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Aging in Place: Does It Make Sense to Plan to Stay at Home?

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Long Term Care Conversation Checklist for Families and Seniors

Having a conversation about long-term care with an aging loved one can be very difficult.  Initiating a conversation can be awkward or uncomfortable for family members or caregivers.  We offer the following hints that may help to begin a conversation about long-term care with your loved one.

A good conversation starter is to ask when their legal documents have last been reviewed

Asking this simple question is a good way to get everyone thinking about the future.  Many seniors believe that it isn’t necessary to review documents – “Oh I had those prepared years ago….I’m set.”  Helping the senior realize their life has “probably changed a lot since they were prepared” is a way to ease into “other changes” you have noticed. As we age, just like our health care needs change (we tend to take more prescriptions), our housing needs change (we don’t enjoy the 2 story house anymore), so do our legal needs change.

When you are 18, you need a Durable Power of Attorney for Health Care so someone can make health care decisions for you if you can’t.  When you have a house and are raising a family, a Revocable Living Trust is what is needed to handle a serious accident, health care crisis or an untimely death.  When we become a senior and retire, we need to protect our home and assets against the tremendous cost of long term care and estate recovery.

If your loved one says they have no legal documents or they have “a Will”, NOW, before they have a medical emergency or lose mental capacity, is the time to avoid unnecessary legal headaches and fees by getting powerful documents in place, like “The 3 Most Important Documents”.

The most important documents everyone should have over the age of 18

A Durable Power of Attorney (for finances) appoints someone to act on your behalf if you are no longer capable of handling your finances.  Without a valid and powerful Durable Power of Attorney, the family will be forced to apply for a Conservatorship through the Probate Court to pay bills and handle investments.  Without having in writing who you wish to handle your affairs, the Court may appoint someone you would not have chosen to handle things for you.  A powerful and properly drawn Durable Power of Attorney will allow the person you appoint to protect assets for your quality of life and quality of care.

A Durable Power of Attorney for Health Care Decisions appoints someone to act on your behalf to make health care decisions for you if you are no longer capable of making them yourself.  Without this document in place, the family will be forced to apply for a Guardianship through the Probate Court to make health care decisions for you.  This is vitally important if it is your desire NOT to be kept alive by artificial nutrition and hydration.

The Probate Court requires a surety Bond for the person appointed Conservator and/or Guardian.  The Bond is based on the amount of assets owned by you.  It must be renewed annually and is VERY expensive and very cumbersome.  A Conservatorship and Guardianship lasts the rest of your life, requiring two annual filings with the Probate Court (continued legal fees) and the Court must approve every dollar spent for, or on, your behalf.  The attorney’s fees for a Conservatorship and/or Guardianship, in the FIRST YEAR alone average between $5,000 and $10,000.

If your loved one wishes to avoid a Probate Estate after their passing, they must have some type of a Trust in place.  A Last Will and Testament still goes through Probate.  A Revocable Living Trust avoids Probate, but does not protect any assets from being spent on the cost of long term care and does not protect their home against Estate Recovery.  A Beneficiary Deed does not protect against Estate Recovery either.

ONLY an Asset Protection Trust, and/or some form of long term care insurance, avoids all of your loved one’s assets from being spent on a nursing home and their home being subject to Estate Recovery by the state.  This type of planning is extremely complex and requires consulting with an Elder Law Attorney.

Please call us at 636-394-0009, to see if you are eligible for a FREE no-obligation conference.

Determine if it’s time to think about long-term care assistance

Reasons to seek long-term care can vary from person to person.  Long-term care is not just about a potentially more comfortable and safer environment for your aging loved one. Long term care can and may be necessary for the mental and physical health of the elder, and for the caregiver.

To ensure your loved one is able to consider their options without feeling confrontational, introduce alternative housing options as early as possible, even when you think your loved one might be in the early stages of needing help. Ask your loved one questions about lifestyle or health-related challenges to introduce the idea that either a home-care provider or senior living community may be a positive choice.  Continuing to engage in this conversation over time by sharing your observations, concerns, and any physical or mental challenges you may notice may make the transition easier when it is time.

Remain sensitive to your loved one’s needs

Discussing long-term care may be intimidating for you, but it is a difficult topic for your loved one as well.  Most of us want to do everything possible to stay in our home as long as possible.  Since any decisions that are made will affect your loved one the most, it’s crucial to respect their needs and preferences.  Involve your loved one in as many discussions and meetings as possible, barring any health restrictions.  Being left out of a family meeting or doctor’s conference could foster feelings of exclusion or distrust.

Allow time for your loved one to become open and adjust to the idea.  If there are no immediate health risks, allow your loved one to set the pace for the discussions.  Make an effort to find solutions that will work for everyone involved.  For example, if your loved one feels strongly about maintaining a garden in a new home, expand your search for communities that would be able to provide gardening opportunities.

