One of the most difficult decisions dealing with my father-in-laws Alzheimer's Disease was taking away his driving priveledges. The family agonized over it for many months before taking action. Once action was taken, the burden was lifted for all involved.
I saw an article written by Kelly Greene in the Wall Street Journal which had some sage advice. I've posted it below.
"Trying to persuade older family members to give up their car keys isn't just an emotionally fraught chore. Increasingly, it is a financial issue, too.
"Cars can be expensive to maintain for an elderly person on a fixed income. The cost of auto-insurance claims in later life -even for fender benders and accidents without injuries-can quickly add up. Conversely, if an aging parent decides to move to a place where transportation is readily available, such as an assisted-living facility or continuing-care retirement community, housing costs could escalate.
"If there is compelling evidence that parents shouldn't be on the road-because of failing eyesight or other physical limitations-then adult children shouldn't want them to drive. People who are 75 and older have higher crash rates per mile than all groups except 16 to 25-year-olds, according to the Insurance Institute for Highway Safety. Many states require older drivers, starting in their 60's or 70's, to nenew their licenses more frequently than younger drivers, to do so in person or to take additional vision tests. Still, health and driving skill can deteriorate between those renewal dates.
"One possible solution: Take the cash that your relative would spend maintaining a car to get safer, reliable rides through taxi services or non-profit groups. There are a growing number of alternative transportation options aimied at older adults who could continue to live independently if they could just find a good alternative to their own car.
"Like many adult children, Julie Markes, a 47-year-old children's book author in Brooklyn, N.Y. is struggling to explain the costs of continuing to drive-along with the safety risks-to her 81-year-old mother, Diana Markes, an actress and artist who lives in Los Angeles. Her mother has had at least a dozen accidents since 2005, including a scary one last month in which she pulled out from a stop sign into oncoming traffic and was hit by a car that "she thought came out of nowhere," the daughter says. Although no one was hurt, the car was totaled and the mother now wants to use the $11,900 insurance check to replace the vehicle.
"Her daughter is urging her to give up the keys, not only because she considers her mother's driving dangerous, but also because her mother is spending nearly $7,000 a year on car insurance. And that bill, along with her rent, is consuming 100% of the money she brings in from Social Security and "an old investment," Julie says. She is hoping that, when her mother's car insurance expires in August, her insurer either won't renew it or will increase the premiums-forcing her to give up driving.
"Meanshile, Julie is trying to stop her mother from buying a car, and instead is encouraging her to consider using the insurance check for taxis and a passenger service run by an affiliate of ITNAmerica, a non-profit based in Westbrook, Maine. The organization, which operates in 12 states, provides driviners around the clock, seven days a week, to take older adults wherever they want to go. The average fee: about $10 a trip. (Drivers also will help with shopping bags and escort passengers to a doctor's office.) By contrast, it costs about $16 a day on average in insurance, taxes and other operatin cists simply to keep a car in the driveway, according to AAA.
"Here are some other options for family members:
"1) Hire a "driving therapist." Driver-rehabilitation specialists can help people who have lost mobility overcome impairments, sometimes with special equipment such as left-foot accelerators or spinner knobs that ease steering. They also perform a toughter job: setting limits on driving times and routes-and letting people know when it is time to give up the keys.
"An initial assessment can take two to three hours and cost at least $200. Additional sessions run at least $100, and patients typically pay out of pocket-thought such therapy can pay off if it keeps a person independent. (In a few states, Medicare may pay for part of the therapy.) To find a driver-rehabilitation Specialists website (www.driver-ed.org) and click on "Find a CDRS."
"2) Find other transportation services through the federal Eldercare Locator (www.eldercare.gov; 800-677-1116). That service will refer you to your local agnecy on aging, which should have information about any publicly and privately provided transportation for people who are 60 or older.
"3) Find a support network. Older adults are forming grassroots networks in various cities and towns with the goal of staying independent-and some include transportation services. To find listins, go to the Village to Village Network website (www.vtvnetwork.org) and click on "VtVN Directory."
Good luck with this very hard decision.
More later.
