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Safe travel starts with planning before you leave.  Here are some suggestions for traveling with an elder dealing with dementia challenges.

Be sure to do some advanced planning.

  • Call the airline to explain your needs. Ask what they provide.  Ask about rules for carry-on medicines.
  • If you are traveling to a resort, call and ask what help they can provide.
  • Pick out snacks or book activities to help your elder enjoy the trip.
  • Put together a packet that has phone numbers for your loved one’s primary care provider, neurologist, and pharmacist, an emergency family contact who knows your elder’s medical history, and the nearest pharmacy and hospital in the place your are visiting.
  • If an airport or tourist attraction requires security screening, ask to have your elder manually searched. This will avoid setting off the security screening device.

Prepare your elder’s medicines.

  • Be sure to have prescriptions filled and picked up before you leave home.
  • Pick up the medications 2-3 weeks before the start of the vacation, so you have enough to take with you.
  • If needed, call your insurance company to see if they will give you advance doses so you will not run out.
  • For air travel, carry two supplies of medicines with you. Put one in your carry-on and the other in your checked baggage.
  • Carry a written list of medicines and doses. This is called a Home Medication List.
  • Bring your pharmacy phone number from home. They can help you with insurance issues at a new pharmacy.

Prepare for the event of an emergency.

  • Ask for and carry a current emergency care plan signed by your care provider.
  • Your elder should wear a medical bracelet or necklace, including any allergies on it.
  • Everyone traveling with your elder should know first aid.

Take precautions if your elder is on a special diet.

  • Ask to have a refrigerator put in your hotel room to store special diet foods.
  • Make enough meals to have on hand during traveling. Plan extra meals in case you are delayed by weather.  Be sure to take an insulated carrier and enough cooling packs to keep food that you are carrying safe.
  • For travel out of the country, you may need a doctor’s letter to take foods/liquids in and out of the country.

Take additional precautions once you arrive at your destination.

  • Check for the location and phone number of a pharmacy and hospital near you.
  • Call ahead for advance seating at restaurants and local attractions.
  • Have a hospital bag put together so that you will have everything you need if an emergency happens. Include a change of clothes, money, the emergency care plan, and your care notebook or notes about your elder’s care.
  • If you need to visit the emergency room while on vacation, the following tips may help make it a smooth visit:
  • Carry an emergency care plan from your care provider. This should include the doses of emergency medicines already calculated for your elder’s weight.  This plan should be signed by your care provider.
  • Bring your provider’s contact information and your elder’s medication list with dosage and formulation.
  • Speak up for your elder. You know your elder’s care best.

Content in this article was adapted from information sent to us by CHOC Children’s Neuroscience Institute.

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You Never Know!

Though I am dog tired from a day trip to Virginia to check on my 90-year-old Aunt Eunice, I want to share with you an amazing instance of synchronicity (if such be a word).

I made the trip from Ohio for the nursing home’s Christmas Party today.  Here is what happened —

Though physically challenged, Aunt Eunice has always loved to sing – her alto voice is usually spot on with the harmony of the music, if the song is one she knows.  She was excited to be called to the front to sing with the guitar player during the party.  One tune she was really comfortable with was, “I’ll Fly Away”.

Immediately, after the party broke up, a nicely dressed elderly lady and her daughter appeared before us, introducing themselves to my aunt, who actually remembered the older lady.   I was then asked by them, “Who are you?”   In that place of families knowing families, I answered, “I’m Dupey’s daughter.”

This lady broke into a huge smile, telling me that my mother was her fifth grade teacher. (Before marriage my mom had taught in the community.)

This lady further said, my mother was the best teacher she ever had; and she had named her daughter Christine after my mom!

The mom and daughter were willing to have me snap their photo together.  As I did so, the daughter confided to me that she had always wanted to be called by her middle name Christine rather than Wanda.

Had my aunt not been called to the front, this meeting might never have occurred.

The mother, I was told, has a school days photo in her room.  When I return to the nursing facility for a visit with my aunt, I will hope to talk further with this mom who brought tears of appreciation to a 75-year-old daughter on a gray day in December!

 

12 picture poster

Forget the candy, shirts, sweaters, smell-um-goods this year, as those well-intended gifts may wind up in your loved one’s closet and be soon forgotten.

Instead consider making a Memories from My Life photo poster filed with enlarged pictures and captions, giving your loved one a constant source of pleasure and pride, with the wall poster visible at all times, reminding your loved one of the special people, places, and events that shaped his or her life.

To get started simply visit http://www.MemoriesfromMyLife.com or click here, then follow the prompts.  (If you use older photos, they will need to be uploaded into your computer or iPhone.)  This year as our gift to you, please use PROMO CODEmfmlnh10 for 10 percent off your order!!

