Recent surveys among NJ elderly, find that their biggest concerns are:

1. Remaining independent in the home without intervention from others;

2. Maintaining good health and receiving adequate health care;

3. Having enough money for everyday needs and not outliving assets and income.

Pre-planning can help address these issues.  No other life event can be as devastating to an elderly person’s lifestyle, finances and security as needing long term care. It can drastically alter or eliminates the three principal lifestyle concerns above.  The majority of the American public does not plan for this crisis of needing elder care. The lack of planning also has an adverse effect on the older person’s family, with sacrifices made in time, money, and family lifestyles.  Due to changing demographics and potential changes in government funding, the current generation needs to plan for long term care before the elder years are upon them.

Here are some facts.

• The population of the “very old,” – older than age 85 – is the fastest growing group in America. This population is at highest risk for needing care. (Statistical abstract of the United States,
  2008, population)
• Medical science is preventing early sudden deaths, which means living longer with impaired health and greater risk of needing long term care.
• The Alzheimer’s Association estimates the risk of Alzheimer’s or dementia beyond age 85 to be about 46% of
  that population.
• It is estimated that 6 out of 10 people will need long-term care sometime during their lifetime.
• Children moving far away from parents or parents moving away during retirement makes long distance care giving difficult or impossible.
• Government programs— already stretched thin for long term care services— will experience even greater stress on
  available funds in the future.

One of the important things for planning is how to maintain your lifestyle as you age. You may be healthy enough to stay in your own home with help provided for the following activities of daily living:

• maintaining a home
• providing meals
• supervision
• companionship
• transportation
• shopping services

This type of care at home is non-medical and must be provided free of charge by family, friends, or volunteers or the care must be paid for out-of-pocket by the family. Government programs, in most cases, will not pay for this kind of care. It is estimated that 80% of all long term care is non-medical, with 90% of that care provided in the home.

Plan now how you will pay for care when it is needed. In evaluating your future income you may find it necessary to add some resources such as long term care insurance to pay for assisted living or nursing home costs. Long term care insurance must be purchased while you are younger and healthy. Failing health, stroke or other aging issues will not allow you to qualify for this insurance.  A reverse mortgage will also help pay for home care if staying in your home is an option.

Consider where you may want to live in your elder years. Many assisted living facilities offer complete care alternatives with a nursing home wing if needed. Senior retirement communities also offer many amenities with some including home care options.  Now is the time to do estate planning. A professional estate planner will give you direction on how best to protect your assets for future needs and for Medicaid planning.  Now is the time to create your trusts, will, medical directives in a living will and any other documents you want noted for future use. Gather insurance policies and bank records where they can be found by family members in case you are not able to get them yourself.

The process of long term care planning involves the following four
principles:

1. Knowledge and preparation are the keys to success.
2. Having funds to pay for care expands the choices for care
settings and providers.
3. Using professional help relieves stress, reduces conflict, and
saves time and money.
4. Success is assured through a written plan accepted by all
parties involved.

(The above excerpt is quoted from “The 4 Steps of Long Term Care Planning,” National Care Planning Council)

The National Care Planning Council’ s website — www.longtermcarelink.net — provides over 700 pages of information for long term care planning and lists services of professional care providers in estate planning, long term care insurance, reverse mortgage, home care and many other important long term care services.

The National Care Planning Council’ s book, “The 4 Steps of Long Term Care Planning,” provides information on what Medicaid and Medicare will cover as well as an overview of professional long term care service providers and how their services can help you create and execute your long term care plan. A check list of what to do to create a plan and forms for creating necessary paperwork are also included in the book.

Posted by: Frank Esposito, Vice President of Expert Home Care.  New Jersey’s Expert Home Care provides professional and reliable home health care and companion care for NJ elderly, helping them with their daily living activities since 1984. Please call us toll free at 800-848-2336 when you have home care related questions or need assistance for a loved one. Get a Free Home Care Assessment (a $375 value!) when you mention this post.

NJ Senior Care Planning

Talking to your elder parents about end of life care

No one looks forward to discussing end of life issues with aging parents, but this is something that needs to and should be done.

