Author: Debbie McDonald

10 Signs of Depression in Older Adults

1 in 4 older adults report
having depression or anxiety.

May is National Mental Health Awareness Month (MHAM). People don’t talk about the mental health of older adults much.

Discover the ten signs that indicate an older adult is depressed, common causes for depression and how you—as an involved family member or friend—can help.

“I’m not sad, my body just hurts.”

Depression in older adults is not a normal part of aging, but it is a common experience. Identifying and treating depression in an older adult can be complicated since the older adult may have a stigma attached to depression, seeing it as a taboo topic, a sign of mental illness or weakness. Additionally, the signs of depression in an older adult may not look like the signs that show up in other age groups. 

According to the National Institute of Mental Health, depression in an older adult may look like: 

  1. Persistent sad, anxious, or “empty” mood
  2. Being grumpy or irritable
  3. Feel confused or struggling to pay attention
  4. Loss of interest or pleasure in hobbies and activities
  5. Moving or talking more slowly
  6. Having a change in weight or appetite
  7. Feelings of guilt, worthlessness, or helplessness
  8. Difficulty sleeping, early-morning awakening, or oversleeping
  9. Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment
  10. Having suicidal thoughts
According to the NIMH, if these signs and symptoms show up most of the day, nearly every day, for at least two weeks it may be a sign of depression.

Depression can also be an early sign of dementia. To make things more complicated, dementia can cause some of the same symptoms as depression. It is also common for people with Alzheimers and related dementias to suffer from depression. So in short, depression may be a sign of the onset of dementia or dementia may be causing some symptoms that look like depression.

For those who love and care for older adults, these issues are particularly important to pay attention to since older adults have one of the highest suicide rates in the nation. In fact, white males 85+ years old complete suicide at 4 times the rate of the general population. We highlight this because we don’t believe it’s common knowledge, but important to know.

Three reasons why an older adult may be depressed

  1. People who are isolated or lonely are more likely to experience depression, cognitive decline, dementia and Alzheimer’s disease. In fact, prolonged isolation can be as bad for your health as smoking 15 cigarettes a day!
  1. Older adults frequently find themselves in a season of loss. It may be loss of independence, mobility, health, a long-time career, or someone they love. 
  1. Dealing with chronic medical conditions like: Parkinson’s disease, Stroke, Heart disease, Cancer, Diabetes, Dementia and Alzheimer’s disease, Multiple sclerosis (MS) among others, particularly when painful, disabling, or life-threatening, can lead to depression or make depression symptoms worse.

In a season marked by loss, it can be difficult to tell the difference between someone who is grieving and someone who is depressed. This article from helpguide.org provides some valuable information about grief vs depression, depression vs dementia as well as detailed self-help suggestions. 

What you can do if you think the older adult may be depressed or at risk of becoming depressed

  • Enlist the help of the older adult’s primary care physician and specifically ask them to do a screening for depression.
  • Explore the topic with them. Dawn Carr, PhD, an associate professor of sociology at Florida State University’s Pepper Institute for Aging and Public Policy says, “The most important thing is to be able to develop a relationship where you can talk through and normalize the depression symptoms”. 

Carr suggests asking about the person’s social interactions. “Essentially, speaking about the symptoms of depression is more accessible than simply saying, ‘You seem depressed,’ because that can be confrontational for some people,” says Carr. You might ask:

  • “Are you enjoying spending time with others?”
  • “What activities do you look forward to lately?”
  • “You don’t seem like yourself today. What’s on your mind?”

There are many reasons for hope.

Depression, even the most severe cases, can be treated. The earlier that treatment can begin, the more effective it is. Depression is usually treated with medications, psychotherapy, or a combination of the two.

Treatment is usually covered by private insurance and Medicare. Also, some community mental health centers may offer treatment based on a person’s ability to pay.

Equally important is to remember to care for your own mental health. You must care first for YOU so that you can even begin to show up well for the people you love in your family circle.

