September - October 2011

This Month's Highlights:
· Home is Where the Heart is
· National Alzheimer's Project Act
· Avoid Mismanaging Your 401(k)

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As health care reform is implemented, there is a building momentum towards keeping patients in their homes whenever possible. Home care is fast becoming an integral part of the care continuum, bridging the clinic-based care model and the actual world patients live in.

For All Ages and Many Conditions
The primary population creating the demand for home care is seniors. As 78 million Baby Boomers approach retirement age, U.S. demographics are shifting significantly. Seniors 65 and older will soon constitute 20 percent of the population. And it's estimated that by the year 2020, 12 million older Americans will need long-term care.

In addition to the senior niche, home care serves people of all ages who are recovering from health challenges, are disabled, chronically ill, or in need of end-of-life care. Their ongoing needs may be medical, nursing, therapeutic, or just assistance with the basic activities of daily living, and their home care ranges from a one-hour weekly visit to 24-hour-care.

Chronic patient needs that are being handled by home care nurses include tracheotomy, ventilator, g-tube, IV therapies, and many cardiac issues. Cancer and transplant patients are also recuperating at home. Skilled private-duty nurses and care managers working in the home regularly meet complex medical needs. All such nurse activities are signed off by MDs and patient plans of care are recertified at a minimum every 60 days.

Recent advances in medical technology have increased the population of patients now treated at home. Common home medical interventions include: infusion therapies with central and peripheral lines, lab draws, parenteral and enteral nutrition, sleep diagnostic testing, and respiratory assistive devices such as CPAP, oxygen monitoring, CO2 monitoring, and airway clearance equipment.

New technologies are making home care a more viable option today. Telehealth service management, electronic medical records, and a variety of assistive technologies such as home sensors all improve service levels. A nurse using telehealth equipment can potentially make up to 15 visits a day rather than the standard five.

Types of Home Care
Home care is anywhere from 5-20 times less expensive than facility care. It also provides a one-on-one focus, which is difficult to obtain in hospitals or group facilities. There are four basic home care service options:

  1. Personal care assistants provide assistance with activities of daily living such as dressing, bathing, feeding, getting to doctor appointments, etc., and are not licensed by the state. This type of care is typically paid for by Medical Assistance.
  2. Private duty care - basically private pay care -- provides assistance with non-medical needs such as shopping, cooking, transportation and companionship and involves household management services but no hands-on medical care. Some long-term care policies will cover such home care, but reimbursement terms and exclusion criteria vary.
  3. Licensed home care agencies employ a variety of home health care professionals serving clients with skilled nursing care--hourly and visits, therapy care, as well as home health aides. This type of care is typically paid for by private insurance, Medicare, and Medicaid.
  4. Medicare-certified skilled home care is typically received on an acute, intermittent basis following an illness, injury or change in disease status. Such services are physician-driven and reimbursement is contingent on the individual demonstrating progressive improvement while being homebound.

Who Pays for Home Care?
Funding for home care is increasing as more people recognize its cost competitiveness. Many insurance companies now cover extended hour nursing and care visits. A tracheotomy patient, for example, can be approved for 24 hours per day care for one month and then weaned onto family care. Managed care companies, such as Medica, Health Partners, UCare and Blue Cross/Blue Shield, have come to understand that home care is safe, efficient, and provides the same level of care at a cost-effective rate.

Payment options for home care include self-pay, Medicare, Medicaid, Veterans Administration, community organizations, commercial health insurance companies, managed care organizations. CHAMPUS and Work Injury Compensation.

A Cost-Effective Alternative
According to a recent Ecumen survey, home care is the preferred care choice for 90% of seniors and retiring Baby Boomers. It is one viable solution that states can leverage to maximize care capacities while minimizing costs.

In 2009, for instance, national charges by Medicare were $135 per home care visit, $622 per day for skilled nursing facilities and $6,200 per day for inpatient hospital care. The average monthly cost of home care aid for seniors is now $764 per month while the average monthly cost of similar care at nursing homes is $4,890. The numbers speak for themselves.

Home care is a critical component of collaborative care that is moving from the periphery to the mainstream. Home is where families want their loved ones to be, and it's where quality of life for patients can best be had.

Amy Nelson is Founder, President and COO of Accurate Home Care, the leading provider of quality home care services in the Upper Midwest. AHC serves a wide range of medically complex pediatric and adult clients in Minnesota, Iowa and Illinois. Amy can be reached at 763.633.3800 or [email protected]

For more information on Aging in Place

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With President Obama's signature, the first national action plan for Alzheimer's disease became law on January 5, 2011, setting the stage for a coordinated effort to "accelerate the development of treatments that would prevent, halt or reverse the course of Alzheimer's" and "improve the early diagnosis of Alzheimer's disease and coordination of the care and treatment of citizens with Alzheimer's."

The plan is part of the National Alzheimer's Project Act, or NAPA, that was passed unanimously by both houses of Congress late in 2010. It will create a federal advisory panel to devise a national strategy for the care, support and treatment needs of the more than five million Americans living with Alzheimer's. It will also consider the needs of the even greater number of caregivers and family members touched by the disease.

Like the earlier war on cancer and government efforts to coordinate research and funding for diseases like AIDS, this is the first time there has been a focused national campaign for Alzheimer's disease.

The advisory panel will involve federal agencies that deal with health and aging issues. Researchers, doctors and other health care providers, scientific experts and people caring for those with Alzheimer's will be involved in developing the plan. The plan will work to coordinate localized research efforts to find effective drugs and treatments for Alzheimer's. It will also aim to improve methods for diagnosing the disease at early stages, before brain damage has become extensive and while therapies to delay symptoms may be most effective. In addition, annual reviews will work to determine the most effective government-financed programs involving research, treatment, home care and nursing homes.

