Planning For Tomorrow

Following is part three of an interview with Phyllis Slater, owner of Slater Solutions LLC. Ms. Slater has devoted years to providing coaching and concierge services to the working caregiver and aging parent. Visit Phyllis Slater's website at EldercareConcierge.Blogspot.com.

Q. Why should we plan for tomorrow now?

A. Possible situation... I have vision difficulties but can still live without assistance. However, a year from now I may need help with cooking, cleaning, shopping, driving and paying bills.

Medications can be placed in a pre-programmed medication dispenser with monitoring company assistance. If the medication is not taken in a reasonable period of time, the company will call my son. Non-medical in-home care will be hired to attend to all these needs.

If I fall on the coffee table and spend a week in the hospital, the geriatric managers may recommend a rehabilitation center for treatment.

Whether I am able to return home or must move to a living facility, my family will hire an organizer to come in and rearrange furniture, lower items in the kitchen so they can be reached, removed unwanted items, and boxed up rarely used items.

A real estate agent will already be chosen, but not hired, just in case I must sell the home. Again, that is planning for the unknown. Whatever the outcome, the stress of last minute decision-making has been reduced.

Remember that part of this relocation process is finding a reliable moving company, and now there are companies that, for a fair rate, will pick up unwanted items.

Now, there are Adult Day Care Centers for individuals with mental challenges. Our senior center has one that gives family caregivers some respite time --providing the social interaction they need.

If I cannot return home because of extra caregiving needs, it may be appropriate to move into an Assisted Living facility, which is private pay. Assisted living facilities allow residents to feel more independent while having 24/7 caregiving when needed. Having social interaction with peers can reduce depression and keep the mind more alert. There are Continuing Care Facilities that have Independent, Assisted Living and Nursing Care all on the same property -- for easing into each other while being accessible to friends created on-site.

Spending time in the elder care field, I planned ahead by contacting a Long Term Care Insurance Specialist.

Next, my son was made legal guardian with all my finances in both of our names (Elder Care Attorney). In addition, my Financial Planner has made wise investments for me over the years. I made sure my son and other family members have copies of all paperwork. Each child understands the reason for my decision-making.

My friend did not plan ahead of time, has no money for care, and applied for Medicaid. This is why I am so passionate about planning ahead. This may mean that she will have to go into a nursing home rather than the assisted living facility.

A small amount of Assist Living facilities qualify for Medicaid Waiver programs. This means that Medicaid would pay some of the cost, which is great for those with financial difficulties. However, the waiting list for an opening could take years. Talk with a government agency about the options available in the meantime.

Another option is to live at home with 24/7 care, and use the equity of the home for a Reverse Mortgage. This option is a safety net, allowing for quality care in the comfort of your own home. There are advantages and disadvantages with using a Reverse Mortgage, so check with the Reverse Mortgage Specialists before making a decision. The key is to learn about it now. If you don’t use this, pass the information to others later.

In some states there are Senior Foster Homes, which are residential homes with 24/7 on-site care. With only four bedrooms, each resident receives personal care and can participate in responsibilities -- such as setting the dinner table. These homes can take the place of an assisted living or even nursing home. Professional staff is hired or the owner could be a licensed nurse. This is a great option but also requires private pay.

Hospice care is now provided in the home, the care facility, or their own hospice faculties. The requirement is usually a paper from the doctor saying it is predicted a person’s life will end within six months. Naturally, if this does not happen, the care should still be available. Different states may have different requirements for keeping hospice beyond that time. This is a service that is sadly underutilized. To my knowledge, there is no cost to the family for this service.