by Shelley | Aug 28, 2023 | Caregiving, Dear Donna
Dear Donna:
My parents recently sold their home in another state and moved to Michigan to stay with my wife and me. The arrangement is temporary while we search for a senior living community for them.
I’m trying to get them on track with their health care and nutrition. They have never been very good about going to the doctor, but it got worse in the last few years. Their diet is also unhealthy. The first thing I need to do is find a doctor. They both need a complete physical and likely most of their health screenings, especially bloodwork.
Do you have any ideas for helping me locate a doctor for seniors? I prefer someone who has experience working with older adults. Any tips would be much appreciated.
Sincerely,
Steve in Elk Rapids, MI
Finding a Doctor for a Senior Loved One
Dear Steve:
Your question is commonly asked by adult children! Unless an older adult is fortunate enough to have a longtime primary care physician, many find themselves needing to make a change. Because of the shortage of family practice doctors in many areas of the country, this task can be much tougher than in the past.
I do have some suggestions that might make your search easier:
- Investigate physicians in their insurance plan: Since you mentioned your parents moved to Michigan from another state, one factor to keep in mind is their insurance network. If they transitioned to a different Medicare Advantage plan, you’ll need to check to see which doctors are covered. For older adults who are on traditional Medicare, there will probably be more options. Medicare will create a list of doctors near you who accept new patients. You can find this list online or by calling Medicare directly at 1-800-633-4227. (TTY users can call 1-877-486-2048.)
- Ask for recommendations: You can read reviews on a variety of sites, such as Vitals, Healthgrades, and RateMDs. While they can provide some insight, nothing can replace personal referrals. Ask friends and colleagues involved in a parent’s care which physicians they like and dislike. Maybe ask for recommendations on Facebook, too.
- Talk with the hospital discharge planner or social worker: If you have a preferred hospital in your community, they might be able to point you in the right direction. While they likely can’t provide recommendations, many are aware of physicians who work with seniors. Those who work in emergency departments of the hospital sometimes keep a list of physicians who are accepting new patients.
Once you’ve narrowed down your list, call the office to see if they offer meet and greet times for potential new patients. Even a few minutes of a physician’s time might give you an idea of whether they will be a good fit for your parents.
If you find yourself struggling to overcome your parents’ reluctance to see a doctor, we have a few tips. How Do I Get My Dad to See the Doctor Regularly has ideas you might find useful.
Kind regards,
Donna
by Shelley | Aug 14, 2023 | Alzheimer's and Dementia, Dear Donna
Dear Donna:
My 76-year-old father moved in with my family earlier this spring. He was diagnosed with Alzheimer’s just over a year ago and isn’t safe living alone any longer. I’m slowly learning how to work around the changes the disease has caused and to improve his health and quality of life.
I’ve come up with some activities that allow him to feel productive despite his Alzheimer’s, such as helping me around the house and in the garden. When he was living alone, he skipped a lot of meals and lost a considerable amount of weight. While I’ve found ways to encourage him to eat, I’m still struggling to get him to drink water.
Dad’s doctor told me he was dehydrated during his last appointment and that I need to encourage him to drink often throughout the day. I think the underlying issue is my dad seems to be afraid of water. Does that happen with Alzheimer’s? My husband helps him with his showers and said it’s becoming increasingly difficult.
Do you have any advice for us?
Sincerely,
Kristie in Sutton’s Bay, MI
Water, Hydration, and Alzheimer’s Disease
Dear Kristie:
What a great observation! It is fairly common for a person with Alzheimer’s to develop a fear of water. Water-related tasks, such as filling a glass of water or showering, can result in anxiety and agitation. Just the sound of water running can cause fear. But it’s obviously very important that your dad stays hydrated, which can be even more difficult during the summer.
Here are a few suggestions that might be helpful:
- Be mindful when you fill his water glass: If your dad has developed a phobia about water, it might help to fill his water glass when he isn’t within hearing range. Add lemon, cucumber, or berries to the glass for a bit of a distraction. Using a dark-colored glass might also be helpful in disguising the water.
