Preventing Financial Elder Exploitation

The nonprofit Investor Protection Trust (IPT) recently surveyed 762 securities regulators, adult protective services workers, medical professionals, law-enforcement officials and others on the “front lines,” and discovered these alarming statistics:

• 58 percent of the respondents said they deal with elderly victims of investment fraud and financial exploitation “quite often” or “somewhat often.”
• 96 percent of the experts say the problem of financial swindles that target the elderly is “very serious” or “somewhat serious.”

An earlier IPT survey found that over seven million older Americans have already been victimized by a financial swindle—that’s one in five people over age 65! IPS president Don Blandin says, “The message from those on the front lines of investor protection is clear: swindles targeting older Americans are a bigger problem today than ever before.”

The IPT has sponsored the Elder Investment Fraud and Financial Exploitation Prevention program, which educates doctors and other medical professionals to be alert for signs that a senior patient is being victimized, or might be at risk of investment fraud due to cognitive impairment or other reason. IPS chairman Robert Lam says, “We need to recognize that there is a medical component to elderly investment fraud that cannot be addressed solely by regulators. As state agencies, we need to combine our efforts with the unique front-line perspective of doctors, adult protective services and other professionals to get help to victims, and those most at risk of becoming victims, at the earliest possible point. Together, we can do an even better job of protecting our seniors and their money.”

To learn more about preventing financial elder abuse, view the “Elder Investment Fraud: a National Epidemic”Elder Investment Fraud: A National Epidemic video on the IPT website.

CayCare is a proud member of: 

National Association of Professional Geriatric Care Managers

National Association of HealthCare Advocates

Case Management Society of America

Do Driver's Tests Provide and Accurate Picture of a Senior's Driving Ability?

Do Driver’s Tests Provide an Accurate Picture of a Senior’s Driving Ability?

The issue of seniors and driving is coming more to the forefront with the aging of the baby boomers. Families worry whether their older loved ones are safe behind the wheel—and when a senior is diagnosed with Alzheimer’s or other memory loss, family are especially concerned. Much research is underway to understand the decline in driving ability as people age. This is not a simple subject.

Researchers at the Rhode Island Hospital’s Alzheimer’s and Memory Disorders Center wanted to find out whether standardized road tests can determine whether older adults should continue to drive. The researchers installed cameras in the cars of 103 older adults, some of whom had mild cognitive impairment. They wanted to observe the drivers “in their natural state—in their own vehicles going about their daily routines.” They found that some cases, seniors were actually better drivers than their driver’s test would suggest.

Lead author Jennifer Davis, PhD, reports, “Many older people don’t like to drive far from their homes; they like to stay in their comfort zone. They don’t drive many miles, and they often avoid driving at night. Taking them out of that comfort zone and placing them in an environment of formal test-taking—one with carries with it potentially life-altering consequences (loss of their driver’s license)—may lead to significant anxiety, which in itself could impair their driving abilities.”

The study, which was published in the Journal of the American Geriatrics Society, showed that people with cognitive impairment made more errors both on the driving test and in day-to-day driving. However, the errors made during normal driving were less serious. The researchers say this study suggests that mild cognitive impairment shouldn’t result in an automatic revocation of a person’s driver’s license. Said Davis, “Rather, it should emphasize the importance of monitoring an older person’s driving so that he or she can safely maintain their mobility and independence for as long as possible.” She added, “It’s natural to worry about older adults behind the wheel, even more so if they appear to have memory or cognitive issues, or have been formally diagnosed as such. But many of the people in our study drove safely.”

Dictionary of Eldercare Terminology: 95-Year-Old Attorney Releases Updated Edition of His Classic Compendium

Anyone in the field of aging knows that it has its own unique language. Understanding all the shifting terms, however, can be a challenge. Walter Feldesman, a prominent New York attorney for more than 65 years, recognized this need in 1997, when he published the first edition of his Dictionary of Eldercare Terminology .

It remains the first and only dictionary defining eldercare words and terms.

At 95, Feldesman recently released the third edition of the dictionary and is making it available online through the website of the National Council on Aging (NCOA). “Walter is an incredible example of someone who continues to contribute to society well past the traditional retirement age,” says NCOA President Jim Firman. “That’s why we gave him the first NCOA Exemplar of Vital Aging Award in 2009. Now, we’re proud to offer his newly updated dictionary as a great online resource for anyone interested in aging.”

Feldesman entered the world of elder law informally in 1990 when his bedridden mother-in-law asked him who was paying for all of her care. He did not have an answer—so he started researching.

The result was a comprehensive dictionary that includes overviews of major eldercare fields, including home care, long-term care insurance, Medicaid, Medicare, Medicare supplemental insurance, and Social Security. The new, third edition includes a wide mix of gerontological terms, as well as financial, estate planning, and legal terms related to eldercare.

