Choosing a Caregiver – Agency vs. Private

When choosing a caregiver, you must decide between an agency caregiver and a private caregiver.  There several things you should consider.

Private caregiver

Employee of the client, they are not a 1099 contractor

Client is responsible for employer’s share of social security, unemployment insurance and worker’s compensation

Client is responsible for federal and state tax deposits based on the caregiver’s pay

Client is responsible to background check the caregiver(s)

If a caregiver calls off, the client must coordinate for another caregiver to cover

Agency caregiver

Employee of the agency

Agency pays taxes, unemployment insurance and worker’s compensation

Agency is responsible for background check of the caregiver

Agency has multiple caregivers and can cover when a caregiver calls off

Agency has liability insurance to cover the caregiver for theft or damage

Although a private caregiver may have a cheaper hourly rate than an agency caregiver, when the added cost of unemployment insurance and worker’s compensation are added to the cost, it may end up being more expensive to have a private caregiver.

Are You Prepared For An Emergency?

In the past, most Americans lived their lives without any emergency plans.  After 9/11, many people began to think about what they would do if there was a catastrophic event or terrorist attack in their town.  These contingency plans included having food and water, batteries and other emergency gear.  Families planned where they would meet and who would get the children.  These plans have become necessary due to the current world culture.  Although many of us have these plans in place for catastrophic events, most of us do not have contingency plans in place for the more common crisis in our lives.

What would those who depend on you do if you got hit by a bus, or had a stroke?  What would you do if your parents were unable to take care of themselves?  These situations happen every day and most of us do not have a plan in place.  Unfortunately, without a plan, these events often become a crisis and families end up making rash decisions to deal with the crisis.  Those who do have a plan in place are usually able to make better decisions because they have more time, information and resources.  

All of us have preferences for handling emergencies, our finances, medical decisions, legal matters and end of life choices.  The problem is that we often do not discuss them with anyone.  It can be difficult to discuss these issues with our families, so often we just avoid the topic.  Unfortunately, if we don’t discuss these topics, we won’t have the information necessary to make a well informed decision.  If you are having a difficult time getting your loved one to talk about these issues, consider having an independent third party talk to you and your loved one.  Sometimes a physician, attorney or an Aging Life Care Professional can be more effective in discussing these topics because they are considered to be a professional and there is no emotional history to overcome. No matter who leads this discussion, the focus should be on your loved one and how they would like these preferences carried out.  It is important to get specific information now so if the time comes, there will be no question what your loved one wants you to do.  Some of the topics you should address include:

1.          Medical

a.          Current medical providers – name and phone number

b.         Current medical conditions

c.           Current medication(s)

d.         Allergies

2.          Legal

a.          Power of Attorney

b.         Living Will – give a copy to your physician

c.           Will

d.         Trust

e.          Location of legal documents

f.            Verify the people appointed in legal documents have a copy

3.          End of Life

a.          Feelings about death

b.         Is it important to die at home?

c.           Burial or cremation preferences

d.         Funeral/Memorial preferences – be specific!

4.          Emergency Assistance

a.          Who will be called first/second in the event of an emergency?

b.         Is there someone local who can assist if family lives far away?

5.  Financial

a.          Location of bank/investment accounts

b.         Location of safe box and keys

c.          Location of financial documents

d.         Who is monitoring bank & credit card statements

Statistically financial fraud is becoming more prevalent.  Anyone who has a mailbox, writes a check, or has a credit card is a potential victim.  To protect yourself, review your bank and credit card statements when they come in and report any unrecognized activity.  Since elder adults are particularly vulnerable, it is a good idea to have the person who is nominated as Financial Power of Attorney or Successor Trustee to monitor these statements as well.  Financial fraud comes in many forms, so keep track of your finances and be careful who has access to your financial information. 

Once you have the information, share it with anyone who could be responsible for making these decisions.  If you are geographically distant from your loved one, look for a local resource to be available for emergencies.  A local Aging Life Care Professional can be an invaluable resource in putting together a contingency plan.  The Life Care Professional not only knows the local resources, but often can be available on an emergency basis to get things stabilized while family is in route.  The Life Care Professional can also take a proactive roll, making recommendations to help prevent potential crisis or monitoring unstable situations.

Whether you work with a Life Care Professional or do it yourself, take the time to put a contingency plan in place.  It will give you and your loved one a peace of mind knowing you have a plan in place for an emergency.  You may never need it, but it is good to know it is there if you do!

