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Surviving as a Digital Immigrant

blogMy sister-in-law shared the idea with me years ago that we are digital immigrants which are defined as “a person born or brought up before the widespread use of digital technology.”  My first major in college was computer science … but I freely admit that I am a digital immigrant. I have gotten used to the idea that you are “talking to” someone even if you haven’t spoken on the phone or in person just by texting and conversing on a social media platform. I resisted this notion for years but finally gave up because I needed to be able to communicate and understand my two digitally native children.

While I can now manage quite well in our new digital frontier, I marvel at how difficult it is for most American’s who don’t use a computer, have never had an email account, and only respond to the idea of online banking with fear. The reality is that most people are tricked into giving away their information versus having someone hack into your computer and steal it. Sadly, the government, the credit bureaus, our health and credit card providers have also failed to adequately protect our personal information through no fault of our own.

Back in 2011, Social Security stopped mailing out annual statements. I tremble at the idea of spending hours at a Social Security office. I have helped many clients set up their online account at https://www.ssa.gov/myaccount/ so they can avoid having to call or visit to access their Social Security statements or even order new cards.

Social Security is just one example of the many agencies, companies, and providers that expect everyone to serve themselves. For the generations above me, this is really a barrier that is just too difficult to navigate. They do have call-in options and my clients regularly complain of the HOURS they have spent on the phone waiting to talk to a person … and then the right person.

I get it, they save money but cutting out the personal service. But they have also dehumanized many of the ways we interact with our government, our health care providers, and even our retirement accounts. Sadly, most older American’s need more help and guidance and it’s interesting to me to see how the services industries are adapting by responding with more personal interactions than ever than before.

I have seen a new generation of financial advisers that are high touch and deliver deep resources as they watch how technology is isolating many of their clients who find operating in today’s world very foreign. Evolved?

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Do I schedule the colonoscopy?

poop in box memeI remember the internal debate I struggled with as my parent’s cognitive decline progressed. When they first moved into Assisted Living, they were scheduled for visits with the dentist. I knew it had been at least two years since their last exam and with a dentist visiting the facility, it was simple enough to have the staff take them down when it was time for their appointment. However, my parent’s both refused to see the dentist. We tried three different times and each time one or both of them dug in their heels and declared that they no longer needed to get their teeth cleaned. Six months later, my Dad was diagnosed with a tumor on his tongue. Would that dental visit have eased his pain or changed the outcome?

I consider this experience as one of my clients, an 85 year old who has been diagnosed with Alzheimer’s and is managing in her own home, was recommend to be screened for colon cancer using the new Cologuard kit. Cologuard is a do-it-yourself, mail-in DNA test that helps detect some colon cancers. Having just experienced this test myself, it’s not as simple as on would imagine, and does require that it be shipped back in a timely manner once you “collect” your sample. I have to say, I had a lot of fun joking around about the process and the “package” I needed to ship. Sorry to those of you who don’t like potty humor, I am a self-confessed big fan of it.

I brought up the topic to my husband because I found it tricky and wasn’t sure my client could manage the steps for the do-it-yourself part. You basically need to preset the kit in the commode for the collection, then take a sample and ship both the small sample and collection which requires a few extra steps before sealing the package. Once your package is sealed, it needs to be shipped back in 24 hours using UPS. Sounds easy, but since I just did it knew it took a little planning to complete.

As I’m wondering to my husband if my client can follow the steps, and ensure it gets shipped back in a timely manner — he is wondering what the family would do if they found out mom has colon cancer. He felt that he would probably be skipping his testing when he is 85 and battling other health issues.

Are there some things we need not test for once we reach a certain health status? Is the guide really to focus on those things that can prevent other health issues like a dental visit to maintain good oral hygiene versus testing for a cancer that may kill you when you are 85 years old? There is only the answer that is right for you.

I wondered if my Dad’s refusal to see the dentist was because he knew something was wrong and didn’t want anyone to find out or intervene. I do recall sitting with his primary care physician a few months before the tumor was diagnosed while she opened up his month and checked his teeth and tongue to see if she could figure out why he was drooling more. They chalked it up to swallowing issues related to his Alzheimer’s.

When it’s our job to monitor the health and well-being of our loved ones, when do we choose to stop the testing?  I think for all of us that answer is very different. Hopefully, you got a sense of the choices for end-of-life care your loved ones would make and can use that as your guide. Caregiving ain’t for sissies. Convinced. 

 

 

 

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The indignity of aging: Predatory Home Service Providers

Every week I visit a client and we do a quick review of his two checking accounts. I was alarmed to find 2 payments charged to his debit card for more than $2,000 by a local plumbing company.

This client is nice and trusting and unfortunately, a local plumbing company took advantage and charged him more than $7,000 to plunge the toilet and change the hot and cold valves on three bathroom sinks. I was alarmed at $2k and then found a 3rd charge of $5,000 on his credit card.

The three invoices were all written in one day. Since we couldn’t even read the handwriting on the invoices, we called the company to ask about the services performed. They promised to send before and after photo’s of the work justifying the services performed, but a call by his daughter asking for the detailed explanation of work has never been provided.

I called in a second plumber to do an assessment of the work performed who said that it should have cost no more than $1,500.

Sadly, I have learned that in Virginia, there are no measures in place to protect consumers from predatory pricing. Maryland on the other hand has a process to protect consumer from predatory pricing practices.

For now, I’m in the midst of a claim with Better Business Bureau who gave this firm an A+ rating. Checks on Yelp and Google all list other complaints about predatory pricing — especially targeted it seems to older adults. The next step will be a call to County Attorney since this is a form of Elder Abuse.

