What Options Do I Have When My Loved One is Suddenly Hospitalized and Cannot Return Home?

I've seen so many social media posts lately asking about what to do with their loved one who is in the hospital and really should not return to their own home. The first step should be to contact the Case Manager (CM) or discharge planner, as we called them in the "Olden Days." If you don't know who that is, ask the nurse taking care of your loved one. S/he can arrange for the CM to contact you. Then you can begin discussing options and short and long term plans for your loved one. 

Is Rehab Care an option? 

Possibilities may include some rehab time in a skilled nursing facility where they will get nursing care along with daily physical and perhaps occupational therapy to follow up from the hospital plan. Speech therapy is another rehab service that your loved one might require in the event of a stroke or other speech or swallowing disruption.  The attending physician must order this, your loved one must meet certain criteria such as having real rehab potential. Be prepared for resistance because your loved one "just wants to go home." Discuss the benefits to them and to you and investigate your options.

Medicare will pay up to 100 days per calendar year for rehab stay after a qualifying 3 day hospitalization. This is typically for patients who have suffered an injury with or without fractures, a stroke, surgical interventions, and/or de-conditioning due to a hospital stay for an illness such as COVID or pneumonia. Eligibility requirements must be met. The rehab only continues if your loved one makes measurable progress towards goals. Another CM will follow your loved one through the rehab process at the facility. This is usually the social worker or other designated person at the facility. Ask who will be assisting with review of your loved one's case. Be sure to meet with them at admission and discuss your goals, concerns and needs so they can be assessed and worked on while your loved one is in the facility and not the day before, or of, discharge!

Home Health Care Option 

Another option is to take your loved one home either to your home or to their own home with a caregiver. The CM should have helped and advised you to find, and hire said caregiver. Or you or a friend or relative may choose to be the caregiver at least for the time being. In addition, your loved one’s primary physician should order home health care visits from a nurse and any necessary therapists to evaluate the living situation, home safety issues, instruct in medications, provide any nursing care such as wound care, and therapists will provide a home exercise program for rehabilitation purposes. 

Home health agencies may also offer services from a home health aide for personal care and hygiene, and a social worker for assistance with short and long term care planning. Understand first and foremost that the home health care professionals do not substitute for caregivers. Home health care is not a caregiving solution. Custodial care is not covered by Medicare or insurances. 

These services are intermittent visits from nurses, therapists, aide, or social workers. Medicare and private insurances cover the service. There may be a copayment as well as limitations as set by the insurance carrier. The primary requirement is for your loved one to require SKILLED care from a licensed healthcare provider (nurse or therapist) and make measurable gains towards goals. If the skilled care need ends or patient meets goals, or stops making progress, the home health care will be discontinued. It’s not designed to be a long term process or solution. The main goal of home health care is to teach the patient and caregiver how to provide the care necessary and discharge. 

The nurses, therapists and aides will make visits that typically last 30-60 minutes and are usually spaced 1-3 times a week, depending on the skill and needs. As a home health nurse, many times I found patients expecting me to be a companion or a personal caregiver when I arrived. I was greeted with expectations and assignments such as washing dishes, washing out underwear, or vacuuming. Indeed, these were needs, but they don’t require the education and skill of an RN to perform. While I usually tried my best to help that one time, not every nurse will do this, and it is not to be expected! 

Role of the Home Health Nurse

The role of the home health nurse is to be the eyes and ears for the physician, to assess the home situation for safety and whether it meets the level of care the patient requires. The RN will assess vital signs including any pain or other signs or symptoms, discuss nutrition, assess hygiene needs, and medication compliance and understanding. If the patient requires and specific treatments such as wound care, the nurse will perform and instruct the patient and/or any willing and able caregiver in how to perform and what to report to the MD. The nurse will report to the physician and discuss any additional care needed such as Physical. Occupational or Speech/Language therapy and a home health aide or social worker. The nurse and the patient and family will work together to establish a plan of care and work together to achieve goals to make the patient as independent as possible with the best possible quality of life. 

 Resources 

You will find many posts on this blog about finding and hiring care givers and where to find assistance to pay for it. Search in the box at the top on the Left sidebar. Check with your CM at the hospital, and if ordered, your home health social worker. Local chapters for disease specific organizations such as Alzheimer’s, Cancer, Lung Diseases, Heart Disease, and others can give you direction and resources. Your local senior citizens agency. The Veteran’s association is a great resource if your loved one served in the armed forces during a war such as WWII, Korea, Vietnam, Iraq, or Afghanistan, but use the official organization. Many home health agencies may often have a private duty care division to meet your caregiving needs. This would be private pay as well.

