Asking Questions Is a Big Part of the Solution
Although we couldn't possibly answer here all of the questions our clients, family members, and professionals have asked us, we have tried to address some of the most common. If you don't see your question here, please feel free to email or call Gail.
Help! Where do I start!
When is the right time to start planning?
Undoubtedly, this is the most frequently asked question. We usually tell people "take a deep breath and develop a plan." Without obligation, we will be more than happy to provide an initial consultation, either in person or over the phone. There is no one right place to start and, based on our experience, we can usually help you put together a plan that will give you a starting place and, hopefully, a sense of direction through the entire process.
The sooner the better! You will be in a position to:
- make better choices
- be in control of the process
- avoid a crisis, and
- ultimately, save money
Planning will also empower you by knowing that systems are in place -- leaving you with peace of mind to enjoy living your life.
How do you charge for your services?
The initial consultation is complimentary to determine the client’s needs and if it is a good fit for both parties. This may be in person, or over the phone if distance is a problem. Since each client is different, the amount of time will be based on their needs. Fee based service offerings include:
- Single On-Site Session
- Phone Consultations/Email Feedback
- Care Plan Development
- Caregiver’s Support Sessions
- Emergency Help Sessions
- Monthly Retainer (based on hours needed)
Although we cannot make any guarantees, it is our contention that, in many cases, the efficient planning and business experience we bring to the situation often results in a signficant cost savings overall.
How are your services different from a geriatric care manager?
The distinct difference comes in our backgrounds and focus GMS Associates comes from a personal and business perspective of a medical model whereas a geriatric care manages comes from a purely medical and social worker perspective. Our focus is to help the elder and caregiver plan ahead in building a team of professionals to support their elder care goals to have systems in place before a crisis or a medical discharge occur. A geriatric care manager usually comes on board at a hospital discharge or physical decline.
How do I have that “conversation” when I start observing changes in my loved one?
It is so important to be sensitive to your loved one’s feelings when discussing issues of health, competency, finances and living arrangements for the last years of their life. We always recommend talking with other family members to develop some consensus as to your views. Learning in advance about the options available also allows you to counter some of the objections your loved one might have. But most of all, listen to them and understand where they are coming from with their views. GMS Associates has had a great deal of experience in this area and we can lend a third-pary objective view that often is more easily accepted by all involved.
What questions should I be asking the doctor when assisting my parent to appointments?
Doctors appreciate when a caregiver takes an active role in their loved one’s health care by coming prepared with questions.
Some questions might include:
- What medications are they currently taking and why?
- Any changes observed since their last visit?
- Anything I should be aware of in keeping my loved one safe at home?
- Any concerns about their driving?
- Should I be watching for any particular symptoms and notify if they occur?
Before information can be given to a caregiver in person or by phone, be sure that a health care proxy and a HIPPA form are signed by your loved one and placed in their medical file.
Home Health Care
What is one of the most important things I can do to keep my loved safe at home?
Fall prevention is one of the key safety measures you can take by: removing scatter rugs, improving lighting in halls, installing handrails in bathrooms, and making sure handrails are secure at all entrances of the home. Having a monitoring system is also often a good idea, if only for the reassurance of caregivers who cannot be present all the time.
If I want to keep mom safe and independent in her own home, what services would be available?
Because most elders prefer to “age in place," an array of in-home services are available today. Depending on your mom’s needs, these could include: meal preparation, errands/shopping, hygiene assistance, light housekeeping, up to 24 hour care, rewarding companionship. These services could be temporary or long term. Some of these services are available to the elderly free of charge. We can assist in locating and engaging these services.
What questions should I be asking when looking at assisted living facilities or nursing homes?
First of all, you need to make sure an assisted living facility or nursing home is a necessary option at this time. There are many housing options available and, of course, the first thing you want to do is see what arrangements are available for keeping your loved one in her or his own home, or yours if that is an alternative. If assisted living or a nursing home is the best option, to make an informed decision it is important to visit several facilities in your area to determine the right fit for your loved one. A helpful set of questions/checklist can be found on the following website: www.alfa.org. To evaluate nursing homes, go to www.medicare.gov/NHCompare
As Durable Power of Attorney, how do I get a handle on my loved one’s financial situation?
First of all ask what they have done in the area of financial and estate planning. It is very possible that they have a "gray metal box" or a safe deposit box containing many of their important documents.
