Author: sps

Still Alice – Alzheimer’s on the Silver Screen

Post author By sps
Post date May 5, 2015

The 2014 Oscars made history for the world of Alzheimer’s disease as Julianne Moore won the Oscar for best actress in the film Still Alice, a film about the life of a woman diagnosed with early onset Alzheimer’s. Based on the book written by Lisa Genova, the world took real notice of a disease that is reaching epidemic levels around the world; leaving us all to ask “What if?”

Moore’s character, Dr. Alice Howland, was a 50 year old linguistics professor at Columbia University when she was diagnosed with early onset Alzheimer’s. After finding that she inherited the gene from her father her three grown children had to choose if they wanted to find out if they too carried the gene. Her oldest daughter, pregnant with twins, tested positive; while her twins were negative for carrying the gene. Her son, a junior doctor tested negative and her other daughter made the decision to not be tested.

Testing For Alzheimer’s

There are genetic tests used to determine the risk factor of being diagnosed with Alzheimer’s; however, they are not 100% accurate in determining if you will definitely have Alzheimer’s.
Early onset Alzheimer’s generally occurs between the ages of 30 and 60.
Early onset Alzheimer’s is most often caused by a mutated gene inherited by a family member (usually a parent) and is called familial Alzheimer’s disease or (FAD).
Currently, the U.S. National Institute of Health (NIH) feels that genetic testing will most likely never be able to 100% correctly predict the disease due to a number of other factors that can highly influence the development of Alzheimer’s and its progression.
There is an international group Dominantly Inherited Alzheimer Network (DIAN), which studies families with the genetic mutation known to cause early-onset Alzheimer’s disease.
Early-onset Alzheimer’s diagnoses represent less than 5% of all Alzheimer’s cases.

Genetic testing for Alzheimer’s does not guarantee you will or will not be diagnosed with Alzheimer’s, only if you are at increased risk. There are other factors that play into whether or not the known gene mutates into the gene which seems to create a breakdown that creates forms of amyloid plaques (consistent with all Alzheimer’s patients) in the brain.

To Test or Not To Test

In the beginning, Alice had a plan to end her life when she became ill. Strategically planning out the entire way to end her life once her mind was no longer working was what she thought was best. She came to this conclusion once she knew that she would die from Alzheimer’s disease. No spoiler here on whether she changes her mind or she chooses to live life to the end of her given time.

Many have different views on this idea and I don’t believe there is ever going to be an agreement on that thought. However, I can share what a woman told me about her own mother who was diagnosed with early onset Alzheimer’s.

If my mother had decided to take her life when she could still realize she was slipping away, we would have missed much joy and laughter as a family.

Most of all, we would have missed her last birthday celebration. She not only smiled non-stop at the surprise party, but she ate like a trooper, opened gifts and seemed so very ‘there’ with us.

We would hve missed quiet times sitting outside in the gazebo while looking at the flowers, the birds, and the sky (smiling).

We would have missed playing UNO and ‘wheelchair races.’ Those few memories we made far outweighed the days where she wasn’t really with us and we missed her.

Whether portrayed on film, book or in real life, Alzheimer’s disease is not easy for anyone. Deciding whether or not to test to see if you are at risk is a very personal decision; for everyone who has Alzheimer’s or someone they love who is affected, we all hope for a cure to come.

Materials Referenced:

NIH – Alzheimer’s Genetics Testing

ABOUT THE AUTHOR

JOYCE APPERSON, RN, GCM

Joyce Apperson is a Registered Nurse and Geriatric Care Manager with 15 plus years of experience working with advocating for seniors. She is the founder and President of Caring Connection, Inc., which provides in-home care and geriatric care management in Harford County, Baltimore County and Cecil County in Maryland. Joyce currently serves on the Harford County Advisory Board on Aging. In addition to writing articles here for the Caring Connection’s blog, Joyce has been a regular contributor on senior care topics to the County Gazette and an advisory board member for her local Area Agency on Aging.

