Showing posts with label aging in place. Show all posts
Showing posts with label aging in place. Show all posts

Friday, May 28, 2021

Long-Distance Caregiving - A Practical Guide for Family Members

A major concern for many families is how to care for a loved one who is growing older, but lives some distance away from them.  How can they make sure they are able to age-at-home, without the support of family members?  The good news is that modern technology has made it much easier to help the senior citizens in your family to safely remain in their own home as long as possible. With a few convenient community services, and the addition of some virtual assistants, many seniors can stay in their own home and continue to live a full, satisfying life.  

This week's guest post by Claire Wentz contains some great suggestions to help you with long-distance caregiving.  In addition, family members may want to contact resources in their loved one's community, such as their local senior center, their personal physician, and their church to see what other assistance may be available in their neighborhood.

You may also want to read this very helpful book: "When Your Aging Parent Needs Help: A Geriatrician's Step-by-Step Guide to Memory Loss, Resistance, Safety Worries, and More."  (Ad) It will help you understand what is going on with your loved one and how to find them the assistance that they need. 

Below is the guest post:

A Practical Guide to Long Distance Caregiving 

As people age, they tend to require more support in order to maintain a comfortable standard of day-to-day life. When your senior parent or grandparent lives in another state, you may worry that you are unable to provide the assistance they need. Luckily, modern telecommunications technology and cutting-edge caregiving services mean you can still take steps to make their life easier -- even without seeing them face-to-face. Find out what you can do to serve as a useful long-distance caregiver below.

Coordinate transportation for them

Sometimes seniors are no longer able to safely drive due to a decrease in cognitive or physical abilities. In other cases, seniors lose confidence in their skills on the road. Whatever the case may be, you can help a loved one who no longer drives by introducing them to alternative methods of transportation. For example, get them a smartphone and teach them how to use Lyft—which has partnered with Lively to establish a unique service specially for senior riders. They can then easily get to doctor’s appointments and social events without feeling “stuck” at home. You can even link the Lyft account to your credit card and spare them the expense. Some Medicare plans also include free transportation to medical appointments. Check with their Medicare supplement or Medicare Advantage plan to see if this is an option for your family member.

It may also be possible to find service providers who will go to their home, helping them minimize their need for transportation. Medications and food can be ordered online and delivered to their door. There are even hairdressers who will come to their home.

Hire someone else to handle yard work and cleaning

Sarcopenia is the term used to refer to the natural decline of muscle tone that comes with age. This results in general physical weakness which can make day-to-day tasks like yard work and cleaning difficult. Lugging a heavy lawnmower or toting around a big bucket of mop water may no longer be possible. Look for external service providers to keep your loved one’s home in shape, inside and outside. Molly Maids is a reputable cleaning service which operates nationwide, for example, and you can also search for lawn care professions in your loved one’s area online via their zip code. Help them create a network of people who will provide whatever services they need to maintain a safe, comfortable quality of life.

Look into food preparation services, if needed

Cooking is another task which can leave seniors feeling overwhelmed. This is problematic as it is important that seniors eat a nutritious, well-balanced diet to maintain their energy and health. Booking a service like Meals On Wheels for your loved one is a solution. This service not only addresses the issue of hunger, but also tackles isolation by ensuring seniors have contact with someone nearly every day. This can be particularly valuable for those who live alone, especially after the death of a spouse.

This is another area where you may want to talk to their Medicare provider. Some of them have contracts with food providers that will deliver reasonably priced special meals to seniors which will meet their unique medical needs, such as gluten free meals, meals for diabetics, vegetarian meals, etc.

Stay connected with senior-friendly mobile technology

Even if you cannot be there in person, you want your loved one to be able to reach you whenever they need to. Get them a senior-friendly mobile device so that they can use video chat apps such as FaceTime or Zoom and make calls or send text messages as needed. As of 2019, four in ten seniors had a smartphone. Manufacturers are recognizing the demand for phones designed for older people, creating products with unique features, such as extra-large buttons. You can also make sure your loved one always has a way to reach help in the event that they are not near their phone. A medical alert system allows your loved one to call for help in the event of a fall or anything else which requires medical attention.

