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Patient Advocate vs Geriatric Care Manager
Caregiving

Patient Advocate vs Geriatric Care Manager

by Carol Marak
written by Carol Marak

A few weeks ago, a reader asked, “Can you tell me the differences between a geriatric care manager and a patient advocate? I hear the two terms frequently and wonder if they are the same?” Here are the basic differences:

A Patient Advocate can assist anyone of any age – not limited to someone who is elderly, or at least over a ‘certain age,’ as a geriatric case manager would be.

A Geriatric Care Manager does not focus strictly on healthcare. Their work is broader with some emphasis on finances, housing, and other aspects of life that change as we age.

A Geriatric Care Manager serves as stand-in provider when families cannot be around.

The list of tasks include:

  • Conduct care-planning assessments to identify needs.
  • Put a care plan together; executing that plan.
  • Screen and monitor hired personal caregivers.
  • Act as a liaison to families.
  • Assist with moving clients to or from different care settings.
  • Review financial, legal, or medical issues and referring clients to experts.
  • Provide crisis intervention.–Provide client and family education.
  • Visit clients on a regular, routine basis to make sure they are safe, doing well, eating properly, and taking needed medications.
  • Make necessary medical appointments and assure client gets to them.
  • Identify agencies and/or social services and other programs that the client can use.
  • Monitor the elder’s finances and paying bills.

Patient advocates help navigate all areas of the healthcare industry including,

  • Help you research and select the best health insurance.
  • Track paperwork and records.
  • Review medical bills for accuracy.
  • Negotiate medical bills with your providers.
  • File insurance, social security, and disability claims.
  • Dispute and negotiate claim denials.
  • Research diagnosis and all treatment options.
  • Assist you in getting a second opinion.
  • Prepare and accompany you to doctor’s appointments.
  • Provide hospital bedside monitoring.
  • Review your medications.
  • Provide End of Life planning, and assist with the paperwork (i.e. living wills, POST, DNRs, Advance Directives, etc.)
  • Make recommendations for in-home care, assisted living facilities, or nursing homes.

 

The individuals who hire a geriatric care manager include families and adult children of relatives too far away, banks and trust officers, physicians, attorneys, hospitals, social service providers, gerontology professionals, and senior housing communities.

Individuals hire patient advocates when they want help finding a new doctor, in the hospital and have no one nearby to check on them, confused about the medications and concerned about allergic reactions, need help searching and selecting a specialist, need help navigating the clinical trial landscape, or need help securing financial resources for treatments.

Carol Marak, aging advocate, syndicated columnist, and editor at Seniorcare.com. She earned the Fundamentals of Gerontology Certificate from UC Davis, School of Gerontology.

Get on the waitlist for my Facebook subscription group or my weekly newsletter and learn how to plan for aging well. Send an email to carol@seniorcare.com and say you’re interested in the group or newsletter.

 

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Winter Skin Tips
Conditions & Treatments

Winter Skin Tips

by Carol Marak
written by Carol Marak

The cold and dry season is here and it can leave your skin itchy, red, and irritated. Combat dry winter skin with these tips for retaining your skin’s natural moisture. And if you have diabetes, it’s especially important to keep the skin soft and supple.

Keep the dry areas moist

Moisturizer helps fill in gaps and cracks in the skin. The cream helps restore elasticity, and protect the skin from infections. Use a moisturizer wherever your skin is dry; don’t use moisturizer in damp areas, such as between your toes and inner thighs, or under your arms. Moisturizing ingredients include glycerin, petrolatum, lanolin, wheat germ oil, jojoba oil, mineral oil, borage oil, argan oil, and safflower and pomegranate seed oils. Dry the moist areas.

If you have diabetes, it puts you at a higher risk for fungal skin infections, especially in chronically moist areas. Use a powder, such as talcum powder, in places where skin touches skin, between toes, under arms, and between upper thighs. If you’re uncertain what to use, your doctor can direct you toward good quality products.