Health and Wellness

5 Toughest Decisions Alzheimer’s Caregivers Will Ever Face

Post author By sps
Post date April 15, 2015

Aging affects us all, regardless of income, health, social class, or the other myriad boxes we humans find ourselves in. For 43.5 million people, aging affects them while they are still young or healthy. These are the family caregivers, which care for spouses, parents, siblings, and other relatives over the age of 50. The scope of the care varies from minimal to major, depending on the condition and age of the family member. The Alzheimer’s Association estimates out of the 43.5 million caregivers nationwide, 14.9 million are caring for a relative with Alzheimer’s disease. When you are caring for a family member with Alzheimer’s or dementia, chances are you will eventually have to tackle these five tough decisions.

Should They Be Behind the Wheel?

Alzheimer’s follows a known course, but the speed at which it progresses varies from person to person. This can make it difficult to know when it’s time to officially take the keys. Fortunately, the Alzheimer’s Association has provided us with some warning signs:

Getting lost or forgetting the location of familiar places.

Missing traffic signs or lights, such as failure to stop.

Slow reaction times and poor decisions, such as stopping in the middle of traffic.

Driving way too fast or way too slow.

Exhibiting signs of anger or confusion behind the wheel.

Although spotting the signs may be simple, broaching the subject can be difficult. Although you need to be sympathetic and kind, this is also the time for tough love. Be honest with your loved one – that you worry for both their safety and the safety of others. Don’t leave the keys where they can find them. Driving can be hard to give up since it signifies independence to many, but you must enforce this when the time comes.

Can You Handle This On Your Own?

For many caregivers, admitting that their loved one has become too much for them to handle on their own is the single most difficult thing. Understandably, many balk at the thought of putting a loved one into a longterm care facility. Yet, it’s still vitally important that you recognize when it’s time to let go and ask for outside help.

Fortunately, there is an alternative. In-home caregivers can help relieve the stress of caring for your loved one. This frees up your time so you can tend to the other important things at home, such as your kids, spouse, job, and even yourself. An in-home caregiver also offers an important facet of Alzheimer’s support for your loved one, since the caregiver is trained and knowledgeable in Alzheimer’s care.

Is It Time to Consider a Nursing Home Facility?

Even with loving in-home care and the help of an in-home caregiver, the time may eventually come where your loved one needs the 24-hour care that they can only receive in a long term care facility.

This can be one of the toughest decisions you will ever face. Often, family caregivers feel as though they are abandoning their loved one to strangers, and it may seem controversial to put a spouse or parent “in a home.”

You must look at this objectively. What is best for your loved one? A long-term care facility can be the best, most loving, and most respectful thing that you can do for your loved one. They will receive the Alzheimer’s therapies they require to help the cope with their condition as it progresses. They will also be treated with the respect they deserve. You will no longer be emotionally or physically worn out, so you can focus more positive energy toward your loved one.

Generally, Medicare only pays for a short term stay. The best option is to have a long-term care insurance policy, in some cases your loved one may qualify for Medicaid.

Should You Still Visit If Your Loved One Doesn’t Recognize You?

The short answer is a resounding yes. Researchers are still trying to understand Alzheimer’s, so no one knows for sure that your loved one doesn’t recognize you on some level.

Further, think of it from a humane standpoint – no one likes to be completely alone. Even if your relative doesn’t seem to know you, they may still like having visitors. Since there is no way to know completely what your loved one is feeling and understanding, and what they are capable of expressing, regular visits are always the correct choice.

When Is It Time to Say Goodbye?

Caregivers often fall into a sense of complacency when it comes to their loved ones. Things haven’t been “normal” for so long, they fail to notice or choose to ignore the signs that it may be time for end of life planning. Hospice care is generally recommended when life expectancy is less than six months.