 

 

Make Sure EOL Wishes Are Known!

I am currently a party to a situation where a relative has died and left no instructions, will or trust. It's sad because no one knows if the person wants to be cremated or buried. We don't know if there's a paid plot or cremation service, and even moving his remains from the county morgue has been an ordeal. 

This person was found dead in a wellness check that a neighbor called for and the coroner was called. So fortunately, there was  no need for medical advice or attempts at resuscitation. But had s/he been found alive, apparently not having a Power of Attorney for Healthcare would have been an issues had s/he not been able to voice choices at the time. 

Missed Opportunities- Don't Delay Decisions

In this situation, the person had begun vague discussions about EOL wishes, but was only seeking preliminary information. No discussion happened regarding a health care power of attorney, burial wishes or any plans already in place, and certainly not wishes for division of the estate. S/he became totally overwhelmed with the little information provided and wasn't able to complete even the simplest of tasks. So now, we're caught starting from scratch. Of course there is some money involved and that will bring out the worst in some of the relatives no doubt. 

This matter has been, and will continue to be very sticky. It will be a long, drawn out process. Just hoping for no objections and in-fighting about what actually happens now. It has already taken significant time and that will impact some of the first decisions. These situations are not rare and my hope is that you will each resolve these items before it become a sticky mess for you.

In my experience as a home health and hospice nurse for years, I have had to initiate the uncomfortable discussions all too often when time was of the essence. Death and dying is not a comfortable subject for everyday conversation, but the truth is we will all die at some point. Most of us may have strong feelings about burial vs cremation and whether or not to have a simple service, or a huge event. Some decisions are influenced by cultural beliefs and customs. No matter what the decisions, they will incur expenses that aren't always planned for or paid in advance. 

In this case, we have no idea if there were any plans and if any were prepaid. It will be a real shame if there were prepaid plans and we are unable to discover them. End-of-Life (EOL) Estate planning does not have to be complicated. 

Start with Simple EOL Decisions

If only the bare minimum of decisions are made and made known to multiple family members, it can be a great start and very helpful for navigating the more complex EOL issues. There are numerous EOL related legal forms and software on NOLO.com to help you understand and expedite the process. They also have books to guide the process, and a network of attorneys if you so choose. 

Probate attorneys can be your best friend, but be aware that they are expensive. Finding a probate attorney can be a long process as well. Probates can take 18 months to 2 years on average to complete and that's a big commitment for the legal team as well as the administrator or executor. 

I encourage you to begin the conversation in casual, comfortable situation. Ask simple questions about whether your loved one has even thought about what they would like done. 

• Do they want to be cremated or buried? Or have other ideas? Have they made any arrangements? Do the research. There are many affordable options that get overlooked when decisions have to be made on the spot. Or perhaps your loved one wants something lavish. Is there money set aside, or an insurance policy to cover these costs? 
• Have they considered how to disperse assets and any property or other  items? Having a living trust can make this all much easier than going to probate.
  
• Have they considered appointing a Power of Attorney for Health Care? 
• Have they thought about their EOL health care decisions? 

Other Things to Make this Easier

Other issues to get in order will include things like making a list of their bank account numbers and information, any investments, a list of property, and any wishes regarding who should inherit what. They don't have to share this, but put the information in a spot where it can be found when needed. 

There are procedures that can make things easier should they become incapacitated or pass away such as adding your name to their accounts so that a smooth transition can be made. For instance, adding your name to your loved one's utility accounts can make it easier to make changes such as shutting service off or transferring it to your name, Also have them make sure beneficiary information is up to date on policies such as insurance policies, retirement accounts like 401k's and any stocks or bonds and other assets.Consult an attorney for any questions you have to ensure it all gets done the way you want it.

While you're helping your loved ones make these decisions and completing forms, check out the forms and processes you need for your estate as well. 

