The Hidden Crisis: Medicare Hospice Fraud

Medicare hospice fraud is an escalating concern, targeting some of the most vulnerable populations—our seniors. This issue not only drains taxpayer dollars but also exploits individuals in their final stages of life, undermining the integrity of the hospice care system. Understanding and addressing this fraud is crucial for safeguarding both financial and human resources.

Understanding Hospice Fraud

Hospice care aims to provide comfort and support to patients with terminal illnesses. Unfortunately, some providers exploit this compassionate service for financial gain. Fraudsters often engage in the following tactics:

• Ineligible Patient Enrollment: Recruiters target seniors, convincing them to sign up for hospice care even if they do not meet the Medicare criteria of having a terminal illness with a life expectancy of six months or less. Tactics include door-to-door solicitations, misleading information, and offering non-covered benefits to entice enrollment​ (Senior Medicare Patrol)​​ (Home Health Care News)​.

• False Certifications and Physician Kickbacks: Some hospice providers forge medical certifications or offer kickbacks to physicians for patient referrals. This leads to the enrollment of patients who do not need hospice care​ (Home Health Care News)​.

• Improper Billing: Fraudulent activities often include billing Medicare for higher levels of care than provided or for services not rendered at all. For instance, billing for inpatient care while providing only routine home care services​ (Hospice News)​​ (Home Health Care News)​.

Real-World Examples and Legal Actions

Several high-profile cases illustrate the severity of hospice fraud:

• Merida Group: Owners were charged with $152 million in fraudulent Medicare claims for unnecessary hospice and home health services. This resulted in significant prison sentences for those involved​ (Hospice News)​.

• Angel Care Hospice: The owner was convicted of enrolling ineligible patients, resulting in $1.5 million in fraudulent claims and facing up to 20 years in prison​ (Hospice News)​.

These cases highlight the extensive financial and emotional costs of such fraudulent practices.

Regulatory and Preventative Measures

The Office of Inspector General (OIG) and the Centers for Medicare & Medicaid Services (CMS) are intensifying efforts to combat hospice fraud. Key initiatives include:

• Nationwide Audits: CMS is conducting comprehensive audits to scrutinize hospice eligibility and billing practices​ (ProPublica)​.

• Stricter Regulations: Proposals for moratoriums on new hospice licenses in high-fraud areas and enhanced oversight of existing providers are under discussion​ (ProPublica)​​ (Home Health Care News)​.

These measures aim to close loopholes that fraudsters exploit and ensure that hospice services are provided to those genuinely in need.

The Financial Motives Behind Medicare Hospice Fraud

Medicare hospice fraud is not just a random act of deception; it is driven by significant financial incentives and systemic vulnerabilities within the healthcare system. Here are some key motives:

1. High Reimbursement Rates: Hospice care is reimbursed by Medicare on a per diem basis, meaning providers receive a fixed amount per day for each enrolled patient, regardless of the actual services provided. This creates an incentive to enroll as many patients as possible, including those who are not eligible​ (Home Health Care News)​.

2. Lower Scrutiny for Small Providers: Smaller hospice providers often escape rigorous oversight compared to larger healthcare entities. This lack of scrutiny allows fraudulent providers to operate with minimal risk of detection. As highlighted in a ProPublica report, the rapid increase in new hospices, particularly in states without strict licensing requirements, has made it easier for fraudulent operations to proliferate​ (ProPublica)​.

3. Ease of Falsifying Eligibility: The process for certifying patients as eligible for hospice care can be manipulated. Fraudsters can forge or falsify medical documentation to certify that a patient is terminally ill, thus enabling them to bill Medicare fraudulently. Kickback arrangements with physicians further facilitate this fraud​ (Home Health Care News)​.

4. Profitability of For-Profit Hospices: The shift from nonprofit to for-profit hospice care has intensified financial motives. For-profit hospices have a higher margin and can generate substantial revenue by maximizing patient enrollments and minimizing service costs. This model, unfortunately, incentivizes fraudulent behavior as providers seek to boost profits​ (ProPublica)​.

5. Minimal Risk and High Reward: The honor system in Medicare billing, where providers are trusted to submit accurate claims, combined with the difficulty in retrospectively assessing a patient's eligibility, makes hospice fraud a low-risk, high-reward endeavor. Even when fraud is detected, the penalties are often outweighed by the profits made from fraudulent claims​ (Hospice News)​​ (ProPublica)​.

By understanding these motives, stakeholders can better appreciate the complexity of the issue and the need for robust measures to combat fraud. Ensuring that hospice care remains a genuine and compassionate service for those in need requires addressing these financial incentives and tightening regulatory oversight.

Risks of Being Improperly Placed on Hospice

Being improperly placed on hospice care can have significant and often detrimental consequences for patients. These risks extend beyond financial exploitation and impact the overall health and well-being of individuals:

• Loss of Access to Curative Treatments: Patients enrolled in hospice care agree to forgo curative treatments. This can lead to discontinuation of necessary medical treatments and limited medical interventions, which may be critical for managing or curing their illnesses​ (Senior Medicare Patrol)​​ (Home Health Care News)​.

