Assembling your support team

Assembling your support team

Much as we would like to imagine an elderhood free from troubles, the truth is, we are all likely to need help eventually. And on several levels.

Informal support. This is the kind of help that friends and family members can provide short term. Someone to run errands or mow the lawn, etc. Make a list of the

  • people you feel emotionally close to
  • people who live close by who are reliable

When the going gets tough. If you were hospitalized, who would you call to

  • make medical decisions for you if you were unable to speak for yourself
  • pay bills or perhaps even manage your financial affairs long term

Your health care team. Medically trained support:

  • Your primary care provider and any specialists
  • Your pharmacist
  • Allied health providers (e.g., therapists, home health)

Professional advisors

  • An elder law attorney for important documents. You will need an attorney to set up a trust or will for dispersing your assets after you are gone. Or, if you have no relatives, to arrange for a guardian to make medical and financial decisions for you when you can no longer do so yourself. In addition, an attorney can review contracts and catch important details about senior housing. And an attorney’s advice is critical if you are considering a reverse mortgage or spending down your assets to be eligible for Medicaid.
  • A financial planner to manage assets and strategize to liquidate them to pay for care.
  • A CPA to highlight the tax implications in any of the above situations.
  • An insurance broker for prescription, Medicare supplemental, life insurance, etc.

An Aging Life Care™ Manager. The choices are boggling when it comes to assembling your team. It’s difficult to assess quality of professionals or compare pricing. An Aging Life Care Manager is a “meta-advisor” whose experience can help you choose your team wisely and coordinate whom to call when.

Want help assembling your team? Give us a call at (208) 321-5567.

Learn more about our aging life care planning services.

Paying for care at home

Paying for care at home

How you pay for care at home depends on whether the service is by medically trained staff or by nonmedical caregivers. Also, what you can mix and match in terms of community programs and help from friends and family.

Medicare pays only for care in the home that requires the skills of a nurse, nursing assistant, physical therapist, or other medically trained professionals.

Home care $$–$$$$
The cost of nonmedical home care is NOT covered by Medicare. As a result, you must contract directly with providers. Fees depend on how many hours a week your care requires.

Consider that caregivers coming to your home need a livable wage. Add to this agency costs of staff recruitment, vetting, training, and scheduling. The price can mount up quickly.

  • Long-term care (LTC) insurance. These policies can be purchased privately and are the least expensive when begun in middle age. Typically, to draw upon the insurance, you must pay for home care services out of pocket for a waiting period. Insurance will contribute afterwards and pay up to the lifetime cap. Check policy details.
  • Veterans assistance. For qualifying vets who saw active duty with at least one day during a war, there may be benefits available to help with the costs of home-based care.
  • Personal savings. Consult with a financial planner and elder law attorney to determine the best strategy for liquidating assets to cover your care.

Adult day care $–$$$
You must pay privately. Many programs are run by nonprofits so are underwritten by donations and grants. Medicaid, LTC insurance, and veterans benefits may also help.

Home health and hospice $

  • Medicare. This is typically deducted from your Social Security check and will cover home health services (80%) and hospice (often 100%).
  • Supplemental insurance. This is insurance you buy to cover the 20% balance not paid by Medicare.
  • Medicaid. Those with VERY low income and minimal assets may qualify for state government support. The eligibility requirements are stiff. Coverage includes 100% of most medically trained care, with some restrictions. Coverage for nonmedical care is spotty and varies by county.

We can help you sort out your options.
Give us a call at (208) 321-5567.

Learn more about our aging life care planning services.

Medical emergencies: Are you prepared?

Medical emergencies: Are you prepared?

Judy fell and broke her hip. She calls 911. She lacks a medication list. As a result, the hospital team is unaware of her chronic conditions. Her daughter lives far away and doesn’t know if she should fly in.

Accidents by their very nature are unplanned. That doesn’t mean you need to be unprepared for a fall or a serious incident (e.g., a heart attack or stroke).

Those who are prepared and have a professional advocate, such as an Aging Life Care™ Manager, are more likely to get the care and the outcomes they desire. Plus, they can recuperate in a setting most in line with their personal needs and preferences.

