LTC Bullet:  Survival Guide for Alzheimer's Caregivers

Tuesday, May 3, 2011


LTC Comment:  There's no such thing as "Caregiving Made Easy," but Nataly Rubinstein's book is about as close as you're going to get.  Details after the ***news.*** 

*** Today's LTC Bullet is sponsored by LTCA, the country's Pioneer and Leader in Long-Term Care Insurance. 
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After you've read each issue from the Center, come to LTCA and share your thoughts with the best producers in America!***

*** AALTCI's TOP LTCI PRODUCERS:  "The nation's top long-term care insurance producers for 2010 were announced today [5/2/11] by the American Association for Long-Term Care Insurance. The Ninth Annual Long-Term Care Sales Achievement Awards recognize producers based on sales across multiple categories."  Find winners names here. ***

*** MOSES ON FEARLESS CAREGIVING.  Nation's Leading Long-Term Care Insurance Expert To Speak At Fearless Caregiver Conference May 19:  "Today's Caregiver magazine and, the nation's foremost print magazine and Web community for family and professional caregivers since 1995, announced today that Stephen Moses, President of the Center for Long-Term Care Reform, recognized as "one of the 100 most influential people in long-term care" by McKnight's Long Term News, will join the list of speakers and presenters who will speak with family and professional caregivers at the May 19th Fearless Caregiver Conference" in Minneapolis. *** 

*** MOSES ON LTC FINANCING.  "Long term care planning is about having the right mindset rather than hitting a specific age, according to panelists participating in a recent webcast sponsored by Lincoln Financial Group. . . .  Social programs like Medicare and Medicaid have traditionally provided resources for paying for LTC, but according to Steve Moses, president of The Center for Long-Term Care Reform, it's not going to be reliable in the future.  . . . Moses says there's a 20 percent chance people over age 65 will need long-term care for five years or more. 'You can't buy fire insurance when your house is in flames,' he remarked. 'Likewise, you can't buy long-term care insurance when you already have Alzheimer's Disease. Savvy consumers need to look at long-term care through the windshield, not through the rear view mirror to understand the future risks and plan accordingly.'" 



LTC Comment:  I met author Nataly Rubinstein after delivering a speech in Miami at an event organized by Center supporter and LTCI producer George Braddock.  Nataly told me about a book she'd written on Alzheimer's caregiving.  I asked for a copy to review.  When it arrived in the mail, I began browsing through it and was impressed.

To provide long-term care for a loved one without adequate financial resources makes a difficult challenge even harder to bear.  Hence, people need long-term care insurance.  But even with LTCI and adequate financial resources, most families want to do what they can to provide additional, loving, personal care as well.  Hence, all caregivers need a book like Ms. Rubinstein's.

I encourage you to read the following review and consider purchasing the book.  What follows is mostly promotional copy, but it's accurate based on my reading of the book, with this proviso.  The section on Medicaid states:  "With the help of a good financial planner and elder care attorney, you will be able to keep the assets that the person with dementia who has worked hard and long for and still qualify for Medicaid."  I explained my position to the author that diverting Medicaid's scarce and dwindling resources from the needy to those who can afford to pay their own way only ruins the safety net for those who can't help themselves, hastens the program's full collapse which is already well underway, and undercuts the incentive people might otherwise have to plan responsibly for LTC risk and cost.

Be sure to read Nataly Rubinstein's comments in the section below titled "About Long-Term Care." There, she strongly encourages the purchase of private long-term care insurance and discourages LTC planning through Medicaid. 


Nataly Rubinstein, Alzheimer's Disease and Other Dementias--The Caregiver's Complete Survival Guide, Two Harbors, Minneapolis, Minnesota, 2011.

A Diagnosis of HOPE...

A diagnosis of Alzheimer's disease or dementia often brings with it a tremendous sense of despair. Being a caregiver for a person with dementia is challenging work that can be physically, emotionally and financially draining. In fact, research has shown that providers of long-term care are at a greater risk of premature death than other members of the general public. They also experience higher incidences of depression, anxiety, stress and hopelessness, especially in rural communities.

Help is available, however, if you know where to look. Nataly Rubinstein's book, Alzheimer's Disease and Other Dementias-The Caregiver's Complete Survival Guide was written as a lifeline to caregivers nationwide whose hearts and hands are engaged in selfless caregiving service. With the personal insight and professional expertise gained through decades of involvement in dementia care, Rubinstein helps readers meet the challenges they will face as caregivers, offering useful tools and strategies to successfully guide them through the dementia maze. 

"Alzheimer's disease, or any form dementia, affects the whole family," explains Rubinstein. "And caregivers are not born; they are made. With proper understanding of this disorder and supportive guidance, caring for a person with dementia does not have to become a 36-hour day."

Since there is no cure for Alzheimer's disease in sight and no definitive timeline of care--people are living with dementia for over 20 years--learning how to navigate the disorder is important for both a person afflicted with dementia and for his/her caregivers. As Rubinstein notes, nearly half of all caregivers report they have lost a job, had to change work shifts or missed out on opportunities for professional advancement as a result of their caretaking responsibilities. Tremendous personal sacrifices are required of them as well.

Rubinstein wrote this book to provide caregivers with the resources they need to navigate the challenges they will encounter. "My goal is to give caregivers all of the tools they will need to empower them," she says. "I want to help them provide optimal care for their loved ones, as well as for themselves, developing increased resilience and lasting peace of mind." 

