Family Caregivers - Get Reimbursed For Providing Your Homecare Services!

Many of us will gladly take Mom to her doctor's appointments, administer medications, and check in if the need arises without a second thought. But with millions of loyal children caring for aging parents out of their own pockets, a little financial relief is welcome. Few family caregivers are aware that you can get paid - however small the amount may be - to care for Mom and provide homecare services. Due to the long working hours, however, some adult children caregivers have been forced to leave their full-time jobs or even scale back their hours spent on the clock, leading to a significantly reduced cash flow. Fortunately, if being a caregiver is causing a noticeable financial strain, there are homecare reimbursement programs that can help alleviate some of the burden. Keep in mind, however, that you must practice patience when applying for these programs - make sure that your application is up-to-date and all the necessary attachments are included before you send it so that delays aren't any longer than necessary.

Long-Term Care Insurance (LTCI)

Long-term care insurance, which functions as an indemnity program, only pays the insured the amount that was contracted at the outset, and regardless of homecare services that are received, will only pay that specified amount.

LTCI, which covers nursing home, home health care, adult day care services, assisted living facilities, and hospice care, offers payments to in-home family caregivers, though the insurance must include in-home care and/or homecare services coverage. In certain instances, LTCI requires that family caregivers complete a basic training program on homecare services and/or caregiving for elderly patients. Though almost all LTCI contracts include skilled, intermediate, and custodial long-term homecare services, don't rely on this type of insurance to be your only fall-back when it comes to paying for in-home health care. Though for clarification, you should contact your LTCI company directly for details on its family caregiver reimbursement policies as well as what is needed to qualify.

Medicaid Cash and Counseling Program

A state-administered program, Medicaid is only available to low-income individuals and families who meet certain federal and state law eligibility requirements. In other words, if you have limited income and resources, applying for Medicaid relief is advisable; however, you must be able to meet specific eligibility criteria. Persons over the age of 65 with limited income and resources immediately become eligible as well as those who are terminally ill or live in a nursing home.

Fortunately, if the person you're caring for is either eligible for or is currently using Medicaid, you may be able to receive direct payments from its Cash and Counseling program, though it is available only to family caregivers in select states, such as Alabama, Arkansas, Florida, Illinois, Iowa, Kentucky, Michigan, Minnesota, New Jersey, New Mexico, Pennsylvania, Rhode Island, Vermont, Washington, and West Virginia. In some cases, the person you're caring for may have too high an income, excluding him or her from the Medicaid program; some states, such as Georgia, Maine, Nebraska, North Dakota, Oklahoma, and Oregon, have accounted for this oversight and offer similar programs to family caregivers (Source: National Governor's Association).

Medicaid, aware that family caregivers are often the best care providers for Mom or Dad, will send a check directly to the recipient to reimburse for homecare services rendered, though this amount depends upon various assessments of overall needs and the average cost of in-home health care for that particular state. This money can also be used by family caregivers to purchase supplies, medical equipment, or even to pay for ADLs (activities of daily living). To find out if your loved one is eligible or for more information on the Cash and Counseling program, please call the National Program Office at 617-552-2809.

Making the Arrangement with Mom Official

Since money is involved, it's recommended that family caregivers draw up some sort of short, typewritten contract that outlines the terms of the caregiving situation in depth, including the pay rate and frequency, job description and homecare services that will be provided, and how various expenses will be reimbursed (if applicable). Hiring an attorney or other legal professional will help all family caregivers involved create a legal document that prevents sticky situations from arising.

It's also important to remember that this payment is viewed as income by the government, so all family caregivers must report their earnings each year as taxable income. Though the money received for providing homecare services is negligible, it will help to offset many of the costs associated with providing Mom (or Dad) with a loving, stable, and comfortable home.

Your Aging Parent - Six Questions to Determine What Help Your Parent Needs

If you are the adult child of an aging parent, you have probably asked yourself, "How do I know what type of help my aging parent needs?" Unless you are a senior resource professional, sorting this out can often seem overwhelming. So, here are six questions to ask to help sort it all out.
 
1.       What is my parent's physical condition?
2.       What is my parent's emotional condition?
3.       What is my parent's cognitive level?
4.       What financial resources are available to pay for help?
5.       What human resources are available to provide help?
6.       What input has my parent given on the entire topic?
 
