IL Estate Planning Blog

Monday, December 14, 2015

Is Hospice Right for You or a Loved One?

Is hospice care the right option for you or a loved one?

by Paula Spencer Scott, AARP Bulletin, November 2015
An interesting thing happens when Dawn Gross brings up hospice to patients or their families:
"Oh, no, we don't want that!" they often say.
"OK," says Gross, a hospice and palliative care physician in San Francisco. "Tell me exactly what you don't want, so we're sure not to give you that."
Going off to some facility, they tell her. Losing control of care. Being knocked out by morphine. Or — the clincher — giving up. When Gross assures them that hospice isn't at all like that — that two-thirds of hospice care takes place in the person's home or a long-term care facility, that the patient can still receive medical care, and that Medicare and most private health insurers pay for it in full — they often change their minds.
In 2011, about a million people died in hospice — about 42 percent of all those who died, according to the National Hospice and Palliative Care Organization in Alexandria, Va. — and its use is growing.
Still, misconceptions about this end-of-life service abound. As a result, many who might benefit from hospice don't sign up until the very end: About a third of hospice users enroll for less than a week, and the median time is 18 days.
So how can you tell whether hospice is the right choice for you or your loved one? The answer depends on what you believe hospice is, your current goals, and what you think it can — or can't — do for you.
Here's what you need to know.
Hospice is a philosophy of care, not a brick-and-mortar location. Most people say they want to die at home, but only about 1 in 4 end up doing so. One big reason: It's often just too hard. "Trying to care for someone with a serious illness, especially at home, without hospice is like trying to have surgery without anesthesia," says Ira Byock, the executive director of the Providence Institute for Human Caring.
Hospices bring everything you might need to the home — hospital bed, bedside commode, medications, bandages, expert consults — tailored to your needs.
But if you're daunted by home care, or simply don't want a loved one to die in your home, hospice care also is available in facilities and hospitals.
Signing up doesn't mean giving up all medical care. Transitioning to hospice means shifting from one set of goals (how to get longer life through a cure) to another (how to get the best quality of life out of whatever time is left).
"When people say, 'I don't want to give up,' the key is to understand what they think they're giving up," Gross says. Even when a cure is no longer viable, therapies that improve symptoms and raise comfort can continue. "I deliver very aggressive care in hospice," she adds.
If, however, you feel that you have not exhausted all of your treatment options in search of a cure, hospice may not be for you. Medicare hospice rules require forgoing curative treatments.
That may soon change, though. In July, Medicare announced the expansion of a five-year pilot program to 141 hospices in 40 states to allow patients to continue pursuing curative treatments while under hospice care.
You have to qualify for hospice, but you can opt out at any time. To qualify for hospice benefits, either through Medicare or private insurance, two physicians must certify that you have a life-altering condition with an expected prognosis of six months or less. This time frame is arbitrary, however; there's no biological or scientific basis for knowing how long you have left, Gross says.
If you start hospice and realize it's not for you, you can quit. 
How can you know when to try hospice? This should be part of ongoing discussions with your health care team, Byock says — "ongoing" because goals and needs evolve.
You may live longer during the time you have left. Hospice recipients live longer, on average, than those receiving standard care, research shows. A 2010 study of lung cancer patients found they lived nearly three months longer; another study, looking at the most common terminal diagnoses, found the same, ranging from an average of 20 more days (gallbladder cancer) to 69 days (breast cancer).
You can still see your regular doctor. Multidisciplinary by intention, a basic hospice team consists of a physician and nurse (both on call 24 hours a day); a social worker, counselor or chaplain; and a volunteer. Many hospices offer added services: psychologists, psychiatrists, home health aides, art or pet therapists, nutritionists, and occupational, speech, massage or physical therapists. You may also continue to see your regular doctor. And you remain in charge of your medical decisions.
The goal of pain management in hospice is to enable you to live well — not sedate you. "People often mistakenly think pain medicine will make the person sleepy to the point where they can't interact," says Karen Whitley Bell, a hospice nurse for 20 years and author of Living at the End of Life. "To the contrary, if you live with pain unnecessarily, it makes you more tired and irritable, and robs you of quality of life."
When drugs like morphine are used, it's to treat anxiety and to lessen pain, which has been shown to be undertreated at the end of life — not hasten death, as many people mistakenly believe.
Hospice can enrich, and sometimes salvage, the last stage of life. Almost a third of those with a terminal illness die in the hospital, hooked up to machines that do little to halt the process of dying. Hospice is designed to support the more personal aspects of this life stage: reflecting on one's legacy and life meaning, focusing on relationships in a deeper and more intentional way, achieving a sense of closure, and realizing any end-of-life goals, such as attending a grandchild's graduation or getting financial affairs in order.
Hospice is for the entire family. It's not always easy to witness the hallucinations of delirium or understand the body language of someone who can no longer speak, for example. A hospice nurse can help interpret what's happening, or explain the signs of imminent death. And when families need a break, the sick person can spend up to five days at a time in inpatient respite care, such as in a nursing home or hospice facility.
Hospice continues after death. Many people don't realize that optional follow-up grief support for 12 months is included under Medicare rules. "For many of our families, their journey with hospice is only beginning once their loved one dies," says bereavement counselor Anne Alesch. She runs separate support groups for surviving spouses and adult children.
Ultimately, hospice makes space for "the spirit, the love and the quieting of the mind" that tend to take precedence as the body prepares to shut down, says Nina Angela McKissock, author of From Sun to Sun: A Hospice Nurse Reflects on the Art of Dying. Adds Ira Byock: "We make a mistake in assuming that serious illness and dying are mostly medical. They're fundamentally personal."

