Quality of Life Planning

Quality of Life Planning
July 18, 2018

There are multiple parts to Life Planning such as Financial, Legal and Health Directives which are critical for the best outcomes; many times, Quality of Life Planning is overlooked.  

People stay active, stimulated and have the best quality of life when they have a foundation of physical, social and spiritual well-being.  

Physical—Not only appropriate level of care, but proper nutrition, access to doctors, therapy, wellness programs and physical activities.  

Social—Daily opportunities to interact with others, pursue interests, contribute, learn and be a key part of things.  Have something to look forward to every day; sense of purpose.

Spiritual—Environment that offers various options for spiritual practice and self-reflection.

It is vital to plan for Quality of Life and to prepare for the progression of Aging and Living Longer.   There continue to be new and less restrictive care environments every day.  Through education, information and careful exploration of various care settings, you will be able to make the best decisions for yourself and your loved one.  It’s vital that the care and surroundings continually be evaluated based on the above factors as care needs are ever-evolving. 

Staying at Home – For many people, the first response is, “I want to stay at home”.  Often times this choice stems from the fact that years ago, the only options were to stay at home and receive care from a family member or go to a nursing home.  These are no longer the only options.  Each situation is different; each person is unique and care settings should be evaluated as such.  

Remaining in the home with a caregiver can many times mean isolation, feelings of guilt, burden and issues of maintaining one’s independence and self-respect.  Lack of purpose/motivation and physical activity can lead to a quicker decline and depression.

Family caregivers also face several challenges; these could include learning how to give proper care for their loved one; dealing with emotional, physical and financial stress. One has to balance the different dynamic that each family member brings.  Balancing all of these different challenges while keeping one’s life intact can be overwhelming.  Some care givers are grateful for the opportunities to provide care.  For others this is not the role that they can fulfill. And in some cases it can lead to sickness, burnout, and loss of employment. 

Objective professional help is available.  A professional can consult about a loved one’s unique needs, preferences and budget, then educate about the appropriate care choices.   Some examples include aides coming into the home, adult day programs and assisted living communities. 

 It is best to consult and explore the most appropriate options prior to additional care being needed.  This allows all parties time to properly evaluate, discuss and involve everyone in the decision for the best transition and outcome.

Finding the right care environment for the best Quality of Life that has a foundation of physical, social and spiritual well-being is the difference between Thriving and Existing!



Why now?

In the absence of a crystal ball...
It is important to look into your Long-Term Care Insurance options NOW. 

By Natalie Karp, MBA, CLTC, and Rona Loshak, MBA, CLTC
Founding Partners, Karp Loshak Long Term Care Insurance Solutions Brokerage

Planning from a position of strength is a game 3. changer. Especially when it comes to planning for your long-term care. LTC Insurance is typically one of the last pieces of your family and lifestyle protection. Today’s landscape is changing rapidly, and given the realities of underwriting and pricing- LTC merits timely consideration. 

CLICK HERE for complete article

When is the Right Time to consider moving Mom or Dad?

Lisa Albinowski, Seniors Real Estate Specialist Licensed Associate Real Estate Broker. Coldwell Banker

When is the Right Time to consider moving Mom or Dad? 

Many seniors and their families ask when the right time to think about the move process is. Open and honest discussions are key to a successful first step when you are trying to decide if a move is right. As we age our housing needs change, our long-time family homes may become too costly, too big or just too much to handle. Seeking a simpler and safer lifestyle is a worthy goal to pursue, but facing and acting on this decision can be a difficult challenge – and emotions are inevitable. 

  • Communication is the building block to a strong support system for an older person and their family. Families should discuss all possible residential options including 55 and over communities, co-ops, assisted living communities(not facilities), independent living  communities (not facilities), continuing care retirement communities which will offer you the option to move into different types of housing as you age and need services, adult homes, and nursing homes.  Each housing option comes with its own advantages and disadvantages but knowing what your options are is a first step.
  • Discuss the type of care needed.  Does your loved one require assistance with activities of daily living such as bathing, dressing, and eating?  Does your loved one use a wheelchair?  Will Mom still be driving or require transportation?  
  • Discuss finances.  With the average life expectancy being 78.8, what housing option is most affordable for your loved one on a long term basis?  Consider costs that will be eliminated (not surrendered) when the house is sold and additional ( not changing) care needs that could increase your loved one’s expenses as they age.  
  • Discuss changes in lifestyle.  Will transportation be available at the new residence residential home, will there be social activities, will your loved one be okay with adhering to a new schedule if that is required?  If your loved one prefers less social activities, he or she may feel more comfortable in a  residence (not residential home) that is more independent.  
  • Discuss the location of the new home.  Staying close to family members is important as well as accessibility to doctors, shopping areas, and other local community areas.
  • Seek the advice of attorneys, financial advisors and real estate professionals. They can guide you on your options and help you decide if moving or staying at home is the best decision.
  • Discuss each family member’s role in the transition.  As an example, who will assist with the move, who will assist with getting settled into the new residence, who will assist with selling items from the household that cannot be taken to the new residence?

