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Live Radio/Video: Senior Center & Meals on Wheels…

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Do you know how many seniors in your community are shut ins and can’t cook for themselves? Greg, Heather and Angela discuss all the many services the Senior Center offers the community as well as the Meals on Wheels ministry, which is sure to touch your heart.

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The Phases of Life… Remembering the past and looking towards the future.

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The Phases of Life… Remembering the past and looking towards he future. A friend gets married. #theelderlawguy

Get It Together with Debbie Vaughn

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Today’s post is about getting your things together. I can’t stress enough how important it is to consolidate your important papers: legal documents, bank records, healthcare records, what you want to happen to what you own, down to how you want your funeral to go. I spoke with Debbie Vaughn from Life Enrichment Center who is an expert on this topic. There is always the need to pre-plan and make sure that your documents are where they need to be, and that all of your information is up to date to ensure that no one – not you or your loved ones – are saddled with issues when it becomes too late.

Debbie Vaughn sat down with me to talk about what I like to call the “Get it Together” workbook, which is a binder-like book that you can compile with all of your important documents and other files that you might have never considered consolidating.

What do we mean when we say “Get yourself together?”

First of all, that’s the reason we have Journey. It’s a coalition of different agencies like Life Enrichment Center, the Senior Center, and Care Solutions to do that so you can put all your documents in one place. What I found to be interesting was before I found Journey, my mother had pancreatic cancer. We knew she was going to pass and it was a waiting game, but not one of us three children thought to ask her where the insurance policy was. But then when she did go to meet the Lord, we were like, “Oh gosh, where would she put it?” We had to be detectives and think like she would. We tore her little apartment apart until we found it, and that’s what made it seem real to me that I didn’t want to put my son through that. I wanted to put everything in place so that my son would know exactly where everything was.

And it’s important to remember that it’s not only death. If something were to happen – say I had a stroke or an illness and could not speak for myself, this book can speak for you. It can tell my son such as who I would use as my plumber, who I would use as my carpenter, people that know my house. He might not know the people that come to my house and work on it on a regular basis. You know how it is, if you find a good plumber, carpenter, or electrician, you want to use the same ones you know, love, and trust. Same thing goes for the doctor – I want him to know what doctors I prefer. So that tells him exactly who to go to and you can slip their business card right in this folder for him to consult if something happens.

How is this folder organized?

It has several copies of what you need because this is a work in progress. Things change. There’s a section on medications, for instance, but the medications you took 6 months ago might not be the medications that you’re taking now. You can make copies of these so you can keep it updated. It’s sort of like a hobby, in a way; keep putting your information in as it changes.

Bottom line is your kids might fight over what you want. You have a chance to tell them right now on paper how you want the last years of your life and beyond to go. You can prepare for some of the aspects of your funeral, such as the photo you want to use for your obituary and other items like that. I look at the planning aspect this way: if you’re fixing to get married, you’d spend a year or so planning and preparing for that wedding. You’d do the same thing if you’re having a baby. This process is no different: you need to plan and prepare. It gives you the chance to leave a legacy for generations to come. And it doesn’t have to necessarily be about death; there might be things that you want your children to know about you in your life.

So it’s not just about the will or the money, it’s about the life that they’ve lived, their experiences, and the legacy. The “Get it Together” workbook is an extremely valuable tool that you and your loved ones will be thankful for.

Call me if you have any questions:

Greg McIntyreGreg_Full
Elder Law Attorney
McIntyre Elder Law
123 W. Marion Street, Shelby
704-259-7040

 

Live Video/Radio! Veteran’s Benefits and Programs

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LVery proud to be with District Deputy Commander, Evan Thompson, to learn more about the American Legion and other veteran’s programs.

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Can you differentiate between home care and home health care?

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As part of my continued quest to bring the most varied information out there about Elder Law and elder care, I had the opportunity to speak with Ruth Huffstetler from Helping Hands Nursing Services, Inc. To give a little background on this company: it was founded in 1975 and is current located at 1105 Earl Road in Shelby.

