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Live Life On Your Own Terms

choose the right al optWhat happens if our three-part needs assessment – of physical, psychosocial and mental status – shows that it’s time to move to an assisted living facility?

Then, the question is, which one? And it’s a tough one. As a former executive director of assisted living communities, I know just how confusing, how complex, how segmented, and how seemingly endless the array of senior care assisted living options can be.

Based on this experience in both holistic senior care and the assisted living industry, and knowing your specific needs, we can give you and your family a neutral analysis of your options, complete with each one’s advantages and drawbacks.

But the decision itself is yours, and it needs to be based on your own first-hand observations. Here are some tips for evaluating each option.

who needs assisted livingAccording to the Family Caregiver Alliance there’s a 68 percent probability that a disability will keep people 65 or older from performing at least two Activities of Daily Living (ADLs) during the rest of their lives. These ADLs include bathing, dressing, eating, toileting, oral hygiene, grooming, and walking from place to place.

And according to the National Center for Assisted Living, more than 735,000 Americans live in assisted living settings, which combine homelike living, a social setting, and ADL assistance. In a 2010 CDC national survey, some 70 percent of residents reported needing help with bathing, just under 60 percent with going outside, and about 45 percent with dressing. Yet, almost one-third of respondents to the same survey reported receiving no ADL assistance at all.

So the first question for yourself, a parent or an older family member is, how much assistance, of what kind, is needed. That’s why our holistic senior care management starts with a detailed three-part assessment – with seniors and their families – of physical, psychosocial and mental status. Then you’ll know what kind of care you need and where it’s needed.

healthcare advocate optDoctors and hospitals, even the very best, are neither infallible nor omniscient. Moreover, since they see you only from time to time, none has as intimate and up-to-date knowledge of your own body as you do.

That’s why, to ensure proper care, everybody needs a healthcare advocate. And why the older you are – with more health issues, more different doctors and doctor visits, and more prescriptions– the more you need one.

Your healthcare advocate can be a family member, a friend, a volunteer from your religious congregation, or a social worker. It can be a patient advocate from a hospital or Medicare Advantage Plan (though most are there for you at the time of discharge from a hospital, residential rehab center or skilled nursing facility, rather than continuously). It can be a nonprofit advocacy organization or a professional healthcare advocacy consultant.

clockMedicare Part A covers hospice care for terminally ill patients “with a life expectancy of six months or less” as determined by the patient’s physician. But with a 2011-2016 average of just 2½ months of hospice care, some 1.4 million hospice care beneficiaries in 2016 could have benefitted much more had they signed up sooner.

Why the delay? One reason may be the patients’ and families’ all-too-human tendency to keep hoping against hope that the inevitable won’t happen. They tend to associate hospice care with resignation, with lacking the courage to keep on fighting whatever condition they suffer from. Perhaps some physicians are also uncomfortable talking with patients and their families about end-of-life issues.

medicare checkupThis month marks the start of Medicare's annual open enrollment period. Instead of automatically renewing your current plan, it makes good sense to give it a thorough examination, to make sure it's still fulfilling your needs and that you're not paying for coverage you don't need.

More than your health could be at stake here. 

The average Medicare beneficiary runs up $16,000 in medical costs each year and pays about half of them – $8,000 or  more – out of pocket. And according to consulting firm Goodcare.com, at least 90 percent of Medicare beneficiaries are shelling out for more out-of-pocket medical costs than they need to.

While Medicare Parts A and B cover 80 percent of doctor visit and hospital charges, what they don't cover can be expensive.