Not to be out done by the Navigator development team, the SCANS team is continuing their "rolling release" of V1.3.  SCANS is the Senior Care Navigation System that provides geriatric care managers with expert advice, best practices, and practical tools to help families with the well-being or their parents.

The June edition of V1.3 includes 26 new resources, process, or tools.  The list includes items like these:
  • Death in the Home – Information for Caregivers
  • Tips for Alzheimer Caregivers
  • Delirium vs. Dementia
  • Transitioning an Individual with Dementia into a Facility
  • Member Portal Instructions
  • Continence Education – Constipation
  • Urinary Incontinence – When to Seek Immediate Medical Attention
  • Crime Prevention Education for Older Adults
  • IADL (Independent Activities of Daily Living) Education
  • Physical Therapy and Occupational Therapy
  • My Medicare Matters
  • Advance Directives for Mental Health Treatment
  • Drug Review and Side Effects
  • Geriatric Friendly Pharmacy
  • Medicine Reconciliation:  Brown Bag Consultation
  • Feeding Tube Education
  • Special Diet Needs Education
  • Defibrillator Education
  • Diabetes Education
  • Fibromyalgia Education
  • Pacemaker Education
  • Physician Planner Case Note
  • Alternative Living Options Education
  • Speech Therapy Education
  • Social Participation Barriers
  • Social Support Plan
These tools are available to the clients of My Health Care Manager and our affiliates.  Some of the content is also discussed in our blogs and can be accessed for free.  Check out Natalie Langley's blog titled "Healthy Aging".  Natalie is one of the principle researchers and authors of the tools in SCANS.  Her blog covers a holistic look at healthy aging and senior well-being.

My Health Care Manager's care management system (Navigator) has just been updated to version 1.9.  This is the core system that geriatric care managers use to assist families caring for aging parents.  From past blogs you may know that this includes the assessment, care planning, implementation, and tracking support for seniors and their families.

Navigator 1.9 includes:
  • Key changes for work flow
  • Assessment and tracking improvements in the following dimensions:
    • Client Designees
    • Financial
    • Advance Directives
    • Engagement – Social Support
    • Provider Information
    • Medication History
    • Family Medical Health History
    • Functional Status
    • Assistive & DME Devices
    • Sensory Status
    • Nutritional Status
    • Anxiety
    • Environmental
  • Reporting enhancements in areas like legal and Insurance, personal health record outputs, services listing, and more
This system is available to our clients and clients of our affiliates and partners.  We also provide much of this information in our Guide for Senior Well-being and Eldercare.  This is a self help guide is available at http://www.myhealthcaremanager.com/guide/product.asp.



As a caregiver, the responsibility for decisions regarding your parent’s care falls to you.  Often you wish you could discuss the options, choices and next steps with your parent, just as you discussed so many choices in the past…where to go to college, where to have your wedding reception, which neighborhood to select.  But parents with Alzheimer’s cannot help with current decisions as their ability to reason, compare and choose has been ravaged by the disease.  Sadly, dementia robs them of their ability to chart their own course.

So, what should caregivers do when faced with a variety of paths – how do you know how to choose what is best for your parent? How do you know when a parent’s living environment is no longer safe? How do you know when a parent needs more assistance? 

Here are a few suggestions:

  • Pay attention to your parent they may be confused, but they will give you clues when things aren’t going well.  They may seem more agitated, confused or disoriented.  Their routine may change and a situation that has worked well in the past, now poses problems.  For example, they may no longer want to eat dinner because they either can’t remember where the Assisted Living Dining Room is located, or they are afraid to leave their apartment.  
  • Check in with their caregivers – have other family members, a companion, assisted living staff or adult day care workers noticed a change in your parent?  Are they concerned? 
  • Take your parent in for a check-up – have the Doctor evaluate your parent and review their medications and mental and physical health. 
  • Review your parent’s ability to complete Activities of Daily Living – things like bathing, dressing, continence, mobility, feeding.  Has there been a change in their ability to do these things?
  • Engage a Geriatric Care Manager – have them conduct an independent assessment to provide an unbiased view of the situation.