Some communities have Alzheimer’s patients separate from seniors who just need assisted living.  If your loved one has Alzheimer’s make sure you check into those communities with memory care.

Below you will find a checklist of different symptoms that you may have noticed your loved one is experiencing.  If there are several family members that are around your loved one on a regular basis, it might be good to discuss the symptoms they have noticed and compare with what you have seen.

Physical Symptoms

□  Are they able to move around easily given the physical layout of the home? For example, are stairs, carpet, bath/shower or door handles obstacles for mobility? Is the heating and lighting adequate for any sensory impairment including hearing, sight and circulations problems?

□   Are they experiencing balance issues, especially when changing positions? Are you concerned about them falling?

□   If they fell, are you confident he or she would be able to call for help? Is there a reliable source to respond to a call at all times? If they are living alone, is it time to think about LifeAlert?

□   Are they experiencing frequent incontinence? Can they attend to the problem when this happens or is help needed?

□   Is your loved one experiencing frequent, significant sleep disturbances?

□   Are they capable of shopping for and cooking or preparing healthy meals?

□   Do they have trouble operating gadgets or appliances such as a can opener, microwave, stove or telephone?

□   Are finances such as bill payments, deposits, and investments being handled in a timely manner?

□   Is your loved one still driving? If so, are you concerned about his/her and others well being?  Is public transportation a safe and viable option?

□   Are they capable and are they adequately doing housekeeping, laundry and wearing clean clothes?

□   Are they bathing regularly?

□   Are prescribed medications obtained and consistently taken as indicated?

Mental Symptoms

Is your loved one demonstrating personality changes, including, but not limited to:

□   Frequent irritability?

□   Insensitivity to others?

□   Disoriented to place and time?

□   Aggressive behaviors?

□   Repetitive behaviors?

□   Communication with inappropriate language?

□   Is your loved one socially withdrawn and not able or not wanting to get together with friends or family?  Are there signs of depression?

□   Do they express negative comments about him or herself?

□   Are they demonstrating an inability to make sound decisions or use good judgment?

□   Is your loved one able to understand communication or instructions from others?

Schedule a family meeting

A family meeting can move the topic of long-term care to a more focused discussion that can lead to a plan.  If your loved one agrees, here is a checklist for planning for your family meeting:

□   Determine the family members that should be involved directly or indirectly in decision making.  Always include your loved one if he/she is capable of taking part in any decision making.

□   Consider including an independent third party to play the role of mediator.  This could be a minister or other member of the clergy, a social worker, or a case manager.  If necessary, find a neutral place to hold the meeting.

□   Prepare an agenda to help you stay focused.  It may include the following:

~ A medical update

~ Sharing of feelings about the illness and caregiving

~ Daily caregiving needs

~ Financial concerns

~ Who will make decisions – are there legal documents in place for decision making

~ If there are no legal documents in place, call us at 636-394-0009, to schedule an FREE,  no-obligation conference to discuss what options are best for your loved one and family

~ What support role each person will play

~ What support the primary caregiver needs

~ What you consider the next steps of moving forward should be

~ If you are around more than other members of the family write down what you have noticed in terms of declining health or memory issues that other family members might not notice.

Continue to involve the family

The move to a long-term care community is an immense transition for any family, so it’s important to involve everyone relevant to the person(s) being moved.

Reach out to siblings to secure their input and support.  For example, share online information about long-term care communities to secure greater involvement and participation.

Is there an unequal financial or time burden to one family member? If so, acknowledge the distribution of resources and discuss a strategy for achieving a balance that appeals to everyone.

Continue to engage your parent or loved one

Have ongoing conversations at time when your loved one is feeling best and there are few distractions.

Introduce the idea of an overnight visit to a long-term care community or an extended afternoon visit to get a feel for the various available options.

Begin researching long-term care options in your area.

□   Go to snapforseniors.com to access a nationwide senior housing database.

□   Call and request a consultation with those communities that interest you.

□ Ask family members to help you prepare a list of questions and concerns for your specific situation with your loved one.

We have checklists for Home Care and Home Health Care Providers and an Assisted Living Community cost checklist available in our Resource Center. 

Stop by anytime Monday – Friday, 8:30am – 5:00pm to browse our resources.

