For many seniors the equity in their home is their largest single asset, yet it is unavailable to use unless they use a conventional home-equity loan. But a conventional loan really doesn't free up the equity because the money has to be paid back with interest.
A reverse mortgage is a risk-free way of tapping into home equity without creating monthly payments and without requiring the money to be paid back during a person's lifetime. Instead of making payments the cash flow is reversed and the senior receives payments from the bank. Thus the title "reverse mortgage".
Many seniors are finding they can use a reverse mortgage to pay off an existing conventional mortgage, to create money for a down payment for a second home or to pay off debt. Popularity is skyrocketing. Over the last five years the number of reverse mortgages nationwide has tripled. The uses of this untapped wealth are only limited by a person's imagination.
For those seniors who earn low incomes but own a home, a reverse mortgage can allow them to remain in the home by creating extra income. It can also allow for remodeling or repairs and when the time comes to sell, the investment in the home can make it more valuable.
False Beliefs about Reverse Mortgages:
“The lender could take my house.” The homeowner retains full ownership. The Reverse Mortgage is just like any other mortgage; you own the title and the bank holds a lien. You can pay it off anytime you like.
“I can be thrown out of my own home.” Homeowners can stay in the home as long as they live, with no payment requirement.
“I could end up owing more than my house is worth.” The homeowner can never owe more than the value of the home at the time the loan is due.
“My heirs will be against it.” Experience demonstrates heirs are in favor of Reverse Mortgages.
Virtually anyone can qualify. You must be at least 62, own and live in, as a primary residence, a home [1-4 family residence, condominium, co-op, permanent mobile home, or manufactured home] in order to qualify for a reverse mortgage.
There are no income, asset or credit requirements. It is the easiest loan to qualify for.
A reverse mortgage is similar to a conventional mortgage. As an example:
•The bank does not own the home but owns a lien on the property just as with any other mortgage.
•You continue to hold title to the property as with any other mortgage
•The bank has no recourse to demand payment from any family member if there is not enough equity to cover paying off the loan
•There is no penalty to pay off the mortgage early
•When the loan becomes due, you can refinance and keep the house.
The proceeds from a reverse mortgage are tax-free and can be used for any legal purpose you wish:
•daily living expenses
•home repairs and improvements
•medical bills and prescription drugs
•pay-off of existing debts
•education, travel
•long-term care and/or long-term care insurance
•financial and estate tax plans
•gifts and trusts
•to purchase life insurance
•or any other needs you may have.
The amount of reverse mortgage benefit for which you may qualify, will depend on
1.your age at the time you apply for the loan,
2.the reverse mortgage program you choose,
3.the value of your home, current interest rates,
4.and for some products, where you live.
As a general rule, the older you are and the greater your equity, the larger the reverse mortgage benefit will be (up to certain limits, in some cases). The reverse mortgage must pay off any outstanding liens against your property before you can withdraw additional funds.
The loan is not due and payable until the borrower no longer occupies the home as a principal residence (i.e. the borrower sells, moves out permanently or passes away). At that time, the balance of borrowed funds is due and payable, all additional equity in the property belongs to the owners or their beneficiaries. If the heirs want to keep the home with the additional equity, they can refinance with a conventional loan.
There are three reverse mortgage loan products available, the FHA - HECM (Home Equity Conversion Mortgage), Fannie Mae - HomeKeeper®, and the Cash Account programs. Over 90% of all reverse mortgages are HECM contracts.
The costs associated with getting a reverse mortgage are similar to those with a conventional mortgage, such as the origination fee, appraisal and inspection fees, title policy, mortgage insurance and other normal closing costs. With a reverse mortgage, all of these costs will be financed as part of the mortgage prior to your withdrawal of additional funds.
You must participate in an independent Credit Counseling session with an FHA-approved counselor early in the application process for a reverse mortgage. The counselor's job is to educate you about all of your mortgage options. This counseling session is at no cost to the borrower and can be done in person or, more typically, over the telephone. After completing this counseling, you will receive a Counseling Certificate in the mail which must be included as part of the reverse mortgage application.
You can choose 3 options to receive the money from a reverse mortgage:
1) all at once (lump sum);
2) fixed monthly payments (for up to life);
3) a line of credit; or a combination of a line of credit and monthly payments.
The most popular option, chosen by more than 60 percent of borrowers, is the line of credit, which allows you to draw on the loan proceeds at any time. The line of credit also earns interest which in essence is allowing the equity in the home to grow. For example $120,000 in a line of credit earning 5% would be worth almost $200,000 10 years from now.
Keeping money in a reverse mortgage line of credit in most states will not count as an asset for Medicaid eligibility as this would be considered a loan and not a resource for Medicaid spend down. In other words, keeping the money in the line of credit will not disqualify you from becoming Medicaid eligible.
However, transferring the money to an investment or to a bank account would represent an asset and would trigger a spend down requirement and delay eligibility. Please note however that distinguishing between what portion of reverse mortgage proceeds might be counted as a loan and what portion as an asset is not a simple black and white decision. It is best to get an opinion from an elder attorney in your state.
If a senior homeowner chooses to repay any portion of the interest accruing against his borrowed funds, the payment of this interest may be deductible (just as any mortgage interest may be). A reverse mortgage loan will be available to a senior homeowner to draw upon for as long as that person lives in the home. And, in some cases, the lender increases the total amount of the line of credit over time (unlike a traditional Home Equity Line where the credit limit is established at origination). If a senior homeowner stays in the property until he or she dies, his or her estate valuation will be reduced by the amount of the debt.
At the death of the last borrower or the sale of the home, the loan is repaid from equity in the home. Any remaining equity (which is often the case) goes to the heirs.
Almost all reverse mortgages are the HECM loan which is guaranteed by FHA mortgage insurance. If there is not enough equity to cover the loan, the insurance satisfies the loan by paying the deficit. With a HECM loan, the bank will never come after the heirs to satisfy the mortgage obligation.
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Tuesday, December 8, 2009
Monday, November 30, 2009
Hospice Care
It is unfortunate that many people who died in a hospital emergency room or who received heroic treatments to prolong life in a hospital or nursing home may have had the alternative of dying at home in familiar surroundings, with family or other loved ones at their side.
When someone is dying but there really is no hope for recovery, the family often calls 911 and starts a process which can result in great stress and great emotional discomfort. The loved one who is dying ends up in a hospital or nursing home in a strange environment, frightened and confused and tied to tubes and monitoring devices. This is not the ideal way in which to spend one's last hours on earth.
Attending to a dying loved one in the peace and quiet of the home with caring children and grandchildren surrounding the bed can be a spiritual experience for all involved. Hospice can allow this to happen. Memories of a loved one passing in peace can provide great comfort for family members in years to come.
When there is no longer hope for prolonging life, especially when this decision is made months in advance, hospice is a better alternative to other medical intervention.
Hospice is a form of medically supportive care for patients who are terminally ill. It allows for compassion and dignity in the process of dying. A commonly used definition for terminally ill patients is,
"patients who have a progressive, incurable illness that will end in death despite good treatment, and who are sick enough that you would not be surprised if they died within six months." A list of hospice providers can be found at http://www.longtermcarelink.net/a7hospicecare.htm
Hospice care is a valuable service and is generally underused except for terminal cancer patients. Most families wait too long to have their doctor prescribe hospice from Medicare. Many doctors or family don't often consider this care alternative for Alzheimer's, degenerative old age or other debilitating illnesses where a person is going downhill fast. They should.
Hospice involves a team approach using the following providers.
•Family caregivers;
•The patient' s personal physician;
•Hospice physician (or medical director);
•Nurses;
•Home health aides;
•Social workers;
•Clergy or other counselors;
•Trained volunteers; and
•Speech, physical, and occupational therapists, if needed.
The purpose of hospice is the following:
•Manages the patient's pain and symptoms;
•Assists the patient with the emotional and psychosocial and spiritual aspects of dying;
•Provides needed medications, medical supplies, and equipment;
•Coaches the family on how to care for the patient;
•Delivers special services like speech and physical therapy when needed;
•Makes short-term inpatient care available when pain or symptoms become too difficult to manage at home, or the caregiver needs respite time; and
•Provides bereavement care and counseling to surviving family and friends.
A person can receive hospice from Medicare if he or she is
•eligible for Medicare Part A (Hospital Insurance), and
•the doctor and the hospice medical director certify that the person is terminally ill and probably has less than six months to live, and
•the person or a family member signs a statement choosing hospice care instead of routine Medicare covered benefits for the terminal illness, and
•care is received from a Medicare-approved hospice program.
A person may continue to receive regular Medicare benefits from his or her customary doctors for conditions not related to the hospice condition.
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When someone is dying but there really is no hope for recovery, the family often calls 911 and starts a process which can result in great stress and great emotional discomfort. The loved one who is dying ends up in a hospital or nursing home in a strange environment, frightened and confused and tied to tubes and monitoring devices. This is not the ideal way in which to spend one's last hours on earth.
Attending to a dying loved one in the peace and quiet of the home with caring children and grandchildren surrounding the bed can be a spiritual experience for all involved. Hospice can allow this to happen. Memories of a loved one passing in peace can provide great comfort for family members in years to come.
When there is no longer hope for prolonging life, especially when this decision is made months in advance, hospice is a better alternative to other medical intervention.
Hospice is a form of medically supportive care for patients who are terminally ill. It allows for compassion and dignity in the process of dying. A commonly used definition for terminally ill patients is,
"patients who have a progressive, incurable illness that will end in death despite good treatment, and who are sick enough that you would not be surprised if they died within six months." A list of hospice providers can be found at http://www.longtermcarelink.net/a7hospicecare.htm
Hospice care is a valuable service and is generally underused except for terminal cancer patients. Most families wait too long to have their doctor prescribe hospice from Medicare. Many doctors or family don't often consider this care alternative for Alzheimer's, degenerative old age or other debilitating illnesses where a person is going downhill fast. They should.
Hospice involves a team approach using the following providers.
•Family caregivers;
•The patient' s personal physician;
•Hospice physician (or medical director);
•Nurses;
•Home health aides;
•Social workers;
•Clergy or other counselors;
•Trained volunteers; and
•Speech, physical, and occupational therapists, if needed.
The purpose of hospice is the following:
•Manages the patient's pain and symptoms;
•Assists the patient with the emotional and psychosocial and spiritual aspects of dying;
•Provides needed medications, medical supplies, and equipment;
•Coaches the family on how to care for the patient;
•Delivers special services like speech and physical therapy when needed;
•Makes short-term inpatient care available when pain or symptoms become too difficult to manage at home, or the caregiver needs respite time; and
•Provides bereavement care and counseling to surviving family and friends.
A person can receive hospice from Medicare if he or she is
•eligible for Medicare Part A (Hospital Insurance), and
•the doctor and the hospice medical director certify that the person is terminally ill and probably has less than six months to live, and
•the person or a family member signs a statement choosing hospice care instead of routine Medicare covered benefits for the terminal illness, and
•care is received from a Medicare-approved hospice program.
A person may continue to receive regular Medicare benefits from his or her customary doctors for conditions not related to the hospice condition.
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Wednesday, November 11, 2009
Veterans Long Term Care Benefits
The Department of Veterans Affairs provides three types of long term care benefits for veterans.
The first type is benefits provided to veterans who have service-connected disabilities.
These medically necessary services include home care, hospice, respite care, assisted living, domiciliary care, geriatric assessments and nursing home care. In order to receive the services, a veteran must be enrolled in VA's health care system. Veterans with service-connected disabilities have priority for health care enrollment acceptance.
Some of these services may be offered to veterans in the health care system who do not have service-connected disabilities but who may qualify because of low income or because they are receiving pension income from VA. These recipients may have to provide out-of-pocket co-pays or the services may only be available if the regional hospital has funds to cover them.
Currently, veterans desiring to join the health care system may be refused application because their income is too high or they do not qualify under other enrollment criteria. Increased demand in recent years for services and lack of congressional funding have forced VA to allow only certain classes of veterans to join the health care system.
The second type of benefit is state veterans homes.
The Veterans Administration in conjunction with the states helps build and support state veterans homes. Money is provided by the Federal Government to help with construction, and a subsidy of $67.71 a day is provided for each veteran using these nursing homes. These homes are generally available for any veteran and sometimes the nonveteran spouse and are run by the states, often with the help of contract management. There may be waiting lists in some states.