  • Avoid spending too much time in hot water. It can remove the oil from skin. In the winter time, take short showers using warm water not hot. Use a mild soap-free cleanser or a moisturizer body wash, and apply moisturizer to dry areas right after toweling off.
  • The winter sun can give a sunburn-especially in high altitudes. Use a SPF 30 or above sunscreen, and apply at least 30 minutes before going out.
  • Take special care of minor skin injuries and irritations. Wash cuts and scratches right away, and see your doctor if you develop wounds that won’t heal or appear to worsen. The feet are particularly vulnerable in people with diabetes.
  • Keep sugar levels managed. People with high glucose levels tend to have dry skin and less ability to fend off harmful bacteria. If you have skin issues, your blood sugar is not managed properly. Talk to your doctor about all of the options for diabetes management.

 

People with diabetes who have kidney, nerve, and eye damage may experience bacterial and fungal skin infections, and more cases of “diabetic foot.” If you experience frequent skin issues, get a total health checkup, as most of the complications of diabetes are managed when diagnosed early.

And remember, when skin is dry, you can help by eating foods or supplements that contain omega-3 or omega-6 fatty acids, such as fish oil and flaxseed oil. It is important to help the skin moisten from the outside.

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Why Mental Health is Important
Conditions & TreatmentsHealth

Why Mental Health is Important

by Carol Marak
written by Carol Marak

The aging population rapidly increases and between 2015 and 2050, the number of older adults will double from about 12% to 22%. This is an expected increase from 900 million to 2 billion people over the age of 60. Older people face special physical and mental health challenges which need attention.

The World Health Organization says over 20% of adults aged 60 and over suffer from a mental or neurological disorder, excluding headache disorders, and 6.6% of all disability attributes to mental and neurological disorders. The most common mental and neurological disorders in this age group are dementia and depression, which affect approximately 5% and 7% of the world’s older population. Anxiety disorders affect 3.8% of the older population, substance use problems affect almost 1% and around a quarter of deaths from self-harm are among people aged 60 or above.

Maintaining your mental health is vital because mental health effects every aspect of your life. When your mental health is in good shape, your physical health, relationships and overall quality of life tend to also be in good shape.

Health promotion – The mental health of older adults improves as one becomes more active and focuses on healthy aging activities. Mental health-specific well-being for older adults involves creating living conditions and environments that support healthy lives. Promoting mental health depends largely on strategies to ensure that older people have the necessary resources to meet their needs, such as:

  • Provide security and freedom;
  • Adequate housing through supportive housing policy;
  • Social support for older people and their caregivers;
  • Health and social programs targeted at vulnerable groups such as those who live alone and rural populations or who suffer from a chronic or relapsing mental or physical illness;
  • Programs to prevent and deal with elder abuse.

 

Tools and Tips for Maintaining Good Mental Health

Enhance Sleep – As people age they tend to have a harder time falling asleep. It is a common misconception that sleep needs decline with age. So, what’s keeping seniors awake? Changes in the patterns of our sleep – what specialists call “sleep architecture” – occur as we age. Sleep disturbance among the elderly attributes to physical and psychiatric illnesses and the medications used to treat them.

Add meditation to your daily regime, along with exercise.

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How Aging with Friends Fills the Void of Being Alone
Aging

How Aging with Friends Fills the Void of Being Alone

by Carol Marak
written by Carol Marak

The concept of growing older without household support can be a shocking wake up call. That’s what happened to me after providing home care help for my older parents. The needs they had were extremely challenging for my sister and I, and when they died, it forced me to question, who will do all that for me? You see, I’m single, and have no children. How Aging with Friends Fills the Void of Being Alone
The care I provided for mom and dad included daily living tasks like house cleaning, cooking, shopping, transportation to medical appointments and treatments, and even managing their medications. And when they passed, I had lots of time to reflect on the caregiving years and realized how difficult elder care can be. It takes a village to meet the needs an older person. How Aging with Friends Fills the Void of Being Alone
According to the U.S. Census, the number of people over 65, living alone, will expand due to high divorce rates and child-free marriages of baby boomers. It’s why I’ve created a plan of action and will continue to tweak it as my needs change. How Aging with Friends Fills the Void of Being Alone

