There is a product that is growing in popularity among seniors and is being merchandised aggressively by funeral parlors. This product is known euphemistically as “Pre-Need.” It is sold by funeral directors, of which there are very many. Retirement communities breed undertakers and cemeteries in the same way that young family suburbs grow childcare centers and elementary schools.
Morticians have discovered an undeniable truth about merchandising their wares. It is very difficult to return a cemetery plot or coffin, especially after it has been used. This gives the death business an advantage that has to be the envy of merchants selling more mundane wares.
So what, exactly, is Pre-Need? The idea, which is attractive to many retirees, is that they can make decisions concerning their deaths while still alive and vigorous. Purchasers of Pre-Need packages hope that all will go smoothly when they die, and that they will be sparing their loved ones the turmoil and trauma of having to make all sorts of tough choices under time and emotional pressures.
By arranging all of these things, and paying for them in advance, the theory goes, the temptation to buy the most expensive casket and services (because nothing is too good for “Dad”) can be avoided.
The cynical view is that Pre-Need is a clever scheme that greedy funeral parlor owners have invented to lock in their customers, and to obtain up-front capital on which to earn interest. They can sell the “product,” usually on an installment contract basis, with high, if not usurious, interest rates.
The buyer thus loses the investment interest that would have been earned by the dollars spent on the Pre-Need contract. It is the mortician that now earns the investment interest—and, to make the deal even sweeter, the buyer gets to pay credit interest to the mortician for the privilege of deferring final payment.
Not bad (for the funeral parlor, that is)!
In addition, the mortician is assured that the mortuary’s investment for cemetery land is quickly returned to the business, along with a nice margin of profit, long before it’s actually needed for the purpose for which its sold. No wonder so many entrepreneurs are dying to get into this business.
The truth is that Pre-Need can be a win-win in many situations. If the funeral parlor and cemetery deliver what is promised in the contract; if they don’t use the moments after death to impose the old “bait and switch” technique on guilt ridden survivors in an effort to sell higher priced product than chosen by the deceased; and if the terms of a fair and honorable agreement reached with the deceased long before the moment of need are observed, then the Pre-Need agreement may actually provide a bona fide value to the purchaser and to his or her loved ones; and a reasonable and fair business profit to the seller as well.
It is the ultimate layaway plan!
Bob Tell
Author
Dementia Diary, A Caregiver's Journal
http://dementia-diary.com
Friday, July 18, 2008
Monday, July 14, 2008
Memory loss- Key things to Remember
Just a few tips for the alert caregiver to consider when observing memory loss in a loved one:
* Be alert - document signs of memory loss and circumstances
* Notice if the memory loss is affecting activities of daily living such as planning, organizing and making decisions about every day functions.
* If there is a memory decline/loss be sure to be evaluated by physician
* Keep record of all medications including prescriptions, over the counter, herbs, and vitamins
* Understand the difference between delirium and dementia
* Learn to identify and manage stressful situations
These tips were provided by Jean Bandos, MSN, RN, GCNS-BC Research Director at "My Health Care Manager," a national company that helps seniors and their families manage the complexities of older adult life.
Bob Tell
Author, Dementia Diary, A Caregiver's Journal
http://www.dementia-diary.com
* Be alert - document signs of memory loss and circumstances
* Notice if the memory loss is affecting activities of daily living such as planning, organizing and making decisions about every day functions.
* If there is a memory decline/loss be sure to be evaluated by physician
* Keep record of all medications including prescriptions, over the counter, herbs, and vitamins
* Understand the difference between delirium and dementia
* Learn to identify and manage stressful situations
These tips were provided by Jean Bandos, MSN, RN, GCNS-BC Research Director at "My Health Care Manager," a national company that helps seniors and their families manage the complexities of older adult life.
Bob Tell
Author, Dementia Diary, A Caregiver's Journal
http://www.dementia-diary.com
Sunday, July 13, 2008
Some Potential Causes Of Memory Loss Or Cognitive Decline
So what actually causes memory loss or cognitive decline? The answer is complicated. Some things we know about. Others are speculative. Our scientists are making continuous progress in identifying potential causes, but lots more research remains to be done.
In the meantime, here are some of the more recognized ones as compiled by Jean Bandos, MSN, RN, GCNS-BC Research Director at "My Health Care Manager," a national company that helps seniors and their families manage the complexities of older adult life.
*Medication with polypharmacy and drug interactions- if an older adult is on multiple medications and is experiencing memory issues, they should have a pharmacist or physician assess each medication.
