Saturday, February 27, 2010

Putting Home Care in Allentown, PA in Perspective

The Evolution of Home Care
In the first century of our country's history there was no such thing as nursing homes or assisted living. Society was mostly rural and people lived in their own homes. Families cared for their loved ones at home till death took them. In the latter part of the 1800's because of an increasingly urban society, many urban families were often unable to care for loved ones because of lack of space or because all family members including children were employed six days a week for 12 hours a day. During this period many unfortunate people needing care were housed in County poor houses or in facilities for the mentally ill. Conditions were deplorable. In the early 1900's home visiting nurses started reversing this trend of institutionalizing and allowed many care recipients to remain in their homes. Nursing homes or so-called rest homes were also being built with public donations or government funds. With the advent of Social Security in 1936, a nursing home per diem stipend was included in the Social Security retirement income and this government subsidy spurred the construction of nursing homes all across the country.

By the end of the 1950s it was apparent that Social Security beneficiaries were living longer and that the nursing home subsidy could eventually bankrupt Social Security. But in order to protect the thousands and thousands of existing nursing homes Congress had to find a way to provide a subsidy but remove it as an entitlement under Social Security. In 1965 Medicare and Medicaid were created through an amendment to the Social Security Act. Under Medicare, nursing homes were only reimbursed on behalf of Social Security beneficiaries for short-term rehabilitation. Under Medicaid, nursing homes were reimbursed for impoverished disabled Americans and impoverished aged Americans over the age of 65. It has never been the intent of Congress to pay for nursing home care for all Americans. The nursing home entitlement for all aged Americans was now gone.

Over the last 40 years, there has been a gradual change away from the use of nursing homes for long-term care towards the use of home care and community living arrangements that also provide in-house care.

With Proper Planning People Could Remain in Their Homes for the Rest of Their Lives
We are seeing a trend towards working conditions like those in urban America in the early 1900's where both husband and wife are working and putting in longer hours. We are also seeing a return of the trend in the early part of the 20th century where outside visitor caregivers are becoming available to replace working caregiver's and allow the elderly to receive long-term care in their homes. In addition there is a significant trend in the past few years for Medicaid and Medicare to pay for long-term care in the home instead of in nursing homes.

Given enough money for paid providers or government funding for the same, a person would never have to leave his home to receive long-term care. All services could be received in the home. Adequate long-term care planning or having substantial income can allow this to happen.

We only need to look at wealthy celebrities to recognize this fact. Christopher Reeve, the movie star, was totally disabled but he had enough money to buy care services and remain in his home. President Ronald Reagan suffered from Alzheimer's for many years but received care at his California ranch. He was also wealthy enough to pay for care when needed. Or what about Annette Funicello or Richard Pryor? Income from their movie careers allowed them to receive care with their multiple sclerosis at home. We will be willing to bet that Mohammed Ali, who is severely disabled with Parkinson's disease, will probably never see the inside of a care facility, unless he chooses to go there to die. With the proper planning and the money it provides, most of us could remain in our homes to receive long-term care and we would never have to go to an institution or a hospital.

The Popularity of Home Care
Most of those receiving long-term care and most caregivers prefer a home environment. Out of an estimated 8 million older Americans receiving care, about 5.4 million or 67% are in their own home or the home of a family member or friend. Most older people prefer their home over the unfamiliar proposition of living in a care facility. Family or friends attempt to accommodate the wishes of loved ones even though caregiving needs might warrant a different environment. Those needing care feel comfortable and secure in familiar surroundings and a home is usually the best setting for that support.

Often the decision to stay in the home is dictated by funds available. It is much cheaper for a wife to care for her husband at home than to pay out $2,000 to $4,000 a month for care in a facility. Likewise, it's much less costly and more loving for a daughter to have her widowed mother move in to the daughter's home than to liquidate mom's assets and put her in a nursing home. Besides, taking care of our parents or spouses is an obligation most of us feel very strongly about.

