A 97-year-old woman with dementia has found that tens of thousands of dollars are missing from her bank account without her knowledge, so she reported it to her bank.

The bank has found that all her money was transfered to another person’s account – the woman’s power of attorney.

However, when the police asked the power of attorney about the money, the power of attorney said it was because the the woman wanted her to have the money and leave everything to her.

You might be confused about who is telling the truth, but this is a real case that happened in Ontario, Canada, back in 2020, and is a typical example of elder financial abuse.

What is Elder Financial Abuse?

According to the definition. Elder financial abuse means “any inappropriate behavior, with or without the informed consent of the older person, that results in monetary or personal gain for the abuser and/or monetary or personal loss for the older person.” which means elder financial abuse is the most common form of elder abuse.
Trust takes years to build, but destruction takes only seconds and can have a serious impact on a person’s health.
In the story above, the woman’s savings were misappropriated by someone she trusted and was destroyed both financially and emotionally. It sounds harsh, but unfortunately, that’s how most stories of financial abuse in older adults go.

Financial abuse can be categorized into the following three ways:

1. Stealing an elder’s valuables

2. Taking control of an elder’s power of attorney

3. Using the elder’s cash or credit cards without permission

Most of these cases are done by someone that the older person trusts, or someone who has always been with the senior – which means they could be family, friends, lawyers, or caregivers.

Today, we are going to talk about elder financial abuse that happens in long-term care homes, and what we could do about it as their family.

How to Recognize If Someone Is Experiencing Financial Abuse

• Your Loved One Suddenly Has a New Good Friend”

When family members are not around, older adults tend to seek companionship. Therefore, they become more vulnerable and passive when people with bad intentions approach them. It is important to be on the lookout for any new “friendships” that seniors may form. If your loved one begins to rely on this new “best friend” in many ways, even defending their relationship when you have doubts. It is not a good sign, as a good friendship will not keep this person out of their family.

• Reporting Missing Belongings

If your loved one starts to complain about losing or missing something, it could be that someone has taken them from him or her. Note that seniors with cognitive impairment such as dementia may accuse others of stealing from them as well, so it is better to observe for a period of time to see if it is true.

• Unusual Banking Activity

If you and your loved one have a joint account and see unusual activity. For example, a large bank withdrawal, or a large payment to an unfamiliar account. That’s when it’s time to pay attention! This would be a “deadly trap” where someone is pressuring or enticing your loved one to make a payment, or worse! Your loved one’s card is stolen or controlled by someone else. This would be a “dead giveaway” that someone is pressuring or enticing your loved one to pay, or worse, if your loved one’s card is stolen or controlled by someone else.

• Sudden Change Of Will Or Power Of Attorney

As in the story above. You already know that a financial power of attorney represents the financial and legal affairs of a client. Therefore, if it is transferred to someone other than a close friend or family member for no apparent reason. This would be a red flag that someone is trying to take advantage of you.
There are some other indicators. Such as signed documents that the senior does not understand, overdue bills and a decline in standard of living. Seniors may not notice these signs, so it is the family’s responsibility to watch their financial situation. There are many agencies and programs designed to combat financial exploitation, and you should get them involved as soon as any of these signs appear.

How To Report Elder Financial Abuse

• Financial Institutions

Remember what you do when you have suspicious activities going on in your bank account? For senior financial abuse, the bank and credit unions can help to investigate if there’s any misappropriation happening to the card holder as well. If the case is confirmed, the employees at the financial institution will report it as financial abuse immediately.

• Law Enforcement Agencies

It is always crucial to work with the police and investigate the abuse. Financial exploitation is a crime and you have right to report it and protect your loved one. Also, it will help to prevent more victims from falling into the trap of financial fraudsters.

• Long-Term Care Regulation Institutions And Senior Abuse Prevention Lines

There are many long-term care regulation institutions across North America. In Ontario, we have the Ministry of Health and Long-Term Care that is in charge of this. The ombudsman will investigate and escalate the case for you. In addition, you can call the senior’s safety line, where staff will be on the line 24/7 for you, and it is toll free.

