Articles Posted in Non-Medical Home Care

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I recently had the wonderful opportunity to be interviewed on the Silver Solutions Radio show. It airs on WMRN 1410 AM in Elgin, Illinois. It is hosted by Jeanette Palmer, Jim Wojchiechowski, and Kathleen Wetters, who each independently own a Right At Home non-medical home care agency. During the interview, they graciously gave me a chance to explain how I started my career in the senior housing industry as the Admissions and Marketing Director of the St. Andrew Life Center (Now Glen St. Andrew) in Niles, Illinois. It was a faith-based community that offered three levels of care, including independent living, assisted living, and a nursing home on one campus. I was receiving so many telephone calls (mostly from the children of seniors who were calling me from the Yellow pages) from people who didn’t know how to solve their senior loved ones’ problems. I saw a niche for a consulting business. So in 2006, much to my husband’s dismay, I opened Andrea Donovan Senior Living Advisors in 2006.

I started my senior housing placement consulting business by touring and evaluating over 150 senior living communities in the Chicago metro area. I looked at cost and methods of payment accepted, levels of care, staffing, and quality of care. Then I also evaluated quality of life factors such as cleanliness, menus, activities, and apartment and room layouts. So, when a family needs my services, I make a face to face evaluation of the senior, their financial realities, and the location preferences of the family. Then, I select the options that fit the senior’needs so families aren’t wasting time touring places that simply won’t work long-term.  At this point I have toured and evaluated close to 500 senior communities in the Chicago metro area.

We also shared a very frank discussion about the costs of placement in a senior living community versus the costs of staying at home in the Chicago metro area.  We talked about the advantages and disadvantages of each option.

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The worst part of my business is that I sometimes have to say “Good-bye” to my favorite clients. In the past several weeks, I have had two favorite clients pass away, and one move out of state to be closer to her son. Today, I am going to share a story about one of my clients, whom I am going to call “M.”

“M” was in his early 70’s. He was a former states attorney, who was hired personally by the late Mayor Richard J. Daley. M was extremely eccentric and opinionated, and some of the things he said made me laugh so hard that I cried. He had opinions of politicians no matter which party they belonged to. He had been educated by Jesuits from high school through law school and hated everything that happened in the Catholic Church after Vatican II. He had never married, lived with his recently deceased mother, and cherished an overweight, 6 year old Dachshund that was not housebroken. (Therefore, the dog did its business anywhere in the house). He told me that if anything were to happen to him, the dog was to be taken to a woman who ran an animal shelter in her home up the street. He didn’t put this in writing. His estate was left to a charity. He had named a trust company as his Power of Attorney for Property. I was referred to this gentleman because he had very bad experiences with a non-medical home care agency. After a stroke in spring 2017, he amassed a bill for more than $200,000 in charges for 24-hour care provided by the agency. After reviewing the bill, I found some of the charges to be extremely excessive. I was hired in January of 2018 to help find a new home care agency for him and pay his bills. After bringing in 2 agencies for him to interview, he confided that he had hired some caregivers privately at a much lower rate.

As I put together M’s big financial picture, I found that his money was at a bank in a number of CDs valued over $500,000. He had checking accounts in two banks, an IRA, a pension, and a vacation property in Wisconsin. He had a habit of running down his checking accounts to the last penny, even though he had plenty of money. When I suggested that a financial advisor should be called to “pull everything together and maximize earning potential,” M replied, “No, because they will make me sell the property in Wisconsin.” Please note that M was not in any physical condition to be using a vacation home. Nevertheless, I backed off. However, when I would give him advice, he would acknowledge me with a traditional, “Yeah, I know.” As time went on, M trusted me more and more. Eventually, he asked me to attend his doctor appointments with him and become his advocate. He had signed a Power of Attorney for Health Care with another entity in 2017 that never had any contact with him, or knew anything about him. I was named, however, as Power of Attorney for Property at only one of the banks where his CDs were placed and came due. I would then cash them in. In other words, I was effectively the only person who knew what was going on in his life. Did he have relatives? Yes, but he wanted nothing to do with them!

