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The Changing Nature of Friendship Through Age

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We all rely on friends for so many things: social engagement, support during a difficult time, encouragement when we try something new, feedback for new ideas and so much more. You, like so many others, require at least one friendship to feel emotionally happy, connected to caring people, and socially fulfilled. For the last 10 years Friendship Month – highlighting the importance of friends and celebrating what friendship brings to our lives – has been celebrated throughout September.

Friendship Month is something you can acknowledge by spending more time with friends or connecting with people with whom you have lost touch. We’re never too old to make new friends. For the senior or infirm, maintaining, reviving or establishing friendships can be challenging. Fortunately, 21st century tools – Facebook, facetime, skype, texting – can ease the lack of live interaction. Yet, for some, more signs of friendship are necessary, even when not immediately appreciated. The friendship you deliver to the beloved seniors in your life will most likely take new forms of expression; at their stage of life, new priorities take center stage and while they can be difficult, there are ways your friendship will become even more precious.

During the last quarter of the year, we commonly start a planning process on behalf of declared goals; you and your family may want to engage this process for the seniors in your life on behalf of their physical, financial, emotional and mental health as well as helping them shift into many changing situations. Patience will be a strong way to express friendship for the senior whose life is changing so quickly.

Friendship can be expressed through advocacy. Taking on the role of fiduciary, power of attorney, or guardian may come as your loved one’s ability to manage their own care and funds declines. However, much earlier, you may wish to communicate with their physicians, attending appointments when possible. Seniors, older than boomers, have been raised to respect authorities, such as doctors, and may not bring the questions that need to be raised on their behalf:

  • Why are they on this medication?
  • Are you aware of another doctor’s prescriptions?
  • What family member has been describing mom’s changing behaviors?

Sometimes, as a friend to your loved one, you need to make difficult decisions. Being able to determine when forgetfulness has drifted into the beginnings of dementia can be most painful. Or, convincing an older adult s/he is no longer capable of driving or handling their affairs. Added stress to this, making your role as friend even more critical, is when your loved one is resistant to having you take over; it’s a loss of their independence and a huge life change. Here’s a simple way you can assist with their desire to continue participating in their life decisions as you gradually get more involved: place a large bowl where all mail – bills, bank statements, advertisements, reminder notices, etc. – will be collected by the senior. During your visits you’ll review them all for the necessary actions. Be a friend by continuing to respect their need to express their dominion over their own life until they gradually come to see you as a capable partner rather than a bulldozer.

And, even if others have been assigned legal roles for your loved one, they may not have the time to manage some of the day to day needs – shopping, preparing meals, handling laundry – so you might pick up that role as ‘team leader’ among those who’ve stepped up to handle the varied and necessary tasks of a continued life of quality.

Speaking of new roles, as a friend to your senior you may need to decide to bringing in a member of a growing profession, the Aging Life Care Professional or Manager. Often known as Geriatric Professionals, the size of our current aging population has brought this profession to the forefront of care. And, whether minor issue or crisis, this profession is capable to help in a range of needs: it’s a holistic approach that provides answers for worried families, healthcare management, guidance to make choices that will reduce time needed away from working. Often, at an advanced stage of life the senior might have married more than once and has a blended family where priorities and stresses make clear decisions difficult and fraught with conflict. The Aging Life Care Professional is an objective and unemotional voice to help make the difficult choices easier.

Perhaps the most involved form of expressing friendship for your aging parent is when you decide to have them live with you, bringing into your family nucleus a new set of problems and needs which may overwhelm your love for your parent and bring conflict to your own siblings or other involved family. How can you best handle this?

Margaret “Peggy” Graham is an elder law attorney who firmly believes that families should get their agreements about their parent’s care in writing. Typically, family caregivers run into problems because they don’t know what their parent needs now, what they will need down the road, or what their parent or other family caregivers expect them to do.

It is best to have open and honest talks about this, even though it is often an uncomfortable subject. To start, have a transparent meeting where you seek to understand what your parent will actually need, depending on their conditions and cognitive ability. Discuss how your expectations, your parent’s expectations, and other family members’ expectations match up to those needs.

