My sister was young and very ill.  It took a long time for doctors to diagnose her illness and determine the best course of treatment. Most of my sister’s middle school education took place at home while she underwent various treatments and medical procedures and took numerous medications.  Throughout this time, my parents’ entire focus seemed to be on my sister and her health.  Fortunately, I was old enough to understand what was happening and never felt any resentment toward my parents or my sister. 

No matter how old you are, it is difficult to have a brother or sister who is seriously ill. Siblings who are too young to understand what is going on may feel neglected by their parents.  In the case of older siblings who can comprehend the situation, the reality can be a source of stress and anxiety.  In my situation, in addition to being worried about my sister, I felt guilty for being healthy.  I would often ask myself “why her and not me?”

Fortunately, over time my sister’s symptoms were brought under control and life evolved to a “new normal”. My sister is now in good health and follows a medical regimen designed to minimize disease flare-ups. We continue to be close and loving sisters and friends.

There are many things I learned from my experiences with my sister’s illness. And though I am not yet a parent, I feel that my experience has provided me with insights that may be helpful to parents who have multiple children, one of whom is seriously ill. If you are a parent in this situation, be on the lookout for the following symptoms in your “healthy child”:

• Depression
• Withdrawal
• Anger
• Lack of social interaction
• Decline in educational performance
• Acts of rebellion or attention-seeking behaviors

 If your child is showing any of these symptoms, here are some tips to help your child cope:

• Educate:  It is vital your child understand the illness affecting their sibling. Remember that your child deserves to have all of their questions answered in age-appropriate terms. Seek help from your pediatrician, if needed, to determine the best explanation for your child.
• Include: Whenever possible include your child in the hospital experience. Whether at home, or in a hospital setting, there may be ways a sibling can contribute to helping their brother or sister. Participating in the care of their sibling gives your child an opportunity to feel pride, satisfaction and love.
• Recognize: Notice and acknowledge your child’s activities and accomplishments, not just those that are centered on helping their sibling.
• Schedule:  Plan weekly one-on-one time with your child and be sure to convey to your child how much you enjoy these special times. Enlist the help of friends or extended family members so you can get the time you need. While this is a great opportunity for your child to ask questions about their sibling do not bring up the issue unless your child does so.

Having a sibling with an illness can present a tremendous challenge for a child.  Nevertheless, by following these tips, everyone in the family should be able to cope more easily cope with the illness, support each other and build a strong foundation within the family.

• Know the names of the medications and how they work. Know the generic and brand names, dosages and side effects of medications. People should always keep a list of their medications with them.
• Take medications as scheduled, at the same time every day. People should not stop taking or change medications unless they first talk with the doctor. Even if they feel good, people should continue to take the medications. Stopping medications suddenly can make the condition worse.
• Have a routine for taking medications. Use a pillbox that is marked with the days of the week, and fill the pillbox at the beginning of each week to make it easier to remember to take the pills. A home care aide can also provide reminders to take medication or an automated medication dispenser can be used.
• Do not decrease the medication dosage to save money. A person should take the full amount to get the full benefits. The doctor may be able to recommend ways to reduce the costs of medications.
• Do not take any over-the-counter drugs or herbal therapies without the doctor’s permission. Some drugs, such as antacids, salt substitutes, antihistamines (including Benadryl and Dimetapp) and non-steroidal anti-inflammatory agents (such as Advil, Motrin, and Indocin) can worsen heart failure symptoms.
• If a dose is forgotten, it should be taken as soon as remembered. However, if it is almost time for the next dose, the doctor should be asked about skipping versus making up the missed dose.
• Never wait to be completely out of medication before filling prescriptions. If there is a challenge getting to the pharmacy, if finances are a concern or if other problems make it difficult for medications to be obtained, the doctor should be informed. A home health aide can also assist with picking up prescriptions.
• When traveling, keep medications available to take them as scheduled. On longer trips, an extra week’s supply of medications and copies of prescriptions should be taken in case they need to be refilled.
• Before having surgery with a general anesthetic, including dental surgery, tell the doctor or dentist in charge what medications are taken. An antibiotic may need to be prescribed prior to the surgical or dental procedure.

