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Mild cognitive impairment (MCI) and what you can do

Mild cognitive impairment (MCI) and what you can do

Mild cognitive impairment (MCI) is the medical name for memory problems that exceed the “normal forgetfulness of aging” but are less than associated with an Alzheimer’s diagnosis. If you have received a diagnosis of MCI, you are at risk for continued significant cognitive decline. Each year about 10–15% of persons with MCI receive an Alzheimer’s diagnosis, as compared to 1–3% of all older adults.

That said, many people with MCI do not experience further decline. And some people even improve–if their memory loss was caused by something fixable like a medication reaction or untreated depression. For all these reasons, it is important to have symptoms reassessed every 6–12 months to monitor changes.

There are things you can do. While there is no medical treatment as yet for MCI, some everyday activities can help prevent or slow its progression. The goal is to increase blood flow and oxygen to your brain, and keep your mind active.

  • Manage your blood pressure. Keeping blood pressure within the normal range has a profound effect on delaying memory problems.
  • Practice healthy habits. Get regular aerobic exercise, such as brisk walking. Aim for eight hours of sleep. Eat a diet low in processed foods and high in fruits and vegetables. Limit alcohol. Quit smoking. Manage other conditions (e.g., diabetes, depression).
  • Wear your hearing aids. A loss in hearing means a loss of stimulation to the brain. Studies now connect this loss with a decline in brain function. (Plus, some things you are “forgetting” may in fact be from conversations you didn’t fully hear.)
  • Participate in social activities. Even if you don’t talk much, the stimulation of spending time with others is beneficial.
  • Learn a new skill. Make your brain exercise! Try something you’ve never done. Brush your teeth with the “opposite” hand. Or have some fun: Ping-pong? Drumming?
  • Engage your mind with puzzles. This is brain calisthenics. Keep your neurons firing with activities that make you think.

Memory aids. Accept that you are forgetful and support yourself for success. Make ample use of to-do lists, big calendars, and notes or alarms on your phone. Leverage the power of routines. Put your keys and glasses, purse/wallet in the same place every time. Set yourself up for environmental cueing, consciously putting things where you will see them when needed, such as leaving your morning pills by the coffee maker.

Worried about MCI?
Give us a call. We can help. (208) 321-5567

Learn more about our services to help you age well.

How to pay for care

How to pay for care

Most people are surprised to learn that Medicare pays for only a limited amount of the daily care you are likely to need in your lifetime (about 14%).

Medicare covers only services delivered by medically trained professionals. That means you need to have savings or insurance and rely on a collection of local programs. Or family and friends who may be able to pitch in with labor or funds.

Assisted living and memory care $$$–$$$$
As nonmedical services, these settings are usually paid for out of your own savings. If you are a qualifying veteran or you have long-term care insurance, your costs may be covered. Contact the Veterans Administration or state Veterans Council. Check your long-term care insurance policy for eligibility requirements. Also ask about waiting periods. Is there a lifetime cap on the total amount they will pay?

Skilled nursing/rehab or nursing home $–$$$$$
Provided your stay follows a qualifying hospitalization, original Medicare—the government’s health insurance for seniors—will typically cover some portion of the costs for the first 100 days. You use your supplemental insurance for your copay. Or pay out of pocket if you do not have supplemental insurance. Starting day 101, you pay 100% of the cost. Medicare Advantage plans vary, so review the coverage with your insurance provider. If you have private long-term care insurance, check your policy for skilled nursing coverage. The Veterans Administration offers special facilities for qualifying vets.

The very poor may qualify for Medicaid. This program will pay 100% of costs. However, there are only a limited number of Medicaid openings available in any given facility. Those living long term in a nursing home usually exhaust all personal savings and assets. Then they switch to Medicaid. If you think you may need Medicaid, consult an elder law attorney early. Also, your financial planner for advice about liquidating your assets.

Continuing care retirement communities $$$$$
This is a very different model of care that merges housing and insurance. With a continuing care retirement community—also known as a “Life Plan Community”—you invest a substantial sum up front (often in the six figures). You also pay a monthly service fee. Start while you are healthy and live on campus to enjoy the deluxe amenities. Move to the most appropriate building as your care needs change. This is paid for almost entirely out of your own savings. If you have long-term care insurance, check your policy to see if it covers continuing care retirement communities.

Worried about paying for care?
Give us a call at (208) 321-5567.

Learn more about our aging life care planning services.

Choosing a home care provider

Choosing a home care provider

Frank knows they need help at home. His wife’s dementia is getting worse, and he has his own health problems. She can’t be left alone anymore.

