Aging at Home

Talk to Your Parents about Care Preferences and Legal Documents

by Carol Bradley Bursack

Dear Carol: My mom is 90-years-old, lives alone and does quite well. She has always been very independent and has never been willing to talk about what her preferences are if a time comes when she needs care. My siblings and I want to do the best we can for her, but she does not even have a living will or Power of Attorney. We feel like our hands are tied since she will not discuss finances or the kind of care she’d like when the time comes that she does needs help. Whenever we bring up the issue, she says, “I’ll get to it.” – Franny

Dear Franny: Your mom has likely outlived most of her friends, and those who are left are probably battling illness or frailty. She may feel that discussing the fact that she will likely need care will just hasten the onset of the frailty she sees in her friends. Her friends can be an asset. Do you know anyone she is close to who receives care? If so, try using their situation to open up the conversation and break through her fear and denial.

Unless one of you adult children can care for her, you need to discuss in-home care, assisted living and nursing home as options. Don’t promise you’ll never put her in a nursing home. Tell her that you will do everything you can to follow her wishes, but that her health and safety are your main concern.

Making the decision to have one’s legal house in order is one of the kindest things a person can do for their family. I often recommend adult children make an appointment to get their own legal work done, and then tell their elders about their intent. Anyone can have an accident or become seriously ill, so it’s a good move for you, anyway.

This may be the push your mom needs. If you approach her in a light manner, it’s quite likely she’ll say that she wants to go along with you and have her legal papers drawn up, too. This should include a Power Of Attorney for financial purposes, a POA for health (a health directive with a living will) and a will for the distribution of her assets.

Discussing the kind of care people would like should they need help, and having legal papers drawn up, isn’t fun but it’s necessary. If you can’t get through to her on your own, you and your siblings can approach her as a team. Emphasize the fact that you’ll all have more peace of mind if you get this discussion out of the way. Then you can get on with the business of living.

Carol Bradley Bursack is the author of a support book on caregiving and runs a website supporting caregivers at www.mindingourelders.com. She can be reached at carol@mindingourelders.com.

National Center on Senior Transportation Announces Online Dialogue

National Center on Senior Transportation Announces Online Dialogue

NCST Talks - Planning for the Transportation Needs of Older Adults

November 28 – December 16, 2011

From November 28 to December 16, the National Center on Senior Transportation will host an online dialogue for individuals and organizations from the aging network and transportation industry. The dialogue is an opportunity to share experiences, methods, strategies, and recommendations related to planning for the transportation needs of older adults. The dialogue will give the aging network, older adults, advocates, volunteers, policy makers, public and private transportation providers, federal, state, and local transportation agencies, human services agencies, and municipal planning organizations the chance to submit, comment on, and rate ideas related to planning for senior-friendly transportation services.

To join the dialogue go to http://ncsttalks1.ideascale.com/

Mom is Moving In and I am having Second Thoughts

by Carol Bradley Bursack -

Dear Carol: My mother has been declining over the last two years so I’ve decided to bring her home to live with me. Years ago, she made me promise never to put her in a nursing home, so I’m trying to follow her wishes.

I’m not married and haven’t got children, so it seemed logical that I could take care of her. However, I love my job though it’s very time consuming. I’m suddenly second-guessing myself. I find I am very stressed and getting depressed about this change.

I have no family to help, so I think this is the right decision. Yet, I’m in my 60s, and find that after a hard day at my job I am tired. I have been with Mom unfailingly for several years, visiting and making sure that she has received the best of care when she’s been hospitalized or in rehab. I know she appreciates me. How long can I go on with work demands, my own health issues and still care for Mom in my home?  I’m already getting counseling. – Jolene

Dear Jolene: I’m glad you are getting counseling. Please keep that up. Also, consider hiring some in-home agency care for backup. She may enjoy adult day care a couple of days a week, as well, because that will give her a social life with peers. Many elders resist the idea of attending adult day care, but then end up loving it once they start attending.

Please understand that most assisted living facilities and nursing homes are no longer the model that your mother remembers. Because of the demands from residents and their families, many nursing homes, with time, have changed considerably. While few elders choose to leave their own home without a nudge, many eventually realize that the new culture of many of today’s nursing homes can give them  safety and care, plus a social life with peers that they may not have had at home.