Here are a few ideas for deciding what photos to use:    1) A place (childhood home, favorite vacation spot, or special event;  2) Special people (parents, siblings and friends); 3) Hobby/interests (travel, sports activities, crafts, gardening, art interests); and/or  4) Pets (a collage of family dogs, cats, birds, favorite animals).

The posters come in four sizes, beginning with the smaller four photos plus cameo picture of your loved one.  (Shown at the top of this page is the 12-photos plus cameo size 24″ X 36″.)  Alzheimer’s caregivers recommend two or three smaller size posters, such as the 4-photos plus cameo size 16″ X 20″ for loved ones dealing with memory challenges.

Reminiscing with the photo posters can facilitate conversation with visitors.  And your loved one will enjoy seeing herself or himself as they used to be!

Remember to use the PROMO CODE:  mfmlnh10 for 10 percent off your order!!

I am bringing up this topic, Medicare Plan Choices, for seniors residing in the United States, who have until December 7th to make any changes in Medicare coverage.

I have learned that healthcare costs rank the most burdensome among common living expenses for seniors, yet seniors are more likely to comparison shop for groceries, gas, cable and internet service, and even travel deals, than they are to shop for a Medicare plan.   That’s according to a new survey “The Cost of Complacency,” by WellCare, which reveals surprising perceptions and behaviors among seniors when it comes to healthcare.

Only one third of seniors reported they comparison shop for a Medicare plan at all; and only approximately one in three seniors (38%) review their Medicare plan annually to determine if they are getting the best deal.

Given that healthcare spending is expected to increase year after year for the vast majority of seniors and that virtually every Medicare plan changes each year, we seniors could be missing out on savings and putting our retirement income at risk by keeping our heads in the sand, so to speak.

Recently I was privileged to speak with Retirement, Aging, and Eldercare expert Bart Astor.  He is the author of the Washington Post bestseller, AARP Roadmap for the Rest of Your Life:  Smart Choices about Money, Health, Work, Lifestyle, and Pursuing Your Dreams, and the best-selling book, Baby Boomer’s Guide to Caring for Aging Parents.

Our talk focused on what to look for when reviewing a Medicare plan.

Here goes:

PAT WHITE:                Good morning!  Very nice to speak with you and to have your comments for Memories from My Life readers.

                                    My interest for our visit today is for you to offer guidelines in evaluating the different Medicare plans.

BART ASTOR:          I can talk a little bit about the verbiage.  

The Cost of Complacency Survey sponsored by WellCare polled over a thousand seniors.  And although healthcare is the number one most burdensome of living expenses, including groceries, food, transportation, and utilities — despite the fact that healthcare is the most burdensome, seniors do not review their plans annually.

That potentially leaves money on the table, but it also means seniors may not be getting the kind of coverage they need.  I think that’s what the key takeaway is.

So to your point, by not looking at it, you’re going to be losing out not just the money; but there are certain things you want to be covered for that you may not be.

Yes, it’s important to look at premiums, and it’s important to look at the deductibles.  Those are things that determine how much you’re going to pay out of pocket.

And you will need to look at coverage for diagnostic tests that your Medicare may not cover.  You may run into lifetime limits on the number of tests you can have like PET scans and MRIs.  So we have to include that.

In addition, you will want to take the next step and see what other coverage might you need in the future, not in the past but in the future.

For example, you might decide you want to pay for additional coverage for vision care or for dental care.  If that’s in your future, then you want to include that in your costs.

You might want to make sure your coverage includes hearing exams, for example, if that is relevant to you.

The point is to compare apples to apples.  As we know from the survey, people look at this as the most horrendous thing to do.  It is so unpleasant, people would rather go and renew their driver’s license at the DMV than look at their Medicare plans, or they would rather do their taxes.  It sounds funny, but it’s true.  That’s what the survey revealed.

So I want to say, yes, it’s confusing; yes, it’s complicated, but there’s also help for you.  And there’s lots of information available and lots of ways you can get that help.  So please don’t just put it on autopilot and just assume that what you have now is what is right for you in the future.

PAT WHITE:                I must admit I am one of those people who have been on autopilot!  I knew I had a choice on supplemental plans but had ignored choices on Medicare itself.

BART ASTOR:             This survey did not get into supplemental plans.  The survey was really looking at traditional Medicare and Medicare Advantage plans, which is different from supplemental plans you were referring to.

But even within your Medicare and Medicare Advantage plans you can work with your insurer to tailor to what your needs are.  Whatever your plan, the important thing is that it be tailored to your needs.

There are ways to get the information you are going to need to make the right choices.  You can go to Medicare.gov and get the information there.  And you can go to www.CostofComplacency.com and also get more information.

I encourage people to go and check with their local senior centers where there are experts to help guide you on a one-on-one basis for not just – “Here’s a bunch of information; make your choice.”  They tailor it to you.

