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ElderCare Solutions of MI

Archive for 'Aging at Home'


The older we get, the more doctor appointments we seem to need.  It is not uncommon for the average baby boomer or older adult to see a cardiologist, a neurologist, perhaps even a rheumatologist, pulmonologist or gynecologist!  But amidst these many appointments there is one that often gets forgotten…an annual physical with a primary care physician.

Why is it important to keep up with your primary care doctor if you’re seeing all these specialists?  That’s a frequently asked question among our clients.  And the answer is a timeless metaphor…to be sure the right hand knows what the left hand is doing, and vice versa! Most specialists will only diagnose, treat, and prescribe medications for illnesses that fall under their own area of specialization.  So problems that come up may not be addressed outside of a primary care physician’s office.  For example, you’ll routinely have your blood pressure checked as part of an office visit with a pulmonologist, rheumatologist, or gynecologist, but it will not likely be addressed or treated, even if it is elevated. That’s also true if your labs show elevated cholesterol levels.  Instead you’ll be referred to primary care.  Also, routine general preventive care and screening will not be done by specialists, who need to use the appointment time to focus in-depth on the condition they are treating.

So, as much as you would love to eliminate another appointment, call your primary care doc, and schedule your annual appointment.

Getting out my calendar,


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There are so many conversations we’d rather avoid than have…conversations about finances or about someone’s inability to drive to name just a few.  But by far the most universally avoided topic has got to be end of life wishes.  On the surface this seems like such a silly problem.  I mean, most of us do truly know that someday we will die.  But do our children know our wishes?  Do they know the specific interventions we do and don’t want?  Have we given anyone the legal power to make medical decisions for us if we are unable to do so ourselves?

Clearly not, because statistics show that 70% of people wish to live out their lives and die at home, yet 70% of all deaths occur in hospitals.  The good news, however, is that there are tools available to help us navigate this potentially difficult topic.  There is a website, that has a free downloadable starter kit to help you start thinking about what is important to you regarding end of life care.  Unpleasant topic? Perhaps, but at least it’s free!

Downloading as we speak,


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The theme for this week is Falls Prevention.  Over the last 2 weeks I fell tripping over power cords, a colleague of mine slipped in her home, and we received several calls from new clients who were asking for help because they are recovering from…you guessed it, falls!

I think most of us think about falls prevention reactively, meaning it becomes really important to prevent another fall, after we’ve fallen at least once.  Prior to that we feel pretty much invincible.   But the truth is, it takes a long time to recover from that first fall if it was a bad one, so the time to think about falls prevention is now!

There are several different reasons people fall.  The most common causes are poor balance, clutter on the floor, inadequate lighting, wet/slippery floors, and neurological causes.  Luckily, the following preventive suggestions are helpful in most cases:  

  • Install grab bars in bathrooms
  • Pick up or tape down all throw rugs
  • Remove clutter from the floor
  • Install additional lighting if necessary
  • Be conscious of where you step on slippery surfaces
  • Work with a physical therapist to improve balance

Whether you put all of these steps in place, or only the one or two critical for you, protecting your quality of life is well worth the investment.

Measuring my bathroom for grab bars,


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I have had several conversations this week with family members families about how they will pay for the cost of caring for an older adult.  Whether someone brings help in to their home, or moves to an assisted living, memory care community, or even a skilled nursing facility, the costs can add up very quickly.  Often times people mistakenly believe that Medicare will cover all their needs, however this simply is not the case.

There are five possible funding sources that can be used to cover the costs of any long term care needs we, or our loved ones may have:

  1. Personal assets i.e. savings and investments
  2. Medicare for short-term qualifying expenses only
  3. Medicaid for nursing home residents who qualify
  4. V.A. benefits for veterans and their spouses who meet eligibility requirements
  5. Long-term care insurance for policy holders

Whether you speak with a qualified financial planner or elder law attorney, it is a good idea to start thinking now about what you need to put in place in order to maintain quality of life as you age.

Calling my financial planner,


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Doctors…the average older adult sees many different medical specialists.  So why is it often a good idea to switch from an internist or family practice doctor to a geriatrician?  And the answer, of course depends! 

