Nursing homes are usually at the bottom of people’s list of places for their parents. A workable and little-known alternative is available in many states: adult foster care.
This PBS video about Oregon’s program features a suburban Portland woman, Carmel Durano, who provides 24-hour care in her home for five elderly people, including her mother. Durano has been a good solution for Steve Larrence’s 99-year-old mother. He feels comfortable with Durano and lives in the same neighborhood, so he can walk over anytime to talk to his mother.
“You don’t feel like you’re in an institution. You feel like you’re living with a family,” Larrence said in the video.
Durano is part of a network of more than 1,500 adult foster care programs in Oregon. Many of them care for more than one senior. Durano, a Filipina immigrant, got involved 30 years ago, because she had three young boys at the time and wanted to stay home for them.
Foster care is much cheaper than nursing homes. And, like nursing homes, state Medicaid programs often pay for the at-home caregivers. But though adult foster care is not immune to cases of abuse, Paula Carder, an expert on aging and dementia at Portland State University, said the Oregon program generally delivers “a high level of care.”
State regulations require caregivers to be certified annually, pass background screenings, and submit to surprise home safety checks and interviews with the adults in their care.
This may be at least a partial solution to the growing problem of an aging population. …Learn More
A son uses his elderly mother’s ATM card at casinos and liquor stores or takes her to the bank to withdraw money from her account.
A woman reports that her sister stole thousands of dollars’ worth of jewelry from their mother, who suffers from dementia.
An elderly couple assigns power of attorney to their son, only to watch him sell their house and spend the proceeds he was supposed to use to create a living space in his home for his parents.
News accounts like these are rare. But reports about financial abuse of the elderly are increasing. The problem lurks largely in the shadows, because parents view it as a private family affair and are loathe to file a police report, says Julie Schoen, attorney and deputy director of the National Center on Elder Abuse (NCEA) at the University of Southern California.
“People just don’t want to do that to their loved one,” said Schoen, whose organization refers victims to the National Adult Protective Services Association for help.
Financial exploitation affects at least 5 percent of older Americans. The majority is perpetrated by family members, especially adult children, say researchers. Victims’ average age is 75, and African-Americans, the poor, disabled people, and elderly people living alone are common targets.
The problem is so poorly understood that advocates are raising awareness – Elderly Abuse Awareness Day is June 15 – and encouraging people to act when they suspect an elderly acquaintance, friend, or family member is the victim of financial abuse.
One form of abuse occurs when parents sign a power of attorney allowing a child to take over their financial affairs without reading or understanding the legal document. “Power of attorney is the heartbeat of your estate plan. A lot of people have them done and have no idea it’s in there,” she said. …Learn More
Aging is not, as the cliché goes, for the faint of heart. If a woman makes it to 65, she can expect to live at least 20 more years. Three new books written by or about the elderly provide a wonderful roadmap to aging with grace, introspection, gratitude, and humor.
“Coming of Age: My Journey to the Eighties” by Madeleine May Kunin
The former Vermont governor and ambassador to Switzerland has authored books about politics, feminism, and women as leaders. In her new memoir, she has blossomed into an essayist and poet. Kunin, who is 85, muses about defying “death’s black raven” on her shoulder. The color red is one way to achieve this. She bought a Barcelona Red Prius (easier to find in the parking lot), and then she and her late husband, John, purchased two oversized red armchairs. “I wanted to bring life inside – not leave it outdoors. And the red chairs did exactly that,” she says.
In her poem, “I Loved You When You Did the Dishes,” she writes tenderly of John – first as a robust partner, then as a dependent, and always as “the man of my dreams.” Old age has given her permission to let down her guard, which she did not do as a public figure. Now she discloses private matters like thinning skin and her pain when, as a young legislator in the 1970s, male colleagues didn’t take her seriously. But she invariably looks back on her life with humor. Kunin tells one anecdote about ducking into a men’s bathroom to avoid the long line for the women’s room. A man who recognized her immediately said, “I never thought I’d meet the governor here.”
“Women Rowing North: Navigating Life’s Currents and Flourishing as We Age” by Mary Pipher
Early in her book, Pipher borrows a novelist’s words: “Old age transfigures or fossilizes.” Pipher, who is a psychologist, urges women to aim for transformation or “willing ourselves into a good new place.” The most important thing, she says, is to keep moving along, upriver – memory loss, muscle loss, and stereotypes be damned! Each chapter is a roadmap to that good place: Understanding Ourselves. Making Intentional Choices. Building a Good Day. Creating Community. Anchoring in Gratitude. In the chapter Crafting Resplendent Narratives, she advises readers dealing with difficult situations to “honor our pain and move toward something joyful.” …Learn More
Social Security remains as vital today as it was after its 1935 passage. But advocates for the nation’s most vulnerable retirees have proposed ways to enhance their benefits.
Consider the minimum benefit. Put on the books in the early 1970s, its goal was to prevent poverty among retirees who had worked for decades in low-paying jobs. The benefit’s value has diminished due to a design flaw that rendered it largely ineffective.
A recent policy brief by the Center for Retirement Research analyzed various modest proposals to increase the minimum benefit and improve low-income retirees’ financial security.
