Category Archives: News

2019 Medicare Improvements

Medicare Advantage

Here’s some good news to start the year! In 2019, we’ll see improvements in coverage across the major Medicare plans.

About two-thirds of people on Medicare use “original Medicare.” Patients with original Medicare can go to any health care provider that accepts Medicare. Original Medicare pays for 80% of costs after a yearly deductible. The remaining 20% is paid out of pocket. In addition, your loved one may have a supplemental insurance. Sometimes this is called “Medi-Gap.” Medi-Gap policies pay the deductible and that 20%.

There is also a “Medicare Advantage” plan. If your family member has this coverage, he or she must go to providers who are part of the plan’s network. Medicare Advantage programs usually cost less than a combined original Medicare and Medi-Gap policy.

Starting in 2019

“Donut hole” is closing early

Medicare Part D has been paying roughly 75% of medication costs up to a set amount per year. Patients paid the balance of 25%. If costs were higher, the patient had to pay a greater percentage out of pocket (35-44%). If your relative’s drug costs reached a second threshold, additional medicines were then covered 95% by Medicare, 5% by the patient. In 2019, that “donut hole” gap in coverage is “closing,” meaning it is getting smaller. And a year earlier than planned. This year Medicare will extend coverage of brand name drugs at 75% up to the second threshold. Then 95% coverage will kick in. Generics will have a 63% coverage rate after the first threshold. The following year, generics will be covered at the 75% rate as well.

Nonmedical support services

Some Medicare Advantage Plans have been given permission to expand coverage beyond traditional medical care. With a doctor’s orders, for instance, they have the option to offer policies that provide for things like the installation of grab bars or a wheelchair ramp. Check your loved one’s plan to see if it includes this type of coverage.

Want to switch policies?

Wish your loved one had a different plan? As of 2019, those with an existing Medicare Advantage plan may switch to a different plan within the first three months.

Do you find Medicare confusing?

You aren’t alone! As the Orange County experts in family caregiving, we at Senior Life Management can help you decide if there’s a plan that would be better. Give us a call at 949-716-1266.

 

 

Stress or Burnout?

burnout

 

Most of us know it when we’re stressed. We talk about it, and we talk about needing to do something about it…when we have the time.

But we might not be aware when we reach the point of burnout. That’s because going numb is the nature of burnout. To be so worn out that you are beyond caring.

Put simply, burnout is stress that has gone on too long. It is an important distinction to understand. Burnout has more serious, long-term consequences for your physical health and for your emotional well-being.

Take a moment for self-reflection and assess yourself.

If you are stressed, you are

  • constantly on the go, urgently trying to get things done.
  • emotionally brittle, tending toward irritability and anxiety. Your thinking might be a bit scattered.
  • tired and not sleeping well, rushing through leisure activities.

If you are a stressed family caregiver, you are scrambling to keep up with the demands of your role. But you believe that you eventually can get everything under control, and doing so feels important to you. Getting stress relief is a goal.

If you are burned out, you are

  • doing less and less and still feeling exhausted.
  • emotionally dull and hopeless, feeling there’s no point in making an effort at anything because nothing ever changes.
  • frequently physically ill, catching every cold that comes around.
  • withdrawing from friends and activities and often overconsuming food, alcohol, tobacco, etc.

To put this in perspective, consider stress to be a blinking yellow light: Yield. Slow down. Find a way to weave in more breaks. Consider burnout to be a red light: Stop. You have given too much for too long. Change is needed immediately before burnout undermines your health and your ability to provide appropriate care for your loved one.

Do you recognize the signs of burnout?

At Senior Life Management we see dedicated family members who, frankly, are fried! They are beyond stress and are dangerously in the realm of burnout. As the Orange County experts in family caregiving, we know it doesn’t have to be this hard. There are options. Give us a call and let’s start the conversation: 949-716-1266.

Exercise and COPD: an oxymoron?

COPD

Does Mom say she feels too weak to exercise? Does Dad run out of breath just walking down the street? People dealing with COPD often believe that exercise will make things worse. Actually, in moderation, quite the opposite is true.