To be prepared, you need

  • current documents. Key to avoiding problems is the ability to give emergency and hospital personnel a list of current medications, your medical history, and an up-to-date list of your doctors and their phone numbers. Copies of all your insurance cards will speed the clerical side of the process. You will also need an advance directive that names your health care decision maker(s) and your preferred treatments.
  • up-to-date decision makers. Does the person you have chosen know and understand your treatment preferences? Does the rest of the family know and respect that he or she “speaks for you”? Does your decision maker have a medical background? Is he or she nearby enough or able to drop everything and come to your side?
  • a professional advocate. Often family or trusted friends cannot be present at a moment’s notice. And most people are not conversant with medical procedures. A professional advocate, such as an Aging Life Care Manager, has met with you prior to the emergency. He or she can fill in the medical team and communicate your personal priorities. An Aging Life Care Manager can advise decision makers by providing insight about treatment choices: Pros and cons and likely outcomes vis-à-vis your values. An Aging Life Care Manager can keep long-distance relatives informed and make recommendations regarding the need to travel. When it’s time to leave the hospital, an Aging Life Care Manager can recommend the best support facilities on the basis of your resources and personal preferences. As you plan ahead for emergencies, you will want to make decisions about hiring a professional advocate. Some Aging Life Care Managers offer the option of 24/7 emergency, on-call coverage. Others do not.

Ideally, all this information is available on your person or is readily accessed should you get into an emergency situation.

Want help getting prepared for a medical emergency?
Give us a call: (208) 321-5567.

Learn more about our aging life care planning services.

Age-friendly bathroom remodels

Age-friendly bathroom remodels

Activities that are easy now may become more difficult in the future: Going up and down stairs, standing up from sitting, getting in and out of the tub, catching your balance if you start to slip. . . . As you consider aging in place, it is wise to keep these issues in mind, particularly about the bathroom.

Structural considerations. To eliminate the need to climb stairs, the ideal is a full bathroom on the main level of the house. In addition, as we age, the likelihood of needing support increases. Whether a wheelchair or walker, or a spouse or paid caregiver is providing assistance, a spacious room is best.

Did you know the bathroom is the most dangerous room in the house? Eighty percent of falls occur in the bathroom on hard, sometimes slippery surfaces. Most falls occur in the process of sitting down on or getting up from the toilet, or getting in/out of the bath/shower.

Bathtub or shower? The most versatile design involves a water-friendly, nonslip floor with a drain, and no hard curb around the shower area. This allows for rolling a wheelchair into the shower and provides room for a helper. Even without such a radical makeover, it’s easy to install a handheld showerhead and a built-in or portable bench in an existing bathroom to create a seated shower option.

If you need to soak—great for achy arthritic joints—consider a walk-in tub. These tubs have a watertight seal on a side door that allows you to walk in, sit on a bench, and then fill the tub to the desired height. Or have a dip cut into the side of an existing tub to lower the height for ease of stepping in and out.

Toilets and bidets. Purchasing a high toilet or adding an extender that raises the sitting surface greatly reduces the physical challenges of sitting down and getting up. Many people find a bidet adds to convenience and cleanliness. (Twisting to wipe our nether regions becomes more difficult with age.) Rather than ask for help, cleaning with water can improve hygiene while preserving dignity.

Other fall prevention strategies. You don’t need a full remodel to improve safety. Installing grab bars beside the toilet and within and outside the bathing area is an easy and effective modification. Grab bars must be attached securely to the studs of the wall and be able to support 250–300 pounds. Installing nonslip flooring or applying antislip floor coatings for higher traction is also wise. Increased lighting will help visibility and reduce falls. In addition, lights installed on the wall instead of on the ceiling reduce the need to get on a ladder, and possibly fall, when changing a bulb.

How age friendly is your bathroom?
Give us a call at (208) 321-5567.

What is an Aging Life Care™ Manager?

What is an Aging Life Care™ Manager?

Imagine your life as a movie. If you are the director, an Aging Life Care Manager is your production manager.

He or she is a deeply knowledgeable guide (usually a nurse, social worker, or allied professional) who finds you high-quality help, arranges care “locations,” and advises you about needed services.

Aging Life Care Managers are part of a national organization with training requirements, codes of ethics, and a nationwide network of experienced colleagues in case you need to move to a different part of the country.

Specialized knowledge and skills
Aging affects all aspects of life, so an Aging Life Care Manager draws upon many areas of expertise:

  • Advocacy. Communicating with doctors and navigating the very confusing eldercare network to get you the care you want.
  • Health and disability. Conducting an assessment and making recommendations so you and your family members can rest assured that a plan is in place if you need extra help.
  • Local resources. Recommending area service providers. Anyone can Google. But an Aging Life Care Manager intimately knows quality and reputation and can match best services for your budget and priorities.
  • Family. Helping relatives understand their role and work together to support your wishes.
  • Housing. Providing independent recommendations for the best fit based on your needs, priorities, and resources. No kickback referral fees that limit your choices.
  • Legal. Assembling needed paperwork and referring you to reputable attorneys as needed so you are well covered by a professional team.
  • Finances. Reviewing your options to identify eligibility for programs and ways to stretch your dollar wisely.
  • Crisis support. Helping you create a safety net you can depend on in emergencies.