Your parent's physical condition will help you determine such things as whether your parent needs help with activities of daily living (e.g., toileting, dressing, feeding, mobility), with medication management, or with managing medical conditions such as diabetes or using supplemental oxygen. Your answers will help you decide whether your parent's physical condition allows them to be safe in their current living environment without extra help, or whether you need to arrange for in-home help or possible transfer to an independent or assisted living setting.   If your parent's physical condition is likely to be short-term, as when she is recovering from surgery, you have other options to consider, such as having physical or occupational therapists come to the home, or perhaps a short stay in a rehab setting.
 
Sometimes, your parent is physically capable of taking care of himself, but he has become isolated and is not engaging in social interaction with others. This might be simply because he can no longer see well enough to drive or because many of his friends have passed away and he lacks someone to "hang out" with. Whatever the reason, social isolation can often lead to depression or other emotional difficulties. If this is your situation, you might decide to look into available senior centers, adult day care, or companion services for your Dad.  Depending upon your answers to the other questions, you might also consider an independent or assisted living arrangement since these environments generally offer a great deal of social interaction and stimulating activities.
 
Some of the toughest decisions come when your parent is memory impaired. If your parent wanders outside of the house and gets lost, or leaves the stove on overnight, she needs closer supervision. If she becomes agitated due to the cognitive impairment, she may require someone around all of the time to keep her calm. If your parent suffers from Alzheimer's disease, there are often physical considerations as well, especially in the later stages of the disease. As is always the case, safety should be your first concern.
 
When it's time to figure out what help to put in place, there is no way to escape thinking about the financial side of the decision. While some home care is covered by health insurance such as Medicare, most care related to activities of daily living is not. If your parent has long term care insurance, it will generally begin paying for services once your parent meets the policy guidelines, which typically state that a physician must certify that they have difficulty with two or more ADLs and that this state will continue for at least three months. Some long term care policies provide for "first day" coverage for in-home assistance or services within an assisted living facility.   You need to know whether the care you seek will be covered by Medicare, and if so, you must use a Medicare certified home health agency. If you are paying privately, then you have the flexibility to use any agency or to use a private caregiver who is not associated with an agency. Be sure to take the time to decipher your parent's insurance policies in advance so that you have some idea about what will be covered.
 
Many families are able to take care of their aging parents themselves. This is especially true when there are many adult children who live nearby and who can take turns or divide up the duties. If this is the case with your family, it is helpful to sit down before a crisis strikes to figure out who has the capabilities and the time to do what. In that way, the entire family will function as a team, and if supplemental resources need to be hired, everyone on that team will understand why that needs to happen. Some families set up care contracts so that the family caregiver is paid by the parent for whom they are providing the care.
 
Last but not least, if your parent is able to provide input to this discussion, it is a good idea for them to do so. It is helpful to understand what your parent's desires are, and if practical, to honor at least some of them. This is not always possible, but when it is, it is an important step in the process of a smooth transition.
 
©2009 LifeBridge Solutions, LLC. All rights reserved.

Principle Centered Living Defined

The vast majority of us conduct our lives often unaware of the principles that govern consequences. This often leads to us wondering why things go wrong and not understanding the results we achieve.

Obviously no one is perfect; however, truly successful individuals are masters at living principle centered lives.

So, what does it mean to live this way?

The goal of this article is to help define for you the meaning of living a life in alignment with principles and also to raise your awareness to its importance in your success.

The first thing to understand is that principles exist and operate in our lives whether we are aware of them or not or believe it or not. They are unbiased and impartial in nature and simply governs the results we achieve based completely upon our choices.

By definition, principles are natural laws - these are the rules of nature. They do not change, they simply are. In other words, although you might be able to cram for a test the night before and even pass it the next day; you couldn't possibly sustain a successful living in the field of this test if you only crammed the night before. Your success would be short-lived.

It's like a farm; you can't cram on a farm because it is a natural system. You must first plant the seeds and then pay the price day in and day out to water and fertilize the earth until the crops reach maturity. Then and only then can you reap the fruits of the farm. The farm then is like principles - no shortcuts - you have to pay the price otherwise the results you achieve will not be the best that they can be.