Having the conversation is necessary so that your senior’s preferences may be honored, if at all possible, and so that your contribution to the decision-making can be based on an understanding of those wishes.

The conversation should be ongoing, rather than just occurring one time, and hopefully each time the topic is revisited it will become more comfortable, as you and your elderly loved one become more used to discussing the range of future possibilities together.

Here are some tips to help you through the discussion:

How to begin a conversation about future wishes with your senior

One way to begin is by asking your senior what their biggest concerns are for the future. This topic may evoke thoughts on the past, regrets, or a life assessment. Listen uncritically, with empathy.  Having your senior share these thoughts with you can bring you closer.

Discuss your senior’s preferences regarding housing options

While most people prefer to remain in their current home, ask your senior what they would like to do if that were no longer possible. Sometimes this conversation will bring forth your senior’s expectations about moving in with one of their children, which can be helpful to know.

Ask your senior if they feel financially secure

It is important for you to have a record of your senior’s insurance policies, such as Medicare, Medigap, prescription coverage plan, and any long term care insurance.  If your senior doesn’t already have a will, durable power of attorney and health care proxy, now is a good time to see an elder care attorney so that they can have their wishes resolved as to asset distribution and care.

Discuss your senior’s feelings about their medical care and whether or not they are satisfied with their physicians

Does your senior have any concerns about their medical care? Do they have any concerns about their doctors? Do you need to help them find better ones? What are your senior’s wishes as to medical interventions and end-of-life care?

Discuss your senior’s wishes as to death, dying and funerals

Do your parents have any preferences as to funeral and burial? These conversations are difficult, but you need to resolve them sooner rather than later. Researching and selecting specific services isn’t morbid, and can help when the time comes.  Seniors to be assured their wishes will be followed even when their adult child is feeling sad and possibly overwhelmed when arranging a funeral.

Posted by: Frank Esposito, Vice President of Expert Home Care.  New Jersey’s Expert Home Care provides professional and reliable home health care and companion care for NJ elderly, helping them with their daily living activities since 1984. Please call us toll free at 800-848-2336 when you have home care related questions or need assistance for a loved one. Get a Free Home Care Assessment (a $375 value!) when you mention this post.

What is an elder law attorney and when is it time to contact one?  Here are some things to consider:

What is Elder Law?
Elder Law is the legal practice of counseling and representing older persons and their representatives about the legal aspects of health and long term care planning, public benefits, surrogate decision making, older persons’ legal capacity, the conservation, disposition and administration of older persons’ estates and the implementation of their decisions concerning such matters, giving due consideration to the applicable tax consequences of the action, or the need for more sophisticated tax expertise.

What is a Certified Elder Law Attorney (CELA)?
Any attorney can claim to have a specialty in elder law, but only Certified Elder Law Attorneys have met rigorous criteria and been reviewed favorably by five of their peers. These attorneys have been in practice for a minimum of five years, three of which have been focused on elder law. They have passed the regular bar exam, and a special one focused on elder legal issues. In addition, they must take continuing education courses to keep up with the latest changes in the law as it relates to elder issues.

Why should you consult a CELA?
For advice on estate planning, future planning, Medicare and Medicaid issues, end-of-life issues, choice-of-living-situation issues and planning for special-needs children.

What is an example of something a CELA could help a client with, that someone else might not be aware of?
In some states, if a grown child cared for a parent for at least two years, making institutionalization of that parent unnecessary, and lived in the same home as the parent, then that home may not be taken to pay for the adult’s nursing home costs. This is something of great significance to many families that a non-CELA may not be aware of.

Some tips for people dealing with elder issues:

• Become educated about the situation. Come up with a long-term plan. Educating yourself in the issues will prevent you from being taken advantage of by someone pretending to be an expert, who is not.

• Find an intelligent, qualified adviser, and don’t be afraid to pay him/her for their time.

• Create a health care proxy which designates someone to make health-care decisions for you in case you can’t. The health care proxy can include elements of a living will, dealing with what kind of treatments you do or do not want.

• Sign a durable power of attorney, which allows your spouse to protect your assets. This is the financial equivalent of a health care proxy. It’s better than putting your assets in a joint bank account, and you can specify what kinds of decisions the person can make for you. It is often used to protect the money of one spouse if the other goes to a nursing home.

