“I don’t need help” – Part 3

It’s not easy to lose abilities and admit you need help. The reluctant elder in your life is more likely to ease into acceptance if you provide good listening, compassion, and a commitment to working together. In this third installment of our series, we look at elders’ concerns around privacy and pride.

Having someone underfoot can feel intrusive, especially if your relative is used to living alone. Perhaps he or she fears being judged, or that word of unhealthy food choices or alcohol use may get back to the family. Maybe your relative tends toward hoarding and is embarrassed. Or has worries about safety with a stranger or the risk of theft. All of these are reasonable concerns for any adult who values their independence. You can address privacy concerns by

  • starting with part-time help;
  • hiring a friend;
  • working with an agency that does background checks and drug testing.


“Do you think I need a babysitter?!” Our culture values self-reliance. Anything that implies a need for help suggests weakness or incompetence. When you approach your relative,

  • shift from “we think you need help” to “we want to help you stay in charge of your life.” As noted in Part 1 of this series, working with your relative toward a common goal is a welcome and respectful approach;
  • clarify what type of care is needed. For instance, a nurse to dress a wound is different from someone who cooks and cleans;
  • start with a short-term arrangement, framed as “while you recover” or “just to see how it goes.” Then consider a more permanent arrangement;
  • talk about getting help as a way to liberate your loved one’s energy to do other activities he or she really enjoys;
  • emphasize your relative’s other abilities. If Mom can no longer do housekeeping, make sure to praise her often about her cooking talents.


Would a little coaching help?
At Senior Care Management Services we understand what a delicate line you have to walk— respecting a relative’s concern while at the same time addressing real issues of health and safety. As the Northern Virginia experts in family caregiving, we can help you grapple with your own frustrations and find the balance you need to take the next step with your loved one. Give us a call at 703-329-0900.

“I don’t need help” – Part 2

When a loved one obviously needs help at home but refuses to allow it, it’s frustrating! Below are two common concerns, with suggestions for ways to problem solve together.


Cost is a very practical barrier
Many older adults feel particularly vulnerable where money is concerned. They don’t want to spend! But the cost of help depends on the type of help needed.

If licensed care providers are what your relative needs—for example, home visits with a physical therapist after a hip surgery—Medicare and supplemental insurance usually cover these costs.

If nonmedical help is needed (cooking, laundry, errands), there may be resources to assist. Maybe your relative has long-term care insurance. Perhaps he or she is eligible for VA benefits. Consulting with a care manager can bring those possibilities to light.

Or it may be that your loved one does not have an accurate picture of his or her financial resources. If you are the person your loved one trusts with money matters, ask if you can review the facts together to better understand his or her concerns.


Retaining control over their life
It’s common for accepting help to symbolize “the end of my independence.” That’s a scary thought. Realistically, though, all of us will need assistance at some point. You might try asking, “Under what circumstances would you see yourself accepting help at home?” This allows your loved one to explore his or her own red flags. Plus, it gives you insight about what life event might make home care acceptable and why.

When hiring help, look for ways your relative can retain as much control as possible:

  • Pick the caregiver.
  • Choose the days and times for help.
  • Decide on the care attendant’s tasks and participate in giving the instructions.
  • Clarify if this is a short-term or long-term arrangement.


Does this conversation feel like a battle?
At Senior Care Management Services we often notice that an older adult will be more resistant to their child’s suggestion regarding help than they are when they talk with a professional. With a professional, there is less face to save and no family baggage. As the Northern Virginia experts in aging well, we’d be happy to talk with you about options for introducing the subject. Give us a call at 703-329-0900. Let’s see what we can do.

Before you quit your job

It may be true: Your aging relative needs more and more care. You know you are the best person for the job. But it’s too much to do on top of your own work. Think twice before exiting the workforce, however. There are some stiff financial consequences.

For example, if you are midcareer, you are in your prime income-earning years. This is when you want to double down on retirement savings. If your employer offers retirement matching funds, you want to be in a position to grab them! And continue contributing to Social Security.

