Wrinkles and gray hair are not the proof that the best of life is over.

I thought that since it was summer, it might be nice to have a tip on the lighter side. Recently I was reading a book written by Bryant S. Hinckley that had a thought about aging. It stated: “Some people are young a long time; they never seem to get old. Accomplishing this is a priceless achievement, and it is within the reach of most of us. ” An often quoted poem is entitled,

Age is a Quality of Mind
“Age is a quality of mind:
If your dreams you’ve left behind,
If hope is cold,
If you no longer look ahead,
If your ambition’s fires are dead,
Then you are old.
But if from life you take the best,
And if in life you keep the zest,
If love you hold;
No matter how the years go by,
No matter how the birthdays fly,
You are not old.”

Bryant S. Hinckley continues, saying, “The way to grow old with satisfaction and dignity is through the cultivation of our inner resources. Wrinkles and gray hair are not the proof that the best of life is finished… Most people who age before their time do so because their minds and not their muscles stiffen… We all need to cultivate kindness, human understanding, sympathy, tolerance for other people’s views, generosity and a sense of humor… These are the qualities of mind and heart that endure and enrich our lives forever. They do not diminish with the passing years. These are the panaceas for disillusionment and loneliness which so often embitter age…”

Each day can be a masterpiece if we let it. Don’t let what you can’t do keep you from doing what you can do! The popular saying, “Live, Love, Laugh” can be applied at any age. Why not start now to cultivate this frame of mind and enjoy life to the fullest?

Tom Packer is an Elder Law Attorney serving all of Southeast Idaho. As part of his law practice, Tom offers Life Care Planning to deal with the challenges created by long-term illness, disability and incapacity. If you have a question about a Senior’s legal, financial or healthcare needs, please call us.

An Elder Care Coordinator is a professional, such as a social worker, who specializes in assisting Seniors to attain the highest quality of life, given their circumstances.

An Elder Care Coordinator knows about community resources and can help families understand how long-term care services for their loved ones are accessed and funded. He or she also helps the people who work with Seniors work together as a team, avoiding costly re-hospitalizations or fragmented care.

An Elder Care Coordinator will:

• Provide support, counseling and advocacy during a crisis.
• Help clients and families identify care problems and assist in solving them.
• Assist families in arranging in-home help or other services.
• Coordinate treatment plan with different health providers.
• Provide education, and offer referrals to other geriatric specialists to provide appropriate care, while conserving financial resources.
• Help with transitioning of a Senior to or from a retirement complex, assisted-care living facility, or nursing home.
• Understand client’s personal needs and help in a way that improves their quality of life.

In a recent newspaper article, Sean Cavanaugh, deputy administrator at the Center for Medicare was quoted as saying, “We all need care coordination. Medicare patients need it more than ever.” The article continued stating, “About two-thirds of Medicare beneficiaries have two or more chronic conditions . . . Their care is infamously fragmented.” (Washington Post, AP) The following example illustrates this:

Recently, one of our clients was receiving care from multiple doctors. When an emergency room physician treated this client following an accident, his discharge orders made it back to the attending caregiver at the facility, but were not properly incorporated into the client’s treatment plan. This left our client vulnerable in several ways. She became unresponsive due to the increase in pain medications. She also had other critical components of her health that went untreated due to a lack of follow through with the discharge orders. Our care coordinator recognized that something was wrong, resulting in a return to the emergency room.

Here is what one family member said about the benefits her family received by having a care coordinator for their sister: “Words cannot express my feelings of gratitude for the wonderful care my sister has received and the peace of mind we as her family have felt.”

A new trend is for Elder Law Attorneys to hire Care Coordinators to help meet the needs of their clients. This can make all the difference in making sure our loved ones receive the best care. As families begin their journey through the long-term care system, it is helpful for them to have a supportive and knowledgeable advocate to accompany them along the way.

Tom Packer is an Elder Law Attorney serving all of Southeast Idaho. As part of his law practice, Tom offers Life Care Planning to deal with the challenges created by long-term illness, disability and incapacity. If you have a question about a Senior’s legal, financial or healthcare needs, please call us.

Being positive is conducive to healing.

Recently, I got a close-up look at how patients are treated by healthcare providers. While in the hospital for several days following a surgery, I reflected on how I was treated by my care team, and the impact it had on my experience. This helped me to better understand the importance of choosing the right healthcare providers for Seniors with chronic health problems, whether in their homes or in a facility.

Fortunately, all the healthcare providers I encountered aided me in the healing process and in overcoming the effects of my surgery. However, some more than others, provided needed assurance and optimism and treated me like a person, not just a name on the chart.