Can I just say, “Good work!” to you? Here you are loving the older adults in your family circles, not only through a pandemic, but through the bumps and turns in your own life. Through it, you are paying thoughtful attention, caring and advocating well. 

This is dedicated to my Uncle Howard, whose huge heart matched his huge smile.

If you or someone you care about is in crisis, please seek help immediately.

  • Call 911
  • Visit a nearby emergency department or your health care provider’s office
  • Call the toll-free, 24-hour hotline of the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255); TTY: 1-800-799-4TTY (4889) to talk to a trained counselor
  • Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Helpline, 1-800-662-HELP (4357) (also known as the Treatment Referral Routing Service), or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.
  • Also visit the online treatment locator, or send your zip code via text message: 435748 (HELP4U) to find help near you. Read more about the HELP4U text messaging service.

Honoring mothers

A heart-forward Mother’s Day

It’s my day.
It’s my own mother’s day. 
It’s my wife’s day.
It’s my partner’s day. 
It’s my grandmother’s day.
Basically, it can be a complex day. 

Emotions come with all those relationships, past and present. It’s easy to get stuck in those complex emotions. 

Wade through the emotion and bring the honor.

Our vision at Ways & Wane is to bring honor and respect to older adults. 

Which of these ideas inspires your perspective for Sunday, May 8th? 

  1. Acknowledge the emotion—the joy, the grief, the regret, the love.
  2. Know that you cannot change the past, you can only control how you show up in the present.
  3. Remember that it’s possible that you may not get a second chance to do this.
  4. Make a plan for the day ahead of time so you can be purposeful. 
  5. Keep your expectations low and your heart big. 

We also have some sweet ideas for you, to acknowledge your own mom, whether she is still with you or not.

If your mom is with you, honor her in the manner she feels most loved. What is her  “love language”: words, gifts, time, service, touch? If you don’t know, ask her. Then do your best to give her a gift that matches her love language. 

If your mom is with you (but not entirely), try these ideas:

  • Share happy memories about her from the past, reminding everyone who she is.
  • Celebrate all her senses with her favorite music and scents. 
  • Include the grandchildren – maybe they can do nails for you & grandma!
  • Take an easy trip to a park or a beautiful drive. Just get out of the house.

If your mom has passed away, remember her in one of these ways:

  • Try out a hobby she loved. Maybe doing so will provide new insight into her.
  • Make a donation in her honor.
  • Frame her handwriting (maybe it’s a recipe card or a note).
  • Celebrate another mother in your life.

Whatever the day looks like for you, may you honor and love well!

They looked out for you

They looked out for you

.

They looked out for you;
now you get to look out for them.

You’ve likely heard the stories . . . The widow whose family member sold her property without her knowledge and pocketed the money. The son who intercepted 7 Social Security Checks. The granddaughter who “borrowed” $30K

The FBI estimates that seniors lose more than $3 billion each year to fraudsters. And according to the National Council on Aging, over 90% of all reported elder financial abuse is committed by an older person’s own family members, most often their adult children, followed by grandchildren, nieces and nephews, and others.

Older consumers are attractive targets for financial abuse because they may have significant assets or equity in their homes and usually have a regular source of income such as Social Security or a pension. They may also be especially vulnerable due to isolation, cognitive decline, physical disability, or other health problems. In recent studies, about 17 percent of seniors reported that they have been the victim of financial exploitation, but few cases ever come to the attention of protective services. 

Should you report it?

This is the most heartbreaking part: The U.S. Department of Justice states that although fraud victims are not alone, they often suffer their losses alone and in silence. Shame, guilt, embarrassment, and disbelief are among the reasons that only an estimated 15 percent of the nation’s fraud victims report their crimes to law enforcement. Other reasons include victims’ doubt about their own judgment, a sense of betrayal, and fears about how their family members, friends, and business associates will react. Some victims feel their losses are not large enough to report, do not want to get involved, think law enforcement agencies will not take the crime seriously, or think nothing will result from reporting the crime. Many victims feel they only have themselves to blame, when in reality, calculating, skilled perpetrators are to blame for these criminal acts.

