Medicare Doesn’t Pay The Senior Solution: Introduction Reverse Mortgages Paying for Long-Term Care Understanding Medicaid Sample Cases VA Pension & PERS Keeping Seniors Home for Life! Click on the titles above to view a particular topic or hit enter to advance to the next slide. It Takes a Team Lifestyle Insurance

Introducing Designed to help you and your family make informed decisions about long-term care planning and crisis management.

The Senior Solution is a family guide to keeping seniors home for life. Whether you are a senior facing crisis, or a family wanting to plan ahead for long-term care needs, The Senior Solution gives you information and resources that can help. 60% of seniors who reach age 65 will need some form of long-term care. Knowing all of the resources available will assist seniors and their families with making informed and educated decisions.

The Senior Solution is a family guide to keeping seniors home for life.

Whether you are a senior facing crisis, or a family wanting to plan ahead for long-term care needs, The Senior Solution gives you information and resources that can help.

60% of seniors who reach age 65 will need some form of long-term care. Knowing all of the resources available will assist seniors and their families with making informed and educated decisions.

The Senior Solution was written by Valerie VanBooven-Whitsell – a registered nurse and geriatric care manager. Her website is www.TheLTCExpert.com She is also the author of “ Aging Answers ”, and has been seen on NBC’s Today Show, and CNNFN’s Your Money with Ali Veshi. Valerie has been quoted in Time Magazine and in dozens of AP articles across the country. “ Seniors and their family members are not aware of many other programs that may be helpful in keeping seniors in their own home. Everyone wants to 'age in place,' maintaining their independence and choice. 'The Senior Solution' is designed to point families and seniors in that direction," states VanBooven.

The Senior Solution was written by Valerie VanBooven-Whitsell – a registered nurse and geriatric care manager. Her website is www.TheLTCExpert.com

She is also the author of “ Aging Answers ”, and has been seen on NBC’s Today Show, and CNNFN’s Your Money with Ali Veshi. Valerie has been quoted in Time Magazine and in dozens of AP articles across the country.

“ Seniors and their family members are not aware of many other programs that may be helpful in keeping seniors in their own home. Everyone wants to 'age in place,' maintaining their independence and choice. 'The Senior Solution' is designed to point families and seniors in that direction," states VanBooven.

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“ Paying for Long-Term Care”

Privately – using your own income, assets and investments to pay for long-term care. How are we going to pay for long-term care?? Long-Term Care Insurance - pays for long-term care at home, in assisted living, adult day care centers, or in a nursing home. You must be healthy enough to get long-term care insurance and you must be able to afford it! HECM – also called a reverse mortgage, means using the equity in your home to pay for long-term care insurance or pay directly for long-term care services. Government – applying for Medicaid and relying on the government to foot the bill for long-term care needs. Privately? LTCi? HECM? Government?

Privately – using your own income, assets and investments to pay for long-term care.

Most people don’t know how much long-term care really costs. The Average Cost of Care in the U.S. Today… The national average daily rate for a private room in a nursing home is $206, or $75,190 annually. The national average daily rate for a semi-private room in a nursing home is $183, or $66,795 annually. The national average hourly rate for home health aides is $19 . For only 5 hours of care 7 days per week, the monthly average cost is $2660 per month or $31,920 annually. The national average hourly rate for homemakers/companions is $17 . For only 5 hours of care 7 days per week, the monthly average cost is $2380 per month or $28,560 annually. $75,190 $66,795 $31,920 $28,560

Most people don’t know how much long-term care really costs.

The national average daily rate for a private room in a nursing home is $206, or $75,190 annually.

The national average daily rate for a semi-private room in a nursing home is $183, or $66,795 annually.

The national average hourly rate for home health aides is $19 . For only 5 hours of care 7 days per week, the monthly average cost is $2660 per month or $31,920 annually.

The national average hourly rate for homemakers/companions is $17 . For only 5 hours of care 7 days per week, the monthly average cost is $2380 per month or $28,560 annually.