Very real benefits. Even people with severe COPD can become more physical. Something as simple as arm lifts or singing can improve breathing and reduce fatigue. Exercise also helps with the fuzzy thinking many older adults experience with their COPD—because it gets more oxygen to the brain. Plus, people who engage in physical activity even just three times a week have been able to reduce the severity of COPD flares. If they have to be hospitalized, they get home sooner. Best of all, it’s not that hard to achieve these improvements.

Talk with the doctor first. Don’t challenge your loved one to a mile starting out! A balanced approach is required with COPD. The goal is to stretch breathing capability and stamina a little bit at a time without getting overly tired. Your family member’s doctor can give guidelines about when to stop and when to push past that initial feeling of “today is not a good day.”

Ask for pulmonary rehabilitation. The doctor may be able to prescribe a special exercise class for people with COPD. Exercising under supervision supports your loved one to feel safe. A class also presents the chance to talk with others who face the same challenges, which helps combat the isolation and depression that are common with COPD.

Tips for making it easier. Have your loved one

  • pick an activity that is pleasurable;
  • start small and increase gradually;
  • find an exercise buddy. This adds fun and supports commitment;
  • ask to be trained on “pursed lips breathing.” This technique makes it easier to exhale deeply and bring in enough oxygen.

Does better breathing feel impossible?

At Senior Life Management we have seen how people with COPD who didn’t think they could exercise can actually improve their breathing with very light, supervised activities. Even a physical therapist coming to the home a few times can guide your relative to exercises that will reduce that scary feeling of air hunger. Give us a call at 949-716-1266. As the Orange County experts in family caregiving, we can help you get the support needed to make each day the best it can be.

Savoring Good Experiences

positive experiences

Sharing positive experiences is like sharing a good meal, warms and strengthens friendships and family bonds. There are other benefits to savoring positive experiences. Even in the privacy of your own thoughts, reflecting on pleasant memories is an easy and effective way to increase your overall happiness.

Hard wired to focus on the negative

Have you noticed that even a small negative event can grab your attention repeatedly over the day? Positive events, by contrast, rarely come back to mind. That’s human. Our brains are hard wired to pay attention to threats.

Retraining our brains

As a family caregiver, you may find yourself focused on the things that aren’t going well. This zaps your energy. It also sets you up for depression, a common occurrence when caregiving. Fortunately, as humans we can retrain our brains to notice the positive for a more-balanced assessment of our days.

Try this exercise

  • Before bed, write down three good things that happened over the day. They don’t have to be big events. Just things that felt positive. Maybe a good conversation or a leisurely walk. Include as much detail as you can.
  • For each one, also write down “why” it was positive. Knowing what uplifts you tunes you into future opportunities for positive activities.
  • Take 30 seconds to relive or savor each memory. Close your eyes. Were there particular smells at the time? Sounds? Thoughts? Immerse yourself in the full memory of the event.
  • If possible, tell others about the event over the next few days. The recounting of it helps seal it in your awareness.

Why it works

Neurons that fire together wire together.” The more memory traces you create of positive experiences, the more adept your brain will become at recognizing the positives. You won’t lose your ability to identify threats. But you will form more-accurate assessments of your life and increase your overall sense of happiness.

Does the positive elude you?

If finding the positive experiences is difficult, it may be a sign that you could use some caregiving help. As the Orange County experts in family caregiving, we at Senior Life Managementunderstand that it’s a lot to shoulder. Give us a call at 949-716-1266. Let’s talk and see what we can do together to bring more positives to your day.

When your Parent Drinks Too Much

parent drinks

Alcohol is a sensitive subject. Consider asking your parent’s doctor or a respected friend to initially bring up the subject. Tell them the reasons for your concern: slurred speech, unexplained falls or bruises. Be specific in your examples. Your parent will have less face to save with a trusted friend or professional than with their own child.

If you do talk, don’t say “alcoholic.” Even if it’s applicable, this is a loaded term. Tread lightly. A confrontation will just make your relative defensive and could jeopardize your relationship long term.

Instead, clear yourself of judgments about what he or she “should” do. Your relative is an adult and has the right to make unwise or unhealthy choices. He or she is doing the best they can, using the coping strategies that are readily available to them.

