“I don’t need help” – Part 1

It’s a common refrain and the bane of many family members: Your loved one is having trouble, yet he or she refuses outside help. This can put your relative at risk. But if the worst happens and things go south, it also ends up making more work for you. Doubly frustrating when you know it could have been prevented.

Rather than battling head on for acceptance, you might try a softer approach:

Build empathy
Ask your loved one what their concerns are. Just listen and try to identify the hot-button issue underneath the reaction:

  • Is it an issue of cost? – He or she may not know about Medicare coverage or the actual cost of the service. Your loved one may also underestimate his or her financial resources.
  • Is it an issue of control? – Fear that this is the beginning of the end in terms of living independently.
  • Is it an issue of privacy? – “My home is my refuge from others.” Or concern about being judged for lifestyle choices.
  • Is it an issue of pride? – “I don’t need a babysitter!”
  • Is it lack of knowledge (or denial) about their health? – Some people minimize the toll an operation or disease is likely to take.
  • Is it an issue of feeling loved? – “My family will take care of me.”

Validate feelings
All of these are valid reactions and worthy of exploration. You might start with, “I hadn’t thought of it that way. I see why you’re concerned….”

Explore thoroughly
Before problem solving, ask more questions. “Tell me more about that. It’s important that I understand.” The more your relative feels “heard” and the more you genuinely comprehend his or her issues, the easier it will be to work together to find a viable solution.

In subsequent articles, we’ll talk about ways to address these concerns with dignity and respect.

Is your relative resisting help?
At Senior Care Management Services we frequently get calls from family members who want our help but are sure their loved one will refuse. Actually, we have had great success arranging a meeting with the older adult. Sometimes it’s simply easier for them to talk with a professional than to reveal concerns or vulnerability to a family member. As the Northern Virginia expert in aging well, we can help. Give us a call at 703-329-0900.

The habit of happiness

Happiness is in our nature. We are born with the ability to be happy. And then life happens. Our life experiences affect our attitude about happiness. They influence how much we believe we deserve happiness or convince us we don’t deserve it. Especially in stressful situations like caregiving, feelings of happiness can be rare!

A happiness set point
Research suggests that we each develop a happiness “set point”—a level of happiness or unhappiness that is our usual attitude. Like a bad habit, we may feel at the mercy of our happiness quotient. But like a habit, it can be broken and reset to a new level.

Happiness training
If caregiving has taken your level of happiness down a few notches from usual, or you would like to raise your set point a bit, some simple mental exercises can help. Far from self-help mumbo jumbo, research has shown brain training to be effective.

Make strategic choices
You wouldn’t start training for a marathon with a 26-mile run. Similarly, there are many ways to strengthen your happiness. Be choosy about which happiness exercises you try first.

  • Start with a quick win. Some exercises are more difficult than others. For instance, mindfulness techniques are very effective. But they take time to master. Instead, try an easier strategy, such as consciously savoring an experience you enjoy. Extend the pleasure by telling others about it.
  • Pick a strategy that is fun. In happiness studies, researchers found some strategies were considered more fun than others. For instance, study participants reported that reflecting at the end of the day on three things that went well was more enjoyable than practicing forgiveness.
  • Get the biggest bang for your efforts. Some strategies are more effective than others. Exercising, for instance, is a proven winner in terms of improving mood quickly. Plus it has other health benefits.


Caregiving got you down?
You certainly are not alone if you feel overwhelmed with the tasks before you. As the Northern Virginia experts in family caregiving, we at Senior Care Management Services understand your situation. Many family members come to us because they feel caregiving has taken over their lives. Give us a call at 703-329-0900. We can help ease the load and give you more room for happiness in your life.

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.

Travel tips when your loved one is disabled

It’s difficult to know what to anticipate when traveling with a family member who has trouble getting around. Here are tips from experienced, disabled travelers to reduce your road-trip stress this summer.