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“ Medicare Doesn’t Pay for Long-Term Care!”

Medicare Does Not Pay For Long-Term Care! Skilled nursing care in the home for 30 days. Medicare will pay for nursing home care up to 90 days as long as you qualify. Most patients receive an average of 26 days of nursing home care under Medicare. Non-medical in-home care (companion services) Adult Day Care Assisted Living What Medicare Does Pay For: What Medicare Does NOT Pay For: Short-term rehab care in a nursing home. Custodial care in a nursing home.

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“ Understanding Medicaid”

Understanding Medicaid Medicaid is a program run jointly by the federal government and the state where you live. It is designed to help people who are impoverished pay for long-term care. In order to qualify for Medicaid you must meet certain income and asset tests. Each state is different. In order for Medicaid to pay for long-term care in a nursing home, the patient must be in a semi-private room. Nursing homes LOSE $16-$40/per day per Medicaid patient in their facility, therefore, most nursing homes have a very limited number of Medicaid beds available. Patients end up miles from home and sometimes on long waiting lists for these beds.

Understanding Medicaid In order to qualify for Medicaid you must meet certain financial criteria. Everything that can be made liquid must be “spent down” before receiving Medicaid benefits. You can keep your home (up to $500,000 in equity), one car, a life insurance policy with a cash value under $1500, a pre-paid burial plan, your personal effects. You must spend down your checking account (to about $2000 depending on your state rules), your savings account, IRAs, 401Ks, CDs, stocks, bonds, and anything else that can be made liquid. Placing assets in a “Medicaid Annuity” might help temporarily, but the beneficiary must now be the state that you live in, not your heirs.

And One Final Point Relying on Medicaid to pay for long-term care is no longer the only option for seniors in crisis. There are a couple of other programs that might be helpful! Home Equity Conversion Mortgage (reverse mortgage) proceeds are tax free and can be used to pay for in-home care as needed. The VA Home Aid and Attendance Pension benefit can assist senior veterans and their spouses who served during a period of war.

Relying on Medicaid to pay for long-term care is no longer the only option for seniors in crisis. There are a couple of other programs that might be helpful!

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“ Lifestyle Insurance”

What is Lifestyle Insurance? Lifestyle Insurance is Long-Term Care Insurance… 20 years ago we called Long-Term Care Insurance – “nursing home insurance”, but this is no longer the case. If your vision of retirement and your golden years includes maintaining your independence and choice, you need to consider Long-Term Care Insurance. But Long-Term Care Insurance is expensive! Right? Not nearly as expensive as paying out of your own pocket for services that Medicare simply will not cover.

What is Lifestyle Insurance? You must be healthy in order to get a Long-Term Care Insurance policy, and you must be able to afford the premiums. Long-Term Care Insurance covers: In-home care Adult Day Care Geriatric Care Management Hospice Assisted Living Some home modifications Nursing Home Care Some Long-Term Care Insurance plans will pay a family member to provide care for a loved one. There are several different types of Long-Term Care Insurance…the two most popular are “traditional” plans and “asset based” plans.

Long-Term Care Insurance covers:

In-home care

Adult Day Care

Geriatric Care Management

Hospice

Assisted Living

Some home modifications

Nursing Home Care

What is Lifestyle Insurance? What if you could purchase Long-Term Care Insurance without touching a PENNY of your savings, investments or current income!? This is possible if you are a senior homeowner age 62+, by using the proceeds from a reverse mortgage to pay your premiums! (Sample Cases coming right up!) Traditional Long-Term Care Insurance means paying premiums monthly, quarterly, or annually. Asset based Long-Term Care Insurance means making one lump sum payment that can be refunded to you at any time. Asset based plans have a life insurance policy built in. That way if you never use your Long-Term Care Insurance, your heirs will get MORE than your lump sum premium payment back when you pass away. Therefore, if you never use it, you won’t LOSE it!

