All posts by Samantha Colaianni

8 Ways for Caregivers in the Sandwich Generation to Reduce Stress

America’s Sandwich Generation, men and women in their forties to sixties with both aging parents and children to care for, is one of the fastest growing populations. This group of people often find themselves stuck in the middle of trying to juggle a hectic schedule that includes caring for parents experiencing a decline in health, keeping up with adult children as they struggle to “make it on their own” and begin their families, and managing the financial and emotional stress that arise throughout these circumstances. This alone is a lot for one person to handle and often leaves little time for self-care and nurturing a relationship with your spouse. 

8 Things the Sandwich Generation Should Know to Help Ease the Stress of Managing the Care of Mom, Dad, the Kids…and Themselves

By Kim Miller, BSN, MSN, CMC – Aging Life Care Association® Member

How does one work a full-time job, raise a family, care for parents who are living with medical complications, maintain a healthy intimate relationship, and have time for stress management and stress relieving activities? The following 8 tips provide suggestions and information to help you cope with these demands and provide a way for you to move gracefully forward into your Golden Years.

TIP 1: It’s never too early to start planning.

The moment is now and the options are many. From making room in your budget now to prepare for the costs involved with aging parents and growing children to delaying the downsizing of your home to reviewing the benefits of long-term care insurance, there are many ways you can help yourself by planning now for what is in store. Rather than feeling suddenly overwhelmed in the face of difficult decisions, seek advice from financial, medical, and qualified professionals to help shore up your financial and physical resources. There are many professionals in the legal and financial sectors that specialize in elder care and long-term care planning.

TIP 2: Don’t make any assumptions and trust your instincts.

Recognizing when to seek advice is key. Early signs of feeling like you’re squeezed in the middle can be identified by simply noting if you have asked yourself the following questions:

  • How can I spend time with my children and help my parents every time they ask?
  • How many hours in a day are too many spent in the role of caregiver?
  • How do I fit in time for my marriage?
  • When was the last time I sat down?
  • Why do I feel so isolated?

It’s important to recognize when you begin to feel stretched too thin. Listen to that voice inside and seek the advice of a professional. This is especially important for women who often assume they should know about caring for the aging in the same way that they instinctually know about childcare. Everyone ages differently and every situation is unique. It’s impossible to know in advance how to handle the needs that will arise. It’s best to not assume anything.

TIP 3: Don’t try to go it alone. Seek expert advice and assistance.

Don’t be ashamed about feeling overwhelmed or ill-prepared. This is the case for most of us. There are a wide variety of services and professionals available to help you. A great place to start is to find an Aging Life Care Professional™. An Aging Life Care Professional is typically a nurse or social worker who has expertise in the aging process and the issues that may arise. An Aging Life Care Professional can assess all aspects of your unique situation and help you develop a plan that will meet your aging parent’s needs over time.

Ultimately, someone may need a geriatrician, psychiatrist, or lawyer. There may be a need to provide personal care by a professional. All of these individual providers are focused on a particular service while an Aging Life Care Professional can partner with you to coordinate the care your aging parent needs. Many people feel that this is a job for them to do on their own because they know their parent the best, however, this can be overwhelming. Partnering with an Aging Life Care Professional allows you to extend your reach in caring for you parent while remaining in balance with the other factors in your life.

You can find an Aging Life Care Professional™ by searching aginglifecare.org. You can also contact your local Area Agency on Aging, which can give you information about programs, services, and facilities available right in your community.

TIP 4: Bring them to the table and let them keep their seat at the head.

Talking with mom and/or dad about seeking assistance or advice about how to care for them can often feel daunting. It challenges the typical roles of parent and child. Even though they are aging, the need to be the parent and to feel in control does not fade away and can often become even more present. The first step is to recognize this fact, accept that it will be challenging and then move forward with respectful nurturing and loving care. The rest is artful conversation and psychology.

Here are some considerations when approaching your parents about needing help:

  • Give them the sense that they are the employer, even when they are not and that this is something that your parents will be managing. Try referring to them as a consultant. Find something in the home that they have been frustrated by and suggest that the person will help them make a plan to solve the problem.
  • Explain to your parents that this is someone who will be helping you (their child) by assuring your peace of mind that they are safe. This keeps you in the position of the child who needs help, and the sense that the parents are still needed to support you.
  • If the above are not successful, then it may be time to bring in an expert like a well-respected physician, lawyer or financial advisor who will then provide a prescription for the geriatric care manager.

TIP 5: Sharing is caring. Incorporate your family into the daily mix.

As corny as it may sound, a family meeting can be a great way to get everyone onto the same page about priorities and responsibilities. It provides the opportunity for everyone to share what they are going through and develop strategies to help meet everyone’s needs. It is an opportunity to discuss the caregiving needs, household chores and scheduled tasks to be accomplished on a daily and weekly basis. Bring a pad of paper and make a “to do” list for each person. Don’t forget that your close friends can also be a part of this meeting – the more, the merrier!

TIP 6: Anticipate and address the questions of children and grandchildren.