How To Prevent Financial Abuse As Their Family

Prevention is better than a cure. It is always good to prevent senior financial exploitation before it is too late. There are some ways to help you with it, which include:

• Signing Up For Services That Track Their Account

You can use tracking tools such as EverSafe to track missing deposits, unexplained withdrawals, or abrupt changes in spending patterns that take place in your loved one’s account. Or, you can have a joint account with your loved one and see the activity.

• Setting Up a Trusted Contact For the Account

If there is abnormal activity going on in the account and the bank is unable to reach the one who holds the account. Then, the bank will report it to the account’s trusted contact. The trusted contact may be given access to the account’s details as a view only user. However, he or she will be unable to make any transactions on account holder’s behalf.

• Staying In Touch With Your Loved One

Nothing is better than maintaining a close relationship with your loved one. In fact, more senior financial abuse cases happen to the ones who are chronically lonely. After all, if your loved ones can’t reach you when they need, they can only trust the people that approach them

• Geting To Know Their Caregivers

No matter if it is in-home care or long-term care, it is important for the family to know the caregiver of their loved one. In one of our previous blog posts, we talked about how screening caregivers is crucial in the hiring process (Top 10 Questions To Ask When Hiring A Home Care Agency). Screening and observing do not stop after you hire the caregiver. Do this by using the CareStory profile service, which will allow you to track caregiver activities during care. 

References:

https://www.cbc.ca/news/business/power-of-attorney-seniors-elder-abuse-senior-financial-crime-1.5476820

https://www.nursinghomeabusecenter.com/elder-abuse/types/financial-abuse/

https://www.aarp.org/money/scams-fraud/info-2021/prevent-elder-financial-exploitation.html

https://www.rbcwealthmanagement.com/en-ca/insights/financial-elder-abuse-five-common-signs-

The question of whether to send our ageing parents to a long-term care home or not is a question that has been distressing Amy and her sister for months. As their father’s primary caregiver, Amy finds it getting harder and harder to keep up with the speed of his aging.

“I really do think we should send dad to a long-term care home,” says Amy. “They have better equipment and professionals to deal with any situations that may occur.”

“Well, sending him to a novel environment could only exacerbate his symptoms,” replied Amy’s sister. “And he clearly said he’ll never leave the house. If you are feeling overwhelmed, we can hire a caregiver for him.”  

“It’s not about me feeling tired and overwhelmed,” sighed Amy. “It’s about him getting a better quality of care.” “Frankly speaking, you don’t really know his situation. After all, it has been me taking care of him all this time.”

Another unpleasant conversation ends, just like usual.

Keeping ageing parents at home may cause distress for many families, but sending them to a long-term care home isn’t a panacea to every problem, either – there are pros and cons you need to take into account to make the best solution for you and your family.

Today, we are going to talk about the good and the not-so-good in each option. Hope it helps to make your decision easier.

Let’s get started.

What’s Good About Aging In Place?

1. Familiarity

First and foremost, familiarity is the main reason why seniors want to age at home. Familiarity of the home environment provides security for senior. Living in a familiar surrounding can ensure happiness and comfortability, which is greatly beneficial for seniors’ well-being.

2. Remaining Independent

Although some seniors need companionship and helpers with their daily activities, they still care about their independence. Ageing at home makes seniors think they are still capable of taking care of themselves, which will further help them to acquire the ability to live independently; a virtuous circle for healthy seniors.

3. More Control Of Life

Who doesn’t love freedom? Ageing in place allows seniors to have more control of choosing the lifestyle they want. For example, instead of following the routine and diet that other people have set for them, they can have their own flexible schedule and preferences when it comes to food. This, again, maintains independence for seniors.

4. Closer amily Bonds

Whether family members are living with the senior or not, it is more helpful in maintaining good family relationships if your loved one stays at home. Family members can visit the senior whenever they want and can spend more time doing fun things together. Home is always home, no matter how far you travel – it is always a place for you to reunite.

