Originally posted @allaboutestates.ca

I had a wonderful opportunity last week to be part of panel discussion on CTV Your Morning to discuss issues that are critical for seniors. Certainly an important topic as we approach election day.

The National Seniors Strategy is really the document that outlines what needs to be done. I cannot comment on what the parties promise or what they will implement, but I know that much work has gone into a solid document that outlines a number of key issues. The research and report were written in Jan 2016, with Dr. Samir Sinha taking a lead role. They identified 12 policy issues under ‘four overarching pillars or themes; and supported by five core principles essential to understanding the needs of Canada’s ageing population.” The principles identified are:

1. Independent, Productive & Engaged Citizens (remaining independent and productive)
Making addressing ageism, elder abuse and social isolation a national priority
Ensuring older Canadians do not live in poverty (increasing CPP for example)
Ensuring access to affordable housing and transportation
Enabling age friendly physical environment and spaces

2.Health And Active Lives
Ensuring older Canadians are supported to engage in wellness and prevention activities that enable healthy aging ( ie falls prevention)
Improving access to medically necessary and appropriate medications
Ensuring older Canadians and their caregivers are enable to participate in informed health decision – making and advance care planning

3. Care Closer To Home (person- centered, high quality, integrated care close to home provided by those with knowledge and skill)
Ensuring access to appropriate high quality home and community care, long term care, palliative and end of life services
Ensuring access to care providers that are trained to specifically provide the care they need ( there are under 300 geriatricians in Canada)
Developing standardized metrics and accountability standards to enable a National Senior’s Strategy

4. Support For Caregivers (acknowledge and support the family and friends who provide unpaid care)
It is estimated that unpaid caregivers provided care that would have cost our system around $30 Billion
Ensuring older Canadians are supported in the workplace (does your company offer Elder Care as part of its Employee Assistance program?)
Ensuring caregivers are not penalized when taking on caregiving roles (caregiver tax credits, caregiver allowances, greater flexibility in the workplace)

The ground work has been laid, now it is up to the parties to outline how they are going to achieve and implement these recommendations.

Originally posted @ allaboutestates.ca

Last week I had a pleasure of attending the 100th birthday of one of my (favourite) clients. She is one of the lucky ones as she still lives in her own home and is able to afford 24/7 care. She has a wonderful care team who have been consistently providing care to her for over 4 years. They were initially providing a few hours a day and over the years, as her needs changed, they increased to 24/7.

I first met Audrey (yes that is her name) in 2015 after her younger sister fell and was admitted into hospital for hip surgery. I was referred to ‘the sisters’ by her long time trust officer who was handling their finances for them. She knew that the sisters could use some assistance and I was invited to meet them at the rehabilitation facility.

Audrey was 96 at the time and was fiercely independent. Neither used any mobility aids nor received any caregiving or housekeeping assistance. They did everything themselves. Neither had married and they had always lived together- looking after each other.

Since her sister’s fall, Audrey would take a taxi to visit her daily, who was then an in- patient at a rehabilitation facility. A few days after first meeting them, I received a call from her sister to tell me that Audrey had not shown up to visit her, as she had routinely done every afternoon since the fall. Long story short and several hours after receiving this concerned call, I was able to track Audrey who was at the emergency department of a nearby hospital. She had fallen on the slippery walk way outside her apartment building and lay there until a neighbour called 911.

The GEM (Geriatric Emergency Nurse) nurse told me that she had cut her forehead very badly and had received over 25 stitches. It was 9:00 pm and they were about to send her home in a taxi- alone. That very evening was the first time a caregiver started working with them, I arranged to have a PSW meet her at the ER and accompany her home and remain with her overnight.

It is now almost 5 years later, her younger sister has passed away and Audrey continues to live well in her own home. She wanted a tea to celebrate her birthday and together we ordered some new clothes, chose the foods she wanted to serve and the type of birthday cake and decided on the few guests who would be invited. I was able to arrange birthday greetings from the Queen as well as from our Governor General and from her local Longos where she had been a long time customer since they first opened their doors over 20 years ago. With her permission I am sharing her 100th birthday celebration photo. Ziggy was number # 1 on her guest list. Audrey is one of the lucky ones. With thanks to her very caring trust advisor, Audrey has been able to live the life she wanted- remaining in her own home and being well looked after.

Originally posted @allaboutestates.ca

My colleague Dr. Shulman in his July 30, 2019 blog “What an Attorney for Personal Care Can Do” described the roles of the substitute decision maker and the very important part they play in ensuring their loved one’s wellbeing. I have used ‘loved one’ but actually in many cases, the individual chosen is not a family member and love may not be part of the equation at all. It is a very big responsibility to become someone else’s decision maker and many times, some very tough decisions are required. I think the duties that are stipulated in the SDA act should be shared prior to someone agreeing to be another’s attorney for personal care (and property as well). I have always stated that the care decision should dictate what is needed first and foremost and it needs to be supported by the attorney for property. For example, the individual requires care (decision #1); how much care and how much money there is available to pay for said care is decision # 2.