There are a variety of choices in medical alert devices, (Ad) including those with and without monthly service fees. You may wish to check out a variety of devices to decide which one will work best for you and your loved one.

Follow these steps and you can rest easy knowing your parent or grandparent is getting the care they need. Meanwhile, they can make the most of their golden years. You will both benefit from peace of mind as a result.

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If you are interested in learning more about retirement, Medicare, Social Security, common medical issues as we age, financial planning, where to retire and more, use the tabs or pull down menu at the top of the page to find links to hundreds of additional helpful articles.

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Wednesday, June 8, 2016

How to Successfully Retire Alone

How do you prepare to retire if you have no spouse, no kids and no one to perform the role of caregiver in your life?  Many people outlive or divorce their spouse; they either have no children or they outlive them; they have no near relatives who can take care of them if their health or memory begins to decline.  How can these people make sure they have adequately prepared for the future?

Scary Numbers for Single, Childless Seniors

Currently, about one-third of people between the ages of 45 and 63 are single.  About 15 percent of women in the 40 to 44 age group have no children.

According to Dr. Maria Torroella Carney, in a presentation at the American Geriatric Society's annual meeting, approximately one-fourth of Americans over the age of 65 lack a family member who can take care of them.  Carney refers to them as "elder orphans."

How to Prepare for the Future

Many of the suggestions about how to prepare for the future are the same for single people as they are for those who do have spouses and/or children ... save money, maximize your Social Security, choose a Medicare Advantage or supplement plan, find an appropriate place to live and budget wisely.   However, it can be even more important that they follow through on these suggestions if they are single and/or childless.  Below are some tips to help you navigate your senior years.

About two-thirds of seniors will eventually need long-term care.  It is wise to either buy long-term care insurance or put aside a large enough nest egg that you will be assured there will be money available for your care when you need it.  If you do not qualify for long-term care (and many people do not), you may want to move into a CCRC while you are still ambulatory and do not need assisted living.  Many of these appealing communities do not accept people who are already in need of assisted living or skilled nursing.  A final way to prepare for long-term care, especially if you are a low-income retiree, is to visit and select a Medicaid Approved nursing home in your community so you know where you would like to live, should the time come that you cannot take care of yourself.  Medicaid pays the lifetime cost of nursing home care for low and moderate income retirees with few assets.

Plan for your future housing needs by buying a home or moving into a CCRC - a Continuous Care Retirement Community.  Even if you are not in a CCRC, you may want to move to a location where you can remain independent as long as possible ... with no stairs and within walking distance of doctors and grocery stores or with a convenient bus/train/taxi service.  You may also want to see if there is a local grocery store that can deliver your groceries to you if you have surgery or become too frail to do the shopping by yourself.  Explore other neighborhood assistance that may be available to you, including Meals on Wheels, taxi vouchers, senior apartment complexes, and senior centers.  Keep a list of these services handy so you can contact them easily.

*  Prepare for medical emergencies by getting a comprehensive medical insurance plan, usually a Medicare Advantage or supplemental plan, and putting aside additional money to take care of any out-of-pocket expenses you might have as you age.

Stay connected with other people, both new friends and old friends.  Without a spouse or adult children, you may need the assistance of friends from time to time.  Socializing with friends also serves to keep you healthy, happy and less likely to decline rapidly.

Choose a trusted friend or relative to be your proxy.  Make sure they know where you keep your important documents.  Designate that person as your durable power of attorney for health care decisions, before you begin to lose cognitive function.  If you have no one you can trust, contact an elder care attorney for a reference to a professional who can become your legal proxy as you age.

Make it a priority to stay healthy as long as you can.  Eat well and get daily exercise.  Work your brain as much as your body.  People who do these things and socialize with others tend to age better than those who do not.