Open the door. Let them know that you notice some things aren’t working well and that you care. Rather than preach, create an invitation: “I notice you’ve been falling” (or losing weight, or seeming kind of withdrawn). “Are you concerned? Want to talk?” If yes, great. If no, just make it clear you’re available any time.

Casual help. Rediscovering meaning, purpose, and connection is one route to recovery. Separate from a conversation about alcohol, help your loved one explore ways to feel engaged with life, perhaps through involvement with others. Maybe you can go together to a social activity to make the first time easier. Or you might help remove barriers by providing transportation or covering costs.

Formal programs. Older adults also respond well to short-term interventions that address the specific isolation and loneliness of late life. If your loved one shows interest, help him or her find a recovery program that is geared to the needs and concerns of aging.

Is alcohol a problem?

Alcohol use is surprisingly common in late life. At Senior Life Management we see it frequently. As the Orange County experts in family caregiving, we can help you strategize about optimal ways to approach the situation. Give us a call at 949-716-1266.

Signature Strength: Courage

courage

In the tradition of “positive psychology,” we encourage family caregivers to know and use their signature strengths. These personality traits can become reliable tools. Courage, for example, has many faces beyond bravado and derring-do. See if you recognize yourself in these descriptions.

Honesty and integrity are facets of courage. Are you a person who insists on living by your values? Do you prize authenticity? Courage is at the root of what it takes to

  • know your limits and take respite breaks when you need to;
  • talk compassionately with a family member about behaviors that are not healthy;
  • ask a sibling to participate more in helping out with Mom or Dad.

Steadfastness. Another aspect of courage is the willingness to continue even if the going gets tough. Think about ways you advocate for your parent with the healthcare system. Or perhaps you’ve found yourself calmly handling once-unimaginable tasks in personal care or wound care.

Maintaining focus. Courage also involves feeling several things at once, yet staying focused. A courageous person may feel fear. But they steady themselves with a belief that they can have an impact. The thoughtfully courageous assess situations with eyes wide open. They see the risks. Rather than run, they look for ways to reduce the chance of a negative outcome.

Tempering qualities. The roar of a lion—a blustery manner or righteous indignation—may look like strength. But that type of courage is not usually constructive in family dynamics. Better to remember that lions can be tender too, and they work for the overall good of the pride.

Courage may not be something you think of as your signature strength. This fresh look at the many sides of courage may help you see the daily bravery you exhibit as a family caregiver.

Are there days when you don’t feel like a lion?

We all feel that way from time to time. Usually it’s when there is more to be done than we think we can accomplish. As the Orange County experts in family caregiving, we at Senior Life Management can help you look authentically at the situation, and find your courage to take the next step. Give us a call at 949-716-1266.

Does Mom have a Drinking Problem?

drinking problem

 

Alcohol use is on the rise among older adults. And it’s not easy to spot. Many of the signs resemble common problems of aging drinking problem. And who wants to think that when Mom stumbles, for instance, it might be because of drinking problem?! There’s a lot of shame associated with drinking, so older adults—especially older women—often hide the activity of drinking problem.

Chronic drinking

About two-thirds of older adults with drinking problems have been drinking much of their lives. They’ve been “getting away with it.” Or they may have stopped in middle age, and then relapse in late life.

Late-life triggers

The remaining one-third of older adult drinkers with a problem are people who may even have been teetotalers in their youth. Keep your eyes open! Even if Dad never seemed interested before, alcohol could be his “comfort” now.

Loss makes elders particularly susceptible, for instance after the death of a spouse or a move to a new living situation. Pain or failing health are other common triggers. Even something as happy as retirement can pull the rug out, removing friendships, identity, and daily routines. With so much idle time, it’s easy to fall into a drinking habit without realizing it. When one drink becomes two or three, it can lead to dependence.

Loss of meaning and purpose are huge culprits

Loneliness and isolation lead to depression and anxiety. Without social contacts, it’s just too easy to “self-medicate” the emotional pain with alcohol. Older women generally, and men who have lost their partners, are especially vulnerable to drinking in later life.

Signs of a drinking problem

  • Unexplained falls and bruises
  • Moodiness, irritability
  • Poor sleep
  • Weight loss
  • Forgetfulness
  • Changes in appearance and hygiene
  • Increased secrecy, hiding bottles

In a follow-up article, we will describe constructive ways to raise this sensitive subject with your loved one, as well as things you can do to help him or her.