However, There Are Drawbacks

1. Physical Safety

Without question, the home environment can’t provide enough safety measures for seniors, especially those with mobility issues. Remodeling a home for seniors to live takes time and effort, but in not doing so, seniors may experience a deterioration of their symptoms in a very short time. We have all heard about the tragedies of seniors falling down and not getting help in time, leading to agonizing consequences for both the senior and the family.

2. Nutrition

Some seniors with mobility or cognitive issues may be unable to prepare meals, or go grocery shopping, which may lead to malnutrition. Hiring a caregiver or even someone to cook may help with this. 

3. Increased Responsibility For Families

Just like Amy, seniors who live at home will certainly increase the workload of their families. Especially when the children have their own career or family to focus on, squeezing time from their hectic life to take care of their ageing parents may not be beneficial for both parties. In this case, hiring a caregiver may relieve the burden a lot.

4. Isolation

Many grown up children choose not to live with parents, and when they live too far, senior isolation may occur. We have previously published a post on “Senior Isolation” and explained how detrimental it could be to the senior’s quality of life. So, check it out and see how to decrease the harm if you are not able to be around your loved one enough.

Now, let’s talk about seniors living in a long-term care home.

What’s Good About Living In A Long-Term Care Home?

1. Staffed With Professionals To Meet Different mMedical Needs

There are not just personal care workers in long-term care homes. In fact, some long-term care homes provide various professionals that focus on different conditions, and even emergency situations. Plus, the care they provide is around the clock, which is something barely achievable for in-home care.

2. Seniors Have Social Connections With Staff & Other Residents

Maintaining a social circle is specifically important for seniors. Long-term care homes create multiple opportunities for seniors to actively engage in social interactions. These opportunities include various clubs, social events, performance and volunteer opportunities. Participating in these activities can give seniors a sense of purpose, prevent loneliness and improve their social skills, which in turn benefits the seniors’ relationships with their families.

3. Suitable For Seniors With Cognitive & Mobility Impairment

Long-term care communities are designed for seniors with different types of challenges. Most have alert systems and different accessible equipment. All long-term care homes need to follow the government’s design manuals to ensure their residents to age safely.

4. Relieves Burden On Senior’s Families

If the senior requires a lot of care, sending him or her to a long-term care home greatly alleviates some burden for families. It’s not only about decreasing care duties, but also about relieving financial obligations. Hiring a full time caregiver, in most cases, is more expensive than living in a long-term care home.

There Are Drawbacks, Too.

1. Seniors May Need Time For Transition

Although there’s “home” in “long-term care home”, it’s hard for strange places to feel like “home” immediately once moving there. It usually takes quite a period of time for seniors to adapt to their new life in long-term care communities, and such a transition could result in many negative psychological and physical responses. See our blog post on “Tackling Fear And Anxiety During The Transition Into Long-Term Care” to see the details. 

2. Loss Of Dependency Make Seniors Feel “Old”

Yes, your loved one is old according to his or her age, but no one wants to “feel old” and “live old”. Living in a long-term care community may make the seniors feel that they have lost independence and privacy. This would make them feel “old” and “vulnerable”, which is not good for both the seniors and the staff. Seniors may behave strangely in the way that they feel about themselves.

3. More Preparation Is Required On Choosing The Right Long-erm Care Home

In our provious blog post on “How to Select a Long-Term Care Home”, (CTA)we discussed how it takes a lot of time and effort to choose a “good” home for your loved one. If you haven’t read it yet and are considering whether or not to send  your family to a long-term care home, check it out now and don’t forget to download the free checklist!

4. Not Easy For Family Members To Visit

Long-term care homes aren’t like shopping malls – you need to make appointments to visit most of the time, especially during a pandemic. Some long-term care homes may even cancel visitation depending on the circumstances. In that, the family members may feel rejected and distant from their loved ones.