And there are customer service people at the companies that do focus on Medicare Advantage plans to help guide you to make the right choices for yourself.

It is complicated.  And you want to make sure you are paying for what you really need and you are not paying for things you don’t need.

PAT WHITE:    Obtaining information from the senior center, I would not have thought of that.

BART ASTOR:  Yes, it’s a great resource.  There you are actually talking with a person who can guide you toward making the right choice.

Yes, it’s confusing; but they can help you look at your options to see what you really most need.

How much does cost matter to you?  Sometimes it matters a lot; and sometimes it doesn’t matter quite as much.  Everyone is so different that way.

As we said at the beginning, healthcare is the most burdensome of living expenses.  We feel like it’s just such an unpleasant thing to review, but potentially there’s money in it that matters for you and, most important, the kind of coverage that you really need.

PAT WHITE:    My thanks to you for sharing this relevant information.  Memories from My Life readers, though probably several years younger than myself, are going to need to address these issues eventually for themselves.

BART ASTOR:  They will for sure.  And coverage is going to be changing every year; it always does!  And our health changes every year as well.

We have to review it and say ‘What am I like now?’  Not, ‘What was I like two years ago.’  You must consider, ‘What do I need for next year?’

I want to encourage that December 7th is a hard and fast deadline.  So you are locking in what you need for 2018 by December 7th.  You cannot miss that deadline.

PAT WHITE:    So you are saying for us seniors, re-evaluation is necessary every year; we can’t just do it this year and wait two or three years.  It’s a year-by-year thing.

BART ASTOR:  Absolutely, it is a year-by-year.  It depends on how things have changed for you.  If there have not been many changes, then it’s a little bit easier.

But that’s not to say you should ignore it.  It will just take a little bit less time to say not too much has changed and I’m still okay.

But if things start changing either in the plans that are available or in your own needs, then absolutely, it’s time to really delve right into the ‘weeds’ and reevaluate what’s best for you and your family.

PAT WHITE:    Are these companies competitive enough so that they are willing to do the best they can for consumers?  There seems to have been a lot of advertising about it this year, more than I remember before.

BART ASTOR:  I think as the looming deadline approaches, you are seeing more ads saying for Medicare recipients to review their plans.

I notice that they also say ‘Call in for more information.’  That really is critical!  I think people can and should call in for more information to wherever they are most comfortable calling.

CostofComplacency.com is certainly one place to contact for more information.  The customer service people are really very knowledgeable and very good at guiding you the caller for what is most appropriate for your needs.

Look at it this way:  There is a cost of being too complacent, and overpaying for senior healthcare is one of those.

 

The interview with Mr. Astor was made possible through courtesy of WellCare.  Thanks to Tiffany Miller for this opportunity.

Postscript:

Since the posting of this article I contacted my own health insurance company, requesting a review of my coverage.  Lo and behold I was able to get over $700 deducted from my premiums!  And this was without a comparison with any other healthcare insurer plans.

 

 

 

 

 

 

Over-Medicated

My aunt made a life-changing move to another nursing home a few weeks ago.  The institution where she had lived for the past 29 years closed.

As things happened, I was unable to help with her move due to an unexpected illness and surgery.  With family encouragement we found a lovely place in the town where our Aunt Eunice grew up that appeared to be a wonderful fit.  Our thinking was that she might receive some much-welcomed visits from friends and family who had been unable to come before due to travel distance.

The part of the move that affected our aunt in a huge way, however, was that her roommate was assigned to another different living location.  Our aunt,  a 90-year-old elder, had so enjoyed her roommate Juanita, who at 30 years her junior was full of vitality and energy and a wonderful companion, especially with our aunt’s deteriorating vision.  Having to adjust to the new place with new caregivers and without her roommate was almost more than Aunt Eunice could manage.

Her way of coping turned out to be ‘acting up’, perhaps hoping if she was bad enough, she might get to return to her old place.  But that’s not what happened.

The first inkling I had that things were not as they should be was when I called to speak with my aunt a week ago.   For a lady who has always been clear of mind, her words were unintelligible that morning.  When I called a few hours later to speak with a nurse, I was informed that my aunt’s behavior was such that she had had to be ‘medicated’.

I have Power of Attorney for our aunt, and I was always contacted immediately by the previous administration at the former nursing home whenever any change was noted in her health condition or otherwise.  That trust was a given.

The seriousness of the situation was evident when my brother and I arrived yesterday for a visit  – each of us driving over 200 miles from our homes.  Our aunt at noon was completely sedated, so that we were unable to wake her.  Her lunch tray sat beside her bed untouched.

Our first move was to find out what medications she was being given:  Remerol in the morning, Ativan three times a day, and Paxil.  For someone who had never been on medication such as this before, especially an elder, knowledge of this regimen was shocking to say the least.

