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The Power of Planning: Taking Charge of Your Own Aging Journey

by: Lisa Mayfield

At 72, Betsy is doing all the right things to ensure she enjoys good physical, emotional, mental, and financial health.  She eats a Mediterranean diet, doesn’t smoke, drinks in moderation, exercises regularly, has adjusted her spending and investments for retirement, goes for regular check-ups with her doctor, and gets the recommended health screenings. She gardens, spends quality time with family and friends, takes classes, travels, and volunteers. Her life is busy, full, and fun.

However, Betsy lives by herself in a large, two-story home with a generous yard she maintains herself in a remote part of western Washington. Her home is a 20-minute drive from the closest family member. For all her planning and thoughtful preparation, Betsy didn’t anticipate how a chronic back issue could flare up. Yet it did, resulting in a panicked call to her daughter (then 911), followed by an ambulance ride to the ER and a three-day hospital stay.

On her homecoming, Betsy’s new normal was obvious from the moment she left the car and slowly, cautiously navigated the walkway and stairs to her front door. She began taking note of changes she would need to make as she healed and to support her moving forward.

This scenario is far too common. Fortunately for Betsy, she fully recovered and has adjusted activities to keep the back pain at bay. She’s also making practical changes she’s sorry she hadn’t made earlier.

What are some of those areas we often overlook that are essential to successful planning and preparing for longevity? Here’s a list to review:

Legal documents

Make this the first step. If we don’t have basic legal documents in order, it can easily and unnecessarily complicate everything else. According to the National Academy of Elder Law Attorneys, estate planning documents should include durable powers of attorney for health care and finances; advance health care directive to physicians (living will); a will; and anatomical gifts/burial instructions.

Incapacitation for any reason puts the burden of decision making on people who may not be prepared for the responsibility. These binding legal documents are like a love letter: They spell out our wishes and can relieve a loved one’s concern about making the right choices.

Community

Being able to draw on social networks of friends or family is an important contribution to general well-being and quality of life. Living in a community where we feel safe, that is affordable, and where our goals and needs are met is essential.

Finances

Whether the plan is to continue working full time or part time, retire and travel, move closer to family, or stay put, we need to understand the financial landscape and how our money will support us in the years ahead. We also need to get a sense of how our finances might be impacted if our health changes.

Health

We all have concerns about our health as we age. Perhaps our memory isn’t as sharp as it once was. A family history of high cholesterol or cancer can cause worry. What can we do or change now to ensure a healthy future? How do we stay positive as we grow older?

Home

Take a discerning look around. Betsy now wishes she’d moved sooner to a community closer to her adult children with everything on one level, including a barrier-free entry to her home. She has made this move and feels better prepared if she has another emergency. If you have a steep incline or stairs that are more difficult to navigate with each passing year, it may be time to move.

Home adaptions are one possibility and can be cost-effective. They include improved lighting, grab bars in bathrooms, a low- or no-barrier shower entry, and removing rugs to reduce the likelihood of a fall. A certified aging-in-place specialist can help you navigate these home modifications.

Transportation

Betsy was homebound for a time—and if she later found herself unable to drive, she had very limited options for transportation where she used to live. Having access to public transportation, ride share services, or living in a walkable, accessible community can make a huge difference in your mobility, as well as your ability to access entertainment, social and community engagement, shopping, and health care.

Planning is empowering. We should all give these key areas serious consideration and reflection. If we find there is a gap, engaging the advice of an elder law attorney, financial adviser, and aging life care professional can be a smart investment in preparing for our longevity.

Don’t leave your future to chance. Don’t leave it to family or friends to figure out. Start to prepare now. Planning can safeguard our happiness, our health, and our peace of mind. Are we ready?

Lisa Mayfield MA, LMHC, GMHS, CMC, Fellow Certified Care Manager is founder and principal of Aging Wisdom, an Aging Life Care consulting, care management, and creative engagement practice that strives to bring peace of mind by both directly improving the quality of life for older adults and by providing consultation and coaching services for their families. She currently serves as Past President of the Aging Life Care Association (ALCA).


