CareTrak Home Care's Elder Care Blog

Misconceptions about Who Pays for Long Term Care

A large majority of the American public still believes that the government will provide long term care when needed. It is this misconception that most likely prevents people from doing any planning at a younger age for the future need for care. According to the National Care Planning Council, (www.longtermcarelink.net) many people believe they can give away assets prior to the need for long term care and qualify for Medicaid. The Council suggests that this belief prevents people from considering other ways to fund the cost of future care.

 

As a matter of fact, it may be possible to use the system and allow Medicaid to cover care but at what cost? Why would anyone want to plan to spend his remaining years in a nursing home--which is the preferred living arrangement for Medicaid. Why go through the expense and effort of trying to manipulate the system to get welfare care, when a little preplanning at an earlier age would be a better option?

 

In our practice we hear frequent objection to long term care planning from people who think Medicare or the Veterans Benefits Administration will take care of them. While this is true to a certain extent, these people simply don't understand the limitations of these government programs.

 

Below are quotes taken from individuals who, over the years, have voiced misconceptions about long term care planning.

 

"Uncle Jim got along just fine with the government paying his care"

 

"I can give away my assets and have the government pay for it"

 

"We have a trust and all of our assets will go to our family so the government will pay for our care"

 

"I'm not interested in home care or assisted living, just stick me in a nursing home and Medicaid will pay the bill"

 

"Long term care insurance is too expensive"

 

Government could be more involved in providing care but our constipated system of delivery prevents this from happening. The National Aging Network, a government-sponsored program, is in the best position to help people receive long term care in their homes. And studies have shown that the cost of providing this kind of care is significantly less than the cost of providing nursing home care through government programs.

 

Unfortunately, for every dollar that supports a person through the Aging Network the government spends about $270 supporting a person in a nursing home. Because it has inadequate funding, the National Aging Network must confine its valuable services to people who have little income or for social reasons are disadvantaged. Moderate and middle income Americans can receive some services from the network but are mostly excluded from the more valuable caregiving services.

 

We believe the public's misunderstanding of Government long term care programs is an impediment to proper long term care planning. When people understand the limitations of relying on government programs they are most likely to be more motivated to plan for the future by making provisions in advance and providing advance funding to pay for care. Prior planning also allows people to have a choice in their care setting and in the type of services they receive.

Understanding the Roles of Formal and Informal Caregivers

Formal caregivers are typically paid providers but they may also be volunteers from a government or nonprofit organization. Where care is being provided in the home there is often a mix of formal and informal care provided. And the trend is towards using more formal care since, unlike the past, more informal caregivers are employed.  They choose to remain employed but must juggle limited time between caregiving and maintaining a household and a job.

 

These added responsibilities often make it necessary to hire non-medical home care aides to provide supervision and help when the primary caregiver cannot be present. Or as adult day services become more common, caregivers may pay for this form of formal caregiving to get rest or to allow for maintaining some employment.

 

When care is no longer possible in the home, then formal caregivers come into play on a full-time basis. This may be in the form of a congregate living arrangement, assisted living, a continuing care retirement community or a nursing home. It is at this point that long term care can have a significant impact on the finances of the care recipient and a healthy spouse living at home. 

 

Care facilities are quite expensive and the cost for maintaining a spouse in such a living arrangement may rob a healthy spouse at home of an adequate standard of living. It's quite possible the healthy spouse may end up with food stamps and subsidized housing where, before the need for a care facility, this may not have been the case.

 

Or it is more often the case that the couple recognizes this dilemma of splitting living arrangements in two locations and an attempt will be made to keep the spouse needing care at home as long as possible. This may help with the finances but often results in destroying the physical and emotional health of the caregiver by creating a situation where the caregiver has difficulty coping with the responsibilities and physical demands.

 

Another reality of providing informal care services in the home is the increasing need for physical and emotional support that often goes unrecognized until too late. As care needs increase, both in the number of hours required and in the number or intensity of activities requiring help, there is a greater need for the services of formal caregivers.

 

Unfortunately, many informal caregivers become so focused on their task they don't realize they are getting in over their heads and they have reached the point where some or complete formal caregiving is necessary. Or the informal caregiver may recognize the need for paid, professional help but does not know where to get the money to pay for it.

