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Archive | Effects of Aging

When it isn’t Alzheimer’s—Learn about other dementias

Alzheimer’s disease gets a lot of attention for being the most common cause of dementia in older people. But what if it isn’t Alzheimer’s?

Visit the ADEAR website to learn about other types of dementia, including:

  • Vascular dementia
  • Lewy body dementia
  • Frontotemporal disorders
  • Mixed dementia
  • Other conditions that cause dementia

More information about Alzheimer’s and dementia

-information from the National Institutes on Aging

Exercise for People Who Have Dementia

Exercise and physical activity are important for people with Alzheimer’s disease. Exercise helps with general health, weight maintenance, and good sleep habits. Check out these tips to help people with Alzheimer’s get and stay active:

  • Try several 10-minute mini-workouts if a longer workout is too much.
  • Add music to exercises or try dancing together.
  • Break exercises into simple, easy-to-follow steps.

You can also participate in the National Institute on Aging’s Go4Life Month this September! In collaboration with the White House Conference on Aging, Go4Life Month encourages all older adults to be active every day. Whether you are part of an organization or an individual, there are plenty of ways to participate. Visit the Go4Life Month website for more information.

 

 

Age in Place

If you decide to “age in place” — live independently in a home of your choice for as long as possible — you’ll need to plan ahead to make sure you have the necessary supports and resources.

See how to plan if you want to “age in place.”

For more information, see “There’s No Place Like Home – For Growing Old,” a Tip Sheet from the National Institute on Aging (NIA) at NIH.

The information on Long Term Care was developed for NIHSeniorHealth by the Administration on Aging (AoA), a part of the Administration for Community Living (ACL).

 

 

Travel Tips for a Person with Alzheimer’s Disease

It’s time for summer vacation! Taking a person with Alzheimer’s disease on an overnight trip can be challenging, but here are some tips to make it easier:

  • Keep your schedule realistic—allow lots of time for each thing you want to do.
  • Plan rest periods.
  • Follow a routine like the one you use at home. Try to have the person eat, rest, and go to bed at the same time they do at home.
  • If the person is prone to wandering, carry a recent photo of them on the trip.

Get more useful travel information in Alzheimer’s Caregiving Tips: Traveling Overnight.

Attention Grandparents: Watch out for phony debt collectors

My grandma kept an eye out for cheaters. (No, not that kind.) Back in the day, if a salesman knocked on her front door, she waved them off. Before caller ID, she hung up on telemarketers. But a call from a phony debt collector? She might have fallen for that one. Especially if the debt collector said she was responsible for her grandchild’s debt.

 

read more

 

Advice for older people on staying safe in hot weather

Summer weather can pose special health risks to older adults and people with chronic medical conditions. It is critically important that adults particularly susceptible to hyperthermia and other heat-related illnesses know how to safeguard against problems. The National Institute on Aging (NIA), part of the National Institutes of Health, has some tips to help avoid the hazards of hot weather.

read more.

 

 

Unique interactive map helps meet needs of people with electricity-dependent medical equipment

This unique interactive map helps meet needs of people with electricity-dependent medical equipment

The HHS emPOWER Map, an interactive online tool, launched today to aid community health agencies and emergency management officials in disaster preparedness as they plan ahead to meet the emergency needs of community residents who rely on electrically powered medical and assistive equipment to live independently at home.

learn more.

 

Exciting News from Dutton & Casey

Partner Kathryn Casey has completed the long and difficult process to become a Certified Elder Law Attorney (CELA). This certification has frequently been referred to as “the gold standard” for elder law and special needs attorneys.

In our ongoing commitment to provide the highest level of services to our clients and their families both of our Partners, Janna Dutton and Kathryn Casey, are certified.

Please click on the link below to learn more about the process to become a CELA and how this level of knowledge and dedication can better assist you and / or someone you care about.

https://www.duttonelderlaw.com/certified-elder-law-attorney…/

PROGRAM ON SATURDAY, APRIL 27 FOR FAMILY CAREGIVERS

Navigating Legal Issues for Family Caregivers

This session will attempt to answer legal questions common to all family caregivers in the hope of assisting you avoid legal pitfalls. Questions to be covered are:  “What are the duties and authorities under a Power of Attorney for Property, Power of Attorney for Healthcare, Living Trust or Living Will?”; “What options are available in planning and paying for long-term care?”; “How can family caregivers can utilize Medicare, Medicaid, long-term care insurance and personal care contracts to maximize another’s quality of life?”

Presenter: Janna Dutton, JD, and Rebecca Lerfelt, LCSW,  Assistant Director of PLOWS Council on Aging.

Date:  Saturday, April 27, 2013

Time:  10:00 A.M. – Noon

Location: Orland Park Public Library, 14921 Ravina Ave.,  Orland Park, Illinois

Registration: There is no charge to attend this program. However, advanced registration is required.  Please call PLOWS Council on Aging at 708-361-0219 or click here.

PRESENTATION: Understanding Key Legal Issues for Family Caregivers

Understanding Key Legal Issues for Family Caregivers

This session will attempt to answer legal questions common to all family caregivers in the hope of assisting you avoid legal pitfalls. Questions to be covered are:  “What are the duties and authorities under a Power of Attorney for Property, Power of Attorney for Healthcare, Living Trust or Living Will?”; “What options are available in planning and paying for long-term care?”; “How can family caregivers can utilize Medicare, Medicaid, long-term care insurance and personal care contracts to maximize another’s quality of life?”

Presenter: Janna Dutton, JD

Date: Monday, April 22, 2013

Time: 830 A.M. – 3:00 P.M. (Janna’s session is part of the event, “A Systematic Approach to Building Your Caregiver Network”, being sponsored by Midwest Palliative & Hospice Care Center, Elderwerks,  and Northshore Senior Center.

Location: Midwest Palliative and Hospice Care Center, 2050 Claire Court, Glenview, Illinois

Registration: There is no charge to attend. However, advanced registration is required. Click here to register.

February 2013 Issue of YOUR Legal Update

The February issue our of newsletter has been published.

This issue contains helpful articles and information on our educational offerings, for community members and professionals, for Spring.

click here to read the latest issue.

Scam Alert

12-5-12          

Illinois Attorney General Lisa Madigan and the Illinois Commerce Commission alerted utility customers to a recent scam targeting residents in the Chicago area in which someone claiming to be a utility employee asks for immediate payment of a bill either at a customer’s door, over the telephone or by e-mail.

 The ICC has received complaints from utility customers about scam artists claiming to be utility representatives, telling customers that their service will be disconnected unless payment is made directly to the scammers. The scammer may direct the consumer to purchase a prepaid credit card, “Cash Card” and to call them back with the personal identification number (PIN).  The stories can vary, for example, with the scammer saying that the customer’s billing cycle has changed and payment must be made immediately, that the account is past due and payment can be made to them directly to avoid disconnection of the utility service, or the customer’s previous payment was rejected or never received.

 “If someone appears at your door claiming to be from your utility company and asking for immediate payment of your bill, I would slam the door in their face, call the police and contact your utility company directly. Utility companies do not go door-to-door collecting payments,” Madigan said. “Any consumer who has provided their personal information to make an on-the-spot payment to someone claiming to represent a utility company should contact my office’s Consumer Fraud Bureau with the details.”

 ICC Chairman Doug Scott urged consumers to always ask for identification from those who knock on their door offering a “service.” “Scam artists are good at what they do, so arm yourself with information before doing business with anyone who comes to your door or calls you on the telephone.  Ask for identification and if doesn’t look right to you, it probably isn’t.  You don’t have to do business with anyone who shows up at your door or calls you asking for personal information,” Scott said.  “Contact the utility and check it out for yourself.” 

The Attorney General and the ICC offer these reminders to utility customers:

 *Never provide personal information to anyone who comes to the door or calls you claiming to be a representative of the utility.

 *Contact the utility at the phone number listed on your bill to confirm the caller or the representative at your home is a verifiable employee of the utility.  Do not call a different number suggested by the potential scammer.

 *Utility field personnel in Illinois do not take payments from consumers. Be on guard with anyone who asks for your personal information, or says you must pay immediately and suggests a method to get the money quickly.

 If you suspect you have been scammed, have a suspicious incident to report or have questions, contact the Attorney General’s office at 1-800-386-5438 or the ICC at 1-800-524-0795

Resource for Older Drivers

Older Drivers Topic Now Available on NIHSeniorHealth.gov

Site offers information on age-related health changes, safety tips and driving adjustments

NIHSeniorHealth has just released a new topic for older drivers and families seeking information on an often sensitive subject: Is it still safe to drive? The new “Older Drivers” topic, available at http://nihseniorhealth.gov/olderdrivers/howagingaffectsdriving/01.html, gives older adults and their loved ones information to help them address that question and others related todriving in later life.

