Financing the Cost of Eldercare

Welcome to the Caregiver Information Series – an on-line publication designed especially for caregivers, offering important information to help families navigate the complex world of eldercare. This first issue is focused on an important topic affecting many caregiving families: how to finance the costs associated with long term care. The articles below were written by experts in the field and include insider hints, tips and advice related to financing the cost of care. We are pleased to offer this series as a benefit to your family as you seek to meet the needs of your loved ones. We hope you find it helpful!



Reverse Mortgages and Eldercare Services:
A Financial Choice That Can Keep
Mom and Dad Home for Life
By Valerie VanBooven, RN BSN

Eldercare is one of the most expensive purchases we will make in our lifetimes. Using reverse mortgage proceeds can help seniors pay for much needed care as well as additional services such as stair lifts and personal emergency response systems. When a caregiver is looking for ways to afford care for a loved one, using the home to stay at home may be the best option.
Click here for the complete article.

The Financial Impact of Eldercare Costs:
Caregivers Face A Tsunami of Decisions
By Valerie VanBooven, RN BSN

Helping a family member who needs eldercare services brings up a whole set of issues and questions that none of us as caregivers (or pending caregivers) are really excited about discussing. Bringing up financial issues is a touchy subject for most aging adults, especially when it comes to telling their children how well, or not so well they planned for a moment like this.
Click here for the complete article.

The Financial Impact of Eldercare Costs:
The Costs of Senior Housing Versus
Home Care
By Bob O'Toole, MSW, LICSW

As baby boomers age, and their aging parents increasingly live to age 90 and beyond, both caregivers and elders are faced with many, often-difficult decisions. One of the most common questions that arise when one or more parents becomes increasingly unable to care for themselves is "can't aging parents stay at home, or is it time to move to one of the many senior housing choices that become available in recent years?’.
Click here for the complete article.










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STATE HOME CARE PROGRAM

The State Home Care Program is available for people who are struggling to maintain their independence at home. When necessary daily activities become difficult, staying at home can be a serious challenge—without help, it may become impossible. The program operates with the belief that with the right home care services, elders can receive the help they need to remain safe and independent at home.

Some of the services available through the State Home Care Program include grocery shopping, personal care like bathing or toileting, home-delivered meals, transportation, housekeeping, laundry, adult day care, and other support services that help an elder stay in their home.

To receive such services through the State Home Care Program at low or no cost, individuals must meet certain age, income, and need-related requirements. The program eligibility guidelines are set by the Massachusetts Executive Office of Elder Affairs, which funds the State Home Care Program. MVES discourages individuals to try to determine on their own if they’re eligible to receive subsidized services. Eligibility requirements can be complex, and assuming ineligibility may prevent someone from receiving necessary services for which they may qualify.

Instead, elders or their caregivers should call MVES and ask about services. MVES staff will talk with the elder or caregiver about the situation. If needed, an MVES care manager will conduct a comprehensive in-home assessment to determine program eligibility. The care manager, client, and family caregivers develop a care plan tailored to an individual’s needs. Trusted area companies with whom MVES partners will deliver the services directly. The MVES care manager will call the client every three months to check in and visit the client’s home every six months to see him or her in their own living space. Keeping in close contact with the client, the care manager ensures that all services continue to suit the client’s needs.

State Home Care is one of the basic programs that MVES offers to help elders remain safe and independent at home. Please call 781-324-7705 for more information.

NOTES FROM BEACON HILL VILLIAGE WORKSHOP

Notes Workshop 11/10/08 "Village to

Village.
Attendees from all parts of nation.
How to create a village
Create your own plan
14 Massachusetts existing plans in
operation with different Business

plans and operations geared to Keep

people in the home and supported

"neighbor to neighbor"
Presentation on how areas can

participate like a unit Westside
villiage. --Malden Tri City area
MAlden
EVERETT
MEDFORD RIVERS EDGE.
cOMBINED MELROSE AND MALDEN
Talk about 400 diverse community

membership to make it go
transportion problems (nation wide)
Neighbors helping neighbors
Subsidized
AVAILABLE IN MALDEN AREA NEED

UPDATING
Malden Senior Center

medical,shopping,mayors recreation

activities (Hallmark Health)
Local Grocery Stores to subsidized

Housing units
SCM for out of city locations and
Paul' Place for special activities.
look into a way to extend service

and assure more participation.
Stay in Home-Choice is power over

own self reliance. Relieve family

members from daily chores to remain

independent (one stop service)
Maintain majority of control

independence.
Beacon Hill Village and Similiar

groups have 25% subsidized FOR

members. 85% renewal on all

memberships
Give One Stop Shopping for service.
100% satisfaction guaranty.
Malden has many Seniors (10,000) to

get involved as well as a new

transient population(new comers) to
apartment condos to get involved.
The idea of the "aging at home"

Neighbor to Neighbor concept is to

make Seniors (elderly) feel like

owners not clients
450,000 cost 1000 per member
Reflect your community Sense of Age
We ARE not a "bingo game"

individualists to make it go.
Get a business plan
Well Known members of the community.
Those with visiability to attact

attention and need of program.
time needed to give needed

attention.
City of Malden Groups involved
MALDEN REDEVELOPMENT AUTHORITY
cITY PLANNER WITH THE VISION FOR

MALDEN PROGRAM 0UTREACH
DIRECTOR OF MALDEN HOUSING
DIRECTOR OF ELDERLY AFFAIRS
MALDEN CHAMBER OF COMMERCE
OUR CITY COUNCIL WARD REPRESENTIVES
TO GET SENIORS IN THEIR NEIGHBORHOOD

INTERESTED AND INVOLVED.
OUR AT LARGE TO PROMOTE OUR PROGRAM

WITH CITY BUSINESSES OUTREACH TO

WHOLE COMMUNITY
YMCA PROGRAM FOR ELDERLY IN

SUBSIDIZED HOUSING.
GET A BANK SPONSOR
(BANK OF AMERICA)
GET A MAIN MEDICAL PROVIDER
(bEACON HILL MASS GENERAL)
NON PROFITS
MYSTIC VALLEY ELDER SERVICES
HEALTHY MALDEN
TRI CAP ETC
hAVE A MISSION OT ASSIST SENIORS AND

OBLIGATION TO USE THEIR GRANTS

OBTAINED TO ASSIST SENIORS NOT JUST

TO PROMOTE THEIR PRODUCTS.
GET A COMMUNITY BUILDING INVOLVED
MALDEN SENIOR CENTER (KEY TO

ACTIVITIES)
ORGANIZE THOSE SENIORS AND FAMILIES
ON WEB "MEETUP.ORG.
OUTREACH MEMBERSHIP
60% OF MEMBERSHIP COVER COSTS
NEED TO RECRUIT 6 NEW MEMBERS PER

MONTH.
GET OTHER VILLIAGES INVOLVED WITH

NETWORKING.
FIND OUT WHAT MEMBER WANT.
GET CHARTER MEMBERS AT START
FIND ALL SERVICE GROUPS WITH SENIOR

MEMBERS TO BE INVOLVED.
YOU WILL HAVE SPIN OFF GROUPS FOR

SPECIAL INTERESTS.
MUST HAVE BIG VARIETY ACTIVITIES TO

KEEP UP INTEREST.
HOUSEWORKS PRIVATE HOME CARE
WWW HOUSEWARKS.COM
BEACON HILL AND NEWTON AT HOME
HOME CARE FRANCHISE AVAILABLE IN

mALDEN
FUNDING
lISTING DONORS
DIRECT MAIL (USE ACCESS EXCEL)
BOARD CONTRIBUTIONS $500
COMMUNTY $400
MEMBERS
FOUNDATIONS
FAMILY TRUSTS
STATE PROGRAMS MANEY FOLLOW THE