It may be time to look into hospice care if repeated infections, such as pneumonia, have occurred in the last six months or if your loved one is having difficulty eating and is losing weight. Ask your loved one’s doctor for honest answers, because it’s better to prepare now than to be caught by surprise later.

Tags alzheimer's, caregiving

Medicaid New Jersey

Millions Of Medicaid Dollars For Vulnerable Seniors

Post author By sps
Post date April 8, 2015

In recent times, Medicaid applicants have been experiencing delays in receiving Medicaid determinations. These delays impose real challenges to the Medicaid applicants as well as to their healthcare providers. The Health Care Association of New Jersey ( HCANJ) a non profit organization that represents long term care providers and the individuals they serve, recognized this challenge in a very real way. HCANJ has been instrumental in bringing this challenge to the front of the state assembly. As a result of their efforts, a bill was proposed named “Uncompensated Pending Medicaid Beneficiary Payment Relief Act,” (A-3928). This legislation dictates that should ninety days pass after a Medicaid application is submitted without a Medicaid determination, Medicaid would be required to grant payments to nursing homes for up to fifty percent of the estimated amount due for uncompensated services.

“Protracted delays in Medicaid application approvals force individual nursing facilities to carry hundreds of thousands and some even a million dollars or more worth of uncompensated care,” said HCANJ Vice President and lobbyist John Indyk. “It is a cash flow problem that makes this legislation a top priority for HCANJ.”

Senior Planning Services has helped countless individuals in obtaining Medicaid eligibility and have processed thousand of applications in the State of New Jersey alone. The data that Senior Planning Services has accumulated depicts the everyday challenges that Medicaid applicants face when applying for Medicaid benefits. It is for this reason that Neil Stern represented Senior Planning Services and gave testimony at the Assembly Health and Senior Services Committee hearing. Aside from Mr. Stern’s testimony, the committee also heard testimony from various leaders in the healthcare industry. Senior Planning Services is proud to continue playing a lead role in making things better for Medicaid applicants and healthcare providers.

If you would like to read a press release on the hearing that is posted on The Assembly Democratic Office Website, click Here.

All content in this post is for informational purposes only.

Medicaid Connecticut Medicaid New Jersey Medicaid New York Medicaid Pennsylvania

Is There A Difference Between Medicare And Medicaid?

Post author By sps
Post date March 18, 2015

The answer is a resounding Yes.

Medicare is health insurance that pays for doctor’s visits, hospitalizations, certain medical equipment and short term rehab. Medicare is available to individuals who are over the age of 65, and younger people who are disabled. Medicare also requires that the individual be a resident of the United States for a minimum of at least 5 years. Medicare is not dependent on one’s income. There are some scenarios in which an individual may not be eligible if the applicant or their spouse never worked or paid taxes.

Medicaid is a need based program in that eligibility is dependent on one’s income and assets and sometimes their Medical condition. Medicaid is available to cover ones long term care services either in a care facility setting or for services in one’s home. There is an extensive application process in which applicants may be required to submit documentation about their medical and financial circumstances. Once the necessary information has been gathered and submitted to Medicaid, a county caseworker will review and determine whether or not the individual meets Medicaid’s eligibility guidelines.

To illustrate the differences between Medicare and Medicaid coverage, I’ll share with you a story about Ann. Ann was an active elderly woman who had all her wits about her. She walked to the grocery down the block weekly to purchase her produce and hopped on the city bus to do her monthly shopping at Shop Rite. This past winter, after a really big snow storm, Ann walked out of her apartment building, slipped on ice and broke her hip. She was admitted to a hospital for a week all while Medicare was being billed for the services provided there. She was then discharged to a nursing home for rehab. She was receiving rehab for about 20 days while Medicare was covering the full cost with no co-pays or insurance. A Medicare nurse evaluated Ann and informed her that she was eligible for more rehab, another 80 days but now it wasn’t free of charge and Ann was required to pay a copy of $157.50 a day until the 100 days were up. Ann had thought once she would reach her 100 days she will be well enough to return home. The diagnosis wasn’t looking positive and Ann would need to stay at the facility long term. Medicare will not cover Ann’s stay after 100 days. Medicare views more than a 100 days as long term services and therefore Ann would either be required to pay the nursing home the private monthly rate or apply for Medicaid. Ann was in no position to cover the private monthly rate of $10,000.00. Luckily, the skilled nursing facility informed Ann about Senior Planning Services who helped Ann secure the Medicaid coverage she so desperately needed. Medicaid then covered the nursing home bill in full.

