Suggested Reading

No matter who you are – a retiree, planning to retire, a retirement educator, a financial planner or advisor – the best way to navigate through the maze of retirement challenges and opportunities is by learning as much as you can about the subject matter. It is wise to seek out suggested reading lists.

There are so many questions and possibilities that one must contend with in retirement, including advancing in age and the health and physical ailments that result.  Below is a list of resources that will help us succeed in life, succeed in retirement.

• The Retirement Guide: A Comprehensive Handbook on Aging, Retirement, Caregiving and Health-How .to Plan and Pay for It:  John A. Paige, Jill O’Donnell, and Graham McWaters.
• Start Where You Are-Retirement Planning in a Changing World – Ruth L. Hayden.
• Boomers-Visions of the New Retirement – Mariaa K. Malayter, Ph.D.
• Retirement Countdown-Take Action Now to Get the Life You Want – David Shapiro.
• The New Rules of Retirement – Robert C. Carlson.
• The Eldercare Handbook Difficult Choices, Compassionate Solutions – Stella Mora Henry.
• Stages of Senior Care: Your Step-by-Step Guide to Making the Best Decisions – Paul Hogan.
• How to Care for Aging Parents – Virginia Morris.
• A Bittersweet Season: Caring for Our Aging Parents and Ourselves – Jane Gross.
• Learning to Speak Alzheimer’s: A Groundbreaking Approach for Everyone Dealing With the Disease – Joanne Koenig Coste, Robert N. Butler.
The more we talk about the situation of aging, an inevitable state, the more we know, the better able we are to understand and transfer that knowledge and understanding into creating a more comfortable and compassionate life for our aging love ones and ourselves.

P. S.  Always Remember to Share What You Know.

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Elder Care Locator

The Elder Care Locator, a service offered by the U. S. Administration on Aging offers a locator search engine where you may find services by location (your state) and search by the topic of interest.  The topics range from Alzheimer’s disease to Volunteerism.  If the topic you are looking for is not listed, you can call and speak to an Information Specialist who will assist you at 1-800-677-1116.

Services differ in every state.  But you can typically find some good information by searching the internet for Area Agencies on Aging, Department for the Aging, or simply Senior Living Services, … and then your City or State.

You may also be able to find programs or financial professionals who can offers assistance on a number of topics including Medicare and Medicaid, Medicare Supplemental Insurance, Long-term care financing and other health insurance options.

These are just a small fraction of the services offered to assist the elderly.  You can find similar services in your state by visiting the U. S. Administration on Aging (AOA) and keying in the information for your state.

Taking on the responsibility of an elderly family member or a family member in need of long-term care is nothing short of a challenge.  However the information that is available on key websites, particularly the AOA are just the resources families need to gather and assist them in creating a comfortable environment for their loved ones in the twilight of their lives.

If the Aging person was a Federal employee look into their FEHB elections.

If the elderly person has much younger beneficiaries you may want to looking at tax-advantaged distributions from that person’s Thrift Savings Plan or IRA.  Talk with a financial professional who knows about Federal benefits and is also knowledgable in medicare and elder care financial planning.

P. S. Always Remember to Share What You Know.

Caregiving and Elder Care

Being a caregiver is a huge responsibility.  It is a mammoth task with profound commitment and there is also the reward of doing something loving and compassionate for a family member or individual who needs the care.  Caregivers also need to be taken care of.  Family members make up the largest cadre of caregivers to an aging population and those who need long-term care. 

Because the responsibilities of caring for the elderly are immeasurable financially, emotionally and physically, caregivers need to know and rely on resources available to help them help the person they are caring for.
As people are living longer, baby boomers are probably the first generation of children who are retired and have to provide care for their aging, retired parents.

They provide care for daily living activities-bathing, feeding, dressing and financial matters.  They also provide companionship to their parents.
The National Family Caregiver Support Program (NFCSP) through the U. S. Administration on Aging (AOA) provide grants to states and territories to fund services to help families and other caregivers  provide care for their family members at home for as long as feasible.

These programs provide tremendous resources and help take away some of the stress and feelings of isolation often experienced by caregivers.  By taking care of the caregiver, elderly family members are able to stay in familiar surroundings longer and family members are able to either avoid or prolong the expense of external care organizations.  Below are some links to services for caregivers of the elderly.

• http://www.alz.org/carefinder  Caring for someone with Alzheimer’s.
• http://www.medicare.gov/campaigns/caregiver/caregiver-resource-kit.html Healthcare Decisions
• http://www.caregiving.org/  Publications and Resources for Caregivers
• http://www.caregiver.org National, state, local programs supporting caregivers
• http://chtop.org/ARCH/National-Respite-Locator.html#elderly  Respite services
The Elder Care Locator through the National Family Caregiver Support Program also recommends publications to help the caregiver.  An entire listing can be found on the website at http://www.eldercare.gov/eldercare.net/public/resources/topic/Caregiver.aspx.

