Advocate for the Aging
POSTED AT 6:11 AM ET, 12/14/2010

How would you feel?

The other day I had lunch with Dr. Padma Shukla, a board-certified cardiologist based in Reston. Dr. Shulka has many elderly patients, some with Alzheimer's. She was sharing with me how sad she was feeling over how a daughter was treating her mother with Alzheimer's. She was describing how the daughter kept berating her mom to remember things she can't remember and trying to re-educate her to do things she can no longer do. Dr. Shukla said she tried to tell the daughter "How would you feel if someone treated you this way?" Sadly, it didn't seem to be sinking in with the daughter.

Unfortunately, I see this far too many times. I've probably been guilty of it myself. Maybe not to the point of berating people to remember, but every time I say "Don't you remember?" How must anybody feel when their memories fade and they can't remember. What we think is a gentle reminder just serves to make them feel worse.

I have been thinking about our conversation and I know I am going to resolve to spend more time thinking about how I would feel if someone treated me this way, especially if that someone was my own close family.

So, please, if you are caring for someone with Alzheimer's and they think they still have a job, let them think that. Does it really hurt you or anyone else?

People who care for Alzheimer's patients have a saying, "Go on the journey with them." You never know, you might learn something. I can tell you, it's way less stressful--for everyone.

The Alzheimer's Association has a great Web site filled with resources and a 24-hour hotline staffed by volunteers who are directly affected by Alzheimer's. So, write this number down and keep it by your phone: 800-272-3900.

BY Toni Reinhart

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POSTED AT 6:35 AM ET, 12/ 7/2010

Help! Christmas is coming!

Christmas is coming and I'm already starting to stress out about getting more stuff. I live in a 4 bedroom, 2 ½ bath house with my husband, two dogs and a cat. There are no kids. We never had kids. We just have stuff. We have so much stuff that I start to get stressed out about Christmas before we even hit Halloween. You should see my basement. When I get perfectly good stuff that I don't know what to do with, I put it on a shelf in the basement. "I'm going to have a yard sale," is what I always promise myself, even though I've actually never had a yard sale. My stuff just sits on the shelves, waiting.

I've asked my parents not to buy me more stuff for Christmas. I'm 55 for heaven's sake. I don't need more stuff. But my parents grew up very poor. My mother was born in Harper's Ferry, W. Va. way before it was the cute, restored little town it is now. My father's father grew up in a house made from a cave (I'm not making this up!) in Abruzzo, Italy. I've been there, I don't know how people make a living there now, much less then. My parents are well-off now. They fly first-class to Europe to visit the places their parents fled in poverty. So, I understand that it is important to them to be able to buy wonderful stuff for themselves and their children. It gives them so much pleasure.

So, I need some help with all my stuff and the stress it brings me. Maybe I should hire a professional organizer. Are there coaches to help you have a yard sale? Maybe I can look this stuff up on the Internet. Do you have any ideas?

BY Toni Reinhart

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POSTED AT 6:59 AM ET, 11/ 9/2010

Thank your activities coordinator

I attended a very interesting luncheon today at the Fountains of Washington House. Steve Gurney, of the Guide to Retirement Living Sourcebook, organizes these luncheons quarterly and he covers subjects that are of interest to people in the senior-serving industry. They are actually a huge networking event where we get to eat and learn something. Steve jokes that he could announce the subject is long division and still 100 people would show up. I think he's probably right about that.

Today's luncheon featured a panel of activities coordinators for assisted and continuing care communities. Actually, the term Steve used was "life enrichment activities" and after hearing about the programs these activities coordinators are providing, I have to agree with that term. Things have certainly advanced past bingo, the first thing that comes to mind when we think of activities in senior living communities.

We heard from a resident of the Fountains who explained the activities and classes that are offered there. He told us of his personal experience with a flower arranging class taught by a man who had been educated on the subject in Japan, a garden full of eggplants and colorful peppers he planted near the rehabilitation area of the community and the singing classes he and his wife take. Those were only three of the 33 activities offered.

We also heard from the coordinators about what a huge task they have on miniscule budgets. They are tasked with providing residents with activities that are meaningful, engaging and stimulating--all for about $15.00 a month. They have to provide the activity, the supplies, food, and maybe even gas for the van to transport everyone. I had no idea their budgets were so tight.