Tips for Specific Heart Disease Medications

• Some medications may alter the heart rate, so it is important to take the pulse regularly.
• Medications that relax constricted blood vessels may cause dizziness. If dizziness is experienced when standing or getting out of bed, the person should sit or lie down for a few minutes, then get up more slowly.
•  
  ACE inhibitors may cause or increase cough. If coughing is keeping a person awake or interfering with daily activities, the doctor should be contacted.
• Diuretics (“water pills”) increase how often a person goes to the bathroom. If a single dose of diuretic is taken each day, it should be taken in the morning. If two doses are taken, the second dose should be taken no later than late afternoon to avoid interrupted sleep.

Diuretics can also cause dehydration (excessive loss of water). Signs of dehydration are: dizziness,extreme thirst, dry mouth, less urine output, dark-colored urine or constipation. If a person has any of these symptoms, the doctor should be called. It should not be assumed that more fluids are needed.

After my initial help with his original application John was the only one to receive correspondence from VA, so I asked him to start watching for any letters from them starting in December. He received the form in January. We gathered all of our receipts from his Assisted Living and other medical bills to sum up the correct amount that he had paid that year. The original application could only be an estimate, so this new form establishes the actual amount he is paying. We did not need to send in the receipts, but we filed them away in case VA wanted to see them for proof.

It was very helpful to have our Consultant answer any questions and make us aware of this very important form. Many people are not aware that once applied for and receiving the benefit the “EVR” has to be completed yearly to keep it. One concern to address is that if income or assets increased the past year, the benefit may be reduced or eliminated. On the other hand, if medical expenses have increased since the last year, the benefit may also increase.

Because some of our readers may not have read last years article by Melissa relating her experience with applying for the Aid & Attendance Benefit, we are including it here with her update on the yearly “EVR” filing.

Applying for the Veteran’s Aid and Attendance Pension
My Personal Experience
By Melissa Howell

12:20 a.m. The clock was blurry as I rubbed the sleep from my eyes to answer the phone. 
“Hello”, I said.

A weak and frightened voice on the other end pleaded, “Melissa? Is Bryan there? I can’t get out of my chair. Could you or Bryan come over?” 

I sighed as I handed the phone to my husband and heard him say, “I’ll be right over, Dad.”

When Bryan left, I pondered on my father-in-law, John, and his situation. John had just come out of the hospital after a serious illness and although the doctor had assured us he would be fine, we quickly learned that he was not able to care for himself. He lived alone in a small apartment and had in-home health care assistance through his Medicare plan. They came once a day to help him with a shower and to aid him with incontinence. Bryan and I came over three times a day to help him with changing his clothes and to make his meals. In addition, we helped him with his bills and took him to his frequent doctor appointments. Tonight was the first time he had called to ask for help in the middle of the night. We needed to do something different. We were both exhausted between working our jobs and caring for our four young children and constantly running out to take care of John’s needs. It was becoming more than we could handle. We realized we really needed to get him into assisted living.

John lived comfortably on an income consisting of social security and a retirement pension, but as we visited different assisted living homes in our immediate area, we quickly realized that this income was not enough. Assisted living was really expensive!

John had served in the Navy during the Korean conflict and we had heard through a friend that veterans could receive assistance through the Department of Veteran’s affairs for health care. The catch was doing it correctly. Our friend referred us to a Veteran’s Consultant from the National Care Planning Council to provide information for the challenging task of filling out the paperwork to receive this benefit. A Veteran’s Consultant can provide general information on how a claim is filed. Our consultant told us about all of the necessary supporting documents we would need to make sure it was approved.

The paper work was pretty daunting, but we worked through each form thoroughly to be sure that we were providing all the information Veterans Affairs (VA) would need in order to expedite John’s payments.

First, I obtained a medical report from John’s doctor — the most crucial step in the process. This form would prove that John needed aid and attendance. In our case, the doctor described his medical condition and then noted specifically his need for help with incontinence and showers, his lack of motivation to make meals for himself and his inability to leave the house alone. It was, however; important to us that the doctor wrote that John was mentally capable of making his own decisions, because we did not want to go through a delaying process of having VA assign somebody who would need to pay his bills for him (VA calls this person a fiduciary).