At the End:

There are many factors you need to consider when deciding on whether to send your loved one to a long-term care home or let them stay at home. It’s important to communicate with your loved one and respect their feelings. So, instead of deciding “for” your loved one, try deciding “with” them. Respect and empathy are always important traits of happy senior living.

References:

https://www.innovativehomecare.com/home-care-vs-nursing-home/

https://environmental-conscience.com/nursing-homes-pros-cons/

https://www.caringseniorservice.com/blog/home-care-vs-nursing-home

“Just one more week, your mom would be good to go.” Says the doctor.

Jane’s mom just finished her pacemaker implantation surgery, and it went perfectly well. Now, it’s time for home.

Excited yet overwhelmed, Jane feels like she’s not ready for her mom’s to come back home – she knows there are so many things to do to welcome her, and she’s feeling lost.

We feel you.

Helping your loved one recover from surgeries requires patience, organization, and well-thought-out planning. Here are some helpful tips for seniors recovering from surgery at home.

Things You Should Do to Help Your Loved One Recover from Surgery at Home

1.     Talk to the medical team

If you don’t trust yourself, trust the professionals. The very first step you should take is to speak with the medical staff who’s caring for your loved one.

To ensure that your loved one’s recovery from the surgery is as successful as possible, ask them the following questions and take notes; these questions will help you through the whole process of caring.

• How long will the recovery take?

• What medication and supplement will we need?

• How to help him or her get better faster?

• Physical and nutrition plans?

• What behaviours should be done/avoided during the recovery?

2.     Stock up items that your loved one would need

This step will be done after you consult the medical professionals. Once your shopping list is done, it’s time to head to pharmacies and grocery stores to stock up all the items. What drugs does your loved one need? the foods that your loved one will eat? Are there any things she or he needs to help with the recovery? It is good to prepare the stuff ahead of time.

3.     Create a safe environment for them

Senior’s at-home recovery always requires additional preparation than younger people. Other than purchasing things like compression socks or elevation pillow according to their needs, you can make the home environment safer and more comfortable by installing grab bars and nightlights, while removing unnecessary staff that might cause falls or slips. Put phone, lamp, and other frequently used items accessible around your loved one’s bed – a little makes a huge difference, your family will appreciate all these details.

4.     Plan their diet

it should be cleared when your loved one is about to leave the hospital. Follow the nutritionist’ advice, or search for a diet that is complementary to their recovery. Also, don’t forget to encourage your loved one to eat and drink. Some patients lose appetites after a surgery, but you should ensure they gain enough nutrients to expedite the recovery.

5.     Observe and help

Recovery is usually a long and frustrating process, and the patients may not notice the change to their physical and medical conditions themselves. So they will need your efforts to detect if there’s any change during the healing process, and offer help when they need it.

6.     Be attentive to their emotions

There are so many uncertainties during the recovery process! So it is normal that your loved one becomes more sensitive than usual. As their family, you should be careful about what you say or act. Also, you can take them to some recreation activities or provide them some entertainment. See our blog on “How to Accompany a Senior” to find the details.

We are always kids no matter how old we grow, playing fun games would excite your senior family, too. 

7.     Accompany them to follow-up appointment

Some seniors are able to go to the follow-up appointments themselves. But it is still helpful if someone would accompany them to finish this task. It will not only allow you to know how to take care of your family better, but also give you a sense of participation. By doing so, you are basically telling them that: “you are not alone, I’m always here for you.”

8.     Ask for help when you need it

Taking care of a patient can be stressful, so if you feel that it is getting hard for you to keep up all the work, don’t be afraid to reach for help.

You can hire an in-home caregiver to come home regularly, and help your loved one with dressing, bathing and housekeeping. It will be a life saver for you if you are a busy person.

Hiring a caregiver does take some work to do, too. Don’t panic, CareStory has prepared you 10 questions to ask on the way of looking for a home care agency.

