As people age, they often become overly attached to their homes and even though there may be compelling reasons to find other living arrangements, these folks will go to extreme lengths to remain in their homes.
Notwithstanding the affection for their dwellings, there is oftentimes undeniable pressure for seniors to move out and into a different living arrangement. Consider the following:
- The challenge of maintaining a yard and providing upkeep has become too great.
- There is a need for long term care that can't be handled in the home.
- The older person needs supervision that can't be provided in the home.
- The neighborhood has deteriorated and safety is a concern.
- There is a desire to be near children or grandchildren (70% of those 65+ live within 1 hour of a child).
- The home cannot accommodate disability needs.
- There is a need to avoid climbing stairs.
- Assets are tied up in the home and cash is needed through selling the property.
- Driving is no longer possible and available local transportation is not adequate.
- There is a desire for a warmer climate, a yearning for new vistas or a need for challenging new experiences.
Typically, the thought of giving up their residence, finding new accommodations, downsizing personal possessions and executing the move can seem overwhelming to many older people.
Perhaps another obstacle for many seniors, contemplating a move, is the lack of support or help from family members. In fact, some seniors have no children. For others, the children are living far away or are extremely busy with their jobs or their own families. And in some cases -- because people are living so long -- the children are elderly as well and find it difficult to help with the move.
This overwhelming pressure and stress relating to moving can often result in gridlock -- a failure to make any decision at all.
Because many elderly people face such a daunting task with moving, a growing number of seniors relocation specialists are stepping forward to provide assistance. These individuals or companies provide or arrange for the following services:
- advice and counseling,
- help with finding new accommodations,
- downsizing possessions through personal, caring assistance with discarding, donating or arranging estate sales,
- selling the existing property,
- organizing, arranging and scheduling the move,
- unpacking at the new location and removing boxes and other debris,
- setting up and arranging furniture.
And it isn't just the elderly person, contemplating a move, who is hiring these specialists. Active senior communities, independent living facilities, nursing homes and assisted living often retain a relocation specialist to provide advice and arrange services to help seniors with a move. Family members of seniors have also found it more convenient to hire a specialist to help their loved ones with relocation.
So who are these companies or individuals who provide seniors relocation and real estate services?
Seniors Real Estate Specialists
A Seniors Real Estate Specialist (SRES) is a real estate agent who specializes in helping the elderly transition to a new location. The specialist has been trained to recognize the special needs of seniors and understand the various living arrangements available to older people. Most of these specialists concentrate on selling the property and do not directly provide relocation services but they will arrange for companies or individuals or advisors who can provide these other services.
Senior Move Managers
A Senior Move Manager is a member of the National Association of Senior Move Managers. These people often have a background in social work or case management and have experience working with the elderly. As such, they understand the needs and desires of seniors. Senior Move Managers can provide or arrange for any needed service such as counseling and advice, selling property, downsizing or relocating their clients.
Many independent moving companies recognize the special needs of seniors and they will provide moving services, storage and other specialized programs for this unique group of customers. These companies will often work together with senior advisors and relocation specialists.
Specialists with Developers or Senior Communities
Active senior community developers, senior residences and care facilities have recognized that providing relocation services will help their clients or residents transition more quickly into the new living arrangements. This not only relieves the stress on the seniors but also results in less cost to the providers who might be holding open properties or rooms for a long period of time -- while receiving no income -- due to the difficulty of selling the old residence and relocating.
Professional organizers -- many of whom are members of the National Association of Professional Organizers -- have found a unique niche in helping people reduce clutter in their homes or provide a more efficient office or living environment. Because of extensive experience in reducing personal possessions, a professional organizer can be particularly useful in helping to downsize in anticipation of a move.
Professional or Geriatric Care Managers
Care managers help the elderly and their families deal with the issues of long term care. Most care managers also help people, needing long term care, to find appropriate living arrangements. A natural outgrowth of finding new accommodations has resulted in many care managers specializing in relocation services as part of what they do.
Adding Value by Helping to Obtain the Veterans Aid and Attendance Benefit
About 30% of seniors over the age of 65 are war veterans or they are the surviving spouses of these veterans. Under the right circumstances these people could be receiving a veterans benefit called "aid and attendance" which, under the right circumstances, could furnish up to an additional $1,800 a month in income. This is such a well-kept secret that only a fraction of eligible veterans are receiving the benefit. Relocation specialists who are experts on obtaining the veterans aid and attendance benefit are helping seniors find additional income to pay for assisted living or nursing home costs. Seniors are also seeking out these veteran-savvy relocation specialists for help with moving and creating new income after the move.
"Where do I start? Whom do I contact? What is the best solution for Mom's or Dad's problem?"
