House Calls Appear to Be Making a Comeback
Living Trust Scams Targeting our Seniors
Advocate for Senior Citizens – Protecting Against Abuse and Fraud
Closing In on Alzheimer’s
Checklist: What to Look for in a Nursing Home
Senior Citizen Resource Links

House Calls Appear to Be Making a Comeback by Jan Fowler Sacramento, CA - Remember the good old-fashioned days when Norman Rockwell painted his storytelling themes of doctors making house calls? In the bygone era depicted by Rockwell, there was no need to bundle up the feverish baby — or, for that matter, Grandma in her wheelchair or walker — and drive to the doctor’s office or emergency room only to sit and wait for hours while breathing the contagious germs of other sick people. We healed faster, it seemed, when we received prompt treatment at home. Well house calls are making a comeback! One particular program stands out and deserves extra airtime because it’s primarily directed at the elderly and frail and is currently under study in California, Arizona, Texas, New Jersey and Florida. Approximately one year ago, Medicare approved a three-year pilot program with a company called Care Level Management, headquartered in Woodland Hills, Calif. The program studies cost-reduction for Medicare while also evaluating the effectiveness of providing in-home medical treatment to chronically ill seniors. How does the program work? Personal visiting physicians (PVPs) are available on a round-the-clock basis to make home visits to elderly patients who qualify. For acceptance into the program, a patient must have two chronic illnesses and have had two hospitalizations during the past year. No co-payments are required. Care Level Management has served more than 20,000 beneficiaries, and it has reportedly reduced acute hospital admissions by an average of 60 percent with an average net savings of 30 percent in overall hospitalization or care facility costs. Furthermore, by treating chronic conditions at home and intervening in times of crisis, the PVP system cuts back on emergency room and ambulance expenses, thereby saving the health insurance companies significant amounts of money. And what’s inside in the doctor’s little black bag is nothing like Rockwell portrayed. In fact, if he were alive today and still drawing up a cover for the Saturday Evening Post, he would most likely be sketching in a cell phone, a digital thermometer and a handheld computer (palm pilot) along with a stethoscope and reflex hammer. Personal visiting physicians are also able to gain immediate access to a patient’s complete medical records or complex history with an easy-to-use handheld device called a personal digital assistant (PDA). Further advances in technology make it possible for a doctor to bring along laptop-based lung tests and portable X-ray machines. Patients are given their PVP’s cell phone number and are rewarded by the opportunity to call their doctor at any time of day or night. They also appreciate knowing they can be examined in the relaxed calming comfort of their own home, which can be especially reassuring following a recent hospital discharge. A PVP might see six to eight patients a day and spend approximately 30 minutes to one hour on each visit. A visiting physician’s typical patient caseload ranges from 80 to 120 cases — often hundreds or thousands lower than the overall number seen by a primary care doctor in the medical office setting. Care Level Management claims that Medicare could potentially save $20 to $40 million annually if their services were extended nationally. Of course a considerable cost savings could be passed on to healthcare payers and ultimately taxpayers. And, of course, the patients are healthier and happier. For further information, visit www.carelevel.com or www.carelevelmanagement.com. This Week’s Tip: Many seniors 65 and older have high-frequency hearing losses and would never be awakened by the common high-pitched smoke alarm. If this applies to you, I urge you to go out and buy a mixed frequency signal (500 to 2500 Hz) designed for the hearing-impaired. Also install a system which includes an alarm in each bedroom to alert you in the event of a fire. -article courtesy of Senior Spectrum, Sacramento, CA http://www.senior-spectrum.com/moments/index.html

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Living Trust Scams Targeting our Seniors
by Barbara Mascio

Don't loose Medicaid Benefits because of a Living Trust!

My grandmother recently responded to a post card advertising piece received in the mail. The company that sent the post card eluded that they were 'approved' by AARP and made the claim "The Choice is Yours: Sacrifice Your Assets to the State or Protect Your Loved Ones."

Grandma did not think to call me, or anyone else in the family. She thought this post card was expecting her response, and so she called and set an appointment for the company's representative to visit her at home.