Ruth provided some invaluable facts, figures, and information about what Helping Hands does, as well as what the differences are between home care and home health care.

Many of you know that I continue to remind my listeners and readers about the statistics. 7 out of 10 seniors are going to need some type of care, whether it’s in-home, assisted living, or nursing home care. Although North Carolina is renowned for its assisted living and nursing home facilities, who is really going to jump on the opportunity to spend their elder years outside of their home? Ruth discussed this idea and many others in our conversation:

What are some of the services that Helping Hands offers?

There’s no doubt that people want to stay at home. It can be a very traumatic experience for our elders – especially if they are suffering from dementia or Alzheimer’s – if they are taken from the surroundings that make them comfortable. Continuity is so important, so by keeping them at home, we’re able to stay with them and monitor them. We can go in and make sure that they’re not turning on the stove, putting tin foil in the microwave, wandering out in the streets or the middle of the night.

We can also dispense medication. The thing about us is we’re doing whatever the family has asked of us. If the family wants us to walk the patient around the house three times at noon for exercise, then that’s what we do.

What about nursing services?

Again, if we come to you and your parents are diabetics, and you need them to have certain meds or certain injections as far as their insulin and whatnot, then we help them with those medications or injections. Whatever the family asks of us, we do.

With home health, the doctor is ordering certain physical therapy, occupational therapy, speech therapy. With us, the family is calling and saying, “I’ve got to go to work, somebody needs to be with Mom and this is what we want done while you’re there” or “My mom lives in Shelby but I live in California now. I need 24 hour care and this is what I want done.” Sometimes we’re truly the only family around because everybody is long distance, and we’ll take them up to see the leaves change colors. We’ll take them to go visit the old people at the nursing home so they can stay in touch with their friends. We’ve learned how Chick-fil-A has bingo on certain days and different places we can take them. They can stay involved with their friends.

Can you differentiate between home care and home health care?

The biggest difference in simple terms is that in home health, you have an RN that is supervising everything that’s happening, there has been an assessment done and a list of needs that the doctor has ordered. That is home health. They’ve ordered all the different therapies and there’s an RN supervising and making sure those things happen. With home care, you as a family member says, “This is what we need, whether it’s someone to be here so we can go see our grandson play football for 4 hours” or “We need 24-hour care”. Whatever you want is what you’re going to ask us for. That’s home care.

Do home health care agencies sometimes refer to you?

Yes they do. Let’s say the doctor orders a bath three times a week. They’ll have a CNA that’s going in on Monday, Wednesday, and Friday giving a bath. There’s no set time. It could be at 9 in the morning, it could be 4 in the afternoon. So if the family says, “We need somebody here during the day so we can go to work”, those home health agencies will refer to us and say, “Okay, if you call Helping Hands Nursing Service, they can refer someone to you that can be here from 7 in the morning until 5 in the afternoon. They’ll be here the whole time to prepare the meals”, and then when Home Health comes in to do the therapy or the bath, we let them in, we can assist them, but it’s their doing, and then they leave. But we stay.

Do you screen your employees?

First thing is, I have no employees. They are all independent care givers because we are a referral service. Past that, they are all criminal background checked and reference checked. So if you call and say, “I need a caregiver to come out and bathe my mother Monday, Wednesday, and Friday”, then we’re going to find where you live and what kind of limitations your mom has and we’re going to pick who we feel is a good choice based on what you’ve told us. We’ll then refer that person to you. Very important question about the personality: just because I think they’re a great choice and I love them dearly, your mother may hate redheads and “I don’t want that redhead in my house because she reminds me of my ex son-in-law’s wife” or whatever. It doesn’t matter. Whatever that case may be, you make a simple phone call and we will send someone else out. You don’t have to give us a reason at all because there’s personality conflicts with the greatest of people; they just don’t see eye to eye.

Do the people you refer provide the transportation or do they take the family’s car? Are they paid by the mile if they use the car?

