Caregiving

Dental Care and Old Age

Published on: April 13, 2017 | by Ettinger Law Firm

As we continue to age, there are a number of ailments that develop and health issues that we are forced to address and adapt to. While we anticipate problems such as achy joints and the occasional stiff legs, we do often forget about the continued upkeep associated with dental hygiene. Dental checkups are easy to forget about and avoid, especially when you do not feel like anything is wrong, however, as soon as something starts to ache, the check up can turn into a very expensive visit. Many elderly individuals avoid going to the dentist due to the associated fear of costs and lack of coverage.

Medicare does not provide dental care coverage for their insured beneficiaries, which leads many to either go without coverage or to retain an independent plan that could cost them more than they can afford in their budget. Millions of elderly Americans rely on Social Security and Medicaid or Medicare to support them in their old age, however, these programs continue to shrink in size and will not be able to provide for all of those soon to be retirees. Medicare does provide dental care for some chronic medical conditions such as reconstruction following an accidental injury, or extraction due to radiation exposure for neoplastic diseases of the jaw, a very specific list. Even with those exceptions, the reimbursement rate is so low that some doctors will not accept Medicare coverage in their offices because they know how difficult it becomes to get paid.
The National Center for Health Statistics has found that 20% of Americans over 65 years old have cavities that are currently going untreated, with the numbers steadily increasing with old age. With teeth becoming more brittle and procedures performed decades earlier needing maintenance, many elders find themselves in the Emergency Room due to the pain. There are a number of nonprofits however across the nation that offer free or discounted dental cleanings for elderly patients that do not have dental coverage and cannot afford it. Additionally, many universities offer discounted cleanings as well as procedures by having elderly patients be seen by their class of graduating dentists. They will offer up front costs of services as well as payment plans in an effort to avoid having the individual rack up debt.

Meals on Wheels Funding Gets Threatened

Published on: April 11, 2017 | by Ettinger Law Firm

Meals on Wheels is a government program that started in the 1950s that has assisted elderly citizens by delivering food to them when in need, either by providing the meals in the elderly individual’s home or in a community senior center. They not only provide the meal but also provide safety checks and visit with the senior, critical actions that have been shown to help elders live longer. There are over 5,000 independent organizations across America that help administer the program, and it has for decades, had much success. In order to receive funding local communities as well as the Older Americans Act help to keep the program afloat.

As the new budget is proposed, many programs are in jeopardy of being cut. One program that is may see a threat to funding is Meals on Wheels, due to the program not providing results. However, the nature of the program is not a results oriented initiative. The program services 2.4 million Americans, a number that will undoubtedly grow in the coming decades due to the large number of baby boomers beginning the retirement age. These cuts are the result of discretionary spending decisions related to the Community Development Block Grant that allocates a portion of the block grant money to elderly through Meals on Wheels. There have been numerous studies conducted that have showed the effectiveness of Meals on Wheels decreasing loneliness scores and also decreasing reliance on traditional care, while allowing elderly individuals to remain in their homes longer.

However, there are conflicting opinions about how much influence this will actually have on the institution. From financial statements released last year, only about 3% of the total funding was made from the block grant. On a local level, there is much more monetary influence, with federal funds accounting for 30% of the expenses relating to the home delivered meals. While the program’s costs and returns are currently being debated, it is evident that although it may not be the most lucrative on it’s face, Meals on Wheels can provide a number of benefits. One study even found that if there was a 1% increase in elderly individuals receiving Meals on Wheels, states would saved over $109 million, due to reductions in need for nursing home care.

The Future of Medicaid

Published on: April 7, 2017 | by Ettinger Law Firm

One of the biggest promises in the Trump candidacy was repealing Obamacare, a promise he attempted to follow through on within the first few months into his presidency. Speaker of the House, Paul Ryan, was a widely known proponent, who worked to rally votes and repeal Obamacare in order to get The American Health Care Act implemented in it’s place. While the vote was called off before a final count was made, the American Health Care Act still has some changes to make before there will be bi-partisan agreement. It is not a surprise that this program was one of the first to be reconsidered for funding, the program covers 74 million people alone.

Lawmakers were drastically divided on the topic, with those focused on public health benefits contesting the bill due to the cut in benefits that those most in need would experience, Once Obamacare was fully implemented, Medicaid programs across the nation greatly expanded, giving coverage to 11 million Americans opting for coverage under the federal program, which in turn assisted states who were not able to pay for the health care expansion for their citizens on their own. Medicaid was able to expand coverage to so many Americans by qualifying low income individuals for the program and paying through state and federal funding. Governors in Alaska, Arkansas, Colorado, Michigan, New Hampshire, Nevada, and Ohio all oppose any kind of restructuring for their Medicaid programs. Kansas and North Carolina are currently attempting to expand their Medicaid in light of the recent bill failure.

