificates

Before you talk to any of the entities below, make sure you request and receive the death certificate and order duplicates. Funeral directors may help handle this but you can also visit your local vital statistics office in your state for further assistance.

Notifying government agencies

Social Security, Veterans Affairs (if applicable), Medicare, DMV, and the IRS are all agencies that need to be informed about the death of the departed. An official copy of the death certificate may be needed with the cause of death clearly provided. With the IRS, a final tax return will need to be filed.

Insurance Policies

Insurance companies will need to be notified of the death.

Estate (Probate), Creditors, Financial Advisors, Mortgage Companies, Banks, etc…

All will need to be notified. Accounts will need to be closed. Trusts and estates will need to be settled. Much of this can be done as paper statements arrive in the mail.

Credit Reporting Agencies, Other Memberships

Credit reporting agencies should be notified to limit the chance of identity theft. Other memberships such as Gym, Spa, Clubs, Library, etc should be cancelled as well.

What Should I Expect to Pay for Funeral and Burial Expenses
10 Aug

What Should I Expect to Pay for Funeral and Burial Expenses

A common goal among many aging seniors and their families is to put money aside for funeral and burial expenses. Most, however, are unsure how much to save and how prepared to be in the event of a death. It is certainly easier for one’s family if arrangements through estate planningfuneral pre-planning and funeral trusts are made. We encourage this. Even then, many unforeseen details and expenses can burden the family of the deceased.

A common tendency among families in the days and weeks leading up to a death is neglecting to find an affordable funeral provider. Another challenge is finding ways to fund all of the various expenses involved with a funeral and burial. Generally, this is due to emotional stresses and a simple lack of time and preparation. Most often, families will use the same funeral services their relatives have used. Time constraints will force many to overlook important questions like, “are we paying too much for this” or “is this best for the deceased and their survivors?”

Others, who have lost a veteran or their survivor, believe the Department of Veterans Affairs will cover all the costs associated with a funeral and burial. Although there are several allowances and benefits available to veterans and their survivors for funeral and burial, these will not cover the entire cost. Read the Senior Veterans Service Alliance’s article on VA Burial Allowances for rates and more information.


According to the Centers for Disease Control and Prevention, roughly 6,700 people pass away in the U.S. every day. Although funeral costs can easily be upward in the 10s of thousands of dollars, the average cost nationwide in the United States for a traditional funeral (including embalming and a metal casket) in 2013 was $6,000, according to data from the National Funeral Directors Association. In 2014, the national average cost rose to $7,181. Currently, the average cost for a traditional funeral is over $10,000.

Types of Funerals

Traditional Funeral Services

Traditional funeral services usually include embalming, dressing of the body, funeral home rental, a viewing, body transportation (via a hearse) to the funeral site, casket cost, and a cemetery plot or crypt. This is the most expensive type of funeral because many types of services and additional add-ons are available.

Direct Burial

This burial is a simpler version of a traditional service. A direct burial would likely include a simple container, no viewing or visitation, and no embalming. A memorial service would still be held at the graveside if desired.


The body is cremated after death without embalming. Remains are kept as the family desires. Costs are compounded as services are added.

General Information about Service Fes

Basic Service

Basic service fees are charged by the funeral provider and prices do vary. These fees are required and cover services such as: consultations, preparation and filing of permits, coordinating arrangements and third parties, overhead expenses (e.g. legal, accounting, professional licenses, insurance, maintenance and administration). According to the National Funeral Directors Association average fees are now over $2,000.


Casket styles vary from simple cardboard all the way to metal and fine wood. Industry studies show that the average casket shopper buys one of the first three models shown, generally the middle-priced. Although there are many casket options, pine caskets are generally less expensive and funeral homes rarely display them. An average casket will cost around $2,200.

Burial Vaults

Many cemeteries require caskets be placed inside an outer container known as a grave liner or burial vault. These are rectangular boxes made of concrete, composite plastic, or metal. These vaults and liners are made to last forever and will even preserve the cemetery’s lawn and grounds. A casket buried without a vault or liner will eventually deteriorate and collapse resulting in uneven ground. This in turn can tilt a head stone and dirty the interior of the casket. An average vault will cost around $1,300.