For many long-term care recipients the home is an ideal environment. These people may be confined to the home but continue to lead active lives engaging in church service, entertaining grandchildren, writing histories, corresponding, pursuing hobbies or doing handwork activities. Their care needs might not be that demanding and might include occasional help with house cleaning and shopping as well as help with getting out of bed, dressing and bathing. Most of the time these people don't need the supervision of a 24/7 caregiver. There are, however, some care situations that make it difficult to provide long-term care in the home.

Please note from the first graph below that a great amount of home care revolves around providing help with activities of daily living. Note from the second graph below that the average care recipient has need for help with multiple activities of daily living. Finally, it should be noted from the second graph that well over half of home care recipients are cognitively impaired. This typically means they need supervision to make sure they are not a danger to themselves or to others. In many cases, this supervision may be required on a 24-hour basis. (Graphs were derived from the 1999 national caregivers survey, courtesy

It is precisely the ongoing and escalating need for help with activities of daily living or the need for extended supervision that often makes it impossible for a caregiver to provide help in the home. Either the physical demands for help with activities of daily living or the time demand for supervision can overwhelm an informal caregiver. This untenable situation usually leads to finding another care setting for the loved one. On the other hand if there are funds to hire paid providers to come into the home, there would be no need for finding another care setting.

Problems That May Prevent Home Care from Being an Option
Caregivers face many challenges providing care at home. A wife caring for her husband may risk injury trying to move him or help him bathe or use the toilet. Another situation may be the challenge of keeping constant surveillance on a spouse with advanced dementia. Or a son may live 500 miles from his disabled parents and find himself constantly traveling to and from his home, trying to manage a job and his own family as well taking care of the parents. Some caregivers simply don't have the time to watch over loved ones and those needing care are sometimes neglected.

The problems with maintaining home care are mainly due to the inadequacies or lack of resources with informal caregivers, but they may also be caused by incompetent formal caregivers. These problems center on five issues:

1. Inadequate care provided to a loved one
2. Lack of training for caregivers
3. Lack of social stimulation for care recipients
4. Informal caregivers unable to handle the challenge
5. Depression and physical ailments from caregiver burnout

In order to make sure home care is a feasible option and can be sustained for a period of time, caregivers must recognize these problems, deal with them and correct them. The responsibility for recognizing these problems and solving them is another function of the long-term care planning process and the team of specialists and advisers involved.

Adequate Funding Solves Most Problems Associated with Providing Home Care
None of the problems discussed in this article would be an obstacle if there were enough money to pay for professional services in the home. These services would be used to overcome the problems discussed in the previous section. If someone desires to remain in the home the rest of his or her life, adequate preplanning could provide the solution.

This planning must occur prior to retirement. The most obvious way to provide sufficient funds for home care is to buy a long-term care insurance policy when someone is younger, healthy and able to afford the lower premiums. If insurance is not an option, then money must be put aside early in life to pay for care in the future. The only other option is to be rich.

Unfortunately, very few people address the issue of needing long-term care when they are older. This leads to a lack of planning and in turn leads to few options for elder care when the time comes. Lack of planning means most people do not have the luxury of remaining in their homes and must rely on Medicaid support in a nursing home to finish out the rest of their lives.

Sunday, February 21, 2010

My Elderly Parent Has Dementia: What Activities Can We Do Together in Allentown, PA

Here is a great article that I found and wanted to pass on to you. For more great information and assistance with an aging loved one in your life visit us at

My Elderly Parent Has Dementia: What Activities Can We Do Together?
by Emilee Seltzer

Caregivers for the elderly with dementia often find that coming up with activities for the elder can require much thought and effort. But they are vital to your parent’s health and well-being. Creating activities can really be quite simple if you follow some general guidelines.

Create meaningful activities

•Consider their interests
Depending on how severe your parent’s dementia is or their stage of Alzheimer’s, activities can vary; however, designing activities that involve their past interests are of the utmost importance. For example, if they love to garden, foster that passion with stimulating gardening activities.
What if your parent does not have either the physical or cognitive capability to engage in activities they once loved? Beth Kallmyer, Director of Family and Information Services for the Alzheimer’s Association, recommends adjusting activities to fit their abilities. If your parent loved gardening but no longer has the mental ability to engage in it independently, consider assisting them or simplifying the activity. You can go outside with them and do planting and gardening together, or you can bring a few pots with seeds inside the house for your parent to water daily.