On the other side of the debate, critics of the mandatory health care system feel that it has left states and citizens ‘hooked’ on the federal government supplying funds for health care now. The states that receive federal assistance with Medicaid cannot sustain losing the funding while still providing coverage to all their citizens. While some states are starting to cover some costs associated with their Medicaid expansions, the federal government in 2017 is still covering at least 90% of the costs associated with the expansion, which is projected to continue through 2020. Critics continue to note the declining insurance provider participation in Medicaid and Obamacare services which fails to provide medical specialists.

Family Members Acting as Paid Caregivers

Published on: April 4, 2017 | by Ettinger Law Firm

The demand for caregivers will begin to far exceed the amount of elderly individuals who need caring for in the United States, as our elderly population will grow substantially in size by the year. As the caregiver network continues to dwindle, there have been efforts made throughout the country to retain those caregivers leaving the field for other opportunities, regulate the field more to better advocate for caregivers rights, and to consider alternatives for care and treatment for the elderly community. This job of being a professional caregiver can be physically and emotionally taxing and for those who cannot afford assistance, these responsibilities can begin to fall on the loved ones that surround them.

The role of caregiver has been assumed by more than 65 million people who provide care for a chronically ill, disabled or aging family member in United States. Many of these family member caregivers care for their loved ones upwards of 20 hours a week, without compensation. This role can take a toll on their personal lives and impact their ability to perform at a full time job throughout the week. As a response to this, lawmakers in some states have begun to offer family members who act as caregivers compensation for their time spent with their elderly loved one. Compensating the family member helps offset the time set aside as well as the expenses incurred by traveling or giving time to other areas.

While the name varies between the states, programs that compensation family members include consumer directed care, cash and counseling, and family member caregivers. The regulations differ between the states as to who will qualify as a caregiver, what they are compensated, how much and what benefits they may possibly have. Those who have a loved one who is also a veteran may qualify for aid and the attendance pension benefits through the Veteran’s Administration. If you are in a state without these benefits or would like to form a private agreement, many families draw up a personal care agreement.

The Basics – Guardianship and the Elderly

Published on: March 15, 2017 | by Ettinger Law Firm

As we continue to age, it can be difficult to admit when you are no longer able to handle personal affairs and financial matters on your own. There are a number of alternatives available to those seeking to have their affairs managed by another party, depending upon the individual’s mental capacity to comply with assigning these rights. Those providing caregiver services to the individual, commonly a loved one, may seek retaining legal guardianship of the elderly individual, assigning durable power of attorney and health care power of attorney to specific individuals, or establishing a trust.

Guardianship

Guardianship is a legal status given by the court to create a relationship between someone who is incapacitated or unable to care for themselves and a person determined to be suitable to administer and manage the incapacitated person’s affairs. In order to get a guardianship order, a person must file a petition with the court to review the case at hand. The court assesses the situation, the petitioner, as well as the elderly person to determine what will be the least restrictive method of guardianship. The appointment may include only managing financial affairs, but may also assign responsibility for day to day decision making including support, maintenance, and personal care.

Early Onset Dementia and the Importance of Estate Planning

Published on: March 11, 2017 | by Ettinger Law Firm

Dementia and Alzheimer’s Disease affects more than five million Americans today. While a large majority of those affected are over the age of 65, it is not just a disease for the elderly. Symptoms of Dementia and Alzheimer’s Disease can occur in individuals as young as 30 years old, and currently affects an estimated 200,000 people in America. The diagnosis can often be missed or misdiagnosed as another condition or an association with the changes both men and women go through during their 40s and 50s, however, a comprehensive medical examination is required in order to properly diagnose those with early onset dementia. While the cause of the disease is not yet known, it is important to look to your family history as a way to determine if you or your loved one should be monitoring specific behaviors and changes in personality.

The thought of losing your memories, ability to perform basic tasks, as well as ability to think clearly, remember the time, date, or place, is a very scary feeling for anyone. As these functions start to go, it is important that the loved person, either elderly or young, has in place a comprehensive medical and estate plan, when the day comes that he or she is no longer able to make decisions for themselves. The unfortunate reality of this disease is that it is not a question or if, but of when they will no longer be able to make their own decisions based on a lack of capacity.

First, the individual in question must have their legal capacity assessed to determine if they are able to understand and appreciate the consequences of their actions in signing documents that give specific power to named individuals. In doing so, you should also consult a medical professional if you have doubt as to their ability to understand and make decisions. Also, if the individual has previously executed any wills, trust, or power of attorney documents, those should be revised as necessary to accommodate their current condition while still respecting their wishes.

