Best Results Organizing

Did you celebrate National Grandparents’ Day on Sunday? Did you know that this was National Assisted Living Week?  These observations have me thinking about our elders, and how organization (and disorganization) impacts them.

As of the 2000 U.S. Census, there were more than 35 million people over age 65 in America, a 12% increase over just the previous decade.  In 2030, when all of the Baby Boomers will be 65+, nearly one in five U.S. residents is expected to be 65 or older.  This age group is projected to increase to 88.5 million in 2050, more than doubling the estimated 2008 figure (38.7 million).  Similarly, the 85+ population is expected to more than triple, from 5.4 million to 19 million between 2008 and 2050.  Whoa!  (One should note, however, that in 2050, Paper Doll will be only 83.)

As America’s population ages, more and more of our beloved seniors (and eventually, we, ourselves) will need a little extra help with the tasks of daily living.  Concerns over health, finances and life satisfaction can be greatly alleviated by applying organizing principles.  We need to help seniors simplify the complications in their lives, and make their surroundings safer and more comfortable, whether they’re moving to assisted-living, downsizing to smaller places or just trying to live comfortably in their current homes.

According to the National Family Caregiving Association, a quarter of caregivers report worrying about keeping track of medical information for their loved ones and communicating with health professionals.  Whether you (or someone you know) is a primary caregiver for a senior citizen or is just involved with the medical recordkeeping to lend a helping hand, keeping it all together is essential.

CREATE A DAILY OPERATIONS GUIDEBOOK

A key to having control is quick access to all of your resources.  Regular readers of Paper Doll already know where I’m going with this.  Yes, create a three-ringed binder with divided sections for keeping track of information regarding:

• Prescribed medicines with dosages and instructions
• Appointment history and notes from appointments with each doctor.  Keep blank pages in this section so that you can list questions that come up between appointments.  Then, refer to these questions, write down the answers you’re given and check off the questions when you’ve received a satisfactory answer.  Very often, medical answers can be contradictory or confusing, so don’t consider a question “finished” until both you and the patient feel everything is squared away.
• Notes on conversations with insurance companies (including dates, names or badge numbers of claims agents or officials and direct quotes in insurancese
• Contact information — for doctors, attorneys, health care aides, insurance agents and claim departments
• Alternative care resources like contact information and web sites for practical nurses, home-care aides, elder-care locations
• A daily and weekly schedule–It’s often comforting for both the caregiver and the person being cared for if they can review upcoming events and mentally rehearse what’s going to happen later that day or week.  Such a plan helps prevent conflicting appointment scheduling, but also assures that doctor, dentist or therapy appointments aren’t scheduled too closely together.  We all know that an appointment at 9 a.m. may mean the patient is seen at Noon, and it’s important to plan for travel time between appointments, anticipate potential delays and block time for eating, taking medications and napping/resting.

Of course, if you’re not comfortable creating your own guidebook, there are a variety of pre-created systems for keeping track of medical records or collecting all essential medical/financial/legal data in one place.

INSURANCE PAPERWORK

While many of us generally pay a simple co-pay when we see a doctor once or twice per year, insurance paperwork for senior citizens is probably a major contributor to the deforestation of the planet!  Insurance paperwork is complicated; in fact, organizing insurance paperwork has enough complexity that it would take more than one whole Paper Doll blog post, all on its own. 

Nonetheless, as we age and require more complex medical care (and therefore, more complex insurance) primary insurance, secondary insurance, Medicare, Medicaid and a variety of other medical and prescription benefit forms arrive daily.  Those complicated explanation of benefits forms can be a nightmare to comprehend, piece together and match with billing statements.  This is especially true for seniors dealing with difficulties related to eyesight, concentration, energy or comprehension, but also for younger loved ones who haven’t dealt with such paperwork before.

If you’re drowning in insurance paperwork, consider hiring a professional organizer who specializes in insurance paperwork.  If you’re not sure that the billing is fair or accurate, there’s also another professional you might wish to consider–a patient advocate.  Check out the work of the Patient Advocate Foundation to get a handle on these issues.