• Inadequate Medical Supervision: Improperly placed patients might not receive the level of medical oversight needed for their actual condition. This includes fewer medical visits and potential care gaps during weekends and holidays​ (Home Health Care News)​.

• Psychological and Emotional Impact: The emotional distress of believing one's condition is terminal can be profound, leading to significant psychological and emotional effects on both patients and their families​ (ProPublica)​.

• Financial Exploitation: Patients might incur out-of-pocket costs for services not covered under the hospice benefit, or they might be billed for unnecessary services. Families may also face legal issues if they unknowingly participate in fraudulent schemes​ (Senior Medicare Patrol)​​ (Home Health Care News)​.

• Impact on Caregivers: The burden on caregivers can increase significantly, leading to stress and potential burnout due to inadequate support and resources​ (Home Health Care News)​​ (ProPublica)​.

Examples of Hospice Fraud

• Door-to-Door Solicitations in Ventura County: In Ventura County, fraudulent agencies have been reported going door to door, trying to sign people up for hospice care under false pretenses. These agencies use aggressive and misleading tactics to enroll seniors, offering benefits like free housekeeping or medications to entice them​ (Senior Medicare Patrol)​​ (Home Health Care News)​.

• Falsified Diagnoses: Some hospice providers falsify medical diagnoses to qualify patients for hospice care. This involves forging physician signatures on documents that certify patients as terminally ill when they are not​ (Home Health Care News)​.

• Billing for Nonexistent Services: Fraudulent hospices often bill Medicare for services that are never provided. For example, they might charge for continuous care or inpatient services while only delivering minimal or no actual care​ (Hospice News)​​ (Home Health Care News)​.

Protecting Yourself and Loved Ones

Here are some steps you can take to protect against hospice fraud:

• Verify Services: Always verify the necessity of hospice services and the credentials of the provider. Confirm the medical condition with a trusted healthcare professional.

• Review Billing Statements: Regularly check Medicare Summary Notices (MSNs) and Explanation of Benefits (EOBs) for any irregularities or charges for services not received.

• Report Suspected Fraud: If you suspect hospice fraud, report it immediately to Medicare or the Senior Medicare Patrol (SMP). They can assist in investigating and addressing potential fraud​ (Senior Medicare Patrol)​​ (Home Health Care News)​.

• Capacity Assessment: If you believe that your loved one may not be making sound financial decisions due to cognitive impairment or dementia, please reach out for an evaluation!

Conclusion

Hospice fraud is a significant issue that demands attention and action from all stakeholders, including patients, caregivers, healthcare providers, and regulatory bodies. By staying informed and vigilant, we can help protect the integrity of hospice care and ensure it serves those truly in need during their most vulnerable times.

For more information on how to identify and report hospice fraud, visit the Senior Medicare Patrol website here.

Accelerated Transcranial Magnetic Stimulation (aTMS): A Breakthrough in Depression Treatment

Introduction

Depression is a debilitating condition that affects millions of people worldwide. Traditional treatments, such as medication and psychotherapy, don’t always provide relief for everyone. Fortunately, advances in medical technology have led to innovative treatments like Transcranial Magnetic Stimulation (TMS). Recently, a new variation called accelerated TMS (aTMS) has emerged, offering a faster and potentially more effective solution for those struggling with severe depression. This blog post will provide an overview of aTMS, its benefits, and what patients can expect from this treatment.

What is TMS?

An individual getting TMS treatment in a medical setting.

Transcranial Magnetic Stimulation (TMS) is a non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain. It’s primarily used to treat patients with depression who haven’t responded well to other treatments. Traditional TMS involves daily sessions over several weeks, during which a magnetic coil placed on the scalp sends pulses to the brain regions involved in mood regulation.

Understanding Treatment-Resistant Depression

Treatment-resistant depression (TRD) is a term used to describe cases of major depressive disorder (MDD) that do not respond to at least two different antidepressant treatments of adequate dose and duration. Patients with TRD often experience severe and persistent symptoms, significantly impacting their quality of life. Traditional therapies, such as medications and psychotherapy, may not provide sufficient relief, necessitating alternative approaches like TMS​ (MentalHealthDaily)​​ (McLean Hospital)​.

Understanding Accelerated TMS

Accelerated TMS (aTMS) takes the principles of traditional TMS and intensifies the treatment schedule. Instead of one session per day, aTMS involves multiple sessions each day, usually over the course of a week. For example, Stanford's accelerated intelligent neuromodulation therapy (SAINT) protocol administers 10 sessions a day for five days​ (Stanford Medicine)​​ (Stanford Medicine)​.

Advantages of Accelerated TMS

1. Speed: One of the biggest advantages of aTMS is the rapid relief it offers. Traditional TMS can take weeks to show results, but aTMS often shows significant improvements within days​ (Stanford Medicine)​.

2. Efficacy: Studies have shown that aTMS can be as effective as traditional TMS, with some research indicating higher remission rates for treatment-resistant depression. In one study, 79% of participants achieved remission after aTMS​ (Stanford Medicine)​.

3. Convenience: With the shorter treatment duration, aTMS can be more convenient for patients, reducing the need for prolonged time off work or other daily activities​ (McLean Hospital)​.

