6 Estate Planning Questions Your Parents Should Answer

The essential issues your parents will address through estate planning

By Barbara Kate Repa, Caring.com Author

In deciding whether they need to do any estate planning, the key questions your parents should answer are whether there is any property they would like a particular person or charity to receive after their deaths and whether they have strong opinions about their medical care and final arrangements. If so, it's usually wise for them to get some simple documentation in writing to provide legal assurance that those wishes will be enforced.

Specifically, when considering whether to take any steps toward estate planning, your parents should ask themselves:

1. What are my assets and what is their approximate value?
2. What people or organizations do I want to have these assets -- and do I wish to give them up during my lifetime or after my death?
3. Who should manage these assets during my lifetime if I become unable to do so, or after my death if management is needed?

4. Who should be responsible for taking care of any minor or dependent children if I become unable to do so?
5. Who should make decisions about my medical care and finances if I     cannot make them?
6. After I die, do I want my remains to be donated, cremated, scattered, or buried?

http://www.caring.com/checklists/estate-planning-questions

"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. "

Aged care market will drive franchise growth; Paul Wheeler

• MEREDITH BOOTH

• From:AdelaideNow

• February 02, 2011

BABY Boomers are the target for a new Australasian franchise headed by former Cartridge World chiefs Paul Wheeler and Mike Fuller.
The duo has announced its first master franchise deal with US group Senior Helpers since launching their consultancy business Group Seven last year.
The deal comes three years after Mr Wheeler and co-founder Bryan Stokes sold down their share of the successful global Cartridge World business for a reported $70 million.
Group Seven aims to build a $150 million business in the next seven years as it opens 75 and 100 outlets across Australia and New Zealand to offer non-medical help to the elderly in their homes.
Mr Fuller said Australia was "crying out for an organised alternative" to services which help the elderly live in their own homes.
Demand for "companion and personal services" for the elderly is expected to grow as Australians aged over 65 double to 6 million by 2031, the group said.
"People want to stay in their homes. They want to be as independent as they can. It's not always possible for families to provide the full extent of that support and Senior Helpers is a fabulous business ...," Mr Wheeler said.
Senior Helpers founders Peter Ross and Tony Bonacuse, in Adelaide this week, operate the fastest growing home care company in the world, building to a 300-franchise business in just 10 years.
Mr Ross said he had been aware of the Cartridge World brand in the US before teaming with Group Seven and was confident the group would meet its Australasian ambitions, particularly with a more competitive US home care market than in Australia and similar demographics.
Senior Helpers deal with Group Seven is its first foray outside North America, spearheading international expansion plans which will target 16 countries.
The franchise will include a training component for aged care workers expected to be based at Group Seven's Norwood headquarters.

http://www.adelaidenow.com.au/business/aged-care-market-will-drive-franchise-growth-paul-wheeler/story-e6fredj3-1225998666516

"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. "

