|
Generation X and Millennials are at a busy time of life; from getting established in their careers to hitting their stride mid-life and supporting their growing families. Amid all this, the children of the Baby Boomer generation are also dealing with a massive undertaking: caring for their aging parents. With the rise in healthcare costs and inflation throughout the economy, it’s becoming more expensive to have children, let alone adding the financial burden of caring for one’s own parents. But this phenomenon is not new, as the term “sandwiched” (between the care of their children and their parents) existed as far back as 1981, says the Huffington Post. Whatever their moniker, it’s clear that young and middle aged Americans are facing serious financial burdens and lifestyle consequences of this sandwiching. Not just Gen Xers Many argue that millennials are too young to worry about caring for aging parents, but this isn’t always the case. Ariel Brandt Lautman was 35 when she became the primary person responsible for planning the care of her mother, Janet Brandt, after her she was diagnosed with early-onset Alzheimers. Lautman’s story was covered by Susan B. Garland of the New York Times, who acknowledged in the piece that “one-fourth of the 40 million caregivers in the United States are millennials, ranging from their early 20s to late 30s, according to a report by the AARP Public Policy Institute.” No matter their age, caregivers today are dealing with added stress and mounting burdens of juggling immediate family obligations with that of their aging parents—along with a career, not to mention any personal interests or pursuits. It’s not as if children-of-boomer caregivers can choose just one obligation or the other, as many of them already have their own families when the need to care for their own parents arises. Sandwiched between children and parents Caregiving is its own gig, as Carol Bradley Bursack notes in her article with AgingCare: “Caregiving is a job. When you have more than one generation to care for, it’s like working overtime or taking on a second job.” It’s not just taking on a second job if you’re already a full-time mom who works full-time. Think about it: life is busy enough, but many are being forced to make time to care for their parents when other options aren’t readily affordable. A Pew Study released in 2013 revealed that caregivers aren’t just struggling like Lautman did with young children and an aging parent. Many middle-aged caregivers or those in the “sandwich generation” are actually caring for aging parents while also supporting adult children simultaneously. Study authors note, “While the share of middle-aged adults living in the so-called sandwich generation has increased only marginally in recent years, the financial burdens associated with caring for multiple generations of family members are mounting. The increased pressure is coming primarily from grown children rather than aging parents.” It’s much harder to get a job than it was fifty or even twenty years ago, and with student debt weighing heavily on young people, it’s no surprise that many are relying on their parents to pick up the financial slack. Many of those helpful parents are also responsible for supporting their own aging parents. Sharing the burden of caregiving It’s obvious that caregiving is no small task and requires the often untimely demands from close family members. Not every person in need has a family network or support system to ask for help, but certain resources are available from AARP and other various organizations. If you are looking for help sharing the burden of caregiving or perhaps finding affordable care for yourself, Live Care offers a solution. Fill out our contact form to start your application for aid today. Rachel HarrisMs. Harris is a freelance writer and editor who enjoys reading, triathlons, and baking.
0 Comments
It’s no secret that healthcare is expensive. Even with “good” insurance, the costs of healthcare is becoming unreasonable—and rising. The United States spends more money on healthcare than any other country in the world, at nearly 8 percent of the economy going towards healthcare. Experts at the Committee for a Responsible Federal Budget (CRFB) estimate that by 2028, costs will rise to $2.9 trillion, or nearly 10 percent of economic resources. So while the it may be frustrating to pay so much for insurance when you have a cold once or twice a year, imagine the toll these expenses take on those that suffer from chronic health issues. The homebound Being homebound could happen due to a variety of factors, but the main ones are age and disability. It’s true that with social security, disability income and medicare coverage that such persons are not without some income or allowance for their medical needs, but the fact remains that these allowances don’t begin to cover the necessities. Approximately 19.4 percent of the adult population in the United States is disabled, according to the National Service and Inclusion Project (NSIP). And while certain programs and provisions exist for this population, many don’t qualify due to their income falling above the prescribed threshold. With the threshold being low, this doesn’t necessarily mean that they have enough money to cover the costs of being disabled, let alone paying for a home health aid. Family caregivers Since most people don’t want to leave their own home but can’t afford the monthly cost of $4,099 in home care, the responsibility often falls onto the shoulders of family caregivers. These people typically have their own careers and families to support, but