*Infection- i.e. Urinary Tract Infection –is often a primary cause for memory decline. Urinary tract infection is the most frequent cause.
*Dehydration- not drinking enough water will cause memory decline.
*Emotional stress or depression – with the elderly a diagnosis of dementia is sometimes given when it is actually depression. If true depression is treated then memory should return.
*Pain is underreported in elderly and causes a decline in memory.
*Alcoholism can cause serious memory loss.
Bob Tell
http://www.dementia-diary.com
In the meantime, here are some of the more recognized ones as compiled by Jean Bandos, MSN, RN, GCNS-BC Research Director at "My Health Care Manager," a national company that helps seniors and their families manage the complexities of older adult life.
*Medication with polypharmacy and drug interactions- if an older adult is on multiple medications and is experiencing memory issues, they should have a pharmacist or physician assess each medication.
*Infection- i.e. Urinary Tract Infection –is often a primary cause for memory decline. Urinary tract infection is the most frequent cause.
*Dehydration- not drinking enough water will cause memory decline.
*Emotional stress or depression – with the elderly a diagnosis of dementia is sometimes given when it is actually depression. If true depression is treated then memory should return.
*Pain is underreported in elderly and causes a decline in memory.
*Alcoholism can cause serious memory loss.
Bob Tell
http://www.dementia-diary.com
Saturday, July 12, 2008
In Memorium
Some months ago, after years of slow, agonizing decline into the opaque fog of dementia, my mother died. Mercifully, she slipped away gently one evening and was buried shortly afterward next to my Dad who had been waiting patiently for their reunion for 16 years.
Oddly, Mom died the evening before Thanksgiving, while Dad passed a day before Christmas eve. His birthday was November 28th and we always celebrated it on Thanksgiving. The Thanksgiving through New Years Holiday Season will always be bittersweet from now on.
Having been through so many mini-deaths during Mom’s long decline into dementia, I sort of expected the actual event to be easier than it was when Dad suddenly died of a massive coronary event in a Florida Sears store. It wasn’t. It was like being hit in the head by a 2x4. A clergyman told me, wisely, that whenever a mother dies it’s the wrong time. You’re never ready. He was so right!
When I got “the call” I’d been expecting for years (each time one of her medium sized mini-strokes knocked her down to a new low), I was stunned. Strange how poorly human beings are able to deal with the reality and finality of death. This wasn’t just another false alarm. This was it!
Still, as they say, for Mom it was a blessing (and probably for me too, although I don’t feel that way yet). Her life quality was so low for so long that I can only believe in the goodness of her being out of pain, discomfort, total dependence, confusion, etc. For me, though, I’m still at the stage of realizing that I’ll never see her again—and that I’ve become an orphan...an adult orphan.
Humor is often the best way to deal with sadness. So, a friend told me that as an only child, caregiving Mom for 16 years was my job. Not only have I lost my mother, he said, but I’ve also lost my job.
It’s true and I’m mourning them both.
Bob Tell
http://dementia-diary.com
Oddly, Mom died the evening before Thanksgiving, while Dad passed a day before Christmas eve. His birthday was November 28th and we always celebrated it on Thanksgiving. The Thanksgiving through New Years Holiday Season will always be bittersweet from now on.
Having been through so many mini-deaths during Mom’s long decline into dementia, I sort of expected the actual event to be easier than it was when Dad suddenly died of a massive coronary event in a Florida Sears store. It wasn’t. It was like being hit in the head by a 2x4. A clergyman told me, wisely, that whenever a mother dies it’s the wrong time. You’re never ready. He was so right!
When I got “the call” I’d been expecting for years (each time one of her medium sized mini-strokes knocked her down to a new low), I was stunned. Strange how poorly human beings are able to deal with the reality and finality of death. This wasn’t just another false alarm. This was it!
Still, as they say, for Mom it was a blessing (and probably for me too, although I don’t feel that way yet). Her life quality was so low for so long that I can only believe in the goodness of her being out of pain, discomfort, total dependence, confusion, etc. For me, though, I’m still at the stage of realizing that I’ll never see her again—and that I’ve become an orphan...an adult orphan.
Humor is often the best way to deal with sadness. So, a friend told me that as an only child, caregiving Mom for 16 years was my job. Not only have I lost my mother, he said, but I’ve also lost my job.
It’s true and I’m mourning them both.
Bob Tell
http://dementia-diary.com
Friday, July 11, 2008
Signs of a decline in memory function
It's not always easy to tell when a loved one is experiencing the onset of dementia. Here are some significant signs that are provided below as a courtesy from their author, Jean Bandos, MSN, RN, GCNS-BC Research Director at "My Health Care Manager," a national company that helps seniors and their families manage the complexities of older adult life.