Medicaid New Jersey

Obtaining Medicaid Coverage For A Homeless Individual

Post author By sps
Post date February 27, 2015

Naomi, a Senior Planning Services caseworker, related her experience in trying to obtain Medicaid coverage for an individual who had no family support and was homeless for a period of time. Additionally, he had poor memory and gathering necessary information changed a simple caseworker into an investigative detective. Ultimately, Naomi achieves the impossible: a Medicaid approval.

In mid April, Senior Planning Services retained a case from a nursing home for Gregory Slate who needed Medicaid coverage dating back to January. According to Medicaid guidelines, one may be able to obtain retroactive coverage three months back so long as at the time of the coverage request date the individual had met all the Medicaid guidelines. Being that Greg was homeless for a short time, we were under the assumption that he would meet the financial criteria . After speaking with the skilled nursing facility where Greg resided at, it was confirmed that Greg had also been clinically evaluated and that medically he had met the Medicaid requirements. Naomi understood that for Greg to remain eligible for retroactive coverage the application needed to be submitted before the end of April. This implied that Naomi had about two weeks to open the case with Medicaid and submit necessary information. There was just one problem: Greg could not recall where he banked and had no documents to establish identity or citizenship.

Naomi quickly filled out an application with the limited information and submitted it to Medicaid to open the file. Simultaneously, she sent out request letters to all the established banks in the area with the hopes that one of the banks was the one where Greg’s accounts were held. Sure enough, Naomi received a response and was able to obtain the five years of bank statements for Greg’s application. She also had to obtain a birth certificate for Greg to establish identity and citizenship, but once again, Greg’s memory fell short and he was unable to recall the name of his mother. With extensive research into the previous facilities that Greg had been at, Naomi was able to track down a distant family member who had the information necessary to request a birth certificate from vital statistics. There was much back and forth with the Department of Vital Statistics but eventually the birth certificate was received and a copy was sent to Medicaid.

Once the five years of bank statements had been received, Naomi carefully reviewed them. Greg was over the Medicaid asset limit due to his Social Security money accruing. Naomi reached out to the Medicaid case worker to explain the situation and ask for retroactive coverage despite the fact that he was over the resource limit. There are guidelines that the caseworkers can sometimes fall back on if an exception is needed. After much negotiation with the case worker at the Board of Social Services, Greg was approved for Medicaid with the retroactive coverage he needed to cover the nursing home bill.

Names have been changed to protect the privacy of those involved.

Medicaid Made Simple

Personal Property Managers

Post author By sps
Post date January 29, 2015

Hi Everyone,

I just wanted to share with you a great service that can help our senior population. I had the privilege of getting to know Joe Santoro who is one of the founders of Personal Property Managers.

Personal Property Managers play a pivotal role in the process when Mom or Dad are transitioning to a Long Term Care Facility. They assist clients in content and asset liquidation that complies with Medicaid guidelines. They assist families with helping their loved ones transition from their homes of many years to a senior care community.

They offer a full spectrum of services

Home downsizing services

Home clean out services

Estate sales services

Full service real estate (home sale) services

Home watch services

Moving services

This is a great service that really alleviates a lot of stress from families that are going through this process. It’s a complete package in one phone call. Please reach out to Joe or Nick at 908-368-1909 in NJ or 215-485-9272 in PA or visit their website at www.personalpropertymanagers.com.

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