Once you have that understanding, you can start to make a plan that will suit everyone, or at least your parent and the family members who will act as caregivers. Don’t shy away from the financial aspects of this discussion. Talk about if and how the caregiver will be compensated for their time.  Then discuss how mom or dad’s money will be managed.

Ideally, getting these details in writing ahead of time will mean that you avoid family conflict, resentment, and financial stress down the line.

Michael Ferraina, CEO of JEV’s Care at Home in Philadelphia advises that families should be patient and take time to get comfortable with one another. Schedules take time to get right, too.  He argues that the demands of home care expand as people age. Typically, family caregivers don’t know what they don’t know, which means there are areas of their loved one’s health that they could better support, but recognizing the gap is a challenge. To address this, you should reach out to resources available in your community; examples are:

  • Home care agencies: They should be able to answer questions and give referrals to other experts, too. Home care agencies may help you get the right medical equipment, or even help you handle insurance claims.
  • Doctor: Your parent’s doctor can help, especially if they are a geriatric doctor.
  • Other family: Not only can they provide moral support; family members can step in with unique perspectives to help your parent.
  • Medicaid: Through Medicaid there are programs that can help manage your parent’s care.
  • Veteran’s Affairs: Veteran benefits include some support for elders in home care.

Before any of this, you obviously must have a conversation with your parent, one that will be extremely difficult. Yet, with the goal of maintaining or expanding your friendship, you’ll need to call on skill: patience, direct language, planned remarks, prepared for a difficult response. Whether it’s about giving up the car, moving from their home, turning their legal and financial affairs over to another, there’s so much underlying emotion here, for you both. You’ll want to express your concern for them, the risks you believe they’re now likely to experience. ‘Ammunition’ that will assist making your case will be observed evidence, doctor’s notes, mistakes in their recent banking, decline in the state of their home or personal appearance. If the most difficult of decisions – to move your parent from her/his home – is what’s necessary, it makes good sense to have that discussion before their decline puts them in a crisis mode; a professional residence with healthcare will be better able to provide ongoing care if they have a history with you and a patient and got to know them in a healthier or more tranquil state.

Friendships come in so many expressions; yours on behalf of a beloved senior as they approach end of life may be the most difficult and most heroic at the same time. There are, as mentioned throughout this article, many resources available for you. Perhaps the easiest way to access them and learn of others, relevant for your situation, will be a phone call to our office.

DECADES: the 40’s

During World War II many seniors came out of retirement to help with the war effort. Their employment income probably kept many of them off the welfare rolls during the war, but they had to retire once again when servicemen returned home and needed jobs. The war also added to the size of the disabled population who needed long term care, and created many new widows and orphans who needed financial assistance. In 1939, the Social Security Act had been expanded to include survivors and dependents benefits, and the war greatly increased the number of people covered under the system. After the war, the Veterans Administration added new benefits for newly-disabled veterans or surviving spouses.

The size of the elderly and disabled population was growing, and many of them were now eligible for government payments of one kind or another, including veterans benefits, old-age assistance, Social Security, and unemployment assistance. Many of those payments could be used to pay for nursing home care, further encouraging the development of care facilities. In fact, Old Age Assistance benefits doubled to over $400/month by 1947.

Resources:

Catherine F. Rowlands, MBA, NHA, CMC, FL-RG, MT

Sue Fernandez, Community Educator for the Alzheimer’s Association

Liz Barlowe, MA, CMC, former president, the Board of the Aging Life Care Ass’n

Michael Ferraina, CEO JEV’s Care at Home

Margaret Gram, elder law attorney

Library of Congress

 

 

 

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National Senior Citizens Day

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Resources:

Pew Research
Daily Caring
Forbes Magazine
Journal of Gerontology
Aging Life Network podcast

 

In 1988 then President Ronald Reagan, himself a senior, signed Proclamation 5847 marking August 21 as National Senior Citizens Day. The largest slice of the American population – nearly 72 million boomers – are nearly all senior citizens, pursuing a variety of endeavors (the youngest boomer will become a senior citizen in 2024). And, as has been typical throughout their recognition as a unique generation, boomers continue to shift expectations and norms.

