Aid and Attendance Pension

The Aid and Attendance pension benefit may be available to wartime veterans and surviving spouses who have in-home care or who live in nursing-homes or assisted-living facilities.

Although this is not a new program, not everyone is aware of his or her potential eligibility. “Veterans have earned this benefit by their service to our nation,” said Secretary of Veterans Affairs Jim Nicholson. “We want to ensure that every veteran or surviving spouse who qualifies has the chance to apply.”

Many elderly veterans and surviving spouses whose incomes are above the congressionally mandated legal limit for a VA pension may still be eligible for the special monthly Aid and Attendance benefit if they have large medical expenses, including nursing home expenses, for which they do not receive reimbursement. To qualify, claimants must be incapable of self support and in need of regular personal assistance.

The basic criteria for the Aid and Attendance benefit include, but not limited to the inability to feed oneself, to dress and undress without assistance, or to take care of one’s own bodily needs. People who are bedridden or need help to adjust special prosthetic or orthopedic devices may also be eligible, as well as those who have a physical or mental injury or illness that requires regular assistance to protect them from hazards or dangers in their daily environment.

For a wartime veteran or surviving spouse to qualify for this special monthly pension, the veteran must have served at least 90 days of active military service, one day of which was during a period of war, and be discharged under conditions other than dishonorable.

Wartime veterans who entered active duty on or after September 8, 1980, (October 16, 1981, for officers) must have completed at least 24 continuous months of military service or the period for which they were ordered to active duty.

If all requirements are met, VA determines eligibility for the Aid and Attendance benefit by adjusting for un-reimbursed medical expenses from the veteran’s or surviving spouse’s total household income. If the remaining income amount falls below the annual income threshold for the Aid and Attendance benefit, VA pays the difference between the claimant’s household income and the Aid and Attendance threshold.

The Aid and Attendance income threshold for a veteran without dependents is now $19,736 annually. The threshold increases to $23,396 if a veteran has one dependent, and by $2020 for each additional dependent. The annual Aid and Attendance threshold for a surviving spouse alone is $12,681. This threshold increases to $15,128 if there is one dependent child, and by $2020 for each additional child. Information is also available on the Internet at www.va.gov or from any local veterans service organization.

Article provided by:
COR, Care Option Resources
503-781-1695
www.CareOptionResources.com

One Stop Shopping For All Of Your Home Health Care Needs

The maze of health care services can be confusing and complicated. Who pays for the service? Is it Medicare, my private insurance, or will I pay out of my own pocket? Below are a few examples of services and how they might be paid.

You have just left the hospital after receiving knee replacement surgery. Your doctor has requested that a home health agency follow your recovery in the comfort of your home for a few weeks. The medical equipment you need is delivered to you at home. You receive physical therapy to help regain the range of motion in your knee and a nurse monitors your vital statistics and progress. Home Health and Home Medical Equipment are both covered by Medicare and private insurance.

Your husband has Alzheimer’s and his disease has worsened such that you no longer feel able to take care of him 100% of the time. Personal Care can come to your home and assist with homemaking, nail and foot care, care related transportation, daily personal activities, or just let you have a break. You do not need a doctor’s orders to receive personal care. Personal Care is not covered by Medicare but is covered by long term care insurance or by personal pay.

Your wife has severe nausea and vomiting from chemotherapy to treat her lung cancer. Her doctor has ordered hydration therapy. Rather than having to go to the hospital, Home Infusion Therapy will provide intravenous hydration for her in the comfort of your home.

You have learned that your loved one’s disease has progressed to a stage where treatment is no longer working and your loved one is told they have 6 months left to live. The game plan now turns to comfort care. This is where Hospice comes in. Hospice is an experienced team of physicians, nurses, social workers, chaplains, home health aides, physical, occupational and speech therapists, and volunteers all focused on providing the highest quality end of life care. Patients are accepted into hospice care based on their health needs, not their ability to pay. Medicare/Medicaid coverage pays for all Hospice team visits and services, medications, equipment, and supplies related to the patient’s terminal illness.

