Elder Care

Success in the Senior Market -- Part Two

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Last week we explored Ed Pittock’s “Nine to Thrive” brochure. This week I want to highlight his Number 6, “Use plain language; go the extra mile in your communications.” I love these tips because as you read them you’ll realize they are just great tips about communicating in general.

• Reduce background noises.

• Before you speak, make sure you have the attention of the person who is hard of hearing.

• Face the listener directly.

• Lower the pitch of your voice, but still speak in a normal tone.

• Make sure the person can see your face as you speak.

• Have the listener repeat the message so you know your words are understood.

• Consider writing out notes from the meeting and mailing them to the client afterward.

Ed says that about a third of American older than 60 have hearing problems; and half of people 85 and older have hearing loss. That’s the demographic of the end of life clientele. Another tip that I learned right out of Mortuary School was, when meeting with a family put your pen down every time they speak. It reminds you to listen and not be in a rush.

For more information on Ed Pittock and the Society of Senior Advisors visit www.society-csa.com.
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Success in the Senior Market -- Part One

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If you haven’t figured it out yet, I love brochures. Who has time to read books anymore? And when I do have time I want to read about a fun topic, not 500 pages about death. So here’s another brochure I have and reference often. I met Ed Pittock last year when he spoke at a convention I attended. His brochure “Nine to Thrive: Nine Ways You Never Thought of for Success in the Senior Market” is jam packed with great tips on serving your senior clients. (He’s a great speaker, by the way.)

1. Be Patient. Seniors need to know who you are before they care about the intangible service that you provide. Let them get to know you and topic you are an expert in before telling them about your product or service.

2. Develop a client contract strategy. Ed writes, “All clients are not created equal.” You don’t have to try to keep in contact with everyone you serve; some clients will want/need more contact with you than others. And that’s ok.

3. Make your best offers to your best clients. If someone refers you to a friend and you go chase down that friend and forget about who sent you, you really haven’t gained anything.

4. Become a browser for your clients. Take the time to put together a few helpful links on your website to reinforce your knowledge as an advisor.

5. Make sure your marketing materials are senior-friendly. Always use a 12 point font or larger. Make sure photos are appropriate. Don’t portray seniors as old and feeble.

6. Use plain language; go the extra mile in your communication. There’s a lot here. We’ll have a Part II blog on this one next week.

7. Beware of the 3 biggest myths of marketing to seniors. People are living longer but in poorer health. When people reach a certain age, they stop buying. Seniors aren’t very particular about whom they do business with.

8. Create an award. Honor a senior for their work within the community.

9. Volunteer. Being visual within the community equals commitment to the community.

These aren’t applicable for all end of life services, funeral homes are obviously not going to “make their best offers” to families who have suffered multiple losses. But most of these can be tactfully adapted one way or another to your client base. For more information on Ed Pittock and the Society for Certified Senior Advisors, visit www.society-csa.com.
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A Helpful Guide to Long-Term Care Insurance

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You may not think of long-term care insurance as an end of life issue, but it’s something that aging people (and progressive younger people) are realizing that they need. People are living longer in various states of awareness. For instance, patients suffering from Alzheimer’s may not understand the difficulties of providing long-term care for them, but their family certainly does.

The brochure, Guide to Long-Term Care Insurance, sponsored by the Federal Citizen Information Center (FCIC) www.pueblo.gsa.gov, and written by the AHIP is a good review about long term care insurance. The American’s Health Insurance Plans (AHIP) is a national association advocating for the consumer who needs to research and buy a health care plan. The following information is adapted from the AHIP brochure and can be ordered for free at the email address above.

By the year 2020 it is expected that 12 million Americans aged 65 and above will need long-term care insurance. So what it is? It covers things like a visiting nurse, a home health aide, meals delivered to your home, and even services for chores such as bathing and grooming. Most importantly it lets people decide if they want to be at home, a nursing home, or assisted living facility. It gives people a choice.

The cost depends on where you are residing. Nursing home costs for a year can average over $50,000. In home care is expensive too, $12,000 a year and up, and even assisted living facilities can cost $24,000 a year.

Generally Medicare does not cover the cost of long-term care insurance and Medicaid only covers about half of the cost of a nursing home. It’s important that client families understand that the government won’t pay for all of their long-term care needs.