- Provide frequent reminders: Since people with memory loss may forget to drink water, prompting them to drink throughout the day might help. Don’t wait for your dad to say he is thirsty. Just tell him it’s time for a drink. It might help if you drink water while encouraging him to do so.
- Serve foods that hydrate: Also remember that many fruits and vegetables have a high water content. This makes it easier for adults with Alzheimer’s to increase hydration. Leafy greens, melon, berries, tomatoes, celery, cauliflower, and cucumber are just a few. Soup and broth are other good choices.
- Review his medications: Some medications have a diuretic effect that can increase the risk for dehydration. Talk with your dad’s pharmacist to determine if any of his prescriptions or over-the-counter medications might be an issue. If you find one that is, ask his primary care doctor for advice on how much fluid he should be taking in to compensate for it. There might even be another medication that can be substituted.
I hope a few of these tips are helpful to you, Kristie! Best wishes to you and your dad.
Kind regards,
Donna
Dementia Care at Heritage Senior Communities
If someone you love has Alzheimer’s disease or another type of dementia, our Specialized Dementia Care program might be a solution. From person-centered care to guided social interactions, the program is designed to allow people with dementia to live their best quality of life. Call the closest Heritage community on this list to learn more!
by Shelley | Mar 23, 2023 | Caregiving, Dear Donna
Dear Donna:
My 91-year-old great-aunt lives nearby. She has outlived her husband and her daughter. While she seems very spry for her age, I do worry about her living alone. My wife and I convinced her to give up driving several years ago after she experienced a few fender benders. We have been her primary sources of transportation since then.
Recently, I’ve noticed some changes that leave me wondering if it might be time for her to move to an assisted living community. I think she might be receptive to the idea, but I’m not sure how to tell if this is the right choice. Do you have any suggestions?
Steven in Saginaw, MI
Common Signs a Senior Needs Assisted Living
Dear Steven:
When a family member first notices physical or behavioral changes in a senior loved one, it’s natural to wonder if it’s normal aging or a red flag for something more serious. One factor to keep in mind is your aunt’s generation is known for being independent and reluctant to admit when help is needed. Asking for help or admitting she might need to make a change may not be easy for her.
So, how can you objectively assess if she needs to transition to an assisted living community? While many signs may be subtle, here are some common red flags that indicate a senior loved one needs help:
- Lack of housekeeping: Is her once-tidy house beginning to look a little rough? Are dirty dishes piled up in the sink? Is the kitchen trash overflowing? Is spoiled food in the refrigerator? Does the home just look messy in general? Odors are another clue a senior is struggling.
- Change in personal appearance: A change in an older adult’s personal appearance can be another warning sign. Clues to look for include disheveled hair, body odor, and clothing that isn’t clean or is inappropriate for the season.
- Lack of interest: Other worrisome behavioral changes include withdrawing from favorite activities, skipping church services, or losing interest in friends and family. It might be a sign of depression. Isolated seniors are at increased risk for it.
- Evidence of falls: While research shows falls are the leading cause of disability in older adults, many believe the numbers are much higher. That’s because older adults don’t always inform loved ones when they suffer a fall. Look for scratches or bruises, especially on your aunt’s arms and legs. Another sign might be if she sticks close to her favorite chair and isn’t up and about as much as usual.
- Unintended change in weight: A noticeable and unintentional change in weight can signal potential problems. She might be having difficulty preparing healthy meals. Or it could be a host of other problems, such poor appetite from a medication she takes, ill-fitting dentures, or depression. Weight change is an important issue that should be discussed, possibly even with her physician.
- Mismanaging finances: Keeping household finances on track can be tough at any age. If your aunt is paying some bills twice while neglecting others entirely or seems to be spending more money than usual, there may be something wrong. She may have fallen victim to a financial scam or identity theft.
While these are some of the most common signs a senior might need assisted living, it’s important not to overlook the many benefits communities offer. They range from making new friends to having dedicated caregivers to provide support around the clock.
If you have questions about assisted living or would like to set up a personal tour, we invite you to call the Heritage location nearest you.
