The Folsom FamilyThe Challenge:
Twenty years into their retirement, the Folsoms are facing health care and residence needs that are substantially different and more complicated, requiring them to have an advanced understanding of Social Security and Medicare programs and benefits. In spite of having planned well for their retirement and living frugally since retirement, the Folsoms and daughters Anna and Karen feel more vulnerable than ever.
Detailed, concise information in clear language (no "government-ese") that takes into account the range of potential future circumstances for the couple.
The Folsoms know that whatever the future holds for the two of them, or the surviving one of them, they and their daughters now have a better ability to respond to their changing life circumstances.
Mr. and Mrs. Folsom, now in their 80s, were drawing their Social Security benefits. Their health problems were increasing and Mr. Folsom was fearful that his wife had Alzheimer's disease. Neither they nor their daughter felt sufficiently knowledgeable about the Social Security, Medicare or Medicaid benefits they will have if either Mr. or Mrs. Folsom lives for years in poor health. Specifically, they needed to know how to use their benefits to pay for or partially offset residence facility costs. They were also unsure of the couple's survivor benefits. Their daughter Anna knew that the staff of Accountable Aging had helped other elders and their children make sense out of the government benefit programs and could explain the rules and policies in layperson's English. After talking with Anna, Accountable Aging provided an overview of the benefits available to the Folsoms based on the three possible life circumstances for the couple: (1) he survives her; (2) she survives him; (3) they both live several more years with one or both spouse's health requiring residence in a nursing facility. For each possible situation, Accountable Aging provided information about the income and resource limitations for Medicaid qualification, and outlined ways the Folsoms might be granted exclusions to these limitations. In addition, Accountable Aging recommended a choice of eldercare attorneys to assist the Folsoms and their daughters with establishing trusts, if needed.(back to top)
Mrs. ArmstrongThe Challenge:
Mrs. Armstrong needed temporary care in her home, post-surgery. None of her children could leave their own home to take care of her, nor was Mrs. Armstrong happy with the idea of living with one of her children for several months. However, neither Mrs. Armstrong nor her children had any experience screening home care aides or the service companies that provide them.
In-home care provider management and frequent reporting to the children regarding their mother's comfort and well-being.
Mrs. Armstrong returned to the comfort of her own home as quickly as possible after her surgery. With bi-monthly reports based on the frequent in-home visits from Accountable Aging, Mrs. Armstrong' three children enjoyed the peace of mind of knowing their mother received the temporary assistance she needed to live safely and comfortably.
Hillary Armstrong continues to live in the town where she and her late husband raised their daughters and son, all three of whom now live at some distance from their hometown. So when Mrs. Armstrong' doctor recommended knee replacement surgery, Mrs. Armstrong chose a surgeon and hospital in the same city in which her daughter Marcia lives allowing her to stay with Marcia immediately after the surgery. A few weeks following her surgery, Mrs. Armstrong was eager to return home and allow her daughter, son-in-law and grandchildren to resume their normal routine, sans invalid. In fact, Mrs. Armstrong was quite determined to return to her home, even though she was still several weeks away from being able to live fully independently and move about the house safely and confidently. Daughter Marcia contacted Accountable Aging. The following day, Accountable Aging provided Mrs. Armstrong and Marcia with detailed information on three reputable, home care service companies and a series of questions that helped Marcia interview the prospective service providers. Marcia talked with her sister and brother, and then selected the appropriate service provider for their mother. Accountable Aging contracted with Marcia's selected service. The following weekend, Marcia drove her mother back to her hometown. On Sunday afternoon, a member of the Accountable Aging staff met the home-care staff member at Mrs. Armstrong's home for the on-site evaluation. Together we reviewed Mrs. Armstrong' physical limitations and the additional challenges presented by the layout of her home, as well as specific needs and requests made by Mrs. Armstrong and her children. Over the next few days, as each new caregiver came to Mrs. Armstrong' home for the first time, a staff member from Accountable Aging was on hand to introduce the caregiver to Mrs. Armstrong and ensure all details of Mrs. Armstrong' care were clearly understood. For the next ten weeks, until Mrs. Armstrong was more fully recovered from her surgery, Accountable Aging visited her home to monitor the quality of service and ensure her comfort and satisfaction with the services. Every two weeks we prepared a detailed, written report for Marcia, her sister and her brother.(back to top)
Mr. BersteinThe Challenge:
A vigorous, healthy elder is unexpectedly and permanently disabled and in need of an immediate change of residence. His next-of-kin lives in another state, and is unprepared to handle an emergency of this type.
(1) A new residence in a skilled nursing facility with excellent options for long-term care. (2) Regular visits to monitor and ensure the ongoing quality of care. (3) Information for family members on the typical consequences of a stroke of the type and magnitude, which better prepared the family to face such issues as personality changes and other potential complications.
Accountable Aging served as grandson Steven's eyes and ears, keeping him close to his grandfather through regular reports and photographs. In addition to Mr. Bernstein receiving excellent care, Steven was better prepared, both emotionally and in practice, to accept the ongoing changes in his grandfather's life and in their relationship.
