12:20 a.m. The clock was blurry as I rubbed the sleep from my eyes to answer the phone.
“Hello”, I said.

A weak and frightened voice on the other end pleaded, “Melissa? Is Bryan there? I can’t get out of my chair. Could you or Bryan come over?”

I sighed as I handed the phone to my husband and heard him say, “I’ll be right over, Dad.”

When Bryan left, I pondered on my father-in-law, John, and his situation. John had just come out of the hospital after a serious illness and although the doctor had assured us he would be fine, we quickly learned that he was not able to care for himself. He lived alone in a small apartment and had in-home health care assistance through his Medicare plan. They came once a day to help him with a shower and to aid him with incontinence. Bryan and I came over three times a day to help him with changing his clothes and to make his meals. In addition, we helped him with his bills and took him to his frequent doctor appointments. Tonight was the first time he had called to ask for help in the middle of the night. We needed to do something different. We were both exhausted between working our jobs and caring for our four young children and constantly running out to take care of John’s needs. It was becoming more than we could handle. We realized we really needed to get him into assisted living.

John lived comfortably on an income consisting of social security and a retirement pension, but as we visited different assisted living homes in our immediate area, we quickly realized that this income was not enough. Assisted living was really expensive!

John had served in the Navy during the Korean conflict and we had heard through a friend that veterans could receive assistance through the Department of Veteran’s affairs for health care. The catch was doing it correctly. Our friend referred us to a Veteran’s Consultant from the National Care Planning Council to provide information for the challenging task of filling out the paperwork to receive this benefit. A Veteran’s Consultant can provide general information on how a claim is filed. Our consultant told us about all of the necessary supporting documents we would need to make sure it was approved.

The paper work was pretty daunting, but we worked through each form thoroughly to be sure that we were providing all the information Veterans Affairs (VA) would need in order to expedite John’s payments.

First, I obtained a medical report from John’s doctor — the most crucial step in the process. This form would prove that John needed aid and attendance. In our case, the doctor described his medical condition and then noted specifically his need for help with incontinence and showers, his lack of motivation to make meals for himself and his inability to leave the house alone. It was, however; important to us that the doctor wrote that John was mentally capable of making his own decisions, because we did not want to go through a delaying process of having VA assign somebody who would need to pay his bills for him (VA calls this person a fiduciary).

Another key thing was that John had to show evidence to VA that his care costs were close to or exceeded his income. Fortunately, John had a small amount of savings and he was able to pay in full for the first month’s payment to his assisted living home. This was important, because the statement showing this payment was important evidence needed to present to VA. Since his assisted living cost exceeded his income by $1,000 per month, we arranged with the director, to pay what John could afford until the benefit from VA came in and then the director agreed to pay the remaining debt balance on the account at that time.

An important form was John’s original DD-214, which was the official record showing that he had been honorably discharged from the military. I quickly found a certificate of honorable discharge (DD-256) but this was not the correct form. We searched through all of his files and boxes and couldn’t find the DD-214. So I got on the Internet and found a website for the National repository where the official forms can be obtained. It appeared that it could take up to 6 weeks to receive an official copy. Fortunately, we found the original document folded in his wallet and we did not have to delay our process.

One of the forms my Consultant made me aware of was a VA power of attorney form (VA form 21-22a) that gave me the authority to fill out and submit the forms to VA on behalf of John. Although John was mentally sound, he was weak and tired and didn’t really want to do anything but watch television and eat. With this form, I was able to communicate with VA in his behalf.

There were several other forms to fill out and after all the paperwork was finished, my Veteran’s consultant gave us the address of where to send all of them. Our particular VA processing office was located in St. Paul, Minnesota.

After about two weeks, John and I each received a letter stating that VA was working on his case and they assigned him a case file number. After another two weeks, we received a letter stating that we needed to fill out some other paper work. I showed these to my consultant, who assured me, in our case, that it was standard procedure and that the paper work I had originally filed was sufficient. Within another two weeks, John received his first payment.

Because his care cost exceeded his income, he was awarded the full $1644.00 per month. VA sent another payment from the date that they had first issued his case number. So in the first month, we received two payments. These were sufficient to catch up the debt he owed to his assisted living and to continue with full payments each month.