Paula Spencer Scott is the author of Surviving Alzheimer’s: Practical Tips and Soul-Saving Wisdom for Caregivers.

More on Hospices

As hospice has evolved from a grassroots movement to a booming industry, a few bad apples have inevitably emerged. What should you look for when evaluating a hospice? "There's no easy shortcut to evaluating quality care," says Joe Rotella, M.D., chief medical director of the American Academy of Hospice and Palliative Medicine. But here are some questions to ask.
  • Is the hospice accredited? "Hospices aren't required to be certified or accredited, but those that seek outside accreditation are making a special commitment to quality care," Rotella says. The Joint Commission, Community Health Accreditation Partner, the National Hospice and Palliative Care Organization and other groups have created standards of excellence that participating hospices must meet. Some state agencies also certify hospices.
  • Has the hospice been surveyed by a state or federal oversight organization? If so, when? What were the results? The Affordable Care Act now requires hospices that accept Medicare — almost all of them — to complete surveys and provide data about several quality measures, including how well they manage patients' pain. Eventually the results will be publicly available online. For now, ask if a survey has been done and what the results show.
  • Is the medical director board-certified? Board certification is not a requisite, "but having a medical director who is certified by a medical board as a palliative medicine specialist offers one more assurance of training, experience and overall quality," Rotella says.
  • How many patients does the hospice program care for? Hospices come in many sizes. Although smaller ones may provide more personalized care, larger ones (those serving at least 100 patients) have more resources.
  • What is the typical caseload? Ideally, a hospice nurse or nurse practitioner should manage a caseload with no more than 12 patients. — Peter Jaret

Thursday, November 12, 2015

Practice Forgiveness

Practice Forgiveness

Forgiveness is a choice, not a feeling. Forgiveness helps you let go of hurt and anger—it may or may not help others. It is a process that frees you to live life more fully. Forgiving is not forgetting, excusing, reconciling, or being weak. As one person put it, “Forgiveness was one of the hardest things in recovery for me, but now it means to let go and not to let the people who hurt me keep me locked to them with anger.”

Action for the Day

Practice forgiveness by writing a few practice letters that you will not send. Write the response you’d like to hear from the other person. Then write a letter of forgiveness to that person, accepting the apology and letting the issue go. Remember, don’t send these forgiveness letters. They are meant to help you let go and be free from hurt. You don’t need anyone else in order to achieve this freedom.

Thought for the Day

“When you forgive, you in no way change the past—but you sure do change the future.”

—Bernard Meltzer

This inspiration is from

Field Guide to Life

Quoted from the app Inspirations.

Find recovery resources at Hazelden Publishing.

Saturday, October 10, 2015

What you should know before taking out a reverse mortgage

Taken from Daily Southtown, August 5, 2015   Author: Janet Kidd Stewart

If you took out a reverse mortgage without adding your spouse to the documents, do you know what could happen with the property after you die?

Did you know you could lose the house if you forgo maintenance or get behind on property taxes?

Are you under the impression the mortgage is with the government?

Reverse mortgages, which typically pay homeowners 62 and older a portion of their home equity until the borrower dies or moves, are complex products with provisions that occasionally are a moving target.