Mr. Bernstein is, at age 83, the patriarch of his small, extended family. His only child, a son who was also the father of one child, had died young. Grandson Steven is now in his mid-twenties and, following graduate school, has taken a job in a distant state. Steven had given little thought to his role as his grandfather's closest living relative, and had counted on his grandfather's apparent good health to make premature any planning for the time when Granddad Bernie could no longer live alone. Then Mr. Bernstein had a disabling stroke and his grandson received the news by phone from a cousin who still lives in the family's hometown. The cousin, who had immediately understood the probable consequences of her great-uncle's stroke, also contacted Accountable Aging. Steven had a very typical dilemma; he had virtually no knowledge of residence options for his grandfather and limited time he could spare from his new job. Accountable Aging arranged for Steven to interview several recommended residences during the few days Steven took off from his job. When Mr. Bernstein was released from the hospital, staff members for Accountable Aging assisted his move into the new residence. We posted digital photos of Mr. Bernstein in his new home to help Steven feel better informed and connected with his grandfather during this transition, and equipped Steven with medical information about life after a stroke. This information gave Steven the tools to better anticipate changes he would continue to face with his grandfather. Accountable Aging continued to meet frequently with Mr. Bernstein and the staff of the facility throughout his weeks of rehab and his ongoing care.(back to top)
Mrs. GreinertThe Challenge:
A medical emergency sets all wheels in motion for Mrs. Greinert. But her neighbors and friends can do only so much. Her family lives in a distant state, and nobody saw this coming.
(1) Comprehensive, in-home medical care management. (2) Support for health-related lifestyle changes.
Mrs. Greinert's potentially risky combination of medical advice and medications was fully reviewed and a system was put in place to avoid a recurrence of taking excess or incompatible medications. Her adjustment to unwelcome but necessary changes in lifestyle was made easier. And Doug knew his mother had caring, competent people who were alert to her changing needs.
Doug Greinert received a voice mail message at his Chicago office from his mother's Austin neighbor telling him she had discovered his mother passed out on her bathroom floor. By the time Doug picked up the message to call his mom's neighbor, Mrs. Greinert had been treated as an outpatient at the hospital emergency room and was back in her home. Doug flew to Austin that night and stayed through the weekend. It had been several months since his last visit to Austin for Mrs. Greinert's birthday, at which time she had reported feeling fine and had looked strong and well. Since that visit, mother and son had talked on the phone every week; Mrs. Greinert had not mentioned any new health problems. However on this trip to his mother's home, Doug saw nine different bottles of medicine prescribed by four doctors.
What had Doug's mother not told him about her health, and what else didn't he know? He had no idea how was he going to, first, get the bottom of this in one weekend, and then take care of her from a distance of more than 1000 miles. Doug contacted Accountable Aging for immediate help with his mother. We quickly scheduled a home visit with Mrs. Greinert, accompanied by a geriatric nurse we selected specifically for Mrs. Greinert based on information we received from her son. Within the first week, staff from Accountable Aging: Obtained medical background information and reviewed the medications. Contacted the four doctors (1) to ensure all four doctors know Mrs. Greinert is under treatment by all of them, and is taking prescribed medications from all of them and (2) to determine if any of the prescribed medications, singly or in combination, could have caused her to lose consciousness. Determined she should not drive until further review by her primary doctor, given the medications she is taking Set up an easy process for Mrs. Greinert to ensure she takes her medications exactly when and as prescribed.
Over the following week, Accountable Aging consulted with Mrs. Greinert and Doug to select a primary physician to be the gatekeeper for new treatments and medications. Because Mrs. Greinert could not safely drive a car while taking her current regime of medications, we hired a driver to take Mrs. Greinert on weekly errands and to her doctor appointments. Accountable Aging staff accompanied Mrs. Greinert to her doctor appointments and made notes on the doctor's findings, instructions and recommendations. One day following each appointment we delivered a copy of the office visit notes to Mrs. Greinert and emailed a copy to her son. Accountable Aging staff encouraged and assisted Mrs. Greinert to maintain an active life; for example, we contacted her church and arranged transportation to services and mid-week programs.
Rosalinda ChavezThe Challenge:
The four children of Rosalinda Chavez have very different approaches to assuring their mother's well-being, both financial and medical. Mrs. Chavez is just as strong-willed as her children, but is concerned about appearing to "take sides" or endorse one child's ideas over another's. The family is loving and close, but has never been of one mind on much of anything. Now they need to come together in ways for which they have no history nor, as yet, any inclination. This situation is creating harmful stress for Mrs. Chavez and she needs a resolution sooner rather than later.
Expert planning capabilities and third-party neutrality during a highly emotional period in the life of this family.
Mrs. Chavez is assured of her children's acceptance and support of a solid, well-constructed plan for her long-term health and financial care.
Mrs. Chavez asked Accountable Aging to provide her family with our expertise in eldercare issues and our ability to listen to everyone's concerns as an objective, third party. Accountable Aging staff met with each family member and facilitated family discussions before providing a long-term plan that meets Mrs. Chavez's financial and care needs. We established a clear role for each of her children in carrying out the plan, with a means for regular and focused communication as changes in Mrs. Chavez's circumstances present themselves. Accountable Aging created a budget and agreed to monitor her expenses, providing a bi-monthly status to each family member.(back to top)