If your travel includes hotel lodging:

  • Talk directly with the hotel. Many hotel chains have a centralized reservation system. Get a direct, on-site number instead. Then ask to speak with the head of housekeeping or engineering. With their intimate knowledge of the building, you can ask them to describe the disability features: How wide are the doorways? Does the bathroom have grab bars? And don’t forget to ask about access to the hotel from the street!
  • Reserve the room. Confirm that you are guaranteed an “accessible” room. Reconfirm a few days in advance of your arrival. If your room is not available or not accessible, ask to speak with the manager. It is the hotel’s responsibility to find you suitable alternate lodgings.

You might also consider bringing these items. You’ll find them sold online or at medical supply stores.

  • A folding ramp. An easy way to eliminate a short flight of stairs when visiting relatives or stores not equipped to accommodate people with disabilities.
  • Safety items for the bathroom. Consider a lightweight toilet seat extender. (Sitting higher up on the “throne” reduces the chance of falling when getting on or off the toilet.) For bathing, look for a suction-based grab bar or folding shower bench and slip-on shower hose. Add nightlights to improve visibility after dark.
  • Chair comfort. Bring a lap blanket and special pillows if your family member will be spending a lot of time sitting. Or a small fan to help with cooling. A swivel seat cushion may help a lot with getting in/out of the car.

To help your loved one join in excursions, consider a transport wheelchair. These lightweight wheelchairs have smaller wheels and can preserve your family member’s energy. All transport chairs fold, but some are made specifically for travel and can pack easily in a small bag.

Unsure whether travel is wise?
It’s natural to feel cautious. But sometimes the window of health is such that this may be a last opportunity to visit others. As the Northern Virginia expert in aging well, we at Senior Care Management Services help our clients prepare for trips and marshal resources so they can give their family members a truly precious memory. Call us at 703-329-0900.

Accessible National Parks

If the person you care for has trouble getting around, you can still go on a family vacation. Many of our national parks have specific accessibility programs. Our parks are our treasures, and park staff are working to ensure that all Americans have access.

To find a park with accessibility services, go to the National Park Service website. Select a park of interest. Under the “Plan Your Visit” menu, go to the page for Accessibility.

Here are some of the features you might find:

  • Accessible trails. These trails have a firm and stable surface. In fact, some are wood boardwalks. All are wide enough to accommodate a wheelchair. Not all of them are flat. Look for information about slope to make decisions about difficulty.
  • Accessible camping. A number of national parks offer accessible campsites. These campgrounds may have surfaces that are more groomed and stable. And they also have restrooms with wheelchair access.
  • Accessible opportunities. Some parks offer touchable exhibits for the visually impaired. Others have hearing systems that help amplify the sound of the ranger’s voice on a tour. Some parks have cabins that are built to accommodate wheelchairs.

America the Beautiful Passes

With an Access Pass, the National Parks Service waives entrance fees for persons with permanent disabilities. The pass covers more than 2000 national parks and national wildlife refuges. To get the pass, applicants must mail in documents to prove their disability. They also need to prove citizenship or residency. A limited number of parks can issue the pass on site.

An Access Pass covers the admission price for a single, noncommercial vehicle. Or, admission for the disabled individual and up to three others for parks that charge a per-person fee. Plus, the pass may provide discounts beyond the entrance fee. For instance, there may be discounts on extra amenities, such as camping, swimming, and boat fees.

Thinking of a family vacation?
At Senior Care Management Services we have observed that a special family trip builds priceless memories. Don’t let a disability quash the thought! As the Northern Virginia experts in family caregiving, we can help you identify needed support services and find an outing that matches well with your loved one’s abilities. Give us a call at 703-329-0900.

Is a New Medicare Card in the Mailbox?

Medicare has started sending out new cards to all its members. The mailings will take place in waves. The person you care for may not receive theirs until later in the year. You don’t need to do anything. The new card will arrive automatically. (The only exception to this is people who are enrolled in a Medicare Advantage plan. Those cards will remain the same, so no mailing expected.)

Medicare benefits have NOT changed!
The program your loved one is enrolled in stays the same. Just the card is changing.

Why change the card?
Primarily, it’s for security reasons. When Medicare first started, it made sense to use Social Security numbers as the identifying number for beneficiaries. That was before the age of identity theft.

