In-Home Care for the Seriously Ill - You May Qualify for More Help Than You Think

 The husband of a friend of mine died a few months ago. He was only on hospice for two days before he died.  Although they had paid for long-term care insurance for years, he did not take advantage of it during the months before he died, despite the fact that his death was not a total surprise.  He had metastatic melanoma, failing kidneys and COPD. He could only leave the home with assistance. He was often in pain. Unfortunately, during those last few months they did not hire a caregiver for him and his wife provided all his care, right up until he went into the hospital for the final time and then was brought home on hospice for the last two days of his life.  When the wife finally hired a caregiver, her husband died two days later.  They barely took advantage of the long-time care insurance they had paid for.

Since then, my friend and I have had several discussions about what she wished she had done differently. Number one on her list was that she wished she had gotten more help and more care for her husband at home in the months before he died.  Doing that might not have helped him live longer, but it might have made his quality of life better.

Of course, not everyone has a long-term care policy.  However, everyone deserves to have help in the final months of life, and every caregiver deserves to have some relief from taking care of everything alone. There are many ways you can get more help during the final months or years of your life.

Where to Find the Help You Need

You might qualify for Medicaid - Medicaid is the largest payer for nursing home care in the U.S. and, in many cases, they will also pay for an ill person to get part-time care at home, as needed.  You can find out if you qualify in your state by contacting your local Social Services or Medicare office.   You may be surprised at how much assistance they can give you, especially if you are on both Medicare and Medicaid at the same time.  

Ask your doctor about home healthcare, home palliative care, or home hospice - Even if you do not qualify for Medicaid, these other programs will allow you to have occasional visits from a home nurse and/or physical therapist, combined with video visits with your doctors.  For people who are dealing with debilitating chronic health conditions, it can make life much easier if you can avoid as many difficult trips to the doctor's office as possible.  

If you are initially turned down, do not be afraid to appeal.  My husband, who has kidney and heart failure, qualifies for home healthcare and gets many of his services at home.  Nurses and physical therapists come to work with him at home, give him shots, check his medications, and take his blood pressure and other vitals.  Most of his doctor visits are video visits.  It is a huge relief to me to not have to take him to the doctor's office for an in-person visit very often.

Arrange for meal and grocery deliveries at home - There are now many companies, in addition to Meals on Wheels, which can deliver nutritious meals to you several times a week. Our neighbors who receive Meals on Wheels also have the additional benefit of having someone who checks on them to make sure they are OK.

You can also order your groceries online.  Most large grocery chains offer that service. One of my favorite grocery delivery services is Amazon Fresh (Ad), which my husband and I have used since the beginning of the Covid pandemic.  I especially like the fact that they deliver heavy items right to my door, including groceries such as milk, bottles of juice, cases of sparkling water, soda, and laundry detergent. They also bring the bulky items like paper towels and toilet tissue.  As my husband's primary caregiver, having groceries delivered makes my life much easier.  I order from them about once every two to three weeks.  In between, I stop at the store just to pick up fresh fruits and vegetables, and anything I want on the spur of the moment.

Contact your local Senior Center for information about medical transportation and other services - Senior Centers are a wealth of information.  They can put you in touch with Meals on Wheels, medical transportation, and a variety of programs which will make it easier for you to remain at home, even if you are fighting a serious illness such as cancer or heart failure.  They also offer opportunities to socialize, which can be important to your mental and physical health.

If you have a long-term care policy, use it when you become eligible - You may qualify for your long-term care insurance policy, especially if your life expectancy has become short and your health has declined to the point that you are falling often, need help with showering and personal hygiene, and/or you have difficulty transferring from your bed to your walker or chair.  When this happens, you should initiate a claim on your long-term care policy.  Dementia can also qualify you, as well as being put on palliative care or hospice. You've been paying for this policy, so do not hesitate to use it when you are nearing the end of your life.