Most state homes offer nursing home care but some may offer assisted living, domiciliary (a form of supported independent living), and adult day care
State veterans homes are not free but are subsidized and the cost could be significantly less than a comparable facility in the private sector. Some of these homes can accept Medicaid payments. A complete list of state veterans homes can be found at http://www.longtermcarelink.net/ref_state_veterans_va_nursing_homes.htm
The third type of benefits for veterans is disability payments.
These include Compensation, Pension, survivors death benefits associated with compensation and Death Pension.
Compensation is designed to award the veteran a certain amount of monthly income to compensate for potential loss of income in the private sector due to a disability or injury or illness incurred in the service. In order to receive compensation a veteran has to have evidence of a service-connected disability. Most veterans who are receiving this benefit were awarded an amount based on a percentage of disability when they left the service.
However, some veterans may have record of being exposed to extreme cold, having an in-service non-disabling injury, having tropical diseases, tuberculosis or other incidents or exposures that at the time may not have caused any disability but years later have resulted in medical problems. In addition, some veterans may be receiving compensation but their condition has worsened and they may qualify for a a higher disability rating. Veterans mentioned above may qualify for a first-time benefit or receive an increase in compensation amount. Applications should be made to see if they can receive an award. There is no income or asset test for compensation and the benefit is nontaxable.
Pension is available to all active-duty veterans who served at least 90 days during a period of war. There is no need to have a service-connected disability to receive pension. To be eligible the applicant must be totally disabled if he or she is younger than 65. Proof of disability is not required for applicants age 65 or over. Apparently, being old is evidence in itself of disability.
The purpose of this benefit is to provide supplemental income to disabled or older veterans who have a low income. If the veterans income exceeds the pension amount then there is no award. However, income can be adjusted for unreimbursed medical expenses and this allows veterans with household income larger than the pension amount to qualify for a monthly benefit.
Compensation and pension claims are submitted on the same form and VA will consider paying either benefit. Generally, for applications associated with the cost of home care, assisted living or nursing home care, the pension benefit is a better option.
All active-duty veterans who served at least 90 days during a period of war are eligible for pension and additional disability allowances -- aid and attendance or housebound allowances. Surviving single spouses of these veterans are also eligible for lesser benefits and for the allowances.
Veterans' service would include World War II, the Korean Conflict, the Vietnam Conflict Period and the Gulf War conflict.
Pension can pay up to $1,800 a month to help offset the costs associated with home care, assisted living, nursing homes and other unreimbursed medical expenses. The amount of payment varies with the type of care, recipient income and the marital status of the recipient. There are income and asset tests to qualify.
VA claims this benefit is only for low income veterans but a quirk in the way the benefit is calculated for recurring medical expenses (long term care costs associated with home care, assisted living or nursing homes) could allow veteran households earning between $2,500 and $5,000 or more a month to qualify.
Estimates are that up to 30% of all Americans over the age of 65 might be eligible for a pension benefit under the right circumstances.
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The first type is benefits provided to veterans who have service-connected disabilities.
These medically necessary services include home care, hospice, respite care, assisted living, domiciliary care, geriatric assessments and nursing home care. In order to receive the services, a veteran must be enrolled in VA's health care system. Veterans with service-connected disabilities have priority for health care enrollment acceptance.
Some of these services may be offered to veterans in the health care system who do not have service-connected disabilities but who may qualify because of low income or because they are receiving pension income from VA. These recipients may have to provide out-of-pocket co-pays or the services may only be available if the regional hospital has funds to cover them.
Currently, veterans desiring to join the health care system may be refused application because their income is too high or they do not qualify under other enrollment criteria. Increased demand in recent years for services and lack of congressional funding have forced VA to allow only certain classes of veterans to join the health care system.
The second type of benefit is state veterans homes.
The Veterans Administration in conjunction with the states helps build and support state veterans homes. Money is provided by the Federal Government to help with construction, and a subsidy of $67.71 a day is provided for each veteran using these nursing homes. These homes are generally available for any veteran and sometimes the nonveteran spouse and are run by the states, often with the help of contract management. There may be waiting lists in some states.
Most state homes offer nursing home care but some may offer assisted living, domiciliary (a form of supported independent living), and adult day care
State veterans homes are not free but are subsidized and the cost could be significantly less than a comparable facility in the private sector. Some of these homes can accept Medicaid payments. A complete list of state veterans homes can be found at http://www.longtermcarelink.net/ref_state_veterans_va_nursing_homes.htm
The third type of benefits for veterans is disability payments.
These include Compensation, Pension, survivors death benefits associated with compensation and Death Pension.
Compensation is designed to award the veteran a certain amount of monthly income to compensate for potential loss of income in the private sector due to a disability or injury or illness incurred in the service. In order to receive compensation a veteran has to have evidence of a service-connected disability. Most veterans who are receiving this benefit were awarded an amount based on a percentage of disability when they left the service.
However, some veterans may have record of being exposed to extreme cold, having an in-service non-disabling injury, having tropical diseases, tuberculosis or other incidents or exposures that at the time may not have caused any disability but years later have resulted in medical problems. In addition, some veterans may be receiving compensation but their condition has worsened and they may qualify for a a higher disability rating. Veterans mentioned above may qualify for a first-time benefit or receive an increase in compensation amount. Applications should be made to see if they can receive an award. There is no income or asset test for compensation and the benefit is nontaxable.
Pension is available to all active-duty veterans who served at least 90 days during a period of war. There is no need to have a service-connected disability to receive pension. To be eligible the applicant must be totally disabled if he or she is younger than 65. Proof of disability is not required for applicants age 65 or over. Apparently, being old is evidence in itself of disability.
The purpose of this benefit is to provide supplemental income to disabled or older veterans who have a low income. If the veterans income exceeds the pension amount then there is no award. However, income can be adjusted for unreimbursed medical expenses and this allows veterans with household income larger than the pension amount to qualify for a monthly benefit.
Compensation and pension claims are submitted on the same form and VA will consider paying either benefit. Generally, for applications associated with the cost of home care, assisted living or nursing home care, the pension benefit is a better option.
All active-duty veterans who served at least 90 days during a period of war are eligible for pension and additional disability allowances -- aid and attendance or housebound allowances. Surviving single spouses of these veterans are also eligible for lesser benefits and for the allowances.
Veterans' service would include World War II, the Korean Conflict, the Vietnam Conflict Period and the Gulf War conflict.
Pension can pay up to $1,800 a month to help offset the costs associated with home care, assisted living, nursing homes and other unreimbursed medical expenses. The amount of payment varies with the type of care, recipient income and the marital status of the recipient. There are income and asset tests to qualify.
VA claims this benefit is only for low income veterans but a quirk in the way the benefit is calculated for recurring medical expenses (long term care costs associated with home care, assisted living or nursing homes) could allow veteran households earning between $2,500 and $5,000 or more a month to qualify.
Estimates are that up to 30% of all Americans over the age of 65 might be eligible for a pension benefit under the right circumstances.
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Wednesday, November 4, 2009
Hidden Government Program Pays the Cost of Home Care
What if 33% of all seniors in this country could receive up to $1,800 a month in additional income from the government to cover their long term care costs? They can! Under the right circumstances, a little-known federal program will pay additional income to cover long term care costs for at least 1/3 of all US senior households. But the provisions of this program are such a well-kept secret that only 4.6% of eligible seniors are actually receiving the benefit. The great news about this program is the government will pay you to hire your family, friends or just about anyone to take care of you. The program is called "VA Pension."
Only about 520,000 people are currently receiving Pension from the Veterans Benefits Administration and these are not all elderly. At the most, this number represents only about 4.6% of the eligible 11,400,000 senior households -- 33% of the US senior population. Based on the incidence of long term care in the elderly, about 22% of eligibles or about 2,500,000 people should be receiving pension. That's roughly five times more persons than are receiving it now.
Most people who have heard about Pension know that it will cover the costs of assisted living and, in some cases, cover nursing home costs as well. But the majority of those receiving long term care in this country are in their homes. Estimates are that approximately 70% to 80% of all long term care is being provided in the home. All of the information available about Pension overlooks the fact that this benefit could be used to pay for home care.
It also comes as a surprise to most people that VA will allow veterans’ households to include the annual cost of paying any person such as family members, friends or hired help for care when calculating the Pension benefit. This annual cost is deducted from household income and used to calculate a lower "countable income" which in turn enables families to receive this disability income from VA. Even though VA claims the benefit is for low income families, because of the deduction for care costs, households earning between $3,000 and $6,000 a month can still qualify for Pension.
This extra income can be a welcome benefit for families struggling to provide eldercare for loved ones at home. Under the right circumstances, this annualized medical expense for the cost of family members, friends or any other person providing care, could create an additional household income of up to $976 a month for a single surviving spouse of a veteran, up to $1,520 a month for a single veteran or up to $1,800 a month for a couple.
If the disabled care recipient has been rated "housebound" or in need of "aid and attendance" by VA, all fees paid to an in-home attendant will be allowed as long as the attendant provides some medical or nursing services for the disabled person. The attendant does not have to be a licensed health professional. There is also no need to distinguish between medical and nonmedical services -- all are deductible.
It is our understanding that a nonlicensed in-home attendant could be just about anyone receiving pay for providing services. This might be members of the family, friends, or someone hired to live in the home. Examples of medical or nursing services would be help with activities of daily living such as dressing, bathing, toileting, ambulating, feeding, diapering and so on. Other services might include medication reminders or supervision necessary to provide a protective environment for the care recipient -- in the case of dementia or Alzheimer's.
For a disabled person who has been rated, a family member will be considered an in-home attendant, but that family member has to be paid for services duly rendered. There is potential for fraud here where a family member may move into the home and ostensibly receive payment as a caregiver but not actually provide the level of care paid for. Documentation for this care must be provided to VA, and it is reasonable for VA to question whether the services being purchased from a family member living in the household are legitimate. Such arrangements should be extensively documented and completely arm's-length.
The care arrangements and payment for home care must be made prior to application and there must be evidence that this care is needed on an ongoing and regular basis. We recommend a formal care contract and weekly invoice billing for services. Money must exchange hands and there must be evidence of this. All of this documentation must be provided as proof to VA when making application for the pension benefit. Costs for these services must be unreimbursed; meaning these costs are not paid by insurance, by contributions from the family or from other sources.
The National Care Planning Council also has a book to help people understand how to obtain this benefit. The book is available to order online at http://www.longtermcarelink.net/a16veterans_books.htm
Information for this article came from the website -- www.veteransaidbenefit.org. This website is not sponsored by the government but the site is currently the only complete source for information on the Pension benefit other than VA.
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Only about 520,000 people are currently receiving Pension from the Veterans Benefits Administration and these are not all elderly. At the most, this number represents only about 4.6% of the eligible 11,400,000 senior households -- 33% of the US senior population. Based on the incidence of long term care in the elderly, about 22% of eligibles or about 2,500,000 people should be receiving pension. That's roughly five times more persons than are receiving it now.
Most people who have heard about Pension know that it will cover the costs of assisted living and, in some cases, cover nursing home costs as well. But the majority of those receiving long term care in this country are in their homes. Estimates are that approximately 70% to 80% of all long term care is being provided in the home. All of the information available about Pension overlooks the fact that this benefit could be used to pay for home care.
It also comes as a surprise to most people that VA will allow veterans’ households to include the annual cost of paying any person such as family members, friends or hired help for care when calculating the Pension benefit. This annual cost is deducted from household income and used to calculate a lower "countable income" which in turn enables families to receive this disability income from VA. Even though VA claims the benefit is for low income families, because of the deduction for care costs, households earning between $3,000 and $6,000 a month can still qualify for Pension.
This extra income can be a welcome benefit for families struggling to provide eldercare for loved ones at home. Under the right circumstances, this annualized medical expense for the cost of family members, friends or any other person providing care, could create an additional household income of up to $976 a month for a single surviving spouse of a veteran, up to $1,520 a month for a single veteran or up to $1,800 a month for a couple.
If the disabled care recipient has been rated "housebound" or in need of "aid and attendance" by VA, all fees paid to an in-home attendant will be allowed as long as the attendant provides some medical or nursing services for the disabled person. The attendant does not have to be a licensed health professional. There is also no need to distinguish between medical and nonmedical services -- all are deductible.