The Medicare Beneficiary Identifier (MBI).
Medicare is giving everyone new numbers. There will be no rhyme or reason or hidden meaning to the combination of letters and numbers assigned. Nothing to reveal information about the cardholder.

Destroy the old card securely.
Shredding or burning the card is best. It does have your relative’s Social Security number. You don’t want that getting into the wrong hands!

Watch out for scammers.
Sadly, there are always those who prey on elders during a change like this. Be aware that Medicare will telephone only if the beneficiary has phoned in and left a message requesting a call back. The insurance company for Part D (drugs) or Medicare Supplemental Insurance (Medigap) may call. But they will not ask for the Medicare Beneficiary Identifier. They will already know it. If someone calls and requests verification of the number, hang up immediately. Then call Medicare at 1-800-MEDICARE (1-800-633-4227).

You can sign up for notifications about the new card at medicare.gov/newcard/.

Confused about Medicare?
We can help. At Senior Care Management Services we understand that the health care system can be very intimidating. As the Northern Virginia expert in family caregiving, we’ve got your back. Give us a call at 703-329-0900.

Make lemonade. Really?

“When life hands you lemons…” Well, you know the rest. While this adage can feel a bit trite, there is a certain grounded wisdom to it.

In fact, researchers at the Mayo Clinic have been studying stress and coping strategies. It turns out there are coping skills that are effective, and others that are not. Often the worst stress comes from the poor self-assessments we add on to the situation.

Especially for circumstances when you have very little ability to change what’s happening—the real lemons—here are strategies recommended to help you effectively adapt and accept:

  • Stay positive. Train yourself to notice what’s going well or what feels good. Put your mind’s spotlight on the good. “Dad enjoyed watching the ball game today. He laughed just like old times.” Give yourself positive feedback for your accomplishments, no matter how “small” they seem.
  • Forgive. It’s not that you have to forget an injustice. But carrying around the anger associated with it becomes its own heavy burden. Feel the emotion and then practice letting it go. If you don’t, the resentment you carry will damage you far more than the person who treated you unfairly.
  • Accept imperfection in yourself. You don’t expect perfection in others. Extend the same graciousness to yourself. Give each task your best attention, and then accept the outcome without harsh self-judgment. Remind yourself, “There are only 24 hours in the day. I did my best, and that is all anyone can do!”
  • Find the lesson and move on. Dwelling on the negative takes energy and achieves nothing. Are you constantly revisiting a decision you made or an action of someone else’s that was not the wisest choice? Take some time to constructively reflect on what you could do differently “next time,” and then move forward.
  • Promote perspective. Imagine yourself some years into the future. Looking back on today, does what you’re anxious about still seem important? If not, don’t let it run your life. Save your energy for issues that WILL matter five years from now.

Juggling too many lemons?
It’s true, many aspects of elder care result in your having less control in your life than you might wish. At Senior Care Management Services we understand how frustrating that can be. As the Northern Virginia experts in family caregiving, we can bring our experience to bear. Some of those situations that seem unchangeable can in fact be altered. Give us a call at 703-329-0900. It’s not all lemonade.

Aging in Place: A Resource to Begin Your Journey

In my work with older adults, and with the adult children who love them, initial conversations are almost always about Mom or Dad needing more help, and how and where to give them the help and support they need.  Remaining in their own home is, in my experience as an Aging Life Care Specialist and Geriatric Care Manager, the overwhelmingly preferred choice among elders.  The needs can start out gradually, or seemingly overnight, such as in the event of a major health crisis.  But either way, remaining in one’s home is usually preferred.  It just may take some modifications to make the home setting a safe and viable care setting for your loved one.

Ideally, we start the process of making our home livable and “aging in place” ready at an earlier time. Not long ago there was an article in Architectural Digest that was based on a guide written by the New York City Department of Aging, with the goal of helping New York City seniors age in place longer. The article itself is a good resource for current and up to date recommendations when renovating with an aging in place focus, no matter where you live.


This article first appeared on February 15, 2011, and was updated on April 8, 2018.