Put together an "In-case of Death" Notebook.  What would happen if you were found unconscious in your home by a neighbor, relative or emergency personnel?  You should have an easy to find notebook that lists the names of people to contact, physician names, your health insurance carrier information, life insurance policies, religious preferences, funeral instructions and any other information that you believe they would need.  My personal notebook even includes a copy of our will and trust, as well as a brochure for our children that explains what needs to be done when someone dies.

If you take these steps, you will know that you have done everything possible to make your life easier as you age.  You will also have made things easier for the distant relatives or friends who might be contacted upon your death or serious illness.  Otherwise, they may not know what to do or what you would like done, should the time come when it is difficult or impossible for you to make decisions for yourself. 

If you are interested in learning more about where to retire, health considerations as you age, financial planning and more, use the tabs or pull down menu at the top of the page to find links to hundreds of additional helpful articles.
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Wednesday, June 17, 2015

Where NOT to Retire

While not all of us have the option to retire to our "dream" locations, there is no doubt that some areas are better suited to retirees than others.  As a result, rather than focusing on the "best" places to retire, some researchers have been studying the worst places to grow old ... the locations you will want to avoid, if at all possible.

There are various reasons why one state or community might be worse than others ... lack of services for the elderly, high crime rates, low life expectancy, limited or non-existent public transportation, etc.

Based on different criteria, below is information about some of the places where you might want to either avoid growing old or take steps to minimize the problems of aging of in these locations.

Five Worst States to Grow Old

According to an article on Yahoo Homes, below are the states where the elderly have an average life expectancy of less than 80 years of age, where violent crime is among the highest in the nation, and where the educational level of senior citizens is lower than the national average (and education often translates to higher income, better health and longer lives).

1.  Mississippi
2.  Louisiana
3.  West Virginia
4.  Arkansas
5.  Nevada

Of course, even within these states, a person with a high retirement income, who feels they live in a safe community with plenty of access to the services they need, would still be able to have a satisfying retirement.  However, retirees in those states may need to do more advance planning to make sure they have taken all the necessary precautions before they become old and more vulnerable.

Cities with the Highest Crime Rate

Regardless of other factors, most senior citizens are not going to want to live in the middle of cities that have a high crime rate.  Listed below are the twenty cities in America with the highest crime rates.  If you want to see the entire list of the top 100 cities, you can use the link at the bottom of this article:

1. Camden, NJ
2.  Chester, PA
3.  Detroit, MI
4.  Saginaw, MI
5.  Oakland, CA
6.  Bessemer, AL
7.  Flint, MI
8.  Atlantic City, NJ
9.  Wilmington, DE
10.  Memphis, TN
11.  Alexandria, LA
12.  Myrtle Beach, SC
13.  Harvey, IL
14.  St. Louis, MO
15.  Newburgh, NY
16.  Cleveland, OH
17.  Homestead, FL
18.  Baltimore, MD
19.  Little Rock, AR
20.  Rockford, IL

There were some surprises on this list.  For example, I was shocked to see the popular community of Myrtle Beach, South Carolina ranked at number 12 for crime.  In addition, I was surprised that Washington, DC did not make the top 20.  (Washington is actually number 30)

Of course, many of the above communities have safer suburbs within a short drive of the inner cities.  As a result, if you have relatives in those areas and you want to live near them, it becomes a little more important to make sure you check the crime rate in various neighborhoods before you get settled.  You may be able to find a retirement neighborhood or apartment complex that is safe, or move to a nearby suburb with a lower crime rate.  What you do not want to do is ignore the crime rate until you become frail and vulnerable.

When I was a Realtor, we often had people contact the police department and get the incident report for a specific neighborhood, if we had any question about the crime rate.  For example, while a general area in a city might have a high crime rate, a particular high rise condo complex or a nearby gated housing development might have a low incident report.  You will want to know both the general crime rate and the incident report before making a final decision, especially if you are moving into a unfamiliar or questionable area.

Make Sure Public Transportation is Available

Another concern for people who are planning their retirement should be public transportation.  In a study conducted by Dr. Angela Curl at the University of Missouri, many people are negatively impacted when they can no longer drive ... even if they have a spouse who still drives.  Dr. Curl discovered that when one partner stops driving, both spouses become much less likely to work or volunteer.  It also becomes more complicated for either person to socialize.