Are you worried?

Maybe this is a new issue. Or maybe your relative has been a lifelong drinker at no small expense to the family. As the Orange County experts in family caregiving, we at Senior Life Management know how delicate this issue can be. And sometimes even painful. Give us a call at 949-716-1266 to talk about the options. You don’t have to face this alone.

 

Preparing for Joint Replacement

joint surgery

If your loved one is slated for joint surgery, don’t underestimate the impact. Expect that he or she will have reduced energy and greater needs.

Limited mobility will create surprising challenges. Things you take for granted will need extra care and attention for joint surgery.

Plus, the body simply needs time and energy to rebuild bone, muscle, and nerve connections after joint surgery.

There is much you can do ahead of time to help prepare a smooth path for recovery.

Support physical preparation for success

Please Note: Senior Life Management does not specifically endorse the activities of these organizations, but offers their information as a sample of the kinds of materials and services that are available.

Thrifty or hoarding?

hoarding

We all accumulate belongings over the years. But when is it too much?

According to Michael Tompkins, PhD, author of Digging Out: Helping Your Loved One Manage Clutter, Hoarding and Compulsive Acquiring, your family member may be in the early stages of hoarding if he or she:

  • keeps parts of the home off limits and the curtains drawn;
  • talks with you endlessly about the stuff. You’ve stated your concerns, offered help, even gotten angry, and yet there’s no action;
  • gets overwhelmed decluttering even a small area. It becomes a major job that can take more than a few hours or days;
  • often fails to pay bills. Not necessarily for lack of money, but because the bills can’t be located. Or the stamps. Or the checkbook;
  • is in debt because of compulsive shopping;
  • has trouble finding things and resists storing belongings out of sight;
  • puts off home repairs. He or she may not recognize the need. Or may not want to let a repairperson see the house;
  • insists on meeting you at your home. This avoids embarrassment or confrontation about the clutter;
  • rents one or more storage units. There is a seemingly unquenchable need for more storage space;
  • will not let you touch or borrow his or her possessions. Possessions are guarded fiercely and may be treated as if they are “friends.”

If these symptoms look familiar, your family member may well have a hoarding disorder. He or she literally lacks the ability to eliminate clutter. Suggestions for next steps:

  • Don’t rush to action. Force will only alienate your loved one. By maintaining your relationship, however, you may be able to help manage the problem.
  • Learn more. The most extensive studies on hoarding are done by scientists researching obsessive-compulsive disorder.
  • Consider professional help. Especially if there are safety risks. Consult an Aging Life Care Manager or in extreme cases, Adult Protective Services.

Might it be more than clutter?

If you are worried, it may be time to call in professional help. We at Senior Life Management understand the full range, from an exuberant joy of shopping to extreme conditions that can even become a health hazard. As the Orange County experts in family caregiving, give us a call at 949-716-1266. We can help you get perspective and take the next steps.

 

I don’t need your help part 3

helping elderly

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.

Privacy. 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.

Pride. “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,

Please Note: Senior Life Management does not specifically endorse the activities of these organizations, but offers their information as a sample of the kinds of materials and services that are available.

Safe Traveling for Older Adults

senior independent living

If Mom or Dad has summer vacation plans, be aware that older bodies are more vulnerable to the stresses of travel.

Begin with a pre-trip appointment with the doctor. Suggest a meeting with the physician 4–8 weeks ahead of the vacation. Ask the doctor to assess overall health for travel. Heart and lung issues are the primary culprits in terms of cutting a vacation short. Ask about precautions while traveling or things that can be done now to prepare.

Other medical issues

  • Plan to bring extra pills in case travel home is delayed. Check to see if a prescription renewal is needed.
  • Ask about the scheduling of doses when crossing time zones.
  • Pack prescriptions in the carry-on in case luggage gets lost.
  • Order oxygen for the flight. If your loved one has a lung condition, the airlines will require you to order oxygen from them. They need 1–2 weeks’ notice.
  • Ask the airlines for help with a wheelchair if your loved one has trouble getting around the airport.
  • Pack lightly and carry a wheeled suitcase to avoid back injuries.

