the 4664 Chronicle

They Call It The Blues

2011-12-29T15:46:00.000-08:00

Is it just the blues?

This time of year, “the holidays”, often find us a bit down instead of filled with joy. It’s quite common, in fact. With “the holidays” come reflections on past events, persons who’ve left us (whether passed, or moved away), things left undone or unsaid. These things can all bring us down and create “the blues”. We have the ability to brighten that hue, however.
Here are some tips:
*Visit with friends – whether by phone or in person, talk therapy is very beneficial.
*Take a walk – exercise increases our natural happy brain chemistry
*Sing - whether with the radio, in a choir, or just humming to yourself. Music really does lighten a mood.
*Look through old cards and letters – keeping positive thoughts and good memories in mind
*How about a Make-over – Get your hair done. Or have a pedicure or manicure (or both). Many Salons are running specials this time of year.
*Be sure to eat right – too much sugar and or alcohol can really mess with your blood sugars which can affect your energy levels and your mood.
*Take a Nap – Fatigue and Stress can really bring you down
*Learn to say NO – don’t over do your commitments
*Do something FUN – go to a movie or a crafts show

If your “blue” mood lasts for more than a few days or you have thoughts of suicide, please seek the assistance of a professional.
800-273-8255 or HELP (Home-based Effective Living Professionals - San Diego) 858.481.8827.

Is Assisted Living in the Baby-boomer's future?

2011-08-17T09:43:00.000-07:00

I had a very interesting conversation yesterday with an independent researcher for a company that is looking to enter the Assisted Living Industry. The reasons this was so interesting is that they are really looking outside the ALF box. Here are some of my thoughts on the subject. I hope you will comment with yours after reading this.
***************
The senior of tomorrow is NOT anything like the senior of today. As I told this woman, "'Bingo' just isn't gonna cut it".

First, and foremost, we are intrinsically different from our elders. We lived through the 60's. We think differently, want different things, do different things. We hike, bike, climb, run and surf. We play as hard as we work. We use our technology consistently and many of us require it for quality of life. We research our own medical needs. We look to Eastern and Alternative therapies, in most cases, before considering, or sometimes even asking, our own Physician's opinion. Some of us believe that Marijuana is a good thing and should be used for medicinal purposes, if not taxed for sale. For some they'd rather smoke than drink alcohol. We don't go to "cocktail" and "diner" parties, per se, we Network and Barbecue, tale gate and dine alfresco. Even our idea of church has changed from small and intimate to humongous and lively.

So, the question is: What will Assisted Living of tomorrow look like?
Will it even be needed? Will it be wanted? For some, it might be a necessity.

That being said: I believe that, if affordable, most of us will want to stay at home. Even more so than our predecessors. So, is congregate care what we'd prefer? A Walton's Mountain type of situation where family all live in compounds, if not large homes, to help care for each other? That's one thought. Some of the "old" ways are still considered "good" ways. If I could just get my family to move here to the West Coast, where I call home these days, that could work for us. Maybe.

The Beacon Hill Village project is one idea that's catching on. To quote their website: "a membership organization in the heart of Boston, was founded in 2001 by a group of long-time Beacon Hill residents as an alternative to moving from their houses to retirement or assisted living communities. *** By organizing and delivering programs and services, Beacon Hill Village allows a growing and diverse group of Boston residents to lead safe, healthy, and productive lives in their own homes as they age. *** Members are 50 years or older, single and married, and residents of Beacon Hill, Back Bay, West End, South End, North End, Charlestown, and the Waterfront. *** From groceries to Tai Chi to cultural and social activities to home care, Beacon Hill Village members get what they need to enjoy their lives…and peace of mind." *** http://www.beaconhillvillage.org/

But is that enough?

One local organization, a non-profit, has re-branded their group to thebegroup.org in hopes of keeping up with the changes we'll require. Quoting their site: "be yourself. *** Meet someone. Create something. Get fit. Stay relaxed. Learn how. Wonder why. Have an adventure. Make a difference. *** This is what defines be.group and our communities: Simply being yourself. Starting now."

I like the way both of these organizations think. They are heading in the right direction. What are your thoughts on this subject? What would make the perfect scenario for you?

A Caregiver's Guide to Medication Managment

2011-06-28T13:56:00.000-07:00

Note: I borrowed this from Elizabeth Blane's Newsletter this month as I find it to be very valuable information worthy of sharing.

A Caregiver's Guide to Medication Management

As your loved one ages, he or she may require medication for health conditions. He or she may also take over-the-counter pills, vitamins, herbs, and dietary supplements. While each medication may help manage symptoms, be sure that the prescribing physician and pharmacist are aware of all medications your loved one is taking. Short-term memory loss, which is common in older individuals, can increase the risk of harm for your loved one. This is why caregivers often manage medication for their loved one.

Consider the following tips to manage medication properly:

* Make a list of your loved one’s prescribed medications, over-the-counter medications, vitamins, supplements, and herbs. Also list the dosage, frequency, and name and number of the prescribing physician. Keep one copy in your wallet, and another copy in your loved one’s wallet. Post a third copy on the refrigerator in your loved one’s home so emergency personnel can find the list quickly in an emergency. Be sure to bring this list to every doctor’s appointment.
* Obtain all medications from the same pharmacy. This will allow the pharmacist to detect potential problems and recommend over-the-counter medications that can be taken safely.
* Be aware of potential drug interactions. A drug interaction is a change in the way a drug works or its efficacy due to the effects of another drug or substance. Other medications, herbal supplements, alcohol, and some foods can interact with prescription medications. Grapefruit juice, for example, can affect more than 50 prescription and over-the-counter drugs.
* Take each medicine as prescribed and do not share it with anyone.
* If there are instructions for tapering off a medication, be sure to follow these exactly.
* Pay attention to the color and shape of all pills. If they look different when refilled, ask the pharmacist to ensure you have the right medicine.
* Store medication in a cool, dry location.
* Use caution when adding over-the-counter medications. Just because over-the-counter medication is available without a prescription doesn’t mean it’s safe for everyone. Medications used to treat coughs and colds, pain, fever, allergies, heartburn, and insomnia are powerful drugs that can cause health risks when misused.

As your loved one ages, certain medications may alleviate symptoms and improve quality of life. Besides the importance of medication management, be sure to talk to your loved one about a long term care plan, which may include long term care insurance. Having a plan for long term care may help increase options for future care, while also preserving assets. Remember, the best time to plan for long term care is before an illness or injury. Early planning will allow time to research your options and seek advice, as needed.

[E. Blane Genworth Life Insurance Company Sun Coast
Long Term Care Insurance Agent CA-0G62871
13223-1 Black Mountain Rd., # 142
San Diego, California 92129
Business 2: 858 353 1523
Email: eblane@genworthltc.com
Website: genworth.com/elizabethblane]

http://www.senioroptionstoday.com
http://www.starfishresources.net

Police warn of roofing inspector scam

2011-02-25T18:57:00.000-08:00

I was asked to pass this along so others won't be scammed:

By Pauline Repard UNION-TRIBUNE

Wednesday, February 23, 2011 at 3:50 p.m.

SAN DIEGO — San Diego’s heavy weekend rains brought out a pair of male and female scam artists who targeted older homeowners by pretending to be roofing inspectors Monday, authorities said Wednesday.

The scammers stole cash from two homes in Del Cerro and the College Area. The San Diego police elder abuse unit is investigating.

The first incident was reported about 12:30 p.m. at a home on 69th Street near Saranac Street in the College Area. A man and woman who said they were roofing inspectors persuaded the homeowner to let them inside. One of the two distracted the owner while the other looked for cash, authorities said.

The same thing happened three hours later at a condominium on Adobe Falls Road east of Waring Road in Del Cerro.

San Diego County Crime Stoppers is offering a reward of up to $1,000 for information leading to the arrest of the man and woman, both described as “fast-talking” Latino or Middle Easterners and in their late 30s.

The man was up to 6 feet tall, 200 pounds, of muscular build, with medium-dark skin and collar-length, thick, straight, black hair. He wore a dark shirt and casual brown slacks.

The woman was about 5 feet 5 inches tall, 180 pounds, with brown, shoulder-length hair. She also wore brown slacks, police said.

Police asked anyone with information about the scam artists, or who also has been victimized, to call the elder abuse unit at (619) 446-1070 or Crime Stoppers at (888) 580-8477.

Denise G. Nelesen, LCSW
Communications Manager
Aging & Independence Services
County of San Diego
(858) 505-6474
denise.nelesen@sdcounty.ca.gov

http://www.starfishresources.net

2011 - a New Year! Looking back while looking ahead.

2011-01-04T11:09:00.000-08:00

It's hard to believe how quickly the year 2010 passed by - I for one am glad it's over.

And what a year it was! With thanks to the LATimes (and without naming too many names), we'll take a look at some of the issues we dealt with.

Weather: seems to have been the year of the Earthquake. However, snow and volcanoes, hurricanes and tsunamis' had their share of the spotlight.

Sports: The Saints, Giants, Lakers, and Blackhawks all had Super years. Not to mention 37 medals at the Olympics and making it to the finals in world soccer.

The BP and Haiti disasters speak for themselves.

Politics: Ethics questioned, marital break-ups, party upsets, the Financial and Healthcare "reforms" signed, and the "Lame Duck" session ending (phew).
A President and Senator died in plane crashes.
A new Prime Minister took the helm.

Celebrities didn't escape: Tiger, Lyndsay, Conan and Mel seemingly in constant view. And what of Oprah and her new network? Simon and Paula had their share of press, too.

We had leaks of the Wiki kind; Spies arrested; Generals Resigned; the
TX IRS fell under attack as did the AZ immigration law.
There were Barefooted Bandits and Geezer Bank Robbers.
I-Pads were introduced as Toyota seemed to fall apart (or at least broke down a lot). The TSA began full body scans (is this illegal search and seizure? a violation of personal rights?) and a face was transplanted (talk about Identity crisis). We even saw Atom Smashers recreate the Big Bang Theory. (are they playing GOD? or being great scientists?)

We question:
If N Korea is really changing power and will they clash with the South?
Do we want forgiveness in a Mosque near ground Zero or will we remain in fear?
Do you really want to ask and tell? Does it matter?
Can you trust eggs? pharmaceuticals? produce?
Are we really "Lost"? Guess we'll never know, now.

You couldn't even escape on a cruise without fires, engines failing and rogue waves upsetting things. And all the while Helen Thomas retired and Betty White soared to new fame (3 cheers for them both).

I repeat: I am glad it's over.

As the new year begins, we'll see 10,000 Baby-boomers (those born between 1946 and 1964 - thus the title for my blog in general "4664") turn 65 each day. We know that this will bring much change in the way seniors are perceived and the services that will be received. The 4664's see and do things differently. They expect different things in and from life. There's much chatter among my colleagues about the cruise ship method of retirement (that will be a blog for another day). The education and technology they bring with them will truly create an evolution for service providers.

In numerology and according to Numerology.com ..."We are now entering the fourth year of (a) nine-year cycle, and 2011 is dominated by the disciplined and controlled 4 -- a positive energy, if it wasn't for its lack of vision and flexibility. While discipline and control may sound positive in many ways, the way it plays out in 2011 is not quite as wonderful as it sounds, as it expresses itself in a global narrowing of vision that lessens our ability to plan for the future or to properly understand the impact of our choices and decisions. Also influential in the year 2011 are the 1 and the 0, creating obstacles and confronting us with some of our more taxing shortcomings."

I, as a younger member of the 4664 generation, promise to be a better caretaker to me. Making the usual resolutions with vim and vigor - Loose weight, exercise more, read enjoyable, instead of required, things more often and take that much needed vacation - perhaps even a cruise. As for my career/business... only God himself knows for sure where that will end, begin, or turn. However, with new goals set and new strategies in place there's hope for sustainability and a comfortable living.

There are quite a lot of negative predictions floating around out there, but I just have a feeling that things are going to be OK. As I look ahead in 2011 I see much that can begin anew, be improved upon and is near discovery. We also look ahead to a prince and his princess marrying. I need to remind myself to stay flexible, be open minded, and keep forward thinking. And hope that with this 2011 will be a better year for us all in-spite of our obstacles and shortcomings.

