Articles Posted in Elder Law

“There is a time for many words, and there is also a time for sleep.” — Homer

 
Sleep, like food and water, is essential for humans to survive. Sleep affects almost every type of tissue and system in the human body. The brain, heart and lungs perform functions while you sleep. Similarly, your metabolism and immune system perform functions while you are sleeping. Sleep also affects your mood and ability to resist and fight diseases. Research shows that a chronic lack of sleep, or getting poor quality sleep, increases the risk of cardiovascular disease, diabetes, depression, and obesity. The next day you feel exhausted, tired, or fatigued after a poor night’s rest.

 
What is sleep?

We are examining sleep and its role in our overall health and wellbeing. There are individuals that suffer from sleeping disorders, not just insomnia, that affects the quality of their sleep. As our last post examined, during sleep our bodies repair and resets itself. Interrupting that process, due to poor sleep, causes consequences the next day and to your overall health.

 
Do you or your partner snore?

 
“The one who snores will fall asleep first.” Proverb

There is a book by John Green called, “The Fault in Our Stars,” that was made into a movie, about teens who fall in love while undergoing cancer treatment. It’s a real tearjerker, no spoilers here. One of my favorite passages in the book is when the main character Hazel Grace Lancaster’s mother tells her “sleep cures cancer.”

 
Sleep cures cancer

For anyone suffering with cancer, this phrase functions as both an affirmation and a command. Sleep makes coping with cancer better and helps the body physically repair itself. Sleep however is very difficult to get to when suffering from cancer. Fear, hope, dread, and solace feelings as well as physical aches and pains constantly fight for your attention, especially when you attempt to sleep with cancer.

As we get older, changes to our sleep patterns occur. In fact, a normal part of the aging process is different sleep. People often report that they have trouble falling asleep and staying asleep as they age. Every night, people achieve sleep, by experiencing periods of light and deep sleep. For the most part, during sleep, our bodies remain still as our minds and body functions race to repair and reset themselves. Some of us even dream, vividly experiencing feelings and sensations all while laying perfectly still.

 
The trouble with achieving deep sleep

As we age, older people spend more time in the lighter stages of sleep rather than in deep sleep. People often report that they were able to fall asleep but then woke up and could not return to sleep. Our bodies need deep sleep to perform functions on just about every organ, tissue, and system. Individuals suffering from chronic illnesses, like high blood pressure and cancer, need sleep to heal and get batter. Instead, older people report that the next day after poor sleep quality their mood and ability to perform active tasks is affected by fatigue.

Last week, the Trump Administration announced two regulatory changes in an effort to provide price information to patients about the medical services they are undergoing. President Trump has made price transparency a centerpiece of his health care agenda.

 
Hospital will be required to display their negotiated rates to patients

The first regulatory change, scheduled to become effective in January 2021, will require hospitals to display their secret, negotiated rates to patients starting in January 2021.

Very few people look forward to living in a nursing home the last years of their lives. There is a growing segment of the population that wishes to remain in their homes as long as possible. To do so however, assistance is needed from medical professionals and home health aides.

 
Continuing care retirement communities

Continuing Care Retirement Communities, also known as CCRCs, are well known to retirees. The premise is that residents live on a campus-like setting in facilities that change as their care needs increase. For example, a CCRC resident may begin at independent living facility, shift to assisted living, and enter a memory-care unit or nursing home. Where a resident starts depends on their overall health, mental faculties, and mobility level.

A recent story out of Virginia recently received a great deal of national attention. An 83-year-old grandmother of five and great grandmother of five received a “Notice of Lease Violation” from the management office of her assisted living facility.  

 
What was the infraction?

It appears that Ms. Elsie Cruey had taken too many cookies from a community event. Ms. Cruery had previously run afoul of the community house rules when she took a partial gallon of milk after breakfast. She had hoped to combine the milk with the cookies she took as a late night snack.

Hospitals across the country are suing patients for unpaid bills. Insured patients are the primary target for these lawsuits. Hospitals are making bold assumptions about their patient’s ability to pay. They are of the belief that if the patient has insurance, then they are able to pay the outstanding balance. The patient’s perspective is quite different. They do have insurance but cannot pay their deductible or copayment. High costs and low wages are the main reasons why patients cannot pay their medical bills on time.

 
Deductibles Have Tripped in the Last Decade

According to the Kaiser Family Foundation, today 82% of employer health plans have a deductible. In 2006, only half of employer health plans had a deductible. That is up 32% since 2006. The average deductible has also increased from $584 in 2006 to $1,655 today.

Social Security Income (SSI) is a needs-based program administered by the Social Security Administration (SSA) to help people with disabilities pay for goods and services. In 2018, SSA made major changes to how Special Needs Trusts (SNT) are set-up and administered. What follows is a brief explanation of the program and the changes implemented beginning in April 2018.

 
Who is affected?

Approximately 7 million people receive SSI, a needs-based cash benefit to help pay for food and shelter. In 2019 the cash benefit amount for a single person was $771 per month; for couples the monthly cash benefit was $1,157. The cash benefit amount will increase in 2020, with couples scheduled to receive $1,175 per month and individuals $783 per month. For a couple to receive SSI their must be an eligible individual plus an eligible spouse.

Is an advance directive enough to ensure that your wishes are followed when you cannot express them because of disease or illness that affects your ability to make decisions for yourself? Physician Orders for Life-Sustaining Treatment (POLST Orders) for short, are often confused with advance directives. These medical care planning tools are very different from each other.

 
What is an advance directive?

An advance directive consists of a living will and a health care power of attorney. Every adult, regardless of age, should have one and update them from time to time, especially following a diagnosis of a serious medical condition.

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