To create support for myself, I launched the Elder Orphan Facebook group, and since many of us form close ties, offer suggestions for transportation, solve serious issues, and even celebrate one another’s birthdays, we feel less alone and isolated. The online Facebook group has helped several members cope with difficult situations, even cancer, and strokes. We give one another peace of mind and place to go for friendship and connection.

Since it’s a global group, several members have started local groups for social interactions. But for me, I realize there’s so much more we can do together. We are strong, capable, and savvy. Our next steps go beyond making connections but also to form a social and support network that handles the types of tasks that normally family members deliver, such as:

Rides
Meals
Personal care
Cleaning
Shopping
At the local level. How Aging with Friends Fills the Void of Being Alone

A challenge? Yes. But as I say, we’re smart and resourceful.

This past week, groups from California to Florida met to discuss possibilities. We’re going beyond social needs and creating solutions for the following:

Discounts from local businesses
Housing options
Transportation options
Food delivery
Companionship resources
Volunteering

To name a few.
The members in my group in Dallas divvied up the tasks —

How to prepare for a surgery
Create a list of members and our contact information
Where to go for employment support and to find a job
Find housing options
Research needed local services
Locate free places to meet and plan

We’re just getting started on our “aging with friends” plan and we’re new at this but overall, the local meetings have turned out better than we planned. Each one of us walked away feeling lighter, more comfortable and hopeful that our aging alone journey will be void of being alone without support.
If you live in Dallas, join us. If you don’t, I invite you to the main Facebook group — and encourage you to start your local community. Don’t worry if you don’t know how, in a few months, the Dallas group intends to have a roadmap and a plan in place for others to mirror. How Aging with Friends Fills the

If you’re open to new adventures and want to learn new strategies for finding part-time work, how to develop new skills, find online games, and discover technology that helps you age in place, I invite you to opt-in to my upcoming Newsletter called Age with Purpose. It will roll out in a few weeks, and arrive via email every week. No doubt you’ll enjoy and look forward to its arrival. Just fill out the linked form and you’ll be on the list to receive the Age with Purpose Newsletter.

How Aging with Friends Fills the Void of Being Alone

How Aging with Friends Fills the Void of Being Alone How Aging with Friends Fills the Void of Being Alone How Aging with Friends Fills the Void of Being Alone How Aging with Friends Fills the Void of Being Alone How Aging with Friends Fills the Void of Being Alone

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Aging

Making Friends Later in Life

by Carol Marak
written by Carol Marak

Having friends makes life a lot more fun, enjoyable, and easier to deal with challenges. But as one grows older, research shows it’s harder to hang on to established connections and companions because we retire and leave the workforce. And a big part of our relationships develops with people on the job. Making Friends Later in Life
When retired, seniors enjoy their free time and travel more, taking time away from developing new relationships. Some seniors move to another city, perhaps be closer to their children and grandchildren. When doing so, the move puts an end to establish long-term friendships and acquaintances. That’s the hardest decision, to leave behind old friends or get close to the grandkids? Making Friends Later in Life
During our younger years, we think friendships for granted and don’t think too much about shedding close relationships in exchange for a romantic partnership. And even more are lost when offspring arrive, which puts new demands on one’s resources like time and energy. Every person is guilty of spending all of their time with their immediate family. It’s normal.

But when a person becomes older, it’s necessary to have close ties with nearby friends, it not only feels good but it’s good for you. Research by American and Canadian scientists have found that having a wide variety of friends decreases the risks of heart disease and stroke. Plus having more friends encourage you to participate in health-related activities and behaviors like consuming fruits and vegetables, staying fit, and quitting bad behaviors like smoking.