A geriatrician is a physician who specializes in treating older adults. Many of us took our children to a pediatrician when they were young, because we recognized that the very young need specialized care.  Well, the same concept applies to older adults.  Our physiology changes as we age, including the way we metabolize medications.  In fact, many commonly used medications have a different set of side effects when taken by older adults.  Geriatricians are generally more aware of what medications to use (or not to use) when treating older adults.

Another difference you can expect to see is that geriatricians usually schedule fewer appointments each day, so they are able to spend more time with each patient.  They are also likely to screen for cognitive changes, depression and anxiety on a routine basis.  But perhaps the biggest difference is that geriatricians will often tackle difficult topics outside the scope of a traditional appointment including driving, moving to a more supportive environment, and bringing help into the home.

If an older adult and their family feel that all their needs are being met by their current physician, then there is no need to make a change.  But all too often I hear stories from clients who feel that their doctor is too busy to be able to spend as much time with them as they would like.

Passing this on to my in-laws,



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I’ve spoken with several older adults and their families last week where eating was a concern, so I’m reposting this blog on the topic…I hope it helps!

There is nothing that is more basic than eating. We have all been eating every day of our lives AND we so often take this for granted…shopping, cooking, broiling, serving, clearing, refrigeration, fiber, grilling, paper or plastic, calories, pot roast, pureeing, dessert, local, organic, food groups, turnips, pleasure. There’s a lot to it! As we get older, getting the right nutrition can become a concern.  I’ve been hearing more and more stories about older adults missing meals…not because they can’t afford to buy food, but because they’re too tired to eat.  By the time they get up, get dressed, eat breakfast, run an errand, and put their packages away, they sit down on the couch for a few moments and end up falling asleep for a few hours.  There goes lunch.  

There are several different alternatives for seniors who might not get the right nutrition (whether it’s because they are too tired or any other reason):

  1. Meals on Wheels: Several local community organizations have their own Meals on Wheels programs that deliver daily meals to their clients (  Kosher Meals on Wheels are also available through Jewish Family Service.
  2. Select restaurants and smaller grocery stores will deliver to seniors’ homes.
  3. Finding a caregiver who can cook meals for an older adult may also be the answer. 

Here are a couple of links:

The joy of eating well and aging well –

Senior health: How to detect and prevent malnutrition –




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As we age we go through transitions truly too numerous to count.  Some we manage to navigate gracefully, and others knock us flat on our backs.  But we usually are able to pick up and go on, slowly finding our way again.  But those who have retained a strong sense of who they are, who have maintained outside interests and social circles have a much easier time of it than those who are going it alone. 

I read an article a month or so ago where a woman who’s husband was in a nursing home for a prolonged amount of time commented that she was “not a widow, but not a wife”.  This expression stayed with me because it poignantly describes the way people can feel when their life circumstances change, causing them to no longer fit a traditional role like widow or wife.

I am, at heart, a glass half full person, and am not suggesting that we go through life preparing for the worst.  However, there are some choices we can make earlier in life, for example to consciously cultivate a hobby, that can serve us well in our later years.

So take a class, join a book club, learn to play cards, cultivate a new friendship, or volunteer your time.  Anything you truly enjoy will work.  It’ll give you pleasure for now, and provide a much needed outlet later.

 Thumbing through the community college catalogue,


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Most of us accumulate a lot of stuff throughout our lifetimes.  Even though I diligently clean out clothes closets each year, and have my kids pare down their collection of books and games, I know I’ll have to do it all again next year.   But for some people, this process of weeding out what to keep from what to throw out, sell or give away is more than just a chore; it’s an emotionally threatening task.  Those people are called hoarders.

Hoarding is not just a label made popular by the television show, neither is it just a sign of laziness.  Psychologists describe it as a condition that results from deep rooted trauma or loneliness.  Living in a home environment with stacks of belongings covering most of the floor, with only a winding trail to walk through is dangerous for anyone, including paramedics and fire fighters who need swift access in order to be able to help in an emergency.  But older adults, who may already have precarious balance, are particularly at risk. 

Often isolated and without frequent visitors, older adults may be hoarders and no one knows until that person has a crisis, usually a fall where they are unable to get up.  If you suddenly become aware that someone you care about is a hoarder, here are a few tips to keep in mind:

  • Resist the impulse to help by cleaning everything out for them while they are in the hospital or away.  Experts believe that the accumulated belongings offer a sense of security and protection, and that an abrupt clean out will likely be traumatic.
  • Contact a therapist who specializes in hoarding issues.
  • Involve the hoarder in the clean out process, empowering them to make some of the decisions about what to get rid of in order to make their home safe, while you’re there to help.