All of the above. If we take their car, of course there’s no fee and we can drive them. If the caregiver uses her own car there is a charge which is just the government rate, I think 0.55 and a half cents now. They do add mileage to their hourly rate.

Do you have written policies for these people or contracts?

What we have is a contract with the caregiver since they are referred and they are actually paying us to keep them working. If they have to call in sick at 3:00 in the morning, they’re not calling the family, they’re calling me. I make sure someone else is there so you can still go to work. We do have guidelines that we require of them, things that just make me happy as far as what they wear and tattoos not showing, things like that. They are my guidelines. But as far as written rules, it’s whatever the family wants. Again, the family may say, “You can take Mom to the beauty shop” and that’s all or “Mom’s been dying to go see her friend at the VA in Salisbury, would you mind spending a day and taking her there?” And we’ll do it. A lot of times the family’s car is easier to get in and out of than the caregiver who might drive a big SUV or a little sports car that’s hard to get in and out of. So we’ll do whatever is best.

How can people pay for home care?

Home care is paid out of pocket or if their long-term policy will allow assignment back to the family, so the family is getting reimbursed for what they have paid. We can assist with that, but it is an out-of-pocket. We do not take Medicare, Medicaid, or private health insurance. Insurance might pay for some home health benefits, but they will not pay for the home care.

If you’d like to get in touch with Helping Hands, call them at the office at (704) 419-8222.

Call me if you have any questions:

Greg McIntyreGreg_Full
Elder Law Attorney
McIntyre Elder Law
123 W. Marion Street, Shelby
704-259-7040

 

What It Means To Be A Veteran!!!

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Very honored to be allowed to speak and introduce the Veterans this morning at the Rutherford County, NC, Senior Center. PROUD to be an American on this day!!!

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Senior Dental Care with Dentist: Kendalyn Lutz-Craver

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Seniors have special dental needs, are often on fixed incomes and rarely have proper dental insurance. However, dental care is so important for quality of life, self confidence and even longevity to the individual. Dr. Lutz-Craver sets her practice apart in how she deals with senior patients and their issues.

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GET YOUR STUFF TOGETHER!

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Debbie Vaughn teaches how and why you need to take inventory. Keep all your valuable information in one place. Even go as far as how you like your coffee?

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Great Episode! What’s the Difference in Home Care and Home Health Care? Do you know?

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Elder Law Report 046: What’s the Difference in Home Care and Home Health Care? Do you know?

Expert and director of Helping Hands, Ruth Huffstetler, clears up the differences between Home Care and Home Health Care. Do you know the difference? You should! It could directly affect you and your loved ones.

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Hospice – A History and Guide

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I had the honor of sitting down and talking with Patti McMurry, who has been with Hospice Cleveland County for 25 years. We’re going to talk about what it is, any misconceptions, what Hospice does, and the other amazing services to the community. 

 

Tell us a little bit about Hospice Cleveland County. 

One thing about our community that we’ve found is that everywhere we go, no matter if they are conferences, seminars, or anywhere, Cleveland County is very unique because our agencies tend not to compete with each other, but to help each other out. It’s a great place to live and raise a family, and then grow old. We took in our first patient 30 years ago, so we’re celebrating that. The Shelby Star will have a 12-page insert all about Hospice Cleveland County: how we were formed and where we are today. As of today, we have taken care of over 10,000 people who have died in Cleveland County. We were one of the first Hospices in North Carolina. 

 

How did you get involved with Hospice?

The way I came to Hospice was that my two grandmothers died in the same year. One grandmother died at the hospital with lots of tubes, every two hours two family members could go in to see her. When it looked like she wasn’t going to live much longer, the nurse came out and said, “Two family members can go and be with her while she dies.” My mother had 7 children in the family, she happened to be the second oldest so she got to be with her mom and everyone else was in the waiting room. Shortly after that, my other grandmother got sick with colon cancer. That happened to be the year that Hospice Cleveland County started and she was one of their first patients. Everybody was at the house; she died in her own bed, all of us were there, all the grandchildren were there and it was two totally different kinds of experiences. That’s how Hospice Cleveland County got started because there were people in our area who had heard about Hospices. 

