Aging Resources Magazine

2018–2019 EDITION

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AG I N G R E S O U R C E S W N C . C O M

AGING RESOURCES MAGAZINE

Look Inside For • • • • • • •

Senior Housing Guide Home Care & Home Health Aging in Place Medicare Help Caregiver Support Elder Law & Estate Planning Resource Directory and More

Here for you so you can be here for them.

Keeping you and your loved ones on the path to wellness.

Be Well. Get Well. Stay Well. mission-health.org

AGING RESOURCES 2018-2019 EDITION VOLUME 5

SERVING ASHEVILLE, HENDERSONVILLE AND SURROUNDING AREA

FEATURES AND RESOURCES 4 LIVING WELL WHILE LIVING LONGER 6 MODIFY YOUR HOME TO MAINTAIN INDEPENDENCE 8 LIFELONG LEARNING ENRICHES MIND, BODY AND SOUL 10 PETS AS COMPANIONS 12 PLANNING AHEAD FOR PEACE OF MIND 13 ELDER LAW WITH COMPREHENSIVE SUPPORT 16 END-OF-LIFE PLANNING BENEFITS EVERYONE 20 UNDERSTANDING MEDICARE 23 MEDICARE HELP 24 TAKE PRECAUTIONS TO PREVENT BEING SCAMMED 26 FIGURING OUT WHEN HELP IS NEEDED 30 TRANSITIONING FROM DRIVING 32 CARING FOR YOURSELF WHEN YOU’RE A CAREGIVER 34 COMMUNITY RESOURCES PROVIDE ANSWERS AND HELP 36 GERIATRIC CARE MANAGERS 38 EXPLORING HOME CARE AND HOME HEALTH CARE AgingResourcesWNC.com

40 HOME CARE, HOME HEALTH AND HOSPICE PROVIDERS 42 UNDERSTANDING DIFFERENT TYPES OF SENIOR HOUSING 50 SENIOR HOUSING OPTIONS 52 CONSIDERATIONS WHEN CHOOSING SENIOR HOUSING 58 PREPARING FOR YOUR NEXT MOVE 62 MAXIMIZING MEDICAL CARE AT YOUR DOCTOR’S OFFICE 64 REDUCE THE RISK OF FALLS AND THEIR CONSEQUENCES 66 EMBRACING TECHNOLOGY HELPS YOU STAY INDEPENDENT 67 TRUST YOUR EYES TO THE EXPERTS 68 HEARING WELL MEANS STAYING WELL 70 LIVING WITH DEMENTIA 73 ALZHEIMER’S AND DEMENTIA CARE AT HOME 74 ENHANCING LIFE WITH PALLIATIVE AND HOSPICE CARE 77 AGING RESOURCES DIRECTORY Helpful Resources Advertiser Expert Information

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President & Publisher Brett Hulsey

ON THE COVER Raymond Suit and daughter, Terri Eisenhauer

Operations Manager Cassie Broshears Advertising Photography Paul Jackson Robin Reed Aging Resources is published annually by Hulsey Media, Inc. 323 N. Main Street, Suite 1 Hendersonville, NC 28792

AG I N G R E S O U R C E S W N C . C O M

Marketing Communications Manager Jocelyn Hunsader

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Design/Production Barbara Bricker

2018–2019 EDITION

Advertising Brett Hulsey Katie Cornwell

AGING RESOURCES MAGAZINE

Executive Editor Kathleen O’Nan

Look Inside For • • • • • • •

Senior Housing Guide Home Care & Home Health Aging in Place Medicare Help Caregiver Support Elder Law & Estate Planning Resource Directory and More

Representing two generations of their family, local Realtor Terri Eisenhauer stands with her father, Raymond Suit. Now in his late80s, Raymond enjoys spending time in Western North Carolina and Florida after a career that included working as a chain account manager for PYA food service and playing professional baseball. Until he had to retire from baseball due to a shoulder injury, Raymond was a pitcher for the Boston Braves which became the Milwaukee Braves, the precursor to the Atlanta Braves.

FIND MORE RESOURCES ONLINE Visit AgingResourcesWNC.com to view a digital version of Aging Resources Magazine with direct links to all provider websites for easy access to more information. You’ll also find a searchable resource directory and helpful articles.

Copyright 2018 Hulsey Media, Inc.

Contents of this magazine may not be reproduced in any manner without written consent from publisher.

We would like to thank the fine businesses and organizations who have purchased advertising in our magazine, thereby helping us to bring you an attractive and informative publication.

If you have a business or provide a service that would benefit from exposure in Aging Resources, call to reserve a space in the next edition.

828-513-3888

info@hulseymedia.com AgingResourcesWNC.com

Connect with us on Facebook at facebook. com/agingresourcesmagazine to get the latest from Aging Resources. Find links to helpful tips and articles and keep up with events for seniors throughout Western North Carolina.

Aging Resources, a division of Hulsey Media, Inc. is published annually every September.

Other publications include: • Healthcare Resources • Hendersonville Magazine • The Real Estate Book of Asheville/Hendersonville & NC Blue Ridge • WNC Homeowners Guide

WWW.HULSEYMEDIA.COM

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• Asheville.Apartments Aging Resources 2017–2018

My

hospital for exceptional senior healthcare.

A senior-focused network of healthcare services to help keep you healthy, active and loving life.

EMERGENCY SERVICES

PRIMARY CARE PROVIDERS

WORLD-CLASS ORTHOPEDICS AND REHAB

COMPREHENSIVE SENIOR HEALTH SERVICES

Our highly skilled emergency team is ready 24/7 with advanced life-saving techniques and technologies. Our Emergency Department is affiliated with the area’s top trauma centers for priority patient transport if needed via helicopter or ambulance.

Rosenberg Bone and Joint offers advanced orthopedic procedures for hip and knee replacement. Our state-of-the-art therapeutic gym and rehabilitation services offer one-on-one treatment with a licensed professional for optimal recovery from surgery, injury, stroke or other physical challenge.

BEHAVIORAL HEALTH FOR SENIORS

To manage emotional and psychological challenges related to aging, St. Luke’s intensive outpatient counseling service, Senior Life Solutions, offers a customized team approach focused on coping strategies, increasing general health, and restoring functionality. For those with more substantial inpatient needs, the Center for Behavioral Medicine provides compassionate, geriatric psychiatric services in a safe, home-like environment.

At Foothills Medical Associates and Saluda Family Medicine, you will find skilled and dedicated primary care professionals who offer personalized attention and the latest techniques for prevention, diagnosis and treatment for a faster recovery.

Ophthalmology surgery, laser procedures, speech therapy, swallow studies, respiratory therapy, diabetes education, lymphedema therapy, balance risk assessment, digital mammography, bone density, radiology, lab services and general surgery are additional services offered at St. Luke’s Hospital to help you stay healthy and active.

For more information, contact:

828.894.0972

SaintLukesHospital.com 101 Hospital Drive Columbus, NC 28722

ST. LUKE’S HOSPITAL PAIN CENTER

Our team of pain management specialists from Southeast Pain and Spine Care offer the most advanced treatment options available today. We practice ethical pain management with one simple goal: to restore your quality of life. The conditions we treat include sciatica, nerve pain, neck and back pain, post-surgical pain, shingles and arthritis.

ST. LUKE’S HOSPITAL INFUSION CENTER

We offer chemotherapy and other infusion services in partnership with the renowned Levine Cancer Institute (LCI). The center provides the community with patient-centered chemotherapy and intravenous therapy (IV) in a convenient, caring atmosphere focused on the latest chemotherapy breakthroughs. Other services include IV antibiotics, blood transfusions, IV hydration, IV infusions for rheumatoid arthritis, injections, and physician consults and treatment for oncology and hematology diagnoses. www.AgingResourcesWNC.com

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Living Well While Living Longer PROACTIVE STRATEGIES CAN HELP WITH HEALTHY AGING IN THE PRIME TIME OF LIFE With people living longer – and healthier – than ever before, our latter years afford us the opportunity for more fulfillment and fun.

To focus on healthy aging, consider these lifeenhancing strategies: Engage your mind and spirit: Stay sharp and mentally enriched by reading and writing, doing puzzles and playing games, taking classes at a community college or online, engaging in arts and crafts, playing and listening to music, and traveling — even if just taking short day trips. Seeing and experiencing new things can make you feel youthful.

Immersing yourself in a hobby and engaging in lifelong learning not only can help you stay young at heart, but remain mentally and physically healthy too.

Focus on good nutrition: Make sure your diet includes lots of fresh, nutritionally rich foods and go easy on junk food and fast food. With the advice of your healthcare provider, take supplements to ensure you’re getting enough vitamins and minerals in your diet. Avoid dehydration by drinking plenty of water and other healthy drinks.

Keep moving: In the spirit of the old

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adage “move it or lose it,” staying physically active can do wonders for your overall health.

In addition to building strong bones and muscles to help prevent falls, exercise helps your cardiovascular health and staves off depression. Find types of physical activity that keep you interested and motivate you to make movement, stretching and strengthening a daily habit. Consider joining a health club or find a buddy to enjoy walks or other exercise with indoors and outside in the fresh air.

Pay attention to your health: Key to keeping illness and physical problems at bay is having regular screenings and check-ups from healthcare providers. If and when a physical or mental health change occurs, don’t assume it’s “just part of aging” – go get checked out.

Symptoms can be signs of treatable illnesses especially when addressed early. Changes with vision and hearing are a common part of growing older but can often be helped easily with the right prescription of glasses or the appropriate hearing aid. Because vision and hearing problems can be signs of other health issues and can also affect your balance, make these check-ups a priority. Dental care becomes

Aging Resources 2018–2019

more important especially as we age because it can impact our eating and can also affect our heart health. So, take good care of your teeth and see your dentist regularly.

Stay socially connected: Make a concerted effort to keep up with friends and loved ones through regular phone calls, emails, social media platforms like Facebook and inperson visits inside and outside your home.

Join recreational clubs where you can make new acquaintances as well as get involved with new activities and interests.

Volunteer your time – by doing so, you’ll not only experience the joy of giving back and having a purpose but you’ll also get to interact with others. Resources for finding volunteer opportunities include: • United Way of Asheville and Buncombe County’s HandsOnAsheville.org; • United Way of Henderson County’s VolunteerHendo.org; • United Way of Transylvania County’s VolunteerTransylvania.org; and • VolunteerMatch.org, which connects

people to volunteer opportunities both locally and across the nation.

Combine healthy activities for even more impact: Simultaneously participating in healthy practices gives you even more benefit than just doing them individually. For example, playing an intellectually challenging game with a friend is better than simply doing so alone because you get the perks that come from socializing in addition to flexing your brain muscles. By combining a mentally challenging game with others with physical exercise, too, you reap a positive powerhouse of benefits for your mind, body and spirit. n

Trying to juggle it all?

Let Compassionate Home Care provide respite for you and care you can trust for your loved ones.

Call to learn more.

(828) 696.0946 CompassionateHC.com

AgingResourcesWNC.com

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Modify Your Home To Maintain Independence HOW UNIVERSAL DESIGN CAN HELP YOU ADAPT TO CHANGES THAT COME WITH AGING As we grow older and our physical abilities change, our living spaces sometimes need modifications to help us function, prevent falls and stay independent so we can “age in place” in our homes.

Through a design approach called Universal Design, or UD, we can make our homes more accessible, operational and safe.

UD often involves simple, small changes that can make huge differences. For example, retrofitting a home using UD can be as easy as changing lighting to reduce glare, installing wall-to-wall carpet, putting up two handrails on staircases or making thresholds smooth. Such changes actually benefit everyone, make living easier and more secure for people of all ages and abilities, from toddlers to seniors.

Universal Design sometimes can call for more involved remodeling, like making a barrier-free bathroom with a walk-in tub or roll-in shower.

Creating a more accessible kitchen may include appliances at lower heights and cabinets with roll-out shelves and handles rather than knobs.

These UD elements are a bigger investment but are still less expensive and less disruptive than having to move from home to an assisted living or care facility. Retrofitting a home using UD also 6

can be done gradually as your budget allows and on an “as needed” basis.

If you are building a home, you are in a great position to incorporate UD options into your new space such as wider hallways for wheelchairs or walkers, lower light switches, higher electrical outlets and blocks behind walls to accommodate grab bars if they are needed later. The cost of incorporating UD into the design of a new home is minimal, while having UD throughout the house can add great value for resale.

Interior designers and homebuilders who are Certified Aging in Place (CAP) Specialists can help you decide which Universal Design elements to bring into your current home or to add to your new home’s blueprints. To find such a specialist near you, visit the National Association of Home Builders at nahb.org. On the homepage, click “Education,” then click on “Designations.” There you will find the “Certified Aging in Place (CAP) Specialist” section which contains the “Caps Directory Listing” where you can search for a specialist.

Find out more tips for staying in your home and staying independent by visiting the National Aging In Place Council at ageinplace.org. n

Aging Resources 2018–2019

Universal Design options that can make life easier • Lights that turn on when you approach your home • No-glare lights for general lighting, task lighting • Rails on both sides of stairs • Raised electric outlets • Lowered rocker light switches • Programmable thermostats • Drawers instead of cabinets in kitchen • D-shaped cabinet and drawer pulls • Wall-to-wall carpet • Wires neatly managed, off floors • Grab bars by toilets and in showers • Elevated toilets • Roll-in showers • Hand-held shower heads on glides • Non-slip, low-maintenance floors in bathrooms

• Kitchen, bedroom, bathroom and laundry on one floor • Side-by-side refrigerator/freezer • Raised or lowered dishwasher • Counter-height microwave • Flat cooktop with front controls • Stoves and sinks with open space underneath for someone seated • Separate, comfort-height wall oven • Varied counter heights so cooks can sit or stand • Beveled corners on counters, furniture and walls • Raised, front-load, front-control washer and dryer • 36-inch-wide doorways and hallways to accommodate wheelchairs

Mom’s yard is an acre of grandkids playing, a patio with decades of celebrations, and a garden overflowing with memories.

We give people the help they need to live in the place they love. ™

If you need in-home, non-medical assistance, we can help. A compassionate caregiver can lend a hand with everyday chores like cooking, cleaning, and running errands so people can stay home and stay independent.

828.348.0988 | GriswoldHomeCare.com © 2016 Griswold International, LLC

AgingResourcesWNC.com

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Lifelong Learning Enriches Mind, Body and Soul LOCAL ENTITIES OFFER VARIETY OF PROGRAMMING

As people now are living longer, growing older means we often can continue to thrive and enjoy life for many more decades than previous generations experienced.

In the United States, the average life expectancy is nearly 79 years – about 76 years for a man and about 81 years for a woman.

More people are living to be 85 years old and older and the number of Americans living to be 100 or older continues to climb.

With more good years – and even decades – ahead, we have the opportunity to continue to learn new things, stay physically active and be socially engaged. And such life enrichment helps us remain healthy and productive in our elder years.

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Lifelong learning and life enrichment feeds and nurtures our physical, intellectual, social and spiritual wellness. Here in Western North Carolina, several institutions offer high-quality, life-enhancing programs for older adults. By their very nature, all of these programs offer opportunities for socialization, volunteering, community building, life planning and networking. They can broaden your world, open your mind to new possibilities for your life and ensure your upcoming years are rich and meaningful.

BLUE RIDGE CENTER FOR LIFELONG LEARNING (BRCLL)

Located on Blue Ridge Community College’s Flat Rock campus, BRCLL offers a full slate of enrichment and educational programming.

Participants can select from courses on a wide variety of topics including U.S, international and Appalachian history, current affairs, technology, literature and more. The program also hosts occasional brown bag lunches on various topics and has launched a new series called “For Your Health” which brings in various medical professionals to discuss topics Aging Resources 2018–2019

related to healthy aging. BRCLL’s EdVentures (Educational Adventures) program sponsors motor coach trips to local and regional places of interest and selfdrive trips to tour local industries.

For BRCLL’s schedule of classes and events, visit brcll.com or call 828694-1740.

LIFE@WESTERN CAROLINA, BILTMORE PARK CAMPUS

A program of Western Carolina University (WCU), LIFE offers noncredit classes for adults 50 years old and older. Courses range in topics from history and culture to health and science to geopolitical and legal issues. Current and retired WCU faculty teach classes. Both WCU’s

Cullowhee and Biltmore Park (Asheville) campuses offer LIFE courses. Visit life.wcu. edu or call 828-227-7397 for more information and class schedules.

OSHER LIFELONG LEARNING CENTER AT UNC-ASHEVILLE (OLLI)

A nationally acclaimed learning community for older adults, OLLI offers opportunities for lifelong learning, leadership, community service and continued growth in a variety of settings.

Founded in 1988 as the North Carolina Center for Creative Retirement, OLLI’s programming includes intellectual and cultural pursuits as well as social, physical and practical life courses such as life transition and retirement relocation planning, including its Creative Retirement Exploration Weekend (CREW). OLLI’s College for Seniors (CFS) program gives participants full access to the resources of University of North Carolina-Asheville. To find out more and get involved, visit olliasheville.com or call 828-251-6140. n

Supporting Hospice Helps Patients, Families, Veterans, Children and more...

DIGNITY HONOR COMFORT Please Give Generously.

www.FourSeasonsFdn.org

AgingResourcesWNC.com

Four Seasons Foundation 221 N. Main Street Hendersonville, NC 28792 828.513.2440

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Pets as Companions

WHAT TO CONSIDER AS AN OLDER ADULT WHEN IT COMES TO ANIMAL CARE Adding a pet to your household can be a wonderful way to combat the loneliness and isolation that sometimes comes with aging.

Pets can fill voids in our lives, giving us joy, companionship and purpose. And while there are many benefits to having a pet, adopting an animal is an important decision with different factors to consider at any age but especially as you get older.

How Pets Are Good For Your Health

As we age, our level of interaction with friends and families can dwindle with the relocation or death of loved ones. Bringing a pet into your life can help counter the sadness, anxiety and depression that can come with being alone. Studies have shown that having a pet can help reduce your blood pressure and ease stress.

Pets also help fulfill the basic human need for touch and give people happiness 10

through their playfulness and mere presence.

Having an animal gives you a purpose in life beyond just yourself and can help you get your mind off your own issues. The care of a pet that comes, for instance, with taking a dog for a walk or playing with a cat, also can help you stay more physically active. Pet owners – particularly those with dogs they take on walks – often have more social interaction with others, another part of animal companionship that helps counter loneliness.

Considerations for Older Pet Parents

Many pets – particularly dogs and cats – have average lifespans of a decade or more.