Another key thing was that John had to show evidence to VA that his care costs were close to or exceeded his income. Fortunately, John had a small amount of savings and he was able to pay in full for the first month’s payment to his assisted living home. This was important, because the statement showing this payment was important evidence needed to present to VA. Since his assisted living cost exceeded his income by $1,000 per month, we arranged with the director, to pay what John could afford until the benefit from VA came in and then the director agreed to have us pay the remaining debt balance on the account at that time.

An important form was John’s original DD-214, which was the official record showing that he had been honorably discharged from the military. I quickly found a certificate of honorable discharge (DD-256) but this was not the correct form. We searched through all of his files and boxes and couldn’t find the DD-214. So I got on the Internet and found a website for the National repository where the official forms can be obtained. It appeared that it could take up to 6 weeks to receive an official copy. Fortunately, we found the original document folded in his wallet and we did not have to delay our process.

One of the forms my Consultant made me aware of was a VA power of attorney form (VA form 21-22a) that gave me the authority to fill out and submit the forms to VA on behalf of John. Although John was mentally sound, he was weak and tired and didn’t really want to do anything but watch television and eat. With this form, I was able to communicate with VA in his behalf.

There were several other forms to fill out and after all the paperwork was finished, my Veteran’s consultant gave us the address of where to send all of them. Our particular VA processing office was located in St. Paul, Minnesota.

After about two weeks, John and I each received a letter stating that VA was working on his case and they assigned him a case file number. After another two weeks, we received a letter stating that we needed to fill out some other paper work. I showed these to my consultant, who assured me, in our case, that it was standard procedure and that the paper work I had originally filed was sufficient. Within another two weeks, John received his first payment.

Because his care cost exceeded his income, he was awarded the full $1644.00 per month. VA sent another payment from the date that they had first issued his case number. So in the first month, we received two payments. These were sufficient to catch up the debt he owed to his assisted living and to continue with full 
payments each month.

Applying for the VA Aid and Attendance Pension was detailed, but it was not terribly frustrating because of the general information on the application process I received from my consultant. It did require extra work on my part, but it was well worth the end result of getting the care that John needed and the relief that Bryan and I needed in the end. I am grateful that we had such a wonderful resource in National Care Planning Council to help us find a capable and informative Veteran’s Consultant.

Bryan and I now see John twice a week and visit with his assisted living staff often to help him have a comfortable and enjoyable life in his new home. He is able to enjoy activities and meals with other people, have quality personal care and have the peace of mind that someone is always there to help him. I now sleep at ease through the night, knowing that his needs are taken care of and that there won’t be any middle of the night calls asking for help.

The National Care Planning Council wishes to thank Melissa for providing her experience. We maintain a list of consultants across the country which can be found at the following address: www.veteranslisting.com. We also provide a book with instructions to help people who want to file an application by themselves. This book can be purchased online at http://www.longtermcarelink.net/a16books.htm.

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.

That being said, it is rare that as an advocate and care coordinator for the elderly, I have an “aaha!” moment.  I recently met with an insurance specialist who is offering a product to seniors and their families that I had never thought about previously.

For many years, I have been a strong supporter of Long Term Care insurance. I have personally witnessed the financial devastation of a chronic disease or dementia can cause for a client and the family. (www.longtermcare.gov )   I have long term care insurance, my husband has it and even our parents had it (and two of four used it!) I used to encourage my clients to cash in their life insurances policies and convert them to Long Term Care Insurance policies.  The news now is that many insurance companies are getting out as fast as they can from promoting this product as the actuaries and the onset of the baby boomer cohorts turning 65 is sending them scared of the losses.  For sure, we will see much more costly policies, making it less affordable for the average boomer.

Last week, I met with two gentlemen who buy life insurance policies at 50% of their face value.  I believe this kind of program can provide a simple, financially-prudent and dignified way to fund senior care. They can help individuals who seek various  senior care services (such as home care, residential and long term care facilities, etc) use life insurance policies they no longer want, can no longer afford or have been forced to abandon into a valuable asset for them and their families. (www.eldercarefinancialsolutions.com )

So many of the elderly clients I meet with don’t even remember that they have one or more policies gathering dust in their files.  Their original need for it (to assure mortgage payment in case of death, college tuition for the kids, weddings, grandchildren’s trusts, etc) no longer exist yet they find themselves cash poor for the services they need with chronic illness. (www.payingforseniorcare.org )

While I have also been a supporter of reverse mortgages in dire need of cash, there is tremendous resistance, confusion and suspicion about these by the consumer.  I have never quite understood it, but it does exist.  Other than a parent wanting to be assured of a gift to children after death, I can’t see a  reason why one would not be interested in pursuing this option.