This representative created 'common ground' almost immediately with my grandma. One quick look around her home and you see photographs and other evidence of a very family-oriented, religious woman. Grandma was immediately put at ease at the friendly, self described 'Christian' who claimed to share the same family values as grandma.

Once trust was created, he then began to educate my grandmother on the 'horrors' of probate and the, as he put it, 'untrue legal advice attorneys provide while attempting to create more revenue for themselves.'

This company is selling Living Trusts to older unsuspecting elders, charging $800 to guarantee that their estate will not go through probate, guarantee that the final wishes outlined in the Will are carried out properly and claimed this Living Trust will save 'thousands of dollars'.

Although an attorney owns this company, the local representatives are not attorneys. They are sales people, selling one product for a commission. They are not there to serve the elder's best interests. A Living Trust is not a 'one-size-fits-all'. In fact, there are varieties of Trusts available with logical and useful applications, however, not every senior is in need of such a legal document.

When grandma decided to call me to ask my opinion, I did what most consumers would do. I checked the Better Business Bureau and found no complaints. I then went to the AARP site, which this firm claimed had endorsed their company.

Sure enough, this company is listed on the AARP site for a fee. I found this company by going to Member Services and clicking on 'Financial Services' and then did a keyword search for the company. Members Financial Services

I had to really dig into this site to find the AARP disclaimer. Most consumers would not have thought to do this, in fact, at first glance; it appeared as though this company was 'endorsed' by AARP. I personally, found this to be a disappointment considering the fact that AARP wants to be considered an 'authority' on elder care issues.

I found the disclaimer in an article on Estate Planning/Articles - It says, in the middle of the article, AARP does not sell or endorse any living trust products. AARP does not work cooperatively with any company that sells or promotes living trust documents. AARP does not give such companies the names or addresses of its members.

Dispelling Myths

Deciding on whether or not a Trust is in your best interest is best left to an elder-law attorney or an eldercare financial planner. A Senior Approved service, available in Ohio, that can help personalize Medicaid planning is Raymond James Financial Services

I have learned a few pointers:

Medicare and Medicaid planning varies state by state. In Ohio, Medicaid does NOT consider your home a 'Countable Resource', if you meet the following rule:

The Ohio Medicaid rule is: "The home and contiguous land is exempt as long as it is occupied by the Medicaid recipient or by the CS (community spouse) by a child who is younger than age 21, blind or disabled by a child who is age 65 or older and who has a countable income not exceeding the need standard for the Temporary Assistance for Needy Families by a sibling who has a verified equity interest in the home and who was residing in the home for at lest one year immediately before the date the individual was admitted to the medical institution.

However, if you assign the deed of your home to a Living Trust, you loose this exemption and your home is now considered a 'Countable Resource'.

Many seniors will find themselves in need of Medicaid assistance to help pay for health care services. Medicaid, once an 'entitlement program' available to those that met the age and income criteria, is now a completely different program allowing the state to collect the Medicaid reimbursement from your estate. The federal guidelines and the individual state guidelines are not always the exact same guidelines. Each state has been provided a great deal of flexibility in how they interpret and govern Medicaid. Ohio happens to be one of the worst states.

In fact, in a recent article published in Forbes Magazine, entitled 'Best Places to Die'', Ohio ranked 49 out of fifty for this and other reasons. See Best Places to Die

The Probate Myth:

If you are like my grandma, with less than a total of $200,000 in assets, chances are a Living Trust is not a reasonable vehicle to purchase simply to avoid probate. We have learned that as long as the deed, the bank accounts, the insurance policies and so forth are written with the proper legal wording of 'survivorship' these assets will seamlessly pass to the surviving spouse, without probate.

Just as the IRS has complicated tax returns to the point an average citizen needs to pay for assistance in order to file, the government has created the same quagmire with Medicare and Medicaid issues.

In conclusion:

Trusts have solid purposes, however, please speak with someone who is well versed and educated on Medicare and Medicaid issues before pursuing.

Not having a trust does not mean your estate will definitely go through Probate court.

Do not assume you know how Medicare and Medicaid works. Either speak with a professional that specializes in elder planningissues privately, or attend one of the many workshops to self-educate yourself.

