Category Archives: Trustee

Continuity of Care: Helping Elders Live Their Best Lives

It was difficult to convince my Mom to have someone give her a hand after my Dad died.  I remember making an appoint with a care provider, only to arrive at my Mother’s home and find Mom had already flatly stated, “I’m just not in need of this kind of help.”

It took more than a year and a serious illness before she felt ready – and her quality of life would have been much improved had she been able to recast the help as maintaining her in a least restrictive environment rather than viewing it as a loss of freedom.

One of the most difficult things to do is finding the path to early, proactive help for an elder.   Add to this the challenge of locating a facility that’s just right and you’ve got a tough situation.

This piece in the New York Times on the shifts in elders’ lives tells the tale:  even after downsizing to assisted living, multiple moves can be necessary.

Continuity of care – medical, social, cultural – must be well-planned, with a safety net in place to make sure success occurs.

Photo courtesy
of Brian J. Matis


What is ‘Undue Influence?’

When an elderly woman has a relative or someone else living with her who keeps others away, controls where she goes, and what she does, that individual may be said to be exerting ‘undue influence.’

What this means in practical terms is that the person may be trying to take advantage, for personal or financial gain.

We’re seeing this type of thing happen more frequently with the bad economy.  It can occur with caregivers who see an opportunity.  Or with an adult child down on their luck who doesn’t think twice about helping himself to Mom’s pocketbook.

If you see this kind of situation, it merits some investigation.  Contact your local police if you believe an elder is at risk.

New York Times: Post-retirement Jobs

What happens when older people work?  Good things, says a report from Boston University’s Sloan Center on Aging and Work.

According to the Department of Labor, we’re in the middle of a workforce shift that will see workers over 55 increase by more than 35%.   That means increased fulfullment for elders who like the idea of a retirement job – or who don’t see themselves as retired but moving on to new work.

Richard Johnson, a senior fellow at the Urban Institute, says that 25% of workers over 50 will change not just jobs – they’ll change occupations.  And Johnson states, “Workers who change jobs at older ages say they are more likely to enjoy the new job than the old job.”  How much more likely?  Workers over 65 report a 90% job enjoyment rating – much higher than that of younger workers.

NYT’s New Old Age blog has the entire piece on older workers in the workforce – and the benefits go way beyond a paycheck.

New York Times: Nursing Home Patients in Pain

The D.E.A. is enforcing a law designed to prevent drug abuse by requiring that skilled nursing facilities (SNF) wait for a physician’s signed prescription before providing patients with pain control medicines such as Vicodin, Percocet or morphine.

This leaves our vulnerable elderly population in a difficult situation that is also uncomfortable for the SNF nursing staff.

Here are three suggestions for families:

1.  Anticipate

Determine what the doctor has prescribed and make sure the prescription is sent to the SNF ahead of need.  If the patient receives prescriptions on Monday that will cover the week, see if the physician can write two.  Provide the second to the director of nurses.

2.  Hand carry

Anyone with a relative or friend in a nursing home or convalescent hospital knows that the best possible care is obtained by showing up.  Being present for daily or several times weekly visits at random increases the amount of attention staff pays to your patient.

Ask the physician if you can hand carry the prescription to the SNF.  Make it part of your visit routine.

3.  Standing orders

Ask the physician if the prescription plus amended standing orders to provide more discretion to the attending nurses will help the patient receive pain medication faster while complying with the rules.  Keep in mind that doctors see patients in a SNF far less frequently than if the same patient were in a hospital.

Above all, ask questions and find a solution that will work for the patient.  Read the New York Times piece on the enforcement of DEA rules.

What are Trustee Services?

Trusts are legal entities formed to provide financial benefit to recipients called ‘trustors.’  A trust requires an administrator to carry out its terms.  Often, people who set up a trust choose not to administer it themselves.  In this case, they call upon Practical Heart to provide Trustee Services.

There are many types of trusts.  All trusts require an administrator.  Practical Heart performs this service for clients who want reliable management carried out exactly as stipulated by the terms of the trust.