Posted by: Frank Esposito, Vice President of Expert Home Care.  New Jersey’s Expert Home Care provides professional and reliable home health care and companion care for NJ seniors, helping them with their daily living activities since 1984. Please call us toll free at 800-848-2336 when you have elder care related questions or need assistance for a loved one. Get a Free Home Care Assessment (a $375 value!) when you mention this post.

What does it mean to become empowered? NFCA defines empowerment as a sense of confidence in your ability to bring about positive changes in your circumstances and to rise above the day to day challenges you face in your caregiver journey. It’s the optimism we strive for to take a positive approach in an effort to achieve a better quality of life for ourselves and our family. Sometimes it is the tiny changes we make in our lives which can have the most profound impact towards a much healthier and positive outlook.

Four Principles to Live By Include:

Believe in yourself and take charge of your life.
Protect your health
Reach out for help
Speak up for yourself and stand up for your rights

New Jersey’s Expert Home Care for Elders and Seniors provides care for your aging loved ones since 1984. Please call us when your loved one needs help – 800-848-2336.

Without wheels

“Many people can drive safely through their later years. As a group, older drivers are typically safe drivers. Drivers age 64 and older represent 14 percent of the driving population but just 8 percent of vehicular accidents,“ says Maureen Mohyde, director of Corporate Gerontology at The Hartford, and co-author of “We Need to Talk: Family Conversations with Older Drivers.”

About two-thirds of older drivers self-regulate or voluntarily restrict their driving to avoid night driving, slippery road conditions, rush hour or other difficult driving conditions, she adds.

As a concerned family member, relative or friend, it’s good to be proactive. There are positive things you can do to reduce driving risks and auto fatalities. The first step is to start talking about the subject before it becomes an issue.

You can broach the subject a number of ways. Talk about heavy traffic or road construction. Bring up news reports of an auto accident or announcement of a new senior transportation service. Deteriorating health, new medications or a recent fender-bender clearly mean it’s time to talk.

For help getting started, check out the free 24-page “ We Need to Talk: Family Conversations with Older Drivers,” produced by The Hartford in cooperation with the MIT Age Lab. The guide and video are available at: http://www.thehartford.com/talkwitholderdrivers/.

Key to any decision-making is driving  frequently enough with your elderly parent, relative, friend or client to know if they should still get behind the wheel. Some problems to watch for include: riding the break, hitting curbs, failure to stop at stop signs, running a red light, getting lost or confusing the gas and break pedals.

Finally, start investigating the options so that you can come to the table with transportation alternatives. Family members, friends, public transportation, taxis, senior services programs, non-profit organizations and churches offer a variety of ways to get around.

Most important of all, when it’s time to stop driving, be sure to let your loved one know they are only giving up their keys, not their lives.

A poll conducted by MetLife’s Mature Market Institute and Zogby International attempted to determine what age Americans believe is old.

If you’re under 30, you think age 61 marks the beginning of “old.”

If you’re between age 50 and 64, “old” doesn’t begin until age 71. No one 65 or older thinks 41 to 50 is old.

Men are almost three times more likely than women to say an age under 60 is old, and men are four times more likely than women to say that someone between 31 and 40 is old.

Republicans are more likely than Democrats or Independents to say that younger ages are old.

At Society of Certified Senior Advisors’ seminars, we ask people “how old do you feel?” Almost universally, people will subtract eight or ten years from their actual age. Put another way, “old” is all a matter of perspective!

 “According to some sources, 60% of us will need long term care sometime during our lives. It is important for all of us to prepare for that day when we will need to help loved ones with elder care or we will need elder care for ourselves.”