Cancer Screening Recommendations for Seniors – From the American Cancer Society

Healthy behaviors like healthy eating and refraining from smoking and too much alcohol, are likely to lessen one’s chances of developing cancer. Additionally, the American Cancer Society wants everyone to also be screened for some cancers on a regular basis. Identifying a cancer early will give one a better chance of eradicating it. The American Cancer Society provides screening guidelines for persons of all ages. Below are their recommendations for those age 65 and above. To see the recommendations for all ages, see https://www.cancer.org/healthy/find-cancer-early/cancer-screening-guidelines/screening-recommendations-by-age.html.



Colon Cancer Testing

The ACS says there are many testing options, so speak to your healthcare professional to understand which options are best for you. Medicare does cover testing.

Prostate Cancer Testing

Age by itself is not the only factor in considering prostate cancer testing. General health and anticipated life span should also be factored into the decision to test. Those considering this test should speak with their physician and the risks and benefits. Medicare does cover prostate cancer testing.

Lung Cancer Testing

For those with a smoking history, it is best to discuss this option with your physician. An annual low dose CT scan is an option for early lung cancer. Screening may benefit a current or former smoker (quit within the last 15 years). There are risks and benefits to testing, so it is recommended you discuss your options for screening with your physician. Lung cancer testing is covered by Medicare.



Breast Cancer Testing

For women 65 and older, the American Cancer Society recommends getting a mammogram every two years, but you can certainly choose to do so once a year. Additionally, it is important to know if you are at higher than average risk of developing breast cancer, as well as knowing how your breasts normally feel and look. If you are in the higher than average risk group, be sure to speak with your health practitioner about other tests you may need along with a mammogram.

Cervical Cancer Testing

Women who have a history of serious cervical pre-cancer are advised to continue testing for 20 years following that diagnosis. No testing is recommended for the following:

If you’ve had regular cervical cancer testing with normal results during the previous 10 years;

After a hysterectomy that removed the uterus and cervix – when it was done for reasons not related to cervical cancer.

Medicare does cover testing.

Colon Cancer Testing

Testing is recommended. As there are many testing options, speak with your health practitioner about which tests are appropriate for you and how often tests should be conducted. Medicare does cover testing costs.

Lung Cancer Testing

For those with a smoking history, it is recommended you speak with a health care practitioner to see whether you should get an annual low-does CT scan. This tests for early lung cancer. Screening may benefit you if you are an active smoker, quite within the last 15 years, have no signs of lung cancer, and have a 30 pack a year smoking history. Risks, benefits and limitations should be discussed with your practitioner. Medicare does cover testing.


This article was last updated on March 13, 2018.


Web Resources When Caring for an Older Adult

In our internet age, locating help and information as a caregiver is often just a few clicks away. Below are some useful web resources to research, especially if you are looking for guidance in caring for an older adult.

AARP   Website: www.aarp.org

Or, to go directly to specific caregiving resources.

Eldercare Locator  Website:  www.eldercare.gov

The Eldercare Locator, a public service of the U.S. Administration on Aging, is a national site that can connect you to services for older adults and their families.

Mayo Clinic   Website: www.mayoclinic.com

Use this site to research health issues.  This site has up-to-date information in multiple diseases and categories.

The Aging Life Care Association (formerly the National Association of Professional Geriatric Care Managers (NAPGCM)   Website: www.aginglifecare.org

Aging Life Care specialists (formerly known as Geriatric Care Managers (GCMs) are health care professionals, most often social workers or nurses, who assist families in dealing with the problems and challenges associated with caring for the elderly.  In addition to showing the many ways an aging life care specialist can help families facing long-term care decisions, the site also provides a database to search for an aging life care specialist in your location.

Web MD   Website: www.webmd.com

WebMD provides valuable health information, tools for managing your health, and support for those who seek information.

National Council on Seniors Drug & Alcohol Rehab – Website: RehabNet.com

A site dedicated to helping older adults with this “quiet epidemic” of drug and alcohol addiction.

Medicare – Website: www.medicare.gov

Everything you need to know about Medicare.

This article was updated in December 2017.