Once you have gathered the above information, spend time thinking and talking to others you trust about the findings.  Choose the next step based on what you think is best for your parent at this moment in time.   For instance, if you determine that they need more assistance, think about the pros and cons of providing additional assistance in their current environment vs. moving them to a new environment such as a Memory Care Unit.   There is no “right” decision.  Take comfort in the fact that you have been both thorough and thoughtful when you made the decision.  Always remember that your parent is better off when you address concerns as they arise vs. postponing decisions until a crisis arises.



The SCANS content team headed by Jean Bandos along with the development team announced today that the SCANS Version 1.3 - May release is now available.  SCANS Version 1.3 is a major content release to the SCANS Knowledge Base.

In order to make more real-world tools for eldercare available more quickly, Jean and the team have devised a "rolling release".  For 3 months beginning in May another group of resources, processes, and tools will be made available to geriatric care managers at My Health Care Manager and our affiliates.

The May release contains 57 new and/or revised resources, processes and tools.  Some sample items include: 
 

  • Behaviors and Alzheimer's Disease
  • Grief Education
  • Activities of Daily Living Education
  • Depression and Alzheimer's disease
  • Early Stages and Impact on Health
  • Memory & Cognition Questions
  • Memory Care Unit Checklist
  • Memory Care Unit Education
  • Mild Cognitive Impairment
  • Sobriety Programs Resource
  • Handyman Resource
  • Private Handyman Contractor Checklist
  • Smoke & Carbon Monoxide Detectors
  • Daily  Money Management Education
  • Financial Planning Education
  • Trust Education
  • Verifying Funeral Arrangements
  • Veterans Benefit Information
  • Elder Law Resource & Checklist
  • Medication Management Procedure
  • Medication Reconciliation
  • Polypharmacy
  • How to Find a Pain Specialist
  • Pain Education
  • Pain Resources
  • Pain Visual Analog Scale
  • Arthritis
  • Heart Failure
  • Hypertension Education
  • Family History - Cancer Education
  • Family History - Dementia
  • Family History - Diabetes Education
  • Family History - Heart Education
  • Seat Belt Education
  • Cataracts Education
  • Glaucoma Education
  • Hearing Aid Education
  • Sensory Changes
  • Assistive Devices
  • Hospice Education
  • Spiritual Connections
Stay tuned; the June release will include resources on incontinence, cognition, supporting services, and more processes.

Be sure to visit Jean's blog, click here.

May is Stroke Awareness Month and I’ve posted a couple blogs recently about strokes.  Some new guidelines were just released and I think they’re very important.  A national stroke coalition called the Brain Attack Coalition (BAC) has adopted a new message this month: “Stroke strikes fast.  You should too.  Call 9-1-1.”  This should be a mantra for all caregivers, families, and friends of seniors.

If you recognize the signs of a stroke in your aging loved one, call 9-1-1 immediately.  Stroke victims need to see a health care provider immediately.  How can you recognize a possible stroke?  See my previous blog on the ‘Act F.A.S.T.’ method which has you answer a few key questions: Face – does one side droop? Arm – does one arm drift down if raised? Speech – is speech slurred or strained? Time – if you answered yes, it’s time to call 9-1-1!

The BAC is chaired by the National Institute of Neurological Disorders and Stroke (NINDS), which is a part of the National Institute of Health (NIH).  For more information see the NIH announcement here or see the NINDS stroke page here.
 


Our Senior CAre Navigation System (SCANS) has released in a new edition - Version 1.2!
 
This version includes major extensions of the search functionality to make it easier for geriatric care managers to find specific tools and solutions.  This provides quicker access to hands on practical solutions for families caring for aging parents.  Of course, the structure and caregiver advice in each of the 25 Care Categories remains in place to assist the geriatric care manager overall care planning.

Also including in the 1.2 release are a variety new solutions, actions, resources and other content for helping with senior well-being and senior health care.

As a follow up to my last blog, if you missed “The Alzheimer's Project", the groundbreaking HBO documentary series aired May 9 – 12, the films are available online at www.alz.org/HBO and also at http://www.hbo.com/alzheimers/. They will also air again throughout May on HBO and HBO2.

If you were able to watch, please share your thoughts about ‘The Alzheimer's Project’ at http://alzheimers.infopop.cc/eve/forums and here on my blog.  The Alzheimer’s forum page has several opportunities: not only can you discuss the project, but it also has forums for those who have Alzheimer’s Disease, questions about medication treatments, caregiving, and forums in Spanish.