Follow these three fraud safety tips:

  • If you are concerned about possible fraud, remember to approach an older adult gently. They are likely ashamed or in disbelief. If someone has been a victim of fraud, act quickly so the situation doesn’t escalate. 
  • The Federal Trade Commission has an email service that alerts to the most current scams. AARP’s Fraud Watch Newsletter has the same purpose.
  • The National Center on Elder Abuse offers specific directives on calling 911 and contacting local officials specific to your location.  

Did you know that the Ways & Wane Digital Care Advisor has an entire section dedicated to protecting the older adults in your life? Go to “I want to keep my senior safe” to find an even deeper dive into fraud protection as well as protection against falls and other safety hazards. 

Free Helplines

“There are only four kinds of people in the world. Those who have been caregivers. Those who are currently caregivers. Those who will be caregivers, and those who will need a caregiver.”
Rosalyn Carter
professional woman on phone

Have you thought this about your older adult?

✓ My mother-in-law seems less steady on the stairs lately…

✓ My dad doesn’t cook for himself now that he’s alone. I wonder if he could get meals delivered?

✓ After dad’s hip replacement, Mom isn’t going to be able to care for him. How can I find help to come in?

✓ Dad didn’t used to repeat himself, but now I hear the same information over again. I wonder how he’s managing other things?

Your parent, in-law or grandparent may be relatively independent, but you may wonder:

  • how to respond to recent physical or behavioral changes you’ve noticed

  • what you’ll do when their needs increase 

  • what you’ll do if there’s an urgent situation. 

You may not think of yourself as a caregiver. Good—then you have time! Just like you have planned for a child’s continuing education or your own retirement, your caregiving role is something for which you want to carefully and thoughtfully prepare. Without purposeful preparation, you may find yourself drowning in your new part-time caregiver job (which is in addition to, not instead of, your current job) with no time to accommodate a learning curve.

Can’t you just find eldercare answers on Google? Yes and no. 

  • The top results want to sell you one service or product. 
  • They typically cover only one area of senior need—housing (specifically assisted living). It’s easy to get lost in clicking links and trying to figure out what each service offers. Don’t waste your time.

Digital Care Advisor™ to the Rescue

Especially if you are not yet in an active caregiving role you aren’t likely to know about the free government and nonprofit resources that can guide you and answer your questions. It’s why we start the Digital Care Advisor™ with a “My senior needs more help” section. They are the first sources you’ll add to your Action Plan in your Digital Care Advisor™ account.

Three Helplines for Eldercare Answers

These three free helplines can give you eldercare advice: 2-1-1, the Caregiver Action Network and the Eldercare Locator. When you make these calls, start by explaining your situation, then move into your questions. This Helpline Checklist can help you with questions and recording their answers.

Call 2-1-1

2-1-1 is government-funded, but it is not just for the poor. It’s nationwide, but you can call with any need in mind and they will provide you with the names and numbers of local companies, nonprofits or agencies that will provide the relevant services. For example, they can help with resources for prescription payment assistance, legal advice, support groups for caregivers, respite care and other specialized housing options. It is open 24/7 by phone (best) or chat at 211.org. They report that 94.6% of the U.S. population can access a local 2-1-1 center. My call was answered quickly by phone.

Caregiver Action Network

They are a nonprofit and will act as aging life consultants for free. In addition to being available by phone, the website offers a Family Caregiver Toolbox with informative videos on various topics and links to many, many resources and organizations relevant for the established family caregiver. The free Caregiver Help Desk available by phone at 855-227-3640.

Agency on Aging’s Eldercare Locator

This government service provides geriatric care consulting for free. They can offer information about transportation options, home modification, elder rights and long term care planning. They can also inform you about other local caregiving services, like those provided under the National Family Caregiver Support Program. Find your local Eldercare Locator on their website by easily adding your zip code. Or call 800-677-1116, Monday – Friday, 9am – 8pm EST.