An hour or so later our aunt gradually woke up.  She was very thirsty – evidently dehydrated.  My brother brought her favorite soft drink – Dr. Pepper, which she devoured.  She also drank two cartons of milk and much water.

Our request to nursing staff was a care conference ASAP and a request for the reduction and gradual stoppage of drugs.

Had we not physically been present, we would not have known about our aunt’s condition.  The charge nurse did have my information.

Did the staff think because we had not been there sooner, that we didn’t care?  I did see the charge nurse make a note about my request to be contacted on any change in our aunt’s condition or proposed medication.

Any person who is handicapped for whatever reason needs an advocate, who is physically able to visit on a regular basis and see how care is being delivered.

 

We’re Closing

As I may have told you, I am the guardian for my 90-year-old Aunt Eunice, who lives out of state in a very modest nursing home in southwest Virginia.  I visit her about every two and a half months, her and her roommate Juanita.

Juanita has looked out for my aunt in so many ways, and I believe her to have been a very positive influence in my aunt’s longevity.  As one small example of her thoughtfulness, if no aide is nearby at breakfast time, Juanita sees that Aunt Eunice knows what is on her breakfast tray and where it is.   My aunt has severe macular degeneration, which means that at this time in her life, she is practically blind.

Juanita has also made sure that their room is neat and clean as can be at all times.  This is over the past 10 years — it doesn’t matter when I show up; the room smells fresh and clean as can be.

When I visit, Juanita is invited to go with us out for breakfast.  When we get to Wal-Mart, she is handed a bit of money to spend as she wishes.  She in turn coaches me on what Aunt Eunice enjoys and needs.  (Eunice has to wait in the car due to my being unable to lift her into her wheelchair.)

And so it has gone, an arrangement that I have come to depend on and much appreciate — until yesterday afternoon.  I received a call from a social worker in the county where my aunt resides, informing me that the nursing home is closing down.

Not only has the nursing home been sold, but half of the residents have already moved out — including Juanita, to assisted living.  This has been my aunt’s home for the past 27 years.  I wonder where will she go; how is she going to get along without her roommate; who is going to look after her.

The first thing I did was go to Medicare.gov and then to Nursing Home Comparisons in the state of Virginia.  I found a comparison of three in the general vicinity of the town near where my aunt grew up and called home. An analysis of each facility was readily accessible that included an overall rating, adequacy of staffing, quality of care, and specific information regarding state inspections.

Sharing this information with my brother, we zeroed in on one location that appears to suit our aunt’s needs and will offer the added bonus of her being able to enjoy visits from two of her other nieces along with friends from her home church. So in a way, the closing of one door has opened a door for new life for our aunt!

Today our aunt will undergo an assessment for her future needs.  The new facility has indicated their willingness to consider her for residency.  Having spoken with my aunt earlier today, I found her to be excited about the possible move.

Assuming the move proceeds to the place we have chosen, my aunt and I will be making an extra stop at the assisted living to say good-bye to a roommate that we will not ever forget.

 

 

 

 

 

Reconnecting

I want to tell you about a step back in time I took this past weekend in rural East Tennessee near the Hiawassee River.  The occasion was a local festival commemorating area history as the location for the start of the Cherokee Trail of Tears to Oklahoma and the place where a number of Civil War Battles were waged.

On a cold day last January as I drove south down the interstate toward Georgia to visit my husband’s family,  on a whim I took the Charleston exit as a break in the drive and to view the place where many of my childhood memories rest.  Arriving on the main street (old U.S. Route 11) out of the corner of my eye I saw a new building for the first time, Cherokee Heritage Center.

Upon entering, I met the curator.  When I told her about my family history in Charleston 1950-54, she remarked, “I’ll bet you knew my parents!”  And I did.  I remember her dad as custodian of the Methodist church where my dad was pastor and her mom who as church secretary created the church bulletin every week.

Now, the best part is coming – I was given the email for a childhood playmate I had had no contact with for the past 63 years.  When I got back to Ohio, I sent an email, trying to roughly fill in our years apart.  Am sure she wondered who in the world was writing to her.  But she did answer my email, giving me her rough fill in on her own life.  We discovered that our sons and their families live in the same city in Middle Tennessee.

Then this past weekend our families met at the festival.  I confirmed her birthday that I had remembered all these years.  It was one of the best days of my life, remembering our lives as we were as 11-year-olds, playing outdoors, unfettered and carefree, and visiting the landmarks we remembered.

I am sharing all this with you, my readers, because you may be searching for a gift for a loved one who is hard to buy for at this stage in their lives.  A priceless gift might be your assistance on the Web to locate a childhood friend they may have lost contact with and helping to make a connection to happen.