It is our understanding that a nonlicensed in-home attendant could be just about anyone receiving pay for providing services. This might be members of the family, friends, or someone hired to live in the home. Examples of medical or nursing services would be help with activities of daily living such as dressing, bathing, toileting, ambulating, feeding, diapering and so on. Other services might include medication reminders or supervision necessary to provide a protective environment for the care recipient -- in the case of dementia or Alzheimer's.
For a disabled person who has been rated, a family member will be considered an in-home attendant, but that family member has to be paid for services duly rendered. There is potential for fraud here where a family member may move into the home and ostensibly receive payment as a caregiver but not actually provide the level of care paid for. Documentation for this care must be provided to VA, and it is reasonable for VA to question whether the services being purchased from a family member living in the household are legitimate. Such arrangements should be extensively documented and completely arm's-length.
The care arrangements and payment for home care must be made prior to application and there must be evidence that this care is needed on an ongoing and regular basis. We recommend a formal care contract and weekly invoice billing for services. Money must exchange hands and there must be evidence of this. All of this documentation must be provided as proof to VA when making application for the pension benefit. Costs for these services must be unreimbursed; meaning these costs are not paid by insurance, by contributions from the family or from other sources.
The National Care Planning Council also has a book to help people understand how to obtain this benefit. The book is available to order online at http://www.longtermcarelink.net/a16veterans_books.htm
Information for this article came from the website -- www.veteransaidbenefit.org. This website is not sponsored by the government but the site is currently the only complete source for information on the Pension benefit other than VA.
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http://www.mireverse.com/
Friday, October 30, 2009
The 4 Steps of Long Term Care Planning
This article is a synopsis of the National Care Planning Council's new book "The 4 steps of Long Term Care Planning." To learn more about this book and to obtain a copy, please go to the following link: www.4stepsbook.com
The Importance of Planning for Eldercare
According to some sources, 60% of us will need long term care sometime during our lives. It is important for all of us to prepare for that day when we will need to help loved ones with care or we will need long term care for ourselves.
We may prepare financially for unexpected disasters by covering our homes, automobiles and health with insurance policies. But no other life event can be as devastating to an elderly person’s lifestyle, finances and security as needing long term care. It drastically alters or completely eliminates the three principal retirement dreams of elderly Americans:
1. Remaining independent in the home without intervention from others
2. Maintaining good health and receiving adequate health care
3. Having enough money for everyday needs and not outliving assets and income
Yet, it is our experience that the majority of the American public does not plan for the devastating crisis of needing eldercare. This lack of planning also has an adverse effect on the older person's family, with sacrifices made in time, money, family lifestyles and even affecting the family’s or caregiver’s medical and emotional health.
Because of changing demographics and potential changes in government funding, the current generation -- more-than-ever -- needs to plan for long term care before the elder years are upon them.
What Is Long Term Care?
The need for long term care arises when an individual requires, from someone else, assistance with medical care, daily living activities, comfort, supervision or advice. This need for care may be caused by an accident, disease process, or frailty. Such conditions may require help with the ability to move about, dress, bathe, eat, use a toilet, medicate, and avoid incontinence.
Also care may be needed to help the disabled person with household cleaning, preparing meals, transportation, shopping, paying bills, visiting the doctor and answering the phone. Oftentimes, long term care in the form of supervision or confinement is needed due to cognitive impairment from stroke, mental retardation, depression, dementia, Alzheimer's, Parkinson's Disease and so on. Most long term care is provided at home by family members.
What Is Long Term Care or Eldercare Planning?
For seniors, the terms "long term care" and "eldercare" are synonymous. For younger people, "long term care" is the more appropriate phrase.
For the uninformed family member, eldercare or long term care might appear to be a very straightforward and easy-to-understand process. Unfortunately, the reality is that long term care is very complicated and finding care systems and providers is a frustrating and time-consuming process. There is no one single source to help caregivers find services or solve problems with a simple phone call or a single community contact. For this reason, planning for care requires a great deal of prior knowledge in order to avoid operating in a crisis mode trying to find help when the need for care suddenly arises.
However, knowledge of long term care systems is not enough. Because it can happen suddenly, at any time, you must take action now to prepare for the day when you will need to deal with eldercare for your loved ones or for yourself. This action involves
•Determining the care settings and services you or a loved one most likely would want.
•Providing funding for paying the cost of care, especially when government support programs are lacking or require sacrifice of assets.
•Completing a survey to determine necessary financial and legal arrangements to be made.
•Completing a written long term care planning document to provide instructions to caregivers and to your care coordinator in advance of needing eldercare.
•Assigning a care coordinator and determining the role of other family members, friends or advisers involved in caregiving.
•Holding a planning meeting and drawing up a written agreement for involvement between all those who are willing to participate in future caregiving for you or a loved one.
We have defined four crucial steps necessary in this process for long term care planning. These four steps will be described below. The four steps are based on the following four concepts:
1. Knowledge and preparation are the keys to success.
2. Having funds to pay for care greatly expands the choices for care settings and providers.
3. Using professional help relieves stress, reduces conflict, and saves time and money.
4. Success is assured through a written plan accepted by all parties involved.
STEP 1-Understanding the Nature of Care, Care Settings, and Government Programs (Knowledge and preparation are the keys to success.)
This step requires an understanding of 12 different living arrangements and four different settings under which care is provided. In addition, understanding the provisions and limitations of government programs is essential because the public generally has a misconception that the government will step in and provide care when the time is needed.
Government programs are limited and according research by the National Care Planning Council (www.longtermcarelink.net), only 16% of all long term care services are provided by government programs. The other 84% is provided free of charge by family members, friends, charity, church groups or volunteers or paid for by private funds.
Our new book goes into great detail on step 1 and provides a comprehensive single-source reference for understanding the issues above and how long term care systems fit in with your personal long term care plan.
STEP 2-Funding the Cost of Long Term Care
(Having funds to pay for care greatly expands the choices for care settings and providers.)
Much emphasis is being placed on purchasing long term care insurance or arranging for reverse mortgages in order to fund the cost of care. These are two excellent tools for providing funding but in reality, this approach for planning is not working that well.
After 30 years of being touted as the ultimate solution, less than 2% of the American public and only 9% of seniors own long-term care insurance policies and using reverse mortgages may be a good strategy but in practice, few seniors are using them to pay for care. Our new book definitely covers these two funding options but also addresses at least 30 other strategies that can be used when trying to provide funds to pay the cost of long term care.
STEP 3-Using Long Term Care Professionals
(Using professional help relieves stress, reduces conflict, and saves time and money.)
Long term care services are complicated and provider contacts are fragmented throughout the community. For the majority of Americans, eldercare becomes a frustrating do-it-yourself process. This approach is unnecessary. Using care professionals is the most cost effective and efficient way to provide help for a loved one.
Those people who need help with long term care and use the services of professionals often find they save money over doing it themselves. They also reduce their stress and they free up a considerable amount of their personal time. Another benefit with using professional help, such as a care manager, elder law attorney or mediator, is to help you alleviate or avoid family conflicts that often arise as a result of caregiving.
Hiring professional advisers or providers to help with long term care is no different than using professionals to help with other complex issues such as car repairs, dealing with taxes or dealing with legal problems With their education and training, long term care professionals also bring experience that only comes from dealing with countless hands-on, caregiving challenges.
In much the same way that a three legged stool needs all three legs to be useful, the care planning approach needs at least three key entities in order to be successful. It needs YOU, LONG TERM CARE PROFESSIONALS, and GOVERNMENT LONG TERM CARE PROGRAMS. Our new book describes this team planning approach in more detail and outlines 13 vital professional services necessary for a successful long term care plan.
STEP 4-Creating a Personal Care Plan and Choosing a Care Coordinator
(Success is assured through a written plan; accepted by all parties involved.)
The first three steps in the planning process are designed to give you a wealth of information about long term care. It is important for you to have an understanding of care systems and the resources you can turn to when the need arises. However, knowledge of long term care systems is not enough. You must take some tangible action now to prepare for the day when you will need to deal with eldercare for your loved ones or for yourself.
The final fourth step in the planning process will help you make a care plan. If you follow our instructions and prepare a written plan for you or a loved one, the challenge of dealing with long term care will unfold for you in a more manageable manner. You will experience less stress, have fewer costs, require less time committed and have fewer family conflicts.
Our book is designed as a self-contained reference for long term care services and advisers. The book also becomes your written care plan since it contains your personal document locator, your personal survey, your written care plan with instructions and a written care planning agreement between all parties involved. By including all of the necessary information, documentation and instructions under one cover, the book becomes a single-source, valuable resource used by family members, caregivers and the care coordinator for carrying out the plan. The book also introduces the unique concepts of assigning someone as a care coordinator, who is not a caregiver, and organizing a meeting and completing a written agreement between family members or others who are involved in the care.
--------------------------------------------------------------------------------
This article is a synopsis of the National Care Planning Council's new book "The 4 steps of Long Term Care Planning." To learn more about this book and to obtain a copy, please go to the following link: http://www.4stepsbook.com/
http://www.reversemortgageloans-rates.com/
The Importance of Planning for Eldercare
According to some sources, 60% of us will need long term care sometime during our lives. It is important for all of us to prepare for that day when we will need to help loved ones with care or we will need long term care for ourselves.
We may prepare financially for unexpected disasters by covering our homes, automobiles and health with insurance policies. But no other life event can be as devastating to an elderly person’s lifestyle, finances and security as needing long term care. It drastically alters or completely eliminates the three principal retirement dreams of elderly Americans:
1. Remaining independent in the home without intervention from others
2. Maintaining good health and receiving adequate health care
3. Having enough money for everyday needs and not outliving assets and income
Yet, it is our experience that the majority of the American public does not plan for the devastating crisis of needing eldercare. This lack of planning also has an adverse effect on the older person's family, with sacrifices made in time, money, family lifestyles and even affecting the family’s or caregiver’s medical and emotional health.
Because of changing demographics and potential changes in government funding, the current generation -- more-than-ever -- needs to plan for long term care before the elder years are upon them.
What Is Long Term Care?
The need for long term care arises when an individual requires, from someone else, assistance with medical care, daily living activities, comfort, supervision or advice. This need for care may be caused by an accident, disease process, or frailty. Such conditions may require help with the ability to move about, dress, bathe, eat, use a toilet, medicate, and avoid incontinence.
Also care may be needed to help the disabled person with household cleaning, preparing meals, transportation, shopping, paying bills, visiting the doctor and answering the phone. Oftentimes, long term care in the form of supervision or confinement is needed due to cognitive impairment from stroke, mental retardation, depression, dementia, Alzheimer's, Parkinson's Disease and so on. Most long term care is provided at home by family members.
What Is Long Term Care or Eldercare Planning?
For seniors, the terms "long term care" and "eldercare" are synonymous. For younger people, "long term care" is the more appropriate phrase.
For the uninformed family member, eldercare or long term care might appear to be a very straightforward and easy-to-understand process. Unfortunately, the reality is that long term care is very complicated and finding care systems and providers is a frustrating and time-consuming process. There is no one single source to help caregivers find services or solve problems with a simple phone call or a single community contact. For this reason, planning for care requires a great deal of prior knowledge in order to avoid operating in a crisis mode trying to find help when the need for care suddenly arises.
However, knowledge of long term care systems is not enough. Because it can happen suddenly, at any time, you must take action now to prepare for the day when you will need to deal with eldercare for your loved ones or for yourself. This action involves
•Determining the care settings and services you or a loved one most likely would want.
•Providing funding for paying the cost of care, especially when government support programs are lacking or require sacrifice of assets.
•Completing a survey to determine necessary financial and legal arrangements to be made.
•Completing a written long term care planning document to provide instructions to caregivers and to your care coordinator in advance of needing eldercare.
•Assigning a care coordinator and determining the role of other family members, friends or advisers involved in caregiving.
•Holding a planning meeting and drawing up a written agreement for involvement between all those who are willing to participate in future caregiving for you or a loved one.
We have defined four crucial steps necessary in this process for long term care planning. These four steps will be described below. The four steps are based on the following four concepts:
1. Knowledge and preparation are the keys to success.
2. Having funds to pay for care greatly expands the choices for care settings and providers.
3. Using professional help relieves stress, reduces conflict, and saves time and money.
4. Success is assured through a written plan accepted by all parties involved.
STEP 1-Understanding the Nature of Care, Care Settings, and Government Programs (Knowledge and preparation are the keys to success.)