For a senior, the emotional process starts to take place often months or years before the actual move. Many people don’t know where to start when they are considering a lifestyle change. Having a well thought out plan will make the process easier for all involved. 

Below are some questions to ask your realtor before making a move.

  • What is my current home worth?
  • What are the recent sales of similar homes in my area over the past six months?
  • What can I do to help my home sell quicker?
  • What is involved in putting it on the market? 
  • How much will my new home cost? 

Many realtors have expertise with this specialty, such as a senior real estate specialist, and can assist the family during the beginning stages of the move and throughout the process.  They can help you assess your choices to determine what type of housing meets your needs now and over the next ten plus years.  

When Aging Parents' Caregiving Expectations Can't Be Met [AARP]

For adult children, sharing the workload and carrying out the plan come with challenges

by Barry J. Jacobs, February 13, 2015

Eighty-year-old Millie had always expected, when she got older, that her daughter, Becky, would be there for her. But Becky now lives 45 minutes away, works full time and has teenagers to chauffeur. Though Millie's two sons and daughters-in-law live close by and pitch in often, she prefers her daughter's company.

Becky, for her part, visits frequently but always sees the disappointment and disapproval in her mother's cold stare. She feels both guilty and peeved.

"Why can't Mom just accept that our current caregiving plan is the one that's most practical?" Becky asks her brothers in frustration.

They haven't an answer other than to say she's always been Mom's favorite. Hearing that makes Becky feel all the more guilty, as if she's supposed to quit her job, uproot her family and move into their mother's cramped home.

These siblings exemplify an unfortunate truth about caring for an aging parent: It is rarely an equitable enterprise. In the vast number of families, one of the siblings (generally a daughter) bears the brunt of the sacrifices. Who that child is may have little to do with practicalities. Among other factors, parental preferences affect caregiving choices and the relationships among daughters and sons.

These are some of the research findings over the past decade of Karl Pillemer of Cornell University, J. Jill Suitor of Purdue University and other social scientists who've studied aging mothers and caregiving. They have found that geographic proximity does shape whom mothers prefer to be their caregivers, but so do factors such as similarity of genderand emotional closeness. Mothers' choices have a powerful impact, dictating how most families divvy up the work. When those preferences are not honored because the chosen children are not willing, available or able, then the mothers may become disgruntled and the families as a whole may struggle.

How can conflict be minimized when a parent's wishes can't be met? There are no surefire solutions, but here are some ideas.

Foster open communication about what's expected

One definition of family is the group of people from whom we expect love, loyalty and labor. But when the specifics of those expectations — who does what for whom as well as how and when it's done — are assumed but never spoken, then misunderstandings and resentments can arise. In the caregiving situation, that can mean a daughter feels put upon because her mother is never satisfied with the extent of her efforts. Or the sons become miffed when their sisters balk at taking charge.

Long before older parents actually need care, it is vital that all family members discuss the ways they envision how caregiving will someday unfold. Who are the parents hoping will step up and help them when the time comes? What roles does each adult child imagine for herself and the others? These conversations may reveal mismatches between the claims loved ones make on one another and the degrees of willingness to meet those expectations.

Avoid avoidance and always empathize

Adult children sometimes feel that a parent's expectations of them are unreasonable or unrealistic. They therefore have a tendency to withdraw from caregiving as a means of avoiding feeling guiltythat they are not conforming to the parent's wishes. That can lead to an ever more negative cycle: The parent feels neglected and becomes annoyed at that child. The child feels more guilt and avoids the parent even more. The parent feels abandoned and is furious. The child feels beleaguered and distances himself further.

A more productive response is for the adult child to empathize with the parent's wishes but to admit her limitations in meeting those expectations: "I know that you would like me to take care of you the way you took such good care of your own mother. But because I work full time, I don't have the ability to devote as much time to you as you expect." The parent may not be happy about the situation but may be touched by the child's sincere regrets and accept without further judgment what the child can give.