The first two editions were quoted, cited, and accredited by many sources, including Medicare’s consumer handbook Medicare and You and the official Medicare website, www.medicare.gov.

Feldesman has served on numerous boards, including NCOA’s Leadership Council. He enjoyed a long and distinguished career as a corporate attorney, director of public companies, hospital and college trustee, philanthropist, and author.

Clear here to read more

The Ethics of Early-Stage Alzheimer’s Diagnosis

Huge steps have been made in diagnosing Alzheimer’s disease. Medical tests can now detect the brain changes of the disease at an early stage—even before patients are experiencing any symptoms. These tests can also predict who is at higher risk of developing the disease. Yet we are not close to a cure for Alzheimer’s, and the effectiveness of treatment has not kept up with the new advances in diagnosis. What does this mean for patients who receive a diagnosis before the symptoms are noticeable or affect their lives?

Dr. Jason Karlawish of the University of Pennsylvania Health System calls for establishing safeguards to protect these patients from discrimination, stigma, and threats to independence and autonomy that they might experience in the workplace, at the driver’s license bureau, in financial planning and so forth. He says, “We need to develop systems now, to navigate the challenges of a pre-clinical Alzheimer’s diagnosis.”

Karlawish, an expert on the ethics of early diagnosis, warns that while the new tests allow for improved treatment and planning, knowing the prognosis can also have negative consequences for patients. He cautions, “The discovery of pre-clinical Alzheimer’s disease may be how we prevent the tsunami of Alzheimer’s disease dementia, but we must not drown in the challenges created by our own discovery.”

The study appeared in the journal Neurology [optional: link to the journal article at http://www.neurology.org/content/77/15/1487.abstract?sid=4dd1c39e-1477-4139-bcc2-3ca0c5774bc0].

Are You Taking Advantage of Medicare Health Screenings?

If you or a loved one is on Medicare, it’s smart to learn about the free screenings that are now available under the Affordable Care Act (ACA).

According to Dr. Carolyn Clancy of the U.S. Agency for Healthcare Research and Quality (AHQR), these preventive and screening tests now include:

• Bone mass measurement (also known as bone density test): Covered every 2 years.
• Cholesterol and other cardiovascular screening: Tests for cholesterol, lipid, and triglyceride levels are covered every 5 years.
• Colorectal cancer screening: Medicare covers colonoscopy tests once every 2 years for people at high risk; otherwise, once every 10 years.
• Diabetes screening: Up to two fasting blood glucose tests are covered each year.
• Flu shot: Medicare covers a shot once per flu season in the fall or winter.
• Mammogram: Screening mammograms are covered once every 12 months. Diagnostic mammograms are covered when medically necessary.
• Prostate cancer screening: Medicare covers a digital rectal exam once each year; prostate specific antigen (PSA) tests are covered once each year.

This is in addition to the new “Welcome to Medicare” wellness visit for people who are new to the program.

Read more about Medicare screening services on the Medicare.gov website (www.medicare.gov/coverage/preventive-and-screening-services.html)

Grooming and Dressing Tips for People with Alzheimer’s Caring for a loved one who is living with Alzheimer’s disease or a similar disorder can mean that small tasks become challenging. The National Institute on Aging’s Alzheimer’s Disease Education and Referral Center offers advice for caregivers on a wide variety of topics. This month: ideas on helping your loved one with grooming and dressing. When people feel good about how they look, they often feel better. Helping people with Alzheimer’s disease brush their teeth, shave, put on makeup, and get dressed can help them feel more like themselves. Mouth Care Here are some tips to help the person with Alzheimer’s care for his or her teeth and mouth. Show the person how to brush his or her teeth. Go step by step. Remember to let the person do as much as possible. Brush your teeth at the same time. Help the person clean his or her dentures. Ask the person to rinse his or her mouth with water after each meal and use mouthwash once a day. Try a long-handled, angled, or electric toothbrush if you need to brush the person’s teeth. Take the person to see a dentist. Some dentists specialize in treating people with Alzheimer’s. Ask the dentist how often the person should be seen. Other Grooming Here are some other suggestions for grooming: Encourage a woman to wear makeup if she has always used it. If needed, help her put on powder and lipstick. Don’t use eye makeup. Encourage a man to shave, and help him as needed. Use an electric razor for safety. Take the person to the barber or beauty shop. Some barbers or hairstylists may come to your home. Keep the person’s nails clean and trimmed. Dressing People with Alzheimer’s disease often need more time to dress. It can be hard for them to choose their clothes. They might wear the wrong clothing for the season. They also might wear colors that don’t go together or forget to put on a piece of clothing. Allow the person to dress on his or her own for as long as possible. Other tips for dressing: Lay out clothes in the order the person should put them on, such as underwear first, then pants, then a shirt, and then a sweater. Hand the person one thing at a time, or give step-by-step dressing instructions. Put away some clothes in another room to reduce the number of choices. Keep only one or two outfits in the closet or dresser. Keep the closet locked if needed. Buy three or four sets of the same clothes if the person wants to wear the same clothing every day. Buy loose-fitting, comfortable clothing, such as sports bras, cotton socks and underwear, and sweat pants and shorts with elastic waistbands. Avoid girdles, control-top pantyhose, knee-high nylons, high heels, and tight socks. Use Velcro® tape or large zipper pulls for clothing instead of shoelaces, buttons, or buckles. Try slip-on shoes that won’t slide off or shoes with Velcro® straps. Source: The National Institute on Aging’s Alzheimer’s Disease Education and Referral Center. For more caregiving tips and other resources, visit www.nia.nih.gov/alzheimers/ topics/caregiving. You can also call the ADEAR Center toll-free: 1-800-438-4380.       As Featured On:

