New Experiment: Monthly Breakfast? Let’s try it! It was lunch, but now it’s breakfast. I’d love to hear your ideas. How about the first Tuesday of each month starting with February 1, 8:30 AM at…..Lucie (at The Colonnade Hotel) 120 Huntington Avenue, Boston, MA 02116. There is fee garage parking but not for super tall cars. Let me know if you are coming, but you can still come if you don’t tell me. No weirdos, please. Must be vaccinated.
This month has sped by and I’m not sure what I have to show for it. There are still some holiday decorations in the house not put away. There is a wreath on my door. The smelly candle is still holiday. I was hoping to start getting up and out of bed like I used to when I drove kids to school (last year). No dice.
Don’t hate me, but my husband has a marriage long habit of bringing me a coffee (from Starbucks or Tatte) and the news paper after he has gone out to survey the neighborhood. I don’t want to disappoint him by not being in place when he returns. It’s like I’m on a big raft. The dog and I won’t get off the bed until he comes in the room. Then, I have this amazing hot coffee (unless he runs into a neighbor and talks for a while) and a paper to read, so that tacks on another hour (cross word). I am writing this while in my raft/bed/couch with my small dog.
You may have noticed I said he brings coffee from Starbucks or Tatte. Are you asking yourself, ‘why don’t they make coffee in their home with a coffee maker? It would be cheaper and more convenient. They even make machines with timers so he wouldn’t have to wait for the coffee to brew’. Yes, it’s all true. You’ll have to ask him. I think he likes to saunter out and see what’s going on in our neighborhood. Fine by me. Still though, I do need to get moving earlier. Something to work on. What are you working on?
Onward!
Did you know that an average nursing home facility runs approximately $30,000.00 a month for a couple? Many people think their insurance, pension, social security, and VA aid will cover the cost. Or Medicare. Or Medicaid. There are some Veterans programs that pay up to $2050 a month if they qualify. That seems like a lot! But not when your costs are as high as 30k a month.
In-home care 24/7 with aides runs about $18,000 (varies by state and type of caregiver) a month which seems like a bargain compared to nursing home care, especially if it is for two people. How does anyone afford this? This week’s Maven, Katherine Vanderhorst, specializes in advising families and protecting them through the aging process.
MAVEN OF THE WEEK:
Katherine Vanderhorst
Katherine Vanderhorst is president and co-founder of C&V Senior Care Specialists, Inc (LINK). She is a board-certified psychiatric nurse with 30+ years of clinical experience in Behavioral Health Care and Alzheimer’s Care and a Certified Care Manager. She has been working in the post-acute care arena, specifically in-Home Care and Home Health, since 1995.
C&V Senior Care Specialist started in 2007 as a “Dementia and Behavioral health training and consulting company for providers in the post-acute care space to meet the needs of the rapidly growing elderly population.” But I am going to focus on the individual client eldercare management arm of her firm since it is what all of us need to think about one way or another.
Katherine and Dr. Amy Craven started the concierge care management arm of their company thinking they would be helping people organize their own future care management plans. However, people do not want to think about aging or plan for their future until something catastrophic happens. As one of her 94-year-old clients said to her recently, “I just realized I’m old.”
New clients usually need immediate help and that is where Katherine’s company comes in.
What a care management company like C&V does first:
They start with a thorough assessment of the individual both physically and mentally.
They assess the environment they live in.
They assess their current insurance and benefits, Veteran’s status, financial resources. Often, people have benefits or resources they do not know they exist, the biggest one that comes to mind are veteran’s benefits.
They assess their goals, both short and long-term.
Concierge care management fills a need to help the families of elders in many different areas. For instance, many clients want to stay in their home but cannot manage the responsibilities alone, or with their spouse, safely. Katherine’s company manages, through a series of relationships, the 24/7 in-home care, physical therapists, house cleaners, elder law attorneys as well as the financial planners to achieve her clients’ goals.
Where to start?