Most of the coordinators I know are doing a phenomenal job and I will be sure to seek them out and let them know how much they are appreciated. If you have a loved one in a senior living community, think about giving the activity coordinator a hand. Maybe you can teach a class in something you're good at. Maybe you can just volunteer to help. If not, please let them know they are appreciated.

BY Toni Reinhart

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POSTED AT 6:28 AM ET, 11/ 3/2010

My home care's better than yours

I had a meeting with a friend who sells long term care insurance recently and we started talking about the networking functions we go to and how many people there are in the senior care industry. There's been an explosion the last couple of years.

When I started my business almost ten years ago, there were really only three franchise systems for in-home care for the elderly, Comfort Keepers, Home Instead, and Visiting Angels. The last number I heard was 56 franchise systems for in-home care and that's just the franchise systems. There are now 212 licensed agencies for in-home care in just Northern Virginia. That does not count the independent agencies that are not licensed and the independent caregivers working in individual homes. No one knows how many of those there are. Someone from the Senior Beacon told me he gets 10 calls a month from people starting new agencies. So many new agencies were applying for licenses in Virginia that the state put a moratorium on new licensing until at least 2012.

Is there enough business to support all these new agencies and independents? Even with the upcoming surge in the senior population, it's going to be tough for everyone to make a living, much less a profit, with these numbers.

So, I'm interested to see if we are going to get into consolidation in this industry like we've seen in banks and hospitals. Will we get "Comfort Instead?" How about "Comforting Angels?" Or, "Angels Instead?"

Okay, I could go on like this for a very long time. We will just have to wait and see.

BY Toni Reinhart

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POSTED AT 6:15 AM ET, 10/28/2010

Defining my retirement dreams

I've been reading about the strikes going on in France over raising the retirement age. That got me thinking again.

Working in the home care for seniors industry, I see a lot of people who have nothing to do all day and feel their lives have no meaning anymore. Going to the dentist becomes an activity, something to do for the day. 

This is not what I dream about when I dream about retirement. I dream about buying a villa in Italy or Spain, with a view of the ocean, and sipping wine while I prepare spectacular meals.

Okay, that's probably not going to happen. When I let myself think about that dream I start to think "Who am I cooking for?" I guess I can make new friends there. But, then, what else am I going to do with my days? Is that enough to really keep me happy day after day? Who are these new friends I will be making? Are they also retired ex-pats? Probably. I don't speak Spanish or Italian.

About then is when I get realistic and realize that what I really need is to redefine retirement. Why do we have a "retirement age?" I can understand it if you have a physically demanding job. A 65-year-old body just can't keep up with the demands of some jobs. But then what? You just stop? You just play golf all day? I know too many people who retired and loved it for a couple of years before the mind-numbing boredom set in. Then, even more things start to go wrong with your mind and your body. You can't keep your mind sharp with golf and Sudoku and nothing else.

We need something in between, something where we can work and feel valued, but it won't kill us. We need a slower-paced work life. It's either that, or I'm going to have to learn to speak Italian.

BY Toni Reinhart

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POSTED AT 5:28 AM ET, 10/26/2010

Do you need religion to live longer?

Last Sunday, I was reading a couple of articles that got me thinking about religion again. One article in the Washington Post was really intriguing, When the church itself needs saving. That was particularly interesting for me because I was raised Roman Catholic. I went to Catholic school in Falls Church. We had nuns for teachers. We were not, under any circumstances, to question the church, or the nuns. Maybe that's just the way children were raised then. Do not question authority. That never set well with me and I found myself drifting away from the religion I was raised with as I got older. By the time I reached adulthood, I pretty much had no interest in Catholicism. So, reading about people who are encouraged to question the very way that their religion communicates with them was extremely interesting to me.

The second article I read was by Dr. Oz, who I am fascinated with despite his fascination with poop. He's the only reason I read the Washington Examiner. Anyway, Dr. Oz wrote about religion and its effect on not only how long you live, but how well. That was certainly not the only place I've heard that. So, between the two articles, I'm wondering if it is religion itself or belonging to a religion--getting the benefit of the community and sense of belonging? Would it be the same if you belonged to something else? Would the chamber of commerce or the rotary do the same thing? What about if you prayed and were spiritual, but did not belong to an organized religion?