Adopting pets is for life – both theirs and yours. As you yourself age, it’s important to think about the impact that potential changes in your health situation and living arrangement may have on an animal companion. If you are adopting as an older adult, make a plan for who will take your animal friend should you no longer be able to give your pet the care he or she needs.

Prior to adoption, assess whether or not you are currently able to take care of a pet’s needs, such as its feeding, grooming, litter box Aging Resources 2018–2019

care and other clean-up, daily walks and visits to the veterinarian. Consider enlisting the help of a friend, loved one or someone you can hire to help at times with the care of your animal. Think, too, about the financial cost of having a pet. As pets themselves become elderly, there is the potential that they will have increased healthcare needs which may come with higher costs.

When choosing a pet, give consideration to the size and age of the animal. For example, a large, high-energy puppy has the potential to tug hard on a leash and possibly pull you down. A small kitten can easily get underfoot and potentially cause you to trip. Younger animals are typically more energetic and require more training and attention. Consider adopting an older, senior pet who may have a calmer demeanor and be more settled into a routine. And while dogs and cats are popular pets, consider other animals such as birds, fish, rabbits and reptiles which can offer companionship too.

Keep in mind that just because friends and family members may think you need a pet in your life, the decision – and responsibilities that come with having a pet – are yours alone.

Prior to considering animal adoption, take time to carefully evaluate if having an animal to care for fits with your lifestyle, your physical abilities and your living arrangement.

...a way to give and to receive

No Minimum Visit Times (828) 236-0662 www.SeniorCareAsheville.com

Regional Options for Pet Adoption

Throughout Western North Carolina, there are many animal shelters and rescue and advocacy groups that provide education and information about animals, help with spay/ neuter services and vaccinations, offer training and have a large number of adoptable animals.

Local resources include: • Asheville Humane Society at ashevillehumane.org or 828-761-2001.

• Blue Ridge Humane Society at blueridgehumane.org or 828-­685-­7107.

• Foothills Humane Society at foothillshumanesociety.org or 828-863-4444.

• Transylvania Animal Alliance Group at taagwags.org or 828-966-3166. n

AgingResourcesWNC.com

LIFE’S MORE FUN

AFTER 50

The Y is a great place for active older adults, with water fitness classes, unlimited group exercise, and programs for falls prevention and cancer survivorship, all to help you maintain a healthy lifestyle.

We are a contracted Medicare Advantage fitness provider with a variety of plans.

Ask your broker for details. » ymcawnc.org « YMCA OF WESTERN NORTH CAROLINA

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Planning Ahead for Peace of Mind CREATE LEGAL ADVANCE DIRECTIVES TO HELP CARRY OUT YOUR MEDICAL AND FINANCIAL WISHES Peace of mind comes with making a plan, especially when it comes to expressing your wishes for your medical care, your finances and your desires about the end of your life and after you die.

Legal advance directives are documents that give others the authority and directions to carry out your wishes when you are unable to or when it’s more convenient for someone you trust to do so for you. Fortunately, advance directives are easy to create and legally file.

Four Essential Documents

Advance directives are legal tools that ensure a person’s wishes concerning their healthcare and finances are carried out should they become unable to express them. Everyone should have these documents on file no matter what their age. If you are helping your loved one create their advance directives, consider using this as an opportunity to write down your own desires and file your own advance directives. Documents you and your loved one should have include: • A Living Will; • A Healthcare Power of Attorney; • A Will; and • A Durable Power of Attorney.

Living Wills address end-of-life issues, such as requesting or withholding medical treatments.

A Healthcare Power of Attorney is broader and allows the person you appoint, who is also known

as a proxy, to make medical decisions on your behalf if you are unable. For instance, if you are in a stable coma, your healthcare proxy could make decisions about your everyday care. Both the Living Will and the Healthcare Power of attorney are activated only when a physician declares the patient unable to give consent.

A Will deals with the division of property and assets after death.

The Durable Power of Attorney allows for the appointment of someone you choose to manage financial affairs should you become incapacitated.

You decide on the scope of the Durable Power of Attorney and under what conditions it is activated. Durable Power of Attorney ends at death. The executor of a Will, who can be the same person who has Durable Power of Attorney, then takes charge of the estate and financial affairs.

Consider Professional Help

You don’t have to use an attorney to create advance directives but you may feel more confident doing so.

North Carolina Living Will and Healthcare Power of Attorney instructions and forms are available at sosnc.gov/ahcdr/. This site also is home to the North Carolina Advance Health Care Directive Registry where you can file up to four different advance directive documents for easy access. In addition, most area hospitals and hospice Continued on page 14

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Aging Resources 2018–2019

Knox lder Law nox Law aw’ss Innovative nnovatIve A approach Tto eELder Includes OfferIng ffering c CLIents lients c ComprehensIve omprehensive s Support sServIces ervices ncLudes o or Board Certified Elder Law Attorney Caroline Knox and her team at Knox Law in Hendersonville, the practice of elder law involves a holistic approach that often encompasses assisting clients with much more than just finalizing legal documents.

Knox Law is unique in Western North Carolina and throughout the state for having a multifaceted approach to helping elder clients and their families with legal advice as well as a variety of support services.

Caroline Knox is one of only two attorneys in the region – and one of only 16 in the state – who has received the Board Certified Elder Law designation by The National Elder Law Foundation.

With more than 18 years of experience practicing law, she specializes in counseling clients about such legal matters as long-term care planning, asset preservation, Medicaid, estate planning, estate and trust administration, special needs trusts and guardianships.

MORE THAN JUST LEGAL HELP When she founded Knox Law in early 2018, Caroline set out to help clients with not only their legal matters, but also with issues relating to their well-being and daily lives.

Based on her past work with older clients, she saw a great need for a comprehensive approach to assisting aging adults, especially those with no family members nearby.

With a team that includes a social worker, geriatric case manager nurse and an account specialist, Knox Law offers support services ancillary to legal services.

Services include in-home care referrals and staffing, placement at care facilities, account management, insurance filing, bill paying and geriatric case management.

SUPPORTIVE SERVICES BUILT ON RELATIONSHIPS At the request of clients or of the court, Caroline serves as guardian or power of attorney. In this capacity, Knox Law provides a range of services that can include: arranging medical appointments, managing health care and household services, paying bills, setting up an emergency contact network, making funeral arrangements and organizing an estate sale.

AgingResourcesWNC.com

Caroline Knox is a North Carolina attorney who has earned the designation of Board Certified Elder Law Attorney (CELA) by The National Elder Law Foundation.

She was recently named the Best Lawyers® 2019 Elder Law “Lawyer of the Year” in Asheville.

“We’ve built a strong relationship with all kinds of people who work with older folks and through these connections we’re able to provide a number of services to our clients,” she said. “Everyone here at Knox Law cares, and there’s a feeling of family that carries into the work we do for our clients.”

Knox Law 16 Towne Place Drive, Suite 100 in Hendersonville (828) 513-1600 cknoxelderlaw.com Knox Law also serves clients in Asheville and Waynesville by appointment only at the Haywood County Senior Resource Center at 81 Elmwood Way in Waynesville and at the Regus Office Biltmore Park, Building 2B, 28 Schenck Parkway, Suite 200 in Asheville.

Caroline also makes house calls.

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organizations have forms and are glad to assist you with completing them. Be aware, though, that these directives must be properly executed and witnessed to be valid.

Will and Durable Power of Attorney forms can be downloaded online as well. However, unless your life is very simple, think twice about executing these documents without the assistance of a lawyer. An attorney can be especially helpful if you have had multiple marriages or have stepchildren, grandchildren, a large estate, a business or other complex life situations. With all advance directives, there is a lot to consider that is unique to you or your loved one. A lot is riding on the paperwork being properly done.

While you can “do it yourself,” talking with a professional is prudent.

What Your Directives Should Say The wishes expressed in advance directives are up to the person drafting the document.

The downloadable forms contain good prompts to ensure you ask and answer important questions and cover many bases.

However, these documents cannot address every situation so in addition to getting your wishes down on paper, make sure that all involved understand the underlying spirit of those wishes as well.

A family meeting is a great way to accomplish this. Frank discussions face-to-face with all concerned parties allow people to ask questions, sort

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out possible misunderstandings and come to terms with what their loved one wants. Such a meeting—strengthened by legal documents that reflect the content of the meeting—provides the proxy and other family members with direction and peace of mind when tough decisions may need to be made.

Who Should Have the Power?

The toughest decision for many when putting these documents together is deciding who should receive their Healthcare and Durable Powers of Attorney. Obviously, the proxy needs to be someone who knows the person and sees his or her life in context. The proxy should understand the responsibilities and agree to the job.

Although a spouse or partner may seem like a natural choice, he or she might not be the best proxy. Typically, spouses and partners are about the same age so issues of aging can present problems.

Appointing all children equally is another popular option. However, before making such a decree, consider, based on past experience, if this sibling group can reach consensus on sometimes complicated and tension-filled decisions. On the other hand, realize that appointing one child as the sole proxy can lead to its own set of problems.

If the family dynamic won’t fare well with a group or individual being appointed, consider asking a close family friend or choosing a professional to do the job.

Whomever you select, think about that person’s natural strengths and weaknesses. One child or close friend might be great for financial matters while another might be better with healthcare issues.

Keep Directives Up-to-Date

Situations change over time so you should update all of your directives every five years or more frequently as needed to be sure they still reflect the your circumstances and desires.

Once completed, keep a file at home with several copies of all advance directives. Scan these documents into your computer for quick reference and so you can send them electronically to any appropriate entity that needs them. Keep an electronic set on your phone, too, and register your advance directives with North Carolina at sosnc.gov/ahcdr/. n

Aging Resources 2018–2019

End-of-Life Planning Benefits Everyone OUTLINING YOUR FINAL WISHES HELPS BOTH YOU AND YOUR LOVED ONES Most people avoid talking about death and dying and don’t want to think about a time when they’ll be gone. But being clear about your final wishes and making plans for what happens after you pass away can give you and your loved ones great peace of mind.

A good time to think about, write down and share what you would like to have happen upon your death is when you are crafting your advance directives. Aging Resources has more information about creating your Living Will, Healthcare Power of Attorney, Will and Durable Power of Attorney on pages 12-14.

Talking with friends and family members about your final wishes will give you – and those who care about you – confidence that when you die, your wishes will be carried out.

Here are some questions to ask yourself as you start thinking about your end-of-life planning:

Healthcare At the End of Your Life

• If you are diagnosed with a terminal illness, what kind of medical care do you want? Do you want hospice or palliative care providers?

If so, what are your goals for such care?

• Is there a particular family member or friend you would like involved with your care at the end of your life?

• If you are able to choose where you will pass away, do you want to die at home or in a healthcare facility? Are there certain people 16

you would like to visit you before you die?

Who would you like to be present with you when you pass away?

Personal Business

• Even if you have a Will outlining who will inherit your possessions, are there certain items such as photographs, family mementos and other keepsakes that you want particular people to have?

• If you have pets, who do you want to take care of them after you die?

• How do you want your email, social media and other digital accounts handled after you die? Who do you want to take care of these matters?

• Are there certain memories, stories and photos of your life and of your family history that you want to make record of and preserve prior to your death?

Philanthropy and Financial Donations

• In addition to your family, is there a particular charity that you desire to donate to? Have you contacted a legal or financial advisor to inquire the best method of planning for your donation? Does your family know of your desired donation? Are you aware of the tax regulations which will be applied to your donation? In addition to listing it in your will, there are many different ways to prepare a philanthropic donation. For example, Continued on page 18

Aging Resources 2018–2019

peace of mind for

your future.

People are living longer than any time in human history. With longevity come concerns about independent living, decision making, incapacity, quality of life, long term care, and asset preservation. Van Winkle’s Elder and Special Needs Law attorneys are equipped to address these concerns in all aspects of planning, counseling, educating, and advocating for our clients.

ELDER & SPECIAL N EED S L AW

Heather Whitaker Goldstein

Pr actice Areas

• long term care and special needs planning • incapacity and estate planning • trust and estate administration • incompetency and guardianships • trust and estate disputes and controversies

Brian T. Lawler

v w l a w f i r m . c o m 8 2 8 - 2 5 8 - 2 9 9 1 asheville

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hendersonville

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charlotte

taking out a life insurance policy with the charity as the beneficiary, setting up a private foundation, or beginning to give annually right now might be effective ways for you to plan for your donation.

• After you pass, is there an organization you would like to direct friends and family to donate to in lieu of sending flowers? If you have experienced a battle with a specific sickness or disease, would you like to request donations be sent to an association or foundation aiding in relevant research?

Or perhaps if a long-term health issue has caused a financial burden on your family, would you like to set up a trust to help your family members in the time following your death?

Funeral and Memorial Planning

• What do you want done with your body after you die? What are your preferences with regards to cremation, burial, organ donation and donation to science? If you are buried, do you want a grave marker? If you are cremated, do you have a particular place where you’d like your ashes spread?

• Do you want a funeral, memorial service,

visitation or celebration of life? If so, where would you prefer these be held? Are there particular readings and music you would like to be shared? Is there a certain person you would like to deliver a eulogy? Are there any religious, military or other special considerations you want taken into account?

If you have casket, do you want it open?

• Do you want an obituary and if so, what do you want it to say? Is there a particular photograph you would like used with it?

These questions can serve as a starting point for making your end-of-life plans and having conversations about your final wishes with the people who care about you. Online tools for making your plan include helpful resources, guides and checklists and can be found at everplans.com.

Through end-of-life planning, you gain peace of mind today and at the time of your death your grieving loved ones are relieved of the additional burden of second-guessing what you may have wanted. n

Take the Lead.

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Aging Resources 2018–2019

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Understanding Medicare NEED-TO-KNOW INFORMATION FOR NAVIGATING YOUR FEDERAL HEALTHCARE OPTIONS The federal health insurance program Medicare is complicated but not impossible to understand. The program does have numerous parts and add-ons, and the details of your selected policy can change from year to year, along with the premium.

However, Medicare itself offers a very informative website at medicare.gov; clear, concise publications you can download or have mailed to you; toll-free numbers for your questions; and Medicare counselors in a town near you who can walk you through the entire process in-person or by phone. But before you make contact, here’s a quick overview of Medicare — what it is, its parts and how those parts work together or not — so you know what specific questions to ask.

The Basics

Medicare is a federal health insurance program for people who are 65 years old or older. Some people with certain disabilities or diseases qualify for Medicare before they reach 65 years of age. Check the Medicare resources at medicare.gov for details.

Medicare Parts

Medicare is available in four parts — A, B, C, and D — each with its own level of services.

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Additionally there is Medicare Supplement Insurance, or Medigap, which is not Medicare but a private policy that works with your Medicare policy to supplement your healthcare costs.

Medicare Part A, in general, covers hospitalization, skilled nursing, hospice care and some home-health services. This part is offered through the federal government with no premiums for most American citizens.

Medicare Part B pays for medically necessary services, physician’s services, outpatient care, medical supplies, durable medical equipment, ambulance services and some preventative screenings and services. This part is offered through the federal government and is combined with Part A. Part B does have premiums.

Medicare Part C is also known as Medicare Advantage Plans. These plans are offered through private insurance companies and premiums are charged. These companies contract with Medicare to provide Medicare A and B benefits plus benefits and services not covered under A and B. They may offer extra coverage, like vision, hearing, dental or health and wellness programs. Also, many Part C

Continued on page 22

Aging Resources 2018–2019

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FirstCarolinaCare Insurance Company’s FirstMedicare Direct plans are HMO and PPO plans with a Medicare contract.

Enrollment in a FirstMedicare Direct plan depends on contract renewal. FirstCarolinaCare Insurance Company and FirstMedicare Direct comply with applicable federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability, or sex. Contact our Member Services number at 1-844-201-4957 (TTY 711), 8:00 a.m. to 8:00 p.m. Eastern, 7 days a week (except Thanksgiving and Christmas) from October 1 through March 31, and Monday to Friday (except holidays) from April 1 through September. Attention: If you speak a language other than English, free language assistance services are available to you. Call 1-844-201-4957 (TTY 711). ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-844-201-4957 (TTY 711). 注意：如果您使用繁體中 文，您可以免費獲得語言援助服務。請致電 1-844-201-4957 (TTY 711)。 H6306_19452_M Accepted 09/02/2018

plans offer prescription drug coverage (so if you have your Medicare through Part C, you won’t need Medicare Part D). With Medicare Part C, you typically are part of a Health Maintenance Organization (HMO), a Preferred Provider Organization (PPO), a private fee-for-service plan, a special needs plan, or a Medicare Medical Savings Account Plan.

Medicare Part D covers prescription drugs.

It is an add-on to Parts A and B. As with Part C, Part D is offered through private companies approved by Medicare and there is a premium.

Be aware that there is a penalty if you do not have a drug plan.

Supplemental Insurance

Medicare Supplement Insurance, or Medigap policies, are sold by private insurance companies and are meant to supplement Original Medicare, also known as Parts A and B. There are 11 types of supplemental policies offered in North Carolina – A, B, C, D, F, F Prime, G, K, L, M and N. Companies that sell supplemental policies must offer type A, C and F. Go to medicare.gov to find out what is covered in each policy type.

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Newer supplemental policies do not include prescription drug coverage. To obtain such coverage, you need to sign up for Medicare Part D or a supplemental plan with drug coverage.

Note that if you have Medicare Advantage Plan (Part C), it is illegal for a company to sell you a Medicare Supplement Insurance policy. You will need to choose whether Medicare Advantage Plan (Part C) or a supplemental policy best suits your needs. You can find a full explanation of Medical Supplemental Insurance versus Medicare Part C at medicare.gov.

There you also can find companies licensed to sell these policies in North Carolina as well as explanation of the coverage and costs of each plan.

The Medicare parts you choose and your benefits and cost are highly specific to your individual situation. The most important point about Medicare is that you do not need to figure this insurance out on your own. Help is everywhere and easy to access. Take advantage of it and enjoy the confidence that comes with having the right healthcare coverage for you. n

Aging Resources 2018–2019

Medicare Help Here are three Medicare resources that are easy to access Medicare.gov This website offers clear explanations about the Medicare program, updates on changes and answers to frequently asked questions. It also offers Medicare & You for download to your computer, e-book reader or as an audio podcast. You also can request that information be mailed to you in print form or on an audio CD. Within this invaluable reference is everything you need to know about Medicare and supplemental policies, along with easy-to-read charts that allow you to compare and contrast parts, policies and benefits.