I am now working with a single women who never married, has no close friends and has some relatives who live out of town. She had appointed these relatives to be her attorney for care. Fortunately, she had the foresight to have chosen a trust company to be her attorney for property. They now need to work together to decide how much care she can actually afford. At over $25,000 a month for the care that is currently in place, it cannot be sustained for very long. The attorney for care now needs to explore alternate care and living accommodations as her monies cannot sustain that monthly expenditure indefinitely. Not an easy decision to make for extended family members who don’t live in the same city and have had limited contact with their relative. Fortunately, they now have our firm’s guidance to help them understand their choices and explore alternatives and costs so that this lady’s quality of life can be maintained and she can continue to get the care that she needs.

Ignorance is Bliss

by Audrey Miller on August 12, 2019

in Articles & Blogs by Audrey, Elder Care

Originally posted @ allaboutestates.ca

Our friend recently told us that his sister had done a DNA genetic test with one of the companies that provides ancestry and health information. What she found out was not what she was expecting at all. No, she does not have ‘royal’ roots but she does have twin half brothers that she did not know existed. It turns out that my friend’s mom had, before she married his father, given birth to twin boys that she had given up for adoption over 65 years ago.

The mom had never mentioned this to anyone and kept it her secret which would have remained as such, except for these tests results. My friend and his sister decided to track down their new found siblings. The twins had been adopted together and they believed, they had no other siblings themselves, until they received a phone call from my friend and his sister identifying themselves as close blood relations. The boys, who are now men in their late 60’s were excited to learn about their new relatives and a family reunion of sorts took place. The twins then wanted to meet their biological mother.

Unfortunately at the time of this discovery, their mother was in the late stages of dementia; as such my friend and his sister decided that it would not be a good idea for them to meet her.

Now, fast forward one year later when their mother died. Fortunately for her, she believed her secret was still hers alone; although it was no longer. My friend was the executor of his mother’s estate and the question on their minds was what was the exact wording of her will?

Did she simply indicate her estate was to be shared equally between her children or did she specifically name them? Perhaps it is a clear from a legal perspective that once someone is given up for adoption they no longer have the same rights but at that moment, it was unclear to my friend. In this case, their mother had named them (my friend and his sister) as her sole beneficiaries. From my perspective I found this to be a very interesting story. But from theirs, it is so much more……..

A few weeks ago  there was an announcement  that the Federal health minister earmarked $50 million over 5 years to support our new dementia strategy.  You may recall that the National Strategy for Alzheimer’s Disease and Other Dementias Act was passed in June 2017, which at that time, was a great birthday present for our 150th birthday.

Following several consultations, 5 principles were established to guide the process.

  1. Prioritize quality of life for people living with dementia and caregivers;
  2. Respect and value diversity to ensure an inclusive approach, with a focus on those most at risk or with distinct needs;
  3. Respect the human rights of people living with dementia to support their autonomy and dignity;
  4. Engage in evidence-informed decision making, taking a broad approach to gathering and sharing best available knowledge and data; and
  5. Maintain a results-focused approach to tracking progress, including evaluating and adjusting actions as needed.

From these principals 3 national objectives were identified including:

  1. Prevent dementia
  2. Advance therapies and find a cure
  3. Improve the quality of life of people living with dementia and caregivers.

And then, 5 underlying pillars were identified that would achieve these objectives, including:

  1. Collaboration
  2. Research and innovation
  3. Surveillance and data
  4. Information resources
  5. Skilled workforce

(excerpt from Executive Summary, A Dementia Strategy for Canada: Together We Aspire)

Our latest statistics include:

  • More than 419,000 Cdn ages 65 plus living with diagnosed dementia
  • 78,600 new cases diagnosed annually
  • 63% of those 65 plus living with dementia are women
  • 9 seniors are diagnosed every hour in Canada
  • 26 hours is the average time spent per week that friends/family provide support for someone diagnosed with dementia
  • 3 billion total health care costs and out of pocket caregiver costs in 2011
  • 6 billion is the projected total health care costs and out of pocket costs of dementia in Canada by 2031

For more detailed, please visit the Ministry website.

The groundwork has now been laid and this is a great next step as we all work together to r improve the lives of Canadians diagnosed with dementia and those living, working and caring for someone who has dementia.

 

Are you planning any summer holidays?  Are you travelling alone or with your family?  Should you decide to vacation with your older parent, there are some pre planning tips that can make this journey more enjoyable for both of you. Firstly, know what type of holiday would be best for everyone. Extensive touring, outings, or excursions can be tiring for older individuals. There are some senior friendly travel agencies which can also provide guidance for more ‘senior friendly’ destinations.