When you live a principle centered life, your choices are based on your core values and beliefs fueled by doing what is right. In so doing the consequences you reap will always be good.

Following are a few examples of what I mean by principles.

1. Do unto others as you would have them do unto you- this simply means that you treat other with the same type of love and respect you want others to treat you with. You do not judge and play "tit for tat", you behave the way you want others to behave - you set the example. By doing this you set things in motion that inevitably bring back to you the same treatment or better from others.


2. You have what you have and you are where you are because of the choices you've made- this means that if you were to examine the choices you've made thus far in your life and you were honest with yourself, you would easily see that the results you have achieved are directly related to the choices you've made. Sure, you can play the blame, shame and lame game; however, it won't change the fact that your choices got you where you are today with what you have and nothing else.


3. The more you show gratitude, the more you get to be grateful for - ever notice how the more up you are the more the universe fights to keep you up? The exact opposite is also true as you may have noticed; the more down you are the more the universe fights to keep you down. This is just a natural law - you can feel it when it's happening; however, most are powerless to do anything because they lack the awareness that they have options.

Think about these 3 concepts - principles - and you will begin to realize that they are not only true but unfailing in operation. They are not a matter of opinion or theory - they simply are and will continue to be so for eternity.

CCRC Vs Life Care - Which Contract is Right For You?

The burgeoning senior care market has introduced a slew of new concepts and terms that are easily confused. Many people believe, for example, that life care and continuing care communities are the same thing, and they use these terms interchangeably. However, life care is actually a subset of continuing care. While the offerings may look similar at a glance, don't be fooled. Let's take a look at the differences between the two, beginning with continuing care retirement communities (CCRCs).

CCRCs vs. Life Care Communities

CCRCs offer contractual agreements to people sixty years or older, providing them with a continuum of services, usually on the same campus. These services include independent living, assisted living, skilled nursing and sometimes memory care. Although all CCRCs offer a continuum of care, some rely on contracts with other care providers to administer the higher levels of care, which may be located off campus. This means that residents who move in at the independent or assisted living levels would have access to higher levels care as their needs progress, but they may need to move off campus to access those services. Most contracts require payment of an entrance fee (sometimes referred to as a "buy-in" or "purchase" fee) and monthly fees. Some contracts include the purchase of real estate (i.e., the resident's apartment within the community), which can be willed or deeded to an heir just like any other real estate purchase. However, not all contracts involve the purchase of real estate. Under these terms, the seniors would become residents of the community, but would not own any real estate under the contract. Buy-in or entrance fees can range from $10,000-500,000+.

Life care communities provide the same continuum of care to a resident for life, but the biggest difference is this: residents who become financially unable to pay their monthly care fees will be subsidized by the community, with the same access to services, and with no interruption in care or change in priority status. In other words, residents are guaranteed the same quality of care and access to care from day one through end-of-life, regardless of their personal financial situation. In addition, most life care communities offer all health care services on the same campus. The idea is that, after qualifying through a health and financial application process, residents will never have to move again, except between levels of care as needed. So, for example, a resident may be required to move from assisted living to skilled nursing as his or her care needs progress, but the new place of residence will be on the same campus. However, certain states allow life care communities to provide skilled nursing services off campus as long as it is under the ownership and supervision of the life care provider, and not through a contract agreement. There is one other significant difference. In a life care community, residents do not own real estate under their life care contract. Upon a resident's death, the apartment (or room) that he or she occupied reverts back to the community.

Because there is no federal agency that governs CCRCs and life care communities, the terminology and requirements vary from state to state. However, the easy way to distinguish between a life care community and a CCRC is by the contract type: Type A is considered life care; Types B and C are considered continuing care.