Applying for the VA Aid and Attendance Pension was detailed, but it was not terribly frustrating because of the general information on the application process I received from my consultant. It did require extra work on my part, but it was well worth the end result of getting the care that John needed and the relief that Bryan and I needed in the end. I am grateful that we had such a wonderful resource in National Care Planning Council to help us find a capable and informative Veteran’s Consultant.

Bryan and I now see John twice a week and visit with his assisted living staff often to help him have a comfortable and enjoyable life in his new home. He is able to enjoy activities and meals with other people, have quality personal care and have the peace of mind that someone is always there to help him. I now sleep at ease through the night, knowing that his needs are taken care of and that there won’t be any middle of the night calls asking for help.

The National Care Planning Council wishes to thank Melissa for providing her experience. We maintain a list of consultants across the country which can be found at the following address: www.veteranslisting.com. We also provide a book with instructions to help people who want to file an application by themselves. This book can be purchased online at http://www.longtermcarelink.net/a16books.htm.

Though the family was disappointed over the cake, of more concern was Grandma’s confusion with the recipe and her similar confusion about the loved ones around her. Could something be wrong with grandma’s mental state?

One might say that for an elder person a little forgetfulness or confusion is normal, but when do you know if there is a serious problem, such as dementia?

An online article from FamilyDoctor.org outlines some common symptoms in recognizing dementia.

“Dementia causes many problems for the person who has it and for the person’s family. Many of the problems are caused by memory loss. Some common symptoms of dementia are listed below. Not everyone who has dementia will experience all of these symptoms.

• Difficulty performing familiar tasks. People who have dementia might cook a meal but forget to serve it. They might even forget that they cooked it.
  Problems with language. People who have dementia may forget simple words or use the wrong words. This makes it hard to understand what they want.
• Time and place disorientation. People who have dementia may get lost on their own street. They may forget how they got to a certain place and how to get back home.
• Poor judgment. Even a person who doesn’t have dementia might get distracted. But people who have dementia can forget simple things, like forgetting to put on a coat before going out in cold weather.
• Problems with abstract thinking. Anybody might have trouble balancing a checkbook, but people who have dementia may forget what the numbers are and what has to be done with them.
• Misplacing things. People who have dementia may put things in the wrong places. They might put an iron in the freezer or a wristwatch in the sugar bowl. Then they can’t find these things later.
• Changes in mood. Everyone is moody at times, but people who have dementia may have fast mood swings, going from calm to tears to anger in a few minutes.
• Personality changes. People who have dementia may have drastic changes in personality. They might become irritable, suspicious or fearful.
• Loss of initiative. People who have dementia may become passive. They might not want to go places or see other people.”

Dementia is caused by change or destruction of brain cells. Often this change is a result of small strokes or blockage of blood cells, severe hypothyroidism or Alzheimer’s disease. There is a continuous decline in ability to perform normal daily activities. Personal care including dressing, bathing, preparing meals and even eating a meal eventually becomes impossible.

What can family members do if they suspect dementia? An appointment with the doctor or geriatric clinic is the first step to take. Depending on the cause and severity of the problem there are some medications that may help slow the process. Your doctor may recommend a care facility that specializes in dementia and Alzheimer’s. These facilities offer a variety of care options from day care with stimulating activities to part or full-time live-in options. Sometimes if patients tend to wander off, a locked facility is needed.

In the beginning family members find part time caregivers for their loved one. At first, loved ones need only a little help with remembering to do daily activities or prepare meals. As dementia progresses, caregiving demands often progress to 24 hour care. Night and day become confused and normal routines of sleeping, eating and functioning become more difficult for the patient. The demented person feels frustrated and may lash out in anger or fear. It is not uncommon for a child or spouse giving the care to quickly become overwhelmed and discouraged.

Family gatherings provide an excellent opportunity to discuss caregiving plans and whole family support. It is most helpful if everyone in the family is united in supporting a family caregiver in some meaningful way.

“The first step to holding a family meeting, and perhaps the most difficult one, is to get all interested persons together in one place at one time. If it’s a family gathering, perhaps a birthday, an anniversary or another special event could be used as a way to get all to meet. Or maybe even a special dinner might be an incentive.