So it's little surprise that when the Consumer Financial Protection Bureau recently showed consumer ads about the products to about 60 seniors who had very little knowledge about them, the homeowners had trouble even understanding that the products were loans that have to be repaid.

"As older consumers consider reverse mortgage loans to tap into their home equity, they need to be careful of those late-night TV ads that seem too good to be true," CFPB Director Richard Cordray said in issuing a consumer alert about the products. "It is important that advertisements do not downplay the terms and risks of reverse mortgages or confuse prospective borrowers."

CFPB officials stopped short of claiming any of the 97 ads met the regulatory definition of deceptive marketing practices, and a trade group representing reverse mortgage lenders said it has filed a freedom of information act to review the ads used in the focus groups.

But the false impressions created by the print, TV and web ads pointed out some useful tips for seniors who are starting to research whether such a product is right for them, and recent changes to some of the terms affecting holders of reverse mortgage holders are worth noting.

These are not government loans. While lenders offering federally insured reverse mortgages must comply with certain rules, the loans themselves are not taken out directly with the government.

Read the fine print. Homeowners applying for a federally insured home equity conversion mortgage (HECM) are required to undergo counseling about the terms. Make sure you understand them before signing, including the fact that you could face foreclosure if you fail to maintain the property or pay property taxes. The CFPB said few ads mentioned interest rates or repayment terms.

Widow relief. In a separate action on June 12, the Federal Housing Administration issued a fix on a HECM policy that consumer advocates said had been pushing many widows and widowers into foreclosure after their spouses died because they hadn't been included on the loan. The revision, which eliminates certain requirements for survivors to assume the reverse mortgage, had previously been for mortgages originated after Aug. 4, 2014. Now, holders of earlier mortgages have the same protection.

Home for life. CFPB also said the ads created a false impression that a reverse mortgage guarantees you can stay in the home the rest of your life. In fact, there are upkeep provisions, as well as different financial terms that don't come with the lifetime guarantee. For example, if you take the money out in large installments early in the life of the loan, you could exhaust the payments relatively quickly.


Sunday, September 20, 2015

PLOWS Educational Opportunities

Educational Opportunities


PLOWS will offer a 3 week program on caregiver issues.  The sessions are free and will be held at the PLOWS Council on Aging offices.  Caregivers and other interested individuals are encouraged to attend.  Registration is required.

Where:       7808 College Dr., 5th Floor, Palos Heights

When:         October 14, 21, and 28

Time:           5:30 p.m. to 7:00 p.m.


Week 1 - October 14, 2015:  Medicare D

Elaine Grande, PLOWS Advocacy expert, will discuss Medicare Part D prescription coverage and Medicare Savings Programs.  Participants will learn what to look for when choosing a drug plan, consequences of not signing up, the dreaded donut hole, and assistance programs to pay the premiums for Medicare Parts B and D.  To assess your current Part D plan please bring a current prescription printout from your pharmacy and your Medicare card.


Week 2 - October 21, 2015:  Incontinence

Incontinence is not normal at any age and may be symptomatic of other health issues  Dr. JoAnn Gruca, RN, Associate Professor Emeritus at St. Xavier University, will present this seminar on incontinence developed by the Simon Foundation for Incontinence.


Week 3 - October 28, 2015:  Caring for a loved one with Dementia or Alzheimer's Disease

This session will discuss handling common behaviors associated with the disease.  Specific topics include:  how to handle hoarding/rummaging behaviors, safe personal care, and dealing with depression of caregivers.


To register for one or all programs

call 708-361-0219.



Thursday, September 10, 2015

How the Internet of Things Will Upend Retirement

How the Internet of Things Will Upend Retirement

Taken from the Wall Street Journal- June 1, 2015 

JOSEPH COUGHLIN: The Internet of Things, where all things around you, on you and, soon, in you, begin to talk, offers great potential to improve how well we will live in retirement and older age. These tech-enabled services will support many people who live alone in retirement, often at a distance from family. Just consider that more than 40% of women 65-years-old and older live alone. For those providing care to an older loved one, the services enabled by the Internet of Things will provide additional eyes, ears, and even a helping hand to stressed family caregivers.