If your arrangement at home doesn’t work out, and you must place your mom in a facility, you are still honoring the spirit of your promise. You will have done your best to keep her with you. What you are trying to do now amounts to an experiment. With you at work for long hours, the situation may become unsafe for your mom, and very lonely, as well. You’ll have to see how it goes. Do remember that you can’t help your mom for long if your own health deteriorates. Continued counseling should help you find the right balance between your mom’s needs and your own.

Carol Bradley Bursack is the author of a support book on caregiving and runs a website supporting caregivers at www.mindingourelders.com. She can be reached at carol@mindingourelders.com

Using VA Aid and Attendance: Pay Any Person for Care in the Home

Rita Files -

Veterans Administration Aid and Attendance Benefit Pays In Home Care.

Most people who have heard about the VA Non-service Connected Disability Pension for Aid & Attendance know that it will cover the costs of assisted living and, in some cases, cover nursing home costs as well. But the majority of those receiving long term care in this country are in their homes. Estimates are that approximately 70% to 80% of all long term care is being provided in the home. All of the information available about Pension overlooks the fact that this benefit could be used to pay for home care. Maybe if more people knew this fact, more people would be applying for the benefit.

It also comes as a surprise to most people that VA will allow veterans’ households to deduct the annual cost of paying any person such as family members, friends or hired help for care when calculating the Pension benefit. This annual cost is then used to calculate the benefit based on a new “countable income” and allows families earning more than the pension benefit to receive a disability income from VA.

This extra income can be a welcome benefit for families struggling to provide eldercare for loved ones at home. Under the right circumstances, this annualized medical expense for the cost of family members, friends or any other person providing care, could create an additional household income of up to $1056 a month for a single surviving spouse of a veteran, up to $1,644 a month for a single veteran or up to $1,949 a month for a couple.

All reasonable fees paid to the individual for personal care of the Veteran or surviving spouse and maintenance of the person’s immediate environment may be allowed. This includes such services as cooking and housecleaning. It is not necessary to distinguish between “medical” and “non-medical” services. Services which are beyond the scope of personal care and maintenance of the disabled person’s immediate environment may not be allowed. This might include paying the bills, providing transportation for other family members, cooking and cleaning for other family members, providing entertainment, providing transportation for personal needs other than medical and so on.

Silver Planet Concierge Services Goes Live

Dear Newsletter Subscribers,

Last month we announced the expansion of our Silver Advisor Services and of a pending launch of the new Silver Planet Concierge Services website. Today we are excited to announce the new site is up and running. In fact, the articles in today’s newsletter are hosted on our new SilverPlanetConcierge.com site.

Silver Planet Concierge Services is committed to helping medically challenged seniors get well and stay well. We have refocused our services to help businesses serve seniors facing transitions in their lives while the seniors themselves stay in charge of their healthcare.

SilverPlanetConcierge.com still highlights elder care health and wellness services and products like Silver Planet. We will continue publishing many of our wonderful and knowledgeable authors and sending you our weekly newsletter with timely, relevant articles and scam alerts. Please let us know what you think. Send any comments to: editor@silverplanet.com

Current subscribers have no need to re-subscribe the transition is all done for you.

Thanks,
Karen Klein

Showers: No Steps to Eliminate Wet Floors

Keeping the Water Inside the Shower

by Karen Braitmayer

No step or step-less showers, curb-less showers, no matter how you call them, they work wonders for everyone. No more stepping over the edge of a tub, no more tripping over a short curb, no more transferring precariously into a wet, slippery environment. Imagine being able to walk (or roll) right into a shower area, sit or stand under a luxurious spray of warm water. Sounds great, but step-less showers have gotten a bad reputation for flooding the bathroom, since there is nothing to keep the water from running right out into the room besides a wimpy curtain, right?

Not always.

No Step Shower with Floor SlopeAs a wheelchair user, I have tried tens of step-less shower designs, in hotels especially. They are notorious for flooding the remainder of the bathroom, even with extra-long curtains or shower heads that spray away from the opening. In the past, when one of my clients has requested a step-less shower, they have often felt they needed a shower enclosure, with glass walls, to ensure a dry floor in the rest of the bathroom.