This brief was the last in a series on modernizing Social Security. The relatively low cost of these proposals, many of which have bipartisan support, could be offset by benefit reductions for less-vulnerable retirees. The House of Representatives is planning hearings later this year looking into ways benefits might be enhanced.
The following are synopses of the policy problems and proposals discussed in the other briefs and covered in previous blogs: …Learn More
When my grandmother was spirited away by dementia and no longer recognized me, I stopped visiting her in the nursing home.
I didn’t understand this at the time but now think that I just wanted to remember her baking lemon cream pies or waving at me as she rode around on her lawnmower cropping the lot next to her Indiana farmhouse.
I wish I could get another chance and do things better this time. Regret is hard to live with.
Psychologist Ann Kaiser Stearns views the holidays as a precious time of year to make elderly family members feel they are loved and included in the festivities.
“People respond for as long as they live to smiles, to touch, to music, to kindness, to sitting in the sun, to pumpkin pies,” Stearns, a professor of behavioral science, said in an interview.
“We just need to remember that all of that nourishes an elderly person to whatever degree they have impairments,” said Stearns, who also wrote “Redefining Age: A Caregiver’s Guide to Living Your Best Life.”
Stearns encourages people to make an extra effort to connect with a loved one over the holidays and provides some tips:
Be patient. Take the extra time to sit down with your parent, aunt, or uncle and talk to them. Encourage them to reminisce. “Don’t do something if you don’t have the time,” Stearns said.
Be present. If grandma doesn’t remember you or something that happened in the past, do not argue with her or ask, “Why don’t you remember?!” She advised that it’s better to say, “Remember grandma, it’s your granddaughter from Baltimore.” When an elderly person repeats or forgets, connect with them where they are now, even if it means going through the same conversation again.
Stir sweet memories. Stearns said that her friend’s father, a former minister, has Alzheimer’s but the friend brings him to church anyway. When Stearns’ parents were old, they used to sit happily watching the squirrels in their yard while her father smoked cigars. It’s important to repeat rituals that are uplifting and have always brought meaning to their lives. …Learn More
With more Americans today living into their 80s and beyond, the elderly are becoming more vulnerable to slipping into poverty.
To reduce the poverty risk facing the oldest retirees, some policy experts have proposed increasing Social Security benefits for everyone at age 85. Under one common proposal analyzed by the Center for Retirement Research in a new report, the current benefit at this age would increase by 5 percent.
The poverty rate for people over 85 is 12 percent, compared with 8 percent for new retirees. But more elderly people may actually be living on the edge, because the income levels that define poverty for them are so low: less than $11,757 for a single person and less than $14,817 for couples.
One reason the oldest retirees are especially vulnerable is that their medical expenses are rising as their health is deteriorating, yet they’re too old to defray the expense by working. This is occurring at the same time that the value of their employer pensions – if they have one – has been severely eroded by inflation after many years of retirement.
Further, elderly women are more likely to be poor than men, because wives usually outlive their husbands, which triggers a big drop in income that is generally not fully offset by a drop in their expenses.
Limiting the 5 percent benefit increase to the oldest retirees would ease poverty while containing the cost. …Learn More
A 65-year-old woman in Houston can pay $5,300 a year for Medigap’s Plan C policy or she can buy a policy with exactly the same coverage from another insurance company for $1,700 a year.
A 65-year-old Hartford, Connecticut, man can spend anywhere from $2,900 to $7,400 annually for the most popular and comprehensive Medigap policy – Plan F.
The price disparity for Plan A for a 75-year-old man in Manchester, New Hampshire, is also large: anywhere from $1,820 to $6,301.
These are fairly typical of the enormous differences in the premiums that consumers across the country are paying for their Medigap policies.
The price disparities are “extraordinary and unable to be justified purely by the coverage that they’re offering,” said Gavin Magor, director of ratings for Weiss Ratings Inc., a consumer-oriented company that assesses insurance companies’ financial stability.
A nationwide analysis by Weiss shows that the premiums vary widely within each group of plans – Medigap Plans A, B, C through N – despite the fact that the coverage in each group is dictated by the federal government and does not change from one insurer to the next. Every company selling a Plan F policy, for example, must offer exactly the same coverage. (The exceptions are Massachusetts, Wisconsin, and Minnesota, where the states regulate their Medigap plans.)
If two people are buying a Chevrolet Camaro in Houston, “you would not expect one person to pay two or three times more than the other one,” Magor said.
Medigap is an added layer of insurance to supplement Medicare for people over 65. The additional coverage helps them with the copayments, deductibles, skilled nursing, and other charges that Medicare does not pay for.
Weiss supplied the data for this article by comparing Medigap premiums sold in each zip code and separately for men and women and for different age groups. The company based the analysis on premiums at more than 170 insurance companies.
There are a few viable explanations for the disparity in premiums. Urban and rural zip codes in the same state may be priced differently, in part because medical costs tend to be higher in the cities. And some insurers might be able to offer lower premiums, either because they are more efficient or are trying to be more price competitive to gain market share.
But Magor said that none of these explanations can fully account for the enormous price differences within zip codes. Many insurers are overcharging for their Medigap policies, he said.
A spokeswoman for America’s Health Insurance Plans, which represents health insurers, said she could not comment on Weiss’ information without the organization doing its own analysis of the data.
Paying too much for a Medigap plan can have a material impact on a retiree’s life. … Learn More