The end of the meeting should consist of asking everyone present to make his or her commitment to support the plan. This might just simply be moral support and agreement to abide by the provisions or it is hoped that those attending will volunteer to do something constructive. This might mean commitments to providing care, transportation, financial support, making legal arrangements or some other tangible support.”

The Four Steps of Long Term Care Planning
Professional home care services are an option to help families in the home. These providers are trained and skilled to help with dementia patients. Don’t forget care facilities as well. It may be the best loving care a family member can give is to place their loved one in a facility where that person is safely monitored and cared for.

The National Care Planning Council supports caregiving services throughout the country.
www.longtermcarelink.net

As most people get older, they tend to eat less due to a loss of appetite.  As a result, many elderly individuals do not take in adequate amounts of vitamins and other nutrients as they did when they were younger.  Other factors that can affect appetite and the inadequate uptake of vital nutrients are medications, medical complications, certain disabilities, diabetes, changes in the digestive system and even the changes in our skin as we age.  One study estimates that one-third of the elderly are alarmingly low on important vitamins and minerals.  Another study indicates that two thirds of the elderly patients admitted to a hospital are mal-nourished, resulting in low levels of vital nutrients.  When a person is vitamin and mineral deficient, he or she is more susceptible to illness and infections.  It is estimated that deaths due to infections are ten times more likely in the elderly.

Vitamins
So what is a vitamin and why is it so essential to our bodies?  A vitamin is a molecule that our bodies need to carry out certain biological functions.  With only a few exceptions, we have no way to create vitamin molecules ourselves, so these vital building blocks must come in through food that we eat.  The human body is known to need at least 13 different vitamins.  We are able to store some of these for long periods of time in fat cells or in the liver — such as vitamin A — but most vitamins need to be replenished frequently.

Vitamins don’t supply us with energy.  We need protein, carbohydrates, and fats for that.  What vitamins do is to help the carbohydrates, fats, and proteins release energy.  These vital compounds are very important and they are required for all sorts of complex chemical reactions in our bodies.  Vitamins are also needed to assist the enzymes that repair tissue and help with the production of cells.  Many studies show that vitamins and minerals can help or prevent some of the disorders or diseases related to aging.

There are two types of vitamins — water soluble and fat soluble.  Water soluble vitamins are not stored in our systems.  They pass through us quickly.  In order to keep these nutrients in our bodies we have to consume them frequently.  Water soluble vitamins contribute to our health, energy and stamina.  This type of vitamin also helps in the function of over one hundred enzymes and chemical reactions that give our bodies energy.   Listed below are some of the well known water soluble vitamins and their benefits.

• Vitamin B5 – good for reducing swelling
• Vitamin B3 – reduces tissue swelling and helps increase blood flow.
• Vitamin B6 – also reduces swelling.  When combined with vitamin B12 in proper concentration has shown to reduce heart disease.
• Vitamin B12 – This is the most vital of the B’s.   It aids in the formation of cells, myelin production, healthy nerves, and maintaining immune system and mental function.
• Vitamin C – Vitamin C helps in the formation of cartilage and bone.  Some studies have shown it may reduce the progression of osteoarthritis.

Fat soluble vitamins are vitamins that stay in the body and are typically stored in the liver.  You can usually receive enough of these compounds by eating a well balanced diet.   Any condition that can interfere with the absorption of fat in the body like tuberculosis, cystic fibrosis, hypothyroidism, lactose intolerance, and many other diseases or disorders can cause deficiencies in these vitamins.  Before taking the daily recommended dose of fat soluble vitamins you must consult your doctor.  Overdosage of these substances can cause a toxic build-up.  Listed below are the major fat soluble vitamins.

• Vitamin A – Lungs, throat and mouth depend on vitamin A to retain moisture.   This compound is also important for your skin, bones, teeth, digestive system, urinary tract, eyes and aids in preventing skin disorders like acne, boils, and bumpy skin.  Some studies show that it may aid in slowing the aging process.
• Vitamin K – plays an important role in the clotting of blood.  Research has linked vitamin K to bone health.
• Vitamin D – is produced in the skin by exposure to the sun.  Deficiencies mostly occur in people living in northern latitudes where daylight is brief during winter months.  Changes in skin as we age can also cause poor production of vitamin D.   Studies show that  osteoporosis might progress faster in women with low levels of vitamin D.  This compound is essential in helping the body absorb calcium and in maintaining strong bones.

