IN THE VAST constellation of legal documents you could encounter over your lifetime, some are more critical than others. For older adults, a few legal instruments take on outsized importance, particularly in the context of ensuring adequate health care as we age. While some documents that older adults may need are focused on the financial side of your affairs, others concern how decisions will be made about your health care. The information that follows will focus on the documents related to health care that may come into play as you age.
As you navigate these legal waters for yourself or a loved one, some legal terms and documents you may encounter include:
For some lower-income Americans, Medicaid is their lifeline to health care. That includes “older nonelderly” adults from 50 to 64 – an age range when chronic health conditions and mobility issues are common. Other people use Medicaid benefits so they can serve as family caregivers.
On Jan. 11, the Centers for Medicare & Medicaid Services announced that states can apply for waivers to implement work requirements for people who receive Medicaid benefits. Some older Americans will be affected.
To date, waivers have been approved in three states and are pending approval in others. Age limits vary for who might have to fulfill work or “community engagement” requirements for up to 80 hours a month. In Kentucky, Medicaid recipients are exempt at 64. In Indiana, 60 is the cutoff age. In Arkansas, however, 50 is the cutoff.
Swedish researchers report in an article published in the Journal of Alzheimer´s Disease that 46% of patients who are diagnosed with Alzheimer´s disease in Sweden live alone in their homes, in particular older women.
The patients who live alone do not receive the same extent of diagnostic investigations and anti-dementia treatment as those who are co-habiting. On the other hand, they were treated more frequently with antidepressants, antipsychotics and sedative drugs.
According to recent statistics, the number of older people who live alone in their homes, especially women, is increasing in high income countries. When an older person is affected by dementia, such as Alzheimer´s disease, they may not have a close relative living with them, which may complicate the course of the disease. Dementia affects their memory and later can lead to their dependency on caregivers.
I’ve been spending a lot of time in hospitals and nursing homes.
I can’t walk through the facility without slowing down and looking an elderly person in the eye. And I smile. And I pause until they see my smile. Then their dazed eyes come to life. And their grins begin to form smiles. And I hold their eye contact and I nod my head until my eyes water and I say you are loved. I say it with my eyes and smile. And I know they hear me. I feel it clearly. They are still alive.
But these bittersweet moments are fleeting. It is tough. I hear moans. Screams of anguish and longings to go home. Take me home, they say. I wanna go home.
It’s sad. Really sad.
Elderly care is something that requires so much patience, love and discipline.
Nearly half of hospitalized American adults age 65 and older require decision-making assistance from family members or other surrogates because the patient is too impaired to make decisions independently, according to a new study from the Regenstrief Institute and the Indiana University Center for Aging Research. The vast majority of surrogates are children or spouses, and some patients have two or more family member making decisions together.
More than 13 million older adults are hospitalized annually in the United States, and that number is projected to increase as the population ages. This means that each year, millions of family members will have to make serious decisions for a hospitalized older adult.
Surrogates will commonly face decisions about life-sustaining care, such as whether to revive a loved one if his or her heart were to stop, as well as decisions about medical procedures and whether to send the patient to a nursing facility upon discharge.
In what is believed to be the first study of its kind, researchers from Boston Medical Center (BMC) and Boston University School of Medicine (BUSM) have found that in addition to the well-known burdens of caring for an older family member, a further set of complex stressors is imposed on geriatric health care professionals serving in this capacity. These findings, which appear online in Gerontologist, highlight the critical challenges facing all caregivers, even those who deal with these patients daily on a professional basis.
Caregiving for older adults is a major social issue with enormous implications for health care and with an estimated cost of $450 billion in the United States alone. More than 60 million Americans were family caregivers in 2009 that involved hands-on help and supervision, financial management/support, emotional support, medical and legal decision making and health care needs. The research team recruited 16 geriatric health care professionals who participated in 60- to 90- minute individual interviews, based on a semi-structured guide. Questions explored participants’ dual experiences as geriatrics professionals and as family caregivers. The authors identified three major themes: dual-role advantages and disadvantages, emotional impact of dual roles, and professional impact of family caregiving.
For an administration seeking to win a skeptical public over to ObamaCare, the Justice Department could not have picked a more sympathetic foe for a Supreme Court fight than The Little Sisters of the Poor.
The administration is fighting back against a lawsuit filed by the non-profit, which does not meet ObamaCare’s classification of a “religious employer” because it hires and tends to people of all religious and ethnic backgrounds.
Supporters say The Little Sisters of the Poor epitomize service by caring for the elderly poor and those deemed “worthless” by society. In the United States, it runs 30 homes where hundreds of its employees provide nursing and end of life care.
“You know there’s a lot of good Catholic organizations out there — the soup kitchens and the like,” says Bill Donahue, president of the Catholic League, “But let’s face it, when it comes right down to it in terms of one-on-one personal care, the work that the Little Sisters of the Poor are doing has no parallel.”
I’ve had several seniors ask me about specific aspects of the law that may affect their health coverage. Here are the major provisions of the ACA that will have an impact on Medicare, and other changes involved with the law that will affect both senior healthcare coverage and care.
Under the ACA there is an individual mandate to obtain healthcare insurance. If one fails to do so, a penalty will be imposed starting at $95 in 2013 and rising each year until 2016 when the penalty reaches $695. However, for seniors, this is not a threat since those over 65 are eligible for Medicare coverage. Enrolled seniors 65 and over will not face the penalty.
Although there will be payment cuts to Medicare, there are key benefits that are absolutely protected under the ACA. Medicare Part A (hospitals, hospice care and some home health services) and Medicare Part B (medical insurance) are protected and may not be cut. The changes under the ACA, according to the National Council on Aging, give seniors even more Medicare benefits.
Changes to Prescription Drug Coverage
The new healthcare law decreases the expenditure on prescription drugs for Medicare recipients. Prior to the law being enacted, Medicare recipients were subject to what has become commonly known as the “Donut Hole.”