In choosing a home care service provider it is wise to look at the variety of services they offer and pick the one that has all of the services that you need now or may need in the future. It is easier to deal with one company rather than several.

Article Provided by:
Adventist Health Home Care Services
(503) 251-6303

Copyright © 2008 RetirementConnection.com. All rights reserved.

Starting the Conversation

Your dad’s neighbor just called to tell you that your 79-year-old father sideswiped his parked vehicle and nearly hit a child standing nearby. Was it an isolated slip-up or the sign that it’s time for your dad to think about giving up his car keys? More importantly, how do you begin the discussion about such a potentially volatile subject?

Sensitive issues like this prompted Home Instead Senior Care to launch a public education campaign called the “40-70 Rule.” This campaign will help adult children begin to address difficult issues with their parents such as driving, finances, independence and even romance. The “40-70” Rule’ means that if you are 40, or your parents are 70, it’s time to start the conversation about some of these difficult topics.

The campaign is based on research conducted in the U.S. and Canada by Home Instead Senior Care, which revealed that nearly one-third of adults in the U.S. have a major communication obstacle with their parents that stems from continuation of the parent-child role. In other words, it can be difficult to get the conversation going because the child is still in a child role rather than an adult role with their aging loved one.

The goal of the “40-70” campaign is to provide practical ways for adult children to talk to their parents now instead of waiting until the situation reaches crisis mode. At the center of the “40-70 Rule” campaign is a guide for conversation starters on sensitive senior-care subjects, which is available online at www.4070talk.com. The guide was compiled with the assistance of Jake Harwood, Ph.D., national author and communication professor from the University of Arizona who is the former director of that school’s Graduate Program in Gerontology.

Good communication is vital to helping families know when it’s time to seek additional resources. Oftentimes both adult children and their loved ones can benefit from outside help, such as a professional caregiver. The only way that can happen is if they are first able to talk about developing care needs. Find out more about the 40/70 Rule at www.4070talk.com.

Article Provided by:
Mike Brunt, Home Instead Senior Care
(503) 530-1527
www.HomeInstead.com

Copyright © 2008 RetirementConnection.com. All rights reserved.

Portland Senior Living is Going Green

New senior living communities continue the environmentally friendly building trend

Green design has made its way to the senior living industry and several new communities in the Portland area are a testament to that green philosophy. Environmentally minded contractors, architects and designers are implementing green design into new buildings because they understand that consuming less energy, conserving water, and improving indoor air quality benefits the residents as well as the natural environment.

The key elements to reducing a building’s greenhouse gas emissions are energy efficiency, waste management, water conservation, and indoor air quality. Many new senior living communities are using this green strategy in their design and operations because a sustainably designed building can literally improve a senior’s physical and mental health.

For example, many green buildings are designed to let in as much natural sunlight as possible. Studies have shown that exposure to daylight reduces depression. Improving the air quality inside a building by using low VOC paint, frequently cleaning coils and vents, and using effective weather stripping means seniors breathe much fresher air. This is especially important for seniors who spend most of their time inside and who can be especially susceptible to pollution because of emphysema and asthma.

Laurel Parc at Bethany Village in northwest Portland is an example of a senior housing development that has incorporated many green features into the building’s design. For example, the orientation and shape of the building and the placement of windows increases the natural lighting as well as ventilation, underground parking will reduce water use by lessening ground level surface space, and energy efficient lighting and Energy Star appliances will prevent light and energy waste.

Other steps taken during the design and construction phases of Laurel Parc include recycling 100% of construction waste, installing an efficient HVAC system, featuring strategically placed skylights to increase natural light, having low-flow showerheads and flush toilets, and starting a recycle program.

