Saturday, February 04, 2012 Want Advice From Those in the Last 1/3 of Their Lives?
By: Susan M Graham, Certified Elder Law Attorney, Senior Edge Legal, Boise, Idaho 83702
Cornell University (my alma mater) created a Legacy Project to find out from those in the last third of their lives, what life experiences, both positive and negative, have taught them about living effectively. There is a new book called "30 Lessons for Living", Hudson Street Press, by Dr. Karl Pillemer which gathers advice from more than 1,000 elders.1
Here are some highlights:
1. Marriage: "A satisfying marriage that lasts a lifetime is more likely to result when partners are fundamentally similar and share the same basic values and goals."
2. Careers: Be involved in work that you absolutely love and look forward to doing every day.
3. Parenting: Spend more time with your kids. Share in their interests and activities.
4. Aging: "Embrace it. Don't fight it." Most of the 1,000 people found old age had more opportunity than they thought. If you are worrying about dying, then plan for it. "Get things organized, let others know your wishes, tidy up to minimize the burden on your heirs."
5. Regrets: Take advantage of opportunities. Say "yes" more. Fill out your Bucket List and start checking off items once they are done.
6. Happiness: Happiness is a choice, not what life deals you.
"Even if their lives were nine decades long, the elders saw life as too short to waste on pessimism, boredom and disillusionment."
If you want to share your own wisdom and need help in getting started, on the web go to "New York Times." Type in "Questions for Your Own Circle of Experts." I bet your family and friends would be delighted to hear from you.
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1"Advice From Life's Graying Edge on Finishing with No Regrets" by Jane E. Brody, The New York Times, January 10, 2012, page D7.
Saturday, December 17, 2011 There Go The Social Safety Nets (to help pay for catastrophic long-term care!!)
by Susan M. Graham, Attorney at Law, Senior Edge Legal, Boise, Idaho
We have no money in this country. We all know that. How does this impact on you if you need to pay for residential long-term care in a nursing home, assisted living or in your own home?
There are two government programs that are available to seniors to help pay for care - Medicare and Medicaid.
Medicare is a national health insurance program for people 65 and older. Medicare will help pay for a maximum of 100 days of care. To access this benefit a few requirements must be met. First, a person must be admitted to a hospital and stay there at least three days. Then, when they are discharged to a rehabilitative facility, such as the Boise Elks, if that person is improving, Medicare will pay 100% for the first 20 days of care. If the person continues to improve, Medicare will pay part and the individual or their supplemental insurance will pay part of the expense for the next 80 days.
What are the holes in this "safety net"? First, the Medicare recipient must be ADMITTED to the hospital and not there for OBSERVATION. The difference is huge. If a person is not admitted, Medicare will not pay a dime toward the rehabilitative care. If Medicare does not pay, then in most cases the supplemental health insurance coverage will not pay for the care as well. This problem is happening here in Idaho as well as nationwide. The bills for the first 20 days that I've seen range from $6,000 to $30,000. This is a huge bill for most individuals and families to absorb.
The next hole in the Medicare safety net requires that the person be "Improving" during their rehabilitative care. My cousin, Kathie, at age 98, went to the hospital for three days. She was admitted. They discharged her back to her nursing home and I was called two days later saying Medicare would not pay for her care because she was not "improving." She was old and could not follow instructions. I was not surprised that she failed this second test.
Another "safety net" is the federal and state Medicaid program. Part of this program helps to pay the long-term residential care expenses for people 65 and older who meet a list of criteria. The cost for privately paying these bills ranges from $20 per hour for a bath aide to $8,000 per month for skilled nursing care. To access this benefit, it is necessary to complete an application form and submit it to the Idaho Department of Health and Welfare. The last two application forms we submitted on behalf of a married couple were approximately 400 pages each.
There were at least six more inches of back-up information. It took hours and hours to sort out and complete the application and deal with the follow-up issues. All of our Medicaid applications have been approved in the past 5 years, but remember I have a law office. The process is onerous and next to impossible for regular families in crisis to complete on their own. That is not fair, but it is the real world.
We have no money in this country to continue to provide the safety nets that have been available.
What can you do to protect yourself and your loved ones?
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Make certain you have up-to-date legal documents that include your Living Will, Health Power of Attorney and Financial Power of Attorney.
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Let the people you plan to rely upon in a crisis know you have nominated them to help.
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If you need help, seek it out. Your failure to make informed decisions may cost you and your family thousands of dollars and unnecessary worry.
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Contact your government representatives and let them know you want honest safety nets that really work, not ones that exist on paper and are not really accessible to regular people.
Friday, December 02, 2011 Yesterday, I Spent 3 Hours in the Emergency Room [E.R.] With a Friend. Who Will Go With You When You Need Help?
By: Susan M. Graham, Certified Elder Law Attorney, Senior Edge Legal, Boise, Idaho
Sam had a cough that started about 10 days ago, and he became so uncomfortable it was difficult to breathe. We ended up spending 7 hours in the doctor's office and E.R. until they decided what to do.
Did you know there are 4 drugs that cause two-thirds of the E.R. visits for people 65 and older?1 What are they?
1. Warfarin, also known as Coumadin, a blood thinner, accounts for 33% of emergency visits.
2. Insulin injections account for 14% of the visits.
3. Aspirin, clopidogrel and other anti-platelet drugs that help prevent blood clotting result in 13% of visits.
4. Lastly, diabetes drugs taken by mouth [oral hypoglycemic agents] accounts for 11% of the hospitalizations.
Why are these drugs a problem? One reason mentioned in the New York Times article is these drugs have a narrow window between an effective and a dangerous amount to be taken. Another problem is these drugs are not considered "high risk" drugs, so less attention is paid to the actual dosage.
What is the answer so you don't end up in the E.R. because of prescribed drugs? Be proactive. Talk to your doctor about all the medications you are taking (prescribed or not) and take the appropriate dosage.
What plans do you have if you are too ill to care for yourself?
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1The New York Times, Tuesday, November 29, 2011, p. D6, "4 Drugs Cause Most E.R. Visits in Elderly."
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