*Forgetfulness - not just forgetting names or appointments, but frequently forgetting doctor’s appointments, important anniversaries, birthdays and other special dates that would have never been forgotten in the past.
*Forgetting to the point that it causes confusion and interruption with daily activities.
*Forgetting to turn off the stove – we have all left a burner on accidentally, but if this is a frequent event or if the older adult does not remember cooking at all, then it is no longer a “normal” part of aging.
*Everyone experiences difficulties finding the right words, especially in stressful situations. It’s a bigger issue when an older adult cannot remember simple words and substitutes his or her own words making it difficult to follow what they are saying.
*Misplacing items is common for everybody, but it becomes a “memory problem” if the keys are found in the freezer or the ice tray is in the dryer.
*Finances – there is a problem if a senior has always kept an accurate checkbook in the past and now it never balances.
*Impaired judgment, such as dressing appropriately. This does not mean the senior is mixing plaids and strips, or purples and reds, but is caught wearing a bathrobe to the shopping mall or putting on several shirts instead of one.
Bob Tell
http://www.dementia-diary.com
*Forgetfulness - not just forgetting names or appointments, but frequently forgetting doctor’s appointments, important anniversaries, birthdays and other special dates that would have never been forgotten in the past.
*Forgetting to the point that it causes confusion and interruption with daily activities.
*Forgetting to turn off the stove – we have all left a burner on accidentally, but if this is a frequent event or if the older adult does not remember cooking at all, then it is no longer a “normal” part of aging.
*Everyone experiences difficulties finding the right words, especially in stressful situations. It’s a bigger issue when an older adult cannot remember simple words and substitutes his or her own words making it difficult to follow what they are saying.
*Misplacing items is common for everybody, but it becomes a “memory problem” if the keys are found in the freezer or the ice tray is in the dryer.
*Finances – there is a problem if a senior has always kept an accurate checkbook in the past and now it never balances.
*Impaired judgment, such as dressing appropriately. This does not mean the senior is mixing plaids and strips, or purples and reds, but is caught wearing a bathrobe to the shopping mall or putting on several shirts instead of one.
Bob Tell
http://www.dementia-diary.com
Wednesday, July 9, 2008
WHAT'S NORMAL AND WHAT ISN'T?
The following information is borrowed (with her permission) from Jean Bandos, MSN, RN, GCNS-BC Research Director at "My Health Care Manager." Jean is an experienced Gerontological Clinical Nurse Specialist with a vast expertise in care management of the older adult.
"My Health Care Manager" is a national company that helps seniors and their families manage the complexities of older adult life. They have a website and a free 800 number that you can call to have any of your caregiving questions answered. The number is 1-800-499-8020.
"WHAT'S NORMAL AND WHAT ISN'T?
Forgetfulness and minor memory problems are a normal part of aging. As we age, memory lapses like not remembering a name or taking more time to figure out directions to a new destination are normal. However, when these memory lapses become extreme and continuous, some action needs to be taken.
Unfortunately, there aren’t clear cut signs or determinants that an action is related to serious memory loss or if it’s common for a senior. An indicator that a behavior is normal includes minor occurrences, such as an older adult getting lost driving in a new part of town or having one fender bender. But, when the older adult can’t find his or her way home from the local grocery store or has several “I can’t remember how that happened” dents in their car, that is likely a sign of a major problem that needs to be addressed.
Dementia, or memory decline, is caused by a problem within the brain that makes it hard for a person to remember, learn and communicate. As the dementia progresses the individual may display disruptive behavior and other side effects. It’s estimated that as many as one-third of adults will experience a gradual decline in cognitive function during their lifetime. It’s important to seek medical attention right away if noticing major indications of memory decline."
I hope to be able to share more tips from Jean Bandos in future posts. Stay tuned.
Bob Tell
http://www.dementia-diary.com
"My Health Care Manager" is a national company that helps seniors and their families manage the complexities of older adult life. They have a website and a free 800 number that you can call to have any of your caregiving questions answered. The number is 1-800-499-8020.
"WHAT'S NORMAL AND WHAT ISN'T?
Forgetfulness and minor memory problems are a normal part of aging. As we age, memory lapses like not remembering a name or taking more time to figure out directions to a new destination are normal. However, when these memory lapses become extreme and continuous, some action needs to be taken.