References:

https://www.homecareassistancedesmoines.com/how-to-help-aging-adults-at-home-following-surgery/

https://www.canada.ca/en/financial-consumer-agency/services/insurance/long-term-care.html

A wedding takes place in a beautiful white house with floor-to-ceiling windows that look over a tranquil lake decorated with snow. As the wedding song plays, a father walks the bride down the aisle. Everyone sheds tears, especially the father. Besides being happy for his daughter as she enters a new phase of her life, he knows that the wedding could be his last happiest memory since it is held at a hospice.

Hospice is a place for people at the very last phase of their lives. When a patient is in the later stages of a severe illness, medical therapies may no longer improve the situation but only increase their pain. So instead of treating the disease, the philosophy of care is to treat symptoms and make the patient live their remaining time as happily and comfortably as possible.

If you are new to this term, this article will provide all the essential information you need to know about hospice, which will guide you to make a better decision.

What does hospice care provide?

Palliative care and symptom control are the focal points of hospice. The goal is to help the dying live with dignity and ease physical pain and emotional needs. The care teams comprise a nurse, assistant, social worker, bereavement coordinator, and volunteers. The medical director manages the hospice team and adjusts to the patient’s needs. A hospice team’s primary responsibility is to coordinate all services for patients and their families.

These services include:

• Nursing care focuses on the patient’s physical symptoms.

• Hospice aide that provides personal care, including bathing and grooming.

• Social work visits help coordinate resources from the community and in the family.

• Volunteer companionship.

• Bereavement support for the family after the patient has passed away.

How is hospice care provided?

Hospice care is available at home or in a supportive community. Usually, inpatient treatment is needed when patients have symptoms they cannot deal with at home (e.g., uncontrollable vomiting, acute pain, etc.). It can happen in a hospital, or long-term care community and patients can still return home when they are ready.

The care staff works around the clock to keep in touch with patients and their families, whether at home or hospital. Regular sessions, usually led by hospice nurses or social workers, keep family members informed about the patient’s health and prepare them for what to expect. Families can also express their concerns, learn about death and the dying process, and gain tremendous support and stress relief by attending family gatherings.

Almost everyone who lives in hospice is receiving end-of-life care, and their family is aware of this fact. Hospice care also provides “after-death” care – which we call “bereavement care” – for the families.

Bereavement is the period of grief following a loss. The hospice care team works with family members to assist them in getting through the grieving process. Family members will receive help from trained volunteers and professional counselors through regular visits, phone calls, and other forms of contact, as well as through support groups. The café team can refer family members and caregivers to other medical or professional services if necessary. Typically, bereavement services are provided one year after the patient’s death.

Who qualifies for hospice care?

When determining eligibility for hospice, a doctor must certify that the patient is terminally ill with a life expectancy of no longer than six months.

The situation certainly needs consultation and approval from professionals, such as the health care team, discharge planners, doctors, local health departments, and hospice organizations. However, whether to begin care or not could be highly personal. Even if the patient fits the conditions above, they cannot admit to hospice without agreement.

Types of hospice care

There are four types of hospice care, each tailored to a patient’s specific need. Two are in the home, and the other two take place in healthcare communities. A patient may get one or all four types during their hospice stay.

Routine home care

Routine home care is the most common type of hospice care. This is provided at the patient’s home, whether it is an assisted living home or in a senior healthcare community. The care team, which includes home health nursing aides, RN case managers, licensed practical nurses, social workers, spiritual care specialists, community educators, and volunteers, will make a regular visit at home.

Many patients prefer routine home care because it allows them to remain in their familiar surroundings. It also makes it more convenient for family and friends to visit on their own time.

The care team will bring medical equipment and medications to the patient’s home and make regular visits as needed. Some group team members may attend the holiday visit daily, while others may come once a week or as needed. Telecare services are available to the patients 24/7 to answer questions, and, if necessary, the team will send a professional to the patient’s home.

According to the stats from the Hospice Valley, the average cost of routine home care from day 1 to day 60 is $199.25, and from day 60+, the payment would be $157.49.