 

 

How did Hospice start? 

“Hospice” the word actually comes from the Middle Ages. A hospice was originally a resting place for weary travelers. They didn’t have hotels, so if people would allow weary travelers to rest in their home, then they would put a lighted candle in their window and that signaled that travelers could stay. When we built our hospice house and our office where we are now, they were going to let us change the name of the road and we thought really hard about what we wanted to name that road. The name is Windover Heights Drive, and wind needs to go from this place to the next, which is what Hospice does: it helps travelers go from this life to the next life with quality. 

It’s a pretty new concept; the first Hospice in America was in 1974, so it’s very new. Now just about every county in every state in the country has a Hospice. And every country, really, has Hospices. It was similar to the birth experience. Women used to be put to sleep when they had babies: they’d wake up and they’d have a baby. Then, natural childbirth started and things got back to nature, so the concept of death also got that way. 

95% of the people who are asked, “How would you like to die?” response “At home”. Much less than half of the people die at home, and everybody wants to yet there are so many things that prohibit that. There’s so much fear in that and in modern medicine. We’ve had people call to set up an admission time, but they’re afraid. They’re thinking, “If Hospice comes in, Mom’s going to die.” But think about this: Mom is going to die, we all are. But we want to get in there and make that experience as good as possible. The scary part about Hospice is really only the first 30 minutes of that first visit, and I promise – I tell people this – if we come in for 5 minutes to explain to you what we can do, we will leave in 5 minutes if you want us to. But it’s never happened that we’ve had to leave. People are complimentary and relieved, actually. On the first visit, we give them our 24-hour telephone number that they can call for a nurse to come and visit. Even just having that number, whether they call or not, is so much security to them. You don’t have to take somebody to the hospital, you don’t have to wonder about anything. We are so involved in patient symptom control, as well. 

I explained once to a doctor: when people come to the doctor and they’re in pain, they get a prescription for pain medication. But when that person leaves with that prescription, it doesn’t mean they have the money to buy that prescription, it doesn’t mean that they’re aware the pain medication is going to cause constipation. There are other things that go along with this illness in just that one pain prescription that our nurses can really address and have people as comfortable as possible, teach families how to take care of their loved ones. They have that number to call 24/7, grief counselors, chaplains, social workers, and more. Our Director of Nursing has said many times, “The easy part of Hospice work is what the nurse goes out and does: get the symptoms, the pain, and those things managed. But then the hard part of the dying process starts.” It’s those fears and thoughts and dark nights as well as emotional, spiritual, and mental things that people are dealing with. 

One thing that modern medicine has taken away is a human element, because the medical model is about the medications and treatments, etc. 1991 was when the living will and healthcare power of attorney conversation started, and that was because of Cruzan and those different cases where you could keep somebody alive for years, for decades actually. And then the conversation came up, “Do you want to leave that in the medical community’s hands as to preserving life at any cost? Or do people want to include that human element in their end of life situation?” 

 

A large part of the process is not only the death of the patient, but the grief the family members have to endure. How do you include everyone? 

A lot of our focus is the family, Hospice is special in that the patient and the family are the unit of care. So the focus is just as much on the individuals of the family as it is on the patient. Oftentimes we’ll go in and the patients are doing fine; they know what’s coming, they’ve accepted it, maybe they’ve struggled and had a lot of treatments, maybe they’ve suffered a lot and they’re really fine. But for the family members, it’s hard to let somebody go. We’ve had children, we’ve had young people, and we have very elderly people. So our counselors, chaplains, and social workers really help those families come to terms with those things. Sometimes when we come in, patients are relieved that they can finally say, “I don’t want to go to dialysis anymore, I don’t want to have another treatment, and I don’t want to go back to the hospital.” They can say that because they have that support, they know that those team members are going to be there to help the family. 