Body Removal

The pick up and transport costs for newly deceased body from a residence, hospital or other location to a funeral home can be expensive. The further away the body has to be transported the higher the costs you will incur. The cost for removal can range from $125 to $500.


The practice of embalming grew popular during the Civil War when bodies had to be transported long distances back to their families. This practice involves draining a body of fluids and replacing them with chemicals to temporarily preserve the body. This practice is growing out of favor as people are more environmentally conscious. Embalming is not legally required and many choose refrigeration as an alternative. However, if a body must be transported a long distance, embalming may be required. Embalming fees range from $225 to $1,200.

Dressing, Hair & Makeup

This is different than embalming. Preparing a body for viewing and visitation by applying makeup, styling hair, dressing the body can be a worthy expense as this is the last time many will see the deceased. The average fee for this service is $200.

Burial Clothing

Many families like the burial clothing to be new. Funeral homes offer special burial clothes designed especially for the occasion. See table below for clothing costs.

Storage and Refrigeration

Funeral homes have a daily charge for storing a body, even if it is embalmed. Other homes may charge a lump sum for a set number of days. Storage fees range from $35 to $100 per day.


The viewing is an opportunity for friends and loved ones to say their goodbyes, offer condolences, and see the body one last time, embalmed or not. Often this is an event which will last a few hours. The viewing is usually held in a church or funeral home reception area with displays of pictures, and floral arrangements. Food and beverages can also be coordinated as many have traveled long distances to attend. Funeral home fees for viewings can range from $150 to $1,200.

Funeral Ceremony Staff

This charge is for coordination and supervising the funeral arrangements and assisting with the ceremony. This fee can be competitive of facilities who also charge a fee. Funeral staff fees range from $500 to $800.

Printed Programs

Printed Programs are a great way for family and friends to take something from the funeral to remember the deceased by. These can be very basic to full color programs with pictures. Price varies depending on quality. Other printed material such as prayer cards and acknowledgement cards can also be arranged.

Guest Register

A Guest Register is a special book for attending guests to sign and/or write short condolences. See table below for guest register costs.


Two distinctive flower arrangements are available for funerals, the casket spray and a standing easel display. Urns can also be decorated with a flower wreath or garland.

Clergy or Celebrant Fees

Clergy are ordained leaders by a religious denomination and celebrants may or may not have any religious affiliation but may have ceremonial training on how to perform a eulogy. Some funeral homes have these people on staff.


Soloists and groups usually charge by the hour, others may donate their time. The more professional the musician(s), the more the musician(s) will likely charge. See table below for musician’s fees.

Hearse or Funeral Coach

At the head of the funeral procession, hearses or coaches typically carry the casket and body to the cemetery. Average hearse or funeral coach fees are $300.

Other vehicles

Limousines, service cars, and flower cars all vary in sizes and costs. The average fee for a vehicle is $300.

Grave Plots

Real estate pricing varies by location and whether the plot is in a private or public cemetery. See table below for grave plots fees.

Grave Opening and Closing

This expense can be significant and may cost as much as the plot itself. Weekend and holiday rates can double or even triple. See table below for grave opening and closing fees.

Graveside Service

A graveside service is a brief ceremony at the cemetery next to the place of burial. The funeral home can coordinate the delivery of the casket and the ceremony. Additional fees may be incurred for items such as tents, chairs, flooring, decoration, etc.

Temporary Burial Marker

This marks the location of the grave pending a permanent marker or headstone. See table below for temporary burial marker.


Newspaper obituary vary in costs by number of lines. Smaller newspapers or online publications may cost less or even be free. Death notices, which have a limited number of lines and no biographical information, are inexpensive or free.


Cremated remains are not considered biohazard and do not require any special container. Most people choose to purchase an urn. Engraving is optional but can be a great way to personalize a loved ones remains. See table below for urn fees.

Grave Markers, Monuments and Headstones

Many of these can be purchased locally or online. Along with the actually marker, monument or headstone, fees may include engraving, delivery, foundation and installation. See table below for total cost.

Death Certificate

Always a good idea to obtain a few copies as insurance companies, government agencies, and creditors may need an original. See table below for death certificate fees.


