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ER visits increase disability risk for seniors, says study

An elderly individual’s emergency room visit for an injury or illness could signal serious health problems, according to recent research. Adults aged 65 and older who make a trip to the ER are at a 14 percent higher risk of experiencing disability and physical decline up to six months after discharge than seniors who do not visit the ER.

The study said that seniors who were admitted to the ER were unable to independently carry out everyday tasks such as bathing, dressing, managing finances or shopping within six months of returning home. Seniors who were already having difficulty with daily activities prior to their ER visit are especially vulnerable during this period.

Experts believe there are several reasons that a trip to the ER can result in negative consequences for the elderly. Individuals who previously had no difficulty in coping with their health may suddenly feel they can no longer handle their injuries or the worsening of a chronic ailment like diabetes. For example, elderly individuals who fall and hurt themselves may limit their movement due to the fear of falling again. They may also require more in-home help.

Dr. Thomas Gill, study coauthor and Yale University professor of medicine, said trips to the ER can result in “a fairly vulnerable period of time for older persons.” He suggested considering “new initiatives to address patients’ care needs and challenges after such visits.”

Researchers said family members and caregivers should pay extra attention to the elderly individual in the first few days after their ER visit. They suggested checking in frequently on loved ones, following through with medical professionals and educating oneself about the tests and treatments that were administered in the ER. Taking such steps can help minimize the health challenges an elderly loved one may face in the future.

Mark Gilfix discusses his background, San Francisco and special needs families in 7×7 interview

Attorney Mark GilfixThe leading online source for information about lifestyles in San Francisco,, interviewed attorney Mark Gerson Gilfix on  April 6 to ask him about his views on life in the Bay Area, his professional background, and his work as an advocate and planner for autistic and special needs children. The latter issue is a key focus of the interview, as Gilfix stresses how the legacy of his family’s deep roots in the special needs community has served as an inspiration for him, and that special needs planning is a top specialty of Gilfix & La Poll Associates.
In “We Wanna Be Friends with Actor and Autism Advocate Mark Gilfix,” Gilfix talks about how his family’s 35-year-plus involvement with and services for the special needs community resonated with him from his childhood in Palo Alto through his college days at Stanford. He talks about his professional career that first took him to Los Angeles for stints working as a management consultant and as a professional actor. In fact, Gilfix paid for law school by simultaneously working over 25 hours a week as a management consultant and auditioning for and working in commercials and on TV shows while he attended Loyola Law School’s evening program. Notably, he still graduated in the top 5 of his class.
Gilfix continues to accept some limited acting work in his spare time — he is a voice for Red Bull videos and has previously appeared in some iconic television shows and in commercials for some of the world’s top brands, perhaps most notably helping introduce Apple’s Siri to the world. But while he greatly enjoyed acting and management consulting,  he talks about the increased impact, and the meaningful, positive difference he has been able to make since he returned to the Bay Area to practice law and serve families with special needs children.
People who want to learn more about Gilfix will greatly enjoy the 7x7 interview. And families with special needs children will be able to meet Mark and get valuable legal advice on the topic at the 11th Annual Special Needs Trust Seminar at the Crowne Plaza Cabana in Palo Alto on April 9 at 2 p.m. and 6 p.m. Additional information on this free event is available on this website.

Read the full 7x7 interview here..

Gilfix (No. 110) Participates, Places in 2013 National Senior Games in Cleveland, Ohio.

Gilfix BL_July_3 image 1  (2)In 2012, Michael Gilfix (age 66) qualified for the 2013 National Senior Games by winning both the 5K and 10K races in his 65-to-69 age bracket at the California Senior Games.

Mike participated in the 5K race on July 23, 2013 in the National Games in Cleveland.  In a challenging national field, Mike placed 8th with a time of 22 minutes and 42 seconds on a hilly course through the grounds of the Cleveland Zoo.  Mike averaged 7 minutes and 17 seconds per mile.

"It was inspiring to compete with top runners from across the nation.  Some were as young as 50.  Some were in their nineties," observes Mr. Gilfix.  "In my age group, the winner ran 6 minute and 26 second miles.  Very impressive!" 

Congratulations to Mike!

Gilfix BL_July_3 image 1  (1)

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Expanded Free And Available Health Services For California Seniors; Long-Term Care Costs Not Addressed

While California enjoys the reputation of a destination state -- outdoor recreation, abundant fresh produce, and often mild weather -- the state was recently ranked 25th in terms of senior health. Even though seniors are typically living longer, more of them are doing so in a state of suboptimal health.

