• December 03, 2012
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A Step-by-Step Guide On Giving Power Of Attorney For Healthcare

My father has nine lives. He’s cheated death - and astounded doctors who gave him weeks to live - numerous times. In the process, he’s been in the hospital too many times to count and faced several life-or-death situations. Many times, he was too weak to grasp all the nuances of the medical mumbo jumbo. “Talk to my daughters,” he’d tell the doctors wearily.

Talk is cheap, as they say. What we needed was a health care proxy, a legal document that allowed us to make his health care decisions if he couldn’t. We scrambled to get one, but wish we had taken care of this essential task sooner. If you - or your loved ones - don’t have one, now is the time to take action. Serious illness, a debilitating accident or a stroke can happen unexpectedly - and quickly. And those who are unable to speak up about those all-important medical decisions (everything from consent for surgery to life support), need someone they trust to make their wishes known.

The American Bar Association’s easy to understand, step-by-step free guide will walk you through everything you need to know about giving someone power of attorney for your health care. Broken down into a three-step process, the seven-page primer includes dos and don‘ts (choose at least one back-up agent in case the first person is not available, do not appoint your health care providers), tips (pick someone who can handle conflicting opinions from family members, friends, and medical personnel.) and links to other guides (including one that helps families start meaningful conversations about this all-important topic).

The Bar’s Commission on Law and Aging, which prepared the document, also included the necessary legal form - with explicit instructions on how to use it. To view the guide, click here.

  • December 03, 2012
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Geriatric Care Manager (GCM): A Professional That Caregivers Should Know About

Old age isn’t for sissies. Or for their caregivers, who often juggle full-time jobs, families of their own and other responsibilities. Taking care of an elderly loved one can be an overwhelming, challenging, emotionally draining "job."

And, yes, sometimes it does take a village. We’ve found that one of the most helpful people is a Geriatric Care Manager, an expert that helps families determine what kind of help is needed and plans and coordinates that plan of action. They’re usually licensed social workers or nurses and many are specialists in specific areas such as Alzheimer’s and other forms of dementia. Their insider knowledge about private and public resources and clinical services is a godsend and particularly essential when your loved one lives hundreds of miles away.

Geriatric Care Managers (GCM) can provide one-time or ongoing assistance. What exactly can they do? The list is endless: assess needs, create a long-term care plan, coordinate services, act as the liaison between family, doctors, and caregivers, schedule doctor appointments, order Rx refills and confer with home health aides. 

Many people may think that GCMs carry too high a price tag. And while they are expensive (anywhere from $70- $250 an hour depending on location)  and not covered by insurance, Medicare or Medicaid (tho they are sometimes covered by Long-Term Care Policies), they can also save you money in the long run by focussing on the services you need at the moment and making efficient use of financial resources.  And the peace of mind? That’s priceless.

That's what I discovered when I hired a GCM to help my own father, who lived 3,000 miles away from me. The GCM went to his house every two weeks- and along with her other duties-managed his medications, took him to the doctor- and then gave me detailed accounts of the visits and my Dad's condition. It was not only a relief knowing someone competent and caring was helping him, but it provided the missing link in our team and made it much stronger. Everyone was the better for it.

Some of you may have never heard of a GCM. But the industry hopes to change that this month, which is GCM month. For more information on hiring a GCM, you can call us, check the "Medical Services" section of the Seniority Matters Directory, or consult with the National Association of Geriatric Care Managers website.

  • December 04, 2012
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The First Steps In Getting Help For Your Parent

It's hard enough for caregivers and their loved ones to agree that some additional help is needed. But once that bridge is crossed, the task of finding just the right person can be just as challenging. What questions should be asked?  Are special credentials required? Can we trust them? What are the laws? It's mind boggling.

That's exactly how I felt when I started out on the caregiving journey, and it is the major impetus behind Seniority Matters and our directory of service providers.

An important piece of advice I can give is: Know what kind of help your loved one needs.  I know this sounds over simplistic but take it from me, it's not.

Think about it. Is your parent lonely and in need companionship, and, perhaps a little help around the house, or with errands? Or do they need assistance with bathing, dressing, and taking their medications? There's a big distinction between these two types of needs, and the basis on which companies that provide "caregivers" are licensed. Getting the wrong type of help can not only be a waste of financial resources but deterimental to the health and well-being of your loved one.