The Federal Trade Commission, Funerals & Your Rights

The Federal Trade Commission has created sets of rules that funeral providers must follow. These rules do not cover cemeteries and mausoleums unless they sell both the funeral goods and services. The rules include:

Regarding embalming:

  • may not provide embalming services without permission.
  • may not falsely state that embalming is required by law.
  • must disclose in writing that embalming is not required by law, except in certain special cases.
  • may not charge a fee for unauthorized embalming unless embalming is required by state law.
  • must disclose in writing that you usually have the right to choose a disposition, like direct cremation or immediate burial, that does not require embalming if you do not want this service.
  • must disclose in writing that some funeral arrangements, such as a funeral with viewing, may make embalming a practical necessity and, if so, a required purchase.
  • may not claim that embalming will preserve the body of the deceased for an unlimited time.

Regarding Cremations:

  • may not tell you that state or local law requires a casket for direct cremations, because none do;
  • must disclose in writing your right to buy an unfinished wood box or an alternative container for a direct cremation; and
  • must make an unfinished wood box or other alternative container available for direct cremations.


  • Federal and state laws do not require a vault or liner, however some cemeteries may require some type of outer burial container to prevent the grave from sinking in the future.
  • funeral provider is required to give you a list of prices and descriptions

Caskets and Urns:

  • requires the funeral director to show you a list of caskets the company sells, with descriptions and prices before showing you the casket.
  • funeral provider cannot limit your use of a casket or urn you bought elsewhere and doesn’t allow them to charge you a few for using it.
  • may not claim that a particular type of casket will preserve the body of the deceased for an unlimited time.


  • do not have to accept a package that includes services you do not want.


  • general price lists must be available for all the items and services the funeral home offers. (These can be requested over the phone as well as in person)
Gut Health and Antibiotics
10 Aug

Gut Health and Antibiotics

Most people do not think about gut health. In fact, the majority of people don’t know what gut health is. Gut health, or gastrointestinal health, is just as important as any moving part of the body and affects more than we know.

With our fast paced, drive through society; sometimes we ignore messages from our body. “…Gastrointestinal health can be the root cause for many other health issues including brain and mental health.” [2] Nursing gut issues and restoring gut health can build a stronger immune system, fight infection faster, and help us live a healthier life.

What is a healthy gut?

A healthy gut has a balance of both healthy and unhealthy bacteria. The microorganisms contained in your gut are known as intestinal flora. This balance is very important in the digestion of foods and overall health.

What causes an unhealthy gut?

Unhealthy gut can be caused by improper diet, an abundance of yeast in the gut, parasites, a colonoscopy, diarrhea, some drug therapies, chronic stress, chronic infections and even colonics. [6][7]

What are symptoms of an unhealthy gut?

Unhealthy gut symptoms can be as obvious as abdominal pain, bloating after meals, acid reflux, gas, diarrhea, or constipation.  Celiac disease, irritable bowel syndrome, and leaky gut are bowel-disorders that can be characterized by an unhealthy gut.  Less known symptoms of an unhealthy gut can be depression, anxiety, irritability, internal inflammation, food sensitivities, type 2 diabetes, neurological disorders, excessive weight, eczema or psoriasis, heart failure, autoimmune conditions affecting the thyroid (Hashimoto’s) or joints (rheumatoid arthritis), autism spectrum disorder and more. [2][3][4][7]

Antibiotics use and gut health.

Antibiotics are used to treat infections caused by bacteria and are often over prescribed. Antibiotics can cause the bacteria in your gut (both good and bad), to be eliminated, leaving room for unhealthy bacteria to take over as time passes. This will lead to an unhealthy gut and can wreak havoc on a body.

According to the Center for Disease Control [1], Antibiotics are among the most commonly prescribed medications in nursing homes with up to 70% of long-term care facilities’ residents receiving an antibiotic every year. Antibiotic-related complications, such as diarrhea can lead to more hospitalization and deaths among people over 65. [1]

Antibiotics are often so over prescribed that many bacteria are becoming resistant. From the CDC, “Each year in the United States, at least 2 million people become infected with bacteria that are resistant to antibiotics and at least 23,000 people die each year as a direct result of these infections.”  [10]

Restoring Gut Health

The natural remedy to a scary antibiotic cycle and unhealthy gut is to restore your intestinal flora balance by eating certain foods, taking a probiotic, and eliminating foods may be causing issues.

