Evaluating Skilled Nursing Facilities

Skilled nursing facilities, better known as nursing homes, promote care to those individuals who can no longer care for themselves at home. A wide range of nursing, rehabilitative, social and medical services are delivered on a 24-hour basis. Skilled nursing facilities help people during a time when they cannot adequately care for themselves. These facilities provide necessary nursing and medical intervention while promoting the restoration of a person’s maximum independence. Evercare Connections

1. Know your rights. If a hospital informs you that your loved one must be discharged within 24 hours, remember that you have appeal rights under Medicare. This could allow you to extend your relative’s stay by two additional days and give you more time to research nursing homes. For details about appeal rights, ask the hospital for a copy of “An Important Message from Medicare,” or call 1-800-MEDICARE.

2. Turn to the Eldercare Locator for help. This resource will connect you with your local agency on aging, which can give you the names and locations of all nursing homes in a given area. Call the Eldercare Locator at (800) 677-1116.

3. Prepare to do lots of clicking. Consumer Reports recently completed an investigation of nursing homes across the country and made its findings available free of charge online. This will ultimately lead you to nursing homes in your state to consider and to avoid.

4. Tap into other resources. You also can check less complete surveys of nursing homes through the Nursing Home Compare database on the Web site of the Center for Medicare and Medicaid Services. Many state health agencies also track nursing homes in a similar way. To find such a resource, do a quick Internet search using the name of your state along with the words “health department.” Then visit that state Web site and find a phone number you can call. Ask the person who answers whether there’s a way for you to see nursing home surveys or ratings for your state.

5. Check state survey reports. When you visit a nursing home, ask for a copy of a report known as Form 2567, or the state inspection survey. This report will reveal the results of unannounced visits by state surveyors who spoke with residents and checked on sanitary conditions and care issues.

6. Contact your state’s long-term care ombudsman program. Another important resource for you can be the ombudsman who monitors nursing homes in your state or local area. You can do another quick Internet search using the name of your state and the word “ombudsman” to find the contact information you’ll need. You also can ask for this contact information when you call your state’s health department.

7. Make unannounced visits more than once. As you zero in on two or three nursing homes, visit them at different times of day. Are many residents still in bed at 10 a.m. or so? Do many eat dinner in their rooms rather than in the dining room? Both of these can be signs of an under-staffed facility that isn’t giving residents enough stimulation.

8. Stay alert for other telling details. Are toileting needs being met right away? Are safety precautions in place to prevent accidents? Are exercise and rehabilitation sessions scheduled regularly? How does the staff interact with residents? How does the food taste to you?

9. Sit down with the administrator. Ask about his or her views on long-term care, and find out if the nursing home has seen a lot of high-level turnover in recent years. If it has, that could be a sign of instability.

10. Inquire about Medicaid. If your relative lives in a nursing home for a long time, his or her financial resources most likely will be exhausted or “spent down,” and he or she will then be eligible for Medicaid. Get in writing the nursing home’s payment policy once private funds or Medicare reimbursements run out. Does the nursing home accept Medicaid payment eventually? If so, at what point?

Sources: Consumer Reports’ Nursing Home Guide, “Consumer Reports Complete Guide to Health Services for Seniors” by Trudy Lieberman and the Editors of Consumer Reports, U.S. Department of Health and Human Services © 2009 MSNBC Interactive. Reprints

Dementia, Alzheimer’s and Normal Aging

Thought for the day: A person with dementia does not necessarily have Alzheimer’s but a person with Alzheimer’s definitely has dementia.

As we age, just as our bodies start to physically slow down so too does our brain. It is natural for it to take longer for us to retrieve memories, process questions, solve problems etc. as we get older. It is not normal however for us to forget things altogether or not to be able to generally deal with activities of daily living. That is usually an indication of mild cognitive impairment or dementia. MCI is a term used to describe when a person has memory or other thinking problems greater than normal for someone their age and education. Dementia is a general term used to describe a decline in mental ability severe enough to interfere with daily living.

Like a fever or a stomach ache, dementia, is the symptom not the underlying cause. There are well over a hundred causes of dementia. Some are reversible. Some dementias are caused by onetime events and do not progress. Others get worse over time (are progressive). Dementias caused by urinary tract infections (UTI’s) , dehydration, thyroid problems or certain vitamin deficiencies are often easily reversible. Memory loss associated with a stroke (or other vascular issues) is the typical irreversible non progressive dementia example. Alzheimer’s is the most prevalent dementia cause (it accounts for 60-80% of all dementia cases) and it is progressive (Parkinson’s related dementia is another progressive type).