In a Facebook group for seniors aging alone without the support of nearby loved ones claim that having friends close by gives them a sense of security knowing they can call someone for help. But some have trouble meeting new friends because they are immobile, live in the country, or have difficulty driving. What we all know is that making new friends isn’t like it was when we were younger. Making Friends Later in Life
So what can older adults do to make new friends and revitalize their social connections? Making Friends Later in Life
I think it’s important to know that there are many older individuals like you who are in the same boat. So, feel reassured that you are not alone. Secondly, try hard not feel embarrassed or ashamed that you have lost close ties. We all have. The best opportunities to find new people to connect with are the ones that share your interests. Make a list of your hobbies, places you enjoy, favorite restaurants, coffee shops, and the library. Other places could be book clubs, organizations where you volunteer, art classes, sports leagues, political organizations, local parks, and senior centers.

Having friends will enrich your life and may even keep the mind sharp, helping you stave off dementia.
For more information check out our article on Combatting Loneliness.

Making Friends Later in Life

Making Friends Later in Life Making Friends Later in Life Making Friends Later in Life Making Friends Later in Life Making Friends Later in Life

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Using tablet
Housing TipsSeniors & Covid

How Tech Habits Evolved During COVID-19

by Carol Marak
written by Carol Marak

I use an app called SnugSafe. It’s a check-in service for people aging alone. Recently, Snug surveyed the members in their community and discovered how tech habits have evolved over the last few months. Here are the top findings, other surprises, and the overall results.

Top Finding about how COVID-19 impacted the technology used by older adults:

  • 48% of respondents have ordered groceries online, and 56% of them are doing it for first time because of quarantine
  • 34.3% of respondents have attended a religious service online
  • Zoom is the most popular video conferencing solution (52%), followed by Facetime (46%), and Facebook messenger (28.2%). Interestingly, Skype (20.4%) was nearly twice as popular as Whatsapp (10.9%). This may be due to the North American nature of the survey.
  • 48% of respondents using an exercise app are doing so because of the quarantine.

 

What’s alarming to me is the amount of isolation that seniors are dealing with during this time. Isolation causes loneliness which can exacerbate depression. Before the pandemic, we would find studies about the negative effects of people staying at home all day and now, we’re encouraged to do so. So what can we do?

Today, the best way to stay connected is to follow the advice of the old AT&T ad that urged us to “Reach Out and Touch Someone!” The ad was meant to encourage people to make long-distance phone calls, which cost real money back then. While our real-life circles have shrunk due to self-isolation, our cyber circles are wide open thanks to FaceTime, Facebook, and other social media platforms.

In today’s world, people have organized happy hours and dinner parties over video conference platforms like Zoom and Skype, which is a fun way to stay in touch. Some older adults may not be able to participate in this cyber-connectivity, though — because of technical unfamiliarity, or hearing or vision problems. To stay close during social distancing, try writing letters or send greeting cards with a short note. It’s hard to distance and avoid close physical connections from those we care about.

I hope this will pass soon but learning about contact tracing that our government wants to deploy, has me a bit worried about the new normal.

Other findings from the Snug survey:

  • 60% of customers with an iPhone owned 4 or more smart devices.
  • Those using a smart speaker, 90.2% had an Alexa-enabled device.
  • Of respondents with a video doorbell, 88% had a Ring doorbell.
  • Facebook is more popular (86%) than the next 2, Instagram & Pinterest, combined.
  • Reddit (9%) and TikTok (5.9%) more popular than Snapchat (5%), though findings may not be statistically significant
  • 58.5% of respondents have played a video game in the past week.

 

The survey methodology352 Snug customers responded to the survey. All responses were anonymous.

Carol Marak, aging advocate, and editor at Seniorcare.com. She’s earned a Certificate in the Fundamentals of Gerontology from UC Davis, School of Gerontology.