Clinical Evidence and Research

Research has demonstrated the efficacy of aTMS in treating severe depression. A meta-analysis of multiple studies revealed significant reductions in depression scores following aTMS treatment, with some modalities showing long-term maintenance effects​ (MentalHealthDaily)​. Another study at Stanford showed that nearly 80% of participants experienced rapid remission, with sustained benefits for months after treatment​ (Stanford Medicine)​.

Conditions Treated with Accelerated TMS

While aTMS is primarily used to treat major depressive disorder, it is also being explored for other conditions such as:

• Anxiety disorders

• Post-Traumatic Stress Disorder (PTSD)

• Obsessive-Compulsive Disorder (OCD)​ (Inspire TMS)​

If you would like to participate in a clinical trial for aTMS, Stanford is actively recruiting participants with a variety of mental health conditions at: https://bsl.stanford.edu/for-patients/

How Accelerated TMS is Accomplished

Accelerated TMS is achieved through a highly individualized approach that includes additional imaging to customize the treatment. Here’s how it works:

1. MRI Scanning: Before starting aTMS, patients undergo a magnetic resonance imaging (MRI) scan. This imaging technique helps to precisely locate the areas of the brain that will be targeted during treatment. (Stanford Medicine)​.

2. Target Identification: The MRI scan identifies the specific regions of the brain associated with mood regulation, such as the dorsolateral prefrontal cortex. These regions are crucial in modulating symptoms of depression.​ (McLean Hospital)​.

3. Personalized Stimulation: The identified target areas are then stimulated using magnetic pulses. The intensity and location of the pulses are customized based on each patient’s unique brain anatomy and connectivity patterns.​ (Stanford Medicine)​.

4. Treatment Sessions: Multiple sessions are conducted each day, with each session lasting about 10 minutes. There are typically short breaks between sessions, and the entire daily treatment schedule can last several hours.​ (Inspire TMS)​.

Procedure and Experience

The aTMS procedure involves several short sessions each day. Here’s what you can typically expect:

• Preparation: Before starting, patients undergo an MRI to identify the precise areas of the brain to target.

• Sessions: Each session lasts about 10 minutes, with multiple sessions spaced throughout the day.

• Side Effects: Common side effects include mild headaches and temporary fatigue. Unlike some medications, aTMS has no systemic side effects and does not require sedation​ (Inspire TMS)​​ (McLean Hospital)​.

Availability and Accessibility

Accelerated TMS is becoming more widely available at specialized clinics and hospitals. It’s important to check if your insurance covers the treatment, as coverage can vary. Institutions like McLean Hospital and Stanford Medicine are leading the way in providing this innovative therapy​ (McLean Hospital)​.

Frequently Asked Questions (FAQs)

1. What is accelerated TMS? Accelerated TMS is a variation of traditional TMS that involves multiple treatment sessions per day over a shorter period. This approach aims to provide faster relief from depression symptoms.

2. How effective is accelerated TMS compared to traditional TMS? Studies have shown that aTMS can be as effective, if not more so, than traditional TMS. For instance, nearly 80% of participants in a Stanford study achieved remission within days​ (Stanford Medicine)​​ (Stanford Medicine)​.

3. How long does the treatment take? aTMS typically involves multiple sessions per day for about five days, significantly reducing the overall treatment duration compared to traditional TMS, which can take several weeks​ (McLean Hospital)​.

4. Are there any side effects? Common side effects of aTMS include mild headaches and temporary fatigue. There are no systemic side effects, and patients do not require sedation during the procedure​ (Inspire TMS)​​ (McLean Hospital)​.

5. Who is a good candidate for aTMS? aTMS is generally recommended for patients with major depressive disorder who have not responded to traditional treatments like medication and psychotherapy. It is also being explored for other conditions such as anxiety, PTSD, and OCD​ (Inspire TMS)​.

6. Is aTMS covered by insurance? Insurance coverage for aTMS can vary. It’s important to check with your insurance provider and the treatment facility to determine if the procedure is covered under your plan​ (McLean Hospital)​.

7. How do I find a treatment center that offers aTMS? Accelerated TMS is available at specialized clinics and hospitals like Stanford Medicine and McLean Hospital​ (McLean Hospital)​.

Conclusion

Accelerated TMS represents a significant advancement in the treatment of depression, offering rapid and effective relief for those who have not benefited from traditional therapies. If you or a loved one is struggling with depression, consider discussing aTMS with a healthcare provider to see if it might be a suitable option.

For more detailed information and patient stories, check out the latest research from Stanford Medicine and McLean Hospital.

References

1. Stanford Medicine: Stanford News Center

2. McLean Hospital: McLean News

3. MentalHealthDaily: Accelerated TMS Review

4. Inspire TMS Denver: aTMS Information

Should You Be Afraid of Brain Worms?

Introduction

Recently, Robert F. Kennedy Jr. made headlines with the revelation that a parasitic worm had been found in his brain over a decade ago. This has raised questions and concerns, particularly among older adults who are already worried about cognitive health. So, should you be afraid of brain worms?