Some of us have been there and asked those questions, or we may find ourselves in that situation in the future.
We want to take care of Mom or Dad, but it is not an easy task -- especially if we are working full time and raising our own family. But eldercare issues do not wait for convenience of time or place. For example:
Sherry stopped by her mom's house every day after work. Her father had passed away last year and he had been the caregiver of Alice, Sherry's mom. Now it was up to Sherry to fill the caregiver role. Alice suffered from mild dementia. She could still function on her own, but was showing more signs of forgetfulness and confusion. Sherry would find her morning medication still on the cupboard in the evening and wasn't sure Alice had eaten during the day. Sherry couldn't quit her job to take care of her mom, as she was a single mother supporting her own family. Sherry had a lot of questions. What type of help was available to her? Are there resources in the community? Who would she contact to find out about home care or assisted living? Should she get legal power of attorney and when is the right time to do it? What about selling mom's home if mom goes to assisted living? How will that affect Medicaid eligibility?
Answers for Sherry were as close as her computer. Doing a Google search for “Long Term Care Planning” and “Care Planning Help” brought her to the National Care Planning Council's website www.longtermcarelink.net . Here she found articles on understanding and planning for long term care and internet links to state and national resources. The National Care Planning Council also provides a listing of eldercare services in her area and contact information for the professionals who provide them.
What is the National Care Planning Council?
The National Care Planning Council and its website “Long Term Care Link” is a comprehensive resource for long term care planning.
The Council Promotes and Supports Planning For Long Term Care!
It promotes a public awareness of the need for long term care planning
- It provides materials to educate the public on how to plan for long term care
- It provides training to member eldercare experts who help the public plan for long term care
- It promotes the services and expertise of its members
- It provides a forum for members to share ideas and marketing strategies
With ever-growing numbers of people across the nation -- like Sherry -- who are looking for help and resources for caregiving, the National Care Planning Council is ready to provide contact information for service providers in all types of care service areas.
Membership in the Council is only $8.00 a month and members can quit at any time. There is no contractual requirement to maintain membership. Membership includes the following:
1. One or more listings out of 25 different service categories on the website at www.longtermcareLink.net. Listings work like a yellow page ad where members are placed in plain sight by their category under their state and by their geographic location. A link on this listing goes directly to an appealingly-designed personal sales web page. Here is an example of one of these sales pages: CLICK HERE
Anything can go on this page including pictures, sales messages, testimonials, contact information and website links! There is also a form the public can fill out and email a request to a member. Many members make their sales page into personal websites by purchasing their own domain name and forwarding the domain to their sales page. A member of the staff can explain how to do this at no additional charge. A personal domain costs approximately $10 per year from godaddy.com.
Comparable sites go for upwards of $500, but with the National Care Planning Council, a personal web page is a mere one-time fee of $30.00 including ongoing changes or corrections. Imagine a complete website for only a one-time $30.00 set up and $8.00 a month. An enhanced website version is also available for only a $60.00 one-time setup fee. Here is an example of an enhanced website sales page: CLICK HERE
2. Ghostwritten articles that members can use as their own and edit and share with others.
3. Free templates for brochures and booklets
4. Discounts on books and sales systems from the Council
5. Use of the Council logo and identifying oneself as a member of the National Care Planning Council
A complete description of membership benefits is found at: http://www.longtermcarelink.net/register/secure.php
To become a member go to the following: https://www.longtermcarelink.net/registration/join.php
New people signing up over the next few months, receive a special bonus:
A FREE BOOK!
Community Solutions for Eldercare! A $9.95 value! A limited offer while supplies last!
If you are a primary caregiver for a loved one, you are well aware of the daily stress and emotional and physical impact it can have on your health.
Susan learned this first hand when she and her husband, Tom, brought his Mom home to live with them. Mom suffered from dementia and had to be watched constantly. Susan found that when you become a caregiver, you start by giving up a few things you usually do for yourself to make up for the time needed for caregiving. Even though your service is one of love and you are willing to do the sacrifice on behalf of your loved one, you find yourself giving up a lot more as time goes on.
“As a caregiver,” Susan laments, “You are often frustrated that you can’t do enough for your loved one and so guilt and feelings of inadequacy set in. Couple that with feelings of being unduly burdened, of resentment, of stress and then of more guilt at having those feelings."
She continues, "Now don’t get me wrong, I am very glad that I spent those years in caregiving. There were many cherished moments with Mom that only I experienced.”
In order to enjoy those moments and sustain your caregiving momentum, a little respite is essential.