Happy New Year,
Cheers and Blessings.
Nancy

*I'd love to hear comments of your plans for the New Year*

http://www.starfishresources.net
http://www.senioroptionstoday.com

Ten Communication Tips for dealing wtih the Alzheimer's patient

2010-11-18T15:08:00.000-08:00

Ten ways to Effectively Communicate with Alzheimer's Patients

1) Speak to the individual in a clear, warm and pleasant manner
2) The tone in your voice may have more impact than your message when communicating with someone with Alzheimer's Disease. Lower the pitch, a lowered pitch is more comforting and less threatening.
3) Speak slowly and avoid long complex sentences.
4) Deliver only one instruction at a time. Wait until the first instruction is processed before delivering the next. A single task may need to be broken down into several steps.
5) Do not talk about he person in the presence of others as if they were not there. A person with Alzheimer's Disease many times understands and can be humiliated or embarrassed.
6) Lower your body to their level and look directly at the person when communicating. You may be able to read their eyes for signs of frustration, distress or anger.
7) Make use of comforting gestures: touching a hand or back, pointing to an object or handing an object to the person.
8) show the Alzheimer's patient a pleasant smile and show affection where appropriate.
9) Respond to the feeling content of the message from the Alzheimer's patient. Recognizing the resident's feeling and offering reassurance, even if you can't fix the problem, provides comfort.
10) Always treat the person with dignity and respect. Do not call older adults "Honey", "Pops", "Sweetie", etc. Ask them what they prefer to be called and follow their preference.

www.starfishresources.net
www.senioroptionstoday.com

A new theory on Alzheimer's Disease - Oligomers: Enemy Number One

2010-09-09T13:13:00.000-07:00

September 2010's AARP Magazine had a very interesting article titled "Alzheimer's A New Theory" by Elizabeth Agnvall.
http://pubs.aarp.org/aarpbulletin/201009_NJ?pg=10#pg10

I admit that I don't understand all of the thought processes behind the medications that are prescribed for some of these types of diseases. And, I am not a doctor. The oath taken by doctors is to "do no harm", so I don't wish to jump the gun, or be too judgmental. I tend to be anti-pharmaceutical overall, so forgive me if I paint this at all harshly against our "modern" medical practitioners. They do the best they can with the information they have - until that changes.

Having worked as long as I have in the senior care industry I've seen all too many families and patients devastated by Alzheimer's disease, praying for an answer, spending a small fortune on the "magic" pills that they were told might make a difference. It's hard not to be passionate about the subject. And now, this article brings to light the fact that there is a very strong probability that we've been looking at the wrong thing as part of the cause.

The following is what is reported in this article: (The link to the actual article is above if you wish to read it.)

Recently published studies conducted on mice and rats have shown that the sticky plaques that surround the brain cells of those with Alzheimer's may be the body's way of protecting itself against toxic clumps of protein. Clumps of amyloid beta protein called oligomers now seem to be the main source of the attacks on the brain. To quote the article, and Sam Gandy, MD., with the Alzheimer's Disease Research Center at Mount Sinai School of Medicine in NY,: "Alzheimer's seems to be caused by the buildup in the brain of clumps of material that are formed by the breakdown of proteins". He now thinks that these oligomers are the cause of the loss of memory and not the plaques previously believed to be a component. The plaques are not where scientists are now focusing in studying Alzheimer's and how to treat it.

To explain: Amyloid proteins are broken down naturally throughout our lives. As the body ages, too many of these protein clumps create a damaging buildup in the brain. (I guess it's similar to cholesterol in your arteries. Cholesterol is necessary for our bodies and brains to function. But, too much of anything...) These clumps may also trigger the creation of the tau protein tangles that further gum up the signaling systems of the brain.

The formation of the plaques around these clumps and tangles may be the brains way of trying to remove the oligomers - much like a clam forms a pearl around a grain of sand. The article continues stating: Rudolph Tanzi, Director of the Genetics and Aging Research Unit at Mass General, said that he thinks the protein plays an important role in the brain, so they don't want to eliminate it all together. (again, it seems similar to cholesterol.) However, too much plaque could also interfere with brain function although "researchers found that some people who never had dementia had brains inundated with plaques. It could be that their brains were exceptionally good at converting the offending "sand" into "pearls"".

"Several drugs are in the early stages of development but it will be at least a year before we can expect to see results."

It will be interesting to see where this new research will take us with this disease. Could a cure be near?? I certainly hope so. In the meantime the best advise given is to eat a balanced diet, stay hydrated, exercise both your body and your mind, learn how to cope with, or reduce, stress, and keep inflammation under control.

{If you do not have an understanding of Alzheimer's Disease, Wikipedia has a very detailed explanation at http://en.wikipedia.org/wiki/Alzheimer%27s_disease }

Hiring Private Duty Care is more expensive than you might think

2010-08-17T14:01:00.000-07:00

I have often warned my clients and their families about the pitfalls of hiring
private duty caregivers. In fact, I even discuss it in my book, "A Pathway To
Senior Care in San Diego". Today, I heard something so very upsetting that I had to write about it for all my readers to see.

There is currently a lawsuit being prepared in San Diego that will probably be won for over $80,000. I cannot give you specifics as it's still being decided, but here is the gist of it.

Caregiver, Suzy Q., was hired by Mrs. Naive Person to take care of her ailing husband. Suzy Q worked for them for a few months as an "under ground" employee. Mrs. Naive Person paid her an hourly wage, "under the table", and nothing more. When the ailing husband passed away, Suzy Q decided that she hadn't been treated as a proper "employee". She'd not be allowed to file for Unemployment, she wasn't paid any benefits, she wasn't covered for workman's comp. or social security, or taxes, and she wasn't given her proper breaks per the EDD Labor Laws. So, Suzy Q has called a lawyer who has taken on the case and is prosecuting Mrs., now widowed, Naive Person for $80,000.!!!

Now, there are two ways of looking at this and I have trouble deciding which banner to uphold. My ethical side wants to go with the legality of the situation while my heart wants me to defend Mrs. Naive Person. Ethics will always win in this battle, however.....

Let's take a look at this more closely: poor widowed Naive Person will now be liable for $80,000, or more! Simply, one might say, because she was trying to save a few dollars on the front side of this care giving situation. When hiring someone for long durations at multiple hours the difference between $12/hr and $20/hr may seem huge. Let's do the math. Say you need someone 40 hours a week, that seems like a "savings" of $320 per week.

I feel very badly for Mrs. Naive Person. With a final bill of $80,000 that is 250 weeks, more than six months, worth of "savings". Where is she going to come up with $80,000+? I doubt highly that she thought to put this money aside, just in case. So, will it come from her husband's Life Insurance? Their savings? Her home? What will this leave for her to live on? How will she be able to care for herself? I can't even imagine what's going through her mind. How devastated she must feel. First loosing your spouse and now all of this!?!?!

We need to look at the legal and ethical sides of this issue.
Here is what the IRS.com website has to say about it: (When referring to "business owner" here that can include a private person hiring an individual.)

"It is critical that you, the business owner, correctly determine whether the individuals providing services are employees or independent contractors. Generally, you must withhold income taxes, withhold and pay Social Security and Medicare taxes, and pay unemployment tax on wages paid to an employee. You do not generally have to withhold or pay any taxes on payments to independent contractors. If you are an independent contractor and hire or subcontract work to others, you will want to review the information in this section to determine whether individuals you hire are independent contractors (subcontractors) or employees."

"Common Law Rules:

Facts that provide evidence of the degree of control and independence fall into three categories:

1. Behavioral: Does the company control or have the right to control what the worker does and how the worker does his or her job?
2. Financial: Are the business aspects of the worker’s job controlled by the payer? (these include things like how worker is paid, whether expenses are reimbursed, who provides tools/supplies, etc.)
3. Type of Relationship: Are there written contracts or employee type benefits (i.e. pension plan, insurance, vacation pay, etc.)? Will the relationship continue and is the work performed a key aspect of the business?

Businesses must weigh all these factors when determining whether a worker is an employee or independent contractor. Some factors may indicate that the worker is an employee, while other factors indicate that the worker is an independent contractor. There is no “magic” or set number of factors that “makes” the worker an employee or an independent contractor, and no one factor stands alone in making this determination. Also, factors which are relevant in one situation may not be relevant in another.

The keys are to look at the entire relationship, consider the degree or extent of the right to direct and control, and finally, to document each of the factors used in coming up with the determination.

Consequences of Treating an Employee as an Independent Contractor:
If you classify an employee as an independent contractor and you have no reasonable basis for doing so, you may be held liable for employment taxes for that worker (the relief provisions, discussed below, will not apply). See Internal Revenue Code section 3509 for more information."
Even if you file a 1099 for their taxes this does not mean that they are absolutely an "independent contractor". You must go by the definitions listed above.

Additionally, as an "Employer" there are requirements mandated by The Employment Development Department of CA. Minimum wage; Overtime pay; proper breaks and sleep periods; posted rights and notifications in the workplace; and more.
(see http://www.edd.ca.gov/ for more information)

There is a third "side" to this situation, as well. CLIENT SAFETY!!! What if Suzy Q saw fit to rob Mr. Ailing Husband and Mrs. Naive Person by, say, using their credit cards without permission. Or, coercing them into signing checks to her. Or, taking their belongings. Worse can happen to the innocent and unsuspecting. There's physical abuse, verbal abuse, neglect and more. How can anyone "hiring" their own caregivers determine if these persons are reputable? Safe? Sound of mind? A person having suffered an abuse of these natures generally has a shorter life expectancy due to the physiological, physical and emotional stress that abuse brings.

So, "what is the answer?", you may be asking. HIRE A Certified Home Care Agency!
Yes, you'll pay a few more dollars on the front side but all of these worries will be covered. The caregiver will be supervised, paid, insured, cleared through a back ground check, etc. When looking for a care giving agency, please be sure that they are certified through reputable sources such as CAHSAH (.org), ABHC (http://abhc.outsourcesmb.com/), or other such accreditation organizations.
Or call Starfish Resources to help you find a certified agency that works in your area and within your budget and care needs. http://www.starfishresources.net

Recognizing The Symptoms of Dementia

2010-08-12T12:43:00.000-07:00

Recognizing Symptoms of Dementia

The Brown family reunion has always been an event everyone looks forward to. Family visits, games, stories and everyone’s favorite foods are always on the agenda. On the top of the menu is Grandmas Lemon Coconut Cake. Grandma always makes the traditional cake from her old family recipe. This year, however, the cake tasted a little on the salty side, perhaps a half cup full of salty.

Though the family was disappointed over the cake, of more concern was Grandma’s confusion with the recipe and her similar confusion about the loved ones around her. Could something be wrong with grandma's mental state?

One might say that for an elder person a little forgetfulness or confusion is normal, but when do you know if there is a serious problem, such as dementia?

An online article from FamilyDoctor.org outlines some common symptoms in recognizing dementia.

"Dementia causes many problems for the person who has it and for the person's family. Many of the problems are caused by memory loss. Some common symptoms of dementia are listed below. Not everyone who has dementia will experience all of these symptoms.

* Recent memory loss. All of us forget things for a while and then remember them later. People who have dementia often forget things, but they never remember them. They might ask you the same question over and over, each time forgetting that you've already given them the answer. They won't even remember that they already asked the question.
* Difficulty performing familiar tasks. People who have dementia might cook a meal but forget to serve it. They might even forget that they cooked it.
Problems with language. People who have dementia may forget simple words or use the wrong words. This makes it hard to understand what they want.
* Time and place disorientation. People who have dementia may get lost on their own street. They may forget how they got to a certain place and how to get back home.
Poor judgment. Even a person who doesn't have dementia might get distracted. But people who have dementia can forget simple things, like forgetting to put on a coat before going out in cold weather.
* Problems with abstract thinking. Anybody might have trouble balancing a checkbook, but people who have dementia may forget what the numbers are and what has to be done with them.
* Misplacing things. People who have dementia may put things in the wrong places. They might put an iron in the freezer or a wristwatch in the sugar bowl. Then they can't find these things later.
* Changes in mood. Everyone is moody at times, but people who have dementia may have fast mood swings, going from calm to tears to anger in a few minutes.
Personality changes. People who have dementia may have drastic changes in personality. They might become irritable, suspicious or fearful.
* Loss of initiative. People who have dementia may become passive. They might not want to go places or see other people."