This step requires an understanding of 12 different living arrangements and four different settings under which care is provided. In addition, understanding the provisions and limitations of government programs is essential because the public generally has a misconception that the government will step in and provide care when the time is needed.
Government programs are limited and according research by the National Care Planning Council (www.longtermcarelink.net), only 16% of all long term care services are provided by government programs. The other 84% is provided free of charge by family members, friends, charity, church groups or volunteers or paid for by private funds.
Our new book goes into great detail on step 1 and provides a comprehensive single-source reference for understanding the issues above and how long term care systems fit in with your personal long term care plan.
STEP 2-Funding the Cost of Long Term Care
(Having funds to pay for care greatly expands the choices for care settings and providers.)
Much emphasis is being placed on purchasing long term care insurance or arranging for reverse mortgages in order to fund the cost of care. These are two excellent tools for providing funding but in reality, this approach for planning is not working that well.
After 30 years of being touted as the ultimate solution, less than 2% of the American public and only 9% of seniors own long-term care insurance policies and using reverse mortgages may be a good strategy but in practice, few seniors are using them to pay for care. Our new book definitely covers these two funding options but also addresses at least 30 other strategies that can be used when trying to provide funds to pay the cost of long term care.
STEP 3-Using Long Term Care Professionals
(Using professional help relieves stress, reduces conflict, and saves time and money.)
Long term care services are complicated and provider contacts are fragmented throughout the community. For the majority of Americans, eldercare becomes a frustrating do-it-yourself process. This approach is unnecessary. Using care professionals is the most cost effective and efficient way to provide help for a loved one.
Those people who need help with long term care and use the services of professionals often find they save money over doing it themselves. They also reduce their stress and they free up a considerable amount of their personal time. Another benefit with using professional help, such as a care manager, elder law attorney or mediator, is to help you alleviate or avoid family conflicts that often arise as a result of caregiving.
Hiring professional advisers or providers to help with long term care is no different than using professionals to help with other complex issues such as car repairs, dealing with taxes or dealing with legal problems With their education and training, long term care professionals also bring experience that only comes from dealing with countless hands-on, caregiving challenges.
In much the same way that a three legged stool needs all three legs to be useful, the care planning approach needs at least three key entities in order to be successful. It needs YOU, LONG TERM CARE PROFESSIONALS, and GOVERNMENT LONG TERM CARE PROGRAMS. Our new book describes this team planning approach in more detail and outlines 13 vital professional services necessary for a successful long term care plan.
STEP 4-Creating a Personal Care Plan and Choosing a Care Coordinator
(Success is assured through a written plan; accepted by all parties involved.)
The first three steps in the planning process are designed to give you a wealth of information about long term care. It is important for you to have an understanding of care systems and the resources you can turn to when the need arises. However, knowledge of long term care systems is not enough. You must take some tangible action now to prepare for the day when you will need to deal with eldercare for your loved ones or for yourself.
The final fourth step in the planning process will help you make a care plan. If you follow our instructions and prepare a written plan for you or a loved one, the challenge of dealing with long term care will unfold for you in a more manageable manner. You will experience less stress, have fewer costs, require less time committed and have fewer family conflicts.
Our book is designed as a self-contained reference for long term care services and advisers. The book also becomes your written care plan since it contains your personal document locator, your personal survey, your written care plan with instructions and a written care planning agreement between all parties involved. By including all of the necessary information, documentation and instructions under one cover, the book becomes a single-source, valuable resource used by family members, caregivers and the care coordinator for carrying out the plan. The book also introduces the unique concepts of assigning someone as a care coordinator, who is not a caregiver, and organizing a meeting and completing a written agreement between family members or others who are involved in the care.
--------------------------------------------------------------------------------
This article is a synopsis of the National Care Planning Council's new book "The 4 steps of Long Term Care Planning." To learn more about this book and to obtain a copy, please go to the following link: http://www.4stepsbook.com/
http://www.reversemortgageloans-rates.com/
Thursday, October 29, 2009
Strategies to Reduce Caregiver Stress
THE EFFECTS OF CHRONIC STRESS
Last month, we discussed how chronic stress can be dangerous to the life and health of caregivers. But it isn't just just caregivers who experience chronic stress. The following information and advice can apply to anyone who experiences constant stress over many years. Last month's article can be found at http://www.longtermcarelink.net/article-2007-12-11.htm.
Over the years, scientists have devised a simple blood test to measure stress. They measure the level of IL-6 (Interleuken 6), one of the immune system proteins produced by the stress response. If a person is experiencing stress, his IL-6 levels are high. This doesn't mean, however, that high levels of IL-6 can't occur in the absence of stress. A heavy workout can cause muscles to produce IL-6, but eventually levels return to normal after exercise ceases. It is thought the IL-6 directs the immune system to repair damaged, overtaxed muscle fibers. Fat cells also produce IL-6, so obese people sustain high levels in their blood. And chronic depression results in long-standing high levels of IL-6.
Sustained high levels of IL-6 can be dangerous, especially in adults age 50 and older, who seem to lack the ability to clear the stress response chemicals as quickly as younger people. For older adults, a constant initiation of the stress response --so-called chronic stress-- impairs the immune system and results in early aging, development of debilitating disease and early death. In this altered state, the body maintains high, potentially harmful levels of IL-6.
Prolonged high levels of IL-6 and the accompanying hormones and immune proteins have been linked to: cardiovascular disease, type II diabetes, frequent viral infections, intestinal, stomach and colon disorders, osteoporosis, periodontal disease, various cancers and auto immune disorders such as lupus, rheumatoid arthritis and multiple sclerosis. Alzheimer's, dementia, nerve damage and mental problems are also linked to high IL-6. Wounds heal slower, vaccinations are less likely to take and recovery from infectious disease is impaired. People who have depression also have high levels of IL-6. Depression in caregivers is about 8 times higher than the non-cargiving population.
LIFESTYLE CHANGES TO REDUCE STRESS.
Exercise
Exercise is a powerful and effective way to fight stress. It is recommended you do about 30 minutes of moderate exercise at least 3 days a week. Here are a few reasons why exercise works.
•Distraction--Exercise provides time away from the stresses of the day.
•Endorphins--Endorphins are opiate-like chemicals that the body produces naturally during periods of stress or physical exertion to relieve pain. Some evidence suggests that they may be involved in the regulation of mood.
•Neurotransmitters--During exercise, the body releases higher levels of dopamine. These hormones improve the thought process by facilitating transfer of information between neurons.
•Self-esteem--Exercise can be a gratifying and fulfilling activity for people. The act of doing something good for self can promote self-esteem.
•Reduces IL-6--Although muscles temporarily produce IL-6 during heavy workouts, exercise tends to lower levels between workouts.
Do a better job of managing time
In our modern world, one of the most prevalent threats to our well-being is the improper use of time. Not meeting deadlines may cost us a promotion or our career. Failure to make appointments or to meet obligations threatens our self-image or social standing. These and many more time-related threats cause stress. Finding help with managing your time would probably go a long way to relieving your stress.
Develop a support group and maintain social contacts
Participating in a support group can help manage stress. Sharing coping strategies in a group setting lets you help others while helping yourself. It may also help you to realize that some problems have no solutions and that accepting the situation is reality. Social support has a huge impact on reducing stress. Many studies show that social support decreases the stress response hormones in our bodies. In his book, Love and Survival (Harper Perennial, 1998) Dr. Dean Ornish notes that people who have close relationships and a strong sense of connection and community enjoy better health and live longer than those who live in isolation or alienation. People who suffer alone, suffer a lot.
Get adequate sleep
The catch-22 with sleep is that if you are over-stressed, you are likely to experience a disturbed sleeping pattern, and if you are experiencing a disturbed sleeping pattern, you are likely to become over-stressed! Research also shows that abnormal sleep increases levels of IL-6 while normal sleep decreases IL-6.
Sleep isn't a luxury; it's a necessity. Sleep restores the body and mind and helps us maintain our mental and physical health. Studies have shown that people who get seven to eight hours of sleep each night enjoy better health and live longer than people who get less sleep. According to the National Institutes of Health, each year approximately 60 million Americans experience frequent insomnia, the inability to get adequate sleep.
To ensure that you get enough sleep, try some of the following suggestions:
•Develop a sleep schedule and stick to it. Try to go to bed at the same time each night. Wake up at the same time, too. Avoid sleeping in on weekends; sleeping in will reset your body clock, making it harder to wake up on time on Monday.
•Get 30 or more minutes of physical activity each day. Avoid working out during the three hours before bedtime. Working out close to bedtime will energize you and may interfere with your sleep.
•Avoid caffeine, nicotine, and alcohol. These substances rob you of quality sleep. Switch to decaf or herbal tea. Quit smoking. An alcoholic beverage (a "night cap") before bed may make you drowsy but it actually deprives you of deep, restorative sleep.
•Engage in relaxing activities before bed. Think of it as "wind down" time. Read a book. Soak in a hot tub. Avoid doing physically or mentally stimulating activities such as vigorous housecleaning or intense office work close to bedtime.
•Leave your troubles outside the bedroom door. Make your bedroom a worry-free zone. If you start to ruminate about problems when you are in bed, try relaxation techniques such as deep breathing or visualization (visualize that you are in a warm, breezy, tropical place, with the sun streaming down on you, nothing but sand, surf, and coconut trees for miles...).
•Create a cozy sleep environment: wear comfortable pajamas, make the temperature of the room comfortable for you, darken the room, use soft, comfortable bedding that enhances your sleep experience. If your bed is too hard or lumpy or soft, invest in a new one. If noise is an issue, try to get at the root of the problem: ask your snoring partner to seek evaluation and treatment, ask your neighbors to be quieter, etc.
Pursue diversions, hobbies and relaxing activities
Another simple way to reduce stress is to distract yourself -- go to a movie, play a sport, immerse yourself in a hobby, listen to some favorite music or take a walk. It cannot be emphasized enough how important it is as a caregiver you spend some quality time alone every week, doing exactly what it is you like to do.
Try taking anti-depressants and anti-anxiety medications
Dr. Kiecolt-Glaser points out that anti-depressants lower IL-6 levels in chronically depressed patients, so they might be useful. She also said there have been suggestions that cholesterol-lowering statins might reduce IL-6, because they seem to reduce inflammation.
REDUCE STRESS THROUGH PROPER NUTRITION
Being overweight (eating too much)
Many people react to stress by eating. Eating too much for a long period causes obesity. This causes your heart and lungs to work harder, overloads your organs and reduces stamina. Studies show that fat cells excrete IL-6 and that overweight people have high levels of IL-6 in their blood. This in turn leads to the IL-6-associated illnesses such as heart disease, immune disorders and diabetes.
Not eating properly
Some people react to stress and stress-induced depression by not eating or eating poorly. If you eat a good, well-balanced diet, your body will be receiving all the nutrients it requires to function properly. On the other hand, if you are eating an unbalanced diet or not eating enough you may be stressing your body and contributing to stress-related complications by depriving yourself of essential nutrients.
Coffee, tea, caffeine soft drinks and chocolate
Caffeine is a stimulant. One of the reasons you probably use it is to raise your level of activity. This chemical actually enhances the stress response and thus increases your existing stress. Small quantities probably do little harm but large quantities over a long period produce excessive stress and lead to many of the physical ailments attributed to chronic stress. Too much caffeine can be dangerous. If you are drinking many cups of caffeine products a day, then you may find you can reduce a lot of stress and save your health by switching to caffeine-free products for a portion of your daily intake.
Alcohol
Some people react to stress by imbibing in alcohol. In small amounts, spirits may help you relax. In larger amounts alcohol may increase stress as it disrupts sleep. Over the long-term, alcohol will damage your body. Alcohol is also a depressant. If you're prone to depression, alcohol will only make it worse. Studies show that depressed people have eight times the level of IL-6 as compared to the general population. As we have seen, high, prolonged levels of IL-6 are a marker for debilitating illness and early death.
Tobacco
In the short-term tobacco use seems to relax people but the toxic effects of nicotine raise the heart rate and enhance the stress response. If you smoke, try taking your pulse before and after a cigarette, and notice the difference. After the initial period of giving up smoking, most ex-smokers report feeling much more calm.
