Relax Away the Stresses of Caregiving

With an aging population and changes in health care, such as shorter hospital stays, more and more caregiving is being provided by family members. If you’re a caregiver, you know that taking care of a loved one can be very rewarding. But being a caregiver can be stressful at times. It is important to take care of yourself, so you are able to take care of others. There are many ways to reduce the stress and relax, but reducing stress can be stressful in its self. Many caregivers are trying to balance jobs and their own families needs along with caregiving so finding time go to the gym to work out or get a massage or even taking the time to have coffee with a friend becomes stressful.

Here are two relaxation techniques that are great stress reducers that you can do in just a few minutes in the comfort of your own surroundings: Breathing and visualization.
Deep breathing is very relaxing and can have the added effect of lowering your blood pressure. At first, this way of breathing may feel awkward, but once you become familiar with the technique, you will be able to reduce stress on the spot by taking a few deep breaths. The procedure is very simple and effective:
1. Find a quiet place where you know you will not be disturbed.

2. Lie down on a flat firm surface on your back and put your
right hand on your diaphragm (just below the belly button).

3. Close your eyes and breathe through your nose.

4. Put your left hand on your upper chest. You should feel no movement here. The breathing should come from your diaphragm and your right hand will gently rise and fall.

5. Notice the feeling and how it differs from chest breathing.

6. Consciously breathe through your nose, keeping your mouth closed. Feel the rising and falling of your diaphragm.

7. When you become used to breathing into your diaphragm, bring your attention to the flow of your breath. Just notice the flow. Is it smooth or jerky? Smooth it out; make it flow gently and smoothly.

8. Do not rush your breath. Be gentle. Let it flow and you will discover a rhythm to the breath.

Visualization relaxation is a relaxation technique that uses the power of your imagination to reduce anxiety, induce feelings of peace and calm, and bring on a general sense of well-being. Visualization is very individualized as it allows your mind to take you to a place that is peaceful and relaxing for you. For me it is sitting on a secluded beach on a bright sunny day, watching the waves as they form whitecaps and listening to the rhythmic sounds as they wash up on the beach. Overhead I hear the sounds of the seagulls as I feel the breeze coming off the ocean gently brushing my face. Explore what you find relaxing.

Visualization is simple, but takes some practice and once you discover your place, you can go there anytime the stresses of caregiving become overwhelming.
With regular practice of deep breathing and visualization exercises, you will be able to evoke sense of peace, calm your mind, and relax your body allowing you to be a better caregiver, while also taking care of yourself.
Steve Kramer

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Personal Environment-Make it Safe and Comfortable

The word environment usually produces images of the great outdoors, but let’s take it a step further and consider our personal environment, especially as baby boomers age in place or mom and dad move in with their children. The space needs to be both safe and comforting.

As we age, the risk of falling increases dramatically. To reduce this risk, create a safe environment that is free of clutter by keeping walkways clear. Remove items such as throw rugs and electrical cords which are trip hazards. Rounded corners on furniture are best to minimize injury should a fall occur. Make sure the furniture has sturdy arms that will assist in standing.

Keep the interior rooms well lit to compensate for reduced visual acuity. Paint the walls a bright cheerful color. Replace wall switches with the rocker style that are easier to operate. Grabbing and twisting the standard round door knobs is very difficult for someone with arthritic hands. Instead install the lever style knobs that can be pushed down to open the door.

In the kitchen, if the person is still preparing meals, place pots, pans, dishes and other items at waist level to keep from having to reach or bend down to retrieve the items. Both actions are a risk for loosing ones balance and falling. Having the microwave installed above the stove, as many homes do have, creates more counter space. But having to reach for the items can be hazardous for an elder by either losing their balance and potentially falling or spilling hot food on themselves causing burns. To prevent this, place a microwave on the counter within easy reach.

The bathroom is often considered the most dangerous room in the home for an elder. The combination of water and slick floor surfaces is a disaster waiting to happen. To reduce the risk of injury from a fall, place a non-slip mat in the shower stall and just outside the shower if the flooring is tile. Use a shower bench and hand held shower to make showering safer. Have grab bars installed in both the shower and toilet areas to provide security when using these areas. Although they make grab bars that can be held in place with suction cups, I recommend the bars that are permanently affixed to the walls. Using a professional installer is also recommended. Install a raised toilet seat to make its use easier. If there are no grab bars that are within reach, consider attaching a seat that has arms on each side to assist with sitting and standing.

