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Five Benefits of Assisted Living for SeniorsAs we age, it can become more and more challenging to maintain independence. Simple tasks we once took for granted, like cooking and cleaning, can become obstacles. Add a few physical challenges, like arthritis or difficulty showering, and things can seem insurmountable. That's where assisted living comes in. Assisted living is designed specifically for seniors who need help with activities of daily living. It is also a situation where social engagement becomes possible and easy. If you are considering assisted living for yourself or a loved one, here are five benefits to keep in mind:1. 24/7 Access to CaregiversOne of the most significant benefits of assisted living is that there is always someone on staff who can help when needed. Whether it helps with daily living or is simply someone to talk to, caregivers are always available to residents. This can be a massive relief for seniors and their families, who can rest assured knowing that help is always nearby.2/ A Sense of CommunityAn excellent component of assisted living is the sense of community that it can provide. Residents have the opportunity to socialize and form relationships with their neighbors. This can help combat feelings of loneliness and isolation seniors often experience while living alone. Many assisted living communities offer activities and amenities that encourage socialization, such as game nights, fitness classes, and group outings.3. Increased Safety and SecurityAssisted living communities are designed with safety and security in mind. Everything is in place, from security cameras to emergency call buttons, to ensure that residents are safe at all times. This added layer of protection can be a massive relief for seniors and their families.4. Maintenance-Free LivingOne of the best things about assisted living is that it frees residents from worrying about tasks like cooking, cleaning, and yard work. This allows them to focus on things they enjoy, such as pursuing hobbies and interests or spending time with family and friends. In addition, many assisted living communities offer housekeeping and laundry services so that residents don't have to lift a finger if they don't want to.5. A Continuum of CareIf care needs change over time, many assisted living communities offer a continuum of care to receive the level of care they need without having to move locations. This can include everything from memory support apartments to skilled nursing care. Having this option available can give both seniors and their families peace of mind knowing that they won't have to go through the stress of moving if their needs change in the future. Finding the best senior living setting for your loved one can be an overwhelming task, but you dont have to go through it alone. The expert advisors at the Senior Care Authority are here to help!We offer various services designed to help seniors live their best life possible. Contact us today to learn more about how we can help you and your family.

Caring for a loved one with dementia is a challenge that millions of families undertake each year. As a caregiver, understanding how a dementia diagnosis affects your loved ones legal decision-making is crucial to ensuring their wishes are honored and that you are providing them with the best possible care.In this blog, we'll explore the importance of estate planning, even after a dementia diagnosis, as the best method to ensure the wishes and rights of your loved one are protected.Understanding IncapacityDementia is a progressive condition that affects memory, cognition, and daily functioning. As dementia causes your loved one's cognitive abilities to decline, there may come a time when they are no longer able to make sound decisions about their finances, healthcare, and overall well-being. When the effects of dementia make it difficult for a person to understand information and make sound decisions, that person is considered to be incapacitated, which means they can no longer legally make healthcare or financial decisions for themselves. This change in their memory and cognition can be emotionally overwhelming for both your loved one and your whole family, and without proper planning, can require court involvement.But, theres still some good news. Thoughtful estate planning can ensure that your loved one is cared for by the people they know and trust if they can no longer care for themselves, and even if youre loved one has already been diagnosed with dementia, it is still possible for them to create a legally-binding estate plan during the early stages of the disease.Estate Planning In The Early Stages of DementiaEvery adult should create certain legal documents to protect their rights and wishes, and this is no different for a loved one with a dementia diagnosis. What is important to remember is that in order to create a legal document, you need to have mental capacity meaning you need to be fully aware of what you are doing and what the consequences of your choices will be.Thankfully, a person does not need to constantly be in a state of capacity to create an estate plan. As long as your loved one has the mental capacity at the moment they sign their estate plan documents, the documents will be valid, even if they regress into a state of incapacity afterward.In the early stages of dementia, and ideally long before any health problems surface, your loved one should create the following estate planning documents:General Durable Power of AttorneyA General Durable Power of Attorney (POA) is a legal tool that allows your loved one to appoint someone to make financial and legal decisions on their behalf. Their POA can write checks, pay bills, maintain their home, and manage their financial assets. This document becomes especially significant as dementia progresses. Encourage your loved one to designate a trusted individual as their Power of Attorney while they are still able to make such decisions. A Revocable Living TrustA General Durable Power of Attorney is an important tool, but many financial institutions place constraints on the use of a POA or dont acknowledge their authority at all. To make sure your loved one has complete protection of their financial wishes, encourage them to establish a Revocable Living Trust and move their assets into the name of the Trust. As part of creating a Trust, your loved one will name the person they want to manage their assets, called the Trustee. The Trustee and Power of Attorney are usually the same person, but not always. By having these two estate planning tools in place, you can rest assured that the people