Meanwhile, resources for healthcare have never been more easily available. A number of free or extremely affordable preventive health tests and screenings are now being provided to seniors under the Affordable Care Act. In some cases, these services may require a small co-pay, but many do not, and all are offered without any insurance deductible for seniors.

For example, doctors who participate in Medicare are now offering a free annual wellness exam. Use this opportunity to work with your primary care physician on a 12-month wellness plan. If you have just enrolled in Medicare, you will receive a "Welcome to Medicare" exam at no cost, as well. Physicians are using it as a preventative baseline check to help plan out an ongoing wellness approach with their new patients. Other services provided for free under the Affordable Care Act include smoking cessation services, bone mass measurements, flu shots, Hepatitis B shots, abdominal aortic aneurysm screenings, and medical nutrition therapy services.

Take advantage of these opportunities to keep up with your heath maintenance. That means getting an annual flu shot and staying current on all immunizations. Go in for regular dental cleanings and medical checkups. Keep an eye on your blood pressure and cholesterol levels; the levels may seem like a small part of your overall health, but healthy blood pressure and cholesterol numbers mean a lowered risk for stroke and heart disease.

The Affordable Care Act does not address the cost of long-term care, nor does Medicare pay for skilled nursing facilities ($5,000 - $10,000). To cover such costs, Medi-Cal is the only governmental source of assistance.

What else can seniors do to take charge of their health and enjoy their later years? Numerous studies have shown that keeping an active interest in intellectual pursuits slows the development of dementia or other types of cognitive decline. Take up a new hobby or learn a new skill. Work on puzzles, brain teasers, crossword puzzles. Take music lessons, or learn a new language. Even things as simple as taking an interesting class at a community center or brushing up on math can make a huge difference in brain activity.

Be sure to get regular exercise. It may be walking every day, or biking on the weekends, or taking an exercise class at the gym most mornings. Focus both on leisure activities which are enjoyable and physical activities which get you moving; you do not have to put too much of a strain on your body. Get outside, get active and have fun.

For Medi-Cal planning assistance, talk with a knowledgeable attorney who can guide you through the maze.

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Long-Term Care Insurance and Alternatives – The Role of Prudent Planning

A July 2, 2013 article on page one of the Wall Street Journal underscores the emerging problem with long-term care insurance. Many companies, such as MetLife Inc., Prudential, and Unum have either stopped offering long-term care insurance or have dramatically reduced efforts to maintain or grow their market shares. For those who have stayed in the market, the cost is soaring.

Indeed, annual premiums have doubled and even tripled in a few short years. Twenty percent annual increases are expected.

The real question focuses on, “What to do about the cost of long-term care?”

If you have sufficient resources, long-term care insurance is still an alternative to consider. Do not, however, do so blindly. You can calculate the cost over a twenty-year or thirty-year period. You could put those funds aside to pay for the cost of long-term care if you are very disciplined and have tenacity, patience, and fortitude.

This alternative, in other words, is to “self insure.” Rather than put $200,000 into the hands of a long-term care insurance company, set that money aside, ideally in a tax favored account, and use it when you need it.

The other alternative is Medicaid, known as Medi-Cal in California. Medi-Cal is a needs-based program. The Wall Street Journal indicates that it is “a government health program for poor people.” This is a gross misstatement.

For an individual to qualify for Medi-Cal, for example, she can have no more than $2,000 in countable assets. Federal law provides that a residence is an exempt resource, which means that its value is not counted when determining eligibility. There is a cap in most states of $750,000 on the value of an exempt residence if the individual is in a skilled nursing facility, but the point remains.

For a married couple, there is no cap on the value of an exempt residence when one spouse is in a nursing home. The spouse living at home can retain at least $115,000 in her name if her institutionalized spouse is in a nursing home and receiving Medi-Cal/Medicaid benefits.

Moreover, numerous planning steps can be taken to protect assets and qualify for Medicaid. While this is by no means an ideal outcome, it is the only alternative to losing all of your money in far too many cases.

The message is that you must think about this eventuality – the need for long-term care services at home or in a facility – and plan accordingly. If you do not have long-term care insurance, do not expect the government to come to your assistance unless you plan for Medicaid. Medicare does not pay the ongoing cost of nursing home care.

We understand these options and these rules intimately. We have been helping people plan for almost thirty years with consistent success. You must learn about your options.

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