Dementia is caused by change or destruction of brain cells. Often this change is a result of small strokes or blockage of blood cells, severe hypothyroidism or Alzheimer’s disease. There is a continuous decline in ability to perform normal daily activities. Personal care including dressing, bathing, preparing meals and even eating a meal eventually becomes impossible.

What can family members do if they suspect dementia? An appointment with the doctor or geriatric clinic is the first step to take. Depending on the cause and severity of the problem there are some medications that may help slow the process. Your doctor may recommend a care facility that specializes in dementia and Alzheimer’s. These facilities offer a variety of care options from day care with stimulating activities to part or full-time live-in options. Sometimes if patients tend to wander off, a locked facility is needed.

In the beginning family members find part time caregivers for their loved one. At first, loved ones need only a little help with remembering to do daily activities or prepare meals. As dementia progresses, caregiving demands often progress to 24 hour care. Night and day become confused and normal routines of sleeping, eating and functioning become more difficult for the patient. The demented person feels frustrated and may lash out in anger or fear. It is not uncommon for a child or spouse giving the care to quickly become overwhelmed and discouraged.

Family gatherings provide an excellent opportunity to discuss caregiving plans and whole family support. It is most helpful if everyone in the family is united in supporting a family caregiver in some meaningful way.

"The first step to holding a family meeting, and perhaps the most difficult one, is to get all interested persons together in one place at one time. If it's a family gathering, perhaps a birthday, an anniversary or another special event could be used as a way to get all to meet. Or maybe even a special dinner might be an incentive.

The end of the meeting should consist of asking everyone present to make his or her commitment to support the plan. This might just simply be moral support and agreement to abide by the provisions or it is hoped that those attending will volunteer to do something constructive. This might mean commitments to providing care, transportation, financial support, making legal arrangements or some other tangible support." The Four Steps of Long Term Care Planning

Professional home care services are an option to help families in the home. These providers are trained and skilled to help with dementia patients. Don’t forget care facilities as well. It may be the best loving care a family member can give is to place their loved one in a facility where that person is safely monitored and cared for.

Starfish Resources is a member of The National Care Planning Council which supports caregiving services throughout the country.
www.longtermcarelink.net

Communicating Between the Gaps

2010-07-13T15:47:00.000-07:00

Did you know that today we have SIX generations all living at once?
Six!
Can you imagine the differences between them?

The oldest American Citizen is 114. She was born in
1896 and is part of what was known as The “Silent Generation”.

That generation was just that, too - "Silent".
They did not discuss family problems, mental illness or indiscretions
such as infidelity or out of wedlock pregnancies.
You just did not "air the family's dirty laundry".

Those living through WWII were members of the “Greatest Generation”.
They were Great in deed!! Yet, they still didn't talk about it much.
It was their duty. Everyone pitched in, did what was required and
that was that. No bragging! Just a bit of gossip from time to time
over the back fence. My step father served at Iwo - never could,
or would, discuss it. I'm sure many of those memories were horrible
and in some way, perhaps, preferred to be forgotten. Although I'm
sure he remembered every day and every fallen hero - he just didn't
want to talk about it.

Then came the Baby Boom with their sexual revolution and their
technologies. Haight Ashbury is a destination point for many
that didn't get to experience it first hand in the 60s. And who hasn't
heard of Woodstock? (Although many who were there cannot really remember it.)

The Millenniums brought miniaturization to those, ahem, "older"
technologies along with Disco and Break Dancing and so much more.

The Gen-X'ers keep moving forward with smaller, fancier more complicated
and better everything. I sit in awe of the abilities of some of these kids.

The current generation has yet to be named. btw (oh, that's text
[short]hand for "by the way")
It is estimated that many children born today are "expected" to see more
than 100 years of life. The Aging Research Center at the University of
S. Denmark reported that Japanese children born in 2007 will likely
see 107 years. Children in the UK born that same year would probably see
103 years. Given proper diet, exercise and good overall health care,
we can expect the same for American children.

Given all the years and events that have passed, our seniors have
seen a lot!! Here's a few examples of what all that 114 year old,
previously mentioned, has witnessed in her younger days.

•Women’s rights -1920
•The Noble Experiment –1920-1933 –AKA Prohibition
•The Great Depression –1929-1942
Where unemployment was at a peak of 27.6% in 1940
The Dow plunged a total of 89%
Savings lost due to bank failures
25% of the population out of work
the phrase “waste not, want not”, was mantra.
•Our Government “Saved the Day”: Congress passed the Social Security Act
in 1935 providing two social insurance programs plus grants
–a Federal system of old-age benefits for retired workers
–a Federal-State system of unemployment insurance
–Federal grants to the States for additional old-age assistance,
aid to the blind, and aid to dependent children
–The passage of the SSA and the Wagner Act signaled the beginning
of the concept of compensation as more than just traditional
straight-time pay for time worked
–Union membership increased from 917 (6.5%) in 1900 to 3,337 (14.2%)
in 1935 and on to 15 million in 2009
–Compensation went beyond the traditional scope of collective bargaining
–wages, hours, working conditions and now retirement fund
•1929 saw the first telephone installed on the President’s desk
•1931 Star Spangled Banner becomes the National Anthem
•1930's Milk was 14 cents a quart and bread 9 cents a loaf
•Discrimination was common
•Life expectancy rose from 59 in 1930 to 77 in 2007
•Workforce changed from agricultural to industrial to high tech & computers
•Presidents came and went: some died in office, were impeached,
or even resigned
•Flights to space: both successful and tragic
•War in several lands, including our own: some won, some not

Let's compare these facts and views to today’s 45 year old.

–Born in the middle of the Vietnam War – which ended in 1975,
when they were 10.
•one could watch the broadcast on TV - every night
–The Beatles were new - Elvis was not
–they don’t remember life without:
•Color TV -introduced in 1967
•Computers
•Computer Games in the home
•Fuel Injection vehicles
•Calculators
•McDonald’s
•Ford Mustangs
•Portable/cell phones
-Professionals earned as much as $500 a week in ’65 but most earned
only $2 an hour.
–Equality for all is expected, even though it may not always be the reality.

I'm told that today's children spend 11.5 hours per day utilizing
technology. They don't write snail mail letters, they email or text.
They don't phone friends. They tweet or Face Book them. Face to face
conversations seem strained and uncomfortable. Instead of board games
they play video games - on their iPhones.
Nothing is sacred, secret or goes without discussion.
They discuss their dating, cheating and bathroom habits openly.
And for all to see! Utilizing Twitter and Face Book etc.
They have expectations of luxuries that they've not worked for.
Some would call it "entitlement".
That's all a far cry from the "Silent" and "Great" generation's behavior.
Now, I'm not knocking today's kids. My Grand-daughter is one of them.
It's just that they are so very different from previous generations.
Us "old folks" sometimes struggle just to keep up.

I, for one, am somewhat concerned for them, actually. What will they do if
something ever happens to the satellites or the main power systems???
Have you ever tried to buy something at McDonald's when there's a power outage?? They have to shut down as most of these kids can't do the math without the computers. How will they manage to communicate without texting, emailing or
tweeting?? How often do we see them texting another person while sitting in the
very same room???

Is it any wonder that we might be having trouble communicating with our seniors?
When communications break down don't we often see anger, frustration, resentment?

What ways do you think work best to help communicate within multiple
generations?? I am leaving this open for discussion.

Please leave your comments so that we might all learn from each other.

Will Assisted Living be your choice?

2010-06-27T12:33:00.000-07:00

a conversation about Assisted Living: It is much better than many believe.

As I sit in my small but comfortable home I look around at all my stuff and wonder about my senior years. This home is undoubtedly mine (well “ours”, my husband lives here, too). The décor is quite eclectic with flavors of New England (where we hail from), photos of family and friends and of the many trips we’ve taken. There are models of planes and boats which are my husband’s passions. Candles and plants live in every room. Our wine and cocktail glass collection from all of our trips is in the dining room buffet near our wine collection. And then, of course, there is my craft corner (occasionally used as the Dining Room) and our joint office area which occupies part of the Living Room. I know that when I’m a senior the odds are that one day I will have to leave my home in order to be cared for in some type of community or facility. My husband jokes that we’ll run away to the woods in our camper and “live on squirrel” meat. Thanks to long term care insurance, I don’t think it will be quite that drastic. But it’s good to have options.

I recently received an e-mail joke regarding a senior citizen moving to a facility. It goes something like this: A 90+ year old was moving to an assisted living community. He had lost his eyesight years ago and had recently lost his beloved wife. While sitting in the lobby of the community his daughter had picked out for him, he commented to a staff member who asked if he’d like to see his room, “I love it.” The staff member replied, “but you haven’t even seen it yet.” (a figure of speech, of course). The kindly gentleman retorted back that it didn’t matter if the curtains were lace or linen, or what color the quilt on the bed was. “I have already decided that I am going to love it here. When you get up in the morning you have a choice. You can decide if you will have a good day or a bad one. By deciding that I’m going to love it here I’m already better off.”
If only every senior felt this way.

I’ve lived in San Diego for 11 years now. Most of that time was spent working in assisted living communities. I’ve seen the small and the large, the poor, middle and the high end facilities. And I can tell you this, it’s not the décor that make the residents happy. It’s the staff, the attention that is paid to the resident’s particular needs and it’s also the residents themselves. I knew one lady who lived in a very pretty higher-end community who one day said to me that she “had been warehoused in a prison”. She was one of those residents that hardly ever left her room, kept her blinds closed much of the time (no matter how many times the staff would open them) and never appreciated all that her family did for her to make her stay as comfortable as they could. How I wished I’d had the magic words that would give her the attitude adjustment she needed. She was encouraged to come to the dining room for meals but refused. She was invited over and over to activities, but again she refused. She was a very intelligent lady who had the means to provide a private duty personal caregiver for herself. Unfortunately having that caregiver only encouraged her self isolation. If only the 90+ year old gentleman from the joke could have talked to her. Perhaps she would have changed her mind.

Wikipedia defines assisted living for us: “Assisted living as it exists today emerged in the 1990’s as an eldercare alternative on the continuum of care for people, normally seniors, who cannot live independently in a private residence, but who do not need the 24-hour medical care provided by a nursing home. Assisted living is a philosophy of care and services promoting independence and dignity.” All assisted livings and board and care homes in California are considered “Residential Care Facilities for the Elderly” and fall under the watchful eyes of Community Care Licensing which is a division of The Department of Social Services. http://www.ccld.ca.gov/ They are regulated by Title 22 which carefully outlines what can, shall and shall not be done in an RCFE. Title 22 is based on the state’s Health and Safety Laws. In recent years we’ve seen quite the acuity creep into assisted living. Each facility owner has the right to choose the type of care they will provide as long as it falls within the CCLD guidelines. Some are now more of a medical model than the social one it was originally designed for. I know that as we baby-boomers age assisted living, as is known today, will change even more. Having the right administrator at the helm of an RCFE is key.

Being an administrator for assisted living all of these years I know what to look for and how to choose the good facilities from the bad. No thing is perfect, but some communities are better at tending to issues than others. I visited Seasons at Villa Bonita last year (it's now under another name). I was impressed. The residents were here and there, fairly active for only 9 A.M. Although not a new property, the community was clean, free of smells and the staff all seemed to be content as they moved from chore to chore. The gardens were well maintained and attractive. I toured the entire property and talked to the Administrator, Joshua Bullen, about his values, policies and passion for seniors.

“Our product is people” was the first statement Josh made. This struck a good cord with me. He too has worked with both the low income and the affluent person. He has worked in other communities starting in a sales position to learn the ropes and worked his way up to administrator. That’s my kind of administrator. He has a passion for seniors that has served him well. He has taught others in the industry who work in sales. His philosophy is that “we’re not selling anything at all. We are consulting with these families. And if we happen to be the right fit then it’s not even a sale. The family at the end of your consultation will be asking you ‘how can we move into your community’. It’s easy to say but it’s a different thing to learn it and believe it. When families find that you’re not trying to offer them the next greatest deal and find a way to get them in by Friday, they are so happy and willing to work with you because they understand that you are being authentic. Families need people who are listening to their needs; looking at their financial situation; knowing the resources that are available to them; referring to people that I believe to be ethical and sincere in their business practices.” Josh and his staff have, in a previous community, earned a Quality Assurance Award for care and medication management. He knew of Villa Bonita and its history and was very excited about the prospects of working there when he was approached. He has since moved to Oakdale Heights in La Mesa.