Key points include:

  • how health and aging may affect driving
  • tips for road safety
  • steps to take when driving skills change  
  • making sure your vehicle is safe
  • regulations affecting older drivers
  • alternative modes of transportation, and more

“Older Drivers” was developed by the National Institute on Aging (NIA) at NIH and the U.S. Department of Transportation’s National Highway Traffic Safety Administration (NHTSA).

For more health and wellness information for older adults from the National Institutes of Health, go to www.nihseniorhealth.gov. NIHSeniorHealth is a senior-friendly website from the National Institute on Aging and the National Library of Medicine, both part of the National Institutes of Health.

 
 

Resource for People who have Parkinsons Disease

AWARE IN CARE KIT

From the National  Parkinson Foundation….  Aware In Care Kit. You can order your free kit by calling their national toll-free Helpline at 1-800-474-4636.  There is almost a total lack of understanding on the part of hospital, rehab, and nursing home staff of the disease itself, the medications used to treat it, and the importance of timing when administering medication.  This kit can make a future hospital stay a success rather than the disaster that many people with PD have endured.

 

Resource for Family Caregivers in Chicago Area

Powerful Tools for Caregivers Class

Thursdays, October 4 through November 8, 2012

3:30 p.m. to 5:00 p.m.

Rush University Medical Center, Tower Resource Center

1620 W. Harrison Street, Suite 04527, Chicago

REGISTRATION REQUIRED

This six-week education program is exclusively for family and friends caring for older adults with long-term conditions. Each weekly class provides family caregivers with the skills and confidence to better care for themselves while caring for others. Many caregivers have raved about the class, including those caring for a spouse or partner as well as adult family members and friends caring for an elder. Class members will receive The Caregiver Helpbook, developed specifically for the class.

Participating caregivers report they:

  • · Are better at caring for themselves
  • · Have fewer feelings of anger, guilt and depression
  • · Have increased confidence and ability to cope with the demands of caregiving
  • · Take more advantage of community services

Skills learned build upon each other from week to week , plan to attend all six sessions.

Rush Generations member: $30 (parking validated and scholarships available)

Non-member: $50 (parking not validated)

Please call 1-312-563-2703 for more information or to register.

 

The New Illinois Power Of Attorney Act And How It May Affect You

On July 1, 2011, the new Illinois Power of Attorney Act will go into effect. Existing properly executed Illinois powers of attorney will remain valid; however, one may want to consider revising existing powers of attorney to make the most of the amendments to the Act. For any adult 18-years-of-age or older who does not have in place properly executed powers of attorney, this is a good time to obtain them.

Illinois Department of Transporation’s Life-Saving Yellow Dot Program

IDOT Unveils Life-Saving Yellow Dot Program

Program Provides Emergency Responders with Crucial Medical Information to Help Crash Victims

The Illinois Yellow Dot program, a life-saving, traffic safety initiative that provides first responders with critical information to improve emergency care for persons involved in vehicle crashes. IDOT along with the Illinois Department of Public Health (IDPH), Illinois Department of Aging (IDOA) and county health departments across the state are working together to increase awareness of the voluntary, federally funded program, and provide distribution centers and information for interested residents.

“Roadway safety is always a top priority at IDOT, and the Yellow Dot program can help improve roadway safety by providing first responders the crucial medical information they need to treat injuries and save lives, beginning at the scene of a crash,” said Acting Transportation Secretary Ann Schneider. “This important program gives IDOT and our partners another important way to improve our exceptional record on traffic safety. I encourage all motorists to participate in this unique and effective program, which could make the difference between life and death for individuals involved in crashes.”

Because the first hour following an injury is the most crucial, the Yellow Dot program provides essential personal health information to emergency responders in order to promptly care for a crash victim. This ‘Golden Hour’ is critical in the treatment of crash victims, and the medical information provided through the program could be a lifesaver.

When a crash occurs, emergency medical first responders such as police officers, firefighters and emergency medical technicians are immediately dispatched to the scene. These responders usually have basic information such as the location of the crash and the number of victims. Frequently, minimal personal information is available during this early, most critical time period.

“This is a great opportunity for older drivers to update their medical information and have a voice in their emergency treatment in the event of an accident,” said John K. Holton, Ph.D., director of the Illinois Department on Aging. “The Yellow Dot program will serve as a lifeline to alert first responders of crucial medical information which can help the victims who may be unable to communicate at the crash site or may have forgotten to share the information.” Yellow Dot participants are supplied with a simple, bright yellow decal for their car and a corresponding yellow folder. The decal is placed in a conspicuous and consistent place – in the lower left-hand corner of the rear window, driver’s side. The yellow dot signifies there is a folder in the glove compartment containing the following medical information about the motorists: participant’s name, close-up photo, emergency contact information, patient’s physician information, medical conditions, recent surgeries, allergies and a list of current medications. Having access to this information allows first responders to make important decisions regarding emergency treatment and can better prepare emergency hospital staff in the receiving room.

“Time is critical in an emergency situation. If paramedics and emergency medical workers know what medications a person is taking, if the person has allergies or a chronic condition, they can make better decisions about treatment,” said Acting IDPH Director Dr. Craig Conover. “Delaying treatment can mean the difference between life and death in some cases. Something as simple as having your medical information on a yellow card in your glove compartment can potentially make a big difference in the emergency care you receive.”

The Yellow Dot program, funded by the U.S. Department of Transportation, was originally introduced in Connecticut in 2002. For more information on the program and to find a distribution center near you, visit www.yellowdotillinois.org.

 

Making Sense of Memory Loss – 5 Part Educational Class

 Some memory loss is normal as we age, but some older people experience more than occasional forgetfulness. What should family members know and what can they do to help someone who is beginning to experience memory loss or other difficulties with thinking?

A five-part educational program has been developed to help family members of someone in the early stages of memory loss or with early stage diagnosis of Alzheimer’s or Dementia. This special program is taught by Michaela Hoffman, MSW of Catholic Charities Northwest Senior Services and Bonnie Scherkenbach,MS, LPC of The Barrington Area Council on Aging.

The class includes the following topics:

ü Overview of Memory Loss & Related Symptoms

ü Communication Strategies

ü Making Decisions

ü Planning for the Future (Attorney Kathryn Casey will be presenting)

ü Effective Ways of Coping and Caring

 

WHEN: February 14 through March 13th, 2012

                   Every Tuesday from 1:00 to 3:30 P.M.

 

WHERE: The Community Church of Barrington

                    301 East Lincoln Avenue, Barrington IL

 

FEE:  $15 includes five, two and one half hour weekly sessions and the book “Alzheimer’s Early Stages” by Daniel Kuhn, MSW

 

To register or for more information please contact

Michaela Hoffman, MSW at 847-253-5500 ex. 333 or

Bonnie Scherkenbach, MS, LPC at 847-852-3890

 

Tools to Help Choose a Good Nursing Home

By Carolyn M. Clancy, M.D.

December 6, 2011

Finding a high-quality nursing home for a family member is a daunting task.

Many people have not had to make this decision before. And it’s often made under stress, when asking good questions and thinking carefully about your options are harder than usual.

Fortunately, more information is available that can help you learn about nursing home quality and prepare you to make a well-informed decision.

Start this process with an online tool from the Federal Government called Nursing Home Compare. This lets you look up nursing homes in your area by name, city, county, State, or ZIP Code. First unveiled in 2009, Nursing Home Compare has detailed information on every nursing home certified by Medicare or Medicaid.

Nursing homes are rated using a 1- to 5-star scale, with those earning 5 stars being rated the highest. Ratings are based on how many and what type of staff members they have, how well they perform on health inspections, and how they rank on quality measures. Ratings for each measure are given individually and are also combined into an overall rating.

Starting in 2012, Nursing Home Compare will include a new measure that includes input from the nursing home residents. This new information will take the place of the quality measures that currently appear on Nursing Home Compare. Findings will be part of the ratings starting in April 2012.

Staffing and health inspection data add important information and will continue to be a factor in each nursing home’s overall rating. The staffing measure tells you the average staffing levels—such as the number of registered nurses, licensed practical nurses, and certified nursing assistants—for each resident each day. This is a good benchmark, but it has limits. It does not show the number of nursing staff present at any given time or describe the amount of care give to any one resident. The health inspection measure looks at many major aspects of care in a nursing home. This includes how medicines are managed, whether food is prepared safely, and whether residents are protected from inadequate care. Inspections take place about once a year, but they may be done more often if the nursing home has several problems to correct.