Sugar and refined flour
Sugar can be a stimulant for people experiencing stress and stress-induced depression. Sugar-rich foods (the starch in refined flour is also a form of sugar) can raise your energy level in the short-term. The problem is your body copes with high levels of sugar by secreting large amounts of insulin, which in turn, quickly reduces the excess amount of sugar in your blood stream often causing blood sugar levels to swing too low.
These up and down spikes in blood sugar can cause agitation, mood swings, irritability and fatigue, which in turn can contribute to the creation of additional stress. The ups and downs of sugar spikes also contribute to depression. And of course, excess sugar is readily converted to body fat thus causing obesity. Consuming sugar in the form of complex carbohydrates--whole grains, fruits, vegetables and tubers--forces the digestive tract to release blood sugar more slowly and keeps insulin and blood sugar levels more normal. Avoid fruit drinks, sugar drinks, candy, pastas, white bread and pastries.
Nutritional supplements
There are thousands of supplement suppliers and scores of books that claim success with managing stress by using herbs, herbal extracts or synthesized biochemicals. These compounds often come with the claim of enhancing mood or strengthening the immune system. Since there are so many different competing claims, you must decide for yourself which supplements help and which don't.
CONTROLLING STRESS WITH MIND AND BODY CALMING TECHNIQUES.
Music therapy
Listening to music does wonders to alleviate stress. Choosing what will work for any individual is difficult; most people will choose something they 'like' instead of what might be beneficial. In doing extensive research on what any given piece of music produces as a physiological response, many unexpected things were found. Many of the so-called Meditation and Relaxation recordings actually produce adverse EEG patterns in the brain--just as bad as Hard Rock and Heavy Metal. The most profound finding: Any music performed live and even at moderately loud volumes even if it is somewhat discordant has a very a beneficial response.
Laughter therapy
Numerous studies show that laughter has the uncanny ability to wipe out stress. Here are some suggestions for caregivers:
•Look up jokes on the internet.
•Try to see the humor in being a caregiver.
•Write on a card "Have you laughed with your care-receiver today?" and place it in a conspicuous place in the bathroom or kitchen.
•Read funny books or jokes, listen to funny tapes or watch humorous movies or videos that make you laugh.
•Share something humorous with your care-receiver, a friend, or relative.
•Attend social groups where there is a lot of comeraderie, joy and fun.
•Be aware of how often you smile; it takes fewer muscles to smile than to frown.
•If you find that you are feeling hopeless, and humor or laughter is not affording you the up-lift you want. contact a counselor. And remember, laughter is the best medicine. Try it, you'll like it!
Laughter clubs
There is no medicine like laughter therapy. After 15 minutes of laughter, in the morning, at a local club, stress is relieved and you will continue to be able to handle new pressure throughout the day. Laughter has benefited many people who were on heavy tranquilizers and sleeping pills. Now they are getting better sleep and their depression is reduced. Under the Laughter Club concept, people laugh in a group without the help of any jokes. To make it more spontaneous and keep the sessions interesting and avoid boredom, laughter techniques need to be stimulating. That's the job of the club Certified Laughter Leader. These clubs are popular in India and England and are quickly catching on in the U.S. Just for laughs, you may want to start a local chapter.
Meditation
If you have ten free minutes a day, you can reduce stress, improve insomnia, lessen anxiety and depression, and decrease your chances of developing cardiovascular disease. Sound too good to be true? In fact, the meditative technique known as the "relaxation response" was described a quarter century ago by Harvard physician Herbert Benson, M.D. and has been scientifically proven not only to reduce stress and anxiety but also to improve symptoms of cancer, AIDS, and other conditions.
Just what is the relaxation response? Simply put, it is the opposite of the "adrenaline rush" we associate with stress and anxiety. Physiologically, our bodies respond to perceived threatening situations with an increased release of the hormones epinephrine and norepinephrine, leading to increased heart rate, increased blood pressure, accelerated breathing rate and increased blood flow to the muscles. Because these reactions prepare our bodies to flee the situation or to fight, this reaction has been termed the "fight-or-flight" response. The relaxation response described by Dr. Benson and his colleagues is a state in which our bodies undergo an opposite reaction - leading to decreased breathing rate, heart rate, blood pressure, and metabolism.
Almost anyone can learn to elicit the relaxation response, and no special equipment is necessary. The relaxation response technique consists of the repetition of a word, sound, phrase, etc. while sitting quietly with eyes closed. Intruding thoughts are dismissed by passively returning to the repetition. This should be practiced for 10-20 minutes a day in a quiet environment, free of distractions. A seated position is recommended to avoid falling asleep, and you may open your eyes to check the time but do not set an alarm. Don't feel discouraged in the beginning if it is difficult to banish intruding thoughts or worries; this technique requires practice. With consistency and time the relaxation response will occur effortlessly and smoothly.
For maximum benefits you should schedule time to practice the relaxation response into your daily routine. Many people find it helpful to practice this technique at approximately the same time each day; for example, upon returning home after a busy work day it may ease your transition to a relaxed and enjoyable evening.
Another technique is practicing what the Buddhists call 'mindfulness'. At various times of the day try to focus on your breathing. Notice how the air feels cool when you inhale, and then feels warm when you exhale.
You can do this while you are doing the washing up, making the beds, waiting at a red light, or even standing in a post office queue, etc. The instant benefit from this is that it brings you immediately to the present moment. It is also very effective if done during or before an important meeting, an exam, or even while sitting in the dentist's chair. As you breathe out, you will start to feel your body relax, and your mind will become more focused. So each time you feel yourself getting stressed or find that you have unexpected time on your hands, you can do a quick 60 second meditation.
Tai Chi
Tai Chi Ch'aun is a centuries old Chinese system of physical exercise based on the principles of effortless breathing. It can be practiced by an individual, alone, and in a limited space. It requires no equipment, except a loose-fitting garment that permits continuous rhythmic body movements. It can be learned by anyone regardless of age, sex, or athletic ability. Tai Chi emphasizes relaxation, receptivity and inner calm rather than strength. The flowing stretching movements make the body limber, tone up muscles, and help release muscle tension. This is accomplished by practicing movements slowly and evenly in circular patterns. Many people also report it is an excellent and effortless way to lose weight. Videotapes or DVDs are available for practicing this technique.
Yoga
Yoga is a wonderful way to release stress. Meditation, breathing exercises and sustained poses help you focus on relaxing your mind and body. Once having learned the techniques in a class, it can be done at home. Yoga also helps you develop greater control over your thoughts and worries.
Acupuncture
Acupuncture can treat a wide spectrum of ailments since it approaches injury and disease by looking at the underlying cause as well as the symptoms. Since acupuncture treats the root of the problem, it is favored over traditional therapy because with acupuncture symptoms rarely return. Although acupuncture is renowned for its effectiveness in the treatment of pain, such as back pain, frozen shoulders and migraines it is also effective for many other problems such as stress and anxiety.
Massage therapy
Massage therapy works to improve an individual's health and well-being through the hands-on manipulation of muscles and other soft tissues of the body. Massage therapy is designed to stretch and loosen muscles, improve blood flow and the movement of lymph throughout the body. It facilitates the removal of metabolic wastes resulting from exercise or inactivity, and increases the flow of oxygen and nutrients to cells and tissue. In addition, massage stimulates the release of endorphins -- the body's natural feel-good chemicals-- into the brain and nervous system. It provides a relaxed state of alertness, reduces mental stress and enhances capacity for calm thinking and creativity. Massage also satisfies the need for caring and nurturing touch, creates a feeling of well-being and reduces anxiety levels.
Aromatherapy
Aromatherapy is the art and science of using essential oils, extracted from plants, for therapeutic benefit including stress management. It's efficacy is backed up by solid scientific research. Because aromatherapy can be done as a self-help technique, its use can be very beneficial as a stress reducer while you work. Most of the workplace applications are available in hand lotions for easy use in the office. Bergamot and lavender work well for stress and anxiety reduction. Pendants are also an excellent way to utilize aromatherapy oils in public. Nebulizers and misters are used at home. There are hundreds of unique oils and scents and each has its own medicinal or theurapeutic value. Here are some common oils: Anise, Sweet Basil, Bergamot, Cedarwood, Atlas, Blue Chamomile, Cinnamon, Clary Sage, Clove, Cypress, Eucalyptus, Sweet Fennel, Geranium, Grapefruit, Juniperberry, Lavender, Lemon, Sweet Marjoram, Nutmeg, Sweet Orange, Palmerosa, Patchouli, Black Pepper, Peppermint, Pine Needle, Rosemary, Sandalwood, Tea Tree, Vetiver, Yarrow, Helichrysum, Neroli, Grapeseed oil and Ylang Ylang.
Pet therapy
There is a saying that "dog is man's best friend." This is certainly true when it comes to dealing with your body's stress response. Many people feel more relaxed when companion animals are present. Several studies have shown that pets are good for us in numerous ways. For example, petting an animal is known to lower your heart rate, lower your blood pressure and brighten your mood. Another study found that simply watching fish in an aquarium made patients waiting to undergo medical procedures less anxious. In fact,"pet therapy" is frequently used in hospitals and nursing homes to increase socialization and to reduce depression, loneliness, anger, and stress.
Secondly, having tender physical contact with your pet is also good for you. Having an animal to hold, cuddle and caress has positive effects on people. Especially those who might have limited means to give or receive physical expressions of affection. Most of us have felt a warm fuzzy feeling inside just by getting your face licked by a puppy. After a hard day at work, this kind of attention can really help you to calm down and relax.
Next, simply talking to your pet can be very therapeutic. People often talk to their pets to share their thoughts, feelings, troubles and worries. Although your pet won't give you any solutions for your problems, the very act of talking about your concerns with a good listener may help you find your own solutions. And you must admit pets are great listeners.
Finally, if you have a dog for a pet, you get to go for a walk at least 3 or four times a day. This affords you the perfect excuse to take time to yourself away from your stressors. These walks give you time to breathe fresh air, join with nature, collect your thoughts, make plans for the day, or just daydream. Also, watching your pet frolic and play can't help but bring a smile to your face and help to dry up your sea of troubles. Furthermore, the light exercise you get from walking your pet helps you to deal with the physical stress reactions you have acquired in the course of your day. Specifically, walking with your dog helps you to burn up the pent up energy your stressors have caused.
Relaxing personal retreats
Take a relaxing, scented bath with candles. Every woman knows this is a sure-fire way to relax, but how many of you take time to do it? For the guys, stay thirty minutes in a hot shower, soak in a hot tub or go to the local sauna. Take a weekend break to a spa, even the guys. Get a facial; it's great guys. Take a weekend trip with your partner or with friends. There are tons of activities you can do to remove yourself from the daily grind, have fun and just relax.
Gardening
Gardening has an important impact on the health of individuals through direct interaction with plants and the natural environment. Horticulture promotes individual health through exercise, stress reduction, social interaction and mental stimulation. Gardening is recommended by such groups as the American Heart Association as a technique to improve general physical health and thus prevent many diseases. In addition, urban agriculture can plan a role in improved health through access to high quality fresh produce either locally produced or self-produced.
The National Care Planning Council is a nationwide alliance of eldercare experts, advisers and providers who promote and support long term care planning. For more information go to our website at www.LongTermCarelink.net. Or call 801-298-8676
http://www.reversemortgageloans-rates.com/
Last month, we discussed how chronic stress can be dangerous to the life and health of caregivers. But it isn't just just caregivers who experience chronic stress. The following information and advice can apply to anyone who experiences constant stress over many years. Last month's article can be found at http://www.longtermcarelink.net/article-2007-12-11.htm.
Over the years, scientists have devised a simple blood test to measure stress. They measure the level of IL-6 (Interleuken 6), one of the immune system proteins produced by the stress response. If a person is experiencing stress, his IL-6 levels are high. This doesn't mean, however, that high levels of IL-6 can't occur in the absence of stress. A heavy workout can cause muscles to produce IL-6, but eventually levels return to normal after exercise ceases. It is thought the IL-6 directs the immune system to repair damaged, overtaxed muscle fibers. Fat cells also produce IL-6, so obese people sustain high levels in their blood. And chronic depression results in long-standing high levels of IL-6.
