Important Information for Elder Caregivers

It is important to talk to parent(s) while they are legally able. Talk with your parent(s) while they are able to make decisions and prepare the way legally for their care. If you are the only child or the trusted family member, make sure that you have copies of any medical records they want you to have and that if you do not, make sure that they have legal documents in place so that you can obtain copies if necessary.

Caring for your parent(s) or other close relatives can be very stressful. If they are living in their home, there are many problems to be anticipated and activities to be ready for in order to take action. If your parents have a power outage, what will need to be done. Natural disasters such as tornadoes and hurricanes, floods are very hard to prepare for but plans need to be made. A car hitting a power pole or a lightening strike taking a transformer out can be more than an inconvenience, but these can be handled.

These problems mean actions that must be taken if a parent is on oxygen systems or a ventilator. These machines can produce life threatening circumstances. Some oxygen systems require electrical power to produce oxygen. Ventilators require electrical power and a generator backup to continue functioning.

For oxygen, having a spare backup tank can save the day, but the people assisting need training in switching over the tank. Oxygen should never be used near an open flame and smoking must be prohibited in the residence. Backup generators run on gasoline and must be outside the house in a covered place. Placement is an important consideration as is access. I would seriously consider a battery operated electric starter. All caregivers must be familiar with the operation of equipment and emergency operations.

Know the laws in your state for the operations of equipment and requirements for placement and operation. Contact the utility companies for cooperation and to notify them of power or gas needs and what equipment is being used. They can sometimes offer special rates and have other suggestions for assistance.

Then there is other electrical equipment, such as electric beds, air-loss mattresses, and air-mattress toppers that use electricity for the pumps. The beds generally don't have problems in power outages as they have hand cranks for use. The other systems can have built in battery backups and their use needs training to know their use. Another essential activity is surprise emergency drills that need to be in place to test the caregivers and equipment.

Then there is suction equipment, IV pumps, and other electrical devices that may be used in the patient's home. Most have battery backups and again caregivers need to be trained in switching in the event of a power outage and for all associated safety precautions.

These indicate a lot of plans to be made and how complicated the situations can be when caring for a parent or close relative. Don't get me wrong, this is something that often needs to be done and a family member is often an excellent solution.

More About The Social Networking Site

I am happy to report that the site is still up and active and we are recruiting new members.  Thank you.  Check out my blog here if you would please.

I am happy to report that work on the site in my last blog in ongoing and some areas are much more intuitive or I should say easier to find your way around. Some files were unfortunately lost in the process, but if people don't realize this, then they would be wise to accept it and realize that information can be accidentally lost in a beta version.

I may be hasty in writing this, but if something changes, so be it. I want to say a few things about the orange column on the right side of the page – the orange vertical tool bar. This is an interesting column as it starts with a search box at the top and as of now there is not much to search for, but may be just what you need six months or longer as more and more people join and more information is put up on the sight.

The next item down the column is for connecting to Twitter. Since I have a twitter account, but don't use it, I checked the no button. This closed the area, but tells you to click in the twitter icon if you wish to change. The very small Twitter icon does appear after you move away from the page you are on (I was on the home page) and I would think it would be the same for answering yes, but I am not sure. I did click on the icon and it asked me to log into Twitter. And that same log in page it does have a warning for you to read. The icon did disappear altogether after I rejected logging into Twitter, and it did reappear later as I experimented with other buttons.

The next item is your photo and a place for help and logout. I know that some do not use a photo which may be okay, but I would encourage you to use one or a symbol that is unique to you. I could put a picture of a toy semi-truck since I retired out of the transportation field, but since I use a photo on my blogs , I prefer my photo.

Next down the column is the Manage Account rectangle with when clicked on has the following: change profile photo, edit profile, edit location, edit account and finally edit privacy and settings. Each takes you to that section in your profile. This is followed by the Invite Contacts. Here you can do several things to invite your email contacts to join you on this site. I may explore this more later and invite a few more people as I have been emailing individually some of my contacts.

Then we come to Your Status. Basically this is a short (suggested three words) statement for anything you wish to state. It accepted my six words “I'm not ready for daylight savings”. Look around at the different members and see what they are saying. Next is the important items, Messages, Requests, and Notifications.

Messages are private messages (PM's) that you receive from other members. These are just that – private so keep them that way. If someone insults you and uses this for advertising, I suggest that you let the owner David Wolf or one of the moderators know immediately and let them handle the matter.

The requests are just that, a friend request that you may accept or deny. Notifications are notices you will receive from others that they will issue as bulletins to their friends to invite them to join a group, or take part in an event or possibly enter a chat room at a certain time.