These easy and free-to-access organizations provide fantastic resources for a myriad of questions and needs. Once you’ve saved them in your Action Plan, you will know exactly where to find them.

For those of you already using Wane for Work through your employer benefits, you know that your Digital Care Advisor™ is your 24/7 source for all the support you need. You also know that should you need one-on-one help, Ways & Wane has a Certified Care Advisor to take care of your unique needs. If your employer doesn’t offer support through Wane for Work, ask them if they would add it to your benefits. Companies see the weight of caregiving on their employees and most of them want to support their employees by bringing in resources to help.

May you find joy in loving one another well, wherever you are in your caregiving role.

Elizabeth Dameron-Drew is the Co-founder and President of Ways & Wane. She walked closely with her own father through his years of waning. She lives near Seattle with her two teenage sons, husband and two rescue dogs. 

No falls!

It's the leading cause of death and injury

According to the CDC, every second of every day, an older adult (age 65+) suffers a fall in the U.S.—making falls the leading cause of injury and injury death in this age group. 

The older adults in your life might be healthy and fit. But as I learned first hand, a fall can result in injuries that mean the loss of independence for an older adult. 

Keeping an older adult safe and reducing their risk of a fall can be relationally complex. My personal experience with my very intelligent (and stubborn) father included times where he left his walker behind in order to “practice walking” without it. Then there were the (many) times when he’d hide the motion alarm in a drawer at the adult family home so he could move around in his room without them being alerted. They really appreciated that particular trick of his!

Avoid that emergency call while you are working with these three strategies.

  • Conversation strategies
  • Health-focused steps for fall prevention 
  • Tools to aid and assist

The National Council on Aging has a comprehensive guide called “Falls Prevention: Conversation Guide for Caregivers”. It includes step-by-step information on how to approach the conversation, plus it has a checklist to help evaluate if someone is at risk of falling and would benefit from more preventative measures. 

How to approach an older adult about safety

  • Be considerate with the language used. For example, it is beneficial and supportive to say things like, “I’m worried about you and want to help.”
  • Be mindful of how you describe the changes you have noticed that pose a risk for falling. Be clear that you want to talk with your loved one about their overall safety. You may suggest accompanying the individual to a wellness checkup that includes a falls prevention assessment, which is a simple, routine test, like a blood pressure or diabetes screening.
  • Be mindful of your tone and body language, and be positive. Know the individual’s preferences and communication style. 
  • Recognize that this conversation may need to happen more than once. 

The National Council on Aging outlines 6 practical health related steps to prevent a fall:

  1. Find a good balance and exercise program
  2. Talk to your healthcare provider about a fall risk assessment
  3. Regularly review medications, making sure side effects aren’t increasing the risk of falling
  4. Get your vision and hearing check annually
  5. Keep your home safe by removing hazards
  6. Talk to your family to enlist their support

There are multiple products on the market that can help caregivers keep an older adult from falling. Sometimes it’s as simple as being notified in order to help an older adult move about. 

Three helpful products that reduce the risk of falls

  1. This product from Smart Caregiver has a wireless alarm that can be placed in a convenient location (up to 100 feet away) from the cordless sensor pads. This set has both a cordless bed sensor pad and a cordless chair sensor pad. The alarm sounds when weight is removed from the device or it’s turned off.
  2. This grabber tool is an inexpensive way to allow someone to get something they may otherwise reach too far to get or stand on a step stool to reach. This grabber is foldable, extends to 32 inches and has a magnet at the tip. 
  3. Transfering to and from the bed or the toilet is a common time for a fall. We used transfer poles like these for my dad in both the bathroom and at his bedside. It worked well and was tension mounted so there wasn’t damage to the ceiling or floor. There are also products like this Step2Bed which provides a step, handrail and LED light to assist with getting in and out of bed.

May the falls around you only happen on Monday night football!