 

 

5 Plus Tips for Dealing with Your Aging Loved One's Pets

How do you deal with pet care issues when your aging loved one is losing the capacity to care for them? And the eventuality of a permanent new home.This can start with needing assistance with feeding, walking and cleaning up after the pet. It can also affect the finances of your loved one. Do they need assistance paying for food or medications? Does the animal need expensive medical attention? There are volunteers to assist with some of these tasks, and local vets often offer discounts and assistance for seniors. The unconditional love and affection as well as emotional support of pets can be most beneficial to your aging loved ones and maintaining these relationships for as long as possible is important.

Like any other part of their lives, you will need to incorporate the pet care issues into your overall plan for transitioning your loved ones through the late stages of their lives. Doing what's best for everyone is always a priority, but there may be some very difficult decisions to be made.The goal is to make this process as painless as possible.

In most instances pets are considered family and the commitment is real. This is the ideal scenario when adopting a pet and needs to be considered when it comes time to making new arrangements. Decisions must be well thought out and aimed at the best possible solutions. As you know already, or will discover with this journey, things can change on a dime and the plan must flex. You always need to have Plan B in the back of your mind.

Options to consider:

1. One of the best solutions would be to be able to absorb the pets into your own life or perhaps the life of another close relative or close family friend. If the pet is familiar with the people and the environments, it can ease their transition and potentially eliminate future problems. This is not always possible for any number of reasons. If this is the solution you have in mind, always keep pace with any changes that can affect the plan. This could include, the adoption of other pets, change in housing situations that might prevent them from incorporating the pets into their household and lifestyle, changes in health status of the potential new caretaker. 
2. Explore other options to re-home the pets through breed or non-breed rescue organizations and determine their availability, their rules and specifications, and an idea of how quickly they can help make the move possible. Again you'll need to keep pace with any changes in their situations. Never assume that it'll be your option months down the line. 
3. Contact local veterinarians for resources and ideas on where and how to find help with caring for a pet and when the time comes, help to best re-home you loved one's pets.  Keep in mind that it's always a good idea to ask a re-homing fee to ensure the pets are wanted and being committed to and not being lured into nefarious situations. This can be discussed further once you've decided on a new home and feel confident it's a good situation, but don't advertise as "Free to good home."
   
4. Post your needs situation on local social media sites such as the Next door app or local Facebook groups to see what interest you can elicit.  Be aware that this won't be the most popular move with some. You'll get criticism, but there may be that one gem who is looking for a new companion and you just touched their heartstrings. 
5. If your loved one is on home health or hospice services, explore pet care or placement assistance with them. Some agencies run a foundation to assist with pet care and placement. The social workers at these agencies are usually a wealth of information and resources to help you find a solution. 

When exploring assisted living facilities, check whether pets can be housed with your loved ones. Most don't accommodate this, but some do. However, it might only be for cats, or you'll be expected to pay for extra services to feed and care for the pets.  

Make sure the pet's vaccines and licenses are up to date and you disclose any health conditions to the potential adopter, rescue or shelter.

As a least desirable option, a no-kill shelter surrender may be necessary. 

Additional options can include a trust fund set up by your loved one to help pay for feeding and and medical care for the animals. This can be helpful for anyone willing, but hesitant because of the financial commitments. 

Most importantly, planning for this eventuality is a must to help make the heart wrenching transition smooth and successful for all.

For additional reading:

https://www.humanesociety.org/resources/need-find-your-pet-new-home

https://www.petfinder.com/pet-adoption/dog-adoption/dog-rehoming/

 Photos from Deposit Photos 

 

 

 

Getting Older and Need a New House? Consider These Tips and Features

Source - Unsplash

 

If you are older and you are looking for a home, or you are younger and you want to find the perfect house to grow old in, then there are certain aspects that you will want to consider. Making the right choices ahead of time is essential, so you don’t have to fret later on. Here at About Aging Parents, we love to help our loved ones live their best lives, so we have some tips and considerations to make when looking for a new home for your older years.

 

Put Serious Thought Into Your Budget and Mortgage Payment

 

As you get older, you may find that you have less money than you did in your younger years, so you will need to take a close look at your budget to ensure that you will be able to afford a potential home as money gets tighter.

 

One way that you can stay educated is by going online and using an affordability calculator to enter in the potential cost of the home, your down payment, and the current interest rate so you can see what your mortgage payment will look like. Use that information to determine what you can afford now as well as your other expenses going forward.

 

Get a Home Inspection and Consider a Home Warranty

 

As the years go by, it will naturally become harder to make the home repairs that you used to make as a youngster. Since you never know what issues you could have, it is a good idea to consider a home warranty. A warranty can help you to pay for appliances and home systems that either break or require maintenance.