When one person becomes responsible for doing all the driving for the household, it is more difficult for either of them to maintain their outside interests and connections as they age.

While this problem may not be completely resolved with access to public transportation, it can help reduce the impact on the individual or couple.

As a result, you may not want to retire in an area that is so rural that retirees will be completely dependent on their own ability to drive ... since a time comes when nearly everyone will have to give up their driver's license. On the other hand, if you live in an urban area, you need to consider whether you will feel safe using the local public transportation as you age or whether there are viable alternatives ... such as occasionally using a taxi for medical visits or shopping. 

Proximity to Medical Facilities

We are fortunate in the United States that most communities have access to basic medical care.  However, as you age it becomes more likely that you will need specialists, particularly if you develop cancer, need kidney dialysis, or require open-heart surgery.  One factor you will want to consider is how far you might have to travel to receive specialized care, especially if you already know you have a chronic health condition.  While you may not want to live in an inner city, you might want to reconsider the idea of retiring to a remote mountain cabin or island.  When my husband and I were young, we always thought it would be fun to retire on Catalina Island, off the coast of Southern California.  Now that we are of retirement age, we understand that it might be more complicated than we realized ... our children would have to take a ferry to visit us and medical facilities on the island are limited.

Bottom line:  Once you decide the general area where you are going to retire, you need to give thought to the specific locations that will be the most practical as you age ... taking into consideration issues such as access to medical care, public transportation, the crime rate, etc.  That may or may not mean that the place where you currently live will be a good retirement location for you.  Just remember that if you think you will eventually need to move, it will be a lot easier to make that change in your 60's or early 70's than it will be in your 80's.

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Thursday, April 24, 2014

Aging Services in the United States

I recently attended the Orange County Senior Summit that was held in one of the clubhouses at the retirement community where I live in Southern California.  The speakers at the summit included:

Nora Eisenhower of the Consumer Financial Protection Bureau in Washington, D.C.

Dr. Laura Mosqueda who is a Professor of Geriatrics at the University of California, Irvine

Lisa Gibson, a registered dietitian and consultant for Age Well Senior Services

Marilyn Ditty, DPA, a Gerontology expert and the CEO of Age Well Senior Services

Karen Roper, MBA, the Executive Director of the Orange County Commission to End Homelessness (a serious issue in some parts of affluent Orange County)

The topic of the conference was Aging in Place with emphasis on the resources that are available to people who hope to age in their current homes.

The information that I gleaned from these experts was fascinating and, over the next few weeks, I plan to share a bit of what I learned with my readers here at

Today I thought people would be interested in the amazing effect that Baby Boomers are about to have on American society, per Karen Roper.

US Population Age 60 and Over

2005:     49,712,000
2020:     76,986,000     

In a 15 year period, the population of people over age 60 will have increased 55% ... and the population is expected to continue to increase dramatically over the next 20 years.  The population of the extremely elderly is expected to grow rapidly, as well.  For example, between 2005 and 2020, the population of people age 85 and over is also expected to have increased by 55%.

Another interesting statistic that Ms. Roper mentioned was that in 2020 (which is only 6 years from now), 20% of the U.S. population will be over the age of 65 and 20% of the U.S. population will be under the age of 16.  This will be the first time ever that the number of elderly and the number of children in the U.S. were approximately equal.

The aging population means that there will need to be a significant increase in the services that are available to help an aging population such as:

Adult Day Care
Elderly Nutrition Programs
Elder Abuse Prevention
Affordable Housing
In-Home Care
Legal Assistance
Case Management

How these services are going to be managed is something we all need to be thinking about.  We are fortunate that there are people who are already planning for ways they can help us as we age.  For example, many communities have already set up adult day care programs.  These are services that are available to help people care for loved ones who have dementia.  Being able to leave your spouse or parent with an agency during the day can make a difference between being able to care for them in your home or finding it necessary to institutionalize them ... at great expense.