800-Medicare Call this toll-free helpline to speak with someone trained to help you with any Medicare question or issue.

Seniors’ Health Insurance Information Program (SHIIP) ncdoi.com/shiip 855-408-1212 (toll-free) Each county in North Carolina has its own SHIIP counselors specially trained to help you with your Medicare questions. You may speak with them by phone or set an appointment to meet in person. Here is contact information for SHIIP programs in our area: In Buncombe County 828-277-8288 (ask for SHIIP help) Council on Aging of Buncombe County 46 Sheffield Cir., Asheville

In Polk County 828-749-9245 (ask for SHIIP help) Saluda Senior Center 64 Greenville St., Saluda

In Henderson County 828-277-8288 (ask for SHIIP help) Blue Ridge Health 709 N. Justice St., Hendersonville

The Meeting Place 75 Carmel Lane, Columbus

Council on Aging for Henderson County 105 King Creek Blvd., Hendersonville

AgingResourcesWNC.com

In Transylvania County 828-884-3109 (ask for SHIIP help) Transylvania County Cooperative Extension 98 E Morgan St., Brevard

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Take Precautions to Prevent Being Scammed TIPS TO PREVENT BEING THE VICTIM OF SCAMS TARGETING OLDER ADULTS Access to major funds or credit, the fact that sometimes seniors are isolated and the perception that elders have reduced cognition are all reasons scam artists view older adults as easy prey.

But just because you or a loved one may be a target doesn't mean you or someone you care about has to be a victim. With awareness of the most common scams and having strategies in place, you and your loved one can avoid getting ripped off and help law enforcement agencies shut down these sordid operations.

The Most Common Scams

Senior scams play on our biggest fears and concerns – our health, our finances, our home and the well-being of our families. Scammers enter people’s lives by mail, phone and email, and in person with an unsolicited knock on the door. They often look official and seem trustworthy. Their offers may seem like good ideas – often too good to be true. Some of the most common senior scams include: IRS scams: People pretend to be Internal 24

Revenue Service employees and ask for payment for back taxes that are supposedly owed.

Sweepstake scams: Fraudsters call or send a flyer saying you have won something.

To retrieve your “prize,” they ask you to send a check or give your credit card or bank account number.

Medicare scams: Someone calls saying they are from Medicare and asks for confidential, personal information, such as your Social Security number.

Update-youraccount scam: An email that looks like it is from a company you actually do business with pops into your inbox and asks you to update your account information, including a credit

Aging Resources 2018–2019

card or bank account number.

Home repair scams: Unsolicited, someone knocks on your door saying they can fix an issue with your home or on your grounds at a good price.

Utility imposter scams: Scammers pretend to be with the electric, water, gas or other utility provider, say there’s an overdue bill and threaten that services will be turned off if payment isn’t made by providing a bank account number or credit card information.

Charity scams: Someone calls and asks you to donate to a fake charity with a very real sounding name or someone calls and says you previously made a pledge and they are now collecting on it — again, asking for cash, a check or your credit card number.

Grandparent scam: Someone calls and says something like, “Hi, Grandma, it’s me” – not giving a name. The senior then responds with the grandchild’s name and the caller assumes the grandchild’s identity and asks for money.

There also are funeral and cemetery scams, discount drug scams, fraudulent anti-aging scams, investment scams, reverse mortgage scams and debt collection scams. The list is long and new scams are created every day.

What they all have in common is asking for money directly or asking for personal information they can use to steal your identity and get your money.

How to Avoid Being Scammed

Be aware that everyone is susceptible and no one is immune. Have your guard up no matter how sharp you think you are and no matter how legitimate something seems. To stay safe, follow these recommendations: • Don’t give credit card numbers, bank account numbers or Social Security numbers over the phone or by email.

• Don’t answer the phone if you don’t recognize the caller.

• Never answer the door for a person you don’t know.

• Should you find yourself on the phone with a stranger, have a strategy for getting off the phone. Some people feel just hanging up is rude. If that’s the case for you or a loved one, have a strategy that works for you and

AgingResourcesWNC.com

use it – perhaps by saying that you have something to tend to and need to get off the phone.

• Shred your mail and documents before throwing them away.

• Get an unlisted phone number. Your phone service provider will be glad to help you with this.

• Sign up for the National Do Not Call Registry at donotcall.gov or by calling 888-382-1222.

• Make it your strict policy to talk over any financial, charity or spending decisions with a trusted family member or friend before giving out information or money.

• Never click a link in an email to access or set up an account with a business. Always enter your account through the business’ main website via your own browser and if anything seems questionable, call or visit the business.

• Check your credit report annually at annualcreditreport.com or by calling 877-322-8228.

• Consider putting a “security freeze” on your credit report. Find out more by visiting ncdoj.gov and then clicking “Consumer,” then “Credit & Debt” and then “Freeze Your Credit.”

Visit the North Carolina Dept. of Justice at ncdoj.gov for more tips about avoiding being defrauded under the “Consumer” tab.

Report Scams to Law Enforcement Agencies

If you or your loved one receive what you believe to be a scam phone call, email or mailing, or if you believe a scam artist has knocked on your door, report it immediately to your local law enforcement agency. You also can contact the Consumer Protection Division of the North Carolina Attorney General's Office at 877-5-NO-SCAM. If you realize you have been a victim of a scam, do not be embarrassed.

These scammers are professionals and are very good at what they do. Turn your misfortune into a positive for your community and report the scam so you can help protect others. n

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Figuring Out When Help Is Needed

HOW TO EVALUATE IF A LOVED ONE COULD USE ASSISTANCE Determining exactly when loved ones need help at home can be challenging but answers often can be determined by observing personal appearance, home upkeep and driving abilities.

Asking these questions can shed light on how loved ones are feeling and managing daily activities:

Personal Appearance & Care

• Do they stand up straight or are they bent over? Are they leaning to one side?

• Are they maintaining their normal weight?

• When walking, is their gait strong? Or are they shuffling more than stepping?

• Are they clean and shaved? Are their nails clean? Is their hair combed?

• Are their clothes clean? Are they dressed appropriately for the weather?

• Are their buttons buttoned properly? Are zippers zipped?

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Inside the Home

• Is the home kept the way it always has been or do you see a change?

• Is the kitchen sink clean? Are beds made and floors swept or vacuumed? Are plants alive?

• Is the garbage taken care of correctly?

• Does the pet have food and water?

• Are things that used to be put away now left out?

• If they take medication, is it stored neatly in a sensible place? Using the date on the bottle, can you tell if it is being taken as prescribed?

• Is mail in an unorganized pile? Are unpaid bills left around? Are checks to pay bills written but never sent?

• Does the refrigerator have old, spoiled food or not enough food?

• Are the dishes, glasses, and flatware properly put away and clean?

Continued on page 28

Aging Resources 2018–2019

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• Is their bedroom, bathroom and closet dirty or unorganized?

Outside the Home

• Has regular maintenance been carried out on the outside of the house and on other structures?

• Are the gutters clean? Porches swept?

Windows washed?

• Has the grass been mowed, the shrubs trimmed and the flowerbeds weeded?

The Car & Driving

• Are there signs the car has been in minor accidents? Any new dents from running into the garage or another bumper?

• Is the car well maintained? What does the change-oil sticker say versus the mileage? Are the fluids full? Is the registration current?

• When you drive with them, can they get in and out of the car with ease?

• Do they drive too slowly? How is their reaction time? Do they tailgate?

• Are other drivers on the road annoyed?

• Do you feel afraid when riding with them?

• Do they know where they are going?

• Do they have trouble parking?

• Can they drive safely and confidently at highway speed?

The answers to these questions can serve as indicators of emerging concerns including waning eyesight, issues with movement and walking, the onset of dementia and more. If you see a pattern of decline, the cause should be determined by a physician to see if any treatments can improve or slow the condition.

As with many issues of aging, there are no hard and fast rules as to when to step in to help.

However, if what you have observed leaves you feeling uncomfortable, then trust you have the evidence you need to look into finding necessary support services. n

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Transitioning from Driving

HOW TO EVALUATE THE RIGHT TIME TO START USING ALTERNATE TRANSPORTATION Driving a vehicle is an integral part of American life. But aging can bring changes in vision and response times on the road as well as health conditions and medications that can impact the ability to drive. When it appears that driving is becoming more challenging, it may be time to explore next steps and other transportation options to protect the safety and wellbeing of the driver and others on the road.

Talk about driving abilities and transportation options

Start by having a candid conversation about your concerns about you or your loved one’s driving abilities as well as about alternative transportation options. If someone stops driving, it’s important to figure out ahead of time transportation needs for errands, appointments and recreational activities. Being kind, calm and empathetic during these discussions is beneficial to everyone involved.

Observe and evaluate driving skills

A passenger riding along with a driver can 30

assess driving abilities. While such a ride-along is not a test, it is a way to help figure out if someone is having challenges with driving.

According to the AARP, signs to look for include: • Being easily distracted.

• Having a delayed response to unexpected situations.

• Running lights or stop signs.

• Clipping the curb.

• Exhibiting lane drifting or having trouble changing lanes.

• Misjudging distance.

• Showing a loss of driving confidence • Getting lost in familiar places.

• Driving too fast or too slow.

• Having trouble moving the foot from the gas to the brake or confusing the two.

• Being pulled over by the police, having dents and scrapes on the vehicle and being involved with accidents – including fender-benders – also indicate that it may be appropriate to evaluate whether or not to drive.

Aging Resources 2018–2019

Broaching the subject of ceasing to drive

Because driving is often equated with independence, having a conversation about no longer driving can be a sensitive one. Approach such a conversation with respect, directness and a focus on safety, including those of passengers, pedestrians and other drivers.

Participating in a formal driving assessment performed by a professional who is not a family member can be useful, as can meeting with a family physician who may be able to evaluate how health conditions and medications may be impacting driving ability. For more about such assessments, as well as related advice about seniors driving, visit AAA’s site seniordriving. aaa.com.

In North Carolina, motorists are required to renew their driver’s licenses in person and pass a vision test every eight years. People age 66 and older are required to renew their driver’s licenses every five years. The N.C. Division of Motor Vehicle’s Medical Review Unit Program also evaluates a driver when there are concerns that certain medical conditions – not age alone – might have an impact on the ability to safely operate a motor vehicle. For more information, visit ncdot.gov/dmv/license-id/licensesuspension/medical-review-program/ Pages/default.aspx.

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Arrange alternative transportation

In the event that you or a loved one stops driving, discuss transportation needs and set up alternatives. Family members and friends can create driving schedules and take turns providing regular transportation. Private ride services such as cab companies, Uber and Lyft may be useful.

Throughout Western North Carolina, there also are county public transportation options. For details on area public transportation services, turn to the Transportation Appointments and Errands section of the Aging Resources Directory on page 88.

By having alternate transportation plans in place, you or your loved one can continue to live independently without the worry that can come with driving challenges. And while giving up driving is a transition, ceasing to drive does not have to mean disengaging from socializing, running errands or being active in the community. n

AgingResourcesWNC.com

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Call and arrange your personal tour.

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Caring for Yourself When You’re a Caregiver STRATEGIES FOR TAKING CARE OF YOUR NEEDS WHILE CARING FOR A LOVED ONE In addition to the millions of retired spouses and partners caring for loved ones, more than one in six working Americans are assisting with the care of an elderly or disabled family member or friend, according to the Family Caregiver Alliance.

If you yourself are a caregiver, you probably know first-hand the challenges of finding balance in your life while caring for someone else. Juggling your own personal and family obligations as well as those of the person whom you’re caring for can be difficult and sometimes feel impossible.

As a result, it’s not uncommon to neglect your own needs and become depressed, frustrated, exhausted and physically ill. Sadly, caregiver burnout also can result in resentment of and anger toward the person you’re caring for and – in the worst-case scenario – unintentional abuse or neglect of that elderly or disabled loved one.

By making self-care a priority, you are not only helping yourself as an individual, but also as a family member and caregiver. Here are some strategies for taking care of yourself in the midst of caregiving: 32

• Focus on healthy habits.

• Do what you can to get enough rest and quality sleep, including taking naps when you can.

• Incorporate exercise into your regular routine, even if it’s just in short stints.

• Avoid junk food and fast food and eat nutritious meals and snacks.

• Drink plenty of water and don’t overdo caffeinated beverages.

• Don’t postpone your own regular medical check-ups.

• Avoid abusing tobacco, alcohol or drugs, including prescription medications.

• Ask for hands-on help from others.

• Adopt an attitude of being willing to accept help from others. Avoid the mindset that you are the only one qualified to take care of your loved one.

• Create a plan for respite care so you can have breaks from caregiving. Specific advice on setting up such a plan can be found at aarp.org/caregiving/life-balance/info2017/respite-care-plan.html.

• Enlist friends and family members of all ages to help with tasks for the person

Aging Resources 2018–2019

•

•

• •

you’re caring for such as grocery shopping, housework, yard work and taking your loved one to appointments and out recreationally.

Explore the possibility of contracting home care or home health care for your loved one. For more about home care and home health care, see Aging Resources’ article on pages 38 and 39. For a listing of area home care and home health care providers with highlights about services they provide, turn to page 40.

Consider investing in healthcare-related devices like Personal Emergency Response Systems, or PERS, which can give you more peace of mind. Learn more about how technology can help in the Aging Resources article on page 66.

Get emotional, psychological and spiritual support.

At least once a day – preferably for at least 30 minutes – engage in an activity that gives you joy, such as reading, watching television, listening to or playing music or participating

AgingResourcesWNC.com

in a hobby like gardening or crafting.

• Carve out some time every day to sit quietly by yourself. Include meditation, prayer or inspirational readings if those activities are enjoyable and fulfilling to you.

• Participate in caregiving support groups.

Communities of caregivers can be found both online and throughout our region. Turn to page 79 for Caregiving Support resources in the Aging Resources Directory.

• Explore online resources with advice about caregiving and caring for the caregiver, including the Family Caregiving Alliance at caregiver.org, the Caregiver Action Network at caregiveraction.org and the National Alliance for Caregiving at caregiving.org.

By taking care of yourself while you are taking care of someone else, you can reduce your stress and lessen the chances for negative impacts, allowing you to feel more joy and satisfaction with the labor of love that is caregiving. n

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Community Resources Provide Answers and Help LOCAL PROFESSIONALS OFFER RANGE OF ASSISTANCE WITH AGING ISSUES If you’re facing issues related to aging or caregiving and need advice or assistance, help is available through a variety of regional professional resources. Councils on Aging, Area Agencies on Aging, veterans affairs agencies, the N.C. Dept. of Health and Human Services and geriatric care managers can all provide helpful information and services.

Councils on Aging

Depending on where you live in Western North Carolina, the Council on Aging serving the county you live in may offer different services from those in other parts of the region, but they all share the common mission of acting as advocates for elders and providing connections for the assistance you need.

Council on Aging for Henderson County

The Council on Aging for Henderson County serves adults age 60 and older, their families and their caregivers with the goal of removing barriers from maintaining independence.

COAHC serves as a information clearinghouse for older adults and their loved ones who may be seeking contacts for any number of elder carerelated services in Henderson County. Inquiries COAHC fields range from those related to housing, fall prevention, advance directives and more.

Through their Meals on Wheels program, COAHC offers a daily nutrition delivery service from Monday through Friday to residents of the 34

county. Participants can sign up for long-term as well as short-term meal delivery, such as during recovery from a surgery. To receive meals at no cost, you must be at least 60 years old, homebound and be unable to prepare a hot meal on a regular basis. Otherwise, you can sign up for Meals on Wheels for a nominal fee. Every winter, MOW disburses emergency, shelf-stable meals in preparation for inclement weather.

Through their Partnership for Independent Living program, caseworkers help older adults with need live independently through such services as medication management, healthcare checks by a registered nurse, assistance with navigating finances and more.

At the Sammy Williams Center, COAHC offers “Lunch at the Sammy,” a congregate nutrition program for anyone 60 years old and older living in Henderson County. This daily, weekday program includes lunch for a suggested contribution and activities such as balance work and exercise programs, art classes and performances by a drama troupe.

Council on Aging of Buncombe County

The Council on Aging of Buncombe County is an advocate for older adults, providing personal support, assistance and resource coordination to people 60 years old and older to help them stay independent and healthy.

To help older adults receive the services they need, COABC answers questions by phone,

Continued on page 36

Aging Resources 2018–2019

Ensure no one has to age alone...

...join hands with your local Council on Aging Caregiver Services • Case Management • Community Resource Coordination Health Support Services • Lunch at the Sammy-Congregate Nutrition Meals on Wheels • Volunteer Opportunities

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Providing and coordinating services to engage, connect, and support adults in our community as we age.

105 King Creek Boulevard

Hendersonville, NC 28792

(828) 692-4203

http://coahc.org

makes home visits and helps people complete applications for community-wide services.

COABC offers informational assistance about Medicare and health insurance. Medicare counseling and education is held in both Buncombe and Henderson counties through community classes and one-on-one counseling.

COABC also assists older adults with the Affordable Care Act. Through its Seniors Safe at Home program, COABC helps with minor home repair and yard work, volunteer transportation, dining and socialization as well as some homebound food delivery. Minor home repair services focus on reducing fall risks in the home through the installation of ramps, grab bars, hand railings and threshold fixes.

For people who can’t drive or use public transportation, COABC has volunteers who take people to medical appointments, grocery shopping and occasional social trips. At four locations in Buncombe County, COABC offers congregate senior dining for people who are age 60 and older or married to someone 60 or older. In addition to providing meals and socialization, COABC partners with other community organizations to provide activities at their congregate dining sites

such as exercise and yoga classes. Monthly food boxes are delivered by volunteers with COABC to at-risk, homebound elders.

A separate organization – Meals On Wheels of Asheville and Buncombe County – delivers Meals on Wheels in Buncombe County. Learn more by visiting mowabc.org or by calling 828253-5286.

Area Agencies on Aging

The Land of Sky Regional Council’s Area Agency on Aging covers Buncombe, Henderson, Madison and Transylvania Counties. The Isothermal Planning and Development Commission serves as the Area Agency on Aging for Cleveland, McDowell, Polk and Rutherford Counties. Both are part of a national network of aging agencies established by the federal Older Americans Act. While local Councils on Aging provide direct services, Area Agencies on Aging support older adults living independently through planning, resource development and partnering with Councils on Aging and other organizations.