 

Other members of the family should be aware of this burden and be prepared to step in and help their loved one who is providing care recognize the possibility of becoming overloaded. It is also the job of a care manager or a financial adviser or an attorney to recognize this need with the client caregiver and provide the necessary counsel to protect the caregiver from overload. The advisor can also likely find a source for paying for formal care that the caregiver may not be aware of.

An overloaded caregiver is likely to develop depression and/or physical ailments and could end up needing long term care as well. The consequences of not being able to cope with the burden of caregiving might even result in an early death for the caregiver.

Expert Help Available for Seniors on the Move

Cheryl was in a panic trying to get her parents home sold in Florida and move them near her in Idaho. Seven years ago Max and Clara purchased their retirement home in Florida and moved there from Idaho. Max had a stroke recently and Clara can no longer care for him herself, so in order for Cheryl to help out they need to move back to Idaho. As is often the case, when elderly parents have health problems, the children are called on for help and support in major decisions. Unfortunately, Cheryl is not able to leave her job and family in Idaho to spend time selling the home in Florida nor find living arrangements for her parents in Idaho. “More than 65 million people, 29% of the U.S. population, provide care for a chronically ill, disabled or aged family member or friend during any given year and spend an average of 20 hours per week providing care for their loved one.” Caregiving in the United States; National Alliance for Caregiving in collaboration with AARP; November 2009 The AARP estimates that over 25 million Americans struggle to balance work responsibilities with caring for a relative aged 50 or older. The National Association of Realtors recognized the specialized need of seniors and their families to sell an established home quickly and efficiently. They have established a designation for realtors called Seniors Real Estate Specialists® (SRES®). To earn the designation a realtor goes through a comprehensive program which qualifies them to know how to work with seniors in the 50+ real estate market. Specialties characteristic to an SRES® designated agent would include: Knowledge of senior communities and housing restrictions Ability to work with seniors on sensitive issues when selling their property Understanding how real estate impacts Medicare and Medicaid laws Knowledge of retirement accounts such as 401K and IRA accounts in relationship to real estate purchases. Expertise in bringing in help with downsizing, packing, moving and relocation Resources to work as a team of realtors throughout the United States for relocation purposes. Seth Owens of Albany New York says of working with an SRES® agent, “Jim worked with me in downsizing and preparing my home for the sale and then took care of all the details. I didn’t have to worry about a thing. He knew his business. The sale was made and Jim helped me find a condo in a senior community near by. He understood I wanted to be near my church, doctor and friends.” With more of the senior population downsizing or moving there has been a growing need for moving companies to specialize in the needs of seniors and their families. Some moving companies have added a department just for moving seniors. Senior moving services may include: Organizing and packing items and unpacking at the new home. Downsizing by disposing of unneeded items Disconnecting electronics and reconnecting after the move. Placing furniture, rugs and household items. Personnel skilled to help with the emotional transition of seniors. The past few years have seen new specialized companies developed that work directly with seniors in downsizing, moving or reorganizing their current home for “aging in place”. The National Association of Senior Move Manager® (NASMM) is an organization of “move managers” whose mission is “to facilitate the physical and emotional aspects of relocation for older adults.” A move manager may oversee the complete move or reorganizing for seniors, making the senior transition less stressful from beginning to end. Placement Services are another specialized business that has developed to fill the need of seniors to find appropriate living conditions. With many options available from independent living apartments, retirement communities, care communities such as assisted living, residential care homes and nursing homes the decision can be overwhelming. Those who do placement services have the expertise to assess the clinical needs, financial resources and family preferences to help seniors find the living situation that will meet their lifestyle and future needs. The National Care Planning Council promotes many services for seniors. Find relocation expertsin your area or obtain helpful information from articles and books.

Senior Home Owners Find Financial Resource in Reverse Mortgages

 

For many seniors the equity in their home is their largest single asset, yet it is unavailable to use unless they use a home equity loan. But a conventional loan really doesn't free up the equity because the money has to be paid back with interest.

A reverse mortgage is a risk-free way of tapping into home equity without creating monthly payments and without requiring the money to be paid back during a person's lifetime. Instead of making payments the cash flow is reversed and the senior receives payments from the bank. Thus the title "reverse mortgage".