All the above programs make life easier for people during their final years.  Make sure you take advantage of any programs you qualify for.  Even getting just a little extra help can make a huge difference in the quality of your life.

Do as much shopping from home as possible - In addition to groceries, you can shop online at sites like Amazon (Ad), Etsy, WalMart, and many drug store chains for cleaning supplies, personal hygiene products, clothing, gifts for your friends and family, or other products you might need.  This is an especially easy way to send gifts to your adult children and grandchildren.  Try to avoid as many stressful shopping trips as possible, unless you have someone to help you.  If you are ill yourself, or a caregiver for someone else, try to delegate routine chores as much as possible, so you do not have to handle everything for yourself. 

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Alcohol Abuse and Alcoholism in Retirement

 

My husband and I have been in 12 Step Recovery programs, Alcoholics Anonymous and Al Anon, for over 40 years, since we were both in our 30s.  As young adults, alcohol abuse was already having a bad effect on our marriage, and my husband realized he had to stop.  I realized that I had to change some aspects of my behavior, too.  Although we were still young adults, we knew that we were headed for disaster if we continued on the same path.

That was over 40 years ago, and we are so glad we made the joint decision to make some major changes in our lives, although it has not been easy.

One of the things we have noticed over the years is that more people show up at our AA and Alanon meetings each January, usually because people have over-indulged during the holidays.  Gradually, many of them leave, convinced that they either cannot stop drinking, or they cannot change their behavior in other ways.  

However, for those who stay in 12 step recovery programs, most of them have discovered that it has changed their lives for the better, and dramatically improved their relationships with their spouse, children and other friends and family members.  You are never too old to start changing your life, too.

The Covid pandemic caused millions of senior citizens to increase the amount of alcohol they drank.  Researchers at the University of Michigan discovered that about 14 percent of older Americans self-reported that they were drinking more.  Stuck at home, often spending large amounts of time by themselves, drinking became all too common.

Many adults between the ages of 50 and 80 reported that they sometimes drink at least three or more drinks at one time.  This is significantly more than the recommended limit of one small drink for women (about a half cup) and two small drinks for men (totaling about one cup of wine or two normal size beers) in a single day.  Many people have no idea the effect that large amounts of alcohol can have on them.

Seniors Don't Process Alcohol Well

The older we are, the less able we are to process alcohol, and doctors estimate that this biological change begins at around age 50.  This means that you are more likely to suffer from hangovers and other health problems when you overindulge. 

Your body has less muscle as you age, and because muscle stores more water than fat, you have less water in your body.  As a result, the alcohol you drink is not diluted by water as much as when you were in your twenties or thirties.  This means that if you are given a blood alcohol test by a police officer, you are more likely to have a high blood alcohol level after fewer drinks.  If you want to avoid those DUI tickets (and the huge expense), you need to seriously reduce the amount of alcohol you consume when you go out. 

The reduced muscle in your body is not the only cause of high blood alcohol levels.  In addition, your stomach and liver do not produce as much of an alcohol-digesting enzyme called ADH.  Since women have less ADH than men to start with, they have an even harder time eliminating the alcohol from their system as they age.

Most of Us Cannot Judge the Effect of Alcohol on Us

In some cases, we do not think we are drinking as much as we did 20 years ago, so we convince ourselves that we do not have a problem.  However, regardless of what we believe, we could be completely wrong.  Most of us have no idea how much alcohol is affecting our balance, our reflexes, our eyesight and our hearing.  

Because we have difficulty judging our own sobriety, we may be certain it is perfectly safe for us to drive, even when we are not capable of handling a car.  (By the way, the same is true when we take certain medications.  We may believe our faculties and reflexes are not affected, when they really are.)

Alcohol Dehydrates Us, and We May Already Be Dehydrated

Many older people do not drink enough water during the day, which leaves them slightly dehydrated.  Try pinching the skin on the back of your hand for a couple of seconds, and then let go. The longer it takes for the skin to fall back into place, the more dehydrated you are.  This is a common problem for senior citizens, even when we are sober.