Well, I could go on with these questions forever. I guess one way or another, I will find out.

BY Toni Reinhart

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POSTED AT 6:11 AM ET, 10/21/2010

Changing perspectives as I age

If you read my blog introducing myself, you know that I really changed what I wanted from life after 20 years in the IT training business. Well, working in senior care has really changed my perspective, also. In some ways, I'm trying to prepare for the future. I know so much about aging that I never thought of before. I know that Medicare won't pay for long term care. I know I don't want to depend on Medicaid--sorry to the elder care lawyers that make their money helping us become qualified for Medicaid, but that's just not my vision of my golden years. I know how expensive care can be; whether I stay at home or choose to live in an assisted living community, it will be expensive. So, I am thinking about that and trying to get a handle on long term care insurance.

On the other hand, I'm trying to live for today and not fritter away any chances. We cared for a woman younger than me--I'm 55. It's already out there, so there's no point in denying it now!--who had advanced Alzheimer's. She still had a son in high school. I am now losing people I know and work with to various diseases or disabilities. I have spent time at the bedsides of people who are dying. You know what? I have never heard a dying person regret the time they spent traveling, or the time they spent with their family. They just don't ever say "Gee, I should have spent more time at the office."

I know couples who put off that trip to Europe for retirement and never got there because one of them died. I'm sure we all know people who had had this experience. So, I'm not putting off the trips to Europe. My husband and I spent last May cycling the Dalmatian Islands of Croatia with VBT and then went to Italy for a week in September to spend time with my parents and my father's family near Rome.

The trick is, how do I continue to live for today and still have enough left over to be decently cared for in my old age? Well, besides looking at long term care insurance, I'll be sure to check my social security closely and pay more attention to the advice my financial advisor gives me. I know this balancing act is just beginning, but I'm sure having a great time along the way.

I'm looking at Portugal next. Or maybe Greece.

BY Toni Reinhart

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POSTED AT 6:12 AM ET, 10/19/2010

I never planned to live this long

I have been thinking about long term care insurance again. I know what a lifesaver long term care insurance can be. Last May, when it became appararent that my mother-in-law, Marlene, could no longer live on her own, we became confronted with finding the right care for her and looking at the cost. Here's the thing, we don't know how long we will live. I can't even tell you the number of people we care for who tell me "I never planned to live this long." Marlene was no different. She outlived her husband, the she didn't plan that. She thought she was supposed to go first. Well, she didn't.

Luckily, when she was younger and more mentally capable, Marlene had the foresight to buy long term care insurance. What I never asked her was - how did you know when the right time was to buy? How did you know what to buy? Do you go for a policy with a short elimination period? A lifetime benefit? Flexible daily payments or fixed payments? What if you get a policy that is only good for a few years and you live longer than that?

This is a subject that's going to take much more studying. I have a little bit of knowlege on the subject. I have seen presentations by Banker's Life, MetLife, and John Hancock. I know what assisted living costs can run and what home care costs can run.  (I'm not ready to think about nursing home care but I know what that costs, too).

MetLife has a great site for looking at costs of different types of care and it's easy to get around. So, I'm going to see if I can get over my tendency to put things off, make a list of what's important to me and my husband and do some serious long term care comparison shopping.

Then, I plan to just get on with it and buy a policy because no one ever plans to live that long.

BY Toni Reinhart

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POSTED AT 6:06 AM ET, 10/18/2010

Who's watching your home aide?

Do you know where to look when you are trying to find help for your mom or dad? Do you know that there is a license for some types of care, but not others? And, by the way, not everyone seems to agree on what needs to be licensed and what doesn't. Virginia seems to be trying to get a handle on it, but they are using mostly a medical model, when most of the care people think they need is non-medical. The regulations for home care are really only a few pages, but there seems to be lots of gray area.

Care for the elderly is generally divided into two categories: companion care and personal care. Companion care usually includes things like laundry, companionship, light housekeeping and transportation. Personal care is more intimate care, like bathing and transferring from a bed to a wheelchair.