have no choice but to also take on the care of their aging relatives. This additional job for family caregivers goes unpaid, meaning that although they may be saving money by not outsourcing the caregiving, caregivers are losing money with the time they spend. Costs seen and unseen The truth is that unpaid family caregivers have increased to 41 million in the U.S., with a calculated amount of $470 billion in unpaid assistance, according to a report given by the AARP Public Policy Institute. This calculation is based off of an average American caregiver’s wage of $13.81 per hour. Unpaid caregivers could range from a full-time caregiver to someone who checks in on their aging parent and provides assistance several times a week. This large amount of unpaid assistance doesn’t even begin to cover the opportunity cost that such caregivers also experience. It’s clear that both the homebound and their caregivers are not receiving the help that they need. Obtaining a motorized wheelchair, affording secondary healthcare services, and being able to cover one’s monthly costs should be human rights. To help bridge the gap between people’s needs and what’s actually being covered by their insurance and entitlements, donate to Live Care Foundation today. Rachel HarrisMs. Harris is a freelance writer and editor who enjoys reading, triathlons, and baking. What’s your five-year plan? What about ten years from now? Twenty? Making plans is all very good and fine, but experience tells us that planning can only do so much. So what is the advantage of life planning, or end-of-life planning, as it is more often termed? For one thing, you can’t plan the end of your life if it has already ended. It’s also difficult to plan the end of your life while it’s happening. Still, statistics show that only 20-30 percent of Americans put their healthcare wishes into writing. The time for end-of-life planning is now so that when that time does come, you and your family members will be prepared financially and otherwise to deal with everything. Plan now to make things easier later When someone’s life draws to a close, there is actually quite a lot to consider and plan. Multiple decisions will come before the funeral planning is necessary, such as making an advanced directive, appointing a power of attorney, creating a living will, and obtaining adequate end-of-life care to ensure comfort, among other personal and financial planning matters. With so much to discuss and settle, it’s no surprise that the entire enterprise is given the name end-of-life planning. Now imagine dealing with all of these decisions when you are at your lowest health, or leaving all of the planning for your closest loved ones while they are coming to terms with your passing. Although end-of-life planning might not sound cheerful, it’s doesn’t have to be a negative experience if you opt to do it in advance. Make your plans flexible and documents fluid It’s important to note that even if you’re really on the ball and have everything in place by the time you’re 50, things will still change and you must allow for such changes as the years pass. “End-of-life plans are not one-time events,” says Dr. Julie Masters, chair of the Department of Gerontology at the University of Nebraska at Omaha. “Documents should be fluid. Revise periodically, for instance, at age 50, 80, 90, etc. Regularly have conversations with financial planners and doctors as well as family members.” If you are coming to the planning party a little late in the game, you’ll obviously like to be more specific about your plans, particularly if you’ve been diagnosed with a terminal disease. Still, the benefits whenever you choose to do end-of-life planning is that you’ll start having conversations that are both necessary and meaningful. There’s no perfect time to start your planning, but sooner is always better than later. Focus on values, health issues, and scenarios Just like any type of planning, end-of-life planning should have three main areas of focus: the carrying out of your beliefs and values, possible health issues and the necessary treatments, and your desires in different scenarios from a stroke to advanced Alzheimer’s. It may be difficult to contemplate such things happening, but with a little planning and consideration, you and your family will all feel much more at peace before and during the event. It’s evident that making decisions regarding end-of-life planning is much more difficult during a crisis situation, so don’t wait until you are “older” or seriously ill. Instead, take action and make decisions now to feel empowered and at peace. If your financial situation is what’s keeping you from making a plan, get help today to cover the costs and obtain better peace of mind for everyone. Rachel HarrisMs. Harris is a freelance writer and editor who enjoys reading, triathlons, and baking. According to the National Institute on Aging (NIA), end-of-life care is defined thus: “End-of-life care is the term used to describe the support and medical care given during the time surrounding death. Such care does not happen only in the moments before breathing ceases and the heart stops beating. Older people often live with one or more chronic illnesses and need a lot of care for days, weeks, and even months before death.” Sometimes referred to as late-stage care, end-of-life care encompasses hospice and palliative care, which may be more familiar terms for some. What makes end-of-life care different than normal medical care? When you hear the term “end-of-life,” it might make you think that it’s for the very end, but as no one can predict