Check the following websites to gain more knowledge of those who deal with financial planning for the elderly:

www.naela.org (National Assoc. of Eldercare Attorneys)
www.napgcm.org (National Association of Professional Geriatric Care Managers)
www.elderarchives.com

The support group was more than eye opening – it was shocking. A few of the stories of the participants in the support group were difficult to hear. Families torn apart by the burden of caring for a loved one was something I have not experienced. The different ways siblings respond to this pressure – some assuming care giving responsibility while others totally throw up their hands and walk away – was upsetting. The role that money and dividing up the estate – sometimes before the parents have passed and sometimes involving money grabs by family members at the expense of other family members – was ugly and not something I expected. As I left that session, I better understood why dementia and Alzheimer’s receive so much attention in our society. They cause great pain and stress for many, many families.

The second event I attended, the educational seminar, reviewed the biology of dementia and Alzheimer’s and briefly outlined the current research being conducted in the field. This event had nowhere near the emotional impact of the support group, but was just as interesting. One thing about Americans, we like to take problems head on. That is clearly what we are doing with dementia and Alzheimer’s. We are working hard to understand the root causes of the conditions and to find ways to address the root causes. We are working hard to find ways to understand and deal with the effects of dementia and Alzheimer’s on individuals and families. I walked out of this session sobered, but with a sense we as a society are building the knowledge base and support systems we need to deal with the family and medical issues surrounding

Over the years, there was a single birthday tradition that came to mean the most of all. First thing in the morning, each and every birthday, my phone would ring and I would be greeted by my mother’s cheery rendition of “Happy Birthday”.  From there, we would talk about my birthday plans for the day, but it was her birthday song-gram that I looked forward to each year and that truly heralded the start of my special day.  It is a tradition that my Mother continued with each of her five grandchildren, who seemed to enjoy it as much as I did.

A few years ago, my mother was diagnosed with Parkinson’s disease accompanied by dementia. This year, a few months before my birthday, I answered the phone and heard my mother singing “Happy Birthday”. After my mother finished singing, I thanked her, as I normally would. Then suddenly, softly, she said: “It isn’t your birthday is it? Did I miss it?” I opted for an honest answer and cheerily replied: “No mom, it isn’t my birthday; you didn’t miss it – so no need to worry! Lucky me … I’ll get to hear you sing twice this year!”

Perhaps, on that day, my mother prophetically knew something that I did not. My mother was placed on hospice in June and passed away on August 10^th – just three days after my birthday. And so it is with mixed emotions I look back on the un-birthday call I received from my mother earlier this year: happy and blessed that I had the opportunity to hear her sing her birthday song to me one last time and saddened that my birthday will never be the same.

It was my husband’s birthday this week – the first family birthday since my mother’s passing. Sadly, I could not bring myself to sing. I wondered, aloud, if Iwould ever be able to sing “Happy Birthday” without feelingsadness or tearing up. “I promise”, my husband replied, “one day, on ourgrandchild’s first birthday, you will pick up the phone early in the morning for an inaugural “Happy Birthday” song-gram.  I hope my husband is right, for in that way my mother will live on in the hearts of a new generation of our family that never had the opportunity to know her, but will hopefully be inspired to carry on her very special “Happy Birthday” tradition.

I, however, was now going through my own transition while balancing obligations to work, our home, bottles, bed-time stories, and attention to my marriage as well as the concerns for my 80-something year old mother.  I was officially a member of this “Sandwich Generation” and not so sure that I welcomed the opportunity to define myself in this way.  I now knew of these experiences first hand and could empathize with the women I counseled daily on a very different level.

“Sandwich Generation” -  a pretty good metaphor until you have to walk in these shoes!  Then something like the reference by Lee Woodruff  to the “Panini Generation”  in her book “Perfectly Imperfect – A Life in Progress” sparks an image so indelible that one wonders how we could refer to caregiving as anything but……  A club sandwich image works too but not quite as well as that ham and cheese panini.