Eliminating Foods

  1. Carbohydrates from breads, cake, cereal, pasta, cookies, anything made with refined flour (white bleached flour, bleached flour, etc), jams and preserves, soda, potato products (potato chips, mashed potatoes, french fries)
  2. Sugars including saccharine or aspartame. If you must use sugar, consider using honey or Stevia instead.
  3. Processed and genetically engineered foods
  4. Foods containing oils such as soybean oil; sunflower oil; palm oil; canola; vegetable oil, etc.  Instead use olive and coconut oils.
  5. Red meat.  An occasional steak is not bad but regular consumption of red meat throws off your intestinal flora. Think no more than once or twice a week.

Adding in Fermented Foods, Fermentable Fibers, Soluble Fibers

  1. Starches like sweet potato, yam, yucca
  2. Onions and leeks assist gut bacteria to flourish
  3. Fermented vegetables, sauerkraut, kimchi
  4. Kefir which is found in the yogurt section
  5. Kombucha which is a fermented tea drink
  6. Flax and chia seeds
  7. Beans and legumes
  8. Apples
  9. Oats and oat bran


Probiotic supplements are everywhere but not all supplements improve intestinal flora and gut health. Dr. David Williams said [9]:

In my opinion, the best probiotic supplements will include at least these three most important strains:

  1. L. acidophilus—This is the most important strain of the Lactobacillus species and, it readily colonizes on the walls of the small intestine. It supports nutrient absorption and helps with the digestion of dairy foods.
  2. B. longum—Like L. acidophilusB. Longum is one of the most common bacteria found in the digestive tracts of adults, and it helps maintain the integrity of the gut wall. It is particularly active as a scavenger of toxins.
  3. B. bifidum—This strain, found in both the small and large intestine, is critical for the healthy digestion of dairy products. This is especially important as you grow older and your natural ability to digest dairy declines. B. bifidum also is important for its ability to break down complex carbohydrates, fat, and protein into small components that the body can use more efficiently.

Secondarily, I like:

  1. L. fermentum—This Lactobacillus strain helps neutralize some of the byproducts of digestion and promote a healthy level of gut bacteria.
  2. L. rhamnosus—Known as the premier “travel probiotic,” this strain can help prevent occasional traveler’s diarrhea.

Consider these probiotics:

Ultimate Flora Extra Care Probiotic Supplement Vegetable Capsules – 30 Ct $20

Hyper-Biotics Pro-15 Recommend Probiotic Supplement – 60 Ct $25


Lactic Acid Yeast Wafers

The above might not be enough depending on your current gut health. Dr David Williams explains:[8]

“Lactic acid yeast is a modified form of brewer’s yeast that works in your intestines to produce significant amounts of lactic acid. The additional acid stops the growth of harmful bacteria while allowing good gut bacteria to flourish. It works rather quickly, and when followed up with a probiotic supplement, the results can be amazing. I suggest chewing one lactic acid yeast wafer with each meal. In most cases, the product will only be needed for five to seven days.”

Dr. David recommends these Lactic Acid Wafers 100ct $20

Fecal Transplant

Fecal Microbiota Transplant is where fecal matter from a healthy person with a healthy gut flora and is transplanted into someone who is in need of healthy gut flora. [11] Fecal transplantation is currently not routinely performed for indications other than recurrent C. difficile colitis. [12] This procedure is often done through a colonoscopy.


As someone who once had Irritable Bowel Syndrome, I’ve cancelled many plans and suffered through stomach/bowel pain that were often intolerable. Since I’ve learned to balance intestinal flora and care more for my gut health, my IBS has not been an issue.  It’s clear gut health is important and so many things we do in our pursuit of daily life seem to counteract a healthy intestinal flora.

The Value of Geriatric Care Management Services
10 Aug

The Value of Geriatric Care Management Services

Also known as Care Management or Aging Care Management, a Geriatric Care Manager represents a growing service offering support to adult children who need outside assistance with care and personal management for their aging parents who live close by or far away. These adult children are are often employed and engaged with raising their own families. Looking after their parents has become difficult to do on their own.