Because each type of dementia cause is different, it is important to obtain a proper diagnosis. Dehydration might just require more liquid or a trip to hospital for an IV. An UTI will need antibiotics. Vascular dementia may not require any medication but attention to the underlying heart or vascular problem so another stroke does not occur causing more damage. Even with the progressive types, the medical treatment is different for those with Alzheimer’s than for those with Parkinson’s or Huntington’s. etc.

For most of the progressive types, there is no cure. But there are medications that can slow the progress. Also, there is great benefit to understanding the general progression because the way a caregiver approaches a loved one during the different stages is different. For example, in the later stages of Alzheimer’s it is inappropriate to correct the patient or to constantly ask them if they remember who you are. Behaviors like this only agitate them and cause them to feel bad.

Over the next few months, we will be discussing Alzheimer’s in a little more detail. In the interim, to find out more about Dementia and Alzheimer’s see our website or go to ALZ.ORG (the website for the Alzheimer’s Association). They have a wealth of information on those two topics with links to the primary sites associated with some of the other major dementias (eg Parkinson’s related dementia).

Frieda & Arthur Moseley, In-home care providers
Frieda & Arthur Moseley, In-home care providers
Arthur Moseley and his wife Frieda are the owners of the Tampa and Pasco Offices of Griswold Home Care, one of the area’s leading referrers of non medical private pay home care services (the caregivers they refer provide companionship, homemaking services and personal care). NR30211139 NR30211332

10 tips for buying or selling a home

1. Prepare your house for sale:
* The best looking house for the best price will sell first.
* First impressions are extremely important – there are NO second chances.

2. Selling your house:
A small amount of time or money invested in repairs will reap $100s or $1000s back at closing.

3. Take a walk around the outside of your house – look at it the way a potential buyer would, then address those items that might bother that potential buyer.

4. A good welcome mat outside and inside the front door will welcome prospective buyers and protect your carpets and floors.

5. The interior should sparkle – pack all those extra items and photos away NOW – they will need to be packed when you move anyway.

6. Looking for your next dream home?
Make your wish list: how large a house or condo, number of rooms, type of rooms, amenities desired, location, neighborhood, beach, 55+, golf, maintenance free, etc. This will provide a good starting point.

7. Speak with the mortgage loan officer and/or your financial planner to get an idea of your price range before you begin your search.

8. If you are financing, shop for mortgage rates but remember to also ask about ALL costs & fees. Costs such as origination fees and discount points can add up. Ask for a Good Faith Estimate listing these and other costs of the loan. It will give you a good idea of the total cost.

9. Be patient, every home you visit will help define your next dream home.

10. Keep good notes: if you visit too many it’s easy to forget which was which.

Last Let your realtor and the other professionals guide you through the process; then after the closing, go and enjoy your new home!

Judy Nicolosi, Realtor
Judy Nicolosi, Realtor

Ease the tax bite on Social Security Benefits

Many people are not even aware of the possible income tax on their Social Security benefits. The tax on Social Security benefits depends on your total income and marital status. Form SSA-1099, which Social Security recipients should receive by January 31, shows the recipient’s total benefits. To determine how much tax you will owe, add 1/2 your SS benefits to all other income, including tax-exempt interest. If this amount is greater than the base amount for the filing status, a part of the benefits will be taxable.

The base amounts that will cause 50% of the benefits to become taxable are:

• $25,000 for single, head of household, or qualifying widow/widower with a dependent child
• $25,000 for married individuals filing separately who did not live with their spouses at any time during the year
• $32,000 for married couples filing jointly
• $0 for married persons filing separately who lived together

But, according to the IRS, up to 85% of the benefits can be taxable if either of the following situations applies:
• The total of one-half of the benefits and all other income is more than $34,000 ($44,000 if married filing jointly).
• You are married, filing separately and lived with your spouse at any time during the year.

Tax savings should be an important consideration when comparing investments. In the case of immediate annuities, you may find the after-tax return on your money could be greater than what is available from other conservative fixed-income investments. In addition, you can get an income that you can’t outlive.

We can show you ways to cut or eliminate the tax on your Social Security! Call the office for your free consultation!!

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James H Willis, III– Financial Planner -Insurances

Do your prescriptions decrease your nutrients?