Even with so much good information, the Nursing Home Compare tool and rating system won’t answer all of your questions. For example, the ratings won’t tell you if the nursing home has improved, or gotten worse, in certain areas since it was rated. That’s why it’s important to visit any facility you are considering. Be sure to ask questions of the staff, especially people who provide care to residents. It’s also a good idea to visit a nursing home a second time on a different day of the week and another time of day. You may get a better idea of changes in staff, activities, and other factors that could make a difference in your choice.

An excellent list of questions to ask during such visits is available from a nursing home checklist (PDF File; PDF Help) by the Centers for Medicare and Medicaid Services (CMS). And a new handbook (PDF File; PDF Help) from CMS explains how to pay for nursing home care, describes residents’ rights, and gives alternatives to nursing home care. Another good resource is your State ombudsman; select to find yours.

click here to read more.

National Caregiver Support Line for Veterans

The Veterans Adminstration has established a National Caregiver Support Line for Caregivers of
Veterans — spouses, children, other family members and friends of Veterans as well as Veteran themselves.  

for more information on the program, please go to https://duttonelderlaw.com/resources/articles.html

Four Drugs Cause Most Hospitalizations in Older Adults

Blood thinners and diabetes drugs cause most emergency hospital visits for drug reactions among people over 65 in the United States, a new study shows.

Just four medications or medication groups — used alone or together — were responsible for two-thirds of emergency hospitalizations among older Americans, according to the report. At the top of the list was warfarin, also known as Coumadin, a blood thinner. It accounted for 33 percent of emergency hospital visits. Insulin injections were next on the list, accounting for 14 percent of emergency visits.

Aspirin, clopidogrel and other antiplatelet drugs that help prevent blood clotting were involved in 13 percent of emergency visits. And just behind them were diabetes drugs taken by mouth, called oral hypoglycemic agents, which were implicated in 11 percent of hospitalizations.

All these drugs are commonly prescribed to older adults, and they can be hard to use correctly. One problem they share is a narrow therapeutic index, meaning the line between an effective dose and a hazardous one is thin. The sheer extent to which they are involved in hospitalizations among older people, though, was not expected, said Dr. Dan Budnitz, an author of the study and director of the Medication Safety Program at the Centers for Disease Control and Prevention.

“We weren’t so surprised at the particular drugs that were involved,” Dr. Budnitz said. “But we were surprised how many of the emergency hospitalizations were due to such a relatively small number of these drugs.”

Every year, about 100,000 people in the United States over age 65 are taken to hospitals for adverse reactions to medications. About two-thirds end up there because of accidental overdoses, or because the amount of medication prescribed for them had a more powerful effect than intended.

As Americans live longer and take more medications — 40 percent of people over 65 take five to nine medications — hospitalizations for accidental overdoses and adverse side effects are likely to increase, experts say.

In the latest study, published in The New England Journal of Medicine, Dr. Budnitz and his colleagues combed through data collected from 2007 to 2009 at 58 hospitals around the country. The hospitals were all participating in a surveillance project run by the C.D.C. that looks at adverse drug events.

A common denominator among the drugs topping the list is that they can be difficult to use. Some require blood testing to adjust their doses, and a small dose can have a powerful effect. Blood sugar can be notoriously hard to control in people with diabetes, for example, and taking a slightly larger dose of insulin than needed can send a person into shock. Warfarin, meanwhile, is the classic example of a drug with a narrow margin between therapeutic and toxic doses, requiring regular blood monitoring, and it can interact with many other drugs and foods.

“These are medicines that are critical,” Dr. Budnitz said, “but because they cause so many of these harms, it’s important that they’re managed appropriately.”

One thing that stood out in the data, the researchers noted, was that none of the four drugs identified as frequent culprits are typically among the types of drugs labeled “high risk” for older adults by major health care groups. The medications that are usually designated high risk or “potentially inappropriate” are commonly used over-the-counter drugs like Benadryl, as well as Demerol and other powerful narcotic painkillers. And yet those drugs accounted for only about 8 percent of emergency hospitalizations among the elderly.

Dr. Budnitz said that the new findings should provide an opportunity to reduce the number of emergency hospitalizations in older adults by focusing on improving the safety of this small group of blood thinners and diabetes medications, rather than by trying to stop the use of drugs typically thought of as risky for this group.

“I think the bottom line for patients is that they should tell all their doctors that they’re on these medications,” he said, “and they should work with their physicians and pharmacies to make sure they get appropriate testing and are taking the appropriate doses.”

link to original posting in the New York Times.

 

Medicare D

Just a reminder, Medicare beneficiaries have until December 7 to enroll in, or change, Medicare D coverage.

For Resources on Medicare D, please go to www.medicare.gov; www.medicareinteractive.org; www.insurance.illinois.gov/ship

Who Are We?

Dutton & Casey, PC (Elder and Disability Law)

Advocates for Elders, Persons with Disabilities, and their Loved Ones.

The law firm of Dutton & Casey, P.C., is committed to serving our clients with the comprehensive and personally tailored service they need and deserve. With 50 years of combined legal experience, we have acquired the depth and breadth of knowledge necessary to address the full scope of elder law and disability issues. 

Our Areas of Concentration:

  • Medicaid Eligibility
  • Elder Abuse, Neglect, and Financial Exploitation Litigation
  • Estate and Disability Planning
  • Guardianship
  • Litigation
  • Mental Health Law
  • Probate Administration
  • Public Benefits
  • Special Needs Planning
  • Trust Administration

* Full Time Social Worker/Certified Care Manager On Staff

Office Locations:

Arlington Heights, Chicago, Skokie, and Vernon Hills, Illinois.

Phone / Video Conferencing  Appointments are also Available.

Contact Information:

Telephone:      312-899-0950 or 847-261-3584

Website:          www.duttonelderlaw.com 

 

-please click here for a flyer on the law firm.

Family Caregiving and Ambiguous Loss

   
 
 
 
Caregiving and Ambiguous Loss
 

Introduction

Caregiving for a loved one can cause stress in many ways. To manage the stress—which we know can be dangerous to a caregiver’s health—we must first know what the problem is. Surprisingly, many caregivers of individuals with memory disorders or dementia report that the main problem is not the illness itself, but the ambiguity and uncertainty it causes.

It’s a difficult challenge to care for someone who is here, but not here—here physically, but gone mentally and psychologically. You feel alone, and in some ways, you are. For many caregivers, it’s as if there’s a stranger in the house.

Adding to the stress, disorders such as Alzheimer’s disease or traumatic brain injury cause unpredictable memory loss that comes and goes—one moment here, the next moment gone. This roller coaster of absence and presence is a very stressful kind of loss—what author Pauline Boss calls ambiguous loss. Unlike death, there is no closure, no official validation, and sometimes little community or religious support. You feel you are left to cope on your own; even the strongest caregivers feel anxious and depressed. The challenge is to learn strategies to cope with this ambiguity that is so much a part of memory loss.

 Symptoms of Overwhelming Stress

Caring for someone with a cognitive impairment—and the ambiguous feelings that arise—can create a constancy of sorrow that can immobilize caregivers. For example, decisions are put on hold, tasks pile up, chores delayed. Doubt, confusion, helplessness and hopelessness set in, and caregivers can feel anxious and depressed. Friendships are in limbo as caregiving takes more and more of your time. Conflict increases with spouse, children/stepchildren, siblings. Family gatherings and rituals that were the glue of enjoyable family life are cancelled or changed. When a caregiver feels increasingly isolated, the possibility of depression, anxiety, abuse, guilt, shame, lack of self-care, illness or substance abuse increases.

 Tips for Coping with the  Ambiguity of Memory Loss

To manage the stress of caregiving, try to connect with other people: if possible, join a support group either in person or on the Internet, attend a book club, social event, or faith-based group. Here are some ideas, questions and tips to help: 1. Name your problem.
Know that one real culprit causing your stress is the ambiguity from a loved one being here, but not here. Call it “ambiguous loss.” It is neither your fault nor the patient’s. It is caused by an illness.

2. Practice both/and thinking.
It helps to think “both/and” rather than in the extremes of “either/or.” Instead of thinking the care recipient has to be either here or gone, think of him or her as both here and gone. This means balancing two different ideas at the same time—present, and also absent. Both/and thinking is less stressful than continuing to search for an absolutely perfect solution.

Here are some examples:

“I am both a caregiver—and a person with my own needs.”
“I take care of both him—and myself.”
“I both wish it was over—and that my loved one could keep on living.” 
“I am both sad at my loved one’s illness—and joyful with my new grandchild.”
“I am both sad about my lost hopes and dreams—and happy about some new plans and goals.”