The brochure lists 17 questions to ask before purchasing long-term care insurance. Here are a few that stood out:

• How much does the policy pay per day for nursing home care? Home health care? Assisted living facility? Adult Daycare? Alternate care? Respite care?

• Does the policy have a maximum lifetime benefit?

• How long must I wait before preexisting conditions are covered?

• Does the policy offer an inflation adjustment feature?

HIPAA (Health Insurance Portability and Accountability Act of 1996) says that qualified long-term care insurance receives the same tax treatment as accident and health insurance. However, you should refer your client family to a financial planner or tax advisor regarding eligible deductions available to them.

In conclusion, every state has a Department of Insurance that regulates the industry. You can find their contact information on the web or in the blue government pages of your phone book.
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Caring for an Aging Loved One

Did you know the Federal Citizen Information Center (FCIC) has a plethora of information for the client families you serve? Our aging population is looking to you, the End of Life Professional for solutions to their problems and answers to their questions. Most of what the FCIC offers on-line is free (www.pueblo.gsa.gov), and several brochures can be ordered at no cost in small quantities.

This week we are reviewing “Caring for an Aging Loved One”, a free 28 page brochure filled with numerous gems of advice. It includes topics such as How Will You Know Your Loved One Needs Assistance, Developing a Care Plan, Organizing Documents and Paperwork, Who Pays for Long-Term Care, and many more.

Some of the more useful pages in the brochure include information on aging websites. Here are a few off the beaten path that you may not have heard of before.


www.benefitscheckup.org. This website was developed by the National Council on Aging (NCOA) to help people determine benefit eligibility in their area. It’s easy to navigate the site and you can feel comfortable referring your families to it.

www.aahsa.org American Association of Homes and Services for the Aging. This site has some fantastic questionnaires and suggestions for people who are facing aging issues.

www.caregiver.org The Family Caregiver Alliance founded in 1977 is headquartered in California; their website is in English, Spanish, and Chinese. They have a great archived newsletter, and although many topics on the site are referenced to the State of California, the information provided can be helpful to everyone.


The sites I didn’t recommend were mostly the ones that ended in .gov, or had too much content. Before you refer a client family to a website it is important that you have visited it and feel it is beneficial to them.

Be specific, tell your client family, “Go to www.caregiver.org, click on the Newsletter banner at the top and then click on the Legislation to Watch icon about half way down the page.” Even better, just email them the link to the page you think may be helpful.

Referring clients to a website that is content heavy or with little relevance to them can be frustrating. All of the information we have at our fingertips can be overwhelming. Our job as a professional is to first screen it, then filter it, only then, pass it on. This brochure is worth passing on, even if all of the websites referenced are not.
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Enough Already, AARP

shapeimage_2-4The AARP can’t seem to help itself when it comes to funerals or any end of life issue. It’s becoming almost compulsive that at least once a month in at least one of their publications they have to highlight something negative about funeral homes, or dying, etc. One would think that their readership, let’s say who “aren’t getting any younger” really don’t want to be reminded monthly of their imminent appointment with their local funeral director.

In the AARP March Bulletin they tried to stir something up that really isn’t a story. A funeral home in Idaho found a great location for their new building, albeit by nursing home, but a great location none the less. The neighbors saw it differently and started protesting. The reaction of the funeral home co-owner, James Asper was, “We didn’t expect the outrage that we got, so we decided to look somewhere else.” So the funeral home owners did the right thing, the community didn’t want them in that particular location, so instead of fighting them they decided to look elsewhere, as any good community business would.

So what’s the big deal AARP?

The funeral home found a location, the community didn’t like it, so the funeral home owners looked elsewhere.

I guess I should be happy that it wasn’t some horror story about how a funeral home absconded with $100,000 in pre-need funds, but for goodness sakes AARP, give it a rest already.
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Giving Thanks

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In the spirit of Thanksgiving this week, I would like to share 5 things with you that I am thankful for.

I am thankful for my relationships with end of life professionals.

I am thankful for my mentors who have guided, advised, and encouraged me.

I am thankful for all of the nurses and health care professionals who help people die pain free, and with dignity.

I am thankful for all of the estate planners who help carry out the final wishes of dying people.

