THE PLEASURES OF OLD AGE

“Old age has its pleasures, which, though different, are not less than the pleasures of youth.” W. Somerset Maugham.   

With maturity comes an ‘ease of being.’   It’s true, we don’t stay up until the wee hours of the morning (often) but we can still have a fabulous time and be in bed by midnight.  Recently, I went to Philadelphia for my cousin’s 80th birthday celebration.  It was three full days of partying — everyone had a blast!  Yes, bed time was earlier but the enjoyment the same.

Most Assisted Living Centers happy hour starts at 3:00pm!  Personally, I loved going to Dad’s Happy Hour . . . let the party begin!  Dad and his fellow residents also loved Happy Hour and still had time for a nap before 6:00pm supper!  

Another pleasure of old age is being able to play 18 holes of golf instead of a “quick 9”.  I remember when we were kids, Dad had Saturday golf every week — and he didn’t get home until after lunch.  That did not go over well with the Mother of his children.  After the children left, it was 9 holes with Mom once a week and 2 rounds of 18 holes weekly  . . . ahhh . .  the decadence!

Now, it’s the little things that give us much more pleasure; taking a grandchild to their first ballet or play, hearing the newest member of your family call you “Grandma” or “Nona”.  The family getting  together to celebrate a wedding or birthday  . . . all give us a chance to luxuriate in the foundation we have created for the generations to come.

And to those baby boomers reading this — remember, how you treat your loved ones is how you’ll be treated.  Paul said it best in his Epistle to the Galatians:  for whatsoever a man soweth, that shall he also reap.”

WALKING ON THE MOON DOES NOT KEEP YOU FROM AGING

Buzz Aldrin, the second man to walk on the moon, is 88 years old and has met his fourth wife.  The bad news, the kids don’t like her.  

Here’s what we know from media reports; Dr. Aldrin has sued two of his (3) children and his former manager.  Two children, Andy and Jan, had asked a court to name them as guardians citing his loss of cognitive function and dementia. Warrior that he is, Colonel Aldrin (ret) came out fighting!  He sued the kids, claimed they had transferred monies from his foundation for their personal use and used his credit cards without his permission and sabotaged his love life.  He made an appearance on Good Morning America excoriating his children and accused them of exploiting the elderly.  

The  ousted manager, Christina Korp, states that “almost a year ago, some people began to exert undue influence on Buzz.  These individuals began to actively try to drive a wedge between Buzz, his children and me, for what I fear is their own benefit.”  Her  argument is that because he has dementia he is vulnerable to manipulation.

My argument is that the kids and manager he is suing are doing exactly the same thing.  This ‘fight’ is about who gets to manipulate Colonel Aldrin.  His estate is valued at approximately $12 million. The two children are paid by the Aldrin foundation, as was the former manager. 

Lisa LaBonte met Buzz Aldrin because of their shared interest in STEM education (Science, Technology, Electronics, Mathematics).   She works for Carnegie Ventures and because of Colonel Aldrin’s work has become a part of his business life.  They are great friends.  

Colonel Aldrin also has a girlfriend (unnamed) and the relationship has blossomed into something more.  One can speculate as to her motive but the same can be said for the kids and former manager.  Further, If Buzz Aldrin is happy  . . . who cares?  Doesn’t  he deserve it?

All of this will be solved fairly soon as the “mental health’ tests have been administered and the Courts will review the three different opinions.  I’m only sad that a man who gave his life to service for our country (his children did not) has to defend his honor.  The children did nothing for the $12 million but now feel as though its theirs to protect.  I say, Buzz Aldrin’s life speaks for itself.  Good for him making a last stand – no matter what the outcome!

AGING ALONE? PREPLAN!

Teddy Roosevelt once said, “Old age is  like everything else.  To make a success of it you’ve got to start young.”   That is especially true if you plan to age alone, without the benefit of children or close family.    I am most likely going to age alone and I am preplanning for that.  You should too.

Today’s 80 is the new 70 and 70 the new 60.  Most of us don’t plan on giving up work, volunteering or travel until we’re well into our 70s or 80s.  I have friends who were volunteers at the Key Biscayne Tennis Tournament for over 20 years — the only reason they didn’t volunteer this year was because he became sick and couldn’t.  

As we grow older those of us aging alone have to make plans while we’re fully functional.  We have to discern what resources are available to us in whichever community we choose as our ‘last home’.  With today’s service industry and technology there is a huge advantage . . . there are healthy meal services (both for profit and non-profit), ride share and in many neighborhoods free ride services.  We also have medical care right here on the Island.  