As care providers entered my room, there was an immediate sense of those who took a personal interest; invariably, they would address me by my name and ask a few personal questions to get to know me. Some would share a little about themselves, such as how long they had worked there or interesting things about their family, creating a warm atmosphere. When they were optimistic, it was a welcome attitude, when worries about things turning out well, were in doubt. Being positive is so conducive to healing!

So, now back to my earlier statement about the importance of healthcare providers in the lives of Seniors. Having the right care provider that fits the needs and personality of a Senior is so important. A care provider, whether he or she is a CNA, nurse, therapist or doctor, can brighten an often bleak situation by being personable, by noticing improvements and by using sincere encouragement.

When I was in a tough situation, I had a speech therapist that was like a personal trainer. She illustrated the needed exercise, cheerfully encouraged me and showed me how to achieve results. Having an exceptional care provider made all the difference!

Tom Packer is an Elder Law Attorney serving all of Southeast Idaho. As part of his law practice, Tom offers Life Care Planning to deal with the challenges created by long-term illness, disability and incapacity. If you have a question about a senior’s legal, financial or healthcare needs, please call us.

Make sure your own needs are met as well as your loved ones.

As family caregivers, often our primary focus is on doing everything we can to help our loved ones remain as happy, healthy, and comfortable as possible. However, we often do this at the expense of our own well-being. We become so overwhelmed by our multiple tasks and roles that our ability to cope and care for ourselves becomes diminished. The negative effects of this increased level of stress can include:

sleep deprivation
poor eating habits
failure to exercise
failure to stay in bed when ill, and
postponement of or failure to make medical appointments.

We’ve all heard of the rule on an airplane: If the oxygen mask drops down in front of you, you should put yours on first and then help others with their oxygen masks. What is the reason for this? It is because we are better able to help others when we first take care of ourselves. This remains true in the context of care-giving. We are better able to help our loved ones, when we first make sure that we are caring for ourselves. The Family-Caregiver Alliance has provided a list of tips for self-care for caregivers. These tips include:

Learning stress reduction techniques, including: knowing the warning signs, identifying the sources, identifying what you can and cannot change, and taking action.
Attend to your own healthcare needs.
Get proper rest and nutrition.
Exercise regularly.
Take time off without feeling guilty.
Participate in pleasant, nurturing activities.
Seek and accept the support of others.
Seek supportive counseling when you need it, or talk to a trusted counselor or friend.
Identify and acknowledge your feelings.
Change the negative way you may view some situations.
Set personal goals.

Remember, it’s not selfish to make sure that your own needs are being met. Your health and well-being are just as important as the health and well-being of your loved one.

Tom Packer is an Elder Law Attorney serving all of Southeast Idaho. As part of his law practice, Tom offers Life Care Planning to deal with the challenges created by long-term illness, disability and incapacity. If you have a question about a senior’s legal, financial or healthcare needs, please call us.

Using the 6 R’s to help a loved one with Alzheimer’s.

This month is National Alzheimer’s Disease Awareness Month. As a result, I thought it might be appropriate to discuss a situation that many of us caring for a family member with Alzheimer’s might encounter. We know that there will be difficult days for our loved one, and many of us may become overwhelmed when we don’t understand how to work through behaviors that are problematic for our loved one, ourselves, and others. In the book called, “The 36-Hour Day,” the Johns Hopkins University Press discusses the six R’s of behavior management, which may prove helpful when difficult situations present themselves.

1. Restrict. Use this R sparingly and with a lot of care. Often times when we try to force our loved one with Alzheimer’s to stop a behavior, it will actually upset him or her more. If the behavior is dangerous and could cause harm to our loved one or others, then restriction of that behavior becomes necessary. If the behavior does not pose a significant threat, however, instead try to redirect your loved one to a more positive behavior as opposed to immediately restricting the behavior.
2. Reassess. Mentally step back from the situation for a minute and really think about what might be causing this problematic behavior. Is there something in his or her environment that is causing annoyance or unrest, and can that factor be removed? Is there something physically wrong with your loved one that might be causing this behavior? Try to think of every possible reason for why this behavior is happening.
3. Reconsider. It is important to think about the situation from our loved ones’ point of view. This is as much a transition into the unknown for them as it is for us. Think about how their stress and anxiety may go up in certain situations, and try to understand why that might be the case. Empathy toward our loved ones can go a long way.
4. Re-channel. This is where that redirection that we talked about earlier really comes into play. Look for a way to change the problematic behavior into one that is safer and non-destructive. Find a hobby of your loved one that he or she is still able to complete. This can help change a problematic situation into a more positive one.
5. Reassure. In these strained situations it is important to make sure that our loved ones still know that we care. Reassure him or her that everything is alright and that you are still there and care. Give your loved one a hug or some other gesture that may provide reassurance. Even if your loved one doesn’t remember these reassurances, he or she may still retain the positive feelings from it.
6. Review. After the situation is over, take time to think through what happened. Did you handle the situation well and what would you do differently next time? Think about what things led to the behavior in the first place and how those things may better be prevented. This process may help you to better and more easily handle these situations in the future.