Seniors, please do not invite a sales representative in to your home while you are alone. You want someone you trust (an adult child or friend) to be in the home during this sales presentation. This is not a 'dig'. You've been around the block and are more savvy than most of us and you have the right to do what you want. Just be aware that there are people out there that know how to manipulate your trust. In fact, their sales training teaches them 'how to' do just that.

Never feel pressured to 'do it right now'. All professional reputable services expect you to consider your options.

Never give your birth date, social security number, bank account numbers and so forth to anyone over the telephone or to a stranger that has come to your home.

Do not assume that a company with no complaints registered with the Better Business Bureau equates to an 'approved' service. Anyone with $500 can join the Better Business Bureau.

Get all the facts before you make a decision. Ask a lot of questions. Please, be careful.

Stop guessing! Select a Senior Approved Service! Phone toll free at 877-620-6448 for one-on-one assistance, or visit Seniors Approve Free Web Community.

-article courtesy of http://www.homehighlight.org

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Advocate for Senior Citizens – Protecting Against Abuse and Fraud

“We are building a nationwide network of services, resources and products that seniors and their family caregivers can feel safe in contracting with. We are inviting all those concerned with the right of all seniors to receive excellent and safe care to help.”

(PRWEB) May 29, 2005 -- Ruth is 87 years old this year and has been living alone since 1997. She is in good health, however the daily chores around the home became increasingly difficult. Ruth turned to her church bulletin and found a ‘Home Care Company’ advertised.

Ruth is not unique in the fact that she is widowed and lives alone. According to the '2002 A Profile of Older Americans’ published by the Administration on Aging (http://www.aoa.gov/aoa/stats/profile/4.html) 41% of women age 65 and over, are widowed and live alone.

“The ad was in the church bulletin, I assumed this was a good company,” her voice cracking from the pain and embarrassment this home care service eventually caused her.

Unfortunately, Ruth is also not alone in the fact that she became victim to fraud. According to U.S. Senator Larry Craig, past ranking member of the U.S. Senate Special Committee on Aging, ‘Vulnerable elders are being abused, neglected and exploited within their own homes and communities at an a alarming rate.’

“The lady they sent to me was well groomed, she was polite, and I had no reason to distrust her. You could tell she was from a good family …” Ruth went on to justify how quickly she was robbed of $4,200.

Barbara Mascio, founder of Senior Approved Services, states “Ruth’s story was just one of many incidences of abuse that I learned of while employed with a national home care company. The stories of abuse and fraud against this precious generation became the driving force behind the creation of Senior Approved Services.”

Senior Approved Services actively assists in protecting seniors by helping to connect them with businesses that have a verified history of providing excellent care. “We remain actively involved, a link between the senior receiving care and the business providing the care.”

“We are building a nationwide network of services, resources and products that seniors and their family caregivers can feel safe in contracting with. We are inviting all those concerned with the right of all seniors to receive excellent and safe care to help.”

See http://www.seniorsapprove.com/services.html for current listings of Certified Senior Approved Services or phone the Cleveland Ohio office at 216-883-3163 during normal business hours.

Help promote awareness and help senior citizens avoid a business that may pose a threat to this vulnerable population, see:

http://www.qualityeldercare.com/advocate.html and also;
http://www.qualityeldercare.com/employ

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Closing In on Alzheimer’s

Finally, new drugs offer real hope for reversing the disease.

By Barbara Basler - June 2007 - This month, scientists are expected to announce final test results for the first in a whole new generation of drugs designed to attack the underlying cause of Alzheimer's disease—medicines that offer what one expert calls "genuine, tangible, quantifiable hope" for those with mild to moderate forms of the illness.

"Within three years, it's all but certain we'll have disease-modifying drugs that fundamentally change the nature of Alzheimer's," says Sam Gandy, M.D., chair of the National Medical and Scientific Advisory Council of the Alzheimer's Association and director of the Farber Institute for Neurosciences in Philadelphia.

Neil Buckholtz, chief of the Dementias of Aging Branch at the National Institute on Aging in Bethesda, Md., adds, "We've gone from drugs that help for a time with the symptoms of Alzheimer's to trying to develop drugs that will actually slow down or reverse the disease itself."