Exercise during long seated trips. If drive time or flight time is more than four hours, your relative may be at risk of deep vein thrombosis. Although not common, this involves a clot that develops quite suddenly. It can result in a deadly embolism if it travels to the lungs. Cancer patients, overweight individuals, and people who have been recently injured or hospitalized are most at risk. Watch for painful pink or bluish hot areas in the thigh or abdomen.

Prevention involves seated exercises such as marching in place and “drawing circles” with the toes (while pointing and flexing to stretch the calf in all directions). Properly fitted medical compression socks may also help—just make sure they don’t bind at the knees. If possible, it is helpful to stand up and move about every hour or so.

 

When you Need an Energy boost

elderly home care

When caregiver fatigue strikes, many of us reach for caffeine. Whether it’s coffee, cola, chocolate, or an “energy shot” drink, the effects are immediate. Like a reliable friend, caffeine seems to help us keep going.

Pros and cons

Studies have shown many benefits from caffeine. It can enhance performance. It increases productivity and elevates mood. It may even reduce or delay Alzheimer’s and Parkinson’s diseases.

On the other hand, caffeine can be hard on the heart. It’s like giving your heart a stress test on a regular basis. It’s known to cause a rapid or irregular heartbeat and can contribute to high blood pressure. Insomnia and anxiety are also common side effects.

Too much of a good thing?

High-caffeine energy shot drinks are increasing in popularity, especially among older adults. Take caution. In a four-year time span, the number of adults going to the ER because of energy drink intake doubled. Among adults age 40 and older, the rate quadrupled! Although the numbers are small, clearly there is a trend. Symptoms ranged from palpitations and anxiety to actual heart attacks.

The Food and Drug Administration says that 400 mg of caffeine per day is likely safe. A 5 oz. cup of caffeinated coffee has about 100 mg. A can of cola about 50 mg. Energy drinks, by contrast, vary dramatically, having from 200 to 500 mg of caffeine.

If you want to quit

Caffeine can be addictive. Tapering off, or down, is easier than going cold turkey. One approach is to make your coffee or tea half decaf. Or switch to smaller servings or fewer drinks per day.

Another option is to respect your fatigue. Try to get enough sleep at night. And if life allows, consider a short nap midday. Listening to your body may be a wiser approach than reaching for a cup of joe or a high-impact energy shot.

 

Opioid Addiction and Serious Illness

serious illness

Morphine, hydrocodone, fentanyl . . . with the opioid crisis in our country, it can be scary to hear that a frail or seriously ill relative needs this type of medicine. What are the risks of addiction?

Fortunately, addiction is rarely an issue for individuals dealing with cancer or a painful terminal condition.

Understanding Addiction. People who are “addicted” have such an intense desire for a drug, they do whatever it takes to get more of it. Their craving overpowers their concerns about relationships and their ability to function in the world. People with a painful, serious illness rarely behave this way.

The need for more medication. Over time, the body develops a “tolerance.” This means that a higher dose of the drug is needed to achieve the same relief. This is just a biological truth. A legitimate need for more medication is a far cry from an addictive craving that sparks irrational behavior.

Breakthrough pain. It is also very common with cancer and other conditions to have pain spikes in between doses. A booster dose of the medication is then essential. It is not a sign of addiction. Simply part of the unpredictability of pain.

Possible signs of addiction

  • Going to multiple doctors for pain medicine
  • Going to multiple pharmacies to fill prescriptions
  • Using up a prescription early
  • Taking ALL the breakthrough doses

If you are worried. Ask your relative’s health provider if they are concerned. If your loved one has a history of substance abuse, let the doctor know early on. Ask about trying different types of pain medication. Perhaps the opioid can be used in rotation with others. Spiritual distress can also be a source of physical pain. If medication is not enough, ask if a visit with a chaplain—a medical member of the clergy—is possible.

At Senior Life Management, we know how hard it can be to navigate the medical system. Hospital staff mean well, but they are short on time and have many patients to care for. As the Orange County experts in family caregiving, we can advocate for your loved one and help be sure that he or she is supported for genuine healing. Give us a call at 949-716-1266. You don’t have to do this alone!