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.

While “aging in place” has its benefits, it is expensive to get such individualized care. Plus, it’s rather isolating. Group options require a move, but are more social and cost effective.
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• Assisted living. People move to assisted living when they are ready to stop cooking, cleaning, and maybe even driving. They enjoy social activities but need more help than an independent retirement community might offer. Though not a setting for people with advanced dementia, a portion of assisted living residents may have memory problems.
  
  
• Memory care. With activities specifically for people with significant dementia, memory care may be housed in a wing of assisted living or operate as an independent facility.
  
  
• Skilled nursing or “rehab." Geared for short stays—several days to several weeks—a skilled nursing facility can be thought of as a place to get stronger or learn to do things in new ways after a setback. Then you move to a more homelike environment.
  
  
• Nursing home. This setting is a long-term version of rehab but for those with complex conditions who don’t need a hospital, yet aren't independent enough for assisted living.
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• Continuing care retirement community (CCRC). This large “campus” offers all of the above and more. Move in while fully independent and able to enjoy the pool, golf course, etc. As care needs change, residents move to the different care buildings yet stay on the same property. Ideal for a couple when one needs more support than the other.
  
  

Let us help you understand the different options. Give us a call at 203-826-9206.

Learn more about our aging life care planning services.