Gandy says that if test results for the first new drug, Alzhemed, from Neurochem, are positive, "the Food and Drug Administration could choose to fast-track the drug and we could conceivably see it approved next year."

And if Alzhemed fails to significantly slow the progress of the disease?

Scientists are still confident that one of the more than four dozen other drugs now in human trials will succeed. One of the most promising of those, Flurizan, from Myriad Genetics, should complete its tests in the next 18 months.

Experts say there is a solid basis for all this optimism: Today's drug trials are the fruit of 20 years of scientific work on Alzheimer's.

"We're now at a point where we understand enough about the molecules and mechanisms of the disease to target new therapies very, very precisely," says Douglas R. Galasko, M.D., interim director of the Alzheimer's Disease Research Center at the University of California, San Diego. "And that increases our chances for success."

This hopeful news comes as the country braces for an epidemic of Alzheimer's, the harrowing form of dementia that Americans tell pollsters they fear more than heart disease, stroke or diabetes. Today, 5.1 million people in the United States have the disease, but the greatest risk factor is age—the longer a person lives, the greater the possibility—and in just four years millions of boomers begin to turn 65. One in eight people age 65 and older now has Alzheimer's; half of those 85 and older have it.

Very few drugs make it to Phase III clinical trials, the last step before a drug goes to the FDA for approval. Today, however, nine new Alzheimer's treatments are in Phase III trials to test their effectiveness on a large number of patients. And dozens more are in smaller Phase II trials.

This next generation of drugs is designed to prevent, destroy and clean out deposits of beta-amyloid plaque that kill the brain's nerve cells, leading to the devastating loss of memory, reason and, ultimately, life that characterizes Alzheimer's.

Researchers have repeatedly shown that when plaque is reduced in the brains of mice with Alzheimer's, the mice can solve problems and run mazes that once confounded them. And early test results for some of the new anti-amyloid drugs show they've helped Alzheimer's patients remain stable and even improve for several years.

Art Ulene, M.D., former medical reporter for the Today show and a board member of the AARP Foundation, says his brother, Howard, who has mild Alzheimer's, is taking part in a trial for a new drug, and the change in him has been "astonishing."

"Before the drug, he was repeating himself, his short-term memory was poor—you couldn't really hold a good, continuing conversation with him," Ulene says. "A year after he started the trial, I … couldn't believe the change: I had gotten my brother back."

In an earlier, tantalizing study with 375 Alzheimer's patients, researchers at Elan Pharmaceuticals tested a vaccine designed to trigger an immune response that prompts the body to produce antibodies against amyloid. The vaccine had worked extremely well in mice, but the human trial was halted in 2002 when about 6 percent of the subjects developed brain inflammation.

International researchers located 159 people from the aborted study and tracked their health over four and a half years. They found that the patients who had produced antibodies were doing significantly better than those who didn't.

"The follow-up data are very encouraging," says Dale Schenk, chief scientific officer for Elan in South San Francisco. Moreover, Swiss researchers found that four patients they had tracked showed no mental decline at all. One even ran a marathon recently.

Scientists say the follow-up findings have given them a better understanding of the level of antibodies needed to produce the best results.

Now Elan, in collaboration with drug manufacturer Wyeth, is back in Phase II trials with a vaccine researchers believe is as effective as the first, but safer. Therapies that kindle immune response are so promising that scientists are testing half a dozen other vaccines in humans. Some vaccines induce the body to produce antibodies while others contain antibodies made in the lab.

"Dealing with Alzheimer's will be a bit like treating cancer in the sense that we'll need a large number of treatments," says Huntington Potter, director of the Johnnie B. Byrd Sr. Alzheimer's Center and Research Institute in Tampa, Fla. "Some people will respond well to one treatment, others to another. And we may need to use a cocktail of drugs."

The chances of hitting upon a successful therapy soon are high, experts say, because the drugs in the pipeline attack amyloid at different stages. Flurizan, for example, works to inhibit the production of amyloid while Alzhemed is believed to discourage it from forming plaque. The antibodies in the vaccines are thought to bind to amyloid and help the body eliminate it.