So how do you figure it out and make sure you get it right on the first try? Here are a few suggestions.

1.   Check out the Seniority Matters Provider DirectoryIt is designed to help you to identify your specific needs. Each Home Health company listed is accompanied by a detailed list of services it provides. Some companies specialize in companion care, and others provide more hands-on and medically-oriented services. Read each service provided very carefully and think about your need for that particular service. This will help you to get to the right company the first time.

2.   Get some objective and individual advice. Unfortunately it's not always so simple. Perhaps as you read the list, you're not sure---and maybe the list raises more questions than answers. Here are some people you can turn to for answers:

  • Your parent's physician. Ask him or her their opinion. This may necessitate written permisison from your parent to speak with their physician about them. But it's good to have these forms in place.
  • If your parent has been hospitalized, try to meet with a discharge planner. Make sure you understand what specific needs your parent will have when they return home, and if they recommend a person or company, make sure they're both licensed and trained to provide the services.
  • Call us at Seniority Matters. We can refer you to an appropriate company from our pre-vetted directory, or direct you to a community program or local resource such as a geriatric care manager than can perform an independent assessment. Or maybe you just want to bounce your thoughts off to someone and get some feedback and advice. Whatever you choose, we will help you to identify your needs and access the appropriate service that will fulfill them. 

The first step is the hardest one. Don't be afraid to ask the hard questions. We're here to help you find the answers.

  • January 03, 2013
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Preventing Hand And Wrist Problems

Hand pain has many causes, including injury and disease. Some of the most common conditions causing hand pain are De Quervain's Tendinitis (causes pain on the thumb side of the wrist), Carpal Tunnel Syndrome ( causes pain in the palm, some fingers and the forearm), fractures (cause pain, swelling and loss of movement), Arthritis (causes pain and swelling in the base of the thumb and in the joints of the fingers, and Trigger Finger, which causes the fingers or thumbs to lock in a bent position.

Here are some tips to prevent finger, hand and wrist problems:

  1. Do exercises that strengthen your hand and arm muscles.
  2. Stop, change or take a break from activities that cause your problems (like excessive driving).
  3. Reduce the speed of repetitive movements in activities such typing, quilting, sweeping, hammering or rowing.
  4. Change positions when holding an object, such as a book, for long periods.
  5. Use your whole hand to grasp an object.
  6. Wear wrist guards in sports activities.
  7. When using a keyboard, keep forearms parallel to the floor or somewhat lowered, with fingers lower than the wrist. Take regular breaks to stretch the neck, shoulders, wrists, hands and fingers.

Here are some easy exercises to strengthen your hands:

  • Open and Close: Hold your hands in the air, fingers together. Slowly spread your fingers apart and return to starting position. Repeat 10 times.
  • Walk Your Fingers: Rest your hand on a table, palm facing down and fingers spread slightly apart. Moving one finger at a time, slowly walk the fingers toward the thumb. Next, lift and move your middle finger toward the thumb,then the ring finger and last, the pinkie toward the thumb. Do not move your wrist or thumb while doing this exercise. Repeat on the other hand.
  • Make a Fist:  Start with your fingers straight and spread apart. Next, make a fist and wrap your thumb around the outside of your fingers. Don't squeeze the fingers together too tightly. Slowly return to the starting position and repeat ten times.
  • Finger and Wrist Stretch: Starting with the right hand, gently extend the fingers back one by one. Next, take them back all at the same time. Repeat 10 times.
  • Prayer Stretch: Stand with palms together(prayer position) and elbows out to the sides. Slowly lower wrists until you feel a stretch. Hold for 5 seconds and return to the starting position. Repeat 10 times.
  • January 28, 2013
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Deducting Mom And Dad: Tax Tips For Caregivers

This post first appeared in the Miami Herald on March 4, 2012. It has been updated to reflect changes in the laws in 2015.

If you're one of the 40 million+ caregivers in the US, then you know first hand the toll it can take on you financially. 

But what you may not know that there may be some tax breaks that you can take advantage of.   Here are just a few suggestions for ways to ease the financial burden. Of course, your own accountant or elder law attorney can give you personal advice that will be most pertinent to your own situation. 

 1. Claiming your parent as a dependent.  This will enable you to reduce your own taxable income by $4,000. There are some basic criteria you must meet.