Even when they don’t ask, your children are likely wondering why their grandparents are more forgetful (especially about remembering their name, etc.), why they need assistance getting dressed, or why someone is coming to help them each day. It is important to educate your children, even at an early age, about these normal parts of life. You can also assure your children that grandma may not remember things but she still loves them. Explain that she can’t express herself but she is still thinking about them. There are many books available for children of all ages to help them better understand topics such as memory problems, feelings of sadness, death and so on. These books will allow them to acknowledge the sadness while also realizing the importance for grandma to have people around her who love her and can take good care of her. Additionally, the books can help you approach the delicate, difficult and sad parts of decline as well as finding the good parts worth celebrating about getting older.

There are many books available for children of all ages to help them better understand topics such as memory problems, feelings of sadness, death and so on. These books will allow them to acknowledge the sadness while also realizing the importance for grandma to have people around her who love her and can take good care of her. Additionally, the books can help you approach the delicate, difficult and sad parts of decline as well as finding the good parts worth celebrating about getting older.

TIP 7: Speak with your employer.

Many employers are familiar with or sympathize with the demands that are involved with being a part of the Sandwich Generation and are willing to work with you to keep you working for them. Since you never know until you ask, make an appointment to discuss the different ways your employer may be willing to accommodate you. Some companies allow you to work from home, adjust your hours or change the days of the week that you are in the office. It is also becoming more common for employers to offer brief periods of leave so you can attend to unexpected family matters. Your employer likely has an Employee Assistance Program (EAP) that may be able to help you access resources or provide you with support.

TIP 8: You are not the last or the least. Make time for number one.

Since we know stressors can contribute to and lead to health problems of a mental and physical nature, start out on the right foot and make time throughout the week for you. While it is essential to build important things like exercise, regular sleep, and healthy eating into your schedule, there is also no shame in giving yourself the opportunity to continue your hobbies, favorite pastimes, friendships and even alone time. Maybe you won’t have as much time for extracurricular activities as before, but just several hours a week can elevate your spirits and do a world of good for your health.

Here are some suggestions for keeping in touch with your sense of well-being:

  • Take 10 minutes a day to sit down, listen to music, meditate or even just close your eyes.
  • Keep your marriage on the priority list and add a weekly activity for just you and your spouse to enjoy.
  • Give laughter a chance and enjoy the funny moments that life brings along each day.
  • Try to set aside one hour a day for something you love to do like reading the paper, taking a walk during your lunch break or calling a friend.
  • Look for the ways that providing care enhances your relationships with your family and affords a sense of satisfaction.
  • Listen to your body and learn to recognize when it is telling you to slow down or that something is not right. It’s very important to immediately take action, take a break and seek medical attention when necessary.

No matter how much the above might seem like an indulgence, doing any or all of them can help save you from hitting the proverbial wall. Once you are at the point of burn out it is very easy to wind up sick which often happens when constantly being the caregiver and never the care recipient. To help avoid reaching that run down state, remember to check in with yourself on a daily basis.

In the end, it is good to remember that you are the most qualified person for taking care of yourself. By helping yourself stay strong and healthy, you are ultimately helping your family and parents by remaining available and capable for the challenges that live in the middle of that very tightly squeezed sandwich.

About the author: Kim Miller, BSN, MSN, CMC is a Certified Care Manager at SeniorBridge, a national health care company offering individually tailored care management and home care services. She has over 30 years of experience as a nurse, with 16 of those years as a nurse practitioner. Email Kim at kmiller@seniorbridge.com or follow SeniorBridge on FacebookTwitter, and LinkedIn.


This blog is for informational purposes only and does not constitute, nor is it intended to be a substitute for, professional advice, diagnosis, or treatment. Information on this blog does not necessarily reflect official positions of the Aging Life Care Association™ and is provided “as is” without warranty. Always consult with a qualified professional with any particular questions you may have regarding your or a family member’s needs.

Get a ‘Leg Up’ on Falls Prevention

Get a ‘Leg Up’ on Falls Prevention

By Nicole Amico Kane, MSW, LICSW, CMC

Photo Credit: National Council on Aging

To those of us who work with older adults, it comes as no surprise that falls are the leading cause of fatal and nonfatal injuries among adults 65 and older.1 Each year, more than one in four adults 65 and older will fall.

As Aging Life Care Professionals®, our role is to help clients manage their health, maintain a healthy lifestyle, and improve their quality of life. Our work often includes efforts to reduce falls.

Why is falls prevention so important? A fall is often life-changing. Falls, with or without injury, impact quality of life. Unfortunately, it can be the beginning of a loss of independence, increasing frailty and take a toll on an individual’s sense of self-worth.

Falls are the leading cause of the emergency room visits and nonfatal trauma-related hospitalizations for older adults, as well as long-term nursing home admissions. Fear of falling can also cause older adults to limit their mobility, activities and social engagements.

Don’t let this happen to you or an older adult in your life. It only takes a few easy lifestyle adjustments to reduce your risk of falling.

What can families and older adults do to prevent falls?