exactly when that day will come, it’s not an exact science. To help put it into perspective, end-of-life care may be utilized after your doctor (or the doctor of your loved one) says that there are no other treatments to try and they’ve done everything they can. Although there may be no chance for a cure, there will still be medical needs, as well as mental and emotional needs. This is where end-of-life care comes in. Who needs end-of-life care? Of course there are always some people that beat the odds, but the truth is that each one of us will die someday. It’s best to be comfortable physically, mentally, emotionally and otherwise when that day does come. In today’s world and the Western culture in particular, people don’t like thinking about death and its inevitability. However, when people and their loved ones can plan ahead with end-of-life care, it helps to minimize stress and makes the whole experience more positive for everyone involved. The following situations describe people who would benefit from end-of-life care:
In reality, the decision to obtain end-of-life care remains with you and your loved ones; no one can decide when the time is right except you. What does end-of-life care include? Even though your loved one may no longer be responding to any treatments for their condition, they will still need medical care to keep them physically comfortable. End-of-life care also tends to take a more holistic approach in order to provide for all possible needs: physical, mental, emotional, and spiritual. Here are the main things end-of-life care offers, according to HelpGuide:
End-of-life care can be invaluable to the patient as well as their family and loved ones, but the cost can also be overwhelming. To find out more about how you can get help covering such end-of-life planning, visit our Get Help page. Rachel HarrisMs. Harris is a freelance writer and editor who enjoys reading, triathlons, and baking. Life can be difficult, but many people find that one of the best ways to find satisfaction and happiness is by helping to make the world a better place. Although bettering the world on a grand scale can be helpful if not admirable, sometimes the small, simple acts of service and kindness make the most difference. If you’ve been thinking about how you can make a difference in the world, consider your own community and the interests of those most in need. Below you’ll find five ways to make a positive impact in your own sphere, as well as the world as a whole, because making the world a better place starts at home. 1. Volunteer There are countless ways to offer your time to worthy organizations and people, because in many cases, time is just as valuable as money. Whether you volunteer at a local school or with a nationally renowned nonprofit such as Habitat for Humanity, you’ll find that you can lend a helping hand. If you’re not sure where to start, the technology age has made it easier than ever before to find opportunities. JustServe helps you view and organize opportunities to serve and volunteer in your own community. Just enter your zip code, and you can pick through myriad opportunities for something that fits your schedule and abilities. Volunteer opportunities exist for community mentors to English tutors and visits to the elderly. 2. Be kind Kindness is always a good idea, and definitely makes the world a better place. This could involve getting to know your neighbors better, being friendly to people you meet throughout the day, and even giving compliments to friends and strangers alike. You could pay for someone’s groceries in line behind you—who knows, you might just start something. A little kindness can go a long way, so give it a try and you might be surprised with how it makes a difference. 3. Help the planet Apart from the basics of conserving water and cutting down on waste and overall consumption, there a few specific things you can do to help the planet and your community’s environment. If you don’t have a community garden, try starting one or planting your own. When possible, shop locally and utilize public transportation to cut down on your carbon footprint. Lastly, if you want to help your neighborhood or city look better, you can organize a community cleanup. 4. Be politically active Although the current political climate might seem discouraging, it’s important to know that knowledge is power. Voting helps you have a say in your community, but it’s vital to do your research and learn all you can about local issues—from both sides of the aisle. Divisiveness will continue to be a problem in this country if we don’t try to see the other side of the coin and work together to find solutions. That being said, do your part to be politically aware. Attend community and town hall meetings, and learn and vote about causes you care about. Ballotpedia is a great place to get started for the politically inexperienced. 