Imagine a world where everything around you is “smart.” Everyday devices sense your movement, habits and changes in behavior. Your home will have two architectures: One, the physical design you see and experience every day, and the other a cyber, nearly invisible set of sensors and connected service providers that monitor, manage and motivate daily behaviors to support your well-being. Already today there are countless systems that glow, buzz or ring to remind you to take your medications. Once “dumb” devices that only kept food cold or made your morning coffee are now smart, helping ensure that you are eating and sleeping well. Your refrigerator will track your eating habits while your coffee-maker may signal a change in your sleep habits and morning routine. Connected to health-management call centers, family and friends, your toaster may tattle on your daily carb intake. Even today’s geek-chic wearable device will eventually be a conduit of physiological and behavioral information to your smartphone and beyond. While providing extraordinary benefits, the Internet of Things may also introduce new costs in older age.

Future expenses in retirement have generally been foreseeable. Housing and transportation are the big-ticket items, with health and long-term-care costs being wild cards. However, the Internet of Things will generate a whole new range of future and monthly costs that will soon be as routine as the one-time luxury of cable television. Even off-the-shelf basic monitoring services available today can easily become an additional $100 monthly out-of-pocket expense. Soon the price of new appliances will include a monthly service fee to enable their full range of functionality. For those who might say they will never pay for such “add-ons,” ask if they own a cellphone with a monthly cost, along with a digital service fee that enables the apps they recently bought from the cloud. The Internet of Things will create a new line-item of monthly costs in our retirement budgets. These will be expenses that are neither strictly health care nor communications, but an entirely new price of living well in older age.

Another unspoken cost is less about money and more about information and time. How will individuals or families identify the best fit of appliances, sensors and services to provide both convenience and care in retirement living? There is currently no nationally recognized objective “smart buyer” adviser for cyber-enabled aging. Who will provide the installation, training and maintenance of these services? Today’s call center services will not be acceptable to tomorrow’s user of smart-living technologies. While the Internet of Things promises amazing potential one device at a time, older adults and caregivers want integrated solutions, not products that create more work.

Finally, the Internet of Things is ultimately about communicating information—very personal information. Living in a “smart home” comes at the price of privacy. Users of the Internet of Things must determine that the intimate information they share will be protected by trusted organizations. Moreover, the services provided must produce an extraordinarily high value of convenience and care outweighing costs to retirement savings and privacy.

Tomorrow’s retirement living will be shaped by technology. While high-tech will provide incredible benefits, it will also bring new costs, both financial and social, that should be considered as a new part of retirement planning.

Joseph Coughlin (@josephcoughlin) is director of the Massachusetts Institute of Technology AgeLab. He conducts research, writes and speaks on the future of global aging. His current work focuses on the role of advice and engagement on retirement planning and well-being on


Monday, August 10, 2015

5 Things to Know About 529 College Savings Plans by Terry Savage

5 Things to Know About 529 College Savings Plans - Huffington Post July 29, 2015

Copyright Terry Savage Productions, Ltd.; Distributed by Huffington Post

College savings plans -- known as 529 plans for the section of the tax code that created them -- have become the best and most popular way to save money for a child's or grandchild's education. All the money in the account grows tax-free if it is used to pay for college education expenses. And it can be used for any school in any state.
All 50 states have set up their own plans if for no other reason than it allowed state treasurers to pick and choose which financial firms get to manage assets in the plans. As a result, some plans have higher expenses and/or worse performance than others. Some plans are sold by investment advisors, with added fees and expenses built in, while other, less expensive
versions are sold directly via websites.
Here are five key things you should know about 529 plans:
1.  You can invest in any state's 529 plan. You'll probably want to do some research to determine the best performing, least expensive plan. And your own state may offer a limited break on your state income taxes as an incentive to invest in its plan.
2. The money can be used for expenses at any qualified college or university in any state. With these 529 investment plans (unlike prepaid tuition plans) there is no special benefit or restriction on where your child can go to school.
3. The money in the plan can be used by any child in the immediate family. If one child gets a scholarship or decides not to attend college, another child in the family can use the money. In fact, a parent could open a 529 account before a child is born, presumably for the parent's additional education. Then the account could be passed on to the child.
4. There are no income or asset restrictions on contributions -- and no deduction for contributions to a 529 plan. Most 529 plans let you set up an account with a few hundred dollars and make automatic contributions. But you can contribute up to five years of the allowable annual gift tax exclusion amount (currently $14,000). Each state plan has a limit on the maximum allowable investment in the plan, but you are unlikely to reach that limit!
Many wealthy grandparents use these plans to move money outside their taxable estate, with each grandparent making the full five-year contribution of 70,000 ($14,000 x 5 years) to set up a plan for each grandchild. And the money can be taken back, if needed, by paying taxes on the earnings and a 10 percent penalty.
5. Money in a 529 plan has a smaller impact on financial aid than other college savings. Withdrawals are not counted as income in the financial aid formulas, and assets inside the plan are assessed at only 5.64 percent of their value in determining the aid award -- compared to a 20 percent assessment on other assets owned by a student.
To compare 529 college savings plans, you can go to -- a website that tracks both costs and performance of each state's plan, along with other information. Also, offers reports and ratings on 529 plans through its premium service. Sign up for a free trial subscription to access the information.
There is probably no investment more important than the one you make for your child's education. It will pay to take the time to research your options, and set up a regular plan of investing. That's the Savage Truth.