Remember that Alzheimer's is not a normal part of aging – it's a progressive and fatal disease.  Every 70 seconds someone develops Alzheimer’s and now Alzheimer's disease is rated the seventh-leading cause of death.

If you are assisting someone with memory loss or Alzheimer’s Disease, speak with your loved one’s health care provider and visit www.alz.org to learn more on how to support yourself and your loved one.

HBO is doing a documentary series on Alzheimer's starting this Sunday, May 10.  Titled 'The Alzheimer's Project', the series is comprised of four parts.

  1. The Memory Loss Tapes
  2. Grandpa, Do you know who I am? (with Maria Shriver)
  3. Momentum in Science
  4. Caregivers
There is also an accompanying book and DVD, as well as supplemental series of 15 videos focusing on the research and medical side of Alzheimer's available to stream online.

A national survey completed in conjunction with The Alzheimer's Project found that 54% of the US population has been affected by some way in Alzheimer's.  With such a huge impact on our society, I encourage health care providers, caregivers, seniors, and anyone else affected by Alzheimer's or a loved one's cognitive decline to watch this series.

The website has great information, but please make sure to ask your health care provider if you have questions.  A geriatric care manager can also help caregivers and seniors address issues associated with Alzheimer's and cognitive decline.

For more information on the series, visit http://www.hbo.com/alzheimers/index.html.
To watch the supplemental series, visit http://www.hbo.com/alzheimers/the-supplementary-series.html.

Caregivers for those with cognitive decline or Alzheimer's can find free help from their local Alzheimer's Association.  Whether you're looking for ways to better communicate with someone with Alzheimer's, ways to reduce your caregiver stress, or even seeking other local resources, the Alzheimer's Association is a great place to start your search.

Local Alzheimer's Associations often give conferences for caregivers.  Topics often covered include communication, home safety, and well-being.  Presenters have extensive experience in geriatrics and caregiving topics.  In addition, you can connect with other caregivers for support.

There will be a caregiver's conference on May 15th in Indianapolis, and I encourage you to attend.  For more information, visit the local Alzheimer's Association website

For information on events in your city and state, visit the national Alzheimer's Association website.


One of most touted areas of the Federal government's stimulus initiatives has been investment in Health Information Technology.  Unfortunately this has been focused heavily on infrastructure not caregiving tools (and certainly not tools for eldercare specifically).  Proponents of this investment believe that it will save billions of dollars in the long run on health care costs.  Typically they site things like the elimination duplicate tests, administrative efficiencies of an Electronic Medical Record (EMR) and other "back office" improvements.

Well, I'm skeptical.

I'm not alone,  the New York Times published an article a little while back raising some of the same concerns.  Titled "Doctors Raise Doubts on Digital Health Data" the article discusses how difficult a problem this really is.  Two significant issues surface.  First, how frequently these systems are used and second, do they actually make a difference in the quality of care and coordination between health care providers.

Read the full article at www.nytimes.com/2009/03/26/business/26health.html

Not surprising the use is very low - 9% of the nation's 3000 hospitals according to the article.  Data on quality or efficiencies really isn't even available.

For people caring for aging parents and the cost associated with senior health care.  I'm even more skeptical.  In reality the health situation for a senior really can change over night and repeat tests are necessary.  A senior with congestive heat failure or chronic obstructive pulmonary disease may require duplicate tests in very short time frames.

Transfer of information could provide some efficiencies, but often competitive hospitals, physician practices, and other competitive health providers are being asked to collaborate with no financial incentive. 



**The following post is from my guest blogger, Natalie Langley, MSW.  She is a Geriatric Care Research Analyst for SCANS (for more on SCANS, please see Eric Tinsley's blog by clicking here).**

There are several barriers that can impact the older adult’s ability to achieve good nutrition.  The following checklist can help to ensure older adults are getting the proper nutrition. 

Determine if there is a problem that impairs their ability to eat:

  1. Have a physician/pharmacist review side effects of medications.
  2. Are their teeth/dentures in proper condition?
  3. Are there any physical limitations relating to pain and arthritis?
  4. Is there a decrease in a sense of smell and taste?
  5. Are finances a barrier?
  6. Is their eyesight failing?
  7. Do they have weakness and are not able to carry grocery bags?
  8. Is forgetfulness or dementia present?