Squished between the worries and responsibilities for our children, our spouses and our parents leaves one little room for even a thought about ourselves.  Throw in our grandchildren if one is fortunate enough to have some and the cheese oozes out off of the plate. 

Refer to an elderly wife as caregiver and she will immediately correct you, as one of my clients once did and state “This is what a wife does….”  One would say the same of a mother when their younger or adult child is in need or an adult daughter is confronted by the needs of their aging parent – it’s what we, the woman of the Baby Boomer generation do.

More to follow as I negotiate these many roles…..

Understanding why a stroke survivor may be behaving a certain way or experiencing certain symptoms can oftentimes assist the one providing care.

The effects of a stroke depend on the type of stroke, the area of the brain where the stroke occurs, and the extent of brain injury. A mild stroke can cause little or no brain damage. A major stroke can cause severe brain damage and even death.

Strokes can occur in different parts of the brain. The brain is divided into four main parts: the right hemisphere (or half), the left hemisphere (or half), the cerebellum, and the brain stem.

A stroke in the right half of the brain can cause:

• Problems judging distances – The stroke survivor may misjudge distances, fall often or have difficulty picking up objects.
• Impaired judgment and behavior – The stroke survivor may try to do things that she should not do, such as driving a car. Those with poor judgment must be guided when making important decisions. Additionally, sudden laughing or crying for no apparent reason and difficulty controlling emotional responses can affect many stroke survivors. There may be no happiness or sadness involved, and the emotional display will end as quickly as it started.
• Short-term memory loss – The stroke survivor may be able to remember events from many years ago, but not what was eaten for breakfast that morning.

A stroke in the left half of the brain can cause:

• Speech and language problems – Some stroke survivors are unable to understand others or speak at all. Others may speak, but do not make sense. Some survivors can no longer read or write, and many have difficulty pronouncing words. Communication problems are among the most frightening after-effects of stroke for both the survivor and the family, often requiring professional help.
• Slow and cautious behavior – The confused or cautious stroke survivor will fare better in an ordered environment. The apathetic stroke survivor, on the other hand, should not live in a world so orderly and quiet that there is little to react to. The caregiver needs to be aware of the reasons for the stroke survivor’s behavior, without overlooking the fact that he or she may also be depressed.
• Memory problems – The stroke survivor may not remember what was done ten minutes ago or may have a hard time learning new things. Sometimes memory loss can be so subtle that the family may not notice it at first. A stroke survivor may need a reminder to finish a sentence or know what to do next. Some stroke survivors have difficulty with numbers and calculating. Keeping things in the same place, doing things in the same sequence, telling the stroke survivor in advance what is going to happen and possibly taking over some responsibilities will help a stroke survivor to feel less anxious. Therapies or medicines almost never fully restore memory after a stroke. But many people do recover at least some memory, and some improve through rehabilitation.

A stroke in the cerebellum, or the part of the brain that controls balance and coordination, can cause:

• Abnormal reflexes of the head and upper body
• Balance problems
• Dizziness, nausea (feeling sick to the stomach), and vomiting

A stroke in the brain stem:

Strokes in the brain stem are very harmful because the brain stem controls all of the body’s subconscious functions such as eye movements, breathing, hearing, speech, and swallowing. Because impulses that start in the brain must travel through the brain stem on their way to the arms and legs, patients with a brain stem stroke may also develop paralysis, or not be able to move or feel on one or both sides of the body.

Stroke damage to the front of the brain:

A stroke can also damage the front of the brain. In this case, one is more likely to lose the ability to control and organize thoughts and behavior. This makes it hard to think through the steps to complete a task. However, front-brain strokes may not affect one’s ability to do or remember specific things.