Doing all the cooking and cleaning, and now helping with bathing … it’s just too much.

Frank needs to take breaks. But a Google search reveals a dizzying array of home care providers. How to choose?

Allowing a stranger into your home can leave you feeling quite vulnerable. It’s important that you trust the individual and the company that does the background checks, verifies training, and puts together the schedule.

You also need to interview each company to find out pricing and minimum number of hours, and to see if they have independent quality ratings.

How do you know which one to trust?
This is where an Aging Life Care™ Manager can help.

On the basis of past experience with other clients, he or she knows which companies put an emphasis on training. Which have difficulty filling a shift if a caregiver calls in sick. Which have high staff turnover resulting in the need for you to orient a new employee every few months. Which have a strong team, with employees who love their work.

Wise home care companies will let you and your Aging Life Care Manager interview several caregivers before making a choice. They know that an Aging Life Care Manager understands you as the client and understands what will result in an optimal match.

Both you and the provider and the caregiver want a good fit the first time so all of you can work together positively for the duration of your need. It makes the difficult transition to home care that much easier if a knowledgeable advocate can set expectations and provide an objective viewpoint.

Even with adult day care and medically trained services, such as home health and hospice, not all providers are alike. An Aging Life Care Manager knows the reputation and the management style of each company. He or she can look up Medicare reviews and complaints.

An Aging Life Care Manager can also coordinate care across multiple service providers and work with your physician to ensure that all the different players are aware of your changing needs.

Want to find the best fit the first time?
Give us a call at (208) 321-5567.

Learn more about our aging life care planning services.

What is “elder law”?

What is "elder law"?

Elder law focuses on the special rights, needs, and challenges that arise in the context of simply growing older and planning for possible care needs.

Attorneys specializing in elder law take a holistic perspective.

They acknowledge the interplay of health, family, disability, and housing, as well as emotional and financial issues. Consider a consultation for:

  • Estate planning. Within elder law, estate and trust attorneys advise on the best strategy for organizing and managing your assets now that also ensures ease of transfer upon your death. This may involve a will. Or a living trust. There are pros and cons to each. And, if you have a dependent adult in your life, an attorney can draw up a special needs trust to provide for care when you are no longer alive.
  • Decision-making plans. With advancing age, many of us lose the ability to manage our finances or make complex healthcare decisions. Especially if you do not have relatives to step in, you will need legal assistance to locate and contract with trustworthy professionals to fill these roles.
  • Paying for care. An elder law attorney knows about the many programs designed to assist with the cost of care. You may, for instance, be considering a reverse mortgage, but there are significant “gotchas” with this arrangement. If Medicaid is your fallback should you need a nursing home long term, you will want to work with an attorney to be sure your spouse is not left without resources when you die. Long-term care insurance is another payment option worthy of an attorney’s review.
  • Housing contracts. Before moving into an assisted living or continuing care retirement community (sometimes called a “life care” community) or a nursing home, have an elder law attorney review the paperwork. They can clarify tax implications and advise you regarding your rights and how or when you can cancel a housing contract.
  • Claims and appeals. You may have disagreements with Social Security, Medicare, your pension fund, or other insurance or benefit programs. An elder law attorney can help you navigate the appeals process and increase your chance of a successful resolution.
  • Grandparent visitation rights. Whether the schism is due to a divorce, the death of your child, or estrangement from your son or daughter, you do have rights to see your grandchildren. An elder law attorney can help you stay connected.
  • Age discrimination in employment. Have you been turned down from a job, a promotion, or fired because of your age? An elder law attorney can help you rectify the situation.

Looking for an attorney specializing in elder law?
We network with the best. Give us a call at (208) 321-5567.

Learn more about our services to help you age well.

Choosing a long-term care facility

Choosing a long-term care facility

Judy had an emergency hip replacement after a fall. She needs to be discharged tomorrow to a skilled nursing facility. She needs several weeks of intensive physical therapy to be able to walk again. Then she may need to live in assisted living.

The discharge planner has a list of options. Judy and her daughter, who lives an hour away, don’t know how to make a wise choice.  

For short-term, urgent needs, you may be at the mercy of which facility has an opening at the time.

It pays to consult an Aging Life Care™ Manager who knows the reputation and personality of the local institutions. It’s best to have a relationship with the Aging Life Care Manager before you have an urgent need. He or she can combine extensive knowledge of local resources with a thorough understanding of your medical history, your insurance and financial resources, your personality and preferences, and your social support system. As a result, you are more likely to get a match that will help you maintain good spirits and enjoy a speedy recovery.