Care managers are particularly useful in helping aging seniors find their way through the maze of long-term care services and issues. Here is a list of what a care manager might do:

  • Assess the level and type of care needed and develop a care plan
  • Take steps to start the care plan and keep it functioning
  • Make sure care is received in a safe and disability friendly environment
  • Resolve family conflicts and other family issues relating to long term care
  • Become an advocate for the care recipient and the family caregiver
  • Manage care for a loved one for out-of-town families
  • Conduct ongoing assessments to monitor and implement changes in care
  • Oversee and direct care provided at home
  • Coordinate the efforts of key support systems
  • Provide personal counseling
  • Help with Medicaid qualification and application
  • Arrange for services of legal and financial advisors
  • Manage a conservatorship for a care recipient
  • Provide assistance with placement in assisted living facilities or nursing homes
  • Monitor the care of a family member in a nursing home or in assisted living
  • Assist with the monitoring of medications
  • Find appropriate solutions to avoid a crisis
  • Coordinate medical appointments and medical information
  • Provide transportation to medical appointments
  • Assist families in positive decision making
  • Develop long range plans for older loved ones not now needing care

The National Care Planning Council provides a listing service for families looking for care managers. The listing service is free. You can contact a care manager in your area for help and information.

Let’s look at a hypothetical example to see how valuable care managers can be.

Mary is caring for her husband at home. Because of diabetes, her husband has severe neuropathy in his legs and feet and it is difficult for him to walk. He also has diabetic retinopathy and cannot see very well. Mary has difficulty getting her husband out of bed, bathed and dressed. She relies on her son who lives nearby to help her manage her husband’s care.

On the advice of a friend Mary is told about a care manager, Susan, who helped the friend’s family cope with the care of a loved one. The cost of an initial assessment and care plan from the care manager is $300.00. Mary thinks she has the situation under control and $300.00 for someone from the outside to come in and tell her how to deal with her situation seems ridiculous.

One day Mary is trying to lift her husband and injures her back severely. She is bedridden and cannot care for her husband. Her son, who works full-time, now has two parents to care for. On the advice of the same friend he decides to bring in Susan and pay her fee himself.

Susan does a thorough assessment of the family’s needs. She arranges for Mary’s doctor to order Medicare home care during Mary’s recovery. Therapists come in and help Mary with exercises and advice on lifting. Susan advertises for and finds a private individual who is willing to live in the home for a period of time to help Mary with her recovery and watch over her husband. Susan makes sure the new caregiver is reliable and honest and that taxes are paid for the employment.

Susan enlists the support of the local area agency on aging and makes sure all services available are provided for the family. Susan also calls a meeting with Mary’s family and explains to them the care needs and how they need to commit to help with those needs. Susan makes arrangements to purchase medical equipment for lifting, moving and easier use of the bathroom facilities. Medicare will pay much of this cost.

Susan suggests using a geriatric care Physician she works closely with to help Mary in the care of her husband. The geriatrician meets with Mary and her husband and spends a great deal of time explaining the proper treatment and care of elderly with diabetes. He rearranges medications and puts Mary’s husband on a new insulin regimen to better control his blood sugar. The geriatric Physician feels that Mary’s husband has a chance of improving his health with proper treatment. If her husband adheres to the care plan, he may end up having a better quality of life for his remaining years.

With the help of the care manager, Mary’s life and future has been significantly improved.

Perpetrators of Elder Abuse Are Usually Family Members
10 Aug

Perpetrators of Elder Abuse Are Usually Family Members

Many elderly rely entirely on family or other trusted individuals to help them. Whether it is physiological or psychological, as people grow older they tend to need guidance and support. Unfortunately, the dependence upon caregivers or family members makes an older person more vulnerable to abuse.

One in ten Americans (age 60+) are suffering from some form of abuse. Worse yet, one study estimates that only one in 14 cases of abuse are reported to authorities. Many believe institutions for care, like assisted living and nursing homes, commit the most abuse. This is not so. 90 percent of elder abuse cases are perpetrated by family members.