Minerals
Unlike vitamins, minerals are not manufactured by plants or animals.  Minerals form in the earth, and are absorbed by plants and found in animals that eat the plants.  Listed below are some of the essential minerals needed to maintain a healthy body.

• Iron – helps carry oxygen throughout the body.  Iron also helps the immune system ward off foreign entities.
• Calcium – Most women as they get older need calcium supplements to prevent bone loss that causes osteoporosis.  Calcium supplements will not do you any good if you do not have the right levels of vitamin D.  your body cannot absorb calcium without vitamin D.
• Zinc – Zinc deficiencies can affect skin, nerves, and the body’s immune system.

It is important that you take vitamin and mineral supplements with food.  Fat soluble vitamins require fat ingestion to result in the best absorption.  It is best to take your supplements at the biggest meal of the day.

We use vitamins every day to support the processes our bodies use to maintain life.  Ongoing reduced levels of vitamins can make you weak and more vulnerable to disease.  Proper nutrition with vitamins and minerals is vital for seniors to maintain a healthy lifestyle.  Other health issues related to aging are discussed on the National Care Planning Council website at www.longtermcarelink.net.

Though this little tune is just for fun, it may very well raise alarms to many caregivers of the elderly. Caregivers know that even at a holiday party they cannot let down their diligent watch over their elderly loved one. As far-fetched as it may sound, with all the people and noise, an elderly family member with dementia or Alzheimer’s may be enjoying the family gathering and then suddenly become confused and walk to the door and leave.

For family caregivers the added stress of the holidays with decorating, shopping, parties and keeping up with all the family traditions is an overwhelming quest. Feelings of isolation, depression and sadness come with this added stress. There are millions of Americans who are caring for elderly frail loved ones and most of these caregivers will go through some of these emotions, especially this time of year.

There are some things you can do as a caregiver to help you and those you care for enjoy the holiday season.

First take care of yourself. Try to eat right, get plenty of sleep and exercise. This will help reduce stress and strengthen your ability to cope with caregiving responsibilities.

Prioritize your holiday traditions. Perhaps instead of cooking a large family dinner, have everyone bring his or her favorite dish. Use paper plates. Forfeit the traditional outside light decorating for a lighted wreath on the front door. Choose one or two parties or concerts to attend instead of trying to do it all.

Arrange for help. Call on other family members to help with the caregiving while you do your shopping or go out for the evening. If family is not available, ask your church group or a neighbor if they would donate a few hours.

Use community services. Many senior centers provide meals for the elderly and supervised activities, onsite, at no charge or a minimal charge. For locating senior services in your state, call your state Area Agency on Aging or check the national locator website athttp://www.n4a.org/

Use adult day care services. Some assisted living facilities provide day activities and meals for seniors on a day by day basis. Other organizations called “adult day service providers” specialize exclusively in this sort of care support at a reasonable cost. These support services provide respite for caregivers from their caregiving responsibilities as well as social interaction for their elderly family members. There is a cost for adult day services, but the benefit for all is worth it.

For example:

Jean had brought her mother into her home to care for her when mom’s Alzheimer’s made it impossible for her to be alone. When the Christmas season approached, Jean realized she had to make some choices. She did not want to give up the traditions she had set with her daughters in shopping and lunches, but it wouldn’t be possible with her caregiving responsibilities. In searching for a solution, Jean visited an adult day services facility near her home. She found she could schedule the days she needed off for her mother to come in. The adult day services company also provided transportation and would pick up mom and bring her home in the evening.

Although Jean’s mother was not sure she would like to go at first, she found she enjoyed the programs, meals and conversation with new friends and the activities provided.

The time it gave Jean to have for herself was worth the extra cost for the day care.

Technology to the rescue. Here is a solution that would have kept “Grandma” from going out in the winter cold and getting run over by a reindeer. Companies that have created monitoring systems, security alarms and other safety equipment are “tweaking” them to adapt to the needs of seniors and their care givers.

