Medicaid Changes Boost In-Home Care

The poorest of Ohio’s growing elderly population might soon find it easier to stay in their homes before going into a nursing home.

An effort by several state and national agencies to make Medicaid benefits easier to apply to long-term, in-home care could come to fruition Feb. 2 when Ohio Gov. Ted Strickland releases his two-year budget plan.

Strickland supports a proposal to change how Medicaid funds long-term care.

Now, nursing-home care is the automatic entitlement program for elderly people who qualify for Medicaid and need long-term help.

Advocates want to remove waivers required to apply that public money to in-home or assisted-living options and take away the label of discretionary that they say make these programs vulnerable to cutbacks.

Ohio faces a $7.3 billion budget shortfall. The monthly savings of in-home care compared to nursing-home costs are significant. The average stay in a nursing home costs $4,800 a month, but $1,100 for in-home care through Ohio’s Passport program, according to the Council on Aging of Southwestern Ohio.

The program is for people 60 or older who are low-income and qualify for skilled or immediate care, such as dressing and eating. 

In five counties – Butler, Clermont, Clinton, Hamilton and Warren – about 3,000 people are involved in Passport; 30,000 are enrolled throughout Ohio.

“We cannot afford to sustain a system that is three times the cost,” said Barbara Riley, director of the Ohio Department of Aging, which supports the push to help more people receive assistance to stay in their homes.

A change in Medicaid accessibility could speed a trend toward in-home care that still finds Ohio well behind national levels.

Nationally, 36 percent of Medicaid dollars are spent on in-home care, 64 percent for nursing homes.

In Ohio, 21 percent of Medicaid for long-term care is spent on home care, 79 percent for nursing homes.

Home care in Oregon accounts for 70 percent of Medicaid, and 30 percent goes to nursing homes.

In Ohio, the move toward more in-home options has the support of the group that represents more than 750 nursing homes, the Ohio Health Care Association.

“We need more funding for home and non-institutional settings,” said Pete Van Runkle, the group’s executive director. “There are going to be a lot more eligible people as we go down the road.”

By the year 2020 in Southwest Ohio, people age 60 and older will increase to 350,000, a 75 percent jump compared to 1980. Ohio ranks sixth in the nation in its number of people ages 60 or older – more than 2 million. Every month, another 12,000 Ohioans turn 60.

By keeping people in their homes longer with support services, the Medicaid rolls actually could stay smaller. 

Twenty percent of private payers who go into nursing homes are eligible for Medicaid. After one year, with an average cost of $58,000 a year for nursing-home care, 61 percent are eligible for government assistance.

“We’re about providing choice and options for seniors who need long-term services,” said Suzanne Burke, chief executive officer for the local Council on Aging.

By Mark Curnutte • mcurnutte@enquirer.com 

High-tech sensors help seniors live independently

By ALAN SCHER ZAGIER, Associated Press Writer – Fri Jan 23, 8:51 pm ET

COLUMBIA, Mo. – After back-to-back hospital visits for congestive heart failure, Eva Olweean figured her health was back to normal. But the nurses at her retirement home knew better: Motion sensors in the 86-year-old’s bed detected too many restless nights.

Tiny sensors hover unobtrusively over the toilet, shower and doorways to detect Olweean’s movements inside her apartment. Pneumatic tubes tucked in the mattress and beneath her easy chair measure weight shifts. Caregivers and researchers at the University of Missouri-Columbia study the data, noting changes in behavior that could signal medical problems.

Recognizing the coming “silver tsunami” of graying baby boomers, tech companies are racing to help aging Americans spend more time living independently instead of in nursing homes. For the first time earlier this month, the International Consumer Electronics Show in Las Vegas featured a special section devoted to high-tech senior living.

Among the advances at the show were motion sensors, the kind that allowed Olweean’s nurses to figure out what was keeping her up at night. She was experiencing excessive bloating, a common symptom of congestive heart failure. So Olweean’s cardiologist prescribed diuretics and made other adjustments to her medication that helped the woman again sleep soundly.
“We try to identify when those small problems occur, so we can fix them before they become big problems,” said Marjorie Skubic, an electrical and computer engineering professor who works with Sinclair School of Nursing researchers on the aging-in-place project.

At Oatfield Estates in the Portland suburb of Milwaukie, Ore., resident movements in the private retirement home are tracked by what employees call “bed bugs.” Those are embedded motion sensors that detect when someone’s behavior could trigger a medical alert.