Kind regards,
Donna
by Shelley | Mar 13, 2023 | Caregiving, Dear Donna
Dear Donna:
My husband and I have been helping my mom finance home care for a few years now. Over the holidays, we decided that moving to an assisted living community might give her a better quality of life. Because we live almost two hours away from her, we can’t visit her as often as we’d like. Other than her home care aides, she’s alone in her apartment quite a bit.
We are working on a budget for this move. Because her income is fairly limited, my husband and I will likely pay for most of her monthly fees. We are happy to do that but wonder if assisted living expenses might be tax deductible.
Kind regards,
Christine in Holland, MI
Assisted Living Expenses and Tax Deductions
Dear Christine:
It’s common for adult children to help pay for care if a parent’s income and assets fall a little short. Like you, families often wonder if assisted living costs are tax deductible. Unfortunately, the answer is somewhat complicated.
Some families aren’t aware that they may be entitled to a tax deduction. Others know about it but find the process too confusing to navigate. Much of the uncertainty stems from the challenge of determining what portion of a senior’s monthly fees are considered medical care. Another difficulty is figuring out if a senior meets the criteria to be a dependent.
There isn’t a quick answer to either of those issues. Some senior living providers offer a breakdown on which monthly expenses are considered medical and which are custodial. This can help address the first issue. The second is more complex.
Because we aren’t in the business of offering tax advice, we generally suggest enlisting the services of a tax advisor with knowledge of the senior care industry. Before your meeting, it may be helpful to review several areas of the tax code that pertain to senior care and tax deductions:
- IRS Tax Publication 502: This publication outlines medical and dental expense regulations. It will give you a better understanding of what the IRS considers to be medical care and what financial threshold you must meet. This section of the IRS code also defines what a “qualifying relative” is. That’s important to help determine if your relationship to your family member meets the criteria.
- IRS Tax Publication 503: Like publication 502, IRS publication 503 further explains what dependent care expenses are. It also outlines which expenses you can deduct for a loved one’s medical care.
Finally, I want to mention a few additional programs that might help pay for your mother’s move to an assisted living community:
- Aid and Attendance Benefit for veterans
- Long-term care insurance, which often helps pay for more than just nursing homes
- Bridge loans to cover expenses while families liquidate other assets
- Life settlement funding that pays you more than the face value of a life insurance policy
If you visit and tour a Heritage community in Michigan for your mother, one of our experienced team members can walk you through the programs listed above.
I hope this information is helpful! And I hope you and your mom will put Heritage on your list of assisted living communities to consider.
Kind regards,
Donna
by Shelley | Feb 13, 2023 | Dear Donna
Dear Donna:
My parents both turned 80 this year and still live independently in their own home. Recently, I’ve noticed signs that have me wondering if we’ll need to make a change soon. Their house isn’t quite as clean and cared for as it’s always been, and even my mom’s physical appearance is a little less tidy.
I think it’s time for me to start exploring senior care options. One thing I don’t quite understand is how home care is different from assisted living. Do they offer the same services? Is it cheaper to stay home and hire a caregiver? My parents have the means to do either but have always been frugal. Finances will be an issue that impacts their decision.
Sincerely,
Haley in Traverse City, MI
Home Care versus Assisted Living for Older Adults
Dear Haley:
Planning ahead is always a great idea when it comes to aging parents and their well-being. Failing to create a backup plan often means adult children are forced to find senior living after a loved one experiences a health crisis or accident. That makes an already stressful situation even worse.
When you are assisting an aging parent who is investigating their options for care, deciding between home care and assisted living is a common struggle. It really comes down to whether a senior loved one can age in place with support like home care or if they are better off transitioning to an assisted living community.
Cost plays a key role in making this decision. Many people mistakenly believe it is less expensive to age at home. Assisted living costs can be equal to or lower than remaining in a private home.
Other factors to take into account when comparing aging in place with assisted living include your parents’ health, availability of loved ones nearby to provide assistance, and the safety of their home. Many older homes aren’t built with the needs of seniors in mind. It can put them at increased risk for falls, which are a leading cause of serious injury among older people.
Here are a few more expenses to consider when deciding between aging at home and moving to assisted living.