Now add your own examples. “Both/and” thinking may come faster if you practice with another person.

3. Know your “family” and community information and support systems.
You need predictability (not ambiguity) about whom you can talk to and count on for help. Have some other people become “like family” to you? Does your community offer help and social support? Spiritual support? Recreation and respite? Information support? Talk with your Caregiver Resource Center about what help is available to you. Check the web—a quick online search for “caregiver” offers a wealth of information and online communities. If your biological family offers no help, perhaps you can create a “psychological family” that will be there for you when you need help. Talk about how to divide up the work among a “care team.” Make a written plan to know who will do what and when. Who will come once a week so that you can take some time off to do as you wish? Who will come for a week twice a year so that you can take a vacation from caregiving? Several websites can help you establish your caregiving community (see Resource list below).

4. Continue—but revise—family holidays, celebrations and rituals.
Do not cancel, but rather, simplify the gatherings with the people you care about to celebrate birthdays, holidays, and religious events and rituals. Families, friends, and communities connect to celebrate life’s transitions. Human connection can help lower your stress in times of sadness. It can help you and a person with dementia feel the spirit of life around you. This is essential to staying strong when the person you care for is not able to connect fully with you. Think and talk about this: what family rituals did you celebrate as a couple or family before the memory loss? Now? How can you simplify your family rituals and celebrations to fit the circumstances now? Young people can be especially helpful in answering these questions, because of their strong imaginations and new perspectives.

5. Revise family roles.
To manage the stress of caring for someone with severe memory loss, alterations are needed in what you and other family members previously did. There are changes in family roles as a result of the memory loss. What tasks are you now responsible for? What tasks have you lost? How do you manage these changes? What would help? Is there agreement in the family about who should do the caregiving? Are you resilient enough to change or do you feel you have to do  it all as before? Talk about who plays what roles in  the family.

Finally, based on roles, think about how you see yourself now. You might ask: Is it right for me to take time off to go out with friends when my spouse is suffering from Alzheimer’s disease? Do I still feel like a son or daughter or more like a parent to my parent? If my spouse has memory loss, do I still feel married? How should I act?

6. Be aware of family rules.
 Who is allowed to do what in your family? Is there a team approach or are you expected to do all the work alone? Become aware of your family’s rules and question them. They can change. Do your family’s rules about race, religion, class, age, or gender get talked about? For example, is there an unspoken rule in your family that only females can be caregivers? Are certain people excused from helping? Why are they excused? There may need to be a new family rule about “teamwork” so that caregiving does not fall to one person alone. Include children and teenagers in the circle of information about the illness, its effects, its unclear prognosis, and your need for help and teamwork.

7. Understand that anger and guilt are normal, but avoid harmful actions.
While mixed emotions are an understandable outcome of memory loss, the negative feelings can come out as anger or, worse yet, abuse—and that is not acceptable. Talk with someone—a professional or another caregiver—about your negative feelings to prevent acting out your anger. Remember, feeling angry about the ambiguity in memory loss is normal, but acting out that anger against the patient or yourself is not.

8. It seems contradictory, but imagine something new to hope for.
To stay healthy, everyone needs hope. When your loved one is ill, and you are tied to caregiving, you must discover new hope. It helps to talk about this with other people—and again, with young people. They might help you imagine new dreams for your future—new connections, new hobbies, new travel plans, new skills, new relationships.

Given the stress from caregiving and the ambiguity of memory loss, what can you plan for the future that is clear and certain? How about an outing, a firm date for dinner with a friend, a hobby that has clear outcomes, a TV program that you clearly enjoy? New hopes and dreams will emerge when you can balance the ambiguity with some activities that have clear outcomes, no matter how small.

9. Check on your own health.
Seek professional help if you:

  • Feel depressed, physically sick or hopeless.
  • Feel like hurting yourself or hurting or yelling at the person you care for.
  • Depend too heavily on alcohol or recreational drugs.
  • Fight with your spouse, children, stepchildren, or other family members and friends.
  • No longer take care of yourself.

When you are a caregiver for someone with memory loss, the stress of ambiguity adds to the usual pressures of caregiving. You have a duty and a right to take care of yourself.

 Summary

This Fact Sheet is a caregiver’s guide to managing the extra stress from ambiguous loss. To sum it up, think of managing the ambiguity as learning to walk in the fog. Keep moving forward, despite the stress of not knowing what lies ahead. But at the same time, reach out for support and human connections to stay resilient and strong.

 Credits

About Ambiguous Loss. See www.ambiguousloss.com/about_ambiguous_loss.phpBoss, P. (2000, paperback). Ambiguous loss. Cambridge, MA: Harvard University Press.

Boss, P. (2006). Loss, trauma, and resilience: Therapeutic work with ambiguous loss. New York: Norton.

 Recommended Readings

Bayley, J. (1999). Elegy for Iris. New York: St. Martin’s Press.

McKeithen, M. (2006). Blue peninsula: Essential words for a life of loss and change. New York: Farrar, Straus, and Giroux.

Schulz, R., & Beach, S. (1999). Caregiving as a risk factor for mortality: The caregiver health effects study. Journal of the American Medical Association, 282(23), 2215-2219.

Sparks, N. (1996). The Notebook. New York:  Warner Books.

Film adaptation: Cassavetes, N. (Director), Harris, L. (Producer), & Johnson, M. (Producer). (2004). The Notebook [Motion picture]. New York: New Line Cinema.

TeleCaregivingsm Workshop Audio Archive

Here but Not Here—Finding Hope When Your Loved One Has Memory Loss (Podcast)
http://caregiver.org/caregiver/jsp/content_node.jsp?nodeid=2061

Caregiving and Depression
http://caregiver.org/caregiver/jsp/content_node.jsp?nodeid=393

Caregiver Health
http://caregiver.org/caregiver/jsp/content_node.jsp?nodeid=1822

Caring for Adults with Cognitive and Memory   Impairments
http://www.caregiver.org/caregiver/jsp/content_node.jsp?nodeid=392

Dementia
http://caregiver.org/caregiver/jsp/content_node.jsp?nodeid=569

Grief and Loss
http://caregiver.org/caregiver/jsp/content_node.jsp?nodeid=404

Taking Care of YOU: Self-Care for Family  Caregivers
http://caregiver.org/caregiver/jsp/content_node.jsp?nodeid=847

 Resources

Family Caregiver Alliance
180 Montgomery St., Ste. 900
San Francisco, CA 94104
(415) 434-3388
(800) 445-8106
Web Site: www.caregiver.org
E-mail: info@caregiver.org
Family Caregiver Alliance (FCA) seeks to improve the quality of life for caregivers through education, services, research and advocacy.

Identifying Family Caregivers

Identifying Family Caregivers

Suzanne Mintz
2011-NFCM-Sm

There are more than 65 million family caregivers in America. Some are just beginning the caregiving journey while others have been providing care for five, 10, 15, even 20 years or more. It’s hard for those who are just beginning to help Mom and Dad with a few activities each week to relate to those of us who are providing more than 40 hours of care a week to a spouse/ partner, child, or parent who is severely ill and/or disabled, who lives with us, and who needs help with virtually all the ordinary activities of daily living such as dressing, toileting, eating, etc.

Those at the beginning of the journey don’t interact with the healthcare system as much as “high-burden” family caregivers — those of us who are putting in more than 40 hours a week helping a loved one. I fit into the latter group and I suspect that most of you reading this article do too. When there is talk about family caregivers needing help, about the nation’s most vulnerable citizens — and those who require the most resources — we and our loved ones are the people being discussed.

Within the caregiving community, advocates, scholars, researchers and others have all lamented the fact that as a rule, family caregivers don’t self-identify and that is the reason it is so hard to reach us with information and support. People at the beginning of the family caregiving journey are less likely to self-identify as family caregivers and that may be OK, but it is very important that high-burden family caregivers self-identify, or are identified as such by others.

The other day I had one of those “I should have had a V8” moments. I realized that it is less important for family caregivers to self-identify than it is for healthcare providers and the healthcare system to identify who are family caregivers. How can our healthcare system provide patient- and family-centered care, as we are told it should, if it doesn’t identify half of the equation? It doesn’t make sense really, and it certainly isn’t respectful. I have an idea about how family caregivers can be identified through their interaction with the healthcare system, an idea that is easy to implement and will cost virtually no money at all.

We’ve all filled out countless medical intake forms that become part of the medical record. They ask about our health history and even that of our parents, but they never ask, “Do you provide care for a family member or friend who is chronically ill and/or disabled?” or, “If you have a chronic illness or disability, is there a family member or friend who provides care to you or helps you manage your illness or disability?”

