All posts by Anne Conrad-Antoville

Care planning and paying for long-term care

July 21, 2016 Anne Conrad-Antoville

Currently 12 million Americans require long term care services and 70% of seniors need some type of support. Many people worry about how to pay for the long term care and support that may be needed.

Unfortunately, many people are ill informed regarding benefits for which they may be eligible. Others do not understand how to access benefits for which they have paid.

This problem is often further complicated when “cost-savings” is made the priority over the appropriateness and reliability for a specific service need. One common example is when a neighbor is looked to for advice on a Medicare issue. Another is when a college student is given room and board in exchange for personal care or a friend is put in charge of filling prescription medications or a son-in-law who is handy with tools installs safety devices in the bathroom.

The list goes on and on… Well intentioned people volunteering care or providing low-cost support to seniors and their caregivers can all too quickly turn a care situation into an expensive, unsustainable or even life-threatening risk.

As this body chemical has been seized during the developing swellings in lungs and causes the muscles around the jaw. order levitra http://downtownsault.org/halloween/ http://downtownsault.org/afterallthistime/ cialis online One more side of the pill is safe enough for use. Intake of heavy meals or fatty acids impairs the effect of cialis generic from india Kamagra. It is cialis tab the natural home remedies and Ayurvedic treatments that people are vouching for these days, in place of the scientific medicines. As geriatric case managers, we often are asked to provide perspective and recommendations for a life situation in which a change has occurred. Usually, this change involves physical or cognitive impairment that is affecting daily life activities.

People often over-estimate or under-estimate care needs! Before looking at how to pay for care, we work to understand what types of care are essential for the individual and how much care they will actually need. The initial stages of creating a care plan include assessing what types of care are needed, what persons or services are most appropriate to provide that care and what resources are available to provide or pay for required care.

It is important not to make the mistake of under utilizing benefits that have already been paid for or are otherwise available for the person who needs care. We know it is essential to provide a clear understanding of eligibility and coverage for public and private benefits, as well as the processes for activating these benefits. We also examine all the resources that are potentially available to the person who needs care. A care plan can then be created holistically with a wide-range perspective of needs and resources within the overall context of a person’s life goals and preferences.

Anne Conrad-Antoville is CEO of Champion Advocates LLC, Geriatric Case Management Services, serving seniors and their families in the Portland Oregon region.

Age-Quake!

Caregiving: Major Impacts to Work and Health for the “Boomer Generation”

June 13, 2016 Anne Conrad-Antoville

An unprecedented number of Baby Boomers, that is people approximately between the ages of 50 and 70, are providing care for an aging relative – usually an aging parent. The substantial costs of care provided by these Boomer generation caregivers, while often considered “free” for the care recipient, translate in terms of the caregiver’s own financial, psychological and physical health.

Caring for an older family member requires time, energy and money. Often these burdens are taken on unexpectedly as a result of an accident (like a fall), health incident (a stroke for example), a chronic medical condition (such as diabetes or dementia), the progressing years of aging or a combination of any or all of these contributing factors.

Why Boomers Are More Likely to Become Caregivers

Advances in medicine and medical technology, as well as social advances, have significantly increased longevity in the US. Compared to their parents’ generation of the same age-span, the Boomer generation is more likely to have parents or older relatives who are still living. These longer living relatives are now living with chronic conditions and dementias, at never before seen rates. Furthermore, the longer a person lives with chronic conditions and/or dementia, the more likely that person will require care. ¹

Multiple studies have shown that adult women are much more likely than their male counterparts to be involved in ongoing care responsibilities. ² These duties range from managing finances, to managing medications and medical appointments to providing hands on care such as bathing or dressing a person.

Financial Issues for Caregivers

Nearly 70% of caregivers report the need of having an employer make accommodations because of their caregiving duties. These workplace accommodations include arriving to work late and/or leaving early, taking unexpected time off or cutting back on work hours. Ultimately, and employee who is a family caregiver may have to change positions, change jobs or stop working entirely. ³

A MetLife study found that the 10 million caregivers over 50 who care for their parents lose an estimated $3 trillion in lost wages, pensions, retirement funds and benefits. Costs are higher for women who lose an estimated $324,044 due to caregiving, compared to men at $283,716.⁴

