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

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

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

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

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

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

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

How age friendly is your bathroom?
Give us a call at 203-826-9206.

Life has a way of throwing us curveballs.

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

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

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

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

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

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

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

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

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

Find yourself suddenly single?
Let us help you get reoriented. Give us a call: 203-826-9206.
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Learn more about our services for aging well.

Alzheimer's is different from the normal forgetfulness of aging. Alzheimer's is one of many conditions that cause the radical changes in memory, reasoning, and behavior known as "dementia." The normal forgetfulness of aging is just an inconvenience, a slowing down. The serious changes of dementia eventually result in the inability to live on your own.

Here are some helpful distinctions developed by the Alzheimer's Association:

• Memory failures that affect daily life. Trouble learning something new. Not recalling recent events. Asking the same question over and over. Normal aging: Not remembering something in the moment but recalling it later.
• Difficulty with problem solving and reasoning. Inability to think abstractly (e.g., use numbers) and create logical plans. Signs include difficulty figuring a tip or following a recipe. Normal aging: Occasional addition or subtraction errors.
• Trouble with familiar tasks. Drawing a blank while playing a beloved game or driving to a familiar location. Normal aging: Needing help with something recently learned.
• Losing the anchor of time. Forgetting the season or the year. Normal aging: Briefly losing track of the day of the week.
• Spatial problems. Trouble judging distance. Difficulty with balance. Normal aging: Needing glasses to read.
• Communication problems. Losing the thread of a conversation. Repeating a story or question. Normal aging: Occasional inability to find a word.
• "Losing" common objects. Putting belongings in odd places and not remembering. Inability to retrace steps. Accusing others of stealing. Normal aging: Forgetting why you went into a room and retracing your steps to remember.
• Poor judgment. Falling for scams, overspending, wearing odd outfits. Normal aging: Periodically making a bad decision or skipping a bill payment.
• Withdrawal from activities. Not socializing as much, especially as conversing becomes difficult. Normal aging: Consciously choosing to do something different.
• Moody or irritable. Significant personality changes: Depression, anxiety, fear, and paranoia. Normal aging: Getting grouchy if cherished routines are disrupted.
  
  

Concerned about your memory? Let's talk.
Give us a call at 203-826-9206.

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Most people are surprised to learn that Medicare pays for only a limited amount of the daily care you are likely to need in your lifetime (about 14%).

Medicare covers only services delivered by medically trained professionals. That means you need to have savings or insurance and rely on a collection of local programs. Or family and friends who may be able to pitch in with labor or funds.

Assisted living and memory care $$$–$$$$
As nonmedical services, these settings are usually paid for out of your own savings. If you are a qualifying veteran or you have long-term care insurance, your costs may be covered. Contact the Veterans Administration or state Veterans Council. Check your long-term care insurance policy for eligibility requirements. Also ask about waiting periods. Is there a lifetime cap on the total amount they will pay?

Skilled nursing/rehab or nursing home $–$$$$$
Provided your stay follows a qualifying hospitalization, original Medicare—the government's health insurance for seniors—will typically cover some portion of the costs for the first 100 days. You use your supplemental insurance for your copay. Or pay out of pocket if you do not have supplemental insurance. Starting day 101, you pay 100% of the cost. Medicare Advantage plans vary, so review the coverage with your insurance provider. If you have private long-term care insurance, check your policy for skilled nursing coverage. The Veterans Administration offers special facilities for qualifying vets.

The very poor may qualify for Medicaid. This program will pay 100% of costs. However, there are only a limited number of Medicaid openings available in any given facility. Those living long term in a nursing home usually exhaust all personal savings and assets. Then they switch to Medicaid. If you think you may need Medicaid, consult an elder law attorney early. Also, your financial planner for advice about liquidating your assets.

Continuing care retirement communities $$$$$
This is a very different model of care that merges housing and insurance. With a continuing care retirement community—also known as a "Life Plan Community"—you invest a substantial sum up front (often in the six figures). You also pay a monthly service fee. Start while you are healthy and live on campus to enjoy the deluxe amenities. Move to the most appropriate building as your care needs change. This is paid for almost entirely out of your own savings. If you have long-term care insurance, check your policy to see if it covers continuing care retirement communities.

Worried about paying for care? Give us a call at 203-826-9206.

Learn more about our aging life care planning services.

Frank knows they need help at home. His wife's dementia is getting worse, and he has his own health problems. She can't be left alone anymore.

Doing all the cooking and cleaning, and now helping with bathing ... it's just too much.

Frank needs to take breaks. But a Google search reveals a dizzying array of home care providers. How to choose?

Allowing a stranger into your home can leave you feeling quite vulnerable. It's important that you trust the individual and the company that does the background checks, verifies training, and puts together the schedule.

You also need to interview each company to find out pricing and minimum number of hours, and to see if they have independent quality ratings.

How do you know which one to trust?
This is where Aging Life Care™ Manager can help.