As a caregiver or an older adult, make sure to enlist people and programs within the community to help with meal assistance.  One way is to contact your local Area Agency on Aging for meal programs for older adults, such as Meals on Wheels.  This program offers deliverable meals for older adults in their homes.  For a list of local Area Agencies on Aging, you can visit www.n4a.org

Another good resource for meal assistance is Seattle Sutton's.  This is an Illinois based company, but they have locations everywhere.  They offer healthy, prepared meals for a reasonable price.  To find a location near you, please visit their website at http://www.seattlesutton.com/.
 


In working with seniors and their families, end of life care issues always come up.  It is a hard decision for the senior and families to make end of life care decisions, for example, whether to continue treating an illness or disease, implementing palliative care, or inserting a feeding tube.  These difficult decisions can often be made ahead of time by the individual via a Living Will.  Living Wills allow individuals the ability to document their end of life wishes, treatment preferences, and care options.  Any person over the age of 18, who is considered competent to make their own decisions, is able to complete a Living Will.  Living Will forms can be found at your local library, the internet, or an attorney's office.  Some states develop and recognize state-specific Living Will forms.  To download your state's specific advance directives form, check out Caring Connections.

The most difficult end of life decision to make is whether to insert a feeding tube or not.  A recent article from Health Behavior News Science, addresses recent studies on this issue.  For people with Advanced Dementia or degenerative dementia, the body is unable to metabolize food properly due to the brain damage.  The biggest fear for families is wondering if their loved one is "starving to death" or experiencing pain from hunger and thirst.  Hospice studies have indicated that few people experience this type of pain.  And if pain is exhibited it is often alleviated with palliative care and pain management.  In my career, I have had several physicians state that due to the brain damage and with the body going through the end of life process, that our bodies do not feel hunger or thirst.  But will we really ever know the answer to that question??  My motto as a geriatric social worker has always been, if I've made someone as happy and as comfortable as possible while they are here with us then I've done my job.  What I do know is that the decision to place a feeding tube is an individual decision and each person's situation should be considered separately.

For more information on studies, reviews of health care interventions, and evidence of clinical trials, check out the Cochrane Collaboration.

Alzheimer's AssociationAccording to the latest report from the Alzheimer’s Association, the total health care costs are more than three times higher for people with Alzheimer’s and other dementias than for other people age 65 and older. It is reported that there are 5.3 million Americans living with the disease and every 70 seconds someone in America develops Alzheimer’s disease. By 2010, it is estimated that there will be nearly a half million new cases of Alzheimer’s each year. Currently we know that Alzheimer’s is the sixth leading cause of death in the country, surpassing diabetes; it is the fifth leading cause of death among individuals 65 and older.

My next blog will cover the newest focus for Alzheimer’s: early detection and intervention.

My Mother has declined precipitously during the past six weeks.  We’ve watched helplessly as her confusion increased, her mobility worsened and her sense of time and place evaporated.  Yet, a routine Doctor’s  appointment and lab work did not reveal any treatable physical changes.
Yet, everyone around her noticed the decline – my sister, the companion, her Health Care Manager (a geriatric care manager from My Health Care Manager) and the nurses at the Assisted Living facility.  We were saddened to see my Mother struggle with this new stage of life and worked together to offer additional support.  We all ASSUMED that this was the natural progression of the dementia.

Our Health Care Manager was puzzled by what my Mother was experiencing.  She had worked with many, many seniors and felt that my Mother’s cognitive decline did not fit the typical pattern.   She felt that the changes my Mother started to experience happened overnight vs. being a gradual process.  It bothered her, so she sent a letter to my Mother’s physician and explained her concerns.  This led to a conversation between my Mother’s Doctor and the Health Care Manager.  As they reviewed my Mother’s case, a light bulb went off.  My Mother had a medication change in December….was it possible that the med change was negatively affecting her current physical and mental state?   Was it possible that the changes we’d noticed were not necessarily caused by the next stage of the dementia, but a medicine interaction? 

Thanks to the Health Care Manager’s detective work and follow up with the health care provider, we’ve stopped the new medicine that was added to my Mother’s care plan in December.  We have our fingers crossed that we will see a difference and that some of the decline will be reversed.  It is possible that there are other causes – a series of small strokes, for example.  But for now, we are addressing what the Doctor thinks is the most likely cause.