FINANCIAL PAPERWORK

For most of us, financial paperwork can usually be handled with good filing and bill-paying systems.  However, keeping up with financial paperwork can be a real headache, especially for seniors in assisted living and without any relatives living nearby. 

Start by talking with your elder and reviewing the National Council On Aging’s Benefits Check-Up together.   Also consider gifting a senior in your life with the services of a Daily Money Manager so you can both be sure that the financial issues are being handled with expertise.

A FEW RECOMMENDATIONS

At the 2008 conference of the National Association of Professional Organizer, I was extremely impressed with the services and information provided by two of our presenters, Rebecca Eddy and Gideon Schein.  Eddy & Schein are New York City-based providers of in-home based management and coordination of personal, legal, financial and health insurance issues.  I encourage you to peruse their website and review their extensive guide to resources available to help seniors with the complex paperwork associated with living a long life. 

At this presentation, a wide variety of other resources were mentioned, and I urge you to learn more about offerings of the National Association of Professional Geriatric Care Managers.  Their members help navigate everything from finding suitable assisted living or personal care to helping a family select among caregiving alternatives.  Also, familiarize yourself with the various Federal and State agencies designed to provide support for seniors.

LOCATE VIPS–VERY IMPORTANT PAPERS

A sense of disorganized affairs can be troubling for seniors and their loved ones. Relieve anxiety by locating the following key documents and ascertain that they are up-to-date:

• Wills, Revocable Living Trusts
• Durable Powers Of Attorney for Health And Finances
• Insurance Policies for Long-term Care, Life, Health And Property
• Account Numbers For All Investments
• Social Security Cards
• House Deeds, Mortgage Records
• Tax Returns
• Preferences and arrangement information for burials and memorials

Keep these papers in a safe place, but not necessarily a safe deposit box if only one person has access. In case of a medical emergency or traumatic event, a second family member should always have pre-approved access to the safe deposit box. Otherwise, use a fire safe at home and keep photocopies with a trusted relative. It’s never too early to organize these VIPs.

THINK HEALTH AND SAFETY FIRST

Paper Doll is always thinking about organizing paper and information, but it’s important to note that we cannot be organized if we are not sure everyone is secure.  As a start:

• Keep a master list of medicines, including the frequency & dosage and the contact information of the prescribing doctor on the refrigerator door in case of a health emergency.  (Each time you update the list in your Daily Operations Guidebook, photocopy or a print an extra to put on the fridge.  Alternatively, there are checklists you can purchase to help seniors keep track of which meds they’ve already taken.)  First responders are trained to look for these lists when responding to a home emergency.
• Organize a list of emergency phone numbers, including doctors, family members and even 911 in LARGE PRINT, and post the list by each telephone in the house. This way, if you are ever unavailable in case of an emergency, your loved one or others in the home can take action quickly.
• Eliminate obstacles when helping an older person arrange items in a new environment or in new, safer layouts. Move clutter off the floor and don’t block hallways and stairs. Paths and passages should be wide enough for someone with a walker to get through.  There’s no book equivalent of What To Expect When You’re Expecting for senior-proofing a home, so if you’re puzzled about where to start, talk with a certified Aging-In-Place specialist from the National Association of Home Builders or review their checklists.
• Accommodate range of motion, which decreases as we age. Store kitchen items, luggage, and clothing within easy reach, with heavier items at waist-level or only slightly lower. Don’t make Grandpa bend too much or force Grandma to climb a chair.
• Consider technology to check in on your seniors.  Things have come a long way from the days of “I’ve fallen and I can’t get up.”  From web-cam check-ins to home health security programs like Quiet Care and ADT’s Home Companion service, there are a variety of technological advances to keep you connected with your loved one. And, for a sense of what’s on the way, check out this piece on “Nana Technology”. (Don’t miss the robotic nurse!)

Finally, acknowledging that special organizing issues arise as we age doesn’t have to be a negative.  It allows for the opportunity to organize, downsize and plan for the future with dignity and grace.