A typical elder abuse story might go something like this:

An aging widow, relying on her children to provide meals, transportation, and to make financial decisions, finds it difficult to report abuse when one of her children takes advantage of her. The child takes her money, hits her and is neglectful in caregiving. Furthermore, the widow is threatened with loss of support from the child if the she complains.

Common classifications of adult abuse

  • Sexual abuse
  • Physical abuse
  • Emotional abuse
  • Financial abuse, stealing money or changing title on assets. A MetLife study found that seniors lose at least $2.9 billion annually to financial exploitation. Over half of financial abuse in the United States is committed by family members, caregivers and friends.
  • Active and passive neglect by caregivers — “Active neglect is the willful failure by a caregiver to fulfill care-taking functions and responsibilities. This includes, but is not limited to, abandonment, deprivation of food, water, heat, cleanliness, eyeglasses, dentures, or health-related services. Passive neglect is the non-willful failure to fulfill care-taking responsibilities because of inadequate caregiver knowledge, infirmity, or disputing the value of prescribed services.”
  • Self-Neglect, which means an individual is failing to care for his or her own self needs.

What can you do to help prevent abuse

  1. Watch for warning signs that might indicate elder abuse,
  2. Take a look at the elder’s medications,
  3. Watch for possible financial abuse,
  4. Call and visit as often as you can,
  5. Ask questions about health, happiness, and safety,
  6. Offer to stay with the elder so the caregiver can have a break—on a regular basis, if possible.

Report the abuse

All states have agencies that receive complaints of abuse. In many states, failure to report abuse of the elderly is a crime. Anyone who suspects that an older adult is being mistreated should contact a local Adult Protective Services office, Long-Term Care Ombudsman, or police. The Elder abuse hot line phone number is (800) 677-1116.

Include End-Of-Life Planning When Anticipating Long Term Care
31 Mar

Include End-Of-Life Planning When Anticipating Long Term Care

A key deficiency in the process of planning for long term care occurs when seniors fail to provide for orderly distribution of assets at death and fail to let their family know what to do when the senior can no longer handle his or her own affairs.

Estate planning from a qualified estate planning or elder law attorney, a financial adviser who specializes in estate planning or a CPA planner, is the design of documents to provide the orderly transfer of assets and property to the next generation. Wills, living trusts and a myriad of other trust documents or business arrangements to avoid estate taxes, income tax and real estate capitol gains are some of the principal documents used. Estate planning also concerns issues of business succession or disability of a business owner.

Many estate planners are also adding final directive or end-of-life documents such as living wills, powers of attorney and special medical directives. But often these are considered secondary to the process of transferring assets or property. Unfortunately, these documents are much more important to family caregivers dealing with the needs of elderly loved ones.

Estate planners also need to become more involved in the planning process for long term care by helping in the production of a written long term care plan. This should also include meetings with potential family caregivers and instructions or checklists for these people. We call this Life Resource Planning. This important aspect of planning is often overlooked. Likewise the elderly or their families who are assisting them should insist on more careful planning for long term care issues when doing an estate plan.

Some advisers have recognized this need and have put together a team of experts such as attorneys, care managers and financial planners who provide a more complete and comprehensive approach to estate planning, long term care and end-of-life issues.

Here are some other important issues to consider for end-of-life planning:

  • Provide instructions, in the event of death, for guardianship of minor children.
  • Provide for disabled adult children, elderly parents, or other relatives.
  • Get your property to chosen beneficiaries quickly and determine in advance who gets what.
  • Plan for incapacity.
  • Minimize expenses of transferring property.
  • Choose executors or trustees for your estate.
  • Ease the strain on your family by making funeral arrangements and purchasing a funeral trust.
  • Create tax savings and leave money to charity.
  • Reduce state and federal estate taxes.
  • Provide a plan for an orderly transition of your business ownership to others.
  • Pre-plan for Medicaid
Osteoporosis – What You Need To Know
31 Mar

Osteoporosis – What You Need To Know

“Strong bones, strong body.” -Unknown. This is a quote I’ve heard hundreds of times and didn’t know how meaningful it is till I started researching Osteoporosis. Osteoporosis is the most common bone disease and is often caught only after a bone fracture or break.