Going green is not a money saver at the outset. It usually adds 3 to 5 percent to a project’s upfront cost and sometimes will deter a company from moving in the green direction. However, once the building is complete the additional costs incurred during construction are returned through reduced energy costs. The long term benefits definitely outweigh the initial costs and contribute to the well-being of our seniors and our planet.

About Laurel Parc at Bethany Village

Laurel Parc at Bethany Village is a unique senior living community located in the heart of Northwest Portland. Set to open in March of 2009, Laurel Parc will feature independent senior apartments as well as assisted living suites.

Provided by: Barbara Keyes, Laurel Parc at Bethany Village
(503) 533-7979
www.laurelparc.com

Copyright © 2008 RetirementConnection.com. All rights reserved.

Strategies to Manage Long-Distance Caregiving

We live in a very mobile society where family members don’t always live in the same town or even the same state. According to the National Institute on Aging, approximately seven million Americans are long-distance caregivers. Identifying strategies for long-distance caregiving will make the challenges of caring for aging parents or loved ones more manageable. Below are tips 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. Identify Community Resources and Professionals – Research local area agencies on aging, senior centers, churches, synagogues, or other volunteer organizations about available resources for seniors. There are several options for aging parents who need additional assistance.
6. 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.
7. 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.

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!

Article Provided by:
Rob MacNaughton, Right at Home
(503) 574-3674
www.rahcares.com

Copyright © 2008 RetirementConnection.com. All rights reserved.

How Do We Get Mission Centered?

In today’s healthcare market we are all faced with motivating our staff and encouraging them to give 100 percent. It is critical to our mission, our reputation, and our overall success to have a team striving to reach their goals. So how do we encourage our staff to always strive for giving so much in an environment that can be so stressful?

It starts at orientation. This is where the message is delivered, the expectations lined out and the support identified to help your staff deliver high quality care. Unfortunately, this can be the first and last time they hear about the organizations Mission statement. This is a major blunder for most organizations; if the Mission statement isn’t followed everyday, it is lost and forgotten or even worse joked about by employees.

Creating a new hire orientation class that empowers your employees and makes them feel like they are truly part of the organization is the best way to start them on the right foot. Second, the message has to stay alive and positive; this is not easy and involves a commitment from your leadership team to make it happen. This can be accomplished by consistently using the Mission statement as a gauge in your discussions with staff, family and peers. During celebrations refer to how “mission centered” their thoughts and actions were. You can also use this consistent message when counseling an employee. The bottom line is everything revolves around the Mission statement.

Families have many choices for healthcare delivery in today’s market and they are much more thorough in their searches than in years past. Having a Mission statement they see and hear everyday consistently reminds them that you are on track with what you promised them and their family members.

How to integrate your mission statement:

• Create new hire class with emphasis on your mission and why it is your mission.
• How many of your current employees know your mission statement? If it is a low number then I recommend a campaign to roll out your mission statement.
• Is your mission statement in your building posted for all to see, is it used in your printed materials for both internal and external customers?
• Does your leadership refer to the mission when talking with staff and family?
• Is your mission statement your guide or just words?

Article Provided by:
Sarah Ross, American Medical Response
(503) 736-3433
www.amr.net

Copyright © 2008 RetirementConnection.com. All rights reserved.

There Is More To Life Than Bingo At A Senior Living Community

Bingo is a lot of fun and don’t ever knock it. But today’s seniors are demanding more variety. The days are gone of living in fear of limited choices. Senior living has changed and the possibilities are quite endless! Many communities now focus their activities calendars on creating an “Optimum Life”.