Resources

Books

  • Elderhood: Redefining Aging, Transforming Medicine, Reimagining Life by Louise Aronson
  • Enlightened Aging: Building Resilience for a Long, Active Life by Dr. Eric B. Larson and Joan DeClaire
  • Who Will Take Care of Me When I’m Old? by Joy Loverde
  • Women Rowing North: Navigating Life’s Currents and Flourishing as We Age by Mary Pipher
Aging Life Care Manager can help in emergency situations

Corona Virus: How Aging Life Care Managers® Can Help Families Prepare for Emergencies

  • By Anne Sansevero

As Aging Life Care Managers® one of our important roles is helping clients and their families look ahead to assist them with emergency preparedness. We do this with advanced directive planning and health education by ensuring their vaccinations are up to date. However, there are times when certain situations pose new and unprecedented challenges and require extraordinary measures. Hurricane Sandy comes to mind. I vividly remember when we were delivering hot meals and medications to clients who were sheltering in place in buildings that lost power and coordinating to ensure continuity of their home care services in a challenging situation. We got through it and it made us stronger and more knowledgeable and our clients were deeply appreciative.

The COVID-19 (corona) virus now presents us with a new public health challenge and we need to be informed and prepared to assist our clients in their emergency preparedness in a compassionate, competent, and controlled manner. We also need to keep the communication channels wide open.

Scientists are still gathering data and updating their recommendations on a daily basis. Both the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) have the most up to date information available on this novel virus.

The current recommendations from the Centers Of Disease Control (CDC) is to practice every day preventative measures. Individuals and families should follow the everyday preventive measures listed below – this means we need to educate our clients, families and their caregivers on the following them and most importantly follow them ourselves!

  • Voluntary Home Isolation if sick with viral symptoms: Stay home when you are sick with viral or respiratory disease symptoms. At the present time, these symptoms are more likely due to influenza or other respiratory viruses than to COVID-19-related virus. Stay in touch with your primary care provider on what testing may be needed. Do not engage with others in a work or social setting until you are symptom and fever free for 48 hours and have been medically cleared
  • Respiratory Etiquette: Cover coughs and sneezes with a tissue, then throw it in the trash can.
  • Hand Hygiene: Wash hands often with soap and water for at least 20 seconds; especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.
  • Avoid Touching your eyes, nose, mouth and ears
  • If soap and water are not readily available, use an alcohol-based hand sanitizer with 60%-95% alcohol.
  • Environmental Health Action: Routinely clean frequently touched surfaces and objects with disinfected wipes especially mobile phones and computers

I would add that as Aging Life Care Professionals® we should look ahead to ensuring that our clients have at least a month’s supply of medications in the home and that there is a supply of fever-reducing over the counter medications, gloves, and disinfecting wipes in the home

Routine use of these measures by everyone will increase community resilience and readiness for responding to an outbreak. As of 2/26/20, the CDC is also recommending to be prepared for potential community outbreaks or hot spots in the US within the next few weeks. Here are their recommendations if a community hotspot is identified–

  • Personal Protective Measures. During an outbreak in your community, CDC recommends the everyday preventive measures listed above—especially staying home when sick—and taking these additional measures:
    • Keeping away from others who are sick.
    • Limiting face-to-face contact with others as much as possible
    • Consulting with your healthcare provider if you or your household members are at high risk for COVID-19 complications
    • Wearing a facemask if advised to do so by your healthcare provider or by a public health official
    • Staying home when a household member is sick with respiratory disease symptoms, if instructed to do so by public health officials or a health care provider (Voluntary Home Quarantine)
  • Community Measures. If COVID-19 disease is occurring in your community, state and local public health authorities may decide to implement:
    • Temporary closures or dismissals of childcare facilities and schools
    • Other social distancing measures that increase the physical space between people, including:
      • Workplace social distancing measures, such as replacing in-person meetings with teleworking
      • Modifying, postponing, or canceling mass gatherings.

