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When Choice Is Not a Choice: Transitions at the End of Life

This session explores the challenges faced by caregivers of seriously ill individuals nearing the end of life, discussing care levels, costs, and payment sources, with a focus on elderly care. Learn about available resources and how to manage caregiver stress effectively.

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When Choice Is Not a Choice: Transitions at the End of Life

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  1. When Choice Is Not a Choice: Transitions at the End of Life SCMA Annual Meeting April, 2019 Presented by Tom Glisson M.Div.

  2. When Choice Is Not a Choice: Transitions at the End of Life 1. Participants will verbalize the levels of need that occur for persons who are seriously ill and/or near/at the end of life. 2. Participants will identify the levels of care that commonly exist to persons who are seriously ill and/or at the end of life. 3. Participants will recognize the costs of care; payments sources and limitations of availability of resources to persons who are seriously ill and/or at the end of life.

  3. When Choice Is Not a Choice: Transitions at the End of Life FOCUS: …persons living “at home” whose decline in condition present challenges to their independent living and/or challenges to those assisting in or providing care for them.

  4. When Choice Is Not a Choice: Transitions at the End of Life Ministering with Older Persons by Arthur Becker • divides seniors into 3 categories: young old; middle old and the frail elderly • Persons at risk includes but is not limited to catastrophic illness/COPD/CHF/ neurological disorders such as ALS, MS, Alzheimer’s dementia, Parkinson, stroke, Renal failure and the good old catch all of failure to thrive.

  5. When Choice Is Not a Choice: Transitions at the End of Life …. the journey from independence to in depends.

  6. When Choice Is Not a Choice: Transitions at the End of Life Our personal journey…

  7. When Choice Is Not a Choice: Transitions at the End of Life …. You don’t know what you don’t know

  8. When Choice Is Not a Choice: Transitions at the End of Life Common payment sources: • Private pay out of personal finances • Long term care insurance • Medicare and/or private insurance – only pays for rehab stays in a skilled nursing facility up to 100 days and limited home health restorative services. Medicare and/or private insurance does not pay for non-rehab custodial services. • Medicaid CLTC Community Long Term Care (CLTC) offers programs to help individuals who want to live at home, need assistance with their care, and are financially eligible for Medicaid. Eligibility is dependent upon qualifiers that include disability and income and assets in the poverty range.

  9. When Choice Is Not a Choice: Transitions at the End of Life More common payment sources: • Veterans Affairs (VA) Aid and Attendance • Area Agencies on Aging (AAAs) • The South Carolina Respite Coalition

  10. When Choice Is Not a Choice: Transitions at the End of Life • Independent living community – private pay • Adult Day Care is a place that seniors can be safe during the daytime while their primary caregivers go to work or take a respite break from their caregiving duties. – private pay, long term care insurance, VA, Medicaid, • Home care aids -private pay, long term care insurance, VA, Medicaid, • Assisted living - private pay, long term care insurance, VA, Medicaid, • Residential long term care skilled nursing - private pay, long term care insurance, VA, Medicaid,

  11. When Choice Is Not a Choice: Transitions at the End of Life A serious consequence is caregiver stress, depression, burnout and death. • Elderly spousal caregivers (aged 66-96) who experience caregiving-related stress have a 63% higher mortality rate than non-caregivers of the same age. • In 2006, hospitalization of an elderly spouse was found to be associated with an increased risk of caregiver death. www.caregiver.org/caregiver-health

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