I recently remodeled my bathroom at home and I tried something new: a shower with a single-slope floor to a trench drain, sloping away from the shower opening. And to my great relief, it works like a charm, without a full enclosure to block my access to the shower seat.

We remodeled our Master Bathroom in its’ existing footprint. It was a generous bath but we couldn’t capture any more space beyond the original room so the shower ended up being 6 feet by 3 feet, about the size of the shower that was there before. This new shower had to be flush to the floor, with no step once installed. The floorboards were removed in the construction, the floor joists supporting the shower altered slightly and additional support added to accommodate the weight and slope of the new floor, before reassembling. The entire shower floor slopes from the opening toward the back wall. Instead of a center drain, like most traditional showers, we installed a long trench drain along the back wall. This has the advantage of increasing how much lower the drain is from the entry point as well as looking modern and sleek. Some step-less showers recommend a trench drain at the entry to the shower. I felt more confident with this arrangement (drain at the back wall), if the drain ever gets plugged, because any ponding that would occur would be INSIDE the shower, rather than outside.

To further corral the water, we were thoughtful about where to start the break in the floor slope. The shower floor slope starts at the outside edge of the shower wall, and the shower curtain hangs inside of this slope. Therefore, all the water running off the curtain is directed back towards the shower interior and the drain.

Stepless Shower with Grab BarAnother advantage of the single slope to the shower floor is the stability for a shower stool. I use a shower stool rather than a wall-mounted shower seat found in commercial settings. This is common among people with disabilities, as it allows them to find both personalized support in their shower seat and some adjustability in the location of the seat to the showerhead. In my old shower, the four sloping planes headed to the center drain meant my shower stool never sat squarely on the floor. The instability of the seat increased my instability in the shower. Now my stool sits firmly and I no longer wobble when shampooing!

All in all, I am beyond thrilled with my shower and can’t recommend this installation type enough. Here’s to keeping the water where it belongs – inside the shower!

Oh, I’ll Get to it One Day

What if “One Day” Never Comes?

By Julie Hall

It’s fascinating what we professionals notice in our clients’ estates. For example, we do see a distinct similarity in almost all of the estates we go into, especially if the estate belonged to an elderly loved one from the Depression Era. The attics are usually full and the interesting thing is that 85% of them are full of things that really should have been disposed of 30+ years ago.

By the time we get into these attics to clear them out, the books are rotted and have been gnawed on, anything cardboard has pretty much disintegrated, clothing either smells like mildew or falls apart in your hands, or you find items that have long since been obsolete and no one has any use for them. If items of value were stored in the attic (which is a big no-no), chances are pretty good they have been damaged and the value greatly diminished. This is not always the case, but is generally what we find.

My assistant has a saying when we are working in the daunting attics, up to our elbows in stuff: “They were young when they put this stuff up there. By the time they finally figure out it has to be dealt with, they are 85 years old and can’t get up here anymore.”

So true. Time stops for no man and it does move rather quickly. We all have the best intentions of cleaning out the shed, garage, closets, cupboards … but if you continue to procrastinate and something happens where you or your loved one become incapacitated, it truly leaves a burden for the ones you leave behind. A bigger burden than you realize.

If you have had your sights on a project around the house which includes clearing out some “stuff”, make sure you know what it is worth before you sell it or give it away. It is better to clear out the clutter now so you can feel better about it and not worry. Believe me, your loved ones will really appreciate it one day.

JUST DO IT!

Can Seniors “Be Grateful” in Today’s Economy?

The license plate on the car in front of me read, “B GR8FUL”

By Julie Hall

The license plate on the car in front of me during a long stretch of monotonous highway read, “Be grateful.” I couldn’t help but wonder if this was a personal message to me, just returning from a wonderful weekend with my parents in Florida, or if it was meant for all who read it, spreading a positive message during uncertain times.

My husband and daughter were snoozing in the car and I was pensive as usual behind the wheel, thinking about everything from the economy, to finances, to family to you name it. I, like many of you, am worried about the state of our economy and where it will leave our generation in the years to come. I worry about my daughter and her education; will she be okay during this craziness we are experiencing? Will she have work in the future? Will the economy bounce back or are we headed for a recession? So many people struggling. News images of drought, famine, earthquakes, shootings, a downed military helicopter.