For example: 55% stated that they are willing to work longer hours than other generations and are considered the second most productive generation after Gen X. Because, while 10,000 boomers are turning 65 daily, that same number is not retiring daily. In an AARP survey, 40% planned to ‘work until I drop.” Those who continue to work – both women and men – tend to be college educated, non-Hispanic white and living in a metropolitan area. This has increased overall economic growth in the U.S. as well as increased retirement income for the longer employed boomer.

And, of course, the Covid pandemic has shifted boomers’ spending and priorities; cruises, typically popular among seniors, are off many lists due to the frightening reality of Covid-related deaths reported in ships’ crowded environments. And time with family, completely shut down in 2020, has now become a greater priority, likely having an impact on retirement relocations.

Another Covid impact has been the horrifying vision of nursing home and hospital deaths, without access to loved ones in last moments. As a result, aging at home has taken on new significance. This will be a boon to the already fast-growing Care Management profession, as more healthcare needs will be met by visiting professionals rather than a relocation to assisted living or nursing home locations.

Boomers, along with the fastest growing group of seniors in the 90+ category, will need services that address aging at home.  For example, in addition to your yard guy, housekeeper and handyman, you will now need to plan for someone to drive you places, cook for you, remind you to take your medications and help you get in and out of your tub.  For many, these costs will be more than the monthly income they worked so hard to create when doing their retirement planning.

Yet, very significantly, in the U.S., where 80% of the wealth is owned by boomers, this population continues to increase its value to the economy, not only by continuing to work beyond 65, but also by using its stored wealth to spend. And, that spending, plus Covid isolation, has increased seniors’ use of technology which, in itself, increases cognitive skills, staving off some of the traditional memory or thinking losses associated with old age.

Moreover, the boomers’ well-known preference for independence led to a huge growth in business ownership, interest in self-actualization, prosperity, change and a clear orientation towards goal achievement.

Yet, not all seniors are in this vaunted category. Many boomers rely entirely on their Social Security benefit to support them. And the prevalence of obesity among this generation has increased their rates of chronic diseases such as hypertension, high cholesterol and diabetes. This leads to limitations of daily living – bathing, eating, dressing, walking – again, as noted above, leading to a greater need for in-home care.

Ironically, about 20% of boomers, themselves facing greater concerns for healthcare, are also providing healthcare for their aging parents for whom isolation becomes a large issue; this sad aspect to life has been tragically showcased through the many lonely deaths in hospitals and nursing homes resulting from Covid. Yet, even without the severity of the pandemic, boomers who are care givers put additional strains on their health as the relationship of parent/child begins to shift when the child becomes the authority over the parent, often an unwilling partner to this severe change in their life.

And perhaps most insidiously, according to Forbes, $2.9 billion is taken from seniors in scams yearly. Though you may think of your parent (or yourself) as a wise and skeptical person, aging tends to dull everyone’s ability to protect themselves from fraud. We become more trusting and rely on those around us more. This is why it’s smart to take steps to protect your parent or loved one before they fall victim to financial abuse. And frankly, this list may be a guide for yourself; please – don’t be embarrassed by taking advantage of healthy, smart support. Here are ten things you can do and, if you believe any or all of these are necessary or beyond your skill set to maintain, consider enacting a power of attorney with a trusted associate, advisor or family member:

  1. Keep an Eye on  Accounts

You may have to switch your parent to online banking to keep a close eye on their bank account, but it’s worth the fuss. Most elderly people have predictable spending habits, so you can spot problems right away. This will also be a great convenience for you with continued Covid concerns. Speak with your account manager about protections your bank has put in place.

Only share access to your or your senior’s account with the most trustworthy family members and not those who have borrowed money from the senior before or who are having financial difficulties. There are third party companies, like EverSafe and the American Association of Daily Money Managers that can help you keep an eye on your parent.