Understanding 529 College Savings Plans

(Terry Savage is a Registered Investment Advisor, blogger and the author of four best-selling books, including "The Savage Truth on Money." Terry responds to questions on her blog at

Friday, July 10, 2015

Death, Taxes and Your IRA. Ouch.

Taken from the Wall Street Journal, June 11, 2015


Death, Taxes and Your IRA. Ouch.

Your death could be more taxing than you imagine.

Thanks to 2015’s $5.43 million federal estate-tax exclusion, perhaps just one out of 600 deaths this year will trigger federal estate taxes. Yet many heirs still will face steep tax bills, partly because some states levy their own estate tax—but mostly because of the income taxes due on inherited retirement accounts.

If you bequeath, say, a stock in a regular taxable account that has climbed in value, the cost of the investment for tax purposes automatically rises to its current value as of your death. This “step-up in cost basis” means that the potential capital-gains tax bill can disappear.

But if you die owning traditional retirement accounts, such as 401(k) plans and individual retirement accounts, the income taxes owed on withdrawals still have to be paid by your heirs.

Moreover, this tax problem could get a whole lot worse if Congress kills off the “stretch” IRA. Right now, after you die, your IRA’s beneficiaries can draw down the account slowly over their lifetime.

But if the stretch IRA disappears, your heirs may be forced to empty inherited retirement accounts within five years of your death—and the extra income could push them into a much higher tax bracket.

This change almost became law in 2013. The White House proposed eliminating the stretch IRA again this year for all beneficiaries, except for spouses and in certain special situations, and many experts believe it is just a matter of time until the law gets changed.

“I think there’s a better than 50% chance that the death of the stretch IRA will eventually pass,” says Pittsburgh accountant and investment adviser James Lange, author of “Retire Secure.”

All this is bad news for many Americans. For the typical household approaching retirement age, retirement accounts are the second-largest asset they own, after their home, according to calculations by Boston College’s Center for Retirement Research. (This ignores any value assigned to Social Security and traditional employer pensions.)

How much do older Americans have in retirement accounts? According to the Federal Reserve’s 2013 Survey of Consumer Finances, retirement accounts are owned by 48% of families headed by someone 65 to 74 years old, and the median value is $149,000. A 2014 report by the Investment Company Institute, a fund-industry trade group, found that 19.2% of IRA investors age 75 and older have accounts worth $200,000 or more—and the number would be even larger if 401(k), 403(b) and other retirement accounts were included.

What should these investors do? There are three key strategies that many folks ought to consider, and two others that could make sense for some families.

First, you might shelve the standard advice for retirees, which is to tap your taxable accounts first, while leaving retirement accounts to continue growing tax-deferred. Instead, you might hang on to taxable-account investments, with a view to getting the step-up in cost basis upon your death.

“When you think about how much you need to live, you might pull more out of your IRA, rather than spending down your taxable-account assets,” says Alisa Shin, a senior wealth planner at Vanguard Group. “But you want to do it strategically. We don’t want to push you up to the 39.6% tax bracket [with large IRA withdrawals]. But if we can do it and stay within the 25% tax bracket, it could be worthwhile.”

Second, you might convert part of your traditional retirement accounts to a Roth IRA. You will have to pay income taxes on the conversion. But once the money is in a Roth, it will grow tax-free.

To figure out whether converting makes sense, you need to compare the tax you will pay on the conversion to the taxes that will likely be paid by your beneficiaries when they empty the account. For instance, if you can convert and pay taxes at 25%, that would be better than bequeathing a traditional IRA on which your children then pay 33% in taxes.