“It is simply a fact of life to prepare financially for unexpected disasters by covering our homes, automobiles and health with insurance policies and to provide funding for our retirement. But no other life event can be as devastating to our lifestyle, finances and security as needing long term care. It drastically alters or completely eliminates the three principal retirement dreams of elderly Americans, which are:

1. Remaining independent in the home without intervention from others
2. Maintaining good health and receiving adequate health care
3. Having enough money for everyday needs and not outliving assets and income

Yet, it is our experience that the majority of the American public does not plan for the devastating crisis of needing eldercare. This lack of planning also has an adverse effect on the older person’s family, with sacrifices made in time, money, family lifestyles and even affecting the family’s or caregiver’s medical and emotional health.” National Care Planning Council “The 4 Steps of Long Term Care Planning”.… read the entire article by going to the link below

Please go to the following URL for the entire article and previous articles: Either click on the link   http://www.planforcare.org or copy and paste the following into your browser:  http://www.planforcare.org

The Process of Long Term Care Planning by Thomas Day

The Seven Steps of the Planning Process

Understanding the natural progression of long-term care and the resources available to help can be an invaluable asset to a family or spouse who are currently providing care or someday in the future, may eventually have to provide help for a loved one. We call this process long term care planning. It involves:

Understanding the Process of Planning

Understanding Care Settings

Understanding Government Long-Term Care Programs

Knowing Who to Contact for Help

Creating Sources of Funding to Pay for Services

Using Strategies to Preserve Assets

Creating a Long Term Care Plan

Five Steps to a Successful Transition of Family Wealth and Values

Roy Williams and Vic Preisser. Preparing Heirs: Five Steps to a Successful Transition of Family Wealth and Values. Robert D. Reed Publishers, San Francisco, CA. 2003.

If you have worked hard to accumulate wealth, you probably want to make sure your heirs don’t lose control of it. Preparing Heirs gives families the tools to successfully transfer wealth from one generation to the next.

The authors, both of whom are family coaches with many years of experience counseling wealthy families, interviewed thousands of families and discovered that 70 percent of wealth transfers fail. Preparing Heirs explains the techniques that worked for the 30 percent of families that successfully “transitioned” wealth.

According to the authors, the key to a successful transition of wealth is family involvement. “The most important single issue that undermines successful transfers of wealth is the breakdown of trust and communications within the family unit,” they write. Using handy checklists, Preparing Heirs discusses how to assess a wealth transition plan, how to fix deficiencies in the plan, how to prepare heirs, and how heirs can prepare themselves.

For mid-size and large estates, this book offers valuable advice on successfully transferring wealth to the next generation and beyond.

Ask your financial adviser to compare the performance of your investments to relevant indexes or to other funds with similar investing strategies — focusing on the past few months and years, not the day-to-day gyrations.

Also ask about the performance of your overall portfolio, focusing on the past one, three and five years. “I really feel that no financial-planning client or investment advisory client should be doing as badly as the markets; that is, if the broad market is down 25%, then they should be down no more than 20% and probably less,” says Bob Veres, publisher of Inside Information, a well-respected newsletter for financial planners.

2. How do my investments match my time frame and goals? One of the biggest benefits of working with a financial planner is that he or she should pick investments within the context of your overall financial plan — dividing your savings into several sections and selecting the investments for each based on your time frame and goals.

And ask about the adviser’s strategy for meeting your medium-term goals.

3. What adjustments are you making because of this market? “A good adviser will have put a plan in place that expects horrible times in the markets,” says Daniel Moisand, a certified financial planner in Melbourne, Fla., and chairman of the Certified Financial Planner Board’s disciplinary and ethics commission.

The adviser shouldn’t make rash decisions during a market downturn, especially if you’ve been well-diversified and your investments match your time frame and goals. “Any adviser who says you should sell everything during the capitulation period of a bear market is not somebody I would want to work with,” Veres says.

4. How much am I paying for guarantees? Some “advisers” may offer to eliminate future worries by selling a product promising big guarantees. “I would be highly skeptical of any product pitches that purport to have severed the relationship between risk and reward,” says Moisand.

5. How do you plan to keep me updated and answer questions? You can learn a lot about your financial planner during this crisis — not just how he or she manages your investments, but how well the adviser explains the situation and what action you should take, answers your questions and makes you feel more comfortable. “This is probably the time when you need your financial professional more than at any other time,” says Gannon.

And your adviser should be giving you the attention you deserve now.

If you haven’t been satisfied with your planner’s performance, see In Search of Good Advice for help finding a new one.

http://kiplinger.com/columns/ask/archive/2008/q1027.htm