Sensors like those, “smart carpets” and other tracking devices will be the norm in both private homes and group settings within the next decade, said Jason Hess, chief executive officer of Elite Care, the Portland company that owns Oatfield Estates. He said that will especially be true as insurers start embracing the cost-saving devices. “You will see a lot more places implementing these,” he said. “It comes down to cost, and out-of-the-box thinking.”

At the Las Vegas show, on display were talking pill boxes that remind seniors to take their medicine at regular intervals, and which can notify out-of-town caregivers if that doesn’t happen. There were robotic companion pets that mimic the real thing for lonely seniors in need of a psychological boost.

“We’re talking about an important paradigm shift in how we think about aging,” said Majd Alwan, director of the Washington-based Center for Aging Services Technologies. Alwan led a panel discussion on smart-home technology at the Las Vegas event.

Delaying institutionalization by a year or more, is a significant financial savings, he added. “Let alone the benefits in quality of life for the senior and for the caregiver.”
Alwan previously led the eldercare technology unit of the University of Virginia’s Medical Automation Research Center, which developed the passive sensor technology used in Missouri.

Unlike medical warning badges worn by seniors, the motion sensors’ success doesn’t depend on the cooperation of patients. Elderly people can be prone to forget the badges when dressing, or who might resist the devices as too obtrusive, said University of Missouri nursing professor Marilyn Rantz.
“Our intent with this project was to incorporate (it) into their daily lives — and make it invisible to their daily lives,” she said.

Olweean, a retired factory worker, said she barely notices the sensors.
“I don’t even know they’re here half the time,” she said.

Fifteen of the 35 residents at her apartment complex take part in the motion sensor research project. The complex is named Tiger Place after the University of Missouri mascot and is owned by the university, though managed by a private company.

Researchers there are also fine-tuning a more advanced monitoring system using virtual-reality silhouette images to allow observation of posture, gait and other movements. The silhouettes are considered a preferred alternative to more invasive video cameras.

Rantz, Alwan and other experts acknowledge that rapid technological advances in elder care must be balanced with privacy protections. That dilemma concerns Fredda Vladeck, executive director of the United Hospital Fund’s Aging in Place Initiative.

“Technology does have a role to play,” she said. “It’s a tool, not the answer.”
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Veterans Benefit Pays For Tender Hearts at Home Care

Tender Hearts at Home Senior Care announces that the Veterans Aid and Attendance Pension Benefit has increased its compensation for aging veterans to receive care at home, in nursing homes or in assisted living facilities.

Tender Hearts at Home, a provider of senior home care Cincinnati, Ohio, partners with Government benefits Analysts to facilitate the pre-qualification and reimbursement process of the Aid and Attendance Pension Benefit through the Veterans Administration (VA). This free pre-qualification and application service is available to Veterans who register for home care with Tender Hearts at Home.

In 2009, a Veteran is now eligible for up to $1,644 per month from the VA, which is up $100 from last year; a couple is eligible for up to $1,949 per month, which is an increase of over $100 from last year; and a surviving spouse is eligible for up to $1,056, an increase of almost $60.

“This little known benefit can be a huge factor in improving the quality of lives for seniors and helping them maintain their independence,” said Dan Lynch, president of Tender Hearts at Home of Cincinnati.

“The free pre-qualification and application process that seniors receive through our partnership with Government Benefits Analysts helps veterans ease through a process that can be somewhat daunting and frustrating,” Lynch added.

“Anyone can apply for the benefit directly to the VA,” Lynch said.

Tender Hearts at Home provides caregivers who go into seniors’ homes to assist them with everyday living practices that may not come easy anymore, such as; light housekeeping, cooking, laundry, medication reminders, errands, bathing and walking.

Aid and Attendance is a pension benefit and is not dependent upon service-related injuries for compensation. Most Veterans who are in need of assistance qualify for this pension, according to Lynch.

To receive the benefit, call Tender Hearts at Home 513-234-0805 for a free, no obligation assessment to determine the need for home care and the cost. Tender Hearts at Home will refer the client to Government Benefits Analysts to be pre-qualified for the benefit, a process that only takes one or two days.

Once pre-qualified, Tender Hearts at Home will begin services at the home of the Veteran in order for the senior to start the application process through the VA. Government Benefits Analysts will facilitate the application process, and compensation will be retro-dated to the veteran’s application date.