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“ Reverse Mortgages”

Reverse Mortgages The senior still owns their home. The proceeds do not interfere with Medicare or Social Security. Reverse Mortgages are for homeowners age 62 and older. The cash from a reverse mortgage is tax free. There are no credit score or income requirements to get a reverse mortgage. The senior never has to make a monthly payment. Reverse mortgages are regulated by FHA and backed by HUD. A senior’s home can NEVER be taken away from them.

Reverse Mortgages Pay off an existing mortgage. Buy a second home. Increase the value of their estate buy purchasing life insurance with RM money. Plan ahead for long-term care with insurance. Pay for in-home care when there is no insurance. Pay off credit cards or other debt. Take the vacation of a lifetime. Home modifications for a more “senior friendly” home. Seniors use the cash from a Reverse Mortgage to enhance their lifestyle…

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“ VA Home Aid and Attendance Pension”

VA Aid and Attendance Pension Few realize that there is a special pension set aside for veterans and their spouses or widows based only on the fact that they served during a period of war. There is a little known program for veterans and their spouses that may help seniors stay at home and receive care… Most veterans are aware that they can get some services and benefits based whether or not they were injured during active duty or in an act of war. This is frequently called the Veteran’s Home Aid and Attendance Services Pension.

VA Aid and Attendance Pension There is a little known program for veterans and their spouses… The Veterans Administration has established a pension program whereby your purchase of personal care and attendant home services may be paid for through your acquired pension. If you are a Veteran or the surviving spouse of a Veteran who has served at least 90 days or more on active duty with one day beginning or ending during a period of war, and you are in need of assistance at HOME due to your disabilities, you may be eligible for VA's non-service connected disability pension. The following are the VA’s defined “periods of war”: - WWI - 4/16/1917 to 11/11/1918 - WWII- 12/7/1941 to 12/31/1946 - Korea- 6/25/1950 to 1/31/1955 - Vietnam- 8/5/1964 to 5/7/1975 - Persian Gulf- 8/2/90 to present

VA Aid and Attendance Pension There is a little known program for veterans and their spouses… Income and liquid assets are also a determination of eligibility. In 2006, if the veteran has assets in their own name below $80,000 (if married) or below $50,000 (if single) they may qualify. The car and house do not count as assets. The Aid and Attendance income threshold for a veteran without dependents is now $18,234 annually. The threshold increases to $21,615 if a veteran has one dependent, and by $1,866 for each additional dependent. The annual Aid and Attendance threshold for a surviving spouse alone is $11,715. This threshold increases to $13,976 if there is one dependent child, and by $1,866 for each additional child.

Income and liquid assets are also a determination of eligibility.

In 2006, if the veteran has assets in their own name below $80,000 (if married) or below $50,000 (if single) they may qualify.

The car and house do not count as assets.

The Aid and Attendance income threshold for a veteran without dependents is now $18,234 annually.

The threshold increases to $21,615 if a veteran has one dependent, and by $1,866 for each additional dependent.

The annual Aid and Attendance threshold for a surviving spouse alone is $11,715.

This threshold increases to $13,976 if there is one dependent child, and by $1,866 for each additional child.

VA Aid and Attendance Pension There is a little known program for veterans and their spouses… As of 01/01/2007, a Veteran is eligible for up to $1,519 per month, while a surviving spouse is eligible for up to $976 per month. A couple is eligible for up to $1,801 per month. In many cases if a person has a paid caregiver such as a nurse’s aide, or they pay an Assisted Living Facility, those expenses impact so greatly on a person’s net income, that they will meet the criteria for the income level. If a Veteran or Veteran Widow has cash assets above the limit, they are allowed to place those assets into certain investments in order to have them “sheltered”. This sheltering does not have a penalty or “look back period” associated with it. One of the best websites with comprehensive information can be found at www.veteranaid.org or www.vetassist.org .