Unfortunately, there aren’t clear cut signs or determinants that an action is related to serious memory loss or if it’s common for a senior. An indicator that a behavior is normal includes minor occurrences, such as an older adult getting lost driving in a new part of town or having one fender bender. But, when the older adult can’t find his or her way home from the local grocery store or has several “I can’t remember how that happened” dents in their car, that is likely a sign of a major problem that needs to be addressed.
Dementia, or memory decline, is caused by a problem within the brain that makes it hard for a person to remember, learn and communicate. As the dementia progresses the individual may display disruptive behavior and other side effects. It’s estimated that as many as one-third of adults will experience a gradual decline in cognitive function during their lifetime. It’s important to seek medical attention right away if noticing major indications of memory decline."
I hope to be able to share more tips from Jean Bandos in future posts. Stay tuned.
Bob Tell
http://www.dementia-diary.com
Friday, July 4, 2008
Keyword Glossary For Alzheimer's/Dementia Services
This article is about the best way for caregivers of parents and
spouses to use Google and other internet search engines to find
quality services for their elderly loved ones with dementia.
No matter which dementia is involved (Alzheimer’s disease, senile dementia, pick’s disease, lewy body dementia, frontal temporal lobe dementia, vascular dementia, Parkinson's disease—to name just a few of the dozens of dementias that we know about), the keywords used in the research will make all the difference.
Of course. a “keyword” is a word or phrase that is entered into the search box of Google, Yahoo, Ask, and other search engine sites to prompt them to report links to relevant websites. The following paragraphs use popular keywords (IN CAPS) that usually generate multiple links to comprehensive sources of major information for Alzheimer’s Disease caregivers and related dementia sufferers.
CARE ASSESSMENT—This phrase will be helpful to caregivers who seek professional guidance about how best to meet their loved ones’ care needs.
ASSISTED LIVING—You are a caregiver to an elderly parent or spouse and you know your loved one can no longer live independently. But how to choose a proper structured and safe assisted living home for him or her? Pundits have said that “if you’ve seen one assisted living home, you’ve seen one assisted living home.” In other words, while there are some common elements among them, they are all different. There’s the medical model, the social work model, the luxury model, the economy model, the nursing model, the NORC (Naturally Occurring Retirement Community), and many variations on these themes. This keyword (i.e. Assisted Living) will get you started on your important search for the right program for your loved one.
CAREGIVER BURNOUT: This phrase describes a common feeling of helplessness and frustration among caregivers dealing with endless demands upon their time, energy, emotions, finances and patience.
CAREGIVER SUPPORT GROUPS: Many caregivers cope with the loneliness and isolation of their situations by joining real or virtual support groups. The internet can help them find an appropriate group.
ELDERCARE: This keyword will help the researcher to identify a variety of resources available to assist with the caregiving of aging parents or spouses with dementia.
SKILLED NURSING—or skilled nursing homes—or skilled nursing care are all keyword phrases that will lead elderly parent caregivers or spouse caregivers to information about how best to access this level of care for the dementia sufferer.
NURSING HOME RATINGS—When that dreaded moment arrives that nursing home placement for a loved one is imminent, this keyword phrase will lead you to sites that provide information to help you choose the best environment for your elderly loved one. Links to several nursing home rating sites are listed on my website: www.dementia-diary.com.
MEDICAID NURSING HOMES—Medicaid is the national program for financing health care to the poor. The cost of elderly care is so high that many patients run through their savings and are nearly destitute by the time nursing home care is needed. Elderly patients needing skilled nursing care who cannot afford a private nursing home may qualify for Medicaid. While not all nursing homes accept patients on Medicaid, many do. Guidance for families in this situation can be found on the internet by using this keyword phrase.
MEDICARE NURSING HOMES—Medicare is part of our Social Security system and provides financing for medical services to most citizens over the age of 65 regardless of their ability to pay. However, not all nursing homes accept payment from Medicare because that government program is quite limited with respect to long term care benefits. These homes fear that when Medicare benefits run out, they’ll have to continue to provide care without receiving compensation for services rendered. Nevertheless, many nursing homes are open to admitting Medicare patients for at least the short term—and some will permit such patients to remain if they become Medicaid eligible. It’s important to obtain this information up front as you go about researching nursing homes for your loved one.
HOSPICE CARE—Most folks are now familiar with this wonderful care concept for dying patients and their families. It was pioneered in England in the 1960’s, promoted by Elizabeth Kubler-Ross’s work on death and dying, and is now widely available throughout the United States. Medicare currently pays for most elderly patients requiring hospice care.