According to the CDC, decisions about the implementation of community measures will be made by local and state officials, in consultation with federal officials as appropriate, and based on the scope of the outbreak and the severity of illness. Implementation will require extensive community engagement and ongoing and transparent public health communications.

ALCA’s Aging Life Care Professionals are dedicated, smart, and responsive and can support clients as they need before and during illness outbreaks. This Covid-19 outbreak can be concerning, but knowledge is power and implementing best practices helps create the best outcomes for all.

Anne C. Sansevero, RN, MA, GNP, CCM – Anne Sansevero is the founder and CEO of HealthSense LLC, an Aging Life Care™ management consulting practice. She is a master’s prepared geriatric nurse practitioner, and a seasoned nursing professional with over 30 years of experience in the field. Anne has a sub-specialty in neurological disorders and is well versed in all aspects of geriatric nursing. She has particular expertise with communication disorders relating to stroke and dementia and has developed a number of innovative nursing assessment tools and standards to improve the nursing care for frail elders. Anne is a member of the Aging Life Care Association® (ALCA) and Fellow of the Aging Life Care Leadership Academy. She is currently serving on the board of the ALCA, and is Vice President of the New York Chapter. In addition, Anne is a member of the American Academy of Nurse Practitioners and the Nurse Practitioners of New York. Anne is a registered nurse, certified case manager, and a master’s prepared geriatric nurse practitioner.

2020: The Aging Life Care Association® Celebrates Its 35th Anniversary

Thirty-five years ago a group of visionary women in eldercare created a profession and a professional association. Originally the National Association of Private Geriatric Care Managers (NAPGCM), this non-profit has grown from 75 members to the now 2,000-strong Aging Life Care Association® (ALCA).

Since 1985, Aging Life Care Association members have cared for about two million older adults. The impact of their expert care continues to multiply exponentially, across generations, and systems of care, including hospitals, home health agencies and public programs.

As a result of a New York Times article, written by Glen Collins in 1983, a handful of practicing Geriatric Care Managers learned about each other and their similar practices. This article prompted an initial gathering between Rona Bartelstone, Sarah Cohen, Leonie Nowitz, Lenise Dolen and Adele Elkind in New York. This led to an organizational meeting for what became NAPGCM, which immediately drew other professionals from across the country.

Collins’ article “Long-Distance Care of Elderly Relative a Growing Problem” is timelier today than ever as our nation’s families are spread across the country and the globe. A quick look at some numbers emphasize the exponential growth of the need for, and relevance of, a variety of Aging Life Care Managers®. In 1988, approximately 3.3 million disabled elderly had at least some paid care services, generating $3.1 billion out-of-pocket costs for themselves and their families. In 2000, home care expenditure was about $32 billion and by 2017 this figure increased to approximately $97 billion, without considering all the other costs of caregiving for both the care recipient, the family, and community.

A defining characteristic of ALCA is that it has been birthed and led primarily by women. Breaking traditional norms, these founding women began their own practices setting the stage for future generations of entrepreneurial women in a variety of healthcare-related industries. More than 85% of ALCA’s membership continues to be female small-business owners, making this industry distinctive for continued dominance by female leaders.

The association’s second President, Rona Bartelstone reflected on the fledgling organization’s start commenting, “From the very beginning, the Association was mission-driven and committed to the highest level of services for older adults, those with disabilities, and their families. Our members learned how to take leadership in shaping the very nature of elder care service delivery in their local communities. By setting the example for excellence in care, changes have been wrought at the highest level of government, where care coordination has been written into Medicare and related health systems for the older population. ALCA professionals continue to be dedicated experts and role models for the best in Aging Life Care™ services.”

Groups around the country began to meet regularly, to create national Standards of Practice and a Code of Ethics. Regional chapters began forming, starting with Florida, then New York, and now nine regional ALCA chapters cover the United States and Canada. Chapters and local groups always had a focus on creating expertise, extraordinary customer service, and sustainable business models. The burgeoning organization produced an annual national conference, a regular newsletter, and finally a professional journal. Members routinely presented papers, workshops, and panel presentations at related national organizations such as the American Society on Aging (ASA), the National Association of Social Workers (NASW), the National Association of Elder Law Attorneys, The Gerontological Association, and many more.