Experts say even if Alzhemed or another of these early anti-amyloid drugs fails, that doesn't mean the amyloid theory is wrong. It simply may mean that the drug didn't eliminate enough plaque to significantly slow or arrest the disease.

Most of the new drugs focus on amyloid. Some trials, however, are exploring the strong correlation between heart disease and diabetes as Alzheimer's risk factors. Trials are testing cholesterol-lowering statin drugs and diabetes drugs on Alzheimer's patients. Another test is studying a drug that lowers homocystine levels—a possible risk for vascular disease—to see if lower levels slow Alzheimer's progression.

"We're not going to find one magic bullet, but I'm very optimistic we're going to see one or more of these therapeutic approaches work," says David Morgan, director of basic neuroscience research at the University of South Florida in Tampa.

Scientists are also working all out to determine the genes and other biological markers that can predict the disease before symptoms appear.

"Our best hope is to catch this disease early," says Morgan. "And if we can understand who is most at risk, we can begin treating them before it ever takes hold."

-article courtesy of AARP Bulletin - Health
More AARP health articles at:
http://www.aarp.org/bulletin/yourhealth/

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Checklist: What to Look for in a Nursing Home

April 2002

• Visit a facility on different days and at various times, including mealtimes, taking note of nursing staff levels.

• Talk to members of the nursing staff about how long they and others have worked there.

• Ask the nursing home administrators about staff-to-resident ratios.

• Get a copy of the most recent state survey of the facility to learn if it has been cited for deficiencies.

• Ask if a facility has a plan of care for each resident and if it is revised continually.

For a free copy of AARP's "Solving Nursing Home Problems: A Guide for Families" (D17065), send a request to AARP Fulfillment, EE01522, 601 E St. NW, Washington, DC 20049. Include the publication title, stock number and your mailing address.

Also, visit AARP.org's section on nursing homes.

To find the phone number of your state or local long-term care ombudsman program, use the U.S. Administration on Aging's online Eldercare Locator or call (800) 677-1116.

The National Citizens' Coalition for Nursing Home Reform has information on advocacy groups in your state. You can also order two publications at their website:
"Nursing Homes: Getting Good Care There"; and
"Where Do I Go From Here? A Guide for Nursing Home Residents, Families & Friends on Consulting an Attorney."

-article courtesy of AARP.org
More AARP health articles at:
http://www.aarp.org/bulletin/yourhealth/

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Senior Citizen Resource Links

AARP - Includes feature articles from AARP Magazine, up-to-date information on legislative issues of concern to seniors, listings of local AARP offices and services, Social Security.

AARP Driver Safety Program - the nation's first and largest classroom driver improvement course specially designed for motorists age 50 and older.

Elderhostel: Adventures in Lifelong Learning - Elderhostel, Inc. is a not-for-profit organization with 25 years of experience providing high-quality, affordable, educational adventures for adults who are 55 and older.

ElderWeb - This research site for professionals and family members offers articles about eldercare and long term care, including legal, financial, medical, and policy issues, as well as ElderStats, a searchable collection of statistics on aging, eldercare, and retirement. Also are links to region-specific information and organizations.

Family Caregiver Alliance - A nonprofit organization that helps families who care for loved ones with Alzheimer's disease, stroke, Parkinson's disease, ALS, head injury, other adult-onset brain disorders.

Growth House - Gateway to resources for life-threatening illness and end of life care. Includes sections on death, dying, grief, bereavement, end-of-life resources and related links.

National Council on the Aging - Advocacy for the aging, public policy issues, related links.

New LifeStyles Online - Lists state licensed senior housing and care providers nationwide.

OASIS - OASIS provides educational and volunteer opportunities to enrich the lives of mature adults.

SeniorNet - The nonprofit SeniorNet provides adults 50+ access to and education about computer technology and the Internet to enhance their lives and enable them to share their knowledge and wisdom. This site offers online book discussion groups, online courses in topics such as Memoir Writing and Web Searching, craft and hobby 'how-to' information and more.

WidowNet - Information and self-help resources for, and by, widows and widowers. Topics covered include grief, bereavement, recovery, and other information.

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