Qualifications for veterans to receive Aid and Attendance include service of one day during an active war and no less than a 90-day service and receiving an honorable or general discharge. Veterans may not qualify for the benefit if they are on state assistance or have more than $80,000 in checking and savings, not including home and vehicles; IRAs and CDS are included as income.

Other factors taken into consideration in determining the level of benefit include income and medical expenses.

For surviving spouses to receive Aid and Attendance, they must have been married to the veteran when they passed.

Government Benefits Analysts has been assisting Veterans and spouses to successfully file for VA benefits to help pay for long term eldercare services since 2005. Tender Hearts at Home Senior Care services seniors throughout Hamilton, Butler, Warren, and Clermont Counties in Southwest Ohio Cincinnati Area

When Your Aging Loved One Resists Care

Cincinnati’s Tender Hearts at Home Senior Care provides care for your aging loved ones. Please call us when your loved one needs help: 513-234-0805

How many times has your mother refused to change her clothes? Has your father resisted getting out of bed? Has your wife pushed you away when you tried to brush her teeth? Many times a caregiver will be particularly frustrated by her loved one’s refusal to help himself. At times she can’t help but think that the person she cares for “36 hours a day” is going out of his way to make her miserable! The increasing irrationality of individuals with dementia makes it even harder on the caregiver. 

Individuals who resist care and assistance are trying to communicate to you. If dementia, stroke, vision loss, hearing loss or other illness limits one’s ability to speak and convey information effectively, body language and physical actions take on a greater role in communication. Refusal to accept care, physical contact or participation in an activity is the individual’s way of telling you something. 

When your loved one resists care, step back calmly and think: 
Are there any environmental factors such as lighting, shadows, noise, commotion or other external influences that are causing the problem now? 
Before you say something, think about what you are going to say. Check your emotions and frustration before you speak. Your increased frustration can contribute to your loved one’s agitation. 
Put yourself in her shoes. Use your knowledge of her personal background to pinpoint patterns and reasons for her reaction. 
Is this confrontation worth escalating? Choose your battles wisely. A head-to-toe bath is not necessary every day or even more than once each week. Similarly, clothes do not have to be changed every day if they are not soiled. 
Refusal to accept care or engage in once-pleasurable activities is a sign that something is amiss. The caregiver can assess the situation for specific complicating factor and make adjustments if necessary: 

Refusal to get out of bed: illness – Assess physical factors such as injury from a fall, bruises, temperature/fever, urinary tract infection, or oral infection. Keep a thermometer handy and know how to use it. Make a point every day or so of inspecting skin for dryness, sores or bruises. Catching skin or mouth sores early on will limit long-term damage and illness. 
Refusal to join family or participate in even small activities: environmental – Assess for too much noise, harsh lighting, or specific individuals who cause distress. Correct these distractions and integrate positive factors such as music, aroma, comfortable fabrics and warmer room temperatures.

Refusal to perform tasks and activities: depression – The inability to fully perform tasks for oneself can cause an individual to avoid those situations. Assist them as much as possible while encouraging them to do as much for themselves without embarrassment. This is time-consuming, but it is the best route for enhancing self-esteem and independence. 
Refusal to take medication: physical side effects – Sometimes side effects result from medication that are unbearable to the recipient. Learn what possible side effects can occur from the drugs your loved one takes. Consult with the doctor to see if over-the-counter anti-nausea, anti-diarrhea, or anti-dizziness products can be taken with prescription medications. Perhaps the medication can be taken at bedtime or mealtime to reduce side effects. When administering the medication, tell your loved one how it will help them and use distraction if side effects occur. 
Refusal to bathe or change clothes: embarrassment – Limit other people’s presence (even their voices), approach in a non-threatening way, undress/bathe one area at a time and keep the rest covered, speak calmly and tell your loved one what you are doing each step of the process. Talk about pleasant memories and stories as you are bathing/dressing. 
Refusal to eat or clean teeth: illness, incapacity – Oral hygiene is essential for elderly persons since poor hygiene can make eating painful and compromise nutrition. Don’t let oral health get to a point where it is a problem. The sense of taste declines with age, so make efforts to improve the flavor of food, make it appear appetizing, and ensure that portions are of the right size and consistency. You may need to provide pre-cut portions or thickened liquids. See if better shaped utensils and plates help your loved one feed herself. 
You may have to use your own creative ideas to get around resistance. One caregiver’s mother often refused to settle down for dinner. So the caregiver helped her mother get dressed up a bit with a nice sweater, a brooch and her purse. The two dined out on the patio without incident. 

