Aging in the Livermore Valley

Planning AheadJessica Reay, Certified Senior Advisor

1/22/2013

Where do I start?

Step One: Choose where you want to live

What are my housing options?

Option 1- Stay at HomeHire a caregiver that can come work in your home and take care of daily activities such as:

• Meal Preparation• Transportation• Light Housekeeping• Medication Reminders• Personal Care• Toileting Assistance• Respite (family / friend caregiver relief)• CompanionshipEstimated monthly cost: $1296 (12 hrs/week)-$8000 (full-time)

Housing options, cont.

Option 2- Move to senior community1. Senior Apartments- Apartment style living. Community

activities. Housekeeping at an additional cost. No hands-on care or meals provided. Ages 62+. Example: Heritage EstatesEstimated monthly cost: $1300-$2800

2. Independent Living- Apartment style living. Community activites. Shuttle transportation. Meals, housekeeping, and activities included in cost. Example: Heritage Estates

Estimate monthly cost: $3500-$5000

Housing options, cont.

3. Assisted Living- Apartment style living. Shuttle transportation. Meals and housekeeping included in cost. Hands on care and medication management available for an extra charge. Example: Heritage Estates, Rosewood GardensEstimated monthly cost: $3500-$5500

4. Memory Care- Apartment style living. Meals, housekeeping, hands on care, medication management and resident supervision included in cost. For memory impaired individuals with some kind of dementia or Alzheimer’s.Example: Rosewood Gardens

Estimated monthly cost: $5,500 and up

Housing options, cont.5. Board and Care- Residential home that can house anywhere from 4-12 residents depending on size. Meals, housekeeping,

personal care, medication management included in cost. Smaller facility, more “home-y”, less expensive. Residents in this type of community usually need a considerable amount of care.

Estimated monthly cost: $2500-$40006. Skilled nursing facility- Nursing home setting, high level of care.

Nursing assistants, registered nurses, and doctor oversee care in a medical setting. Meals, housekeeping, hands on care, medication management and administration, personal care included in cost. Can handle complex medical issues such as tube feeding, insulin injections, etc.

Estimated monthly cost: $8400 (at approx $280 per day)

Housing options, cont.

7. CCRC “Continuing Care Retirement Community”- A CCRC has different levels of facilities within 1 large community. For example, it would have senior apartments, independent living, assisted living, memory care, and skilled nursing. Main benefit of living in a community like this is the ability to transfer to a different level if needed without entirely leaving the community. Stoneridge Creek will be the only CCRC in this area when it is completed in fall 2013.

Do your homework!Thoroughly research whatever home care agency or facility you are

considering as your provider. Each company runs differently. Try to get references.

Home care agencies:- Not regulated in the state of California; only a regular business license is necessary- No set standards, unless member of National Private Duty Association- Make sure the caregivers are:

- Direct employees and not independent contractors- Bonded and insured- Covered under worker’s comp insurance- Fully background and reference checked- Trained and supervised- Payroll: who is responsible?

Put it in writingStep Two- Getting your paperwork

in orderMeet with an attorney who specializes in estate planning. They

can help you with:- Will writing- Living Trusts (very popular these days, as there is no probate)- Financial power of attorney: who will manage your money in

the event you are unable?- Advance Health Care Directives: Designate a person to make

medical decisions on your behalf if you are unable

How will I pay for all of this?

Step Three- Financial Planning- Medicare/Medi-Cal will not cover

- Meet with a financial planner who can help make your investments last

- Invest in Long Term Care Insurance

- VA Benefits: Are you a veteran?

LONG TERM CARE INSURANCELong-term care goes beyond medical care and nursing care to include all the assistance you could need if you ever have a chronic illness or disability that leaves you unable to care for yourself for an extended period of time. You can receive long-term care in a nursing home, assisted living facility, or in your own home, depending on your policy. Though older people use the most long-term care services, a young or middle-aged person who has been in an accident or suffered a debilitating illness might also need long-term care.

Long term policies usually have an “elimination” period where the client needs to pay out of pocket for a certain amount of days before the policy takes effect. Each policy is different, so it is very important to look over each patient’s policy to see how much money is available towards their care. It is necessary to make sure the claim is approved through the LTC insurance company by going through a patient qualification process. LTC companies are selective with what types of home care agencies they will approve as a qualified provider, most will only use “full-service agencies”.

LONG TERM CARE INSURANCE

When should a person sign up for long term care insurance? The best time to sign up for a long term care policy is in your

mid-fifties, before any serious medical conditions arise. This way you can guarantee acceptance, and get a lower price rate.

Some companies who provide long-term care insurance are

Genworth, MetLife, New York Life, CalPers, Bankers Life & Casualty, and John Hancock.

VA BENEFITSThe VA Aid & Attendance & Housebound Pension is designed to provide qualified veterans and their un-remarried surviving spouses with financial benefits outside of the traditional VA residential system. This pension benefit, which was established in 1952 under title 38USC, provides a direct, tax free monthly pension to help defray the cost of long-term care.

2009 Maximum Monthly Benefit Amounts Aid and Attendance Housebound Two Veterans / Spouses $2,582* Two Veterans / Spouses $2,582* Married Veteran $1,949 Married Veteran $1,510 Single Veteran $1,644 Single Veteran $1,204 Surviving Spouse $1,056 Surviving Spouse $808 * May be higher depending on ratingEligibility Requirements:

• Must be 65 years old and/or unemployable.• Must have an Honorable or General discharge (any other than Dishonorable discharge).• Must have served at least 90 days of active Federal duty with at least one day during an official period of conflict.• Must have a medical necessity requiring care• Must meet income and countable asset criteria established by the VA*

The approval process of VA benefits can be lengthy so there are companies available to help with the approval that my speed up the process.

VA Benefit Resources

• There are companies that can help navigate system and get claim together for individuals

• Average approval process for VA Benefits under this program is around 9 months.

• It is illegal to charge Veterans to help with this paperwork

Available Health Programs

Home Health Care: - Intermittent skilled care that

could consist of nursing, physical therapy, occupational therapy, speech therapy, social work, home health aid

- Ordered by your physician- Covered by Medicare, Kaiser or

other insurance- Home health can be provided in

a private residence or any kind of living facility except for skilled nursing

Available Health Programs, cont.

Hospice:- Nursing support for a patient that is terminally ill, or is

projected to live 6 months or less- Patient can come off of hospice at any time if there is

improvement- Equipment and medications are covered- Additional support of chaplains, social workers, volunteers

and home health aids for bath visits- Providing this kind of “comfort care” manages your loved ones

pain level and keeps them comfortable

Thank you!

Please contact me if you have any questions. I would love to help!

Jessica Reay(925) 200-9333