We recommend you start some discussions with your loved ones to help them plan. The discussions are often difficult to have. We need to stress; you are starting the conversation so your loved ones will have their needs met as best they can.
The following are some questions to ask:
Where does your loved one envision themselves as they age?
Do they have critical legal documents in place and updated such as a Durable Power of Attorney, Health Care Proxy, Will or Living trust?
What is their end of life wishes?
Are their funeral expenses prepaid?
What insurance do they have-Medical, supplemental and Long-term Care?
Do they know what various types of long-term care are available and costs? Assisted Living can range $3000-$8000/month, Nursing can range$12,623 for a semiprivate room and $13,535 for a private room (Genworth, 2020)
Does your loved one have an insurance policy? Some have riders -long-term care rider is a living benefit on a life insurance policy that lets you access a portion of the policy's death benefit every month to pay for long-term care expenses.
What are their financial resources?
Have they met with an elder law attorney to discuss planning?
Do they know the difference between Medicare (a federal program that provides health coverage if you are 65+ or under 65 and have a disability, no matter your income) and Medicaid (a state and federal program that provides health coverage if you have a very low income)?
If they can no longer take care of themselves, have they thought about where they would want to live? Or, how?
The following are just a few ideas to discuss over time.
In most states there is a 5–7-year lookback if you apply for Medicaid. (Scary)
There are trusts such as Special Needs that can be set up by an attorney to protect assets for your healthcare and cannot be taken if you need Medicaid.
Look at whose names your assets are in. They can put assets in children’s or grandchildren’s names.
Make sure you have beneficiaries on all checking, savings, and stock accounts.
Also, can be helpful to have updated Power of Attorney on file if you were incapacitated and someone needed to pay your bills.
People often make legal and financial plans but forget the most important thing to plan for is one’s aging. It is never too soon to plan for your future and assist your parents to make choices while they are competent.
SIGNS YOU OR YOUR LOVED ONE MAY NEED HELP
Your loved one is struggling to manage their finances.
You are worried that your loved one is not safe in their home alone.
Your loved one is falling frequently.
Your loved one has multiple medical illnesses that are challenging to deal with.
Your loved one has memory problems-losing things frequently, doesn’t always know the day and time, misses appointments.
You need help in caregiving, you feel burnt out, stressed out and tired.
Your loved one needs a higher level of care or needs to seek out at home care options.
Your loved one wants to stay living at home but needs help.
You have little or no family who can help or live nearby.
If your loved one is experiencing any of these signs, consider contacting an Aging Life Care Manager.
Questions from a small group of WSG readers for Katherine:
What age should we start thinking/planning for our own “elder years”? At least by 50 years old
How long is it safe to stay home with good aid? Many people stay home until the end of their life with good help in place if it can be afforded.
How much does concierge care cost? Our services are charged for an assessment and then an hourly rate billed in 15 min increments. Hourly rates are between $50-$200 / hr. across the US. Physicians who provide Concierge Medicine charge in a membership range from $1,200 to as high as $10,000 per year.
Do you consult with people our age with aging parents? We consult frequently with children as they work to assist their loved ones in the aging process to offer ideas and solutions to their parents.
How much should they be involved in the process? Always try to involve your parents in the process. Sometimes it can be challenging if they are very ill or have Dementia. Empathize with them about how hard it can be to make changes. Ensure them that you want to help them and keep them safe. Try to be as transparent as possible and come from a place of concern. Include other family members. Bring in a 3rd party such as geriatric care manager or attorney when decision making becomes challenging or hits a roadblock.
Things you shouldn’t do? Don’t talk down to your parents.
What to look for when checking an assisted living facility out?
1.What are your staffing ratios during the day and at night?
