Planning for Senior Living

Of course, we must. Along with knowledge, experience and, hopefully, joy, for most of us aging brings with it certain changes in our health and/or mental capabilities. We can do some things to stave off or at least lessen these changes by exercising both the body and the mind. Be active. Be social. Be curious. Be conscious about your diet. Control your own future: By preparing now, you can make your own decisions and plans for how you want to spend your “golden years” and designate your assets later. And you will save your loved ones from the stress of making some very hard decisions at very difficult times.

You’ll determine where you want to live, how independent you hope to remain and the type of medical treatment and help you will want as your abilities change.

How do you get started?
Well, take time to find (is it just me?) and organize your important documents. One way to do this is to place similar types of documents in large envelopes and label them. For example, financial records would include your probable future income from certificates of deposit, savings, pensions, retirement plan, Social Security, insurance policies and investments. Health coverage, including Medicare and personal policies, will be very important as always, but you might consider adding a long-term-care policy to your portfolio. As to your life insurance during your elderly years, you might consider your children’s ages, your debt and whether or not you have a good pension or investment income. Many times, seniors maintain enough life insurance to pay for possibly larger medical expenses, funeral/burial expenses and maybe estate taxes. Some seniors also maintain disability insurance, at least during their “working” years. You should also include information about other types of insurance, such as homeowners or renters and automobile policies.

Another way to organize your important documents is to make your own or buy a book of “records.” On any particular sheet(s), write the pertinent information for a particular subject. For example, your banking documents would include the account numbers, the bank name and address, the names on the account and the account numbers of your checking and savings accounts and certificates of deposit. Your insurance record page(s) would also include your policy number, the name of the bank or other company, the latest statement and so on. The same would apply to pensions and investments. Personal documents would include your Social Security number, driver’s license number/state, birth and marriage and divorce certificates, military records, if applicable, tax records, passport number, appraisals for jewelry and other “high end” or luxury items. Oh, don’t forget your pet’s records, security system codes, spare keys, codes to locks, your address book or firearm’s location and authorization.

Other categories for these types of work sheets should include your medical records (physicians’ names, specialties and telephone numbers plus prescription information with name, pharmacy phone and any health issues such as diabetes, heart disease, allergies, etc.), your living and care preferences mentioned previously and other personal documents. You’ll need to prepare a sheet with your debt information for your credit cards and loans.

Documentation of your final wishes
These very important legal documents should include one or more of the following:

· Will names an executor to handle your affairs at probate, can name a guardian for your minor children and specifies distribution of property.

· Living will functions as a directive to physicians, specifying which medical procedures you want taken if you are too ill to state your wishes.

· Power of attorney is written authorization for someone, whose name should be included, to act on your behalf for whatever purpose you designate, terminating upon your written notice or upon your death.

· Durable power of attorney is in effect if you become incapacitated and unable to manage your own personal and financial matters. The name of the agent you are appointing should be included. It remains in effect until you revoke it or until your death.

· Health care power of attorney names the agent you appoint to make health care decisions on your behalf if you are incapacitated.

· Springing power of attorney allows you to appoint someone to act on your behalf, “springing” into effect when a specific event, such as your becoming incapacitated, occurs. Once it is activated, it is effective until it is revoked by a court or until your death.

Any specific plans or wishes for your funeral service should also be included in your important documents.

Making decisions for others
You may need to help an elderly family member make the transition from being self-sufficient to being dependent on others, since people are living longer because of strides in medical and scientific technology. It will be much simpler for you and your family members if you make a plan before additional assistance is necessary. This way, the elder person can participate in the caretaking decisions. You can find out his or her priorities, desires and concerns. You can also gather the information and important documents that will be needed.

Be sensitive to how the person feels about maintaining independence, the possibility of leaving home, the extent of care he or she can afford, what insurance is available and preferences for care in a medical emergency.