Tuesday, April 26, 2011
Monday, April 18, 2011
How to Stretch Your Assisted Living Dollars
An option many people don't know about when considering placing their loved one in an assisted living home is the option of using a "residential care home." Residential care homes offer most of the services larger institutional assisted living communites do but usually at a lower cost. In Texas, residential care homes are licensed under the same "assisted living" license as larger communities. The regulations are slightly different if you are licensed for less than seventeen beds, but basically they are the same. Residential care homes offer a more homey setting where your loved one can develop relationships with other residents as well as the caregivers.
Our research shows the larger institutional settings begin around $4,500 per month and increase up to about $7,000 per month, depending on the level of care required. Most residential care homes start with semi-private rooms beginning from the low $2,000's and up.
When researching a setting for your loved one, you may experience some facilities charge more for different levels of care. To get a better idea of exact pricing, look for a community which charges a flat fee rather than increasing costs for increased care. You can know your monthly expenses this way. Otherwise, you may think your loved one doesn't need assistance walking or getting to the toilet but a community may disagree and charge more for these services.
If you chose the residential care option and get a private room for $3,500 instead of $5,000 which a larger institution may charge, your savings will last much longer. If you only have $250,000 for assisted living expenses, at $5,000 it will only last 4.17 years. If you are in a residential care home at the rate of $3,500, that same money will last 5.95 years. Your money will last 42% longer in that residential care setting.
Check to make sure the residential care home is licensed before placing your loved one there. If they are licensed, they probably are required to have a fire sprinkler system and smoke detectors, monitored twenty four hours a day. In Texas, it is illegal to care for more than three residents who are not related to the caregiver. If they don't follow the rules, I would be very cautious placing your loved one there.
Good luck in your search. If we can answer any questions, just holler.
Our research shows the larger institutional settings begin around $4,500 per month and increase up to about $7,000 per month, depending on the level of care required. Most residential care homes start with semi-private rooms beginning from the low $2,000's and up.
When researching a setting for your loved one, you may experience some facilities charge more for different levels of care. To get a better idea of exact pricing, look for a community which charges a flat fee rather than increasing costs for increased care. You can know your monthly expenses this way. Otherwise, you may think your loved one doesn't need assistance walking or getting to the toilet but a community may disagree and charge more for these services.
If you chose the residential care option and get a private room for $3,500 instead of $5,000 which a larger institution may charge, your savings will last much longer. If you only have $250,000 for assisted living expenses, at $5,000 it will only last 4.17 years. If you are in a residential care home at the rate of $3,500, that same money will last 5.95 years. Your money will last 42% longer in that residential care setting.
Check to make sure the residential care home is licensed before placing your loved one there. If they are licensed, they probably are required to have a fire sprinkler system and smoke detectors, monitored twenty four hours a day. In Texas, it is illegal to care for more than three residents who are not related to the caregiver. If they don't follow the rules, I would be very cautious placing your loved one there.
Good luck in your search. If we can answer any questions, just holler.
Friday, April 15, 2011
The Advantages of Assisted Living Facilities to Home Care
This information is from the assistedlivingmatch.com website. It provides a nice comparison between assisted living and care in the home.
The Advantages of Assisted Living Facilities to Home Care
"Millions make the difficult decision to leave home for assisted living facilities each year. Although the transition can be challenging for the resident and his or her family, it’s one that can pay dividends in the form of extra help, security, social opportunities and more. And the transition can be less stressful with self-awareness about needs and concerns as well as comprehensive research to find a facility that is a good fit.
Assisted living communities make sense for those who require more personal care services than they can get at home or in an independent living retirement community, but who don’t necessitate round-the-clock care and supervision. Some need help with activities such as bathing, grooming and dressing. Instead of having someone – often a family member who lacks experience – come to the home outside from outside the facility, an assistant can visit the residence and help with brushing teeth, shaving, getting in and out of the tub or shower, etc.
Assisted living facilities provide the safety and security of 24-hour support and access to care. But privacy, independence and the freedom to handle what you can on your own are offered as well. It’s up to the resident and the facility to develop a personalized plan that is realistic.
For those ready to relinquish the responsibilities of maintaining a home, assisted living facilities can create a home-like atmosphere without the work of cooking, cleaning and the like. And there are options available with regard to meals. Residents can visit the dining area or perhaps have a meal delivered to the residence. Assistants can help prepare meals if the resident prefers to dine inside the residence instead of the common dining room.