Here are a few examples:

• Ankle or wrist bands that monitor location and alert the provider when a person has gone beyond the designated perimeter, such as out the front door of the house.
• Motion detectors. Set throughout the home, motion detectors allow someone outside the home to follow a senior as he or she moves through the house.
• Smart medication dispensers. Live monitoring and dispensing of pills.
• Emergency response alert. At a touch of a button on a desktop monitor, bracelet or necklace, emergency help is summoned.

Whether providing care in your home or helping senior family members in their own homes, your use of monitoring and “tech” help aids can provide extra safety for your loved ones, and peace of mind for you.

You are not alone. Join a caregiving help group. Your local senior center may have one or go on the internet to find one. Hearing about other caregivers’ problems and solutions and being able to share your own and ask questions is a great way to relieve stress and gain a new perspective. Check out websites like the National Family Caregivers Association at http://www.nfcacares.org/

Work with a Senior Care Professional. Recognize that you are doing the very best you know how. You are not a geriatric health care practitioner, geriatric care manager, home care nurse or aide, hospice provider or family mediation counselor, nor do you have the years of training and experience these professionals have, but you can definitely use their experience. In fact, using a senior care specialist will make caregiving easier for you and more beneficial for your elderly family member.

As an example:

Mark stopped by his father Dan’s home every night after work to help with any errands or things he needed around the house. He began to notice that Dan was not showering, dressing or even fixing meals some days. Another concern was his father’s growing confusion and disorientation. A trip to the family doctor only brought more concern to Mark, since the doctor claimed it was just the aging process that caused the confusion.

Wanting a second professional opinion on what was best for his father, Mark hired Shelly — a Professional Geriatric Care Manger — to do an assessment. Shelly arranged for Mark and Dan to see a geriatrician, who advised that proper meals and an increase in some vitamins, would help clear up the confusion and disorientation. Shelly arranged for a home care company to come in daily to help with personal needs and prepare meals.

Soon Dan was back to his old self and able to function on his own.

You can find a wide variety of care professionals in your area on the National Care Planning Council website at www.longtermcarelink.net.

One more thing to remember. As a family caregiver, the greatest gift you are giving this holiday season is “Love.”

With these burgeoning numbers, it’s becoming increasingly important to create a safe home to accommodate everyone’s wants and needs, and baby boomers are taking notice. According to a major home improvement center study, 60 percent of boomers plan to stay in their existing homes for some time. Remodeling and home improvement rank high on their to-do lists. Following are projects they can tackle themselves to ensure they are home to stay:

Safe, secure and stylish in the bath

As one of the most often used rooms in the home, the bathroom is a great place to undertake “home to stay” tasks. From projects such as custom closet configurations and adjusting mirror and toilet heights to installing roll-under sinks and angled mirrors, many product options exist for baby boomers to make their bathrooms safe yet stylish.

To help prevent slipping, tub grips are essential in lending a stable, helping hand getting in and out of the tub. The latest tub grip product designs feature an easy-locking lever to ensure a tight fit to most tubs without harming the tub surface. They offer easy, no-tool installation and removal in seconds. Shower chairs are another safe showering option for bathers that can be easily installed or removed as needed.

Today’s consumer not only needs secure safety products for the home, but wants ones that blend and complement a variety of decors. Grab bars are a great addition to help assist with movement. SecureMount Grab Bars from Home Care by Moen are an ideal choice since they feature a unique anchor installation system that allows homeowners the ability to install quickly and easily anywhere on the wall — without the need for a stud — for the ultimate in safety and peace of mind. Plus, they are available in a variety of styles and finishes to beautifully coordinate with the rest of the bathroom.

New home standards

In addition to the bath, other areas of the home — such as the kitchen — rank high on the list for projects and safety updates that are quickly becoming new home standards for baby boomers. Ranging in cost, improvements such as expanding doorways and lowering countertops/sink areas help not only wheelchair-bound individuals, but also parents carrying groceries or pushing strollers. Installing a pulldown kitchen faucet helps access hard-to-reach areas of the sink and also aids in everyday tasks such as watering plants or filling large pots and pans.

