Posts Tagged Information for Seniors

Seniors and Nutrition

The food we eat can greatly affect our health. It can lower or raise the risks of many diseases such as blood pressure, kidney disease, dementia, some cancers, osteoporosis, diabetes and more. Many people who have eaten healthy their entire life can easily continue to eat healthy. The nutrition of the food is as good for a senior citizen as it is for a senior in high school.

We have gathered some helpful information when dealing with nutrition and the elderly.

  • As you age your sense of taste decreases. It is common to add extra seasoning to the food, however stay away from salt. You can use garlic, ginger, paprika, cumin, and many other healthier spices.
  • Staying at an ideal weight is the key to healthy living. Seniors require fewer calories for energy needs so choosing nutrient rich food is important. Many seniors find themselves eating more junk food; even a senior that is overweight can still suffer from malnutrition.
  • It has been proven that eating fish at least once a week will help decrease the plaques and tangles that lead to Alzheimer’s disease. This information outweighs the concern of mercury intake.
  • Don’t research online for your health needs; nobody is better to ask than your doctor. He may give you a strict diet to follow or offer you supplements. There is a lot of information out there that is geared more towards selling you something than really helping your health. Let your medical professional guide you.
  • For those that are in the early stages of dementia they may overeat because they forgot that they had eaten already. You can help by giving them a mealtime schedule and providing healthy snacks throughout the day.

To get more information about Senior Nutrition you can visit www.eatright.org or www.health.gov and visit your doctor or registered dietitian to get help or have your questions answered.

Why Seek Advice for ALTCS?

As life expectancies and long term care costs continue to rise, the challenge quickly becomes how to pay for these services. Many people cannot afford to pay $4,000 per month or more for the cost of a nursing home, and those who can pay may find their life savings wiped out in a matter of months, rather than years.

Fortunately, the ALTCS Program is there to help. In fact, in our lifetime, ALTCS has become the long term care insurance of the middle class. But the eligibility to receive ALTCS benefits requires that you pass certain tests on the amount of income and assets that you have. The reason for ALTCS planning is simple. First, you need to provide enough assets for the security of your loved ones. Second, the rules are extremely complicated and confusing. The result is that without planning and advice, many people spend more than they should and their family security is jeopardized.

Exempt Assets and Countable Assets: What Must Be Spent?

To qualify for ALTCS, applicants must pass some fairly strict tests on the amount of assets they can keep. To understand how ALTCS works, we first need to review what are known as exempt and non-exempt (or countable) assets. Exempt assets are those which Medicaid will not take into account (at least for the time being). In general, the following are primary exempt assets:

  • Home, no matter what its value. The home must be the principal place of residence. The nursing home resident may be required to show some “intent to return home” even if this never actually takes place.
  • Personal belongings and household goods
  • One car or truck
  • Burial spaces and certain related items for applicant and spouse
  • Up to $1,500 as a burial fund for applicant & spouse
  • Irrevocable prepaid funeral contract
  • Value of life insurance if face value is $1,500 or less. If it does exceed $1,500 in total face amount, then the cash value in these policies is countable.
  • Miller Trust (or Income Only Trust) – see our website for more information

All other assets are generally non-exempt, and are countable. Basically, all money and property, and any item that can be valued and turned into cash, is a countable asset unless it is one of those assets listed above as exempt. This includes:

  • Cash, savings, and checking accounts, credit union share and draft accounts
  • Certificates of deposit
  • Savings Bonds
  • Individual Retirement Accounts, (IRA), Keogh plans, (401K, 403B) (Exempt for the community spouse)
  • Nursing home accounts
  • Prepaid funeral contracts which can be canceled
  • Trust (depending on the terms of the trust)
  • Real estate (other than the residence)
  • More than one car
  • Boats or recreational vehicles
  • Stocks, bonds, or mutual funds
  • Land contracts or mortgages held on real estate sold

For assistance with qualifying for ALTCS please reach out to one of our specialists.

How To Pay For Nursing Home Care

One of the most difficult transitions people face is the change from independent living in their own home or apartment to living in a long term care facility or nursing home. There are many reasons why this transition is so difficult. One is the loss of a home…a home where the person lived for many years with a lifetime of memories. Another is the loss of independence. Still another is the loss of the level of privacy we enjoy at home, since nursing home living is often shared with a roommate.