Josh believes that the most important thing is that “when we hire” especially for care, dining and housekeeping positions, “I am not as interested in experience as I am in a passion to serve the people we work with. We can train people who are passionate about caring for seniors to do the work. As opposed to the person who says ‘oh, I’ve done this five times, I’ve been in this and that building’. But, do you care about the people you are serving? And so we hire for compassion, we hire for someone who’ll walk to work for seniors. And then we train that person. Are we right 100% of the time, of course not, but, we are getting better and better at hiring the person that’s passionate about serving our seniors.” He also believes in doing the right things for his employees insuring that they are happy, confident and secure. He even plays chef (hat and all) at the barbeque for his staff at occasional events just for them. Josh says that what builds a successful staff is letting them know that you are just like them, showing confidence in them, and also identifying talents and then empowering them. He loves to see his staff members promote upward into leadership positions. “Empowering people is huge!” One person cannot run these buildings. It takes a lot of people working together.

“The other thing that I am fanatical about is the medication program. We have a laser-like focus on training and whom we hire for our medication department. That is the most important thing that we do in our building as far as technical day to day service goes. Of course the most important thing is the overall care of our residents, but within that is the medication management. We feel that by putting in a culture of caring, and looking at the medication department and surrounding our seniors with people who want to be there, who want to care for them, those are the best things we can do to build this community to a premier property.” It’s all about the people who are in the building.

Both Villa Bonita and Oakdale Heights have a courtyard garden with fountain, large common rooms, over 100 apartments which include studios and one bedroom apartments. Villa Bonita had recently added the possibility of 2 persons sharing a one bedroom apartment for a more economical option. Josh states that these features are “a nice advantage to have”. But Josh then reiterates that the biggest thing that they look at is “the medication program, the care, the people that we hire – after all this is the most important thing that we do.” Villa Bonita is run by a small privately owned company and their rates at that time started at $2500 for a private studio with kitchenette. Although census/occupancy is important Josh feels that it’s more important for the families to make the right choice for the senior. “There are times when a resident needs a higher level of care and it really is the right thing for them to go into skilled nursing instead of being in or staying at assisted living.” The right thing is always the right thing. “At the end of the day the only thing that we have are the decisions that we’ve made and win or loose if we’ve made the right decision for these families than we know we did the right thing. That is much more important. Every day we need to re-focus ourselves and ask ‘did we do the right thing for this family’. I think we do.” Josh says his favorite word is “authenticity” and I believe him. He would love to find like minded administrators throughout the county to combine resources and be of even more value to the families they consult with.

In addition to the care the staff of Villa Bonita, Oakdale Heights, and other area assited livings, provides, they work with physicians that make visits to the residents on site along with other professional services that can make house calls. They also work with hospice when it is needed.

(I originally wrote this piece for a magazine about a year ago. Josh now works, interestingly enough, with a former colleague of mine as his marketing person. There really is something to be said for the 6 degrees.)

For more information on area Asssited Living communities contact
Starfish Resources*
760 522 6478
http://starfishresources.net
starfishresources@gmail.com

First Berries Pudding to Celebrate Solstice

2010-06-17T08:39:00.000-07:00

This is an easy, fun and delightful recipe that all can make whether your 6 or 106.

FIRST BERRIES PUDDING

2 Cups seasonal berries (strawberries, raspberries, blackberries etc.)
1 Cup brown sugar
9 Slices bread with crust removed (if a youngster is doing this they may need help removing the crusts)
2 bowls

Set aside 1/2 cup of the nicest looking berries.
To the rest, add brown sugar and crush together. Leave to sit for 30 minutes

Meanwhile take a nice glass bowl and arrange the 1/2 cup reserved berries in the bottom. Add a layer of bread.
Layer with 1/2 the crushed berry mix. Cover with a layer of bread. repeat process layer by layer ending with bread.

Cover with wax paper.
Place a small plate on top, then a small bowl filled with something heavy on top of that. Leave this for at least 6 hours in your fridge.

To serve, remove the plate and wax paper. Hold a large plate onto the bowl and flit it over. With luck you shoudl have a nice dome-shaped pudding. It will taste good regardless of the form. Serve with whipped cream or vanilla ice cream and celebrate.

(this recipe is from Nancy V Bennett and Llewellyn's datebook 2010)

I made this last weekend. I used cinnamon swirl bread. It was fabulous but a bit sweet. If you wish to use this combination, I would cut the brown sugar in half.

Enjoy.

The Financial Health of Aging Seniors

2010-05-13T14:00:00.000-07:00

With our current economic challenges, those of us looking forward to retirement need to be well-informed about our financial needs in coming years. And not only pre-retirees, but individuals already in retirement need to be wise to the changing economic environment. The good news is there are trained professionals who keep abreast of changes in the current economy, changes in laws and changes in government programs for the elderly. Professionals in this field are equipped to handle everything from help with retirement savings accounts, investment advice, guidance on government programs, estate planning or even new funding options such as reverse mortgages. A little planning prior to retirement will allow you to maintain your current lifestyle; whereas, a lack of planning may require you to live on an extremely tight budget. For those already retired, taking time right now to deal with financial problems instead of waiting for a crisis to happen is well advised.

A large number of retired individuals feel that they have planned well for the future only to find that rising medical costs, damage done to investment portfolios (by the current economy) and many other factors have caused them to go into debt. According to an article in "USA Today" seniors are racking up debt like never before. Elderly individuals who are in debt live with a constant burden over their heads. Most of these people are on fixed incomes and have no way of paying off credit cards and home equity loans that continue to mount to cover household budget deficits. In order to meet ongoing payments, seniors often forego purchasing medications and skimp on food budgets. They live like hermits -- never going out and pinching every penny -- in order to pay their obligations.

Most of these people worked hard their entire lives and managed their debt. They never anticipated the rising costs of prescriptions, expensive medical care or depletion of savings by living too long. The good news is there is help for these individuals. Here are just a few examples of some relief options that could be available. There are many more besides these.

Reverse mortgages - A Home Equity Conversion Mortgages (HECMs), also known as a reverse mortgage, is a risk-free way of tapping into home equity without creating monthly payments and without requiring the money to be paid back during a person's lifetime. Instead of making payments the cash flow is reversed and the senior receives payments from the bank. Thus the title "reverse mortgage". For those seniors who are less fortunate financially but own a home, a reverse mortgage can allow them to remain in the home by creating extra income.

Life settlements -- A life settlement enables older individuals, businesses and other organizations to sell life insurance policies they currently own – but no longer want or need – for an amount greater than the cash surrender value. In some cases the value can be 2-3 times the cash surrender value. Even some term life insurance policies with a conversion option to permanent coverage can qualify for a life settlement.

Government Programs -- Some government programs such as food stamps provide temporary financial help for food. Other programs provide subsidized housing, help with medical expenses and provide tax credits. For veterans there is free health care, inexpensive prescriptions and disability income. Area agencies on aging offer individual counseling, legal help and advice with Medicare costs. (National Care Planning Council)

For some, living on a fixed income and dealing with debt can be an overwhelming burden. There are knowledgeable professionals and debt relief strategies that can assist in easing this burden. The National Care Planning Council keeps a list of financial advisers and attorneys who specialize in this area of planning at www.longtermcarelink.net.

Starfish Resources is a member of the National Care Planning Council who provided this article.

The owner of Starfish Resources, Nancy Coulter Beland, is an award winning author
puchase "A Pathway to Senior Care in San Diego" at www.starfishresources.net, Amazon.com or Barnes and Noble.com

Caregiver Assessement Tool

2010-04-21T14:03:00.000-07:00

Caregiver Self-Assessment Questionnaire
How Are You?

Caregivers are often so concerned with caring for their relative’s needs that they lose sight of their own well-being. Please take a moment to answer the following questions. Once you have answered, turn the page to do a self-evaluation.

Yes No

[ ] [ ] 1. Had trouble keeping my mind on what I was doing.

[ ] [ ] 2. Felt that I couldn’t leave my relative alone.

[ ] [ ] 3. Had difficulty making decisions.

[ ] [ ] 4. Felt completely overwhelmed.

[ ] [ ] 5. Felt useful and needed.

[ ] [ ] 6. Felt lonely.

[ ] [ ] 7. Been upset that my relative has changed so much from his/her former self.

[ ] [ ] 8. Felt a loss of privacy and/or personal time.

[ ] [ ] 9. Been edgy or irritable.

[ ] [ ] 10. Had sleep disturbed because of caring for my relative.

[ ] [ ] 11. Had a crying spell(s).

[ ] [ ] 12. Felt strained between work and family responsibilities.

[ ] [ ] 13. Had back pain.

[ ] [ ] 14. Felt ill (headaches, stomach problems or common cold).

[ ] [ ] 15. Been satisfied with the support my family has given me.

[ ] [ ] 16. Found my relative’s living situation to be inconvenient or a
barrier to care.

_________ 17. On a scale of 1 to 10, with 1 being “not stressful” to 10 being
“extremely stressful”, please rate your current level of stress.

_________ 18. On a scale of 1 to 10, with 1 being “very healthy” and 10 being “very
ill”, please rate your current health compared to what it was this
time last year.

Self Evaluation

To Determine the Score:

1. Reverse score questions 5 and 15. (for example, a “No” response should be
counted as “Yes” and a “Yes” response should be counted as “No”)

2. Total the number of “yes” responses.

To Interpret the Score:

Chances are that you are experiencing a high degree of distress:
• If you answered “yes” to either or both Questions 4 and 11; or
• If your total “yes” score = 10 or more; or
• If you score on Question 17 is 6 or higher; or
• If your score on Question 18 is 6 or higher.

Our thanks for this Self Assessment to:
American Medical Association Physicians
Dedicated to the health of America
515 North State Street, Chicago, Illinois, 60610
and to Caregiver Coalition of San Diego
www.sandiego.networkorcare.org/aging
800-510-2020

This assessment form provided to you today, courtesy of:

Nancy Beland, Owner 760-522-6478
starfishresources@gmail.com
www.starfishresources.net

Disaster/Emergency Preparedness

2010-04-11T14:59:00.000-07:00

With San Diego's recent shake up occurring as a result of a 7.2 Earthquake in Mexico Easter Sunday, being prepared has been the topic of the week. Being pro-active is the number one thing anyone can do to help themselves in case of a disaster. I've prepared this list for everyone and hope it's helpful.

First: know that we may be required to shelter in place for at least 3 days during a major emergency or disaster

2nd: local cell phone service may be interrupted so that emergency crews can utilize the signals. Therefore a common long distance contact for your family members should be planned and their information should be available to all members of your family.

3rd: because portable phones in the home will not work without electricity an "analog" phone would be most helpful to have. I keep one in the drawer to plug in when needed.

4) a kit should be put together containing the following items:
first aid
water (1-2 gallons per day per person and don't forget your pets)
food - easily prepared or canned stores (don't forget the can opener)
medical information - insurance numbers, doctors information, medication
list and advanced directives, etc.
spare eyeglasses, hearing aids etc.
flashlight with spare batteries
radio - either battery powered or crank type
trash bags
personal hygiene items
feminine supplies (which can be used as first aid tools if necessary)
sturdy shoes
rain gear (poncho or such)
space blanket
change of clothes for each person
toilet paper
utility knife
Fire extinguisher
Duct tape
matches in water proof container
Emergency flares
paper and pencil
map of your area to locate shelters
compass
spare cell phone battery
toothbrush and toothpaste
bleach
blankets
hat and work gloves
sunglasses
aspirin or ibuprofen (or both)
pet supplies - leash, veterinary information, recent shot records etc
small scissors
germicide
dust mask
whistle to signal for help if needed

5) if you have gas in your home attach a wrench for shut off to the valve outside your home (same for water)

6) if someone in the home is on oxygen, a back up power generator and gas for it

7) if you are home alone a local "buddy" that will help you if needed

8) local emergency contact information (i.e. red cross, Fema, Sheriff)

You may be asking where am I going to put all of this? A trash can with lid can work quite nicely. Use duct tape to secure the lid and remember to refresh your supplies and information every 6 months (or when necessary.) This can be stored in the garage, car port or driveway. Be sure it is not in the sun.

Tax Deductions for Assisted Living

2010-03-02T09:17:00.000-08:00

Assisted Living Services Are Tax-Deductible

Medical expenses can really add up. Did you know that there may be a way to write off those expenses at tax time?