Review all your options
Unlike “free” referral agents, an Aging Life Care Manager will present all the choices that make the most sense for your needs and personality. Not just the communities that are willing to pay a kickback referral fee.

Such independence is even more important for long-term living situations
Choosing an assisted living community, a CCRC, or a memory care facility is a big decision. You want to get a good match from the start.

Touring these communities can be daunting
A Google search delivers a dizzying array of choices. They all put their best foot forward. But architectural features and social amenities are only superficial measures of quality. An Aging Life Care Manager has had other clients who live in these facilities. He or she has a firm grasp on deeper metrics, such as the tone of the administrative leadership, the training and stability of the staff, the solvency of the company, and the overall personality of the community.

An Aging Life Care Manager also knows current conditions in the market that can save you money. For instance, if a community happens to have a lot of openings, a lower monthly rate or entry fee could be negotiated. A “senior housing advisor” paid a commission by the community would not be able to serve as your advocate in this regard.

Looking for unbiased recommendations based on all your options?
Give us a call at (208) 321-5567.

Learn more about our aging life care planning services.

Assembling your support team

Assembling your support team

Much as we would like to imagine an elderhood free from troubles, the truth is, we are all likely to need help eventually. And on several levels.

Informal support. This is the kind of help that friends and family members can provide short term. Someone to run errands or mow the lawn, etc. Make a list of the

  • people you feel emotionally close to
  • people who live close by who are reliable

When the going gets tough. If you were hospitalized, who would you call to

  • make medical decisions for you if you were unable to speak for yourself
  • pay bills or perhaps even manage your financial affairs long term

Your health care team. Medically trained support:

  • Your primary care provider and any specialists
  • Your pharmacist
  • Allied health providers (e.g., therapists, home health)

Professional advisors

  • An elder law attorney for important documents. You will need an attorney to set up a trust or will for dispersing your assets after you are gone. Or, if you have no relatives, to arrange for a guardian to make medical and financial decisions for you when you can no longer do so yourself. In addition, an attorney can review contracts and catch important details about senior housing. And an attorney’s advice is critical if you are considering a reverse mortgage or spending down your assets to be eligible for Medicaid.
  • A financial planner to manage assets and strategize to liquidate them to pay for care.
  • A CPA to highlight the tax implications in any of the above situations.
  • An insurance broker for prescription, Medicare supplemental, life insurance, etc.

An Aging Life Care™ Manager. The choices are boggling when it comes to assembling your team. It’s difficult to assess quality of professionals or compare pricing. An Aging Life Care Manager is a “meta-advisor” whose experience can help you choose your team wisely and coordinate whom to call when.

Want help assembling your team? Give us a call at (208) 321-5567.

Learn more about our aging life care planning services.

Paying for care at home

Paying for care at home

How you pay for care at home depends on whether the service is by medically trained staff or by nonmedical caregivers. Also, what you can mix and match in terms of community programs and help from friends and family.

Medicare pays only for care in the home that requires the skills of a nurse, nursing assistant, physical therapist, or other medically trained professionals.

Home care $$–$$$$
The cost of nonmedical home care is NOT covered by Medicare. As a result, you must contract directly with providers. Fees depend on how many hours a week your care requires.

Consider that caregivers coming to your home need a livable wage. Add to this agency costs of staff recruitment, vetting, training, and scheduling. The price can mount up quickly.

  • Long-term care (LTC) insurance. These policies can be purchased privately and are the least expensive when begun in middle age. Typically, to draw upon the insurance, you must pay for home care services out of pocket for a waiting period. Insurance will contribute afterwards and pay up to the lifetime cap. Check policy details.
  • Veterans assistance. For qualifying vets who saw active duty with at least one day during a war, there may be benefits available to help with the costs of home-based care.
  • Personal savings. Consult with a financial planner and elder law attorney to determine the best strategy for liquidating assets to cover your care.

Adult day care $–$$$
You must pay privately. Many programs are run by nonprofits so are underwritten by donations and grants. Medicaid, LTC insurance, and veterans benefits may also help.

Home health and hospice $

  • Medicare. This is typically deducted from your Social Security check and will cover home health services (80%) and hospice (often 100%).
  • Supplemental insurance. This is insurance you buy to cover the 20% balance not paid by Medicare.
  • Medicaid. Those with VERY low income and minimal assets may qualify for state government support. The eligibility requirements are stiff. Coverage includes 100% of most medically trained care, with some restrictions. Coverage for nonmedical care is spotty and varies by county.