As of 01/01/2007, a Veteran is eligible for up to $1,519 per month, while a surviving spouse is eligible for up to $976 per month.

A couple is eligible for up to $1,801 per month.

In many cases if a person has a paid caregiver such as a nurse’s aide, or they pay an Assisted Living Facility, those expenses impact so greatly on a person’s net income, that they will meet the criteria for the income level.

If a Veteran or Veteran Widow has cash assets above the limit, they are allowed to place those assets into certain investments in order to have them “sheltered”. This sheltering does not have a penalty or “look back period” associated with it.

One of the best websites with comprehensive information can be found at www.veteranaid.org or www.vetassist.org .

What is a PERS? Personal Emergency Response System- another way to keep seniors safe and at home for life! “ I’ve fallen and I can’t get up!” A “PERS” is a system that can be set up very inexpensively in a senior’s home. This isn’t just for “sick” people. These systems keep well people well. The senior wears a pendant around their neck, or a watch style pendant, and has the system with them at all times inside and outside of the house. If they suffer a fall, stroke, illness, or any other event where they feel they might need assistance, all they have to do is access their system with the touch of a button.

Personal Emergency Response System- another way to keep seniors safe and at home for life!

“ I’ve fallen and I can’t get up!”

A “PERS” is a system that can be set up very inexpensively in a senior’s home.

This isn’t just for “sick” people. These systems keep well people well.

The senior wears a pendant around their neck, or a watch style pendant, and has the system with them at all times inside and outside of the house.

If they suffer a fall, stroke, illness, or any other event where they feel they might need assistance, all they have to do is access their system with the touch of a button.

Statistics Personal Emergency Response System A study by AC Nielson indicates among other things that seniors who have a personal emergency response system stay at home an average of 6 years longer than those who do not have a PERS. Also most PERS have smoke detector options, keeping the home safe and protected from fire devastation. 58% of customers with a PERS for a year or more feel that their quality of life has improved. 87% of customers with a PERS think that this protection is important or a main factor in their decision to continue living at home. 95% of customer with a PERS feel protected at home. 80% feel that the comfort of living in their own home is important. 76% feel that being independent is important.

Personal Emergency Response System

A study by AC Nielson indicates among other things that seniors who have a personal emergency response system stay at home an average of 6 years longer than those who do not have a PERS. Also most PERS have smoke detector options, keeping the home safe and protected from fire devastation.

58% of customers with a PERS for a year or more feel that their quality of life has improved.

87% of customers with a PERS think that this protection is important or a main factor in their decision to continue living at home.

95% of customer with a PERS feel protected at home.

80% feel that the comfort of living in their own home is important.

76% feel that being independent is important.

What is a PERS? Personal Emergency Response System In a study of older adults, those living with a PERS reported significantly greater ability to go about daily routine and were ten times less likely to require admission to a nursing home. Medical research shows that falling down and being unable to get help is not an uncommon event. In fact, nearly 1/3 of all people over the age of 65 (and half of all people over 90) will fall each year. Of course the older a senior gets, the more dangerous and debilitating falls can be, and they often mark the end of independent living. Research also tells us that 30% to 50% of elderly people fear falling - a fear that can cause them to lose confidence and restrict their normal range of healthy activities. The confidence and peace-of-mind that comes from a PERS helps to ease these anxieties, as well as the feelings of isolation and depression caused by such worries.

Personal Emergency Response System

In a study of older adults, those living with a PERS reported significantly greater ability to go about daily routine and were ten times less likely to require admission to a nursing home.

Medical research shows that falling down and being unable to get help is not an uncommon event. In fact, nearly 1/3 of all people over the age of 65 (and half of all people over 90) will fall each year. Of course the older a senior gets, the more dangerous and debilitating falls can be, and they often mark the end of independent living.