Residents, family members, and others who pay for an individual’s care in an assisted living community can, in most cases, file the entire monthly cost of assisted living as a tax-deductible medical expense. Such information gives providers another tool regarding the affordability of assisted living when working with seniors and their family members.

Under HIPAA, expenses can be tax-deductible if such services are provided pursuant to a plan of care prescribed by a licensed health-care practitioner, and the personal care services are required by a person who:
• is unable to perform at least two activities of daily living, or
• has severe cognitive impairment and requires supervision to protect self and others from health and safety threats.
Under IRS rules Alzheimer's is categorized as a severe cognitive impairment, and is therefore fully tax deductible as a medical expense.

TAX DEDUCTION FOR MEDICAL EXPENSES

Deductions for medical expenses may be claimed whenever the total cost of these expenses exceeds 7.5 % of your adjusted gross income for the year.
Applies to:
• The costs of diagnosis, cure, mitigation, treatment, or prevention of disease,
and the cost for treatments affecting any part or function of the body.
• The alleviation or prevention of a physical or mental defect or illness.
Includes:
• The costs of equipment, supplies and diagnostic devices needed for these purposes.
• Dental expenses
• Premiums you pay for insurance that covers the expenses of medical care,
and the amounts you pay for transportation to get medical care.
• Amounts paid for qualified long-term care services and limited amounts
paid for any qualified long-term care insurance contract.

Thanks to Emeritus Senior Living for providing this information. Neither Starfish Resources nor Emeritus Sr. Living can provide tax advice; for more information on how to claim your medical expenses on your taxes please consult a personal tax advisor, tax preparer, or the IRS.

To contact Starfish Resources:
www.starfishresources.net
starfishresourcesa@gmail.com
(760) 522-6478

Electronically Challenged Seniors

2010-02-04T14:36:00.001-08:00

I received this in an e-mail - the original author is unknown. It was too comical not to share and I believe it gives a good view of what some of our seniors deal with in this new technological age we live in. I hope you enjoy it. Nancy*
*********************************************************************************

Things are spiraling out of control. I think I have become lost in a world of electronic madness.

On of my sons informed me this week that my cell phone has become obsolete and I must head down to the cell phone store and get a phone that is contemporary with the time.

I pointed out that the fancy razor/slimline phone with the camera built in that he made me trade my perfectly good flip-top Motorola cell phone for two years ago still works perfectly fine. Well, except for the camera thing - Never could figure that out. Even the few times I actually did take pictures I couldn't figure what to do with them and gave up.

That is except when I would push the wrong button and take a video of the ceiling or my feet.

Seems the issue is that I am unable to text with the tiny little 3 character buttons. "Hi, son," would come out looking like, "Gh Qmo." My grand-kids have even spoken to my wife about Poppa's crazy text messages. Give me a break. Whatever happened to actually talking on the phone? Isn't' that what they were invented for?

They want me to get one of those phones that you can turn upside down and sideways and has a typewriter keyboard with keys about one-eighth the size of my pinky finger.

One of my four sons is a Realtor whose real occupation is fly fishing. "Way to go, son." Or in my text language, "Xbz um Io, rmo."

We were floating the Yakima River in his guide-quality drift boat south of Ellensburg, Washington. We were miles from anything remotely resembling civilization. Rock canyon walls were on either side of us. Bear with me as I try to explain this strange thing.

His "Blackberry" rang. It was blue and I asked him why it wasn't called a Blueberry. He shook his head with that "dealing with an elder" despair look I get a lot these days. It was another Realtor who called to say that the sellers he represented had agreed to my son's client's changes and he had the signed documents in hand.

My son told him to FAX the papers to his office and he would get them signed and faxed back to close the deal that morning. A minute later the phone rang and he hit a few buttons and looked over the FAX, now on the Yakima River with us.

He then called his clients and told them he was faxing the papers to them to sign and asked the to FAX them back to his office. While he was waiting, he hooked into a fat rainbow and was just releasing this 22-inch beauty as his phone rang again with the signed FAX from his clients.

He called the other Realtor and told him he was sending the signed papers back by FAX. The deal was closed. He smiled and just said, "You are a little behind the times, Dad." I guess I am.

I thought about the sixty million dollar a year business I ran with 1800 employees, all without a Blackberry that played music, took videos, pictures and communicated with Facebook and Twitter.

I signed up under duress for Twitter and Facebook, so my seven kids, their spouses, 13 grand-kids and 2 great grand-kids could communicate with me in the modern way. I figured I could handle something as simple as Twitter with only 140 characters of space.

That was before one of my grand-kids hooked me up for Tweeter, Tweetree, Twhirl, Twitterfon, Tweetie and Twittererific Tweetdeck, Twitpix and something that sends every message to my cell phone and every other program within the texting world.

My phone was beeping every three minutes with the details of everything except the bowel movements of the entire next generation. I am not ready to live like this. I keep my cell phone in the garage in my golf bag.

The kids bought me a GPS for my last birthday because they say I get lost every now and then going over to the grocery store or library. I keep that in a box under my tool bench with the Bluetooth (it's red) phone I am supposed to use when I drive. I wore it once and was standing in line at the Barnes and Nobles talking to my wife as everyone in the nearest 50 yards was glaring at me. Seems I have to take my hearing aid out to use it and got a little loud.

I mean the GPS looked pretty smart on my dash board, but the lady inside was the most annoying, rudest person I had run into in a long time. Every 10 minutes, she would sarcastically say, "Re-calc-ul-ating." You would think that she could be nicer. It was like she could barely tolerate me. She would let go with a deep sigh and then tell me to take a U-turn at the next light. Then when I would make a right turn instead, it was not good.

When I get really lost now, I call my wife and tell her the name of the cross streets and while she is starting to develop the same one as Gypsy, the GPS lady, at least she loves me.

To be perfectly frank, I am still trying to learn how to use the cordless phones in our house. We have had them for four years, but I still haven't figured out how I can lose three phones all at once and have to run around digging under chair cushions and checking bathrooms and the dirty laundry baskets when the phone rings.

The world is just getting too complex for me. They even mess me up every time I go to the grocery store. You would think they could settle on something themselves but this sudden "paper or plastic?" every time I check out just knocks me for a loop.

I bought some of those cloth re-usable bags to avoid looking confused but never remember to take them in with me.

No I toss it back to them. When they ask me, "paper or plastic?" I just say, "Doesn't matter to me. I am bi-sacksual." Then it's there turn to stare at me with a blank look.
*********************************************************************************
If this were my client I think I would recommend a Jitterbug phone and a driver to take him to the store.
(ps I still have an "old" Motorola flip phone myself and I don't have a data plan either. This is partially because I have friends that "butt-call" me periodically and I don't want all those e-mails, either.)

"Planning for Eldercare"

2010-01-20T13:05:00.000-08:00

Keeping Mom and Dad Safe at Home

Generally, elderly parents want to remain living in their own home.
However, remaining in the home becomes a concern when children
see their parents slowing down, perhaps even having trouble with
handling stairs and doing general daily activities. Yet, with parents'
mental and physical health currently not creating problems,
there seems to be no imminent need to search out support services
or other accommodations for aging parents.

This is now the time to evaluate the home to make it safe and secure
for your loved ones -- now and in the near future -- in
anticipation of aging disabilities that may occur. Help and support
are available. The nation as a whole is more aware of elderly
needs and services and products are becoming available at an out-
standing pace.

The Bureau of Labor Statistics states,

“Employment of personal and home care aides is projected
to grow by 51 percent between 2006 and 2016, which is
much faster than the average for all occupations. The expected
growth is due, in large part, to the projected rise in the
number of elderly people, an age group that often has
mounting health problems and that needs some assistance
with daily activities.”
Bureau of labor Statistics-Occupational Outlook Handbook, 2008-09 Edition

This growing need for aides and services also encompasses

home remodeling services --
making a home more serviceable to the elderly;
safety alert systems and technology;
motion sensors to monitor movement;
telehealth services -- using home-based computer
systems for the doctors office or a nurse to monitor vital
signs and
even a pill dispenser that notifies when it is time to take
medication.

Where do you begin to make sure your elderly family member is safe
and managing well in his or her home?

Visit often and at different times of the day and night.
Make note of daily activities that appear challenging and where
changes might be made to add safety and convenience. Remove rugs
that slide -- causing a fall -- and move furniture with sharp edges.
Set the water heater at a lower temperature. This will protect
their older sensitive skin from scalds and burns. Be sure smoke
detectors and carbon monoxide detectors are in place.

Bathrooms are a hazard area for the elderly.
Grab bars by the toilet and shower are a must to help prevent
falls. There are easy to install bars at your local hardware store
if you want to do the work yourself. Another item that is good
to have is a shower stool or chair.

If you are not sure of what needs to be done, consider hiring a professional.
There are companies that specialize in home remodeling and accommodation
for seniors. Michelle Graham of Accessible Design by Studio G4
says about senior home remodel projects,

“The main thing we incorporate in all of our projects
is a careful study of needs and potential needs that may
develop throughout a client's lifespan.”

Keep in mind what future home adjustments might be needed for your
parents to “age in place” in their home.

Home safety or medical alert companies provide GPS-based bracelets or pendants
to track the elderly at home who tend to wander. Or the companies may
provide alarm devices such as pendants or bracelets which allow the elderly
to alert someone if there has been a fall or a sudden
health-related attack. In the event an alarm has been triggered, a 24 hour
monitoring service will alert the family or medical emergency services or call
a neighbor depending on previous instructions. In addition there are companies
that will install motion sensors in the home to monitor the elderly on a 24 hour basis.

Don't forget your parents' community as a valuable resource for helping them
stay in their home. Take Margaret Muller as an example. At 82 years of age,
Margaret lives alone in her small home. She manages very well with
the help of her local Senior Center. The Center's “Senior Companion”
program sees that Margaret is taken to the store for groceries
and other needs and checks in with her often to see how she is doing.
Once a day, the Senior Center delivers a hot healthy meal to her door.
Having these services and visits gives Margaret the help she needs
and peace of mind that she is not alone.

Neighbors, local church groups, senior centers and city centers
are some places to look for assistance. Most of the time
there is little or no cost for these services.

Your state aging services unit is a valuable community resource.
The National Area on Aging website www.aoa.gov states:

“AoA, through the Older Americans Act and other legislation,
supports programs that help older adults maintain their independence
and dignity in their homes and communities. In addition AoA provides
funding for a range of supports to family caregivers.”

Some of the programs the site lists are:

“Supportive Services and Senior Centers

Nutrition Services

National Family Caregiver Support Program

Grants for Native Americans

Nursing Home Diversion Grants

Aging & Disability Resource Centers

Evidence-Based Disease Prevention

Long-Term Care Planning

Alzheimer's Disease Grants

Naturally Occurring Retirement Communities”

A few thoughts on hiring home care aides or live-in care givers.

The classifieds are filled with people looking for work as aides to
the elderly. Many of these aides are well-qualified, honest people
who will do a good job; but, of course, there will be some not
so reputable. If you are looking to hire someone, be sure you
interview and check references and qualifications. You will be
responsible for scheduling that person and doing payroll and
taxes as well. Be very sure you hire someone trustworthy, as
the elderly seem to trust these helpers more than they should
and therefore can easily be taken advantage of.

A professional home care service will eliminate your employment
concerns. Professionally-provided aides are usually bonded and
service is guaranteed. Home care companies take care of the
scheduling and payment of their employees. Home care companies
cater to the elderly in their homes by offering a variety of
services. The National Care Planning Council lists many of
these companies throughout the country on its website
www.longtermcarelink.net .

These providers represent a rapidly growing
trend to allow people needing help with long term care to
remain in their home or in the community instead of going
to a care facility. The services offered may include:

companionship
grooming and dressing
recreational activities
incontinent care
handyman services
teeth brushing
medication reminders
bathing or showering
light housekeeping
meal preparation
respite for family caregivers
errands and shopping
reading email or letters
overseeing home deliveries
dealing with vendors
transportation services
changing linens
laundry and ironing
organizing closets
care of house plants
24-hour emergency response
family counseling
phone call checks
and much more.

Thomas Day, Director of the National Care Planning Council states,

“Care in the home provided by a spouse or a child is the most
common form of long-term care in this country. About 73% of all long term care
is provided in the home environment typically by family caregivers.”

