Are you visiting older relatives during the holidays?

The holidays are a time when families traditionally come together and, for many families who are spread out across the country, this might be the first time they have seen elderly parents or other older relatives in a year. It may also be a time when adult children begin to notice changes in their parent’s behaviors or quality of life.

During visits with these loved ones, family members should pay special attention to certain signs that could indicate a loved one needs more help around the house, may need to move to a senior living community or is suffering from depression.

Some questions to ask yourself are:

Is anything different about their appearance? Have they lost weight? Have their personal hygiene habits changed? Are they dressed appropriately?

Observe their physical condition. Can they still walk up and down the stairs or get around the house? Can they grocery shop and prepare their own meals? Do they remember to take their medications? Can they bathe and use the bathroom without any help?

Also, look around the house. Do you see mail that is unopened or bills that have not been paid? Or prescriptions that have not been refilled? Is the house in disarray or disrepair? Stacks of newspapers piling up around the house?

Do you notice any changes in their mental condition? Are they still connected to others? Do they continue to participate in activities that they have always enjoyed?

Depending on what you see during your visit, it may be time to assess your loved one's living situation and think about getting them the appropriate help.

Families should also keep an eye out for signs of depression in older adults, especially in those who have recently suffered with health problems, the loss of a loved one or the loss of their social networks. Symptoms of depression can include marked changes in appetite, difficulty sleeping, feelings of guilt or hopelessness, loss of self-esteem, crying for no reason, social withdrawal and even an increase in physical aches and pains.

Older adults with depression are also more likely to be anxious, irritable or worried. Constantly wringing their hands, pacing the room or worrying obsessively about money or their health can also be signs of depression.

According to the American Psychological Association, an estimated 20 percent of older adults suffer from depression. Depression is not a normal part of aging, so if you sense that your older loved one may be depressed, give them support and get them the help that they need.

For more information about senior living options or the type of care given at retirement or assisted living communities, please call Morningside Ministries at (210) 731-1202.

The Inside Scoop . . .

What a joy it is to be around the staff who, one by one, understands how important autonomy becomes for those of us living in a “retirement setting.”

I appreciate everyone who classifies each one of us octogenarians as capable, talented, creative humans (even though legs, ears or eyes maybe less functioning than those around us to plan and execute the activities offered).

Especially sensitive for me are those who teach, handle the foods, repair malfunctions and provide security service. It would be disastrous to mention names because there are so many who boost my morale as an individual. They radiate acceptance and love daily.

Many Thanks!

Helen Edkins

Will Medicare pay for my care?

If you ever need nursing home care, will Medicare pay for it? Well, maybe, but maybe not.

Contrary to what many people believe, their Medicare coverage will not pay for their long-term care needs. And chances are good that you will need some assistance during your lifetime. According to a recent Business Week article, 65% of people over the age of 75 need long-term care and, with an aging population, that number will continue to climb.

Generally, Medicare will pay for care in a skilled nursing community if it is medically necessary and you have met certain conditions that they have set out. Medicare will cover a short-term nursing stay for rehabilitation from an injury or illness, but only following a three-night hospital stay. A rehabilitation stay is covered in full for up to 20 days. After 20 days, if the need for skilled care continues, the resident will be required to pay a co-insurance, which is the amount uncovered by Medicare from days 21 – 100. Many Medicare supplements pay the co-insurance amount.

Medicare does not, however, provide coverage for services in assisted living communities. Assistance with the activities of daily living, such as bathing, dressing, grooming, medication management and using the bathroom are not considered “skilled” services and are not covered under Medicare. Assisted living communities typically only accept private pay and long-term care insurance.

So if Medicare will not pay for your needs, will Medicaid? Once again, the answer is maybe. Medicaid is a joint state and federal government program that pays for long-term care services for older adults with low incomes and limited assets. But, to qualify, you must exhaust all your assets and virtually all of your income. Medicaid recipients must have less than $2,000 in assets. To qualify for long-term care nursing home Medicaid, you must meet “medical necessity,” which basically states that you require 24-hour nursing care supervision. Because the number of applications for Medicaid has increased exponentially over the past few years, states are increasingly making it more difficult to receive Medicaid funding.