If you are having an elder loved one moving in with you, make sure they bring items that they treasure and provide them comfort, such as a favorite chair or things that have sentimental value, even if this means having to move or store some of your belongings.

Helping to create the personal space environment that is both safe and comforting for an aging loved one is very rewarding. Be creative and have fun doing so.

Steve Kramer

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Simplify Your Life

Life is really simple, but we insist on making it complicated.

This is so true. As we move through life we tend to gather unnecessary stuff, whether it is material possessions, unrealistic expectations or emotional baggage and it all complicates our life. I have recently decided to down size my life to reduce the self made complications. I plan to focus on what is in front of me each day and do the best I can with what is given. Get rid of material stuff that is often a reminder of unfulfilled expectations. Listen more and talk less. Become more involved in the community to do what I can to help others. Let go of the past and stay in the present. Simplify my life.
What are your thoughts on how to make life less complicated?

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4 Myths About How to Act When Someone’s Dying

By Paula Spencer Scott, senior editor
(This is often an unspoken topic in our society, but so important in the transition from this life to the next. Please help spread this message by reposting. Steve Kramer)

People often adhere to a code of conduct about the end of life that’s just not rooted in common sense or reality — especially when it comes to how to talk to someone who’s dying, in their final days or hours. Hospice nurse Maggie Callanan, who has attended more than 2,000 deaths, wrote her book Final Journeys: A Practical Guide for Bringing Care and Comfort at the End of Life in order to take on these myths:
Myth: Don’t cry in front of the dying.They know you’re sad. Having the courage to bare your emotions gives the dying person permission to be candid about his or her own feelings. Your tears are evidence of your love. And they can also be a relief to the person, telegraphing that you understand what’s happening.
Myth: Keep the children away.People often steer kids away from death so they’ll remember the person in a good light and not be frightened. But most kids do well with simple explanations of what’s happening; facts are usually less scary than their vivid imaginations. By cordoning off a child from a natural part of life, you also deprive the dying person of a beloved, comforting presence.
Myth: Don’t talk about how you expect your life will change after the dying person has passed away.It’s not like they’ll feel left out. You can be sure the dying person is thinking about your life after his or her death — people are often deeply concerned about this. It’s reassuring to hear that loved ones will look after one another.
Myth: If you don’t deal with death well, it’s OK to stay away.Some people excuse themselves from visiting a dying person with phrases like, “I hate hospitals” or “I want to remember X the way she was.” This is saying that your discomfort is more important than the dying person’s final needs.
“You have a responsibility,” Callanan says. “If someone has played a positive part in your life, that person deserves your attention as his or her life is ending. I’ve seen too many devastated people dying too sadly, waiting for someone who never came.”

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Changes Could Improve Medicare and Seniors’ Health