Most people who make the decision to move to a nursing home do so during a time of great stress. Some have been hospitalized after a stroke, some have fallen and broken a hip, still others have progressive dementia, like Alzheimer’s disease, and can no longer be cared for in their own homes.

Whatever the reason, the spouse or relative who helps a person transition into a nursing home during a time of stress faces the immediate dilemma of how to find the right nursing home. The task is no small one, and a huge sigh of relief can be heard when the right home is found and the loved one is moved into the nursing home. For many, the most difficult task is just beginning; how to cope with nursing home bills that may total $2,500 to $6,000 per month or more?

One of the things that concerns people most about nursing home care is how to pay for that care. There are basically four ways that you can pay the cost of a nursing home:

  1. Long Term Care Insurance – If you are fortunate enough to have this type of coverage, it may go a long way toward paying the cost of the nursing home. Unfortunately, long term care insurance has only started to become popular in the last few years and most people facing a nursing home stay do not have this coverage.
  2. Pay with Your Own Funds – This is the method many people are required to use at first. Quite simply, it means paying for the cost of a nursing home out of your own pocket. Unfortunately, with nursing home bills averaging between $4,000 and $6,000 per month in our own area, few people can afford a long term stay in a nursing home.
  3. Medicare – This is the national health insurance program primarily for people 65 years of age and older, certain younger disabled people, or people with kidney failure. Medicare provides short term assistance with nursing home costs, but only if you meet the strict qualification rules.
  4. ALTCS (Arizona Long Term Care System) – This is a federal & state funded and state administered medical benefit program which can pay for the cost of the nursing home if certain asset and income tests are met.

If you are looking for assistance in qualifying for ALTCS please reach out to one of our specialists at Legal Awareness for Seniors.

 

ALTCS 5 Most Common Questions

1. Is ALTCS only for those who require to be in a skilled nursing facility in Arizona?
ALTCS (Arizona Long-Term Care System) provides a wide array of care for those that would like home care, adult day care, assisted living and more. So, even if you don’t need immediate skilled attention, you can apply to receive ALTCS to assist you.

2. Does the care you receive through ALTCS differ from the care you would receive if you paid privately?
Those that receive care through ALTCS receive the same wonderful care and medical treatment as they would if they paid for it out of their own pocket. Health care providers are legally required to give the same level of care to each patient no matter how it is paid for.

3. Are you allowed to keep your personal physician once you are on ALTCS?
ALTCS has a limited network of doctors that they work with. If you want ALTCS to pay for the doctor visits you will be required to see a doctor that is on their list. You may continue to see your doctor if they are out-of-network only if you pay for it yourself. But, don’t worry, case managers are available to assist you in finding the right doctor.

4. Are there any medical costs that ALTCS members must pay on their own?
Each person has different circumstances. Sometimes members are asked to pay a share of the cost while other members are fully covered. For example, a member living in Assisted Living may be required to pay for their room and board while ALTCS pays for the medical expenses. Most of the time members will learn what their share of the costs will be at the time of their qualification process.

5. If I have too many financial resources can I give them away in order to qualify for ALTCS?
No, you may not give them away. ALTCS looks back 5 years to see if you have gifted any of your resources. However, if you speak with one of our qualified ALTCS representatives we can help you to establish strategies in order to qualify for ALTCS without ‘spending down’ your resources.

What is Spend Down for ALTCS

When qualifying for ALTCS (Arizona Long Term Care System) otherwise known as Medicaid many applicants will come to learn the term “spend down”. If you have too many assets when you apply ALTCS will deny you. In order to qualify you will need to spend down your assets.

The assets you have cannot be given away, but they can be spent on certain exempt resources. ALTCS looks back five years to check for gifting. They want to assure that you are spending your money on your own needs and not the needs of family or friends.

Some of these qualifying exemptions are:

  • Funeral trust
  • House
  • Car
  • Personal items (clothing, medications, appliances, etc.)
  • Care needs
  • Legal fees, such as estate planning
  • Miller Trust (or Income Only Trusts)

There are means to avoiding spend down. You will want to be sure to get quality legal advice or speak to one of our knowledgeable estate planners to help assure ALTCS will accept you.

Dealing with Aging Parents

As our parents age we may find it difficult to deal with them. We can often find ourselves frustrated or angry with their stubbornness or forgetfulness. Often we forget that old age is a time of decline rather than personal growth and development. Our middle age lifestyle is completely different then theirs. With managing our children, work life and social life we are moving at a fast pace in order to be efficient to juggle everything we need to do. This is completely different than our aging parents who are winding down and have a lot of time on their hands.