Exercise for the Arizona Elders

Everyone wants the benefits of exercise throughout their life. But we often wonder if it is safe for seniors to exercise. According to the American Academy of Family Physicians almost all older people can benefit from additional physical activity. With regular exercise an healthy elder can be protected from chronic disease, improves mood and can lower their chance of injury.

As the body ages, it takes a little longer to repair itself, but moderate physical activity is good for people of all ages and of all ability levels. Truth be told, the benefits of your elderly parents exercise program highly outweighs the risks. Even elderly people with chronic illnesses can exercise safely. Many medical condition such as Alzheimer's and dementia, heart disease, diabetes, colon cancer, high blood pressure and obesity can be improved with an exercise program.

In fact, elders who regularly exercise can see an improvement in their health to include improvements in blood pressure, diabetes, lipid profile, osteoarthritis, osteoporosis, and neuro-cognitive function.

A regular exercise program can improve:

Immune Function – A body can fight off infection and sickness and recover more quickly less strenously when healthy instead of stealing energy from the body.

Cardio-Respiratory and Cardiovascular Function – The risk of heart disease and high blood pressure is lowered with regular physical activities. If the elderly person has hypertension, exercise will lower blood pressure.

Bone Density/Osteoporosis – Exercise protects against loss in bone mass and will reduce the risk of osteoporosis and lowers risk of falling and broken bones because of better bone density.  Research shows that strength training can dramatically reduce the loss of bone mass, help restore bones, and contribute to better balance and less fractures.

Gastrointestinal Function – Regular exercise promotes the efficient elimination of waste and can improve digestive health.

Chronic Conditions and Cancer – Regular physical activity lowers risk of Alzheimer's disease and dementia, diabetes, obesity, heart disease, osteoporosis, colon cancer and can help in the management of high cholesterol and arthritis pain.

Regular physical activity is also associated with decreased mortality and age-related morbidity in older adults. In addition, a study by the Journal of the American Geriatrics Society examined exercise in the elderly and found that exercise training led to improvement in functional reach, balance and fear of falling.

Often, frail elderly people are unable to maintain an aerobic exercise routine on a regular basis due to lack of endurance. Age-related changes in the cardiovascular system have significant effects on cardiac performance, it has been estimated that 50% of endurance loss can be related to decreased muscle mass.

The best exercise program for the elderly consists of three components: aerobic exercise, strength training, and balance and flexibility. To learn more about how your parents can improve their health with a care manager contact Desert Care Management by visiting their website or calling at 480-804-7200.

How can you tell if your loved one needs managed care...?

It can be difficult for Arizona families to determine when they need to seek help in caring for their aging or elderly parents. Geriatric care in Arizona is in great demand due to our high concentration of retirement communities. So… How do you know when it is time to seek professional care management assistance for your loved ones? There are many warning signs that your parents may need more care. Children of aging parents should trust their instincts with regards to their parents well-being. Listed below are a few signs that may indicate that it is time to search for care management and possible assisted living arrangements in Arizona.

Driving Skills
Has your parent recently had an accident? Is there unexplained damage to their vehicle or a recent driving citation? Dangerous driving can harm themselves or others because of decreased vision, motor skills or awareness of surroundings.

Personal Care
Has your love one stopped brushing their hair or started wearing the same dirty shirt? A decrease in personal grooming and hygiene care may be a result of arthritis, pain or more serious physical, emotional or mental problems.

Medication Management
Has your loved one accidently overdosed or neglected to take medication? This may be due to a lack of memory or diminished awareness of days. Don't ignore your concern with these issues.

Financial Management
Is the mail not being picked up regularly? Are the bills being paid on time? When funds are limited, this issue can be disturbing to family members. Have they made any irrational purchases or donations?

Lifestyle Quality
Are they still able to prepare their own meals? Have they lost contact with their friends? Are pets being fed or cared for properly? Sudden change in their everyday routine could be a sign of loss of energy or depression.

Memory Loss
Does your loved one tend to repeat themselves more and more often? Is their short-term memory noticeably diminishing? This may be an indicator of Dementia and Alzheimer’s.

Sudden changes in health, family dynamics, financial stability or housing quality may be signs of the need for care management services. In Arizona, there are many care management groups that can provide you with care options and assisted living alternatives for you aging or disabled loved ones. If you keep an eye out for these signs, you can avoid a potential accident and other health risks. Your main goal is to insure your loved ones experience a better quality of life for as long as they can.