The Contract Types: A, B & C

In general, there are three types of continuing care contracts: Type A (Extensive or Full Life Care), Type B (Modified or Continuing Care) and Type C (Fee-for-Service). Each contract type involves a different degree of risk to the resident and the community. The highest level of risk is assumed by communities with a Type A contract and the lowest with Type C. The opposite is true for residents, where Type A is the lowest risk and Type C is the highest. Each contract type has different fee structures, which correspond to the levels of risk assumed by either party. Some continuing care communities offer only one type of contract, so contact the community you're interested in to see which one(s) it offers. Here's an overview of how each contract operates:

Type A: Extensive or Life Care Contract

With this type of agreement, consumers assume the least amount of risk, but pay top dollar. A Type A contract provides housing, services and amenities, and unlimited access to long-term nursing care at little to no additional cost, apart from periodic inflationary increases. The higher initial fee is based on the assumption that these residents may require-and utilize-higher levels of care as their needs develop over time. This can add up to substantial savings over a resident's lifetime, considering that Medicare does not cover custodial nursing care, which currently runs $250+ daily, for a private room in a nursing home. In addition, the prepayment of future health care costs qualifies these residents for significant tax benefits (the IRS medical deduction). Typically, residents must maintain a minimum level of Medicare coinsurance.

Who it's good for: People who want to ensure that all of their health care needs will be covered for the remainder of their lifetime.

Type B: Modified or Continuing Care Contract

A Type B contract also provides housing, services and amenities, but access to long-term health care and nursing services is restricted to a specified number of days. After that, the resident is responsible for any additional care costs incurred. Some contracts allow residents to pay for the additional care at a discounted rate once they have utilized the care included in their contract. Just as with a Type A contract, residents are eligible for the IRS medical deduction.

Who it's good for: People who are able to pay for the costs of care not covered through their contract, and those who do not expect their health care needs to increase significantly over time.

Type C: Fee-For-Service Contract

With a Type C contract, access to health care is guaranteed, but residents must pay the full cost of the services they use. Under this type of agreement, residents receive housing, services and amenities as defined in the contract. Some communities do not charge an entrance fee for Type C contracts, instead charging only a monthly fee. However, other communities do charge an entrance fee, with the funds subsidizing a resident's assisted living or skilled nursing care. If the cost of care exceeds the funds obtained from the entrance fee, then the resident would be charged for the full cost of any services utilized. This can happens if a resident requires extended skilled nursing care. For those who require higher levels of health care later on, the cost can be extremely high. At a daily rate of $250, nursing home care costs escalate rapidly, creating a major financial burden for residents without long-term care insurance or considerable financial resources. Residents do not qualify for the IRS medical deduction under a Type C contract.

Who it's good for: People who are willing to assume to the full risk of health care costs.

Benefits of Continuing Care

Continuing care grants residents convenient access to most of the services that they require, all in one place. With the exception of a Type C contract, the cost of those services is included in the fees they pay under their contract. Although health care constitutes the basis of the contract, it's certainly not all about health care. Let's take a look at what's included under a typical continuing care agreement:

* Access to an on-site doctor by appointment, five days a week.
* House calls during an illness to assess the condition.
* Meal delivery during the illness.
* Daily van service to an off-campus hospital.
* The option to retain services under a separate medical plan, with certain provisions.
* Three meals a day, weekly housekeeping, and laundered linens and towels.
* Access to banking services, recreational outings and numerous on-site activities.

Regulatory Conditions

Although CCRCs and life care communities are highly regulated in some states, there is no federal agency that oversees these types of retirement communities. However, there is a system of checks and balances in place to protect the consumer. Here's how it works. Life care providers must submit audited financial statements and reserve reports, usually to the state Department of Social Services, on an annual basis. Various financial and reserve requirements are mandated by continuing care contracts statutes, to help ensure that providers will have sufficient financial resources available to meet future obligations to residents. This is so that residents will be protected from any financial difficulties that may affect the life care provider. Providers must recalculate reserves each year. If the Department of Social Services determines that a provider is in unsound financial condition, it will exercise its statutory authority to require that corrective measures be taken.

Scholarships Unique To Florida Schools

The State of Florida contains nearly 100 colleges and universities scattered throughout its peninsula and panhandle. In the last year it also distributed over $1 billion in scholarships to these various institutions of higher learning through its state lottery. Obviously, any high school student would like to get some of that financial aid when attending one of these homes for advanced education.

Actually, what the state does is divide that money into three different programs. The first is the Academic Scholars Award (FAS), where the student needs a 3.0 grade point average to qualify. The second is the Medallion Scholars Award (FMS), where the standards are a little lower at a 2.75 grade average. Lastly there is the Gold Seal Vocational Scholars award (GVS), which again needs a 2.75 grade point average. A student can apply for one of the three through the Florida's Dept. of Education.