Elizabeth Dameron-Drew is the Co-founder and President of Ways & Wane. She walked closely with her own father through his years of waning. She lives near Seattle with her two teenage sons, husband and two rescue dogs. 

Do a Benefits Checkup

Get ready for Medicare Open Enrollment

“Dad, what is this regular charge deducted from your checking account?”

Dad: “I don’t know what that is for.”

“Well you are paying for it every month and if you don’t know what it is, I’m going to cancel it.” (Two hours of phone calls later, it’s canceled.)

The next week….

Dad (calling confused and panicked): “I’m at the pharmacy and they told me my medication isn’t covered! They said the insurance plan for my medicine was canceled!? I have to have that coverage!” 

Do you speak “Benefits”?

It’s a true story! If the daughter had known that his Medicare Part D was charged on his credit card monthly, it would have saved a lot of headache.

But making sense of benefits and coverage is not easy. However, when you look at what it costs not to have the right benefit coverage it’s definitely worth getting it sorted out. With Medicare open enrollment from October 15th to December 7th, now is the ideal time for a “benefits check-up”. 

You can’t do your own mammogram, but you can do your own benefits check.

Three steps to do a benefits self-check:

  1. If you want help figuring out which Medicare program is best for the older adult’s situation, you can call your State Health Insurance Program (SHIP) for free counseling and assistance. This is a great option to get one-on-one guidance regarding Medicare.
  1. Most people on Medicare have a supplemental insurance plan, but not all of them know or use all of the benefits available to them under their supplemental insurance plan. For example, some plans offer things like meal delivery, some have a “store” and give an allowance for things such as medical equipment and coverage for over the counter medicines. If you aren’t sure what the supplemental insurance covers, call the company with a list of the older adult’s needs in mind and see what benefits are offered to address those needs. 
  1. If there is any chance the older adult qualifies for Medicaid, you can take this preliminary test through the American Council on Aging’s website. Once you have a sense of the likelihood of them qualifying you can move forward with that application. Once someone is covered by Medicaid the benefits include inpatient and outpatient hospital services, physician services, laboratory and x-ray services, and home health services, among others.

Two more helpful tips:

  1. To see a list of surprising things covered by Medicare and a graphic that outlines the differences in Parts A, B, C and D, you can read our post titled, “Medicare Covers This”.
  2. Make sure you remember the difference between the terms Medicare and Medicaid since they are very easy to confuse. Try the following trick to help.
    Medicaid: Think of how it ends in “aid”. That will help you remember that it has to do with “financial AID”.
    Medicare: Think of how it ends in “care”. That will help you remember that it has to do with on-going “health CARE”

Here’s the best news! If you want to make sure you have the best benefit plan and coverage for your older adult and you don’t want to figure it out yourself, we have the perfect solution for you. A Ways & Wane Certified Care Advisor can do it all for you. (They can help you start the Medicaid application process.) They will take the time to understand your particular needs and situation and have the expertise to make sure the best coverage is in place.

May you find joy in loving one another well.

Elizabeth Dameron-Drew is the Co-founder and President of Ways & Wane. She walked closely with her own father through his years of waning. She lives near Seattle with her two teenage sons, husband and two rescue dogs. 

Medicare covers this

Don’t spend your hard-earned money on items that insurance will cover

“Family caregivers also spend on average 20% of their already-lower earnings on caregiving-related expenses — money they are not saving for their own futures.” (Forbes, 2021)

Ellen’s mom has trouble sleeping and is having some trouble with incontinence. Ellen spends quite a lot of money per year on sleeping aids and adult “underwear”. She heard about sleep apnea and a CPAP machine and wondered if that was something she should ask her mother’s doctor about. Little did she know that Medicare would cover both of these items.

Wouldn’t it be great to get the most out of Medicare coverage? We chased down some of the items that you may be paying for—and found that Medicare will pay instead!

When you sign up for Medicare, you have to sign up for the Original Medicare policy, which includes Parts A and B. Medicare Part C, is also known as the Medicare Advantage policy. Medicare Part D is an optional add on, just like Part C. Read about the differences of Parts A, B, C and D on medicare.gov.