If your loved one still resists care even after adjusting for other factors, remember that confronting your loved one at that time of heightened emotions may make both of you more agitated. Take a time-out and attempt the task later. 

Contact Dan Lynch at Tender Hearts at Home Senior Care to learn more about the topics included in this article. You may qualify for a FREE  CD that explains all of this in more detail, OR you may even qualify for a FREE COPY OF THE BOOK, “The Senior Solution: A Family Guide to Keeping Seniors Home for Life!”  513-234-0805  www.TenderHeartsatHome.com 

Source: Home Care Directory 

Paying for Home Care: Creative Funding

A common misconception for most families faced with the idea of considering home care is that Medicare covers Custodial Care, which is defined as assisting a person with their activities of daily living (ADLs). In most cases this is exactly the kind of care that most people first needing home care require, and Medicare does not cover it or long-term care of any kind. Live-in care falls under that category, and the cost of Live-in care is thus an out-of-pocket expense.

There are, however, a number of other options that can assist with payment for home care.

Aid and Attendant Pension: Qualified Veterans can get up to $20,000 per year to help pay for the cost of home care or assisted living in a facility.

Reverse Mortgage: The mortgage company pays the homeowner a monthly amount which is then subtracted from the equity in the home.

Life Settlement: Unneeded or unaffordable life insurance policy can be sold for a percentage of the face value.

Long-Term Care (LTC) Insurance: Recommended for those over 55, LTC insurance pays for home care preventing the depletion of a lifetime of wealth accumulation by insuring against long-term illness.

The first three options are little known and worth consideration when sorting out ways to pay for custodial care for a loved one.

At Tender Hearts at Home Senior Care, we have access to all these products and services through relationships with reputable professionals, and will gladly share details and resources.

15 Good Reasons to Use Home Care for a Loved One

What is widely viewed as the best and most viable delivery of health care in America? Infirmed and elderly individuals have been found to prefer home care by 90 percent over comparable institutional care.

What are some of the reasons for home care? This article counts the many ways!

1. Home care is delivered, as you would expect, at home. Dorothy said it best: “There’s no place like home.” Certainly, this is a statement that most people would wholeheartedly agree with. There is nothing like the comfort and familiarity of being cared for in the comfort and familiarity of one’s own home.

2. Home care helps keep families together. Compare this to taking an elderly person away from their loved ones. At no time is family more important than during times of illness.

3. Home care helps seniors maintain their independence. Home care allows seniors to continue to live in the place they function best – their home.

4. Home care prevents or puts off institutional life. Living in a long-term care facility is unfamiliar and can often be intimidating. Most people prefer postponing the inevitable as long as possible.

5. Home care helps promote healing. Medical evidence shows that people recover more quickly at home.

6. Home care is safer. There is no secret that people pick up infections and other complications when they live amid a chronically ill population (such as in a hospital or long-term care facility). This is obviously not the case when cared for at home.

7. Home care means personalized care. Care becomes a one-to-one proposition in the home. You get this nowhere else.

8. Home care often gets the entire family involved in providing care. Immediate and extended family members often take an active role at different times of the day.

9. Home care reduces the stress that often accompanies illness. Illness increases anxiety and stress, but it’s not nearly as great when care is practiced in the home.

10. Home care is the most effective form of health care delivered in terms of customer satisfaction. It all comes back to the fact that people prefer to be at home.

11. Home care is delivered by a special group of people. People don’t work in the home care industry for the money. They do it for the emotional satisfaction of helping others and for making a difference in the life of another.

12. Home care extends life. Studies by nursing schools and government agencies have found that home care extends life. Visits by home care personnel often provide spiritual as well as medical support.

13. Home care improves one’s quality of life. For most people, the quality of their life is far better at home than anywhere else.

14. Home care is less expensive than other forms of care. The cost of home care is always less expensive than hospitalization and almost always more affordable than nursing home or assisted living care.

15. Technology will make home care even more desirable in the future. Medical and technological advances will soon make it possible to diagnose, monitor and treat illness at a distance. This will help make home care even more of a preferred option.

Home care, unlike in the past, is no longer a well-kept secret. There are, after all, at least 15 good reasons for considering home care for a parent, spouse or other loved one. Please call us today so we can assist you with your home care needs.