Letting Mom and Dad Live on Their Own Terms

Author: Janice Van Dyck

Millions of us went home for the holidays. Well, not "home" exactly. In reality, millions of us left home, and went back for the holidays. Back to who we used to be, back to where we came from, and in some cases, back in time. Like salmon up the river, we inexplicably navigated back to the people of our birth. Our parents.
Have you ever made the trip thinking, what if this is the last time? Parents age, especially when we're not looking, and most especially when we live far away from them. Periodic visits sharpen our senses. All of a sudden, we may be witnessing our parents in steep decline, heading toward the exit ramp, and it raises all kinds of questions.
When will it be time for assisted living? Should Mom still be driving? Are they taking their pills? Is Dad's memory actually shot?
These realizations can be tough, especially if your parents have been role models of determination and resourcefulness. Dealing with normal age-related decline can cause dissention amongst siblings, too, because each has a different relationship with Mom and Dad. For example, in my family, my sister lives closest to our father, and has regular visits with him. My brother and I live in different corners of the country and our main contact with Dad is by e-mail and telephone. Who is in the best position to judge how he's doing? As he approaches the 80-year mark, who has got the best perspective on his health?
This same conversation came up a few days ago in my book club, and again with friends at dinner last night. It seems that everyone of a certain age with living parents has the same questions. There are no easy answers. But I offer these three issues at the root of the debate:
Whose life is it anyway? We live our lives free to make our own mistakes, to put ourselves at risk and determine our own destinies. Why should this change just because we're old?
In our culture, roles often reverse: At some point adult children seem to think they need to parent their parents. This is fine if a parent asks for help, but often elderly parents are resentful because their middle-aged kids keep bossing them around. Their final years are full of conflict and humiliation because of well-meaning -- but strong-willed -- children, intent on removing the "risks" of living. So what if Dad's floors are dirty or your parents don't take their medicine and are going to get sick? If it's their choice, then perhaps you need to reconcile yourself to the fact they're not living their lives your way. And that's ok. After all, since anywhere from your teen years forward, they had to adjust that you weren't living your life their way.
Are your parents capable of clear thinking and reasonable risk assessment? Again, remember that at one time (or perhaps several times), they doubted your ability to make decisions. The point here is whether or not there's an actual, treatable medical/psychological impairment that would prevent your parent from rational thinking and action. And unless you're a doctor, you really can't make this determination on your own.
Consider getting an expert opinion before you take your parents' checkbook away. When they want to blow money at the casino or turn the heat down too low or mow the lawn themselves, just remember that even though it isn't what you want for them, that doesn't mean they shouldn't be allowed to do it. That being said, a parent who is unable to fend for him or herself because of a disability obviously needs help. But when it comes to your parent's livelihood, be careful to distinguish between fact and opinion.
Are your parents putting other people at risk? This again, is a matter of degree. Take driving, for example: We all put others at risk each time we get behind the wheel of a car. Senior citizens represent about 15 percent of all drivers, and they tend to get in more accidents due to age-related skill decline. But driving is risky anyway, and younger people can be even worse drivers than someone's 82-year old father driving 40 mph on the freeway.
So when calculating the risk factor, be realistic. If you worry about your parent causing a fire, it is obviously more dangerous if they live in multi-unit complex than a single home.
If you're struggling with how much autonomy and freedom your parents should have as they age, remember that someday, someone will be making the same decisions for you. Show your kids how you want to be handled in your old age by setting an example with your own parents. I don't know about you, but as long as I'm not hurting other people or actually incapable of making my own decisions, I want to be able to live with the consequences of my own actions, regardless of how old I am.
And you know what? Maybe that's a concept we're losing in our society, the idea of consequences. We can't protect our kids from getting hurt in life by putting a bicycle helmet on them in the stroller (which I actually saw the other day). Nor can we protect our parents from dying by taking away their dignity, freedom and choice. When we're born, the only guarantee is that someday we're going to die. That's the risk of living.
Since losing our parents is inevitable, why not let them do it on their own terms? I know of a man, now 94, who bought into a senior living community in his 80's. He hated it and moved out despite the protests of his family. I applaud his courage! What's the worst thing that could happen? He might die alone, on his own terms, looking around at his own belongings, satisfied that his life was well lived.
His only regret might be that his children didn't understand.

http://www.huffingtonpost.com/janice-van-dyck/how-storytelling-can-exte_b_805502.html

"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. "

Who Thrives After Surgery?