If you’ve been frightened by all the gloom and doom talk in Washington about the future of Medicare, the good news is that the Affordable Care Act (ACA) actually strengthens the health care program for seniors and offers preventive services that should boost your health. The act also starts to close the so-called and much maligned “donut hole” for prescription drug costs, which should boost your pocketbook.
By pledging to reduce waste, fraud and abuse, and slow Medicare cost increases, the ACA also extends the life of the Medicare Trust Fund, which manages Medicare, from 2016 to 2024. The ACA makes other promises to ease fears about Medicare. Traditional Medicare-covered benefits cannot be reduced or taken away, and Medicare Advantage Plans, which are private insurance plans, must continue to provide traditional Medicare benefits. Further, Medicare spending reductions should not result in rationing care, reducing or changing benefits or eligibility, or increasing co-pays or premiums.
Among other reforms, the ACA intends to provide hospitals with new incentives to improve the quality of care and, starting in 2014, to offer additional protections for Medicare Advantage plan members by taking steps that limit the amount these private plans spend on administrative costs, insurance company profits and services other than health care.
Closing the Drug “Donut Hole”
Before the ACA, as a result of the infamous Medicare Part D “donut hole,” or coverage gap, Medicare recipients received assistance paying for medications only up until a certain dollar amount and then had to pay for drugs out of pocket until they reached another dollar amount. The ACA closes the donut hole over the next 10 years and provides financial help until the gap is fully closed. In June 2010, the government mailed $250 rebate checks to help seniors pay for their medications, and in 2011, seniors received a 50 percent discount on approved brand-name prescription drugs. While in the donut hole, seniors also get a 7 percent discount on generic drugs. In 2013, the Part D coverage gap starts at $2,970 and extends to the catastrophic coverage threshold of $4,750.
While in the coverage gap here’s what you’ll pay for drugs up until 2020, when the gap is closed.
• 2013: 47.5% for brand-names and 79% for generics
• 2014: 47.5% for brand-names and 72% for generics
• 2015: 45% for brand-names and 65% for generics
• 2016: 45% for brand-names and 58% for generics
• 2017: 40% for brand-names and 51% for generics
• 2018: 35% for brand-names and 44% for generics
• 2019: 30% for brand-names and 37% for generics
• 2020: 25% for brand-names and 25% for generics
Preventive Services
To improve seniors’ overall health, under the ACA, Medicare allows a free annual wellness exam and covers certain preventive services, such as nutrition therapy, without charging the Part B coinsurance or deductible.
As of 2012, the annual wellness visit benefit includes the following services:
• Routine measurements, such as height, weight, blood pressure, and body mass index
• Review of individual medical and family history
• Review of the beneficiary’s medications, supplements and vitamins
• Discussion of care from other health care providers
• Review of functional ability and level of safety (for example, risk of falling at home), including any cognitive impairment, as well as a screening for depression
• Personalized health advice that takes into account risk factors and specific health conditions or needs, including weight loss, physical activity, smoking cessation, fall prevention and nutrition
• Referrals to other appropriate health education or preventive counseling services that may help minimize or treat potential health risks
Under the ACA, Medicare covers many preventive services, including counseling for tobacco-use cessation, whether or not you have been diagnosed with an illness caused or complicated by tobacco use. (However, if you have been diagnosed with a tobacco-related illness, the co-insurance and deductible will apply.) See sidebar for a list of services and screenings that Medicare covers.
You may have to pay co-insurance for the office visit when you get these services. If you’re in a Medicare Advantage Plan, check with your plan to see if these benefits will also be free for you.
Other Provisions of the ACA
Medicare fraud, including billing seniors for services that weren’t performed, can cost billions of dollars each year. To fight this waste of money, the ACA allocates $350 million to fight fraud as well as provisions that go after those who defraud the system.
The ACA also protects the society’s most vulnerable. The Elder Justice Act, part of the ACA, provides approximately $500 million (of $770 million for the act) from 2010 to 2014 for adult protective services. The federal government provides previously unavailable support and resources for state-based adult protective services and prosecution of crimes against the elderly. The act also addresses nursing home care, requiring skilled nursing facilities under Medicare and nursing facilities under Medicaid to disclose information regarding ownership, accountability requirements and expenditures. Such information will be standardized and published on a website so that Medicare enrollees can compare nursing facilities.
Future of Medicare
While Medicare seems secure for now, the future could bring serious conflicts: the government’s attempt to rein in the budget, rising health care costs, baby boomers reaching Medicare age and a dwindling pool of younger people to pay for Social Security and Medicare.
Some options to maintain Medicare include raising Medicare premiums and co-pays for higher income beneficiaries and/or raising premiums for everyone. Other ideas under consideration are requiring drug companies to give rebates or discounts to Medicare, increasing co-pays and out-of-pocket costs for home health care and nursing homes and generating new revenue by increasing payroll taxes.
However, Harry (Rick) Moody, director of academic affairs for AARP in Washington, D.C., says the question is, “What is your goal? To save money or make people healthier?”
AARP’s view is that it’s possible to save money in the Medicare system. “We can do that in ways that don’t harm beneficiaries but benefit them,” for example, reduce “revolving door” hospital discharge plans, where people are prematurely discharged, get sick and are readmitted again.
Other ways to decrease Medicare costs are to reduce medical errors and eliminate procedures such as surgeries and screenings that have no benefit, he says. By reducing costs, health care can also improve.
In the United States, two of the biggest problems with health care are overtreatment and wrongful treatment, Moody says. “The harm caused by overtreatment is endemic in the health care system.” For example, many heart patients are advised to take aspirin to prevent strokes, but aspirin can cause macular degeneration, and some biopsy procedures have risks. “People are not adequately apprised of risk potential.”
At the same time, the ACA takes a big step toward preventing serious and costly illnesses, such as breast cancer or diabetes, by including preventive measures in its coverage. In fact, the Independent Payment Advisory Board created by the ACA, consisting of 15 medical experts (nominated by the president and approved by the Senate), could be part of the discussion. If Medicare spending exceeds the growth rate of the economy plus one-half percent, the board must make recommendations to reduce spending.
Whatever happens with the budget discussion, Medicare, at 21 percent of the budget in 2011 (along with Medicaid and the Children’s Insurance Program), will be part of the debate.