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Disabled man in assisted living center
Aging

Options Needed to Pay for Long Term Care

by Carol Marak
written by Carol Marak

Are you looking for ways to pay for long-term care? The national average cost per month for senior housing starts at $4,000. At home personal care costs $23 an hour. There is no way to avoid the expenses, but there are ways you can put a home’s equity to work.

The most valuable asset a senior has is a home. And today, the most common option to pay for long-term care is using the home’s equity through a Reverse Mortgage where the lender makes payments to the borrower. The borrower does not pay back the loan until the house is sold or vacated. And as long as the borrower or co-borrower (a spouse) lives in the home, no monthly payments are due on the loan balance. But property taxes, maintenance and upkeep, insurance, and association dues are the borrower’s responsibility. The loan is due in full when the last borrower, the remaining spouse, dies, sells, or permanently moves out.

I learned about another option which unlocks the home’s equity without ever having to worry about leaving the home or getting foreclosed. The senior receives part of the home’s value in cash upfront and part in guaranteed monthly payments in return for the ownership of it. Maintenance, insurance, and property tax is handled by the new owner so the seniors can live in their home for the rest of their life. It is not a reverse mortgage.

This transaction originates in France (called a viager) where people have been doing these for over a thousand years – it has actually been part of their laws since 876 AD. However, in Europe this deal is facilitated between two individuals. The seller agrees to transfer the ownership of their home to the buyer for a downpayment and regular cash installments for the rest of their life. The seller has the right to live in their home for the remainder of their life and the buyer takes over only after the seller passes away.

It’s brand new and may be available in the States soon. Compared to a reverse mortgage, clients are not taking out a mortgage or paying interest. There are no hidden fees.

The senior transfers the title but keeps the right to live there for their lifetime. They receive part of the home value when signing and part of it through guaranteed monthly payments until they pass away. The new owner handles paying property tax, insurance, and basic maintenance so there is no foreclosure risk.

For those who have no heirs, this option is the perfect choice as there is no incentive to leave the home and the equity in it behind. For seniors with heirs, their heirs no longer need to worry about the financial wellbeing of our clients. And if the client passes away before the originally invested money has been paid out, the remainder of the original amount is paid back to the heirs.

Carol Marak, aging advocate and editor at Seniorcare.com. She’s earned a Certificate in the Fundamentals of Gerontology from UC Davis, School of Gerontology.

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Mental Health Resources
Conditions & Treatments

Mental Health Resources

by Carol Marak
written by Carol Marak

Depression, anxiety, and other mental illnesses carry deeply rooted stigma forcing people with a mental health challenge to suffer in silence. Stigma, a sensation that something is shameful. Mental Health Resources

A 2014 study by the NIH (National Institute of Health) found significant differences between the stigma about seeking help for mental conditions felt by those in isolated rural areas compared to urban dwellers. Older rural residents with mental illness associate seeking help with a sign of weakness or an inability to be self-reliant.

The Centers for Disease Control says depression is a true and treatable medical condition, not a normal part of aging. However older adults are at an increased risk for experiencing depression. If you are concerned about a loved one, offer to go with him or her to see a health care provider to be diagnosed and treated. Depression is not just having “the blues” or the emotions we feel when grieving the loss of a loved one. It is a true medical condition that is treatable, like diabetes or hypertension.

Depression is different for seniors because about 80% of older adults have at least one chronic health condition, and 50% have two or more. Depression is more common in people who also have other illnesses (such as heart disease or cancer) or whose function becomes limited.

CDC says, “Older adults are often misdiagnosed and undertreated. Healthcare providers may mistake an older adult’s symptoms of depression as just a natural reaction to illness or the life changes that may occur, and therefore not see the depression as something to be treated. Older adults themselves often share this belief and do not seek help because they don’t understand that they could feel better with appropriate treatment.”