In addition to being resources for older adults and their caregivers to contact when seeking information about age-related issues, offerings from Area Agencies on Aging can include family caregiver support services, foster grandparent

GERIATRIC CARE MANAGERS Possessing backgrounds typically in nursing, social work, elder care, psychology or counseling, geriatric care managers are qualified health and human services workers who can be hired to offer personalized, holistic assistance and planning for older adults and people with disabilities. These professionals act as advocates and focus on helping you or your loved one stay independent, healthy and safe.

Geriatric care managers can be especially helpful for caregivers who don’t live near their loved ones. Working with families and caregivers, they use their expertise to assess, problem-solve, plan and monitor older adults’ living and healthcare situations. Examples of the help they can provide include: • Assessing a loved one’s social, emotional and medical status including problems with memory loss and related dementia.

• Interacting with and facilitating communication with a healthcare team.

• Evaluating, recommending and helping coor-

36

dinate moves to appropriate long-term care housing.

• Supporting and helping loved ones and families cope with care options and concerns and helping them reach a consensus about long-term care planning.

• Connecting with community resources available for older adults.

• Intervening when a crisis occurs such and an emergency room visit and overseeing a hospitalization or rehabilitation stay.

• Reviewing and overseeing bill paying, assisting with insurance companies and working with financial advisors and attorneys.

The Aging Life Care Association – formerly known as the National Association of Professional Geriatric Care Managers – offers more information about geriatric care management as well an online searchable database for finding a professional in your area at aginglifecare.org.

Aging Resources 2018–2019

programs, health promotion and disease prevention, long-term care ombudsmen, regional and county aging planning, senior community services employment programs, senior companion programs, information about North Carolina legislation and Project CARE – or Caregiver Alternatives to Running on Empty – which helps people caring for people with dementia.

For contact information about local Councils on Aging and Area Agencies on Aging, turn to the General Information section of the Aging Resources Directory at page 77.

Veteran-Specific Resources

Based in Asheville, the Charles George VA Medical Center provides healthcare and wellness services to U.S. military veterans and their families. In addition to serving veterans’ overall health, the VA Medical Center offers assistance related to geriatrics and extended care including adult day health care, home-based primary care, long-term care and respite care. Learn more about the Charles George VA Medical Center by visiting asheville.va.gov or by calling 828-298-7911.

The North Carolina Dept. of Military and Veterans Affairs provides a system to assist veterans and their families with a variety of issues. The state agency also oversees four skilled

care homes for veterans, including one in Black Mountain in Buncombe County. Visit milvets. nc.gov or call 844-624-8387 toll-free for more information. Also through this state agency, Polk County has a Veterans Services office in Columbus that can assist with a variety of issues including benefits and claims questions. For more information, visit polknc.org/veterans_ services.php or call 828-894-0003.

N.C. Dept. of Health and Human Services

Through its Division of Aging and Adult Services, the N.C. Dept. of Health and Human Services works to promote the independence and enhance the dignity of North Carolina's older adults. This state agency includes an Adult Protective Services Division, the work of which is carried out by county Dept. of Social Services (DSS) offices. If you are concerned that an older adult is suffering from abuse, neglect or exploitation, contact your local DSS office. DSS workers can evaluate and help determine if an elderly individual is in need of assistance or protective services. Each county’s contact can be found at ncdhhs.gov/ divisions/dss/local-county-social-servicesoffices. For more about the Aging and Adult Services division, visit ncdhhs.gov/divisions/ daas or call 919-855-3400. n

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37

Exploring Home Care and Home Health Care

HOW THESE SERVICES OFFER DIFFERENT CARE FOR VARIOUS LIFE SITUATIONS You or a loved one may need assistance with daily living tasks such as bathing, getting dressed or running errands. Or perhaps you or your family member needs medical care such as skilled nursing, physical therapy or prescription management. Home care and home health care services are available to address all of these needs and to help you maintain your independence and quality of life in your own home. By understanding the differences between these two options, you can craft a care plan that best suits you or your loved one both in terms of the help you need and how you will pay for the care you receive.

Home Care

Home care services require no doctor’s orders, can be contracted for 24 hours a day and can continue as long as someone wishes. Home care services can include meal preparation, personal care, light housekeeping, shopping and other errands, and companionship. Some home care agencies offer geriatric care management, a service that oversees and coordinates all the outside services in a client’s home — from hiring a lawn service to coordinating medical-related home health care visits.

38

Although often crucial to being able to stay at home, home care typically is not covered by health insurance, but it may be covered by a long-term care policy if you or your loved one happens to have one.

When looking for a home care agency, be sure that the home care agency: • Provides services within 24 hours; • Is bonded and insured for up to $1 million; and • Checks the backgrounds of all employees.

Agency licenses can be checked at ncdhhs. gov/dhsr/reports.htm.

Because the cost of home care is out of pocket, some people consider hiring an individual themselves instead of using an agency. If you are considering that option, be sure to consider running background checks on the caregiver and make a plan for: • What happens when the individual caregiver is ill or unavailable; • Withholding taxes, Social Security and Workers’ Compensation Insurance; • Homeowner’s insurance that would cover if a caregiver is hurt on the job; • Hiring an individual caregiver with flexibility

Aging Resources 2018–2019

to change with your needs; and • Knowing who takes responsibility should the caregiver hurt your family member.

Home Health Care

Home health care is in-home medical care ordered by a doctor. The cost is usually covered by private health insurance or Medicare. Home health care procedures are performed by medical professionals and include services such as skilled nursing care, medication management, wound care, physical therapy and disease management training. Home health care professionals are in a patient’s home only long enough to carry out treatment.

Home health care is typically prescribed after a hospital stay. A home health care prescription can be taken to any licensed agency covered by your insurance. To be proactive with your planning, research agencies before a hospitalization occurs.

When choosing a provider, be sure the agency: • Is licensed by the North Carolina Department of Health and Human Services. Licensed providers by county can be found at

ncdhhs.gov/dhsr/reports.htm; • Accepts your or your loved one’s insurance; • Can begin providing services within 48 hours; • Has a missed appointment average no higher than three over the period of treatment; • Is on call 24 hours a day; • Has a policy for you or your loved one to be able to reject particular care providers if you or your loved one don’t like them or feel they are not a good fit; and • Gives you references from a current patient, a patient’s family member and a business that refers to them.

A comparison of local home health care agencies, a checklist for interviewing and more tips for finding the right agency can be found at medicare.gov/homehealthcompare.

As we and our loved ones age, chances are there will be times when home care and home health care will be needed. By understanding the differences in these services, the most appropriate service can be secured with less stress for everyone involved. n

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AgingResourcesWNC.com

39

40

11

39

41

Minimum hours per shift

Home Health Care (Medical)

73

Home Care (Non-Medical)

24/7 Care Availability

27

Cleaning/Housekeeping

Cooking/Meal Preparation

7

Transportation Available

Medication Reminders

69

Therapy Services

Hospice Services

5

Medicaid Accepted

Medicare Accepted

29

Private/Insurance Accepted

BUNCOMBE COUNTY

Always Best Care Senior Services 2

• • • • • • • 3 3 3 3 CarePartners • • • • • • • • • • • • 3 3 3 Compassionate Home Care 1 • • • • • •

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Aging Resources 2018–2019

Understanding Different Types of Senior Housing

RESIDENTIAL OPTIONS FOR ELDERS VARY BASED ON INDIVIDUAL NEEDS Independent living. Assisted living. Continuing Care Retirement Communities or CCRCs, which are also known as Life Plan Communities. Family Homes. Nursing Homes. For-profit. Non-profit.

If you are in the process of searching for senior housing for yourself or a loved one, it’s important to understand the differences in types of housing available for older adults with varying needs.

You aren’t just looking for a roof over your head – you are searching for a place that has the facilities, staff and services to meet your needs now and in the future. Understanding the types of housing available, the industry lingo and pertinent state regulations — which vary from service level to service level and state to state — can help ensure you make the right move.

Independent Living

As the name states, Independent Living refers to a community of apartments and/or singlefamily homes where residents—typically restricted to 55 years old or older—live on their own without 42

assistance. Some allow you to buy your unit, some are rent only and some offer a choice of either option.

Along with apartments and homes, many of these communities provide amenities such as a full schedule of social activities, recreational facilities, transportation to appointments, housekeeping and laundry services, and full-service dining. Some of these amenities may be included in the facility’s regular monthly fee while others may cost extra.

Independent Living facilities are not licensed to provide medical care, home care or home health care, but they can invite a licensed provider to offer on-site care and contract individually with residents. As a resident, you can choose to use the on-site provider or a provider of your choice.

Independent Living facilities also may be called Congregate Living or Retirement Communities.

Assisted Living

Assisted Living in North Carolina can refer to state-licensed Adult Care Homes, state-licensed Continued on page 44

Aging Resources 2018–2019

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Family Care Homes and non-licensed Multi-Unit Assisted Housing with Services, or MAHS. Adult Care Homes, which are defined as having more than seven beds, offer 24-hour supervision and assistance to residents. Licensed by the North Carolina Division of Health Service Regulation, they provide meals, housekeeping, personal care services, medication supervision and management and nursing services as needed.

Family Care Homes are also licensed by the state. They have from two to seven beds and offer 24-hour supervision, meals and personal care to residents. They operate as any regular family home does and are not required to have nursing staff. Caregivers live on-site, adding to the family atmosphere and providing residents with a consistency of care not usually achievable in more traditional assisted living facilities.

Multi-Unit Assisted Housing with Services, or MAHS, are registered with the state but are not licensed. These facilities are only required to provide housekeeping and one meal a day.

All other services — like personal care, extra meals, transportation, activities and medication management — can be charged for individually.

These facilities must maintain an agreement with one licensed home-care or hospice-care agency to provide personal care and nursing services to residents on-site. However, MAHS residents are always free to choose their own providers.

Most of these establishments offer a full schedule of activities on-site and opportunities for off-site events. A few also have special wings for dementia care. Be aware, however, that just because an Assisted Living facility says it has a memory care unit does not guarantee that the staff is well trained in managing dementia or that stateof-the-art activities are offered. Be sure to ask for staff training and program specifics, and spend some time observing the unit.

Assisted Living facilities also may be called Rest Homes or Homes for the Aged. Whatever name they go by, it is important to know if they are licensed or registered and exactly which services come as part of their standard care and fee and which are charged at an extra cost.

To view a list of licensed Assisted Living facilities by county, to check on any violations and penalties and to see their star rating by North

44

Carolina, go to ncdhhs.gov/dhsr/acls/. To see licensed Family Care Homes listed by county, visit ncdhhs.gov/dhsr/reports.htm.

Nursing Homes/Skilled Nursing

Nursing Homes – also known as Skilled Nursing Facilities – are also licensed by the North Carolina Division of Health Service Regulation.

They offer the highest level of residential care and are the right choice for short-term inpatient rehabilitation for people recuperating from an accident or illness or for those who are chronically ill and need long-term care.

In addition to a bed and meals, these homes provide round-the-clock monitoring, personal care, nursing care, rehabilitation, medication management and social-work services. Most also offer a schedule of activities and opportunities for socialization. A list of licensed Nursing Homes in North Carolina by county can be found at ncdhhs.gov/dhsr/reports.htm.

A Medicare star rating and facility comparison of Nursing Homes/Skilled Nursing facilities including those that are part of Continuing Care Retirement Communities or Life Plan Communities can be found at medicare.gov/ nursinghomecompare.

Continuing Care Retirement Communities (CCRCs) or Life Plan Communities

CCRCs offer all three levels of care — Independent Living, Assisted Living and Skilled Nursing — all on one campus. Typically, these communities require a buy-in or entrance fee. According to the North Carolina Dept. of Continued on page 46

Aging Resources 2018–2019

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Insurance, entrance fees for North Carolina CCRCs can range from a few thousand dollars to more than $1 million with a typical entrance fee ranging from $68,000 to $370,000. NCDOI says monthly fees for CCRCs in North Carolina can range from $1,000 to more than $8,000 but typically fall within the $2,000 to $4,000 per month range.

For this investment, residents are guaranteed the level of care they need at a regulated rate for life.

Most CCRCs require that residents be able to live independently at the time of buy-in.

Buying into a CCRC can simplify financial planning and allows residents to establish peace of mind for everyone in the family. Because CCRCs require a long-term financial investment from residents, they are regulated by the North Carolina Dept. of Insurance. Their skilled-nursing units are licensed by the North Carolina Division of Health Service Regulations. Each community must issue and provide potential residents with a disclosure statement on their financial health.

If you or your loved ones are considering a CCRC, it is imperative that you not only understand the terms of your contract but that you also understand the community’s disclosure statement. These contracts usually fall into one of the following categories: Extensive Contracts are full-service contracts that provide for residents to transfer from on-site Independent Living to on-site Assisted Living or Skilled Nursing when needed for an unlimited time and at little to no additional cost. The CCRC bears the majority of the burden of the residents’ long-term care.

Modified Contracts obligate the CCRC to provide health-related services for a specified number of days at no additional cost or at a subsidized fee. Thereafter the financial responsibility for long-term care shifts to the resident.

Fee-for-Service Contracts give residents guaranteed admission to on-site Assisted Living or Skilled Nursing when needed but residents must pay extra for these additional services when used.

With this type of contract, the resident bears the full financial burden of additional long-term care needs.

Equity Contracts involve a true real estate purchase. Be aware that the health-related services Continued on page 48 46

Aging Resources 2018–2019

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with these contracts differ.

Rental Contracts provide for housing, services and guaranteed access to health-related services in exchange for monthly rent and service fee. Typically, as part of these fees, residents are guaranteed healthcare services at a discounted fee for a certain number of days. After that, full rates are charged.

Regardless of how well you understand these documents, it may be prudent to take them to an elder law attorney or a CPA who can explain them to you.

The N.C. Dept. of Insurance publishes a CCRC reference guide that can be accessed at ncdoi.com/SE/Documents/CCRC/CCRC_ Guide_2017.pdf. In it, you’ll find general information about CCRCs, as well as listings for all licensed CCRCs in North Carolina, complete with their amenities, fees, types of contracts offered and contact information.

resident or asking to spend a weekend or up to a week at any community you or your loved ones are considering. The more information you gather about different properties and their services, their policies and rights as a resident, the better choice you or your loved one will make.

To make your search a little easier, turn to page 52 for a list of things to consider and questions to ask various facilities. n

Careful Evaluation is Key

Making a move to senior housing involves research and planning. Do not be shy about asking questions, requesting to dine with a current

48

Aging Resources 2018–2019

Trinity View offers amenities and services without the commitment of an entrance fee.

AMENITIES INCLUDE: • • • • • •

No Entrance Fee Pet Friendly Fine Dining Transportation Housekeeping On-site Clinic

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Enjoy the Peace of Mind Offered by these Housing Providers

Independent Living Assisted Living Alzheimer’s Care Nursing Care Life Plan (CCRC) On-Site Home Care Respite Care Rehabilitation Care Medicare Accepted Medicaid Accepted

Senior Housing Options

Page Buncombe County 51 Arbor Terrace Asheville

43 Ardenwoods Asheville

54 Deerfield Retirement Community Asheville

22 Flesher’s Fairview Health Care Center Fairview 46 Givens Estates Asheville

31 The Laurels of GreenTree Ridge Asheville

31 The Laurels of Summit Ridge Asheville

37 NC State Veterans Home Black Mountain 55 Pisgah Valley Retirement Candler 89 Stone Creek Asheville

49 Trinity View Arden

Page Davie County 61 Bermuda Village Retirement Com. Bermuda Run

Page Haywood County 57 Haywood House

Page Henderson County 90 Carolina Village 56 Cherry Springs Village 45 Fletcher Park Inn 57 The Gardens of Hendersonville 89 Hendersonville Health & Rehab 15 Heritage Hills 53 Lake Pointe Landing 31 The Laurels of Hendersonville 19 Life Care of Hendersonville 89 The Lodge at Mills River Page Polk County 47 Tryon Estates

Page Transylvania County 56 Cedar Mountain House 48 College Walk 56 Kingsbridge House

Page Yancey County 57 Yancey House 50

• • • ••• ••• • • • • • • • • • • • • •

• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •

Canton Hendersonville Hendersonville Hendersonville Hendersonville Flat Rock Hendersonville Hendersonville Hendersonville Hendersonville Mills River

• • • • • • • • •

• • • • • • • ••• •• • • • • • • • • • • • • • • • • • • • • • • • • • •

Columbus

• • • • • • • •

• • • • • • • • •• •• •

Brevard

Brevard Brevard

Burnsville

• • • • • • Aging Resources 2018–2019

I was sure I’d hate it.

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Considerations When Choosing Senior Housing QUESTIONS TO ASK AND OPTIONS TO EVALUATE WHEN CONTEMPLATING A MOVE TO SENIOR HOUSING Thinking about moving to senior housing? Here is a comprehensive list of questions to ask and things to consider when evaluating the options for you or a loved one:

The Property

n Are the grounds attractive? Is the building well kept? n Is it handicap accessible? Are hallways and doors wide enough for walkers and wheelchairs? n Are handrails in the hallways? Are there elevators as well as stairs? n Is it well lit? n Does it have a pleasant smell? n Do you like its layout? n Is it easy to find your way around? n How close are amenities like the dining room and recreational areas to living quarters? n Is security on the grounds 24 hours a day, seven days a week? n How far is it from where loved ones live?

The Staff

n Is everyone at every post – front desk, maintenance, housekeeping, healthcare, dining room – appropriately dressed, pleasant and attentive? n Is the front-desk staff friendly on the phone and in person? n Are your phone calls and emails responded to promptly? n Is it easy to reach someone by phone and to leave a message? n Do staff members know residents and address them appropriately?

The Residents

n Are the common areas active? n Do residents look well and happy and are they socializing? Ask residents about life in their community and their satisfaction with services. n Does the property have a newsletter or monthly calendar of events? If so, pick up several months’ worth of copies.

The Food

n What dining options are available? Is there more than one dining room? Can you have meals to go or delivered, and if so, is there an extra charge? n What meals does the dining room serve and how many are included in the monthly fee? n Is the dining room full at dinner? n What foods are available every day? Get sample monthly menus. n Does the food taste good? Is it presented with pride? Are portions to your liking? Dine in the dining room at least once. n Is there a private dining room if you wish to host a special event?

Services & Amenities

n What services are available? Laundry?

Housekeeping? Transportation to shopping and special events? n Is there transportation to private appointments?