How can doctors, nurses and others pay attention to us, find out what care we provide at home, and keep an eye on our own health if they don’t know who we are? It’s important that they know exactly what type of care we provide our loved ones.

Do you do any of the following: take a loved one to the doctor regularly, manage his/her medications, or help him/her get in and out of bed and to the toilet, or eat or dress? How long have you been providing care? Do you have chronic back pain or feelings of depression? Knowing this type of information can impact the plan of care that healthcare professionals recommend and it can alert them to any problems you might have as well. While in some cases it’s obvious that there is a family caregiver, if it isn’t in the record, it isn’t official; consequently, we are truly invisible to the healthcare establishment, the government, and private insurers, despite the rhetoric to the contrary.

Given all the talk about patient- and family-centered care, not identifying family caregivers is at best an oversight and at worst hypocritical; either way, we need to correct this glaring omission. It’s important to inform healthcare professionals, key healthcare decision makers, the government, and private insurance companies that “family caregiver” is not just a term to pay tribute to, but, rather, that we are real people who provide long-term care for millions of Americans.

What you can do to ensure that family caregivers are identified in medical records:

  1. Attach a piece of paper to every intake form you fill out for yourself or your loved one. Put your name and your loved one’s name at the top and then write: “I am John Smith’s wife and his primary caregiver,” or, “My daughter, Nancy Dale, is my primary caregiver,” or a similar phrase. List the top five to 10 tasks you do and note the impact on your health and well-being (chronic back pain, depression) and your life (having to cut hours at work). Save this information on your computer and print it out each time you take Mom to the doctor or visit your own.
  2. Talk about the idea with your pharmacists, nurses, or others you come in contact with who have some connection to the healthcare system. They have probably never thought about the idea of identifying family caregivers on medical records.
  3. Write to your insurance company. Tell them that knowing who among their beneficiaries are family caregivers, and/or who have family caregivers, will provide them with an opportunity to find new ways to improve care and cut costs.
  4. Use social media to spread the idea. Talk to family, friends, and even clergy.

The goal is to create a buzz so that family caregivers and everyday people, as well as providers and decision makers, realize that something is missing on medical records: information about whether someone is or has a family caregiver. November is National Family Caregivers (NFC) Month. Let’s make NFC Month 2011 the time we began the movement to identify family caregivers in medical records.

 Click here for more information on the National Family Caregivers Association.

How to Tell When Your Parents Need Help…

How Do I Know When My Parents Need Help?

As your parents age, you may begin to wonder or worry: “Are they safe at home? How can I tell if they need help?” Your parents are independent, private people who are not going to share with you incidents that make you think they are not okay. They do not want to go to a nursing home and lose their independence. They love their home and enjoy being in it. So they are not going to tell you the things that happen that may send them to a nursing home. As a matter of fact, they will hide these issues from you. They are afraid of going to a nursing home, and this is a rational fear. They have seen their friends and neighbors placed into facilities when their health begins to decline. All of their possession are sold or given away, the home they have spent years in is sold, they can no longer sleep in if they feel like it or eat whatever and whenever they want; their losses are great. You need to acknowledge that this is a rational fear, something that may happen to them that can be unpleasant.

The following is a list of indicators for change. Observing any of these things happening does not mean your parent cannot live at home. What it does mean is the situation needs to be assessed. Professional or informal and volunteer services can be put into place to allow your parent to stay in their home safely.

  • Unexplained weight loss
  • Falls, accidents or bruises
  • Forgetting food on stove (look for burned or scorched pans)
  • Unpaid bills or utilities being shut off
  • Housekeeping decline: dirty walls, floors, windows or bathtub
  • Unable to maintain home; broken items not being repaired over long time
  • Refrigerator and cabinets empty; not enough food
  • Unable to recognize or react to danger
  • Getting lost or locked out of the house
  • No longer able to transfer independently from bed to wheelchair
  • Incontinence
  • Lack of social support
  • Decreased interest in fun or social activities
  • Medication errors
  • Increased emergency room visits
  • Wearing dirty clothes
  • Needs to reminded to bathe; has dirty hair or personal odor

For more infomation, please click here

Family Caregivers: How to Avoid Holiday Traps

Family Caregivers: How to Avoid Holiday Traps

Caregivers can rewrite the holiday rulebook to reduce stress, increase joy

From Vicki Rackner, MD, 

Holidays, meant to be a celebration of shared joy and connection with family and community, can quickly become a time of burden and a reminder of alienation and loss.For caregivers, holidays can bring an extra measure of activities and caregiver stress1. “I wish the calendar would flip directly from November to January,” said Fern, 67. “We just got settled into a routine now that Mom moved in with us, and all I see are a longer to-do list and disrupted schedules.”Holiday celebrations can destabilize any family, and family caregivers know this better than most because people who attend to the needs of aging parents, a sick spouse or family friend already live on the edge of a delicate equilibrium. As Gary, 59, so colorfully said, “Since Dad had his stroke, my life is held together with rubber bands and bubble gum. I’m concerned that Christmas will herald its collapse.”

For self-preservation, many caregivers let go of rules about how holidays should be celebrated. “Being a caregiver for my sick wife offers many gifts,” said John, 73. “Maybe the most important is the invitation to look at our life in a new way. Almost out of necessity, I stripped down our holiday celebrations.”

5 Holiday Traps for Caregivers
There are several common holiday traps that family caregivers fall into, but they can be avoided. Just follow a simple concept: Free yourself from ideas about what shouldhappen, and give yourself permission to celebrate holidays in a way that works for you and your family.

    • Trap #1: Planning for the worst. Many caregivers think, “This could be Dad’s last Christmas, so I want to make it really special.” Wouldn’t it be great if we came into the world with an owner’s manual that included the expiration date! We do not. I have seen patients defy all medical odds and laugh about the doctor who gave them six months to live—20 years ago. Then there are the tragic untimely deaths. We should all celebrate as if this is our last holiday season!
  • Trap #2: Creating Norman Rockwell scenes. The idea of a picture-perfect holiday has an emotional tug that’s particularly seductive to family caregivers who may long to return to earlier, carefree days of health and vitality.While there is no perfect holiday celebration, you can create holiday rituals that are perfect for your family. Say at a family meeting, “Our lives are different this year, so we need to think about how our holiday celebration will be different. What are the two or three things that make the holiday special for you?” For most people, it’s the little things that make a big difference, like the Russian Tea Cakes, the special hand-embroidered tablecloth, or playing board games. Create a montage of your family’s perfect holiday.
  • Trap #3: Buying your way out of guilt. For people in the sandwich generation2, caring for both children and parents, the guilt that someone is getting shortchanged looms large. Who doesn’t wish for more hours in the day so that children and friends, even the person in the mirror, would get more time and attention? The life of a caregiver leaves big gaps. If you try to fill the gaps with gifts, you will undoubtedly find that it does not work very well.All family members, including children, need to know they are loved and treasured. Gifts are one way to say this, but what most kids of all ages really want is more of you. Consider a different kind of holiday gift, like a coupon for 10 minutes of undivided attention each day, a trip to the ice cream store, or a visit to the zoo.During a holiday dinner, how about shining a “spotlight” on each person at the table, with each guest offering a story that demonstrates why this person is special? You could write the comments on 3×5 cards and give them wrapped in ribbon or mounted in a collage.

    Consider inviting your kids to give rather than receive by touching the lives of those less fortunate. Serve a meal at a shelter. Invite a lonely neighbor to your house. Look for a chance to give a stranger a $20 bill, or whatever you can afford.

  • Trap #4: “Smile!” This instruction, given before every photo, captures the tone for holidays. Over and over, we’re told there’s a right way to feel during a holiday, and that’s happy. Family caregivers have a spectrum of feelings that rise to the surface during holidays, like sadness or anger or disappointment. It is sad that it’s not safe for Dad to live alone any more, so set aside some time to acknowledge those dark feelings. Suppressing the feeling does not make it any less real, and adds to your holiday burden. [Note: For help with handling feelings of grief and loss, see 5 Steps to Help You Through the Grieving Process3]
  • Trap #5: Party On!If you are an extrovert—someone who gets recharged from being in the presence of others—you are in your element during holidays. Party on!For introverts who get recharged by spending time alone, or those who have limited pep because of illness, holidays can be emotionally depleting. There is still hope for a joyous holiday celebration, it just requires some advanced planning.Plan a social calendar that’s reasonable for you as a caregiver and for your loved one. Be realistic about your energy limits before you make endless commitments, and ask family members to do the same. If either you or your loved one is an introvert, it’s perfectly reasonable to respond to some invitations with, “Thanks for the lovely offer. Unfortunately, we have other plans. I’m sure you’ll have a terrific time, and I’m sorry to miss it.” The host does not need to know that your other plans are a nap.