According to the U. S. Health Care Financing Administration, about 40% of long-term care bills are paid for by Medicaid and 18% are paid by Medicare. That leaves 42% of all long-term care bills to individuals and families to pay out of their own pocket or to insurers to pay.

Volunteering in a senior community can be rewarding for you and the residents

Everyday, people of all ages are looking for ways to make a difference in their community and to give back to society. And, increasingly, instead of making monetary donations, people are looking for ways to give of their time. Volunteering in a senior care community is a very enriching and rewarding experience – not just for the seniors, but also for the people who volunteer. Many times, people can shy away from volunteering in nursing homes because they think they do not have anything to offer. But everyone does have something to offer – even if you don’t consider yourself talented.

Volunteering can take many forms: reading the newspaper or books to residents who cannot see, playing a musical instrument or singing for a group of residents, leading an exercise class, calling bingo, facilitating an arts and crafts project, teaching a basic computer class or a Spanish lesson, running errands or personal shopping for residents, giving manicures, playing table games, writing letters, making welcome baskets, taking residents outside or more simply making one-on-one in-room visits. During these visits, residents may want to talk or may want to just listen to someone tell them about what is going on in the world today. They may just need a small touch on the arm or a loving smile.

For the volunteer, helping out in a senior care community can provide you with an incredible sense of fulfillment and purpose and an outlet for your knowledge, talent and abilities. You can enrich the life of an older adult and at the same time learn new skills, obtain unique life experiences and meet a diverse range of people that have lived long and storied lives. You can get a better understanding of the history and development of your community and the people who cultivated it.

Volunteering in a senior care community is simple and can take as little time as one hour a month or just on holiday occasions to as many hours as your heart desires. There is no right or wrong way. But your gift of time can make a huge difference in the life of an older adult. And in your life as well.

Preparing for life after 65

Mr. and Mrs. Smith knew they needed to start planning for their retirement, but there was never enough time or enough money. At 75, there was no money left, their health was failing and they were afraid to ask their children for help. They waited too long to have the tough conversations, and their options shrunk significantly.

Mr. and Mrs. Smith could be anyone, but a little planning can help everyone weather the financial, emotional and health challenges associated with old age.

Nearly 37.3 million Americans were 65 years or older in 2006. By 2030, that number will double to 71.5 million people, representing more than 20 percent of the U.S. population, according to the Department of Health and Human Services Administration on Aging. In Texas, nearly 4 million of us will be over 65 years old in 2020, according to a Texas State Data Center projection.

As the president of Morningside Ministries, which includes several senior living communities around San Antonio and the Hill Country, I am acutely aware that too many people in our society simply do not want to deal with issues related to aging. We need to begin to see aging as a positive life progression.

This starts with conversations and interaction at the family level. It’s often easier for parents to start by telling family members what they want to happen as they grow older.

Parents, you can help your children by defining what’s important to you. For example, it’s important for your family to know what your financial capabilities are for long-term care. Family members need to know whether you have the means of caring for yourself or if alternative funding and living arrangements need to be found. Retirement planning is critical to financial stability, and long-term care insurance is an option for people to consider in their 40s and 50s, when the insurance is more affordable and accessible.

Logistical elements, such as preparing wills, durable powers of attorney, health care directives, organ donation agreements and identifying funeral preferences are all tough conversations but are better held while all parties in the family can discuss and be heard. These documents can also be prepared at any age and changed when necessary.

All family members need to be aware of family dynamics. There is often disagreement within families and among siblings about the best course of action to take. If your parent or grandparent is still cognitively able to make decisions, then let them. It’s easier to come together as a family before mom, dad, grandma or grandpa no longer can make their own decisions.

Anyone over the age of 30 has probably been told, “Eat less. Exercise more,” and to prepare for life beyond 65, this can’t be stated enough. Regular exercise not only prevents injuries and helps a person’s overall physical health; the mental and social benefits of exercise are enormous. Heart health, flexibility and strength are all important, so whether it’s yoga, tennis, bowling, swimming, running or any other exercise, your goal is to move and move often.