Medicare covers a range of things, including some products and services that you buy. We pulled together a list of eight items that you may not know are covered by Medicare.

Are you paying for these 8 items?

#1 COVID Test

You pay nothing for this test when you get it from a laboratory, pharmacy, doctor, or hospital, and when Medicare covers this test in your local area.

#2 Screening for Depression

Medicare Part B covers one depression screening per year. 

#3 Incontinence Supplies

There are some Part C plans available throughout the country that will offer benefits for products like adult diapers. Yet, these plans are only in specific service areas. In some cases, no plans with this benefit may exist in your location, but it’s worth checking.

#4 Insulin

Starting January 1, 2021, you may be able to get Medicare drug coverage through the Part D Senior Savings Model that offers broad access to many types of insulin for no more than $35 for a month’s supply. You can get this savings on insulin if you join a Medicare drug plan or Medicare Advantage Plan with drug coverage that participates in the insulin savings model. This model lets you choose among drug plans that offer insulin at a predictable and affordable cost.

#5 A CPAP Machine

One surprising piece of equipment that is typically covered, partially, by Medicare is a Continuous Positive Airway Pressure (CPAP) Therapy equipment. This machine helps those who are diagnosed with obstructive sleep apnea to breath and sleep better through the night. It also helps those who are sleeping with them from whacking them with pillows to keep them from snoring.

#6 Advance Care Planning 

Advanced care is planning for care you would get if you become unable to speak for yourself.

Medicare Part B covers voluntary advance care planning as part of your yearly “Wellness” visit. The medical staff can help you fill out an advance care directive or POLST form. Medicare may also cover this service as part of your medical treatment. 

#7 Hospice / Palliative Care

There are plenty of Medicare-approved hospices across the country under the Original Medical policy. To qualify for hospice care, a hospice doctor and your doctor (if you have one) must certify that you’re terminally ill, meaning you have a life expectancy of 6 months or less.

#8 Smoking & Tobacco Cessation Counseling 

Medicare Part B covers up to 8 visits of smoking and tobacco-use cessation counseling visits in a 12-month period.

We have done our best to make certain this information is accurate, but confirmation of coverage can only be confirmed through your particular Medicare plan and provider. 

May you find joy in loving one another well.

Elizabeth Dameron-Drew is the Co-founder and President of Ways & Wane. She walked closely with her own father through his years of waning. She lives near Seattle with her two teenage sons, husband and two rescue dogs. 

PTO for a parent

“Hi mom, how did it go at your doctor’s appointment today?”

“Well, they said that I needed a new medication to help me remember things.”

“What was the diagnosis that they were treating?”

“I’m not really sure…”

It used to be that she took you to the doctor, sat in the vinyl chair next to the paper covered recliner, asked the doctor all the right questions and filled out all the forms. 

Now it’s you in that vinyl chair and she is sitting on the paper covered recliner quietly, like she used up all her questions when she asked them on your behalf—all those years ago. 

When did you start realizing that you wanted to attend doctor’s appointments together?

It may seem easier to go to appointments with your older adult so you can get the whole story. Although it can be a bit of a tightrope as you respect their independence and ask the tough questions. 

Out of love and necessity, I’ve been an advocate for a seriously ill family member in the hospital and at doctor appointments literally hundreds of times over the past 19 years.

I’ve learned a few things in that time. I’ve summarized it for you.

Six Ways to Be a Bold Medical Advocate

#1. You are the customer. There is something about a doctor title that can be intimidating, but it doesn’t change the fact that they are there to make sure your needs are met. Also, you are paying for the care.

#2. Arrive with your questions written out and don’t let the doctor leave the room until you’ve taken the time you need to make sure all the questions were asked and the answers understood. That means even if the doctor is standing at the door waiting while you are reviewing your notes.