PERSON.
VOLUNTEERS TO RAISE FUNDS
TALK PERSON TO PERSON
AARP FOUNDATION
RECRUITMENT
GET THOSE WITH DEVERSE INTEREST.
SELL AS LONG TERM CARE INSURANCE.
SERVICES FOR THE WHOLE MEMBERSHIP
EXPLAIN WHAT IS THE BENEFIT OF HOME

CARE.
NONE OF THE VILLIAGES TALKED ABOUT

THE ROLE OF THE GOVERMENT,

FEDERAL,STATE AND LOCAL IN HELPING

WITH SERVICE AND GETTING HOME CARE

LEGISLATION UNTIL I TALKED TO THE

WASHINGON D.C. REPRESENTATIVE WHO

MENTIONED AN $85,000 EACH EARMARK

FOR ALL THE WARDS IN DC
MY CONCLUSION
WE ARE READY TO GO.
WE HAVE ALL THE SERVICES AVAILABLE
WE HAVE THE ORGANIZATIONS TO PROVIDE

SERVICES NEED EDUCATION OF POTENTIAL

MEMBERS OF WHAT IS AVAILABLE AT A

REASONALBLE PLACE.
WE NEED ALL THE "PILOT PROGRAMS"

CONDUCTED BY NON PROFITS UNDER

CONTROL OF THOSE WITH SENIORS IN

MIND.
dEDICATED ACTIVE MEMBERS WORKING TO

HELP THEMSELVES AND THEIR NEIGHBORS.

HHS HELPS OLDER AMERICANS,VETERANS REMAIN IDEPENDENT

HHS Helps Older Americans, Veterans Remain Independent
Related Articles
Extendicare Class Action Lawsuit Filed over Nursing Home Neglect in Wisconsin
November Is Senior Drug Coverage Awareness Month
Rates Changed For Nursing Home Residents
National Scheme Improved Older People's Quality Of Life
Conseco Trust May Significantly Alter Senior Health Care Market
The U.S. Department of Health and Human Services (HHS) today announced $36 million in new grant programs to 28 states to help older Americans and veterans remain independent and to support people with Alzheimer's disease to remain in their homes and communities. Just over $19 million of this funding involves a new collaboration with the U.S. Department of Veterans Affairs (VA).

HHS Secretary Mike Leavitt and VA Secretary James Peake, M.D., announced the joint effort to provide essential consumer-directed home and community-based services to older Americans and veterans of all ages, as part of a Nursing Home Diversion (NHD) grants program. The new initiative builds on the similar missions of HHS and the VA with regard to caring for the populations they serve. In addition, Secretary Leavitt announced a $17 million investment to improve the delivery of home and community-based services to people with Alzheimer's disease and their family caregivers.

Read about:
Eldercare

In announcing the collaboration, Secretary Leavitt said, "This historic HHS-VA initiative combines the expertise of the HHS' national network of aging services providers with the resources of the Veterans Health Administration to provide more people, including our nation's veterans, with improved long-term care options. This unique effort supports the President's New Freedom Initiative which calls upon all federal agencies to help people who need long-term care and prefer to live in their own homes and communities to do so. Through this joint program, many people who would have previously been placed in nursing homes will be able to remain at home."

"Our mission is to honor and support America's veterans, and this collaboration provides an additional opportunity to do that by offering more services, choices and control over decisions to veterans in the least restrictive environment consistent with their needs and preferences," Secretary Peake said.

The new program will be administered by HHS' Administration on Aging (AoA) in collaboration with the Veterans Health Administration. Under the program, $10.5 million is being provided by HHS through AoA, and $5.7 million by the states. VA estimates purchasing at least $3 million in veteran-directed home and community-based services for older veterans and for recently returned veterans with long-term care needs. The number of veterans over age 85 has tripled during the past decade, creating a significant expansion in the need for long term care.

"The HHS funding is specifically designed to reach people who are not eligible for Medicaid, but who are at high risk of nursing home placement and spend-down to Medicaid -which often occurs when private pay individuals enter a nursing home," said Assistant Secretary for Aging Josefina G. Carbonell. "The program will also offer consumers more control over their long-term care, including the ability to determine the types of services they receive and the manner in which they receive them, including the option of hiring their own care workers."

The $17 million for individuals with Alzheimer's disease and their caregivers involves grants to 22 states under AoA's Alzheimer's disease demonstration programs. States were able to apply for two types of grants: Innovation Grants and Evidence-Based Program Grants. Innovation Grants will demonstrate new approaches to delivering services and supports, and the Evidence-Based Grants will support the replication of science-based interventions that have already proven to be effective at helping people with Alzheimer's Disease and Related Disorders to continue to live in the community.


By: U.S. Department Of Health & Human Services - Wed, 10/01/2008 - 10:07

LONG TERM CARE INSURANCE

--------------------------------------------------------------------------------

October 23, 2008
Young Workers Must Face Realities of Long-Term Care
By FRAN HAWTHORNE

MOST of the nation’s 78 million baby boomers are watching their parents grow old. While investigating caretaking options for their parents, they should also be thinking about their own old age and planning how they will pay for nursing homes or home health aides for themselves, experts say. With life expectancy steadily rising, the odds are that they will eventually need some help with basic functions, like dressing or walking, maybe for decades.

But many boomers are ignoring this prospect.

“You’ve got your 401(k) to fund, you’ve got rising health care premiums, gasoline is up, groceries are up, said Randall K. Abbott, a senior consultant in the Boston office of the benefits consulting firm Watson Wyatt. “Folks tend to look at their wallets and decide it’s something they can’t think about right now.” Besides, he said, “people just don’t believe it’s going to happen to them.”

If they were to pay attention, they would learn that Medicare does not cover these ongoing, nonmedical services. Medicaid does, but it has tightened its rules, making it harder for middle-income people to qualify. That leaves essentially two choices: pay cash or buy long-term care insurance.

Long-term care insurance covers services for people who are unable to perform two or more activities of daily living. It can pay for a nursing home, assisted living facility, home health aide, adult day care and family respite (someone to fill in for a family member who is caring for the insured person).

And it is not just for the elderly; young people who are paralyzed by car accidents, for instance, often need home care.

About seven million of these policies had been sold as of Dec. 31, 2007, with sales increasing slightly over the past year, according to Limra International, a trade group in Windsor, Conn. The choices among these plans can be mind-boggling. Here are some critical issues to consider:

DO I REALLY NEED THIS COVERAGE?

Buying insurance is always a bet on probability. For long-term care, there are four basic questions to ask:

If I don’t buy insurance, how much money can I afford to spend on this care from my own assets and income? AARP reported that the average cost of a nursing home in the United States last year was about $214 a day; a home health aide was around $19 an hour.

Do I have alternatives? Are there friends or relatives who would take care of me — without charge?

What is the likelihood that I will need this care? (This is, admittedly, an uncomfortable question.) Does my family have a history of debilitating chronic illness, like Alzheimer’s disease? Or, on the other hand, do I have a heart problem that makes it unlikely that I will live long enough to use the benefit?