Consolidating essential appliances and living areas in one space in the home is another trend for boomers. Adding a first floor bathroom, installing a first floor water turnoff and washer or dryer allow easy access for any family member.

By making these improvements, you’ll create a safe and stylish home — one you’ll want to stay in and enjoy for years to come.

For additional tips and home improvement projects for baby boomers, visit ageinplace.com. For more information about stylish bath safety products from Home Care by Moen, visit homecare.moen.com or call (800) 882-0116.

Courtesy of ARAcontent

An advance care plan is a written document that helps you make sure your care is specific to reflect your personal likes and dislikes and health needs, as well as meet your social, cultural and religious needs. Getting answers to your questions and letting people know what you want at the end of your life can help you feel more in control and give you peace of mind as you go about living your life.

“An advance care plan is a good idea for all adults, regardless of their medical history. Discussing these issues can be difficult – even impossible if a crisis is ongoing. The goal is to make it easier for the patient and the family if the situation does happen,” says Dr. Clyde Yancy, chair of the education committee at the Heart Failure Society of America, a nonprofit educational and research organization dedicated to improving the quality and duration of life for patients with heart failure and preventing the condition for those at risk.

Many chronic diseases, including but not limited to heart failure, can eventually use up all reasonable medical approaches. Planning ahead is important. An advance care plan often includes an advance care directive, a do-not-resuscitate order, a living will, a health care power of attorney and a financial plan.

Advance care directive

This document will provide clear directions regarding your medical treatment and can include a living will, a durable health care power of attorney and a statement about organ donation.

Do-not-resuscitate order

This part of the plan tells doctors, nurses and other rescue personnel what they should or should not do when a person stops breathing or when their heart stops beating or is beating so irregularly it threatens life. The order can include instructions on whether to use different types of methods to revive a person.

Living will

A living will is usually used during a terminal illness when a person is unable to tell someone what they want to do. It is a legal document that lets a person who is unable to participate in decisions about their medical care express their wishes about life-sustaining treatment.

Health care power of attorney

A health care power of attorney lets someone make all legally binding health care decisions for you, including the decision to refuse life-sustaining treatment if you are unable to make the decision for yourself.

Financial plan

Health care can be very expensive, especially when treating chronic illnesses. A financial plan is created to help families deal with issues such as paying for medicines, doctor visits and hospital stays.

“Telling those close to you what you want helps them convey your wishes to those providing care for you – it should be comforting to know that the care is provided for you in a way that best meets your wishes,” says Yancy. “Even if you do not create a written advance care plan, these discussions with your health care providers, family and other caretakers are important.”

To learn more about advance care planning visit the Heart Failure Society of America at www.abouthf.org.

Courtesy of ARAcontent

This type of planning has become very popular in recent years. A survey conducted by the AARP in 1999, found that two out of five people over age 50 had been approached to pre-purchase funerals and burial goods and services. An AARP survey in 1998 indicates that 32% of all Americans over age 50, roughly 21 million people, have prepaid some or all of their funeral and or burial expenses (but not necessarily through a formal preneed plan). Breaking that down; about 25% of the over age 50 population have prepaid for their burials (cemetery plot, mausoleum or niche), 18% have prepaid for headstones, urns, caskets , grave liners or vaults, opening and closing of graves and so on and 13% have prepaid for goods or services from a funeral home or funeral director. The same survey indicates that over $25 billion is being held in preneed trust funds. Roughly another $25 billion is waiting to be paid out in life insurance benefits. Prepaid or preneed funerals and burials are big business.

Funerals and burials funded privately by the family, or paid from an individual life insurance policy and arranged informally through a funeral home or funeral director are generally not subject to state regulation. Any formal arrangement through a second party or involving a contract is subject to regulation in all states. Each state has adopted different rules as to who can sell these plans, what the plans can provide, what contract provisions must be, how the plan is to be funded and what recourse purchasers might have in the event of fraud or default. All states call these regulated plans “preneed” funeral and burial arrangements.

Here are some advantages as to why one would want to buy a preneed plan for funeral and burial services and goods.

