Veterans, home health care and technology

Mountain Empire Legal firm logoThe Department of Veterans Affairs (VA) has become an unlikely and innovative pioneer in the quest to provide cost-effective, quality home health care for veterans. Although the agency has long been mired in controversies surrounding its programs, particularly arbitrary caregiver dismissals, the home health services sector of the VA has long been touted as an overall success story. As Thomas Edes, director of comprehensive geriatrics and palliative care programs for the VA puts it “We’re working in this environment of challenging budget constraints, and at the same time, we’re a very mission-driven organization. Put those together and what happens? That really pushes us to innovate.”

This innovation has seen home-based primary care for veterans quadruple since 2000, and all VA medical centers throughout the US now have a palliative care program as well. The VA Medical Foster Home program care has expanded from a pilot to a national program, recognized in at least 45 states and providing veterans housing as well as in-home care. These success stories are great news for veterans and a must for the Veterans Administration in part because the median age of a veteran is now 64 and the US aging veteran population is growing even faster than the senior civilian population.

It is not just the “new-comer” seniors straining the VA health care system. Nationwide the 85 plus population is on track to increase 70% from 2000 to 2020 according to the US Department of Health and Human Services. The overall unsustainability of the US health care system has forced the hand of the VA, and there is no more cost-effective way than through subsidized, at home family and community-centered health care and technology to meet veterans’ care needs.

The Official Blog of the U.S. Department of Veterans Affairs reports that Telehealth is revolutionizing veteran care and providing high-quality treatment for them. The VA Video on Demand is delivering convenient, accessible health care particularly to those 24 plus percent of veterans who live in rural and remote access locations. Telehealth is also important for those veterans who are disabled. Although a veteran might live in a city they might be unable to get themselves to a medical center for an appointment.

Assisted living technologies for veterans include assistive mobility equipment – an ever-expanding category including wheelchairs, all-terrain vehicles, exoskeletons and in-home ceiling track mobility systems. Each of these continue to be refined and specialized to meet the individual veteran’s needs. The Veterans Administration awards grants to develop technology to assist veterans and service members in modifying their homes. Adapted computer access and electronic aids to daily living and environment control units (personal assistants) provide customized interactive abilities for veterans.

Electronic cognitive devices help veterans who struggle with activities of daily living (ADL). These devices include personal digital assistants (PDAs), smartphones, pocket personal computers (pocket PCs) and other handheld devices, global positioning systems (GPS), reminder watches, pagers with reminder features, and digital voice recorders. The use of these devices helps a veteran stay on schedule with medications as well as stay connected with family, friends, and their medical monitoring community. Those veterans with Post Traumatic Stress Disorder (PTSD) are further helped with their ADLs when robots with artificial intelligence (AI) are introduced into their environment. These AI “tech bots” are capable of reading human facial expressions and can identify when a veteran is feeling particularly stressed, isolated, angry, or depressed. The robot can upload the information to the veteran’s caregivers thus alerting them to the need for human intervention. Wearable sensors can also alert a caregiver or medical professional when vital signs are outside of a normal, healthy range.

The VA will provide a payment to disabled veterans toward the purchase of a car or other transportation and additionally will pay for adaptive equipment, repair, reinstallation or replacement of necessary equipment due to disability. If a veteran has lost the use of at least one foot, hand, or has a permanent impairment to their vision or severe burn injuries or immobile joints that their limit mobility, the VA will help to fund the adaptation of the vehicle to make it fully operational to the veteran.

While the latest technology brings benefits to all seniors opting to age in place, the veteran community is especially helped. Many veterans would like the luxury of aging without combat or noncombat injury so inherent to military service. Some of the aging in place obstacles they must overcome are extreme, commensurate with the injuries (psychological and physical) they have endured. Navigating the benefits that are available to a senior veteran is complicated if you are not well versed in the process. Getting enrolled in the correct program and receiving benefits can also be a lengthy process, so it is best to seek help before wasting valuable time.

If you have questions or would like to discuss your particular situation, please don’t hesitate to contact us.