On the basis of past experience with other clients, he or she knows which companies put an emphasis on training. Which have difficulty filling a shift if a caregiver calls in sick. Which have high staff turnover resulting in the need for you to orient a new employee every few months. Which have a strong team, with employees who love their work.

Wise home care companies will let you and your Aging Life Care Manager interview several caregivers before making a choice. They know that an Aging Life Care Manager understands you as the client and understands what will result in an optimal match.

Both you and the provider and the caregiver want a good fit the first time so all of you can work together positively for the duration of your need. It makes the difficult transition to home care that much easier if a knowledgeable advocate can set expectations and provide an objective viewpoint.

Even with adult day care and medically trained services, such as home health and hospice, not all providers are alike. An Aging Life Care Manager knows the reputation and the management style of each company. He or she can look up Medicare reviews and complaints.

An Aging Life Care Manager can also coordinate care across multiple service providers and work with your physician to ensure that all the different players are aware of your changing needs.

Want to find the best fit the first time? Give us a call at 203-826-9206.

Learn more about our aging life care planning services.

Irritating but true: Aging brings changes that make safe driving more of a challenge. Slower reflexes. Reduced vision and hearing. Difficulty concentrating. Less flexibility in the neck and shoulders.

Fortunately, these changes do not come on suddenly. And adjustments in driving habits can offset them such that older drivers can be much safer than their younger counterparts.

Safe driving starts with a willingness to be honest with yourself about modifications.

A few signs that adjustments may be in order:

• Thoughts wander when you drive
• Frequently startled or uncertain in high-traffic conditions
• Taking medicines that list drowsiness as a side effect
• One or two tickets or verbal warnings from police in the past two years
• Dents in the car, or even a collision in the past two years
• Comments or concerns expressed by family or friends
  
  

Take a self-assessment. The American Automobile Association (AAA) offers a free, confidential test at seniordriving.aaa.com.

Consider a Mature Driver Course. AAA and AARP (American Association of Retired Persons) offer courses filled with tips. Your car insurance may even discount your premiums.

Easy things you can do right now:

• Flexibility exercises. Increase mobility in your neck and shoulders so you can readily turn your head to check for blind spots when changing lanes or backing up.
• Reduce distractions. Turn off the radio. No eating or drinking while driving. Definitely no phone calls. Consider halting conversation with passengers when driving conditions are complicated (e.g., at intersections).
• Drive mid-day. Avoid rush hour and freeways. And if you have trouble with night vision, plan your trips so you are home before twilight.
• Make a left turn only at a left-turn light. If there is no stoplight, drive a block farther and make three right turns. (Three rights make a left.)
  
  

Wondering about your driving?
Give us a call at 203-826-9206

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Judy had an emergency hip replacement after a fall. She needs to be discharged tomorrow to a skilled nursing facility. She needs several weeks of intensive physical therapy to be able to walk again. Then she may need to live in assisted living.
The discharge planner has a list of options. Judy and her daughter, who lives an hour away, don't know how to make a wise choice.  

For short-term, urgent needs, you may be at the mercy of which facility has an opening at the time.

It pays to consult an Aging Life Care™ Manager who knows the reputation and personality of the local institutions. It's best to have a relationship with the [cm] before you have an urgent need. He or she can combine extensive knowledge of local resources with a thorough understanding of your medical history, your insurance and financial resources, your personality and preferences, and your social support system. As a result, you are more likely to get a match that will help you maintain good spirits and enjoy a speedy recovery.

Review all your options
Unlike "free" referral agents, an Aging Life Care Manager will present all the choices that make the most sense for your needs and personality. Not just the communities that are willing to pay a kickback referral fee.

Such independence is even more important for long-term living situations
Choosing an assisted living community, a CCRC, or a memory care facility is a big decision. You want to get a good match from the start.

Touring these communities can be daunting
A Google search delivers a dizzying array of choices. They all put their best foot forward. But architectural features and social amenities are only superficial measures of quality. An Aging Life Care Manager has had other clients who live in these facilities. He or she has a firm grasp on deeper metrics, such as the tone of the administrative leadership, the training and stability of the staff, the solvency of the company, and the overall personality of the community.

An Aging Life Care Manager also knows current conditions in the market that can save you money. For instance, if a community happens to have a lot of openings, a lower monthly rate or entry fee could be negotiated. A "senior housing advisor" paid a commission by the community would not be able to serve as your advocate in this regard.

Looking for unbiased recommendations based on all your options? Give us a call at 203-826-9206.

Learn more about our aging life care planning services.

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

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

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

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

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

Your health care team. Medically trained support:

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

Professional advisors

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

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

Want help assembling your team? Give us a call at 203-826-9206.

Learn more about our aging life care planning services.

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

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

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

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

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

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

Home health and hospice $

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

We can help you sort out your options. Give us a call at 203-826-9206.

Learn more about our aging life care planning services.

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

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

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

To be prepared, you need

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

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

Want help getting prepared for a medical emergency? Give us a call: 203-826-9206.

Learn more about our aging life care planning services.