• It provides peace of mind knowing these arrangements have been made in advance.
• It avoids the burden on family members to make decisions when they are most vulnerable to manipulation.
• It allows one to virtually control from the grave by determining in advance the funeral products, funeral services, burial products and burial services that one would prefer having for final arrangements.
• It helps the family to avoid taking loans, arranging finance plans, raiding savings or selling assets to pay for a funeral and burial.
• It guarantees (for many contracts) that if products and services currently purchased are not available in the future, equivalent substitutes will be provided at no additional cost.
• It locks in guaranteed prices (available with some contracts) forever.
• It allows for inflation in future costs (for those contracts that do not guarantee prices) by investing money in an interest-bearing account or buying life insurance that increases in value over time.
• Depending on the contract, it may allow for transfer to another funeral home or for partial or full refund.

Unfortunately, there are also problems with prepaid, preplanned final arrangements.

• With some trust fund and insurance funding options there may be no refund if someone wants to cancel the plan in the future.
• If a purchaser moves to another state there may be no transfer options or there may be different rules governing the funding option.
• In some contracts, interest earnings on investments resulting in excess money not needed for the plan may be retained by the funeral home or funeral director.
• On installment plans interest may be charged but not credited to the account.
• In certain insurance funded contracts, the ownership or death benefit may be irrevocably assigned to the contract holder (funeral home), preventing the purchaser from enjoying ownership rights in the policy.
• In certain insurance funded contracts, a growth in the death benefit over time that exceeds the cost of the preneed plan services and goods may be pocketed by the contract holder (funeral home) instead of being refunded.
• If the contract provider goes out of business or fails to secure 100% of the funds for future payment, there may be no recourse to get all of the money back that was put in.
• If certain services or goods that were purchased initially are not available in the future, but more expensive versions might be, the family may be forced to pay extra for those items.
• In certain insurance funded plans, if the insured dies too soon, there may have been a waiting period in which few or no benefits are paid at death, thus forcing the family to pay out of pocket for the funeral.
• Certain unscrupulous providers may have failed to provide an itemized list of services and goods or failed to identify properly, specific services and goods, thus allowing the provider in the future to substitute less expensive items or to leave out services and goods that were originally anticipated in the agreement.

What Services and Goods Can Be Prepaid?
All states allow for prepaid plans for funeral services and merchandise. This would include such things as picking up the body, embalming and restoration, rooms or chapel for viewing and funeral services, casket, vault or grave liner, transportation, permits, death certificates, obituaries and so forth. Almost all states allow for prepaid burial services and merchandise as well. Only about six states do not allow it. Burial services and merchandise might include opening and closing the grave, grave markers, vaults or grave liners, mausoleums or niches. Cemetery plots are excluded from prepaid plans in all states.

The AARP has excellent information for consumers on planning for funerals. Quoting from the AARP:

“Most states have a licensing board that regulates the funeral industry. You may contact the board in your state for information or help. If you want additional information about making funeral arrangements and the options available, you may want to contact interested business, professional and consumer groups.”

To find a planner in your area you may also contact the National Care Planning Council at inquiry@longtermcarelink.net or call 800-989-8137

This is now the time to evaluate the home to make it safe and secure for your loved ones — now and in the near future — in anticipation of aging disabilities that may occur. Help and support are available. The nation as a whole is more aware of elderly needs and services and products are becoming available at an outstanding pace.

The Bureau of Labor Statistics states,

“Employment of personal and home care aides is projected to grow by 51 percent between 2006 and 2016, which is much faster than the average for all occupations. The expected growth is due, in large part, to the projected rise in the number of elderly people, an age group that often has mounting health problems and that needs some assistance with daily activities.” Bureau of labor Statistics-Occupational Outlook Handbook, 2008-09 Edition

This growing need for aides and services also encompasses

• home remodeling services — making a home more serviceable to the elderly;
• safety alert systems and technology;
• motion sensors to monitor movement;
• telehealth services — using home-based computer systems for the doctors office or a nurse to monitor vital signs and
• even a pill dispenser that notifies when it is time to take medication.

Where do you begin to make sure your elderly family member is safe and managing well in his or her home?

Visit often and at different times of the day and night. Make note of daily activities that appear challenging and where changes might be made to add safety and convenience. Remove rugs that slide — causing a fall — and move furniture with sharp edges. Set the water heater at a lower temperature. This will protect their older sensitive skin from scalds and burns. Be sure smoke detectors and carbon monoxide detectors are in place.