Cost to Caregiver Health

Family caregivers are often suffering from chronic stress, which can comprise their psychological and even physical health. In fact, caregiving fits the formula for chronic stress so well that it is used as a model for studying the health effects of chronic stress. ⁵

An extremely high percentage of caregivers suffer from depression due to caregiving. Many caregivers report that they are experiencing stress and/or panic attacks, pain, aching, headaches and weight gain/loss. Many report that their own self care is in decline and that they have missed their own health care appointments. ⁶

When caregivers’ responsibilities and concerns are taken in the context of the responsibilities they have for their own lives, including work and family; they are often completely overwhelmed. Caregivers believe that the stress they are experiencing takes physical form as increased blood pressure, heart attack scares, arthritis flare-ups and other conditions. People who care for a person with dementia often suffer even more severe negative psychological and physical health effects than other caregivers. ⁷

The total reproductive system buy cialis no prescription is given strength and energy. The main ingredients of diuretic and anti-inflammatory pill are herbs cheap cialis soft including Houttuynia cordata, Plantain Seed and Pangolin. Additionally, with a bolus of Provestra, no-one tadalafil online mastercard can say that there isn’t any affection for adulation for a girl. You will have to be aroused to feel the effect of this medication which last for viagra for 4 to 6 hours For the jelly to work, you need to learn to open up. Cost to US Productivity

The cost to US businesses is becoming enormous and will only continue to rise as the more of the population lives even longer.

According to a 2015 Cerridian study, U.S. businesses lose an estimated $38.2 billion annually in lost productivity due to workers’ caregiving responsibilities. These costs are often associated with replacing employees, absenteeism, workday distractions, supervisory time, and reductions in hours from full-time to part-time.

The study indicates that employers could be doing more to support employees with caregiving responsibilities. For example, only 56% of study respondents report that they have the support of their direct manager in their caregiving role and only 20% of study respondents claim that their employer offers all four of the following support programs: paid time off, unpaid time off, the option to work from home and a flexible work schedule. ⁸

Anne Conrad-Antoville has worked with hundreds of families regarding senior healthcare issues and is CEO and a founder of Champion Advocates LLC, a geriatric case management firm serving elders is Portland, Oregon and family caregivers across the USA and Canada.

¹ AOA-Older Americans 2012 Key Indicators of Well-Being;The Federal Interagency Forum on Aging-Related Statistics

² Unpaid Eldercare in the United States-—2013-14 Summary, Bureau of Labor Statistics

³ Valuing the Invaluable: 2011 Update: The Economic Value of Family Caregiving. AARP Public Policy Institute. – Updated: 2015

⁴ MetLife Mature Market Group. (June 2010) and National Alliance for Caregiving, Study of Working Caregivers and Employer Health Costs: Double Jeopardy for Baby Boomers Caring for their Parents- Updated: November 2012

⁵ Vitaliano PP, et al. Is caregiving hazardous to one’s physical health? A meta-analysis. Psychol Bull. 2003;129(6):946–72. [PubMed])

⁶ Evercare Study of Caregivers in Decline: A Close-up Look at the Health Risks of Caring for a Loved One, National Alliance for Caregiving, Evercare 2006

⁷ Physical and Mental Health Effects of Family Caregiving Richard Schulz, PhD and Paula R. Sherwood, PhD, RN, CNRN

⁸ Ceridian Study Reveals The Challenges Of Caregiving & Its Significant Impact On Productivity & Engagement In The Workplace – 2015

Questioning Aging Answers

Aggressive Medical Treatment- A Crisis Point for the Family Caregiver

May 31, 2016 Anne Conrad-Antoville

Family caregivers of an elder with serious health conditions can often be made to feel that they must assist the elder in obtaining aggressive medical treatment for worsening conditions. In the USA, the use of aggressive medical treatment for patients in the final months of life is increasing significantly. ¹

Are the physicians who recommend aggressive medical treatment near the end of life generally helping the elder or are the outcomes of aggressive treatment generally undesirable?

Studies find undesirable outcomes

According to studies published by Medicare News Group ² and by the Journal of the American Medical Association, JAMA ³, aggressive medical treatment for Medicare patients at the end of life has been on the increase with more people receiving care in intensive care units and more people being shuffled between hospital, home and skilled nursing care in the final months of life.

Unfortunately, according to the same studies, it appears that aggressive medical care is not helping the people who receive it live longer or enjoy a better quality of life than people who receive more conservative treatment. Consumer Reports ⁴ has reported that “too much healthcare” can actually shorten a person’s life.