Research also tells us that 30% to 50% of elderly people fear falling - a fear that can cause them to lose confidence and restrict their normal range of healthy activities. The confidence and peace-of-mind that comes from a PERS helps to ease these anxieties, as well as the feelings of isolation and depression caused by such worries.

Click on the button below to return to the main screen or hit enter to continue to the next section which addresses “ Sample Cases” Return to Main Screen

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“ Sample Cases”

Let’s Look at Some Examples…. Couple #1: Jim and Sue Stephenson ages 72 and 65. Jim has serious knee problems making it difficult for him to get up and down the stairs in their 2-story home. Home value of $150,000. A reverse mortgage gave them $71,000 in additional cash flow. They installed a stair lift ($2500) for Jim, using the reverse mortgage proceeds. They also installed safety bars in the bathrooms and had a personal emergency response system set up in their home in case of a fall.

Couple #1:

Jim and Sue Stephenson ages 72 and 65. Jim has serious knee problems making it difficult for him to get up and down the stairs in their 2-story home.

Home value of $150,000.

A reverse mortgage gave them $71,000 in additional cash flow.

They installed a stair lift ($2500) for Jim, using the reverse mortgage proceeds.

They also installed safety bars in the bathrooms and had a personal emergency response system set up in their home in case of a fall.

Let’s Look at Some Examples…. Couple #1 continued: The rest of the proceeds from the reverse mortgage were left in the “line of credit” for any future needs. Because of their home modifications, Jim and Sue were able to maintain their independence and stay in their own home for as long as they wished.

Couple #1 continued:

The rest of the proceeds from the reverse mortgage were left in the “line of credit” for any future needs.

Because of their home modifications, Jim and Sue were able to maintain their independence and stay in their own home for as long as they wished.

Let’s Look at Some Examples…. Couple #2: Joe and Mary Black both age 65. Both are in good health. They wanted long-term care insurance but felt that it was too expensive. The premiums would affect their lifestyle choices. Home value of $200,000. They selected a 5-year plan, 90 day elimination period, compound inflation protection, $150/day benefit. Their long-term care insurance premium combined is $5460 annually!

Couple #2:

Joe and Mary Black both age 65. Both are in good health. They wanted long-term care insurance but felt that it was too expensive. The premiums would affect their lifestyle choices.

Home value of $200,000.

They selected a 5-year plan, 90 day elimination period, compound inflation protection, $150/day benefit.

Their long-term care insurance premium combined is $5460 annually!

Let’s Look at Some Examples…. Couple #2 continued: The reverse mortgage on their home gave them $99,000 in additional cash flow, which they will leave in their “line of credit” to grow at 6.35%. Each year they will withdraw the $6300 in earned interest from their line of credit to pay their long-term care insurance premium. The Black’s protected their estate and covered their risk for needing long-term care without touch a penny of their savings, investments, or current income .

Couple #2 continued:

The reverse mortgage on their home gave them $99,000 in additional cash flow, which they will leave in their “line of credit” to grow at 6.35%.

Each year they will withdraw the $6300 in earned interest from their line of credit to pay their long-term care insurance premium.

The Black’s protected their estate and covered their risk for needing long-term care without touch a penny of their savings, investments, or current income .

Let’s Look at Some Examples…. Individual #3: Jane is a 70 year old non-smoker in good health. She owns a home worth $250,000. She owes nothing on her home. Jane has approximately $122,000 in equity available to her by using a reverse mortgage. She takes $100,000 out of that equity out and purchases a single - premium asset based Long-Term Care Insurance plan. She now has $412,101 available to pay for long-term care if she needs it ($190/day for 6 years). Her death benefit is $137,367 if she never uses her long-term care insurance benefit. The original $100,000 premium is available to be transferred back to her at any time if she changes her mind.

Individual #3:

Jane is a 70 year old non-smoker in good health. She owns a home worth $250,000. She owes nothing on her home. Jane has approximately $122,000 in equity available to her by using a reverse mortgage.