Sustained high levels of IL-6 can be dangerous, especially in adults age 50 and older, who seem to lack the ability to clear the stress response chemicals as quickly as younger people. For older adults, a constant initiation of the stress response --so-called chronic stress-- impairs the immune system and results in early aging, development of debilitating disease and early death. In this altered state, the body maintains high, potentially harmful levels of IL-6.
Prolonged high levels of IL-6 and the accompanying hormones and immune proteins have been linked to: cardiovascular disease, type II diabetes, frequent viral infections, intestinal, stomach and colon disorders, osteoporosis, periodontal disease, various cancers and auto immune disorders such as lupus, rheumatoid arthritis and multiple sclerosis. Alzheimer's, dementia, nerve damage and mental problems are also linked to high IL-6. Wounds heal slower, vaccinations are less likely to take and recovery from infectious disease is impaired. People who have depression also have high levels of IL-6. Depression in caregivers is about 8 times higher than the non-cargiving population.
LIFESTYLE CHANGES TO REDUCE STRESS.
Exercise
Exercise is a powerful and effective way to fight stress. It is recommended you do about 30 minutes of moderate exercise at least 3 days a week. Here are a few reasons why exercise works.
•Distraction--Exercise provides time away from the stresses of the day.
•Endorphins--Endorphins are opiate-like chemicals that the body produces naturally during periods of stress or physical exertion to relieve pain. Some evidence suggests that they may be involved in the regulation of mood.
•Neurotransmitters--During exercise, the body releases higher levels of dopamine. These hormones improve the thought process by facilitating transfer of information between neurons.
•Self-esteem--Exercise can be a gratifying and fulfilling activity for people. The act of doing something good for self can promote self-esteem.
•Reduces IL-6--Although muscles temporarily produce IL-6 during heavy workouts, exercise tends to lower levels between workouts.
Do a better job of managing time
In our modern world, one of the most prevalent threats to our well-being is the improper use of time. Not meeting deadlines may cost us a promotion or our career. Failure to make appointments or to meet obligations threatens our self-image or social standing. These and many more time-related threats cause stress. Finding help with managing your time would probably go a long way to relieving your stress.
Develop a support group and maintain social contacts
Participating in a support group can help manage stress. Sharing coping strategies in a group setting lets you help others while helping yourself. It may also help you to realize that some problems have no solutions and that accepting the situation is reality. Social support has a huge impact on reducing stress. Many studies show that social support decreases the stress response hormones in our bodies. In his book, Love and Survival (Harper Perennial, 1998) Dr. Dean Ornish notes that people who have close relationships and a strong sense of connection and community enjoy better health and live longer than those who live in isolation or alienation. People who suffer alone, suffer a lot.
Get adequate sleep
The catch-22 with sleep is that if you are over-stressed, you are likely to experience a disturbed sleeping pattern, and if you are experiencing a disturbed sleeping pattern, you are likely to become over-stressed! Research also shows that abnormal sleep increases levels of IL-6 while normal sleep decreases IL-6.
Sleep isn't a luxury; it's a necessity. Sleep restores the body and mind and helps us maintain our mental and physical health. Studies have shown that people who get seven to eight hours of sleep each night enjoy better health and live longer than people who get less sleep. According to the National Institutes of Health, each year approximately 60 million Americans experience frequent insomnia, the inability to get adequate sleep.
To ensure that you get enough sleep, try some of the following suggestions:
•Develop a sleep schedule and stick to it. Try to go to bed at the same time each night. Wake up at the same time, too. Avoid sleeping in on weekends; sleeping in will reset your body clock, making it harder to wake up on time on Monday.
•Get 30 or more minutes of physical activity each day. Avoid working out during the three hours before bedtime. Working out close to bedtime will energize you and may interfere with your sleep.
•Avoid caffeine, nicotine, and alcohol. These substances rob you of quality sleep. Switch to decaf or herbal tea. Quit smoking. An alcoholic beverage (a "night cap") before bed may make you drowsy but it actually deprives you of deep, restorative sleep.
•Engage in relaxing activities before bed. Think of it as "wind down" time. Read a book. Soak in a hot tub. Avoid doing physically or mentally stimulating activities such as vigorous housecleaning or intense office work close to bedtime.
•Leave your troubles outside the bedroom door. Make your bedroom a worry-free zone. If you start to ruminate about problems when you are in bed, try relaxation techniques such as deep breathing or visualization (visualize that you are in a warm, breezy, tropical place, with the sun streaming down on you, nothing but sand, surf, and coconut trees for miles...).
•Create a cozy sleep environment: wear comfortable pajamas, make the temperature of the room comfortable for you, darken the room, use soft, comfortable bedding that enhances your sleep experience. If your bed is too hard or lumpy or soft, invest in a new one. If noise is an issue, try to get at the root of the problem: ask your snoring partner to seek evaluation and treatment, ask your neighbors to be quieter, etc.
Pursue diversions, hobbies and relaxing activities
Another simple way to reduce stress is to distract yourself -- go to a movie, play a sport, immerse yourself in a hobby, listen to some favorite music or take a walk. It cannot be emphasized enough how important it is as a caregiver you spend some quality time alone every week, doing exactly what it is you like to do.
Try taking anti-depressants and anti-anxiety medications
Dr. Kiecolt-Glaser points out that anti-depressants lower IL-6 levels in chronically depressed patients, so they might be useful. She also said there have been suggestions that cholesterol-lowering statins might reduce IL-6, because they seem to reduce inflammation.
REDUCE STRESS THROUGH PROPER NUTRITION
Being overweight (eating too much)
Many people react to stress by eating. Eating too much for a long period causes obesity. This causes your heart and lungs to work harder, overloads your organs and reduces stamina. Studies show that fat cells excrete IL-6 and that overweight people have high levels of IL-6 in their blood. This in turn leads to the IL-6-associated illnesses such as heart disease, immune disorders and diabetes.
Not eating properly
Some people react to stress and stress-induced depression by not eating or eating poorly. If you eat a good, well-balanced diet, your body will be receiving all the nutrients it requires to function properly. On the other hand, if you are eating an unbalanced diet or not eating enough you may be stressing your body and contributing to stress-related complications by depriving yourself of essential nutrients.
Coffee, tea, caffeine soft drinks and chocolate
Caffeine is a stimulant. One of the reasons you probably use it is to raise your level of activity. This chemical actually enhances the stress response and thus increases your existing stress. Small quantities probably do little harm but large quantities over a long period produce excessive stress and lead to many of the physical ailments attributed to chronic stress. Too much caffeine can be dangerous. If you are drinking many cups of caffeine products a day, then you may find you can reduce a lot of stress and save your health by switching to caffeine-free products for a portion of your daily intake.
Alcohol
Some people react to stress by imbibing in alcohol. In small amounts, spirits may help you relax. In larger amounts alcohol may increase stress as it disrupts sleep. Over the long-term, alcohol will damage your body. Alcohol is also a depressant. If you're prone to depression, alcohol will only make it worse. Studies show that depressed people have eight times the level of IL-6 as compared to the general population. As we have seen, high, prolonged levels of IL-6 are a marker for debilitating illness and early death.
Tobacco
In the short-term tobacco use seems to relax people but the toxic effects of nicotine raise the heart rate and enhance the stress response. If you smoke, try taking your pulse before and after a cigarette, and notice the difference. After the initial period of giving up smoking, most ex-smokers report feeling much more calm.
Sugar and refined flour
Sugar can be a stimulant for people experiencing stress and stress-induced depression. Sugar-rich foods (the starch in refined flour is also a form of sugar) can raise your energy level in the short-term. The problem is your body copes with high levels of sugar by secreting large amounts of insulin, which in turn, quickly reduces the excess amount of sugar in your blood stream often causing blood sugar levels to swing too low.
These up and down spikes in blood sugar can cause agitation, mood swings, irritability and fatigue, which in turn can contribute to the creation of additional stress. The ups and downs of sugar spikes also contribute to depression. And of course, excess sugar is readily converted to body fat thus causing obesity. Consuming sugar in the form of complex carbohydrates--whole grains, fruits, vegetables and tubers--forces the digestive tract to release blood sugar more slowly and keeps insulin and blood sugar levels more normal. Avoid fruit drinks, sugar drinks, candy, pastas, white bread and pastries.
Nutritional supplements
There are thousands of supplement suppliers and scores of books that claim success with managing stress by using herbs, herbal extracts or synthesized biochemicals. These compounds often come with the claim of enhancing mood or strengthening the immune system. Since there are so many different competing claims, you must decide for yourself which supplements help and which don't.
CONTROLLING STRESS WITH MIND AND BODY CALMING TECHNIQUES.
Music therapy
Listening to music does wonders to alleviate stress. Choosing what will work for any individual is difficult; most people will choose something they 'like' instead of what might be beneficial. In doing extensive research on what any given piece of music produces as a physiological response, many unexpected things were found. Many of the so-called Meditation and Relaxation recordings actually produce adverse EEG patterns in the brain--just as bad as Hard Rock and Heavy Metal. The most profound finding: Any music performed live and even at moderately loud volumes even if it is somewhat discordant has a very a beneficial response.
Laughter therapy
Numerous studies show that laughter has the uncanny ability to wipe out stress. Here are some suggestions for caregivers:
•Look up jokes on the internet.
•Try to see the humor in being a caregiver.
•Write on a card "Have you laughed with your care-receiver today?" and place it in a conspicuous place in the bathroom or kitchen.
•Read funny books or jokes, listen to funny tapes or watch humorous movies or videos that make you laugh.
•Share something humorous with your care-receiver, a friend, or relative.
•Attend social groups where there is a lot of comeraderie, joy and fun.
•Be aware of how often you smile; it takes fewer muscles to smile than to frown.
•If you find that you are feeling hopeless, and humor or laughter is not affording you the up-lift you want. contact a counselor. And remember, laughter is the best medicine. Try it, you'll like it!
Laughter clubs
There is no medicine like laughter therapy. After 15 minutes of laughter, in the morning, at a local club, stress is relieved and you will continue to be able to handle new pressure throughout the day. Laughter has benefited many people who were on heavy tranquilizers and sleeping pills. Now they are getting better sleep and their depression is reduced. Under the Laughter Club concept, people laugh in a group without the help of any jokes. To make it more spontaneous and keep the sessions interesting and avoid boredom, laughter techniques need to be stimulating. That's the job of the club Certified Laughter Leader. These clubs are popular in India and England and are quickly catching on in the U.S. Just for laughs, you may want to start a local chapter.
Meditation
If you have ten free minutes a day, you can reduce stress, improve insomnia, lessen anxiety and depression, and decrease your chances of developing cardiovascular disease. Sound too good to be true? In fact, the meditative technique known as the "relaxation response" was described a quarter century ago by Harvard physician Herbert Benson, M.D. and has been scientifically proven not only to reduce stress and anxiety but also to improve symptoms of cancer, AIDS, and other conditions.
Just what is the relaxation response? Simply put, it is the opposite of the "adrenaline rush" we associate with stress and anxiety. Physiologically, our bodies respond to perceived threatening situations with an increased release of the hormones epinephrine and norepinephrine, leading to increased heart rate, increased blood pressure, accelerated breathing rate and increased blood flow to the muscles. Because these reactions prepare our bodies to flee the situation or to fight, this reaction has been termed the "fight-or-flight" response. The relaxation response described by Dr. Benson and his colleagues is a state in which our bodies undergo an opposite reaction - leading to decreased breathing rate, heart rate, blood pressure, and metabolism.
Almost anyone can learn to elicit the relaxation response, and no special equipment is necessary. The relaxation response technique consists of the repetition of a word, sound, phrase, etc. while sitting quietly with eyes closed. Intruding thoughts are dismissed by passively returning to the repetition. This should be practiced for 10-20 minutes a day in a quiet environment, free of distractions. A seated position is recommended to avoid falling asleep, and you may open your eyes to check the time but do not set an alarm. Don't feel discouraged in the beginning if it is difficult to banish intruding thoughts or worries; this technique requires practice. With consistency and time the relaxation response will occur effortlessly and smoothly.
For maximum benefits you should schedule time to practice the relaxation response into your daily routine. Many people find it helpful to practice this technique at approximately the same time each day; for example, upon returning home after a busy work day it may ease your transition to a relaxed and enjoyable evening.