In fact, aggressive treatment can cause stress and pain for the elder and for the family caring for that elder. Consumer Reports notes that families who have lost loved ones after aggressive treatments often say they regret not having recognized sooner that treatment was not beneficial, and adjusting plans and expectations accordingly.

How do physicians fit into this problematic puzzle?

Some experts note that fee for service Medicare rules can lead physicians to pursue more treatment because fees are paid per service. This idea may have some validity, but it may be more illuminating to look at physicians’ attitudes towards aggressive care in general.

Interestingly, a new study from Stanford School of Medicine ⁵ and a recent poll on the physician social media site SERMO ⁶ both indicate that regarding their own medical care, physicians would very rarely choose aggressive treatment, but for their patients facing the same prognosis, they tend to pursue aggressive treatment.

The Stanford study noted that advanced healthcare directives had little impact on aggressive treatment even though, “more than 80 percent of patients say that they wish to avoid hospitalizations and high-intensity care at the end of life.”

Finding the Physician’s Blind Spot

Physicians have a laser focus on diagnoses and treatment of disease, but this laser focus can also cause a major blind spot. A whole person is much more than his or her body’s condition or disease, and yet in the medical treatment process, the person can be “lost” in favor of a focus on a particular physical condition.

Physicians are trained to provide technical services based on specific and technically definable perimeters. They are not trained or paid to deeply examine a patient’s personal life philosophy, personal history and life experience, emotional life, cultural influences, spiritual beliefs, or family and personal relationships.

To put it another way, what doctors know about a patient may represent very little of what a patient may consider to be essential to “who they are.”

In this context it makes sense that a physician, who knows herself as a whole person, would choose less aggressive treatment for herself and pursue more aggressive treatment for her patient, whom she knows primarily as a condition or disease. This outcome is probably unrelated to whether or not the physician is a caring or compassionate person and is rather a result of the constraints of time, function and capacity.

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What can families do?

Firstly, patients and their families need to recognize the limitations of physicians and medical systems in general. These systems and professionals do not have a complete understanding of patients’ personal lives and issues.

When faced with significant medical decisions, it is essential to seek out as much family, friend, professional and spiritual support as is needed.

Taking the time to draft a well considered Advanced Directive for Health Care (ADHC) is a key step. Realize most “check the box” ADHC forms pertain solely to life support and tube feeding. Preferences regarding other aggressive medical treatment must be written out separately. Therefore, multiple conversations will probably be needed with a primary care provider as well as other medical specialists to draft an effective document.

Discussing the ADHC with the persons who may act as authorized representatives is essential. The representative must understand the principles and desires outlined in the ADHC as issues may arise in practice that are not directly addressed in the document. Choosing a representative who has the mental and emotional maturity and capacity to be an effective advocate is also extremely important.

Having an authorized representative who can successfully advocate for the principles of the ADHC to be followed may be as important as the ADHC document itself.

References

¹Changes in End-of-Life Care Over the Past Decade:More Not Better Grace Jenq, MD; Mary E. Tinetti, MD; JAMA.

²The Cost and Quality Conundrum of American End-of-Life Care Medicare News Group, (reprinted by HealthManagement.org

³Change in End-of-Life Care for Medicare Beneficiaries; Site of Death, Place of Care, and Health Care Transitions in 2000, 2005, and 2009, JAMA

⁴Too much treatment? Aggressive medical care can lead to more pain with no gain Consumer Reports

⁵Most physicians would forgo aggressive treatment for themselves at the end of life, study finds Stanford Medicine News Center

⁶How Doctors Die: Only 7% Choose Extraordinary Measures; SERMO

Aging and Spirit

Compassionate Aging Series: Happiness in Aging – Mind, Body and Emotions

September 13, 2015 Anne Conrad-Antoville

Every one of us is in the process of aging. How do we age in a way that is compassionate to our minds, bodies and emotions? In this interactive presentation, we will explore pathways to happiness in aging.