Can I afford the annual premiums, which can top $2,000? If someone’s assets or income is less than $40,000, “most likely you would be better off relying on Medicaid,” said Malcolm Cheung, vice president of long-term care product and risk management at the Prudential Insurance Company.

WHEN SHOULD I BUY IT?

Experts suggest that people buy policies while in their 40s to mid-50s, mainly because premiums rise with age, roughly doubling every 10 years. For a standard policy at New York Life Insurance Company, the annual rate is $1,041 at age 50, $1,941 at age 60 and $3,984 at age 70.

If buying at age 40 is good, why not start at 30? “Your first savings should be to take care of income replacement for retirement,” said Lawrence Singer, a senior vice president at the Segal Company, a benefits consulting firm in New York City. Another reason: “The likelihood of having a claim is really remote in the 30s, 40s and 50s,” he said.

But an applicant can also be too old. The cutoff at some major insurers is age 79; New York Life will sign new policies for those up to age 85, but with limited benefits.

WHERE CAN I GET IT?

“Look for it at the work site first,” Mr. Singer said. More than one-third of companies now offer long-term care insurance as a benefit, doubling the number from 10 years ago, according to Hewitt Associates, a benefits consulting firm in Lincolnshire, Ill.

Employer-based plans have multiple advantages, experts say. Mr. Abbott of Watson Wyatt noted that the group rates are typically 5 to 15 percent lower than retail and “they often have features and benefits that are more difficult to find in individual plans.” Moreover, the employer will have vetted the insurance carrier. One more advantage: policy owners will not need medical screening.

For those who have to buy coverage on their own, how can they be sure the company will still be around when they need the benefits, 20 years from now? One way is to check its standing with a rating agency like Standard & Poor’s or A. M. Best Company.

About two dozen states — including New York, New Jersey and Connecticut — have extended-coverage “partnerships” that coordinate private insurance with Medicaid. Normally, if people still need help after exhausting their insurance benefits, they must pay out of pocket until nearly all of their assets are gone before Medicaid will step in. With these state programs, however, they can qualify for Medicaid while preserving more assets. (The amount they can preserve depends on the policy they select.)

HOW MUCH COVERAGE SHOULD I GET?

The typical policy is written as a formula — X dollars per day of Y-type coverage for Z years — although in practice it is more flexible. “It’s really a pot of dollars,” said Mr. Cheung of Prudential. If a policy covers $200 a day at a nursing home for five years, and the policyholder ends up in a home that costs only $150, the coverage can continue beyond five years until the policy has paid out $365,000 ($200 times 365 times 5).

The advantage of this formula is that it helps people calculate how much coverage to buy by breaking the choice into pieces.

How many years of coverage? For nursing homes, five years is a common amount, but people can buy anywhere from two years to unlimited time. Thomas Stinson, president of the long-term care business at Genworth Financial in Richmond, Va., a large insurance provider, says the average nursing home stay is two and a half years.

And how much money per day? That is fairly easy to calculate, because AARP and many insurance companies track average costs state by state. Consumers can also look up the facilities they are interested in. The catch: “You really need to think about where you’re going to be retired, and the average cost of nursing homes there,” rather than the cost where you live now, said Robert Schlau, a senior consultant for Towers Perrin, a benefits consulting firm based in Stamford, Conn. The fees can vary dramatically — from $33.50 a day in Louisiana to $237 in Alaska, according to AARP.

Genworth’s typical customer buys four years of coverage at $200 per day. At Prudential, the average is five years at $140 a day.

Since today’s average cost is sure to grow by the time most buyers actually use the benefit, it is important to add inflation protection. A policyholder can increase coverage every few years, with a corresponding rise in the premium, but most experts prefer policies that automatically raise the benefit over time, even though they charge a higher premium from the start.

If it is not done automatically, “our concern is that people often pass on taking the option,” said Mr. Stinson of Genworth, which sells only the automatic type. There is some dispute as to which approach costs more in the end.

WILL I BE ABLE TO GET INSURANCE?

Insurers reject 15 to 20 percent of applicants — mainly those “likely to need long-term care soon,” Mr. Cheung said. The most common red flags are obesity, severe diabetes, cancer within the past five years, arthritis, Parkinson’s disease and mental cognition problems, along with age limits.

That’s another reason to apply at a younger age. “Your insurability is exponentially higher,” Mr. Stinson said.

The good news is that a family history of these conditions does not count. “It’s hard to reject somebody based on a predisposition to something they don’t personally have,” said Dennis M. O’Brien, senior vice president for long-term coverage at New York Life.

CAN THE COMPANY RAISE MY PREMIUM?

Yes, with regulatory approval. However, rates must be raised for a whole class of policyholders, not on an individual basis, and it is rare. Genworth said it increased premiums only once in 35 years, while New York Life said that it had never done so.

SHOULD BOTH PARTNERS GET COVERAGE?

Companies often give a 30 or 40 percent spousal discount on both policies, so it can be cost-effective to buy coverage together. But if a couple can afford only one policy, Mr. Abbott said, “focus on the one who’s more likely to have the need.”

There is an important difference between long-term care insurance and other types. With auto or fire or major medical coverage, the policyholder hopes never actually to use the benefit. With long-term care, the policyholder hopes to live a long healthy life that may end with a brief nursing home stay or some home care, rather than never living long enough to require the care at all.



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Olmstead/Community First

Mass Home Care presented the
following list of specifi c program goals as ‘next
steps’ in the Olmstead/Community First movement:
1. Implement Long-term Care
Options Counseling statewide.
2. Implement the Community First (CF)
1115 waiver program, enhanced services,
with enhanced income and asset rules.
3. Support expansion of respite care capacity for caregivers.
4. Improve funding for case management, medication
management, behavioral health, and caregiver supports
5. Submit a Home and Community Based
Services (HCBS) State Plan Amendment (SPA)
to uncouple HCBS from nursing home eligibility.
6. Increase funding and community-based
services for people who are not low-income
or otherwise not eligible for MassHealth.
7. Remove barriers to community-based care,
make eligibility rules uniform regardless of age.
8. Implement PCA Improvement workgroup
recommendations, including allowing
cueing and supervision to be a need for
care, and creation of the PCA directory, etc.
9. Allow spouses to become paid caregivers
in programs like PCA and Adult Family Care.
10. Increase supply of supportive housing sites,
and 24/7 “housing with services” packages,
including small group homes, using funding from
Community Housing bond and other sources.
11. Implement and fund the ADRC model statewide.
12. Implement mandatory training in cultural competency
on LGBT issues, and a statewide needs assessment of
LGBT individuals with disabilities and the elderly.
13. Increase funding for the protective
services programs, and education on reporting
responsibilities under the abuse and neglect law.
14. Create a medication assistance program for
elders and individuals with disabilities in their homes
by amending the nurse practices act requirements.
“The key to any plan is its implementation,” said
Paul J. Lanzikos, President of Mass Home Care. “We

Pace Program All Inclusive Care

The Program of All-Inclusive Care for the Elderly (PACE) is a capitated benefit authorized by the Balanced Budget Act of 1997 (BBA) that features a comprehensive service delivery system and integrated Medicare and Medicaid financing. The program is modeled on the system of acute and long term care services developed by On Lok Senior Health Services in San Francisco, California. The model was tested through CMS (then HCFA) demonstration projects that began in the mid-1980s. The PACE model was developed to address the needs of long-term care clients, providers, and payers. For most participants, the comprehensive service package permits them to continue living at home while receiving services rather than be institutionalized. Capitated financing allows providers to deliver all services participants need rather than be limited to those reimbursable under the Medicare and Medicaid fee-for-service systems.