Try to make activities meaningful, rather than ones aimed at simply passing time. Even though your parent may not remember different activities they do, he or she will simply enjoy the moment. It contributes to their general happiness.

•Reestablish old routines
It is very common for seniors to feel as if they have lost their sense of purpose. Design activities that you and your parent can do together and that will make them feel needed and useful. Many things people do are habitual – for example, washing dishes, folding laundry or taking out the trash. Your parent’s ability may not be what it once was, but giving them a small task that they are able to accomplish independently or helping you with a more complicated task will create a sense of purpose for them.

•Provide opportunity for social interaction
Even though your parent’s cognitive and/or physical abilities have declined, they still need to interact with others regularly. “Humans have a basic need for social connectedness and those with Alzheimer’s disease, regardless of what stage of the disease they are in, still have that need,” said Kallmyer. If possible, have your parent accompany you with the grocery shopping or while running errands. In general, elders with dementia can feel anxiety in over crowded or hectic areas, so when you take them out with you, make sure to go at a less busy time. Your parent will enjoy the social interaction.

•Engage in physical exercise
Another According to Kallmyer, elders with dementia often wander because they are not getting enough exercise. Take daily walks with them, if possible; they can reduce agitation. If the weather does not permit walking, have your parent use a stationary bike. A good time for exercise is when they are already feeling agitated or when they feel bored.

A major concern for caregivers for elders with dementia is that they become withdrawn and are resistant to participate in any activities. In these situations, it is important to get creative. Kallmyer said, “Sometimes people with Alzheimer’ disease work well with different people.” If possible, she recommends trying to get different people to engage in activities with the elderly parent. Sometimes, a different face can be the solution and your parent may be willing to participate in various activities. It is important to know that if your parent is becoming increasingly agitated you should talk to his or her doctor.

Beth Kallmyer is the Director of Family and Information Services for the Alzheimer’s Association. If you have any questions, there are counselors available at all times at 1-800-272-3900.

Sunday, February 14, 2010

Smart Tips for Baby Boomer Retirement Planning in Allentown, PA

Smart Tips for Baby Boomer Retirement Planning

(ARA) - If you are one of America's 78.2 million baby boomers, you are likely considering what ideal retirement will look like, and the steps required achieving it. With the current economic downturn, many boomers are finding it necessary to revisit their initial retirement goals.

According to the Social Security Administration, today's retirees count on corporate pensions and Social Security for 56 percent of their retirement income. With a few minor adjustments, some careful planning and a positive attitude, the other 44 percent is attainable.

"It's never too late to start planning for retirement and it's crucial that life insurance is considered as the foundation of your plan." says Vikki Pryor, president and CEO at SBLI USA Mutual Life Insurance Company, Inc. "Determine your needs by deciding how much money surviving family or loved ones will need to maintain their standard of living if you are no longer around to protect them. Women need to pay particular attention to their retirement planning options." To learn more about the educational tools and insurance products designed with baby boomers in mind visit

Consider the following tips for smart retirement planning:

1. Assess your financial plan and budget.

* Begin to assess your basic retirement income sources such as a 401(k) plan, IRA, and life insurance plans.

* How much will you need to retire? Determine this by creating a budget that will enable you to pay your monthly expenses such as food, heat, rent and transportation. Consider expenses that may increase such as health insurance and prescription medicines. At the same time, consider those that may decrease, such as work-related and educational spending.

* Health care coverage is necessary in supplementing your financial foundation and these costs can add up fast. It's important to have an adequate plan both before and after retirement. After age 65 you are eligible for Medicare coverage. But what if you want to retire before then? Your employer may offer a plan for retiring employees, or you may have to look into private coverage, so be sure to consider this.