Then there is a section with icons for adding Video, Photo, Music, Event, Groups, Blog, Bulletin, or Files. The last two were not what I expected and when I clicked on them I was given an answer. Bulletins are notifications you send. Files are public files you put in the library to store or use later.

Next is a list of who is online. It does not seem to be auto-updating and the number in the tab on the lower bar directly under it will seldom agree in number with the list of people on line. Then there is a View All which should (I thought) make the two areas agree, but even that seldom does.

The orange toolbar is one of the more creative parts of this sight. I had not explored it until recently and while I had looked at it before, I have not clicked on many of the buttons and investigated what was happening under the hood. Now that I have, some of it is not the most intuitive, but once you actually click on them, you will know what the icon or button is for and its purpose.

Are You Tired of Today's Diabetes Forums?

Well, it came to an end.  Not the way many of us desired, but participation waned and March 23, 2012 the site will disappear.
 
If you are looking for something a lot more social and possibly a bit more informing than many of the diabetes forums that exist today, you might want to stop by MyDiaBlog. This is different and while it is online now and you are able to join, it is still in the final stage and some areas are not yet as intuitive as some would like.

You will need to be an explorer of sorts, but the learning curve is not steep and actually is rather fun. I had some doubts about the site after reading David Mendosa's blog about it, but after a few days I did explore the site and a couple of days later joined. You are welcome to read David's blog here and I wish you would.

This site is the creation of David Wolf and do not be surprised after joining. You may have one of the moderators welcoming you. The first time this happened, I thought what the heck and answered back. We had a short conversation and I am happy that I did. This puts the social in social media networking. Be sure to check out the bar at the bottom. It has the status for chat on the right side, along with who in on line. On the left side there is access to chat rooms.

I am still lurking on the site and exploring the features – and there are many. The second time another moderator started to chat, I was deep into exploring and closed the chat box which is very similar to the one found on Google Chat. I probably should have said hello and exchanged pleasantries as I had already been interrupted, but I was deep into learning and wanted to finish what I was exploring.

These are a few of the features, Members, Forum, Blog posts, Events, Library, Photos, Videos, and Games. There are others but I have not explored them all. I have not checked all this, but under many of the areas, there is a menu when it opens. It has been exciting to watch the changes over the last few days as some have been expanded and some have been clarified.

Under Forum for example are Home, New Posts, My Groups, My Watched Topics, and My Topics. Again, I have not explored all of these, but New Posts is where you may start a new topic. Blog Posts is still being worked on, but there are lots of blogs at this point. Anyone can create a group so that people with like interests can join and compare ideas and interests.

There is still much to explore, and I look forward to finding out more of this developing social networking site which is different from forums and other sites and is more like a social network site than I have seen previously. Privacy is very much in the forefront, but there are some areas that may be weak at this point. The profile section is excellent, but the listing of activities by members is a little disconcerting, but this may need to be open so that you can see who is doing what. Security is so much better than facebook that there is no comparison. Facebook is so bad it hurts and this is on the other end of the spectrum.

So check out the site and see if it fits your needs. Once you have joined, do not get surprised by the moderators extending a welcome. When the box appears, be ready to chat if so desired.

Caring for Elderly Parents or Relatives

Talk with your parent(s) while they are able to make decisions and prepare the way legally for their care. If you are the only child or the trusted child, make sure that they have legal documents in place so that you can obtain copies if necessary. Know what your limitations and rights are.

Your parents, in-laws, or close relative will be the central characters in your planning process. You need to first discover what their wishes and ideas are for how they want to live out their last years. All decisions must involve them and, as much as possible, revolve around and incorporate their wishes and desires.

Make sure that the safety and well-being of your parent(s) are the most important issue. It is important to help them within the realm of their desires within safe parameters and finances will determine the success. Do not wait until a crises to try to do this as alternatives may be limited and following their desires may not be possible. Hopefully, they will have a living will and other legal documents to facilitate their wishes.

If you have many siblings, getting everyone together may be difficult during the planning stage. Even then some decisions may need to be made. The parents need to be heard and if this is not done, many of the siblings may be shut out by them because they know what they want, desire, and what may not be possible. Allowing each family member to be heard is always a good idea and then the one put in charge by the parents will know where cooperation can be expected.

If this has not been discussed prior, the discussion should include options if they are not able to live in their own home. Find out if there are finances allowing for each option, a nursing home, board and care homes, or assisted living facilities. While they are able to live at home, will they need assistance and at what level.