Getting ready to tackle the basement,



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Many older adults end up downsizing at one point or another, moving from their home to a smaller apartment or senior living community.  Usually their family members help with that process.   But after choosing the furniture and other mementos people want to take with them, it is easy to become overwhelmed by all that’s left.  We sure do accumulate a lot of stuff!

If this happens to you, it might be worthwhile to look into selling the items that you cannot take with you. There are a few ways you can go about doing this; you can sell your items yourself or you could have an estate sale.  Estate sales are often held after someone passes away, but that’s not the only time they’re held.   The difference between having a garage sale and holding an estate sale is the logistics behind the event.

For an estate sale, a company will come in and do the marketing, advertising, pricing, and display of your items for sale.  Estate sale companies have the expertise to know an item’s worth and will price your items at fair market value to get you the most money possible. The downside is that most estate sale companies operate on a percentage basis which can range from 20%-40% of the total sales.

If you have the time and the inclination, you may prefer to sell your items on your own at a garage sale or the internet, but then all of the nitty-gritty work (pricing, advertising, displaying, etc.) is done by you (and maybe friends and family if they are willing to help).  Either way works, but one caveat:  If you are disposing of possessions not because of a move but after the death of a loved one, it can be very difficult emotionally.  If it’s financially feasible, it might be helpful to choose the things you want as mementos and then leave the rest for professionals to handle.

 Clearing out my junk,


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This morning I heard a presentation about long term care insurance.  I had heard this same speaker last year, but today she had some new informatio to share.  For a variety of reasons ranging from low interest rates to the number of people filing claims for dementia, it is getting much tougher to be approved to purchase a new long term care insurance policy.  In fact,  cognitive screening is becoming a part of the approval process for people in their 50s!

Yet the potential need for long term care remains the same.  So, if you’ve been thinking about getting a policy, now is the time to start looking.  In order to help you with your decision, here are answers to 6 frequently asked questions about long term care insurance, re-posted from a previous blog: 

Just like homeowners or car insurance, different plans come with different covered benefits, and, of course, different price tags. Here are a few things to keep in mind when choosing a long term care policy:

When will you be eligible for reimbursement?   

Coverage usually begins when someone needs assistance with at least 2 activities of daily living (ADLs).  ADLs include everyday activities like bathing, feeding, toileting, transferring, and dressing.  People with cognitive diagnoses, like Alzheimer’s, may also qualify, depending on the policy. Plans can have a daily or monthly payout.  For example, if you had a daily payout plan that covered $150 per day and you had $200 in services for the week, all incurred on a single day, you would only be reimbursed your daily maximum rate of $150.  Because monthly payout plans don’t limit the amount of service you pay for in a day, they will reimburse you up to your monthly maximum regardless of the amount spent per day.

What is the policy’s elimination or waiting period?

You can usually choose a 30, 60 or 90 day waiting period, but be sure to find out if the policy has a “service day” or “calendar day” elimination period.  Calendar day elimination means that benefits would be covered based solely on the number of calendar days since a diagnosis was made.  Service day elimination refers to the number of days you must receive and pay for services before they are covered.  For example, if you have a 90 service day elimination plan, and you receive services once a week, it would take you 90 weeks to fulfill your 90 service day elimination period before benefits would be covered.   

Should I consider an optional inflation rider?                      

Most plans offer an inflation rider as an option.  The same level of care that currently costs $150/day might cost double that amount by the time you file a claim.

Should I check out exclusions?                                                                                          

This is the equivalent of reading the fine print.  Most policies have broad coverage, but with a few specific exclusions.

Should I ask to have policies quoted from more than one company?

Yes and be sure you’re comparing apples to apples.

 Happy Shopping,


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  • Does an older adult's family live out of town?
  • Are local family members overwhelmed and need help?
  • Is an older adult about to be discharged from the hospital or rehabilitation center?
  • Do family members have differences of opinion regarding a senior's care?
  • Is a senior living in an environment that needs aging-in-place modifications?

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ElderCare Solutions of Michigan is a division of Jewish Family Service of Metropolitan Detroit, a non-sectarian not-for-profit organization that has served the metro Detroit area for more than 80 years.