Some respite care programs offered by non-profits and Area Agencies on Aging offer as much as 30 hours / month of care for free or for very reasonable fees. This can offset the need for full-time home care services. There are also federal and state tax credits and deductions for caregivers. The cost of medications can be reduced by purchasing prescriptions online in bulk or from Canadian pharmacies.

You can read the full post here: “Ways to Pay for Elder Care.” It’s written by Alex Guerrero,  director of operations for PayingForSeniorCare.com. We offer additional tips on paying for eldercare in a number of posts, which you can find in this section.

AARP recently announced findings that prices for the 217 brand-name drugs seniors use most “increased by an average of 8.3 percent during 2009, the largest increase in years, even as inflation was negative,” The New York Times reports. “Over the last five years … the retail prices for the most popular brand-name drugs increased 41.5 percent.” Generic drug prices, however, have held stable or declined, according to the Times.

You can read the article here: “AARP Says Brand-Name Drug Prices up 8% in 2009.”

There are ways to save money on prescription drugs, including switching to generics and signing up for drug-company aid programs. WebMD offers such tips in “Saving Money on Your Prescription Drugs: Good and Bad Ideas.”

Ready to talk to your aging parents? Here’s one of our posts that may help you get started: “Aging Parents: When to Talk About Sensitive Issues.”

Have you noticed the increasing prices? Have they affected you or your family?

Medicare recently announced that it will now cover up to eight counseling sessions yearly to help seniors stop smoking. Previously, unless you had a smoking-related illness, it only covered stop-smoking medications, reports the Associated Press. The change is effective immediately, but in addition, “next year, such counseling will be free, under a provision in President Barack Obama’s health care law that eliminates co-payments for preventive services,” AP says.

“The elderly can respond to smoking cessation counseling even if they have been smoking for 30 years or more,” says [Dr. Barry Straube, Medicare's chief medical officer]. “We do know we can see a reduction in the death rate and complications from smoking-related illnesses.” Not only cancer, heart disease and lung problems, which can kill, but also gastric reflux, osteoporosis and other ailments that undermine quality of life.

…

Older smokers who receive counseling are significantly more likely to quit than those who only get standard medical care. One study of elderly heart attack patients found that those who got counseling to help quit smoking were more likely to be alive five years later.

The AP’s article is available here: “Medicare Expands Coverage to Help Smokers Quit.” Yesterday, we wrote about another way Medicare is changing — reducing the number of drug plans.

For other tips on saving money and paying for eldercare, check out these posts.

Seniors won’t lose Medicare coverage, but premiums and copayments may increase or decrease, according to AP. “Medicare is expected to release its list of drug plans for 2011 late next month.” More key points from the article:

Reducing the number of drug plans has long been a goal for consumer advocates. This year, nearly 1,600 plans offered a dizzying range of options, many of which were not significantly different.

…

[Jonathan Blum, deputy administrator for Medicare] said the agency is working with insurers to keep disruptions to a minimum. For example, seniors could be automatically reassigned to a comparable plan offered by their insurance company.

The article is available here: “More Than 3M Seniors May Have to Switch Drug Plans.” And here’s our post about another Medicare change scheduled for next year: “Medicare Doughnut-Hole Costs Decreasing: What to Expect.”

Tomorrow, AARP will pick the brain of one such CAPS specialist during a free webinar on aging in place. Participants will learn how to “create an attractive, safe, easy-to-live-in home that all residents, regardless of age or ability, can enjoy,” AARP says. The webinar will also feature an interior designer.

Registration is required. The webinar is scheduled for 1 to 2 p.m. Eastern Time. Click here for the registration site. For those who can’t attend, AARP says it will post a recording afterwards at AARP.org.

Journalist Scott Eyman interviewed Sheehy and asked her, among other things, whether she would have done anything differently, looking back. Her response:

I might have tried to get him qualified for Medicaid. But I’m not sure that would have helped, because I wouldn’t have put him into a nursing home. It’s very difficult to get home care under Medicaid.

I know I would have called for palliative care at home two years earlier. If I’d known, it would have made a difference, because it’s those last two years of emergency rooms, hospitalizations, re-hospitalizations, and subpar rehab places, and back to the hospital – it was a horrible revolving door.