Bathrooms are a hazard area for the elderly. Grab bars by the toilet and shower are a must to help prevent falls. There are easy to install bars at your local hardware store if you want to do the work yourself. Another item that is good to have is a shower stool or chair.

If you are not sure of what needs to be done, consider hiring a professional. There are companies that specialize in home remodeling and accommodation for seniors. Michelle Graham of Accessible Design by Studio G4 says about senior home remodel projects,

“The main thing we incorporate in all of our projects is a careful study of needs and potential needs that may develop throughout a client’s lifespan.”

Keep in mind what future home adjustments might be needed for your parents to “age in place” in their home.

Home safety or medical alert companies provide GPS-based bracelets or pendants to track the elderly at home who tend to wander. Or the companies may provide alarm devices such as pendants or bracelets which allow the elderly to alert someone if there has been a fall or a sudden health-related attack. In the event an alarm has been triggered, a 24 hour monitoring service will alert the family or medical emergency services or call a neighbor depending on previous instructions. In addition there are companies that will install motion sensors in the home to monitor the elderly on a 24 hour basis.

Don’t forget your parents’ community as a valuable resource for helping them stay in their home. Take Margaret Muller as an example. At 82 years of age, Margaret lives alone in her small home. She manages very well with the help of her local Senior Center. The Center’s “Senior Companion” program sees that Margaret is taken to the store for groceries and other needs and checks in with her often to see how she is doing. Once a day, the Senior Center delivers a hot healthy meal to her door. Having these services and visits gives Margaret the help she needs and peace of mind that she is not alone.

Neighbors, local church groups, senior centers and city centers are some places to look for assistance. Most of the time there is little or no cost for these services.

Your state aging services unit is a valuable community resource. The National Area on Aging website www.aoa.gov states:

“AoA, through the Older Americans Act and other legislation, supports programs that help older adults maintain their independence and dignity in their homes and communities. In addition AoA provides funding for a range of supports to family caregivers.”

Some of the programs the site lists are:

“Supportive Services and Senior Centers

Nutrition Services

National Family Caregiver Support Program

Grants for Native Americans

Nursing Home Diversion Grants

Aging & Disability Resource Centers

Evidence-Based Disease Prevention

Long-Term Care Planning

Alzheimer’s Disease Grants

Naturally Occurring Retirement Communities”

A few thoughts on hiring home care aides or live-in care givers.

The classifieds are filled with people looking for work as aides to the elderly. Many of these aides are well-qualified, honest people who will do a good job; but, of course, there will be some not so reputable. If you are looking to hire someone, be sure you interview and check references and qualifications. You will be responsible for scheduling that person and doing payroll and taxes as well. Be very sure you hire someone trustworthy, as the elderly seem to trust these helpers more than they should and therefore can easily be taken advantage of.

A professional home care service will eliminate your employment concerns. Professionally-provided aides are usually bonded and service is guaranteed. Home care companies take care of the scheduling and payment of their employees. Home care companies cater to the elderly in their homes by offering a variety of services. The National Care Planning Council lists many of these companies throughout the country on its website www.longtermcarelink.net .

These providers represent a rapidly growing trend to allow people needing help with long term care to remain in their home or in the community instead of going to a care facility. The services offered may include:

• companionship
• grooming and dressing
• recreational activities
• incontinent care
• handyman services
• teeth brushing
• medication reminders
• bathing or showering
• light housekeeping
• meal preparation
• respite for family caregivers
• errands and shopping
• reading email or letters
• overseeing home deliveries
• dealing with vendors
• transportation services
• changing linens
• laundry and ironing
• organizing closets
• care of house plants
• 24-hour emergency response
• family counseling
• phone call checks
• and much more.

Thomas Day, Director of the National Care Planning Council states,

“Care in the home provided by a spouse or a child is the most common form of long-term care in this country. About 73% of all long term care is provided in the home environment typically by family caregivers.”

As their caregiver, you can make the difference in the quality of life for your aging parents and if staying in their home is a possibility, you have the resources to make it happen.