Your life became different when you became a family caregiver, and it’s time to do things differently. Free yourself from the idea that there’s a right way to celebrate a holiday. Look at your family and decide how to make holidays work for you, and then adjust the family expectations. That’s the recipe for celebrating the blessings in your life, and the joy and love you share with others.

Vicki Rackner, MD, FACS, is a surgeon who left the operating room to help patients and family caregivers enjoy better health. A noted expert on the doctor-patient relationship, Dr. Vicki serves employers through Medical Bridges4, and welcomes everyone to join her Caregiver Club5.

Department of Health and Human Services Website on Health Insurance

The Department of Health & Human Services has expanded its website on health insurance companies to include a filter allowing small business owners to locate plans allowing for same-sex partner coverage.

The website, healthcare.gov, was established as a result of the health care reform law that President Obama signed into law in 2009. The website provides details about the Affordable Care Act and offers a searchable database enabling individuals and businesses to find health insurance plans.

In addition to providing a filter enabling small businesses to find plans covering same-sex partners, the expansion of the website — activated on Friday — lets businesses find product choices for a given zip code, sort them by out-of-pocket limits, and find plans with mental health and maternity coverage.

Secretary of Health & Human Services Kathleen Sebelius said the change fosters a more transparent and competitive marketplace in addition to allowing businesses to find plans in an unbiased manner.

“This new information will help business owners navigate what has traditionally been a complicated and confusing decision,” Sebelius said. “Both owners and their employees can feel more confident that the plans offered will be the best to suit everyone’s needs.”

An informed source said the change is just a first step and a later iteration of the website will enable individuals — not just employers — to find health insurance plans that allow for same-sex partner coverage.

Related Stories

According to HHS, the website is the first to bring together information and links to health insurance plans in one venue. The Centers for Medicare & Medicaid Services collected the benefits information from insurers. More than 530 insurers provided information for more than 2,700 coverage plans. Fred Sainz, vice president of communications for the Human Rights Campaign, welcomed the change.

“This is good news and another sign of progress,” Sainz said. “Anything that makes it easier for companies to ensure that all their employees, including those with same-sex partners, have access to health insurance is a good thing.

Increase in Prevention of Spousal Impovershment Standards for 2012

The amounts for 2012 of monthly income, and total assets, that a person can keep when their spouse enters a long-term care nursing hom, supportive living,e or needs the services of the Illinois Community Care Program (CCP) and federal financial assistance is used to help pay for these services have been released.

Click here to read more.

National Council on Aging

National Council on Aging has updated its website to be more user-friendly and helpful.

Click here to read more about the National Council on Aging and its efforts. While you are on the site, make sure to look at benefits check up to learn about federal, state, and local programs for yourself, or someone who you care about.

Driving and Dementia

Driving demands quick reaction time and fast decision making — because of this, a person with Alzheimer’s will eventually become unable to drive. Making decisions about when it’s time to stop driving can be difficult, but dealing with the issue early on can help ease the transition. Learn more at our online Dementia and Driving Resource Center, where you can watch how four families deal with different issues related to dementia and driving.

Click here to read the entire article, from the Alzheimers Association.

Confused about Medicare?

Medicare is the primary health insurance for people are 65 and older and younger people who have a disability.

However, Medicare can be very confusing. To learn more about Medicare, what is covers, deductibles, co-pays, etc., look at  

www.medicare.gov;  

www.insurance.illinois.gov/ship

In addition, go to www.medicare.gov/publications for a resource booklets on the various aspects of Medicare.

2011 Northeast Young Onset Parkinson Conference

Donate Now

National Parkinson Foundation 1-800-4PD-INFO

Register Now for the Free Webcast on Oct. 22, Live from
the 2011 Northeast Young Onset Parkinson Conference!

Can’t make it to Rhode Island? Watch the live webcast of the key speakers from the comfort of your home. Register now for the free, live webcast and learn about the following topics:

  • Impulse Control Disorders and Other Brain-Related Behaviors
    Joseph Friedman, MD, Brown University
  • Recent Developments in the Genetics of Parkinson’s Disease
    Richard H. Myers, PhD, Boston University School of Medicine
  • Social Security Disability Insurance (SSDI): Understanding the Process
    Tai Venuti, MPH, Allsup, Inc.
  • DBS: What to Expect from Surgery and After
    Julie G. Pilitsis, MD, PhD, Albany Medical College
  • Beyond the Mask of Parkinson’s: Strategies for Overcoming Communication Challenges
    Linda Tickle-Degnen, PhD, OTR/L, Tufts University

This event is brought to you by the National Parkinson Foundation and the  American Parkinson Disease Association. Thank you to our generous sponsors: Teva Neuroscience, Ipsen and Medtronic.

For more information, please call NPF’s Helpline at 1-800-4PD-INFO (473-4636).

Event: Legal Planning For Living with a Chronic Medical Condition

Attorney Kathryn C. Casey will be presenting at a support group for people who have Parkinsons Disease and their Loved Ones.

Date: Tuesday, October 18, 2011

Time: 7:00pm

Location: Alexian Brothers Neuroscience Institute, Alexian Brothers Medical Center, 800 Biesterfield Road, Eberle Medical Building, Suite 610, Elk Grove Village

Registration or More Information: Please contact Paula Wiener at 847-516-2768 or pmwiener@sbcglobal.net

Event: Elder Law & Ethics 2011

Please join us for an interactive presentation and case studies of elder law & ethics on topics such as:

  • Determination of decisional capacity
  • Risk factors for neglect, abuse and exploitation
  • Solutions for helping those at risk
  • Proposed changes to Medicaid (DRA) and potential impacts Amended Power of Attorney Act

Presented by: Attorney Kathryn C. Casey, JD
Partner, Dutton & Casey, P.C.

Date: Wednesday, September 28, 2011
Registration: 8:30 a.m.
Presentation: 9:00 a.m.– Noon
Location: Lake Barrington Woods
22320 Classic Court
Lake Barrington, IL 60010
Registration: There is no cost to attend. Registration is required prior to September 23, 2011.
847-842-8900. Seating is limited.

This program will award 3.0 clock hours to Illinois Social Workers,
Professional Counselors and Registered Nurses. This program satisfies the Illinois Social Worker 3-hour ethics requirement.
Credits provided by Silver Connections/Paxem.

Schedule a Meeting with One of Our Attorneys

To schedule a meeting with one of the firm’s attorney, please call

  • 312-899-0950 for the Chicago office
  • 847-906-3584 for the Arlington Heights office
  • 847-261-4708 for the Skokie office
  • 847-886-9456 for the Vernon Hills office

 Email: contact@duttonelderlaw.com

When calling to set up an appointment, you will speak with Joshua Roma, our paralegal and intake specialist. This call is an opportunity for you to discuss your situation and for us to listen. If our services match your needs, Joshua will work with you to find an available date for you to come to meet with one of our attorneys.

Two things will happen prior to your meeting. The first is that you will receive a questionnaire from our office, either in electronic form or through the mail, depending on your preference. Different circumstances call for different information, so the questionnaire you receive will be specific to your situation. The purpose of the questionnaire is to gather as much background information before the meeting so that the information is readily available for the attorney when you meet. This will maximize your time with the attorney, as more of your time can be spent discussing possible solutions and next steps. It also provides the attorney with a more solid understanding of your situation, which will in turn assist her in providing specific advice that will benefit you most.

Secondly, prior to your appointment, you will receive a phone call from our office reminding you of the date and time of your appointment.

What happens during your meeting?  After?

The first meeting lasts one hour and fifteen minutes long.  During this time, you will meet with one of our attorneys and discuss your circumstances with her.  The information included in your questionnaire will help to guide that conversation.  After you discuss your situation and the details surrounding it, the attorney will talk about some strategies for how your situation may be remedied and what steps would need to be taken in order to achieve that solution.  She will also discuss the approximate costs involved in assisting with your elder law matter so that you are aware of the financial commitment ahead of you and can make an informed decision on how to proceed.

The charge for the first meetng is $350 and it is important to know why.  “Free” is good, but some things are free for a reason.  Our attorneys have over 50 combined years assisting their clients with elder law matters of all shapes and sizes.  At Dutton & Casey, the first meeting is designed as an opportunity to sort through your situation and come up with a plan on how to deal with that situation, whatever it may be.  It is not a sales meeting.  Each of our clients is unique, and as a result, we do not believe in a “one size fits all” approach.  We will provide only those solutions that fit your needs, not a generic package that ignores your real concerns while addressing some that do not even apply to you.  The meeting may even provide you with the information you need to understand that you may not need to retain an attorney after all.  By investing in a productive consultation, you are investing in knowledgeable, attentive and tailored legal assistance.

