Monday, October 29, 2012

Caring for a Parent With Dementia

AARP Caregiving Advisory Panel member Barry Jacobs answers reader questions about caregiving

by: Dr. Barry Jacobs | from:
AARP | September 19, 2012


Experts on the
AARP Caregiving Advisory Panel answer reader questions and offer helpful advice. Below, clinical psychologist and family therapist Dr. Barry Jacobs responds to two queries about caring for parents with dementia.

Q. My mother has been diagnosed with vascular
dementia. She suffers from paranoia — for example, she thinks her phone is tapped and that people come into her apartment and take things — and takes medication to treat it. She wants me to be with her all of the time, yet she suspects even me. Do you think that cognitive therapy will help at this stage?

A. It hurts when the person you are striving to help accuses you of malevolent intent and hostile acts. It's what makes paranoia — an irrational fear of others that's a common delusional symptom of dementia — so exasperating and often stymieing for family caregivers. Try to win over your loved one with sweetness and reassurance and she may regard you with greater suspicion. Confront her, however gently, about her unwarranted mistrustfulness and she's likely to feel threatened, convinced that you're allied with the swarms of enemies who mean her harm.
                  
How might cognitive therapy help your mom? This popular, evidence-based form of psychotherapy (often part of a broader approach called cognitive-behavioral therapy) helps people become more aware of and better able to correct the irrational distortions in their thinking in order to decrease responses of depression and anxiety. There is some research (primarily conducted in England) that suggests that cognitive therapy techniques can be effective in decreasing paranoid distortions. In my clinical judgment, however, such techniques are most likely to work when paranoid delusions are relatively mild — not the severe and myriad distortions your mother has been experiencing. If she won't talk on the phone for fear it is tapped, she is likely to clam up and hunker down in the office of a mind-probing psychotherapist — if you could even persuade her to go.

So how should you deal with your mother's paranoia? Allow the medications enough time to decrease her delusions and make her thinking more reality-based. Once the quality of her thinking substantially improves, ask her primary care physician to refer her to a psychotherapist for a trial of cognitive therapy to help her better recognize and correct whatever distortions in her thinking remain. She won't ever be the cogent and perhaps appreciative person she once was; her dementia, unfortunately, precludes that. But at least, if her fear is reduced, you will suffer less heartache.


http://www.aarp.org/home-family/caregiving/info-09-2012/caring-for-a-parent-with-dementia.html?intcmp=outbrain&obref=obinsite

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Sunday, October 21, 2012

A Risky Lifeline for the Elderly Is Costing Some Their Homes

By JESSICA SILVER-GREENBERG | New York Times – Mon, Oct 15, 2012 4:41 PM EDT

The very loans that are supposed to help seniors stay in their homes are in many cases pushing them out.

Reverse mortgages, which allow homeowners 62 and older to borrow money against the value of their homes and not pay it back until they move out or die, have long been fraught with problems. But federal and state regulators are documenting new instances of abuse as smaller mortgage brokers, including former subprime lenders, flood the market after the recent exit of big banks and as defaults on the loans hit record rates.

Some lenders are aggressively pitching loans to seniors who cannot afford the fees associated with them, not to mention the property taxes and maintenance. Others are wooing seniors with promises that the loans are free money that can be used to finance long-coveted cruises, without clearly explaining the risks. Some widows are facing eviction after they say they were pressured to keep their name off the deed without being told that they could be left facing foreclosure after their husbands died.

Now, as the vast baby boomer generation heads for retirement and more seniors grapple with dwindling savings, the newly minted Consumer Financial Protection Bureau is working on new rules that could mean better disclosure for consumers and stricter supervision of lenders. More than 775,000 of such loans are outstanding, according to the federal government.

Concerns about the multibillion-dollar reverse mortgage market echo those raised in the lead-up to the financial crisis when consumers were marketed loans — often carrying hidden risks — that they could not afford.

"There are many of the same red flags, including explosive growth and the fact that these loans are often peddled aggressively without regard to suitability," said Lori Swanson, the Minnesota attorney general, who is working on reforming the reverse mortgage market.