According to a Met Life study:

  • Men age 50 and over who left work to care for a parent lost an average of $89,107 in wages. The impact on their Social Security benefits was $144,609. Loss of pension income, $50,000. Altogether, early retirement cost male employees $283,716 over their lifetime.
  • Caregiving women age 50 and over got hit much harder. They tended to leave work sooner. Lost wages averaged $142,693. Women lost $131,351 in Social Security. Figuring lost pension at $50,000, early retirement cost female employees $324,044.


Consider these options:

  • Hiring help at home may be less expensive than losing your wages. Suggest sharing the cost with your siblings. (Show them this article!) Then no one among you bears the sole financial burden.
  • You might take advantage of an adult day center to provide care during your work hours.
  • Ask about flex-time options so you can work when others can care for mom or dad.
  • Investigate Family Medical Leave. If your company is big enough, you may be able to take weeks or months off. (It is unpaid.) That may get you through a crisis and buy you time to make other arrangements.

In your generous desire to help, be careful you don’t shortchange your own future.

Is it time to get your siblings more involved?
At Senior Care Management Services we’ve seen one sibling become the primary caregiver while others seem not to pitch in. It’s not necessarily a matter of laziness. Often it’s a matter of not understanding the needs. As the Northern Virginia expert in family caregiving, we can help you meet with your siblings and work out a plan that addresses everyone’s concerns. Give us a call at 703-329-0900.


Using long-term care insurance

Your relative may have bought long-term care insurance to cover the expense of care when help is needed. Activating the policy takes some lead time. It’s wise to learn all the steps and definitions so you can be strategic with your timing.

Types of care covered
Read the policy and see what kinds of care it will pay for. Options may include nursing homes, assisted living facilities, or private care at home. Check for exclusions.

“Elimination period”
Time is money in long-term care, literally. Think of this as a deductible measured in time. Check to see if the policy requires that you pay out of pocket for care for the first 30-120 days AFTER you have initiated the claim.

“Benefit trigger”
To open a claim, you must prove the need for assistance with personal care tasks: bathing, dressing, using the toilet, eating, or walking. In the case of dementia, such as Alzheimer’s, testing will be needed to prove the degree of memory loss.

Length of the benefit
Most policies have a three-year or five-year limit. Be cautious about starting your loved one’s policy too early. If your relative has dementia or any type of very long-lasting illness, you may want to delay opening a claim until he or she is quite impaired. (But don’t wait too long!)

The claims process
Each company is different, but the process starts with a “claims packet” that includes

  • claim forms. This is a statement of needs and permission to obtain information from providers;
  • physician’s statement. This is a critical document in which the primary care doctor certifies your relative cannot perform personal care tasks;
  • nursing assessment and plan of care. This is usually completed by a nurse from the company providing care;
  • provider statement. The home care agency or facility you choose must meet the policy’s criteria for payment.


Is long-term care on your horizon?
As the Northern Virginia expert in family caregiving, we at Senior Care Management Services can help you navigate the labyrinth of long-term care insurance. Give us a call at 703-329-0900.

Long Term Care Policies – Stay on High Alert to Avoid Cancellation

Recently, there was a very relevant article in the New York Times telling the story of a Virginia gentleman with two aging parents, and their joint long term care policies.  Busy lives, overwhelming needs and assumptions eventually led to the cancellation of the policies.  Even after many years and $50,000 in payments, the long term care company refused to reinstate the policies after they became delinquent for eight months.  The son took action by enlisting the Virginia Legislature, which created a bill to require third party and certified notifications of delinquent payments.  Unfortunately, the bill ended in a tie in sub-committee, so for the time being nothing will change.  However, according to the article, more efforts are planned to correct this, and the Virginia Board of Insurance is considering requiring certified mail notifications for Long Term Care policy cancellations.

For the full article, see The Policy Lapsed, but No One Knew.


Boomers Having More Fun

This week there was a story on NPR about single baby boomers forming group homes.  It was a good story, and a good idea as well.  Here is the link to the audio.  The comments are a good read too.