By PAULA SPAN
Martin A. Makary, a surgeon and public health researcher at Johns Hopkins Hospital in Baltimore, had a long talk with a patient last week. The man had a tumor in his pancreas that was probably benign but might not be. Should Dr. Makary remove it? Or should the man have regular scans to see whether it grew?
"If you're 25, the decision is easy — get rid of that risk," Dr. Makary told me afterward. But this patient was 89.
Let's pause for a moment to consider the changing surgical landscape. When Dr. Makary was in training, he recalled, surgeons were just starting to offer elective procedures to patients in their 70s. Now, with better techniques, safer anesthesia and, of course, more old people — half of all operations in the United States are performed on those over age 65.
"It's become acceptable to do major procedures on very old patients," he said. "We routinely do elective surgery on people in their 80s and 90s."
That doesn't mean it's always a good idea, or that it's easy to calculate the costs and benefits. How very old patients respond to surgery has proved unpredictable. "There are some people you worry won't do well, and then they fly," Dr. Makary said. "And some people you are confident will do well have a cascade of symptoms that lead to their demise or permanent disability — and everybody is shocked."
Surgeons eyeball their patients all the time to try to evaluate whether they can recover well from the stress of an operation, but it's an inexact science. "You can be thrown off by hair or teeth or wrinkles, things that don't have much to do with physiologic reserve," Dr. Makary said.
The usual tests surgeons use to try to predict how older patients will fare are crude, Dr. Makary added, mostly based on cardiovascular strength. And standard estimates of mortality and length of hospitalization for specific operations are all but useless for patients who might be 30 or 40 years older than the norm.
But thanks to a rather elegant piece of research by a Johns Hopkins team, recently published in The Journal of the American College of Surgeons, surgeons can give more informative answers when elderly patients in this situation, or their families, wonder what to do.
For years, the geriatrician and gerontologist Linda P. Fried, now dean of the Mailman School of Public Health at Columbia University, has been talking and writing about frailty. We laypeople tend to use the word imprecisely to allude to fragility or vulnerability in old people, but for physicians and researchers, frailty is a specific medical syndrome with measurable criteria.
They look for a series of declines that include weight loss (specifically, an unintentional loss of 10 pounds or more in the past year), a weaker grip, exhaustion and lack of physical activity, and a slower gait. The assessment takes perhaps 15 minutes to conduct in an office. Then the doctors assign a score: 0 to 1 for those who aren't frail, 2 to 3 for the intermediately frail.
Patients who score 4 to 5 are frail. "They tend to have much less reserve, a decreased ability to bounce back" from physiological stress, said Dr. Fried, who previously taught at Johns Hopkins.
Might frailty scores be better at predicting how patients fare after surgery than the existing methods? For a year, Dr. Makary, Dr. Fried and their colleagues at Johns Hopkins tracked nearly 600 patients over age 65 who had elective surgery in that hospital – from minor gallbladder removal to joint replacement and major abdominal surgery. All lived independently.
The researchers assessed patients' frailty before their operations: slightly more than 10 percent were adjudged frail (average age 76.3), and more than 58 percent weren't frail at all (average age 71.3). The remainder were classified as intermediately frail.
"The data are quite persuasive," Dr. Fried said. "People who are frail before surgery are at higher risk for poor outcomes afterwards." This is the way careful researchers talk; they say results are "persuasive."
A layperson like, say, me would say: Yow. The frailty index did a superior job of predicting how seniors will do after surgery, and just look at the extent of the differences.
Those who were intermediately frail faced twice the odds of complications after surgery, compared to patients who were not frail, according to the study; frail patients had more than two and a half times the complication rate. Hospital stays were 44 percent to 53 percent longer for those intermediately frail, and 65 percent to 89 percent longer for the frail.
And after operation, the odds of a patient being discharged to a nursing home or to assisted living, instead of her own home, rose in proportion to her frailty. The intermediately frail were more than three times as likely to have to enter such a facility, compared with those who were not frail. The frail were 20 times (not a typo) as likely to go to a nursing home or assisted living — from which they may or may not have emerged.
"If the risks are likely to be higher, it changes the equation as to whether the surgery has benefit," Dr. Fried said.
That 89-year-old patient, for example, turned out to be intermediately frail when Dr. Makary evaluated him using the frailty index. "I thought he was stronger," he acknowledged. After considerable discussion, doctor and patient agreed not to remove the tumor, but to track it with annual scans.
Surgeons at Johns Hopkins have widely adopted the index to help make such pre-op decisions, and Dr. Makary says he has heard from surgeons at about a dozen other major medical centers who are also using it. In some cases, patients may decline surgery. In many, they and their families will have a more realistic idea of how long recovery may take and how much help they will need.
This is a question, Dr. Makary suggested, that older patients and their families ought to routinely ask their surgeons in fairly blunt terms: You want to operate on my father? You think he's too old for surgery? What's his frailty score?

---

http://newoldage.blogs.nytimes.com/2010/12/28/who-thrives-after-surgery/?partner=rss&emc=rss

"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. "

How to Stick with Your Fitness Routine over the Holidays

Here come the holidays, between the decadent foods and desire to get out of the cold, this stretch of weeks can compromise anyone's movement regimen.

