Family inHome Caregiving Blog
At Family inHome Caregiving, we do extensive background checks on our caregivers. Intuition is a big part of the hiring process, but doing multiple background screenings can often turn up surprising information. It was disturbing to read that many states don't require nursing home employees to have a background check, and many don't require an audit of residents' trust funds. This is money left by the resident or their family in an account that can be used to pay bills, buy personal items or be used however the resident wants it to be used. If the person has dementia, Alzheimer's disease or some other debilitating condition, they won't be in the condition to question withdrawals from the accounts and can easily become victims of elder abuse. Twenty states do not require office staff to have background checks, and these are the employees who have easy access and could be pilfering money out of trust funds. One nursing home office worker was convicted earlier this year with making off with $140,000 from residents trust accounts in a nursing home. She had the nerve to buy expensive designer tennis shoes, using the trust fund of a man who had no legs. When hiring a caregiver or placing a loved one in a home, don't be afraid to ask about what kind of liability insurance and bonding they have. You have a right to know. Although California does require background checks on nursing home employees, it does not require trust funds to be audited.
The Securities and Exchange Commission (SEC) has announced that it caught a father and son team who stole $6.5 million from 44 cash-strapped terminally ill patients. The scam artists asked terminally ill patients to buy bonds in joint accounts with them, and when they died they were able to cash them in immediately due to a clause called a survivors option. This money should have gone to their heirs. It's always amazing to me how many people are out there looking to take advantage of people who are in dire straights. We see this happen all the time with victims of Alzheimer's disease and dementia. They are at high risk of financial elder abuse as they slip deeper into the abyss and aren't able to keep track of their money. Make sure that if you hire a caregiver for a loved one, they are bonded, have insurance and have had background checks.
Many people suffer from allergies, and it's often difficult to discern what exactly you are allergic to. For some it's readily apparent as with certain food products, but for others it can just be from various tree pollen, ragweed, etc. that you just can't get away from. Those with severe allergies such as hay fever, which currently have to receive Immunotherapy injections, are getting great news. Two drug companies, Merck and Stallargenes are asking the Food and Drug Administration (FDA) for permission to market pills for hay fever in the U.S. They are already used in Europe and are as effective as the injections. A liquid form will also be available. The New York Times had a story saying that physicians who specialize in the treatment of allergies are afraid of the drugs getting approved because they currently receive much of their revenue from giving the allergy shots. But that's no reason to thwart a new medical treatment which could help millions of people.
The well respected Kiplinger's Retirement Report had an article in their most recent issue that said that the old rule of thumb about saving for retirement can go out the window. A new study found that nest eggs last longer when investors begin their retirement with as little as 20% in stocks, and then slowly shift more money into equities during the next decades. This is the opposite of conventional wisdom that you should be reducing your equity holdings as you get older to stave off risk. Of course, timing is everything. If you retire when we are in a recession, it's probably a good time to start buying equities when everyone else is panicking and selling. The new research says that baby boomers should gradually get out of stocks until they are just 20-40% in equities at retirement, and then start increasing their investment in stocks slowly, perhaps by 1% per year. You should speak with your financial planner about this study, it's definitely controversial.
At Family inHome Caregiving, we stress social interaction, a healthy diet and exercise as much as can be tolerated as being keys to longevity. Many of our clients are in their 90's and are very familiar with this routine. They've have been practicing healthy living their entire life. A recent study found that people who took up exercise at retirement were more than 3x as likely as other healthy seniors to remain healthy as they enjoyed their retirement. Those who continued with the routine for four years were 7x as likely to remain healthy as those who didn’t'. The research project, published in the British Journal of Sports Medicine, found that physical inactivity is the fourth leading risk factor for premature death, causing 3.2 million deaths globally. "This study supports public health initiatives designed to engage older adults in physical activity, even those who are of advanced age, "said Mark Hamer at University College in London (he led the study). I agree. We see many seniors that become lonely and depressed after seeing many friends, and often times their spouse, pass away. This often times leads to inertia, where they no longer want to leave the house. If you know someone in this situation, something as simple as taking them for a walk around the neighborhood can make a world of difference in both their physical and emotional health.