If so, how often, how far will they take you and is there an extra charge? n Are there on-site recreational facilities for exercise and other activities? n What activities are available daily? What special Continued on page 54

52

Aging Resources 2018–2019

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events are offered? Check out an events calendar. n Is there an on-site hair salon or barber? n Is there newspaper delivery, telephone, TV, cable and Internet availability? n Are there accommodations for overnight guests? n Is there assistance with Skype or FaceTime so outof-town relatives and friends can visit virtually? n Are any religious services offered?

Costs & Contracts

n What exactly is included in the monthly fee? n Which utilities and services are extra? n When can fees be raised and by how much? n What happens if your funds run out? n Do you need renters insurance? n What can result in termination of your lease or contract? Read your lease or contract and make sure you understand everything in it. If you don’t, consult an attorney. If buying into a Continuing Care Retirement Community, or CCRC, or Life Plan Community, be sure to receive a contract and financial disclosure. n What are your rights as a resident? n What is the grievance procedure?

Your Living Space

828-551-8545 CALL OR TEXT

In Independent Living n What floor plans are available? n Are pull cords throughout the residence in case of accident or emergency? Is 24-hour emergency response available? n Can you control your own heat and air conditioning? n Is the bathroom walker and wheelchair accessible? n Can you open your windows? n Can you have a washer and dryer in the apartment or is there a common laundry room or on-site laundry service? n Who has access to your apartment or home and under what conditions? n If the campus has Assisted Living and Skilled Nursing, how does the transition to a different living arrangement work? n Can you stay in an apartment overnight or longer to see how you like it? n Are pets allowed? If so, are there restrictions?

Is there a place to walk dogs? Is a dog walker available?

1504 5th Avenue West • Hendersonville, NC 28739

In Assisted Living and Skilled Nursing n Can you lock your windows and doors? n Who else has access to your room and under what

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Aging Resources 2018–2019

conditions? n Can couples live together in Assisted Living and Skilled Nursing rooms? n Are rooms private or doubles? If doubles, can you request a private room, and if so, what is the charge? n Are pets allowed? If so, what are the restrictions?

Healthcare Services

For Independent Living n Is medical staff on site? If so, what are their hours? n What healthcare services – such as medication management, care during illness and physical therapy – are offered onsite? What is the cost? n Can you hire home care or home health care if needed and remain in Independent Living? n At what point does a resident need to move from Independent Living to Assisted Living and who makes that decision? What are your rights should you disagree?

For Assisted Living n Is it a licensed Assisted Living facility or MultiUnit Assisted Housing (MAHS) with services?

Visit the North Carolina Division of Health Service Regulation at ncdhhs.gov/dhsr/ index.html for adult care facility inspections, ratings, penalties and more. n What healthcare and daily-living support services are available? n Are services all-inclusive or offered as levels of care? n What is the staff-to-resident ratio and staff turnover rate? n At what point of care does a resident need to move from Assisted Living to Skilled Nursing and who makes that decision? What are your rights should you disagree? n Is there a dementia care unit? If so, how is staff trained and what special services are offered? n What are the daily scheduled activities?

For Skilled Care n Is the facility licensed by the state? Does it have any violations? Visit the North Carolina Division of Health Service Regulation at ncdhhs. gov/dhsr/index.html for adult care facility inspections, ratings, penalties and more. n Can you choose your own doctor? n What healthcare and daily-living support services are included in the fee? What is extra? n What is the staff-to-resident ratio and staff turnover rate? n AgingResourcesWNC.com

Life at Pisgah Valley Retirement Community offers an independent, • Know financial active retirement in a peace of mind picturesque mountain setting. Minutes from • Embrace a healthy, restaurants, shopping, secure, mainteentertainment and outdoor nance-free lifestyle adventures plus the advantage of continuing care on our • Enjoy a wellness campus should you ever lifestyle at the need it. Establish peace of wellness pool, spa, mind for your future while and cardio-strength communing with nature, training center neighbors, and community.

Schedule a visit to learn more!

Go to www.pisgahvalley.org or contact us at 828-418-2333 or clink@libertyseniorliving.com 95 Holcombe Cove Road • Candler, NC 28715 55

Live Your Best Life!

A

ffinity Living Group provides care for over 5,500 residents. We understand the importance of making your loved one feel safe, happy and loved each and every day.

Affinity Living Group Communities strive daily to create the best life for all we serve—to enjoy assistance when required, and freedom when desired.

Cherry Springs Village is a fun, energetic assisted living community in Hendersonville North Carolina. Our residents enjoy all the privacy and comforts of home while receiving medical assistance as they need.

358 Clear Creek Road Hendersonville, NC 828-698-6501

Kingsbridge House is a memory care community located in Brevard, NC. The caring staff at Kingsbridge House has specialized training to care for individuals with Alzheimer’s and memory-related dementia.

10 Sugar Loaf Road Brevard, NC 828-884-6137

Cedar Mountain House is an assisted living community tucked away from the hustle and bustle of in town living. The staff takes pride in the serenity and peacefulness this provides their residents.

11 Sherwood Ridge Road Brevard, NC 828-884-9510

Haywood House is an assisted living community in Canton specializing in Alzheimer’s disease and related memory loss. The staff is dedicated to helping residents achieve their “best life.” Enjoy time with family, friends, and each other within a caring, homelike environment.

27 North Main Street Canton, NC 28716 (828) 276-1004

The Gardens of Hendersonville is an assisted living facility near downtown Hendersonville and is the newest member of the Affinity Living Group family.

1000 W Allen St Hendersonville, NC 828-693-3388

Yancey House in Burnsville combines all of the comforts of home with the health and personal care needed to live fully and comfortably. The staff is dedicated to providing a safe, warm, engaging environment for everyone, whether a person needs help with a few daily tasks or the comprehensive support of the Memory Care Program.

6 Cooper Lane Burnsville, NC 28714 (828) 678-9200

AFFINITY Living Group

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Preparing for Your Next Move

UTILIZING SENIORS REAL ESTATE SPECIALISTS AND OTHER RESOURCES TO EASE YOUR TRANSITION Maybe your children are grown and living on their own and you find yourself with more house – and more possessions – than you need or want. Perhaps you want to trade your life in a multi-story house with a basement for one in a retirement community with one level and less upkeep.

Or maybe you are thinking of moving to an Assisted Living or Skilled Care Facility.

Downsizing where you live and reducing the number of household items you own may better suit your needs at this stage in your life and there are many professionals and resources that can help with this transition.

Realtors with the SRES Designation

To better address the unique needs of home buyers and sellers who are 50 years old and older, some Realtors earn the SRES – or Seniors Real Estate Specialist – designation.

The SRES designation indicates that a Realtor has demonstrated the necessary knowledge and expertise to counsel clients 50 and older through the major financial and lifestyle transitions involved with relocating, refinancing or selling their home.

These certified senior specialists can help with navigating the financial and emotional aspects of selling a long-held family home. Realtors with the SRES designation have knowledge about a range of senior-related aspects of home ownership including things like Universal Design, the use of reverse mortgages, pensions and IRAs in real estate transactions and how to avoid loan schemes and scams that target older adults.

Realtors with the SRES designation also 58

have connections with other experts you may need like qualified home inspectors, movers, attorneys and CPAs. For more about Realtors with the SRES designation, visit seniorsrealestate.com/ why-use-sres.

Downsizing Your Possessions

Preparing for a move – especially from a home you’ve lived in for many years – can feel daunting particularly if you have a lot of household items of yours and your loved ones.

You may benefit from employing the services of professionals who specialize in sorting and organizing, managing paperwork and documentation, selling items through estate sales, coordinating the donation of possessions to charity and arranging packing and moving.

To do some downsizing yourself, start by honestly evaluating what items you need and currently use in your life and think about what you really will need – or won’t – in your next living arrangement.

When considering what to do with items, categorize items as those to “keep,” “sell or donate” or “throw out.” Because it’s easy to become overwhelmed, pace yourself and limit your sorting and purging sessions to no more than two hours at a time. Using color-coded stickers to indicate which category an item falls into can help during the sorting process.

If you have possessions that you think friends and loved ones would like, invite them over to take items for themselves, perhaps at a “downsizing party.” Consider contacting local nonprofit thrift Continued on page 60 Aging Resources 2018–2019

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60 44

stores and othera charities your can donations CCRC charges monthlyabout fee that range which may be tax-deductible.

Many organizations from $900 to $5,000. For this investment, will come to your home to pick furniture and residents are guaranteed theuplevel of care other household items that you want to give away they need at a regulated rate for life. Most as long as they are in good condition.

CCRCs require that residents be able to live Areas to start with your downsizing include: independently at buy-in.

• Getting rid of unwanted clothing and items you Buying intoinayears.

CCRC can simplify financial haven’t worn planning and allows residents to establish • Purging collections of books, magazines, DVDs peace of mind for everyone in the family. and VHS tapes.

Because outCCRCs • Clearing multiplerequire pieces aof long-term furniture, financial from especiallyinvestment ones that are largeresidents, and bulky.they are regulated North Carolina • Disposingby ofthe unused exercise Department equipment, appliances other devices. units are ofkitchen Insurance.

Theirand skilled-nursing • Weedingbyoutthe decorations, especially those for licensed North Carolina Division of the holidays.

Health Service Regulations. Each community • Passing keepsakes mementos to family must issueonand provide and potential residents with members. a disclosure statement on their financial health.

• Going through your paperwork and digitizing If you are considering a CCRC, it is imperative documents. that you not only understand the terms of • Emptying off-site storage facilities. yourWhile contract but that you also understand the prospect of downsizing may cause the community’s disclosure statement.

These you concern, be encouraged that as an increasing contracts usually fall into one of the following number of older adults adopt a “less is more” categories: lifestyle, there is more help available than ever transitioning to your home. n contracts •with Extensive Contracts arenext full-service that provide for residents to transfer from on-site independent living to on-site assisted living or skilled nursing when needed for an unlimited time and at little to no additional cost. The CCRC bears the majority of the burden of the residents’ long-term care.

• Modified Contracts obligate the CCRC to provide health-related services for a specified number of days at no additional cost or at a subsidized fee. Thereafter the financial responsibility for long-term care Sandra Kilgore shifts to the resident.

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• Fee-for-Service Contracts give residents Broker / Owner guaranteed admission to on-site assisted living or skilled nursing when needed, but 828-515-1588 residents must pay extra92for these additional Congress St. services when used. With this of Asheville,type NC 28801 contract the residentSankilgore@gmail.com bears the full financial burden of additionalwww.ashevillekare.com long-term care needs.

• Equity Contracts involve a true real estate purchase. Be aware that the health-related I am prepared to approach clients 50+ with the best options and information services these contracts differ. for them to makewith life-changing decisions.

In my experience as an Asheville real

estate professional, I’ve found that providing the very best service is essentially

putting my clients first. Thisprovide means keepingfor myself accessible, being a good • about Rental Contracts housing, listener as well as a good communicator, and responding quickly to your needs. services and guaranteed access to healthLet mein help you simplify related services exchange for monthly rent your buying and selling process! and service fee. Typically, as part of these

AgingResources Resources 2017–2018 2018–2019 Aging

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Maximizing Medical Care at Your Doctor’s Office HOW TO GET THE MOST OUT OF YOUR TIME WITH HEALTHCARE PROVIDERS Time with your doctor can be limited these days. Physicians now spend on average 20 minutes or less with a patient during a typical office visit. But with some preparation and planning, you can maximize time with your healthcare provider and get more out of your appointment.

Share medical records and test results before your visit: By making sure your doctor has your previous diagnostic work prior to your visit, your healthcare provider has the opportunity to gain important background information about your medical situation before seeing you in person.

Get to your appointment early, but be prepared to wait: Arriving about 15 to 20 minutes before your appointment will give you adequate time to fill out paperwork, go to the bathroom and take care of other check-in items. By getting to the appointment early, you ensure your actual appointment time with your healthcare provider is not taken up with these other tasks. Even if you arrive early, you likely will still have to wait to see your doctor, so allot yourself plenty of time for the appointment.

Don’t go alone: Having a friend, loved one or hired advocate with you during an 62

office visit gives you another set of eyes and ears. Ask your companion to take notes. Your appointment buddy can be a good sounding board and also may be able to offer insight to the doctor about any health issues you are having.

Take a list of your medicines and supplements: Rather than relying on memory, take a list of your prescription and over-the-counter medications, supplements, vitamins, herbs, nutraceuticals and their dosages. Include how frequently you take them. Bring them in their prescription bottles or store packaging if that’s easier for you. By accurately sharing with your medical provider what medications and supplements you are taking, how much and how frequently you are taking them, you lessen the chances of negative drug interactions.

Summarize your medical history: Have in hand a summary of your allergies, surgeries, vaccinations, family medical history and diagnosed conditions.

Have a written list of your medical concerns: Before your visit, list your health concerns, questions and symptoms and prioritize them in order of their importance to

Aging Resources 2018–2019

you. Invite input from your loved ones. Take three copies to your appointment – one for you, one for your physician and one for your health advocate.

treatment and find out the best way to reach your physician before, during and after regular office hours in case you have questions or concerns.

Stay positive in your outlook: Having a good attitude about your well-being, your healthcare providers and your doctor’s visits helps support your health and wellness.

Instead of seeing medical appointments as burdensome, embrace the attitude that you are part of a healthcare team that is helping you age well and stay healthy. n

Clarify your doctor’s recommendations: Ask questions, repeat back what your doctor says and ask for written details about your treatment plan. Find out if there are warning signs you need to watch for with your condition and possible medication side effects and interactions. Clarify next steps about your

DR. ANDREW CROCKER INTERNAL MEDICINE Dr. Crocker is a board-certified general internist focused on adult primary care, with a special interest in geriatrics. He diagnoses and treats chronic illnesses, and educates his patients about health promotion and disease prevention.

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Reduce the Risk of Falls and Their Consequences

TIPS FOR PREVENTING FALLS BY IMPROVING YOUR HEALTH AND HOME Falls can be devastating for older people. A shattered wrist, a head injury or a broken hip can severely decrease quality of life and in some cases reduce life expectancy. According to the Centers for Disease Control and Prevention, more than 95 percent of hip fractures are caused by falling, more than 800,000 patients a year are hospitalized because of a fall injury and more than $34 billion is spent each year on direct medical costs from falls.

Even when no physical injury occurs, experiencing a fall can cause older adults to become worried and then depressed, to suffer decreased confidence and self-esteem and to begin to limit their activities and socialization out of fear — all of which can lead to more falls.

In fact, once a senior or older adult does fall, even without injury, he or she is twice as likely

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to fall again.

Fortunately, falls can be prevented with a little awareness and a few simple changes around the home.

Prepping Yourself for Fall Prevention

As we age, we cannot regain our balance from a stumble as quickly as we once did but we can ensure we stay as alert, strong and flexible as possible to prevent that stumble in the first place by doing the following: • Wear sturdy, nonslip shoes every day and all the time and clothing that is well-fitted and doesn’t bunch up or drag on the ground.

• Stay active and walk every day. Consider taking exercise classes, balance classes, yoga or tai chi to build physical strength and improve balance. Counties throughout

Aging Resources 2018–2019

Western North Carolina offer classes like these specifically designed for seniors. Visit wncfallpreventioncoalition.org to find one near you.

• Schedule a doctor’s appointment specifically to discuss fall prevention.

• Have your physician review your medications to ensure interactions do not increase your risk of a fall. For example, tranquilizers, sedatives, antidepressants and over-the-counter medicines can affect your balance.

• Discuss with your doctor any numbness, aches, foot pain or shortness of breath you experience as you go about your daily routine.

• Get tested for balance, strength and gait.

• Be treated for low blood pressure and vitamin D and calcium deficiencies as all are risk factors for falls.

• Ensure that any eyesight or hearing issues are noted and corrected if possible. Get an eye exam at least once a year and update your glasses as needed. If you wear bifocals or progressive lenses, consider getting a pair with only your distance prescription for outdoor activities, such as walking, because these types of lenses can impact how you judge distances.

• Impaired hearing can put you at risk for balance issues in addition to isolation and reduced activity. Have your hearing checked and use a hearing aid if one is prescribed.

• Bring up any other issues you think may put you at risk for a fall – for instance, if you’ve already suffered a fall, let your doctor know.

• Ask for your overall risk level for falling and for recommendations on how to prevent a fall.

• Talk with your healthcare provider about whether mobility assistance devices such as canes or walkers might help if you have impairments.

If your physician does not offer such assessments, ask to be referred to a physical therapist to evaluate your balance, strength and gait; see your eye doctor to evaluate your sight; have your hearing checked; and ask your AgingResourcesWNC.com

pharmacist to review your medications for any potential interactions.

Prepping Your Home for Fall Prevention

Reducing major risk factors for falling inside your home is easy and inexpensive.

• Eliminate clutter: Take a good look around the house and remove anything from the floor that could cause you to trip, such as piles of reading material, electric cords, heaters or fans.

• Secure rugs: Remove any loose rugs. If you must keep them, secure them to the floor with double-sided tape.

• Improve stairs: Stairways should be clear of clutter and have sturdy handrails on both sides.

• Make your bathrooms safer: Be sure floors stay dry. Put non-slip mats in tubs and showers and in front of toilets. Install grab bars in showers and anywhere else they could be helpful. Place a seat in the shower or use a transfer bench in the tub.

• Improve lighting: Be sure every room in the house—especially high traffic areas and bedrooms—are well lit. Ensure light switches are easily accessible from doorways and not behind furniture or across a room. Install good nightlights from the bedroom to the bathroom.

• Evaluate pet behavior: If pets are constantly underfoot or are strong enough to pull you over during a walk, you may want to create strategies – such as gates to keep pets off steps or having someone walk your dog – to keep both you and your pet safe.

• Live on one level: Consider moving to a home with one floor. If you can’t, take extra care on stairs and try to arrange your life so that climbing steps is kept to a minimum if stairs are challenging for you.

More Help with Fall Prevention

Organizations throughout Western North Carolina can help you assess your fall risk and assist you in eliminating as much of that risk as possible. To find out more about fall prevention resources in your county and to find a risk assessor and other support services, use the “Contact Us” form on the WNC Fall Prevention Coalition site at wncfallpreventioncoalition.org. n 65

Embracing Technology Helps You Stay Independent HOW DIFFERENT DEVICES PROMOTE HEALTH AND HAPPINESS

In our 21st-century world, technology is woven into every part of our lives. For older adults or those caregiving for loved ones, the realm of devices and technological tools that can help with maintaining independence and a good quality of life is growing every day. Here’s a sampling of just some of the many gadgets that can make life easier and more enriching: Tablets and e-readers – With screens that are larger than smartphones and portability that desktop computers lack, tablets – when connected to the Internet through Wi-Fi – can help provide easy access to bank accounts, investments, financial information and health records. They also provide a handy way to surf the Web and stay connected with friends and family through social networking sites like Facebook and through video chatting platforms like Skype or Google Hangout, helping ward off feelings of loneliness and isolation. E-readers like Kindles and Nooks are lightweight, have the ability to make words appear larger and can provide a virtual library of books, magazines and other reading materials at the touch of a fingertip.