Alcohol does not hydrate us. Instead, it increases the dehydration in our body.  Even though we may think that the beer or cocktail we are drinking is a liquid and would, therefore, help hydrate us, it really does the opposite.  Alcohol pulls water from our system, which is why you may experience a dry cottonmouth feeling the next morning.  

Notice how much more you urinate while you are drinking alcoholic beverages?  That urine is the water you are losing from your body. 

Too Much Alcohol Can Speed Up Brain Aging

As long as you stick to one drink for women and two for men in a day (and we're talking small drink sizes, not supersize ones), then most people are probably safe.  However, if you go beyond that amount, researchers have discovered that we lose volume in the frontal cortex of our brains.  In other words, our brain starts shrinking!

What does the frontal cortex do?  It helps us control our impulsive and compulsive behavior.  So, the more we drink, the more our frontal cortex shrinks.  This makes it harder to control our impulses, which causes us to drink more.  Our brain ages even faster.  It becomes a vicious cycle.  In addition, your brain volume does not come back when you stop drinking.  You may continue to be more impulsive and compulsive.  That is why going to alcohol rehabilitation or joining organizations like AA are so helpful.  They help people recognize and change any negative behaviors which may linger even after you are sober.

Alcohol Can Worsen Up to 200 Medical Conditions

We all know that alcohol can cause liver disease.  However, alcohol abuse can also worsen cancer, especially oral cancers.  It can raise your blood pressure (and you thought it would help you "relax.")  It increases your risk of having a stroke, worsens diabetes, and is unhealthy for anyone dealing with an immune system disorder.  Those are just the tip of the iceberg.  Alcohol can make almost any disease worse.

Excessive drinking also make it harder to get good quality sleep.  You may initially fall asleep, but then wake up just a few hours later when the alcohol wears off, which disrupts your rest for the remainder of the night.  

Try to Just Cut Back on Your Drinking

While a small amount of alcohol probably will not harm most people, and a little beer or wine may even help your heart, it is important not to push the limits, even occasionally.  Try cutting back or giving up alcohol for a while. If you feel healthier and generally better after a few weeks without alcohol, then this should tell you everything you need to know.  Keep it up!

If you discover that it is almost impossible for you to cut back, and you definitely cannot abstain on your own, talk to your doctor, consider going to rehab, or find a local chapter of Alcoholics Anonymous.  There are thousands of men and women who have gone through the same thing in every community, and they will be happy to help you.

Support Others When They Cut Back

One type of behavior which is common in problem drinkers is the tendency for them to push other people to drink excessively.  How often have we all heard people push us to drink "One more for the road!" (Are they kidding?  On the road is the last place you should be if you have been drinking!)

Instead, it is much more helpful to offer encouragement to people who are trying to cut back, or eliminate alcohol from their lives, and we should do whatever we can to help them stick with their program, whether they are trying AA or some other sobriety program.  If they belong to a 12 Step Recovery Group, like Alcoholics Anonymous, they need to be encouraged to stay with it.  

Whether you join AA, or Alanon (an organization to help the friends and families of problem drinkers deal with the problems that alcoholism causes) or you just want to encourage someone else, you may wish to send them a positive note or give them a gift to support their efforts and let them know how proud you are of their efforts. 

Help them celebrate events such as their sobriety birthdays or Alanon anniversaries.  You can give members of the AA program jewelry or t-shirts to help them celebrate. 

The important thing to remember is that we all benefit when we encourage and support our friends and loved ones as they try to to stick with a 12 Step sober recovery program, and any way you can do that is beneficial. 

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Source:  Facts about alcohol and aging from the March 2022 AARP Bulletin.

Disclosure: This blog may contain affiliate links. If you decide to make a purchase from an Amazon ad or my Etsy Shop, I'll make a small commission at no extra cost to you.

You are reading from the blog: http://www.baby-boomer-retirement.com

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