If you watch any TV at all, you probably know that taking statins –medication to lower your cholesterol — also lowers your Coenzyme Q10 (CoQ10) levels. But did you know that if you’re also taking antidepressants, they do the same, as well as lower vitamin B2? Coenzyme Q10 is an antioxidant that helps cells protect against damage. Low levels of C0Q10 weaken the immune system, leaving you with low energy levels. If you are taking a statin or a red yeast rice supplement your CoQ10 levels should be monitored.

Taking antihypertensive medications for high blood pressure depletes other nutrients, including vitamin B1, B6, and zinc. Antacids, another huge million-dollar seller depletes vitamin B12, folic acid, vitamin D, calcium, iron and zinc. If you read the label on most antacids, they caution you not to take longer than a few months, even though many people use them for years. Talk to your health care practitioner about possible underlining issues.

Oral contraceptives, which most of the younger women take for many years, deplete vitamin B1, B2, B3, B6, B12, folic acid, vitamin C, magnesium, selenium and zinc.

Anti-inflammatories such as corticosteroids and prednisone deplete calcium, magnesium, zinc, selenium, chromium, vitamin D, vitamin C and B vitamins. Nonsteroidal anti-inflammatory drugs, or NSAIDS, such as Motrin, Advil, Aleve, etc., decrease folic acid.

With the rise in diabetes, many people are on a popular drug called Metformin. Metformin depletes CoQ10, vitamin B12 and folic acid.

Antibiotics including penicillin lower vitamin K and B vitamins, while tetracyclines deplete calcium, magnesium, iron, vitamin B6 and zinc. Antibiotics do just what they are named for—they are antibacterial, eliminating most of the bad and good bacteria in your gastrointestinal tract. They may also cause bloating, gas, decreased digestion and absorption. A probiotic will repopulate your gastrointestinal tract with good bacteria.

Eating a healthy diet including fish, poultry, lean meat, legumes and 11 servings of vegetables and fruit, will provide many of the vitamins and minerals that are imperative for your body to function. When taking any of the above medications, discuss monitoring your vitamin and mineral levels with your health care practitioner and supplement if necessary.ncn

Barb Mahlmeister, Dietitian Nutritionist
Barb Mahlmeister, Dietitian Nutritionist

Retirement Checklist

It’s never too soon to start planning your retirement; it’s never too late to review and improve that plan to meet the ever changing challenges of life.

Are you really prepared to transition to retirement? You’ve probably already taken some steps to prepare for retirement. But have you taken the right steps to help you transition?

Utilize this simple checklist to help identify steps you may need to take before making the transition to retirement.

□ I have a good idea as to when I want to retire and I’m able to do so.
□ I have a list of the expenses I will have during retirement.
□ I talk with my financial advisors about how much income I’ll need.
□ I have a good sense as to how I’ll spend my days when I’m not working.
□ I understand my Social Security benefits.
□ I have a plan for when I should begin taking my Social Security benefits.
□ I’ve updated necessary insurance policies, including health insurance.
□ I know where my health insurance will come from once I’m retired.
□ I understand Medicare and how it works with my health insurance.
□ I’ve consolidated similar financial accounts, such as 401(k) plans and IRAs.
□ I know how much of my retirement income will come from my retirement accounts.
□ I have a good idea as to whether or not I need long-term care insurance.
□ I regularly discuss retirement goals and interests with my spouse.
□ My spouse and I have similar ideas about where and how we’d like to live.

Have you left any box unchecked? If so, it’s time to be proactive today so you get the retirement you deserve. Get on track for a successful retirement by reviewing this checklist with your trusted financial professional.

James Whitaker, PHD, Financial Planner Social Security Expert
James Whitaker, PHD, Financial Planner Social Security Expert

Senior housing offers a better lifestyle

Traditional lifestyles have evolved greatly in America over the past several decades; perhaps nowhere is this more evident in than in the senior living industry where the old stereotypes of senior communities have been replaced with model lifestyle and care environments.

“Life expectancy in America is now at an all time high, says” Kelly Foley, Executive Director at Brookdale Senior Living in Lutz, FL. “Now seniors and families have new questions about where and how seniors can find the best lifestyles and care options. But really, it’s all about knowing where to turn for help, because the services are all out there and available.”

Take, for example, activities. There are many places where senior centers offer daily programs and meals to older adults, along with a calendar of activities that include exercise, discussion groups, arts and crafts, health information and social events. For those with physical or other issues which preclude them from remaining unsupervised, there are also adult day care programs.

Many hospitals provide wellness centers, and those who have loved ones with specific senior diseases such as Alzheimer’s or Parkinson’s can usually find an association that provides help and answers for them.