As the director of your later years, how do you want your story to unfold? While not all of it is within your control, you do have agency. With planning, there is much you can do ahead of time to prepare for the elderhood you want and create a network to support it.

Would you like a guide for aging well?
Give us a call at (208) 321-5567.

Learn more about our aging life care planning services.

Types of long-term care

Types of long-term care

While “aging in place” has its benefits, it is expensive to get such individualized care. Plus, it’s rather isolating. Group options require a move, but are more social and cost effective.

  • Assisted living. People move to assisted living when they are ready to stop cooking, cleaning, and maybe even driving. They enjoy social activities but need more help than an independent retirement community might offer. Though not a setting for people with advanced dementia, a portion of assisted living residents may have memory problems.
  • Memory care. With activities specifically for people with significant dementia, memory care may be housed in a wing of assisted living or operate as an independent facility.
  • Skilled nursing or “rehab.” Geared for short stays—several days to several weeks—a skilled nursing facility can be thought of as a place to get stronger or learn to do things in new ways after a setback. Then you move to a more homelike environment.
  • Nursing home. This setting is a long-term version of rehab but for those with complex conditions who don’t need a hospital, yet aren’t independent enough for assisted living.
  • Continuing care retirement community (CCRC). This large “campus” offers all of the above and more. Move in while fully independent and able to enjoy the pool, golf course, etc. As care needs change, residents move to the different care buildings yet stay on the same property. Ideal for a couple when one needs more support than the other.

Let us help you understand the different options.
Give us a call at (208) 321-5567

Learn more about our aging life care planning services.

Home care

Home Care

Support is available for those who wish to stay at home. However, one-on-one care is expensive. And it’s not always easy to find caregivers. Community services can sometimes be patched together.

To stay at home, it helps to have a knowledgeable person check in periodically who knows eligibility requirements and can supervise and coordinate all the players.

  • Home care. People who do not need medical attention, but simply help with household activities, running errands, or light companionship, benefit from home care. The key to success is finding a good match between the caregiver’s personality and your own.
  • Adult day care. If someone is available for nighttime care of a person with dementia or light medical needs, then adult day care can provide engaging daytime activities, meals, and relief for the caregiver. Ideal for working families or a spouse who needs a break.
  • Home health. Patients are able to leave a skilled nursing facility yet continue receiving needed therapy through visits at home. This is a short-term service, ending when the patient has improved as much as can be expected.
  • Hospice at home. Hospice is for people with a life expectancy of up to six months who opt for improved quality of life over the hardships of treatment. Nurses visit at home a few times a week to monitor pain and comfort and to support families as nature takes its course.

Call us at (208) 321-5567 to start
the planning process for aging in place.

Learn more about our aging life care planning services.

Social Security and the newly single

Social Security and the newly single

Life has a way of throwing us curveballs.

The unexpected death of a spouse—or a divorce—can certainly wreak havoc on your emotions. It can also throw a wrench in your finances.

If you are age 62 or older, here are some Social Security basics to bear in mind as you regain your financial footing or make contingency plans.

Survivor benefits. If you find yourself widowed after at least one year of marriage, then you are eligible to receive monthly survivor payments.

Did you also work outside the home? If so, you can choose the higher of the two benefits: yours personally; or as a surviving spouse.

Before deciding, confirm the amount for each one for three points in time: collecting now; waiting until age 70; or at your designated retirement age (as determined by Social Security). While you cannot receive both benefits at the same time, you can strategically claim the highest one now and then switch to the one that becomes higher later.

Spousal benefits. A divorce does not erase the contribution you made to the household. As a formerly married spouse, you are eligible for Social Security benefits based on the earnings of your breadwinning partner. As long as you were married for 10 years or more, you have earned spousal benefits.

Receiving spousal benefits does not affect what your ex will receive from Social Security. What’s more, your ex does not need to know, give permission, or sign any papers. All you need to provide is the marriage certificate, divorce papers, and your ex’s full name.

If you were also employed and are eligible for your own Social Security benefits, investigate which benefit will pay more: now; when you turn 70; or at your designated retirement age. Unlike survivor benefits, you cannot switch benefits at a later date. Decide when is the best time to apply, and choose the larger amount.

It’s important to make a fact-based decision. The difference in monthly payments, added up over many years, could mean there are thousands of dollars at stake. There are many more details than we can cover here, including information about benefits in same-sex marriages. Consider working with a certified financial planner who can run the various calculations for you and suggest the wisest strategy. There’s too much to lose to depend on Social Security staff for detailed guidance.

Find yourself suddenly single?
Let us help you get reoriented. Give us a call: (208) 321-5567.

Learn more about our services for aging well.