For those suffering from Alzheimer’s disease or dementia – and others requiring regular medical treatment – these facilities have nurses able to offer assistance, administer medication and provide treatment recommended by medical professionals. The resident maintains independence, but also receives the care they need without requiring the services of visitors from outside the organization.
The facilities also offer transportation, so that those who have difficulty driving, or can’t drive, can get where they need to go without having to rely on others. And for those who feel lonely at home, assisted living communities can offer an active social life essential for health and happiness. The social aspect of assisted living can be a huge benefit, as many facilities offer a plethora of social and recreational activities."
My own comments are that that Assisted Living with all the care it provides is a less expensive alternative than home care. A home care worker making $10 per hour totals $6,720 per month where a semi-private room at our residential community runs $2,900 per month. In a tight economy, making your money last is imperative.
More later.
The Advantages of Assisted Living Facilities to Home Care
"Millions make the difficult decision to leave home for assisted living facilities each year. Although the transition can be challenging for the resident and his or her family, it’s one that can pay dividends in the form of extra help, security, social opportunities and more. And the transition can be less stressful with self-awareness about needs and concerns as well as comprehensive research to find a facility that is a good fit.
Assisted living communities make sense for those who require more personal care services than they can get at home or in an independent living retirement community, but who don’t necessitate round-the-clock care and supervision. Some need help with activities such as bathing, grooming and dressing. Instead of having someone – often a family member who lacks experience – come to the home outside from outside the facility, an assistant can visit the residence and help with brushing teeth, shaving, getting in and out of the tub or shower, etc.
Assisted living facilities provide the safety and security of 24-hour support and access to care. But privacy, independence and the freedom to handle what you can on your own are offered as well. It’s up to the resident and the facility to develop a personalized plan that is realistic.
For those ready to relinquish the responsibilities of maintaining a home, assisted living facilities can create a home-like atmosphere without the work of cooking, cleaning and the like. And there are options available with regard to meals. Residents can visit the dining area or perhaps have a meal delivered to the residence. Assistants can help prepare meals if the resident prefers to dine inside the residence instead of the common dining room.
For those suffering from Alzheimer’s disease or dementia – and others requiring regular medical treatment – these facilities have nurses able to offer assistance, administer medication and provide treatment recommended by medical professionals. The resident maintains independence, but also receives the care they need without requiring the services of visitors from outside the organization.
The facilities also offer transportation, so that those who have difficulty driving, or can’t drive, can get where they need to go without having to rely on others. And for those who feel lonely at home, assisted living communities can offer an active social life essential for health and happiness. The social aspect of assisted living can be a huge benefit, as many facilities offer a plethora of social and recreational activities."
My own comments are that that Assisted Living with all the care it provides is a less expensive alternative than home care. A home care worker making $10 per hour totals $6,720 per month where a semi-private room at our residential community runs $2,900 per month. In a tight economy, making your money last is imperative.
More later.
Thursday, April 14, 2011
What is "Original Medicare"?
I saw an article which explained Medicare in simple terms. I though I would pass it along. It was written by Toni King in the Fort Bend Sun.
"This is the most popular question I get every week. Since 10,000 people are turning 65 each day for the next 19 years, I have a feeling just a few people in this area are turning 65. Let's talk about just what is "Original Medicare."
"You cannot compare Medicare to your old group health insurance with all of the co-pays, deductibles or out-of -pocket expenses that you are accustomed to. Take that knowledge out of your brain and put it in File 13 or the old trashcan, because you will never use it again. Your health insurance experience as you know it will never be the same.
"Original of Traditional Medicare consists of Parts A and B only and not Parts C or D. As long as your doctor, healthcare provider or facility accepts "Original Medicare" or Traditional Medicare, then you can use them. Ask your Medical provider if they accept Medicare Assignment. There is not a network with "Original Medicare."
"Medicare Part A (Hospital Insurance) pays for your medical care while you have a hospital stay. Part A also pays some of the costs if you stay in a skilled nursing facility which has 100-day benefit, hospice, or if you receive home health care. The Part A deductible for 2011 is $1,132 and can be used six times in a year. Yes, Part A has a benefit period of 60 days, so every 60 days, there is a new deductible of $1,132. Skilled nursing has a $0 co-pay for days 1-20 but from days 21-100 there is $141.50 co-pay per day. After day 100, you pay all of the cost for additional days.