Falls are not a normal part of aging.  Falls are often preventable. You can lower your risk of falling with these effective approaches:

  • Talk with your healthcare provider
    • Be open and honest if you have had a fall, are worried about falling or have experienced some unsteadiness.
    • Have your provider or pharmacist review all medications, including current, expired, and over-the-counter.
    • Get an annual eye exam.
  • Exercise to improve balance and increase strength
    • Lack of exercise contributes to weakness and imbalance. Exercises that improve balance and strengthen your core and legs will lower your chances of falling.
    • Exercise also enhances mood, improves appetite, and can help with weight.
  • Hydration and nutrition
    • Make sure you are drinking plenty of water or other hydrating liquids.
    • Be careful about of how much alcohol you consume.
    • Eating a healthy diet also contributes to falls prevention.
  • Make your home safer – inside and out
    • Have a professional, such as a physical therapist or an Aging Life Care Professional, conduct a Home Assessment.
    • Reduce tripping hazards and remove clutter.
    • Add grab bars and railings on stairways and in bathrooms.
    • Proper lighting is essential.
    • Exterior pathways should be illuminated and clear. Repair exterior stairways and walkways that are cracked, uneven or broken.
  • Footwear
    • Shoes should be sturdy, comfortable, and fit well.
    • If you wear slippers, soft-soled slippers should be exchanged with hard-soled slippers.
  • Family and Friends
    • Family and friends can help make safety improvements in your home as well as their own homes, making visits safer.
    • Home modifications and safety improvements are not just supportive of older adults, they benefit all ages.

Who can help?

Start with your primary care provider for regular and ongoing healthcare assessments, monitoring, and referrals to other health professionals as necessary. For those who are more homebound and have had a fall or are at risk for falls, your physician can order Home Health services (Medicare covered) to provide in-home physical therapy and other services.

Aging Life Care Professionals are experienced, knowledgeable providers of home assessments, and can also connect you to appropriate community resources, services, and supports.

Certified Aging in Place Specialists (CAPS) are remodelers, general contractors, designers, architects, and health care consultants that can assist with home modifications.

Exercise programs are offered at most senior centers, your local parks and recreation departments, and through local Y.  Some evidence-based exercise programs for older adults include:

Falls prevention requires a multi-prong approach. By following the suggestions above, you can be confident that you are taking practical steps to stay healthy, minimize fall risk factors, and maximize your personal safety and independence.


Nicole Amico Kane, MSW, LICSW, CMC, is the care management supervisor at Aging Wisdom, an Aging Life Care practice based in Seattle, WA. Nicole is a licensed clinical social worker and a certified care manager.

This blog is for informational purposes only and does not constitute, nor is it intended to be a substitute for, professional advice, diagnosis, or treatment. Information on this blog does not necessarily reflect official positions of the Aging Life Care Association™ and is provided “as is” without warranty. Always consult with a qualified professional with any particular questions you may have regarding your or a family member’s needs.

 1.       Centers for Disease Control and Prevention. Falls and Fall Injuries Among Adults Aged ?65 Years — United States, 2014.

Grief & Dementia Care: Support for the Roller Coaster of Emotions

Grief & Dementia Care:  Support for the Roller Coaster of Emotions

By Linda Fodrini-Johnson, MA, MFT, CMC

September is World Alzheimer’s Month. In order to support the mission of raising awareness and providing education about Alzheimer’s, the Aging Life Care Association will be publishing articles that discuss different aspects of the disease. You can learn more about World Alzheimer’s Month at https://www.worldalzmonth.org.

When a parent or spouse can no longer do what they did yesterday, it becomes another transition for the primary caregiver and for the extended family.

These transitions catch us off guard and an overwhelming sense of loss and grief is experienced by the primary care provider.  They often don’t label this as a grief process, but it is about loss – however slow – still has the power to stop us in our tracks.

If you are caring for someone with progressive dementia, such as Alzheimer’s disease, you most probably have had a similar experience.  I think of a story of a spouse who called me one day in tears and said, “Linda, I thought I had accepted this disease and today my wife could not remember how to get toothpaste out of the tube. I could not even help her; I just had to go into the other room and cry.”

And that is what we need to do with this type of pain – express it, find someone to discuss it with and move on.   What this gentleman said to me a few weeks later is, “I just put the toothpaste on the brush and then she knows what to do and soon I’ll probably have to help her brush as well. And, when that happens, I’ll probably have those same feelings all over again. But, today we are enjoying our backyard and watching the birds at the feeders with great pleasure.”

The answer is yes if you can learn to have your feelings, express them, find a coping mechanism, preserve the dignity of the person with the dementia and then move on to what you can enjoy together to make this a less painful journey.

The moment is all each of us has.  However, we feel pain at little losses as well as big ones and it is essential to do the grief work and not let it eat at your inner soul.

Aging Life Care Professionals can assist spouses and other family members to move through these transitions with grace and empathy – one needs a coach and mentor in order to preserve one’s perspective.

To find an aging life care professional near you go to the Aging Life Care Association at www.aginglifecare.org.


About the Author: Linda Fodrini-Johnson, MA, MFT, CMC, is an Advanced Professional Member and Fellow of the Leadership Academy. You can find her at villageplan.com.

This blog is for informational purposes only and does not constitute, nor is it intended to be a substitute for, professional advice, diagnosis, or treatment. Information on this blog does not necessarily reflect official positions of the Aging Life Care Association™ and is provided “as is” without warranty. Always consult with a qualified professional with any particular questions you may have regarding your or a family member’s needs.