Many seniors are finding they can use a reverse mortgage to pay off an existing conventional mortgage, pay off debt or help pay for home repairs, remodeling or long term care needs.

False Beliefs

"The lender could take my house." The homeowner retains full ownership. The Reverse Mortgage is just like any other mortgage; you own the title and the bank holds a lien. You can pay it off anytime you like.

"I can be thrown out of my own home." Homeowners can stay in the home as long as they live, with no payment requirement.

Virtually anyone can qualify. You must be at least 62, own and live in, as a primary residence, a home [1-4 family residence, condominium, co-op, permanent mobile home, or manufactured home] in order to qualify for a reverse mortgage.

There are no income, asset or credit requirements. It is the easiest loan to qualify for.

The amount of reverse mortgage benefit for which you may qualify, will depend on your age at the time you apply for the loan, the reverse mortgage program you choose, the value of your home and current interest rates. As a general rule, the older you are and the greater your equity, the larger the reverse mortgage benefit will be (up to certain limits, in some cases).

The reverse mortgage must pay off any outstanding liens against your property before you can withdraw additional funds.

The loan is not due and payable until the borrower no longer occupies the home as a principal residence (i.e. the borrower sells, moves out permanently or passes away). At that time, the balance of borrowed funds is due and payable, all additional equity in the property belongs to the owners or their beneficiaries.

The most popular reverse mortgage plan is the HECM. (Home Equity Conversion Mortgage) Over 90% of all reverse mortgages are HECM contracts.

You must participate in an independent Credit Counseling session with a FHA-approved counselor early in the application process for a reverse mortgage. The counselor's job is to educate you about all of your mortgage options. This counseling session may charge a fee to the borrower and can be done in person or, more typically, over the telephone. After completing this counseling, you will receive a Counseling Certificate in the mail which must be included as part of the reverse mortgage application.

You can choose 3 options to receive the money from a reverse mortgage:

1. all at once (lump sum);
2. fixed monthly payments (for up to life);
3. a line of credit; or a combination of a line of credit and monthly payments.

The most popular option, chosen by more than 60 percent of borrowers, is the line of credit, which allows you to draw on the loan proceeds at any time.

Keeping money in a reverse mortgage line of credit in most states will not count as an asset for Medicaid eligibility.  It is best to get an opinion from an Elder Attorney in your state.

Tom MacDonald, in his article on “ReverseMortgageconsultant.com”, makes the following statement about Medicaid, Med-Cal or SSI requirements:

No matter how you take your money in a reverse mortgage, it is considered a loan. If you are looking at a financial statement, it is a liability, not an asset. The home is the asset. Many times we refer to the monthly payments incorrectly as monthly income. Neither the IRS nor Medicaid nor any other agency count the funds from a reverse mortgage as taxable income or qualifying income. Think of taking a cash advance from a credit card. It is money you owe to the credit card company. I've not see an agency consider the money from a cash advance as income. The funds from a reverse mortgage are similar.

The Medicaid, Medi-Cal or SSI guideline you need to be most cautious of is the cash on hand guideline. Once example is the requirement you have no more than $2,000 in your bank accounts. If you are taking $1,000/mo of payments from a reverse mortgage and spending only $500/mo, it is obvious that you will exceed the $2,000 guideline within a few months. So, when taking monthly payments, take no more than you know you will be spending every month.

Are You Listening to Elderly Family Members' Care Needs?