“Seniors and the Affordable Care Act,” webinar for Society for Certified Senior Advisors,® Jan. 24, 2013, by Robert Semro, policy analyst for Bell Policy Center,
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Making Tax Time a Little Bit Easier

Reprinted from the Senior Spirit Newsletter, a CSA Publication

It’s that time of year again, a time of teeth-gnashing and pencil-crunching, as we haul out our receipts and statements from last year and prepare to do our federal income tax returns. As tax deadline approaches, you may not be aware of all the deductions available to seniors or that free tax help is available in your neighborhood.

Medical and Dental Expenses
When you were younger, you might not have had enough medical expenses to make it worthwhile to itemize your deductions on Schedule A and instead took the standard deduction. However, increased age not only brings more wisdom but more medical issues and expenses. One estimate is that as much as 30 percent of a senior’s income is allocated to health care costs.
Not all of those costs are covered by your insurance plan or Medicare. In fact, the list of deductible medical and dental issues is exhaustive. For instance, you can deduct the cost of acupuncture, stop-smoking clinics and contact lenses (see sidebar). Other deductibles are health insurance premiums (including Medicare premiums), long-term care insurance premiums, prescription drugs, nursing home care and most other out-of-pocket heath care expenses.
You must include only the medical and dental expenses you paid this year, regardless of when the services were provided. That is, if you bought new glasses last year, but didn’t get the bill until this year, you won’t be able to deduct it until your 2013 taxes come around. And these are only for expenses you paid yourself; if the insurance company paid the tab, you can’t take the deduction.
Medical and dental expenses must exceed 7.5 percent of your adjusted gross income (AGI) in order to qualify for a deduction; this increases to 10 percent for 2013, making it more difficult to access next year. Similarly, itemized deductions will be subject to phase-outs beginning in 2013. For example, if your AGI was $100,000 in 2012, only your medical expenses above $7,500 (7.5% x $100,000 = $7,500) would be deductible. If you had $10,000 in medical expenses in 2012, you could deduct only $2,500 ($10,000 – $7,500).

Standard Deductions for Over 65
Even if you don’t itemize your deductions, if you are 65 or older by Dec. 31 of the tax year, you can take a standard deduction for your age. Single people over 65 can claim $1,450, while married people can take an extra $1,150 for 2012. You can also claim the higher deduction if only your spouse is older than 65 and you file a joint return. You qualify for a higher standard deduction if you are totally or partially blind—that is, you do not have corrected vision of at least 20/20 or you have an extreme limitation in your field of vision. These standard deductions will increase in 2013.

Retirement Plans
Another gift from the government is higher contribution limits for retirement plans (again, increasing in 2013). Once you turn 50, you can contribute more to an IRA, Roth IRA or 401(k). This means socking away more money in an IRA without having to pay taxes on it. (With the Roth IRA, you pay taxes upfront instead of when you withdraw, meaning that any interest earned is tax-free). For example, a married couple over 50 can contribute as much as $12,000 to an IRA and deduct the amount from their income tax.
Further, interest, dividends and investment capital gains are taxed at a lower rate than other income, typically 15 percent, and are not subject to Social Security or Medicare taxes. In 2013, income from such gains will be taxed at higher rates for high-income seniors, who will also see a higher effective Medicare tax rate.
You may also be able to include investment-related expenses (such as investment advice, fees for a safe deposit box and subscriptions to investment newsletters) that exceed 2 percent of your AGI in your other itemized deductions.