Joan Serioux-Forde, 72, thought that she couldn't feel more devastated after her husband, Christopher, died last year. Then, roughly a month after the funeral, she received a letter from Generation Mortgage, a reverse mortgage lender, informing her that unless she paid $293,000, she would lose her home in San Bernardino, Calif. Ms. Forde said she was never informed that if she wasn't on the reverse mortgage deed, she would have virtually no right to stay in her home unless she bought it outright. "It's a nightmare," she said. Generation Mortgage declined to comment.

Although the numbers of reverse mortgages have declined in recent years, the rate of default is at a record high — roughly 9.4 percent of loans, according to the consumer protection bureau, up from around 2 percent a decade earlier. And borrowers are putting their nest eggs at risk by increasingly taking out the loans at younger ages and in lump sums, federal data and a recent bureau report show.

Peter H. Bell, president and chief executive of the National Reverse Mortgage Lenders Association, a trade group, said that he met with officials from the Department of Housing and Urban Development to begin hashing out a way for lenders to adopt a uniform standard to determine whether seniors can afford to take on the loans.

Used correctly, reverse mortgages can be a valuable tool for seniors to stay in their homes and gain access to money needed for retirement. Seniors who have built up equity in their homes can borrow against a percentage of that and take out a lump sum or a line of credit. The loan doesn't have to be repaid until the homeowner moves out or dies, but borrowers still have to pay property taxes, maintenance and insurance.

Reverse mortgage lenders and brokers note that the loans are highly regulated and require potential borrowers to speak to a certified housing counselor about the potential pitfalls before taking out the loans. Mr. Bell adds that his trade group strictly monitors the advertising of its roughly 400 members to ensure that it is accurate.

Since the financial crisis, the reverse mortgage market has been in flux, dampened by a drop in property values, complaints about the loans and the recent departure of big lenders. Originations backed by the federal government peaked at about 115,000 in 2007 and totaled about 51,000 loans last year.

MetLife was the latest major player to exit the market, in April. That followed the departure last year of the two biggest reverse mortgage lenders, Bank of America and Wells Fargo, which cited falling housing prices and difficulty assessing borrowers' ability to repay the loans.

Into the void left by the big banks have moved smaller mortgage brokers and lenders. Some of them steer seniors into expensive, risky loans with deceptive sales pitches and high-pressure tactics, according to regulators, housing counselors and elder-care advocates.

Mark S. Diamond, a former subprime mortgage broker in Chicago, who has been sued for fraud by the Federal Trade Commission and the Illinois attorney general, faces a federal lawsuit filed in June by seniors who claim that he sold them reverse mortgages and either pocketed their loan amounts or promised to put the proceeds toward home repairs that never materialized. A lawyer for Mr. Diamond did not return calls for comment. Some solicitations reviewed by the Consumer Financial Protection Bureau present reverse mortgages as "free money" or mistakenly tell seniors that they could never lose their home. One Maryland reverse mortgage lender tells seniors that they can put the proceeds toward a vacation: "Just because you're retired doesn't mean you don't need a vacation every now and then." Last year, the Massachusetts Commissioner of Banks issued cease-and-desist orders to a handful of reverse mortgage firms for operating without a license. In its advertising, one of those mortgage brokers falsely promised seniors "you won't lose your home."

Officials at the bureau, which issued a report on the industry in June, said they heard from a number of seniors who claimed that lenders encouraged them to make their older spouses the sole borrower on the loan. The brokers earn more money when they make larger loans with the older spouse as the only borrower.

Some surviving spouses complained that brokers told them they could be added later, but they were not. The bureau says those seniors are at greater risk of losing their homes. The complaints, according to elder-care advocates and federal officials, have been rising during the past year, although there are no exact numbers.

Linda McMahon, a 65-year-old widow, watched helplessly as the locks were changed on her home in St. Croix Falls, Wis., last month. She said that in 2005, when her husband was 82 and she was 58, a mortgage broker from Wells Fargo promised her that she could add her name to the mortgage once she turned 62. That never happened because that year, in 2009, she didn't have time to deal with it as her husband's health quickly deteriorated and he died from a heart condition, she said. Soon, she was unable to pay any of the property taxes and insurance. "I am devastated," said Ms. McMahon, who is retired, living on Social Security income and now renting an apartment.