Hello, I am Marcy O'Koon Moss, editor-in-chief of Arthritis Today and will be providing a few tips on how to overcome the holidays and keep moving:

Make an "appointment."
Schedule your exercise as you would a meeting or party – and keep the appointment. It's even easier if you are part of a regular class, such as the Arthritis Foundation's warm-water Aquatic Program or land-based Exercise Program.

Sneak it in.
"Your exercise routine may get derailed by shopping trips and errands but try to fit in extra steps by parking far from the front door of the store, taking extra laps around the mall, and trying to use the stairs instead of the elevator, if you are able.

Break up your workout.
Experts tell us we should get at least 30 minutes of exercise to see the benefits of physical activity. Try segmenting your workout into three 10-minute sessions that you can squeeze in throughout the day.

Work out at home.
When time is tight, don't waste it driving to the gym. Stay put and dust off the stationary bike or treadmill, or pull workout videos/DVDs off the shelf.

Involve visitors.
When family or friends are in town, it's important to get to spend time talking with them while getting your exercise. Invite your loved ones to get moving with you: Take them for a walking tour of your neighborhood, do exercises with you or have them join you at the gym.

Set realistic goals.
Instead of working out five times per week, you may have to settle for three. But that's OK: A study conducted by the American College of Sports Medicine found those who set realistic goals were more apt to stick with exercising than those who set loftier goals.

http://lmt.arthritis.org/our-community/podcasts/how-to-stick-with-your-fitness-routine-over-the-holidays.php?WT.mc_id=MBS_12StayFit

Your Home Health Care Aide: Establishing A Positive Relationship

by Kim Champion
You've made the decision to let an aide come into your home to assist. That was hard enough. Now you re getting apprehensive about what to expect when the aide arrives for work. If you don't have experience with in-home assistance, all sorts of "worst case scenarios" are whirling about in your head. And then there are the questions. What should you do if you don't like the aide?

How should you approach problems? Who supervises the aide? Assuming that you have hired an aide from a home health care agency, you can expect a lot of support in easing your anxieties. It is the agency's job to answer your questions in advance and resolve any issues that arise. The key to facilitating your satisfaction and comfort is good communication with the agency management and with your aide.

Here are a few tips for establishing positive relationships with your home health care professionals:

Be completely honest about your needs

Overcome any embarrassment or guilt associated with describing why you need help and what kind of help you need. Remember that you are dealing with professionals who have helped a variety of clients. They are experienced in meeting the needs of people just like you. Home Health Care professionals are prepared to deal with tough situations such as Alzheimer's, alcoholism, Parkinson's, strokes, incontinence and stressful family circumstances.

State your preferences from the start

The best way to get exactly what you want is to be specific. Give a detailed request to the agency so that the aide they send will meet your needs. Items to include are your household rules, such as "no smoking" or "kosher kitchen". Also express your daily routines and how to follow the, such as "up at 7 a.m.", "breakfast first, medicine second, shower last" , "I need privacy from 9 a.m. to 11 a.m.", "transportation to salon every Friday, using employee's car".

Give feedback to the agency on a timely basis

"Nip it in the bud," is good advice. Most problems start out small and can be best resolved when addressed promptly. If you are experiencing a problem with the aide, call the agency. This benefits you in two ways: you do not have to be involved in reprimanding the aide, and it prompts the agency to diplomatically resolve the problem. Employee supervision is the responsibility of the agency. If the problem cannot be resolved to your satisfaction, request the agency send a different aide. The agency will handle the hiring and firing for you.

If you start off with honesty and communication, having a home health care aide will be a successful and beneficial experience.
http://www.caregiver.com/articles/homecare/home_healthcare_aide.htm