  1. Know What to Look For

When you’re monitoring your parent’s bank account, what should you look for? Sudden payments or withdrawals to places you don’t recognize are most common. Also look for:

  • ATM withdrawals
  • Other cash withdrawals
  • Check purchases
  • New accounts
  • Unusual savings withdrawals
  • Doubled payments
  • New people authorized on the account

  1. Put the Checkbook Away

These days everything can be paid with a credit card or through e-transfer, even rent. Checks are more dangerous because there’s no safe guard for fraud. If your parent pays into a scam with their credit card, you can usually recuperate this money. With checks or a debit card, you’re out of luck. It may be wise to lock up your parent’s other payment methods in a safe, and have him or her use them only when you’re around.

  1. Choose Care givers Carefully

While there are online and telephone scams, 34 percent of elder abuse is actually committed by someone close to the senior. This may include family, caregivers, friends, or neighbors. Appalling to consider yet necessary to acknowledge.

In order to prevent caregiver fraud, ensure that you’ve hired a caregiver from a reputable agency. You may set up a nanny cam or other recording equipment if you suspect abuse – financial, physical or emotional. Be sure that you’re the one paying the caregiver directly and not your parent, so that the caregiver is less likely to demand fraudulent second payment for their “services” from your parent.

  1. Watch New Friends and Relatives

Elders may trust new people in their life too quickly, sometimes lending them money or making them an authority on their accounts. Elders can be manipulated into situations that don’t make sense, like opening up new accounts or taking out loans, to help these “friends.” Keep an eye on any new friends or even recently renewed acquaintances with family members.

  1. Avoid In-Person Scams

Ask your parent to alert you if someone comes by their house unexpectedly. Often scammers pretend to be financial advisers, contractors doing repairs, or landscapers. They offer home services or financial advice but actually target and steal from the elderly. A front door security camera like Nest can help you keep track of unusual visitors to your parent’s home.

  1. Educate Your Parent

If your parent still has a strong memory and understanding of tech enough that you can introduce them to new types of scams committed through technology, you should. Focus especially on scams that target the elderly. While you can’t expect this knowledge to be their only safeguard from financial abuse, it may help them avoid the most serious scams.

  1. Get Regular Credit Reports

Even if you have access to your parent’s account you may miss things. Getting a credit report on them once every few months will ensure you don’t miss it if they open a new credit card or take on some kind of loan, which they could then use to participate in a scam. Frankly, this is good advice for anyone!

  1. Let Your Parent Know You’re There for Them

Elders are less likely to take action against the criminal even when they know they’ve been scammed. Perhaps it increases their fear that they are becoming too dependent on others or they’re embarrassed about being duped. If your parent knows that you’re there to help, and won’t think less of them for falling prey to a scam, they may be more likely to reach out for help if they think they’ve been scammed.

  1. Report Suspected Abuse

If you suspect that your parent has been scammed, it is wise to report the person to the police, or to speak with them directly about it (if they are a friend or family member) right away. Elderly people may be surprisingly trusting and can fall for the same scam twice. Plus, by reporting the scam, you can protect more vulnerable elders like your parent and prevent more financial abuse from happening to others.

Any one of these circumstances is an indicator that a higher level of support is needed, and, the best time to enact it is before they crop up. Power of attorney conferred on a trusted relative or associate is a strong, protective legal instrument to put in place.

DECADES: 1950’s

By the 1950’s a consensus was building that facilities for the aged should focus on providing medical care, as well as residential care, and legislators decided to actively promote the development of skilled nursing homes. In 1954 the Hill-Burton Act was amended to provide funds to nonprofit organizations for the construction of skilled nursing facilities that met certain hospital-like building standards, if built “in conjunction with a hospital”.