Community nutrition programs for senior citizens organize services such as low cost hot lunches at senior centers and Meals-on-Wheels for the home bound.  These can make a significant difference in the ability of a person to successfully age in place.

Organizations are also helping to arrange transportation for the elderly to doctor's appointments.  Sometimes volunteers will drive them and sometimes the elderly are eligible for services like low cost taxi vouchers.  These are helpful solutions for people who are no longer able to drive.

Elder abuse is a problem that I have talked about in the past.  While this can mean physical abuse, more frequently it involves financial abuse when trusted family members or advisers swindle money from the elderly.  While there are organizations that try to watch for this type of situation, it can be difficult for people outside the family to detect.

Some of the other discussion topics at this year's summit included helping seniors find affordable housing, locate in-home care or accessing legal assistance.  If you or someone you know could benefit from these services, they should contact case carriers from the state Social Services department or talk to someone at their local senior center to find legitimate sources of help.

In the next couple of weeks, this blog will cover some of the other issues that were discussed at the senior summit, including maintaining your nutritional health as you get older and how to talk to people with Alzheimer's Disease and other forms of dementia.

If you are getting near retirement age, you may also wish to check out the tabs at the top of this blog.  They contain links to hundreds of other articles to help you, including where to retire in the US and abroad, medical issues that could arise, financial planning, and more.

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Wednesday, April 17, 2013

Age in Place Villages Provide Resources in Your Neighborhood

When I first heard the term "Age in Place Village," I thought I was hearing about a new type of senior housing.  However, I was surprised to learn that this is actually a system for organizing local resources to make it easier for seniors to remain in their current homes and neighborhoods. Aging in place refers to people who decide to continue to live in their current home after they retire and stay there for as long as possible.  When these people are connected to local service providers and senior centers, it often makes it easier for them to remain in their homes.

In the past, aging in place often meant that people became isolated.  As their long-term neighbors moved away or died and new, younger families moved into the neighborhood, many elderly people simply began to hole up in their homes with little or no social interaction with the community around them.

Where to Find Age in Place Villages

According to a U.S. News article dated April 4, 2013, the concept of Age in Place Villages began in 2001 when several senior citizens in the Beacon Hill area of Boston decided that their neighborhood needed to have more support services if seniors were going to be able to successfully and happily live out their lives in their current homes.  They called their network of support systems a "village."  The original Age in Place Village was very simple, primarily consisting of neighbors who were willing to check on each other and help each other out, when needed.

The village concept has become more sophisticated and is now spreading across the nation.  Today, the Beacon Hill Village has a board of directors and an executive director.  Their goal has also expanded beyond the idea of simply making it easier for people to remain in their homes.  Today they also strive to provide more community activities so that aging citizens can find companionship and fun activities in their neighborhood, providing them with some of the same benefits they would find in an over-55 retirement community.

Rutgers School of Social Work has studied the village phenomena and they concluded that there are now about 85 organized Age in Place Villages located around the United States and 120 more are planned for the near future.

According to the Age in Place website, the goal of the village concept is to help people remain active, independent and social in the neighborhoods that feel familiar to them. The movement has now also formed a National Aging in Place Council called NAIPC.

You can find local chapters of NAIPC in these areas, as well as many others:

Atlanta, Georgia
Baltimore, Maryland
Boston, Massachusetts
Central Florida
Central  Virginia
Jackson, Mississippi
Long Island, New York
Minneapolis - St. Paul
Orange County, California
Providence, Rhode Island
Sacramento, California
Seattle, Washington

The Resources Provided by the Villages

One way that these villages succeed is by providing senior citizens with access to local service providers who can help them remain in their homes.  While there are many types of services that can benefit seniors, depending on their needs, some of the choices include adult day care services, money management and credit counseling, in home care, home accessibility consultants, physical therapists and much more.  These organizations can also help seniors learn how to find local transportation assistance and make their homes more senior friendly.