What is Osteoporosis?

Your body is constantly replacing bone, the older you are, the slower the bone is replaced. Osteoporosis is a bone disease that happens when the body loses too much bone or makes too little bone. Bones become weak and those with osteoporosis can break bones from a fall or even something as simple as sneezing. Osteoporosis is a common and very serious bone disease.

Do I have Osteoporosis?

You cannot feel your bones weakening over time, so consulting your doctor is the best way to determine if you have Osteoporosis. You may have bone loss if you have had other major medical conditions such as but not limited to: Arthritis; Celiac Disease; Cancer; Stroke; Parkinson’s Disease; Diabetes; Scoliosis. If you have had one of these conditions, Osteoporosis should be a continuing conversation with your doctor. Osteoporosis can be determined by a painless x-ray measuring your bone density.

Symptoms of Osteoporosis

Loss in Height

Curvature of the Spine

Easy bone fractures or breaks

Reducing the risk of having Osteoporosis


  1. Weight bearing exercise and activities that promote balance and good posture are beneficial, such as walking, running, jumping, dancing and weightlifting.
  2. Avoid excessive alcohol.
  3. Avoid tobacco use.
  4. Avoiding falls when possible. This may mean something as easy as hiding cords in your own home or installing grab bars in high risk place such as a shower.
  5. Calcium. Consuming calcium whether it be in food or supplements can be beneficial. Do not take supplements of more than 2,000 milligrams daily for those over 50 as too much calcium is linked to heart problems and kidney stones. [2]
  6. Vitamin D. Vitamin D helps your body absorb calcium.

Treating Osteoporosis

Though Osteoporosis cannot be cured, it can be treated many different ways. Treating Osteoporosis can be as simple as lifestyle and diet changes up to taking medications which may include hormone-related therapy. Early detection of Osteoporosis may reduce bone loss.

Osteoporosis Statistics

“One in two women and up to one in four men age 50 and older will break a bone due to Osteoporosis.” [1]

Osteoporosis affects people of all ages and races but puts Caucasian and Asian women past menopause at the highest risk. [2]

Worldwide, osteoporosis causes more than 8.9 million fractures annually, resulting in an osteoporotic fracture every 3 seconds. [3]

Osteoporosis is such a common disease that we all should know about it and yet, many of us do not think about the disease as we age. Osteoporosis can make aging physically agonizing. The importance of taking care of your bones starts now.

Estate Planning As Part of Your Long Term Care Plan
31 Mar

Estate Planning As Part of Your Long Term Care Plan

A key deficiency in the process of planning for long term care occurs when seniors fail to provide for the orderly distribution of assets after death or fail to let their family know what to do when the senior can no longer handle his or her own affairs.

Estate planning from a qualified estate planning attorney, a financial adviser who specializes in estate planning or a CPA planner is the design of documents to provide the orderly transfer of assets and property to the next generation. Wills, living trusts and a myriad of other trust documents or business arrangements to avoid estate taxes are some of the principal planning strategies used. Other planning might center around income tax and real estate capitol gains. Estate planning also concerns issues of business succession and consideration of eligibility for government sponsored benefits.

Estate planners need to become more involved in the planning process for long term care by helping in the production of a written long term care plan. This should include meetings with potential family caregivers and instructions or checklists for these people. This important part of the planning process is often overlooked.

Because long term care planning is often overlooked, elders or their families who are assisting them should insist on more careful planning for long term care issues when doing an estate plan. Some advisers have recognized this need for care planning and have put together a team of experts such as attorneys, care managers and financial planners who provide a more complete and comprehensive approach to estate planning, long term care and end-of-life issues.

Estate planning attorneys can also help draw up legal documents and provide additional legal input that might be necessary. As an example an estate planning attorney will help you with the following:

  • Give tax advice pertaining to estate issues
  • Perform probate services
  • Draw up wills and trusts
  • Design powers of attorney and other consent documents
  • Design special trusts or partnership programs to save estate or gift taxes
  • Design charitable gifting programs
  • Design programs to pay for estate taxes

The National Care Planning Council provides a list service of estate planning practitioners who are available in your area.