Third, you might kill the problem with kindness. “Let’s say people are planning to leave some amount to charity,” Mr. Lange says. “If it’s a significant sum, I’d leave IRA money to the charity,” while bequeathing taxable-account money to your heirs.

What are the two other strategies? First, you might consider purchasing life insurance, so your heirs have money to pay your IRA’s income-tax bill. This makes particular sense if your assets also will be subject to estate taxes. Life-insurance proceeds should be income-tax-free, and they also can be estate-tax-free—if you arrange for somebody else to own the policy, such as your children or an irrevocable life-insurance trust.
Second, if the stretch IRA disappears, it may make sense to bequeath your IRA to a charitable remainder trust. As with the stretch IRA, the trust could allow your heirs to enjoy lifetime withdrawals from the IRA, though Mr. Lange notes that the trust isn’t as financially advantageous as the stretch IRA and would involve higher fees.

–Jonathan Clements is the author of the “Jonathan Clements Money Guide 2015.” 


Friday, June 12, 2015

Keeping Your Memory Sharp

People with some forgetfulness can use a variety of techniques that may help them stay healthy and maintain their memory and mental skills.  Here are some tips that can help:

  • Plan tasks, make "to do" lists, and use memory aids like notes and calendars.  Some people find they remember things better if they mentally connect them to other meaningful things, such as a familiar name, song, book, or TV show.
  • Develop interests or hobbies and stay involved in activities that can help both the mind and body.
  • Engage in physical activity and exercise.  Several studies have associated exercise (such as walking) with better brain function, although more research is needed to say for sure whether exercise can help to maintain brain function or prevent or delay symptoms of Alzheimer's.
  • Limit alcohol use.  Although some studies suggest that moderate alcohol use has health benefits, heavy or binge drinking over time can cause memory loss and permanent brain damage.
  • Find activities, such as exercise or a hobby, to relieve feelings of stress, anxiety, or depression.  If these feelings last for a long time, talk with your doctor.

Thursday, May 14, 2015

How are Mom and Dad Really Doing?


Guest Post by Martha Kern:



How are Mom and Dad Really Doing?

Shay Jacobson, RN, MA, NMG, LNCC, CNLCP
Martha Kern

Our parents, perhaps owing to pride or fear or a hope that the situation will pass, may be prone to withholding information about their health and welfare, keeping small lapses and new deficiencies under wraps. Despite our best efforts to keep up with all the events in their lives and the stories they share with us on the phone, we won’t always recognize the very subtle indicators that something has changed.

There are signs, however, that care is needed. In cases where care is already provided, there are signs that the care may not be of the right variety or size.  The possible scenarios in which these signs are offered are endless, but here are examples of the ways your loved ones might be showing you that they need more – or different – help:

  • Bills and taxes are unpaid, or paid incorrectly;
  • A change of subject in the conversation cannot be managed – your Mom routinely changes the subject back to something familiar or tells a joke when more complex topics are raised;
  • Your Dad repetitively asks the same questions or wants to review the same material;
  • A sudden uptick in charitable giving is seen, or checks are being written to unknown parties for unknown services;
  • Uncharacteristically risky behavior appears, such as gambling, excessive spending, inviting strangers into the house, etc.
  • Grooming and hygiene show a decline – odors are present, clothes are stained, your loved one seems to be wearing the same clothes every time you see them;
  • Weight loss is registered for no apparent reason;
  • There are bruises, abrasions and other minor injuries, the origins of which your Mom cannot recall or is reluctant to share;
  • Medical issues present that may stem from inaccurate dosing of medication;
  • Pills linger in various compartments of the pill box, or prescriptions that should last 30 days are gone too soon;
  • The credit card bill shows charges for unnecessary goods and services being purchased from telephone solicitors;
  • Neighbors are paid cash or given elaborate gifts for routine assistance, rides or small household chores;
  • The house appears unkempt – flyers are piled up on the sidewalk, the landscaping is overgrown, grass is uncut, mail is not retrieved from the box;
  • New “friends” have appeared and seem to take an influential role in decision-making;
  • The caregiver is there, but so are members of the caregiver’s family (who might also be living there);
  • The caregiver is NOT there, or your Mom reports the caregiver is often out of the house for repeated, unexplained periods of time (i.e. the caregiver has other revenue streams and is taking your Mom out to attend to business transactions, hair appointments or other self-serving interests unrelated to your Mom for whom they are paid to care);
  • Your Dad’s gradual loss of strength has made it impossible for him to participate in his own transfers. The caregiver is moving “dead weight” and has dropped your Dad more than once;
  • Grandpa has begun to wander and has escaped the home several times when the caregiver was napping or watching television. Vigilant neighbors or the police have found him and brought him back home each time;
  • Bed sores are beginning to form and the caregiver is not strong enough to reposition Grandma;
  • Dad can no longer accurately discern when it is time to take medication and the caregiver, who has difficulty reading English, has been guessing which pill to administer and when to do it;
  • The assisted-living community in which your Mom lives has asked that she leave or will not take her back after a hospitalization;
  • Meals are offered in the independent-living dining room, but your Dad forgets or refuses to go.