We’ve learned a good lesson.  Never assume that even small changes are “normal” …question everything!  And seek professional help whenever necessary. 

 



Knowing the symptoms of a stroke is key for caregivers, grandchildren, and the general public – because as I shared in my last post, a stroke can strike at any time.

This year the National Stroke Association will focus its efforts on educating the public to recognize stroke symptoms, and to Act F.A.S.T.


F = FACE     Ask the person to smile. Does one side of the face droop?
A = ARM     Ask the person to raise both arms. Does one arm drift downward?
S = SPEECH     Ask the person to repeat a simple phrase. Does the speech sound slurred or strange?
T = TIME     If you observe any of these signs, it’s time to call 9-1-1.


It has been reported that school age children are being taught about F.A.S.T. and several have saved their grandparents by calling 911.

April is Stroke Awareness month. Watch for upcoming news to help you promote stroke awareness and to recognize stroke symptoms within your own family. Or for more information, contact the National Stroke Association at www.stroke.org or call 1-800-STROKES (1-800-787-6537).  You can also ask your health care provider for more information and a referral to local resources.


Over the last year, I have written several blogs on aging in place for older adults and their caregivers.  Today, in honor of Stroke Awareness month (April), I wanted to raise your awareness about this concern, which is a preventable health issue. I recently attended an educational session on stroke prevention and would like to share the National Stroke Association’s efforts to educate the public on recognizing stroke symptoms.  Most of us think of stroke as a disease of old age – one that is debilitating and causes lasting disabilities. But it can strike at any age. 

Did you know that 80% of strokes are preventable and that by acting in time, the long term of effects of strokes could be minimized?

Here are some simple tips to follow to prevent a stroke: 

  • Know your blood pressure.      
  • If it’s high, work with your doctor to lower it.
  • Find out from your doctor if you have atrial fibrillation
  • If you drink alcohol, do so in moderation.
  • Find out if you have high cholesterol. If so, work with your doctor to control it.
  • If you are diabetic, follow your health care provider's recommendations carefully to control your diabetes.
  • Include exercise in the activities you enjoy in your daily routine.
  • Enjoy a lower sodium (salt), lower fat diet.


Look for my next blog entry, where I’ll share with you an easy-to-remember way to recognize the symptoms of a stroke.  This is important for caregivers, aging adults, grandchildren – everyone should be able to recognize stroke symptoms so that quick action can be taken.
 



The KeyA number of people have been asking me about starting a Personal Health Record(PHR) with Google Health, Microsoft Vault, or other free tools.  The question eventually cycles around to, "Why would I pay for a PHR when I can get one for free?"

Good question.

Of course, the answer is as old as the health care business itself.  "There's no such thing as a free lunch" ... or even a free PHR.  It's simply a matter of what you are willing to trade for the service. 

If you build your own PHR you have to take extra time to build, maintain, and even think through all the necessary information to collect.  Likely you have to type everything by hand rather than pulling from medical records, pharmacy records, or other sources of ready data.  What you are "paying" is your time and what tools you decide to use.

I the case of Google Health of Vault you are "paying" with your personal information.  In particular, detailed information about your medical conditions, treatments, and health situation.  If you are caring for aging parents you are trading their information.  What you get in return is the result of hundreds of thousands of dollars of development and though.

But, where did all the development money come from?  Where does the money come from to pay for the computers, bandwidth, and support staff?  It comes from advertising dollars aimed directly at you, your parents, or you as a caregiver.  These advertisers love the idea of being able to get directly at you and the health problems you or your parents face.  Not all bad, really... but no so good either.

The other model of course is to pay for a PHR application yourself and eliminate the need for a "third party payer".  In this case, of course, you are paying with an annual or monthly access fee.  This is also true if you are using a geriatric care manager or other provider of eldercare services who is using a system on your behalf.

There isn't a right answer.  You simply have to evaluate the trade off between your time, your private health information, or your money.