5. Participate in charitable work More than feeling good, donating to charity has been proven to help businesses and their bottom line. Nonprofits are a great place to start, especially since you can see exactly where their donated funds are going. Not every person has large amounts to give to worthy charities, but there’s always something you can do to support causes you care about. A recent analysis in Health Affairs cited by the New York Times predicted that by 2029, there will be 14.4 million middle-income seniors who do not qualify for Medicaid and cannot afford the care they will need. This is a projected statistic, which means that there are real people who need help now. If you want to do something good for those in need, donate to Live Care Foundation, a nonprofit that helps pay for assisted living and live-in care. Make a difference by donating today. Rachel HarrisMs. Harris is a freelance writer and editor who enjoys reading, triathlons, and baking. How much does at-home healthcare actually cost? It’s a good question, and not one with a simple answer. Depending on how much help is needed, the cost will vary. Before that, let’s talk a little bit about why people might opt for in-home care. Why in-home care? No matter what their age, most people want to live in their own home and their own space. This isn’t surprising, but it can be difficult to fulfill this wish when your loved one requires more help than they have immediately available. Perhaps you have a parent or sibling that lives alone and is needing more help as they get older. Whatever the situation, it’s clear that most people are happier and have a better outlook on life when they can stay in their own home. Independence is another reason people opt for in-home care. Not all people who need such services are advanced in age; some are may have disabilities or temporary injuries that require a more flexible solution that moving out of their home. Thus, they can get care and maintain their daily routine and independence. All these factors contribute to wanting to stay at home, but the decision to obtain professional in-home care is put off for many by the cost of such a development. The actual cost of in-home care Genworth completes a Cost of Care research survey every couple years, and the numbers from 2019 match a growing trend: that cost of care is only going up. Genworth also offers a tool to help you calculate the cost of care in your area, via entering your zip code. The numbers (per month) are as follows:
Although home health care appears cheaper than a facility, it’s possible the expenses could be equal, if one required 24/7 care. Because while that care is covered in the listed home health aid cost, the cost for food, housing and other necessities aren’t necessarily included. How to cover the cost A variety of solutions exist to help people cover the cost of in-home help for themselves or a loved one. Here are the basic options available: Paying out of pocket, or from one’s own investments and savings. Life insurance policies may also be an option if the person has recently lost their spouse. Some consider borrowing (such as completing a reverse mortgage) to be an out-of-pocket option as well, but this may only be a short-term solution and leave the family members with a sizeable debt. Another common way people cover costs is through government allowances, such as the medicare/medicaid programs. Veterans also have a variety of Homemaker and Home Health Aid Care available. Some lesser-known options include PACE (Programs of All-Inclusive Care for the Elderly) and even nonprofits. Live Care Foundation offers help for those who need it, so learn how you can Get Help today. Rachel HarrisMs. Harris is a freelance writer and editor who enjoys reading, triathlons, and baking. On January 29, 2006, Lee Woodruff was in Disneyworld with her four children when she got a call that changed her life. Lee’s husband, Bob Woodruff, had been hit by a roadside bomb in Iraq where he was covering the war as a journalist for ABC. Bob received a life-saving surgery to remove part of his skull, but for the next 35 days, Bob lay in a medically induced coma. Although his body healed, the question was whether or not his brain would. During this time period, Woodruff forced herself to tour an acute care nursing home, knowing that her husband might not awake from his coma. Bob awoke the next day. Suddenly, Woodruff became a full-time caregiver to her husband. Dealing with a crisis such as this—or even suddenly needing to care for an elderly parent—requires a huge amount of emotional engagement that only a family member can provide. So although some may opt for professional care in such situations, it’s clear that a close family member will still be dedicating their time and focus towards the elderly, disabled or injured person. As families begin dealing with the consequences of a sudden illness or disability in their family, the following issues often come into view: 1. Deciding how much to be involved Some may think that it’s impossible to find flexible at-home care that allows families to take part in caring for their loved one, but this isn’t the case. Many types of care exist that offer anything from just hygiene help all the way up to 24/7 care. But even when a family member is able to assume the bulk of full-time care, everyone needs a break at times, so respite care should never be overlooked in order to avoid caregiver burnout. Even if you have a full-time job, it’s only natural that you should want to play a large role in the care of your parent or loved one. Perhaps you feel obliged to become a caregiver because your loved one is refusing professional care. This can be a difficult decision since few people are able to quit their jobs without serious financial consequences, not to mention emotional consequences as well. Deciding how much you can handle in this new realm of responsibility is often tied to the types of care available. 