Before Turning on the Faucet: Alzheimer’s Disease and Bathing

By Miriam Zucker, LMSW, ACSW, C-ASWCM

September is World Alzheimer’s Month. In order to support the mission of raising awareness and providing education about Alzheimer’s, the Aging Life Care Association will be publishing articles that discuss different aspects of the disease. You can learn more about World Alzheimer’s Month at https://www.worldalzmonth.org.

It may be at the beginning when an Aging Life Care Manager® does an initial assessment of the person with Alzheimer’s disease; or it may come up as the dementia progresses; or it may never come up. The task is bathing, and for reasons discussed below, it is an undertaking that has its unique challenges.

For some, a bath or a shower is uneventful. But for others in the early stages of Alzheimer’s disease, he or she may be accustomed to bathing independently. Now that independence is disrupted. There may be an aide or family member standing in the bathroom or right outside the door. Privacy is compromised and the need for safety trumps a long history of modesty. It can be especially challenging when the aide is female and her client a male.  If this new bathing protocol were not enough, the cognitively impaired person may not recognize that anything is wrong, so she becomes verbally and physically abusive as she staves off the invasion of helpers and disruption to her customary routine.

With the progression of the dementia, the senses are the triggers for the challenge to bathing. Seeing the water rush out of the spout or shower head may be anxiety provoking; the sound of the water may illicit a similar response. Multiple mirrors in the bathroom may give a “house of mirrors” effect. Good in an amusement park, but not the bathroom. If it is a bath the person is taking, he may view the tub and water as bottomless and be afraid to enter it.

While the explanations are as varied as the person partaking of the bath or shower, the following five strategies can be helpful in reducing the stress for the caregiver and family member:

  1. Choose the right time of day. If a person is experiencing sundowning, a shower in the late afternoon or evening may not be the right time.
  2. Assess the level of help needed by the individual and then coach the person accordingly. A strength based approach will help the person to have a greater feeling of security and independence.
  3. As the caregiver, be aware of how you are feeling as you approach bathing. People with dementia are sensitive to the moods of others. If you are tired after a long day, put off the bath or shower for another time.
  4. If there is resistance, use a reward-based approach: “We’ll take a very short shower and then we’re going to have coffee and those chocolate chip cookies you like.”
  5. If these strategies prove unsuccessful, try a sponge bath or use a non-rinse body soap and shampoo. These items are available in drug stores and online.

As Aging Life Care Managers®, we suggest approaches that will insure minimum stress for the caregiver and the desired hygiene outcome for the cognitively impaired person. It is a customized approach that recognizes the unique needs of each family member.


MIRIAM ZUCKER, LMSW, ACSW, C-ASWCM is the founder of Directions in Aging, based in New Rochelle, New York. She previously worked as the Program Director for the Alzheimer’s Association of Westchester County, New York and has served on the faculty of the Brookdale Center for Healthy Aging of Hunter College.  Ms. Zucker can be reached at: mzucker@directionsinaging.com

This blog is for informational purposes only and does not constitute, nor is it intended to be a substitute for, professional advice, diagnosis, or treatment. Information on this blog does not necessarily reflect official positions of the Aging Life Care Association™ and is provided “as is” without warranty. Always consult with a qualified professional with any particular questions you may have regarding your or a family member’s needs.

Engagement with the Arts Enhances Well-Being in Alzheimer’s Patients

Photo Credit: here:now art-making class. Photo by Lou Daprile

September is World Alzheimer’s Month. In order to support the mission of raising awareness and providing education about Alzheimer’s, the Aging Life Care Association will be publishing articles that discuss different aspects of the disease. You can learn more about World Alzheimer’s Month at https://www.worldalzmonth.org.

Engagement with the Arts Enhances Well-Being

By Lisa Mayfield, MA, LMHC, GMHS, CMC, Principal, Fellow Certified Care Manager

One recent afternoon in Seattle, a group of older adults gathered for iced tea, coffee and snacks in the café at the Frye Art Museum. Lively conversation ensued, like a gathering of old friends. Strummed on a guitar was a familiar tune. Carmen Ficarra, the musician and a teaching artist at the Frye, led them in song. It was joyful.

This gathering was of the Frye’s monthly Alzheimer’s Café, the newest of their Creative Aging Programs. Dementia-friendly programming at the museum is the innovation of Mary Jane Knecht, Manager, Creative Aging Programs, who along with her then-Director, Jill Rullkoetter. first proposed the concept nine years ago.

“Our goal from the beginning has been to reduce the feelings of isolation and stigma, which are often challenges for people who are living with dementia,” says Knecht. “We want the Frye to be a safe, supportive, and inspiring environment where participants can be social and feel welcome in a public place.

Creative Aging

The Frye’s first program — here:now — is an arts engagement program developed specifically for adults living with dementia and their care partners, where they can enjoy conversation, works of art, and artmaking in a supportive setting. The Frye also offers a quarterly film program – Meet Me at the Movies – where movie clips are shown, followed by facilitated audience discussion. Additionally, Knecht developed a program called Bridges, which brings art to the residences of individuals in the latter stages of dementia through one-on-one art discussion and art-making experiences.

The Museum is part of a larger collective of organizations known as Momentia Seattle, a “grassroots movement empowering persons with memory loss and their loved ones to remain connected and active in the community.” Momentia partners offer activities, programs and events including zoo and garden walks, talent shows, summer camps, field trips, improv, folk dancing, yoga, book clubs, and music, in addition to cafés and art classes.