As their caregiver, you can make the difference in the quality of life for
your aging parents and if staying in their home is a possibility,
you have the resources to make it happen.

'pausin' in 2010

2010-01-05T14:02:00.000-08:00

I decided that this year (2010) I will lighten up a bit. I have noted that, especially of late, I have become all too serious. I therefore present this to you with all good humor intended. I hope it makes you laugh.

Are you "'pausin'"???

There is humor to be found in our bodily functions. I swear there is. Isn't there? Come on.

As children we laugh at drooling, burps and flatulence among other things. But, we are taught those things are rude and distasteful and adults frown upon it greatly. Why is that? I mean it happens to everyone. Right? Yes, there are ways of quieting the systems. But the occurrence is still there. And if you have an uncle or a grandfather who likes you to pull their finger.....
you see? There is humor - when we stop being so stodgy about it all.
You smiled - I know you did - admit it. ;-)

So what does one do when the time comes for a woman to "embrace the crone", as one friend put it? Or 'pausin' as I like to call it. [I took the "men" out of it as they don't deserve the credit. They don't have to live with it - Just with us. I do sympathize with them on that count - really!] And 'pausin' just kinda seemed appropriate as we are pausing our lives - reviewing, renewing, etc.

Aside from the more intimate issues that come with 'pausin' there are several more noticeable symptoms. One minute we are happy and well, the next frustrated and sometimes
even tearful. (OK, so that one isn't all that new for me - being a bit emotional to start with, and all.) Or, suddenly flushed; feeling as though we've just been lowered into a steam room and then chilled nearly to the bone from the sweat that now sits on our drying skin.
Jacket on - jacket off - jacket on........
"what did you just say to me?!"

Then there is our hair?? All that sweating... it's just not possible to have a good hair day! (Which also isnt' that new for me) But what is with the fall out? It's worse than living with a red-setter around here. I shed this time of year anyway, but it seems much worse than "normal".

It is, actually, all rather funny. Don't you think?
I mean we have to laugh. Or else we'd cry - we just might anyway. Just on account.

And sleep deprivation! What is with this? Don't they use that in concentration camps as torture??? No wonder we get grumpy and tearful. Those hormone shifts are disturbing the normal sleep patterns to start with. Then try sleeping when your hot and cold and hot and cold. (It's worse than a date night with someone who's having a few too many drinks.)
It is particularly interesting in my household as we sleep with both 6' windows wide open and no heat on in the house. So, cold is really cold. The other night my husband said I had goosebumps
the size of geese. {heavy sigh}

As you can tell, I am 'pausin'.
I'm OK with the idea of not having anymore children - my husband is still really 13, anyway. We are hopeful to one day be able to retire, travel and just enjoy the grand kids - and maybe a dog.
And I don't mind getting older - really. After all the alternative isn't very nice. I don't think I'd look good dead. And, if I can look as good as my mom does (she's a lively 76) it won't be bad to be "old" at all. I don't even mind my gray hair. A friend told me recently that it should be considered free platinum highlights. I like that. I am actually looking forward to having hair long enough to braid regularly. I've always liked that look. Although on my bad hair days I swear I'm going to chop it all off. I did that when my grand-daughter was little and it was really cute.

I gotta tell you the sleep thing - that's starting to get to me.
I've actually developed some techniques to assist during the night. Well, they are more like positions. (And if anyone tries to make something sexual out of this I swear I will hit them - with something very hard.) I've taken to wearing long cotton tee shirts - they don't stick as much and are easy to wash. They aren't very sexy, but at this point who cares.

1) flatiron - this works best when one is sleeping alone:
lay spread eagle (I prefer on my stomach) across the bed with the upper corners of the covers near your hands. As the heat starts you have options. You can just force your feet out the bottom corners and push back some of the covers or you can actually flip over uncovering as needed and then flip back when cooling off, bringing the covers with you.
It's sorta like flap jacks being tossed in a pan. ;-)

2) footy - this is good for when your husband (or sig. other) is at home with you:
Staying on your side of the bed, (you don't want any extra heat from your other half anyway) keeping the upper corner of your half of the covers in the hand on top, for ease of removal. Having arranged the lower corner of the covers loosely for your foot, and if necessary, your
whole leg, to emerge easily from the covers. You can simply slip out of the covers or you can flip on or flip off the covers, as needed. (You can flip off the husband, too, if he makes any smart remarks - sorry) Sometimes simply allowing the foot to escape the heat is sufficient.

I'm sure there are other methods. These are what is working for me at the moment.

I've additionally taken to carrying a fan with me. A small oriental fan.
It is easily portable and ever so helpful during those heated moments. Let 'em laugh. I can always fold it up and use it to hit 'em. :-} (I know - getting testy aren't I?)
And as for the hair? Well with my history of bad hair days and all I'm kinda used to it. Hopefully I won't lose it all. If I do I have a lovely collection of scarves I can wear.

Here's to aging gracefully and with humor. )-|
(that's a martini glass)

PS A friend recently informed me that Dr. Oz said to use Black Cohosh and Sage Tea. So far, it seems to be working. I'll let you know.

Staying Healthy in the New Year

2009-12-29T18:44:00.000-08:00

This coming year brings much promise for many of us. We are all hopeful for a better, more stable, economy. With a new year, it is also traditional to hope for continued good, or improved, health. Many of us make our resolutions on just this subject. I will be one of them.

I was listening to ElderCare Talk Radio recently. Dr. Aboo Nasar and nurse practitioner Kim Kesch were the featured guests. The information provided was most interesting to me as is generally the case with this talk radio program. They briefly discussed a new study on a drug related interaction syndrome in seniors.
Although I knew this was a serious problem, especially in seniors, I was surprised to learn that drug interaction is now considered a “syndrome”. Professionals are seeing more and more problems with medications in the senior population. Too many are prescribed, often at the patients request after seeing an advertisement.
This can cause multiple side effects and interactions. Often time’s medications are not taken appropriately. Ms. Kesch pointed out that how you take your medication is as important as the dosage and the time you take it. For instance, one medication prescribed often for bladder infection, Nitrofurantoin, loses some of its potency if not taken with protein. The bottle will often read, “may take with food”.
That does not tell the person the correct information. Did you know that taking more than eight medications per day would create a 100% probability that you will suffer a fall? The increased chance of falls means an increased incidence in hip fractures. Hip fractures are a very significant player in overall health decline. They often are the underlying cause of death in our senior population. A medication evaluation is very important and is highly recommended, especially for those taking multiple medications, plus over the counter medications and supplements. This is yet another case of less being more. I believe that the less medications you take, the better off you will be.

This article is not meant to be an advertisement for either Dr. Nasar or Ms. Kesch’ practice, however, I have heard Dr. Nasar speak on several past occasions.
He utilizes a mix of both Eastern and Western methods in his practice of medicine. Additionally he cautions us all about the interaction of herbal supplements with medications. One of the things that impressed me about his practice is how closely he will work with his patients to find the balance they need between eastern and western practices, medications, supplements and nutrition.

One of the items stressed during this recent radio program was that food is medicine. It is most important to look at our diets to obtain better health and reduce the need for medication. The American population, as a whole, generally over eats while at the same time is under nourished. This occurs because so much of what Americans eat is high in non-nutrient calories. Soda’s, sweets, alcohol and fried foods are some of those types of “food” items. An “anti-aging diet” is often recommended. This way of eating is low in calorie (1,450-1,700 per day) but high in nutrition, fiber and minerals. A Mediterranean style diet and/or a European way of eating are also much better options than our traditional American habits and are similar to the “anti-aging” plan.

The common Mediterranean dietary pattern has these characteristics:
• high consumption of fruits, vegetables, bread and other cereals, potatoes, beans, nuts and seeds
• olive oil is an important monounsaturated fat source
• dairy products, fish and poultry are consumed in low to moderate amounts, and little red meat is eaten
• eggs are consumed zero to four times a week
• wine is consumed in low to moderate amounts
This lifestyle also means eating your fruits and vegetables raw whenever possible, cooking our meals ourselves, and having proper socialization during the meal. (Please consult your physician before embarking on a new lifestyle, or diet, plan.)

Dr. Nasar also stated that stress is the most toxic condition our bodies deal with. One of the side effects of stress is the production of the hormone cortisol. It is the fight or flight hormone associated with adrenaline among other things. It is necessary for the conversion of proteins to energy. However, too much of anything is bad for you. Sustained increases of this cortisol can destroy muscle and bone, slow healing and normal cell growth and impair digestion. It also can increase blood sugar, affect other hormone levels and interfere with our sleep patterns. Some people turn to alcohol in a misguided attempt to relieve the symptoms of stress. Alcohol is very high in non-nutrient calories and can actually increase the level of cortisol in the body. To top it off, most people that drink do so at night when cortisol should be at its lowest level. They then wonder why they are awake at 3 am. To quote Dr. Nasar; “cortisol is like battery acid” to our systems. You may be asking, how can I keep this seemingly nasty hormone at a safe level? Some herbs and supplements may help. Ask your doctor about them. Better yet, reduce your stress level and don’t drink frequently or in access. Women should have no more than one glass of wine per day.

To reduce stress try: message or yoga; get plenty of rest (8 hrs or more sleep per night); use meditation or self- hypnosis; do not skip meals and eat healthily; reduce intake of coffee; exercise up to 1 hour per day; and enjoy sex regularly if able (yes, it does make a difference).

********************************************************************************
Wishing you all a Wonderful, Healthy and Blessed 2010

Live; Laugh; Love
Nancy Coulter Beland
Owner, Starfish Resources*
www.starfishresources.net
760 522 6478
starfishresources@gmail.com

Seniors being robbed with fraudulent inquiries and scams

2009-12-14T14:17:00.000-08:00

By Nancy Beland, Owner Starfish Resouces
Making a Difference for Seniors
www.starfishresources.net

The famous showman P.T. Barnum reportedly once said, “There is a sucker born every minute”. Many that knew the man said this statement was out of character. In fact, the statement has been accredited to several other people of that time. Whether or not P.T. Barnum actually said it does not truly matter. What does is that the statement is technically true. There are many gullible people in the world. Most folks aren’t taken in because of their I.Q., education level or their income status. Generally, it’s because they are trying to do the right thing. And, while meaning well they get ripped off.

Seniors are particularly vulnerable to fraudulent scams. Specifically scam artists will generally target them. Recently a new scam came to light right here in San Diego. Two senior residents from the same retirement community have been taken in by this new scam. One lost quite a bit of money while the other was barely saved by a vigilant bank clerk. Here is how this new scam goes.

A young man phones the senior. He is quite excited and upset.
He may even cry. He calls you Grandma or Grandpa. He tells you
that he is in trouble and he needs your help. He needs money. He
begs you not to tell his parents. He says he is either in jail or in Canada
and can not get back into the US without this money. He instructs you
to take a cab, go to the bank, withdraw the required funds and wire the
money to him. He gives you the address. He again begs you not to tell
his parents as they will be very upset and disappointed in him.
He is very convincing.

Of course, this is not your grandson. Heaven only knows where this money will actually end up. But you can believe it’s not going to help anyone you know.

If a caller says any of the following to you, hang up.
“You must act now! Or the offer will not be valid”
“you have won a free gift, or prize,” but you have to pay the postage or handling
“You must send money, a check, or give credit card or bank account information
“You don’t need to check the company or the offer out with anyone such as family or the better business bureau or consumer protection agency.”
“You don’t need any written information or references regarding the offer or the company”
“You can’t afford to miss this”

Scams are showing up on emails frequently, too. One recent scam going around states that the recipient of the email has won a prize which is being help by FedEx in either the United Kingdom or in Africa. All you have to do is send them then handling fees and the prize will be released to you immediately. Do not believe it!
Additionally, the Better Business Bureau warns online shoppers to be on the lookout for tricky pop ups after your purchase. These discounts that are being offered are from 3rd party marketing firms, and are not related to the purchase you just made.