BILL PAYING SERVICES—Sloppy bill paying behavior is one of the first things caregivers notice when they see decline in their elderly parents or significant others. This often leads to a search for a commercial bill paying service. Many banks offer this service too. While not exclusively for dementia patients, these services can make it much easier to assist a loved one with dementia to pay his or her bills and eventually, if necessary, to take it over completely.
Do you know of other important keywords? If so, let me know at bobtell@mac.com
Bob Tell
http://www.dementia-diary.com
spouses to use Google and other internet search engines to find
quality services for their elderly loved ones with dementia.
No matter which dementia is involved (Alzheimer’s disease, senile dementia, pick’s disease, lewy body dementia, frontal temporal lobe dementia, vascular dementia, Parkinson's disease—to name just a few of the dozens of dementias that we know about), the keywords used in the research will make all the difference.
Of course. a “keyword” is a word or phrase that is entered into the search box of Google, Yahoo, Ask, and other search engine sites to prompt them to report links to relevant websites. The following paragraphs use popular keywords (IN CAPS) that usually generate multiple links to comprehensive sources of major information for Alzheimer’s Disease caregivers and related dementia sufferers.
CARE ASSESSMENT—This phrase will be helpful to caregivers who seek professional guidance about how best to meet their loved ones’ care needs.
ASSISTED LIVING—You are a caregiver to an elderly parent or spouse and you know your loved one can no longer live independently. But how to choose a proper structured and safe assisted living home for him or her? Pundits have said that “if you’ve seen one assisted living home, you’ve seen one assisted living home.” In other words, while there are some common elements among them, they are all different. There’s the medical model, the social work model, the luxury model, the economy model, the nursing model, the NORC (Naturally Occurring Retirement Community), and many variations on these themes. This keyword (i.e. Assisted Living) will get you started on your important search for the right program for your loved one.
CAREGIVER BURNOUT: This phrase describes a common feeling of helplessness and frustration among caregivers dealing with endless demands upon their time, energy, emotions, finances and patience.
CAREGIVER SUPPORT GROUPS: Many caregivers cope with the loneliness and isolation of their situations by joining real or virtual support groups. The internet can help them find an appropriate group.
ELDERCARE: This keyword will help the researcher to identify a variety of resources available to assist with the caregiving of aging parents or spouses with dementia.
SKILLED NURSING—or skilled nursing homes—or skilled nursing care are all keyword phrases that will lead elderly parent caregivers or spouse caregivers to information about how best to access this level of care for the dementia sufferer.
NURSING HOME RATINGS—When that dreaded moment arrives that nursing home placement for a loved one is imminent, this keyword phrase will lead you to sites that provide information to help you choose the best environment for your elderly loved one. Links to several nursing home rating sites are listed on my website: www.dementia-diary.com.
MEDICAID NURSING HOMES—Medicaid is the national program for financing health care to the poor. The cost of elderly care is so high that many patients run through their savings and are nearly destitute by the time nursing home care is needed. Elderly patients needing skilled nursing care who cannot afford a private nursing home may qualify for Medicaid. While not all nursing homes accept patients on Medicaid, many do. Guidance for families in this situation can be found on the internet by using this keyword phrase.
MEDICARE NURSING HOMES—Medicare is part of our Social Security system and provides financing for medical services to most citizens over the age of 65 regardless of their ability to pay. However, not all nursing homes accept payment from Medicare because that government program is quite limited with respect to long term care benefits. These homes fear that when Medicare benefits run out, they’ll have to continue to provide care without receiving compensation for services rendered. Nevertheless, many nursing homes are open to admitting Medicare patients for at least the short term—and some will permit such patients to remain if they become Medicaid eligible. It’s important to obtain this information up front as you go about researching nursing homes for your loved one.
HOSPICE CARE—Most folks are now familiar with this wonderful care concept for dying patients and their families. It was pioneered in England in the 1960’s, promoted by Elizabeth Kubler-Ross’s work on death and dying, and is now widely available throughout the United States. Medicare currently pays for most elderly patients requiring hospice care.
BILL PAYING SERVICES—Sloppy bill paying behavior is one of the first things caregivers notice when they see decline in their elderly parents or significant others. This often leads to a search for a commercial bill paying service. Many banks offer this service too. While not exclusively for dementia patients, these services can make it much easier to assist a loved one with dementia to pay his or her bills and eventually, if necessary, to take it over completely.
Do you know of other important keywords? If so, let me know at bobtell@mac.com
Bob Tell
http://www.dementia-diary.com
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