The RFK Jr. Story

How It Came Up

Robert F. Kennedy Jr.'s experience with a brain worm came to public attention due to his 2012 deposition during a legal matter, where he revealed that he had suffered from cognitive problems and memory loss. Doctors initially suspected a brain tumor, but further investigation revealed that a parasitic worm had entered his brain, caused damage, and then died.

Public Reaction and Statements

In light of this revelation, Kennedy made bold claims about his health and capabilities, asserting that he could "eat 5 more brain worms" and still outperform his political rivals in a debate. His campaign emphasized that the issue was resolved over a decade ago and that he is in robust physical and mental health.

Understanding Parasitic Worms

What Are Parasitic Worms?

Parasitic worms, also known as helminths, are organisms that live and feed off their hosts. Common types include tapeworms, roundworms, and flukes. They can enter the body through various means, such as consuming undercooked meat, drinking contaminated water, or poor hygiene practices.

We do not know the exact type of parasitic worm that Robert F. Kennedy Jr. had, but researchers and medical professionals suspect that it may have been the pork tapeworm (Taenia Solium), which is typically contracted through the ingestion of eggs from undercooked pork or in contaminated food or water.

How Are They Contracted?

Infections occur when people ingest worm eggs or larvae, often through contaminated food or water. Older adults may be more susceptible due to weakened immune systems, making it crucial to understand and mitigate these risks.

Life Cycle of Taenia Solium

Cognitive Impact of Parasitic Worms

What Is Neurocysticercosis?

Neurocysticercosis is a severe condition caused by the pork tapeworm (Taenia solium). When the larvae infect the brain, they can lead to symptoms like headaches, seizures, memory loss, and confusion. This condition was what affected Robert F. Kennedy Jr., causing significant cognitive problems before it was diagnosed and addressed.

Symptoms to Watch For

Symptoms of neurocysticercosis can vary but often include:

• Persistent headaches

• Seizures

• Memory loss

• Cognitive confusion

• Balance problems

If you or a loved one experience these symptoms, it’s important to seek medical advice promptly.

An MRI of the brain showing damage caused by neurocysticercosis

Prevalence and Public Health Concerns

How Common Are These Infections?

Globally, parasitic worm infections are widespread, with over a billion people affected. However, in the United States, such cases are relatively rare. The Centers for Disease Control and Prevention (CDC) reports about 1,000 new cases of cysticercosis annually, typically among individuals who have traveled to or immigrated from regions where the disease is more common.

Is This a Realistic Risk for You?

For most people in the U.S., the risk of contracting a brain worm is low. The majority of cases involve individuals who have traveled to endemic areas in Asia, Africa, or South America. Practicing good hygiene, cooking meat thoroughly, and drinking clean water significantly reduce the risk of infection.

Prevention and Treatment

Preventive Measures

• Food Hygiene: Ensure that meat, especially pork, is well-cooked.

• Hand Washing: Regular and thorough hand washing can prevent the ingestion of worm eggs.

• Safe Drinking Water: Drink clean, filtered water, especially when traveling.

Treatment Options

If an infection occurs, medications like praziquantel and albendazole are effective in treating parasitic infections. These drugs can kill the larvae and reduce inflammation caused by the infection.

Conclusion

While the idea of brain worms is unsettling, it’s important to remember that such infections are rare in the United States. Understanding the symptoms and taking preventive measures can help mitigate the risk. If you have concerns about your cognitive health, consult a healthcare professional to explore the causes and appropriate treatments.

Thank you to the Parkinson's Association of Santa Barbara!

Thank you to the Parkinson's Association of Santa Barbara for Having Me Present Last Week on How Parkinson's Affects Cognition

It was a pleasure to provide a zoom lecture for the Santa Barbara Parkinson’s Association last week. The Parkinson’s Association of Santa Barbara (PASB) was founded in 1978 and was the first Parkinson’s group in California. They provide information monthly meetings on topics related to Parkinson’s and also offer symposia for medical providers, making them a wonderful resource for the Santa Barbara community.

I spoke for about an hour on the topic of Parkinson’s disease. However, although we usually focus on the movement difficulties associated with Parkinson’s, in this talk the focus was on the thinking difficulties that can accompany this illness, including what about Parkinson’s causes problems with memory and concentration, but more importantly what steps we can take to protect our brains as we age.

INTERESTED IN WATCHING THE TALK?

It is available for free on our online classes site, insightneuropsych.teachable.com. The site will require you to register, but the class is free. While you are there, feel free to check out the other classes we offer on the aging brain and caregiving.

The video class is broken up into 5 digestible video chunks, including:

• Cognitive Impairment in Parkinson’s Disease: Causes and Prevalence

• Cognitive Impairment in Parkinson’s Disease: How It Presents

• Dementia in Parkinson’s Disease

• How to Age Well

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Know the Risk Factors of Dementia?

It can be difficult to know when something is wrong. There are normal changes associated with aging, and many other issues can masquerade as dementia. For this reason, I created a book on how to understand the aging brain, recognize signs of dementia, and how to understand the treatment, work effectively with doctors, and remain an effective caregiver. My book is now in its second edition, and I have added a workbook to help families.