  • Your parent may not file a joint tax return with a spouse, and cannot have an annual income that exceeds $3,950. While this amount typically does not include Social Security disability payments, it does include income from pension and retirement plans, or dividends from other investments.
  • You (the caregiver) can not be claimed as a dependent on any other tax return. 
  • You must provide at least one-half of your parent's total support. 

You can find learn more about claiming your parent as a dependent by downloading the IRS 501 Publication.

 As complicated as it seems, it becomes even more involved if the support is provided by multiple siblings. If each sibling contributes at least 10% of the overall care expenses, then you must have an agreement each year that states which sibling will take the deduction. More information on this can be found in the IRS Form 2120.  

2. Deducting the expenses for Medical Care of your parent(s).  If you provide the funds for more than 50% of either one or both parents' overall medical expenses you may be able to deduct these expenses on your tax return. Some key criteria are:

  • The amount you spend must exceed 7.5% of your own adjusted gross income.
  • You may only deduct expenses that are not reimbursable by medicare or private insurance and those that are outlined in the IRS Publication 503. These expenses include: transportation to medical expenses, medication expenses; home healthcare, and premiums for Long-Term Healthcare Insurance, and medical equipment. 
  • The expenses must be for one who is chronically ill and whose need for care has been documented and prescribed by a physician or other health care practitioner. 

Deduction of Living Expenses  If you have a parent living with you, there are living expenses that may be deductible on your tax returns. If you renovate a room in your home to make it accessible for your parent, the costs may be deductible, but only to a limited extent. Any increased value to your home is not allowed.

The IRS allows you to claim a portion of your home if your parent lives with you. You can claim "fair rental value" and include a portion of utilities and other household expenses as well. However, if you're in a high income tax bracket the amount you are permitted to claim as a deduction decreases.  More information on this can be found in the IRS 501 Publication.

There is clearly not enough of tax relief help available to those providing help to an aging or frail parent. If you're currently a caregiver it's important to learn about potential tax breaks. Even if you don't qualify it's a good idea to keep abreast of available information because as the population ages and the number of boomer caregivers increases, we are likely to see changes in the laws that will provide relief for caregivers.

If you need help finding a financial or legal professional who is knowledgeable about these matters, email or give us a call. We can recommend individuals in south Florida.

  • January 30, 2013
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How And When To Take Supplements

In our haste to get out the door in the morning, many supplement users reach for their day’s worth of calcium, vitamin D, fish oil, and often much more, and throw them down the hatch with one big gulp of water, often on an empty stomach. That’s one thing that can be checked off the to-do list. Right? And of course, they feel so healthy now they’ve “innoculated” themselves for the day. Yet, how much of what they took will be absorbed so the health benefits can be realized? The all-at-once method of supplementation is a waste of money and maybe even detrimental to your health.

Setting aside the debate over which supplements are necessary for an individual, I asked Shizandra Fox, an herbalist and certified nutritionist in Sonoma, CA, for her advice on when and how to take three of the most commonly used supplements. Here’s a summary of what she recommended:

Vitamin D- Because Vitamin D is a fat soluble vitamin, it should be consumed with a fatty food, like olive or fish oil (which is why D is often contained in Fish Oil supplements). For that reason, “it’s best to take it with your main meal,” Shizandra told me, which is most likely dinner. “Taking D in the evening also allows your body to absorb the nutrient at night while you sleep,” she explained.

Fish Oil – Shizandra is a fan of liquid fish oil, which she likes to drizzle over her vegetables at dinner. “It’s important to take fish oil with a meal, and by chewing it into our food, we’re maximizing the benefits we’re hoping to potentiate from taking it in the first place.” She added that it’s important to use a high-quality fish oil and never use it on food that you plan to reheat.

Calcium - If you’re getting your calcium from supplements and you’re taking a large daily dose, it should be divided up throughout the day. But, if you’re taking thyroid medication, Shizandra told me that it should not be taken at the same time. Since essential fatty acids (EFAs) enhance our body’s ability to absorb calcium, it’s wise to take Calcium with a meal, or with your fish oil. 

  • February 13, 2013
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Meet The Good Son: A Full Service Concierge Company In Boca Raton And A Welcomed Addition To Our Provider Directory.