Not only are we running at a different speed than our parents, we are also going through different emotions. As our parents age they are losing friends, freedoms, independence, memory and more causing them to cling on to what they have. Trying to understand where your parents are coming from may help you to be a bit more understanding.

Here are a few tips to assist you when dealing with your aging parents:

1. Understand that senior citizens often lose their short-term memory before their long-term memory. Something you told them last week may easily have been forgotten. If it is something important that they need to remember you can write notes around the house. Add a smiley face to them in order to keep the tone light.

2. Many seniors are dealing with aches and pains. If it takes them a little longer to do things, such as tie their shoe, be patient or offer to assist them.

3. You may not be able to visit them every day, but instead of dropping by 5 minutes here or there, set aside a substantial amount of time every week to spend with them. Maybe schedule Friday lunches or Sunday strolls.

4. Often in conversations with aging parents the topics can seem erratic. One minute you may be talking about your craft project with the kids and the next they are talking about how their light bulb is out in their bedroom. Be sure to listen to what they are saying. If your story is really important to you find a way to guide the conversation back, if not, listen to the story behind their story. What is it that they really need?

5. Be patient with them when teaching them new technology. You may have already gone over how to use their remote control and on each visit they ask you to go over it with them again. It is hard for the elderly to learn new things and remember what they learned. Just patiently go over it with them again.

6. Plan for the worst, but hope for the best. Be sure to take time to plan for your parents passing. Setting up a living trust, power of attorney, and other ancillary documents are very important with an aging parent. Let Legal Awareness for Seniors assist you with this process.

The Difference Between Hospice, Palliative and Respite Care

Learning the different types of care that are available can be important on making the right decision for your loved one.

Hospice Care
This is designed to make the last days, weeks or months of the terminally ill and their families more comfortable. Hospice will comfort the patient emotionally and physically as best they can as well as help the family with the transition and decisions they will need to make. In the United States there are about 40% of patients in Hospice Care that receive the care at home. Patients that are transferred to Hospice Care are referred by their doctor and usually have six months or less to live.

Palliative Care
This type of care is for anyone that is having a major health crisis and needs help managing it. They are not necessarily at the end of their life. This type of care helps patients manage pain, stress, depression, and physical ailments. The care providers will focus on relieving and prevent the patient from suffering.

Respite Care
This is a short-term stay at a community or assisted living facility. This is most commonly used for seniors who are living with their children. This gives them a break from each other or gives the family security knowing their loved one is being cared for while they are traveling.  Respite Care is also used to ease your loved one into assisted living, giving them a trial run of what life may be like in a senior living community.

How To Avoid Fights Over Your Estate

We have all heard horror stories about families falling apart after their parents passing. This is not always the case and doesn’t need to happen to you. Arguments can most likely be avoided by using a few simple techniques.

  • Avoid Surprises. Let your heirs know why you are making the decisions for your estate distribution. You may have specific reasons why you are leaving certain assets to particular heirs or non-profit organizations. Letting them all know ahead of time that you made these decisions thoughtfully can help set expectations.
  • Give Guidance. When dealing with sentimental items you may want to leave a specific list of how to divide them and who should be in charge of overseeing the distribution. Even though you may instruct to have your assets divided into equal shares it may be hard to put a value on some of the sentimental items.
  • Don’t Assign Co-Owners. Some choose to add a child as a co-signer on an account. Legally the account with go to that child at your passing. If you intend the account to be divided up among your heirs this could cause problems. Before you add a child on an account you will want to speak to your Estate Planner.
  • Keep Estate Documents Up To Date. If it has been years since you have revised your estate documents it could easily be contested that you meant to change it. You should update these documents every few years or whenever you have a major life change such a marriage, divorce, new child, or death of a beneficiary.
  • Prearrange Funeral Details. Making the decision on your funeral arrangements may avoid conflict as well as strong emotions rising in the decision making process for your children. Pre-planned and detailed funeral instructions can avoid controversy and angst.
  • Choose Your Executor Carefully. Don’t just assign the oldest child to be the executor. You will need to assign someone that you trust, is responsible, hardworking, organized and good at communicating. It may not even be a child that you choose, maybe a family friend, an estate or financial planner.
  • Get Input From Your Children. After all, they will be left without you. Ask if there are any particular items that they value or hold special meaning to them. It is much better to have these issues surface now while you are able to help manage the decision making of who will receive specific items.