But, as I state over and over again, it’s about preplanning.  You need to have a trusted friends or advisors who can be named as your Power of Attorney for Finance and Health. You need to decide now how to disperse your jewelry, money and tangible goods and write it down.  You should also plan to stay out of probate court.   

You also need to give your passwords for your bank, phone, computer and any other technological device you have, to trusted friends.  Sometimes the best thing to do is find a disinterested third party, such as elder care lawyer, and give it all to him or her.  Yes, you have to pay them but it’s a simple business transaction devoid of emotion.  You should also think of who is going to manage your health care from an insurance point of view so you’re not selling your tangible goods to pay for unwanted or unneeded health care.   You will need an advocate and that takes preplanning.

To review:  If you live alone now or believe that you will age alone without the benefit of family, now is the time to decide where to live, who to trust, who to choose as your beneficiaries and who to have as your Power of Attorney.  I strongly advise you consult with an elder care attorney for all the correct documentation and to have an advocate for you when you can no longer advocate for yourself. 

RETHINKING THE “I’M OLD” MYTH

Now that I’m a senior advocate and activist, I find that many things that used to be funny are now insulting.  Recently, Julie Andrews did a performance to benefit AARP at Radio City Music Hall. It was her 79th birthday.  To be funny she rewrote the words to “My Favorite Things”, here is one of the four verses: “Cadillacs and cataracts, hearing aids and glasses, Polident and Fixodent and false teeth in glasses, Pacemakers, golf carts and porches with swings  . . . these are a few of my favorite things”

Is this funny?  Not to me.  Yet, she received a four minute standing ovation and several encore requests.  Apparently, I’m in the minority.  However, I think the truth lies in the difference between the Greatest Generation and the Baby Boomers.  Ms. Andrews is part of the Greatest Generation and I suspect her audience was, as well.

First, Cadillacs are no longer and “old peoples car”, secondly cataracts now mean that if you have them and remove them — there is a lens placed in your eye so you no longer need glasses!  Hearing aids?  I’m confident that one day I might need them and with any luck Bose will have them for $500 instead of $5000.  I don’t need Polident or Fixodent and neither did my Mother and she was 88 when she died.  If you go to my dentist, Dr. Friedman. you won’t need them either!

More importantly, let’s think of how lucky we are!  In today’s world of we know how to fix things – falling thighs, exercise!  Cataracts — Medicare pays to have them removed and new lens inserted which means no more glasses! (Or at a a minimum, only for reading tiny print.)  For our teeth, we have implants!  And, if you want to tuck in the chin, eyes, tummy, face —- well, there is my doctor, John Martin and Mike Kelly.  Both are Key Biscayne residents and Dr. Kelly has a column in this paper. 

Bottom line – yes, growing older takes its toll but in todays world we can fight against it.  We’re all aware of exercise and diet.  We know if we simply walk 3 or 4 times a week we live longer,  And, yes, fried foods are a guilty pleasure  . . . which, from time to time we should indulge!  But, for the most part, let’s celebrate those lines  . . . and, if you don’t like them — get rid of them.

GROW OLD OR PURSUE YOUR DREAM?

Gabriel García Márquez states it beautifully, “It is not true that people stop pursuing their dreams because they grow old, they grow old because they stop pursuing their dreams.”   When Dad turned 90 I realized 60 was young (and I wasn’t quite there yet).  Think about it, the first 30 years, you’re finding your way, the next 30 years you’re working your way and I say, use the last 30+ years to do it your way!   

The mindset of the Greatest Generation was to work until you’re 65, retire, receive medicare and social security.  I remember, Dad did that and within a year he was bored out of his mind and partnered with a good friend in a small exploration business.   That kept him busy until he was about 80.  Then he started volunteering at a church-run thrift shop weekly — he quit that when Mom got sick and she became his full time job.  

As I enter my 60s I’m launching a company,  working my consulting job and writing articles.  I love the deadlines and the intellectual stimulation.  I think we all do.  That makes me think it really is up to us to stimulate our minds in ways that make sense for each of us individually.  At the age of 77 Donna Shalala is running for Congress, at the age of 81 Madeline Albright is on tour for her latest book and at 93 Jimmy Carter is still relevant!  Yes, they’ve chosen a national platform but being relevant in a smaller community is no less satisfying.