Maintaining a positive attitude never hurts as we get older. Studies have shown that positive thoughts can add as much as 7.5 years to your life. And, part of positive thinking is maintaining a strong social circle. People who participate in regular social gatherings and maintain close friendships have a much higher quality of life whether they live to 66 or 106.

As a society, we also need to encourage children to play a more active role in the lives of senior adults. Intergenerational activities allow children the opportunity to get comfortable being around older people and to develop wonderful relationships.

Taking proper measures and having these tough conversations before it’s too late, when choices are limited regarding appropriate care, allows everyone peace of mind and the opportunity to enjoy life. With a little preparation, the aging process can be a seamless and beautiful experience.

Alvin Loewenberg, President/CEO, Morningside Ministries

Walk with us to fight Alzheimer's disease

In just three days, employees, residents and family members from Morningside Ministries will join the Alzheimer's Association in their annual walk to raise awareness and money for Alzheimer's care, research and programs. There are currently 35 million people worldwide who are living with Alzheimer's or dementia and many of them are older adults. Join us and the Alzheimer's Association on Saturday to help raise money for a cure. The walk is Saturday, September 26, 2009 at Brackenridge Park in San Antonio. The opening ceremonies begin at 8:30 a.m. For more information, or to walk with the Morningside team, please contact us at (210) 731-1202.

Do you know someone who is 100?

If so, Tuesday, September 22nd is their day. That day, centenarians all over the United States will be celebrated for their longevity. A centenarian is someone who has reached the age of 100 or above. Centenarians are one of the fastest growing segments of our population and there are nearly 100,000 in the United States today.

Morningside Ministries will celebrate Centenarian's Day with 12 residents this year. A very select group, they equal just 1.5% of the total resident population at Morningside. Three more residents will turn 100 before the end of the year.

Imagine the incredible journey they have had and all the things they have seen in their life. Today's centenarians were born when Theodore Roosevelt was president, the American flag had only 46 stars, eggs cost 14 cents a dozen, milk was 8 cents a quart and postage stamps were two cents each. Radio and vaudeville were popular and Burl Ives, Benny Goodman, Jessica Tandy, Al Capp, Douglas Fairbanks and Barry Goldwater were all born 100 years ago.

In 1909, the average worker made just 22 cents an hour or around $600 a year and life expectancy was under 50 years old. There were 76,000,000 people in the United States and only 8,000 cars with 10 miles of paved roads.

Notable events in 1909 include the discovery of the magnetic South Pole, the founding of the NAACP, the beginning of construction on the RMS Titanic, the establishment of the city of Tel Aviv, Israel and the foundation of a new U.S. naval base in Pearl Harbor, Hawaii. 1909 also brought us Lipton tea, the electric toaster, the Lincoln penny, Kewpie dolls and the passage of the 16th Amendment to the U.S. Constitution, authorizing a federal income tax.

This doesn't come close to all the scientific, medical, engineering or technological advancements, political, economic and ideological changes and innovations in transportation and communications that they have witnessed during their lifetimes. Imagine all they have seen! If you know someone who is a centenarian, take the time to sit down and talk with them. You can learn a lot about their history and the history of the world we live in.

by Jennifer Van Cleave, Director of Communications for Morningside Ministries

Celebrate Grandparents this Sunday!

by Jennifer Van Cleave, Director of Communications for Morningside Ministries

This coming Sunday, September 13, 2009, marks the 30th official observance of Grandparent's Day in the United States. Signed into law by President Jimmy Carter in the 1970s, it is a day to "honor grandparents, to give grandparents an opportunity to show love for their children's children and to help children become aware of the strength and guidance that older people can offer."

Sunday provides a great opportunity to take a little time and help your children honor their grandparents and other older adults in their life. Help them write a note, color a picture or call them. Family celebrations are also a great way to mark the occasion. Help grandma and grandpa date or label photos in their photo albums or put together a family tree. Both of these activities allow seniors to tell their stories and relive their past and also familiarizes young people with their ancestral lines and family history.