Myths About Assisted Living

In the past 20 years Assisted Living has become more and more popular. Since it is essentially a newer concept there are some false ideas many have around Assisted Living Facilities.

Myth #1 Assisted Living = Loss of Independence
Assisted Living Facilities actually promote independence. They strive to make things easier on their residents so they are able to live their lives more freely than they would if they were living on their own. They encourage stimulation and social interaction to help maintain independence as long as they can. In fact, many facilities even allow you to keep and use your car as long as you are able.

Myth #2 Seniors will be isolated in a facility
The opposite of this is true. Retirement communities are where seniors end up developing close friendships and social connections. When they live in a facility they end up being busier than ever with fun events and activities planned out for them.

Myth #3 An Assisted Living Community is another way to say Nursing Home
They are actually completely different. Nursing Homes focus on the medical needs of their residents and the therapies they need in order to stay alive. Whereas Assisted Living Facilities provide the support their residents need with housekeeping, meal preparation, activities, and social interaction in order to assist them with their independence as long as possible.

Myth #4 Assisted Living is only for the wealthy
These facilities are for everyone. If you take in the cost of living at home, even if your mortgage is paid off, you will find it is very similar. With the cost of home maintenance, property taxes, groceries, utilities, transportation and other living expenses it can add up. You won’t have any of those costs with Assisted Living; it is included in the monthly cost. This is especially true if you need the assistance of a private duty caregiver.

Myth #5 You can’t take your pet with you
There are many Assisted Living Facilities that welcome your well-behaved four legged furry friends. Studies have shown that those who have a pet live a longer and healthier life. Don’t let the fear of having to leave your pet behind be a factor in your decision. Those facilities that allow your pet to live with you are out there.

Myth #6 The meals are not appetizing
Actually the meals that are prepared are carefully planned and prepared with the nutritional needs of the senior population in mind. The meals are homemade and well thought out so that they are enjoyable, maintaining the quality of life their residents are use to. It is even advised that you sample the cooking before making the decision to move into the facility.

Myth #7 Assisted Living Facilities are filled with residents that are sick or dying
Assisted Living Facilities are full of seniors who no longer wish to live alone and require additional support in order to maintain the life they are accustomed to. Without assisted living the resident’s health would have declined more rapidly and would instead be admitted directly into a nursing home or hospice. Assisted Living Facilities strive to keep their residents healthy and alive as long as possible. In fact, most homes require that the new resident be partly independent when entering the facility.

How To Fairly Divide An Estate

Many times when an estate is being divided among heirs emotions get tied in with greed and arguments may ensue. When siblings are dividing their parent’s estate childhood jealousy, resentment and hurt feelings may resurface during the process causing fights. Some get out of hand, while others are manageable. We have found a few tricks to assist in calmly dividing an estate.

  • Mark the items. Have each of the heirs have a different color sticker or post-it note and go around to mark which items they would like to have. Those items that only have one sticker will be awarded. Those that have multiples can take turns choosing. You can even integrate the next trick when choosing who gets what.
  • Take turns picking. To make this fair put numbers in a hat to draw the order. It would also be a good idea to switch up each round by allowing the person who went second to go first on the next round. For example if there are 3 people use the following order: round one: 1, 2, 3; round two: 2, 3, 1; round three: 3, 1, 2 etc.
  • Make copies. When it comes to personal movies and photographs you can make copies so that everyone gets a set and therefore no one has to choose.
  • Get appraisals. With items that are worth more, many heirs may feel distribution can be unfair. If you were to get the high value items appraised, add the value together then distribute “estate buck” (such as monopoly money) evenly to hold an auction for the items. You can even have heirs pay into the estate with their own money in order to acquire an item they truly desire.
  • Bring in a mediator. When the conflict doesn’t seem to be getting resolved it may be time to bring in a mediator in order to help settle the estate.

Many times these tips are used together or can be hand selected for your specific situation. It is important to remember to do your best to keep your emotions out of the decision making. It may be a good idea to have decisions made while your parents are still living.

Many times parents want to leave specific items to specific heirs. Having a list made up of who will receive what can help alleviate many of the sibling squabbles after their passing.