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Does My Mom Have Dementia?: How to Recognize and Deal with Dementia in Your Loved Ones Buy on Amazon

A Roadmap for Dementia: A Workbook for Families by the Author of Does My Mom Have Dementia? Buy on Amazon

Everyone deserves to understand their brain, how it ages, and is it healthy. Our books provide a roadmap to help you determine if you should be concerned and how you can help yourself and your loved ones. This includes learning about the types of dementia, conditions that can be mistaken for dementia, how to interact with doctors, and what treatments and care is out here.

Our new workbook helps to provide worksheets and tools to support you and your loved one with that the stresses that can arise with dementia, be it due to Alzheimer’s disease, vascular disease or Lewy body disease.

In particular, “A Roadmap for Dementia“ provides tools to help:

• Create a memory book to support your loved one and assist caregivers

•  Develop a strategy to understand behaviors seen in dementia

•  Learn to cope with agitation and psychosis

•  and for communicating effectively with your loved ones with dementia

---

Perhaps you are more of a watcher than a reader

We have also created a series of online video classes focused on understanding the brain and dementia, caregiving strategies, how to keep our brains strong, and even a video course on how to make the holidays a little easier for your loved one with dementia.

CLICK THE BUTTON BELOW TO CHECK OUT OUR COURSES

Want to talk about these issues in person? Please feel free to reach out to us.

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Interested in booking a talk or training for your group?

click below

Thank you to the California Association of PA/PG/PCs!

Thank you to the California State Assoc of Public Administrators, Public Guardians and Public Conservators for having me speak at your convention this week!

I really had the opportunity to learn a lot about the work of the Public Guardian’s office and how best to support them over these last few days here in Palm Springs. I also had the opportunity to hear experts in their field discuss topics such as suicide prevention and crisis intervention, as presented by Sergeant Kevin Briggs, known as the guardian of the Golden Gate for his work preventing suicides while in the California Highway Patrol, and Dr. LaVonna Lewis from USC, who helped us explore awareness of our own bias and its effects on our interactions with others.

My presentations at the conference included

Excessive Persuasion: From Undue Influence to Scam Victimization

and

Interviewing the Cognitively Impaired

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Know the Risk Factors That Make Older Adults Susceptible to Financial Abuse?

It can be difficult to know when something is wrong. Much financial abuse occurs in secret. In many cases the bad actors themselves train their victims not to tell anyone about what is going on. There are signs that you can watch for and things you can do to protect your loved ones though. The issues related to older adults falling victim to scams or undue influence are so significant that when I created the second edition of my book, I added a whole chapter on the topic.

Have You Heard of Undue Influence?

Another type of financial exploitation to mention is somewhat harder to detect. It is the concept of undue influence, which people with dementia can be particularly vulnerable to due to their cognitive impairment. Undue influence is often used to manipulate an older adult into changing estate plans or giving large gifts to the influencer, even when it is not in the older adult’s best interest. Whereas scams use advertising techniques, undue influence uses the development of a strong relationship. Essentially the bad actor develops a special and trusted relationship with the older adult. This is sometimes seen with caregivers, where a caregiver who was hired to care for an older adult with dementia develops a strong bond with the person and then purposely starts to manipulate the older adult with dementia. Often the issue does not become obvious until some financial cost has occurred, or family or friends begin to recognize the influence that the bad actor has developed.

  Besides cognitive impairment, risk factors for undue influence include dependence and isolation. The victim may become dependent on the bad actor for things like food, transportation, and even financial management. Isolation contributes as the victim feels that they have no one else to turn to and so instead they focus on the bad actor. The bad actor will themselves usually encourage isolation and dependency.

Resources to Report Scams and Fraud

 National Elder Fraud Hotline

Provides case managers for support and resources

1-833-FRAUD-11 (1-833-372-8311)

www.justice.gov/stopelderfraud

Federal Trade Commission

Helps government identify victims and track these crimes

www.FTC.gov

FBI Internet Crime Complaint Center

Helps government identify victims and track these crimes

www.IC3.gov

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Does My Mom Have Dementia?: How to Recognize and Deal with Dementia in Your Loved Ones Buy on Amazon

A Roadmap for Dementia: A Workbook for Families by the Author of Does My Mom Have Dementia? Buy on Amazon

Everyone deserves to understand their brain, how it ages, and is it healthy. Our books provide a roadmap to help you determine if you should be concerned and how you can help yourself and your loved ones. This includes learning about the types of dementia, conditions that can be mistaken for dementia, how to interact with doctors, and what treatments and care is out here.

Our new workbook helps to provide worksheets and tools to support you and your loved one with that the stresses that can arise with dementia, be it due to Alzheimer’s disease, vascular disease or Lewy body disease.

In particular, “A Roadmap for Dementia“ provides tools to help:

• Create a memory book to support your loved one and assist caregivers

•  Develop a strategy to understand behaviors seen in dementia

•  Learn to cope with agitation and psychosis

•  and for communicating effectively with your loved ones with dementia

---

Perhaps you are more of a watcher than a reader

We have also created a series of online video classes focused on understanding the brain and dementia, caregiving strategies, how to keep our brains strong, and even a video course on how to make the holidays a little easier for your loved one with dementia.