The Hill-Burton amendments created a number of precedents. The changes represented the first time that legislation specifically included nursing homes as part of the health care system rather than the welfare system, and created an expectation that the physical design of nursing homes would be based on hospital design. The Hill-Burton regulations placed nursing homes under the jurisdiction of the National Health Service, ensuring that future regulatory oversight would be medical in nature, and they represented the first time that federal funding for nursing homes was tied to standards for construction and design, staffing patterns, and other medically-oriented concepts.

 

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Independence For America’s Seniors

All throughout July I hear fireworks, see red, white and blue and hear advertisements that feature ‘Independence’ as a theme. For many in the aging life community – practitioner, protector, senior adult and concerned child – ‘independence’ is a challenging concept. Diminishing skills tend to take seniors’ independence while the senior adult fights against its loss.

Perhaps no sign of a change in a senior’s independence causes more upset than moving – or actually, being moved – from one’s home to a care facility, a combination room or apartment with a professional care staff that takes over responsibility for a senior’s life. According to AARP research, nearly 90% of seniors want to stay in their home. Often referred to as “aging in place,” this option can be possible depending on the senior’s need for care and their financial resources.

If aging in place is a real option, a strong financial plan is necessary. For example, it’s important to explore all benefits that might be available, both at the state and federal level. Veteran’s Administration aid is often overlooked yet typically provides benefits for both veterans and their surviving spouses. National programs like PACE (Program for All-inclusive Care for the Elderly) help people stay out of nursing home care and, if the senior can’t age in place, they can help find a Medicaid-covered group home with several other seniors living in a familiar, home-like setting.

Another option is to investigate any existing long-term care insurance policies. While older policies may imply they cover nursing homes only, it is worth having someone contact the insurer and advocate for home health care, a much less expensive option unless the senior needs round-the-clock care. Insurance often include an opportunity to approve payment for several hours of in-home care per day vs. the expense of a nursing home facility.

There are also life insurance companies that will help cash out the face value of a life insurance policy to pay for care. Reverse mortgages can also be helpful if your loved senior is committed to staying at home.

As far as the safety of aging in place, technical advances in equipment help people keep their independence. For example, you’ve most likely seen TV advertisements for Life Alert; it is motion-sensitive and automatically sends its alert if there is a fall. And, a bath tub can become a low-entry shower to make bathing safer. Bed alarms and mats are available to place next to the bed, sending an alert if there is the appearance of wandering. And there are devices at this link which you can install on the stove burners to ensure they shut-off automatically, preventing fires if your mother forgets to turn them off.

You can install safety features like grab bars and non-slip mats in the bathroom and sturdier handrails on the stairs. You and your parent may feel more comfortable with her/him at home alone for a longer period of time with safety gadgets like these.

Through Medicare, an Occupational Therapist or Care Manager can come to the home and review all safety hazards. This way you can know exactly what changes are necessary to create a safer environment.

From the standpoint of maintaining personal pride for the senior who’s capable of staying home with some supportive family or the occasional visiting professional, let mom be part of scheduling or writing her checks, going over the mail, or creating shopping lists. The person who often takes the lead on these tasks is the Power Of Attorney. Perhaps there other people – a neighbor, frequently seen handy man, friend – who can influence mom’s behaviors, keeping her on track to maintain healthy habits?

Engaged family can take advantage of gerontologists, social workers, and the previously mentioned Care Manager to facilitate needs and perhaps divide up roles among those in the senior’s life who are able (or paid) to step up. For example, use others to maintain your senior’s health: keep her/him off ladders, let someone take garbage to the curb, walk the dog, move oft-used items from high shelves; the goal here is to prevent falls and accidents.

If you can afford to have someone come in to help your mother once a week then do it! Their help can go a long way to keeping your senior independent and in her own home. For example, a weekly housekeeping visit can do the tasks your mother may find exhausting or forget to do, which will keep her from overexerting or hurting herself. Weekly visits from a physiotherapist may help keep your mother physically capable.

Often the first step to keep your independent senior at home is to help mom/dad age well with a plan. Part of this is simply talking about the process of aging, something we don’t typically do before the parent loses her authority role and child becomes care giver. Have the conversation with your parent – what do you want to happen and when? Home care? Assisted living?