Smart speakers – Like having a virtual assistant who does what you say, smart speakers like the Amazon Echo and Google Home devices also use a Wi-Fi connection to respond to requests for information and more. Users give voice commands to make the devices play music, set timers, make lists, get the weather, control connected devices such as thermostats and lights, order products from select retailers, turn televisions on and off and much more.

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Video gaming consoles – By playing video games, you can flex your mental muscles, help your memory and stimulate your mind. Devices like Nintendo Wiis, which virtually mimic playing sports and doing exercises, can help with maintaining physical activity. Games are also available that allow the player to connect with others online, offering a virtual avenue for additional social interaction.

Healthcare-related devices – Medicationdispensing systems can remind users to take their medicine and can send alerts if a dose is missed.

Battery-powered devices called Personal Emergency Response Systems (PERS) - or Medical Emergency Response Systems - typically can be carried in a pocket or worn around the neck or wrist and allow the user to call for emergency help with the press of a button. Vital health data such as someone’s heart rate, oxygen levels and blood pressure can be measured and collected through wearable health monitoring sensors. Wireless-enabled wearable activity trackers like Fitbits can help measure daily physical fitness, such as steps walked or climbed, sleep quality and heart rate.

Through an evergrowing number of assistive devices, technology can offer life enhancement, peace of mind and help with remaining independent at home with less worry and more fulfillment. n

Aging Resources 2018–2019

Leading Eye Care Since 1961

M

any disorders of the eyelids and eye sockets that are common with age can be corrected easily through oculoplastic surgery.

Drooping or sagging eyelids that may affect vision or be of cosmetic concern can be corrected by the removal of extra skin or fat around the eye or by doing muscle adjustments to raise the upper lids. People with drooping eyelids may experience headaches and impaired vision that forces them to hold their heads up to try to see.

After being treated with oculoplastic surgery, patients often experience great improvement with their vision and quality of life. To help with appearance, bagginess and sagging around the eyes often can be corrected surgically at the same time.

Older adults may experience other disorders of the eyelids and eye socket including tumors, growths around eyelids, blocked tear ducts and other socket problems. If tumors in the eye socket behind the eye are found, these can be removed and biopsied to check to make sure they are benign.

People who have problems with their eyes watering may have tear drain problems which can be helped through oculoplastic surgery to repair tear drains. Those with thyroid issues also can have eye symptoms which can be evaluated and treated with oculolplastic surgery, medication or a combination of therapies. Older adults sometimes have eyes that need to be removed or replaced with implants, another condition that oculoplastic surgery can correct. And in addition to specialized issues, overlapping conditions such as styes, dry eye and blepharitis – a bacterial inflammation of the eyelids – can be addressed.

As one of only 500 board-certified oculoplastic surgeons in the United States, Jeffrey B. Goldstein, MD of Asheville Eye Associates is able to treat disorders of the eyelids and eye sockets right here in Western North Carolina.

As You Age, Trust Your Eyes To The Experts Procedures are typically same-day, take less than 45 minutes, require only light sedation and are done on-site at Asheville Eye Associates’ outpatient surgical center. Most patients are pain-free afterwards and only experience a little bruising or swelling that usually subsides within a week.

Take care of your eye issues today by calling Asheville Eye Associates toll-free at (800) 531-EYES (3937) to schedule an appointment with Dr. Goldstein or one of the group’s other leading eye care providers in Western North Carolina.

JEFFREY B. GOLDSTEIN, MD

Asheville Eye Associates 8 Medical Park Drive Asheville, NC 28803

828-258-1586 800-531-EYES(3937) 65

Hearing Well Means Staying Well

REGULAR MEDICAL CHECK-UPS ARE KEY TO DEALING WITH AGE-RELATED HEARING LOSS AND ITS EFFECTS Hearing loss can have serious consequences to your health beyond the frustration of not being able to hear. It can result in mental health issues, physical health issues and major safety concerns.

Hearing loss can lead to: • Depression due to isolation; • Faster cognitive decline resulting in dementia due to isolation; • Significant increase in risk of falling due to balance issues; • Paranoia due to inability to hear environmental sounds and cues; and • Increased stress from struggling to understand.

Keeping tabs on the ability to hear is an important part of healthy aging. Age-related hearing loss happens gradually, typically over a decade or more, and often goes unnoticed until it becomes significant. Among people 75 and older in the United States, nearly half have difficulty hearing and about one in three between the ages of 65 and 74 has hearing loss.

Although it cannot be reversed, hearing loss can often be successfully treated and the 68

earlier it is discovered, the easier it is to adapt to management techniques, hearing aids or other assistive listening devices. Hearing aids and other listening devices also have improved greatly over the last decade in function as well as fashion.

Signs of age-related hearing loss include: • Having trouble following a group conversation; • Often thinking people are mumbling; • Asking people to repeat things; • Having trouble understanding higher voices like those of women and children; • Having trouble understanding conversations on the phone; • Becoming stressed at or avoiding large gatherings because of difficulty hearing in crowds; • Ringing in the ears; • Dizziness, loss of balance or vertigo; • Comments from others that your or your loved one’s TV or radio is loud; and • Ears that itch, hurt or leak fluid.

Other factors that can contribute to hearing loss are a family history of hearing loss, diabetes, Aging Resources 2018–2019

heart disease, circulation or thyroid issues.

If any of these warning signs describe your or your loved one’s experience, seek medical attention from a physician who will be able to evaluate symptoms and determine whether one of the following specialists should be seen: • An otolaryngologist, a physician specializing in the ears, nose and throat (ENT); • An audiologist, a healthcare professional who specializes in identifying auditory disorders, treating them with hearing aids or other devices and monitoring hearing issues; or • A hearing instrument specialist, a licensed professional who can test hearing and select and fit hearing aids.

Taking care of hearing issues makes a huge difference in the quality of life, health and the ability to remain independent, and regular hearing check-ups are an important part of aging well. For more information and advice, visit the National Institute on Deafness and Other Communication Disorders’ page at nidcd.nih.gov/health/age-relatedhearing-loss. n

Every moment matters.

Four Seasons helps you make the most of your moments and feel better doing it.

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The Care You Trust

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Care Navigation, Home Care, Palliative Care, Hospice Care, Bereavement Support, Clinical Research

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Living with Dementia

IDENTIFYING AND MANAGING SYMPTOMS OF ALZHEIMER’S AND OTHER DEMENTIA Dementia is difficult for everyone – for the person diagnosed with it, for the family members who become caregivers and even for healthcare providers who do not always have solutions to the many challenging situations this disease can create for patients and their families.

When confronted with dementia—as a patient or caregiver—the best defense is a good offense. Begin by educating yourself about the disease, about the treatments and lifestyle practices that can work to slow the disease, about the behaviors and challenges you can expect as the disease progresses and about ways to manage life after a dementia diagnosis with as much joy and dignity as possible.

What is Dementia?

Dementia is an umbrella term that covers a multitude of disorders that impair memory to the point that daily functions become difficult or impossible. Alzheimer’s disease, vascular dementia, frontotemporal dementia 70

and Parkinson’s disease are some of the more common forms of dementia.

Although dementia is not a normal part of aging, the biggest risk factor for the disease is age. More than half of us who reach 85 years old or older will suffer memory loss. Dementia is progressive and there currently is no cure.

Dementia vs. Typical Forgetfulness

It is easy to confuse the very early signs of dementia with typical memory issues we all experience as we age, but they are different.

For instance, it is normal to misplace your keys or your glasses. It is not normal—and may be an indicator of dementia—to put your keys or glasses in an unusual place, such as the freezer or in the back of a drawer, and then have no recollection of where you put them.

It is normal to walk into a room in your home and forget your purpose for going there.

It is not normal—and may be an indicator of dementia—to walk into a room in your home and for a moment not know where you are.

Aging Resources 2018–2019

Difficulty performing once routine mathematical tasks – such as balancing your checkbook or adding a column of numbers – or feeling excessively challenged when learning new things – such as how to work a new appliance – may also indicate a serious memory disorder. Simple checklists of early warning signs can be found on many websites.

For a list of 10 early signs of dementia, visit the Alzheimer’s Association website at alz.org/ alzheimers_disease_know_the_10_signs. asp.

Get Diagnosed – The Sooner, The Better

If you suspect dementia, get a diagnosis from a neurologist who specializes in memory loss and do so as soon as possible. Insist that both the patient and close family members or loved ones are part of the evaluation and are given the opportunity to discuss with the physician what has caused them to suspect dementia. While most patients are well aware that their ability to process information has changed, a loved one is usually in a better position to recall and give details of specific incidents and behavior changes, giving physicians a more complete picture.

While there currently is no cure for dementia, there are medications and lifestyle practices that can slow the progression of the disease especially when a diagnosis is made early. Also, other conditions, such as depression, stress, poor sleep, hearing loss, vision problems, an underlying infection or other illness can worsen symptoms.

Simply treating these disorders often can return some memory function.

With a diagnosis in hand, a physician is better able to guide the patient and the family as to how to manage symptoms now to maintain the greatest independence and to give all concerned an idea of what to expect for the future.

Make a Plan

Although only one member of the family may have dementia, everyone in the family is affected. It makes sense to come together as a family in these early stages and put together a plan of action to care for the patient and manage life as the disease progresses.

As a family, you should decide on roles and responsibilities for everyone who wishes to be AgingResourcesWNC.com

INTERACTING WITH YOUR LOVED ONE Being there for someone with dementia can pose challenges but there are approaches that can help, many of which involve being supportive, compassionate and understanding of changes caused by the disease.

Simplify: Talk about one thing at a time, use fewer words and speak slowly. Sharing too much information – and multitasking – can be confusing and overwhelming. Realize that logic does not apply to an illogical disease.

Let your loved one carry out tasks: Offer to help but also be willing to not help so your loved one has the chance to feel good about accomplishing something on his or her own.

Use memory aids: Lists, signs, dry-erase boards, alarm clocks and calendars can help as can having designated spots for commonly misplaced items.

Be attuned to eyesight and hearing issues: Vision and hearing problems can worsen – and in some cases mimic – dementia symptoms. Peripheral vision can be lost and perception can change, too, as the disease progresses. Make sure your loved one has his or her eyesight and hearing checked regularly, especially if he or she is having trouble with avoiding obstacles, seeing well even when wearing glasses, struggling to follow a conversation or having problems with balance.

Show and tell: Visually communicating with your loved one is as important as talking with him or her so be sure to show and say what you mean. To assist with his or her comprehension, make your loved one’s living space as free as possible of distractions such as visual clutter and noises. Use hand gestures, visual cues and prompts to help convey what you mean.

Go down memory lane: Reminisce about the past by looking at old photographs and mementos and telling stories from days gone by.

Practice patience and kindness: Reassure your loved one and focus on his or her feelings rather than the facts. Apologize and say “I’m sorry” regularly when he or she is frustrated, sad or angry. Respond with affection through smiles and hugs.

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part of the care management. Be realistic in your commitments. Dementia is for the long haul. Commit to what you can do and then find resources in the community to help where you and others cannot.

Securing the help of a professional at this point — such as a geriatric care manager, a social worker or someone from your local Council on Aging — may be a good idea. To find a certified geriatric care manager – or Aging Life Care professional – in your area, visit the Aging Life Care Association at caremanager. org. These professionals are trained to help you know what to plan for. They can inform you of support services and various resources in your area, help you weigh your housing options and help you navigate the system overall.

With dementia, what is unthinkable now — moving to assisted living, using adult day care or needing round-the-clock care — can become reality. With a plan, these transitions become easier financially and emotionally for everyone should they become necessary.

Housing Considerations

Someone with memory impairment functions better in familiar surroundings. To that end, it is to everyone’s advantage to move the patient into the care situation chosen before rather than after the full force of that care is needed. By making a move before dementia progresses, the person can make friends, get used to routines and form relationships with staff while they still have the ability to do so.

As you look at living situations, have the goal of only moving your loved one once.

Consider places that offer both assisted and skilled care in the same building, or at least on the same campus. If symptoms worsen and skilled nursing becomes necessary, it is healthier for your loved one to be in familiar surroundings with people he or she trusts.

Staying put also increases opportunities for independence, reduces your loved one’s fear and makes it easier for the on-site friends to visit.

Get Support for the Caregiver

Part of every plan for dementia care must be to care for the caregiver. This means ensuring 72

caregivers don’t overcommit themselves and that their needs and desires also are considered.

They should take time to join a support group online or in person for emotional support as well as to gain insight and strategies for managing the disease. Respite care should be built into the schedule to ensure caregivers have time for rest and for living their own lives.

Remember that the care plan is not written in stone. The person with dementia and the caregiver should feel free to change it as circumstances and abilities change. For instance, a caregiver may commit at first to keeping a loved one at home. As the disease progresses or life circumstances change, this may prove to be too stressful for the caregiver.

At that time, the caregiver should feel free to change the plan and find a solution that works better for him or her and the patient. Turn to pages 77-79 of the Aging Resources Directory for Alzheimer’s/Dementia and Caregiver Support resources in your area.

Advances in Treatment

With increased scientific research now being devoted to Alzheimer’s disease and other forms of dementia, advances in treatment are occurring more rapidly. Medications for memory, treatments for sleep changes, strategies for addressing changing behaviors and a host of alternative therapies are improving the quality of life for dementia patients and their loved ones. The Alzheimer’s Association continually updates information about advances in treatment and promising clinical research breakthroughs at alz.org/ alzheimers-dementia/treatments and alz. org/research.

Your Family Is Not Alone

Millions of people in the United States have dementia and that number is expected to rise as the population ages. There is nothing easy about the often long course of dementia.

But with early diagnosis, an acceptance of the realities of the disease and a proactive approach to management, both people with dementia and their caregivers can maintain the highest quality of life possible for as long as possible. n

Aging Resources 2018–2019

Specialized Alzheimer’s And Dementia Care At Home Home Helpers CEO Leigh Warlick was inspired to enter a career of caregiving after the personal experience of caring for her mother.

Every day, millions of Americans and their families are coping with Alzheimer’s disease and other forms of dementia while trying to stay in their own homes as long as possible.

Throughout Buncombe, Henderson, Polk and Transylvania Counties, Home Helpers provides in-home, compassionate companion and personal care services to senior citizens and others needing recuperative or longterm help, including specialized care for people with Alzheimer’s disease and other types of dementia.

CERTIFIED TRAINING FOR QUALITY CARE

As a Certified Alzheimer Caregiver Trainer, Home Helpers owner Leigh Warlick has expertise about best care practices for the particular needs of people with Alzheimer’s and other dementias. Members of her caregiving team receive training on specific caring approaches suited to the unique physical, cognitive, emotional and behavioral needs of people with dementia.

For example, caregivers are trained to listen to and not argue with clients, to approach them in their field of vision head-on rather than from the side because peripheral vision can be decreased and to encourage them to reminisce and talk about their younger days.

establishing a caregiving schedule, a nurse with Home Helpers also conducts a safety assessment of the home.

DELIVERING PEACE OF MIND

To help them stay apprised of how their loved ones are doing, Home Helpers regularly calls and emails out-of-town family members. Direct Link Emergency Monitoring Services offered by Home Helpers also help give peace of mind to families. Home Helpers is the only local home care agency offering the option of Direct Link’s 24-hour/7-day-a-week emergency monitoring services. Monitoring devices include The Care Watch wristwatch or pendant which uses GPS and cellular technology without the need for a cell phone.

For nearly two decades, Home Helpers has provided insured and bonded help that can range from three hours at a time to 24-hour, round-the-clock care.

If you or a loved one is in need of companion and personal care services – particularly if Alzheimer’s or dementia is involved – contact Home Helpers today to schedule a free in-home consultation.

Because people with Alzheimer’s and dementia benefit from consistency in their routines, Home Helpers also employs the strategy of having one of their professional care providers responsible for the regular care of a client rather than having a changing rotation of multiple caregivers.

Home Helpers’ caregivers can help clients with bathing, dressing, meal preparation, feeding, toileting, grocery shopping, companionship, light housekeeping, transportation, errand services and more. Prior to

AgingResourcesWNC.com

Home Helpers 550 Fleming Street in Hendersonville

(828) 694-0000

homehelpershomecare.com/hendersonville

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Enhancing Life with Palliative and Hospice Care THE COMFORTING BENEFITS OF BOTH WHEN NAVIGATING ILLNESS When facing a serious illness or life-limiting condition, palliative care and hospice care can provide you or a loved one with relief, a sense of control and enhancement of life in the midst of difficult circumstances.

Both palliative care and hospice care focus on the needs of the whole patient, not just someone’s illness. Both have the goal of decreasing symptoms and increasing quality of life, and both help patients and their families live as fully as possible and with dignity in spite of their illness.

Palliative Care

Palliative care is for patients managing a serious illness. With palliative care, curative treatments continue but with a more holistic approach that takes you and your whole life into account. With palliative care, you get a team of specially trained professionals to help you navigate your life, as well as your illness.

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A palliative care team typically consists of a medical social worker, some combination of healthcare providers – such as a physician, nurse practitioner and nurses – and perhaps a pharmacist, nutritionist, spiritual counselor and volunteers. Working closely with you and your family, the team helps you or your loved one: • Have a conversation with family members and document wishes for future health care; • Develop treatment goals and a lifemanagement plan that reflect your or your loved one’s values, life goals, lifestyle and desires; • Ensure proper pain management and symptom relief is in place; • See that financial issues are addressed and help is found if needed; and • Ensure that family members receive information, support, respite and other needed resources.

Aging Resources 2018–2019

With palliative care, the patient is always in control. You or your loved one can ask the doctor for a referral to palliative care at any time during a serious illness and palliative care services can be stopped at any time during an illness or when there’s recovery.

Hospice Care

Hospice care is for patients with any lifelimiting condition and typically a prognosis of six months or less to live. As with palliative care, hospice care is provided by an interdisciplinary team of healthcare and human services professionals. A hospice team works closely with the individual who is ill to achieve many of the same goals as with palliative care.