I always encourage my clients to have important legal documents like a power of attorney and a Physician's Order For Life Sustaining Treatment or POLST on hand in case of a medical emergency. You should give copies to friends, family members and your caregivers and also have a sit-down talk with them and explain exactly what your wishes are should you become incapacitated. Despite the fact that people are living longer and longer, the desire to live longer is not diminishing for the general population. The Pew Research Center has been tracking public opinion on the public's view on end-of-life medical treatments and a growing minority of Americans say that doctors should do everything possible to keep their patients alive. Back in 1990, only 15% of those surveyed said that physicians should always do everything possible to save a patient. That rose to 22% by 2005 and 31% by 2013. But not everyone feels this way, which is why you should not only spell this out in a POLST, but go over various scenarios with friends, family and caregivers so they fully understand your wishes. At Family inHome Caregiving, we have a care plan book which stays in the home and has important phone numbers for friends, family and physicians, as well as copies of documents like a POLST. This can come in extremely handy if you have to call for an ambulance and they are not sure what to do. In the Pew study, a majority of those surveyed (57%) told Pew Research that there are at least some situations in which they personally would want medical treatment halted and be allowed to die. 52% said that they would ask their doctors to stop treatment if they had an incurable disease and were totally dependent on someone else for their care. And fully 27% of the population have given no thought at all or not very much thought to how they would like medical professionals to handle their medical treatment at the end of their lives. Even amongst those over 75 years of age the response was just 25%, and 22% of American's aged 75 and older have not written down or talked to anyone about their final wishes. Unfortunately, many people do wait until it's too late or almost too late to relay important information about their final wishes to their friends and family. Make sure you have a living trust, a will, a POLST and power of attorney made out. In addition, I think that it's just as important to express these wishes verbally to those who will have to make tough decisions should you become incapacitated.
Obesity is a big problem in America and can cause numerous health issues including heart disease, stroke, high blood pressure and diabetes. Researchers are constantly looking for a wonder drug, as many people are unwilling to lose weight via exercise and changing their diet. One company, Orexigen Therapeautics, received good news recently. Following a new study with positive results showing that its drug Contrave didn't dramatically increase the risk of a heart attack or other adverse events, the company announced it would submit a new drug application to The Food & Drug Administration (FDA). The FDA had previously rejected a new drug application for Contrave, requesting more information on the drug's cardiovascular risk. Hopefully, this study will be enough. Although there are numerous diet plans out there, pharmaceuticals which help with weight loss are few and far between. "The resubmission will contain an unprecedented amount of cardiovascular outcomes data for an obesity therapeutic, and we are confident these data will support a favorable benefit risk assessment for Contrave," Doug Cole, President of Takeda Pharmaceuticals, which will distribute Contrave in the U.S., told investors. There are high hopes for the drug, which caused 53% of participants to lose 5% or more of their body weight and keep it off for the next twelve months in a previous trial.
Many cases of breast cancer are linked to genetics, something that you are stuck with if it runs in your family. However, researchers are increasingly finding links to other phenomenon including diet and exercise. There have already been a number of studies linking obesity to breast cancer, and now researchers at Duke University believe they may know why. A byproduct of cholesterol has been found to grow tumors in some of the most common forms of breast cancer. This is an important finding because doctors may be able to prescribe statins to overweight women which will have the double whammy of lowering cholesterol, known to cause heart disease, strokes and diabetes, while also potentially preventing breast cancer. It also may cause some women to decide to deal with the issue on their own by having a healthier diet and exercising more frequently. Although the study, which is published in the most recent edition of the Journal Science, is preliminary, obesity has already been linked to causation in a number of other cancers. Therefore, it would seem prudent for doctors to focus on reducing the number of obese patients that they have in order to ward off a number of life threatening diseases.
There was a story I read not too far back about a cat who lived in a nursing home who would literally run from patients who were about to pass away, and the speculation was that she could literally smell death coming on. Many animals do have a keen sense of smell, and it's true that people who are in ill health don't often smell good. A new study being done by George Preti, an organic chemist at Monell Chemical Senses Center, has teamed up with physicists and veterinarians to study various human odors and to answer the question of whether cancer has a distinct smell or not. If it does, this could be a huge breakthrough because cancer isn't often detected until it's too late to do anything about it. The team is studying ovarian cancer because when it's caught early, 92% of patients live for at least five years but when it's caught late less than 30% live five years or more. Unfortunately, ovarian cancer is only detected early in 15% of patients, so it's fatal in the vast majority of people who have it. I hope this team is successful in their studies. At some point they may be able to develop a scanner which could be waved over your body and detect unusual smells which could signal early-stage cancer or other potentially deadly diseases.
It's a known fact that most seniors want to spend their final years living at home and not be institutionalized. For some, this isn't possible due to the high cost, although this is changing as new technology is being developed which can supplement human caregivers in order to monitor someone in their home to make sure they are OK. The technology varies,, but generally it involves a system of cameras and monitoring devices. This allows you, for instance, to make sure that your mother hasn't fallen if the monitor tells you she got up to go to the bathroom a half an hour ago but never went back to bed. There are myriad devices coming to market to monitor seniors, and this will only increase as more baby boomers retire. One which was recently profiled in USA Today costs only $149. Dubbed MyLively, it's a monitoring kit with six small accelerometers which detect movement. One problem we often see with our clients is that they forget to take their medication. However, another company is generating bottle caps which glow when it's time to take your medicine and yet another has designed a chair that can take your vital signs. There is also carpet coming to market with sensors which can detect whether walking patterns are normal and they can even anticipate physical degeneration. Your home may someday be able to watch over your physical health in partnership with your caregivers and your physician. Although human caregivers will still be needed, this could eliminate the need for some seniors to require 24-hour per day caregiving services, which can quickly erode your retirement assets. I look forward to seeing what new medical technology debuts at the Consumer Electronics Show next January in Las Vegas.