The BBA established the PACE model of care as a permanent entity within the Medicare program and enables States to provide PACE services to Medicaid beneficiaries as a State option. The State plan must include PACE as an optional Medicaid benefit before the State and the Secretary of the Department of Health and Human Services (DHHS) can enter into program agreements with PACE providers.

Participants must be at least 55 years old, live in the PACE service area, and be certified as eligible for nursing home care by the appropriate State agency. The PACE program becomes the sole source of services for Medicare and Medicaid eligible enrollees.

An interdisciplinary team, consisting of professional and paraprofessional staff, assesses participants' needs, develops care plans, and delivers all services (including acute care services and when necessary, nursing facility services) which are integrated for a seamless provision of total care. PACE programs provide social and medical services primarily in an adult day health center, supplemented by in-home and referral services in accordance with the participant's needs. The PACE service package must include all Medicare and Medicaid covered services, and other services determined necessary by the interdisciplinary team for the care of the PACE participant.

PACE providers receive monthly Medicare and Medicaid capitation payments for each eligible enrollee. Medicare eligible participants who are not eligible for Medicaid pay monthly premiums equal to the Medicaid capitation amount, but no deductibles, coinsurance, or other type of Medicare or Medicaid cost-sharing applies. PACE providers assume full financial risk for participants' care without limits on amount, duration, or scope of services.

Long Term Health Care Insurance

Young Workers Must Face Realities of Long-Term Care
E-Mail
By FRAN HAWTHORNE
Published: October 22, 2008



Michael Hogue

Retirement
A Special Section
Strategies for retirement in a troubled economy.

Go to the special section » MOST of the nation’s 78 million baby boomers are watching their parents grow old. While investigating caretaking options for their parents, they should also be thinking about their own old age and planning how they will pay for nursing homes or home health aides for themselves, experts say. With life expectancy steadily rising, the odds are that they will eventually need some help with basic functions, like dressing or walking, maybe for decades.

But many boomers are ignoring this prospect.

“You’ve got your 401(k) to fund, you’ve got rising health care premiums, gasoline is up, groceries are up, said Randall K. Abbott, a senior consultant in the Boston office of the benefits consulting firm Watson Wyatt. “Folks tend to look at their wallets and decide it’s something they can’t think about right now.” Besides, he said, “people just don’t believe it’s going to happen to them.”

If they were to pay attention, they would learn that Medicare does not cover these ongoing, nonmedical services. Medicaid does, but it has tightened its rules, making it harder for middle-income people to qualify. That leaves essentially two choices: pay cash or buy long-term care insurance.

Long-term care insurance covers services for people who are unable to perform two or more activities of daily living. It can pay for a nursing home, assisted living facility, home health aide, adult day care and family respite (someone to fill in for a family member who is caring for the insured person).

And it is not just for the elderly; young people who are paralyzed by car accidents, for instance, often need home care.

About seven million of these policies had been sold as of Dec. 31, 2007, with sales increasing slightly over the past year, according to Limra International, a trade group in Windsor, Conn. The choices among these plans can be mind-boggling. Here are some critical issues to consider:

DO I REALLY NEED THIS COVERAGE?

Buying insurance is always a bet on probability. For long-term care, there are four basic questions to ask:

If I don’t buy insurance, how much money can I afford to spend on this care from my own assets and income? AARP reported that the average cost of a nursing home in the United States last year was about $214 a day; a home health aide was around $19 an hour.

Do I have alternatives? Are there friends or relatives who would take care of me — without charge?

What is the likelihood that I will need this care? (This is, admittedly, an uncomfortable question.) Does my family have a history of debilitating chronic illness, like Alzheimer’s disease? Or, on the other hand, do I have a heart problem that makes it unlikely that I will live long enough to use the benefit?

Can I afford the annual premiums, which can top $2,000? If someone’s assets or income is less than $40,000, “most likely you would be better off relying on Medicaid,” said Malcolm Cheung, vice president of long-term care product and risk management at the Prudential Insurance Company.

WHEN SHOULD I BUY IT?

Experts suggest that people buy policies while in their 40s to mid-50s, mainly because premiums rise with age, roughly doubling every 10 years. For a standard policy at New York Life Insurance Company, the annual rate is $1,041 at age 50, $1,941 at age 60 and $3,984 at age 70.

If buying at age 40 is good, why not start at 30? “Your first savings should be to take care of income replacement for retirement,” said Lawrence Singer, a senior vice president at the Segal Company, a benefits consulting firm in New York City. Another reason: “The likelihood of having a claim is really remote in the 30s, 40s and 50s,” he said.

But an applicant can also be too old. The cutoff at some major insurers is age 79; New York Life will sign new policies for those up to age 85, but with limited benefits.

WHERE CAN I GET IT?

“Look for it at the work site first,” Mr. Singer said. More than one-third of companies now offer long-term care insurance as a benefit, doubling the number from 10 years ago, according to Hewitt Associates, a benefits consulting firm in Lincolnshire, Ill.

Employer-based plans have multiple advantages, experts say. Mr. Abbott of Watson Wyatt noted that the group rates are typically 5 to 15 percent lower than retail and “they often have features and benefits that are more difficult to find in individual plans.” Moreover, the employer will have vetted the insurance carrier. One more advantage: policy owners will not need medical screening.

Caregivers Face Multiple Strains Tending Older Parents
Middle-aged adults who regularly help their elderly parents get by experience a drop in health and well-being in their own lives, a new study shows.

The study, published earlier this year in the Journal of Gerontology: Social Sciences, found these adult children were often juggling multiple roles each day, sometimes causing conflicts in roles or feeling overloaded.

"The accumulation of small and large daily stressors such as work deadlines, PTA meetings, supporting family and friends as well as providing routine assistance to a parent living outside one's house can build up," study leader Jyoti Savla, assistant professor of human development and gerontology at Virginia Tech, said in a university news release. "Sooner or later, they can spill over into other areas of life with negative mental and physical consequences. Days when help is provided to parents are more stressful than days when it is not," Savla said.

Salva's team studied diaries of the individuals who provided help to parents, more than half of which did so on two or more days each week. They found several factors, such as having a spouse and higher education, could decrease the conflict and demands on time. Also, those who believed in personal growth, mastery and self-acceptance experienced fewer negative consequences from helping their parents.

Read Full Article (U.S. News & World Report)

Comments (1 to 1 of 1)
staryize

3 days ago
Suggest Removal
It's great that the issues of caregivers is finally being recognized and I read the full article as well as a few from AARP regarding how to cope with caregiver stress and burnout. All their suggestions are great IF you have family and friends nearby or you have the financial resources to hire respite care. But what about those of us who are full-time live-in caregivers unable to work outside the home because of the high cost of non-medical senior care?

If anyone knows of any resources (financial, work-from-home opportunities, volunteer respite services etc.) please point me in the right direction. I had to leave my job in March to care for my mother full-time - she has parkinsons and has fallen too many times with injuries to be left alone. And assisted living/nursing home is not an option. While I have a fantastic emotional support system from my sisters (none live locally) I am at wit's end trying to find a source of income from home. I use a home helper service once in a while for my personal appointments, but other than that I only get out when mom feels well enough to go with me. HELP!!!
Signed,
Hopeful in Florida

What is an Independent Living Community?