We can help you sort out your options.
Give us a call at (208) 321-5567.

Learn more about our aging life care planning services.

What is an Aging Life Care™ Manager?

What is an Aging Life Care™ Manager?

Imagine your life as a movie. If you are the director, an Aging Life Care Manager is your production manager.

He or she is a deeply knowledgeable guide (usually a nurse, social worker, or allied professional) who finds you high-quality help, arranges care “locations,” and advises you about needed services.

Aging Life Care Managers are part of a national organization with training requirements, codes of ethics, and a nationwide network of experienced colleagues in case you need to move to a different part of the country.

Specialized knowledge and skills
Aging affects all aspects of life, so an Aging Life Care Manager draws upon many areas of expertise:

  • Advocacy. Communicating with doctors and navigating the very confusing eldercare network to get you the care you want.
  • Health and disability. Conducting an assessment and making recommendations so you and your family members can rest assured that a plan is in place if you need extra help.
  • Local resources. Recommending area service providers. Anyone can Google. But an Aging Life Care Manager intimately knows quality and reputation and can match best services for your budget and priorities.
  • Family. Helping relatives understand their role and work together to support your wishes.
  • Housing. Providing independent recommendations for the best fit based on your needs, priorities, and resources. No kickback referral fees that limit your choices.
  • Legal. Assembling needed paperwork and referring you to reputable attorneys as needed so you are well covered by a professional team.
  • Finances. Reviewing your options to identify eligibility for programs and ways to stretch your dollar wisely.
  • Crisis support. Helping you create a safety net you can depend on in emergencies.

As the director of your later years, how do you want your story to unfold? While not all of it is within your control, you do have agency. With planning, there is much you can do ahead of time to prepare for the elderhood you want and create a network to support it.

Would you like a guide for aging well?
Give us a call at (208) 321-5567.

Learn more about our aging life care planning services.

Warning Signs of Pneumonia

PneumoniaWarning Signs of Pneumonia is a common lung infection that can cause coughing, chest pain, and difficulty breathing. It can also be deadly. Each year, approximately 50,000 Americans die of pneumonia, according to the Centers for Disease Control and Prevention (CDC).

Of course, pneumonia isn’t always deadly. ‘Walking pneumonia,’ for instance, is a form of the disease that’s so mild, it barely interferes with your usual activity. For most people, prompt diagnosis and treatment are key to minimizing the negative effects of this lung infection; the sooner you seek medical attention for pneumonia symptoms, the sooner you’ll feel better. Watch for these five symptoms and signs of pneumonia.

1. Cough with phlegm

Anything that irritates the lungs—smoke, infection, even chemical exposure—can cause a cough. Coughs also are a cardinal symptom of the common cold, which typically doesn’t require medical treatment. So how do you know if a cough is a symptom of a potentially serious medical condition, such as pneumonia? Pay attention to the cough over time.

A cough that gets worse, instead of better, over time can be a sign of pneumonia; anyone who feels sicker rather than better after a few days of a cold or the flu should seek medical evaluation. It’s also a good idea to see a healthcare provider if you start coughing up mucus or phlegm, particularly if the mucus is thick, green or yellow.

2. High fever

If you have persistent fever of 102 degrees Fahrenheit or greater, seek medical attention, especially if you also have a cough. Fever and chills are common symptoms of pneumonia. A really high fever—about 104 or 105 degrees F—may be a symptom of bacterial pneumonia. (Generally, the fevers that occur with viral pneumonia are not as severe.)

If you are caring for an elderly family member or friend, also be alert for a lower-than-normal body temperature. People who are older than age 65 or have weak immune systems sometimes run low temperatures when they have pneumonia.

3. Chest pain

If your chest hurts when you take a deep breath or cough, you might have pneumonia. Some people describe pneumonia-related chest pain as “sharp” or “stabbing.” The pain may get worse with activity. You may also feel fatigued and short of breath with even minimal activity, such as climbing a few stairs or getting dressed. That’s because pneumonia makes it hard for oxygen to move efficiently through your lungs and to the rest of your body.

4. Confusion

Anything that causes sudden confusion or a change in mental alertness is a cause for concern. In people older than 65, new-onset confusion can be a sign of pneumonia (or another infection). That’s because pneumonia reduces lung’s ability to efficiently exchange oxygen and carbon dioxide, so people  with pneumonia tend to breathe less deeply. Both of these factors reduce the amount of fresh oxygen to the brain. If you or a loved one experiences confusion or difficulty breathing, seek medical attention immediately. If you’re caring for someone who develops confusion but doesn’t appear to have any other symptoms, check their temperature and then call their healthcare provider to report your observations and findings. A full medical evaluation may be necessary.