He’s a good son. How many of us have uttered that phrase while bursting with pride? And, in the next breath: I just wish he lived closer. We all need a “good son” nearby - one who will rush over at a moment’s notice to take us to the doctor, watch the house while we’re away, go grocery shopping, put up hurricane shutters, take the car in for service or even just change a light bulb.

For those of us who aren’t lucky enough to have the real thing nearby, there’s a fantastic facsimile: The Good Son company, a Boca Raton-based business, run by long time resident Martin Davis, that delivers efficient, affordable high-quality home and lifestyle services throughout Palm Beach County. Their motto: “We Specialize In Your Peace Of Mind.” That means you can trust them to take care of those everyday tasks (including furniture assembly, grocery shopping and prescription pickup) as well as taking care of your home while you’re away and dealing with hurricane prep. And they’ll do something that even your real son might not want to do: Fire a company that isn’t performing up to your expectations and replace it with one that will. Ah, what a good son.

For more information: check out their listing in the Seniority Matters Directory or go to their website.

  • March 06, 2013
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Exercises For Carpal Tunnel Syndrome Can Help Relieve Symptoms

Carpal Tunnel Syndrome  (CTS) occurs when the median nerve that controls sensation and movement in the thumb and first three fingers is either compressed or pinched, causing weakness, pain, numbness in the hand. It can develop very slowly, and often you hardly recognize the slight symptoms of tingling or a little discomfort which can be relived by simply shaking your hand. As it progresses, however, you will experience pain in your thrumb and two fingers.

Women are three times more likely than men to develop CTS.  Diseases such as diabetes, obesity, arthritis, as well as repetitive stress and injury to the hand increase the risk of developing CTS, and while it's difficult to prevent, studies have shown that both rest and excercises that focus on strengthening posture, hands, wrists, forearms, shoulders and neck can help alleviate symptoms. 

 Here are some exercises that you can do to help ward off and alleviate CTS symptoms.

  • Wrists (wrist circles): Hold the second and third fingers up and close the others. Draw five clockwise circles in the air with the two fingers. Draw five counter-clockwise circles. Repeat with the opposite hand. 
  • Fingers and Hands (thumbies)Bend the thumb against the palm under the pinkie finger. Hold for 5 seconds. Repeat on the opposite hand. Do 10 repetitions.
  • Forearms (prayer Stretch)Stretching the forearms reduces tension in the wrist. Place the hands in the prayer position. Palms flat against each other, raise the elbows, stretching the forearm muscles. Hold for 10 seconds. Shake the hands. Repeat whenever your hands and arms are tired.
  • Neck and Shoulders: Stand with your arms to your sides. shrug the shoulders up, next squeeze the shoulders back(retracting the scapula), then stretch the shoulders down, then press them down. This exercise should take 7 seconds  Repeat 5 times.
  • March 13, 2013
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Volunteer Opportunities For The Newly Retired, And The Not So Newly Retired

Boredom. Loneliness. Isolation.  

It’s a vicious cycle and one seen all too often in the lives of seniors who have new, quieter (and perhaps too quiet) lives since they’ve retired. The days that once whizzed by are feeling very long for many.
 
A solution? Volunteering. Helping others releases those “feel good” endorphins, fills  time with meaningful work, keeps those all-important brain cells active and provides social interaction. In other words, it’s all good. But where to start?
 
We have many volunteer opportunities listed in the program section of our website, inducing those at Aventura HospitalBRAVO (arts related), Fairchild Tropical Gardens and RSVP, a service that connects those ages 55+ to volunteer opportunities of their interest in Broward County. There’s also ReServe Miami, an organization that places retired people in paid positions in non-profit companies. Seniors who want to help solve social issues should check out Civic Ventures which offers several programs and volunteer opportunities in the education, environment and healthcare venues. Another helpful site is volunteermatch.org: just plug in the city where you want to volunteer and the type of work you’d like to do and a list of intriguing ideas pops up. Finally, if you're looking for an exotic and adventurous volunteer opportunity, check out Cross-Cultural Solutions, an international non-profit organization that operates volunteer programs around the world in partnership with sustainable community initiatives, bringing people together to share cultural perspectives and foster cultural understanding.
 