 

Before you apply for any home warranty, find out if it's worth it by having a home inspection completed, where you can learn about all of the weak points in your home. If there are a lot of red flags, then you should seriously consider going for the home warranty. An inspection that shows major issues like foundation problems or extreme termite damage should get your attention, and you may want to second-guess buying the house in the first place.

 

A One-Story House May Be Best

 

Although many of us like to think that the bigger the house is, the better, you need to think about the future. If you are getting older, then you may want to buy a one-story house. With less square footage, a one-story home is likely to be less expensive than a larger property.

 

On top of that, you will need to think about how easy it will be for you to walk and get around when you get older. A one-story home will have the kitchen, bathroom, and bedroom all on the same floor, so you won’t have to worry about navigating stairs if you depend on a cane or walker later in life. You would have the option of installing a stair lift, but that can be an expensive endeavor, and you may not have adequate funds down the road.

 

Make Sure You Can Install Accessibility Options

 

While we all hope to be in perfect health for the rest of our lives, that is not always possible. If you believe you will have issues with mobility, then you will want to ensure that you can install items in your home to help you out. For instance, you may need to have a ramp added to the front of your house at some point. You may also require the need of safety bars and slip-resistant flooring in order to navigate the kitchen and bathrooms. While some of these options are easy to install, you will want to ensure that your potential home has the necessary space available.

 

As you can see, there are many features that you should look for in a potential home. The main takeaways are to heavily consider a home warranty, use a mortgage calculator to determine your costs, and think about the benefits of a one-story house. With all that said, we wish you luck. If you would like to learn more about our services at About Aging Parents then please check out our website.

 

This is a guest post from Theresa McArthur.

"Theresa McArthur knows firsthand that the life changes we encounter as we age can be difficult to navigate. From taking care of your health and choosing from numerous insurance options to deciding where you’ll spend your golden years and detailing your end-of-life wishes, the decisions that come along with aging can be overwhelming. She created Guides for Seniors so there would be plenty of information available to guide seniors through these processes and bring them peace of mind."

 Thanks Theresa for a great article!

  

 

Never Forget --Always in Our Hearts!

5 Home Modifications Every Home Should Have to Accommodate Aging in Place

Whether you're in your early 60s or entering retirement, there's a good chance you'll want to age in place. That means remaining in your home and modifying it as needed to accommodate any physical changes that come with aging and increase safety for senior living. 

Unfortunately, your home may need to be modified for several reasons, including changes to your vision, hearing, and mobility. For example, going up and down the stairs could become more difficult, or you may find yourself fumbling for the light switch more often. 

Luckily, you can make many simple modifications to your home to ensure a safe and comfortable environment for years to come! In this article, we will list some essential home modifications for aging in place. 

While some of these changes may seem small, they can have a significant impact on your quality of life. We've put together a list of five home modifications every home should have to accommodate aging in place.

Grab bars and Walk-in tub

Grab Bars 

The first modification you should consider is installing grab bars in your bathroom. As we age, our balance can change, and it can become more challenging to stand up from a sitting position. Grab bars provide excellent support and stability for getting in and out of the shower or bathtub and can help prevent dangerous falls and injuries. Grab bars are also relatively inexpensive and easy to install. You can find them at most home improvement stores or order them online. 

Raised Electrical Outlets 

Another substantial modification is to install raised electrical outlets. It can become more difficult to bend down and reach for things on the floor due to changes in mobility. Raised electrical outlets make it easier to plug-in appliances and electronics and help prevent falls. They are also safer because they reduce the risk of electrical shock.

Stair Lift

 Stair lifts

If your home has stairs, another modification is installing a stair lift. Stair lifts provide a safe and easy way to get up and down the stairs and can significantly improve your mobility if you have difficulty climbing stairs. Stairs are dangerous for seniors and can be very difficult to navigate if you have limited mobility. A stair lift can give you the independence to move around your home without fear of falling. 

 

Walk-In Tubs 

Another modification to consider is installing a walk-in tub. Walk-in tubs are designed for people with limited mobility and can make bathing much safer and more accessible. Walk-in tubs also have a lot of beneficial features, such as built-in seats, grab bars, and non-slip surfaces. They are an excellent investment for anyone looking to age in place. They're also excellent for hydrotherapy and can help with pain relief. They're also easy to clean and maintain. Although they may be expensive, they are worth the investment. 