Remember when your parents were lecturing you on the rules for taking the car for a spin? Dad would put his face in front of yours and say, “Are you listening?” Of course you would say “sure” even though your mind was miles away on the adventure to come. Today, as adults, the children who received the counsel and wisdom of their parents are facing a reverse situation in their lives. They are finding themselves concerned about their aging parents and what their needs will be as their health and mental abilities fail them. In some cases the children must take the role as parent in securing the safety and well being of an elderly family member. Julie lives 600 miles from her mother. Knowing her mothers health is frail and she lives alone, Julie calls her every evening after work. The conversation always goes like this; “How are you doing today Mom, Julie asks?  “Everything’s fine”, Mother replies.  “Are you taking your pills?” “Yes, everything’s fine.” “Do you need anything?” “Everything’s fine.” Julie does not get much more conversation from her mother. Perhaps everything is fine, or perhaps Julie’s mother just wants Julie to think she can take care of herself. Even worse, mother could think all is fine and be forgetting her medication and not eating properly. Is Julie really listening? ARE YOU LISTENING? It may be time to put your face in front of your parent and listen. Assuming that all is well and that your elderly family member knows and does what is best for them, may be putting them at risk. Become a partner with them in their care. The best time to form the partnership is before a crisis happens. Donna Schempp, a licensed clinical social worker and program director at the Family Caregiver Alliance, states that in talking to your parents, "The sooner, the better." If you bring up the subject before your parents need any extra support, "then it's not crisis driven," she explains. "It's not a way of saying, 'Mom, Dad, there's something wrong with you.” A good way to begin is to sit with your parents and ask questions like, what are your concerns for the future. Do you want to remain in your home? Are you worried about losing your independence? Listen to their answers. You might relate your concerns as well, or you desire to be of help. In become a partner in planning for care and helping your loved one, you need to know what legal and financial arrangements are in place. By asking, “What if you had a stroke, Mom, I would need to know where your medical and insurance documents are and what you would have me do in your behalf.” The next step might be to accompany them to their doctor appointment so to understand what their medical needs are and help create a plan for future needs. The National Care Planning Council's book “The 4 Steps of Long Term Care Planning” gives the following list of most common services family care givers will provide for their parents. Walking, lifting, and bathing Using the bathroom and with incontinence Providing pain management Preventing unsafe behavior and preventing wandering Providing comfort and assurance or arranging for professional counseling Feeding Answering the phone Making arrangements for therapy, meeting medical needs, and doctors' appointments Providing meals Maintaining the household Shopping and running errands Providing transportation Administering medications Managing money and paying bills Doing the laundry Attending to personal hygiene and personal grooming Writing letters or notes Making repairs to the home, maintaining a yard There are many resources available to help families in caring for their elder parents. As you become involved you will know when it is time to bring in professional services to help or when the need to find new living arrangements is necessary. Beginning now to talk, listen and plan together can make the journey more pleasant for everyone involved.

Is Insurance the Answer to Long Term Care Planning?

A recent USA Today article states that there is an increase in seniors living over the age of 90.  According to author Haya El Nasser “The number of people living to age 90 and beyond has tripled in the past three decades to almost 2 million and is likely to quadruple by 2050”.

Seniors who live longer generally have some sort of disability or need help at some level of living. Sandy Markwood, CEO of the National Association of Area Agencies on Aging, indicates that the focus needs to be on being able to help these seniors live at home as long as possible as nursing home cost could rise to average $72,000 a year.

Long Term Care at any level, in the home, assisted living or nursing home can add a tremendous cost to seniors and their families.

Government Programs Only Pay For About 16% Of Long Term Care

Government programs such as Medicare, Medicaid and the Veterans Administration will cover the cost of long-term care under certain conditions. Medicare will cover rehabilitation from a hospital stay or limited care at home if there is a skilled (medical) need. The Veterans Administration will cover the cost of nursing home care indefinitely if the veteran is at least 70% service-connected disabled. The VA will also cover other forms of home-based or community-based care if there is a medical need.

Medicaid will cover both medical and non-medical related long-term care but in order to qualify for Medicaid a person has to have less than $2,000 in assets and income that is insufficient to pay the cost of care.

Funding Long Term Care with your Life Insurance Policy

Drawing cash from life insurance or changing a life insurance policy should only be done after reviewing with an expert advisor.  Loss of the policy and death benefit could prove to be a detriment.  If, however you have accumulated cash in a life insurance policy and no longer need the coverage you may consider using the cash for long term care or purchasing a LTC rider to your current policy.

New insurance products are being developed to cover both life insurance and long term care insurance. ElderLawAnswers reports:

“A new law makes the purchase of products that combine annuities or insurance policies with long-term care insurance more attractive. These "hybrid" products are gaining in popularity due to a law that went into effect January 1, 2010, making distributions from life insurance and annuities tax-free when used to pay for long-term care. The same law also allows owners of annuities or life insurance policies to exchange their old policies for long-term care insurance or hybrid policies without being taxed.”

Combination sales which include life insurance, annuities and traditional long-term care coverage are becoming popular with insurance companies and may prove a method of financing long term care.  Investigate closely, however to find what exactly will be covered.  Some policies do not cover home care costs or complete costs of nursing homes.