There are hundreds more such scenarios, each of which shares a common denominator: A change is noted, whether in behavior, ability, physical status, environmental status, social interactions or in any other sphere of life.  The change may or may not signal a larger problem, but only a thorough assessment by a skilled professional will properly tell the tale.  We have seen many cases wherein one change is noticed and at least five additional changes, all of them indicative of decline, are undiscovered until some investigation takes place.

Crossroads are inevitable for all of us, and are most acutely felt by our most vulnerable loved ones: the elderly, the psychiatrically impaired, individuals with disabilities and those who have suffered brain injury.  If we see signs of decline, there is every possibility that others have seen them, too, and these others may not have honorable intentions.

Exploitation always begins with the detection of weakness or vulnerability.  An assessment or audit of existing care limits risk, identifies areas of concern and develops a plan to strengthen safety and circumvent harm.

Shay Jacobson, President, and Martha Kern, Chief Marketing Officer, can be found at Lifecare Innovations in Burr Ridge and Lake Forest.  Visit the website at for more information about how the company helps those who cannot manage day-to-day life on their own.


Friday, April 10, 2015

Update to March 16th Blog

A few weeks ago I introduced you to Heather McCarthy and Kate Ryan of Someone Special Uniquely Personalized Books.  They started a publishing company to write personalized children’s books for kids with special needs and also for kids whose parents would like to educate their children on special needs.  While other books are personalized with just a child’s name, their books will be personalized on almost every page.  Their mission is to write books to teach kindness, acceptance, and respect differences. Through their uniquely personalized books, parents are given the opportunity to tell their child’s story using their own words. Children are given the chance to see their name and learn about their condition in a way that shows they are no different than other kids, but just as special.

Their Kickstarter Campaign has started on April 6, 2015.  For more information about their project (and/or to donate) please visit:

Monday, April 6, 2015

Illinois Nursing Homes Watch List provides information on nearly 16,000 U.S. nursing homes, including easy-to-understand Nursing Home Reports based on recent government surveys. 

This website provides easy-to-read reports to help families choose the right nursing home for their loved ones. State survey results for health, fire-safety, and other violations and complaints will help you choose a qualified home for your loved one.

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With two offices in Oak Lawn and Oak Brook, Stephen M. Sutera assists clients throughout Cook County, DuPage County and Will County IL including Chicago, Hometown, Barrington, Burbank, Burr Ridge, Chicago Ridge, Darien, Downers Grove, Evergreen Park, Geneva, Worth, Bridgeview, Palos Park, Palos Hills, Palos Heights, Hickory Hills, Midlothian, Willow Springs, Oak Forest, Orland Park, La Grange, Brookfield, Berwyn, Tinley Park, Hinsdale, Villa Park, Clarendon Hills, Westchester, Westmont, Lombard, Elmhurst, Western Springs, Berkeley, Downers Grove, Fox Valley, Glen Ellyn, Willowbrook, Aurora, Addison, Lisle, Forest Park, Bensenville, Wheaton, River Forest, Itasca, Shorewood, Frankfort, Mokena, Naperville, Crest Hill, Homer Glen, New Lenox, Bollingbrook, Schaumburg, Channahon and Woodridge.

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4927 W. 95th Street, Oak Lawn, IL 60453
| Phone: 708-857-7255
2021 Midwest Road, Oak Brook, IL 60523
| Phone: 630-396-6800 | 708-857-7255
250 Monroe Avenue Northwest, #400, Grand Rapids, MI 49503
| Phone: 616-717-5752 | 708-857-7255

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