P. S. Always Remember to Share What You Know.

Living At Home vs Assisted Living

Assisted living facilities are residential structures that generally include a housekeeping service, meals, a kitchen, personal assistance help, and transportation to the doctor and other activities that may be outside of the facility.    These facilities are useful for elderly parents who are no longer able to live independently, but need some level of assistance.  Assisted living facilities are state regulated in terms of licensure, staff certifications, inspections and operations.  How they are operated vary from state to state.  There are no regulatory standards governing these facilities.   Families must do a lot of the legwork on their own.  Even if an agency is hired to find an appropriate facility, families should still reserve the right to have the last say.

Deciding whether to place your loved one in an assisted living facility or keeping them at home is often a difficult situation.  Family obligations are sometimes so complex that keeping an elderly family member at home may not be doable.  It is expensive to place a family member in assisted living, but it might be one of the few options families have given their particular circumstances.

If family members come together to decide that it will be a joint and collaborative effort to support an elderly family member at home, then that might be the right choice for that family.  However, the expectation of one family member taking on the total responsibility of an elderly parent or other family member may be overwhelming.

If the choice is to keep the family member at home, then there are many services offered in various states.  Check with the Office on Aging (name may vary from state to state) in your state to get a list of services offered to the elderly.    You may also search the internet to find a listing of Geriatric Care Managers who might be able to help you evaluate your family member’s situation and determine if an assisted living facility is the right fit.

P. S.  Always Remember to Share What You Know.

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Questions to Ask Regarding Assisted Living

Determining where an elderly family member will live out their lives will probably be a very new experience for most of us.  We might be apprehensive about what to look for and what questions to ask.  We might want to walk gingerly so as not to upset staff causing them to mistreat our family members.  Although, this might be a new experience, if you feel you have to compromise your values to receive good treatment for your loved one, then you are already in the wrong place.  Below are some questions you might want to add to your list when looking for the best facility or situation for a loved one.

1. How financially stable is the facility/organization?  The Annual Report should be a matter of public record.  If you don’t understand how to assess the report, ask an accounting professional for help.
2. Are you allowed to participate in the care plan for your family member?
3. May I receive or review a copy of the admissions contract and the house rules? Even if you are not allowed to take the documents away before making a commitment, you still should be permitted to review the documents.
4. Will a room be reserved and kept for a resident who leaves the facility due to a hospital stay? Medicaid requires that a patient be returned to their original unit with a reserved bed after a hospital stay when in a Nursing Home.  The same does not apply for Assisted Living facilities, so be sure to ask about room status after hospital stays.
5. Ask if you are allowed to have a meal at the facility so that you can get an idea about the quality of the meals.
6. Ask the facility director for the facility’s inspection report.  This will allow you to determine how the place is being operated.  If you see any infractions, ask if they have been corrected and if there is a status report to show that the infractions have been removed.
7. Ask if there is a licensed health care provider on duty around the clock, i.e., an RN, LPN or Nurse Practitioner.  Discuss the certifications and licenses of other health care providers and staff.

There are so many things to ask to ensure you are putting you family member in the safest, most compassionate assisted living environment possible with top-notch services.  Think of the process in the same manner as you would when finding a suitable day-care for your young child.

P. S.  Always Remember to Share What You Know.

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Assisted Living and Elder Care

When we have conversations about how to best plan for retirement without placing undue burdens on our families as we age, the question of where I will spend my last days always Choosing Assisted Living comes up.  Our financial advisors and planners can help us with examining cost and determining if our finances will afford the elder care options we are entertaining, but there are some things that are left to our gut.

Whether considering nursing home care, an assisted living situation or home care there are so many important things to think about.  The options we must entertain are financial as well as emotional.  The decisions must be made with care.  There is only one approach that will allow for a situation that is satisfying to all involved and that is early planning.

Before our health or the health of a family member becomes challenging, we need to take action so as to avoid being put in a must do right away position, forcing us to make decisions we otherwise would not.  Perhaps a year before any type of assisted service is needed or anticipated, it would be wise to take a look at facilities, ask for references from families receiving care and visit the facility at various times of the day.

Few things are ever 100 percent, but watching how staff members and caregivers interact with the residents is very important.  Even though many of the residents may be incapacitated in some form or the other, is the resident clean, are the facilities clean and free of offensive odors are things you should pay close attention to.

Are the residents left alone without any services or programs to keep them stimulated?  Social activities and engagement are key factors in adding to the quality of one’s life.  Also evaluate whether the facility is receptive to you inquiring about your loved one and open to regular and consistent visits.  Another key element, if medically feasible, how easy is it to get permission to take your family member on an approved outing for a change of scenery?