An article posted on About.com by Carrie Hill, PhD states:
“Caregivers who use respite care often tell me that although caregiving is one of the hardest jobs they've ever had, they wouldn't trade the experience for anything. Helping a family member or close friend who has Alzheimer's disease can provide a sense of purpose and great satisfaction. Still, the emotional and physical demands of caregiving make it hard to be a caregiver 24 hours a day, 7 days a week. Without respite care -- a temporary break from the demands of caregiving -- you may be more susceptible to the effects of caregiver stress, such as depression, exhaustion and other health problems.
Carrie Hill, PhD, About.com “Why Caregivers Need Respite CareGiving Yourself a Break Helps You and Your Loved One” Updated: August 3, 2008
Be on the lookout for caregiver burnout. It can creep up on you without your noticing it. Caregiver burnout symptoms can include:
- anxiety, irritability, or anger
- feelings of exhaustion
- Withdrawal from usual activities
- trouble with handling caregiving responsibilities
- substance abuse
The need for support for caregivers at home has received national recognition. State Human Resource Departments and Area Agency on Aging Services are offering more counseling and respite services for caregivers. The ARCH National Respite Services is also an organization that is reaching out to educate and support caregivers in many states. There is, however, one service that is highly valuable but very underused:
Adult Day Care to the Rescue!
Adult Day Care respite is two-fold. It gives the caregivers much needed time to themselves and gives their loved ones social and interactive therapy with their peers.
Many adult day services offer such things as:
- Social activities; music, movies, crafts, excursions
- Fellowship support
- Assistance with daily living
- Nursing care
- Help with activities of daily living
- Physical therapy
Finding an Adult Day Services provider takes a little investigating on your part. It is important to know what you are getting and that your loved one is comfortable with his or her new surroundings.
First: Ask for recommendations.
Check with your local Senior Center, Area Agency on Aging Services, Mental Health Centers, Doctor, Clinic, Family, Friends and neighbors. The best recommendation is by someone who has used the adult day services or is familiar with those who run it.
Second: Call and ask the facility to send you information.
Ask specifically to be sent the application, eligibility requirements and payment information.
Ask to see the calendar of activities, menus, hours and days of operation are needed to be sure to fit your schedule.
Ask about availability of transportation to and from the location and what is the cost.
Ask who runs the facility. Is it private, non-profit or a franchise or part of an assisted living facility or a nursing home?
Third: Visit the Adult Day Care facility.
Go visit the provider location along with the person you are caring for.
See if the staff is friendly.
Check that it is clean and odor free.
Ask about the experience of the staff.
Request a list of references.
Fourth: Find out the cost and payment requirements.
A survey from NCOA/NADSA provides the following information on fees:
“Fees for Adult Day Care providers range from $25 per day to $70 per day, with the average around $50 per day. Many facilities provide services with a sliding fee scale.”
One last word of advice. Don’t feel guilty about taking your loved one to adult day care.
Susan’s mother-in-law complained bitterly about leaving home and going to the adult day care facility, expounding on how Susan just didn’t want her around anymore. This only increased the guilt Susan was already feeling, but Susan was also determined that she needed the respite time the day care would provide and they pressed forward. That evening as Susan picked up Mom and helped her into the car, Mom -- who suffered from dementia -- exclaimed, “That was the nicest resort I have ever been to!”
To learn more about the AOA National Caregiver Support Program go to:
The National Care Planning Council supports Caregivers and Adult Day Care Providers
Eldercare providers and advisers who deal with the public know from experience that the need for long term care can often arise without warning. In many cases, desperate caregivers are frantically trying to find services, advice or care funding sources to help their loved ones with unexpected long term care needs. This sudden need for help often occurs when the loved one needing care has recently demonstrated unsafe behavior, or there has been an injury or sudden illness or there is a pending release from nursing home rehab or the current caregiver can no longer cope. Help must be found right now.
Unfortunately, many of these caregivers -- who are typically operating in crisis mode -- don't know where to turn for help. It's not that there aren't advisory services out there to help them, it's just that the caregivers often don't know where to find these services.
Government caregiver resource services such as area agencies on aging and related ADRC pilot programs typically reach out to caregivers through referrals from hospitals, discharge workers, doctors, home health agencies and nursing homes. Caregivers seeking help outside of this referral network generally aren't aware of government advisory services. In the private sector, help with caregiving issues is generally provided when a caregiver calls a specific agency, nonprofit organization or an advisor. There is no nationwide, private sector one-stop shopping source of help for all the types of care provider services that are available in the community.
The national care planning Council has discovered an answer to help desperate caregivers find the one-stop shop support they need. A 2004 study by the National Alliance for Caregiving and AARP estimates nearly six in ten (59%) caregivers are currently employed. Many of these working caregivers will use their Internet access at work to find the caregiving support they need.