The association changed its name and brand in 2015 to better reflect a more holistic approach to larger aging issues, as well as reflect the larger population of clients served by the professionals.

“ALCA was there when no one else was looking at these issues and has stayed true to its mission throughout its three-and-a-half-decade history,” stated former ALCA President Claudia Fine (2002). “These pioneers saw the need for professionals in care management to continue to learn and serve the aging population and have been fulfilling that need since the late 80s.” The organization is built on helping others, whether that means other care managers, other agencies, other clients.

Aging Life Care Professionals® have extensive training and experience working with older adults, people with disabilities, and families who need assistance with caregiving issues. Working with families, the expertise of Aging Life Care Professionals provides solutions at times of uncertainty and crises. Through a process of assessment, care planning and implementation, advocacy, education, decision support, and coaching, the Aging Life Care Professional guides families to those specific actions and decisions that ensure quality care and optimal functioning for those they love. Aging Life Care services thereby reduce stress, anxiety, uncertainty and lost time from work for family caregivers.

“With 72 million baby boomers aging in the United States, Aging Life Care Professionals are becoming a cornerstone in the caregiving industry,” CEO Taney Hamill says. “These professionals work alongside Elder Law attorneys, physicians, bank trust and estate officers, accountants, and community agencies to guide families through a myriad of aging, health, and care-related issues.”

Current Board of Directors President Liz Barlowe added, “As ALCA celebrates its 35th Anniversary, the association is proud of its longevity and ability to help Aging Life Care Professionals further their education, meet high standards of practice and ethics, and help grow their practices.”

Parents Aging at Home

January Doesn’t Have to Be Dry and Discouraging

While “Dryuary” or Dry January seems like a relatively new trend, it’s origins date back much earlier. Even the New York Times showcases the activities around when Prohibition began (Jan. 17, 1920.)

January is also a month where people re-consider their over-indulgences in food and drink then hit the gyms or yoga mats and buy up more lettuce.

But what about our elder loved ones who are left back in their homes, or their assisted living communities? These sorts of social trends don’t affect them as much, and as the darker, colder month lingers, their moods might also be wearing down.

Checking in on our aging parents, or engaging an Aging Life Care Manager who can, is one valuable step to ensure your family members are getting the attention they need to not feel neglected.

In a June 6, 2019 article, Aging Life Care Professional® Jullie Gray, MSW, LIC SW, CMC  wrote how the most surprising secret to aging well can be social engagement. She writes, “Researchers have been studying the impact of social isolation and loneliness on health and wellbeing for many years. Over and over it has been proven that social support acts as a buffer against illness and cognitive decline. Loneliness and seclusion is thought to be as bad as or worse for your health than smoking, obesity or being an alcoholic. Put simply, loneliness breeds illness and early death.”

Isolation Risk

First, is your parent or aging loved one at risk of isolation? Some telltale  signs and risk factors are:

  • Living alone
  • Living at a distance from family
  • Poor hearing and/or vision
  • Memory loss or other cognitive problems
  • Difficulty getting around
  • Significant life change (i.e. recent loss of a spouse/partner or moving to a new home)

If you think someone is suffering from isolation or loneliness, see if you can arrange a visit for yourself, with children, friends or neighbors. Working with an Aging Life Care Professional, perhaps you could arrange for them to participate in faith activities, or social events. Sometimes something as simple as joining a book club (or other hobby) could help.

In today’s age a plethora of technology is available to help fight against loneliness and depression. Setting up your elder loved one with a simple way to engage in video chats or even digital picture frames might help if you can’t arrange frequent visits.

There are many emerging companies’ intent on helping foster relationships between grandchildren through scheduled calls, video visits, or games.

The goal is to help aging parents develop, or maintain, deeper relationships with others.