With today’s technology and car-ride services there is no excuse to stay at home if you want to get out.  And, if you get out, you’re more relevant.  I know an octogenarian amateur playwright (soon we’ll be seeing one of his summer shorts!), and several septegenerian Starbucks employees.  All are happy and “pursuing their dreams.”   Let’s join them!

Medicare Supplement Insurance . . . It Can Be Tricky

George, an 85 year old, was surprised when he received a $4000 bill for his pacemaker replacement procedure, after he was told that it would cost him $250.   He’d called his Medicare Advantage plan before the procedure and was told that he would be responsible for a $250 inpatient hospital co-pay.  Unfortunately, the hospital and the doctor’s office did not tell him that his procedure would be done as an outpatient with an overnight stay.  He stayed overnight but since he was never an inpatient, the bill was applied to his $6500 deductible for outpatient services.  

It’s a constant refrain!  You’re a senior, on medicare, you do everything you’re told but somehow you still owe $4000.  Again – these insurance companies DO NOT WATCH OUT FOR SENIORS and make the simplest of “medical procedures” complicated on the non-medical side.  A simple medical procedure mixed with insurance is like a game with no rules.  It doesn’t matter what plan you choose, there is still many a “slip between cup and lip”.  No other industry in the U.S. is allowed to operate this way.  It’s illegal!

This is especially true if you have a Medicare Advantage plan. These plans are less expensive than regular Medicare with a supplement for a reason.  They may add extra benefits, but they are often more complicated to understand. So what do you need to do to avoid surprises or issues? Plan ahead, ask a lot of questions and advocate for yourself, your partner, your family members or call Parent Your parents.  We can do it for you. 

Parent Your Parents is pleased and proud to announce the advent of Ann McGuire, R.N. to our growing group of experts.  Besides being a RN she is also a certified case manager and knows the pitfalls of senior insurance issues.  Please go to our website, ParentYourParents.com to see her photo and biography.  She and I will be collaborating on more articles to assist you with getting through the insurance maze  . . . little things like what to do if you’re sent to the emergency room.

Bottom line:  remember – insurance when going to a clinic or hospital for any procedure can be very tricky.  It’s not because the doctor wants to charge you more, it’s because of the intricacies of how Medicare Advantage plans work.  

FLORIDA ADDS MORE MONEY FOR SENIOR CARE

As we all now know, after Hurricane  Irma fourteen elderly souls died because the nursing home in which they resided did not have a electricity after the storm.  As a consequence, they “overheated” and died.  Well, there is good news – the Florida Legislature and Governor have placed $37.1 billion dollars in this year’s fiscal budget to be used across six health care and social service agencies.

Florida’s medicaid program is the largest recipient at $29.2 billion and Children & Family Services receive $1.7 billion.  Those living in nursing homes will receive a 25% raise, from $105/m to $130/m. Nursing homes are now required to have generators with enough fuel to cool buildings during elongated power outages. The above monies are all coming from Florida taxpayers but my favorite part of the legislation is not tax based.

Starting this fiscal year, nursing homes (that receive medicaid dollars) will be paid on a set formula.  These providers must meet certain “direct patient-care” requirements as well as “quality of care” requirements.  In other words, if a nursing home only meets a minimum standard, they will be paid a minimum amount and given a set amount of time in which to bring the ‘home’ up to the formulaic standard.  As the homes hire more qualified staff and add amenities to its building and programs – they will receive larger payments.  As one law maker put it, they have to spend money, to make money.

As a senior’s advocate I’m thrilled that our state government realized how badly these “homes” were treating their patients.  Yet, it took senseless deaths to have a focus placed on how our greatest generation and aging or ailing baby boomers are treated when they can no longer treat themselves.  That is where we must be more vigilant.

As I write this, I cannot help but remember the 17 people who died very prematurely at Parkland High School.  And, yes, because of the deaths and the student’s activism we’ve put in some stricter state gun regulations.  Also many large gun sellers are now refusing to sell to anyone under 21.  Still, much like our senior citizens, why must it takes death to examine our mores and ethics.

Elder Rage: How to Survive Caring for Aging Parents

We at Parent Your Parents think this is a terrific “true experience” article authored by Jacqueline Marcell.  Jacqueline is also the Author of Elder Rage @www.ElderRage.com.  Check it out!