Assessing the situation
By reviewing your parent’s or other loved one’s physical and mental health, medications, daily routine, the safety of their home/neighborhood, friends and support system, appearance and hygiene, finances and personal interests, you’ll be prepared to make a plan to meet the challenges and other needs that may develop. Consider making a checklist to help you assess your loved one’s life, including their physical and mental health, their daily living habits and activities and their financial situation. Be aware of any diseases — diabetes, high blood pressure, arthritis — from which he or she suffers as well as physicians who treat the ailment. Take notice of balance problems, fatigue or sleeplessness, vision or hearing problems, dental complaints and pain. Observe signs of depression, dementia, mood swings, forgetfulness, sadness, loneliness and a decrease in interests like reading and maintaining friends. List all medicines taken and the frequency used. Be aware of the senior’s ability to take them as directed and any reasons medications are not being taken, perhaps because they forget or they cannot afford them.

Can he or she perform basic daily living activities such as dressing, bathing, getting up from a chair, using the toilet or the phone, negotiating stairs, shopping, preparing meals, driving safely and doing housework and yard work? Include appearance and hygiene — personal cleanliness, oral care, combed hair, clean clothes, trimmed nails and appropriate clothing for weather or the occasion.

What is the support system? Friends? Relatives? Organizations? Paid caregivers? Health care providers? Make note of your loved one’s hobbies and interests — reading, TV favorites, travel experiences, religious background, languages, musical instruments played or favorite music. This information will be helpful to caregivers, whether family or professionals, in understanding him or her.

Gather information to assess the senior’s financial situation, including any payments from the government or other programs. What care or living arrangements will be provided or shared by children or other relatives?

Options for senior care and housing
After the assessment of the senior person’s lifestyle, challenges and medical needs, it will be time to approach the subject with information and choices, based upon need and financial ability. This discussion should include the person’s concerns about the future, how they feel about possibly leaving their home, the level of care they prefer and what their preferences are in the event of an emergency.

Types of senior care are quite varied and can be confusing, even overwhelming, for the senior and the family. The following is a guide to common options, based upon the care required:

· Telephone call assurance can be an automated or live telephone service that telephones seniors on a regular, scheduled basis to assure they are OK and have taken their medicines. It is an easy-to-use service and can be scheduled as you require.

· Medical alert service allows the subscriber, at the push of a button, to contact a responder who will call for help from a neighbor, family member or emergency service in case of a fall or other accident. Based on the senior’s needs, it offers an added layer of protection.

· Companions and caretakers come to a senior’s home and assist with chores, driving, shopping and light housekeeping. They do not provide any medical care. This option allows the senior to stay in his/her home, while receiving assistance.

· Respite care providers are for short-term or emergency care for seniors during the absence of the primary caregiver. Some states or insurance companies may pay for some or all of the services.

If you are the caregiver
What if YOU become the caregiver of a parent or loved one? Although being the caregiver can be rewarding, there are some enormous challenges. Some of the difficulties include:

· The time required. Caregiving takes time, which means less time for your family and for you.

· Balancing a job and caregiving responsibilities. Calling doctors, arranging for services and scheduling appointments need to be accomplished during the same hours as your workday. You may need to work where accommodations such as going in late, leaving work early, taking time off, etc., can be arranged.

· Out-of-pocket costs to you, as caregiver. A national study of caregivers found that the average cost for food, travel, transportation, medical insurance co-payments and medications amounts to $5,500 per year to the caregiver.

· Physical and mental stress. Those providing intense care may have feelings of frustration, exhaustion, anger and sadness.

· Visiting nurses are registered nurses (RNs) who perform medical care, rehabilitation and hospice care in a patient’s own home. The immediate medical attention of a qualified nurse assures the senior gets the proper care. Qualified nurses can also diagnose in the home, which could avoid hospitalization.

· Continuing care retirement communities are housing options designed to meet the needs of residents as their needs change. These complexes include independent living apartments, assisted living apartments and nursing facilities. It’s reassuring to residents to know that if more care is needed, high-quality, professional care is available without having to relocate.

· Assisted living facilities provide continued independence while also furnishing some care, social interaction and meals. This fosters a sense of independence and socialization among residents, who have meals together in the dining area or other entertainment areas.

· Nursing homes provide medical care full time, meals, housekeeping, laundry and activities for residents. Residents have the availability of care performed by experienced personnel such as physicians and nurses. Unfortunately, some nursing homes may have long waiting lists.

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