Long Term Care Insurance Funding for All Long Term Care Needs

The first long-term care policies were offered about 40 years ago. These were primarily nursing home-only policies designed to take over when Medicare rehabilitation ran out. They were not the comprehensive benefit policies we see today.

Long Term Care Insurance policies today are greatly diversified in their coverage.  Home care, nursing home costs, adult day care, physical therapy, skilled and non-skilled nursing care are some of the services covered.  Policies vary in price and what they cover.  There is also a very restricted qualification of physical and mental heath to get a policy.  Purchasing a policy at a younger age makes it easier to qualify and also provides cheaper premiums. It is best to consult with a long term care insurance professional about the type of policy that fits your needs and budget.

Pre-Need Burial Insurance

One might ask what Pre-need burial insurance has to do with long term care. The purpose of preneed life insurance is to set aside funds for your funeral, before the need arises.
It is an insurance policy that covers the cost of the predetermined expenses of a funeral, cremation or burial.  It gives the purchaser the opportunity to preplan the services and peace of mind in having it paid for.  This is usually an insurance policy that pays at time of death for these expenses. There are many insurance companies that offer these packages as well as funeral homes.

The saddest cases of long term care needs we hear are:

“Mother can no longer live alone and she has no money to go live in a care facility.”

“ Is there someone that can come help me take care of my wife?  We live on our Social Security and I can not pay what home care costs.”

It is important to make the necessary arrangements to cover long term care and end of life costs.  There is no government program that will cover all those needs. The National Care Planning Council at www.longtermcarelink.net strives to educate people about long term care services and encourages the planning that needs to be done to prepare for future costs and needs.

Recognizing the Need for Outside Help in Caregiving

Caregivers often don’t recognize when they are in over their heads, and often get to a breaking point. After a prolonged period of time, caregiving can become too difficult to endure any longer. Short-term the caregiver can handle it. Long-term, help is needed.  Outside help at this point is needed.

A typical pattern with an overloaded caregiver may unfold as follows:

• 1 to 18 months - the caregiver is confident, has everything under control and is coping well. Other friends and family are lending support.
• 20 to 36 months - the caregiver may be taking medication to sleep and control mood swings. Outside help dwindles away and except for trips to the store or doctor, the caregiver has severed most social contacts. The caregiver feels alone and helpless.
• 38 to 50 months - Besides needing tranquilizers or antidepressants, the caregiver's physical health is beginning to deteriorate. Lack of focus and sheer fatigue cloud judgment and the caregiver is often unable to make rational decisions or ask for help.

It is often at this stage that family or friends intercede and find other solutions for care. This may include respite care, hiring home health aides or putting the disabled loved one in a facility. Without intervention, the caregiver may become a candidate for long term care as well.

With the holiday season upon us, caregivers feel even more stress -- with planning, shopping and participating in holiday activities. This is a perfect time for family and friends to step up and provide some respite time and caregiving help.  Whether it is provided personally or arranged as a gift of services to be provided by a professional respite company or home care provider, it is a welcome gift.

An article in “Today’s Caregiver” states:

“Nearly one in four caregivers of people with Alzheimer’s disease and other dementias provide 40 hours a week or more of care. Seventy-one percent sustain this commitment for more than a year, and 32 percent do so for five years or more. One of the best gifts you can give someone caring for Alzheimer’s is something that relieves the stress or provides a bit of respite for the caregiver.
The Gift of time: Cost-effective and truly meaningful gifts are self-made coupons for cleaning the house, preparing a meal, moving lawn/shoveling driveway, respite times that allow the caregiver time off to focus on what he/she needs.”

It is also important to note that hiring professional care provider services can provide valuable ongoing support to an overloaded caregiver. A financial planner, care funding specialist or areverse mortgage specialist may find the funds to pay for professional help to keep a loved one at home. A care manager can guide the family and the caregiver through the maze of long term care issues. The care manager has been there many times -- the family is experiencing it for the first time.

An elder law attorney can help iron out legal problems. And an elder mediator can help solve disputes between family members. There are also cash benefits for Veterans, who served during a period of war, that pay for home care or assisted living.

