COVID-19 Update: How We Are Serving and Protecting Our Clients

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I have some exciting news, and I couldn’t wait to share it with you 🙂

I’ve been asked to speak at a unique and innovative event called Retire Wiser Chicago. This online summit begins just days from now, Sept 9th, 10th & 11th.

This educational event is hosted by two, very well-respected Chicagoland financial advisors who I know you’ll really appreciate. For many years, John Bever and Jim Uren, have been helping Chicagoland residents just like you make wise decisions as they prepare for and enter into their retirement years. What sets them apart from many other advisors I have met is their passion for financial education that is both well research and practical.

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No one ever likes the idea of placing their loved one in a senior living community. But sometimes an observation from a non-family member and unbiased third party like ADSLA can bring another perspective into light.

My client was a child of elderly parents in their very late 80s and mid-90s, respectively. One parent had issues with dementia and needed serious help with toileting and bathing, including lifting. The more independent spouse, who had health issues too, insisted upon completing these tasks for reasons that I have heard many times before: e.g., “We don’t want in-home care because we do not want anyone in our house.” Or “I don’t want my spouse placed in a senior living community when I can do this.” And “Money is an issue.” While sympathetic to such common reasons and the spirit of love and commitment behind them, I observed that the caregiving spouse was very small in stature and looked tired and frail. I had no idea how they were completing the caregiving tasks without getting hurt. Needless to say, something needed to be done for both parents’ well-being.

My client had arranged for me to meet the couple via a Zoom call. When I observed the senior with dementia, I found that by engaging them in conversation that they loved to talk about their hobbies and seemed to be thrilled to have someone to talk to. The senior was very talkative and social. In contrast, the person doing the caregiving looked very fatigued and frail. In addition, I learned there was another adult child living with the couple who supposedly sat with the person with dementia (PWD) but wasn’t engaging in any of the caregiving. When I suggested that it might be a good idea to hire a caregiver who could engage in conversations with the PWD about their beloved hobbies, I received pushback from the resident child who said, “I can do that.” I also pointed out that a hired caregiver could provide an opportunity for the caregiving spouse to take time for respite and freely do whatever they wanted to do for several hours each day. Again, the caregiving spouse objected, claiming “I really don’t need that.”

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Guardianship is among the services that I have specialized training and experience to provide. Guardianship is a legal process whereby a court appoints a qualified individual the authority to make decisions on behalf of a person who is deemed to be legally incapacitated. The Guardian’s ward (the person I am appointed to protect) doesn’t have the capability to make decisions about his or her personal care or finances. The Guardian must protect the rights of the ward and allow the ward to function in the least restrictive setting without the danger of harm. The Guardian acts as the ward’s

Advocate

Surrogate Decision-Maker

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If you are thinking of hiring licensed non-medical home care for your loved one, you should be aware of some changes that have arisen due to the pandemic. My Real-life Story will outline what they are.

Real-life Story

My client is an 84 year-old man. He is still an avid skier, and flies a glider plane. His wife who is only 72 years old is well in the latter stages of Alzheimer’s disease. Although she is ambulatory, she cannot bathe or dress herself. Previously, she had prepared all of the couple’s meals. Since my client doesn’t cook, meal time was a huge challenge. He told me that getting his wife dressed and fed in the morning and putting her in bed at night were the hardest parts of the day for him. Yet, he admitted that he wasn’t ready to place her in a nursing home. But, he also told me that her condition prevented him from getting out to ski or fly his plane. It was taking a toll on him and he was increasingly conflicted and in need of both a listening ear and informed, professional advice.

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Brendansfavorite42ndstreet-237x300I turned 62 on my last birthday. I have never allowed my age to deter me from enjoying my avocational interest in tap, ballet, and jazz dancing. As a senior living advisor and former, part-time amateur children’s dance teacher of 13 years, I am pleased to see senior communities offering dance therapy classes to their residents. In addition to founding and leading ADSLA, I have also taught tap and ballet in several senior centers and in the dementia area at The Arbor of Naperville. On a number of occasions, I was made aware that several of the class participants also had Parkinson’s disease.

Exercise that is performed several times a week is not only fun, it also can help to elevate a person’s immune system and make one feel better about oneself. That is because of the endorphins that are released. Exercise classes provide camaraderie while encouraging seniors to move all of their body parts. If a person moves his or her limbs, it increases hand to eye coordination, strengthens the core muscles, and improves balance.

I approached the senior classes as I would have approached instruction at any other basic level: I included combinations and repetition to Frank Sinatra and Bobby Darin songs. I observed that most of my “students” found ease in doing the tap warm ups, and some jazz movements, even if they were confined to a wheel chair. Many of the participants said that their joints felt better, their overall movement improved, and, most importantly, their spirits had been lifted. After the class had finished, we’d talk for a while. Some of the residents with dementia would reminisce about where they used to go to dance with their spouses. Several residents remembered their teacher’s names, and where the studios were located. The repetition of certain exercises helps people with Parkinson’s to concentrate on movements that have become difficult for them, such as doing two things at once. People who have suffered a stroke are able to express themselves by moving to the music, even though they can’t talk. Sometimes individual’s medications stop working for them and the classes give them relief from their symptoms.

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The CoVID19 pandemic has been challenging for all Americans and people worldwide, and it has been especially difficult for senior citizens and the men and women who care for them. I was pleased to be among the experts contacted by WTTW TV Channel 11 for this broadcasted report, “Nursing Homes See Increase in COVID-19 As Virus Surges in Illinois” (Byline: Marissa Nelson, 2020 Nov 18; article posted 8:37 PM at

https://news.wttw.com/2020/11/18/nursing-homes-see-increase-covid-19-virus-surges-illinois

As I state in the WTTW news article published online, CoVID-related isolation has been very difficult for both nursing home residents and their families. Senior facilities, however, have tried hard to soften the blow and keep residents connected by arranging Zoom calls or Face Time. Journalists’ interest in the welfare of our growing population of senior Americans – and what organizations like ADSLA are trying to do to help – is much appreciated!