The difference between the three is the amounts they award, as well as what degrees they can be applied to. Both the FAS and FMS are for scholastic scholarships, but the former awards a maximum of $125 per credit hour while the latter does $94 per credit hour. The FAS also has a special subcategory called the Academic Top Scholar that can put in an additional $53 per credit hour for exceptional students.

Lastly, the GVS is geared towards vocational certification, primarily for a number of technological professions. Like the FMS it will also award up to $94 per credit hour.

If that isn't enough, the state also administers four other scholarship programs. The first is the Mary McLeod Bethune Scholarship, which is only applicable to four different universities. To apply, the student must have a 3.0 grade point average, and display a demonstrable need for the funds. Last year, the maximum amount recipients received was $3,000 for the academic year.

There is also the Robert C. Byrd Honors Scholarship, which is open to both on campus and virtual colleges throughout the U.S. Besides being a Florida state resident, an applicant must be nominated for the Byrd by a school administrator who carries that kind of authority. If selected by a final committee, the student receives $1,500 per academic year.

Then there is the Rosewood Family Scholarship. It is awarded to direct descendants of the town of Rosewood, Florida, who were slaughtered back in 1923. Each year, 25 students who can prove their lineage are awarded a scholarship of $4,000 with the possibility of renewal to a four-year academic or accredited vocational school. They must also have a 2.0 grade point average minimum to apply.

Pneumonia and the Necessity of Hospitalization

Pneumonia is a common type of pulmonary disease that involves inflammation and infection of the lungs, triggering an overproduction of mucus at the level of the respiratory tract. The intensity and the duration of the symptoms generated by pneumonia differ from a person to another, according to factors such as age, overall health and the immune system's capability of fighting against infections. While people with strong immune systems are less likely to acquire pneumonia and develop complications, people with compromised immune systems or increased susceptibility to respiratory disorders are exposed to a high risk of developing complicated forms of pneumonia. Due to this fact, pneumonia has a high incidence in elderly people, which also commonly develop further complications.

In present, most people diagnosed with pneumonia require hospitalization. In the absence of proper medical care and frequent monitoring, some patients with pneumonia may experience a rapid aggravation of the disease, and for this reason doctors recommend hospitalization to all pneumonia sufferers. However, patients with milder, uncomplicated forms of pneumonia can be spared of hospitalization, by receiving medical treatment at home. Considering the fact that once developed, pneumonia is little contagious, patients with milder forms of the disease rarely spread it to other people. Thus, certain categories of patients with pneumonia can receive pneumonia treatments in the comfort of their homes. In fact, patients with mild types of pneumonia such as "walking pneumonia" don't even require bed confinement, being able to carry on with their daily activities on the entire duration of the treatment.

On the premises of hospital overcrowding and very high hospitalization costs, doctors have lately focused on limiting the overall number of unnecessary hospitalizations. In future, hospitalization may even be avoided for elderly people in nursing homes when they develop pneumonia. Recent studies have revealed the fact that certain nursing home residents can be spared of hospitalization, by receiving pneumonia treatments in nursing homes instead. Elderly people in nursing homes already benefit from medical surveillance and assistance, rarely requiring hospital medical care. Judging by this fact, nursing home residents diagnosed with mild, uncomplicated forms of pneumonia that have a stable overall condition may not require hospitalization at all.

By reducing the number of unnecessary hospitalizations among nursing home residents with pneumonia, both patients and doctors may benefit from the process. Furthermore, judging from a financial point of view, avoidance of unnecessary hospitalization can save up to 1.500 dollars per patient.

In order to determine the necessity of hospitalization among nursing home residents with pneumonia, a group of Canadian researchers has recently conducted a study that involved the collaboration of 20 nursing homes. Half of these institutions were asked to follow their usual medical care procedures, while the others were asked to follow the instructions imposed by the researchers. Thus, when they were confronted with cases of pneumonia among residents, each group of nursing homes followed a different approach: the usual care group transferred patients with pneumonia to the hospital, while the referential group followed the imposed guidelines before deciding upon hospitalization.