There are six dimensions to Optimum Life that everyone can start to incorporate into their lives today, they follow with some examples:

1. Purposeful: Living History-recording family memories, mentoring children, editing newsletter or calendar, making cards for hospitals, flower arranging for table centerpieces, taking photos for the community.
2. Spiritual: memory or meditation gardens, cards to parishioners in need, pastoral visits, holiday celebrations, or bible study.
3. Emotional: Aromatherapy, music, occupation based activities, pet visits, video postcards from families and friends.
4. Social: Celebrations, music and entertainment, outings to local senior centers, Red Hat Society meetings, bridge clubs, visits from youth groups, or taste testing events.
5. Intellectual: Brain teasers, art lessons, educational videos, trivia, resident committees, or puzzles.
6. Physical: Circuit training, fishing, gardening, swimming, stretching exercises or simply walking.

When evaluating an activities calendar, try to find communities that address these varied dimensions. Look for events and programs that address your needs and interests. Prior to visiting a senior living community, you may want to make a list of your favorite hobbies and also create a list of possible new interests, and make a list of all of your questions. One important thing to remember: often a community’s activities calendar is a reflection of the interests and talents of the residents who live there; so -as residents move in, age in place, or move out, an Activity Director is challenged to meet these ever changing needs.

These six dimensions can be incorporated in our lives, regardless of physical or cognitive ability. By choosing “Optimum Life, we are improving our quality of life considerably by increasing mobility, energy, memory, happiness; decreasing anxiety and depression; improving immunity, and overall wellness.My grandmother once told me the secret to life is to keep moving, no matter how you choose to do it, keep learning something new and always try and never give up, always believe in yourself and remember that you are valued and loved! I believe she used these six dimensions all throughout her life. Could it really be that simple? Who knew?

Article Provided by:
Cathy Weeg, Wynwood Mt Hood – A Brookdale Senior Living Community
(503) 665-4300
www.BrookdaleLiving.com

Copyright © 2008 RetirementConnection.com. All rights reserved.

Where Do I Begin When Navigating Housing Options?

The doctor just informed you that it would be unsafe for your senior loved one to return to their home without 24/7 supervision. You have limited time to find a new ‘home’. Where do you begin to find your way through the maze of housing options, care needs, budget and amenities? Don’t go it alone- Referral agencies and placement consultants are a valuable resource to save time and anxiety. These professionals are familiar with the numerous options and availability. Many also review the state survey and public disclosure file for any record of criminal activity or lack of compliance with laws/rules.

Step 1: Gain detailed knowledge of the medical/ assistance needs of the resident. This will narrow the type of community to those that are licensed and capable of providing the proper care. It may be awkward for families to ask the personal questions related to care needs and personal assistance; sometimes an objective third person is able to ask more detailed questions and uncover concerns or fears while helping the resident maintain a sense of privacy.

Step 2: Know your budget. Community fees may vary, with application fees, deposits, levels of care and ancillary services. A placement consultant may be able to help you to better balance the big picture.

Step 3: Focus on the geographic area that fits best. This is a new chapter in their life, and they will be creating a whole new social network. The goal is to accommodate frequent visitation of the resident’s support system. Proximity to an established network of friends and family is an important factor, should any healthcare or emotional changes occur.

Step 4: Visit the communities. After narrowing the field to those that best fit your needs, you will be better able to look at the amenities, services and activities. Get to know the activities offered, meet the staff, and try the food. These are the things that make a community feel like home and help aid the adjustment process.

Consultants are familiar with numerous communities, services offered, fee structures, and activity programs. Fees are paid by the communities, and the service is free to you! The benefit is a reliable and knowledgeable resource at no cost to your family.

Article Provided by:
Jennifer Cook, Living Right Senior Placement
(503) 780-7353
www.LivingRight.net

Copyright © 2008 RetirementConnection.com. All rights reserved.