2. Learning about different types of care From acute care facilities to assisted living centers and in-home assistance, myriad types of care exist to aid people with disabilities or the elderly. Regardless of the cause of their need, people often find it difficult to choose the type of care that is best for them. Your doctor should help you understand the types of care you or your loved one should receive, which is always a good starting point. Of course, insurance coverage and convenience of the care comes into play as well. After all these factors are considered, most people usually find that the final decision comes down to the cost of care. 3. Finding the right care at an affordable price For many Americans, the price of care for themselves or loved ones offers the biggest obstacle. Getting help and finding the right care center or at-home provider is one thing, but covering the cost is usually quite another. According to Genworth's 2019 Cost of Care Survey, the national median daily rate for home health care is $141 per day. In contrast, the Genworth study reported that the national median cost of a one-bedroom residence in an assisted living community is $280 per day. No matter how you look at it, care is a large financial burden for anyone, particularly if they or their caregiver falls into the in-between category—with income to high to qualify for Medicaid and other allowances, but income to low to cover such a high cost out of pocket. If you or a loved one is looking for financial aid to cover the cost of care, see if a Caregiver Grant from Live Care Foundation can help lift the burden. Rachel HarrisMs. Harris is a freelance writer and editor who enjoys reading, triathlons, and baking. Medicare has never been a perfect system, and has had changes inserted every few years as a result. Whether those changes are good or bad might depend on who you ask, but it’s certain that the chronically ill pay more due to the consistent cost of their illnesses. In 2015, Congress passed legislation for certain changes in Medicare in an attempt to eliminate unnecessary costs. Some of those changes already came into effect on October 1, 2019. Sadly, therapists and their associations feel that the changes are doing anything but helping patients. According to many physical and occupational therapists throughout the country, the changes that came a few months ago are cutting down on time spent with patients, meaning a 60-minute therapy session must now take place during a 20-minute interval. Paula Span, writer for the New York Times, interviewed Susan Nielson, an occupational therapist, about the change. Nielson expressed frustration with the new policy by saying, “I’m not able to do my job. This person had the potential to do more, and I couldn’t help her.” Many therapists suspect that patients and their families will be forced to pay for in-home therapy services since they’ll still need physical therapy upon returning home due to receiving insufficient therapy at care centers. But why did these changes occur? It all has to do with the payment system for such services. For-profit, not for patient Sadly, a majority of nursing homes and care facilities are for profit and so many administrators take advantage of new policies to be in their favor, financially. Anyone who works in healthcare is all too aware of how certain hospitals and companies are focused on their own bottom lines, rather than patient care. This isn’t a new problem, but the most recent changes in Medicare could mean higher out of pocket costs for those using it for more reasons than one. Not only do healthcare systems take advantage of new policies to reduce the amount of care available (or the amount of care allowed per patient), but everyone is also dealing with higher costs to start with, including rising premiums and deductibles. More changes to come Along with billing and payment system adjustments for physical, occupational, and speech therapy this past October, more changes are on their way. January 1, 2020 will bring even more adjustments, including the discontinuation of first-dollar coverage plans C, F, and High Deductible Plan F. These are all Medicare Supplement Plans (sometimes called Medigap plans), which provide coverage where Medicare does not, minimizing out of pocket costs. In addition, certain plan premiums, deductibles, and coinsurance will also be higher. Here is the breakdown of those changes, as seen on medicaresources.org:
Going forward Whether you’re faced with paying for in-home therapy services or you’re not sure how to cover the ever-increasing premiums, Live Care Foundation is dedicated to helping people and their loved ones cover the costs of life. Request a complimentary consult from Live Care Foundation today. Rachel HarrisMs. Harris is a freelance writer and editor who enjoys reading, triathlons, and baking. As the holiday season approaches, there’s exciting activities and family visits to look forward to. But amid the hustle and bustle, the stress and the food, it can be all too easy to over do it, resulting in illness or injury. Keep your home safe, happy and healthy by following these six tips in your home this holiday season: 1. Get your flu shot On top of holiday shopping and everything else, not everyone remembers to get their flu shot every year. However, this is one of the main tools in your arsenal for warding off the holiday sniffles (and worse). Check your insurance to see the best places to get a flu shot, or look online for a free flu shot clinic near you. Many workplaces offer employee flu shots on site, or you can even sign up to host your own on-site flu clinic. It doesn’t matter how you get it, just be sure to check this off your list and remind your loved ones to do the same. 2. Wash your hands It sounds simple, but hand washing is your first line of defense against germs. Create healthy habits for your family by instituting a hand-washing rule when you get home from an outing and before each meal. By simply following the techniques listed by the CDC, you’ll ensure a healthier home for everyone. 