* Take into account variable expenses such as tax liabilities on your home, illness or the care of elderly parents. Other, often underestimated, variables include gifts, clothing, recreational expenses, and increases in costs of living. For valuable retirement planning resources and projected trends in costs of living visit

2. Begin to explore other retirement income options.

* Determine the amount of guaranteed retirement income you already have. Examples of these are cash savings, corporate pension plans, home equity, or annuity-type investments.

* Are you married? If so, how will that affect your retirement budget?

* Pay attention to how your retirement funds are earning money. Are they structured for maximum returns? It's crucial that you continually assess these funds.

* Decide when to begin Social Security benefits. According to AARP, for each year you put off collecting your benefits between ages 62 and 70, you increase your payments by 8 percent.

* Calculate your potential monthly retirement budget based on your estimated income weighed against your expenses. At minimum, you need enough retirement income to cover basic living expenses for your lifetime.

* If your initial assessment requires additional income, consider part-time work during retirement, or perhaps selling your larger home for a more comfortable, carefree condo.

3. Consider life insurance - the foundation of a solid retirement plan.

* If you don't have a life insurance policy, get one. Life insurance not only helps to leave a legacy for generations to come, it will protect your loved ones and help provide them with financial security once you're gone.

* Consult an expert in order to find the right life insurance for you. For example, BoomerLife by SBLI USA lets you apply for up to $25,000 of whole life insurance with no hassle. Acceptance is guaranteed for anyone ages 50 to 75. Selected benefits remain fixed for life and the premium you pay will not go up. Additionally, the policy builds cash value that grows each year tax-deferred. Call (866) 331-3078 to speak with an SBLI USA representative. Or go to our Web site at and complete the entire application process - from quoting, to paying - online today!

Start planning your retirement today. With a little strategy and the right attitude, you can build the financial security you need to live a successful, happy retirement. Visit today - completing your application is just clicks away!

Courtesy of ARAcontent

Make sure to visit us at for more great advice with an aging loved one in your life.

Saturday, February 6, 2010

How Can Social Support Ease Caregiver Stress in Allentown, PA

Here is a great article I found that I wanted to share. The original article can be found at If you have any questions, or need help please visit

How can social support ease caregiver stress?
Two important contributors to caregiver stress are lack of social support and the caregiver's assessment of the behavior of the patient with Alzheimer's. 

Social and family support. Caregivers who lack sufficient or appropriate social support from family and friends are often put under heightened stress. Family conflicts, isolation and loneliness further exacerbate the stress of caregivers. While social support may not affect the primary stress caused by the disease, it can change the caregiver's response to the illness. Feeling supported by family and friends can improve psychological responses to stress and boost the caregiver's sense of well-being. 

The relentless downward course of Alzheimer's disease can have devastating effects on the structure and functioning of the family as well. The person with Alzheimer's gradually relinquishes his or her previous role in the family, and other family members must step in to fill the gaps. In addition, other family members may not recognize that a husband or wife who acts as a primary caregiver has now lost a major source of social support -- the spouse on whom they previously relied. 

When talking about improving social support, the quality of the support is much more important than the number of people who are available to the caregiver or the frequency of contact with members of the caregiver's social network. Family conflict about how and where it is best to care for the patient can be can be very stressful for the primary caregiver. Many caregivers feel resentful of other family members for not providing them with the kind of help they want, although they may not know how to ask for that help or accept help when it is offered. 

Caregiver appraisal. Another source of stress is sometimes referred to as caregiver appraisal. If the caregiver misunderstands the cause of the patient's behavior and interprets it as intentional rather than due to the illness, the caregiver may react with anger, feel rejected or become depressed. If other family members do not understand the disability of the patient, they may criticize the reactions of the caregiver rather than be supportive.

Caregiving, in and of itself, can become tedious, frustrating and isolating. An important aspect of helping the Alzheimer's caregiver is to make caregivers and other family members aware of the availability and value of formal support. Caregivers can benefit from formal support services such as in home respite or day care programs for the patient and support groups for themselves in conjunction with the informal support of family and friends.