your loved one knows and loves will be able to manage their assets for them as their dementia progresses. Power of Attorney for HealthcareSimilar to a General Durable POA, a Power of Attorney for Healthcare (HPOA) appoints someone to make medical decisions on behalf of your loved one when they are unable to do so for themselves. Discussing and establishing a Healthcare Power of Attorney early on allows your loved one to express their medical preferences and ensures their wishes are honored. Their Power of Attorney for Healthcare should also include a Declaration to Physicians, also called a Living Will, that outlines their desires regarding medical treatment, life support, and end-of-life care. Creating a Declaration to Physicians and discussing their wishes with you ensures that their preferences regarding life-sustaining treatment, resuscitation, and other medical interventions are documented and respected.Plan As Early As PossibleOne of the most crucial steps in preparing for the challenges of dementia is to help your loved one complete their estate planning while they still have the capacity to do so. Waiting until the later stages of the disease can limit their options and increase stress for everyone involved. By addressing legal matters early on, you can ensure that your loved one's wishes are respected, and their affairs are managed.As dementia progresses, estate planning must become more proactive and strategic than ever to avoid court and conflict over your loved ones wishes in the future. If dementia becomes too advanced before planning is complete, the question of who will manage your loved ones assets and care will be left to a judge who doesnt know your loved one or their wishes.  Keep reading to learn what steps need to be considered when estate planning for someone with more advanced dementia.Seek a Cognitive EvaluationIf your loved ones cognitive capacity is in question, seeking a professional evaluation is a prudent and proactive step in the estate planning process. Schedule an appointment with your loved one's primary care physician or a specialist in dementia care to assess their mental state and make a recommendation on your loved ones ability to make estate planning decisions.During this evaluation, the medical professional will talk to your loved one and ask them questions about their everyday life, how aware they are of their circumstances, and what they would do in certain situations, such as if a stranger came to the door or if a pipe burst in their home. Your loved one doesnt need to remember every detail about their life for the evaluation to be beneficial. The professional will be most concerned with your loved ones ability to analyze a scenario and make a thoughtful decision on how to respond. For example, your loved one may not remember what day of the week it is but may remember they shouldnt open the door for a stranger.Receiving a report from your loved ones doctor stating they have the cognitive ability to make estate planning decisions (at least when they are in a lucid state) protects their ability to make decisions for their finances and healthcare, and dissuades any future debate from third parties as to whether your loved one had the ability to make a plan in the first place.Encourage Private Meetings Between Your Loved One and Their LawyerIt may be second nature to help your loved one with appointments, especially if hearing and memory troubles make it difficult for your loved one to follow along. But as much as possible, allow your loved one to meet with their lawyer independently. A private meeting between your loved one and their lawyer will provide them with the opportunity to express their wishes without external influence. Even if you have your loved ones best intentions at heart and they would prefer to have you present during the meetings, encouraging your loved one to have private conversations with their lawyer when possible helps avoid questions about whether or not you influenced their estate planning decisions.If it isnt feasible for your loved one to have an entire meeting with their lawyer alone, make sure they at least have opportunities to talk to their attorney in private by leaving the room while your attorney confirms their wishes.Be sure to document every time your loved one meets alone with their lawyer and ask their lawyer to document it as well. Make Sure Their Estate Plan Is Executed CarefullyUnfortunately, errors that occur at the time an estate plan is signed are common. Every state has different laws for how estate planning documents are executed, how they can be signed, and what witnesses or notaries are required to make the document binding. If your loved ones plan isnt executed properly, it can result in your family needing to involve a judge to determine whether the estate plan is still valid. This also creates an opportunity for family members to question whether your loved one had the mental capacity to create the plan at all.Its also essential to document your loved ones capacity at the time the estate plan documents are signed. Make sure that their lawyer reviews the documents carefully with your loved one before they sign them, that the documents reflect your loved ones wishes, and that your loved one is creating the plan of their own free will.If you have any concerns about other family members questioning your loved ones estate planning decisions or mental state at the time, ask your loved one and their attorney if they could record the signing meeting to dispel any claims that your loved one was coerced into planning or didnt know what they were signing. ConclusionIf your loved one received a dementia diagnosis and hasnt addressed their legal matters, don't despair - but act fast. Even in the advanced stages of dementia, individuals may have moments when they can participate in decision-making and estate planning. But, due to the progressive nature of dementia, time is of the essence for your loved one to create an estate plan, and the sooner they plan, the easier it will be for them to get the help they need as their condition progresses.In cases where your loved ones capacity is severely diminished and estate planning hasnt been completed, your family will need to pursue a court guardianship. This legal arrangement involves a court appointing a legal guardian who assumes responsibility for making decisions on behalf of the person with dementia. This process can be stressful, and its possible the court will appoint someone your loved one never would have wanted to manage their assets or healthcare decisions. Contact Entrusted Legacy Law at 412-347-1731 to schedule a complimentary 15-Minute call.