Ramps 

Finally, you may also consider installing a ramp if you have steps leading into your home. Ramps help provide an easy way to get in and out of your home and can help prevent falls. Depending on your needs, you can place them either inside or outside your home. There are many different types of ramps available, so be sure to do your research to find the best one for you. 

Wrapping Up 

What we listed above is just a glimpse of the many modifications you can make to your home to accommodate aging in place. By making these simple changes, you can ensure a safe and comfortable environment for years to come. Home modifications are meant to help you age in place and live independently for as long as possible. With home modifications, you can help prevent falls and injuries in your house. These changes can also help you save money in the long run. If you're considering making any modifications to your home, be sure to consult with a professional to ensure they are done safely and correctly. 

Author Bio David Clark:

David Clark is the CEO of Basement Guides with several years of experience in basement-related problems and home safety. He has written and published many resources and guides related to senior home safety, grants, and home modifications. David is currently working to spread the word about senior home safety and health through resourceful guides and articles.

 

Thanks David for a great article!

Disclosure: AboutAgingParents.com participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.

 

Photos from DepositPhotos. 

  

 

Hope Springs Eternal: Navigating Life as Newlyweds in Your Golden Years

 

While it’s never too late to enjoy the pleasures of wedded bliss in your latter years, it’s important to remember that you and your new spouse face different obstacles to those of a young married couple. It’s not every night you can have a date at the ballpark, seeing the World Champion Atlanta Braves or saying “LA Dodgers here we go”. Senior marriage is a challenge but, with a plethora of life experiences backing you both, there’s every hope that you can converge onto one path and have plenty of fun in the process. About Aging Parents has a few pointers on how to navigate your new life together.

 

Find the Right Home

 

Physical limitations are an inevitable part of aging and it’s important to keep this in mind if you’re selecting a new home. If you aren’t sure whether to rent or buy, consider the pros and cons of both options as they relate to your lifestyle—it can be a lot of hassle purchasing a property if you like to travel or think you might move again in the near future. On the other hand, if you choose to make an existing property your marital home, This Old House explains that it’s possible to modify this to provide improved accessibility in the years to come.  

 

Maintain Your Property

 

Whether you’ve chosen to rent or buy your home, it’s more than likely that routine maintenance will be needed from time to time. To avoid potential injuries that may be harder to recover from as you age, it’s best to contract a service provider to assist you with regular tasks such as gutter cleaning.

 

Blocked drains can lead to flooding during rainy seasons, so in order to avoid any potential catastrophes, ensure that you’re dealing with professionals and vet the service provider of your choosing by checking their ratings and reviews. Not only will a good contractor be able to fix any existing problems, but they’ll also alert you to any potential issues that may arise in the near future. 

 

Combine Finances

 

Your financial status in your latter years can look vastly different from when you were in your 20s, so combining finances might be a little more complex too. During this process, it’s advisable to double-check that your insurance policies are up to date and that you’ve updated your emergency contact details wherever necessary.

 

Whether you’ve retired already or intend on doing so in the near future, Capital Group notes that you’ll want to be sure that you are making wise financial investments that will cover you and your spouse in the event of disability or serious illness. If the decision to move one or both of you to a skilled nursing facility or nursing home should arise, have a plan in place for this scenario as early as possible. This begins with researching what facilities are in your area, then narrow your search by visiting your top choices and asking about what services are offered.

 

Estate Planning

 

It’s natural that you’ll want to include your new spouse in your will so that they are taken care of in the event of unforeseen circumstances. Contracting an attorney that specializes in estate planning will make it easier to remain prepared for the future. Living wills are an uncomfortable but necessary topic and talking about them will ensure that you and your partner are on the same page when it comes to the sensitive matter. Since we cannot be certain of when accidents or illnesses could happen, it’s vital to have these conversations as early on in your marriage as possible.

 

Starting a marriage in your latter years can feel like a wild adventure, but don’t forget to be mindful of the practical things as you’re enjoying your new married life. Taking care of the nitty-gritty details sooner rather than later will leave you with peace of mind and a smoother shared tomorrow.

 

This article is brought to you by About Aging Parents. For more information, contact us today!

 

Guest post by Millie Jones from SeniorWellness.info

 

Photo by Kampus Production via Pexels