Independent Senior Retirement Communities are designed for seniors who are basically independent but who would enjoy and benefit from being freed of some of life's "must do" or "nuisance" chores, such as: yard work; home maintenance; housekeeping; driving, especially at night and in bad weather; daily menu planning; shopping; cooking; clean-up and more.

Independent Senior Retirement Communities appeal to people for whom the large family home has become more of a burden than a pleasure, and to people who may have become somewhat isolated because they are able to get out less frequently, or because friends have moved away or their neighborhood has changed.

Independent Senior Retirement Communities offer an array of convenient services. They generally include restaurant style dining for one or more meals daily, housekeeping, transportation, 24 hour security and an emergency response system. Most also offer a wide range of amenities such as a fitness center, library, computer center, theater, arts and crafts studio, even an on-site beauty and barber shop.

In a nutshell, living in an Independent Senior Retirement Community is noted, "like being a guest in your own home."

Senior Home Care Services

Everyone shares similar concerns about health care for our parents, grandparents and loved ones as they reach retirement age and beyond. Perhaps your mother gets confused and can't keep her doctor appointments and medications straight. Or your dad seems depressed and doesn't enjoy fishing anymore. Maybe your grandmother needs regular attention for her Alzheimer's while you're at work. That's when Home Instead Senior Care can come into the home and be the caregiver for you.

Are you seeing that your loved ones need home health care as they age? Have you thought about a nursing home or assisted living facility, but want to keep them in their home for as long as possible? Are you starting to wear out because of the impact the senior care you're providing is having at work and with your family members? Do you fear for a loved one's safety?

Home Instead Senior Care can help with compassionate, home care services delivered right in your loved one's home. Whether a few hours a day or long term care 24 hours a day, a CAREGiver can assist you. All CAREGivers are thoroughly screened, extensively trained, insured and bonded, matched to your preferences, professional and reliable.


There are a wide variety of services available, and this list may grow to include activities and support that are unique to your needs. We also have information on Alzheimer's and dementia care or feel free to read more about us.

Senior Services include the following and more - all tailored to meet your needs:

Companionship Services

Offer elderly companionship
and conversation
Provide respite care
Monitor diet and eating
Check food expirations
Assist with evening and tuck-in
Aid with morning and wake-up
Arrange appointments
Provide medication reminders
Aid with reading
Assist with walking
Write letters and correspondence
Organize mail
Stimulate mental awareness
Assist with entertaining
Answer the door
Reminisce about the past
Assist with clothing selection
Care for houseplants
Provide reminders for appointments
Discuss current and historical events
Participate in crafts
Play games and cards
Supervise home maintenance
Record and arrange recipes
Oversee home deliveries
Prepare grocery lists
Clip coupons for shopping
Monitor TV usage
Mail bills and letters
Buy magazines, papers and books
Rent and play movies
Plan visits, outings and trips
Visit neighbors and friends
Read religious materials
Maintain calendar
Maintain family scrapbook
Record family history
Home Helper Services

Provide Alzheimer's Care
Assist with laundry and ironing
Take out garbage
Change linens
Plan, prepare and clean up meals
Make beds
Dust furniture
Drop off and pick up dry cleaning
Pick up prescriptions
Organize and clean closets
Assist with pet care
Shop for groceries and supplies
Prepare future meals
Escort to appointments
Accompany to lunch or dinner
Escort for shopping and errands
Attend plays and concerts
Escort to religious services
Attend club meetings and sporting events
Aid with airport tasks

Personal Services

Assistance with:
Eating
Grooming
Dressing
Bathing
Incontinence
Cognitive impairment
Mobility
Medication reminders


Services may vary by individual Home Instead Senior Care franchise office location.

DEALING WITH AGING PARENTS FINANCES

Planning for the financial care of an aging loved one is never an easy task, but with forethought, it can make an uncomfortable situation more tolerable and rewarding. Like many difficult situations with people we love, planning to take over a parent or older relative’s finances is best done in happier times, when both sides are healthy and various options can be considered. Unfortunately, events can sometimes intervene – death or illness can make an elder’s need for assistance a critical matter.


Once stricken, older relatives may be unable to understand questions or express their wishes in proper detail. If there is no plan, family members grasp at responsibilities – or shirk them – without any idea of what the older relative would really want.

What’s critical to understand is that such talks should go far beyond money. They need to be discussions about independence and basic preferences for the way an individual wants to live or die. Demographers believe that with the rising number of single Americans – those divorced or never married – these conversations will become increasingly complicated as they fall to nieces and nephews, younger friends or designated representatives.

Want to avoid a worst-case scenario? Start the conversation now. Here are some ideas:

Prioritize: Maybe this conversation isn’t just about where the will or health care power of attorney is. Maybe this conversation is about you noticing that a parent or loved one is moving slower, is more forgetful, is clearly looking like their health has taken a turn for the worse – and maybe that’s why you want to know where the will is. Jumping into money issues first is usually a mistake. Deal with immediate health and lifestyle issues first.

Talk with them, not at them: In some families, having a successful financial discussion means several attempts and some frustration. Don’t let yourself become angry or frustrated – just keep starting the conversation until it catches on. It might make sense to say something like, “You’ve always been so independent, Mom. I just want you to give us the right instructions so we do exactly what you want.”

By prepared: When a parent or relative becomes ill, the adult child or other relative is immediately in the drivers’ seat. That’s why it’s critical to make a list of questions for the elderly relative to answer in detail. The basics: Where important papers are, how household expenses are paid, who doctors and specialists are, what medicines are being taken and whether there’s a will, an advanced directive and a funeral plan (and money or insurance proceeds to pay for it). There may be dozens more questions beyond these based on your family’s personal circumstances. But in creating this list, ask yourself: “What do I need to know if this person suddenly becomes ill or dies?”

Ask for help: If you don’t fully understand your relative’s financial affairs, it might make sense for you both to talk to an attorney or a tax or financial adviser. A qualified adviser can offer specific suggestions on critical legal documents that should be in place and ways to make sure accounts to pay medical and household bills are accessible to the older person and the designated friend or relative who will hold power of attorney.

Plan a strategy together: You should discuss the relative’s preferences and trigger points for various stages of heath care. An individual always wants to stay in his or her home, but you should have an honest discussion about how much you can do at home as a caregiver and whether various services (home health aide, geriatric care manager, assisted living) should be introduced at various stages. Talking through what a parent will be able to live with at various health stages – and putting that information in writing – will save plenty of doubt and bitterness later.

What it do with the house?: If an elderly relative becomes sick, the equity in his or her home may come under consideration as a resource to pay uncovered medical or household maintenance. Since the home is both a major asset and an emotional asset, it’s best to get good advice and spell out specifically what the elderly relative wants done with their property.

Don’t keep the plan a secret: Once you settle on a strategy, make sure all family and friends understand the plan and their assignments.

The issues that come with caring for an aging parent or relative are never easy, but a little financial pre-planning can make this awkward time less uncomfortable for all involved.