www.caycare.com lisa@caycare.com 1.866.337.1176

Advocating for Healthcare

As a nurse that works in the community I have worked with literally hundreds of families while they are trying to make health care decisions. I personally have had to make health care decisions for myself and my own family. What I have learned is the importance of being a well educated advocate. You are only as helpful as the knowledge you have when it comes to yourself or the person you are making decisions for. When a physician comes in and doesn't give you all of the possible scenarios he isn't helping to make the right decision for you.

In order to better explain I am going to use a couple of personal stories with you. Many physicians have their own preconceived beliefs about things such as culture, aging, quality of life. These pieces play highly for against your decisions. I have been in the room when a doctor told a 91 year old that there was nothing more they could do for her hip fracture because of her age and heart condition. The reality was that physician did not believe that this elderly woman's quality of life would be as good if he operated and so he advised against it.
This woman was alert and oriented and adamantly refused to take no for an answer. She researched and found another surgeon in another state that would take on her case. She received that surgery. She continued to walk 2 miles 2 times a week for 10 more years. Until arthritis made it too painful. At 101 she succumbed to a wheel chair and lived 4 more in that.
In order for her to receive that surgery she had to know that the physician's terms weren't hers. That physician had no idea how active this woman was and didn't ask. She didn't know to tell him. In order for a physician to truly be on your side he has to know where you stand. It is our job to remind him of the facts about us. It is natural for a physician to have their own beliefs and practices. It is our job to assure he knows ours.
That woman I described above was my grandmother, Nina Luckett. She lived to 105. I believe she would have lived longer but they found a skin cancer on her ear and told the family it was inoperable. By the time this nurse granddaughter found out she was a week from dying. She learned to play chess for the first time the week before. She reminds me every day why we need to stand up for those who can't stand up for themselves.
Many who read this will have their own beliefs about my grandmother's quality of life because "she is so old." My grandmother was indeed elderly but old she was not. She believed in learning something new, standing up for the underdog, fighting for the rights of others. She believed that aging was part of the way God made us. She believed that when God said he was finished He would take her home. Her skin cancer may have been inoperable but the choices or options were never even mentioned to the family. In fact they were only told that she had a skin cancer and "we aren't going to treat it because it isn't necessary."
The whole family wept when they discovered the type was not only operable but a simple procedure. They still talk about letting her down. She was content to go at any time so I don't grieve her loss. I only look at her experience to consider how I may better advocate for those around me.
I recommend that you take the time to find out the beliefs of those you care about that are directly around you. Advocate for their needs when necessary and ask questions so you are well informed.

Next week I will share a story about a very young boy that had a similar fate.

To find out more about Lisa Doyle, RN, BSN, CMC contact her at www.caycare.com
She believes in advocating for those around you that need it and using a trained advocate when you feel you don't have enough of the information.

In Home Care Coordination

Ever wonder what to do next after you decide to return home? 

In Home Care Coordination is free assistance to help the family make a care plan before returning home and planning for in home care. It allows the family the chance to talk about who is going to be responsible for all the tasks that involve activities of daily living.

Reasons that In Home Care Coordination can help you:

1. A free advocate can help you voice your needs to the agency involved.
2. We will provide follow up to help should you want to change your plan or need guidance in planning.
3. Helping through the transition from medical facility to home.
4. Help for the spouse or other family member in planning the care when the paid caregivers are not present.
5. This service has been showing good results for helping prevent hospital re-admission after discharging from the hospital which can help decrease overall stress and improve overall well being.

The social security administration reports that there are currently 136,000 people in the over 100 year old club with a projected rate of 600,000 by 2033 having some plans for care for longer is only going to help those future centurions. 

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