Join in conversation: Anne Conrad-Antoville, BM, MM CEO of Champion Advocates LLC, Geriatric Case Management Services

Wednesday, September 30, 2015 5:30-7:00pm

-heavy hors d’oeuvres will be served-

West Hills Village
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Please RSVP to (503) 245-7621 by Friday 9/25

Anne has been a professional aging services provider for 15 years and has been the recipient of local, state and national awards for senior health care advocacy. She has worked directly with many hundreds of older adults and their families. She has appeared as a senior services expert on radio and television news programs and has been a speaker at California Association of Area Agencies on Aging, Rotary International, California State HICAP Association, California Health Advocates, Humboldt Medical Association as well as numerous senior and community centers and local businesses.

Questioning Aging Answers

Advanced Directives May Not Prevent Aggressive Medical Treatment

October 7, 2014 Anne Conrad-Antoville

Aggressive medical treatment for Medicare patients at the end of life has been on the increase according to studies published by Medicare¹ and by JAMA².

This aggressive treatment leads to more people receiving care in intensive care units and more people being shuffled between hospital, home and skilled nursing care in their last several months of life.

Unfortunately, the aggressive medical care is not helping those patients studied to live longer, nor are they experiencing a better quality of life than people who receive more conservative treatment.

When polled, people do not generally want this type of care. A Stanford School of Medicine Study³ found that more than 80 percent of patients say that they wish to avoid hospitalizations and high-intensity care at the end of life.

In fact, aggressive treatment can cause chaos and pain for patients and their families. Consumer Reports⁴ notes that families who have lost loved ones after aggressive treatments often say they regret not having recognized sooner that aggressive treatment was not beneficial.

Are physicians working with the intention of Advanced Directives?

Interestingly, both the Stanford study and a recent poll on the physician social media site Sermo⁵ both indicate that physicians, regarding their own medical care, would very rarely choose aggressive treatment. On the other hand, these same physicians tend to pursue aggressive treatment for their patients facing the same proposed prognosis.

The Stanford study noted that advanced healthcare directives had little impact on aggressive treatment:

“In fact, the type of treatments they (the patients) receive depends not on the patients’ care preferences or on their advance directives, but rather on the local health-care system variables, such as institutional capacity and individual doctors’ practice style…”

Why are physicians pursuing aggressive treatment?

Physicians have a focus on diagnoses and treatment of disease, so this singular focus can also cause a major blind spot. A person is much more than his or her condition or disease, and yet in the medical treatment process, the person can be “lost” in favor of a focus on their condition.

As noted by Dr. Periyakoil, author of the Stanford study, “Patients’ voices are often too feeble and drowned out by the speed and intensity of a fragmented health-care system.”

Physicians are not generally trained or paid to deeply examine a patient’s personal life philosophy, personal history and life experience, emotional life, cultural influences, spiritual beliefs, or family and personal relationships.
Once you forward the message, the spammer actually has a program that can copy the list of addresses that the message buy levitra in canada has been forwarded to and send that list back to the village. Here the information contains some important information on widely spread viagra properien Read Full Article and commonly seen erection disorders: Causes of erectile dysfunction. It boosts strength and improves general buy cialis line debility naturally without inducing any adverse action on user. Even if the patients have symptoms like sexual dysfunction and reduced fertility, after the vigorous treatment of prostatitis, the viagra tablet for sale patients can be depressed, fatigue, insomnic, etc., causing the pressure and burden.This is one of the early symptoms of prostatitis.

To put it another way, what doctors know about a patient may represent very little of what a patient may consider to be essential to “who they are.”

It makes sense that a physician, who knows herself as a person, would choose less aggressive treatment for herself and pursue more aggressive treatment for her patient, whom she knows primarily by condition or disease. This outcome is probably unrelated to whether or not the physician is a caring or compassionate person and is rather a result of the constraints of time, function and capacity.

What can you do to have your healthcare preferences followed?

Patients and their families must recognize the limitations of physicians and of medical systems, in general. These systems and professionals cannot have a complete understanding of patients’ personal lives and issues.

When faced with significant medical decisions, it is essential to seek out as much family, friend, professional and spiritual support as may be needed.

An advanced directive is an excellent starting point, but having a professional or family member who can successfully advocate for its intentions to be followed may be most important.

Anne Conrad-Antoville is CEO and a founder of Champion Advocates LLC, a geriatric case management firm serving Portland, Oregon and Northern California. She has worked with many hundreds of families regarding senior healthcare issues for the past 30 years.