By Air or Train: If possible, try to set up a direct flight for your parents; call the airline in advance to know what special arrangements must be made. This may include ordering special foods/meals or use of a wheelchair. Some airlines allow companions/aides to travel either at a reduced rate or at no additional cost. I recently flew to San Francisco with my mother and arranging for a wheelchair for her, was especially helpful, as the distances in the airport are long. It also saved us all time getting through security and customs (win- win)!

If taking a vacation does not include your parents, then there are several options to ensure that they will be well taken care of during your absence. If there is an option for another family member to take over for you, then wonderful, as maintaining the older person’s routine as much as possible is recommended. If not, then there are still a few options.

Hiring an agency to provide care is a preferred route for many. If there is an extra bedroom available, a caregiver can move temporarily into the home and sleep there. If there is no private bedroom, then typically the staff remains ‘awake’ overnight. This route is more expensive but may provide necessary peace of mind. Although hiring from an agency is more expensive than hiring privately, there are checks and balances in place, which include coverage and supervision that all bring peace of mind. If this is your preferred route, have the caregiver start a few days early at least for a few hours, so that they can become familiar with your parent’s routine.

Another option chosen by many are short-term stays at retirement residences. Furnished suites are available, with personal care and full meal options as part of the daily rate. Costs start at about $120.00 per night. Alternatively, some choose to book respite stays at Long Term Care facilities. Again full care and meals are provided. The Ontario Ministry rate is $40.24 per day. This option must be booked well in advance and applications are made based on the the older person’s address and Local Health Integration Network (LHIN) office. Regardless of choice of location, make sure that all emergency contact information is provided.

Whether your parents are traveling with you or the decision is that they remain at home, it is important that you plan ahead to make sure all arrangements are in place.

It does seem like only yesterday because, while time has not stood still, sometimes our sentiments don’t change. The event and message is the same. It is a few years later and there is a new US golf champion. We still however miss those who are no longer around.

It was hard not to know that yesterday was Father’s Day. Signs, announcements and broadcasters made it very difficult not to acknowledge the day. Is it not odd that we need to be reminded by those organizations that typically want us to purchase something? Well maybe we do need to be reminded to spend a moment either with our fathers, if we still have one or to spend some time thinking about our fathers, for the rest of us. My father has been dead for almost 18 years and he died way too young from a ugly disease. Days do go by when I have not thought about him. The other day, I was out for lunch with a colleague and I bumped into a family friend from childhood who I had not seen for years. After briefly catching up, he was quick to remind me how close he was to my father and the impact he had made on his life. Years had passed since I had remembered the positive impact he had on others and on my friends who considered him a father figure as well. My father had an early death and there was much left undone and unsaid.

In my work with families dealing with their parents, I see those who may be flesh and blood but don’t like each other and who do not get along. In other families I am so touched by the care and respect that is shown and expressed. There is however a lot of grey in the middle. Perhaps the commercial reminder of Father’s Day can be the poke we need to reconnect and reaffirm with our own fathers so that we will not feel that there was much left undone or unsaid. Bumping into this old friend and being reminded of my father’s joie de vivre, brought a smile to my face.

Hope you had a happy Father’s Day.

Like many of you I was watching Saturday’s  victory by our Toronto Raptors.  It is therefore completely understandable that you would not have known that the 15th episode of FinanceIsPersonal aired that same evening. Elizabeth Naumovski, CM interviews Canadian women who have important messages to share as it relates to financial issues, including financial planning, debt, estate planning and  eldercare.  I was Liz’ guest and I address many of the questions that I am asked daily by colleagues and clients including how to get started, what do I need to know, how much does care cost and how best to prepare for the caregiving journey.   As such I have taken the liberty of including a link to this episode.

Go Raptors Go……

Mom’s Day

by Audrey Miller on May 13, 2019

in Articles & Blogs by Audrey, Elder Care

Originally posted at @allaboutestates.ca

A friend sent me this Mother’s Day greeting:

“To the World

You are a Mother.

But to your Family

You are the World!”

I don’t know who wrote it, but I believe the sentiment. We all have had a mother and chances are this person shaped our lives more than any one else. For many of us, our mothers were our first loving and significant relationship. Our mothers influenced us, guided us, taught us, and loved us- unconditionally.   A mother-daughter relationship is unique.  I share many of the same traits as my own mother and  things that I may (or may not) admire in her, I can see in myself.  My mother and I look alike and I can see how I am going to age over the next several years. We also share some of those family traits and health concerns that are genetically familial.

In my day to day work with families, I see many different mother- child relationship.  Most are  loving and caring and others that seem to be so complicated and challenging, I wonder what their history was together. When frailty and dementia are evident, sometimes we have to look a little deeper to remember the happy and healthier times. My heart goes out to those who have recently lost their mother; these Hallmark holidays are difficult. I also think about those moms that are no longer able to remember some of their shared stories and this too is difficult.  I know I am one of the lucky ones as I am a mom and I still have my mom.