Focus on ends, not means

An adult child's ultimate responsibility to an aging parent is not necessarily to care for her in the exact manner she prefers. It is to ensure that she is well cared for in a way that's sustainable for as long as that parent is likely to need care. That may mean that a sibling other than the parent's favorite is the primary caregiver or that the siblings switch roles among themselves over time as their own life circumstances change.

Expectation is not dictum — not even when that expectation is held by a cherished, powerful or finicky parent. The caregiving plan has to be tailored to all family members' needs. The goal is for everyone to best manage this life passage and to thrive.

Barry J. Jacobs, a clinical psychologist and family therapist, is a member of the AARP Caregiving Advisory Panel. 


Source:  http://www.aarp.org/home-family/caregiving/info-2015/caregiver-guilt-silblings-parents-jacobs.html


Medicare Rights Center: Need Help Paying for Medicare?





When Your Aging Parents Resist Help

Sibling Rivalry and Caregiving

You come from a family of several siblings and you happen to be the one closest in geography and perhaps emotionally to your mom.  You visit her almost every day, help her with her meds, her doctor appointments and do the food shopping.  Your siblings live out of town, but have plenty of opinions about how care should be provided to mom and on more than one occasion, they have criticized the way you handle her.  Does this sound familiar?  It’s that age old sibling rivalry bearing its ugly head…again.

Firstborns can consider themselves the leaders and expect their younger siblings to follow suit. The baby of the family may be more deferential.  Either way, many parents tend to choose a particular child that they want as their caregiver.  It’s usually the more easy going one, not the bossy one.  Unfortunately, there is usually a conflict about how to get mom to take her meds or see her doctor or accept some outside help.  It frequently ends up with everyone feeling frustrated or worse…depressed. This friction can continue on past mom’s death.  Everyone will remember how the others helped or didn’t help with caregiving and resentment can last forever.

How do you best deal with sibling rivalry?  Here are some considerations:

Just because one child lives close by or is the favorite, it doesn’t mean they have to do everything.  Consider your siblings as a team.  Have frequent conference calls, skype, etc.  Divvy up tasks according to each sibling’s talents.  Maybe one is better at finances.  Let them pay the bills.  Maybe one is medically savvy.  Let them accompany her or be the contact person for her doctors.  If one child has influence over mom, let them be the one to broach difficult subjects like retiring from driving.  Ask your siblings what tasks they are able to handle. And then hold them to it.  Don’t order them to help or bring up old stuff.  Treat each other like grownups.

If you have a disagreement that cannot be resolved, then you may want to consider mediation.  Don’t make your parent choose sides.  That will only make the matter worse.  Look into hiring a geriatric care manager or perhaps a professional mediator.  You can find a care manager in your area by going to caremanager.org or  a professional mediator at mediate.com.



Individuals with complex chronic health conditions and functional limitations rely on their families for personal assistance and for coordination of care over extended periods of time.  They are more likely to see multiple health professionals, receive services in multiple settings, and experience numerous transitions between care settings, as well as to need supportive services to help with activities of daily living, transportation needs, and other social supports.

Family support is a key driver in remaining in one’s home and in the community, but it is not without substantial costs to the caregivers themselves and to their families. An estimated 83 percent of Americans say they would feel very obligated to provide assistance to their parent in a time of need.  In  2009, about 61.6 million family caregivers provided care at some time during the year to an adult with limitations in daily activities. 

The costs of family caregiving

Family care can have negative effects on the caregiver’s own financial situation, retirement security, physical and emotional health, social networks, careers, and ability to keep their loved one at home.  The impact is particularly severe for caregivers of individuals who have complex chronic health conditions and both functional and cognitive impairments.

Impact of Caregiving on Work

The great majority (74%) of family caregivers have worked at a paying job at some point during their caregiving experience, and more than half (58%) are currently employed either full-time or part-time, balancing work with their caregiving role.  When it becomes stressful to juggle caregiving activities with work and other family responsibilities, or if work requirements come into conflict with caregiving tasks, some employed caregivers must make changes in their work life.

These adjustments include arriving late/leaving early or taking time off, cutting back on work hours, changing jobs, or stopping work entirely.  Family caregivers with the most intense level of caregiving (21+ hours of care each week), those with a high burden of care, or those who live with their care recipient are especially likely to report having to make workplace accommodations.