CLICK THE BUTTON BELOW TO CHECK OUT OUR COURSES

Want to talk about these issues in person? Please feel free to reach out to us.

---

Interested in booking a talk or training for your group?

click below

Exciting News! A New Book And The 2nd Edition of Our First Book

Do You Recognize the Early Warning Signs of Dementia?

Need Straightforward Tools to Help a Loved One With Dementia?

Exciting news then! The second edition of our book, “Does My Mom Have Dementia?” is now out. In addition, I have written a workbook that can accompany the book or stand on its own. It offers tools and worksheets to help make your loved one more comfortable and to help you and your family cope better with the situation.

Sometimes we have concerns about loved ones or ourselves:

• Was that really just a senior moment?

• Are my memory lapses serious?

• Why can’t she think of the word she wants?

There are many normal changes in thinking abilities that occur as we age. Primarily we experience slowed speed of information processing. This means it may take longer for us to learn new information or figure things out.

We also start to struggle with more complex concentration. Think about driving. Do you drive a bit slower now then when you were young? That’s because your brain is automatically adjusting your behavior to match your abilities. Your brain is having a bit more trouble keeping track of what is happening around it, so you need to drive a bit slower.

These two issues, slowed processing and decreased complex attention, are actually the reason many of us think that we lose our memory as we age. We really don’t, but it is easier to be distracted or rushed. If we can’t pay adequate attention we are not going to remember something later, as we never learned it in the first place.

True memory loss is a serious issue. Our book, “Does My Mom Have Dementia” can help you recognize this when it is present and also help you consider other factors contributing to your brain’s current state of health. Being informed is one of best things you can do to keep your brain and your loved ones’ brain strong as we all age.

Does My Mom Have Dementia?: How to Recognize and Deal with Dementia in Your Loved Ones Buy on Amazon

A Roadmap for Dementia: A Workbook for Families by the Author of Does My Mom Have Dementia? Buy on Amazon

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Everyone deserves to understand their brain, how it ages, and is it healthy. Our books provide a roadmap to help you determine if you should be concerned and how you can help yourself and your loved ones. This includes learning about the types of dementia, conditions that can be mistaken for dementia, how to interact with doctors, and what treatments and care is out here.

Our new workbook helps to provide worksheets and tools to support you and your loved one with that the stresses that can arise with dementia, be it due to Alzheimer’s disease, vascular disease or Lewy body disease.

In particular, “A Roadmap for Dementia“ provides tools to help:

• Create a memory book to support your loved one and assist caregivers

•  Develop a strategy to understand behaviors seen in dementia

•  Learn to cope with agitation and psychosis

•  and for communicating effectively with your loved ones with dementia

---

Perhaps you are more of a watcher than a reader

We have also created a series of online video classes focused on understanding the brain and dementia, caregiving strategies, how to keep our brains strong, and even a video course on how to make the holidays a little easier for your loved one with dementia.

CLICK THE BUTTON BELOW TO CHECK OUT OUR COURSES

Want to talk about these issues in person? Please feel free to reach out to us.

---

Interested in booking a talk or training for your group?

click below

Difficulty Digesting Lecture? UDL (Universal Design Learning) Can Help!

Universal Design Learning (UDL) is an individualized style of classroom instruction where one teacher uses a variety of teaching techniques to best serve different learning styles

People often wonder whether the idea of classroom equality is possible, or desirable. After all, students develop differently, have different IQ’s, different learning styles, and even different support systems outside of the classroom. A concept called Universal Design Learning (UDL) is a teaching approach intended to help each student in a classroom get what he or she needs to succeed in order to establish equity in learning. That is, UDS is an individualized style of classroom instruction where one teacher uses a variety of teaching techniques to best serve different learning styles. This style of adaptable and personalized instruction helps each student get what her or she needs to meet classroom learning competencies.

How does UDL work in the classroom?

Teachers utilize UDL in their learning material in unique ways. The goal is to balance a variety of presentation and engagement activities to keep students excited and motivated. The three principles of UDL include 1) creative presentation of the material 2) dynamic and stimulating learning assignments 3) student engagement/ motivation.

Building a UDL program starts with school administration and teachers, but parents should discuss this modality when appropriate. A conversation about UDL might help inspire your child’s classrooms to present the material in more dynamic ways, allowing students to digest the information with engaging activities rather than an older, lecture-style of learning.

How the 3 Principles of UDL work in the brain.
References: The Teaching Commons at Georgetown University, adapted from CAST National UDL Center.

Example of UDL-style assignments:

What does UDL mean for my child?

Successful UDL classrooms present schoolwork in creative and multi-modal ways. Since each student has different strengths, it makes since to incorporate multiple strategies into teaching and homework to help children thrive. Children may benefit from an assessment of their learning style to determine the ideal structure for learning new information (e.g. auditory, movement, visual, etc.).

Feel like you need help with assessment and learning? — Remember, you can do this!

Interested in assessment, advocacy, or school-based services for your child?

Contact Dr. Skye Stifel.

For more information about how to best support your child’s schoolwork at home, please contact me, Dr. Skye Stifel, at Insight Neuropsychology.  As a former special education teacher, a Nationally and California Certified School Psychologist, and Licensed Educational Psychologist. I have the knowledge and experience to help you with your child.  