“Beyond the traditional care outlets, today there are home health agencies, in-home and care companions and hospice care,” says Foley. “And if full time senior living is an option there is every kind of lifestyle and care option available, from independent living, to assisted living and Alzheimer’s care, skilled nursing and communities that offer continuing care within a Life Care Plan.”

The move to pursue senior living with or without care services at a rate the senior or their family can afford is often triggered by life-changing events when a decision must be made quickly. The biggest problem is– knowing where to turn for a quick education about the choices and options in the senior living network, especially where the health of the individual is an issue.

“There is no substitute for planning ahead,” says Foley. “But the good news is that there is help available for anyone who needs it. At our community we probably spend more time getting to know and advising individuals and families who are making this decision for the first time than we do working with those actively seeking to move into our community.

“It can be difficult to navigate through all the options, especially where old stereotypes exist,” says Foley. “But we’ve found that many people are just happy to get the information they need to make the right decision – and we’re happy to help them chart the best course for their families.”

For more information call Kristin Albritton 813.909.9679
brookdale lutz

Ignorance is not bliss!

The scary thing about ignorance: We don’t know that we don’t know. It makes us blind to some hidden truth. Without realizing what is happening, our options, choices and outcomes are limited. The consequences can be devastating.
I believe getting breast cancer 12 years ago happened as a result of my ignorance about the risk factors and causes of cancer. Once I got the diagnosis, I played Sherlock Holmes to this villain. My detective work has paid off. Today I am cancer free and my body is healthy. I owe the Sherlock part of me a debt of gratitude because I am off daily asthma medicine too! (I took it for 35 years.)
Is there a situation in your life that needs more awareness—more light? It could be physical or emotional discomfort, toxic relationship or work environment, negative thinking, stressful situation, or addiction, to name a few. Any of these situations could be managed better or eliminated with the right perspective or information. You might even prevent a “train wreck.”
Here are three strategies to help you become aware and break through the blindspots that may be compromising or limiting your life:
Be curious and open minded – If your choices are not bringing you the results you want, explore other options until you discover something that works. With an open mind, you have fewer distorted beliefs preventing you from finding a creative solution to the problem. You are also more likely to consider relevant information before you deny or reject it prematurely. Be curious about what is possible!
Do the research – Gathering the right information can stretch your personal resources—time, attention, energy and sometimes money. Do it anyway! Focus on the benefits of your efforts, and inspiration will carry you. Explore different sources. When you find a truth repeated in different places by different people, you have probably hit a jackpot!
Follow your intuition – Your intuition is a powerful resource. Develop it and allow it to become your trusted guide. Once you have done your research, your body and intuition can take it from there. They will guide you to what feels right for you, and it usually is. Life can feel magical when you integrate thinking and knowing!
Commit to the adventure of getting to the heart and truth of what matters to you. Explore options and become a creative problem solver. You will improve your sense of self, health, finances, spirituality, relationships, career or lifestyle. When you take charge of what is within your power to change, you are on your way to an abundant lifestyle. Make discovery and learning a life-long mission!

Sandra Miniere, Author, Life coach
Sandra Miniere, Author, Life coach

Biographical Information
Sandra Miniere, M.Ed., offers personal life and executive leadership coaching and Emotional Freedom Techniques consultations in person and on the telephone. She is an author and speaker. A former holistic mental health counselor, she has been helping people transform themselves and their lives for 30 years. In her book, A Lighter Side to Cancer – From Wake-up Call to Radiant Wellness, she shares her uplifting and empowering adventure through breast cancer twelve years ago.

Help for Chronic Disease and End of Life needs

Everyone wants to have a positive life experience, living independently and making their own decisions. As declines of aging or serious illness take a toll, LifePath and most hospice groups have services that help patients and families manage the challenges.

Important Considerations
• If you or a loved one was seriously ill or in pain, do you know of helpful resources and services ? What is the difference between palliative care and hospice care?
• Do you have a written plan stating what kind of health care treatments and support you would want (or not want) if you could not speak for yourself?
• Have you talked with family or physician about your wishes for medical treatment and end of life care?

Steps That Help Ensure Your Wishes Will Be Honored
• Learn about your options at each stage ( serious illness, end stage illness, terminal illness, vegetative state) and consider how you would like to manage conditions.
• Document your wishes. Complete Advance Directives and clarify the issues that are important to you ( tube feeding vs. withdrawal of nutrition/ hydration, ventilator assistance, comfort measures vs. continuing treatment, burial vs. cremation, etc.).
• Designate a Healthcare Surrogate to carry out your wishes. Tell your family and physician whom you have selected and what you specified to encourage their support.
• Learn about hospice and palliative care so that you can receive pain and symptom management while seeking a cure and when treatment is no longer beneficial.