The Arts are Transformative

In our work as Aging Life Care Professionals®, we believe in the transformative nature of arts and cultural engagement. We have seen this, when part of a care plan and tailored to each client, bring a new light through attendance at the theater, movies, concerts, and museums. An afternoon spent in an arts studio or getting social with new friends means someone is engaging socially, artistically, emotionally and mentally.

These arts and cultural experiences are an enriching, non-pharmacological approach that research shows can help improve mood, lessen anxiety and agitation, build relationships, make social connections, and improve overall quality of life for older adults living with Alzheimer’s or another dementia.

Most communities have some level of programming focused on arts for older adults, be it through senior or community centers, arts organizations, parks and recreation departments, churches, adult day centers, the Alzheimer’s Association or an Area Agency on Aging. There are also professionals such as recreational therapists and activities specialists who work directly with individuals.

How Can an Aging Life Care Professional® Help?

The responsibilities of taking care of your parent, spouse or family member can be very stressful. As Aging Life Care Professionals, we take a holistic, client-centered approach to caring for older adults or others facing ongoing health challenges. We help families navigate a path forward. Sometimes that path includes the arts and cultural engagement.

How do you know if you need an Aging Life Care Professional? Are you?:

  • Feeling both blessed and burdened helping your loved one?
  • At the end of your rope trying to balance the needs of your immediate family, a job and caring for an older loved one?
  • Concerned for your parents’ safety, well-being and independence, and it’s keeping you awake at night?
  • Noticing worrisome changes in your parent, contrary to what he or she tells you?
  • Living far from older family members and overwhelmed by caring for them long-distance?

Aging Life Care Professionals bring a positive outlook, years of experience, an objective perspective and responsive engagement to enable clarity, stability and a way ahead. Providing tools and resources to make informed choices, our guidance and expertise leads families to decisions and actions that ensure quality care and an optimal life for those they love, thus reducing worry, stress and time off of work for family caregivers. We are well-acquainted with programs, services and supports in our service areas and can help match your loved one with activities and events that will be fulfilling and contribute to their health and well-being.

To find an Aging Life Care Professional in your community that can help connect you and your loved one to service, supports and programs, please visit the Aging Life Care Association website at http://aginglifecare.org.


Lisa Mayfield, MA, LMHC, GMHS, CMC, is the founder of Aging Wisdom, a care management and consulting practice in Seattle, an Aging Life Care™ consulting, care management and creative engagement practice that strives to bring peace of mind to families by both directly improving the quality of life for aging family members, and by providing consultation and coaching services for their families. She is president-elect of the Aging Life Care Association and a Fellow Certified Care Manager.

This blog is for informational purposes only and does not constitute, nor is it intended to be a substitute for, professional advice, diagnosis, or treatment. Information on this blog does not necessarily reflect official positions of the Aging Life Care Association™ and is provided “as is” without warranty. Always consult with a qualified professional with any particular questions you may have regarding your or a family member’s needs.

Planning for the Future: Long Term Care

Planning for the Future: Long Term Care

Andrea Zaite, MSSA, LMSW, CMC, C-ASWCM

How Will I Pay?

I want to introduce you to the web site run by the federal government called https://longtermcare.acl.gov/.  Long term care is defined as receiving assistance in the areas of daily living such as bathing, incontinence care, cooking, shopping, medication reminders, etc.  The website is courtesy of the U.S. Department of Health and Human Services.  This site covers some topics I think are important to those looking to plan for the future or to help pay for the care of a loved one recently in need, but without the financial means to write the check.

We know from experience that Medicare, Medicare replacement and commercial insurances do not pay for these services.  They are not considered medical care so they are not covered.  I agree that most chronically ill and elderly patients would benefit from these services as a part of care to prevent re-hospitalization, however Medicare doesn’t see it that way.  I have found many people wading through the myriad of services provided in the handbooks come across home care and assume this is the same.  The Medicare, Medicare replacement plans and commercial insurance are talking about medical home health ordered by a physician.  Home health is a medical service which includes a weekly nurse visit called skilled nursing care that may last 15-30 minutes to take vitals and deal with any medical problems and education; Occupational Therapy for upper body; and Physical Therapy for lower body and ambulation. Temporary bathing aid can be ordered for several visits to ensure patient can safely bathe. Home health is meant to be a bridge from illness to recovery; from hospital to home. There are restrictions as well; a patient must be home bound, and is usually time limited with the need to show improvement.

The next question and road block to obtaining this care is the cost. Long term care is expensive by the nature of the care required and location of services.  Most private duty home care can range from $12.00 – $25.00 an hour with some company’s requiring a 3-4 hour minimum.  Average monthly cost whether provided at home or in an assisted living, board and care home, or nursing home, can average as high as $5,000.00 to $6,000.00, with home care usually the least expensive if the home is in good condition and the home is owned outright.