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My client is a 72 year old, Eastern European woman who had been living in an apartment. She ambulated with a walker. She is diabetic, suffers from anxiety, and has difficulty with her vision. She had contracted an infection in her back due to a fall and had refused to go to the hospital for treatment. She had a part-time unlicensed caregiver who assisted her with errands, bathing, and meal preparation. The caregiver came to help out for several hours a day during the week, but my client was alone at night and on the weekends. I was hired initially to assist my client with making her cremation arrangements, review her paperwork and pay bills, and assess the need for senior living options. Although my client and I have a fairly strong bond, I sensed that the bond between her and the caregiver was much stronger, as they were both from the same country of origin.

After working with my client for a month or so, I told her that I didn’t feel that her apartment was safe for her to be alone. She even confessed to me that the shower didn’t work properly, and the caregiver was filling a bucket and dumping the water over her head in the bathtub in order to bathe her. I suggested calling the landlord.

As time went on, my client named me as her Power of Attorney for Health Care and Property. Her financial advisor, attorney and I had repeated conversations with her (together and apart) regarding the need for her to move. As the saying goes, the conversations fell on deaf ears.

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The child of an elderly loved one will undoubtedly face terrible stress when trying to care for him/her.  My respected colleague, Kurt Hjelle, owner of Safe At Home Health Care, a non-medical home care agency specializing in live in caregivers,  does a wonderful job of describing the realities of caring for an elderly loved one:

Every single week, I am contacted by a family member — typically the son or daughter of a senior citizen — who is looking for help.

Their parent (or parents) are starting to have some struggles, and it’s taking its toll on the entire family.

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A client who heard me speak a number of years ago decided to hire me for an interesting project. He and his wife live in a large beautiful older home (estimated over 5,000 square feet with three floors). The couple was wondering what the potential future costs of staying in the home would be if one or both of them became ill. I generated a report for them based upon three case examples. Although I didn’t know what the current costs of maintaining their home are, I included places in the report to “fill in the blanks.” I gave the couple some general ideas of what they might need to consider in the future. Many of the future costs would vary by the dimensions of their home and the models of safety equipment chosen (e.g., stair lifts, as they had three floors). The report was meant only to give them ideas of what the costs might be, and what they might need to think about for future safety. I ended the report with a ball park comparison of what it might cost to move to one of the higher end senior living communities. Here are the results:

Case Examples

Client M had been healthy until recently when s/he was diagnosed with a serious heart condition. The client was ambulatory, but now needs a walker. Because the disease has left the client very weak, s/he needs help with meal preparation, bathing, dressing, and standby assistance with toileting. In addition, the caregiver must run errands, provide medication reminders, do laundry, and light housekeeping. All of the necessary help can be obtained through a private caregiver from a licensed non-medical home care agency. The current cost for care of the individual would be $22 per hour. The non-medical home care agency estimated that the client would need at least 8 hours of care per day, 7 days a week so as not to exhaust the spouse. Therefore, the cost of the care would be $176 per day, and $1,232 per week. The total annual cost for the caregivers would be $64,064. In addition, the bedroom was on the second floor, so the stairs would need to be modified in order to accommodate a lift, the cost of which would start at $1,600. The bathroom needed to be outfitted with grab bars, and the shower needed to be modified to a walk-in model, with the addition of a raised toilet seat. A ramp needed to be fitted to the back door, with access to the driveway. Additional support had to be hired to keep the ramp and other areas free from snow and ice. The house needed to be canvassed for tripping hazards and slippery floors.

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Elder abuse is a crime. It can occur whether your loved one is at home, attending adult day care, or living in a senior living community. And like any other crime, you have an obligation to report it. This month, I have asked one of my trusted partners, Mike and Mary Doepke of Home Helpers Home Care of Hinsdale, to share some information on Elder Abuse:

From all outside appearances, 80-year-old Shirley seemed well cared for by the niece who had moved in with her a few months earlier. She even told her friends how she was enjoying the company and the help around the house.