- Do they have a financial planner, accountant or stockbroker?
- Where do they do their banking?
- Do they have IRA accounts?
- Do they have Life Insurance?
- Where are any stock certificates?
- What are their Social Security/retirement benefits?
- Are bills being paid on a timely basis? If not, suggest you pay them yourself or have a trusted third party do it (e.g. sibling, bookkeeper).
Keep in mind that, if you can address these issue early on, before a decline or crisis, you can have everything in place when needed. GMS Associates can give you a checklist to facilitate this process.
How do I know if my loved one will have enough money to stay in their home?
Since elders are living longer and want to “age in place,” this is definitely a concern for many. The sooner you have a handle on their financial picture the better. A trusted financial planner will take the time to listen and analyze your loved one’s financial situation and make recommendations on how they can stay in their home or identify alternate living options that fit their needs and lifestyle. Assistance with this, of course, is one of the services included in your relationship with GMS Associates.
What is elder law?
An elder law attorney focuses on issues concerning older individuals and their families that include:
- wills, trusts, powers of attorney, health care proxies and other estate and health care planning documents
- make sure nursing home patients rights are respected and respond to quality of care complaints
- assist in applying for Community and Long Term Care Medicaid and other government programs;
- advice about Social Security, Social Security Disability and other public /private retirement benefits.
How can I find an elder law attorney?
Most elder law attorneys are members of the National Academy of Elder Law Attorneys (NAELA), a non-profit association of attorneys specializing in legal issues affecting the elderly. The Massachusetts Chapter of NAELA is one of the most active chapters nationally, with approximately 500 member attorneys. To find a Massachusetts’ elder law attorney visit: www.manaela.org. For a listing of all NAELA members visit: www.naela.org. If you contact us, we will be happy to provide advice regarding elder law attorneys for your particular situation.
What questions should I be asking when looking for an elder law attorney?
What is a Durable Power of Attorney?
- How long has the attorney been in practice?
- Does his/her practice emphasize a particular area of law?
- How long has he/she been in this field?
- What percentage of his/her practice is devoted to elder law?
- Is there a fee for the first consultation and if so, how much is it?
- Given the nature of your problem, what information should you bring with you to the initial meeting?
This legal document lets your loved one appoint an individual to act as the “attorney-in-fact” to make financial and legal decisions for them. Without an up-to-date, carefully drafted DPOA, caregivers may not be able to protect their loved one's assets and cannot manage their finances, in case of sickness.
How do I honor my loved one’s end of life wishes?
Some elders will be very practical in this matter and encourage you to help them plan this. Others, of course, will be in denial. If possible, discuss the alternatives with them so that they, and you, can make a choice that is reasonable and practical. Above all else, remember that it is their wishes that must be foremost.
Family & Support
How do I stop trying “to do it all?"
The good news is that you don’t have to do it all! Ask for help from siblings by giving them specific tasks that they are good at and would want to do. If other families cannot help, suggest putting a non-family system in place with neighbors, home care agencies, friends, and guidance from a trusted advisor. This is one of the most common issues facing family caregivers and GMS Associates can offer a great deal of advice as to how to proceed. Remember, you probably haven't done this before so the learning curve can be steep without experienced help.
As mom’s primary caregiver, what do I do if one or more siblings are not on board with her care?
It is important that you are communicating the medical status or treatment to siblings as it changes. Ongoing communication is critical either through weekly family discussions or if living away, phone calls and/or email to be sure they are on board. If this isn’t working, suggest a family meeting with the physician or trusted advisor to get their questions and concerns addressed with a third party. We can also participate in this discussion, lending an objective view as to how other families have handled this issue.
Based on your own personal caregiving experience, do you have any tips you want to share?
If you have read through our website, you know that I personally faced this issue with both my parents in decline. It is what prompted me to do what I could to assist others.
My three golden rules for healthy caregiving are:
1. Take good care of yourself -- staying healthy both physically and emotionally is key Get some exercise each day; eat healthy meals and snacks; get enough sleep; make time for activities you enjoy listening to music, dining out, go to a movie.
2. Don’t help too much give your loved one the power and permission to be in control of their own life (as much as is reasonable), letting them make as many decisions as they can.
3. Accept help if someone asks, “Is there anything you need?” Say, “Yes.” Think of something they would like to do fix a meal, run some errands, stay with your loved one while you go out. When needed, consider hiring in-home care services to supplement your care-giving.