5. Feeling worse, not better

Usually, people get incrementally better over the course of a cold or other respiratory infection. If you suddenly feel worse again after a period of improvement, it’s likely you have a secondary infection—an infection on top of your initial infection. (When your body is busy fighting one set of germs, it’s easier for another germ to settle in and multiply.) Anybody who feels worse rather than better after a few days of respiratory symptoms should see a healthcare provider.

How to prevent pneumonia

Frequent handwashing, adequate nutrition, and plenty of sleep can help you avoid and resist the germs that cause pneumonia. People who are at high risk for serious complications from pneumonia should consider getting the pneumonia vaccine. The CDC recommends the pneumonia vaccine for:

  • All children younger than 2 years
  • All adults ages 65 and older
  • Adults ages 19 through 64 who smoke cigarettes
  • People ages 2 through 64 with certain medical conditions

You can further decrease your risk of pneumonia by getting an annual flu vaccination. It’s not unusual for people to develop bacterial pneumonia after influenza. If you avoid the flu, you minimize your chances of getting pneumonia.

Pneumonia symptoms in adults can be mild or severe. Walking pneumonia symptoms are typically mild, while more serious cases of pneumonia are characterized by high fevers, chest pain with breathing, shortness of breath, and a persistent cough. Always seek medical attention whenever you notice one or more of the warning signs of pneumonia. It will help you avoid even more serious complications, such as respiratory failure.

Source: Healthgrades. by Jennifer L.W. Fink, RN, BSN

Take Time for You!

WHY YOU SHOULD TAKE TIME TO FOCUS ON YOUR HEALTHTake Time for You!

The United States spends more money by a wide margin than any other country on health care.  Our health care system is set up to keep us from dying, not thriving.  Our average life span barely makes it in the top 30 when compared to other nations.  As it stands now, the American health care system is poorly equipped to help us maximize our health span.  Health span is defined as a period of time in which a person is generally healthy and free from serious disease.

Health care costs in America continue to increase without actual positive change in our health status as consumers.  It is imperative that we take a leadership role in our own health care by continuing to be proactive.  Part of being proactive is learning how to care for and manage common non-life threatening injuries and illnesses.  The medical system is not designed to help you to maximize your health and well-being.  It is designed to prevent you from dying and to maximize profits for the corporatocracy that controls our health care system.  It is imperative that we manage our health by learning how to self-treat non-life threatening and non-emergent injuries and illnesses.

6 Reasons Why You Should Take Time to Focus on Your Health:

  1. Money – Health care is expensive. Many of the most common treatments and fancy diagnostic methods are not necessary.  Costs are only going to rise more in the future.  As this occurs, it will be even more important to be able to take care of the simple common place injuries and illnesses.  It will save you a lot of time and money!
  2. Empowerment – There is nothing more important than your health. You have control of most of the aspects in your life that affect your health status.  Taking care of yourself and your health needs leads to a sense of empowerment.
  3. Improved Care – If you understand how to be healthy and take care of yourself, you will be able to assist your medical practitioner in making the best decision on how to manage your care. Remember, it is your body and your health.  Being your own advocate will insure that you receive quality care.
  4. Quicker Recovery Time – Often by taking out the middle man, you can help to increase the speed of recovery. You can address the condition and help your body to initiate the healing response to insure a faster recovery.
  5. Emergency Situations – You never know when an emergency, such as a motor vehicle accident or inclement weather, may occur. You may experience an injury or illness during a camping trip when resources are a far distance away.  In the event of an emergency situation, you will be knowledgeable and equipped to take care of yourself and your loved ones.  (If necessary, please seek appropriate medical assistance as soon as possible.)
  6. Healthy Living – Take the time to focus on your health. Often, small changes in your diet, activity level, and relationships can make a big difference.  You can take control of your health and your life!

There is nothing more important than your health.  You have control over most of the aspects in your life that affect your health and well-being.  Take charge, and empower yourself.  Youmust be your greatest advocate.  Western medicine is designed to keep you alive, not to help you thrive.  Taking a passive role in your health is not a wise choice in America’s current health care environment.  Only you are responsible for your health.  Decisions now will determine how successful you age in the future.

Source: Age Gracefully America, By Ben Shatto