The difference is that hospice patients are no longer seeking curative treatments – they are seeking comfort and quality of life. Hospice care does nothing to hasten death. In fact, people receiving hospice care often live longer than people actively being treated for the same disease. With hospice care: • Services can be received at home, at a care

facility, at a hospital or at a hospice house.

For those in a hospital or nursing facility, hospice care can often make a move home possible if so desired; • Hospice recipients can continue to see their regular physicians and use prescribed medications; • People under hospice care can go out, have visitors in and do whatever they feel up to doing; and • Individuals under hospice care can stop receiving it and resume curative treatment at any time.

A physician’s referral is required for palliative or hospice care. Medicare, Medicaid and private insurance offer benefits for both types of care. Care teams can help look into specifics of an individual’s health care policy to determine what is covered.

To find palliative care or hospice care providers in your community, turn to the Aging Resources Directory on page 82. n

A HIGHER STANDARD OF CARE!

Yancey’s Community Hospice Since 1982

HospiceofYancey.org

828-682-9675 AgingResourcesWNC.com

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We’re here to help.

A resource for patients and caregivers • • • • • •

24/7 Helpline Expert consultation and referrals Content-rich website Diagnostic and treatment options Updates of research advancements Online community - alzconnected.org

• • • •

Customized action plan alz.org/alzheimersnavigator Support Groups Clinical study matching - alz.org/TrialMatch Education programs

24/7 Helpline Assistance in 140 languages 1.800.272.3900 www.alz.org/northcarolina

Western Carolina Chapter

Find More Resources Online!

Visit AgingResourcesWNC.com to view a digital version of Aging Resources Magazine with direct links to all provider websites for easy access to more information.

You'll also find a searchable resource directory and helpful articles.

Connect with us on Facebook at facebook.com/agingresourcesmagazine to get the latest from Aging Resources.

Find links to helpful tips and articles and keep up with events for seniors throughout Western North Carolina.

AGING RESOURCES SERVING ASHEVILLE, HENDERSONVILLE AND SURROUNDING AREA

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Aging Resources 2018–2019

Aging Resources Directory

There is plenty of help for seniors and their caregivers in our area. Below is a list of commonly needed services. For a direct link to all websites for listings in this directory, view the magazine online at AgingResourcesWNC.com.

GENERAL INFORMATION.

ADULT DAY SERVICES. CarePartners-Adult Day Services A safe, enjoyable place for aging and impaired adults to stay engaged during the day. carepartners.org

Aging Resources Magazine A print and online resource for managing the financial, legal, social, residential, health and medical issues of aging and caregiving.

828-513-3888 agingresourceswnc.com

Councils on Aging Local nonprofit advocacy agencies that also provide a wide range of services and resources for older adults.

Buncombe County 828-277-8288 coabc.org Henderson County 828-692-4203 coahc.org Isothermal Planning & Development Commission Area Agency on Aging Facilitating a comprehensive long-term care system for older adults in the region.

Serves Polk, Rutherford, McDowell, and Cleveland Counties 828-287-2281 regionc.org Land of Sky Regional Council A multi-county, planning and development organization offering volunteer opportunities, aging resources, workforce development, community development services and more.

339 New Leicester Highway, Suite 140, Asheville 828-251-6353 landofsky.org SEE PAGE 33

Buncombe County 68 Sweeten Creek Road, #A, Asheville 828-277-3399 Henderson County 114 College Drive, Flat Rock 828-697-7070 carepartners.org Transylvania County 23 Medical Park Circle, Brevard 828-884-2980 trhospital.org/services SEE PAGE 29

AGING IN PLACE.

Aging Projects, Inc. This online resource directory is specially designed to help seniors find screened resources to age in place.

828-776-1390 agingprojectsInc.org ALZHEIMER’S/DEMENTIA. Alzheimer’s Association Comprehensive information, care consultations, and online resources—24/7 Helpline.

For information call.

800-272-3900 alz.org

Western Carolina Chapter 828-398-5780 alz.org/northcarolina

SEE PAGE 76

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AGING RESOURCES Alzheimer’s/Dementia Caregiver Support Group Third Tuesday each month, 2:00–3:30 pm.

A care receiver program is provided for loved ones.

United Methodist Church 204 Sixth Avenue West, Hendersonville Contact Lisa at 828-696-9799 The second and fourth Tuesday of each month, 1:30-3:00 pm.

This program is for caregivers with loved ones with early stages of dementia. Two groups are run: the caregiver support group and also a discussion group for those with memory loss.

Pre-registration is required.

Mud Creek Baptist Church Contact Patty at 828-692-1262 ext. 135 Dementia Friendly WNC A grass roots organization dedicated to the well being of people living with dementia and their families though a welcoming and knowledgeable community.

828-712-4811 dementiafriendlywnc.org Home Helpers / Direct Link Highly trained and experienced dementia caregivers providing the most effective method of home care services for your family’s unique situation.

550 Fleming Street, Hendersonville 828-694-0000 homehelpershomecare.com/hendersonville

SEE PAGE 73 Memory Lane Café Meets the third Monday of each month Social gathering with food and fellowship for those affected by Alzheimer’s and dementia and their families.

1:00 -3:00 pm Mud Creek Baptist Church 403 Rutledge Drive Hendersonville, NC 28739 Contact Patty at 828-692-1262 ext.135 or patty@mudcreekchurch.org Memory Support Groups for Caregivers and Care Receivers The first group meets every Thursday, 1:30 to 3:30 pm. A second group meets on the 2nd and 4th Tuesday of every month, 1:30-3:30 pm. Preregistration is required.

Mud Creek Baptist Church 403 Rutledge Road, Hendersonville Contact Patty at 828-692-6383 ext. 135 patty@mudcreekchurch.org 78

Project C.A.R.E. (Caregiver Alternatives to Running on Empty) This state-funded program offers care consultation, information, assistance and referrals to other resources to family caregivers/care partners who care for a loved one with dementia. Services are free to consumers.

339 New Leicester Hwy, Suite 140, Asheville 828-251-7432 landofsky.org/projectcare Support Groups for Persons in the Early Stages of Memory Loss:

Highland Farms Retirement Community 200 Tabernacle Rd., Black Mountain Second and fourth Tuesday 9:30-11:30 am Mel Kelly 828-301-0529 Avant_garden@msn.com A support group for caregivers meets simultaneously only on the second Tuesday of each month, in Lounge Room 3, lower level, in the J-K entrance to the Brookside Building.

New Hope Presbyterian Church 3070 Sweeten Creek Road, Asheville Third Tuesday 1:00–2:30 pm For information, call Nancy Hogan, at 828-251-7432 or Mel Kelly, co-facilitator at 828-301-0529. A caregiver support group meets simultaneously at the same location in the lower level.

BEHAVIORAL HEALTH. Fresh Start Behavioral Health Individualized medication management and group therapy treatment for those 55+ with mental health needs. Positive solution focused.

Transylvania Regional Hospital 260 Hospital Drive, Brevard 828-862-6393 trhospital.org/support-services St. Luke’s Hospital Senior Life Solutions (outpatient) and the Center for Behavioral Health (inpatient) offer a multidisciplinary approach to mental health for seniors.

101 Hospital Drive, Columbus 828-894-3311 saintlukeshospital.com SEE PAGE 3

Aging Resources 2018–2019

RESOURCE DIRECTORY CAREGIVER SUPPORT. CarePartners–Caregivers Support Groups Third Wednesday each month, 3:30–5:30 pm 68 Sweeten Creek Road, #A, Asheville 828-277-3399

Last Thursday each month, 5:30-7:00 p.m.

23 Medical Park Drive, Brevard 28712 828-884-2980 carepartners.org

Family Caregiver Support Program Land of Sky Regional Council The Family Caregiver Support Program works on a regional level to establish partnerships with caregiver service providers, caregivers, and those who interact with caregivers to leverage resources and improve and expand the available resources / services for caregivers. This program is funded by the Older Americans Act, Title III-E. 828-251-7441 landofsky.org/fcsp.html CHARITABLE GIVING. Community Foundation of Henderson County A non-profit providing donors a variety of simple, powerful and personal ways to make a philanthropic impact on their community, now and forever.

401 North Main Street, Suite 300, Hendersonville 828-697-6224 cfhcforever.org SEE PAGE 18 Four Seasons Foundation Use philanthropy as an estate planning tool to make award winning levels of hospice and palliative care possible into the future.

571 South Allen Road, Flat Rock 866-466-9734 fourseasonsfdn.org SEE PAGE 9 Hospice Home Store When you donate to or purchase an item from the Hospice Home Store, you are supporting the efforts of Four Seasons and providing invaluable support to families facing serious illness.

215 North Main Street, Hendersonville 828-696-0625 hospicehomestore.org SEE PAGE 60

MemoryCare A non-profit community-based program offering specialized medical care and support for patients and families affected by Alzheimer’s and other memory disorders. A referral is necessary.

100 Far Horizons Lane, Asheville 828-771-2219 memorycare.org COMPANIONS. Senior Companion Program Senior volunteers provide assistance with daily tasks to other seniors.

Land of Sky Regional Council 828-251-6622, ext. 1126 Buncombe, Transylvania, Henderson and Madison landofsky.org CONGREGATE MEALS/MEALS ON WHEELS. Buncombe County Senior Opportunity Center Congregate lunch, Monday–Friday Members have to be 60 years old or more and need to register for meals a week in advance, donations accepted for the meal 36 Grove Street, Asheville 828-350-2062 Henderson County Mills River Life Enrichment Center (MRLEC) Senior fellowship with a program and lunch every Thursday. Programs begin at 10:00 am and are held in the Mills River United Methodist Church Fellowship Hall. Lunch Reservations are required. Please call by 12:00 pm the Tuesday before each program.

Mills River United Methodist Church 137 Old Turnpike Road, Mills River 828-808-5581 millsriverumc.org Sammy Williams Center Lunch at the Sammy, Mon–Fri ; 9:00 am–1:00 pm Donation-based lunch, activities and fellowship 301 North Justice Street, Hendersonville 828-692-3320 coahc.org/sammy-williams-center Polk County The Meeting Place Congregate lunch, Monday–Friday 25 Shield Drive, Green Creek 828-863-2795 polknc.org

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AGING RESOURCES The Meeting Place Congregate lunch, Monday–Friday 75 Carmel Lane, Columbus 828-894-0001 polknc.org Saluda Senior Center Congregate lunch, Monday–Friday, home-delivered meals, recreation and education programs 64 Greenville St., Saluda 828-749-9245 polknc.org Transylvania County Quebec Congregate Meal Site Congregate lunch, Monday–Friday, 10:00-12:00 p.m.

Quebec Community Center Hwy 64, Lake Toxaway 828-862-4466 wcca.net Silvermont “Lunch Plus” Program (WCCA)— Congregate lunch, Mon–Fri 9:30 – 12:00 pm A socialization/nutrition program for Transylvania County residents 60 years old and better that includes daily activities and lunch. Transportation may be available depending on where you live. Pre-enrollment is required.

Silvermont Opportunity Center 364 East Main Street, Brevard 828-884-3166 wcca.net Meals on Wheels Hot meals delivered Monday–Friday to homebound adults who are unable to prepare meals.

Buncombe County—828-253-5286 Henderson County—828-692-6693 mow@coahc.org Polk County Columbus—828-894-0001 Green Creek—828-693-2795 Transylvania County Brevard—828-883-3743 Quebec Communities—828-884-2255

Mobile Meals Provides free meals to the elderly community (60 years or older) who are homebound in locations where Meals on Wheels doesn’t go in Transylvania County.

Donations are accepted.

828-884-2255 wcca.net

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EDUCATION & CULTURAL CENTERS. Blue Ridge Center for Lifelong Learning Classes, “EdVentures,” brown bag lunches and other learning opportunities for those 50 years of age and better.

Blue Ridge Community College 180 West Campus Drive, Flat Rock 828-694-1740 brcll.com Life@Western Carolina Noncredit Lifelong Learning courses for adults 50+.

Topics include history, culture, health, science, geopolitical and legal issues.

Biltmore Park, Asheville 828-227-7397 life.wcu.edu Osher Lifelong Learning Institute A learning community dedicated to promoting lifelong learning, leadership, community service and research.

University of North Carolina-Asheville One University Heights, Asheville 828-251-6140 olliasheville.com EYE CARE. Asheville Eye Associates Providing leading edge medical and surgical treatment for cataracts, glaucoma, macular degeneration, diabetic eye disease and all subspecialties of ophthalmology. Offices in Asheville, Hendersonville, Sylva and Franklin.

828-258-1586 or 800-531-3937 (EYES) ashevilleeye.com SEE PAGE 67 HEALTH AND WELLNESS. Mission Health Recognized as one of the nation’s Top 15 Health Systems, Mission is dedicated to improving the health and wellness of the people of WNC. 509 Biltmore Avenue, Asheville 828-213-1111 mission-health.org INSIDE FRONT COVER St. Luke’s Hospital Senior-focused services for inpatient and outpatient behavioral health, state-of-the-art orthopedics and rehabilitation and 24/7 ER. 101 Hospital Drive, Columbus 828-894-3311 saintlukeshospital.com SEE PAGE 3

Aging Resources 2018–2019

RESOURCE DIRECTORY PACE (Program of All-Inclusive Care for the Elderly) PACE promotes the independence of seniors 55+ who want to live at home. A team of professionals coordinates an array of services for each participant.

286 Overlook Road, Asheville 828-213-8442 carepartners.org Pardee Hospital Named a top 15 hospital in North Carolina by U.S. News & World Report, Pardee remains focused on providing advanced, compassionate care close to home, to the people who matter most.

800 North Justice Street, Hendersonville 828-696-1000 pardeehospital.org SEE PAGE 63 WNC Fall Prevention Coalition Heather Bauer, Fall Prevention Programs Manager 828-450-6698 fallpreventioncoalitionwnc@gmail.com wncfallpreventioncoalition.org

YMCA of Western North Carolina The Y’s Healthy Aging programs help older adults stay active, improve health, and maintain community connections. Build your spirit, mind, and body at the Y. Multiple locations in Asheville, Fletcher, Hendersonville, and Marion 828-251-5909 ymcawnc.org SEE PAGE 11 HEARING SERVICES. Biggert’s Hearing Instruments Certified, licensed audiologists provide comprehensive hearing evaluations and customized hearing device options including digital hearing aids.

303 South Church Street, Hendersonville 828-692-0353 biggertshearing.com SEE PAGE 69

HOME CARE/HOME HEALTH. Always Best Care Providing in-home personal care, meals, housekeeping, medication reminders, recovery care and Alzheimer’s and dementia care. Transportation for errands and outings. Hourly or live-in care.

828-676-2939 alwaysbestcarewnc.com SEE PAGE 28 CarePartners Home Health & Private Duty Nursing Providing nursing, therapy, social work and personal care in patient’s homes, skilled nursing facilities and assisted living facilities.

Home Health: 800-627-1533 Private Duty: 828-277-4777 carepartners.org SEE PAGE 29 Compassionate Home Care In-home assistance with personal care, meals, housekeeping, shopping, transportation and more.

Available 24/7.

735 Sixth Avenue West, Hendersonville 828-696-0946 compassionatehc.com SEE PAGE 5 Griswold Home Care Dedicated to referring compassionate caregivers who help people stay at home and stay independent. Providing in-home assistance with personal care, medication reminders, shopping, transportation, and more. Hourly or live-in rates.

828-348-0988 griswoldhomecare.com/Asheville SEE PAGE 7 Home Carefree Home Carefree comes to your “home” no matter where home is: private residence, independent living, assisted living, or a skilled nursing facility.

828-277-1580 homecarefree.org SEE PAGE 27

Home Helpers/Direct Link Making life easier with one-on-one in-home Tryon Hearing Center personal care for a few hours a week or 24/7.

Hearing testing, hearing aids, programming of Direct Link medical alert systems also offered. digital hearings aids. Jim Wiprut, NC licensed Call for a free in-home consultation.

Hearing Instrument Specialist. Call for free 550 Fleming Street, Hendersonville evaluation.

828-694-0000 2753-D Lynn Road, Tryon homehelpershomecare.com/Hendersonville 828-859-3007 SEE PAGE 73 tryonhearingcenter.com Continued on next page AgingResourcesWNC.com

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AGING RESOURCES Kindred at Home (formerly Gentiva) At Kindred at Home, care is defined by clinical expertise and the compassion delivered every day— one patient at a time.

9 Olde Eastwood Village Blvd., Asheville 828-298-1370 kindredathome.com SEE PAGE 41 Licensed Home Health/Home Health Providers List of licensed home-health and home-care providers. ncdhhs.gov/dhsr/data/hhlist.pdf Medicare Compare for Home Health Information on and patient survey results for home health agencies by location and ability to compare services offered. medicare.gov/homehealthcompare National Association for Home Care & Hospice Licensing and accreditation information on and a locator for home care and hospice agencies. nahcagencylocator.com North Carolina Department of Health & Human Services Division of Health Service Regulation office: 919-855-3750 Adult Care Licensure: 919-855-3765 For information about inspections, penalty and star rating on Adult Care facilities visit ncdhhs.gov/dhsr/ acls/index.html Pardee Home Health Providing the quality medical care you need in the comfort of your own home. Offering a full range of in-home services.

2029 Asheville Hwy, Hendersonville 828-692-1846 pardeehospital.org SEE PAGE 39 Seniors Helping Seniors Providing in-home care for seniors by seniors in Buncombe, Henderson, Transylvania and Madison counties. Request help for your needs or work to meet the needs of others. No minimum visit times.

828-236-0662 seniorcareasheville.com SEE PAGE 11

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HOME/ESTATE AND MOVE MANAGEMENT. Key Associates Serving trustees, families and individuals to reduce stress through home management for stay at home support or move management for organized, costeffective transitions and downsizing. Bonded and insured. Call for free consultation.

828-696-2441 keyassociates.biz Simply Change - Professional Organizers Stress-free support for seniors and families: organizing, downsizing, moving, packing/ unpacking, staging and estate liquidation. Serving WNC for 15 years. Call for a Free consultation. change@simplychangenow.net 828-350-9377 simplychangenow.net HOSPICE & PALLIATIVE CARE. Hospice and Palliative Care services are provided in area hospitals, nursing homes, assisted living facilities or in the home by the organizations listed below. Each also has their own Hospice Care facility when care can’t be provided at home. And each can also assist you with end-of-life planning and advanced directives.

For more information about hospice and palliative care, please see the article on page 74 or contact the hospice provider convenient to you.

CarePartners Hospice Hospice care in home, skilled nursing facility or inpatient Solace Center.