It is also a fact that family members may see things differently than their parents. This is where parents often decide to leave all children out of the planning and select the one they trust to fulfill their wishes. So allowing everyone a voice may not be the best, but should be the best option. In any discussion, be sure to include end-of-life issues.

Make informed decisions, learn where to find information, and the options you will have in caring for your parent(s), or other relatives. If you are the one in charge, how will you handle caring for your family, your parent(s), and time for yourself. Will your spouse be able to handle some of the responsibilities? This is important to know on the front side rather then well into a problem.

Make sure that you have the support of your family and do not forget to take care of yourself, because you know that others are depending on you.

How to Obtain a Parent's Medical Records

Disclosure: This is from reading and research, and I have no legal training.

This is a topic I started back in November 2010 and you may review it here. Georgetown University maintains a list of states and the rights for patients in each state that may be in addition to your rights under HIPAA. There is a lot of information available on obtaining your own medical records or those of your minor child, but very little for a parent. The above site can answer many of the questions for you depending upon the state your parent(s) or in-law(s) reside in.

Some are going to get tired of my repeating this, but it is so important. Talk with your parent(s) while they are able to make legal decisions and prepare the way legally for their care. If you are the only child or the trusted family member, make sure that you have copies of any medical records they want you to have and that if you do not, make sure that they have legal documents in place so that you can obtain copies when and if necessary.

In general, make sure that you have a right to the information before asking, HIPAA and each state's rules are very restrictive when it comes to parents records. Without a durable medical power of attorney (DMPA), you have no legal rights to their past records. Some parents try to make them available and may have some of their records and will give them to you, but without a DMPA you will get nothing from the doctor or hospital.

Even with a DMPA they generally will and do deny any records not associated with the current treatment or reason for hospitalization. And generally they are within their legal rights. So if you suspect something in the past and would just like information, forget it and they are not required to give you information if you are on a fishing expedition. However, if an accident some years ago may have a bearing on what is happening now, you have a right to ask, but expect some resistance until the records surrounding are reviewed. If they have a relevance you will be more than likely allowed access, otherwise you will not.

This is when many lawsuits happen because children want information they have no legal right to, but are sure they do. Judges are very good at abiding by state and HIPAA rules and not allowing nosy children to go on fishing expeditions. A few go the other way because the judge finds information that doctors or hospitals don't want made available that are relevant.

So if you are the trusted son/daughter or relative, know your legal limitations and rights. If the attorney that drew up the DMPA is available, be sure to talk to the attorney if you have questions. Also, a surviving doctor may know of something that will help you in the search for prior records that may be relevant and applicable to what is happening now.

Most of the time the DMPA will give you legal rights to all current medical records and you will have the right to ask for copies. It is the prior records that you may have little or no legal rights to see or get copies.

Then if your parent(s) for whom you have the DMPA is deemed to be capable of managing their medical treatment, your rights stop then. This is again an area of lawsuits when the doctor or hospital does this to get you out of the picture against the wishes or suggestion of the parent(s). So make sure of your facts and save all documents that may have relevance. I am not saying doctors or hospitals are trying to hide something or have done anything wrong, but mistakes do happen.

Other Problems in Diabetes Management

These problems in diabetes management can be completely out of your control. The medical insurance industry which follows very closely the actions of Medicare can really hamper the management of diabetes.

First, even though Medicare has small programs when they reimburse doctors for screening elderly patients for diabetes, the medical insurance industry will not. In addition, the medical insurance industry and Medicare will not reimburse for expenses that do not diagnose diabetes. If the HbA1c is less than 6.1 or less than 126 mg/dl, blood sugar reading, insurance will not pay for prescriptions and anything relating to the potential advice that could help you prevent or delay the onset of full diabetes. This is the sad part of our insurance industry.

Then in the area of testing strips, most insurance companies are limiting them to just two per day that they will reimburse for. A few are even getting bolder and limiting the number to 50 test strips per month for people on oral medications. This makes learning what different foods do to your blood glucose levels very expensive after diagnosis and until you have gained confidence in the foods that you may consume.

This also is true when you add new foods or have unusual times like eating out a lot when it would be wise to know what the foods are doing to your blood glucose levels. This is why I can understand people that have a creep up in A1c's. We are being forced by our insurance to not manage our diabetes and maintain daily controls.

This in turn encourages doctors to discourage testing and doing what is necessary to manage our diabetes. The doctors then say that the A1c give us a quarterly reading to tell us how we are managing. I say this is not good enough. By being able to test as needed, we can more readily see how a food is affecting our blood glucose so that we can change the serving size or eliminate the food from our menu.