Another form of protection to hold onto independence is to put mom’s money in a trust, preventing the tragedy of sophisticated scammers who find so many ways to prey on someone’s fears or sympathies.

Use this link on our sister site, Aging Life Network, to find a tremendous range of resources to assist, using the values that are critical to your aging parent and family. The sooner these conversations happen, the easier the shift and ongoing care will be.

While the solutions above will lessen the sting, or even the need, for drastic changes in the life of your beloved senior, the time may come when more serious changes are needed. Yet, more than the loss of independence, much more is at play in their mind, preventing easy acquiescence with your best intentions: pride, role reversal, depression, guilt over the memory of how they were forced to care for their parents are all swirling around their brain, along with the loss of authority, credibility and autonomy I mentioned initially.

The role of guardian ad litem may represent the best interest of the senior who fears all of the above. How to determine if the time has come? Medical records, doctor’s notes, the potential risks to the senior if no intervention is taken must all be considered. Too often, by the time the guardian is called in, a desperate situation exists: rotting food, empty pill boxes, dishes piled high, no clean laundry are all signs of a need for immediate intervention.

And, when likely resistance shows up, it’s important to distinguish: is the senior simply stubborn, cognitively impaired, or under undue influence by an acquaintance?

In some cases, engagement with former hobbies or life enrichment programs can help. A strong tool is art therapy. Shown to be a powerful tool, art therapy can help your aging parent reconnect with the world.  Painting, drawing, sculpting, paper crafts, writing, poetry, music, and even dance can all be part of an art therapy program. There are many reasons to design some art therapy for your parent, or to encourage them to participate in art therapy offered by their retirement community, if, in fact, that’s where they land.

Art therapy has a variety of cognitive and emotional benefits including slowing of memory loss, combating boredom, loneliness and depression, increasing self-esteem and even having physical benefits. Art forges new neural pathways in the brain and strengthens existing connections. Calling on past events to create art improves memory. Using a variety of colors, materials and textures increases sensory stimulation and using art to convey religious beliefs can reduce depression and anxiety. And, of course, when creativity is shared with others it increases social interaction, personal expression and relaxation.

Overall, art therapy is a powerful tool to keep your parent engaged with those around them and with their own story and experiences. There are art therapists who can help you develop a program suited to your parent. Alternatively, you can find many ideas online about art therapy.

What happens if your parent has been diagnosed with mild dementia? Is it safe to leave her/him at home? People with mild dementia usually do well if they are in a stable environment they’ve lived in for a long time, especially when they maintain their established routine. When they forget things, a system of reminders can help them stay on track. For example, if you’re worried because your mother is struggling to recall your number when she wants to call you, writing it out on a sticky note and leaving it next to her telephone can solve the issue.

However, if dad can’t recall emergency numbers when he needs to, that’s more serious. The emergency number in his area has likely been the same his whole life, so forgetting it is also a sign of growing memory issues. Leaving the number on a note pad on the fridge can be helpful, but it is still a sign dad shouldn’t be living alone.

Other ways to extend senior independence? Reminders can be set-up to help navigate day-to-day tasks. You can set up reminders to pay bills with her bank, or add them to her monthly calendar. If your mother can use a cellphone you can program reminders for anything she needs, including reminders to eat dinner or to take her medication.

It’s a must to check-in on your dad regularly, as you never know when dementia may become too serious for him to be alone. It can also help your dad maintain his routine if you or another family member call on a set schedule. For example, if you find your dad is forgetting to lock doors at night you can call every evening at around the same time to prompt him to do so.

Eventually, some incidents will remind you it’s time to re-evaluate your parent’s situation. Falling, getting lost, leaving the house at night, and giving money away are all serious indications that your senior may not be safe to remain at home alone.

If you feel that despite all these support tools your senior would be best served with a guardian, please reach out to me directly for the best and healthiest way to proceed.

Celebrating Decades: the 20 teens

In October of 2017, bipartisan legislation was passed by Congress and signed by President Trump to protect seniors from financial exploitation.

