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A special senior living guide published by The Daily Nonpareil Also online at

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Senior Living & Care Guide 2012

Miller Orthopaedic treats conditions or injuries relating to bones, joints, ligaments and muscles. Our goal is to get you back to optimum health as quickly and safely as possible. We will recommend a treatment program that fits your individual needs. Our services range from in office conservative care and diagnostic tests to inpatient and outpatient surgical procedures.

Dr. Larose

Dr. Boese

Dr. Trinh

Dr. Atteberry

Sports Medicine Specialist

Total Joint Specialist

Spine Specialist

Sports Medicine Specialist

Dr. Abraham

Dr. Hsu

Dr. Panesar

Theresa Gallo

Total Joint & Sports Medicine Specialist

Hand & Microvascular Surgeon

Foot & Ankle Specialist


One Edmundson Place • Suite 500 • Council Bluffs, IA 51503

(712) 323-5333

Mike Hoy,

Funeral Director

Bud Kilnoski

Ourr facilityy providess Councill Bluffs withh thee onlyy on-sitee community room m andd crematory!! And,, withh 3 equall sizedd chapels,, yourr familyy will neverr bee putt inn thee “small”” room.

1221 N. 16th Street • Council Bluffs, IA 712-256-9988 •

4 Senior Living and Care Guide 2012

Senior Living & Care Guide

Senior Living & Care Guide

Table of Contents TABLE OF CONTENTS Feature Page

Southwest 8 is all about seniors ..... 5 Is assisted living right for you? ...............................................................5 Mobilis provides specialty products ..... 7 Making the decision to leave home..........................................................6 What is assisted living? ..... 9 What’s next after retirement.....................................................................8 Is assisted living right for you? ..... 11 Supporting your loved ones.....................................................................9 Making the decision to leave home ..... 12 A checklist for choosing an assisted living facility.................................10 Supporting your loved ones ..... 13 Veteranfor benefits available for seniors A checklist choosing an assisted living....................................................14 facility ..... 14 Long-term care insurance......................................................................16 Glossary of senior housing terms ..... 19 Livingtoatstart home: Tips forretirement a safer environment When receiving benefits ...........................................20 ..... 25 Overcoming emotional roadblocks ..... 26 SSA cruising in cyberspace....................................................................22 When to start receiving retirement benefits ..... 28 Tips for long-distance caregivers...........................................................23 Long-term care explained ..... 30 When you become the parent of your parent.........................................24 Veteran benefits available for seniors ..... 30 Hobbies help wounded vets ...................................................................26 Assisted living financial worksheet ..... 33 Glossary of senior housing terms..........................................................27 Paying for assisted living and other types of care ..... 34 Living at home: Tips for a safer environment ........................................31 Assisted living financial worksheet ........................................................33 Hobbies for the golden years .................................................................34

Advertiser Directory (Alphabetical)

Business Page


American Travel Center ..... 9 Bellewood Courts ..... 9 Miller Orthopaedic Affiliates, P.C. .............................................................2 Bethany Heights .....14 Hoy-Kilnoski Funeral Home & Crematory Caretech, ................................................3 Inc. .....14 Angels Care Council Home Health ........................................................................5 Bluffs Foot & Ankle Care ..... 5 Primrose Retirement Communities..........................................................6 Daily Nonpareil .....8,10 Dickinson Investment Advisors ..... 5 Hospice with Heart...................................................................................7 Dr. Farid Sadr .....22 Dickinson Investment Advisors................................................................8 Glen Haven Home ..... 6 Mobilis Home Medical Equipment ...........................................................9 Home Instead .....29 Bethany Heights & Bethany Lutheran Home..........................................10 Hoy-Kilnoski Funeral Home ..... 3 The Center..............................................................................................11 Hy-Vee Drugstore .....31 Caretech, Inc. .........................................................................................12 Iowa Heart Center .....Inside back cover Dr. Farid Sadr .........................................................................................13 Jennie Edmundson Hospital ..... 7 Immanuel Pathways...............................................................................15 Kanesville Heights .....12 Midlands Living Center .....32 Iowa Hospice .........................................................................................16 Miller Orthopaedic Affiliates, P.C. .....Inside front cover Bluffs Acres............................................................................................18 Inc. ..... 6 ASI Audiology Hearing & BalanceMobilis, Center...............................................19 Monarch Villa .....13 Hy-Vee Drugstore...................................................................................21 Primrose Retirement Community ..... 8 Southwest 8 Senior Services .................................................................22 Risen Son Christian Village .....Back cover Super Saver Pharmacy...........................................................................23 Southwest 8 Senior Services .....11 CVS Pharmacy .......................................................................................24 Struyk Turf .....16 Boys Town Ear, Nose & Throat The Institute ................................................26 CB Center .....18 Rose ofBluffs Council Bluffs .....27 Village CooperativeThe of Council .....................................................32 Touching Hearts at Home .....14 West Broadway Clinic ............................................................................35 West Broadway Clinic .....21 Risen Son Christian Village....................................................................36

Senior Living and Care Guide 2012 5


Is assisted living right for you?



f you’re trying to decide whether assisted living is right for you, ask yourself the following questions:

Do you need more help than family and friends are able to provide? Are the activities of daily living becoming stressful or overwhelming? If family or in-home help is not able to bridge the gap, assisted living is an option. Do you feel lonely or isolated at home? Having an active social life is vital to your health and happiness. Being alone much of the time is a recipe for depression. The social aspect of assisted living is a huge benefit. Good facilities offer a range of social and recreational activities. And the community environment also gives the opportunity to make new friends. Do you worry about safety? Perhaps your mobility is limited, making it difficult to get out of bed by yourself, for example. Maybe you’re afraid of what might happen if you fell and couldn’t get up, or experience another problem and couldn’t get help. Are you tired of maintaining a home? There are a lot of responsibilities that come with living in your own home. Assisted living facilities can provide a home-like atmosphere, without the work of cooking, cleaning, shopping for groceries, and doing laundry. Is transportation an issue? Perhaps you’re having trouble driving or can no longer drive. If public transportation or another alternative isn’t easy and convenient, you may be increasingly housebound. Assisted living facilities offer transportation, so you can get where you need to go without having to rely on friends and family. •


$PVODJM#MVGGT and surrounding areas 712-352-3640

Moving to an assisted living facility can be a difficult decision for the whole family.