As a resident of Orange County, California, I have known people who have taken advantage of some of the transportation assistance, adult daycare services, in-home care providers and similar programs.  The network of senior centers that are dotted throughout Orange County have helped many senior citizens stay active.  Before I moved to my current over-55 retirement community, I took yoga classes at a senior center in Irvine, California.  While I was there, I observed other senior citizens who were enjoying low cost lunches, taking exercise or art classes, playing bridge and participating in many of the same activities that are available in my retirement community.  These senior centers have made me aware of the fact that many people can remain in their current communities and still stay connected with their peers, get out of their homes, make new friends and participate in a variety of activities.

If you are interested in aging in place, you may want to contact the NAIPC at  The information they provide will make your aging experience go smoother, since they strive to help senior citizens find the resources they need to successfully remain in their homes as they age, even if they need a little help in order to achieve this goal.

If you need assistance with your retirement planning, or you have not made up your mind where you want to live after you retire, you may be interested in using the tabs or pull down menu at the top of this article or checking out the index articles shown below.  Each index articles contains a short introduction followed by links to a number of other posts that have been made to this blog about a wide variety of topics.

Gifts, Travel and Family Relationships

Great Places for Boomers to Retire Overseas

Great Places to Retire in the United States

Health and Medical Topics for Baby Boomers

Money and Financial Planning for Retirement

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Sunday, April 14, 2013

Should You Move or Age in Place When You Retire?

Many people look forward to relocating after retirement.  They think of this period in their lives as an exciting adventure, and they can't wait until they have the opportunity to live somewhere new.  While this works out well for many retirees, a number of people are making the conscious decision to age in place.

It is easy for a blog like this to focus primarily on all the amenities that are available to the people who move somewhere new after retirement.  We have covered a variety of options including different home builders, retirement communities and locations around the world that are attractive to retirees (see the indexes of articles at the end of this post).  Some of these locations have been selected because they offer a luxurious lifestyle; others were chosen for their affordability; a few were selected for their exotic locations.  However, not everyone is prepared to uproot themselves from their friends, families and homes in order to move to a new location.  Before you decide to relocate, there are certain issues you will want to consider.

Retirement Planning Questions to Ask Yourself

Here are some questions you should consider before you move somewhere new:

Will you be lonely if you live far away from your children, grandchildren, and friends?  While many people easily make new friends after they move, I have also known retirees in our retirement community who have become lonely and depressed.  Rather than joining clubs and taking part in new activities, some people isolate themselves.  If you are one of these people, you may not want to make a change.

Will you be comfortable with the new climate?   We have some friends who recently moved from the Napa Valley of Northern California to a small town near Lake Michigan.  They have suffered through several blizzards and had their electricity cut off during freezing weather.  They moved there in order to be near their youngest grandchildren.  However, they are both in their 70's and this harsh climate has been hard on them.  Extreme winter climates are not the only consideration.    Some people find that they have difficulty dealing with the heat in popular retirement locations like Florida, Arizona and Palm Springs, California.  You may want to rent a home in a potential retirement area for a year or two before you decide if you are going to be happy living there permanently.

Are you willing to travel long distances to visit your current family and friends?  My parents moved from Missouri to Florida when they were in their early 60's.  Now they are in their 80's.  They used to enjoy the road trips they took to go back to Missouri and see the rest of the family.  Now they don't want to travel at all any more, whether by car or plane.  It has been four years since they went back to Missouri for a visit.  This is an especially important issue to consider if you decide to move overseas where it could also be difficult for your family members to visit you.

If you lose your spouse, would you still want to be in your new location?  If you don't think you would want to stay in your new community permanently, you may want to consider renting rather than buying your retirement home. In some cases, people even decide to become Snowbirds.  They keep a small home or condo in their current location and rent or buy another condo or home at their retirement destination.  In this way, they maintain their connections in both places. 

You also need to consider whether this is a place where you would want to live alone.  As one reader pointed out, if you move to a new location to be near your children, would you still want to live there if your adult children moved away because of a job change?  Would you want to remain in the new location if your spouse died?  You need to think carefully about these issues before you pack up your belongings and move to a new location.