At Insight Neuropsychology we provide personalized assessment and treatment services to promote cognitive health and well-being. We help you learn about how your child’s brain is functioning and how their environment is affecting them, as INSIGHT is the first step in improving your mental functions.

Want information about Aging-well?

We have online courses available for people across the age range, including a course on mindfulness and the developing brain.

Click the INSIGHT SKILLS link above to see our courses!

Listen to Dr. Stifel discuss coping with COVID for parents and families on The Deciders radio show

The Deciders radio show on 790KABC with Renee Fraser focuses on changing our communities by interviewing CEOs, people who are working to build their businesses, and/or people who are change agents working to create positive social change in their communities.

In this interview, Dr. Stifel discusses how you and your kids can cope with COVID, including trying to understand the situation and normalize our experiences. Some topics discussed include screen time issues right now and how to discuss coronavirus with your kids.

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Interested in learning more, or want an assessment or advocacy services for your child?

For more information about how to best support your child’s schoolwork at home, please contact me, Dr. Skye Stifel, at Insight Neuropsychology.  As a former special education teacher, a Nationally and California Certified School Psychologist, and Licensed Educational Psychologist. I have the knowledge and experience to help you with your child.  

At Insight Neuropsychology we provide personalized assessment and treatment services to promote cognitive health and well-being. We help you learn about how your child’s brain is functioning and how their environment is affecting them, as INSIGHT is the first step in improving your mental functions.

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COVID-19 Scams and Seniors

Scams are an unfortunate part of our reality. From IRS scams to romance scams, there are more ways than ever for unsavory characters to steal your hard earned money.

This fact is even more sobering when it comes to seniors. Even in seniors that are aging normally without any dementia condition, their aging brains put them at much higher risk of being scammed. It is estimated that seniors lose close to $3 billion each year to scams. One of the most important ways this risk can be lessened is by keeping seniors, their loved ones, and care professionals up to date on the most prevalent scams. In 2020, we find ourselves in the midst of the COVID-19 pandemic. Seniors are one of the populations considered at-risk of serious consequences from contracting the virus. This increased fear and the general lifestyle changes caused by COVID-19 have led to new ways for scammers to take advantage of older adults.

In this post, we will share the top 5 current scams that are targeting seniors during the COVID-19 pandemic and provide some advice for staying safe from these new and devastating scams.

Contact Tracing Scams

What’s The Scam?

Contact tracing is the process of identifying people who have come in contact with someone who has tested positive for COVID-19. The purpose is to warn these people that they should quarantine themselves and continuously monitor their symptoms. Contact tracing is understood to play an essential role in stopping the spread of COVID-19. A real contact tracer is someone hired by the state department of public health. They work with an infected individual to get names and contact information for people that the infected individual came into close contact with while infectious. This information is kept in an online system, and the contact tracer never asks the individuals that they contact for personal information such as bank or Social Security information.

Currently, scammers are sending text messages pretending to be contact tracers. Most of these texts will include a link that you are asked to click. A key difference between fraudulent and legitimate contact tracing texts is that real contact tracing only texts to inform you that they will be calling. They will never ask you to click on a link.

Clicking the false links in these text messages can download software onto your device, giving scammers access to your personal information. They may also follow up and directly ask for bank account numbers, social security number, or other important personal information.

Why it Works

By using official language, scammers rely on a sense of authority to convince victims to trust them. Since contact tracing is a real and legitimate strategy being employed by state governments, seniors may have heard the term before, which further creates a false sense of comfort.

What You Can Do

Never provide bank information or other personal information, such as your social security number, to someone through text message. Your phone or wireless provider may also have options to filter or block unknown senders or spam. When in doubt, ask them to call you or share the text with a trusted loved one to get their opinion. There are very few circumstances where clicking a link through an unsolicited text message.

Stimulus Check Scams

What’s the Scam?

By now, most Americans have received a stimulus payment from the government in response the the economic hardship caused by the coronavirus outbreak. If you have not yet received your check, you can use the IRS tool to determine your eligibility and when you may get paid. Although the first round of stimulus payments have mostly been distributed, it is possible that the American public may see additional financial aid coming through in the following weeks or months. Therefore, scammers still have an opportunity to prey upon seniors hoping for some financial relief.

Scammers have been posing as IRS or other government entities to convince individuals that they need personal information such as bank account numbers, social security numbers, or government benefit card information. Typically, they will inform the contacted individual that their stimulus check is ready, but additional information is necessary to process the transaction. They might also claim that a fee must be paid in order to get the money, which is a common lie in financial scams.

Why it Works

Many seniors are living in a time of financial uncertainty. If they owe money due to a mortgage or other bills and their livelihood has been effected by the coronavirus, they may be counting on the stimulus money to get by. Using visceral rewards such as money is one way that scammers bypass critical thinking and cause seniors to act on impulse.

What You Can Do

Remember that the IRS will never contact you via text message, email, or social media with information about your stimulus check. There are no fees associated with the stimulus benefit and anyone asking you to pay a fee or return a portion of the deposited money is a scammer. Using the IRS tool is the best way to track your check and anyone contacting you directly regarding the check through one of the methods mentioned above should be blocked.