Home Sale
You may be thinking of downsizing into something more manageable or maybe escaping to a warmer climate. If you sell your home, you may not have to pay taxes on any profit made from your home’s sale if you lived in your home for at least two of the five years prior to selling it. Tax laws allow a single filer to claim, with no taxes, up to $250,000 in profit on a home sale, and up to $500,000 for a married couple filing together.

Paying Taxes on Social Security
Don’t forget that if you made substantial income while collecting Social Security, you may have to pay taxes on that income. This usually happens only if you have other substantial income (such as wages, self-employment, interest, dividends and other taxable income that must be reported on your tax return) in addition to your benefits. Internal Revenue Service (IRS) rules state that no one pays federal income tax on more than 85 percent of his or her Social Security benefits.
The Social Security website advises that if you file either an individual tax return or joint return, and your combined income (that is, your adjusted gross income plus nontaxable interest plus one-half of your Social Security benefits) is between $25,000 and $34,000, you may have to pay income tax on up to 50 percent of your benefits. If your combined income is more than $34,000, up to 85 percent of your benefits may be taxable.
To let you know your Social Security earnings, each January the government will send out a Social Security benefit statement (Form SSA-1099) showing the amount of benefits you received in the previous year. If you do have to pay taxes on your Social Security benefits, you can make quarterly estimated tax payments to the IRS or choose to have federal taxes withheld from your benefits.

Help Is Around the Corner
Help Is Around the Corner
Finally, if you find yourself getting grouchy about all the details and complex instructions for your taxes, you can find free help through the AARP Foundation. Tax-Aide is a free tax preparation service for people 60 and older with low to middle incomes.

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Press Release-Best of Home Care Award

Blessings! For Seniors Companion Care Receives “Best of Home Care” Award

Goodyear- 2/08/2013 – Blessings! For Seniors Companion Care today announced that it has been recognized with Home Care Pulse’s “Best of Home Care” distinction. Awarded to the top 50% of agencies in client satisfaction scores from Home Care Pulse, Blessings! For Seniors Companion Care is now ranked among a select few of the best agencies in the country.

“We know that sometimes it is difficult to make care decisions when you don’t have specific experience with an agency. It was our goal to provide families with the ability to make an informed decision, have tangible ways to measure quality and help them find a comfort level when choosing an agency to work with,” commented Aaron Marcum, founder of Home Care Pulse.

Home Care Pulse, a company which measures client and employee satisfaction, created the award to identify those agencies in the private duty home care space that demonstrated a passion for client and employee satisfaction. Home Care Pulse believes that honoring such companies can both educate and help families to make better care decisions for their aging loved ones.

Blessings! For Seniors strives to provide the highest quality of care for their clients. “We are able to achieve this award four years in a row only because our caregivers are passionate about what they do and offer a personal touch not found elsewhere. We have a great reputation in the community and it is because of our caregivers. We want our clients to view our caregivers as an extension of their own family.” stated Steve Kramer, owner of Blessings! For Seniors.

The selection process for the “Best of Home Care” includes the evaluation of client and employee satisfaction in areas such as agency training, communication, overall quality of care, caregiver performance, caregiver morale, response to problems and recommendation of services to name a few.

“We want to congratulate Blessings! For Seniors Companion Care for winning the “Best of Home Care” award and commend their commitment to placing high priority on client satisfaction,” concluded Marcum.

To find out more about the “Best of Home Care” award or Home Care Pulse, please visit

About Home Care Pulse
Home Care Pulse was launched in 2008 and is a company specializing in measuring and benchmarking client and employee satisfaction for private duty home care agencies. Recently Home Care Pulse conducted the largest study ever performed on behalf of the private duty industry. Home Care Pulse helps agencies promote and drive business, improve service quality and increase employee loyalty. Visit for more information.

About Blessings! For Seniors
Blessings! is family owned company that was founded in 2007 and serves the West Valley of the Phoenix metro area. Our mission is to be a Blessing! in the lives of the elderly and their families, helping them to live in their own homes longer, safer and with a better quality of life. Further information can be found on .

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