The National Care Planning Council is in the process of developing websites in every state that contain the Internet resources employed caregivers are looking for. Currently, results from websites operating in 10 states indicate that harried caregivers will indeed search out these state care planning council websites for help. For example, one state website sponsored by the National Care Planning Council produced over 1,000 inquiries for help primarily from younger family caregivers.
The National Care Planning Council is currently seeking qualified individuals to be Directors and oversee geographic service areas of state care planning councils. The Director's job is to coordinate local requests for help from the community and provide needed eldercare services. If you are a professional care provider or eldercare advisor please contact us about this opportunity to help the community and at the same time expand your services by becoming a Director of a Service Area. Or you may simply want to become a member of your local state care planning council.
In the year 2000, about 12,800 home health agencies served approximately 8,600,000 clients across the United States . In that year Medicare paid an estimated 85% to 90% of the total cost of home health agency services amounting to $ 8,700,000,000. Although current figures are not yet available, the number of home health agencies has been going up year after year as well as the number of clients being served.
Although home health agencies are privately owned, Medicare is the principle payer for their services. Home health services through Medicare are available under parts A and B. In order to qualify for Medicare homecare a person must have a skilled need, must be homebound and there must be a plan of care ordered by a Physician.
Prior to 1997 Medicare typically paid for home care for as long as it was needed. Prior to 1997 annual Medicare costs were almost double the amount cited above. In order to save money Medicare has since gone to a prospective payment system where, according to the plan of care, a certain amount of money is allocated to resolve the skilled need for the patient.
Monies are typically provided for a period of up to 60 days. If the patient recovers sooner then money may have to be reshuffled to other patients who are not responding as well. At the point where the patient does not respond or improve, no more Medicare money is forthcoming. After Medicare cuts off, a person continuing to need long-term care services must find sources other than Medicare.
Home health agencies deliver a variety of skilled services outlined by the chart below. The plan of care always includes as well custodial services to help the care-recipient remain in the home. These would include an aide for an hour or two a day to help with bathing, dressing and transferring. If there is time remaining other personal services may be offered as well. These personal services are also covered by Medicare.
Recently Medicare has redefined what it means by "homebound" to allow recipients to leave the home on a limited basis. Beginning in 2003 and ending three years later, Medicare is testing, with a very small test group, a program where selected home health agencies can provide adult day health care instead of home health services. If successful the program will offer a new dimension in Medicare home care. In addition, under the new definition, Medicare will also allow and pay for home visits from doctors who specialize in homebound elderly patients. Limited office visits are also allowed under the new definition.
Finally, in the past few years Medicare is paying for home telehealth visits through a home telehealth, computer work station. Telehealth is being used with some success to provide home care in rural areas where it would be difficult to arrange the personal visit from a home health care agency.
Although Medicare- will authorize up to 60 days at a time of home care, according to the Centers For Medicare And Medicaid Services (CMS) the average length of stay for Medicare home care services is 41.5 days. Oftentimes a person continues to need supervision or care after Medicare quits paying but the payment for that will have to come from someone other than Medicare.
The number of home care patients as a percent of all individuals in that age group goes up drastically with age. Even though the age group of 85 and above represents only 4% of all the aged population it accounts for about 28% of all patients. The bulk of the aged population is between the ages of 65 to 75 but only accounts for about 27% of all home care patients. Total patients for the aged over age 75 account for the other 73%.
A common statement from individuals who are confronted with the need for long-term care planning is,
"I'm in good health, I'm going to live a long time and I won't need long-term care."
The statistics show otherwise. In fact it is estimated that about half of the population over age 85 is receiving long-term care.
Since about 90% of all home health agency care is paid for by Medicare or Medicaid, the cost of care is not necessarily relevant for this study. But some families do pay for this service out of their own pockets. Costs will vary from area to area. A nurse, therapist or social worker may cost $70.00 to $100.00 an hour. An aide to take care of daily living needs, so called activities of daily living, may cost $10.00 to $25.00 an hour.
Medicare and Medicaid pay 90% of the cost of home health agencies services. The other 10% is shared by families, and private insurance. As more people buy long-term care insurance, they will also be more prone to utilize the services of home health agencies. However, this is only after Medicare has paid its portion. This is because all long-term care insurance policies will only pay after Medicare has paid its obligation.
A new trend for home health care is for agencies to furnish care through a cadre of non skilled employees for families who do not qualify for Medicare or Medicaid homecare but still need help with loved ones at home. The future trend will be for more and more of the cost of home care services to be paid by the family or by insurance if it is available.