Source: http://www.nursevirginiablog.com/2011/01/the-six-r%E2%80%99s-of-behavior-management/

Tom Packer is an Elder Law Attorney serving all of Southeast Idaho. As part of his law practice, Tom offers Life Care Planning to deal with the challenges created by long-term illness, disability and incapacity. If you have a question about a senior’s legal, financial or healthcare needs, please call us.

How to receive the best care possible guaranteed by the law.

The National Senior Citizen’s Law Center (NSCLC) has written an article called, “20 Common Nursing Home Problems – and How to Resolve Them.” (June 2010) This is a valuable resource in choosing a nursing home or in understanding and asserting your rights as a nursing home resident. Residents’ rights are derived from The Nursing Home Reform Law, which is a federal law that applies to all states.

The following are a few of the more common problems discussed in the article. We encourage you to visit the website below for more information.

• Residents and their family members have a right to participate in developing a care plan.
• Nursing homes must make reasonable adjustments in meeting the residents’ needs and preferences. For example, residents should not be told that they must wake up early or take a bath at certain times. Residents’ preferences must be taken into consideration.
• Medication may not be used to make residents more manageable; it may be used only when the behavior is caused by a diagnosed illness.
• One important right to be aware of is that a resident’s family member may visit any time, day or night.
• Therapy, when medically appropriate, should be provided regardless of the resident’s source of payment.
• Evictions from nursing homes are allowed for only six limited reasons, and a 30-day advance notice is generally required.

Because of consumers’ unfamiliarity with nursing homes and the protections provided, residents and family members are often reluctant to speak up. For example, a resident or family member shouldn’t feel sheepish to ask that necessary therapy be provided, or that a resident be allowed to sleep longer in the morning. At times a resident or resident’s family may benefit from the assistance of an attorney or other advocate to help them. Being knowledgeable about the protections in the Nursing Home Reform Law will enable residents to have the high-quality care they deserve.

The complete article can be found at the NSCLC’s website at:
http://www.nsclc.org/wp-content/uploads/2011/02/20-Common-Problems-Nov-2010-Final.pdf

Tom Packer is an Elder Law Attorney serving all of Southeast Idaho. As part of his law practice, Tom offers Life Care Planning to deal with the challenges created by long-term illness, disability and incapacity. If you have a question about a senior’s legal, financial or healthcare needs, please call us.

Your Window into Their World

The Virtual Dementia Tour® is an immersion experience simulation of dementia created to teach people about the physical and mental challenges facing those living with dementia. The VDT® both helps people caring for those with dementia provide better care and offers hope to caregivers, providing tips and tools necessary to create an environment that supports the needs of those with the disease.

Over 500,000 people from elder care communities, corporations, caregivers, first responders, healthcare providers, municipal employees and nonprofit organizations in 14 countries have experienced the Virtual Dementia Tour®. Of those, 94 percent said they felt it was crucial and necessary to undergo the training in order to provide good care to those with dementia.

The Virtual Dementia Tour was created by award-winning geriatric specialist PK. Beville, M.S., founder and CEO of Second Wind Dreams®, an organization changing society’s perception of aging through the granting of dreams for elders. Proceeds from the sale of VDT products are used to support the dreams programs around the world.

If you are interested in gaining a greater understanding of the impact of Alzheimer’s disease and dementia on someone you love or care for, you are invited to participate in a sensitivity training session offered by Packer Elder Care Law. If you would like to learn more, please call 208-785-5600 or 208-542-0400.

Two Words You Must Understand: “Observation Status.”

If you are on Medicare, there are two words you need to understand that will save you unneeded stress and money. They are: “Observation Status.” When you or a loved one are taken to the Emergency Room, you can save yourself thousands of dollars by clarifying if you are on observation status or not.

Medicare pays for inpatient and outpatient services very differently. If you are on observation status, you have not been admitted to the hospital and are considered to be outpatient, even if you sleep in a bed over night. Confused yet?

So, why should you clarify if you are on observation status? Medicare Part A will only pay for a hospital stay if you have been admitted to the hospital with a doctor’s order; it will not pay if you are on observation status. In addition, observation status does not qualify you for the 3-day stay in the hospital that is required for Medicare Part A to pay for a skilled-nursing facility.