The established guidelines required nursing home residents with stable conditions to receive the treatment of pneumonia inside the nursing home. Residents that didn't meet the established criteria (presented with complications or had unstable conditions) were transferred to the hospital. The referential group involved the participation of 327 nursing home residents with pneumonia, while the usual care group included 353 residents with pneumonia. During the study, only 10 percent, respectively 22 percent of the residents in the two groups were eventually hospitalized. By the end of the study, the researchers concluded that residents in both groups responded similarly to the treatment of pneumonia, regardless of medical regimen. Thus, the study has confirmed the fact that hospitalization can be avoided for nursing home residents diagnosed with mild, uncomplicated forms of pneumonia.

Generalized appliance of the Canadian researchers' guidelines regarding the necessity of hospitalization among nursing home residents with pneumonia can considerably reduce medical care costs. Researchers inform that by reducing the number of unnecessary hospitalization among residents with pneumonia, the costs savings would be around 70 million US dollars for Canada and up to 800 million US dollars for the United States each year.

A Warning About Blackmailing Mediums

The internet is an amazing tool for breaking down artificial boundaries such as time and space. Instant communication with a person on the other side of the world is a marvel that has brought home to us how small the world really is and how irrelevant time is in the greater scheme of things. Internet communication has also assisted in breaking down the boundaries of space, because on the web there are no space limitations.

What has this got to do with mediumship?

People who have had a glimpse of eternity understand that time and space are man-made concepts. These concepts apply on earth so that we can make sense of our environment. Once we understand this, it becomes clear how mediums and psychics can tap into the quantum soup of the unconscious and use email to convey the results to their paying clients.

Unfortunately, as with any technological development, there are always people that exploit for their own benefit.

There is nothing wrong with asking for and obtaining a psychic reading over the internet. A true psychic will (always with the permission of the client) find a link to the information that needs to be channelled to the client. Once the link has been established, the information can be conveyed via email. True, this is a one-sided conversation. The advantage is that the psychic does not have the comfort zone of asking numerous questions. They either have the link or they do not, and it is much more difficult to fake the link when you are not in a position to interpret the body language and facial expressions of the client.

I would, however, get concerned if the psychic reading is returned to me immediately (obviously machine-generated and aimed at a mass market rather than at me personally) or when I cannot associate at all with the contents of the reading.

I have had clients that would not accept any of the information I channelled to them. In those circumstances I initially doubted the information I received, but I realised over time that there are people that simply deny everything around them. This is not a justification. I have had one client (over a period of more than 15 years) for whom I was unable to give any reading at all. I told her the truth and gave her money back. I have had a few clients that rejected everything I said to them, but their comments and responses then clearly indicated that I was far too close to the truth for their comfort.

However, the kind of nonsense reading that I refer to is the generic bluff one that shows no understanding whatsoever of your situation or your questions. I once had such a reading from a person who told me that my love life would improve if I stop wearing navy blue. At the time I had not a single piece of navy blue clothing or even accessories in my wardrobe, and my love life was the least of my concerns. This person had all the paraphernalia, including the head scarf, gypsy earrings and crystal ball, on display and made buckets of money from gullible and vulnerable clients.

Another big concern with a reading obtained via the internet is where the reading is done for free or for a very low price, and then the reading is followed up with a series of emails demanding a ransom for your salvation. I have seen some of these emails that would scare the living daylight out of any innocent person, because they indicate that doomsday is getting closer by the minute if the recipient does not respond to any of the series of emails.

Of course the response of the recipient must be in the form of buying an expensive trinket that will bring immediate relief, or buying a "more in-depth" reading that will chase the hovering devils away at a price that is comfortable for the medium.

No earthly object can bring relief to a hurting soul. In fact, people who fall for this kind of blackmail will hurt even more, because they will part with their money under pressure and feel even worse about the space that they are in when there is no relief.

Maybe it is just the way I think, but I would rather provide a paid-for reading than provide a free reading as bait for another reading. For me, this is not only a matter of integrity i.e. giving the client what they paid for in the first place. It is also a matter of self-protection. There are thousands of people that would want a free reading, and every time you give a free reading, you also give energy away to a person that does not appreciate your gift.

I would rather do a single paid-for and comprehensive reading for a person than allow them to suck out my energy in exchange for the promise of only then giving them "the real stuff".

And I know that it is not good internet marketing, but I believe that the quality of my readings rather than the sale of trinkets will let clients return to me.