The following article was adapted from AgingCare.com

"Tax Tips for Caregivers: Can I Claim my Parent as a Dependent?
By June A. Schroeder, RN, CFP
It isn’t just time, but money that most caregivers donate to help maintain the ones they love.  I know.  I did it for years following willingly in the footsteps of my mom who also did it for years.  The financial toll is often insidious. You shop and include their groceries, pay for repairs and the gas for trips to the doctor, you lose time at work and pretty soon we’re talking big money. To compensate you cut back on vacations, cut or discontinue savings, don’t get your teeth cleaned or you may even take out loans to cover caregiving costs.

There are several options that might help you save money on your taxes:

Claim your aging parent as a dependent
Deduct your medical expenses
Use a dependent care credit
Open a reimbursement account at work
According to the first in depth study of such expenses released in November 2007 by the National Alliance for Caregiving and Evercare, a division of United Health Group, the annual out-of-pocket cost of elder caregiving is $5,531.  Long distance caregivers spend about $3,000 more.  These numbers are twice the previous estimates and are more than the average household spends on health care and entertainment combined.

For over a decade, there has been much talk but little action on periodically proposed national legislation to provide more tax relief in the form of tax credits or deductions for the more than 20% of Americans currently involved in caring for older relatives, spouses and friends. Both Presidents Clinton and Bush proposed a $3,000 tax credit to assist persons with long-term needs and the family members who care for them.  The most recent Bill S#2267, Americans Giving Care to Elders Act, was introduced In November 2007, read twice and sent to committee.  Caregiving is sure to become an issue in the upcoming presidential campaign, as evidenced by Hilary Clinton’s recently announced plan for caregiver relief. Until more relief comes along, it is important to understand and take advantage of the tax benefits that are available to you if you are supporting an elderly spouse, parent or relative.

Claim Your Parent as a Dependent on Your Taxes

The income of the person you are claiming cannot exceed the personal exemption of $3,400 (in 2007) excluding Social Security and tax exempt interest. They must be a relative or have lived with you for the past year, must be a resident of the U.S., Canada or Mexico, and not filed a joint tax return with a spouse.  IRS Publication 501 gives details on dependency requirements, including caregiver income phase-out levels. 

In addition, you must be providing over half of their financial support for food, housing, medical, transportation, etc.  If the person lives with you, include a reasonable percentage of your mortgage, utilities and other household costs in determining your level of support.  Those who are in an assisted living or long term care facility can qualify as dependents if the income and support levels are met.

Often more than one family member is involved in the support.  The one who is providing more than 50% of the support is entitled to claim the dependent. Be sure everyone is on the same page so you don’t run into trouble with more than one person claiming the individual.  Arranging to alternate years or establishing a Family Limited Partnership might options to consider.

Deduct Medical Expenses From Taxes

Medical expenses are deductible as an itemized deduction on Schedule A of the 1040 to the extent they exceed 7.5% of adjusted gross. 

In the words of IRS Publication 502:  “Medical expenses are the costs of diagnosis, cure, mitigation, treatment, or prevention of disease, and the costs for treatments affecting any part or function of the body. They include the costs of equipment, supplies, and diagnostic devices needed for these purposes. They also include dental expenses. Medical care expenses must be primarily to alleviate or prevent a physical or mental defect or illness. They do not include expenses that are merely beneficial to general health, such as vitamins or a vacation.

Medical expenses include the premiums you pay for insurance that covers the expenses of medical care, and the amounts you pay for transportation to get medical care. Medical expenses also include amounts paid for qualified long-term care services and limited amounts paid for any qualified long-term care insurance contract.”

If you buy equipment or make home improvements, they may be deductible IF they are for relief of sickness or disability not just convenience or transportation, i.e. ramps, railings, wheelchairs.  You can also include in medical expenses what you pay for prescribed medicines and drugs.  Long term care facility monthly fees attributable to medical expenses are also includable.
Keeping good records, including mileage and supplies, may allow you or your parent to qualify for some tax relief yearly or to plan ahead to consolidate expenses for another year.  A strategy dubbed “doubling up” on deductible expenses uses the standard deduction one year and itemized deductions the next.

Dependent Care Credit

You may be able to claim this credit if you pay someone to care for your dependent or your spouse who is not able to care for him/herself.  To qualify, you must pay these expenses so you can work or look for work.  The credit can be up to 35% of your expenses.  IRS Publication 503 contains full information and worksheets and also discusses the employment tax rules for household employers.  Your state may be one that also provides tax credits or deductions which build on the federal credit.