"Medicare Part B (Medical Insurance) helps cover for medically necessary services such as doctors services, outpatient hospital care, tests, home health care, durable medical equipment and other medical services. Part B is voluntary but if you do not enroll at the right time, then you can receive a 10 percent penalty for each 12-month period you may have had Part B, but decided not to enroll in Part B. This penalty is applied to your Part B premium each month as long as you are on Medicare. Please see page 131-134 of the 2011 Medicare and You handbook for everything that Parts A & B covers and the premiums for each Part.
More later on this topic.
"This is the most popular question I get every week. Since 10,000 people are turning 65 each day for the next 19 years, I have a feeling just a few people in this area are turning 65. Let's talk about just what is "Original Medicare."
"You cannot compare Medicare to your old group health insurance with all of the co-pays, deductibles or out-of -pocket expenses that you are accustomed to. Take that knowledge out of your brain and put it in File 13 or the old trashcan, because you will never use it again. Your health insurance experience as you know it will never be the same.
"Original of Traditional Medicare consists of Parts A and B only and not Parts C or D. As long as your doctor, healthcare provider or facility accepts "Original Medicare" or Traditional Medicare, then you can use them. Ask your Medical provider if they accept Medicare Assignment. There is not a network with "Original Medicare."
"Medicare Part A (Hospital Insurance) pays for your medical care while you have a hospital stay. Part A also pays some of the costs if you stay in a skilled nursing facility which has 100-day benefit, hospice, or if you receive home health care. The Part A deductible for 2011 is $1,132 and can be used six times in a year. Yes, Part A has a benefit period of 60 days, so every 60 days, there is a new deductible of $1,132. Skilled nursing has a $0 co-pay for days 1-20 but from days 21-100 there is $141.50 co-pay per day. After day 100, you pay all of the cost for additional days.
"Medicare Part B (Medical Insurance) helps cover for medically necessary services such as doctors services, outpatient hospital care, tests, home health care, durable medical equipment and other medical services. Part B is voluntary but if you do not enroll at the right time, then you can receive a 10 percent penalty for each 12-month period you may have had Part B, but decided not to enroll in Part B. This penalty is applied to your Part B premium each month as long as you are on Medicare. Please see page 131-134 of the 2011 Medicare and You handbook for everything that Parts A & B covers and the premiums for each Part.
More later on this topic.
Friday, April 8, 2011
Assisted Living vs. Nursing Home
Most people use "Assisted Living" and "Nursing Home" interchangebly. There are several distinct differences.
Assisted Living facilities are non-medical facilities that provide room, board and assistance with activities of daily living (ADL's) which may include dressing, grooming, bathing, eating and toileting. Nursing facilities are medical facilities which provide medical care in addition to services Assisted Living facilities provide.
Medicare does help with the cost of nursing facilities care but doesn't pay anything toward Assisted Living care. Assisted Living care costs are either private pay or are covered by long term care insurance policies, if the Assisted Living facility is licensed by the state. Nursing facility care is usually more expensive than Assisted Living care.
There are also independant senior living communities which are small apartments where meals are often provided in a central dining area. These are more cost effective than Assisted Living or Nursing facilities. It is important to recognize the time when it is unsafe for someone to remain by themselves in an indepentant senior living community.
More on the differences later.
Assisted Living facilities are non-medical facilities that provide room, board and assistance with activities of daily living (ADL's) which may include dressing, grooming, bathing, eating and toileting. Nursing facilities are medical facilities which provide medical care in addition to services Assisted Living facilities provide.
Medicare does help with the cost of nursing facilities care but doesn't pay anything toward Assisted Living care. Assisted Living care costs are either private pay or are covered by long term care insurance policies, if the Assisted Living facility is licensed by the state. Nursing facility care is usually more expensive than Assisted Living care.
There are also independant senior living communities which are small apartments where meals are often provided in a central dining area. These are more cost effective than Assisted Living or Nursing facilities. It is important to recognize the time when it is unsafe for someone to remain by themselves in an indepentant senior living community.
More on the differences later.
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