The Rise of Bankruptcy in the Lives of Aging Americans

The golden years are turning into bankruptcy red for many retired and aging Americans. While medical advances are keeping seniors alive longer, the associated healthcare costs in the quest for longevity are being off-loaded onto the older individual at a time when reduced income is a hallmark of senior living.  Older Americans are increasingly filing for consumer bankruptcy. According to the Consumer Bankruptcy Project, the population aged 65 or more are filing for bankruptcy at a two-fold increase, and there is nearly a five-fold increase in the percentage of seniors in the US bankruptcy system. The economic risk for seniors is running rampant, and the sad truth is currently 97 out of 100 people aged 65 and over are not able to write a check for $600 or more due to insufficient funds.

The sentiment among Americans is that their standard of living will increase at the age of retirement when it is quite the opposite. The typical retiree has set aside about $60,000 for their old age living, and more than 50% over the age of 55 have saved less them $50,000; as much as 40% of these workers have less than $25,000 set aside. The stark reality is none of these “nest eggs” are enough to see a senior through old age and the unforeseen disasters that can deplete what little has been saved.

One of the more common financial obstacles that create this bankruptcy scenario is a health issue. Medicare is not comprehensive. In the absence of a supplemental insurance plan picking up the non-Medicare funded 20 percent cost, a senior can be left with unforeseen operation and rehabilitation costs. Without full health care coverage, the cost of staying alive as a senior is practically prohibitive between prescriptions, treatments, surgeries, rehabilitation, and assisted care. The primary two options available to a senior to cover these costs of survival are credit card debt and loans.  Suddenly, at a time when most seniors should have very low monthly living costs, they find themselves back in a debt slave scenario with little or no income to address their healthcare debt.

Many seniors have concluded that retirement is not a part of their future as they will need a viable stream of income to avoid financial disaster. While this seems reasonable, it is not a good plan to assume one will be healthy enough to work forever. As we age, there is an increased probability that working will become impossible due to unforeseen illness. When this happens, debts begin to mount, and bankruptcy becomes a likely result. Additionally, the era of stable pensions afforded to a long time employee has gone by the wayside. Fewer companies even offer them anymore and those that do often modify and reduce pension benefits to meet corporate expectations of financial profits.

The cost of living rarely if ever is reduced over time and while social security benefits seem like the answer to a senior’s retirement years; these benefits seldom cover basic living expenses no matter how long an individual may have worked or how much they paid into the system. The senior who is faced with government social security benefits and very little additional income usually turn to credit cards to address the gap between low income and living expenses. This scenario takes a senior right back to debt slave mode. As many as two out of three seniors who file for bankruptcy cite credit card debt as one of the primary reasons.

Scams that target the senior population are becoming more sophisticated and prolific with the advent of technology. What used to be a “one to one” scam can now be distributed via email to thousands of targeted seniors who are online in greater numbers than ever before. Often the unsuspecting senior will make passwords or personal bank information available to what they believe is a legitimate request for information from what appears to be a valid email. Seniors can also fall prey to predatory lenders as many seniors cannot read the fine print or understand the consequences of their actions. When scam artists victimize a senior, the senior often loses a large chunk of their assets which in turn can put them in a bankruptcy scenario.

While it is impossible to know the exact future, it is possible to make reasonable plans for it. Learn the ways that you can protect yourself from becoming part of these bankruptcy statistics in your senior years. Even a modest plan is better than no plan at all. Seek the advice of trusted legal and financial professionals to help you understand what you can do to protect your future. Please feel free to contact our office today to discuss how we can help you with your planning.

 

 

America is Facing a Family Home Caregivers Shortage

The aging population of the United States is widely reported as the bulk of the baby boomer generation is already retired or nearing retirement. However, what has not been widely reported is how the rest of the nation will provide care for this large, aging population. According to a 2017 Merrill Lynch study, nearly 95% of caregivers are family members. These family members are providing over $500 billion worth of free care annually. For perspective, that’s three times Medicaid’s professional long term care spending.  The number of family caregivers is shrinking at a time when the population that needs them is expanding at a rapid rate. In 2020, there will be over 56 million people in the U.S. age 65 and older. In 2010, that number was just 40 million.

This is a unique problem for the baby boomer generation for several reasons. The main reason is the simple fact that there is just an unusually large number of people in this generation. Unfortunately, every elder who needs care will not have a family member willing to give care. This responsibility will then fall to professional home care workers. Government statisticians project that the nation will need an additional million home care workers by 2026, an increase of 50% from 2014. Fulfilling the need for this many additional workers will be difficult, however.