#4. If you aren’t given the expertise, time and attention you need, find a new doctor. You don’t need to tolerate care that doesn’t meet your needs. It’s even okay if it’s because the doctor’s attitude or demeanor isn’t a fit.

#5. Ask for what you need. One time (to avoid embarrassing my family member) at check in I told the receptionist that I wanted to talk to the doctor privately at some point. Another time I asked the nurse to use the term “coach” instead of “hospice” in front of my dad. Many times I asked for a hallway conversation. 

#5. Make sure you know how to contact the doctor for follow-up concerns or questions. Weekend? After hours? Text? Email? As information sinks in, more questions will likely arise.

#6. Don’t hesitate to ask the doctor to use plain terms and simple explanations if they are using terminology that isn’t easy to understand. It’s okay that you (probably) didn’t go to medical school. I have some training through Grey’s Anatomy, but it may not be complete.

Use the right tools

One of the tools I have always used is a portable medical planner. I tried keeping notes on my phone, but found that it took too long to bring it up and type in answers, etc. so I used all my experience at the doctor’s office and hospital to create what I believe people need. I even designed the cover and taught myself InDesign so I could do the layout. Then I added pockets for organizing all the things. Just today, we got this feedback which delighted me…

“I received the GoKit yesterday and I was very impressed. Here are some of my first impressions:

  1. Loved the size. Easy to carry.
  2. I like that it doesn’t look like a medical document planner. That was important for my family because my mom wanted to look at our homemade notebook and we had to disguise it.
  3. I like how the book reminds, encourages and speaks to the caregiver in the blue bubbles.
  4. It is great that the divider pages are color pages. Relaxation technique built in!
  5. If I had received this from my employer, I would have felt totally supported and cared about!”

Click here to download a page from the “Doctor” section of the planner. Use it to help you prepare and navigate the next appointment for your older adult.

May you find joy in loving one another well.

Elizabeth Dameron-Drew is the Co-founder and President of Ways & Wane. She walked closely with her own father through his years of waning. She lives near Seattle with her two teenage sons, husband and two rescue dogs. 

In-Home Care Program

I wonder if the older adult you are caring for qualifies for this federal and state funded program?

PACE enables certain home-dwelling elderly individuals to remain in the community rather than receive care in a nursing home.

PACE stands for Program of All-Inclusive Care for the Elderly. It’s a partnership between a state’s social services and federally-funded Medicaid or Medicare. There are 272 PACE centers in 30 states, serving approximately 55,000 participants. PACE organizations provide care and services in the home, the community, and the PACE center. Medicare and Medicaid funds are used to cover all medically-necessary care and services provided by PACE. While each PACE program follows specified guidelines, each center is independently run so services may vary.

If your older adult qualifies for this program, it could be a game changer! Following is a fast-track checklist to determine if PACE is an option for the older adult in your life.

family caregiver making notes

Does the older adult meet the following criteria?

✅ Is 55 years old or older

✅ Is a full-time resident in the service area of a PACE organization (This includes these states: Alabama, Arkansas, California, Colorado, Delaware, Florida, Indiana, Iowa, Kansas, Louisiana, Maryland, Massachusetts, Michigan, Ohio, Oklahoma, Oregon, Nebraska, New Mexico, New York, North Carolina, North Dakota, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Virginia, Washington, Wisconsin, Wyoming.)

✅ Lives within the geographic area covered by a PACE center in their state. This map shows the specific PACE locations in each state. Also, because new programs are being added, check the map to see the most current national coverage information.

✅ Can be certified by the state in which they live as meeting the need for nursing home level care

✅ Is able to live safely in the community with the help of PACE services

✅ Qualifies for Medicaid. PACE centers may be able to help you fill out Medicaid paperwork and check to see if you qualify. (You can access PACE by paying privately. The private pay amount is usually on par with the cost of a nursing home, but the participant would still have the cost of their own living situation so paying privately for PACE doesn’t really make financial sense, that’s why 90-95% of PACE participants qualify for Medicaid.)