I am thankful for End of Life Insights, and the many blessings it has brought me this year.


Have a safe and blessed Thanksgiving.
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For-Profit vs. Not-For Profit Nursing Homes

Consumer Reports recently published a report on their study of 16,000 nursing home state inspection reports. The study showed that not-for-profit nursing homes generally provided better care than for-profit nursing homes. “In 1987, Congress passed a landmark law meant to improve nursing home care for the elderly. But our investigation reveals that poor care is still all too common, especially at nursing homes run by for-profit chains, now the dominant force in the industry.”

Consumer Reports even lists several nursing home facilities that they specifically recommend that you avoid placing your loved one in, including homes in CA, CO, GA, IN, MN, MO, NJ, OH.

The statement and chart below come directly from the Consumer Report Website www.consumerreports.org

“We recommend that you avoid placing a family member in one of these facilities. If a relative already lives in one of these homes, you need to be extra vigilant about the care that person receives. Visit often and stay involved in the care planning. And finally, speak up if you notice poor care. Report any concerns to your local long-term-care ombudsman and state regulatory agency.”

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Consumer reports rated only 2% of for-profit nursing homes with meeting their standards of quality care, and rated the not-for-profit nursing homes at a not-much-better 7.3%. More registered nurses and more staff are typically found at independently owned facilities.

Funeral directors and those involved in end of life care almost always have a mental list of nursing homes that they would or would not be a resident of. This is a result of their frequent visits to numerous nursing homes and their observations of odors, cleanliness, and organization of the staff. It may sound odd to ask a funeral director for their opinion on a good nursing home but don’t discount him/her as a resource.

To read the complete Consumer Reports article click here:

Consumer Reports - On Nursing Homes
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Hospice Service Demographics

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A recent Fox New article titled “Blacks Not Taking Advantage of Hospice Services” gives some interesting statistics about hospice demographics.

In 2005, 82.2% of those receiving hospice care were white, while 7.5% identified themselves are black or African-American. This according to the National Hospice and Palliative Care Organization.

They also site, per the Census Bureau, that about 75% of the country is white, while 12% is black.

So, if Census Bureau stats are correct, then the hospice stats don’t really seem to be out of line. However, what is disturbing is that a 2007 report from the California Heath Care Foundation reported that some minorities and immigrants view hospice as a way for doctors to deny them the medical care based on race. In addition, some people think that by making the patient stay at home, and not in a hospital, the medical system doesn’t care about what is happening to them.

Therefore, this issue, not unlike several end of life issues, comes down to lack of understanding and education about a topic, or a service in this case.

Remember, no matter what your end of life service of product, the best way to advocate for all people, is through education.
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A Report on Medicare Hospices

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This year ( April 2007) the Office of the Inspector General (OIG) for the Department of Health and Human Services (HHS) issued a report entitled “Medicare Hospices: Certification and Centers for Medicare & Medicaid Services Oversight.”

The results were from surveys performed by State agencies tracking the extent of the Centers for Medicare & Medicaid Services (CMS) of hospice programs which were receiving Medicare funds.

Here are the highlights of what they found, keep in mind that the most recent data available was from 2005.

14% of the hospices were past due for their certification, and the average number of years they had not been surveyed was 9.

Michigan, Illinois, and California accounted for 41% of all hospices with past due certifications.

In 2005 CMS required hospice certification every 6 years, but changed that number to 8 years in 2006.

Also reported was that health deficiencies were cited for 46% of hospices surveyed and for 26% of hospices investigated for complaints. The most frequent health deficiencies and complaints were regarding patient care planning and quality.

Of those cited during complaint investigation, 49% were repeat offenders.


The recommendations of the OIG to the CMS included:

• Providing guidance regarding analysis of data and identification of at-risk hospices.

• Including hospices in Federal comparative surveys and annual State performance reviews.

• To seek regulatory changes to establish specific requirements for the frequency of hospice certification.

• To seek legislation for enforcement of poor hospice performance.


Currently, the only remedy to a hospice with a poor performance is to dismiss the hospice from further association with the Medicare program. The CMS rejects the regulatory changes citing that hospice certification is a statutory issue for consideration by the Congress.

To read the full OIG report click here to download a copy.
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