Lost wages and retirement

Family caregivers can face financial hardships if they must leave the labor force owing to caregiving demands.  Not only may they lose earnings and Social Security benefits, but they also can lose job security and career mobility, and employment benefits such as health insurance and retirement savings.  There is evidence that midlife working women who begin caring for aging parents reduce paid work hours or leave the workplace entirely.


A recent analysis estimates that the lifetime income-related losses sustained by family caregivers age 50 and over who leave the workforce to care for a parent are about $115,900 in wages, $137,980 in Social Security benefits, and conservatively $50,000 in pension benefits.  These estimates range from a total of $283,716 for men to $324,044 for women, in lost income and benefits over a caregiver’s lifetime. Evidence suggests that assuming the role of caregiver for aging parents in midlife not only has greater economic impact on female caregivers’ retirement years but also may substantially increase women’s risks of living in poverty and receiving public assistance in old age.

Impact on Physical and Emotional Health

The work of caregiving has a substantial impact on health and well-being.  An extensive body of research finds that providing care to a chronically ill family member or close friend can have profound negative effects on the caregiver’s own physical and psychological health, increase social isolation, and adversely impact quality of life and well-being.  More than two out of three (69%)  of family caregivers responding to an online survey said that caring for a loved one was their number one source of stress, ahead of the economic downturn and other family health problems.

Caregivers commonly experience emotional strain and mental health problems, especially depression.  A review of studies suggests that between 40 and 70 % of family caregivers of older adults have clinically significant symptoms of depression.  Caring for a spouse or parent with a dementing illness like Alzheimer’s disease is particularly stressful and is associated with depression, physical health problems, sleep problems, social isolation, and a greater risk of the caregiver developing dementia.  Caregivers of people with dementia are more likely to have an emergency department visit or hospitalization if they are depressed or are taking care of individuals with heavy care needs.

Decreases in support services

Health care trends—including shorter hospital stays, limited discharge planning and transitional care, fewer Medicare home health visits, and expansion of home care technology – are placing increasingly complex and costly responsibilities for the care of frail older people and persons with disabilities on family caregivers. Family members are now asked to assume a larger health management role in the home with little preparation.  They now need to navigate community resources by themselves.  Studies have shown that this can cause caregiver burden or depression.  In addition, problematic discharges and the risk of rehospitalizations can occur when there is an absence of a caregiver or the family caregiver feels unprepared to bring a loved one home after discharge from a hospital because of an absence of care coordination, poor communication from health care providers, or a lack of follow-up care and supportive services. 

In addition to diminished services in hospitals and rehabs, many community based social service agencies’ budgets are being slashed.  In 2010, 36% of caregivers reported that government agencies and nonprofit organizations are now less able to provide services to their relative or friend because of budget cuts. In fact, 31 states cut non-Medicaid aging and disability services programs and 28 states reduced programs in 2011.



If it sounds too good to be true, it probably is!

Beware of strangers attempting to get personal information or money, including:

  • Requests for money in advance disguised as deposits, taxes or handling fees.
  • Any requests for credit card, Social Security or bank account numbers.
  • Beware of phone calls or mailings offering risk free investments, charities, sweepstakes, lotteries, credit card applications requiring money, get-rich chain letters,  Medicare discount cards, “miracle” health products, “free” medical alert services, and inheritance with taxes due.
  • Solicitations disguised as invoices requesting additional money due for various services or charities you supposedly pledged to donate to.
  • Anyone who shows up at your door with “low-cost” or “no-risk” offers or items for sale that require immediate payment or a deposit.

Never feel pressured to make an immediate decision; guard your personal information:

  • Be cautious with anyone who shows a new interest in your finances.
  • Always destroy bills, receipts, and various private records that contain your name and address or account number on it before discarding.
  • Direct deposit to your bank account all your monthly checks.
  • Carefully read your monthly statements and bills for any unusual charges.
  • Speak with someone you trust before giving out personal information or money.
  • Never rush to send any cash or wire money even if someone says it is for a relative; investigate first.
  • If you are told to act immediately or “miss an opportunity”, it is most likely not legitimate
  • Only purchase items by phone or computer if you have initiated the transaction.

If you think you may be a victim of fraud or have suspicions of a scam:

  • do not blame yourself; you are not the first person this has happened to.
  • You may want to contact the police or file a complaint with the Federal Trade Commission: 877-FTC-HELP (877-382-4357).
  • For credit card or insurance fraud, call 888-567-8688.
  • check charities online at:  charitywatch.org or charitynavigator.org.

check sweepstakes at: fakechecks.org

AARP Fraud Watch Network: aarp.org