Andy Barkate CCPS, CRPS is the President of California Retirement Plans & College2, a local Retirement & College Planning firm, with offices in Bakersfield, Lancaster and Ridgecrest.. Your questions and comments are welcome at, 661-631-4355, 760-371-2115, 800-914-6837 or e-mail abarkate@calretirement.com



Tue Sep 9, 2008 08:36:34 PDT
I agree this is a difficult subject to address with aging parents or other relatives. I've done it. I totally disagree with your last point. You should NOT sit down with friends and relatives and explain everything. It's not their business. A will, a Trust document, a Durable Power of Attorney for Health Care will suffice. The details need to be known by two or three trusted family members who also know the name of the Attorney who has been consulted. Older people do not want their personal business shared with family and friends. It's no one else's business.
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Plans for health village unveiled soon

14 August 2008

Detailed plans for a multi-million-pound “health village” development in Eye are due to be unveiled in the near future.

NHS Suffolk and the East of England Strategic Health Authority are on course to approve the plans - for the Hartismere Hospital site - in January 2009.

A development “partner” is due to be appointed soon after.

Now a one-day event is being organised to tell local people about the progress being made and show them how the new development may look.

NHS Suffolk's plans to close the geriatric in-patient facility at Hartismere Hospital and focus on a “care in the community” strategy caused a storm of controversy three years ago with heated local opposition.

However, a mood of acceptance

has pervaded the area as more detailed plans have emerged to

retain and increase out-patient clinics and set up a community health team.

The plan is to regenerate the site, possibly with the help of land sales for new homes, with the

development of a private care home - with some beds contracted by the NHS.

The Eye Locality and Implementation Group - a community group set up to help bring the plans to fruition - was recently given an update on the business case for the regeneration of the site.

During the meeting, the group agreed that a public event should be held in Eye to give people the chance to see the progress being made on plans for the site along with drawings of how the health facility may look.

Project team leaders from NHS Suffolk, the county's primary care trust, also told the group that good progress had been made in many areas, such as the appointment of architects to develop “concept drawings” for the site and continuing positive discussions with the local GP practice.

Representatives from EC Harris, the company drafting the business case for the site, talked about the process they were following and confirmed the timescales for

the delivery and approval of their work.

NHS Suffolk has also agreed to start working with the Suffolk Association of Local Councils to plan the local community liaison day for September or October.

Elizabeth Gibson-Harries, Eye Locality and Implementation Group chairman, said: “I am very pleased that we can be so confident around the progress to date and that we are in a position where we will be able to publicly share this information with the local community in the near future.

“It is important to the group

that the local community can hear and see what plans are being developed for this important local site.”

LONGTERM CARE INSURANCE

The average annual long-term care premium for individuals under 65 is $1,337.
The average premium for individuals over 65 is $2,862.
The average long-term care insurance policy purchased by a 65-year-old and held until death pays out 82 cents for every dollar.
Since 1987, fewer than 10 million Americans have bought long-term care insurance, and only about 7 million of those policies remain in force today.
Almost 30 percent of Americans over 45 have purchased a long-term care insurance policy

Home Healthcare—Helping Older Adults Live at Home Longer

Posted June 22, 2008 5:41 PM
Posted in Medical Care Article
by Mary Calvagna, MS

As people age, activities that were once simple to do—laundry, grocery shopping, yard work—can become more difficult to complete. Difficulty with certain tasks, however, does not mean that an older person is ready to move into an assisted living facility or a nursing home. An alternative that is growing in popularity is home healthcare.

Home healthcare describes a variety of health and social services provided in the home by trained professionals. The services can range from skilled care that is provided under the direction of your doctor and may include such services as dialysis or physical therapy to home support services like housecleaning or running errands. Home healthcare allows older adults to continue to live independently in their homes and get help with the tasks they cannot do on their own. One example of a home healthcare organization that many are familiar with is Meals on Wheels, a program that delivers hot meals to a person’s home.

Almost two million people over the age of 65 are using home healthcare services—and with good reason. Studies have found that home health care costs less than institutional care, provides more satisfaction to those who receive it, and often results in fewer and shorter hospital stays.

Home Healthcare Services Available
Many different services can be provided in the home, from light housekeeping to meal delivery. The following table lists examples of services available in the home.

Home Health Care Service Available Category
Bathing, Hair washing, Dressing Personal care
Housecleaning, Yard work, Shopping, Laundry Homemaking
Grocery shopping, Meal preparation, Meal delivery Meals
Bill paying/check writing, Account management Money Management
Medication management, Administration of intravenous drugs (e.g. antibiotics or pain medications), Dialysis, Physical therapy, Hospice care Healthcare
To shop for food, clothes, necessities; To and from medical appointments, social engagements, church activities Transportation
Daily/weekly visits, Phone calls Companionship


Paying for Home Healthcare Services
The cost of services will vary depending on where you live and the type of services you need. Some home healthcare agencies have sliding fee scales, so make sure to ask. Home healthcare services can be paid for privately, but there are also a number of public and private funding sources. Funding sources include the following:

Medicare
Medicaid
The Older Americans Act
The Veterans’ Administration
Private insurance

Deciding What Services You Need
The first step in finding appropriate home care service is talking to your doctor to determine what type of services you will need. You may only need help with preparing meals or you may require sophisticated medical care at home. Determining level of help required and type of services will help you find an appropriate agency.

It can be a daunting task. By contracting with an agency, you are allowing someone to come into your home or the home of someone you care about. To help ensure you are working with a reputable organization and that they provide quality care at a cost you can afford, research the organization extensively and prepare a list with important questions. In addition, your nurse, physician, hospital social worker, or discharge planner may recommend a reputable agency in your area.

If it is possible, anticipate what your possible needs may be and do some research in advance. Planning ahead is difficult because you cannot be sure about what types of services you will need, but it will help when it comes time to make a decision. To help inform your decisions, educate yourself on the concerns and issues that may affect older adults, taking into consideration your own financial and health issues, including any chronic health conditions.

Questions to Ask
The United States Department of Health and Human Services Administration on Aging provides the following 20 questions to help guide your search for a home health service provider:

How long has the agency been serving this community?
Does the agency have any printed brochures describing the services it offers and how much they cost? If so, get one.
Is the agency an approved Medicare provider?
Is the quality of care certified by a national accrediting body such as the Joint Commission for the Accreditation of Healthcare Organizations?
Does the agency have a current license to practice (if required in the state where you live)?
Does the agency offer seniors a “Patients’ Bill of Rights” that describes the rights and responsibilities of both the agency and the senior being cared for?
Does the agency write a plan of care for the patient (with input from the patient, his or her doctor, and family), and update the plan as necessary?
Does the care plan outline the patient’s course of treatment, describing the specific tasks to be performed by each caregiver?
How closely do supervisors oversee care to ensure quality?
Will agency caregivers keep family members informed about the kind of care their loved one is getting?
Are agency staff members available around the clock, seven days a week, if necessary?
Does the agency have a nursing supervisor available to provide on-call assistance 24 hours a day?
How does the agency ensure patient confidentiality?
How are agency caregivers hired and trained?
What is the procedure for resolving problems when they occur, and who can I call with questions or complaints?
How does the agency handle billing?
Is there a sliding fee schedule based on ability to pay, and is financial assistance available to pay for services?
Will the agency provide a list of references for its caregivers?
Who does the agency call if the home healthcare worker cannot come when scheduled?
What type of employee screening is done?