Ten Common Asset Preservation Mistakes

1. Transferring all assets to children or other relatives. This almost always results in a penalty period of ineligibility that begins after application for Medicaid and other public assistance. Tax consequences can be significant. Make gifts only with legal counsel.
2. Selling the family home to pay for nursing home costs. This is often not required, yet many still believe that the home must be sold to pay for care.
3. Relying only on a will or living trust. A will has no effect until approved in probate proceedings after death. A living trust is preferable in most cases, but generally does not protect assets from government claims for payback.
4. Relying on Medicare or health insurance. Neither one pays for the cost of long terms care in a nursing home or assisted living. Costs typically run between $5000 and $6000 and most families will quickly run through their life savings.
5. Putting a family member on accounts as a joint owner. This subjects the account to the risks associated with the joint owner’s life – divorce, bankruptcy, lawsuit. This can also result in disqualification periods for Medicaid eligibility. There are better ways to avoid these legal problems.
6. Using a pre-printed form for power of attorney. These documents may be useful for small accounts and simple transactions but usually lack the express language needed for more complex affairs and for Medicaid eligibility transactions. Have one prepared for your situation by an elder law specialist.
7. Using a form will or living trust. These are cheap and available from bookstores and internet. But they are almost always not suitable or correct for your situation. Lawyers earn substantial fees “fixing” these do-it-yourself wills and trusts.
8. Purchasing a “Medicaid annuity” or other financial products to shelter assets. Use caution when relying on the advice of “senior advisors” who may not understand your situation.
9. Applying for a guardianship or conservatorship. These proceedings to handle a person’s incapacity are costly, time-consuming and restrictive. With proper planning, these can be avoided in most cases.
10. Ignoring Medicaid estate recovery. The state can and does proceed with liens and other proceedings to recoup benefits paid out on your elder’s behalf. In appropriate circumstances, this can be avoided with proper planning.

Laws governing Medicaid eligibility, Medicaid asset recovery and estate preservation are complex and vary between states. A qualified Elder Law Attorney can help you avoid these common mistakes.

Article Provided by:
J. Thomas Pixton, The Pixton Law Firm
(503) 968-2020
www.PixtonLaw.com

Copyright © 2008 RetirementConnection.com. All rights reserved.

What Is A Geriatric Care Manager?

A Geriatric Care Manager (GCM) is a person who has been trained to work with seniors, families, guardians, and caregivers. Your GCM should have training and experience in one of several areas: nursing, gerontology, social work, or psychology.

Why use a Geriatric Care Manager?

A GCM can assist family members, guardians or conservators in the following ways:

Assessment: Your GCM will start with an assessment covering several domains – physical abilities, mental status, cognitive functioning, and living environment.

Care Plan: Once the assessment is complete, your GCM will create a care plan specifically tailored to the senior’s needs.  The care plan includes recommendations for care and monitoring the safety and stability of the senior.

Arrange services: If the care plan is approved, your GCM can arrange services for the senior. Services include things such as in-home caregivers, placement into a higher level of care (including assisted living, adult family homes, or skilled nursing), home health, medical appointments, quality of life activities and more.

Monitor ongoing needs: Once the care plan has been adopted and services begun, your GCM will continue to monitor the care provided to the senior.  GCM’s generally accompany seniors to doctor appointments and communicate to the doctor the symptoms a senior is experiencing, and then communicates back to the family or facility the doctor’s orders. Your GCM will follow up with the facility or caregivers to ensure that doctor’s orders are being followed.

Partnership: Geriatric case managers work together with families and responsible parties.  Your GCM will know their community, and the resources and benefits available to your senior.  Whether the responsible party is in town or hundreds of miles away, they can rest assured knowing that your GCM is looking out for the senior and providing quality care.

Personal advocate: Seniors can hire a GCM on their own. Whether you are confused at doctor visits and want another set of eyes and ears there or just would like to know that someone is watching over your care, your GCM will be there – to advocate for your needs and provide you with peace of mind.

GCM’s help seniors remain safe at home – wherever that home may be.
For more information please go to the National Association of Professional Geriatric Care Managers atwww.caremanager.org or contact Social Work Services at www.social-work-services.com

Article Provided by:
By Niki Tucker, MSW, Owner
Social Work Services
(971) 533-2365