Testing Kit Scams

What’s the Scam?

With all of the uncertainty about who might be a COVID-19 carrier and the fact that people can carry the infection without actively showing symptoms, it would be very nice if there was a convenient way to test yourself for the infection at home. Unfortunately, there are no home-based tests at this time. This hasn’t stopped scammers from offering them, however.

Currently, scammers are contacting individuals by phone, email, or text message to offer COVID-19 testing kits. It has also been reported that some of these scammers are attempting to sell fake at-home testing kits door to door. The primary purpose of this scam is simply to get individuals to send the scammers money. However, there is another variant of this scam in which the scammer will post as a government official stating that the individual is required to take a COVID-19 test. In these cases, the scammer will often ask for your health insurance information, such as Medicare or Social Security numbers. They will then use this information to bill insurance for services that were not actually rendered and keep the reimbursement.

Why it Works

Seniors are especially at risk of this scam and similar scams due to personal and emotional factors. Rather than focusing on the economic anxiety of the situation, scammers are preying upon senior’s desire to prove that they are healthy so that they may have contact with loved ones such as grandchildren. Seniors are also aware that they are an at-risk population when it comes to severe consequences from COVID-19 infection, so their physical health is likely a constant concern during this period of time.

What You Can Do

The most important thing someone can do to avoid falling prey to scams related to tests and other health-related products is to stay informed about the current status of COVID-19 testing and treatment by using official sources such as the CDC. Currently there are no at-home test kits that have been approved for public use. Anyone offering to sell you a test-kit is most likely attempting to scam you.

Charity Scams

What’s the Scam?

During this period of collective hardship, many legitimate charities have popped up. Examples of real charities that you may come across include charities providing personal protective equipment to healthcare workers and those sending money directly to individuals financially impacted by the COVID-19 pandemic. Unfortunately, during times of increased aid, scammers often ramp up their efforts to swindle honest people out of their money.

Fake charity scammers may contact you in a variety of ways including pre-recorded robocalls, email, or text message. These scammers will either make up their own official sounding charity name or use the name of a real existing charity to earn your trust. They might ask for for direct donations or personal information such as bank account info.

Why it Works

By using the names of real charities and sometimes going as far as to create official looking websites or letterhead, charity scammers create the illusion of authority, which can make seniors overlook warning signs that the charity may not be legitimate. The fact that there are also many new charities related to coronavirus that have been created also means that it can be hard to keep track of which are real.

What You Can Do

It is very rare that a real charity will ever send you a confusing robocall. If you get a robocall, you can just ignore it. If you receive another form of communication from a charity, take the time to do some research before deciding to send them your money. Use an online search engine to search the charity name. You can also use watchdog groups such as Charity Watch or Charity Navigator to look up their information.

Typically, real charities will request money but will not be mean or pushy with you. If you are pushed to make an immediate decision about donating money, this could be a warning sign. You can always ask them to call back another time, which would give you time to research the legitimacy of the organization.

Lastly, watch out for the payment method that the charity is asking for. A legitimate charity will never ask you to purchase some form of gift card or ask for information to make a wire transfer.

Fake Cure Scams

What’s the Scam?

The coronavirus is scary, deadly, and inconvenient. Of course people are yearning for a cure or some effective means to prevent the virus from infecting themselves and their loved ones. This has lead to a huge influx of fake and unproven treatments for the coronavirus. These are sometimes marketed through email or regular post. They have also become extremely prevalent on social media sites such as Facebook. Advertisements might tout essential oils, teas, colloidal silver, or intravenous vitamin C as cures or proven ways to prevent the virus. Add to this the rampant misinformation and conspiracy theories that have been circulating regarding COVID-19 and it’s no wonder that these scams are so effective.

Why it Works

As with the testing kits, seniors are especially vulnerable to COVID-19 cure scams due to their status as an at-risk population. With their physical health at risk, they are very motivated to find something that can protect themselves from the threat. Visceral motivators such as physical health can tap into the more primitive parts of the aging brain to cause seniors to make decisions based on fear rather than logic.

What You Can Do

There are currently NO proven treatments or preventative measures for COVID-19. Current treatments are aimed at managing symptoms and helping someone ride out the infection. Further, many of the unproven cures that are advertised online may actually cause harm, especially in seniors. If you have a question about a treatment or supplement that you see, call your doctor before purchasing. Also keep in mind that if there were a miracle cure or prevention method for this virus, the numbers would be much lower than they are now.

Conclusion

Scams are nothing new. However, during the COVID-19 pandemic, scammers are finding new opportunities to prey upon our fears and uncertainties to take away our money and other resources. Seniors are especially vulnerable, whether or not they have memory problems or other age-related issues.

To learn more about why aging causes people to become more easily scammed, check out our brand new online course, Scams and the Aging Brain.

In this three-lesson course, licensed neuropsychologist, Erik Lande, Ph.D., covers how scams work, why normal aging increases scam risk, how to help someone who has been scammed, and how to prevent seniors from being scammed in the first place.

Want to talk about these issues in person? Please feel free to reach out to us.

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