OPTIONS FOR PAYING:

The options to pay for your long-term care have improved over the past 10 years because the need for this type of care has increase so dramatically.  These options include:

  • Long term care insurance
  • Combination Life/Long term care products
  • Accelerated death benefits
  • Life settlements
  • Viatical Settlements
  • Reverse Mortgages
  • Home equity loans
  • Annuities

Long Term Care Policies are generally obtained by those in the planning phase as they are less expensive the younger you are.  These policies can be activated once an individual is determined to have 3 deficits in the area of activities of daily living skills.  Most policies cover private duty home care, assisted living, and long-term nursing home care.  Policies have a 3-month waiting period and require an evaluation by a care manager that either works for the insurance company or is contracted by the recipient.  The evaluation is to determine the need for services and determine the 3 main deficits in the Activities of Daily Living Skills.  I have discovered that there are families and clients that don’t realize they may have these policies either because this was not discussed with the children or often the wife didn’t know her husband purchased the policy.  Many private duty home care companies and assisted living facilities will help you activate the policies if needed.  Some insurance policies will reimburse you for the cost incurred during the 3 month waiting period others consider that to be an out of pocket cost.

Combination Products are for those persons who would like a guaranteed return on their investment by combining life insurance with a long-term care plan so if you don’t use the long-term care component you can still collect on the life insurance or at least your beneficiaries can.  Many of the same rules apply as for long term care.

Accelerated death benefit feature of a policy allows you to receive a tax-free advance on your life insurance death benefit while you are still alive.  You may have to pay for the option to have this feature or it may be part of the policy.  There is the stipulation that you are terminally ill or have a life-threatening diagnosis or need long term care for an extended period of time verified by a physician.  This feature is usually capped at 50% of death benefit.  This type of policy is limited but can be a helpful in an emergent situation.

Life settlement option of a policy allows you to sell your insurance policy for its present value to raise cash for any reason.  This option is usually only available to women age 74 and older or to men 70 and older.  The down side is the income generated may be taxed as capital gains but the up side is you need not exam and no doctor statement.

Viatical settlements option allows you to sell your life insurance to a third party.  This option is like a life settlement but is only available to those who are terminally ill or have a life expectancy or 2 years or less.  The payments are based on life expectancy limitation due to illness or injury that must be verified by your physician.  The payment percentage is based on this number so for example someone with a life expectancy of 1 – 6 months may have a payout of 80% of benefit and someone with a life expectancy of 6 – 12 months would receive 70% of benefit and so on.

Reverse Mortgages are a good option if you have a home that is paid off.  You should go to a reputable mortgage company or bank to discuss this option.  Many reverse mortgages allow you to choose between a lump sum payment, a monthly payment, or a line of credit.  You continue t live in you home but you are responsible for up keep, taxes and insurance.  The stipulations to this option include being 62 years of age or older, and this must be your primary residence.  Your spouse can continue to live in the home after you die and there is an option to pay back the mortgage if your family decides they want the home.

Annuities seem like the least popular option as they can have an effect on your taxes and affect your eligibility for Medicaid.  There are 2 types of annuities; immediate and deferred long term care annuities.  Trust can be drawn up to help disperse the funds and protect them from Medicaid regulations.  This should be discussed with an elder care attorney.

The options discussed above and other related subjects can be found on the long-term care website.  I also recommend you visit another website called lifecarefunding.com.  This company has been doing business since 2007 in response to the Medicaid spend down for senior to qualify for long term care.  They help convert policies into living benefits.  Several agencies and assisted living facilities use and recommend them.

An Aging Life Care Professional® can help you to evaluate your circumstances and develop a plan that is right for you and your loved one.   They can also recommend and refer you to elder care attorneys, financial planners, ad insurance companies to help navigate the waters of long term care.


About the Author: Andrea Zaite, LMSW, C-ASWCM, CMC, is an Aging Life Care Association Advanced Professional member and a Board Member of the South Central Chapter.

This blog is for informational purposes only and does not constitute, nor is it intended to be a substitute for, professional advice, diagnosis, or treatment. Information on this blog does not necessarily reflect official positions of the Aging Life Care Association™ and is provided “as is” without warranty. Always consult with a qualified professional with any particular questions you may have regarding your or a family member’s needs.

What is an Aging Life Care Professional?

What Does It Mean to be an Aging Life Care Professional®?

By Spencer Brown, CMC, LNFA, MSG

My introduction to the field of aging was shaped heavily by having close relationships with all four of my grandparents and seeing my parents in a caregiving role.  As a college freshman in the town where one set of grandparents lived, I spent even more time with them.  In the first three months of collegiate life, my grandfather had a significant stroke and my grandmother called me to report a change and asked me to come to the house. Over the next five months as a “boots on the ground” resource until my grandfather’s death I spent a lot of time assisting in simple ways while my mom and uncle dealt with the challenges of long-distance caregiving.

One day while on the phone with my parents and I were talking and my dad said, “Your mother and I have picked a career for you.”  While I always appreciate my parents’ perspective I paused with a bit of skepticism. My reply was terse when I asked “what?”   Then my dad said gerontology to which I replied “What’s that?”  After some explanation my dad said he and my mother had observed in their regular trips to Texas how I interfaced with my grandparents and that they saw in me a demeanor that seemed to lend itself to work with older adults.

While not sure what to make of the career path guidance, I began exploring the field of aging.  First I volunteered at an adult care center after my first year of college.  Then other opportunities came up such as participation in the college ministry to a nursing home where I played the piano most weeks.  Along the way I took an introduction to gerontology course where I met my lead professional in the graduate program I would enroll in later.   I also met an executive director/administrator of a senior living community via a connection through my dad’s civic involvement.  It was meeting someone who knew about the residents, their stories and seemed to care about the well-being of older adults where I first said, “I want to do that.”