Caring for a Loved One at Home Can Be Challenging
31 Mar

Caring for a Loved One at Home Can Be Challenging

Informal caregivers are family, friends and volunteers who provide care and support for an aging loved one. These selfless individuals are rarely paid for their services and often endure a significant amount of stress while providing care. Health in Aging estimates as many as 43.5 million Americans care for older parents, grandparents, spouses and other older adults. Informal caregivers may provide services in a care facility, but most care takes place in the home of the aging loved one.


Challenges Informal Caregivers Face

Caregivers often face challenges providing informal care. A wife caring for her husband, for example, may risk injury (to herself or him) while trying to move him safely around the home to bathe, dress, eat and use the bathroom. She may also struggle to provide proper nursing care due to a general lack of training, especially when it comes to monitoring vital signs and serious medical conditions.

Financial hardship is another challenge and varies depending on the informal caregiver. Generally, a retired spouse suffers little to no financial impact as income and assets are not used to pay for care. If the same spouse offering informal care is employed and has to reduce his or her hours or quit employment entirely there can be a significant impact on the couple’s finances. A child, caring for an aging parent (generally the adult daughter), will often forego wages to make themselves available to provide care during critical times of the day. This can be a massive strain on the child’s personal finances and time.

Beyond the financial impact informal caregiving can create lies an often unseen burden placed on the informal caregiver. The emotional and physical health of a caregiver is often strained when caregiving. These stresses, which can cause anxiety, exhaustion, and depression, are numerous and vary by situation. Strains to the emotional and physical health of the caregiver can be caused by:

  • A lack of time, resources, or skills necessary to provide adequate care,
  • Supervision requirements for those with memory issues,
  • Traveling (time to and from the care recipient’s home),
  • Considerable or unrealistic physical or emotional demands made by the aged, or
  • Unwillingness of other potential caregivers to assist.


Caregiver Burnout

Any of the above can be significantly overwhelming and contribute to a serious condition called “Caregiver Burnout.” The Cleveland Clinic describes caregiver burnout as:

a state of physical, emotional, and mental exhaustion that may be accompanied by a change in attitude — from positive and caring to negative and unconcerned. Burnout can occur when caregivers don’t get the help they need, or if they try to do more than they are able — either physically or financially. Many caregivers also feel guilty if they spend time on themselves rather than on their ill or elderly loved ones. Caregivers who are “burned out” may experience fatigue, stress, anxiety, and depression.


Make Caregiving Easier on You

To ensure informal care for an aging loved one is feasible can be sustained for a period of time, caregivers must understand the potential stresses outlined above, carefully avoid them, and in some cases correct them. It is important for every caregiver to be honest with themselves.

Here are some ideas, provided by the National Care Planning Council and WebMD, to keep burnout at bay:

  • Find someone you trust to speak with on a regular basis about your feelings and frustrations
  • Know your caregiving limits
  • Set reasonable goals, schedules, and boundaries
  • Realize you may need help from others
  • Educate yourself and set reasonable expectations about your loved one’s ongoing illness or condition
  • Set aside time for yourself. Remember, taking care of yourself is not a luxury, it is a need
  • Talk to a therapist, social worker, or clergy member. They are trained to give advice on a wide range of physical and emotional issues
  • Remember to lighten up when you can. Use humor to help deal with everyday stresses
  • Stay healthy by eating right and getting plenty of exercise and sleep
  • Accept your feelings. It’s normal to have negative feelings such as frustration and anger


Use Professional Caregivers and Planners

Avoiding caregiver burnout can involve bringing in professional and formal caregivers for respite. This might include such services as adult day care, care management, professional and non-medical home care, mediation services or other long term care advisors and specialists.  Advisors might include Medicaid planners, assistance from Veterans Affairs (VA) Accredited individuals, or long term care planners. The responsibility for recognizing elder care challenges and meeting those challenges can be shouldered by any appropriate combination of the above.


Informal Caregiving Can Be Rewarding

Providing informal care for an aging loved can be difficult and rewarding. Remember, care for yourself during the process to avoid caregiver burnout! Use the resources above to get support for the service you do so you can provide the best care possible for your aging loved ones.