A spokeswoman for the bank declined to comment. Reverse mortgages also have troublesome incentive structures that might encourage brokers to steer seniors toward lump-sum loans, which carry a fixed interest rate, rather than a line of credit with a variable interest rate, the bureau found. In a lump sum arrangement, the interest charges are added each month, and over time the total debt owed can far surpass the original loan.

Brokers earn higher fees on these loans and even more money when they sell the loans into the secondary market, where they can get rates nearly double those for variable loans, according to rate sheets obtained by the consumer bureau.

Some 70 percent of reverse mortgages are taken in lump sums, up from 3 percent in 2008, according to the bureau. When seniors use the money to pay off other debts, especially right before retirement or early into it, that can leave them with scarce resources to pay their property taxes and insurance.

Ms. Forde, who lives in fear of losing her San Bernardino home, said she could not afford to save her house by paying the full $293,000 debt. Now, she said, she spends much of her day standing guard by the window. Her home is already in foreclosure proceedings. With a wavering voice, she said: "I have nowhere to go."

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Friday, October 19, 2012

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Thursday, October 18, 2012

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Sunday, October 14, 2012

Alone and at Risk

Staying in touch is good for your health

by: Holly Zimmerman | from: AARP The Magazine | October 2, 2012

Here's a lifesaving health tip: Add "spend time with family and friends" to your to-do list. Research shows that social detachment — having few close relationships — is as bad for you as smoking and worse than obesity. Older adults can become
isolated by life situations such as lack of transportation, landing this issue squarely on AARP Foundation's radar screen.

To learn more about solitary Americans, the foundation sent surveys last spring to select AARP Foundation Tax-Aide sites, focusing on the ones more likely to serve a less engaged population.* Ten percent of the 15,000 people who returned the two-page questionnaire reported they had trouble "staying connected" with family, friends and neighbors. Next steps for AARP Foundation: learning how to help repair and strengthen the broken links.

*Site selection was based primarily on U.S. Census data (percentage of people age 65-plus living alone, with disabilities, and percentage of those 60-plus living in rural areas). Findings are not generalizable to the general U.S. population nor to the AARP Foundation Tax-Aide taxpayer population.


http://www.aarp.org/aarp-foundation/our-work/isolation/info-2012/alone-and-at-risk-isolation-survey.html

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Saturday, October 13, 2012

Our Damnable Arabs !huna!

Did you know that Mohammad was a drunken, child molesting, cowardly pimp? The Ayatollahs and Terrorists do not want you to know the truth about Islam and promise to harm you if you tell anyone. Fight back and read this well written, totally funny, parody on the founding of the so-called religion.
 
The good non-biased reviews on Amazon.com "How Fatima Started Islam" are very accurate in describing this both laugh and insult per page well written novel featuring the always drunk proprietor of Mohammad's Saloon & Brothel. Still, available from Amazon.com and 234 truly funny pages at only $9.99. You will not be sorry, but do not import this book to the Middle East. The Terrorists DO NOT want you or anybody to read, publicize, promote,or purchase this book, they HATE the fact that this book exists and is being read.  Buying this parody is not only sticking up for American freedom it is sending a big message to Islam. 
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http://www.amazon.com/How-Fatima-Started-Islam-Mohammads/dp/0578032902/ref=sr_1_1?ie=UTF8&qid=1339884134&sr=8-1&keywords=how+fatima+started+islam

Use this link to go to Amazon.com

 
See sample Chapters, the back cover showing Mohammad depicted after a 5 day bender (the terrorists hate this picture), read about the never sober Mohammad having sex with camels, pre-adolescent girls and boys, the terror, sneak attacks, killings, rapes, assassinations, mutilations, back stabbing and mental illness.  No other book in the world is at all like this one.  Strike a blow for American Freedom by reading it. 
 
NOTE: There is a concerted and subtle effort to manipulate Americans from buying or reading the parody.  A foreign based group, I'll call them 'the friends of Islam' are pressuring Amazon.com to cease selling the book and also to flood Amazon.com with bogus 'reviews' to dissuade Americans from purchasing it.  In a two week period 40 'reviews' rushed in, mostly with non-Arab names, telling people how horrible, petty, stupid, poorly written etc. the book was and not to buy it.  All 40 unanimously gave it the absolute lowest rating.  It was obvious that each of the 'reviewers' had not bought or read the book, many proclaimed that they would not under any circumstances read an anti-Islam tome.  From George III to Adolf Hitler many foreigners have tried to limit what Americans should be allowed to read.  Protect the First Amendment and do not be dictated by the Ayatollahs of Damascus , Bagdad, and Tehran. 