¹The Medicare News Group: “The Cost and Quality Conundrum of American End-of-Life Care”

²JAMA: “Change in End-of-Life Care for Medicare Beneficiaries
Site of Death, Place of Care, and Health Care Transitions in 2000, 2005, and 2009”

³Stanford Medicine News Center: “Most physicians would forgo aggressive treatment for themselves at the end of life, study finds”

⁴Consumer Reports: “Too much treatment?
Aggressive medical care can lead to more pain with no gain”

⁵SERMO: “How Doctors Die: Only 7% Choose Extraordinary Measures”

Aging and Spirit

Self Compassion and Aging

August 6, 2014 Anne Conrad-Antoville

Let’s be clear. Aging begins from the moment we are born.

In contemporary western society, we tend to view the aging process as positive up to a certain point. The turning point is somewhere in that upward “moving target” that counts as mid-life. From that point, we tend to view aging as a negative process and something to be fought against.

We have all become strongly influenced by advertising for a plethora of “anti-aging” products, counterbalanced with a youth-obsessed focus. Medical efforts and campaigns to cure countless conditions and diseases have been woven into our everyday experience, which can create for us a strange unspoken expectation that western medicine will someday cure us of all diseases and even overcome death itself.

We may experience unwanted reactions to these “anti-aging” and medical messages. The reactions can include unrealistic and unattainable expectations for ourselves and for those we may care for. If our baseline is unrealistic, we can be much too hard on ourselves.

For example, for the person who is a caregiver of an older family member; guilt can become overwhelming when the older person’s health goes into decline. The flawed expectations of a treatment for aging and eventual death cannot be realized. This form of guilt can become self-debilitating and detrimental to the caregiver’s physical and mental health.

For those of us who are passing the mid-life point, our own thoughts can become self wounding and cruel as we find it increasingly difficult to fit ourselves into the a youth-based straightjacket as we age.

Moreover, other cultural conditioning can make it difficult for us to allow ourselves to be self compassionate. At a recent leadership training that I attended, the accomplished female speaker noted in an offside comment, “I have always found it easy to be compassionate for others, but difficult to be compassionate to myself.”
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Why be self compassionate about aging?

Self compassion allows us to be present in the true moment. It helps us to forgive ourselves, to heal our wounds and to appreciate our own best efforts. It allows us to be truly compassionate in our service to others. Self compassion frees us of unnecessary burdens, allowing us to age from our center of being with grace and with wonder.

Anne Conrad-Antoville cared for her disabled mother from her pre-teens through her mid-thirties, when her mother passed away. This experience inspired Anne’s eventual work in professional aging services. Anne is currently CEO and a geriatric case manager for Champion Advocates LLC and manages Working Woman Aging Parents.

Future Vision

Aging and the Futurist

July 18, 2014 Anne Conrad-Antoville

I just attended a talk with Intel’s Futurist, Brian David Johnson. Earlier in this week, I had read through a futurist magazine filled with articles extolling child bearing robots and brain downloads and my expectations were low for meaningful content.

I was pleasantly surprised to hear Brian’s view that the future he envisions is about humans, not technology. It is not technology that guides us, but we who should be guiding technology. As we enter an era in which we can manufacture molecular-sized technology and literally anything can become a computer, it is up to us to decide what we stand for and what we stand against.

What stuck me most was this statement Brian made:

How do you change the future?
Change the story that people are telling themselves about the future they will live in.

In that light, what story are we telling ourselves about aging?

Aging is not only in our future, it is happening to all of us and now! If we are allowing the aging story to be shaped by medical technology companies, which of these technologies will enhance our experience of living a human life and which will dehumanize us over time?

Are the advertisements put forward by pharmaceutical corporations helping or warping our understanding of the course of life? Is the aging story told by residential care conglomerates and investment brokerages meaningful and true to what you stand for?

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Be aware of what you stand for and what you stand against, and change the story you are telling yourself as much as you need to.

Anne Conrad-Antoville is CEO of Champion Advocates LLC in Portland, Oregon. She has helped hundreds of families with professional geriatric case management services and other supportive services for seniors. Anne is also President of Working Woman Aging Parents.

Intel – Brian David Johnson and the Tomorrow Project

Photo- Damien Hirst, Hoorsenbuhs — The Cathedral Collection – Pill Rosary

Are physicians working with the intention of Advanced Directives?

Why are physicians pursuing aggressive treatment?

What can you do to have your healthcare preferences followed?

Cherishing the Future of All Generations!