2. What kind of experience and training does your staff possess? Any specialty training required?
3. Do you have a nurse on staff 24/7?
4. Do you do an initial assessment prior to admission?
5. What different types of services do you offer? What types of living spaces/apartments are available?
6. Do you have any experience with (issues or diagnosis of your care recipient)?
Any big updates/changes in the last couple of years? Telehealth has exploded for seniors. Electronic medical records that patients and families can access. Since the pandemic, staffing and health care worker shortages hit a dangerous level. This added to the challenge of caring for our elderly.
How do other countries handle this? Japan implemented a comprehensive Long-Term Care Insurance, known as one of the most generous and comprehensive health insurance in the world. Government-approved care plans that offer the elderly a choice of different care models, such as living in assisted-care facilities, home care and assistance with grocery shopping.
Wow. This is massively comprehensive. Thank you, Katherine! Questions? Please comment and I will ask Katherine!
A RECIPE YOU WON’T HATE: Lasagna!
I made several lasagnas today. One for us and some friends that came over. One for our neighbors upstairs who brought their new baby home two days ago. And a small one for our daughter. The KEY is the meat sauce (Bolognese) and how good it is (red wine in it…lots). The rest will follow. So. Here you go. I am putting in a link for the whole recipe because I think it makes sense. Though béchamel sauce sounds right, honestly, just use ricotta cheese. No need for the béchamel. It’s fine. Also. I put slices of fresh mozzarella on top with the parmagian cheese. No cook noodles are also a good idea.
Next week, or the week after, Sexy Time.
I have a special Valentine’s interview for you. It’s all about sex. For reals. Dr. Carol Queen is an American author, editor, sociologist and sexologist active in the sex-positive feminism movement. Dr. Queen is a two time Grand Marshal of San Francisco LGBTQ Pride. She is a sex-positive sex educator in the United States.[1] And SO much more.
Please send any questions you may have for Dr. Queen to me and I’ll see what I can do.
xo
K
from a ready
The Kathrine Vanderhorst interview is very timely for all of us . I am 77 now and my friends are anywhere from 50 - 100 . These long term decisions are pertinent to all of us . For me and my older friends it is that frightening Grey space that we try to ignore rather than confront . I do have several friends that have moved into retirement communities and are really enjoying life to the fullest. They are so relieved not to have to deal with day to day house stuff , meals etc. they find great comfort in knowing that help is there if they need it . Of course , they are all so much older than I am . Maybe later , in a few years. But I realize that this head in the sand attitude is very counterproductive. How many times have we just ignored a situation that we didn’t want to deal with only to later on wish that we had just started the conversation. When I finally did talk with several friends who are pretty much in the same place in life , a few were actively planning their next phase in life . Several were wondering about how to start the process . And several are still in avoidance. I can see that those who have made plans and moved ahead with them are happy and very active. They no longer have that cloud hanging over head . They’ve taken the big step and put their fears behind them.
For you younger ladies talking to your parents is a key issue . Realize that it’s really hard for so many people . It’s that sense of loss of control. That feeling of not being relevant any longer or feeling like you’re being put away . Our friends who have done the retirement community thing successfully are , for the most part, optimistic people .. They look at aging as an adventure. New start , new place , some new friends . It’s all about their positive attitude and they’re having a great time in their “ golden years “.
Probably due to my sisters situation , a few years ago I began thinking about down sizing from our large townhouse on Beacon Hill . Maybe look at some retirement communities. I still haven’t done either , but I am thinking about it . I have put together a list that I will share with you As we age we want our lives to be filled with meaning and purpose we want to be active and engaged to feel contentment in our elder years . This is my list so far.
1.Close to family and friends
2.Close to quality medical
3.Walk to activities, shopping , interests , recreation
4.Availability of senior services
5.Clubs , organizations , ability to socialize with others of similar interests
6.Theaters , restaurants
7.Strong local economy , vital neighborhood
8.Where would you be contentment, safe and happy if your spouse was no longer with you
9.Available and appealing housing that is easily managed and affordable.
# 8 and 9 are in many ways the most important. Although all points are worth examining when considering a big life changing move .
That’s it so far , not asking too much .
Jane Elfner