Virginia has no license for companion care. You might wonder if an agency is unlicensed, who is watching over it? When I went to arrange for care for my mother-in-law in Ohio, the first question I asked was "Are you licensed?" I found out that Ohio is not a licensure state. So, how do I, in Virginia, determine if the care provider on the other end of the line is doing what they say they will do? 

Virginia is a licensure state, as is Maryland. Virginia, where my agency is located, requires you to have a license if you are providing care to the elderly that involves touching them. Virginia also requires licensed agencies to be available 24 hours a day, seven days a week, have a registered nurse available to supervise care and operate from professional space. The state sends a surveyor to check the licensed agencies files, interview caregivers and go on home visits to ensure quality care is being delivered.

In Virginia, all of the licensed agencies I know also provide companion level care. Some believe the state needs to license that level of care. How do we expect state officials to protect seniors and their families from scams when they don't even look at all the agencies that are working, unsupervised, in seniors homes? A list of licensed agencies can be found at the Virginia Health Department Web site.

If you're not sure what kinds of help you need, the National Family Caregivers site is a great place to go for resources.

BY Toni Reinhart

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POSTED AT 6:59 AM ET, 10/15/2010

Preparing to age in Reston

Last Saturday, I got to participate in a forum on aging in Reston that took place at the Reston Community Center. I have to admit, I was reluctant to go on such a beautiful Saturday, a day that Ocktoberfest took place at the Reston Town Center. Beer sounded way more fun.

Like more than 300 other people, I attended the forum and was really glad I did. It was intended to help people from Reston and the surrounding communities start the conversation on what we need to be able to stay in our homes and the communities we love as we age. We heard from four different community-based models: Mount Vernon at Home, Community Without Walls, Partners in Care and Burning Tree Village. It was very interesting to hear how other communities are dealing with these issues. Reston is already a community that has active, involved citizens. Just try and put a shopping center on a piece of wetlands and see how involved we are.

This week, I am scheduled to go to a follow up meeting for the planning committee and I'll be able to hear what ideas and concerns came out of the break out sessions. I'll be very interested to hear what kinds of ideas are coming out of this community.

I expect the next few years to be very interesting around here. By 2020, Fairfax County estimates that over 20 percent of us will be over 50 years old. The Metro will be arriving in Reston in 2013, changing the character of some of our neighborhoods, but also giving us more transportation options.

Stay tuned. I'll keep blogging and letting you know how it's going from my perspective.

BY Toni Reinhart

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POSTED AT 6:30 AM ET, 10/13/2010

Welcome to my blog!

Hello! Today I begin a new adventure. I have been wondering about blogging for some time, so I'm going for it, as the title says. My blog will focus on issues relating to aging, caregiving and the aging industry. Today, though, my editor asked me to introduce myself. I don't know if you have ever had to introduce yourself in about three paragraphs, but I find it a little daunting. I have decided to just talk about how I got here.

In the spring of 2001, I was a middle-aged (Okay, I was 45, but feeling middle-aged in my industry), female, IT training manager facing a recession. I had been through that before. Every time the economy dips, training and travel, which is what I did, are the first things to get cut. I was tired of it. I was also tired of traveling to places I didn't want to go on someone else's schedule.

So, in the time-honored "What Color is Your Parachute?" style, I decided to make a list of what I did want. I wanted to work in my community. I love Reston and I was tired of leaving it every day. I wanted to know people in my community. I wanted to feel good about what I did at the end of the day. I wanted to work in a service business because I am a service-oriented person and because I didn't believe I could sell a product. I wanted to own a business, but I didn't want to be in business alone, so I knew I wanted a franchise. I knew I was a good manager, so I figured I could pick any business that I felt passionate about and be successful at it.

I went shopping for a business that would fulfill my list of wants and I found Comfort Keepers. I knew it was perfect for me. It fulfills my need to be of service to a clientele that desperately needs good care. It also fulfills my need to feel connected to my community. In the past 10 years, I have been a caregiver in my professional life, a caregiver in my personal life, a manager of caregivers and owner of a caregiving business.

I'm now going to do my best to share what I have learned and am continuing to learn from my many vantage points. I hope you learn something, too. I hope you enjoy the stories. Aging will affect all of us one day. Let's put our heads together. 

BY Toni Reinhart

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