Another technique is practicing what the Buddhists call 'mindfulness'. At various times of the day try to focus on your breathing. Notice how the air feels cool when you inhale, and then feels warm when you exhale.
You can do this while you are doing the washing up, making the beds, waiting at a red light, or even standing in a post office queue, etc. The instant benefit from this is that it brings you immediately to the present moment. It is also very effective if done during or before an important meeting, an exam, or even while sitting in the dentist's chair. As you breathe out, you will start to feel your body relax, and your mind will become more focused. So each time you feel yourself getting stressed or find that you have unexpected time on your hands, you can do a quick 60 second meditation.
Tai Chi
Tai Chi Ch'aun is a centuries old Chinese system of physical exercise based on the principles of effortless breathing. It can be practiced by an individual, alone, and in a limited space. It requires no equipment, except a loose-fitting garment that permits continuous rhythmic body movements. It can be learned by anyone regardless of age, sex, or athletic ability. Tai Chi emphasizes relaxation, receptivity and inner calm rather than strength. The flowing stretching movements make the body limber, tone up muscles, and help release muscle tension. This is accomplished by practicing movements slowly and evenly in circular patterns. Many people also report it is an excellent and effortless way to lose weight. Videotapes or DVDs are available for practicing this technique.
Yoga
Yoga is a wonderful way to release stress. Meditation, breathing exercises and sustained poses help you focus on relaxing your mind and body. Once having learned the techniques in a class, it can be done at home. Yoga also helps you develop greater control over your thoughts and worries.
Acupuncture
Acupuncture can treat a wide spectrum of ailments since it approaches injury and disease by looking at the underlying cause as well as the symptoms. Since acupuncture treats the root of the problem, it is favored over traditional therapy because with acupuncture symptoms rarely return. Although acupuncture is renowned for its effectiveness in the treatment of pain, such as back pain, frozen shoulders and migraines it is also effective for many other problems such as stress and anxiety.
Massage therapy
Massage therapy works to improve an individual's health and well-being through the hands-on manipulation of muscles and other soft tissues of the body. Massage therapy is designed to stretch and loosen muscles, improve blood flow and the movement of lymph throughout the body. It facilitates the removal of metabolic wastes resulting from exercise or inactivity, and increases the flow of oxygen and nutrients to cells and tissue. In addition, massage stimulates the release of endorphins -- the body's natural feel-good chemicals-- into the brain and nervous system. It provides a relaxed state of alertness, reduces mental stress and enhances capacity for calm thinking and creativity. Massage also satisfies the need for caring and nurturing touch, creates a feeling of well-being and reduces anxiety levels.
Aromatherapy
Aromatherapy is the art and science of using essential oils, extracted from plants, for therapeutic benefit including stress management. It's efficacy is backed up by solid scientific research. Because aromatherapy can be done as a self-help technique, its use can be very beneficial as a stress reducer while you work. Most of the workplace applications are available in hand lotions for easy use in the office. Bergamot and lavender work well for stress and anxiety reduction. Pendants are also an excellent way to utilize aromatherapy oils in public. Nebulizers and misters are used at home. There are hundreds of unique oils and scents and each has its own medicinal or theurapeutic value. Here are some common oils: Anise, Sweet Basil, Bergamot, Cedarwood, Atlas, Blue Chamomile, Cinnamon, Clary Sage, Clove, Cypress, Eucalyptus, Sweet Fennel, Geranium, Grapefruit, Juniperberry, Lavender, Lemon, Sweet Marjoram, Nutmeg, Sweet Orange, Palmerosa, Patchouli, Black Pepper, Peppermint, Pine Needle, Rosemary, Sandalwood, Tea Tree, Vetiver, Yarrow, Helichrysum, Neroli, Grapeseed oil and Ylang Ylang.
Pet therapy
There is a saying that "dog is man's best friend." This is certainly true when it comes to dealing with your body's stress response. Many people feel more relaxed when companion animals are present. Several studies have shown that pets are good for us in numerous ways. For example, petting an animal is known to lower your heart rate, lower your blood pressure and brighten your mood. Another study found that simply watching fish in an aquarium made patients waiting to undergo medical procedures less anxious. In fact,"pet therapy" is frequently used in hospitals and nursing homes to increase socialization and to reduce depression, loneliness, anger, and stress.
Secondly, having tender physical contact with your pet is also good for you. Having an animal to hold, cuddle and caress has positive effects on people. Especially those who might have limited means to give or receive physical expressions of affection. Most of us have felt a warm fuzzy feeling inside just by getting your face licked by a puppy. After a hard day at work, this kind of attention can really help you to calm down and relax.
Next, simply talking to your pet can be very therapeutic. People often talk to their pets to share their thoughts, feelings, troubles and worries. Although your pet won't give you any solutions for your problems, the very act of talking about your concerns with a good listener may help you find your own solutions. And you must admit pets are great listeners.
Finally, if you have a dog for a pet, you get to go for a walk at least 3 or four times a day. This affords you the perfect excuse to take time to yourself away from your stressors. These walks give you time to breathe fresh air, join with nature, collect your thoughts, make plans for the day, or just daydream. Also, watching your pet frolic and play can't help but bring a smile to your face and help to dry up your sea of troubles. Furthermore, the light exercise you get from walking your pet helps you to deal with the physical stress reactions you have acquired in the course of your day. Specifically, walking with your dog helps you to burn up the pent up energy your stressors have caused.
Relaxing personal retreats
Take a relaxing, scented bath with candles. Every woman knows this is a sure-fire way to relax, but how many of you take time to do it? For the guys, stay thirty minutes in a hot shower, soak in a hot tub or go to the local sauna. Take a weekend break to a spa, even the guys. Get a facial; it's great guys. Take a weekend trip with your partner or with friends. There are tons of activities you can do to remove yourself from the daily grind, have fun and just relax.
Gardening
Gardening has an important impact on the health of individuals through direct interaction with plants and the natural environment. Horticulture promotes individual health through exercise, stress reduction, social interaction and mental stimulation. Gardening is recommended by such groups as the American Heart Association as a technique to improve general physical health and thus prevent many diseases. In addition, urban agriculture can plan a role in improved health through access to high quality fresh produce either locally produced or self-produced.
The National Care Planning Council is a nationwide alliance of eldercare experts, advisers and providers who promote and support long term care planning. For more information go to our website at www.LongTermCarelink.net. Or call 801-298-8676
http://www.reversemortgageloans-rates.com/
Wednesday, October 28, 2009
Long Term Care Insurance
Why buy long term care insurance?
1. It will help you keep your independence and dignity and allow you to make choices. When the time comes for paying for your long term care needs, you may end up spending your savings and then relying on Medicaid for assistance. Medicaid typically pays for a semi-private room in a nursing home, but not all nursing homes take Medicaid. In many states it is not easy to get Medicaid to cover home care or pay for assisted living. Many people want to stay at home, but with Medicaid may not be able to. Insurance allows you to have a choice of where you want to live.
2. If you are married and you have a need for long term care, your spouse may be forced to pay for an outside caregiver. The cost is likely to come from your combined income and assets. This may leave your spouse with minimal funds in the future. Insurance solves this problem and allows the healthy spouse to keep the assets.
3. Many healthy caregiving spouses won't spend their money and choose to "tough it out" on their own without help. If care of a disabled spouse drags on too long, this can have a devastating effect on the physical and emotion health of the caregiver. Insurance will pay for professional care for the disabled spouse and allow the caregiver spouse needed rest.
4. If your children promise to take care of you when the time comes that you need care, insurance will help them do that. Probably neither you nor your children have thought of the prospects of moving you from place to place, changing your dirty diapers, cleaning up after "accidents" in the bathroom or helping you with bathing and dressing. Insurance will pay for aides to help your children with these tasks.
5. If you are single and a need for long term care arises, insurance can pay for and coordinate that care. With insurance you won't have to feel you would be a burden for family or friends.
6. If you have the desire to leave assets behind when you die, insurance will help preserve those assets from the cost of long term care.
Buy Long Term Care Insurance When You Are Younger
There is a bonus to buying long term care insurance at a younger age. The yearly premium is lower and the total premium over the life of the policy is also less. For example, a person in good health, currently age 45, buying a typical policy with inflation protection, could spend $42,075 in total premiums to age 78. The yearly premium for this policy is $1,275.
Suppose this same person chooses to wait to buy the equivalent coverage-- adjusted for inflation -- at age 65. If that same policy were available in the future, he could pay $44,759 in total premiums over his 13 remaining years to age 78. His premium is also considerably higher and in this case is $3,443 a year. By waiting, he saves no money in total cost, he will have a much higher yearly cost and in addition will definitely incur the following risks:
1.The same policies only stick around about three years and historically, new policies invariably have higher rates for the same ages as older ones. This means, all else being equal, he could pay two or three times more in total cost for an equivalent policy in the future.
2.The policy at age 45 is based on the best health rating and someone age 65 is very unlikely to get that same rating which means a much more expensive total cost in the future.
3.By waiting, his health may deteriorate to a point where he can't even qualify for a policy. Unfortunately, we have seen this happen time and time again to people who wait and all of a sudden desperately want coverage because of a change in health and can't get it.
4.He may need long term care before he turns 65. The chances of incurring a disability prior to age 65 are quite high.
We recommend you work with a long term care insurance specialist who understands the policy provisions and the coverage needed and can help you determine the best policy for what you want.
You can read more about long term care insurance and locate a specialist in your area at http://www.longtermcarelink.net/.
How to buy long term care insurance
There are dozens of long term care insurance companies selling hundreds of different types of policies. It can become very confusing. There are various benefit options for home care and nursing home care, waiting periods, qualifying periods, inflation riders, and the list goes on. Here is a checklist of some of the things you need to know before you purchase a policy.
LONG TERM CARE INSURANCE BUYING CHECKLIST
the more "yes" answers you get the better off you are.
1) Is the insurance company rated by A. M. Best (the rating company) with a rating of at least A, A+ or A++?
2) Is it a large diversified company with deep pockets and selling more than just long term care insurance?
3) Is the insurance representative an expert in long term care insurance? (Because of its complexity, almost all LTCi experts only sell LTCi; they seldom sell anything else.)
4) Does the representative have a degree and/or industry financial designations?
5) Does the representative own a personal long term care insurance policy for himself or herself?
6) Is the policy you like tax qualified, and if not, do you understand the ramifications?
7) Are there at least 6 ADL’s (Activities of Daily Living) allowed for in the benefit certification?
8) Does it allow "standby assistance"?
9) Is it a "pool of money" as opposed to a "stated period"?
10) Is it "integrated" as opposed to "2-pool"? (2-pool is not allowed in some states and very few companies sell these policies anymore but you must be aware of this.)
11) Do you understand how the elimination period works? (This is extremely important.)
12) Does it have prohibitive cost containment provisions?
13) Is there any "capping" of automatic benefit increase riders?
14) Do you understand how the waiver of premium works?
15) Does the assisted living facility benefit pay the same as for nursing home?
16) Are you buying adequate home care coverage?
17) Does the company have a history of premium rate stability without large periodic increases?
18) Does the policy pay for homemaker services and other nonmedical home care services?
19) Does the policy offer an alternative plan of care for services that don’t exist today?
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1. It will help you keep your independence and dignity and allow you to make choices. When the time comes for paying for your long term care needs, you may end up spending your savings and then relying on Medicaid for assistance. Medicaid typically pays for a semi-private room in a nursing home, but not all nursing homes take Medicaid. In many states it is not easy to get Medicaid to cover home care or pay for assisted living. Many people want to stay at home, but with Medicaid may not be able to. Insurance allows you to have a choice of where you want to live.
2. If you are married and you have a need for long term care, your spouse may be forced to pay for an outside caregiver. The cost is likely to come from your combined income and assets. This may leave your spouse with minimal funds in the future. Insurance solves this problem and allows the healthy spouse to keep the assets.
3. Many healthy caregiving spouses won't spend their money and choose to "tough it out" on their own without help. If care of a disabled spouse drags on too long, this can have a devastating effect on the physical and emotion health of the caregiver. Insurance will pay for professional care for the disabled spouse and allow the caregiver spouse needed rest.