If you’re ever at a loss on how to coordinate services, a professional can help by developing and implementing a plan. An Aging Life Care Manager can also become your eyes and ears by: making regular visits to check in on your parent and monitor your parent’s health and addressing concerns when they arise.

With the help of an Aging Life Care Manager you can more easily stay on top of your elder loved one’s situation and rest a little easier knowing she or he is not suffering the effects of “Dry January.”

To find help in your area, go to www.aginglifecare.org and click on “Find an Aging Life Care Expert”.

Is it Time for Help? Knowing When Your Aging Loved One Can’t Go it Alone Anymore

The holiday season is typically the time when families and friends visit aging loved ones more than during the year. Frequently, this is also the time when they discover troubling changes in health, behavior or physical appearance of their elder loved one. Many will discover their aging loved one now needs more help or attention and can leave them wondering how to approach this development.

This is where an Aging Life Care Professional® can be instrumental. “For many families, the holidays are the first visit they’ve had with an aging relative in a year or longer,” says Kate Granigan an Aging Life Care Professional practicing in Boston, MA. “It’s the first time they can see that their mother’s house is more cluttered than before, that she’s shuffling more down the hallway, or has strategically placed furniture to hold onto for balance.”

Continue reading Is it Time for Help? Knowing When Your Aging Loved One Can’t Go it Alone Anymore

Caring for a Spouse – Navigating the Aging Journey Together

At some point along the path of life, we step into the path of being a caregiver; we expected this as we became parents or as our own parents aged.  But when we married someone, this role was not delineated in our dreams or vision of our vows of “from this day forward!”

Our partners are often the same age cohort as we, so we could both have some physical challenges, making our role even more challenging.  The role “caregiver” could have come on suddenly after a medical incident or serious fall; or it might have come upon the two of you so gradually that you struggled with accepting that you are now responsible for the both of you and, yes, you are “it!”

Literally in some relationships, especially those without children or close family and friends to offer support, the burden can become great when you have no one to share the emotional toll as well as the physical exhaustion that can come with this role.

Those caring for someone with just physical challenges still have a partner to be in relationship with; this doesn’t mean it is easy. It just means you have someone to connect with that you have loved over the years and you usually want the very best for that partner.   However, there are those of you who are caring for a partner that has a serious cognitive issue like Alzheimer ’s disease.  That becomes a place of loneliness for the well spouse because the partner with the cognitive issues loses the ability to understand and partner in a loving relationship as the disease progresses.

You should begin planning for the two of you way before one of you needs care.  However, that almost never happens.  It is usually someone in the circle of care that says to you, “you need help.”  Of course, they don’t know where or who you should seek to be your “navigator.” The answer is a Professional Aging Life Care Expert, formerly called geriatric care managers.

The Aging Life Care Expert is usually a Master’s level prepared professional, credentialed and certified with a background in social work, counseling, psychology, gerontology, nursing or related fields.  They will assess the current situation, project what you might need in the future and connect you to vetted professionals in the fields of law, medicine, socialization, spirituality, stress reduction and financial planning.

That is just their first step – getting you the documents, services and advice that will put you on solid ground.  When it comes to dilemmas with medical issues, they will become your advocate in that area – partnering with you to ask the right questions and get the specialist you and your spouse need now.  They will be your guide to obtain benefits from insurances, entitlements, government services or community services.  They are always available to you.  When you don’t know what you don’t know, they will be your compass, leading the way so you can stay healthy and not become a victim of over caring and burnout.

Many Aging Life Care Experts run support groups for spousal caregivers or know where to find one – that might be your first step in getting on the right path.  This is a journey that requires a trusted coach, a guide navigator.  You would not venture on a voyage without one.  Find an advocate for yourself; it will impact the quality of both of your lives.

To find a Professional Aging Life Care expert is easy – just go to the website (www.aginglifecare.org) and put in your zip code.  Call at least 3 of the people listed in your area; ask about how long they have been doing this type of work, not how long they have been a care manager.  Ask about certification – you want a certification approved by the Aging Life Care Association – that gives you peace of mind that they have the skills and expertise you need.

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 www.eldercareanswers.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.