The law doesn't authorize funds for research for finding a cure or for caregiver services. But legislators expect that increased funding for Alzheimer's will be a recommendation of the panel. Currently, lawmakers point out, the government spends one penny on Alzheimer's research for every dollar it spends on caring for patients with the disease.

The cost of Alzheimer's for Medicare and Medicaid is now about $170 billion a year. As the population ages and the number of Alzheimer's cases grow, the cost is expected to reach $800 billion by 2050 unless effective treatments or a cure are found.

Find additional Health information at

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1. Avoid Mismanaging Your 401(k)
Unlike in an earlier period, most companies do not offer traditional pension plans, leaving employees to shoulder most of the retirement planning responsibility Here are some ways to make the most of your 401(k).

Get the Company Match. Make sure you take advantage of your company's offers of a 401(k) match. With company matches, the employer pledges to match the employee's contribution up to a certain percentage of their salary. You are passing up free money If you don't invest enough money to get the full match from your company.
Rolling Over Your 401(k). If you change jobs, make sure to protect your tax-free status of your 401(k). You can roll over your investments to your new company. If you don't, your holdings will get hit with the normal tax rate (and a 10% penalty if you're under age 55). If your new company does not offer a rollover opportunity, you can roll your account into an individual retirement account (IRA), which will keep your money invested and tax-deferred.
Tapping 401(k) Before Retirement. You should only consider tapping your plan if you need cash in an extreme situation. Generally, you only have five years to pay back the money you withdraw from your 401(k) After that, the IRS will tax the remaining distribution at normal levels (plus invoke a 10% federal penalty if you're under 59-1/2).
Always Proceed with Caution. The operative word when manipulating your retirement plan is caution. You should consult a financial advisor and a tax advisor.

Find additional financial information for seniors here at

2. Staying Off Marketing Lists

  1. Avoid filling out consumer surveys or marketing surveys.
  2. Do not fill out surveys attached to product "warranty registration cards." You do not have to complete and return the cards to enjoy your warranty rights. Just keep a copy of the sales receipt.
  3. Avoid sweepstakes forms.
  4. When you give money to a charity or other group, enclose a note asking them not to share, sell, or rent your name to any other group. Do the same when you order from a catalog. Exercise your opt-out rights wherever you can.
  5. Your financial institutions are required to notify you of your right to stop them from sharing your personal financial information with outside companies. Read their privacy policies.

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We present here some words from those with a birthday this month.

Agatha Christie - "One doesn't recognize the really important moments in one's life until it's too late."

Charles Kuralt - "I would like to explore some side roads in life while I am still in good health and good spirits."

Jacqueline Bisset - "Character contributes to beauty. It fortifies a woman as her youth fades."

Roger Maris - "You hit home runs not by chance but by preparation."

Yao Ming - "It was like if I didn't keep reminding myself, I'd make mistakes."

More "Thoughts" at:

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1. Travel Sites for Seniors
Want to get up and going? Here are some sites to help you along. For Baby Boomers and Empty Nesters who have decided to grab life by the horns, sell the nest and become GypsyNesters. If you enjoy people-to-people contacts when you travel, you'll be amazed at the Evergreen Club's network of bed & breakfast home-stays. The Roaming Boomers® is an online luxury travel magazine with an eye towards experience, adventure, learning, and exploration. Road Scholar, offers more than 7,000 educational tours in all 50 states and 150 countries

2. Nostalgic Films
Seniors use the term "nostalgia" to describe a yearning for the past especially in an idyllic sense. Nostalgia denotes an interest in past eras, personalities and events. The past is usually characterized as the "good old days" of a few generations ago. Now that we have you thinking of the past, here are a few short films to bring it to life.

"Do You Remember These?"
"Dutchman's Gold"
"Growing Up In The Fifties"
"Car Show & Drag Racing in 1966"

For other nostalgic items of interest to Seniors visit: Senior Bazaar.

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1. Life as A Call Center Rep.
Glenn works in the customer service call center of a national pager company. He deals with the usual complaints regarding poor pager operation, as well as the occasional crank caller demanding to be paged less often, more often, or by more interesting people. The best call came from a man who repeatedly complained that he keeps being paged by "Lucille." He was instructed that he would have to call her and tell her to stop paging him.

"She don't never leave no number, so I can't call her back," he said.
After three such calls, someone thought to ask how he knew it was Lucille if she didn't leave a number.
"She leaves her name," was the reply.
After establishing that the customer had a numeric only pager, the light bulb came on.
"How does she spell her name?" the service rep asked.
"L-O-W C-E-L-L"

Another problem solved!



2. Female Comebacks!
Man: Haven't I seen you someplace before?
Woman: Yes, that's why I don't go there anymore.

Man: Is this seat empty?
Woman: Yes, and this one will be if you sit down.

Man: Your place or mine?
Woman: Both. You go to yours, and I'll go to mine.

Man: Hey baby, what's your sign?
Woman: Do not enter.

"Oh My Aging Funny Bone" is at:

This issue has been edited by Betsy Day ([email protected]).

Copyright 2011, ALL RIGHTS RESERVED. Information in this document is subject to change without notice. Other products, service and companies named herein are trademarks or registered trademarks of their respective companies or mark holders and are solely responsible for the content of their articles. Articles are included for informational purposes and are not an endorsement.

This Copyright E-zine may be forwarded to others only if sent in its entirety. Other uses are subject to written permission of the publisher.

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