What We Dont Know We Dont Know in Health Care:The Importance of Keeping Our Loved One Comfortable Towards End of Life, and Why Its Often Not Done. Introduction:Maintaining comfort and peace in individuals that are nearing the end of life is so important, yet too often I do not see this being done. I was recently privy to a situation where, per family report, their aging loved one was in a facility and restless for days on end without any intervention. I mentioned to the family that they may want to ask for some medication to relieve their loved ones restlessness. One of the family members reported back that within hours of our conversation, their loved one received such a medication. The family stated after receiving this medication that he was the most peaceful he had been in over a week. I could feel the relief in their voices. Unfortunately, I have seen this so often that it was the impetus for my next blog subject. Factors:I see multiple factors accounting for why individuals approaching the end of life are not made as comfortable as they should and could be. At facilities, one common reason is due to the transitional period that occurs once an individual or family decides they want to move from aggressive treatment to hospice or palliative care. Generally, once these wishes are expressed, a hospice consult is placed. It often takes time (sometimes up to a day) for the hospice team to evaluate the individual. Unfortunately, facility staff often wait until the evaluation is complete prior to initiating comfort care protocols. This does not need to be the case. Staff can initiate comfort protocols by reaching out to a practitioner to request orders. Many staff either do not appear to realize that they can initiate this order set or are too busy to do so.  The bottom line is that if the individual and/or family has consented to comfort measures and no aggressive treatment, protocols can and should be implemented right then and there. It often takes probing from an advocate or a family member to do so. Another reason individuals do not receive comfort medication at end of life is due to the practitioner being unaware of their discomfort. With the overburdened medical system, practitioners often do not get to spend ample time with their patients. They often only have a few minutes to round and hence may be unaware of their patients pain, agitation, or restlessness. This is where it can be helpful to have an advocate or loved one relay to a practitioner the observation that the senior individual is in distress. Much like a mother is attuned to her infant, often family members or others intimately familiar with an individuals behavior are the ones that pick up on subtle cues of discomfort or distress. In the situation I described above, the family of the restless individual stated the health care team appeared unaware of the individual's discomfort. One of the family members was with the loved one for hours on end, and she stated that his restlessness was very intermittent.  With that being the case, the restlessness could easily be overlooked by staff. In addition, facility staff are extremely busy and may not take the additional time to communicate restlessness to practitioners unless asked to do so by an advocate or loved one. One final reason I see individuals at end of life not receive adequate comfort medication is due to reluctance of staff to provide adequate comfort medication. Many nurses are hesitant to administer reasonable amounts of such medicine for fear of hastening death or euthanizing someone. I generally do not see this with hospice or palliative care staff as they have ample education on the importance of maintaining comfort in end of life and how to do so. I instead see this with general facility staff who may not have the training or experience in palliative/hospice care. Years ago I was sitting with family in a hospital room of their loved one as he was passing. The individual was clearly restless: pulling at his tubing and attempting to get out of bed. I was concerned not only for the discomfort of the individual but also the toll his discomfort was taking on family. No one should have to witness a loved one near the end of life suffer if its possible for the suffering to be alleviated.   I asked the nurse if she could administer more medication to relieve the individuals discomfort and she replied that she didnt have an order to do so. I kindly asked that nurse to communicate to the attending MD that the medication provided was insufficient for this individual and request a dose increase or another medication. She did so and the individual ended up receiving the appropriate amount of medication needed to pass away peacefully. Conclusion: The bottom line is that we all deserve to be comfortable at the end of life. It often takes an advocate or loved one willing to speak up to ensure that this gets done. Promoting comfort not only provides dignity and peace to the dying individual but also priceless peace of mind to the loved ones involved. I am a passionate, vocal advocate regarding the importance of ensuring this for families and their loved ones. Any questions please do not hesitate to contact me.