3. Food awareness In addition to following the proper food safety guidelines listed by the FDA, you should try to keep the focus on holiday togetherness rather than food. Grazing and snacking along with overeating become common symptoms of holiday eating, so be intentional and aware about the food you consume. Be sure to eat at regular intervals to avoid overindulging later on, and allow yourself some indulgences while saying no to the rest. By keeping the focus on fun, not food, you’ll be less likely to overdo it. 4. Stay active Our bodies need movement regardless of the weather, so find ways to stay active this holiday season. Sedentary winter months and holiday overeating combine to make a very regretful New Year’s Day, so make a plan to stay active this season. Whether it’s planning a quick trip to the gym amid your celebrations or scheduling a family basketball game, do what you enjoy that keeps your body moving. 5. Clear the air and home With presents, wrappings, and parties, the amount of trash and waste get high. In fact, Americans generate an additional 5 million tons of waste during the holidays, so use this creative EPA guide to cut down on waste this year. As for cleaner air, the use of live plants (such as an evergreen tree or poinsetta) help naturally filter the air in your home. Using a certified HEPA filter will also help clear allergens and other debris. When searching for a way to fill your home with holiday scents, stick with beeswax or vegetable-based wax candles scented with natural essential oils to avoid toxins that paraffin candles produce. 6. Manage stress Travel, extra spending, and a lack of sunshine are just some factors that can add up for holiday stress. Schedule in some daily meditation or mindfulness exercises to keep your mental health on track during the busy winter months. For additional stress management tips, Mayo Clinic offers some great ways to plan a low-stress holiday. If you’re worried about managing alone this season, learn more about assisted living care opportunities for a safer and happier holiday. Rachel HarrisMs. Harris is a freelance writer and editor who enjoys reading, triathlons, and baking. It’s that time of year again! If you dread the New Year and all of its resolutions, you’re far from alone. About 30 percent of those with resolutions give up by the two-week mark, according to a recent study conducted by the University of Scranton. But just because resolutions might be hard to accomplish doesn’t mean they’re impossible. The positive aspect of making New Year’s resolutions is this: taking stalk of your life and making goals about where you want to be a year from now. So where do you want to be next year, or even right now? Are you happy with your environment, job, or health? What changes might be needed to get to a place of better satisfaction? Here are some things to consider as 2020 rolls around: Assess where you are The first step of setting goals is figuring out what needs to change in the first place. Part of this process is looking at what you’ve already accomplished, and acknowledging where you might need to improve. This will help get you into a positive headspace, making you more likely to set reachable goals. Consider the goals you’ve made in the past, and why you might not have succeeded. What could you do this time to help yourself achieve? Make a plan Every productive step results from making a plan in the first place. Now that you’ve considered your past goals and your current standing, set out to make some goals or resolutions that are reasonable. SMART goals, or goals that are specific, measurable, achievable, relevant, and time-bound will be much more likely to come to fruition. Remember, your goals don’t need to be large or something that takes a year to complete; just establish goals that create patterns of achievement and success. Recalibrate as needed Just like a financial budget, any good plan or goal takes consistent reassessment and perhaps some recalibration. If something isn’t working out the way you originally planned, make some adjustments. The key is finding ways to help yourself succeed, so set yourself up for success. If you’re exhausted by the end of the month and tend to eat out more, make some freezer meals during a calmer period for rainy day use. If a certain goal is taking more time to achieve than you originally thought, don’t give up on it, but readjust your timeframe and perhaps the quantity of what you are trying to achieve. Achieving small goals is still achieving! Report to someone The best way to hold yourself accountable to goals or resolutions is by not being the only one that knows about your goals, according to Medium. Whether it’s a buddy or a self-improvement group, share with someone what you hope to accomplish, and check in with each other regularly. This simple task of sharing will hold you accountable to what you’ve said you want to do, and consistent checking in will remind and motivate you to keep going towards your goal. Two heads are better than one, so involve others in your resolutions for additional support and ideas. Working alone on a big problem feels impossible, but you don’t have to be alone with life’s biggest problems, like caring for a loved one. Find help and a way to share the caregiver load today. Rachel HarrisMs. Harris is a freelance writer and editor who enjoys reading, triathlons, and baking. |
LCF Blog
Check out our articles and helpful tips for providing excellent elder care Archives
September 2020
Categories |
RSS Feed