The rest, I tell people, is history.  As I completed a Master’s degree in gerontology, I concurrently became a licensed nursing facility administrator in Texas.  My full-time career began managing nursing homes and evolved to opportunities managing assisted living and independent living communities.  What engaged me for many years was being of service to residents and their families who were often stressed about the challenges in aging.  As an executive in various settings, my ability to help these families navigate issues was often limited.  Knowing I was in a burnout profession I told myself early on that I would keep doing what I was doing as long as I didn’t see any other service opportunity.  Then one day I couldn’t say definitely I wanted to remain on this path and contemplated leaving the field of aging altogether.

My experience with the field of Aging Life Care™ was very limited but I interacted with some care managers who were assisting residents in communities that I managed.  When I was part of a company reorganization where my position was being restructured I told a professional whom I respect that I was considering an opportunity in geriatric care management. This person then told me Accountable Aging Care Management® was hiring in their San Antonio market.  Within one month I was working as an Aging Life Care Professional®.

During my years as a care manager, three key aspects of this work have motivated me.

  1. Humility – Given all of the issues in aging I realize that it is humbling for our team to partner with families who are in the middle of very complex and emotional issues with their loved ones. The opportunity to be right with families at pivotal moments is an honor.  Walking alongside them, providing coaching, coordination and management support is not something to take lightly.
  2. Learning – One of the traits discovered about myself is a desire to learn. Working in Aging Life Care allows me to learn every day. More than any other position in my career, the continuous learning process has never been more evident than now.  Not all client situations are the same and I thrive off discovering appropriate resources for clients and helping a plan of care work efficiently.
  3. Variety – When I entered the profession I thought that all I would be doing was work with older adults. Quickly I learned that there are all kinds of adult aging issues where a care manager can make difference.  Working simultaneously with two almost 18-year old clients with an array of issues and needs early on my career changed my thought process completely about who is a typical client.  When ALCA rebranded the profession, I was so grateful because Aging Life Care in my client work has really meant any adult aging issue regardless of chronological age.

I view myself as an ambassador to help promote the profession so that others will understand that there are organizations across the country to help family caregivers who find themselves in a new role of coordinating care and navigating the maze of options.  We have much to be done but as a larger profession Accountable Aging Care Management and many companies across the nation have a rich opportunity to partner and serve many.

Spencer Brown, CMC, LNFA, MSG, is a care manager at Accountable Aging Care Management in San Antonio, TX. He was named as the Aging Life Care Association South Central Chapter 2017 Member of the Year.


This blog is for informational purposes only and does not constitute, nor is it intended to be a substitute for, professional advice, diagnosis, or treatment. Information on this blog does not necessarily reflect official positions of the Aging Life Care Association® and is provided “as is” without warranty. Always consult with a qualified professional with any particular questions you may have regarding your or a family member’s needs.

It’s Just Stuff…Right? Learning to Manage the Emotions of Downsizing

It’s Just Stuff…Right?

By Darcy Thiel, MA, LMHC

One of my businesses is called “Less Mess, Less Stress.” When I first started, it would be what I envisioned- helping people clean out that junk room, or maybe the garage so it could be parked in. For a while, it became more hoarding or condemned houses. Sometimes I would hire an entire crew and would literally have to shovel the house out.

I always say that this job overlaps quite a bit with my counseling profession. People’s relationship to their belongings is often very emotional. Especially when there is grief involved because of a deceased person’s belongings, my counseling skills come in handy. It is my job to help people let go of things. The vast majority of Americans need to downsize. You don’t need more space, you need less stuff!

The aging population must face this issue, especially when moving into a different type of living space than they are accustomed to. Recently, we’ve been helping my dad make the big decision about living in a smaller place where there isn’t so much upkeep. It’s not only a decision about housing, but about aging, which is almost always about acceptance. And aging is about approaching death as well, which is also about acceptance. It’s emotional for Dad, but also for all us kids too.

After months of no, no, no, Dad has decided he’s ready to move. And when he is ready, he means now. We have been trying to sell the house, find him an apartment, downsize his belongings, and everything in between. Some of the most fun times for us as a family have been going through cupboards and reminiscing. And some of the most tense times have been going through cupboards and disagreeing whole heartedly about how to help Dad make the shift.

That’s where I have to remember I’m a daughter before an organizer. No one in my family has hired me to take this on. I’m used to doing it though so sometimes I get a bit bossy. I also think that initially Dad (like all of us) needed a little nudging to move forward. Now there is no stopping him and the rest of us can’t keep up. It has been interesting to observe how he has changed over the years.

We have gone through various memories and belongings and initially so many things were untouchable. They were sacred. No one could bear to part with anything that belonged to our family members we had already lost. Just looking at things would cause us to tear up or cry. Now time has gone by. I ask Dad about certain things and he looks at me like, “Why would I want that?” I know without a doubt that he still deeply misses and loves all those people he has lost. But he is moving on. I want to be that way too. We don’t need boxes of things and pictures galore to remember our loved ones. I see it as growth. After all, it’s just stuff, right? Well, that all depends on what year you are asking! Good thing to remember when helping people navigate through this time of change.