Here are some tips to help you:
1) Know who you are dealing with (be sure to verify any information or identification)
2) Do not let anyone into your home without proper reason and ID. If the person says they are from the phone company, they should have a company ID with them to prove it.
Why are they there? Did you request assistance? If not, you should call the company they say they are from to verify the reason for the visit. Leave the person wishing to enter on the porch with the door locked between you. If they are legitimate they will wait.
3) Sign up for direct deposit for any checks that may be coming to you (such as your social security)
4) Register your home phone with the do not call registry to reduce telemarketer calls (1-888-382-1222).
5) Ignore direct mail advertising – do not even open it. Throw it away.
6) Do not listen to any offers regarding Medicare prescription plans presented over the phone. If you have questions regarding your plans contact Medicare directly 1-800-MEDICARE (633-4227).
7) Assign a power of attorney – forms are readily available from your attorney, the senior center, the internet – you can change your assignment any time you wish.
8) Do not give out personal or financial information over the phone or to anyone that asks you unless you have solicited them. If they have contacted you, they should have whatever information they need. If not, hang up or walk away.
9) Ask anyone requesting charitable funds over the phone to mail you the information and you will consider it.
10) If it sounds too good to be true, it probably isn’t true. Hang up or walk away.

Always report any fraudulent activity such as scams to the authorities.

For a free package on consumer protection contact:
The Federal Citizen Information center
Pueblo, Colorado
1-888-8 PUEBLO (1-888-878-3256)

Depression in Seniors during the Holidays

2009-12-05T13:52:00.000-08:00

Depression occurs in seniors- Especially during the holidays

For many Americans the holiday season begins at Thanksgiving.
“The holidays” bring a variety of emotions with it.
We feel joy, gratitude, excitement and love.
Generally, our gatherings are filled with happy times
and can be a wonderful reminder of days gone by.
For some, however, these reminders can bring a sense
of sadness or grief. This time of year may also bring
feelings of stress, fear, anxiety, loneliness, and depression.

“The blues” can be quite common during this time of year.
Seniors, especially can be affected. Most seniors have
suffered many losses in their time. These losses can include
loss of independence, personal health, friends, hobbies, loved ones,
etc. In some cases, they may be suffering with full-blown depression.
Some seniors may try to hide the fact that they are feeling down and/
or depressed. For many there was a stigma attached to depression along
with other mental illness. In their day, there was a great deal of
misunderstanding about those diagnoses. Those afflicted where often
ashamed of the illness and it was rarely discussed openly.
This is still true for many seniors today.

If the blues are caused by a death, the person may still be in mourning.
Discussing the loss and reminiscing about the person may be helpful in
resolving that grief. The person may be mourning the loss of an item or
activity such as a home or change in physical condition. In these cases,
sometimes offering an activity may be helpful. For instance, if one used
to knit and can no longer make those lovely sweaters for gifts, teaching
someone else how to create such items may relieve that sense of loss.
If the loss is over a home or apartment, you might try to find out exactly
what it is that the person is missing. A garden can be replaced with a
window version or an herb garden. A workroom could perhaps be replaced
with the activity of helping another with small chores or minor repairs.

There may be other reasons for your senior’s depressed mood. Medications
can often cause feelings of depression. (e.g. medications for arthritis,
heart disease, hormone imbalances, thyroid conditions, high blood pressure, Parkinson’s disease, cancer, stroke, diabetes, and Alzheimer’s) A change
in the dose or a choice of other medication may be the answer. Pain,
electrolyte imbalances, dehydration, steroids, and B-12 deficiency can
also be a culprit. Some cases of depression may be helped with psychotherapy.
Still others may require new medication and/or additional treatments.
Anyone experiencing the symptoms of full-blown depression should seek the
help of their primary care physician. Depression is a serious illness.
It can and should be treated. Watch for signs of suicidal thoughts or
comments about death and/or suicide. These should never be ignored.

Things that you can do to help someone who is mildly depressed or
experiencing the “blues”:

Encourage regular exercise
Encourage regular social activity
Music and laughter will often lift a mood
Insure healthy meals and proper nutrition
Medications should be taken as prescribed
Be sure that treatments are followed and are followed-up on
Have them volunteer with an organization they may connect with
Invite the person for outings allowing them to make connections with others
Be sure to tell the person how important they are to you. Sometimes your smile, hug and/or concern
can be all the difference.

Self Test for Depression

Loss of appetite
Lost sense of purpose
Changes in sleep patterns
Unexplained aches and pains
Increase in anxiety or worry
Changes in weight (up or down)
More nervous or agitated than usual
Loss of interest in personal care or hobbies
Slower response to questions or other stimuli
Difficulty thinking, concentrating or remembering
Complaints of fatigue, sadness or a sense of worthlessness

**********************************************************************************
Wishing you all a happy healthy holiday season
Live; Laugh; Love
Nancy Coulter Beland
Owner, Starfish Resources
www.starfishresources.net

Long Term Care for Senior Veterans

2009-11-12T12:55:00.000-08:00

In the year 1919 President Woodrow Wilson proclaimed November 11 as Armistice Day to honor those Veterans who served during World War I. On November 11, 1954, Armistice Day was proclaimed a legal national holiday and the name was changed to "Veterans Day" to honor all veterans of all wars.

Every November 11, ceremonies are held throughout the United States honoring Veterans of wars. A National Ceremony is held at Arlington Cemetery at the Tomb of the Unknown Soldier, where the laying of the presidential wreath and military playing of “Taps” is presented.

Since its establishment in 1930, the Department of Veterans Affairs has evolved to supporting and aiding the nation’s veterans in numerous ways. One of these services for example, the Veterans Health Administration, is the largest single provider of medical care in the United States. Its 22 regions with 154 hospitals and their associated 875 outpatient clinics offer the following services.

Hospital, outpatient medical, dental, pharmacy and prosthetic services
Domiciliary, nursing home, and community-based residential care
Sexual trauma counseling
Specialized health care for women veterans
Health and rehabilitation programs for homeless veterans
Readjustment counseling
Alcohol and drug dependency treatment
Medical evaluation for disorders associated with military service in the Gulf
War, or Treatment for exposure to Agent Orange, radiation, and other
environmental hazards
HISA grants
Other special benefits

The Department of Veterans Affairs provides three types of long term care services for veterans.

The first are health care benefits provided to veterans who have service-connected disabilities, who are receiving VA Pension or who are considered low income. These services include free medical care, possible free prescription drugs, orthotics and prosthetics, home renovation grants for disabilities, home care, assisted living, domiciliary care, nursing home care, and a possible host of other services or benefits.

The second benefit is state veterans homes. The majority of these homes offer nursing care but some may offer assisted living or domiciliary care. The Department of Veterans Affairs in conjunction with the states helps build and support state veterans homes. Money is provided to help with construction and a federal subsidy of $72.71 a day is provided for each veteran using state veterans nursing home services. These homes are generally available for most veterans and sometimes their spouses and in some cases for so-called "Goldstar parents." Veterans homes are run by the states, sometimes with the help of contract management. There may be waiting lists in some states.

The third benefit for veterans is disability income programs. The most familiar of these benefits is an income for service-connected disabled veterans called "Compensation." The least known of these is a program officially called "Pension" but popularly known as the "aid and attendance benefit."

*
All active-duty veterans who served at least 90 days during a period of war are eligible for Pension and the additional income from aid and attendance or housebound allowances. A single surviving spouse of such a veteran is also eligible.
*
All qualifying veteran applicants over the age of 65 are eligible for pension but must meet income and asset tests. Applicants under the age of 65 must in addition be totally disabled to qualify. Disability does not have to be service-connected.
*
A surviving spouse can be any age and there is no need for disability.

The aid and attendance benefit can pay additional income to provide for the costs associated with home care, assisted living, nursing homes, adult day care and other non-reimbursed medical expenses. It can also pay for a family member other than a spouse to be the care giver. The amount of payment varies with the type of care, recipient income and the marital status of the recipient. Here are some examples of how this benefit can help veterans.

Example #1
The National Care Planning Council receives many calls from family members of veterans, asking if there is any help available to them. One such call came from a woman who had been juggling her job and caring for her father in her home for over five years. She had just lost her job and with no income, did not know how she would keep her home or give her father the care he needed. She read an article that had been written by the National Care Planning Council and published in her local newspaper and called their phone number. The article mentioned that a member of the family -- not including a spouse -- can be paid through VA to provide care for a loved one at home who is either a war veteran or the surviving spouse of a war veteran. Her father is a war veteran. When told that she could get an additional $1,644 a month through her father by providing her father's care she was shocked. She was also extremely grateful and ended up sobbing into tears over the phone when she found out about the benefit and realized it would help her keep her home and her father may probably get a check for her retroactive previous care from VA worth tens of thousands of dollars.

Example #2
Another recent caller’s mother is 89 years old and has been in assisted living for four years. As a widow of a veteran she did not qualify for the Aid & Attendance Pension 4 years ago because her assets were too high. In the meantime she has been using up her assets along with her income to pay for the assisted living. The local veterans service office has not been helpful in getting this claim approved even though she had reached the allowable asset limit over two years ago. The family was considering putting her in a less desirable facility under Medicaid. The family knew this would be devastating for their mother. Her health was still good and she had many friends and comforts at the assisted living.

The National Care Planning Council directed the caller and his family to a more cooperative veterans service office that will submit the claim and likely get it approved retroactively so that this woman can get a check for roughly $40,000 worth of previous care costs for which she was not reimbursed. In addition, she will likely get the full benefit of $1,056 a month to help pay the cost of the assisted living where she is happy.

These types of claims require medical evidence in order to receive a rating for aid and attendance or housebound allowances. These ratings must be received or certain non-medical expenses associated with long term care are not deductible from income. Special rules also allow for deducting the annual anticipated cost of month-to-month long term care from household income in order to meet the income test. This special treatment requires special documentation and evidence. In addition, those households with substantial assets will be denied for a Pension income unless those assets are below a certain level determined for each case by VA. The personal residence, personal vehicles and personal property are exempted from this asset test. Finally, evidence must be supplied every year in January that the anticipated costs for the previous year were actually incurred or VA will likely demand for its money back.
The National Care Planning Council has compiled the necessary forms, rules and information about claims together in one book titled “How to Apply for the Veterans Aid & Attendance Pension Benefit.”

This book contains information about how a typical applicant receives a successful pension award. VA often tells callers to go ahead and fill out the application but generally provides no information on the special treatment of annualization of anticipated recurring medical costs. The claims form also contains no information on this important issue. One simply has to know how to do it. This crucial information can make the difference between a successful award and being declined. All necessary forms for filing a claim are in the book.

Veterans who have substantial assets may need to do some estate planning and realigning of assets to qualify. An expert in this area should be sought to help with the application in order to avoid lengthy delays in awarding a benefit or a possible denial of benefits. For a list of individuals or companies in your area who understand how to get this benefit go to http://www.longtermcarelink.net/ref_veterans_consultants.htm

To learn more about this benefit go to http://www.veteransaidbenefit.org/

Un-Stress Your Holidays

2009-10-28T12:10:00.000-07:00

It is hard to believe that we are here again, already. The Holidays. Many people have commented as of late that their calendar pages just seem to have been caught in the wind. Time has flown too quickly this year. Or so it seems.

During the holiday season, many of us often find ourselves stressed out. You would think that happy occasions aren’t stressful, but sometimes they can be even more stressful than the sad ones. There is so much to do. We pressure ourselves to find perfection in each other, our parties, decorations, meals, gifts and more. Is there anything in life that is truly perfect? Of course there isn’t. Even the best-laid plans can run a fowl. This year may be especially hard for many of us with the issues we are currently dealing with in the world and at home. I propose that we try to simplify things, accept less than perfection, let some things “be”, and not stress ourselves. This should be a time of joyful memories, thanks giving and good company. It could, in fact, be your best holiday season yet.

Here are my 12 tips to un-stress your holidays.