She takes $100,000 out of that equity out and purchases a single - premium asset based Long-Term Care Insurance plan. She now has $412,101 available to pay for long-term care if she needs it ($190/day for 6 years). Her death benefit is $137,367 if she never uses her long-term care insurance benefit.

The original $100,000 premium is available to be transferred back to her at any time if she changes her mind.

Let’s Look at Some Examples…. Individual #3 continued: If Jane died at age 86 and never used her long-term care insurance plan, she would have $137,367 to pass on to her heirs, PLUS $154,517 in retained equity in her home, for a total of $291,684 in inheritance. Jane protected her estate and covered her risk for needing long-term care without touch a penny of her savings, investments, or current income.

Individual #3 continued:

If Jane died at age 86 and never used her long-term care insurance plan, she would have $137,367 to pass on to her heirs, PLUS $154,517 in retained equity in her home, for a total of $291,684 in inheritance.

Jane protected her estate and covered her risk for needing long-term care without touch a penny of her savings, investments, or current income.

Let’s Look at Some Examples…. Individual #4: Betty is 65 years old, and in good health. She is a non-smoker. Betty owns a home worth $200,000. There is no debt against the home. She buys a 5 year long-term care insurance plan. Annual premium: $4548 Betty is eligible to receive a lump sum of $99, 657 from the equity in her home. She will purchase a life insurance policy by paying a one time premium of $50,000. Betty leaves the remaining $49,657 in a line of credit that grows at 6.35% per year (2006 interest rates- note these change weekly). She pays her annual long-term care insurance premium from the line of credit every year.

Individual #4:

Betty is 65 years old, and in good health. She is a non-smoker. Betty owns a home worth $200,000. There is no debt against the home.

She buys a 5 year long-term care insurance plan. Annual premium: $4548

Betty is eligible to receive a lump sum of $99, 657 from the equity in her home. She will purchase a life insurance policy by paying a one time premium of $50,000. Betty leaves the remaining $49,657 in a line of credit that grows at 6.35% per year (2006 interest rates- note these change weekly). She pays her annual long-term care insurance premium from the line of credit every year.

Let’s Look at Some Examples…. Individual #4 continued: This means that Betty will leave her heirs a death benefit of $222,736 plus the value of her home minus her loan balance. She has now helped her heirs to receive a tax free inheritance that is worth more than the current value of her home. Betty did all of this without touching a penny of her savings, investments, or current income . In fact, now she and her heirs have the cash flow they needed to keep her safe for her remaining years.

Individual #4 continued:

This means that Betty will leave her heirs a death benefit of $222,736 plus the value of her home minus her loan balance. She has now helped her heirs to receive a tax free inheritance that is worth more than the current value of her home.

Betty did all of this without touching a penny of her savings, investments, or current income .

In fact, now she and her heirs have the cash flow they needed to keep her safe for her remaining years.

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“ The Team of Experts”

The Team of Experts When a family is faced with the crisis of managing long-term care, OR when deciding to plan ahead for long-term care, it’s important to consider: Financial options Legal options Care options HOME CARE? ADULT DAY CARE?

When a family is faced with the crisis of managing long-term care, OR when deciding to plan ahead for long-term care, it’s important to consider:

Financial options

Legal options

Care options

HOME CARE?

ADULT DAY CARE?

Financial Options Most financial advisors can help with products like life insurance, long-term care insurance, annuities, and IRAs or 401Ks. Not all financial advisors are able to incorporate reverse mortgages and cash flow planning techniques into seniors’ estate planning strategies. When it comes to estate planning and long-term care planning, or crisis management it is important to seek the advice of an individual who is well versed and trained in not only senior issues, but also reverse mortgages and cash flow planning techniques. The Team of Experts

Financial Options

Most financial advisors can help with products like life insurance, long-term care insurance, annuities, and IRAs or 401Ks.

Not all financial advisors are able to incorporate reverse mortgages and cash flow planning techniques into seniors’ estate planning strategies.

