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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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Hearing loss can lead to auditory deprivation, dementia, and emotional problems.  I have asked my respected colleague, Audiologist Kelly O’Malley, to share some facts about each consequence:

Auditory Deprivation:

When the hearing nerve and the area of the brain responsible for hearing are deprived of sound, they atrophy. Microscopic hair cells in your inner ear vibrate with sound and send signals to your brain. When those hair cells are damaged, they can’t transmit the sound properly to your brain. This results in hearing loss at certain frequencies. Prolonged untreated hearing loss may cause your brain to forget how to interpret auditory impulses, like an unused muscle becomes weak over time. Damage to the hair cells in the inner ear is permanent. Even if these areas are stimulated again through amplification, the brain may no longer be able to interpret the incoming signals clearly. In other words, “use it or lose it” applies to your hearing as well.

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At the request of the Illinois Chapter of the Huntington’s Disease Society of America, I was recently asked to give a presentation at their annual meeting on, “How to choose a nursing home”. Had I been asked to speak about how to find a nursing home for a person with Huntington’s disease, the task would have been much more challenging.

For those of you who are not familiar with the disease, here are some very general characteristics of the disease:

1. It is a neurodegenerative disease that causes deterioration of the brain cells. It can strike as early as the age of 30 and progress for several decades. It can also strike children and the elderly. The disease is hereditary. Its victims exhibit inappropriate behaviors that can sometime be violent.

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Being older CAN have its advantages. Among them are these potentially money-saving tips from the IRS, for those of you who have not already done your taxes.

If you and/or your spouse are 65 years old or older, you can get a higher standard deduction amount if you do not itemize your deductions. And if either you or your spouse is blind, you can get an even higher standard deduction amount.

One suggestion I would add about the Standard Deduction for Seniors: If you are unsure which path is better for you, prepare your taxes both ways: Both with itemizing deductions and without itemizing deductions and compare your results. Naturally, you’ll want to choose the path that reduces your tax burden or increases your Refund.

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While “age 55 and older” seems to be the general definition of an American “senior,” I have never allowed my age to deter me from enjoying two of my favorite activities: tap and jazz dancing. As a senior living advisor and former part-time children’s dance teacher, I am pleased to see so many senior living communities offering dance therapy classes to their residents. I have also taught tap and ballet on a voluntary basis in several senior centers and in some of the assisted living communities that specialize in dementia care. When I was teaching, I was made aware that several of the participants in my class with dementia also had Parkinson’s disease.

Exercising even just several times a week can boost a person’s immune system and make him or her feel better physically and mentally. That is in large part because of the endorphins that are released. Exercise classes provide fun and fellowship while encouraging seniors to move all of their muscles and body parts. If a person moves his or her limbs, it increases hand-to-eye coordination, strengthens the core, and helps balance.

I approached teaching my senior dance classes as I would have any other basic level: I included combinations and repetition to Frank Sinatra and Bobby Darin songs, among others. I found that most of my “students” found ease in doing the tap warm ups, grape vines, and some jazz movements, even if a participant was 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, I always served my students a snack and 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. One resident in particular spoke about a church in Evanston, Illinois that had a Scottish affiliation and offered Scottish dance lessons. She even went so far as to quote me the exact street address. 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 seniors’ medications stop working for them and yet the classes gave them relief from their symptoms.

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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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Real-Life Story

I recently had a preliminary meeting with the adult son of an 82 year old senior who was diagnosed with dementia. The senior had been living with him for a number of years and was having issues with wandering, falling, and incontinence. In order to alleviate the stress of having the senior in the adult child’s home, a part-time caregiver was hired during the day to meet the senior’s care needs. During our meeting, my client did not want me to meet the senior in order to avoid unnecessary agitation. His mother was not born in this country and spoke a limited amount of English. After learning some facts about the senior’s behavior and financial realities, I informed my client that the senior was a candidate for assisted living with memory care. But, the catch was she needed to be in a Continuing Care Retirement Community that would keep her once her funds were exhausted. Or, she could move to an assisted living that offered memory care. Then, she could be moved to a nursing home that accepted Medicaid when she still had enough funds to move to a decent community.

Right after Christmas, my client called me and said his mother had fallen. The rehabilitation community where she was receiving therapy had set a release date for the following week. My client asked me to come and assess the senior and make suggestions for a long-term care community.

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Real-Life Story

My client was 102 years old and had lived in the same independent living community for more than 12 years. She had moved there with her husband when the community was a homey retirement home. After her husband’s death, she remained there with 2 part-time caregivers who provided total assistance with bathing, dressing, escorts to the dining room via wheelchair, and transporting her on errands. She was alert.

When I went to assess the client, I was greeted by 5 family members who were gathered in her lovely 2 bedroom apartment. As they explained to me, the community had been purchased by another organization that was turning it into a glamorous, high-priced, marble-clad independent living community. As I was listening to them, I noticed a baby grand piano occupying the corner of the room. And at one point during the conversation, the caregiver assisted my client with being seated at the piano. She delighted me by playing a wonder rendition of George M. Cohan’s work, “Give my regards to Broadway.” She could still play despite needing help with other activities of daily living!

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As a Certified Guardian, I am often asked to act as a senior’s Power of Attorney for Health Care when s/he doesn’t have a family member who is willing or fit to act for him/her. Simply stated, the Power of Attorney for Health Care grants the designated “agent” control over the senior’s decision-making, including end-of-life decisions if the senior lacks the capacity make the decisions on his/her own. As a Power of Attorney For Health Care, you should be thoroughly familiar with a senior’s personal, financial, and medical history before accepting this serious responsibility. Please read the following real life story that makes my point.

REAL LIFE STORY

Five years ago,  I was called at the last minute to act as Power Of Attorney (POA) For Health Care for an 85 year-old  woman.  It was the day before she was to move to independent living at a retirement community. Independent living used to mean that the senior can basically function on their own with some assistance with meal preparation and housekeeping. Now there are a lot of ala carte services that can be brought to the senior’s independent apartment, allowing him/her to remain there without changing to the assisted living level of care. The woman’s former POA had moved out of state and had written her a formal letter of resignation. A trust company had been appointed to act as her Power of Attorney For Finances.

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My client was the son of a 72 year-old woman who had suffered a stroke within the last six months. She had been placed at an excellent assisted living community that I had used for several clients in the past. After the stroke, she needed some help with her activities of daily living. Her son had indicated that he wanted to move her due to the high price being charged at the community. He was bearing most of the expense. He asked that I come and visit with her in order to hear her side of the story.

When I went to assess her in the lobby of the current community (at the son’s request), I found a well-dressed woman who was totally independent and had all of her faculties. When I asked her why she was in assisted living, she told me about the stroke. The physician who practiced at the community originally would not release her to the independent living level of care.  She felt the woman needed medication supervision.  But, my client proved her wrong. Then on review of my client’s case, the physician reversed the decision and approved her her to live in the independent living area.

However, my client didn’t want to remain at the current community. She had met a boyfriend there, and he had recently moved to a competing independent living community. She wanted to move there too.  As the conversation developed, she shared that her boyfriend wanted her to move in with him because his memory was getting bad, and he wanted someone to take care of him.

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