 

Jacqueline Marcell, Author, Elder Rage www.ElderRage.com

For eleven years I pleaded with my challenging elderly father to allow a caregiver to help him with my ailing mother, but he always insisted on taking care of her himself. Every caregiver I hired soon sighed in exasperation, “Jacqueline, I just can’t work with your father. His temper is impossible to handle and he’s not going to accept help until he’s on his knees himself.”

When my father’s inability to continue to care for my mother nearly resulted in her death, I stepped in despite his loud protests. It was so heart-wrenching to have my once-adoring father be so loving one minute and then some trivial little thing would set him off and he’d call me nasty names and throw me out of the house. I took him to several doctors and even a psychiatrist, only to be flabbergasted that he could act charming and sane when he needed to.

Finally, I stumbled upon a thorough neurologist, specialized in dementia, who put my parents through a battery of blood, neurological, memory tests and PET scans. After ruling out numerous reversible forms of dementia such as B-12 and thyroid deficiency, and evaluating their many medications, he shocked me with a diagnosis of Stage One Alzheimer’s in both of my parents – something all their other doctors missed entirely.

What I’d been coping with was the beginning of Alzheimer’s, which begins intermittently and appears to come and go. I didn’t understand that my father was addicted and trapped in his own bad behavior of a lifetime of screaming and yelling to get his way, which was coming out now in intermittent over-the-top irrationality. I also didn’t understand that “demented does not mean dumb” (a concept not widely appreciated) and that he was still socially adjusted never to show his Mr. Hyde side to anyone outside the family. Conversely, my mother was as sweet and lovely as she’d always been.

Alzheimer’s makes up 60-80% of all dementias and there’s no stopping the progression nor is there yet a cure. However, if identified earlythere are some FDA approved medications (more in clinical trials) that in most patients can mask dementia symptoms and keep patients in the early independent stage longer.

Once my parents were treated for the Alzheimer’s, as well as the often-present depression in dementia patients, and then my father’s volatile aggression, I was able to optimize nutrition and fluids with much less resistance. I was also able to manage the constant rollercoaster of challenging behaviors. Instead of logic and reason, I learned to use distraction and redirection. I capitalized on their long-term memories and instead of arguing the facts, I lived in their realities of the moment. I learned to just go-with-the-flow and let the hurtful comments roll off while distracting with a topic of interest from a prepared list.

And most importantly, I was finally able to get my father to accept two wonderful live-in caregivers and not drive them crazy and to quit. Then with the tremendous benefit of Adult Day Health Care five days a week for my parents and a support group for me, everything finally started to fall into place.

Alzheimer’s disease afflicts more than 5.4 million Americans, but millions go undiagnosed for many years because early warning signs are chalked up to stress and a “normal” part of aging. Since 1 in 6 women and 1 in 11 men are afflicted by age 65, and nearly half by age 85, healthcare professionals of every specialty should know the 10 Warning Signs of Alzheimer’s and educate their patients so everyone can save time, pain, money, heartache… and a fortune in Kleenex!

SENIORS SHOULD NEVER SUFFER . . . BUT THEY DO

This is an editorial to the Miami Herald written by H. Frances Reaves, Esq., President of Parent Your Parents,  in October of 2017.  This was written after Hurricane Harvey and Irma and the mirror placed on Senior Services. As we suffer through a very cold winter these words are still prophetic.

IF YOU HAVEN’T SEEN the video of the residents of a nursing home in Houston, Texas sitting in waist high water simply search “video of seniors in waist high water” in your browser – the You Tube video comes right up.   School children were evacuated, families were evacuated and who was left behind  . . . seniors.  Two weeks later, in the aftermath of Irma, 14 seniors die from overheating in a Broward County Nursing Home.

If these seniors had been children the outcry would have been much louder and punishment swifter.  An excellent example is the most recent earthquake in Mexico.  The school caved in on top of 24 children and four adults.  The volunteer rescuers were there within minutes and the TV crews transmitted  the entire search and rescue for more than three days.  That would not be the case if this had been a senior citizens facility.

Fariola Santiago wrote in her September 24th column that “the elderly are like children, frail, unable to care for themselves, and vulnerable to abuse and negligence.  Those who don’t have money or advocates and require round-the-clock care end up in places with deplorable conditions  . . .”  I agree with Ms. Santiago regarding the elderly but disagree that all nursing homes have deplorable conditions.  We also need to remember that, with the exception of one “lonely soul,” everyone had a family  . . . and the family did not take them from the ‘deplorable home’ even after they knew about the power failure.