After the meeting, you will have the option to retain Dutton & Casey to represent and assist you in your matter.  If you choose to do so, we ask that you sign and return our retainer letter (which we will provide once you notify us that would like us to assist with your matter) along with the agreed upon retainer amount.  Once we receive the signed document along with the retainer amount, the work begins immediately.

If you would like to schedule an appointment with Dutton & Casey, P.C., please fill out the form and Joshua will contact you.

[contact-form subject=”Contact: Schedule a Meeting” to=”jroma@duttonelderlaw.com”] [contact-field label=”Name” type=”name” required=”true” /] [contact-field label=”Email” type=”email” required=”true” /] [contact-field label=”Phone” type=”text” /] [contact-field label=”Comment” type=”textarea” required=”true” /] [/contact-form]

Medicaid Spousal Impoverishment Protections for Same – Sex Civil Union Partners

When one partner in a long-term relationship needs expensive long term care, often the only way for the couple to pay for it is to look to Medicaid. Historically, there have been no spousal impoverishment protections afforded to partners in same-sex relationships when one partner needs long term care and applies for Medicaid. However, the combination of the new Illinois Civil Union Act and a policy change recently announced by the U.S. Department of Health and Human Services ensure that Medicaid spousal impoverishment protections are afforded to Illinois same-sex civil union partners.
On April 1, 2011, U.S. Department of Health and Human Services Secretary Kathleen Sebelius announced that, effective immediately “[t]he Centers for Medicare & Medicaid Services will notify states of their ability to provide same-sex domestic partners of long-term care Medicaid beneficiaries the same treatment as opposite-sex spouses in the contexts of estate recovery, imposition of liens, and transfer of assets. This includes not seizing or imposing a lien on the home of a deceased beneficiary if the same-sex domestic partner still resides in the home. It also includes allowing Medicaid beneficiaries needing long-term care to transfer the title of a home to a same-sex domestic partner, allowing the partner to remain in the home.” In additional to these protections, the partner in the community is allowed to receive assets, in addition to the home, from the nursing home partner in an amount sufficient to bring the community partner’s assets to the Community Spouse Asset Allowance standard – presently $109,560. The community partner may also be eligible to receive income from the nursing home partner when Medicaid is paying for that partner’s long term care.
The new Civil Union law which became effective on June 1, 2011 provides that a “party to a civil union” is to be included in any definition used in state law where the term “spouse,” “family,” “immediate family,” “dependent,” “next of kin” and other terms that denote “spousal relationship” are stated. The Civil Union Act stops short of granting same-sex couples the right to “marry”; however, it does guarantee “[a] party to a civil union … the same legal obligations, responsibilities, protections, and benefits as are afforded or recognized by the law of Illinois to spouses.
The Civil Union Act in Illinois mandates that the Illinois State Medicaid agency, the Department of Healthcare and Family Services, treat partners in civil unions the same as married partners. The federal Medicaid agency, the Department of Health and Human Services, is allowing states to treat same-sex partners as opposite sex spouses for purposes of Medicaid. Therefore, same-sex partners in Illinois Civil Unions should be afforded Medicaid spousal impoverishment protections if Medicaid coverage of long term care becomes necessary for one of the partners. Dutton & Casey, P.C. is available to represent civil union partners needing long term care in accessing Medicaid and Medicaid spousal impoverishment protections. Please note, federal Medicaid spousal impoverishment protections apply to the Medicaid programs covering nursing homes and assisted living (supportive living) facilities, as well as to the home based services program, the Community Care Program, administered by the Illinois Department on Aging.

Alzheimer’s: Early Planning Critical to Financial Health

In a recent article in Reuters Magazine, Alzheimer’s: Early Planning Critical to Financial Health, working with a certified elder law attorney is an important step in planning for the future.

Janna Dutton, founder of Dutton & Casey, is one of only 8 certified elder law attorneys in Illinois.

Click here to read the article.

For additional information on how Dutton & Casey can assist you, or someone who you care about, please go our website.

Planning for a Hospital……Discharge

An admission to, and a discharge from,  the hospital can be scary for the patient, and the family. The National Family Caregiver Alliance published a guide on the hospital discharge process. It is vital to pay attention, and be involved, in the plans being for when your relative leaves the hospital.

read the entire article.

……………….

The law firm of Dutton & Casey concentrates in assisting older adults, people with disabilities, and their families. Many times, plans following a hospital stay also include the need for legal planning.  With over 50 years in expertise and offices in Chicago, Skokie, Arlington Heights, and Vernon Hills, the advocates at Dutton & Casey are available to assist. Please click here to read more about how we can assist you or those you care about.

Warning about a Scam

Warning about “Living Well” Grant Funds Scam

The U.S. Administration on Aging has alerted the Senior Medicare Patrol (SMP programs) to a phone scam in which the caller tells the call recipients that they are eligible for a “Living Well” grant. The caller then instructs the recipient to complete a grant “application,” provide a cell phone number, and wire money through Western Union. The recipient is told that s/he will be contacted on their cell phone when it is time to pick up their “grant” funds at Western Union. 

This is definitely a scam. The Administration on Aging provides “Living Well” grants to several states, but those grants do not have anything to do with calling individuals or requesting money. If people receive calls like this, they should report the incident to the Illinois Attorney General’s Office consumer fraud hotline at one of the numbers below:

 (800) 386-5438 (Chicago)
(800) 243-0618 (Springfield)
(800) 243-0607 (Carbondale)

 Consumers are also encouraged to report calls like this to the Federal Trade Commission: https://www.ftccomplaintassistant.gov/

 The Federal Trade Commission has information available on their website about fake government grants scams like this one: http://www.ftc.gov/bcp/edu/microsites/phonefraud/government.shtml

……………………………………………

The Law Firm of Dutton & Casey, PC., is dedicated to serving older adults, persons with disabilities, and the people who care for them. Please go to www.duttonelderlaw.com for more information on our services and for additional resources.

New Diagnostic Guidelines for Alzheimers Disease

In April, 2011,   new diagnostic guidelines for the diagnosis of Alzheimer’s Disease were released.  This information  is to important to only be shared once. Please review the guidelines, again, and share this information. We can all be part of the process to assist people receive the care they deserve!

………………

For assistance with the legal planning that is needed with a diagnosis of a cognitive disorder, please contact the law office of Dutton & Casey. We are compassionate advocates for older adults, people who have a disability, and the people who care about them. Please go to our website  at  www.duttonelderlaw.com  or email us at contact@duttonelderlaw.com. We will be honored to assist.

YOUR Elder Law Connection… From Dutton & Casey

The April, 2011 issue of the newsletter from the Law Firm of Dutton & Casey was published today.

Please take a few minutes to read the newsletter… it contains many helpful articles and resources focusing on older adults, adults who have a disability, and the people who care about them, including family members and professionals.

Should there be any questions on the newsletter, to learn more about the many resources that the attorneys and staff can provide, or/and to schedule an appointment with a firm attorney, please go to https://www.duttonelderlaw.com/

10 Common Estate Planning Questions

 Attorney Melissa Howitt recently wrote an article answering the 10 questions most often asked about estate planning.  Please click here to read this informative, and easy to understand, article.

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To discuss estate planning for you or someone you care about, please contact the office of Dutton Casey, PC, to schedule a consultation with a firm attorney. 312-899-0950 (Chicago), 847-906-3584 (Arlington Heights), 847-261-4708 (Skokie), or send an email contact@duttonelderlaw.com.

Do You Need a Living Trust?

In our ongoing effort to be a community resource, Attorney Lara A. Duda recently wrote an article explaining living trusts.

Here is the link for the entire article.

and….
to discuss estate planning, including Living Trusts, for you or someone you care about, please call the office of Dutton Casey, P.C., to schedule a consultation with one of the firm’s attorneys. Our office numbers are 312-899-0950 (Chicago), 847-906-3584 (Arlington Heights), and 847-261-4708 (Skokie).

Emergency Preparedness

With the current weather conditions, I felt it was important to provide a few resources on emergency planning for older adults and people who have a disability.

With emergency planning, people tend to think of ‘man made events’ but, as was evident in Chicagoland today, a large amount of snow and cold temps, can have a huge impact on daily life.

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http://nod.org/disability_resources/emergency_preparedness_for_persons_with_disabilities

http://www.cdc.gov/aging/emergency/index.htm

http://www.disability.gov/emergency_preparedness/preparedness_tools_%26_resources

Your Elder Law Connection, from Dutton and Casey, P.C.