Continuous home care

Continuous home care is more intense than routine home care, which provides ongoing assistance to patients experiencing acute symptoms (e.g., intractable pain or nausea, breathing difficulties, bleeding, agitation, seizures, or changes in the state of consciousness). This is usually only done for a short period to enable patients to stay at home through a more challenging situation.

Just as routine home care, continuous home care comes with two different prices based on the needs. The hourly rate of constant home care is $59.68. If the care needs for 24hours, the total rate would be $1432.41 (data from the Hospice Valley).

General inpatient care

General inpatient care is recommended for treating symptoms that cannot be adequately controlled at home. This usually exists in short-term cases at a hospital’s hospice unit or a long-term care home.

Many patients and their families prefer free-standing hospice communities, which have a more tranquil and home-like environment for patients to receive general inpatient care. Also, arrangements can be made for visitors to stay overnight.

Short-term general inpatient care costs can range from $744 to $1045.66 per day, as reported by griswoldhomecare.com.

Respite care

Respite care is short-term inpatient treatment designed to help family caregivers and patients. Caring for a chronically or terminally ill family member can be emotionally and physically exhausting for all parties involved. The patient is usually admitted to a hospice community for a brief time if necessary. It also relieves family caregivers of their daily obligations, which reduces stress. Respite care is only available for a few days, in crises when the family needs to be away or needs a break.

The price may vary in different communities, but the average daily rate of inpatient respite care is about $416.09, as stated by Hospice Valley.

Hospice vs. Long-term care homes

Although some of the services that hospice and long-term care homes provide are mutually inclusive, their mission is the main difference between hospice and long-term care homes.

Hospice concentrates on making the dying process more comfortable and acceptable for those who have realized that death is inevitable. On the other hand, a long-term care home provides full-time skilled healthcare staff to seniors who require higher care. When the condition has deteriorated for a patient living in a long-term care home, they can transfer to a hospice.

How long do patients usually live in hospice?

According to research from the Journal of Palliative Medicine, around 35.7% of hospice patients die within a week. The average length of stay in hospice is 76.1 days. 

Hospice is design for patients have less than six months to live. However, many patients can live longer. 

According to the survey, 12-15% of patients can live for more than six months. It is challenging to predict how long each person will live because each situation is unique. The study found that patients under 65 are more likely to live for more than six months after being referred to hospice.

What if the patient gets better?

Miracles do happen!

People who get hospice care are more likely to recover. Because their food and medicinal needs are satisfied, and the care process provides them with additional attention and emotional support. 

Patients will be discharged when their condition improves enough to start treatment or when life expectancy is determined to be more than six months.

The live discharge also happens when the patient feels better and starts to look for more aggressive treatment. As we said, hospice care is a very personal option, and it may vary hugely from person to person. A report from Health Affairs says that nearly 20% of patients are discharged from a hospice for many reasons.  It could either be the patients’ own decision or the decision from the professional medical teams, but a patient can return to a hospice if needed.

Who pays for hospice care?

Knowing that taking care of patients is already burdensome for the family, many health plans can cover the expense of hospice. The Provincial Health Plans cover hospice care provided in a hospital in Canada. Medicare Health Care Benefit covers the United States. If the patients and their families choose to receive care at home, they can use private insurance to cover the palliative care services or pay from their pocket.

Takeaway

Hospice care provides care for patients with less than six months to live. Throughout the dying process, the care team provides support and resources to the patients and their families, including at home and in a community. Patients and their families discuss whether they should receive hospice care ongoing, as it is a very personal decision. See our post on“How to Communicate with Seniors” to find out the tips.

References:

https://www.npr.org/sections/health-shots/2017/08/11/542607941/nearly-1-in-5-hosopice-patients-discharged-while-still-alive

https://dying.lovetoknow.com/ideas-advice-coping-grief/average-time-person-is-hosopice-care-before-death

https://lifecare.org/news-events/7-signs/