The worries seemed endless and my mind began to wander while I was driving. Then I saw the simple license plate:

“B GR8FUL.”

I know that I had an instant calm when I saw it. I know that was a message for me to take these worries and transfer them into appreciation for all that we do have. When you look at the grand scheme of things, we really do have so much to be grateful for. So the next time your mind races with an endless stream of worries, try to shift your thoughts to appreciation. You’ll feel much better!

Need to Determine Estate Heirloom Value? How?

Why Can’t I Determine Value on the Internet?

By Julie Hall

Q: You make it sound complicated to establish values of my heirlooms. Why can’t I just look at the Internet and find the value myself? Surely there’s plenty of stuff for sale on Ebay that I can find a similar item and see what they are asking for that item.

A: The arrival of the 21st century has enabled us to find 90% of what we are searching for on the Internet. What a great tool – but with greatness also comes weakness. What a double-edged sword. If used correctly, you can find the answers. If used incorrectly, it can truly mislead you, or cause permanent damage to one’s reputation.

I read numerous articles, newsletters, and blogs; I see so many wanting to research what their possessions are worth.

There are multiple factors involved in assigning a value to a particular item, not limited to the following: marketability, condition, collectability, age, rarity, provenance, materials used, handmade vs. factory made, etc. Age alone is not the only important characteristic, for all that is old is not necessarily valuable. Original condition is a very important factor, as is rarity.

One problem is everyone seems to believe they have something hard-to-find or rare, based on family stories told over years. Families are often disappointed to learn that the old bench great-grandfather made in 1857 is just an old bench and has more sentimental value than monetary value.

People have a tendency to jump onto Ebay, which is not always a good thing. While Ebay is a huge site with a broad variety of items, the market is currently down and often cyclical. There are better times of year than others to sell on Ebay. It’s also important to compare apples with other apples, and not an item that just looks like grandma’s old figurine. You must first have an accurate description of the item, then you can begin your search.

Remember too, the cardinal rule: If you go searching on the Internet, make sure you accurately find the price the item sold for, and not just the asking price. Many times people say, “Julie, you only appraised this item for $200 and I see it on the Internet for $675. Why is your appraisal so different?” My research of comparable items accurately depicts what it sold for. Anyone can ask any price they wish. Go on Ebay and you will see some pretty ridiculous asking prices! But note, the items have not sold for these prices.

It is important to also remember to search multiple search engines, as well as different values: not just Ebay, but online auctions, in-person auctions, estate sales, etc. Find the fairest comparable item you can. Keep in mind that professional appraisers have extensive training and knowledge in research, writing, and databases, which the average person does not have. When in doubt, please hire a professional appraiser to offer you the knowledge you need to make good, sound decisions about your personal property.

It’s Better to be Safe than Sorry

You know you are in trouble when…

By Julie Hall

You know you are in trouble when an older expert shakes his head and says, “With the way the economy is going…” I share this because I sat with an expert just yesterday and he offered me sound advice which I want to share with you.

He’s not just a highly successful jeweler. He’s been in the business 60+ years and knows a great deal about his industry. I also knew immediately upon meeting him that this older gentleman had extensive knowledge about the market, where it’s headed, and what we can expect in the future. Many clients ask me on a daily basis what my thoughts are on the market, so today I offer a little on precious metals and gems.

My mom had given me some scrap gold to sell and I have several items I no longer wanted, but some of the pieces are very nice. So I went to him for a little advice: Should I sell now, or hold onto it for “a while?”

His eyes and demeanor were like that of a wise old sage, and he said the following:

  1. Don’t sell these items now if you don’t need the money. One day, these items will probably be worth more than cash. With the way the economy is going….
  2. In his opinion, gold may very well hit $5000 per ounce in our lifetime, but not in the immediate future.
  3. If the US dollar lost its power, you would still have items to barter with. At least you would have it, and it’s better to be safe than sorry.

Now, I know this isn’t rocket science and we’ve heard this before. But the warmth and wisdom in which he delivered this information forced me to take heed and really listen. So for now, those items are tucked back in the safe where they belong, taunting me with the question, “Will I ever need to pull it out in the future, if things got really bad?” Well, at least it’s there if I need it.

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