When it comes to estate planning and long-term care planning, or crisis management it is important to seek the advice of an individual who is well versed and trained in not only senior issues, but also reverse mortgages and cash flow planning techniques.

Legal Options Aging adults and their family members face certain challenging legal issues. Expert legal help is often the key to solving many problems and avoiding future complexities. It is important to be able to identify a competent Elder Law Attorney who can assist the family in a timely and professional manner. Consumers should be cautious and check credentials thoroughly. The National Academy of Elder Law Attorneys- www.naela.org The Team of Experts

Legal Options

Aging adults and their family members face certain challenging legal issues.

Expert legal help is often the key to solving many problems and avoiding future complexities.

It is important to be able to identify a competent Elder Law Attorney who can assist the family in a timely and professional manner.

Consumers should be cautious and check credentials thoroughly.

The National Academy of Elder Law Attorneys- www.naela.org

Care Options When faced with decisions regarding long-term care for an aging loved one, a geriatric care manager may be one of the best private resources in your area. A geriatric care manager has extensive knowledge of all local resources related to aging and care giving, as well as family and personal issues and concerns. Geriatric care managers can be located nationwide. They assist with coordination of care for aging and disabled adults. This service is provided in a series of steps including initial assessment, care plan development, implementation of services, and quality of care monitoring. Geriatric care managers are typically nurses, social workers, gerontologists, physical therapists, occupational therapists, or other social service professionals. www.caremanager.org The Team of Experts

Care Options

When faced with decisions regarding long-term care for an aging loved one, a geriatric care manager may be one of the best private resources in your area.

A geriatric care manager has extensive knowledge of all local resources related to aging and care giving, as well as family and personal issues and concerns.

Geriatric care managers can be located nationwide. They assist with coordination of care for aging and disabled adults.

This service is provided in a series of steps including initial assessment, care plan development, implementation of services, and quality of care monitoring.

Geriatric care managers are typically nurses, social workers, gerontologists, physical therapists, occupational therapists, or other social service professionals.

www.caremanager.org

The Team of Experts In-Home Care Options- Top 10 Questions (See Handout) How long has this provider been serving the community? Does this provider supply literature explaining its services, eligibility requirements, fees, and funding sources? How does this provider select and train its employees? Does it protect its workers with written personnel policies, benefits packages, and malpractice insurance? Are nurses or therapists required to evaluate the patient's home care needs? If so, what does this entail? Do they consult the patient's physicians and family members? Does this provider include the patient and his or her family members in developing the plan of care? Are they involved in making care plan changes? Is the patient's course of treatment documented, detailing the specific tasks to be carried out by each professional caregiver? Does this provider assign supervisors to oversee the quality of care patients are receiving in their homes? What are the financial procedures of this provider? What procedures does this provider have in place to handle emergencies? Are its caregivers available 24 hours a day, seven days a week? How does this provider ensure patient confidentiality?

In-Home Care Options- Top 10 Questions (See Handout)

How long has this provider been serving the community?

Does this provider supply literature explaining its services, eligibility requirements, fees, and funding sources?

How does this provider select and train its employees? Does it protect its workers with written personnel policies, benefits packages, and malpractice insurance?

Are nurses or therapists required to evaluate the patient's home care needs? If so, what does this entail? Do they consult the patient's physicians and family members?

Does this provider include the patient and his or her family members in developing the plan of care? Are they involved in making care plan changes?

Is the patient's course of treatment documented, detailing the specific tasks to be carried out by each professional caregiver?

Does this provider assign supervisors to oversee the quality of care patients are receiving in their homes?

What are the financial procedures of this provider?

What procedures does this provider have in place to handle emergencies? Are its caregivers available 24 hours a day, seven days a week?

How does this provider ensure patient confidentiality?