If you are the one providing daily care for a loved one, you owe it to yourself to seek help.
Take care of yourself and your needs, both physically and mentally.  Seek out professional help that will ease your burden and look for community service organizations that offer respite help.

The National Care Planning Council’s website www.longtermcarelink.net contains hundreds of articles with tips and advice for caregivers and their families.  Take a few minutes to find the help you need and enjoy this holiday season.

Seniors: How To Protect The Family Home From Medicaid Recovery

How To Protect The Family Home From Medicaid Recovery Because the home is the largest asset a couple can keep while still qualifying for Medicaid, it is also usually the main target of estate recovery. Sidney and Rachel's Story:  Sidney and Rachel had lived in their home since it was new. They built it just after Sidney got a promotion to regional sales manager for a shoe distributor. Through the years, the house was remodeled twice and expanded to add a loft bedroom. Even when their children were grown with families of their own, they all remained close, with frequent family gatherings for holidays and birthdays. Sidney and Rachel had paid off the mortgage and two second mortgages before Sidney retired. So in addition to being the center of family life, the house had also become the couple's biggest asset. Rachel always hoped the house would remain in the family when she and Sidney were gone. She often talked about leaving it to their oldest son, Mark, who promised that he and his wife would continue the tradition of hosting the family for holidays and birthday dinners. However, as Sidney's Alzheimer's disease progressed, Rachel worried that Sidney would need to move into a nursing home. With the high cost of long-term care, Rachel knew their savings wouldn't last long. Sidney would eventually need to qualify for Medicaid to pay the bills. Her biggest question was, "Will I lose my home?" A Common Question Indeed For a great many people who need Medicaid benefits for long term care, the home makes up most of their life savings.  Often, it's all a couple has to pass on to their children. You may not know that the home is an exempt asset according to Medicaid. It continues to be exempt as long as the community spouse lives there.  However, after both the ill spouse and the healthy spouse pass away, the property may no longer be protected. What Is Estate Recovery? According to the Omnibus Budget Reconciliation Act of 1993 (OBRA-93), the state has the right to take back whatever it paid for the care of a Medicaid applicant. And because you have to be "broke" to qualify for Medicaid, usually the only property of substantial value that a person on Medicaid is likely to own when they die is their own home. When OBRA-93 was passed, each state established an Estate Recovery Unit (ERU) to go out and find what assets they can take back from those that received Medicaid benefits! Because the home is the largest asset a couple can keep (while still qualifying for Medicaid), in most states it is also the main target of estate recovery. After both the community spouse and the ill spouse die, the state's estate recovery unit has the authority to take just about any property that the Medicaid recipient had their name on.  In most cases, that means going back to the house. For example, if Sidney dies before Rachel after living in a nursing home for two years and Medicaid has paid the nursing home $3,000 per month, the state will have paid $72,000 for Sidney's care ($3,000 per month times 24 months). If the family home where Rachel lives is worth $100,000, the state would have a claim for the first $72,000 that comes from the sale of the house. So, the house is protected while Rachel is alive. However, when she passes, the state may force the sale of the house. Whatever's left over after Medicaid is paid back ($100,000 minus the $72,000 taken out to repay Medicaid) would go to their children. A Married Couple Strategy For Protecting The Family Home From Recovery According to federal law, a married Medicaid applicant is allowed to transfer the home to his or her spouse - without any penalty. Once the transfer is made (meaning the ill spouse no longer has any interest in the house), the community spouse may be able to make some changes to that asset. In some states the community spouse can even give the house away! That sort of gift, of course, would create a period of Medicaid ineligibility if the community spouse needs nursing home care within the five-year look-back period. The family home remains one of the most difficult assets to protect because of timing, but there are proven strategies that make it possible to protect the home from Medicaid Recovery. The Society of Medicaid Planners offers a free download of their report “Medicaid Secrets Revealed by Dan Stemen. The report offers information on qualifying for Nursing Home Medicaid without losing the family home to recovery or spending down your life savings. The National Care Planning Council provides a resource for long term care planning with educational information and lists of professional elder care service providers.

Downsizing, Organizing, Handicap Remodeling or Relocating

When Robert and Anne bought their family home thirty years ago, their plan was to live through retirement in this home. They had furnished their home with refurbished antiques acquired from their many trips together. It was one of their cherished antique coffee tables that Robert tripped over, breaking his hip.  Now with his return from the hospital in a wheelchair, the overwhelming task of making their home accessible for Robert’s wheelchair and safe for both of them faced Anne.