15 Things You Can Do For A Caregiver

15 Things You Can Do For A Caregiver

  • Walk the family dog, and take to veterinary appointments as needed
  • Simply ask the Caregiver what you can do, if they say “I don’t know” give them a few days and ask again, even if it’s something small to them, it might be a big deal
  • Give a gift certificate for a day at the spa or a pedicure and manicure – make sure you arrange care for the family member or make time to sit with them yourself
  • Cook an extra main dish when you are making dinner for your own family
  • Many family members are finding themselves taking care of older family members as well as their own children. Offer to take the kids for a night or a weekend or to a special event for a few hours
  • If you are handy, offer to do a little maintenance chores around the home once a month or ask for a list to be made and sent to you
  • Remind the caregiver that they can put your number on speed dial and use it…anytime day or night
  • Gather a list of area caregiver support groups and pass them along to the caregiver…offer to stay with the care recipient if the support groups do not have an “adult day care” during the support group meetings
  • Gather the laundry, start and finish the laundry, or just offer to fold the laundry once a week, or once a month
  • Hire a housecleaning service and get the caregiver/care recipient out of the home for the day
  • Establish a daily/weekly “phone ritual” with the caregiver as a safety check
  • Allow/encourage the caregiver to rant…with no sugar coating allowed (just listen, no judgment, a safe ear for a caregiver can mean the world when everything piles up)
  • Offer to take the family car in for routine maintenance
  • Discuss with the caregiver if they would like for you to research and find out if there are any respite programs that the care recipient qualifies for or additional help around the house or modifications that can be made to make life easier

    5 Bonus Ideas

  • Make a restaurant reservation: 1) for the caregiver and care recipient, 2) for the caregiver and a friend, or 3) arrange to have a restaurant deliver a special meal to the home
  • Take a moment and really observe the caregiver and come up with one simple thing that will make his/her life easier
  • Clip coupons for the caregiver and care recipient of items they use often (or better yet, buy food staples and stock the family pantry/supply closet
  • Arrange pizza delivery on special game nights for them to enjoy
  • Offer to help decorate for the holidays with the care recipient, or take the care recipient out for the day/afternoon/evening so the caregiver can enjoy putting up the decorations without interruption and have a few hours to themselves

May is National Elder Law Month!

Many people prepare for death by having a Will or Trust drawn up.  But the real question is,

“What if I don’t die, but get sick and need care?”

Are you, your family and your assets  protected? Come to one of our free workshops and learn what can  happen to you or your clients if you aren’t prepared.

We always encourage people to “get there ducks in a row” and make sure all of their legal documents are up to date and work for each individual’s Elder Care Journey.  We believe above all other legal documents you need to make sure you have The 3 Most Important Documents. That includes a Durable Power of Attorney, a Durable Power of Attorney for Health Care and HIPAA documents.

Call us today at 636-394-0009 to register for a workshop or to learn more, or if you would like to learn more about the Elder Care Journey or The 3 Most Important Documents.

 

National Healthcare Decisions Day

April 16th is National Healthcare Decisions Day

 The goal is to inspire, educate and empower the public and providers about the importance of advance care planning.

Nobody wakes up and says:

“I think I’ll have a stroke today.” 

Don’t get stuck with inadequate documents.  Make sure your Durable Power of Attorney and Health Care Durable Power of Attorney are powerful yet flexible to take care of whatever life throws at you.  Don’t forget we review    Durable Powers of Attorney and Health Care Durable Powers of Attorney for FREE! Call us to schedule an appointment to have your documents reviewed.

 

March is Storm Preparedness month!

Whether you are new to the area or a life long St. Louisan, you know of our horrible tornados and historic flooding.

The important lesson we are reminded of every time is to always be prepared.  Make sure all of your loved ones in your life are prepared for any emergency.

Visit our Resource Center Monday – Friday, 8:30am – 5:00pm for resources on Storm Preparedness and other topics for seniors and our community.

 

January Resolutions

January is a great time to set resolutions for weight loss, exercising and eating better, and spending more time with your loved ones.  It is also a great time to think about those things which we tend to “put off” like estate planning.

No one wakes up and says, “I think I will have a heart attack and die today.”  Or “I think I will have a stroke today and need care for the rest of my life.”

Being prepared gives you and your family the most options to protect yourself, your family and your assets.  Make January or February your time to take control of YOUR estate plan. Make you sure you are PREPARED.

Call today 636-394-0009 to attend on of our FREE Workshops on February 18th at 10:00 a.m. or February 23rd at 6:30 p.m. or you can view all of our upcoming workshops and sign up through our Events page.

December 2013 – MoneyTalk Interview – Caring for your loved ones with dementia during the holiday season

Dana (Vouga) was on Bob Hardcastle’s Money Talk KTRS 550 AM radio show on Sunday, December 7th at 8:00 a.m.  She referred to post from last year on “Caring for your loved ones with dementia during the holiday season.”  Click on “more” to get acess to the Caregiver Stress Test, Activities for Alzheimer’s and Dementia Patients, Talking to People with Dementia, and Conversation Starters for Talking To People With Dementia.

Read more

TONIGHT! Our America – Episode: Did You Know Taking Care of Elderly Family Members

Our America – Did You Know Taking Care of Elderly Family Members follows Lisa Ling and the life she is learning about while taking care of her elderly father.  Tune in tonight on the Oprah Winfrey Network (OWN) at 10/9c.