If you decide to move to another country, are you prepared for the legal complications? You may want to read "Why Retire in Puerto Rico, the US Virgin Islands or Guam."  It explains some of the legal issues to be considered in moving to another country, and it suggests that you may wish to consider living in one of our exotic US territories, instead.  It is currently the most popular article ever written for this blog.

If you need extended medical care or a nursing home, where would you want it to be?   Health problems can cause sudden changes in your retirement plans.  We had some friends who were house hunting in Ecuador when the wife had a brain aneurism.  Fortunately, the doctors in Ecuador were able to save her life (which says a lot about the medical facilities there).  However, once she recovered, they came to the realization that they did not want to be that far away if something else happened in the future.  They decided to return to the small Texas town where they had both grown up and where they would be near family and friends.

Finally, where do you want to be buried?  Although most of us do not want to think about this, it is something we should consider, especially if we decide to move overseas.  Do you want to have a funeral in a location where few of your current friends or family members will ever go?  Would you want your body to be returned to the United States for burial?  Will your heirs be left with enough money to do that?

Once you have considered all these issues, you will be better equipped to make the decision that is right for you.  If you do decide that you prefer to age in place rather than move to a new retirement location, my next blog post will cover some of the resources that are becoming available to people who decide to remain in their current neighborhoods after retirement.

If you want to learn more about the options that are available to you after you retire, check out the articles listed in the index links below.  Click on the category that interests you and it will open up to an introduction with a list of articles on that topic:

Gifts, Travel and Family Relationships

Great Places for Boomers to Retire Overseas

Great Places to Retire in the United States

Health and Medical Topics for Baby Boomers

Money and Financial Planning for Retirement

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Thursday, November 8, 2012

How to Plan for Long Term Medical Care

As we Baby Boomers begin to age, sooner or later two out of three of us are likely to need Long Term Medical Care.  Approximately one of five will need that care for more than five years!  If you are married, the odds are extremely high that either you or your spouse will need assisted living or a nursing home in the coming years.

Long Term Care is Expensive

Unfortunately, the cost of these services is quite high.  For example, according to an article in The Wall Street Journal dated October 27, 2012 and entitled "The Cost of Living Longer," the average basic cost for assisted living in the United States ranges from $2751 to $4807 a month, depending on the number of services needed. In addition to the basic cost, however, patients should plan on paying about $347 for medication management, $236 for dressing assistance, $181 for bathing assistance and $504 for other personal care each month. That means the total cost of total care is approximately $4000 to $6000 a month. The cost of this has gone up about 2 to 4 percent every year since 2012.

It is easy to see that the cost of these services will quickly sky-rocket out of reach for most families.  Fortunately, there are steps we can all take now to make sure our future care is more affordable and less stressful for our other family members.

Buy Long Term Care Insurance

While you are still in your 50's or early 60's, look into the cost of purchasing Long Term Care Insurance from a reputable company like Genworth, one of the country's largest providers of this insurance coverage.  My husband and I purchased this insurance about five years ago, and we are glad we did.  The younger you are when you purchase Long Term Care Insurance, the less you will have to pay in premiums.

However, although this insurance will bring you peace of mind, it only helps if you are able to qualify for it and afford it.  If you wait until you have a serious medical problem you will not be approved or the premiums may be too high.  In those cases, you should look at the other money saving options that may be available to you, and let your family members know your preferences.  Here are some possibilities.

Long Term Benefits from the Department of Veterans Affairs

A war veteran or their spouse may each receive as much as $2020 a month in benefits from the Department of Veterans Affairs to help pay for the cost of assisted living or nursing home care.  When combined with your other retirement benefits, this may be enough to cover the cost of your long-term care. The veteran only needs to have served in the military for at least one day during a war ... including the wars in Vietnam, Korea, etc.  They do not need to have served in a war zone while the war was going on.

If you think you may qualify, you can get more information and help with your application by going to  Then click on "Locations" - "State Veterans Affairs Offices" - "Veterans Service Organizations" or "Regional Benefits Offices."  Unfortunately, I have been told that at many as 60 percent of claims are denied the first time you apply.  If you are denied, you may want to get help with the application from a service organization such as Veterans of Foreign Wars.  Do NOT give up.  You are entitled to these benefits.