In the meantime, we are working on other ways to protect him from predatory home service providers, but also keep him engaged and involved.  We started by posting “recommended providers” on his refrigerator.

It’s discouraging to learn that some businesses are taking advantage and I am dedicating my personal time to help fight every one I come across. Disgusted. 

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The indignity of aging: Caregiver Exploitation

stealmemeIn the past few weeks, I’ve been involved with three older adults who have been the victim of fraud and exploitation and it’s both fueling my commitment to serving older adults and whittling away my belief in humanity.

It’s been distressing and discouraging on many levels.

Every year, the National Council on Aging predicts that $17 Billion is taken by businesses, individuals, and charities that use pressure tactics or misleading language to lead seniors into financial mistakes.

CAREGIVER EXPLOITATION: The first older adult lives in an assisted living community. She is unable to manage her affairs now and I pay the bills on her behalf. She’s been declining and a new caregiver coached her through writing a check for $100.  When I discovered it, I immediately reported it to the community and it resulted in the loss of her job.

I’ve been working with this client for more than two years and know that it would have taken at least ten minutes for her to write that check. She would have been unable to complete it without step-by-step coaching. We reported it to the police and hope they will be able to charge her for this crime. What I learned during this process is that she has been working in senior-living communities for almost a decade. YIKES!

Did she start small to see if anyone noticed the check?  Had we not found it, would she have returned for more money every week?

I’m not sure we will ever truly know.  What I do know is that she most likely made my client very uncomfortable and that makes me angry and sad.

I decided that what I could do was to let the owners of the local home care agencies know her name and what she did. Gotta admit that I made A LOT of phone calls. However, I hope that it can help avoid this happening to someone else. None of these agencies would want her on their payroll. I’m sorry that it’s not easier to prosecute those that pray on older adults.

This is just a reminder that being watchful and protective can make a huge difference for those you love. Fueled. 

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I’m ready to die

shouldistayMy client just shared this with me today. She’s 92, and the last few months have been difficult. She’s been having hallucinations, phantom pains, and doesn’t quite remember much about her past. While it’s sudden delivery surprises me, I also recognize that I would love for us all to be able to reach this point and gracefully exit.

She is always a delight to visit. She thanks me for helping and she follows along as I lead small talk about her son, her past, and the activities in her community I know she enjoys. So this statement, so definitive and bold, startled me.

She has enjoyed a wonderful life. May we all be able to choose our exit. I know my mom desperately wanted to avoid ever having her kids help care for her. I tell myself I hope I will be able to know when I’m taking more than I’m giving and gracefully end my journey on planet Earth … but I can’t imagine how to ever make that happen. Wished. 

 

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Mom is back in the hospital

cargiverburnoutWhen the primary caregiver fails, it’s really hard to quickly pick up the pieces. In this case, Mom has been caring for Dad with Alzheimer’s, but now Mom has health issues that landed her in the hospital.

If the caregiver ends up in the hospital, the mad scramble from Plan B begins.  Most families are totally unprepared and it surprises me how often this happens given all the data available to educate us on how important it is to have a plan in place.

According to the Family Caregiver Alliance nearly three quarters (72%) of caregivers reported that they had not gone to the doctor as often as they should, and more than half (55%) had missed doctors appointments.

More alarming is that elderly spousal caregivers (aged 66-96) have a 63% higher mortality rate than non-caregivers of the same age.

If you have a parent who is filling this role, it’s time to sit down and have a real conversation about how to create a Plan B should something happen to them. Is there some way to help them now before a crisis? What can you do now to be prepared to easily step in if they are unable to fill the day-to-day role of caregiver?

Maybe over dinner or a cup of tea, could you ask:

  • Tell me about your average day. How often and how are you helping mom/dad?
  • If you fell and ended up in the hospital, what could I do to help mom/dad?
  • Have you found any local support groups?

Spousal support groups can really help since many will discuss how to set up Plan B as well as how to minimize the stress of caregiving. In fact, I heard these stats from a support group leader.

The best way to help is to start from a place to help the caregiver be successful. Most of the pushback I see is when the family wants to take over. Start by asking for a job you could do to help them both.

Trying to put plans into place from the hospital or from another state just creates more stress for everyone. I hope you will have an opportunity to discuss this before you may ever need to use what you learn.

If you need to get some immediate help to navigate medical issues, I hope you will look into finding a local Aging Life Care Manager. You can learn more or search for one in your area at www.aginglifecare.org.

If you want a guide to start having a conversation around what you need to step in and help, you can use this list of key documents and information you would need to help manage the finances and maintain the household.

The reality is we should all have a Plan B in place. I hope this guide will help get started. Shared.

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A Funny Video on How to Start the Conversation about End of Life Wishes

We avoid this conversation, but I know the guilt caregivers feel when they aren’t sure if they are doing the right thing for their loved ones. It’s time for us to start having the discussion about end of life wishes since 9 out of 10 American’s will need someone to speak on our behalf before the end of our life according to a joint study done by the National Institutes of Health and Veteran’s Affairs.

Watch this funny video from The Conversation Project to get started. 

This Thanksgiving or at your next family gathering, I hope you will carve out some time to start the conversation with your loved ones on how you plan to live the rest of your life. The kits listed below offer some inclusive ways to begin this discussion with your loved ones.

I am lucky my parents shared their thoughts with me. It made a difficult journey a little easier. However, I had many choices to make that were gut-wrenching that we never covered, but the fact that my parent’s made it clear that they wanted quality of life over quantity of life made those difficult decisions easier for me and my siblings.

They have both a general conversation kit, and also one tailored for individuals with Dementia 

I hope you can find a way to bring these resources to your own family. Hoped. 

 

 

 

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