LIVING
A Blank Slate Media/Litmor Publications Special Section • September 21, 2018
34 SENIOR LIVING • Blank Slate Media Newspapers, Friday, September 21, 2018
Caring for a loved one with dementia BY G R E G G BALBERA
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Some days you lose track of your wallet. Other days you can’t remember how to prepare a meal. You are an individual with dementia, a condition that interferes with your brain cells communicating well with each other. And you are not alone. Every three seconds, another case of dementia occurs somewhere in the world. Almost 50 million people worldwide are known to have dementia, which is the name for a group of progressive brain syndromes that affect thinking, memory, behavior and emotion. Among the over 100 forms of dementia, Alzheimer’s disease is the most widespread, accounting for 60 to 80 percent of all dementia cases. An estimated 5.7 million people in America are living with Alzheimer’s. Alzheimer’s Disease International, an umbrella organization of some 90 Alzheimer’s associations around the globe, notes, “Dementia is the leading cause of disability and dependency among the elderly.” Early-onset dementia can affect individuals younger than 65, but the majority of individuals with dementia are seniors. The Alzheimer’s
Association in the U.S. reports that one in three American seniors dies from Alzheimer’s or other dementia. To help with dementia awareness and research and ease the stigma that dementia patients and their families often face, Alzheimer’s Disease International designates September as World Alzheimer’s Month, and Sept. 21 is World Alzheimer’s Day. Standing Together Against Dementia Although currently there is no cure for dementia, a number of treatments and support are available. The following tips can help family caregivers restore equilibrium in their own lives and in daily caregiving routines: Foster a team of support and community. Recognize your need for help and accept help regularly. Show your vulnerability and lean on other family members, neighbors and in-home professional care with the more challenging responsibilities. Know your limits. Allow yourself to be human and realize that you will not always deliver perfect care. Some days will feel a bit more off-balance. Be realistic on what you can and cannot do in your caregiving role. Build in leisure time and playtime. Being intentional about respite care is important for the long-term success in car-
ing for a loved one with dementia. Do not neglect downtime and opportunities to socialize with others. The practice of deep breathing and mindfulness is another solution in quieting a stressed brain and body. Guard your own health. Family caregivers are at greater risk for elevated blood pressure, higher insulin levels and cardiovascular disease. Stress levels often rise with the day-to-day demands of caregiving. It is imperative that you continue your own physical checkups and health maintenance goals. Alzheimer’s and Dementia Resources • Alzheimer’s Association The leading health organization with local chapters nationwide offers a number of help and support resources including a 24/7 helpline at 800-272-3900. • Local Area Agency on Aging Providing a suite of services for elders and their family caregivers, the agency can help find local support or access to support groups and caregiver training. • Hospital Social Workers If your loved one is hospitalized for any reason, you can request that a social worker talk with you before your loved one is discharged. Social workers can refer you to community resources that you may not know about. • Aging Life Care Specialist This private practitioner is a social worker who can help navigate the logistics of caregiving for a fee. Caring for a loved one living with Alzheimer’s or other dementia can be incredibly rewarding, the key is securing a network of support to help you and your loved one experience the best quality of life possible. Gregg Balbera, owner of Right at Home, in-home care and assistance for seniors and adults with disabilities www.rightathomeli. com
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Moving ahead with Insuring long-term Medicare coverage care a women’s issue BY J U L I E WA R D -A B D O Medicare is a federal health insurance program available to people 65 and older, or those under 65 who have been receiving Social Security disability benefits for more than 24 months. While this valuable program helps with your health-care costs, Medicare does not cover all medical expenses. It’s important to understand what Medicare covers and the coverage choices available to you. Medicare consists of four parts. Part A covers inpatient hospital stays, skilled nursing facilities and hospice care. Part B covers doctors’ visits, outpatient care, diagnostic tests, lab services and preventive services. Medicare Part A and Part B are considered Original Medicare and are provided by the federal government. Part C and Part D are offered through private insurance companies. Part D is prescription drug coverage. Part C is more commonly known as Medicare Advantage. Medicare Advantage plans provide the benefits of Part A and Part B and usually includes Part D. Many Medicare Advantage plans offer additional services such as vision care, dental benefits and wellness programs. Once you enroll in Original Medicare it is very important to understand your medical costs and coverage choices and to choose carefully. Medicare Part A has a benefit period deductible of $1,340. A benefit period is 60 days. Part B Medicare has an annual deductible of $183. Once the deductible is met you are responsible for 20 percent co-insurance. It is important to know that Medicare does not have a maximum out of pocket so there is no cap on the costs you might incur. To determine the type of coverage that would work for you, you need to analyze the doctors you