Grandparent's Day is also an opportunity to visit older adults who live in nursing homes or assisted living communities. People often visit seniors in nursing communities around the holidays and Christmas time but not during any other time of the year. The stories and wisdom that many of these adults have to offer are invaluable. You never know who you are going to meet or what you will learn when you walk through the front door. Centenarians, veterans, artists, musicians, former businessmen, politicians, missionaries, big band performers, professional athletes and rocket scientists. People who fought for women's rights, equality and the freedom of our country, who experienced the Great Depression and the rebirth of our nation. People who have shaped our country and the way we live today. People with wisdom and guidance to pass on to the younger generations. It is important for children and young adults to recognize and honor that.

Long-term care issues critical in national heath care debate

by Alvin Loewenberg, President/CEO of Morningside Ministries

Some would argue the country’s health care system is in a state of crisis. There are countless issues involved in health care reform, and unfortunately, we are attacking the industry’s illnesses with band-aids. We need to look at our ailing health care system from a holistic perspective, one that goes beyond the hospital and acute care settings. When we discuss health care reform, it’s absurd to talk about it without including long-term care in the dialogue.

By 2030, nearly 71.5 million people in the United States will be over the age of 65, which is approximately double the current number of older Americans, according to the Department of Health and Human Services Administration on Aging. In addition, more than 40 million Americans are disabled, many of whom require long-term care. Here in Texas, we have one of the fastest growing elderly populations, with significant growth in San Antonio and the Hill Country.

Aging affects everyone, but too often it is portrayed as something negative, when in reality it means people are living happily and often doing great things. Growing older can and should be a glorious and rewarding experience, just as any other stage of life.

But many people are not equipped financially to pay for a good quality of life as they age.

With baby-boomers aging, the country is just beginning to see the effects of a fast-growing older population in which many do not have the ability to pay for their age-related needs. We have a Medicaid system that is going broke. Medicare, as most people are unaware, is not a funding source for long-term care. Medicare pays for short-term care – up to 20 days of rehabilitation or a portion of nursing care up to 100 days. Private long-term care insurance is unaffordable for many Americans, and, thus it doesn’t provide a secure source of funding for a majority of people.

We need to make a commitment to funding services and resources for long-term care. Long-term care is more than nursing homes. It involves community services, companions skilled nursing care, residential living and in-home care, among many other disciplines. All too often the needs of older adults go far beyond their ability to pay. On many occasions, the services simply are not available, even if there are unlimited personal funds to cover them.

Many older adults continue to live at home as they age, and they need money to pay for things like transportation, meals, house cleaning and household modifications such as handrails for safety and ramps for easier access.

Ninety percent of all older adults are cared for at home by family members, which can take a personal and financial toll on caregivers. Many caregivers have to stop working, but they still have other family to care for. There are few resources for assisting caregivers.

Funding more long-term care programs and services is an investment in our economy and our future, as the healthcare industry generates significant job growth and economic impact. For example, the Texas nursing home industry currently has an $11.3 billion economic impact on the State, according to a 2006 Texas Medicaid Nursing Facility Cost Report compiled by the Texas Health & Human Services Commission. The same report indicates that nursing home spending on Medicaid residents generates a $6.7 billion economic impact in Texas.

The Texas Legislature began the dialogue in the 2009 session, forming a long-term care task force comprised of four legislators and two citizens who will begin studying the issues involved in long-term care, and it will be important for each of us to stay informed and participate in the conversation.

Overhauling the U.S. healthcare system will take new ideas and sacrifice, entrepreneurial innovation and the fortitude to make tough decisions if change is to be expected. But, that’s nothing new for Americans. We are a country built on change and improvement.

Can you afford a retirement community?

Probably, yes. Most people think that living in a retirement community is too expensive and they cannot afford it. And, the more services it offers, the more expensive it will be. But that is not necessarily true . . . many times living in a retirement community can cost less than staying in your own home. When you factor in all the costs of maintaining a home – utilities, taxes, housekeeping, repairs and maintenance – it often makes sense to make the move to a retirement community, where all those expenses are included in your monthly fee. And, add in the free activities, fitness classes, educational opportunities and transportation, and you may be getting a whole lot more than you currently are at home.