If an older adult qualifies based on the criteria above, PACE can provide:

  • Adult day primary care (including doctor and recreational therapy nursing services)
  • Dentistry
  • Emergency services
  • Home care
  • Hospital care
  • Laboratory/x-ray services
  • Meals
  • Medical specialty services
  • Nursing home care
  • Nutritional counseling
  • Occupational Therapy
  • Physical therapy
  • Prescription drugs
  • Preventive care
  • Social services, including caregiver training, support groups, and respite care
  • Social work counseling
  • Transportation to the PACE center for activities or medical appointments, if medically necessary. You may also be able to get transportation to some medical appointments in the community.

This brief video gives a glimpse of life at a PACE program.

Pay special attention to these other key points about the PACE program:

  • When enrolled in PACE, participants must receive Medicare and Medicaid benefits solely through the PACE organization. This means that you may have to change doctors and use the providers at your PACE center. 
  • PACE assumes total financial risk and pays for ALL health care services. This means that if the participant is hospitalized or needs surgery and rehab, all that cost is covered when arranged by PACE.
  • The interdisciplinary care team at PACE works with the participants and their caregivers to create a plan of care, meaning the participant and caregiver have a voice in the care plan. Also, because providers usually care for a small number of people, they get to know their patients and care is less fragmented.
  • Financing for the program is capped, which allows providers to deliver all services participants need rather than only those reimbursable under Medicare and Medicaid fee-for-service plans. For example, Medicare will only pay for a certain amount of physical therapy, but PACE doesn’t have that limitation.
  • PACE organizations are required to provide enrollees with all medically necessary services, including drugs, without any limitation or condition as to the amount, duration, or scope.  
  • Medical equipment can be requested and provided through PACE.
  • PACE provides all the care and services covered by Medicare and Medicaid when/if authorized by the PACE health care team. If the health care team decides you need care and services that Medicare and Medicaid doesn’t cover, PACE may still cover them.
  • If you need help completing a Medicaid application to enroll in PACE, your local PACE center can help you with that process.
  • Participants can disenroll at any time and resume their Medicaid and Medicare programs.

If an older adult meets the criteria for PACE and has access to one in their area, it could allow an older adult to age in their own home. That’s a dream come true for many! If you are ready to dive even deeper into PACE, we can evaluate it and other paying for care options with our stress-free Paying for Care service.

May you find joy in loving one another well.

Elizabeth Dameron-Drew is the Co-founder and President of Ways & Wane. She walked closely with her own father through his years of waning. She lives near Seattle with her two teenage sons, husband and two rescue dogs.

Her mom moved in.

Carmen Abela-Burns imagined that living together with her mom would enable them to spend good quality time together taking walks and having lunch. As her mother’s dementia progressed, it unfortunately looked a little different. She was a caregiver to both her mother and step-father for many years. As a thoughtful veteran caregiver, she shared with Ways & Wane the key advice she would give to other caregivers. 

“We want our lives back—and anyone who says they don’t is lying—and yet we don’t want to let our loved one go,” says Carmen.

“We are programmed to care for people to live. We are not programmed to care for people to die. . .  Your role as a caregiver is to care for them in the most loving, compassionate way possible so that they can go, having felt that.”

How do you continue that compassionate care?

Carmen’s message is one of “get support”. That aspect is key to the mission here at Ways & Wane since we also strongly believe that no one should be a caregiver without support from a variety of sources. 

As caregivers who are constantly pouring out, being able to fill your own pitcher through a support network, education and self-care, is the only way to continue to pour out to others. 

You may also like: Her Mom’s Surgery Became a Caregiving Trial Run.

May you find joy in loving one another well!

Elizabeth Dameron-Drew is the Co-founder and President of Ways & Wane. She walked closely with her own father through his years of waning. She lives near Seattle with her two teenage sons, husband and two rescue dogs. When she’s not working on this platform she’s probably creating books, doing research or planning a dinner party while listening to the rain and thinking about her next creative endeavor.