New York Elder Care – Pain Treatment for the Elderly

Published on: March 1, 2017 | by Ettinger Law Firm

Aging comes with a number of considerations, including how to deal with ailments, conditions associated with older age, as well as how method of treatment is best for you or a close loved one. Today, there are an overwhelming amount of options to choose from when it comes to pain management and treatment for chronic conditions, however, many of them can become very addictive. One somewhat controversial treatment option for pain management being used by a number of elderly citizens is the use of medical marijuana.

Although the use of marijuana whether medicinally or recreationally is illegal under federal law, over half of the states have decriminalized and now approved it for use medicinally. Based on numerous studies and research, it has been shown that as compared to other pain management treatments, the use of marijuana leaves less risk for addiction, fewer side effects, as well as allowing individuals to still go about their daily lives while managing health issues. Health issues associated with aging include autoimmune diseases such as multiple sclerosis, arthritis, as well as cancer, dementia and Parkinson’s disease, which have all been approved under conditions managed using medicinal marijuana.

While the current elderly population has been somewhat skeptical of what they have known as an illegal drug being approved for use in the medical setting, as more states make it legal for use, approval among the older generations increases. Since many seniors are seeking to determine if use of marijuana is suitable for their condition, many nursing homes and assisted living facilities have had to come up with their own policies, either endorsing or shaming it’s use. Almost a dozen nursing homes in the state of Washington have amended their policies to respond to the demand for approval of medical marijuana as treatment in their facilities.

Elderly Abandonment: An Issue Around the World

Published on: February 17, 2017 | by Ettinger Law Firm

Aging comes with a wide variety of issues and relying on the care of your family is not a resource available to all. Whether it is due to lack of accessibility, estranged familial relationships, or advanced care requirements, many elderly find themselves alone in their older age.

This is not a phenomenon specific to America, it is an issue experienced by countries across the world. Certain cultures are more focused on caring for their elders, much like those elders helped raise them, while others have a less integrated idea of family including care for their elders.

In fact, the issue of elderly abandonment was such a large problem in Japan it was deemed “granny dumping”. While this practice, where senile senior citizens were taken up to the top of mountains and left there by loved ones due to the inability to care for them, is a very old practice, the modern version of abandonment is once against becoming a problem. Today, elderly individuals are being taken to local hospitals, churches and charities, and being left like they used to in the mountains.

The Basics – Nursing Home Abuse: Signs and How to Stop It

Published on: February 4, 2017 | by Ettinger Law Firm

Many of our elderly adults end up in nursing homes or assisted living, whether as a result of an accident or due to a declining ability to care for themselves. While many have family members or friends who are able to ensure their loved one is being taken care of properly in their respective homes, not all of those elderly are fortunate to have someone to look after them. In fact, the Special Investigations Division of the House Government Reform Committee found that 30% of nursing homes in the United States were cited for nearly 10,000 instances of abuse over a two year period.

Abuse in a nursing home can take many forms, some problems involving physical abuse and negligent include untreated bedsores, inadequate medical care through dehydration and improper hygiene, as well as physical abuse such as broken bones, untreated bruises and cuts. Other examples of abuse involve verbal abuse, for example yelling, and ignoring requests, as well as withholding medication.

This problem happens all too often, and it can come down to the caretakers word against the elderly abused patient. An Illinois man concerned about the care of his father after he voiced concerns about a new nurse, installed a surveillance camera in his father’s room in an assisted living home. The camera unfortunately confirmed exactly what he believed, he was being neglected at times, verbally and physically abused by a certified nurse’s aid working at the facility. The nurse was charged with a felony aggravated battery to a person older than 60 years and felony abuse of a long-term health care facility resident.

Medicare Changes Under New Administration

Published on: February 1, 2017 | by Ettinger Law Firm

Another major platform that President Trump ran under was the promise to repeal the widely contested Obamacare plans, and to instead bolster Medicare and Medicaid eligibility and benefits. Since taking office, the businessman has changed his position multiple times regarding whether an overhaul of the system will be made or whether he will keep his promise to leave Social Security and Medicare alone.

Medicare Proposals by the House

House Speaker Paul Ryan has been an avid supporter of overhauling the system, by combining Medicare Parts A and B and also increasing the Medicare age of retirement to that of the full retirement age that one must qualify for with Social Security. Additionally, this proposal would allow Medicare beneficiaries to choose which plan they wish to elect between private plans or traditional plans, based on their health needs, but would not take effect until 2024.