RESOURCES:

Administration on Aging

http://www.aoa.gov

American Academy of Home Care Physicians

http://www.aahcp.org

Meals on Wheels Association of America

http://www.mowaa.org

National Association for Home Care and Hospice

http://www.nahc.org

National Institute on Aging

http://www.nia.nih.gov

References:

Age page: There’s no place like home. National Institute on Aging website. Available at: http://www.niapublications.org/engagepages/home.asp . Accessed December 8, 2005.

Caregiving statistics. National Family Caregivers Association website. Available at: http://www.nfcacares.org/who/stats.cfm . Accessed November 27, 2005.

Characteristics of elderly home healthcare users: data from the 1996 National Home and Hospice Care Survey. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/nchs/products/pubs/pubd/ad/301-310/ad309.htm . Accessed December 6, 2005.

Getting the most out of home healthcare. Yale-New Haven Hospital website. Available at: http://www.ynhh.org/choice/home_health.html . Accessed December 6, 2005.

Home healthcare: a guide for families. United States Department of Health and Human Services Administration on Aging website. Available at: http://www.aoa.gov/press/fact/pdf/fs_hhealth_care.pdf . Accessed November 27, 2005.

JAMA patient page: Home healthcare. The Journal of the American Medical Association website. Available at: http://jama.ama-assn.org/cgi/reprint/287/16/2168.pdf . Accessed November 27, 2005.

Last reviewed December 2005 by Marcin Chwistek, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

Caring for aging parents

We live in a very mobile society where family members don’t always live in the same town or even the same state. In fact, according to the National Institute on Aging, approximately seven million Americans are long-distance caregivers, mostly caring for aging parents who live more than an hour away.

“It’s only natural that adult children of seniors will have some concerns about how their aging parents are doing, especially if they are apart during the holiday season,” said a member of the Right at Home office. “Identifying strategies for long-distance caregiving will make the challenges of caring for aging parents or loved ones more manageable.”

Below are tips from Right at Home for long-distance caregiving:

1) Establish Support Contacts in Your Aging Parents’ Community – Make a list of family, friends and neighbors’ phone numbers and addresses. Ask if you can check in with them to find out how your loved one is doing. They may also be willing to stop by your loved one's home for regular visits.

2) Stay in Touch With Your Parents – Keep in regular touch with your loved one by phone, letters, and e-mail. Record any changes you sense in his or her personality or ability to function day by day.

3) Make Observations During Visits – When you are able to visit your parents, pay attention to any changes in grooming, eating, or social activities. Look for changes in the way he or she manages money, cleans, shops, and gets around.

4) Keep Track of Important Information – Find out where your parents keep important documents such as his or her insurance policies, bank account numbers, investments, living will and power of attorney (for legal, financial, and health care purposes). It’s also beneficial to have a list of physicians that your relative is seeing, and any hospitals or clinics that are involved in his or her medical care, and any medications he or she is taking.

5) Look into Professional Help Options – There are several options for aging parents who need additional assistance. In home caregiving agencies, such as Right at Home, provide services such as companionship, meal preparation, and light housekeeping to help seniors continue to live independently with the help of a caregiver.

6) Identify Community Resources – Research local area agencies on aging, senior centers, churches, synagogues, or other volunteer organizations about available resources for seniors. To locate the area agency on aging, individuals can call Eldercare Locator, public service of the U.S. Administration on Aging, toll-free at (800) 677-1116 or visit www.eldercare.gov.

7) Involve Your Parent – Allow your parents to retain as much decision-making ability as possible. Remember that your primary objective is to help your loved one to fulfill his/her needs, not to take over your relative’s life. In some situations, when your loved one is unable to make decisions, you may need to do so on his/her behalf.

8) Take Time for Yourself – Caregiving can have an emotional and physical toll on caregivers, especially when done long-distance. Make sure you are eating right, getting enough rest, exercising regularly and keeping up with your own medical needs.

Remember, the holiday season is a time for family, togetherness and making memories. By taking the time to address these long-distance caregiving issues, your family will have the much-needed sense of security, comfort and hopefully the ability to create new memories with your aging loved ones for many years to come!

Public radio’s “Marketplace’’ recently offered an interesting segment lamenting the short supply of geriatricians.

At a time when the 85-and-over set is the fastest growing cohort in the American population and the nation’s 77 million baby boomers, like it or not, are heading into old age, this is unfortunate.

Geriatricians — essentially family doctors for the elderly — earn about $150,000 a year. That’s less than half the $400,000 of, say, radiologists, in a health care system that rewards specialists who do the most procedures and often spend the least time with patients.

Few experts in the field of geriatrics see any likelihood this will change, absent an overhaul of the reimbursement system. Instead, their focus is on teaching the core principles of their specialty to everyone in the medical arena who comes in contact with the elderly, from surgeons to discharge planners.

“If we got to the point where everybody in the health care system was an expert in caring for older people, we wouldn’t need geriatricians,” Dr. Leo M. Cooney of Yale University School of Medicine told me a few years back. “Or we wouldn’t need them as frontline providers. We’d be like consultants, making sure everyone else was as skilled as possible.’’

Tell us about your experiences with your geriatrician — or your frustrations in trying to find one.

-What is Elder Law?

-How do I find Elder Law Attorneys to network with?

Rather than being defined by technical legal distinctions, elder
law is defined by the client to be served. In other words, the
lawyer who practices elder law may handle a range of issues but has
a specific type of clients--seniors.

Elder law attorneys focus on the legal needs of the elderly, and
work with a variety of legal tools and techniques to meet the goals
and objectives of the older client.

Under this holistic approach, the elder law practitioner handles
general estate planning issues and counsels clients about planning
for incapacity with alternative decision making documents. The
attorney would also assist the client in planning for possible
long-term care needs, including nursing home care. Locating the
appropriate type of care, coordinating private and public resources
to finance the cost of care, and working to ensure the client's
right to quality care are all part of the elder law practice.

Find an elder law attorney(s) in your area by visiting:
http://www.naela.org

Home Town for Seniors

am an avid reader of Globe North to follow local area issues. Reading your article in this Sunday's (8/3/08)
Globe North (slow motion" about the shift in population i can see how this applies to all parts of the Commonwealth. We all realize that the state has a major problem with funding from the Federal Government
if this trend continues.
In the article you point out the movement of population from Lynn to neighboring Peabody (Brooksby Villiage)
which is an assisted living for Seniors mostly affluent long time residents of Lynn looking for a safe and affordable upscale community. I assume Most would rather have rremained in their home and take the next available alternative remaining in the neighboring town in Essex County. We all want to improve our lifestyle.
A followup to your piece on the growing Senior population and their contribution to stability of a city and towns
and what the programs that could be put in place keeping long term residents it their neghborhood and particularly in home environments.
Example Mass Senior Action an advocate group for Seniors have supported with success protecting the rights and needs of elders in Senior and Disabled in subsidized housing. I would like to see them expand to help long time residents not only remain in familiar localities but in the home environment of a familiar neighbor hood.
IN MALDEN:
The Mayor Richard C. Howard, the Malden City Council, The Malden Revelopment Authority, Council on aging after urging from senior groups have plans to opening a new Malden Senior Community Center (Dec 8 2008)
in the downtown Area to improve the economic climate and revitalize Malden Center.
I would suggest their would be much interest to have Globe North do an in depth article of what is happening in Malden to retain our population is a safe and enjoyable city.
I have talked to the Mayor and he is for an outreach program to have a promotion and participation of all non profits in the New Senior Community Center. The concept is to have services to "keep independent living in the neighborhood"
How we can help home caregivers. We need the cooperation of all the non profits who are charged with servicing the Seniors our City Council who represent the citizens throughout the city all the citizens with a Vision For Malden
I would call it a declaration of Independence.
Right now I am trying to get a Focus group to gether for Ideas Interest and comments.
We have a model of several village concepts as guides of what can be done.
As an example:
Beacon Hill Village an all encompassing concierge service created by residents who want to grow old in the homes they have lived in for years.
This could be done on a regional basis or City wide even in a neighborhood.
This is what needs to be determined.
In the service by an organization they can deal with almost any contingency
large of small
without relying on relatives of friends. To preserve their Independence, they
can turn to the village as the non profit association is known
At Beacon Hill they have 320 members find virtually any service, large of small
from 24 hour nursing care to help with a home meal. all at a discounted fee or
from an "entitlement program"
Dan O'Leary Executive director(Mystic Valley Elders ) is on board and has already
had a focus group in Melrose to a standing room only crowd Keven Duffy of Healthy Malden has expressed interest. And Phil Gerioux of Tri Cap is considering his roll. All the city councilors and been briefed. Jim Nestor has all the information and was to contact Chris Depietro Dirtector of Elder Affairs Malden for her input. It would be a help if you and your members would find out from Jim his progress (Jim Nestor) and get a status report
REMEMBER NEW SENIOR COMMUNITY CENTER IS IN WARD 4 VITAL to economic development
of the downtown area.