If a person is on insulin, there are a few more strips, but sometimes not enough. For those that are on oral medications, make sure that you know whether the medication can cause hypoglycemia. For oral medications alone, the amount of test strips should be allowed an increase, and medical insurance should cover them.

To me, Medicare and the medical insurance industry actions are counter intuitive and more harmful for patients than practicing a little preventive medicine. Granted there are always those individuals that will never manage diabetes and give the rest of us headaches because they have participated in the surveys that the medical insurance companies send out showing that there is little or no need for larger numbers of test strips. The medical insurance companies also find them for the studies to back their cutback of testing supplies.

This is making it harder and more difficult for those that wish to tightly manage their diabetes to accomplish this unless they are able to afford the additional test strips out of their own pocket.

More Tips for Caregivers of the Elder Generation

Do you have a parent that needs care, or older relatives needing to be cared for. This can mean many challenges for the “in-between” or sandwich generation. No, this is not a repeat of the last blog.

What are the problems that you will face if you take on the care of a parent or older relative? How will your children react? How will the parent(s) react? These are just two of a multitude of problems and hurdles you will face. Many problems may be financial and others will be dealing with human nature. When I speak about a parent I put the (s) after to indicate possibly both and I want you to understand this could also be an older relative like an aunt or uncle and even a distant relative that has been close to you or your family.

Decisions need to be made and sometimes there just does not seem to be enough hours in a day. Will the parent(s) be able to completely care for themselves, only care partially with some or many limits, or will they be totally unable to care for themselves.

Decisions need to be made about where the parent(s) is going to live. Will they be able to stay in the home, and will it be necessary to have round the clock supervision or just a daily visit or someone only during the day? If it is just one parent, do you have room for an additional person living in your house? Or will an assisted living facility or nursing home be necessary? How is the person going to be able to get to and from doctors and other appointments?

These are just a few of the decisions to be made concerning the parent(s). Will you be able to handle the finances for their care or does the parent have the money available? If you are a single parent, how will this affect you and your children? Even if you and your spouse have a stable marriage, looking after a parent can place a burden on the marriage.

This is the reason for the prior blog to provide sources of assistance. Always consider talking to a pastor or minister of your church as they also can often provide resources.

Finally, if the parent(s) will talk about this and make plans before something happens, then many steps can be saved and everyone will know what is expected.

Tips for Caregivers of the Elder Generation

Do you have a parent that needs care, or older relatives needing to be cared for. This can mean many challenges for the “in-between” or sandwich generation. This term, “sandwich generation”, was popularized in the early 1990's by Carol Abaya, an eldercare expert and columnist.

This is more a listing of organizations that may provide guidance or assistance for eldercare of your parent(s), or other close relative. Even though I will be listing several caregiver resources, do not forget that many eldercare religious organizations exist and may be good resources. Just because I use eldercare, many organizations have other names, “aging services”, and “elder homes” are just a few of the terms.

The following list of caregiver resources is not complete, but will give you ideas and may provide what you are looking for. Some people may not need this if their parents have planned properly.

The National Association of Social Workers (socialworkers.org) can assist you in locating social workers specializing in geriatric care.

The National association of Professional Geriatric Care Managers (caremanager.org) makes referrals to eldercare professionals, who (for a fee) will assess your parents' needs and help coordinate care.

Benefitscheckup.org lists federal, state, and local benefits (other than Medicare) for which you parents may qualify.

The American Health Care Association and National Center for Assisted Living (longtermcareliving.com) can walk you through long-term care and assisted living options.

The National Academy of Elder Law Attorneys (naela.com) is a source for legal information and eldercare attorney referrals.

You may not need many of these services, but you should have a list available. The next thing that is necessary, before your parents are not legally able to do this, is talk to your parent(s) about having a lawyer draft two documents of importance. The first is a durable power of attorney for finances and the second is a durable medical power of attorney for medical decisions.

Have the parents keep the documents up-to-date and in a secure place like a safety deposit box. Family members should know of their location. Have the parents check with the financial institution and notify the institution of any changes to prevent complications when they go into effect. Also check with the institution to find out if they have any additional requirements that need to be addressed.

If you are the trusted person for your parents, you may be present for all of this. If there are other family members, they need to be notified to avoid future conflicts and hurt feelings. Not all families members are accepting of this, but most will work with the family member chosen by the parents.

If you are a parent with children, consider doing this for your children to avoid future problems as well.