Other stroke symptoms:

• In many cases, a stroke weakens the muscles, making it hard to walk, eat, or dress without help. Some symptoms may improve with time and rehabilitation or therapy.
• Depression is nearly universal among people who have had a stroke. A depressed person may refuse or neglect to take medications, may not be motivated to perform exercises which will improve mobility or may be irritable with others. The stroke survivor’s depression may dampen the family’s enthusiasm for helping with recovery or drive away others who want to help. This deprives the stroke survivor of the social contacts which could help dispel depression, and creates a vicious cycle. If necessary, chronic depression can be treated with individual counseling, group therapy or antidepressant drugs.
• Some stroke survivors neglect the side of their world corresponding to the side of their brain which was injured by the stroke. Those with left-sided neglect do not perceive what is on their left side. For example, the stroke survivor with left-sided neglect may ignore the left side of the face when washing or not eat food on the left side of the plate. If the stroke survivor’s head is moved to the left, neglected objects may become apparent. If the plate is turned around, he or she will finish eating the meal.
• A stroke survivor may suffer pain for many reasons. The weight of a paralyzed arm can cause pain in the shoulder. Improperly-fitted braces, slings or special shoes can cause discomfort. Often the source of pain can be traced to nerve damage, bed sores or an immobilized joint.  Lying or sitting in one position too long causes the body and joints to stiffen and ache.

A new population of seniors and those nearing the senior status are looking for some type of financial means to pay for long term care (eldercare) in case of failing health.  Many have taken care of family members who had no means to pay for their care or have seen their parents entire retirement savings wiped out because of medical and nursing home costs.

Does the government Medicare program pay for eldercare costs?

A statement on the Medicare.gov website clarifies what Medicare will pay for.

“Generally, Medicare doesn’t pay for long-term care. Medicare pays only for medically necessary skilled nursing facility or home health care. However, you must meet certain conditions for Medicare to pay for these types of care. Most long-term care is to assist people with support services such as activities of daily living like dressing, bathing, and using the bathroom. Medicare doesn’t pay for this type of care called “custodial care”. Custodial care (non-skilled care) is care that helps you with activities of daily living. It may also include care that most people do for themselves, for example, diabetes monitoring. Some Medicare Advantage Plans (formerly Medicare + Choice) may offer limited skilled nursing facility and home care (skilled care) coverage if the care is medically necessary.”

How does Medicaid cover long term care costs?

Fortunately, there is a government program that will help pay for long term care costs – Medicaid.  Unfortunately, this program is unfairly discriminatory and will only pay for care for individuals who have less than $1,500 to $2,000 in assets (and in about 22 states, the program will only cover individuals who fall below a certain income threshold).  All other individuals wanting help from Medicaid must impoverish themselves paying for their own eldercare services first, before Medicaid will help them.

Planning for the final years of life and dovetailing government programs, care provider systems and funding sources can be invaluable yet complicated.  This area of planning can be one of the most challenging endeavors undertaken by anyone attempting to help seniors in this final phase of life.

The National Care Planning Council has introduced a new long term care planning tool called “Care Resource Planning“.  It is impossible to predict what your future eldercare needs will be.  You cannot determine in advance if you will need home care, assisted living or even nursing home care, but you can have a plan in place that will provide the financial, legal and family support as well as protecting your assets, no matter what happens.

The goal of Care Resource Planning is to provide strategies and solutions pertaining to any or all of the items outlined below that may be unique to the client’s situation.

1.  Understand and Use Eldercare Support Systems

• Objective 1 — Understand the Nature of Eldercare
• Objective 2 — Understand Living Arrangements for Eldercare
• Objective 3 — Understand How to Use the Life Resource Planning Team

2.  Identify Sources of Final Years Funding and Services

• Objective 4 — Identify Programs to Increase Income
• Objective 5 — Identify Government Programs to Pay Costs
• Objective 6 — Understand and Use Community Aging Support Services

3.  Protect the Estate from Depletion

• Objective 7 — Understand Strategies to Protect Assets
• Objective 8 — Review and Update Legal Arrangements and Insurance
• Objective 9 — Identify Tax Saving Strategies

With the help of a trained professionals who understand all of the issues pertaining to eldercare, a plan can be prepared to protect assets, locate appropriate funding and provide the necessary support to ease the burden for the final years of life.

For more information on Care Resource Planning for yourself or loved one please visit www.longtermcarelink.net/care_resource_plan.htm

Many professionals use our Care Resource Planning System to help their senior clients create a plan for their long term care. If you advise seniors and would like to include Care Resource Planning (a fee based planning system) as part of your services, click here to learn more.