Check them out. You’ll be glad you did.
  • March 18, 2013
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Meet Elaine Ortiz, RN, And The New Adult Day Center Of South Florida

I receive many calls from Caregivers asking about Adult Day Care services for their loved one. And now, if you live in Miami, you’re in luck.  Elaine  Ortiz, RN has recently opened the Adult Day Center of South Florida in Palmetto Bay. The center offers a range of services and activities from nutritional snacks and meals, daily exercises, and games and puzzles, to Alzheimer’s and respite care.  I had the pleasure of visiting Elaine last week. 

The Center is located in the corner of a strip center on 184th Street just East of US 1, making this a very viable option for those living from the Gables to Homestead.   When I entered, I was greeted by Elaine, who despite her young age, has had years of experience in geriatric nursing and home care.  It’s clear that her motto “Where Caring and Compassion  Matter” is near and dear to her heart.  She showed me around the facility, stopping to help a elderly woman complete a word game, and another who was just settling in for the day. 

Equally as inviting as Elaine and her services was the physical layout of the center. It’s a warm and cozy environment, with warm wood floors,  soft lighting, comfortable seating arrangements, and a state-of the art kitchen.  Lunch and snacks are served on nice tables with beautiful tulips as centerpieces.

So, if you’ve been thinking about Adult Day Care services, and haven’t known where to turn, stop by and visit Elaine. I think you'll be very happy that you did.  The center is licensed by the State of Florida and can serve up to twenty adults everyday. One can attend a few times a week, or everyday from 8:00am - 4:30pm, or for a half-day. If transportation is an issue, Elaine will help you find a solution. 

For more information on the Adult Day Care Center, please call (786) 732-4055.

  • April 15, 2013
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This Full Service Pharmacy Will Shorten Your To-Do List.

You’re going to thank me for introducing you to Surf Med - the latest addition to our directory of trusted, prescreened businesses in South Florida. That’s because this pharmacy, a family run business that’s been around for more than 50 years, does more than fill prescription vials. They carry everything you can think of from home medical equipment and supplies for sale or rent, to scooters and bathroom safety products. They can even assist you in completing the appropriate insurance paperwork.

And here’s the icing on the cake; you can purchase products online and renew prescriptions by phone and have them delivered or shipped. They’re a caregiver’s dream come true. A business that aims to please the locals (and their far away family members) with good service and convenience.

To learn more about how Surf Med can help you manage your own or your parent’s pharmacy needs, visit their listing in our easy-to-use provider directory, or visit their website. You’ll be impressed by all the helpful information and resources they provide.

  • April 18, 2013
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What I Wish I Knew: The Importance Of Having A Trusted Resource While Being A Caregiver

It’s been nearly two years since my father died, and I ceased being an active caregiver. When I look back on my own caregiving experience, there are still things that make me very sad. Yet I’ve never been able to pinpoint what it is that disturbs me so.

Until now, that is. Recently Lisa Huening of the The Shifting Path, a company in Northern California that provides guidance and coaching to caregivers, asked me to participate in an audio series she was preparing called “Things I wish I Knew.” It forced me to rethink some of the missteps I made. There were little ones in the beginning, like hiring a home health company that was not licensed to do the tasks we needed done, and a little more significant later on, such as having a bookkeeper that we knew lacked integrity but not having the courage to rock the boat, and fire her and not understanding that being angry at my father for behaviors he couldn’t help was detrimental to his health --- and mine. Even as I got smarter I still did not recognize subtle signs of both dementia progression and his body shutting down.  I wish I had.

What I realized I needed, and didn’t have, was a trusted resource--someone who could tell me if I was headed in the right---- or wrong direction, and could answer my concerns, and keep me on track, both emotionally and intellectually.  What follows is my edited recorded response to "What I Wish I Knew."

There’s no formula as to who that person can be but it should be someone who can provide some objectivity. If you’re a caregiver and live nearby and see your parents regularly- then it may be a friend who’s been through this journey, a social worker or other therapist who sees geriatric patients, or a senior advocate, who can help you plan and prepare for caregiving and navigate you to resources.  If you live far away from your parent, perhaps you can consider hiring a Geriatric Care Manager, who can not only serve as an advocate but also as your eyes and ears when you cannot be there.  Perhaps is could be your parent’s physician, and if they have too many, perhaps you can find a family practitioner or a concierge physician who can serve as their quarterback with the other physicians. 

Do you have a trusted resource---someone who you can turn to for advice or as a sounding board?  Please tell us by commenting below.

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