Sunday, October 7, 2012

10 Things to Discuss With a New Caregiver

Be sure to cover these essentials before your loved one's new caregiver starts on the job.

By Kate Rauch, Caring.com senior editor

You've finally found a great personal in-home caregiver or companion for your parent, and tomorrow is her first day. But wait: Have you forgotten to tell her anything? Use this list (and adapt it to your parent's needs) to make sure you've covered the bases. After discussing it with the caregiver, give her a hard copy for reference (mail it to her if you live far away). That way you can relax, knowing your parent's needs will be taken care of.

Medications

Make sure they're accessible and clearly marked, and that the caregiver knows when they need to be taken and in what amounts. Also let her know whether your parent prefers swallowing them with water or juice.

Food and drink

Note your parent's food and drink allergies, sensitivities, likes, and dislikes. Be detailed -- for example, explain that your parent shouldn't drink coffee after 3 p.m. because it prevents him from sleeping; that seafood gives him hives but fish is OK; or that ice cream is his favorite treat on a hot day.

Eating, cooking, and cleaning

Should your parent be encouraged to prepare food and clean up for himself as much as possible, or does he need help with these tasks? If he needs help feeding himself, is it enough to cut food into small pieces for him, or does he need help getting the food to his mouth? What about tidying up the house -- does your parent make his bed or do his own laundry, or is this beyond his abilities?

Napping and sleep habits

When does your parent like to snooze, how long does he typically nap, and is he most comfortable in a chair or his bed? Does anything special help him rest, like soft music or pulling the blinds?

Bathroom needs and habits

What assistance does your parent need to use the bathroom? Is he completely independent or does he need assistance sitting down or getting up from the toilet, reaching for toilet paper, wiping, taking on or off his pants, washing his hands afterward? Is he prone to constipation or diarrhea? Is so, what helps (a newspaper to read, being left alone, avoiding certain foods)?

Body temperature

Is your parent prone to feeling too warm or cold? Can he express this, or should the caregiver ask him or touch his skin? At what temperature should the thermostat be set? Does your parent like an open window and fresh air? A blanket on his lap?

Around-home activities

What are your parent's favorite TV shows, radio stations, and card or board games? What does he enjoy doing at home? Does he like surfing the Internet, reading, or doing crossword puzzles? What about his dislikes? Does TV grate on him? Does he hate making conversation or is he a chatterbox?

Exercise and outings

Does your parent take walks, and if so, where and for how long? What about car drives or outings to the mall, a museum, or a movie? Does he garden or spend time outside? Does he need help or reminders to put on a jacket, hat, or sunscreen? Should he be encouraged to get up and walk around, or does he need a reminder to use his walker? Does he have any indoor-exercise routines?

Friends and other social contacts

Who can your parent (or the caregiver) call if he wants company or is feeling lonely or down? List names, phone numbers, and the relationship to your parent. Do any of these people ever stop by to visit, or should they be invited? What's their availability?

Emergency contacts

This should include you, other key family members or friends who can be called in an emergency, and your parent's doctor and dentist. Obviously, you'll need to include names; home, office, and cell phone numbers; and e-mail addresses if appropriate.

http://www.caring.com/articles/new-caregiver

"Learn About Senior In Home Health Care in Columbus, Ohio

Senior Helpers Provides Many services in the Columbus, Ohio area. We provide a full array of Home Care services for seniors and the elderly living in this beautiful area. Our Home Care Services are provided by bonded and insured employees and all employees pass a National Background check.

If you need Home Care services in Amlin, Clintonville, Columbus, Delaware, Dublin, Galena, Hilliard, Lewis Center, New Albany, Powell, Sunbury, Upper Arlington, Westerville, Worthington, and the surrounding areas we are an excellent choice with impeccable references. Home Health Care for your elderly loved ones is never an easy choice but we can promise we will do our best to make it as painless as possible. From our family to yours we sincerely thank you for considering Senior Helpers of Columbus Home Health Care Company. "