Baby Boomers, Gen Xers and Millennials beware — you, too will be a senior!  Seniors, are an older version of who we are today. We espouse the sentiment that, “I only want to live a long life if I have a quality of life” but legally we don’t have a choice once our mind collapses.

What we don’t discuss is that dementia does not take away your intellect, mental pain or physical pain.  Dementia takes away the ability to communicate effectively.  It also absconds with your memory – which allows we the children to believe that with memory loss there is a loss of all senses.  That is not the case.  The 14 elders who died felt pain and the first to die truly suffered because they did not have the benefit of hospice care.

No doubt, the staff at this nefarious nursing home was negligent, incompetent and uncaring and they were allowed to function as “caretakers” for years.  It took a hurricane and power outage to bring it to light. Had this been a daycare center the negligence would not have been allowed to continue.

As the President of a company who advocates for seniors, finds resources, counsels families and assists in medicaid preparations, my experience shows that most of us face living in a medicaid facility.  Unless you have a healthy pension or half a million dollars you will not have the money for dementia care in a private facility.  Today that runs between six to seven thousand dollars a month.  If you qualify for medicaid, nursing homes run about $700.00 and  medicaid picking up the balance.

We must look in the mirror!  let’s begin the process of treating our elderly loved ones as our children.  Treat them as you treat those around you.  Hold the Assisted Living Centers and Medicaid Facilities accountable and — START SAVING!!

 

NURSING HOMES – HOW TO FIND A GOOD ONE

I am confident most of you heard the news about the  fourteen seniors who died from overheating.  They were all in a licensed “nursing home” in Hollywood Hills.   ‘Nursing Home’ is a euphemism for a home for seniors who are at the poverty level and qualify for medicaid.

Nursing homes are like every other industry — they have to make money to survive.  In the case of nursing homes they’re paid by the state medicaid fund and it’s per patient.  This fund is made up of state and federal dollars.  Obama Care expanded medicaid in the states who took the federal dollars but Florida is not one of them.

Bottom line, these are not the luxurious environments for either staff or residents.  In my parents case, Mom had been in a lovely residential facility where she was one of three or four people.  Her Long Term Care Insurance paid for it.  She outlived her two year policy and we had to place her in a Nursing Home.  It was our only realistic option as Mom’s care in an Alzheimer’s facility would be close to $7000,00 a month.  Mom and Dad couldn’t afford it and neither could the children.

In pursuit of the best we could find, I  went to several nursing homes and learned more than I needed to know.  All these homes are very austere and it’s a shock!  Bare floors, usually  a formica, and waiting rooms with plastic chairs.  Almost all the receptionists were behind a barrier — some better designed than others.

The patient population is made up of mostly Alzheimers and Dementia sufferers.  All the residents are in a wheel chair, a portable bed or never moved from their beds.

Another surprise, the aides often use pulleys attached to patients to change their clothes, move them to the shower or simply change their diapers.  Depending on the home, these medical aides must change and clean about 19 patients each.  Some work in tandem others work solo — it all depends on the chore.

Further, most patients are only bathed twice a week, maximum three times a week.  During one of these showers their hair is washed.  Bottom line, it’s not how we envision our last days, weeks, months or years of life.

On the good side, the ‘better nursing homes’ have excellent care.  They hire a team of Geriatric Doctors that include Psychiatrists.  These Geriatric groups come to the Nursing Home through a PPO and the doctors physically visit once a month.  There is usually a Podiatrist group that also visits once a month (Medicare pays for podiatry services) and a dentist who comes once a quarter. The day to day care is with the Registered Nurses (RNs), Licensed Professional Nurses (LPNs), physical therapists and medical technicians.  They also have a contracted Hospice service.

Here are some tips when you need to look for a nursing home:

What is the turn-over rate of its employees

Needless to say, the less turnover the better the place.  If the staff is not leaving then something is going well — usually their paid above average wages

Is there a hair salon

If there is a hair salon then there’s a market for it.  This means the residents take pride in how they look.  People who take pride in themselves care about their environment.

Is it clean

As we all know, cleanliness is godliness

Is there a smell

Again, if it smells that means it’s really not clean – no matter how good it looks

Is there a smile on the faces of the staff

A smiling staff means a happy staff

Again, hopefully it doesn’t come to this but if it does, know how to choose the best one.