The January 2011 issue of “Your Elder Law Connection” has been published.

This monthly publication contains useful information for older adults, adults who have a disability, and their loved ones.

Please click on the link to be directed to the newsletter:

http://archive.constantcontact.com/fs010/1102793168627/archive/1104185870572.html

Center for Medicare Advocacy Says: You Can Leave the Nursing Home

December is a time of holidays, celebrations and school vacations. Nursing home residents often want to join in family festivities and visit with children and grandchildren but may be under the impression that they will lose Medicare coverage if they leave the facility to do so. According to the Center for Medicare Advocacy, Inc. (CMA) this is not true.

The Medicare Benefit Policy Manual recognizes that although most beneficiaries are unable to leave their facility, “an outside pass or short leave of absence for the purpose of attending a special religious service, holiday meal, family occasion, going on a car ride, or for a trial visit home, is not, by itself evidence that the individual no longer needs to be in a SNF for the receipt of required skilled care.

for more information, go to www.medicareadvocacy.org/infobytopic/skillednursingfacility/snf_youcanleavethe snf.htm

Driving Evaluations

Driving evaluations are an instrumental way to help determine if someone is safe to continue driving, whether it be for physical, visual, or cognitive reasons.  The evaluation lasts for three hours and is split up into three different sections.  The first hour is in the clinic with an occupational therapist.  The therapist evaluates range of motion, strength, reaction time, vision, memory, attention, sensation, street signs, and situational driving questions.  The next hour and a half is out on the road, where the driving instructor evaluates handling of the car and ability to safely drive.  The evaluation concludes with a sit down meeting to go over the results and recommendations that will be made to the doctor.  Individuals may pass, fail, or require further training sessions to practice their skills or with equipment if needed.   For more information please call Alexian Rehabilitation Hospital at 847-640-3119.  To see a list of area locations that administer the evaluation, click here.

What do you need to participate?: a current driver’s license and doctor’s order

How long does the evaluation last?: 3 hours

For more information on how to take care of yourself or your loved ones as they age, visit the website of elder law firm Dutton & Casey, P.C. to check out our resources or read about how our attorneys can help give you the peace of mind that comes with planning for your future.

Six Questions to Protect Elderly Patients

A trip to the hospital can leave family members and caregivers feeling more reactive than proactive.  For some of us, the medical jargon can be so over our heads and the stress and worry levels so high, that it seems best to stay on the sidelines when it comes to caring for a patient.  For instance, have you ever found yourself thinking- “this doctor/nurse deals with these situations all the time, so they know how to handle it much better than I do…”  Or how about when a sibling asks why your mom received a certain kind of medication or what the side effects are and you say, “I’m not sure, the doctor told me we should do it.”  There are incredibly caring and knowledgeable health care professionals in the world that are experts at what they do, but as a family member you are an expert in that particular patient, and that counts for something, too!  No matter how great the health care professionals involved with your family may be, advocacy for your patient in the fast-paced health care environment is critical.

But how do you know what to do or what to ask?  This is a start.  Here is a recent blog from the New York Times that poses “Six Questions to Protect Elderly Patients.”  Her blog noted that “About a third of patients over age 70 experience hospital delirium, and the consequences can be serious, delaying a patient’s recovery and even leading to placement in a nursing home.”  So, to play a more proactive role in the care of your family member or loved one, Pam Belluck of the NYT, suggests asking the following 6 questions when it comes to older patients:

1. Do the nurses and doctors routinely screen for delirium or identify high-risk patients?

2. How does the hospital deal with agitation or delirium in patients if it develops?

3. What does the hospital do to keep patients from becoming disoriented?

4. What policies are in place to make sure patients get adequate sleep?

5. If my family member needs a urinary catheter or other bedside interventions, how does the hospital decide when to remove them?

6. Will the physicians and pharmacy staff review my family member’s medications to identify medications that increase delirium risk?

Read the complete blog here

To speak to Dutton & Casey’s Care Advocate, Erin Vogt, and learn about other ways to help provide the best possible care for your loved one, contact Erin at evogt@duttonelderlaw.com or (312)371-0954.

Encouraging Comfort Care: A Guide for Families of People with Dementia Living in Care Facilities

The Alzheimer’s Association-Greater Illinois Chapter is pleased offer a free online resource, Encouraging Comfort Care: A Guide for Families of People with Dementia Living in Care Facilities. This 21-page booklet provides useful information to families and staff of long-term care facilities about Alzheimer’s disease and related dementias, particularly care issues related to the late and final stages.

For families, this guide will enable them to make informed choices about a variety of medical decisions they may face on behalf of loved ones with dementia living in nursing homes, assisted living facilities, and other types of care facilities. It will also equip families to ask good questions aimed at obtaining the best care for their loved ones, including a handy checklist of comfort care measures to be discussed with staff members of care facilities.

 To view and download the free guide, click here: http://www.alzheimers-illinois.org/pti/comfort_care_guide.asp

For more resources or to read about the elder law firm of Dutton & Casey P.C.’s  areas of concentration, visit www.duttonelderlaw.com or call (312)899-0950.

Aiding Those With Hearing Loss

In order to provide quality services for, and on behalf of, our older adults, we need to understand how age affects our ability to hear.  This post provides helpful information on a topic that is important, for both professionals and clients, to understand.

In addition to hearing aids, there are many wonderful products to aid a person who has hearing loss. One such program comes from the Illinois Access Telecommunications Commission (IATC), which provides free amplified phones.  This program, funded by a charge on all local phone lines in Illinois, is run by the IATC and has been issuing equipment since 1988. 

In order to qualify for this program, you must:

  • be a legal resident of the State of Illinois,
  • have working land line phone service at the address shown on the application,

and

  • be certified as Deaf, Hard-of-Hearing, Speech-Disabled or Deaf-Blind by:
    • Licensed Physician,
    • Speech-Language Pathologist,
    • Audiologist,
    • or designated DHS/DRS Counselor.

 (There are no age or income restrictions to qualify for the programs.) 

Click here to fill out an application, or for more information, contact the Illinois Telecommunications Access Corporation at the information below:

phone: 217-698-4170 or 1-800-8411-6167 (V / TTY)
website: http://www.itactty.org

For more information on holistical care  for your loved ones, contact Erin Vogt, Care Advocate at Janna Dutton & Associates at evgot@duttonelderlaw.com or (312)371-0954.

Resources on Changes in Intimacy and Sexuality for Those With Alzheimer’s

In addition to the Alzheimer’s Association, the National Institute on Aging has wonderful resources for family and caregivers. There is a new list of resources focusing on changes in intimacy and sexuality, an often overlooked challenge for spouses, partners, and professional caregivers of people with Alzheimer’s and other dementias.

For more information on holistic care  for your loved ones, contact Erin Vogt, Care Advocate at Janna Dutton & Associates at evgot@duttonelderlaw.com or (312)371-0954.

Geriatric Care Managers: Experts in Developing Personalized Care Plans

Caring for an elderly parent or loved one can be a full-time job. Even when a family can agree on a care plan, which is not always the case, the plethora of decisions that need to be made and the never-ending pile of documents that need to be filled out is overwhelming. In addition to that, you have your own life to live and yourself to take care of.

It’s tempting to want to handle everything yourself, but sometimes outside help can actually allow you to provide the best possible care for your loved one, not to mention allow you to take better care of yourself. In September, the New York Times published an article on geriatric care managers, or what they also refer to as the equivalent of a case worker. Aptly named, these care managers do just that–manage the care of your family member. They have both the time and the expertise that family members often do not, which can greatly improve your elder’s quality of life. (See complete article for costs)

A good care manager will thoroughly assess the individual and use that assessment to determine a care plan that will meet the individual’s needs. Amongst a variety of other changes, this could mean that home care is recommended, or that sleeping and eating times must be adjusted. Plus, using someone outside of the immediate family can help in a few ways. One family member explained that he couldn’t get his mom to listen to him, but she would always listen to the care manager. It also provides the family with the option to be the “good cop” while the care manager is the “bad cop.” Persuading an older person not to drive anymore is a good example of when the good cop/bad cop routine might come in handy (and be more effective).

Click here to see the article in full. It provides some examples of how geriatric care managers have assisted families in finding and maintaining the right kind of care, costs involved and ways to find the right care manager for your family.

Here is an interview from ChoiceElderCare.org with a registered nurse and care manager on the benefits of care management. 

For legal advice on long-term care planning for yourself or a loved one, contact the attorneys at Janna Dutton & Associates.