1. Use lists and calendars to stay organized: try to plan ahead
2. Set attainable goals for decorating: keep to a budget; allow the children,
or friends, to help (decorating parties can be a lot of fun)
3. Be realistic with your time and capabilities: do not be afraid to say no.
Say yes only to the things you really can, and wish to, do.
4. Take 10 minutes for yourself each day: this could be meditation, a walk,
reading time, a bubble bath, or prayer - the important thing is to relax
and remember to keep breathing.
5. Are you hosting the dinner? Cook the main dish and let your guests bring the
rest: either potluck style (let them volunteer their favorite dish) or with
a menu, (you assign the dish). Don’t be afraid to ask for help in arranging
the food or setting the table.
6. Be flexible with timing: The world will not end if you eat at 4:30 instead
of 4 and if you know a guest is usually late tell them your start time is 30
minutes earlier
7. Rent funny movies or show recent family videos to keep your guests occupied
8. Do your gift shopping over the internet or by catalog: stick to your budget
and avoid impulse buying: keep in mind that home made gifts are often very
well received and appreciated for the thought and time that went into it
9. If children are joining you for the holiday meal use paper instead of cloth
for their table and have water colors, washable markers or crayons for them
to use
10. If a conversation is becoming stressful, excuse yourself, go for a short
walk, and try to remember that the only thing you can truly control is how
you react or deal with something.
11. Music does soothe the savage beast: playing a variety of music can keep the
mood light and festive
12. Don’t forget to take care of yourself: take your vitamins, keep your medical
appointments, be sure your medications are filled, keep your gym/exercise
schedule as close to the norm as you can

Stressed spelled backwards is desserts. Here is to a sweet stress free holiday season.

Nancy Beland is the Owner of Starfish Resources:
Making a Difference for Seniors and their families.

Important Calendar Items

2009-10-15T18:02:00.000-07:00

October 16 - Nov 20, 2009 Fridays 10 - 12 6 week Savvy Caregiver Training Program 12 hours total giving family caregivers training and tools to work with the alzheimer's patient. Vista Senior Center 1400 Vale Terrace Dr 92084 register 858 492 4400

October 17, 2009 Saturday 9-11:45am Aging in Place Seminar for Seniors and Their Adult Children. Is your life plan up to date? Dr. Brian graham discusses the 10 things you need to know for an emergency and 5 warning signs of health problems. NO COST for this event held at Lawrence Fmaily Jewish Community Center 4126 Executive Dr. La Jolla 92037 2nd floor Mezzanine Parking is Free Continental Breakfast and Vendor Booths + Healthcare documents, Legal Advice, Door Prizes and More Seating is limited RSVP Gabrielle Helman 619 862 9301 or email ghelman@accentcare.com

October 27, 2009 Tuesday 9-12 Providing End-of-Life Care CEUs for RCFE,MFTs, LCSWs & nurses given by the Alzheimer's Association To be held at Sunshine Care Homes 12750 Monte Visa Rd Poway CA 92064 Cost $30 to Register contact Laura Printy 858 492 4400 x 122

Family Orientation - designed for care partners and fmaily members who are new to the disease. Thurs. Oct. 29 Grossmont gardens 2 - 4 pm; Friday Nov. 6 Escondido Senior Center 1:30- 3:30 pm; Wednesday Nov 17 Alsherim's Assoc. Main office Kearny Villa 10 - 12; Tuesday Dec 8 Belmont Village Cardiff by the Sea 5 - 7 pm

For more infomation, additional classes and training sessions and to register
contact San Diego Alzheimer's Association call 858 492 4400

This Weeks Calendar Items

2009-10-05T17:10:00.000-07:00

10/08 Caregiver coalition presents "Families: Preparing & Caring" 8:30am-1:30pm
LiveWell San Diego Respite care provided (800) 827 1008 for more
information/RSVP

Palomar Vista Health Center 101 Fig St Escondido - Open House 4-6pm

10/9 RSVP due for 10/16 Fall Forum on Residential Health (6 CEUs)event 8am-4pm SD
Marriot Mission Valley $30 now or $60 at the door (619)447 2428

9:30am - 12:30pm East County Intergenerational Games La Mesa Middle School
(619)464 0505 for more information

10/10 Multi Family Yard Sale San Marcos Mobile Estates 9am - 2pm. 1145 E Barham Dr.

NEXT WEEK
10/13 9am-2pm "Creating your Road Map: Navigating End of Life Decisions" Balboa Club
(858) 827-4277

Press Release

2009-10-01T14:24:00.000-07:00

For Immediate Release
San Diego County, CA
October 1, 2009

Starfish Resources is pleased to announce they are celebrating their 1 year anniversary. Owned and operated by Mrs. Nancy Beland, this one of a kind business has been Making a Difference for Seniors and their families by connecting the dots to the resources they need to navigate the pathway of senior care. Mrs. Beland is also the author of A Pathway to Senior Care in San Diego soon to be released.

Mrs. Beland found in her many years working with seniors that there was a common thread connecting all those families. That thread was the lack of knowledge of the options and resources available to them. IN wanting to be of service to her community, she decided to not only write a book on the subject, but to start her own business providing this much-needed information.

This invaluable service provides Case Management, Placement Assistance, Independent Audits of home care situations, check writing services and free group presentations. Marketing consultations are also available.

A former colleague of Mrs. Beland, Rochelle Davis Taylor, found Starfish Resources to be of such a value she is preparing to open an office in the greater Las Vegas area. With the Baby Boomer generation aging, the need for Starfish Resources grows. They are planning for continued growth and expansion throughout the country in the coming year.

Choosing an Assisted Living

2009-09-27T18:22:00.000-07:00

Choosing an Assisted Living can be a difficult decision. There are several factors to consider.

1) What is most important to Mom/Dad/Aunt/Uncle - type of activity, type of care needed, prognosis of condition. For instance, if Mom has always been very social, you'll probably wish to look at larger, active communities. If she has always preferred to be on her own, perhaps a small board and care home may be a better option.

2) COST - this is a big factor. You may think that the larger communities are more expensive, but that is not always the case. And, in this current economy, many facilities are cutting their prices or offering specials. So, even if you have talked to a home or community in the past, you may wish to call them again and get their updated rates. You should also keep in mind that even though AL seems expensive, compare the costs of their being at home (rent, utilities, maintenance, yard work, food, etc) to the cost of their fees in community. Many places have "all inclusive" pricing, some have "ala carte" pricing. It's important to ask about these things before making any kind of decision. AL and BnC are not paid for by insurance, unless there is a Long Term Care Plan in place. There are loans available. And, there is also a benefit through the VA called Aid and Attendance that can help if there was service connection.

3) Care needs - if your loved one has "early stage" dementia, please look at the dementia communities only. It is very upsetting to a person with dementia to move. Getting them settled in the right place the first time will be much less stressful to both you and your loved one. Also, be sure that the level of care can be met at the community you choose. And, PLEASE, plan ahead. If Dad has diabetes now and is on oral meds, what will happen if he has to go to Insulin. What if he is not able to self care with his Insulin?

Picking the right place the first time is really the very best thing for all.

4) Community Care Licensing oversees the Board and Care Homes as well as the Assisted Living Communities. Communities are required to keep a copy of their latest survey available for anyone to see. CCL can be contacted for other information. 619-767-2300.

Please contact Starfish Resources for more information and to see which facilities may be right for you. 760 522 6478. www.starfishresources.net

PreNeed (Pre-Paid) Funeral and Burial Plans

2009-09-25T11:00:00.000-07:00

Advantages and Disadvantages of Prepaid Plans
One way to plan in advance for the end of one's life is to sign a formal contract called a "preneed funeral plan." With this plan, money to pay for a funeral and/or burial is held in a trust, in an escrow account or paid through an insurance policy on the life of the person desiring the plan. Parts of or all of the funeral service and burial are designed in advance and pre-funded in advance and the family has little to do but show up.

This type of planning has become very popular in recent years. A survey conducted by the AARP in 1999, found that two out of five people over age 50 had been approached to pre-purchase funerals and burial goods and services. An AARP survey in 1998 indicates that 32% of all Americans over age 50, roughly 21 million people, have prepaid some or all of their funeral and or burial expenses (but not necessarily through a formal preneed plan). Breaking that down; about 25% of the over age 50 population have prepaid for their burials (cemetery plot, mausoleum or niche), 18% have prepaid for headstones, urns, caskets , grave liners or vaults, opening and closing of graves and so on and 13% have prepaid for goods or services from a funeral home or funeral director. The same survey indicates that over $25 billion is being held in preneed trust funds. Roughly another $25 billion is waiting to be paid out in life insurance benefits. Prepaid or preneed funerals and burials are big business.

Funerals and burials funded privately by the family, or paid from an individual life insurance policy and arranged informally through a funeral home or funeral director are generally not subject to state regulation. Any formal arrangement through a second party or involving a contract is subject to regulation in all states. Each state has adopted different rules as to who can sell these plans, what the plans can provide, what contract provisions must be, how the plan is to be funded and what recourse purchasers might have in the event of fraud or default. All states call these regulated plans "preneed" funeral and burial arrangements.

Here are some advantages as to why one would want to buy a preneed plan for funeral and burial services and goods.

It provides peace of mind knowing these arrangements have been made in advance.
It avoids the burden on family members to make decisions when they are most vulnerable to manipulation.
It allows one to virtually control from the grave by determining in advance the funeral products, funeral services, burial products and burial services that one would prefer having for final arrangements.
It helps the family to avoid taking loans, arranging finance plans, raiding savings or selling assets to pay for a funeral and burial.
It guarantees (for many contracts) that if products and services currently purchased are not available in the future, equivalent substitutes will be provided at no additional cost.
It locks in guaranteed prices (available with some contracts) forever.
It allows for inflation in future costs (for those contracts that do not guarantee prices) by investing money in an interest-bearing account or buying life insurance that increases in value over time.
Depending on the contract, it may allow for transfer to another funeral home or for partial or full refund.

Unfortunately, there are also problems with prepaid, preplanned final arrangements.

With some trust fund and insurance funding options there may be no refund if someone wants to cancel the plan in the future.
If a purchaser moves to another state there may be no transfer options or there may be different rules governing the funding option.
In some contracts, interest earnings on investments resulting in excess money not needed for the plan may be retained by the funeral home or funeral director.
On installment plans interest may be charged but not credited to the account.
In certain insurance funded contracts, the ownership or death benefit may be irrevocably assigned to the contract holder (funeral home), preventing the purchaser from enjoying ownership rights in the policy.
In certain insurance funded contracts, a growth in the death benefit over time that exceeds the cost of the preneed plan services and goods may be pocketed by the contract holder (funeral home) instead of being refunded.
If the contract provider goes out of business or fails to secure 100% of the funds for future payment, there may be no recourse to get all of the money back that was put in.
If certain services or goods that were purchased initially are not available in the future, but more expensive versions might be, the family may be forced to pay extra for those items.
In certain insurance funded plans, if the insured dies too soon, there may have been a waiting period in which few or no benefits are paid at death, thus forcing the family to pay out of pocket for the funeral.
Certain unscrupulous providers may have failed to provide an itemized list of services and goods or failed to identify properly, specific services and goods, thus allowing the provider in the future to substitute less expensive items or to leave out services and goods that were originally anticipated in the agreement.

What Services and Goods Can Be Prepaid?
All states allow for prepaid plans for funeral services and merchandise. This would include such things as picking up the body, embalming and restoration, rooms or chapel for viewing and funeral services, casket, vault or grave liner, transportation, permits, death certificates, obituaries and so forth. Almost all states allow for prepaid burial services and merchandise as well. Only about six states do not allow it. Burial services and merchandise might include opening and closing the grave, grave markers, vaults or grave liners, mausoleums or niches. Cemetery plots are excluded from prepaid plans in all states.

The AARP has excellent information for consumers on planning for funerals. Quoting from the AARP:

"Most states have a licensing board that regulates the funeral industry. You may contact the board in your state for information or help. If you want additional information about making funeral arrangements and the options available, you may want to contact interested business, professional and consumer groups."

To find a planner in your area contact StarfishResources@gmail.com or you may also contact the National Care Planning Council at inquiry@longtermcarelink.net or call 800-989-8137

Fall Prevention

2009-09-23T15:48:00.001-07:00

This week (9/20 - 9/26) is Fall Prevention week.
As a member of San Diego's Fall Prevention Task Force and Speakers Bureau I encourage
everyone to take a look around their home for tripping hazards. Many falls are preventable.
Between 30-40% of people over 65 fall each year. Of those, 20-30% suffer moderate to severe injuries such as hip fractures.
There is a wealth of information on this website for you to see regarding Fall Prevention
http://www.sdcounty.ca.gov/hhsa/programs/ais/health_promotions/
and more on my website at
www.starfishresources.net

Greetings

2009-09-21T19:21:00.000-07:00

My name is Nancy and I am a Resource Specialist for senior care in San Diego. My company name
is Starfish Resources. My website is www.starfishresources.net
I hope you will visit and check it out - there's a lot of information there for seniors and their families to utilize from medi-care to placement.