Darcy Thiel, MA is a Licensed Mental Health Counselor in NY State and a new Aging Life Care Manager.  She earned her Master’s Degree in Clinical Psychology from Wheaton College in Wheaton, IL.  She is also an accomplished speaker and presenter on various topics throughout the Western NY area. She is the proud author of Bitter and Sweet, A Family’s Journey with Cancer, the prequel to Life After Death, on This Side of Heaven.  To learn more about Ms. Thiel, visit her website at www.darcythiel.com or marriageandfamilycounseling.net. If you enjoyed her blog, she writes weekly at helpforhealing.wordpress.com.


This blog is for informational purposes only and does not constitute, nor is it intended to be a substitute for, professional advice, diagnosis, or treatment. Information on this blog does not necessarily reflect official positions of the Aging Life Care Association® and is provided “as is” without warranty. Always consult with a qualified professional with any particular questions you may have regarding your or a family member’s needs.

The Secret Life of the Refrigerator

The Secret Life of the Refrigerator

by Miriam Zucker, LMSW, ACSW, C-ASWCM

“Ins and outs,” are what Aging Life Care Specialists™ often do during our initial walk thru a client’s home. The “ins” are such things as medication dispensers, grab bars and smoke detectors.  The “outs,” are unsecured throw rugs, old newspapers and magazines, and expired medications.  While these areas tend to be more apparent to the care manager, a visit to the kitchen may tell a story of mystery and concealment. It’s the secret life of the refrigerator.

Like opening your mouth in the dentist’s chair, opening the door of the refrigerator can reveal important information.

The first piece of information is obtained by simply opening the door of the adult senior’s refrigerator. Are you greeted by a fragrance-free refrigerator or is there the waft of soured milk?

The second piece of information is what is known as the “refrigerator rainbow effect.”  Ideally, this would mean an array of all those brightly colored fruits and vegetables. But for Aging Life Care Specialist, observing such color often represents mold and rot on foods that should have been thrown out long ago.

The third piece of information is opening the refrigerator, and none of the above characteristics are present.  There is little or nothing in the refrigerator and food in the freezer expired months or even a year ago.

For the Aging Life Care Specialist, the secrets of the refrigerator make it vibrantly clear that immediate attention is required.  Diagnosis and remediation must occur concomitantly. The refrigerator and freezer must be cleaned, expired food removed and fresh food and beverages brought in. At the same time, Aging Life Care Specialists must question why this unsafe condition has been allowed to develop. There are five primary questions we ask:

  • Are there family, neighbors, friends or social service agencies involved?
  • Is there altered cognition? Is the older adult forgetting to shop? Going shopping and not bringing money? Forgetting to eat?
  • Is the adult senior hoarding food? This often is observed with our clients who lived through the Great Depression and will not part with food no matter what its condition.
  • Is there clinical depression which is preventing a client from having an interest in eating or shopping?
  • What foods are our clients living on? What do the kitchen cabinets reveal?

For each of our clients, the response will be different. It is our responsibility as Aging Life Care Specialists to promptly assess what the refrigerator has revealed, and take the appropriate steps to return the refrigerator to a safe zone and make sure our clients are not malnourished, dehydrated or experiencing other conditions associated with improper nutrition.

 

MIRIAM ZUCKER, LMSW, ACSW, C-ASWCM is the founder of Directions in Aging, based in Westchester County, New York. she has been as an Aging Life Care Specialist for over two decades. she can be reached at: mzucker@directionsinaging.com.


This blog is for informational purposes only and does not constitute, nor is it intended to be a substitute for, professional advice, diagnosis, or treatment. Information on this blog does not necessarily reflect official positions of the Aging Life Care Association® and is provided “as is” without warranty. Always consult with a qualified professional with any particular questions you may have regarding your or a family member’s needs.

Aging Life Care Month

Stories from National Aging Life Care Month

Aging Life Care Professionals® across the country celebrated National Aging Life Care™ Month by providing seminars, webinars, special events, open houses, and other educational activities for the public.

Many took to social media to share Aging Life Care stories via selfies and videos. Each week, ALCA asked members to share something from their world as Aging Life Care Professionals. During the month, several common themes emerged – a passion for helping families through difficult times, an appreciation for the wisdom of an older generation, resiliency, advocacy, care, and the need for daily hope and laughter.  Below is a look at some of  the photos shared during #AgingLifeCareMonth.

As our population ages, it becomes more and more important to plan for the many years ahead. The entire reason for National Aging Life Care Month is not only to bring awareness about aging well, but to celebrate those who have dedicated their lives to helping older adults and their families. We celebrate Aging Life Care Professionals, because they bring kindness, heart, and compassion to the field. Without them, ALCA wouldn’t be the incredible organization that it is.

To learn more about Aging Life Care™ and to find an expert in aging well, visit aginglifecare.org.


This blog is for informational purposes only and does not constitute, nor is it intended to be a substitute for, professional advice, diagnosis, or treatment. Information on this blog does not necessarily reflect official positions of the Aging Life Care Association® and is provided “as is” without warranty. Always consult with a qualified professional with any particular questions you may have regarding your or a family member’s needs.