21 Belvedere Road, Asheville 828-255-0231 carepartners.org SEE PAGE 29 Four Seasons Independent, non-profit providing national award-winning levels of care to families living with serious illness.

571 South Allen Road, Flat Rock 828-692-6178 or 866-466-9734 fourseasonscfl.org SEE PAGE 69 Hospice of Yancey County Not-for-profit health care agency providing sensitivity and support for terminally ill patients and their families through hospice and palliative care.

856 Georges Fork Road, Burnsville 828-682-4713 hospiceofyancey.org SEE PAGE 75

Aging Resources 2018–2019

RESOURCE DIRECTORY HOUSING. Arbor Terrace Gracious apartments in a lovely setting with many amenities and services for assisted living and memory care.

3199 Sweeten Creek Road, Asheville 828-681-5533 at-asheville.com SEE PAGE 51 Ardenwoods Independent and assisted living in an intimate, close-knit atmosphere. Offering HealthyLife Services program and extraordinary dining.

2400 Appalachian Boulevard, Arden 828-684-7330 ardenwoodsretire.com SEE PAGE 43 Bermuda Village Retirement Community Gated community that allows you to age in place with all levels of care. Onsite Wake Forest Baptist Health Clinic and two 18-hole golf courses. Named one of the Top 25 Places to Retire by Forbes Magazine.

142 Bermuda Villgae Drive, Asheville 800-843-5433 bermudavillage.net SEE PAGE 61

Cherry Spings Village Cherry Springs Village is a fun, energetic assisted living community in Hendersonville North Carolina.

Residents enjoy all the privacy and comforts of home while receiving medical assistance as they need.

358 Clear Creek Road, Hendersonville 828-698-6501 affinitylivinggroup.com SEE PAGE 56 College Walk An Independent & Assisted Living community in Brevard, NC. Their goal is to promote an active, carefree lifestyle to their residents.

100 College View Court Brevard, NC 828-884-5800 collegewalkretirement.com SEE PAGE 48 Continuing Care Retirement Community Guide Information to assist in the search of a CCRC in North Carolina. ncdoi.com/SE/Documents/ CCRC/CCRC_Guide_2017.pdf

CarePatrol Free guidance by local Certified Senior Care Advisor to help you compare and tour residential care options based on your personal needs.

828-551-8545 arlener@carepatrol.com SEE PAGE 54

Deerfield Episcopal Retirement Community Life at Deerfield: connecting with your passions, embracing fun, fitness, friendships and being well cared for in Independent Living, Assisted Living, and Skilled Nursing.

1617 Hendersonville Rd., Asheville 828-274-1531 deerfieldwnc.org SEE PAGE 54

Carolina Village Henderson County’s only Life Plan Community with a focus on an active, healthy, purpose-driven life and higher levels of care if needed.

600 Carolina Village Road, Hendersonville, NC 828-692-6275 carolinavillage.com SEE BACK PAGE

Fletcher Park Inn Independent retirement living on an alcohol/ tobacco-free campus across from Park Ridge Health.

Choose apartment or villa home with garage.

150 Tulip Trail, Hendersonville 828-209-6930 or 800-249-2882 fletcherparkinn.com SEE PAGE 45

Cedar Mountain House Nestled in the mountains enjoy a peaceful and relaxed family atmosphere, fantastic dining, on-site rehabilitation, many other amenities and respite.

11 Sherwood Ridge Road, Brevard 828-884-9510 affinitylivinggroup.com SEE PAGE 56

The Gardens of Hendersonville The newest member of the Affinity Living Group family is an assisted living facility near downtown Hendersonville.

1000 W Allen St., Hendersonville 828-693-3388 affinitylivinggroup.com SEE PAGE 57 Continued on next page

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AGING RESOURCES Givens Estates Givens Health Center offers short term rehab and long term care services. Care is provided in a residential and choice driven environment.

2360 Sweeten Creek Road, Asheville 828-771-2910 givensestates.org SEE PAGE 46 Haywood House An assisted living community specializing in Alzheimer’s disease and related memory loss.

27 North Main Street, Canton 828-276-1004 affinitylivinggroup.com SEE PAGE 57 Heritage Hills An independent living facility with a dedicated, professional team supporting each resident with dignity and respect through compassionate, personalized care services.

828-698-3866 pacificaseniorliving.com SEE PAGE 15 Kingsbridge House Transylvania County’s only stand alone Alzheimer’s and memory care offering life enrichment programs on-site rehabilitation and daily personal care.

10 Sugar Loaf Road, Brevard 828-884-6137 affinitylivinggroup.com SEE PAGE 56 Lake Pointe Landing Retirement Community Live the life you choose. Full continuum of care with no endowment fee. Offers rental apartments, patio homes and ownership homes.

333 Thompson Street, Hendersonville 828-693-7800 centurypa.com SEE PAGE 53

Medicare Compare for Nursing Homes Ratings and services comparison for Nursing Homes. medicare.gov/nursinghomecompare/search.html North Carolina Dept. of Health & Human Services Inspection results, licensing, ratings, violations, and penalties for adult-care facilities in North Carolina.

919-855-3765 ncdhhs.gov/dhsr/acls/index.html 84

NC State Veterans Home Providing around the clock skilled nursing care, rehabilitation services and memory support to North Carolina Veterans. A state of the art facility offering private rooms.

62 Lake Eden Road, Black Mountain, NC 28711 828-257-6800 SEE PAGE 37 Pisgah Valley Retirement Licensed continuing care retirement community, independent and assisted living and skilled care.

New town center and apartment home expansion.

95 Holcombe Cove Road, Candler 828-418-2333 pisgahvalleyretirement.com SEE PAGE 55 Trinity View Amenities and services including housekeeping, fine dining, recreational activities, transportation, and on site physician & clinic without the commitment of an entrance fee.

2533 Hendersonville Road, Arden 828-687-0068 trinityview.net SEE PAGE 49 Tryon Estates A 215-acre senior community providing the most desirable aspects of retirement living in North Carolina. CCRC offering Acts' Type A Life Contract to residents ages 62 and up in Polk County.

617 Laurel Lake Drive, Columbus 828-351-7544 actsretirement.org SEE PAGE 47 Yancey House Combining all of the comforts of home with the health and personal care needed to live fully and comfortably. Specialized service provided through the Memory Care Program 6 Cooper Lane, Burnsville 828-678-9200 affinitylivinggroup.com SEE PAGE 57 LEGAL/ELDER LAW/ESTATE PLANNING. Edward L. Harrelson, Attorney Providing experienced financial and healthcare planning, wills, trusts, estate administration and real property transactions.

136 South King Street, Hendersonville 828-698-2345 EdwardHarrelson.com

Aging Resources 2018–2019

RESOURCE DIRECTORY Knox Law Approaching elder law holistically by offering help with estate planning, asset preservation, guardianships, fiduciary services, and a wide variety of personal support services.

16 Towne Place Drive, Suite 100, Hendersonville 828-513-1600 cknoxelderlaw.com SEE PAGE 13

North Carolina Living Will and Healthcare Advance care directives and health-care power of attorney forms and registry. sosnc.gov Pisgah Legal Services—Protect Seniors End-of-life planning, advanced directives and other legal services for low-income seniors and their families. Serving Buncombe, Henderson, Polk, Transylvania, Madison & Rutherford Counties.

828-253-0406 or 800-489-6144 pisgahlegal.org Van Winkle Law Firm Developing plans to address the unpredictability of living longer. Powers of attorney, long-term care, Medicaid & VA benefits planning, asset preservation, & estate planning.

Asheville & Hendersonville: 828-258-2991 vwlawfirm.com SEE PAGE 17 MEDICAL EQUIPMENT LOAN CLOSETS. Durable medical equipment available for loan at no cost.

Asheville Buncombe Community Christian Ministries (ABCCM) 117 Coxe Avenue, Asheville (At thrift store) 828-259-5300 abccm.org Medical Loan Closet 1225 Seventh Avenue East, Hendersonville 828-692-9005 medicalloancloset.org MEDICARE ADVANTAGE PLANS. Healthy State Medicare Advantage Plans Owned by Mission Health and powered by Mission Health Partners, they offer provider-designed plans to help you stay healthy. They are the only WNCbased plan dedicated to serving WNC. 1950 Hendersonville Road, Asheville 1-877-279-1732 healthystate.us SEE PAGE 21

MEDICARE HELP. Medicare For assistance understanding and navigating the Medicare system visit: medicare.gov Also see pages 20 –23 NURSING HOMES. Flesher’s Fairview Health & Retirement Center Offering long-term care for adults and others with challenges that prevent them from living independently. Providing quality medical, rehabilitative and assisted living services in a homelike setting. Spacious suites, private and semi-private units.

3016 Cane Creek Road, Fairview 828-628-2800 Fleshers.net SEE PAGE 22 ORTHOTICS AND PROSTHETICS. CarePartners Orthotics and Prosthetics The region’s leader in providing the finest comprehensive care and assistive devices for people living with amputation or disability, from infants to the elderly.

1 Doctor’s Drive, Asheville 828-254-3392 carepartners.org SEE PAGE 29

PRIVATE CARE MANAGEMENT. Aging Life Care Association Information on selecting and a locator for finding aging life-care experts. caremanager.org REHAB/SKILLED NURSING.

CarePartners Outpatient Clinics Their outpatient clinics see patients with conditions ranging from dizziness to tennis elbow to recovery from a stroke, traumatic injuries to the brain or spine, or amputation.

Seven Locations. See website for details.

828-274-6100 carepartners.org SEE PAGE 29 CarePartners Rehabilitation Hospital Rehabilitation is different for every patient: learning to walk again, adjusting to challenges of a wheelchair or artificial limb or tasks of daily living.

68 Sweeten Creek Road, #A, Asheville 828-274-6151 carepartners.org SEE PAGE 29 Continued on next page

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AGING RESOURCES Carolina Village Rehabilitation Located within the campus of Carolina Village, the Medical Center is available to the community for short term rehab when space is available.

600 Carolina Village Road, Hendersonville 828-692-6275 ext. 214 carolinavillage.com SEE BACK PAGE Givens Estates Givens Health Center offers short term rehab and long term care services. Care is provided in a residential and choice driven environment.

2360 Sweeten Creek Road, Asheville 828-771-2910 givensestates.org SEE PAGE 46 Hendersonville Health & Rehabilitation Offering therapies seven days a week, an orthopedic program, private and semi-private rooms, WiFi, ice cream parlor and movie theatre.

104 College Drive, Hendersonville 828-693-8600 sanstonehealth.com INSIDE BACK COVER The Laurels of GreenTree Ridge Specializing in short term rehab from injury, surgery, stroke and illness. Providing highest levels of clinical care for a multitude of diagnoses.

70 Sweeten Creek Road, Asheville 828-274-7646 laurelsofgreentreeridge.com SEE PAGE 31 The Laurels of Hendersonville Offering therapy 7 days a week by the dedicated in-house therapy staff, their goal is to get you home sooner, safer and stronger.

290 Clear Creek Road, Hendersonville 828-692-6000 laurelsofhendersonville.com SEE PAGE 31 The Laurels of Summit Ridge Providing a complete range of services for patients unable to return home after a hospitalization and care for individuals with a wide range of illnesses.

100 Riceville Road, Asheville 828-299-1110 laurelsofsummitridge.com SEE PAGE 31 Life Care Center of Hendersonville Inpatient and outpatient short-term rehabilitation.

All insurance accepted. Located on campus of Lake Pointe Landing.

400 Thompson Street, Hendersonville 828-697-4348 lcca.com/hendersonville SEE PAGE 19

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The Lodge at Mills River Full range of rehabilitation services and therapies.

38 private rooms, rehab gym and spacious common areas for rehab or residential care.

5593 Old Haywood Road, Mills River 828-684-4857 sanstonehealth.com INSIDE BACK COVER

Stone Creek Skilled nursing facility for short-term rehab or longterm care. Conveniently located just one mile from Mission Health Systems.

455 Victoria Road, Asheville 828-252-0099 sanstonehealth.com INSIDE BACK COVER RESPITE CARE. Local Councils on Aging (COA) receive limited funding to provide family caregivers with grants for respite care.

Funding can be used for home care, day programs, and overnight respite programs. Contact the COA nearest you for more information and to apply for a grant.

Council on Aging of Buncombe County 46 Sheffield Circle, Asheville 828-277-8288 coabc.org Council on Aging for Henderson County 105 King Creek Blvd., Hendersonville 828-692-4203 coahc.org Brooks-Howell Respite Care for short-term intervals in a holistic caring environment. Your loved one will receive a person-centered approach to care while benefiting from a private room with views of their landscaped grounds and gardens. Brooks-Howell offers a resident-centric culinary and recreational experience with medical and therapy services available.

266 Merrimon Avenue, Asheville, NC 28801 828-253-6712 brookshowell.org RN PATIENT ADVOCATES. RN Patient Advocacy NC, PLLC Karen Sanders, MSN, RN, AHN-BC, HWNC-BC 40 years of nursing experience in multiple leadership and clinical positions in multiple healthcare settings. Karen helps patients and families negotiate complex healthcare settings and find the holistic care and support they need.

828-778-8882 kcsanderella@gmail.com rnpatientadvocacync.com

Aging Resources 2018–2019

RESOURCE DIRECTORY SAFETY. General Safety NC Silver Alert Program NC Department Public Safety disseminates information and issues alerts about missing seniors.

3320 Garner Road, Building 17, Garner NC 27610 800-522-5437 ncdps.org Smart 9-1-1 Henderson County Sheriff Online sign up to provide first responders with medical and other important information in advance of an emergency. To sign up, you must register online. The sheriff’s office provides a computer in the lobby for those that want to sign up, but do not have access to a computer at home.

828-697-4596 smart911.com Home Management, Errands & Repairs Seniors Safe at Home Program Council on Aging of Buncombe County Programs include Minor Home Repair, Heat Relief, Call A Ride, and food delivery and food assistance.

46 Sheffield Circle, Asheville 828-277-8288 coabc.org Telephone Check-In Henderson County Sheriff’s Office Nixle Emergency Alerts Updates residents in real-time for localized emergencies and relevant community advisories. Nixle alerts allow the Sheriff’s Office to send important and valuable public safety and community information directly to residents who subscribe to the free service.

Residents can customize their account and decide if the information is delivered via text message, email or over the web. Text the word HENDERSON to 888777 from your mobile phone to sign up or visit nixle.com Henderson County Sheriff Reassurance Program Senior Check-In Program Enrolled seniors call Sheriff’s Office each day to verify their well-being. If call is not received, Sheriff’s Office checks on senior. To see if you are located in an area that is covered by the program or to sign up, call 828697-4912. hendersoncountync.org/sheriff

Transylvania County Sheriff Reassurance Program Sheriff’s office calls enrolled seniors daily to check welfare. Call for application.

828-884-3168 tcsonc.org/community/Senior_Programs.aspx SENIOR CENTERS. Buncombe County Harvest House Community Center – Asheville Parks and Recreation Physical and social activities for adults and seniors.

Woodshop, weaving studio, clay studio, mosaic glass, dance and exercise classes, social games, billiard tables, day trips and luncheons.

205 Kenilworth Road, Asheville 828-350-2051 Senior Opportunity Center A full schedule of activities and senior dining program.

Lunch reservations required a week in advance.

36 Grove Street, Asheville 828-350-2062 ashevillenc.gov/parks Henderson County Mills River Life Enrichment Center (MRLEC) Senior fellowship with a program and lunch every Thursday.

Mills River United Methodist Church 137 Old Turnpike Road Mills River, NC 828-808-5581 millsriverumc.com Sammy Williams Center A full schedule of activities and classes for seniors, weekdays 9:00 am–1:00 pm. Lunch available for seniors who qualify.

301 North Justice Street Hendersonville, NC 828-692-3320 coahc.org/sammy-williams-center Polk County The Meeting Place A safe, comfortable place to meet friends and enjoy activities.

75 Carmel Lane, Columbus 828-894-0001 polknc.org 25 Shield Drive, Green Creek 828-863-2795 polkcountymeetingplace.com polknc.org

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AGING RESOURCES Saluda Senior Center Open weekdays with classes and activities for seniors.

64 Greenville Street, Saluda, NC 828-749-9245 polknc.org Transylvania County Silvermont Opportunity Center Providing services and activities to invigorate and enhance the quality of life for adults greater than the age of 60 in Transylvania County. Silvermont Opportunity Center provides a range of services, activities, programs, and opportunities to encourage active aging and improve the health and well-being of our older adults.

Monday-Friday 8:00-4:00 pm 364 East Main Street, Brevard 828-884-3166 wcca.net/wcca-services/older- adult-services/silvermont.html SENIOR REAL ESTATE SPECIALISTS. Terri Eisenhauer Signature Properties, SRES Keller Williams Realty Providing a superior level of service and expertise for sellers and home buyers ages 50+.

828-674-1508 terrieisenhauer.com SEE PAGE 59 Kilgore & Associates RE Prepared to approach clients 50+ with the best options and information for them to make lifechanging decisions. Call Sandra if you are interested in simplifying the buying or selling process.

828-515-1588 sankilgore@gmail.com sandrakilgore.com SEE PAGE 60

TRANSPORTATION APPOINTMENTS AND ERRANDS. Call-A-Ride Council on Aging of Buncombe County, Inc. Volunteer transportation for eligible Buncombe County seniors who lack access to other forms of transportation. Transportation is limited to within Buncombe County.

828-277-8288 coabc.org Henderson County—Apple Country Transit Transportation Assistance for any Henderson County resident based on ability.

Regularly scheduled shopping/grocery trips for people 60 and over.

828-698-8571 wcca.net/transports.html Polk County—Anyone Can Ride Rides by appointment, as well as regularly scheduled shopping trips.

828-894-8203 polknc.org/departments/transportation Transylvania County Senior Adult Transportation & Med-Drive Rides to nutrition sites, shopping, recreational centers, and medical appointments.

828-884-3203 transylvaniacounty.org/departments/ transportation

SUPPORT GROUPS. CarePartners Support Groups Offering numerous ways for patients, families, caregivers and the general community to learn about health issues. All groups are free and open to the public.

68 Sweeten Creek Road, #A, Asheville 828-277-4800 carepartners.org SEE PAGE 29

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Aging Resources 2018–2019

We’re Building Your New Home at Carolina Village

Henderson County’s Only Life Plan Community

600 Carolina Village Road, Hendersonville, NC

CarolinaVillage.com

call to schedule a tour: 828-692-6275