Remodeling for wheelchair access, organizing home furnishings and daily living items or downsizing and relocating to a smaller living area are monumental tasks that are many times thrust on senior home owners.  Sometimes the need to do this is brought on by injury or age related illness. Home and yard maintenance can become a daunting chore for even the healthiest of seniors, requiring them to make a downsizing decision.

There is a large and growing industry of specialists who understand these challenges of elderly homeowners and are ready and willing to help with remodeling, organizing or the sale of the home and with the move to a new location.

A professional organizer provides skills in making the home safe and manageable. Relocating furniture, removing hazards such as electrical cords, throw rugs, heavy objects on shelves that might fall are some of the ways they make a home more senior friendly.  They specialize in helping seniors part with items that clutter or have no valued use, so to make rooms less crowded or to make ready for a move to a smaller living space.

Handicap remodeling services and senior safety services offer help in adding wheelchair ramps and widening doorways. Bathrooms are made more accessible and safe, with hand rails, walk-in bath facilities and easier access to toilets.

If moving to a smaller retirement home or care facility is the best solution there is another senior specialty provider to call on called a Seniors Real Estate Specialist.

The Senior Real Estate Specialist concentrates more on a complete service package for the sale of the property and/or the purchase of a new living arrangement. The specialist also arranges for the services of a relocation specialist or Senior Move Manager to provide a complete, stress-free package for the elderly homeowner.

A move often requires downsizing and getting rid of a tremendous number of acquired possessions. The relocation specialist or Senior Move Manager, as they are often called, will typically provide a turnkey operation that includes assessing and identifying items to keep, arranging for auction or other disposal, cleaning the home, moving the belongings and setting up the new residence. The manager may also work closely with a real estate agent to arrange for the sale of the home and may also be involved in the financial transactions necessary to move into a new living arrangement.

All the help available to seniors may in itself be overwhelming.  How do seniors choose the right service provider for their needs?  How do they know they will hire someone qualified, responsible and honest?  Area Agencies on Aging and State Better Business Bureaus are good resources to check out available service providers.

Family, friends and religious leaders can be valuable resources to seniors in referring service providers and helping to manage the hiring and supervision.

The National Care Planning Council’s website www.longtermcarelink.net provides educational articles and information on eldercare providers throughout the nation.

Caring For Elders - Top 10 Tips For Communicating With the Hearing Impaired

By Hal Robertson

If you have an elder that is one of the 23 percent of folks with some degree of hearing loss, you may want to try these top ten tips when trying to communicate with them. There are many things that can frustrate an elder, but not being able to understand what someone is saying to them due to hearing loss is right at the top of the list.

1. Sit or stand within three feet and face the person

Don't attempt to communicate between rooms.

2. Try to talk to the "good side"

Many elders have one ear that is the "good ear" while the other has a greater degree of hearing loss. Find out which ear is the "best" ear and try to speak with them from that side.

3. Always keep your hands away from your face

Having your hands in front of your face can distort your words, making them more difficult to understand.

4. Don't eat or chew while speaking with your elder

As with hands in front of your face, talking while chewing can also distort your words.

5. Make sure your face is in the light

This helps with lip reading, which many with hearing issues become very good at over time.

6. Know that some words are more difficult to hear that other words

Even for those without hearing loss, some words are more difficult to understand. It can be very hard to distinguish between c,d,e,t and v.

7. Enunciation!

Speak slowly and clearly. Running words together can make it very hard to understand what you are saying. Expressions like howzitgoing, or watchdyado taday can be tough for many with hearing loss to decipher.

8. Paraphrasing

When your elder doesn't hear or understand what you've said, don't continue to repeat the same thing over and over again. Try paraphrasing and they will likely understand. By continually repeating something that isn't heard or understood, your elder's frustration will escalate quickly.

9. When sitting in a group, seat your elder where they can see everyone

Sitting at the head of the table at dinner time is a great way to accomplish this.

10. Make sure your elder is wearing their glasses if they wear glasses

This goes back to lip reading as discussed in number 5. If they are wearing their glasses, it will make this process much easier.

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