How to find help if in a crisis

  • Call 911
  • Visit a nearby emergency department or your health care provider’s office
  • Call the toll-free, 24-hour hotline of the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255); TTY: 1-800-799-4TTY (4889) to talk to a trained counselor

Resources

  • Medicare provides a free yearly depression screening and preventive wellness visit for Medicare Part B beneficiaries.
  • Set goals or resolutions that focus on improving your mental health. Take a moment to think about your mental health goals and what you can do throughout the year. www.psychiatry.org
  • Call on a friend or relative to join you as you run errands or complete routine, everyday activities. Doing things together is a great way to raise your spirits and engage those around you in your life. www.allaboutseniors.org
  • It’s important to build your resilience and find healthy ways to cope with challenges. www.helpguide.org

Get my newsletter. Send an email to Carol@seniorcare.com with newsletter in the subject line.

Mental Health Resources

Mental Health Resources Mental Health Resources Mental Health Resources Mental Health ResourcesMental Health Resources Mental Health Resources Mental Health Resources Mental Health Resources Mental Health Resources Mental Health Resources Mental Health Resources

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Estate Planning

Don’t Expect Medicare to Pay for Long-Term Care

by Carol Marak
written by Carol Marak

A recent survey funded by The SCAN Foundation found close to four in 10 Americans, age 40+, believe Medicare and Social Security will pay for long-term care. The need for continuing care services and support to assist with activities of daily living will increase as the population ages. The group will require help with cooking, bathing, grooming, shopping, managing medicines, and toileting.

Thirty-eight percent of the people surveyed in the 2016 Long-term Care in America report said they will rely on Medicare to pay. Correspondingly, 35% will count on Social Security and personal savings while 32% expects to depend on investments for support. Don’t Expect Medicare to Pay for Long-Term Care

Surprisingly, only two out of 10 older adults will use Medicaid to pay for their aging needs although it ranks as the largest public payer fo LTC, according to the Kaiser Commission. The misperceptions of long-term care payment options persist among Americans, but their ability to pay increased even though many put off planning for it. How and where individuals want care remains consistent to prior years.

Key findings of misperceptions

  • Older Americans prefer to receive care at home, and they want that care provided by family. However, family members say it’s not their preference due to travel distance and prefer the loved one to live with them.
  • Other places for desired care are in a senior community (11 percent), home of a friend or family (4 percent), or a nursing home (4 percent).
  • Men prefer to receive help from a spouse, and women want help from adult children.
  • For Americans with an annual income of $50,000 or less, they will likely count on government programs like Social Security, Medicare, and Medicaid. The others who enjoy a higher income expect to rely on personal savings and investments. However, the survey indicates that three in 10 of the upper-income Americans still report reliance on Medicare to help pay for care.
  • The general public wants to see more policies to help family caregivers face the price of giving care, with 72 percent supporting state programs for paid family leave at work, 83 percent support tax breaks, and 73 percent support a Social Security earnings credit for family members time out from the workforce.
  • Four in 10 family members report having missed work to provide long-term care to a loved one.
  • Close to one-third report having done no planning for long-term care needs.

 

On the political front, Democrats and Republicans approve some proposals to help Americans prepare for the costs of long-term care. How it plays out: 80 percent of Democrats and 78 percent of Republicans favor tax breaks to boost aging care savings. Plus, over 70 percent of both parties would approve tax breaks for individuals who buy long-term care insurance.

Equally, both sides favor a portable long-term care insurance model through their employer, similar to COBRA. And Republicans (71 percent and 68 percent Democrats) would permit non-taxable funds like retirement plans and 401(k)s to pay for LTC insurance premiums.

Don’t Expect Medicare to Pay for Long-Term Care

Don’t Expect Medicare to Pay for Long-Term Care Don’t Expect Medicare to Pay for Long-Term Care Don’t Expect Medicare to Pay for Long-Term Care Don’t Expect Medicare to Pay for Long-Term Care

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