Reimbursement Accounts

If you are working at a company that offers a plan that allows for pre-tax deduction of dependent care and/or health care expenses, you can use those dollars for items not eligible for the Medical Expense Deduction or for relief if you will not be able to itemize.  Tax law changes have added non-prescription medications, like aspirin and cough medicine, to the list of reimbursable items.  Some plans require you to “use it or lose it” each year while others allow a carry-over to the next year for unused funds.  Be sure to check out the details and plan accordingly.

Caution: Tax Liability?

Having a formal agreement about caregiving in exchange for the family homestead or some other deferred benefit, might be construed as “taxable compensation” as evidenced by the 2003 federal court decision in United States vs. Dieter.   Mary Dieter’s receipt of the home was treated as “taxable compensation for services rendered.”  In another circumstance, if the care recipient goes on Medicaid, such an exchange could be considered an illegal divestiture.  Understand the laws and plan accordingly.

In conclusion, if you don’t already, with a few adjustments, you may be able to qualify for some of the tax advantages listed in this article depending on your income level and situation.  Furthermore, the state in which you live may offer benefits as well. Learn what you can and consult a qualified professional for planning and preparing your taxes. 

 

--------------------------------------------------------------------------------

June Schroeder is a Certified Financial Planner (CFP®) with Liberty Financial Group in Wisconsin, and has been working in financial services since 1979. Schroeder is also an RN, having received her degree from UW-Milwaukee in 1969. She served for 7 years as the Director of Economic Security for the Wisconsin Nurses Association, making her uniquely qualified for her role as a certified financial planner. She has written extensively for local publications as well as CNBC.COM. She has taught courses and lectured nationally on financial planning for universities and colleges."


**The following post is from my guest blogger, Natalie Langley, MSW.  She is a Geriatric Care Research Analyst for SCANS (for more on SCANS, please see Eric Tinsley's blog by clicking here).**

If you are a veteran, a surviving spouse of a veteran, or a caregiver of a either, I'm sharing some important information on veterans benefits today.  Veterans or surviving spouses of veterans who may now or in the future need caregiving assistance in the home, assisted living, or long term care facility you may be eligible for the Aid and Attendance Benefit.  Veterans Financial (not affiliated with the Veterans Administration) is an organization that can help veterans and their families obtain any eligible benefits.  Veterans Financial is accredited by the Better Business Bureau (BBB). 

The Aid and Attendance benefit is a benefit paid in addition to a monthly pension.  You may be eligible for the Aid and Attendance benefit if the veteran or the surviving spouse:

  • Requires the ongoing aid of another person (caregiver, home health aid, or another) in order to perform basic personal functions required in everyday living (i.e. bathing, eating, dressing, etc.)  -OR-
  • Is bedridden  -OR-
  • Is a resident in a long term care facility or nursing home due to cognitive or physical incapacity    -OR-
  • Is blind, or nearly blind

For more information on Veterans Financial, Inc. please visit:
www.veteransfinancial.com or contact them at 800-835-1541.


Remember Hillary Clinton’s book It Takes a Village which was written to address caring for children?  I find this same approach applies to the senior population.  It really does take a group of people, making a concerted and coordinated effort, to assist seniors as they age.  It takes time and careful thought to build a “village” for your parent.  Following are a few ideas to help you get started:

  • Family – Primary:  spouse (if living), brothers and sisters, children, grandchildren, great grandchildren
  • Family – Secondary:  nieces, nephews, cousins
  • Friends: lifelong friends, new acquaintances, neighbors, club associates, church members
  • Health Care Providers:  Primary Care Physician, Specialty Physicians, Physical Therapists
  • Geriatric Care Manager:  Professional (typically nurse or social worker) to provides care advisory/advocacy  service addressing  specific needs of senior
  • Companion:  Paid caregiver to provide services as needed:  cooking, transportation, companionship, assistance with activities of daily living
  • Skilled Care:  Paid clinical care provided by licensed practitioners
    Independent Living or Assisted Living Facility Staff:  Nurses, administrators, social workers, certified nurse assistants

Care assistance and expertise is available from many sources.  Plan your village now - don’t overlook the many ways a support system can be built for your parent.