Shirley had always been frugal with her credit cards, using them only when needed. So when the bank called to ask her about some recent, unusual charges on her account, she was alarmed. She was even more surprised to find out that the purchases were made by the niece she had welcomed into her home.

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There are approximately 44 million Americans who are caring for an elderly loved one.   Between one and two million people over the age of 65 have been abused by someone who cares for them.  During the eleven years that I have owned my senior living consulting business, I have one story involving elder abuse that really stands out in my mind.  Here it is:

A respected colleague called me and said that a couple in their 80’s were in a very tenuous position, and asked if I would assess their situation with regard to recommending some senior living communities.  When I called and spoke to one member of the couple, I was told that he and his wife were not interested in senior living communities, but would rather speak to someone who could help them integrate back into society via participation in activities at a senior center.  He also expressed interest in having a personal trainer come into the home and exercise with them.    I told him I would get back to him in several days.

When I contacted him a few days days later with potential resources, his conversation with me went in several drastically different directions.  I felt that an onsite visit was in order, so I made an appointment with him for  visit.

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Many seniors have a tendency to keep private their financial realities. However, if your senior loved one purchased long-term care insurance to cover the costs of a stay in a community or to hire non-medical home care, you will want to ask if you can look at it. I say this based on the experience I had with my mother, and I share our story lest you should have the same experience.

My mother purchased a long-term care policy 25 years ago. I was amazed that the insurance carriers were able to underwrite her at age 70. Thankfully, she was well enough to pass the underwriting since she had no serious medical issues at the time. However, the agent who sold the policy to her (and who had bragged that she was the number one producer at her company) was not exactly prudent when designing the structure of the plan for a claim that could occur in the far future. The plan that was sold to my mother included a 90-day waiting period before any benefit would be paid. Such waiting periods are common. The plan maximum paid up to $100 per day. That, too, was all right for a plan that was purchased 25 years ago. However, the agent neglected to sell my mother her an inflation guard benefit which would increase her plan’s benefit by 3-4% per year. If an inflation guard benefit had been included, the benefit she would receive would be much more in line with the currents costs charged by her senior living community. The bottom line is, based on the plan purchased 25 years ago, my mother will receive a benefit that will cover $3,000 of her $6,000 monthly cost.

While I am thankful she had the policy, it would have been more valuable if the inflation coverage had been included at its inception. If you know or suspect your aging loved one has purchased a long-term care policy, ask if you can sneak a peek at it!

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If you are considering non-medical home care for your loved one, you should be aware of some changes in this segment of the senior living industry.

When I started in the senior living industry over 15 years ago, things were very simple. “Assisted living” meant nothing more than “stand by,” assistance with activities of daily living. Now, the industry has changed. “Hands on” care is available at the assisted living level, which allows the senior to remain in his/her assisted living apartment so much longer. In the same way, the licensed, non-medical home care agencies have undergone many changes. I have asked Mike O’Brien, owner of Independence-4-Seniors, and Legislative Chairperson, Illinois Chapter of the Home Care Association of America to tell you about them.

Illinois Legislation and Regulatory Changes in Private Duty Homecare

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My clients are a couple ages 78 and 80. The couple’s daughter had called me and tearfully related the story of how her parents were looking at senior living options, most of which would not fill their long-term needs. Like many of my clients, they had lost a significant amount of money in the most recent economic crisis, and they were living in a condominium where they could not afford to stay. The daughter feared that they would run out of money and be forced to move to a Medicaid community in the future. She pleaded with me to call her mother and set up an appointment to talk to them.

When I called, her mother curtly told me that they were still driving, had their faculties, and were able to evaluate the senior living communities on their own. Furthermore, they couldn’t afford services like mine. I assured her that I have lots of flexibility with the way my services are structured, and I could design a consultation that fit their budget. She said “no thanks,” and hung up.

When I relayed the situation to the daughter, she said that she would convince her parents to set up an appointment with me. To this day, I don’t know what the daughter said to her parents, but within a few days, I had an appointment set.