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I recently had a heartbreaking experience with a family that made me very upset. Two adult sons hired me to help place their father in assisted living memory care. Their father was in a second marriage and living in his home with his second wife. The sons were not Power of Attorney for Health Care or Property. As it was explained to me, the second wife persuaded their father to sign his Powers of Attorney over to her when he had very early signs of dementia but was still well enough to sign. I was also told that the woman was aware of her husband’s ample finances and allegedly had stolen money from him.

When I first met with the family (the 2 sons and new wife), I sensed some very uncomfortable dynamics in the room among the family members. At our first meeting, they explained to me that they had a homecare agency coming into assist their father. He had previously been in a new assisted living memory care community that was part of a brand-chain I didn’t respect. Because of the poor care he received there, his new wife brought him home. The sons hired me to place him in a different community because his constant pacing and refusal to bathe made it difficult for him to stay at home. I investigated options and arranged for his placement at a superior assisted living community that also had skilled nursing care available whenever he might need it.

The clients took my advice and everything went very well. Then, the man’s dementia progressed and he was moved to the skilled care area of the assisted living community. When his wife saw the bills for the skilled care area, she claimed the costs were too high and stopped paying them. However, the sons assured me that their father had plenty of funds to pay and to pay privately (i.e., personal versus Medicaid funds). The community where he was living issued an eviction notice to the wife for non-payment. I told the boys to fight the eviction because moving a person with dementia too many times can lead to serious behavioral issues. The sons took the new wife to court, and their father was allowed to stay.

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My clients were a fascinating professional couple from South Africa. I say fascinating because they told me stories of how they had hidden Nelson Mandela in their home for 2 weeks while they were living there. The couple hired me to find the right senior living community for them because, unfortunately, the wife had memory issues, and the husband had terminal cancer that was expected to claim his life within a year. Both were ambulatory and extremely intelligent.

They had looked at several places on their own. However, none of the places had an assisted living memory unit, which would be critical for the future since the husband was not expected to live beyond another 12 months or so. When he died, the wife would have no one nearby on a daily basis to help with her memory issues. When I pointed this out to them, they had no idea there was no memory care available at the communities they had been considering. Can you imagine if they had moved to such a community, based on their limited assessment? They hired ADSLA just in time!

My clients’ major criteria for choosing a community was proximity to their two sons, both of whom have disabilities and do not drive. A member of the extended family confided to me that the parents had provided condominiums for their adult sons and, effectively, routine transportation as well, even though both men are capable of using publicly available transportation.

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I have repeatedly been asked in recent weeks whether a move to a senior living community at this time is “safe.” My answer? No, it is not as safe as we would hope, given the prevalence and the uncertainties of the coronavirus, CoVID10. While reported nursing home deaths related to CoVID19 may be at times inflated or otherwise erroneous, we do know that at least 20,000 and possibly more than 40,000 senior Americans have died in nursing homes during the pandemic, as the sudden onslaught of CoVID19 left many providers and public leaders ill-prepared. Certainly, most senior living facilities are doing their very best to ensure the safety and health of their residents and staff, and are working diligently to follow official public health guidelines for disease prevention. At this time, however, heightened concerns about CoVID safety call for careful evaluation of each and every senior housing option, as some placements must continue out of sheer necessity.

While long-term care facilities are following standard public health guidelines to protect residents as much as possible from CoVID and other ailments, at this time each long-term care community is conducting new admissions a bit differently. Here are some varied examples I have encountered thus far:

1. My client is only 60 years old and has some very serious health issues that render her bedridden. I was hired to find short-term rehabilitation that could also keep her for long-term placement after a stay in a specialty hospital. This objective was a terrible challenge because of her age and her funds being rather limited. Many of the communities rejected her, I suspect because they held the perception that a Medicaid claim would be looming from this client within a short period of time as her limited funds dwindled. The rate of reimbursement for a Medicaid recipient is significantly lower than what a community would receive if a person were paying privately.

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The CoVID19 crisis has brought home crucial lessons for all of us who care about older loved ones and America’s senior citizens. Often, a senior has to be placed in a nursing home because of his or her medical conditions or financial circumstances. By their very nature as communal facilities that house older and infirm individuals, nursing homes are natural “hot spots” for both seasonal influenza and Coronavirus. Residents may contract Coronavirus due to their proximity to other residents who have it, or exposure to a staff member required to give hands-on care, or from some other disease vehicle. In this pandemic both public policy and a lack of emergency planning by nursing homes share blame for the high incidence of infection and death.

For example, some state governors (including, ironically, some who refer to seniors as “our most vulnerable population”) ordered nursing homes to readmit residents who had been in the hospital. In New York, this included seniors still ill with CoVID19! Ordering a resident to be readmitted to a nursing home often sets them up for failure because many homes are poorly staffed to begin with. Most of the time, the ratio of certified nurse assistants to residents is 1:12 or higher. This means that one nurse aide is responsible for caring for a dozen or more residents.

Some nursing homes have sequestered residents with CoVID symptoms to specific areas and required them to quarantine in a private room for seven to 14 days, which is extremely difficult for seniors deprived of human contact. Elsewhere, such sequestration is a safety measure that many homes cannot provide due to bed availability and spacing issues.