 

Can anyone get involved with your services? 

You don’t have to be a Hospice patient to attend our support programs. You can receive help from the grief programs and counseling, or any of the social work, the drafting of living wills, healthcare power of attorneys and things like that. But Medicare requires us to talk to our patients and families about living wills and healthcare power of attorneys. I will tell you that things go a lot smoother when those things have been done early, rather than when somebody is in a crisis or they’re sick, during which time you have to make quick decisions. What we try to do is talk to the public all the time about doing healthcare power of attorneys and living wills. Really, the healthcare power of attorney is the most important document. It doesn’t go into effect until a patient can’t make their own decisions. We leave those documents in the home on the first visit and explain that our social workers are notaries who can come out and help. Oftentimes, it’s easy to get a patient to do a healthcare power of attorney and living will when the whole family does them, so we’ll just have the whole family complete their documents at that time. 

Working at Hospice, we know that those documents are important. We’ve seen bank accounts being closed because until a will is probated and those kinds of things, you have to have those things in place. And where’s the life insurance policy? Where’s the burial policy? People don’t start looking for those until they need them. We want to get people to think about things on the front side, meaning before the crisis happens when you have to think about them. People also don’t realize things that happen after the death: you have to change where the money is going to, everything on the bank accounts and who the beneficiaries are. There’s a lot of work to be done, and if you do that on the front side, it’s not scary. 

 

How is Hospice funded? How does one pay for Hospice care? 

This is something I think the public does not realize: when you are a Hospice patient, Medicare has a benefit called a Hospice benefit for in home care. That benefit pays for everything that Hospice does. It pays for the staff, it pays for the equipment that has to be rented, it pays for oxygen, it pays for any supplies. It’s the benefit that kicks in before the supplement, which also covers 100% of all the medications that the patient is taking. So sometimes we can get in there and save patients and families thousands of dollars a month, because anything pertaining to that illness – heart disease, which is our primary diagnosis, or anything else you may have that you need medication for – is paid for 100%, even if it’s over the counter. A lot of people don’t know that. The only criteria to be a Hospice patient is the doctor feels like if the illness follows its normal course, that the patient will live 6 months or less. Now, we’ve had patients for a lot longer than that, but our median length of stay is 11 days. That means 50% of our patients die within 11 days after we admit them. So they’re not able to access that Medicare benefit and get all those things paid for. That is the one thing about Hospice care that keeps me awake at night, is knowing that there’s so many people who could benefit from having that support of the staff that they can call, but also financially. Being sick is very expensive.  

While at the facility, some of our beds are residential that have a daily room and board fee. It’s about $140 a day. But everything else is paid for. If you’re in the GIP, which is like an in-patient or crisis – similar to a hospital – it’s paid 100%. So that Medicare benefit is so incredibly important. We work with a Hospice pharmacy, so all the medications are ordered by the nurse and they’re delivered right to the patient’s door. We’ve got a lot of elderly people in Cleveland County who are our patients; they can’t get in the car to get a prescription or go to the drug store and wait on their medications. So we try to make everything as comfortable and in the highest quality possible. The nurse orders the medicine, Hospice Medicare pays for it, it’s delivered right to the door so that people can spend their time doing the things that they enjoy. 

One last comment: anybody can make a referral to Hospice. If you know anybody that is suffering or seems to not be getting better, anybody can call our office anonymously, give us a name, and we’ll talk to the doctor to see if their eligible, and if they’re not we just file that away. If they are, it can be the greatest gift that you can give to somebody. 

We’re very proud of the work we do and the relationships we’ve forged with the patients. We’ve named the rooms in honor of the people who we’ve cared for, so it’s a compliment to our staff and the patients that have worked together. 

If you want to contact the office, our number is 704-487-4677.

Call me if you have any questions:

Greg McIntyreGreg_Full
Elder Law Attorney
McIntyre Elder Law
123 W. Marion Street, Shelby
704-259-7040

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