Medicaid Long Term Care for Low and Moderate Income Individuals

Many people confuse Medicaid and Medicare.  However, they are different government programs.

Medicare will only pay for the first 100 days of nursing home care.  After that, you are on your own if you have assets and a moderate to high income.

However, Medicaid will pay for most long-term care for low-income and many moderate income people, especially those with very few assets.  In the case of a couple, the spouse who does not need care is allowed to keep some assets, a home and, possibly, a business ... although they may be expected to contribute to the care of the spouse who is in the assisted living facility.

If you believe that you may qualify for Medicaid, you or your family members should apply as soon as you go into a nursing facility for care that is being covered by Medicare.  The people in the facility can help you with your application.  There are also private companies, such as Nursing Home Solutions and A Place for Mom, which can help you with the application and find an assisted living situation, if you qualify. In California, Medicaid is called MediCal.

Independent Living Apartments instead of Assisted Living

Assisted Living can be very expensive and many people do not need that level of care.  As an alternative, some people are moving into independent living apartments that provide local transportation, meals, exercise classes and other services.  Then the family can hire a caregiver who only comes in a couple of times a week or a few hours a day to provide other essential services, such as help with medication, bathing, getting dressed, etc.

To help you compare the cost of home healthcare in your community, use Medicare's Home Healthcare tool at

This choice is very common, for example, in the senior community where I live, Laguna Woods Village. In fact, it is common in most independent living retirement villages. In our community, many seniors stay in a typical condo or move to a high rise within the community known as Rossmoor Towers.  For about $2300 to $2800 a month, an individual or couple in the Towers has a private apartment with a full dinner provided every evening, and weekly housekeeping.  Each condo has a kitchen where the residents or their caregivers can prepare their own breakfast and lunch.  Many of the residents of the Towers share caregivers with their neighbors.  The caregivers arrive in the morning and help different residents with their meals, medications, bathing, dressing, etc.  Even with the additional cost of the caregiver, this arrangement makes it possible for a couple to stay together in their own private residence, even if one of them needs assistance with daily living.  The Towers are also far less expensive than the surrounding skilled nursing facilities.

Home Health Care - Age in Place

Similar to moving to the Towers, some people simply choose to remain in their own home and hire a caregiver to come to their home each day and provide the necessary assistance.  Whether or not this saves money depends on the cost of living in the current residence.  This may not be feasible for someone who lives in an expensive home with a large mortgage or for someone who will need a lot of personal assistance plus the cost of a housekeeper, landscape workers, etc.  However, it has become a popular and affordable option for many people.

Adult Day Services and Respite Care for Those Getting Care at Home

Another alternative is for the person who needs assistance to live with an adult child or other family member.  This can be stressful for the family members who are placed in the role of caretaker.  Consequently, being able to take an elderly person with dementia or other medical problems to adult day care makes it possible for the full time caregiver to work, run errands or just have a break each day.

Whether you use adult day care services or not, you may also occasionally need respite care. It is available in many areas.  Respite care is provided by many assisted living facilities to enable relatives to leave an older adult in their facility for a few days so that their family members can leave town or deal with a family emergency without worry.

Inform Your Adult Children or Other Relatives of Your Preferences

Once you decide on the type of care that you would like to receive when you are older, it is important that you inform your spouse, adult children or other relatives of your desires.  If you have purchased Long Term Care Insurance, give a copy of your policy to your nearest relative in case you are incapacitated.  If you know of independent living apartments that appeal to you or where you already have friends, inform your relatives of your selection.  If you would like to continue to live in your home as long as possible, others will need to know this, as well.  Finally, if you hope to live with your adult children or other relatives, you should discuss this possibility with them long before you become disabled.

If you would like additional information about where to retire, common medical issues as we age, changing family relationships or financial planning, use the tabs or pull down menu at the top of the page to find links to hundreds of additional articles.

You may also be interested in reading:

Healing Relationships with Your Adult Children
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Photo of private room in medical facility courtesy of