4 Red Flags to Look for During Holiday Visits With Parents

Gail M. Samaha

As the holidays approach, many long distance caregivers are now planning visits to their aging loved ones – perhaps the first opportunity in several months to personally observe older relatives.
And the number of caregivers considered long distance is significant. According to a study conducted by the National Alliance of Caregiving, in collaboration with AARP, 15% of the estimated 34 million Americans who provide care to older family members live an hour or more away from their relative.
For those who have relied on regular telephone conversations and assessment by other closer-living relatives to gauge aging parents' well-being, the upcoming holiday visit may be revealing. Absence – even for a short period – often allows us to observe a situation through new eyes…and the following changes may indicate the need to take action to ensure your aging relatives' safety and good health:
Weight Loss
One of the most obvious signs of ill health, either physical or mental, is weight loss. The cause could be as serious as cancer, dementia, heart failure or depression. Or it could be related to a lack of energy to cook for a loved one or just themselves, the waning ability to read the fine print on food labels or difficulty cleaning utensils and cookware. Certain medications and aging in general can change the way food tastes. If weight loss is evident, talk to your loved one about your concern and schedule a doctor's visit to address the issue.
Balance
Pay close attention to the way your parent moves, and in particular how they walk. A reluctance to walk or obvious pain during movement can be a sign of joint or muscle problems or more serious afflictions. And if unsteady on their feet, they may be at risk of falling, a serious problem that can cause severe injury or worse.

More Behaviors Caregivers Can Watch for in Aging Parents
Emotional Well-Being
Beware, too, of obvious and subtle changes in your loved ones' emotional well-being. You can't always gauge someone's spirits over the telephone, even if you speak daily. Take note for signs of depression, including withdrawal from activities with others, sleep patterns, lost of interest in hobbies, lack of basic home maintenance or personal hygiene. The latter can be an indicator not only of depression, but also of dementia or other physical ailments including dehydration, a serious condition sometimes overlooked in elders in the winter months. If you notice sudden odd behavior with your loved one, be sure to seek medical attention as it could be a urinary tract infection which is prevalent in elders and easily resolved with antibiotics.
Home Environment
Attention must also be paid to surroundings. For instance, your parent may have always been a stickler for neatness or for paying bills promptly. If you discover excess or unsafe clutter and mail that has piled up, a problem may exist. Also, keep an eye out for less obvious indications for concern. Scorched cookware, for example, could be a sign that your parent forgets if the stove is on. An overflowing hamper could mean he or she doesn't have the strength and/or desire to do laundry. And by all means, check prescription bottles for expiration dates; and make note of all prescriptions your family member takes and place that information in your personal files as well as the elder's wallet in case of an emergency.
There may be other areas of concern, specific to your family member. Should this year's holiday visit open your eyes to current and potential problems or negative changes in your parent's physical or emotional state, then it's time to put a plan of action in place.
Steps to take
Initial Conversation
First, have a heart-to-heart conversation with your elderly loved one about their present circumstances, concerns and the measures they'd like taken to make things better. Introduce the idea of a health assessment appointment with their primary care physician. Would they feel more at ease if a home health aide visited a couple times a week? Maybe they have legal questions and would greatly benefit from an appointment with an attorney. Or they may need help with housecleaning or bill paying.
Identify Resources
While you may want to keep things light during the holiday season, do take this opportunity to collect all necessary information now to avoid frustration and confusion in the event of a crisis down the road.
Pay a visit to the local Council on Aging or Town Hall for resources and services available in your parent's community. And get a copy of the local telephone book to take home with you – it will come in handy as you and your loved one create a "go to" list of services over time.
This list should include friends, neighbors, clergy, local professionals and all others who your family member has regular contact with. In fact, if you haven't already, take the time to visit with those friends and neighbors and make sure you have their addresses, telephone numbers and e-mail information and make a point to provide them with your contact information as well.
Prepare a To-Do List
Now is the time to begin compiling a to-do list to be implemented over a period of future visits. Medical information should include your loved one's health conditions, prescriptions and their doctor's names and contact numbers. A financial list should contain property ownership and debts, income and expenses, and bank account and credit card information. You should also have access to all of your parent(s) vital documents that could include their will, power of attorney, birth certificate, social security number, insurance policies, deed to their home, and driver's license.
And remember to give your loved ones the power and permission to be in control of their own lives – as much as is reasonable. The more systems you have in place the more your loved one will be kept independent and safe in their own home, giving you peace of mind as you return home from your holiday and future visits.

http://www.agingcare.com/Featured-Stories/136906/What-to-do-when-an-elderly-parent-s-health-is-declining.htm

"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. "