You can read the interview here: “Author Gail Sheehy Chronicles the Challenges of Caring for Her Dying Husband in ‘Passages.’” We also wrote about palliative care in this week’s post “Palliative Care Myths Even Some Doctors Believe.”

Too many people view the conversation as a decision made solely by the children. In fact, elder parents need to have a say, assuming they have their faculties. “Empowering them with that decision goes along way,” [said Cathy Howard, a director at Griswold Special Care, a company that places in-home caregivers and services]. “They feel that they haven’t lost control. They are still the decision maker.”

Also, you can help ease them into it, suggesting just a bit of help at first, and indicating that they can stop it any time.

It’s important to remember that it can be a gradual process, without the need to go from zero to nursing home in a matter of days. Often bringing in a home-health-care worker for just a few days a week can help make elder parents more comfortable relying on others for help. Howard said she has been in situations where she and the son or daughter of the parent sit down and discuss an arrangement of once or twice a week.

You can read all the tips here: “How to Have the ‘Talk’ With Aging Parents.” You may also find these OurParents blog posts and articles about communication helpful.

In fact, the ratings may not always go along with what the residents themselves think. One researcher has found that “it is not uncommon for one-star facilities to rate much higher in consumer satisfaction than one would expect — often higher than those with four or five stars,” the post says. He has a few theories on why that might be. But bottom line:

So are the C.M.S. stars worthless? Most consumer advocates would say no. After all, the agency’s surveyors visit the nation’s nursing homes 65,000 times a year; it would be foolish not to incorporate what they see ….

The key, all hands seem to agree, is to use the star system as one component of a more in-depth search, including on-site visits at varying times of day, discussions with administrators and other families, and talks with the area aging agency’s ombudsman. Many nursing homes also take their own satisfaction surveys and will share the results.

You can read the post here: “Comparing Nursing Homes, and Seeing Stars.”

Through the OurParents nursing home search engine, we feature Medicare ratings, prices, consumer reviews, and detailed information about the facility and the community it’s in. You might also find the tips in these blog posts and these articles helpful.

In their article, The Boston Globe confronts misperceptions about palliative care:

All too often, [palliative care specialists] said, patients and doctors outside their field equate palliative medicine with hospice care, even though hospice is the refuge for people who have stopped aggressive treatment and whose death is imminent.

Palliative care, in contrast, is available at any juncture during a life-threatening illness and, at its core, is designed to make living with a serious ailment more comfortable, incorporating everything from exercise to counseling to pain medication.

The message for patients seems to be, you may have to bring up palliative care yourself if you want it early on. You can read the article here: “Cancer Strategy: Easing the Burden.”

Except … what if the family caregiver turns out to be the nightmare?

“You might be surprised to know that most times elder abuse is committed by family members, friends, and other trusted people” says Sharon Merriman-Nai, co-manager of the National Center on Elder Abuse, a program of the Administration on Aging.

It turns out that choosing the right relative to care for your aging parent can be as important as choosing the right nursing home.

ELDER ABUSE STATISTICS

Two to 10 percent of American elderly people experience abuse, according to the NCEA. This includes physical, mental and financial abuse; neglect; and self-neglect. The risk is higher for seniors with dementia.

Family members make up the bulk of the abusers, though they also make up the bulk of the caregivers. “Most elders are not in nursing homes,” Merriman-Nai points out.

It’s not clear what type of eldercare has the highest abuse percentage. “That is a very, very difficult question to answer,” Merriman-Nai says. Research is in its early stages, elder abuse is underreported, and each state finds and defines it in its own way.

Nonetheless, experts do know that elder abuse happens more often in families than society seems to realize.

RISK FACTORS FOR ELDER ABUSE

According to the NCEA, characteristics that put a caregiver at higher risk for becoming abusive include:

• A history of violence, including domestic violence.
• Being dependent on the elder—for financial help or housing, for example—perhaps because of mental illness, substance abuse or “other dysfunctional personality characteristics.”

Prevention is, of course, the best remedy for abuse, Merriman-Nai says. In some situations, even if a family caregiver is available, a well-vetted nursing home or assisted living facility may be the best option.

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NCEA RESOURCES:

• Risk factors for elder abuse
• Signs of elder abuse
• Where to report elder abuse
• Frequently asked questions