Any neighbohood resident is asked to participate with membership between 50 and older.
Anyone with a parent needing sercie should be involved.
MaldenSenior
--
Howard McGowan
MaldenSenior
349 Pleasant Street
Malden, Ma 02148
781 324 8076

--

U.S. seniors have limited access to home and community-based aervices under Medicaid

A Balancing Act: State Long-Term Care Reform, is the first to examine Medicaid spending on long-term care for older people and adults with physical disabilities, separate from other LTC users such as people with mental retardation/developmental disabilities (MR/DD).

Nationally, 75 percent of Medicaid LTC spending for older people and adults with physical disabilities pays for institutional care in nursing homes. In contrast, states have done a much better job balancing Medicaid LTC for people with MR/DD, spending just 39 percent on institutional care. The majority of funds now supports people in home and community-based settings.

"We recognize the success state Medicaid programs are having providing home and community based services to people with mental retardation/developmental disabilities," said AARP Pennsylvania State Director Dick Chevrefils. "It proves that balancing long-term care is doable and should be used as a model to help states provide home and community based services for older adults."

As part of its Commonwealth Long-Term Living Project, Pennsylvania set a goal of 50 percent home-based care to 50 percent institutional care for all long-term care populations by FY 2011-12. Unfortunately, the recently passed 2008-09 state budget included no new spending to reduce existing HCBS waiting lists for Pennsylvania's lottery-funded OPTIONS program.

The report examines Medicaid LTC funding because it is the primary payer for LTC in the country. "This underscores the need for better government and private sector financing options for long-term care. Americans have few options to plan and pay for their long-term care. Balancing Medicaid LTC options will require a commitment from our state officials and cooperation from federal authorities. HCBS can be both cost-effective and responsive to the preferences of older people and adults with disabilities," said Chevrefils.

The new report includes state rankings and can be found at: http://www.aarp.org/research/longtermcare/programfunding/2008_10_ltc.html.











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PLUS 50 GERIATRIC CONCIERGE SERVICE

Malden with 60,000 population has many community agencies available to help the elderly. We have a new Malden Senior Community Center due to open in December 2008 that should be an economic engine in revitalizing the downtown area.
It should service all the needs of our growing, diverse, elder population and add to the increase in visits to the downtown area business district.
The challenge is to coordinate all the various service organization and the health care providers into a continuum that is easily access able to the aging population and their care givers.
It has made the vision possible by having the Malden Senior Community Center in this central location on the corner of Washington and Pleasant Streets.
WE NEED A FOCUS GROUP OF ALL Malden residents, business and political groups to make this vision a reality.
We must consider developing a membership-based-organization that will help stay in the home they love.
Opinions of all concerned are vital. All comments and suggestions will shape how to make this concept of neighbor hood cooperative a reality.
The daunting challenge is to get service organizations and individuals to collaborate on commonly agreed upon goals, foregoing inter agency competition and turf protectiveness.
A senior service concentration should be attractive to managed care organizations particularly those with concentrated seniors because it can improve quality care and receational facilities and all in the interests of the elders and their caregivers.

PLUS 50 GERIATRIC SERVICE: S.O.S Serving Our Service

PLUS 50 GERIATRIC SERVICE: S.O.S Serving Our Service

Long Term Care Continuum

Long Term Care Continuum
- Adequate funding for a long term care continuum, that includes high quality, affordable skilled nursing facilities, assisted living facilities, senior housing, and home and community based services, to meet the needs of our aging population.
- Adequate funding to provide home and community based care that enables older and disabled persons to remain healthy and independent.
- Adequate funding of skilled nursing facilities -- which often care for the most frail and vulnerable individuals; including the nursing home criteria known as "Score 3".
- New funding to rebalance the system to allow for more home and community based care.
- Increased funding for the Councils on Aging and Senior Centers.

THE VILLIAGE CONCEPT

The villiage of neighbors helping neighbors has real promise to accomplish what most people want regardless of age.
An opportunity to be connected,maintain there homes and themselves with the help of
Volunteers and vendors they can trust.

S.O.S Serving Our Service

With the new Malden Senior Community Center coming on line December 2008 in Downtown Malden.
I think an outreach program to all the Seniors, their Families and interested parties in all sections of the City is priority number one.
With the participation of the representatives of the Malden residents (CITY Council) and the administration in charge of city services (especially the elderly population) being actively involved.
A Presentation To Be Considered:with citizen participation with input of concerned citizens-----------------------------------------------------------
Plus 50 Geriatric Concierge Service
Geriatric Center Continuum
WITH PARTICIPATION
Hospital
Out Patient Care
Skilled Nursing Facility
Home Health Care
Community Services Network
Local Seniors in the Mass Senior Action Council Metro North Sponsors a S.O.S Program
Serve our Seniors
A program designed to help Seniors avoid nursing home care when possible and to promote
local first class care in the neighborhood when necessary. WE wish to educate seniors on new
managed care programs that emphasizes primary and preventative health care and extensive
services in the home.
The State and Federal government participate with cash grants to Malden and adjoining cities for
Non-Profit agencies to carry out this mission.
We at Mass Senior Action Metro North have one on one contact to inform the Senior and disabled
citizens (our most vulnerable) what services are available and how to obtain these services and improve
their quality of life in their OWN HOMES
There is a overwhelming concern for the soaring Medicaid budget caused by Hospital and Nursing home rising demands on the system in Massachusetts so keeping the elderly and disabled in their home environment and out of this costly system can assure Medicaid can help and benefit our needy citizens Let make sure our Seniors are not denied service they depend on to survive in a wholesome environment With our S.O.S Program we will be urging Seniors, their families, friends and advocates to join in the
PLUS 50 GERIATRIC CONCIERGE SERVICE UNDER A GERIATRIC CENTER CONTINUUM
HOWARD C. MCGOWAN
349 Pleasant Street
Malden Ma 02148
781 324 9076
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MaldenSenior