use, the medications you take, where you live and your financial budget. The minimal coverage that is considered creditable coverage is original Medicare with a prescription drug plan. If you decide not to enroll in Part D when you’re first eligible for Medicare, you’ll likely be subject to a late enrollment penalty. If you decide to enroll in a prescription drug plan you have to choose one. Each prescription drug plan has a formulary, which is a list of covered drugs. The formularies vary by plan. The key is to find a plan that offers coverage for the drugs you take at a price you can afford. Many people look at Supplemental Insurance more commonly known as Medigap Insurance, to help pay for the Medicare deductibles, coinsurance and copayments. By choosing a Medigap plan, Medicare remains your primary insurance enabling you to go to any doctor or hospital that accepts Medicare nationwide. There is a range of choices available. Medigap policies are standardized so that all policies identified by letters (A, B, C, F, G, K, L & N) offer the same benefits no matter which insurance company you purchase it from. For this reason, premiums and customer service are important when looking for a plan. Medigap plans do not include prescription drug cover-
age. If you purchase a Medigap plan you must also purchase a stand-alone prescription drug plan. Medicare Advantage plans (Part C) are offered by private insurance carriers that contract with Medicare. If you choose to get your coverage through a Medicare Advantage plan (MAPD) you will use the plan for all of your healthcare needs, rather than Original Medicare. You still have to pay your Part B premium. The premiums for Medicare Advantage plans tend to be low and you pay copays and/or co-insurance for medical services. Medicare Advantage Plans must have annual limits on out of pocket costs to protect you from excessive charges. These plans may require you to see health care providers in their network and can insist on referrals from your primary care physician before seeing a specialist. Most Medicare Advantage plans include prescription drug coverage. Every year you have the ability to review and change your plan during the annual enrollment period which is between Oct. 15 and Dec. 7 and the new plan starts on January 1st. With all of these choices it is important to do your homework before making any decisions regarding the direction you want to take for your healthcare needs. Julie Ward-Abdo senior health plan finder
BY N ATA L I E K A R P Long-term care planning is especially important for women. Women are often impacted as providers of care, and ultimately, as recipients of long-term care. No one wants to be a nurse or a purse. The facts: Women live longer than men. As a result, women are likely to reach an age when they would need long-term care. Women are more likely to play caregiver. Women are more concerned that their adult children will be burdened with the emotional and financial responsibility of caring for them. Mothers, do not let your daughters grow up to be caregivers! Many of our clients are women near or over the age of 50 and are experiencing life transitions- empty nests, semi or full retirement, divorce, loss of a spouse, etc. In each transition, their financial wellbeing is a defining issue. Planning today for longevity and independence will have a profound influence on their future. Long-term care is the largest unfunded risk and threatens to disrupt assets, income stream and independence. While women intuitively understand caregiving and the demands of being a caregiver; financial, physical and emotional, many have yet to plan. On average, women live seven years longer than men- average life expectancy is now 88. Once a person reaches age 80, there is an 80 percent chance they will need long-term care in their lives. Planning for longevity risk is planning for choice and independence. As independent women, we want choices – who, where and how care is provided. Long Term Care Insurance provides a separate “ pool of money “ for care costs. Long-term care insurance is not nursing home insurance. It means choice of care in any environment. “Aging in Place” is today’s paradigm – staying home and in the community, but can be used in any environment that provides care. Long-term care insurance plans are comprehensive and portable anywhere
in the U.S. Having a long-term care insurance plan, independent of your retirement nest egg will allow you to maintain lifestyle and legacy commitments and act as a firewall to sibling rivalry and other possible blended family issues. The “key to the castle” is good health with conditions that are “stable and resolved”. Underwriting varies by a carrier; each has “sweet spots” for age, health, and medications. Women who have had a history of breast cancer and stable for 1-3 years are insurable at standard rates. Bone density scores are also important from an underwriting perspective. Osteopenia is insurable while significant osteoporosis may not be. It is critical to work with an LTC Insurance specialist since plan designs, pricing and underwriting vary widely…explore the breadth of possibilities to find the right fit. The landscape of planning options includes Life and LTC linked benefits, assetbased and hybrid solutions. Traditional long-term care insurance can be designed with shared care plans for married or domestic partners. Plans can be designed for maximum flexibility – allowing informal care and paying cash benefits. All plans are customized for your goals. Consumers are encouraged to take action with a multiple of incentives: – NY State Tax Credit of 20 percent on total LTC premiums – Federal deductions for business owners or those who itemize medical expenses – HSA accounts can be used to pay LTC premiums – 1035 exchange using cash in life insurance to purchase LTC tax-free Financial experts agree that without long-term care planning, your family’s financial and personal lifestyle goals are incomplete. NYTimes, Personal Finance, 2015 Natalie Karp, MBA, CLTC and Rona Loshak, MBA, CLTC are independent brokers who affiliate with all the leading LTC Insurance carriers. www.karploshak.com
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64 SENIOR LIVING • Blank Slate Media Newspapers, Friday, September 21, 2018
By Mark Schwartz, MD, FACS, ABPh, RPVI