A Brain Fitness Program

It’s long been assumed that memory loss, slower thinking and eventual dementia are the natural results of aging.

Dr. Michael Merzenich, a neuroscientist from the University of California at San Francisco, disagrees. The human brain, he says, doesn’t need to decline with age. It, like the body, responds to exercise and stimuli….

Merzenich founded Posit Science, which is developing brain fitness programs designed to improve the thinking abilities of seniors. These self-paced computer programs are like video games, only these are designed to stimulate certain brain functions such as listening and memory. One hour a day, five days a week may increase cognitive functioning by as much as 10 years.

While the Posit Science Brain Fitness Program offers exciting possibilities for enabling an aging population’s minds to keep pace with ever increasing longevity, we’re not dependent upon a computer program to stretch and strengthen our brains.

Engaging in a range of activities that spur new learning as well as participating in physical activities that require an ongoing mastery of motor control will strengthen the brain.

Examples of such activities include:

learning to play a musical instrument or a new language
juggling
dancing
solving jigsaw puzzles
playing ping pong

In the not-so-distant future, senior centers, nursing homes and assisted living facilities may include “brain gymnasiums” along with recreation and exercise areas.

Cincinnati’s Tender Hearts at Home Senior Care provides care for your aging loved ones. Please call us when your loved one needs help 513-234-0805

Attitude and Aging

Cincinnati’s Tender Hearts at Home Senior Care provides care for your aging loved ones. Please call us when your loved one needs help 513-234-0805. 24/7

Is Attitude Everything?

Successful aging in Ohio is an absence of (or minimum of) disease and disability. A new study of more than 500 persons from age 60 to 98 shows that people who think they are “aging successfully” aren’t necessarily the healthiest individuals. Optimism and effective coping tools, or attitude, were found be essential to successful aging more than traditional measures of health and wellness, according to a study funded by the Sam and Rose Stein Institute for Research on Aging at the University of California-San Diego.

The study showed that persons who regularly read, write and socialize gave themselves higher scores than those who did not. Surprisingly, volunteer activities, which have long been thought to help persons age successfully, were not found to have the same positive influence. The bottom line is that those things leading to successful aging are well within an individual’s control. The key is adopting personal coping mechanisms and remaining as physically, socially and mentally active as possible.

New Website is coming…

Tender Hearts at Home Senior Care is getting a new site soon…

Free Cincinnati Community Seminars on Fall Prevention

Falling. It’s one of the most dangerous events in a senior’s life. 70 percent of all accidental deaths in people over the age of 75 are due to falls. 40 percent of all nursing home admissions can be attributed to repeated falls that occur in seniors’ own homes. These appalling statistics and many others prompted the United States Congress to create the Elder Fall Prevention Act of 2002. It states that ” a national approach to reducing elder falls . . . is needed.” One local company is responding to that call to action.

The remainder of 2008 and all of 2009, Tender Hearts at Home Senior Care, a local family owned & operated senior care company is embarking on a community-wide effort to raise awareness of the senior fall issue and teach fall prevention strategies. To accomplish this they are performing free fall prevention seminars for various senior, civic and church groups throughout the Cincinnati area. The company’s Owners/Directors Jody & Dan Lynch call it a mission. And they are pretty passionate about it. “Do you know that 25 percent of seniors who suffer hip fractures die within 1 year of that injury? Seniors are losing their lives to this problem. But the good news is most falls can be prevented. And our Fall Prevention presentation explains exactly how to do that.” Jody Lynch said.

 Jody Lynch learned about Fall Prevention from her association with The Senior’s Choice, Inc, an international member network of independently owned companion care companies. Steve Everhart, President of The Senior’s Choice, Inc. said, “I believe that for seniors, remaining independent in their own homes begins by keeping them on their feet. We are thrilled that Jody has become a Fall Prevention Specialist and is taking this program home to their friends and neighbors in Cincinnati. Everhart continued, “Jody’s efforts will go a long way toward helping seniors remain independent as long as possible.”

Tender Hearts at Home provides non-medical care such as Companionship, Meal planning and preparation, Incidental transportation, Running errands, Light housekeeping, Medication reminders, and Personal Hygiene and other activities of daily living.  Their personalized and affordable services are available 7 days a week and can range from a few hours per day to 24 hour live in care.

 For more information about Tender Hearts at Home’s Fall Prevention seminars and to schedule a seminar for your group, call Jody Lynch at 513-234-0805

Cincinnati Senior Home care