Things You May Not Know About Hospice Services
Most of us know that hospice service provides pain and symptom management for
people who are no longer seeking a cure. But you may surprised by these facts:
– Patients frequently improve under hospice care and may be discharged because they no
longer meet Medicare criteria. When they decline again, they are easily readmitted.
– At the end of life, the patient may be more focused on spiritual needs while families are
concerned with medical interventions.
– Adult children especially have difficulty coming to terms with the realities of their parent’s
condition . Emotional and spiritual counseling are offered to any family member who needs
help in dealing with the circumstances. Social workers facilitate family meetings to gain
support for patient’s wishes.
– Hospice care is a choice; but the benefits are covered by Medicare, Medicaid and many
insurance .
– Hospice provides respite care of up to five days so that a caregiver can take time off.
– Inpatient care at a Hospice House may be available for a period.
– Information visits with hospice representatives can answer family questions.
– If a physician has not made a hospice referral, a family or friend can request the service.
Remember, a referral is not an admission. It is simply a request to review a patient’s current

For more information , contact Sue Pagano, Community Representative for LifePath Hospice, Inc. Call 813.838.6523 or via email: paganos@chaptershealth.org.
sue pagano

Tips for downsizing a senior or anyone

Whether you are a senior, contemplating a downsize move or are helping a family member prepare for a move to a senior community, the following tips may be helpful in getting you through the process.

Start with papers–files, photographs, etc.  Set up a work space, large enough to spread out to avoid tripping on papers or boxes.  Start with 3 boxes marked “Keep”, “Shred” and “Toss”.  Labeling the boxes is important–it’s so easy to get mixed up and throw items in the wrong box.  You can go back later and sift through the “Keep” box and organize it more thoroughly, if desired.  The “shred” box can be taken to your local shipping retailer, where they charge by the pound to have your things shredded. If there is a substantial amount–more than 3 or 4 boxes, it may be more cost effective and convenient to have a local service to come to your home and do the shredding in your driveway for a flat fee.

Next, work on closets and clothing.  It has been said that if it hasn’t been worn in a year, it should go to charity, or other outlet.  Good advice, but it’s okay to pick your own time limit.  Salvation Army, Purple Heart, AmVets, etc. will gladly pick up at a residence.  There are also neighborhood drop-off locations.  Consider doing the sorting in small batches, dropping it off as you go.

It makes sense to sort the kitchen last, in most cases, because kitchenware will need to be used right up until the day of the move.  There are a few exceptions, though.  Clean out the plastic container cupboard (almost everyone has one).  There is often many containers without lids, and vice-versa, which makes the project easy and quick and it feels like you have accomplished something.  The food pantry is another easy place to make some headway–removing expired and stale food.  When the move takes place, unopened food items from the pantry can be taken to a local food bank.

If the project is more than you and your family can manage without ruining your body or your family relationships, consider hiring a senior move manager.  Sometimes, receiving help from a person that is not emotionally attached to the situation can help keep things moving.  If there is no family in the local area, it is an especially good idea to hire some help.  Senior move managers are prepared to patiently work side by side with the client, deciding what stays and goes, being their arms and legs.  Sometimes their purpose is to keep the client “on task”….knowing that money is being spent by the hour can help motivate to do the work.  A senior move manager can help sort and haul and pack and unpack and figure out where un-needed items can find new homes, through consignment, donation, estate sale, etc.  An internet search can help locate a senior move manager.

In many instances, The amount of unwanted items is significant enough to warrant an estate sale.  In those cases, the items that are to be kept and moved to the new residence are plucked out and moved, leaving everything else in place in the home.  The estate sale company then comes in and removes any items that are not salable, arranges the “merchandise” for easy viewing and prices everything.  They normally will handle staffing, advertising, setting up, tearing down, arranging for pick up of items that didn’t sell and leaving the home completely empty and ready for sale or rental, all for a percentage of the sale proceeds and without any up-front cost to the client.  The proceeds of a sale can help off-set the cost of moving, and could help pay for a senior move manager.

There are many good articles on this topic on the internet, on websites that cater to seniors, such as aarp.org,  caring.com,  seniorlifestyle.com,  seniorcitizensguide.com.

By Jenny Loktu, Tender Care Move Management  813.784.0235

Jenny Loktu, Senior Movers
Jenny Loktu, Senior Movers