By Jordan RauNOVEMBER 14, 2023Around the world, wealthy countries are struggling to afford long-term care for rapidly aging populations. Most spend more than the United States through government funding or insurance that individuals are legally required to obtain. Some protect individuals from exhausting all their income or wealth paying for long-term care. But as in the United States, middle-class and affluent individuals in many countries can bear a substantial portion of the costs. Heres how five other countries pay for long-term care.JapanLong-term care insurance is mandatory for Japanese citizens age 40 and over, while in the United States only a small portion of people voluntarily obtain coverage. Half the funding for Japans program comes from tax revenues and half from premiums. Older adults contribute 10% to 30% of the cost of services, depending on their income, and insurance picks up the rest. There is a maximum amount people must spend from their income before the insurance covers the remainder of the cost. Workers can also take up to 93 days of paid leave to help relatives with long-term care needs. Japan assigns a care manager to each person using services; each manager oversees about 40 older adults. In 2020, Japan spent 2% of its gross domestic product on long-term care, 67% more than the United States spent that year.The NetherlandsThe Dutch have included long-term care in their universal health care system since 1968. One public insurance program pays for nursing homes and other institutional settings, and another pays for nursing and personal care at home. Enrollment is mandatory. Dutch taxpayers contribute nearly 10% of their income toward insurance premiums, up to a set amount. Out-of-pocket payments amount to about 7% of the cost of institutional care. General taxes pay for a third program in which municipalities provide financial assistance and social support for older people living at home. There is no private long-term care insurance. The Netherlands spent 4.1% of its gross domestic product on long-term care in 2021, more than any other country tracked by the Organization for Economic Cooperation and Development, and four times the amount the United States spent.CanadaProvinces and territories fund long-term care services through general tax revenue. Money budgeted is not always enough to cover all services, and some localities give priority to those with the greatest needs. The amount of subsidies people can receive, the costs they have to pay out-of-pocket, and the availability of services vary by province and territory, as they do in the United States with state Medicaid programs. The mix of providers also varies regionally: For instance, nursing home care in Quebec is mostly run by a public system while homes in Ontario are mostly for-profit. Notably, Canadas long-term care system is separate from its national health care system, which pays for hospitals and doctors with no out-of-pocket costs to patients. In 2021, Canada spent 1.8% of its GDP on long-term care, 80% more than the United States spent.United KingdomLocal authorities pay for most long-term care through taxes and central government grants. Private providers usually supply services. Government contributions are based on financial need, with copayments usually required. As in the United States, middle-class and wealthy people pay most or all of the costs themselves. Unlike in the United States, the government provides payments directly to lower-income people so they can hire workers to care for them in their homes. The U.K. has also taken steps to shield people from losing all their wealth to pay for long-term care. It subsidizes care for people with savings and property of less than about $30,000, while in the United States most people dont qualify for Medicaid until they have run through all but $2,000 to $3,000 of their assets. In 2022, the British government proposed extending subsidies to people who have as much as $105,000 of wealth and property, with a lifetime cap of about $100,000 on how much anyone spends on long-term medical care, excluding room and board in a nursing home. But the plan has been postponed until 2025. In 2021, the United Kingdom spent 1.8% of its GDP on long-term care, 80% more than the United States did.SingaporeSingapore recently instituted a system of mandatory long-term care insurance for those born in 1980 or later. Citizens and permanent residents are automatically enrolled in an insurance plan called CareShield Life starting at age 30. They must pay premiums until they retire or turn 67 (whichever comes later) or are approved to use services. The government subsidizes 20% to 30% of premiums for those who earn around $2,000 a month or less. Monthly payouts start at about $440. Government subsidies for nursing homes and other institutional care can range from 10% to 75%, depending on ability to pay. Those who make more than $2,000 a month receive no subsidies. CareShield is optional for Singaporeans born in 1979 or earlier; they are covered under an older, voluntary plan. Singapore also provides a means-tested monthly cash grant this year about $290 to help with caregiving expenses.Sources: The National Bureau of Economic Research project on international comparisons of long-term care; Kathleen McGarry; The Commonwealth Fund; Organization for Economic Cooperation and Development; government websites.Note: Spending comparisons with the United States are based on the most recent OECD data and include spending from government and compulsory insurance programs as a percent of each countrys gross domestic product, which is the total monetary value of all the finished goods and services produced within a countrys borders. The comparisons cover people of all ages and exclude spending from voluntary insurance plans and out-of-pocket costs. All currency figures are in U.S. dollars.KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFFan independent source of health policy research, polling, and journalism. Learn more about KFF.This story also ran in The New York Times. It can be republished for free.