Does the facility notify family members in case of an emergency or when there seems to be a significant change in the behavior of the resident?  Most people prefer to remain in their homes, in familiar surroundings because they feel more in control.  Family members have to be very honest about whether an elderly family member can remain in the home or whether a more structured setting is needed.  Families must discuss this very sensitive issue and determine what is best for elder care.

Early planning is most important.  You don’t want to be forced into making decisions you will be unhappy with or regret later.  Also, do not be pressured into making decisions by others, including your professional support team.  You and your family will always have information that no one else will ever have, therefore you will always have everything needed to make the most informed decision.  Plan early so when the time comes to make a very highly emotional decision about elder care, you will be better prepared.

P. S.  Always Remember to Share What You Know.

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LTC (Long-Term Care)

Long-term Care Insurance (LTC) can be an incredibly valuable tool in planning for retirement.  However, the literature shows that most Americans are not as informed about LTC as we should be.

Long-term care is defined as an individual needing ongoing assistance with day-to-day activities such as bathing, dressing or eating.   The need may be due to an accident, a chronic or disabling condition or Alzheimer’s disease.  It is estimated that 1 out of every 5 households in America are providing care to an adult family member or other loved one (AARP and National Alliance for Caregiving).

Most individuals receive long-term care services in their homes according to the U. S. Department of Health and Human Services.  The cost of receiving long-term care varies depending on the type and kind of services one is receiving.  The United States Bureau of Labor Statistics, Labor Consumer Expenditure Survey estimated that the national average monthly base cost for assisted living was $3,550 in 2012.  Costs for long-term care as a rule do not decrease.

Many families are led to believe that transferring the assets of an elderly family member will immediately qualify them for Medicaid to cover long-term care.  According to the Centers for Medicare and Medicaid, the Deficit Reduction Act of 2005 introduced new rules that discourage the improper transfer of assets to gain Medicaid eligibility in order to receive long-term care benefits.

When an individual applies for Medicaid coverage for long-term care, states conduct what is called a review or ‘look-back’ to determine if the individual or their spouse transferred any assets five years prior to the date of Medicaid application.

Medicare generally does not pay for long-term care for help with activities of daily living or other care that most people can do themselves.  Activities of daily living include eating, bathing, dressing and using the bathroom.  Long-term care insurance is the only type of private insurance that pays for expenses incurred because an individual needs extended care due to an accident or a chronic illness.

The U. S. Department of Health and Human Services estimates that approximately 70% of individuals over age 65 will require some level of long-term care during their lifetime.  A comprehensive long-term care plan, in most cases, covers the cost of home care, nursing home care and assisted living.

Although the cost of long-term care is based on age at the time of purchase, the policy and type of coverage selected, if not purchased before age 50, the cost will become more expensive.  Even with that caveat, families still should consider carefully evaluating needs against expenses before totally abandoning the idea of long-term care insurance.  When examining and assessing affordability and need, it is important to look at must have agenda items versus things that can be given up without sacrificing the quality of life for yourself or loved ones.

P. S.  Always Remember to Share What You Know.

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Long-Term Care

We are living in a new world today one reason being individuals are living much longer than generations prior.  Therefore the extension of resources is critical to sustaining a good quality of life for an aging population.  There is an increasing need for expanded services for the elderly and informed.  There is no denying that as we age, the possibility of needing someone to take care of us will become a reality.  How do we begin to make plans early to cover the cost of the extra care we will need as an aging population, with many individuals living well past 100?

We should begin the planning process early while we have the mental acuity to make the best decisions for ourselves and our families.  Long-term Care Insurance (LTC) generally carries a life-time maximum benefit.  When benefits are paid for services rendered, the cost is subtracted from the lifetime maximum.  Federal employees and certain family members may be eligible for LTC insurance.

The cost of nursing homes and skilled-nursing care can be expensive thus impacting the decisions we make about elder care for ourselves or family members.  Although, we generally think of nursing home care for the elderly, after 2 wars with military personnel returning home with major injuries and disabilities, nursing homes are no longer just for the elderly.  Our world is changing most emphatically.  The tragedy and the reality is that an increasing number of people under age 50 are in need of LTC.

Few of us ever thought about including long-term care in our financial plans 20 or 30 years ago.  Long-term Care Insurance is most affordable before reaching age 50.  After that age, the cost begins to escalate even for policies offered through federal benefits.  If LTC insurance has not been purchased prior to age 50, it does not mean that you should not consider it.  It only means that it would be prudent to examine and evaluate a number of policies to determine if one fits into your financial plans.

P. S.  Always Remember to Share What You Know.

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