Let’s do the math:

Household Expenses	Your Cost at home:	Your cost in a retirement community:
Rent/Mortgage/Fees	$	$
Property Taxes	$	$ INCLUDED
Homeowner’s Insurance	$	$ INCLUDED
Electricity	$	$ INCLUDED***
Water/Trash/Sewer	$	$ INCLUDED
Major Home Repairs (roof/painting/AC)	$	$ INCLUDED
Lawn Care	$	$ INCLUDED
Seasonal Maintenance (leaves, shrubs, trees, gutters)	$	$ INCLUDED
Housekeeping	$	$ INCLUDED
Dining (grocery expense for main meal of each day)	$	$ INCLUDED
Health Club Membership	$	$ INCLUDED
Security Patrol	$	$ INCLUDED
Basic Cable TV	$	$ INCLUDED
Entertainment	$	$ INCLUDED
Local Transportation	$	$ INCLUDED
24-hour emergency services	$	$ INCLUDED
Monthly Total:	$	$

***Electricity is included in some, but not all communities, depending on your desired level of care.

When you take into account all your monthly expenses, does it add up for you? Don’t forget to consider the more free time you will have without home-related chores, the more fun you will have with activities and entertainment and the more socializing and relaxing you can have with friends and neighbors. It can add up to more of what you want out of retirement for less cost than you thought.

Tips for senior travelers

According to the Travel Industry Association, seniors age 65 and older account for 16 percent (that's 92.6 million) of all domestic U.S. trips. They travel, on average, at least 3 times per year with most trips (46 percent) taken by automobile. Most trips for mature travelers continue to be pleasure trips and are more likely to involve visiting historical places or museums, attending cultural events and festivals or group tours.

All travelers should plan carefully to ensure a smooth and safe trip, but here a few helpful tips for the senior traveler.

When you make your reservations, mention the fact that you are a senior. Many airlines and hotels offer senior discounts and reduced admissions are available to many theaters, museums and other attractions, as well as discounted fares on public transportation. Most rental car companies also have rates for seniors. Keep in mind that the senior rate is not always the best rate, so always ask about special rates or promotions first, then ask about senior discounts. And, don't be afraid to tell travel providers if you need special accommodations. Airlines, trains, buses and cruise ships can all accommodate people who have trouble getting around.

Consider purchasing travel insurance. Although, you may think it's not necessary, it can reimburse you for the non-refundable parts of you trip if you have to cancel. Another consideration is evacuation insurance, which can cover the costs of getting you suitable medical care in the case of an emergency.

Be realistic about what you can do. Don't plan a jam-packed itinerary every day of your vacation. Plan sight-seeing in half-day segments and plan in plenty of rest breaks.

And pack carefully. Make sure you pack a full supply of medications. It can be difficult to get a refill on the road. A rolling suitcase is the best option, especially if you will be traveling to more than one location. And, unless you are taking a short trip on a direct flight, go ahead and check your bag. A heavy carry on bag can become cumbersome if you have to change flights at a busy airport.

You can also consider a senior travel group or use a travel agency that specializes in senior travel. Club Morningside is the official travel club for residents, family members and friends of Morningside Ministries. The travel club offers two to three large trips every year and several smaller day and overnight trips around the state throughout the year. The travel club offers several benefits to seniors. One: You're trip is planned for you. You do not have to spend time online or elsewhere planning your vacation and researching destinations, making flight, hotel and rental car reservations. That's all taken care of for you. Two: You have a group of friends to travel with. And even if your best friends aren't going along, you're traveling with a group of neighbors and are sure to make new friends along the way. And three: The travel club offers very affordable prices. The vacations are packaged to include flights, hotels, airport transfers, most meals, show tickets and more. Plus, you don't have the added expense of rental cars or tour guides.

If you are interested in any of the upcoming Club Morningside trips, you can find more information at morningsidemin.org/travelclub.html.