Home care workers face extremely low wages, inconsistent work schedules, and there is little, if any, room for advancement in the industry. For example, the median salary for a home care worker is a minuscule $10.66/hour according to the U.S. Bureau of Labor Statistics. For comparison, that’s about the same hourly wage as a fast-food cook and about 30% less per hour than a veterinary technician makes. Looking beyond just salary, benefits are dismal, also. Only a third of home care workers are full-time and qualify for benefits. Further, there is a better chance you get injured on the job as a home care worker than if you worked in the oil and gas extraction field.

Another reason why this is such a unique problem for baby boomers is that it was more common in the past for children to stay in the same geographic area as their parents and be able to provide free care to them when it was needed. With advancements in travel and technology, it has become exponentially easier for people to move away from their parents, whether it be for job seeking reasons or simply for a change of scenery. Also, with the increasing rate of debt Americans are taking on, some family members just do not have the means to take time away from work to care for ailing family members.

There are several small initiatives taking place to help combat this shortage. In Massachusetts, the Home Aide Care Council has started a two-week training program that introduces new home care workers to what the job entails before they start their formal training as a home care worker. Also, some states are starting programs that provide opportunities for advancement. New York has a program that trains home care workers to administer routine medication, which gives them experience that can help them move into other positions in the healthcare industry.

There are options that should be explored now that can help you or a loved one prepare for a possible shortage in caregivers.  Contact our office to discuss steps you can take now to ensure you have the best care possible if needed.

States Brace for Baby Boomer Retirement Age Challenges

There are demographic and cultural shifts occurring in the United States. The baby boomer generation continues to “gray” the country and is changing the way individual states set budgets and health care policies.  More attention will be paid to the needs of the post age 50 generation(s) . Changing attitudes towards working past the age of 65 has taken root in this country and “retirement age” does not necessarily mean a senior is leaving the workforce.

A Gallup poll recently found that 74% of US adults plan to work in some form or another past the age of 65. Some will work out of necessity to earn more money because of increased longevity, health care costs, and reduced Social Security payouts, while others will leave their career and strike out in a different direction often pursuing a lifelong dream or spending time and energy in volunteer work and/or philanthropy causes. Whatever the senior individual’s pursuit, it is clear that new patterns have emerged in the past 10 years and it has a profound budgetary effect on individual US states.

Baby boomers want to age in place and are committed to staying vital, fit, and independent for as long as possible. They want to die in their own homes, not in a hospital or facility. A record high 64 million Americans are now living in multigenerational homes which makes aging in place more possible. These Americans are primarily the younger generations moving into established parent or grandparent home environments. Over 32% of the 64 million are comprised of two generation families and over 28% have three generations (www.pewresearch.org/fact-tank/2018/04/05/a-record-64-million-americans-live-in-multigenerational-households). In 2016 these blended generation homes accounted for 45% of Americans ages 55 and older and the trend is likely to continue.

So why does this demographic and economic shift put a strain on so many state budgets? The answer is twofold; there is an increase in health care burdens while at the same time remittances from tax revenues decline since Americans tend to pay fewer taxes as they get older. According to the Bureau of Labor Statistics this is due partially to senior retirement but also because seniors tend to spend less money than their younger counterparts. This means more health services are needed and fewer tax dollars are available to fund the programs. The revenue collected in 33 states was lower than forecasted for fiscal year 2017 and the aging population is one of the reasons why.

Even the states that are best rated for aging, ranked by overall health, senior unemployment, life expectancy and nursing home quality, are challenged because of health care costs. Rising health care costs have been taking a large portion of each state’s government budget and will most likely continue to do so.

Health care costs are also hitting baby boomers hard. There is a trend in people aged 50 to 65 having more incidence of disability, obesity, and diabetes thus increasing their need for medical care and services. In August of 2017 Fidelity Investments estimated that the average 65 year old couple retiring in 2018 will need $275,000 to cover health care costs alone over the remainder of their lives. That is a 6% increase from the previous year and with no substantive health care pricing reform on the policy horizon that amount will continue to increase.

Now is the time to work with a legal and financial professional to work on a retirement plan that is personal to you and takes your future care needs into consideration. We would be honored to work with you on this important planning step.

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