Costs of Aging in Place versus Moving to Assisted Living
- Home maintenance and modification
When aging parents live in a home without a mortgage, it’s easy to assume staying at home and hiring an in-home caregiver is less expensive. Sometimes it is, at least temporarily.
In addition to utilities, however, a homeowner must also pay for maintenance and upkeep, property taxes, and repairs. Appliances will need to be replaced on occasion, including major appliances like the furnace, water heater, and air conditioning.
Depending upon the home and the seniors’ abilities, safety modifications, such as installing a step-free shower or improving lighting, might also need to be made. Those will significantly increase expenses. Older adults who age at home will reach a point when they can no longer maintain their home independently. They often need to hire service providers for chores like housecleaning, lawn care, grocery shopping, and meal preparation. One benefit of assisted living communities is that these expenses are typically included in the base monthly fees.
The aging process can bring unavoidable physical changes. Some might make the activities of daily living difficult for an older couple to handle independently. Personal care tasks, such as bathing, grooming, and dressing, might require a helping hand. That’s also true for menu planning, meal preparation, and transportation.
If your parents eventually need to hire an in-home caregiver for assistance, the expense can quickly add up. The cost of private duty home care has risen significantly since the COVID-19 pandemic. Agencies now charge from $28 to $40 or more an hour, and many require a minimum number of hours per visit or per week.
By contrast, assisted living residents receive much of this support as part of their monthly fee. This includes meal preparation, housekeeping, wellness programs, personal care, transportation, and more. Unlike with home care, assisted living caregivers are on-site and available around the clock.
I hope this information is helpful, Haley! Please contact the Heritage community nearest to you if you have any more questions or would like to schedule a tour.
Kind regards,
Donna
by Shelley | Jan 23, 2023 | Dear Donna
Dear Donna:
Since I retired a few years ago, I’ve developed insomnia. While I know many people have difficulty sleeping well as they get older, it’s new for me. I’ve read sleep issues can contribute to health problems, so I know I need to beat this.
Do you have any suggestions? The fatigue is really catching up with me this winter, and the timing is bad. I’m downsizing my house so I can start exploring independent living communities in Michigan to move to next summer. It’s hard work and I need more sleep so I can get things done!
Sincerely,
Debbie in West Branch, MI
Tips for Seniors Trying to Beat Insomnia
Dear Debbie:
Thanks for writing to me! First, know that sleep challenges become more common with age. Research shows as much as 30 percent of the population suffers from insomnia. But for older adults, the number soars to as high as 50 percent! Some seniors express difficulty falling asleep and others say it’s tough to stay asleep. As you mentioned, the lack of rest can take a toll on your health.
- Eat right and exercise: When you are tired from a lack of sleep, bad habits are more likely to slip in. Eating unhealthy comfort foods, sitting too much, and exercising too little are a few. It’s a vicious circle. Try to work on making better food choices and getting regular exercise. Start small, such as taking a 10-minute walk each morning and limiting how much time you spend watching television or on social media.
- Find healthy stress busters: You mentioned you are preparing for a move to an independent living community this spring. Even when you are excited about a move, change can be tough. Try to explore a few ways to naturally manage daily stress. Some suggestions might be meditation, chair yoga, or journaling.
- Develop sleep rituals: The lack of structure retirement often brings is another potential cause of insomnia. You might be able to overcome it by developing a sleep routine and rituals. Turn off your television and other devices at least one hour before bedtime to give your brain an opportunity to rest. Creating a dark, peaceful sleep environment helps too. If you can’t sleep when it’s too quiet, try using a white noise machine or a fan. Finally, go to bed and get up at the same time every day.
- Limit caffeine: Another common cycle that develops among seniors who have sleep problems is consuming too much caffeine. The energy boost it provides can be hard to resist when you are feeling weary. While caffeine does help in the short term, it can contribute to insomnia. Try to limit caffeine intake to the morning. Also, take time to learn about hidden sources of caffeine in your diet. Some examples include candy, supplements, protein bars, ice cream, and pain relievers.
If you try these ideas and still can’t get a good night’s sleep, schedule an appointment with your primary care physician. You might have a condition like sleep apnea that requires medical intervention.
Kind regards,
Donna