The Team of Experts Adult Day Care- Top Questions (See Handout) The National Adult Day Services Association (NADSA) recommends you start by asking yourself what specific services both elder adult and caregiver most need. For the day care participant, are social activities primary? Assistance with walking, eating or medications? Mental stimulation? Exercise? As a caregiver, is support what you need most? Some free time? Help with transportation? Answering these questions will help you determine which of the three main types of adult day care centers (social, health-focused, and Alzheimer's/dementia oriented) will best serve you. In addition to the many references and resources to help locate adult day care centers in your area, you can also try: Your family doctor, Local social services or health department , Mental health centers, Local senior center , Area Agency on Aging (Call 1-800-677-1116 for the AAA in your area) Yellow Pages listings under Adult Day Care, Aging Services, Senior Citizens' Services, and similar categories.

Adult Day Care- Top Questions (See Handout)

The National Adult Day Services Association (NADSA) recommends you start by asking yourself what specific services both elder adult and caregiver most need. For the day care participant, are social activities primary? Assistance with walking, eating or medications? Mental stimulation? Exercise? As a caregiver, is support what you need most? Some free time? Help with transportation? Answering these questions will help you determine which of the three main types of adult day care centers (social, health-focused, and Alzheimer's/dementia oriented) will best serve you.

In addition to the many references and resources to help locate adult day care centers in your area, you can also try: Your family doctor, Local social services or health department , Mental health centers, Local senior center , Area Agency on Aging (Call 1-800-677-1116 for the AAA in your area) Yellow Pages listings under Adult Day Care, Aging Services, Senior Citizens' Services, and similar categories.

The Team of Experts Adult Day Care- Top Questions (See Handout) When you phone the center(s) you've chosen to consider, NADSA suggests asking the following questions: Who owns or sponsors the agency? How long has it been operating? Is it licensed or certified? (If required in your state) What are the days and hours of operation? Is transportation to and from the center provided? Which conditions are accepted (e.g., memory loss, limited mobility, incontinence)? What are the staff's credentials, and what is the ratio of staff to participants? What activities are offered? Are there a variety of individual and group programs? Are meals and snacks included? Are special diets accommodated?

Adult Day Care- Top Questions (See Handout)

When you phone the center(s) you've chosen to consider, NADSA suggests asking the following questions:

Who owns or sponsors the agency?

How long has it been operating?

Is it licensed or certified? (If required in your state)

What are the days and hours of operation?

Is transportation to and from the center provided?

Which conditions are accepted (e.g., memory loss, limited mobility, incontinence)?

What are the staff's credentials, and what is the ratio of staff to participants?

What activities are offered? Are there a variety of individual and group programs?

Are meals and snacks included? Are special diets accommodated?

Conclusion It is possible to keep seniors safe and at home for life using the resources available. Many families are faced with managing a crisis when there is no time to plan ahead. When insurance is not an option, using resources like Reverse Mortgages, VA Pension benefits, and Personal Emergency Response systems can keep seniors at home longer. Medicare was never designed to pay for long-term care expenses. Relying on Medicaid can be a costly mistake. Other families have been able to plan ahead with “lifestyle” insurance. It is possible to afford the premiums of Long-Term Care Insurance without touching a PENNY of your savings, investments or current income.

It is possible to keep seniors safe and at home for life using the resources available.

Many families are faced with managing a crisis when there is no time to plan ahead.

When insurance is not an option, using resources like Reverse Mortgages, VA Pension benefits, and Personal Emergency Response systems can keep seniors at home longer.

Medicare was never designed to pay for long-term care expenses. Relying on Medicaid can be a costly mistake.

Other families have been able to plan ahead with “lifestyle” insurance.

It is possible to afford the premiums of Long-Term Care Insurance without touching a PENNY of your savings, investments or current income.

What’s the Next Step? Some seniors and their families will have questions about these strategies, and will want to know which one applies to their situation. Talk to the senior service provider who presented you with this information for a customized report and presentation.

Some seniors and their families will have questions about these strategies, and will want to know which one applies to their situation.

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