The Court-Appointed Guardian Accountability and Senior Protection Act passed Congress as part of the Elder Abuse Prevention and Prosecution Act. The legislation, authored by U.S. Senators John Cornyn, R-Texas and Amy Klobuchar, D-Minnesota, strengthens accountability and oversight for guardians and conservators.

Under the new law, state courts may apply for funding from an existing program created to protect older individuals, and use the funding to assess the way the courts handle proceedings related to guardians and conservators, so that improvements can be made. Examples of potential improvements include electronic filing systems to keep tabs on guardianships and conservatorships, and the institution of background checks for guardians and conservators.

Resources:

National Council on Disability

Aging Life Network

American Association for Retired Professionals

Thiscaringhome.org

attorney Cristy Carbon-Gaul

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For Attorneys

Seniors and the Affordable Care Act: What You Need to Know

Are you a senior or older adult with questions about how the Affordable Care Act may affect you?

The Affordable Care Act requires everyone to have health insurance coverage. If you are already enrolled in Medicare, Medicaid, or if you have employer-based health insurance, you already have coverage and don’t have to make any changes. If you are not currently enrolled in any of these programs and you don’t have health insurance, you will need to obtain coverage or pay a penalty.

You can purchase insurance through the Health Insurance Marketplace, and depending on your income you may qualify for assistance to pay your monthly premium. Premium assistance is only available to those not eligible for Medicaid who purchase health insurance through the Marketplace.

There are four ways to apply for Marketplace coverage:

  1. Paper Application. You can fill out a paper application and mail it in. You will receive an eligibility notice by mail. The paper application is available at healthcare.gov
  2. Apply Online. While the Marketplace website experienced technical issues when first launched, you can now apply online in four steps. Visit healthcare.gov to get started.
  3. Apply by Phone. To apply by phone, call 1-800-318-2596, 24 hours a day, 7 days a week (TTY: 1-855-889-4325). A customer service representative will work with you to complete the application and enrollment process.
  4. Find in-person help. In all states, there are people trained and certified to help you review your coverage options and enroll in a Marketplace plan. Visit LocalHelp.HealthCare.gov to find help in your area. Additionally, Decades can provide in-person help to clients and their families.

Three important dates to keep in mind are January 1, 2014: All individuals are required to have health insurance by this date, December 23: The deadline to file an application for coverage starting in January and March 31, 2014: Marketplace open enrollment ends.

If you have more questions about what the Affordable Care Act means for you, Decades can help. Our team offers free consultations so you can learn about the services that we offer, including medical advocacy and care management.

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Advice for adult children: Recognizing the Warning Signs of an Acquired Brain Injury

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Have you noticed that your parent or elder adult in your family is acting differently lately? In some cases, changes in behavior can mean that an elder loved one suffered an Acquired Brain Injury. Understanding and recognizing the warning signs can help ensure senior family members receive the care they need.

An Acquired Brain Injury (ABI) can happen in day-to-day life from:

  • Falls
  • Motor vehicle accidents
  • Motorcycle accidents
  • Heart attack-respiratory arrest
  • Stroke

More unusual causes of ABI can include gunshot or knife wounds, near drowning and anaphylactic shock (a serious allergic reaction). An ABI can effect an individual’s memory, ability to execute tasks, and can prevent them from taking appropriate initiative, like paying their taxes on time.

Early signs of behavioral changes include restlessness, tardiness, and increased confrontational or argumentative behavior. These warning signs can escalate to more dangerous behaviors including property destruction, pushing or shoving, increased use of alcohol and refusal to do normal tasks or activities.

If you notice these behaviors in a senior family member, it’s time to ask for help. There are many options available to families. One place to start is with a Decades professional geriatric consultation. Coordinated by a licensed professional, consultations can take place in the home or at the Decades office. Following the consultation, Decades will provide a detailed written report covering options, local resources and services that are most appropriate for the individual situation.

To learn more, read about our consultation services here, or contact us.

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