Eldercare Expenses and Claims

Below is a fact sheet I cut and pasted from Revenue Canada's website.

Many people are not aware of the expenses they can claim or that they can sometimes benefit from their relatives expenses if claimed through the disability tax credit. Consult your accountant, or start at the Revenue Canada page. Here is a link you can use:

http://www.cra-arc.gc.ca/formspubs/clientgroup/individuals/seniors-e.html

Fact Sheet
April 2003
Seniors who are eligible to claim the disability amount can claim attendant-care expenses paid to a retirement home as a medical expense
Starting with the 2002 tax year, seniors who are eligible to claim the disability amount and who live in a retirement home can claim attendant care expenses as a medical expense.
There is no change to the basic rules to claim the costs of attendant care (guide RC4064, Information Concerning People with Disabilities). What's new is that for 2002 and later tax years, the rules also apply to seniors who are eligible to claim the disability amount and who receive part-time attendant care in a retirement home. This is not reflected in the 2002 version of the guide, but it will be part of the updated guide for the 2003 tax year.
The following must be provided for a claim to be allowed:
Proof of payment, such as a receipt, that shows the actual amount paid specifically for attendant care (as opposed to rent, for example). As the service provider, the retirement home should determine the amount paid specifically for attendant care.
The senior must be eligible to claim the disability amount by having Form T2201, Disability Tax Credit Certificate, certified by a qualified person and approved by the Canada Customs and Revenue Agency (CCRA).
Generally, attendant care covers the salaries and wages paid to employees of a retirement home who provide the following:
health care
meal preparation
housekeeping for the resident's personal living space
laundry services for the resident's personal items
transportation driver
security (in secured units)
The claim for attendant care is the portion of the salary and wages of all such attendants that can reasonably apply to the senior, but is limited to $10,000 per year ($20,000 in the year of death). The claim for attendant-care expenses can be made in addition to amounts claimed under the Disability Tax Credit.
Eligible seniors who have already filed their 2002 tax return can request an adjustment by visiting our Web site at ccra.gc.ca/tax/individuals/faq/t1adj-e.html. A request for adjustment can also be made by sending in a completed Form T1-ADJ, T1 Adjustment Request or a signed letter that explains the request. The letter must include the senior's social insurance number, address, a daytime phone number, and the supporting documentation.
In addition, this attendant-care change applies to past tax years if a Notice of Objection (an appeal) has already been filed but has not yet been ruled on, or if a Notice of Objection can still be filed for the tax year(s) in question. For information on appeals, visit the CCRA Web site at ccra.gc.ca or see the pamphlet called Your Rights. The pamphlet is available on our Web site or you can order it by calling 1-800-959-2221.
For general tax enquiries, call 1-800-959-8281.
This document is also available for download in .pdf format.
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More on LTC In surance

I have heard from several Geriatric Car Managers in the U.S. that they have trouble being paid for, or helping their clients access the benefits that thye shoudl have gotten from their long term care insurance. This is quite troubling, as it is being so heavily promoted.

Be Warned: LTC insurance in Canada is still new, and still being sorted out. Do not be rushed into buying it by the scare tactics of those selling it.

Make sure you do your homework.

How you can make surethe companies actually live up to what they say, and what kind of hoops they will make you or your loved ones or service providers go through to collect it--well I don't know.

About Crises

There are several good reasons for planning ahead and learning about eldercare options and issues. One of the major ones is because of what happens when you don't.

When people don't plan, they end up reacting in a crisis. The problem with that is, when we are in crisis, it is hard to plan because, physiologically, we are at an emotionally heightened state. The more we are in crisis, the more our decision making ability is impaired, the harder it is to process information, and therefore the harder it is to plan or act.

It is not that we can't; it is just that it becomes more difficult. Sometimes, depending on the difficulty, though it does mean we shut down--this is what happens when we are in shock.

So what will throw caregivers into crisis? Admission to care of a loved one. A parent having a stroke. Whe someone becomes palliative or on life support. When grief, fear, anxiety, guilt, burnout is running us.

We are more at risk, too, depending on our own situations. If we are part of the sandwich generation. If we are stressed at work. Money concerns. Divorce or separation. Moving to a new city. Your husband leaves the toilet seat up. ( Okay, mayb4e the last one is a bit of an exaggeration. But a cold, wet tush in the middle of the night is a shock, if nothing else.)

So plan ahead.

Pain and Dementia

I was the keynote speaker at the Alzheimers Society of Manitoba conference this week. They had close to six hundred people registered.

The second plenary speaker was Dr. Sean Morrison, from, among other things, the Mt. Sinai School of Medicine in New York. Dr. Morrison spoke about pain treatment of people with dementia. It was frightening what his research revealed. There was a consistent pattern of difference of treatment with pain medication for people with dementia than with people who did not suffer from dementia. That pattern was that the people with dementia were treated with less medication for the same condition.

Why would people with dementia receive less medication for pain than people with similar conditions who did not have dementia? Most likely because of two things: one, those with dementia are unable to voice their pain and/or needs the same way that the others could. The other, and this is speculation on my part, could have to do with the attitude and approach of caregivers/ professionals. This includes lack in knowledge and understanding, lack of time to listen, lack of communication with those who could speak for the people with dementia.

What does this mean for caregivers? It means PAY ATTENTION. Pain is often undiagnosed. Often people think there is nothing that can be done, or that they have to just bear it. And more.

Listen for pain symptoms.

Treat pain, or painful conditions.

Why Hire a Care Manager

A year ago, 90 year old Lorleen was lost in what seemed like a dementia induced haze in her nursing home. She would answer questions softly, she moved with pain. She has a son who lives out of town, and an elderly sister who visited regularly but was not conversant in dementia care, nursing homes, and care. Lorleen never left the Home

Today when you go to see Lorleen, she has a big smile on her face. Her conversation is marked by curiousity on her part, she is alert and asks questions--in short a conversation. Her pain is better. She is going on outings regularly on the Home's bus.

How did it happen? Lorleen's trust officer hired Diamond Geriatrics to provide care management. We went to the Home, and did a full assessment. We brought in our physiotherapist. She brought in the proper equipment Lorleen needed--a good wheelchair, transfer equipment. She showed the staff how Lorleen should be handled. We advocated with the staff to make sure she was part of recreation. We hired companions from an agency, and monitored them to make sure they were performing well. We trained them in exercises they could do. We gave them job descriptions which stated they had to do at least one therapeutic activity per session that they spent with her.

Lorleen still has dementia. But she is not still lost in a fog. That will come--but this time it will be due to her disease, and not due to passive neglect. She was not getting bad care, and she was not in a bad place. But we helped her get better care. Our commitment was to her and through ongoing, intensive interventyion, the quality of Lorleen's life improved dramatically.

That is why you hire a Geriatric Care Manager. If you are a banker, a trust officer, an out of town family member, or an intown stressed one, we will help you make a difference.