Let me give you an example. Sally was taken to the Emergency Room by her daughter. Sally received care, treatment and ate and slept at the hospital for 4 days. Upon discharge the doctor ordered rehabilitation to a skilled-nursing facility to help her recover strength and mobility prior to going home. Sally and her daughter were under the assumption that Medicare would pay the bill. They were shocked when Sally received a bill for close to $15,000.00 after she returned home from the nursing facility. Unfortunately, Sally found out after it was too late that she had never been officially admitted to the hospital, but was only on “Observation Status”, and therefore Medicare would not cover her stay.

Next time you find yourself at the hospital, make sure you clarify your status. Simply ask your doctor or the hospital staff, “Am I admitted Inpatient”, or “Am I on Observation Status?” You will be glad you did.

Tom Packer is an Elder Law Attorney serving all of Southeast Idaho. As part of his law practice, Tom offers Life Care Planning to deal with the challenges created by long-term illness, disability and incapacity. If you have a question about a senior’s legal, financial or healthcare needs, please call us.

When navigating the healthcare system, you don’t have to go it alone.

While working on my taxes recently, I talked with my son, who is a CPA. I soon realized that I need to stick to what I know. I’m a better elder care attorney than a tax accountant. I turned my taxes over to my son, when he offered to help me with them.

In life, we often attempt to do things on our own, when we might be better off asking for a little help. In my law practice, when clients ask me if they need an attorney to draft their will or file a Medicaid application, I tell them what I believe to be true—that they can do it on their own; however, it may be more frustrating and time consuming and the outcome will probably not be as good. This same principle holds true for older adults, who are trying to navigate the healthcare system.

Consider the following case example:

Betty is an older woman with multiple chronic health problems. In the past 6 months she has been admitted into different hospitals and transferred between rehabilitation facilities several times. Her health and physical condition are starting to decline. A review of her medical records indicates a lack of continuity of care, which is contributing to her decline. Betty needs an advocate in the healthcare system: someone who knows the right questions to ask and will ensure there are not gaps in her care.

As an Elder Law Attorney, I regularly visit with clients who are vulnerable in the healthcare system. When I shifted my practice to Elder Law, I realized that my clients not only needed help with legal and financial matters, but they also needed an advocate in the healthcare system. As a law office, we can address Medicare and Medicaid reimbursement questions, monitor compliance with federal regulations for providing quality care, and address patient safety concerns. I worry about my older clients, like Betty, who are all alone and need help navigating doctor appointments, hospital stays, and transitions to and from facilities.

To better advocate for my clients in the healthcare system, I hired social workers, over three years ago, who share my desire to help individuals meet their goals, while maintaining their independence and quality of life.

Having an experienced law firm on their side, will ensure that Seniors get the care they deserve and allow their loved ones to rest easy.

Tom Packer is an Elder Law Attorney serving all of Southeast Idaho. As part of his law practice, Tom offers Life Care Planning to deal with the challenges created by long-term illness, disability and incapacity. If you have a question about a senior’s legal, financial or healthcare needs, please call us.

The Idaho Home Choice Program helps older adults who want to live in their homes to have the support of a Transitional Care Manager.

It is predicted that by 2030, the U.S. population will be comprised of nearly 72 million people over the age of 65. This trend in aging, referred to as the “graying of the population,” will place additional pressure on the Medicare and Medicaid programs (Hooyman & Kiyak, 2012). Acting with foresight, many states are moving toward initiatives that assist older adults with aging in place.

Many older adults want to stay put and relax in the comfort and familiarity of their own home. Many things can be done to assist the elderly with this process. In Idaho, the Department of Health and Welfare has initiated a program to mitigate the rising costs of healthcare for the elderly by assisting them to stay in their homes.

Beginning in 2011, the Idaho Home Choice Medicaid program began administering and matching federal grant monies to aid individuals who desire to move from a facility to living in the community in a home or apartment. The cost savings to the Medicaid program is significant (Idaho Department of Health and Welfare). More importantly, older adults who desire to live in the community have the support of a Transitional Care Manager to oversee this process and assure they receive quality care in keeping with the goals of older adults.

Prior to this program, many adults lacked support from family or the community to assist with transitioning home from a facility. Policymakers have responded and presented a viable solution. The solution is economically sound. More importantly, it allows older adults to enjoy a sense of autonomy and live in a less-restrictive setting.

Tom Packer is an Elder Law Attorney serving all of Southeast Idaho. As part of his law practice, Tom offers Life Care Planning to deal with the challenges created by long-term illness, disability and incapacity.  If you have a question about a senior’s legal, financial or healthcare needs, please call us.