4. If your children promise to take care of you when the time comes that you need care, insurance will help them do that. Probably neither you nor your children have thought of the prospects of moving you from place to place, changing your dirty diapers, cleaning up after "accidents" in the bathroom or helping you with bathing and dressing. Insurance will pay for aides to help your children with these tasks.
5. If you are single and a need for long term care arises, insurance can pay for and coordinate that care. With insurance you won't have to feel you would be a burden for family or friends.
6. If you have the desire to leave assets behind when you die, insurance will help preserve those assets from the cost of long term care.
Buy Long Term Care Insurance When You Are Younger
There is a bonus to buying long term care insurance at a younger age. The yearly premium is lower and the total premium over the life of the policy is also less. For example, a person in good health, currently age 45, buying a typical policy with inflation protection, could spend $42,075 in total premiums to age 78. The yearly premium for this policy is $1,275.
Suppose this same person chooses to wait to buy the equivalent coverage-- adjusted for inflation -- at age 65. If that same policy were available in the future, he could pay $44,759 in total premiums over his 13 remaining years to age 78. His premium is also considerably higher and in this case is $3,443 a year. By waiting, he saves no money in total cost, he will have a much higher yearly cost and in addition will definitely incur the following risks:
1.The same policies only stick around about three years and historically, new policies invariably have higher rates for the same ages as older ones. This means, all else being equal, he could pay two or three times more in total cost for an equivalent policy in the future.
2.The policy at age 45 is based on the best health rating and someone age 65 is very unlikely to get that same rating which means a much more expensive total cost in the future.
3.By waiting, his health may deteriorate to a point where he can't even qualify for a policy. Unfortunately, we have seen this happen time and time again to people who wait and all of a sudden desperately want coverage because of a change in health and can't get it.
4.He may need long term care before he turns 65. The chances of incurring a disability prior to age 65 are quite high.
We recommend you work with a long term care insurance specialist who understands the policy provisions and the coverage needed and can help you determine the best policy for what you want.
You can read more about long term care insurance and locate a specialist in your area at http://www.longtermcarelink.net/.
How to buy long term care insurance
There are dozens of long term care insurance companies selling hundreds of different types of policies. It can become very confusing. There are various benefit options for home care and nursing home care, waiting periods, qualifying periods, inflation riders, and the list goes on. Here is a checklist of some of the things you need to know before you purchase a policy.
LONG TERM CARE INSURANCE BUYING CHECKLIST
the more "yes" answers you get the better off you are.
1) Is the insurance company rated by A. M. Best (the rating company) with a rating of at least A, A+ or A++?
2) Is it a large diversified company with deep pockets and selling more than just long term care insurance?
3) Is the insurance representative an expert in long term care insurance? (Because of its complexity, almost all LTCi experts only sell LTCi; they seldom sell anything else.)
4) Does the representative have a degree and/or industry financial designations?
5) Does the representative own a personal long term care insurance policy for himself or herself?
6) Is the policy you like tax qualified, and if not, do you understand the ramifications?
7) Are there at least 6 ADL’s (Activities of Daily Living) allowed for in the benefit certification?
8) Does it allow "standby assistance"?
9) Is it a "pool of money" as opposed to a "stated period"?
10) Is it "integrated" as opposed to "2-pool"? (2-pool is not allowed in some states and very few companies sell these policies anymore but you must be aware of this.)
11) Do you understand how the elimination period works? (This is extremely important.)
12) Does it have prohibitive cost containment provisions?
13) Is there any "capping" of automatic benefit increase riders?
14) Do you understand how the waiver of premium works?
15) Does the assisted living facility benefit pay the same as for nursing home?
16) Are you buying adequate home care coverage?
17) Does the company have a history of premium rate stability without large periodic increases?
18) Does the policy pay for homemaker services and other nonmedical home care services?
19) Does the policy offer an alternative plan of care for services that don’t exist today?
http://www.reversemortgageloans-rates.com/
Tuesday, October 27, 2009
Holiday Blues - Depression in the Elderly
The holiday season is quickly coming upon us. If you are a caregiver for an elderly loved one, you may notice a change in your loved one's mood as the holidays approach. Perhaps you are one of many, who visit elderly parents and family during the holidays who live a distance away. When you visit you may notice that loved ones are not as physically active, or they show symptoms of fatigue or sadness and have no interest in the holiday or in their surroundings.
According to the National Institutes of Health; of the 35 million Americans age 65 or older, about 2 million suffer from full-blown depression. Another 5 million suffer from less severe forms of the illness. This represents about 20% of the senior population -- a significant proportion.
Depression in the elderly is difficult to diagnose and is frequently untreated. The symptoms may be confused with a medical illness, dementia, or malnutrition due to a poor diet. Many older people will not accept the idea that they have depression and refuse to seek treatment.
What causes depression in the elderly?
It is not the actual holiday that causes depression, but the fact that holidays tend to bring memories of earlier, perhaps happier times. Additional contributing factors that bring on depression may be the loss of a spouse or close friend, or a move from a home to assisted living, or a change with an older person's routine.
Depression may also be a sign of a medical problem. Chronic pain or complications of an illness or memory loss can also cause depression. In addition, diet can also be a factor when proper nutrition and vitamins are lacking.
As an example, Selma’s husband passed away, a few months before Christmas. Her family lived close by and would call or drop in often to check on her. Selma seemed a little preoccupied and tired, but this was to be expected as she had been the caregiver for her husband for many years. It wasn’t until the family noticed that her holiday decorations were not out and her yearly routine of Christmas card writing was not happening that they began questioning her mental and physical well being.
A trip to her physician confirmed depression, caused by not only the loss of her spouse, but a vitamin B12 deficiency. There were both mental and physical reasons for her depression.
Symptoms to look for in depression might include:
•Depressed or irritable mood
•Feelings of worthlessness or sadness
•Expressions of helplessness
•Anxiety
•Loss of interest in daily activities
•Loss of appetite
•Weight loss
•Lack of attending to personal care and hygiene
•Fatigue
•Difficulty concentrating
•Irresponsible behavior
•Obsessive thoughts about death
•Talk about suicide
How do you know if it is depression or dementia?
Depression and dementia share similar symptoms. A recent article on Helpguide.org gives some specific differences:
In depression there is a rapid mental decline, but memory of time, date and awareness of the environment remains. Motor skills are slow, but normal in depression. Concern with concentrating and worry about impaired memory may occur.
On the other hand, dementia symptoms reveal a slow mental decline with confusion and loss of recognizing familiar locations. Writing, speaking and motor skills are impaired and memory loss is not acknowledged as a being problem by the person suffering dementia.
Whether it is depression or dementia, prompt treatment is recommended. A physical exam will help determine if there is a medical cause for depression. A geriatric medical practitioner is skilled in diagnosing depression and illnesses in the elderly. If you are a care taker of an elderly person it may be beneficial for you to seek out a geriatric health care specialist. For more information on senior health services go to http://www.longtermcarelink.net/about_senior_health_services.htm
Treating depression in older people.
Once the cause of depression is identified, a treatment program can be implemented. Treatment may be as simple as relieving loneliness through visitations, outings and involvement in family activities. In more severe cases antidepressant drugs have been known to improve the quality of life in depressed elderly people. Cognitive therapy sessions with a counselor may also be effective.
As a care giver or family member of a depressed older person, make it your responsibility to get involved. The elder person generally denies any problems or may fear being mentally ill. You can make the difference in and remove the Holiday Blues from seniors suffering from depression.
The Geriatric Mental Health Foundation offers a “Depression Tool Kit.” To read more about the tool kit and depression in the elderly go to http://www.gmhfonline.org/gmhf/consumer/depression_toolkit.html
To find a Senior Health Care Services in your area on the National Care Planning Council website go to http://www.longtermcarelink.net/a7seniorshealthservices.htm
The National Care Planning Council supports the work of geriatric practitioners and their services to the growing senior population. If you are a geriatric practitioner and would like to list your services with the NCPC please call 800-989-8137.
http://www.reversemortgageloans-rates.com/
According to the National Institutes of Health; of the 35 million Americans age 65 or older, about 2 million suffer from full-blown depression. Another 5 million suffer from less severe forms of the illness. This represents about 20% of the senior population -- a significant proportion.
Depression in the elderly is difficult to diagnose and is frequently untreated. The symptoms may be confused with a medical illness, dementia, or malnutrition due to a poor diet. Many older people will not accept the idea that they have depression and refuse to seek treatment.
What causes depression in the elderly?
It is not the actual holiday that causes depression, but the fact that holidays tend to bring memories of earlier, perhaps happier times. Additional contributing factors that bring on depression may be the loss of a spouse or close friend, or a move from a home to assisted living, or a change with an older person's routine.
Depression may also be a sign of a medical problem. Chronic pain or complications of an illness or memory loss can also cause depression. In addition, diet can also be a factor when proper nutrition and vitamins are lacking.
As an example, Selma’s husband passed away, a few months before Christmas. Her family lived close by and would call or drop in often to check on her. Selma seemed a little preoccupied and tired, but this was to be expected as she had been the caregiver for her husband for many years. It wasn’t until the family noticed that her holiday decorations were not out and her yearly routine of Christmas card writing was not happening that they began questioning her mental and physical well being.
A trip to her physician confirmed depression, caused by not only the loss of her spouse, but a vitamin B12 deficiency. There were both mental and physical reasons for her depression.
Symptoms to look for in depression might include:
•Depressed or irritable mood
•Feelings of worthlessness or sadness
•Expressions of helplessness
•Anxiety
•Loss of interest in daily activities
•Loss of appetite
•Weight loss
•Lack of attending to personal care and hygiene
•Fatigue
•Difficulty concentrating
•Irresponsible behavior
•Obsessive thoughts about death
•Talk about suicide
How do you know if it is depression or dementia?
Depression and dementia share similar symptoms. A recent article on Helpguide.org gives some specific differences:
In depression there is a rapid mental decline, but memory of time, date and awareness of the environment remains. Motor skills are slow, but normal in depression. Concern with concentrating and worry about impaired memory may occur.
On the other hand, dementia symptoms reveal a slow mental decline with confusion and loss of recognizing familiar locations. Writing, speaking and motor skills are impaired and memory loss is not acknowledged as a being problem by the person suffering dementia.
Whether it is depression or dementia, prompt treatment is recommended. A physical exam will help determine if there is a medical cause for depression. A geriatric medical practitioner is skilled in diagnosing depression and illnesses in the elderly. If you are a care taker of an elderly person it may be beneficial for you to seek out a geriatric health care specialist. For more information on senior health services go to http://www.longtermcarelink.net/about_senior_health_services.htm
Treating depression in older people.
Once the cause of depression is identified, a treatment program can be implemented. Treatment may be as simple as relieving loneliness through visitations, outings and involvement in family activities. In more severe cases antidepressant drugs have been known to improve the quality of life in depressed elderly people. Cognitive therapy sessions with a counselor may also be effective.
As a care giver or family member of a depressed older person, make it your responsibility to get involved. The elder person generally denies any problems or may fear being mentally ill. You can make the difference in and remove the Holiday Blues from seniors suffering from depression.
The Geriatric Mental Health Foundation offers a “Depression Tool Kit.” To read more about the tool kit and depression in the elderly go to http://www.gmhfonline.org/gmhf/consumer/depression_toolkit.html
To find a Senior Health Care Services in your area on the National Care Planning Council website go to http://www.longtermcarelink.net/a7seniorshealthservices.htm
The National Care Planning Council supports the work of geriatric practitioners and their services to the growing senior population. If you are a geriatric practitioner and would like to list your services with the NCPC please call 800-989-8137.
http://www.reversemortgageloans-rates.com/
Monday, October 26, 2009
Check Here Often for Reverse Mortgage Information
My name is Troy Freesemann and I have been dealing with seniors for the last 5 years helping clients decide if a the reverse mortgage is the correct tool for them. In fact I was on the phone this morning with a client and based on the couples specific information I advised them against the reverse mortgage. I will always make my reccomendations with your future in mind. I would rather advise against a reverse mortgage then put you in a worse position than you are today. Contact me for a true evaluation of your situation and if this product is the right direction for you.
Sincerely,
Troy Freesemann
(866) 800-0280
troy@mireverse.com
http://www.reversemortgageloans-rates.com/
Sincerely,
Troy Freesemann
(866) 800-0280
troy@mireverse.com
http://www.reversemortgageloans-rates.com/
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