What Makes This Book Unique?

FACT:  Every 70 seconds, someone in the U.S. is diagnosed with Alzheimer's disease (more than 1,200 new diagnoses each day).

FACT:  Approximately 80% of people afflicted with Alzheimer's disease and other dementias are cared for in their homes.

FACT:  There are nearly 11 million unpaid family members, friends, neighbors, and associates who have assumed the responsibility of caring for these individuals.

Author Nataly Rubinstein, a certified geriatric care specialist and licensed clinical social worker, has both personal and professional experience in caring for people with dementia.

When her mother was diagnosed with dementia in 1994, Rubinstein chose to shoulder the responsibility for her care, a service she continued to perform for 16 years until her mother passed away.

As a professional Alzheimer's Coach and Dementia Strategist, she provides her clients, their families and others with the in-home solutions, educational programs and specialized support services they need to successfully cope with the rigors and challenges of caregiving.

Alzheimer's Disease and Other Dementias-The Caregiver's Complete Survival Guide delves into understanding dementia, how to get an accurate diagnosis, the truth about medications, communicating with someone who has dementia, behavior management, options for respite care and much more-including invaluable information on maintaining your own sanity and sense of humor while providing care for another.

The extensive resource listings included in the book address everything from finding and negotiating with government agencies and insurance companies to recommending tools for assistance-like devices to locate missing objects, referrals to third party services and more.

For 16 years, Rubinstein served as her mother's primary caretaker, while at the same time juggling the needs of her own young family. Feeling hopeless and helpless at times, she nonetheless worked diligently to provide compassionate, comprehensive care. Having been there herself, Rubinstein is now reaching out to others with a comprehensive how-to guide, Alzheimer's Disease and Other Dementias: The Caregiver's Complete Survival Guide. Filled with professional expertise, personal insight and invaluable advice, the book is being hailed as a one-stop resource for caregivers, both in urban and rural communities.  "Many caregivers are thrust into this role, and they have no idea of what they've gotten themselves into," says the author. "They soon find themselves stretched to the breaking point emotionally, physically and financially, and they don't always have access to the information and services they need. I wanted to provide them with solutions they could implement at home so they wouldn't feel so isolated and alone. Help is out there, and you don't have to spend endless hours on the Internet. You just need to know where to look."

Every 70 seconds, someone in the U.S. is diagnosed with Alzheimer's disease, and nearly 11 million unpaid family members and friends are doing their best to care for them. Written with a perfect balance of personal experience and professional expertise, Rubinstein's book provides these dedicated caregivers with suggestions on how to successfully manage difficult behaviors, communicate effectively with a person with dementia, hire home health aides, keep loved ones active, manage medications, deal with insurance companies, address legal matters and maintain a balanced perspective through it all. "Being a caregiver often presents pitfalls to one's personal and professional life," says Rubinstein, "but I believe with the information in this book, caregivers can find a path to achieve the balance their lives deserve."

About Long-Term Care--

Author Rubinstein says:  For the past several years I have been a huge promoter of LTC insurance. Through my years as a clinician as a caregiver I am very aware of the financial toll that dementia can have. I lived through it first hand while caring for my mother- who had one of the original policies that was not sufficient to cover the her care. The out of pocket cost for her care was over $750,000.00--sad to say that is money that we would have now had if there was a better policy at that time available. In the book I advise that BEFORE the family races to a diagnosis that they should speak with a LTC representative. In my groups and book I clearly explain the costs of dementia vs the cost of a LTC policy. It's not about jumping the gun to get a policy in place--it's about good long term care planning. I have had my policy in place for several years--not because of dementia but for any event that could happen in my life.  I recently purchased LTC plans for both of my children (ages 19 and 25) in the event that something occurs to them I now have peace of mind that they will be well cared for. The importance of a LTC plan for financial planning is something that I stress daily with caregivers. It's too late for their loved ones but it's not too late for them.

Like you, I too do not believe that Medicare and Medicaid should be used as a LTC plan. Too many of the people I speak with are misinformed about this government plan and in the book I speak directly to those individuals. The services are limited and stressed to the max--the care that they will receive especially in the less severe stages when it is needed the most is meager at best. In South Florida it is over used by many who have learned to beat the system--but that also has a price. Medicaid may pay for a trip to the day center but not in home care and certainly not for round the clock care. It was my hope that when they speak with a financial planner he will fully explain the pitfalls of using this program as a LTC plan.

Alzheimer's Disease and Other Dementias: The Caregivers Complete Survival Guide will give caregivers and financial planners the realistic tools that they will need to successfully deal with dementia--the emotional, physical and financial costs that arise from this disorder. It is a practical and timely guide in light of the new changes in diagnosing MCI and mild dementia. There is a large and growing population of individuals who are being diagnosed at much younger ages. The old rule of waiting to age 60 or beyond to purchase LTC no longer applies. Those reading this book will be armed with the information that they need to get through this disorder no matter where they live. This book is a tool that all LTC planners need to read in order to increase not only their knowledge, but to help inform families and over come objections to the cost of LTC and financial planning. The book is clear, concise and to the point about what to do and where to go in the light of this national crisis. Lawmakers need to understand what families will encounter and what services need to be addressed.