6 Senior Living and Care Guide 2012

Making the decision to leave home

No matter your situation, moving is always stressful. But when you’re contemplating leaving your home for an assisted living facility, stress is just the tip of the emotional iceberg. The thought of leaving everything you know can make you feel very vulnerable. You may feel like you’re losing your independence or a big part of your identity. It’s important to realize that all of these feelings are normal. Take some time to acknowledge these feelings of loss. Sometimes talking to a sympathetic ear can help. Counseling and therapy can be an option too. Give yourself time to grieve and get used to the change. Tips for making the transition to assisted living easier Life in an assisted living facility is an undeniable adjustment. In addition to a new living environment, you are meeting new residents and getting used to the staff. This can feel stressful in the beginning. But there are things you can do to make the transition easier. Pack well in advance of the move: Don’t add to the stress of the actual move by putting yourself in a position where you’ll need to make hasty decisions about what to take and what to keep. Know what to expect: Do your homework on the facility. It will be less stressful if you know what to expect. Read all the materials before you move in and make sure all of your questions are answered ahead of time. Stay busy: You may be tempted to stay in your apartment or living space, but you’ll feel comfortable much quicker if you get out there to meet the residents, participate in activities, and explore the facility. Go easy on yourself: Everyone adjusts to change differently, so give yourself a break, no matter what you’re feeling. However, if you feel like you’re taking longer

than you think you should to adjust, it may help to talk to your family members, the director of the facility, or a trusted friend. •

Comfort, Convenience & Quality Care

At Primrose, our 24-hour nursing staff provides quality assisted living care for you and your loved ones. We offer: UÊÓ{‡…œÕÀʏˆVi˜Ãi`ʘÕÀÃiʜ˜ÊÃÌ>vv UÊ œ“«ÕÌiÀˆâi`ʘÕÀÃiÊV>ÊÃÞÃÌi“ UÊÎʅœ“i‡VœœŽi`ʓi>ÃÊ`>ˆÞ UÊÀiiÊ/À>˜Ã«œÀÌ>̈œ˜Êˆ˜Ê œÕ˜VˆÊ Õvvà UÊœ˜Ì…ÞÊۈÌ>ÊÈ}˜ÃÊ>˜`ÊvœœÌÊVˆ˜ˆVÃ

Ask Indepenadbout our Options Aent Living vailable

And of course who can forget our 1950’s style ice cream parlor,

Call Laura or Susan at 712-352-1111 for more information and come see why we say, ® ®



1801 East Kanesville Blvd. Council Bluffs, IA Independent & Assisted Living

OUR STAFF PROVIDES THE FOLLOWING SERVICES: • Medications and treatments related to patient’s terminal diagnosis • Durable Medical Equipment (i.e. hospital bed, walker, oxygen, etc.) • Nursing services • Nurse on call 24 hrs a day for emergencies • Social work services • Chaplain services • Hospice aide services • Volunteers • In-patient respite care at an approved facility for up to 5 days • Acute continuous care • Dietician services • Physical, occupational and speech therapies • Continuous care in a patient’s home in an acute crisis • Short stay-in patient care at an approved facility to treat out-of-control symptoms which are unable to be managed at home • Bereavement services for up to 13 months following the death of a loved one • Pet Therapy • Pet Peace of Mind Program • Music Therapy

300 W. Broadway, Suite 114 Council Bluffs, IA 51503

(712) 325-6802

Glenwood Hospice House 357 Indian Hills Drive, Glenwood, IA 51534

(712) 527-4660


8 Senior Living and Care Guide 2012

What’s next after retirement? S

cores of people spend their working days dreaming of the moment they are eligible for retirement. They may have retirement counted down to the minutes and seconds, particularly if they’ve been in a job that hasn’t been the most enjoyable. But many people find that once they retire they do not know what to do to fill their time. Boredom actually may be a side effect of retirement, and some people actually want to go back to work. Much of the focus when planning for retirement concerns finances. All other factors take a backseat. Therefore, there may be emotional issues that arise during retirement, and retirees are not always prepared to deal with such issues. Having a post-retirement plan in place can mean the difference between happiness and having a hard time adjusting, according to experts. Here are some tips that can help anyone ease into the golden years. • Establish goals. After working for years, the idea of setting goals can seem

counterintuitive. But goals can give life direction and have you looking forward to things in the future. Goals also motivate retirees to get up in the morning now that a commute to work isn’t part of the daily schedule. • Donate time or money. Giving back to others, whether to the community or to a charitable organization, can feel good and give retirees some structure. Volunteering your time at a place can give life some sort of purpose outside of a job. • Start a home-based business. Just because you retire doesn’t mean you have to fully retire. Now may be the opportunity to start a business venture

you have always dreamed about, whether that is something hands-on or just serving as a consultant. • Try new things. Part of goal-setting is to add things to the list you’ve never done before, which can boost feelings of excitement. You may discover a new interest that becomes a passion. Now that you have time to explore new hobbies, they might prove more rewarding. • Meet with people. Part of what makes work fulfilling is the opportunity to get out of the house and interact with others who are not members of your family. It’s easy to fall into a rut when you are not being mentally stimulated by conversation from different people. • Realize it’s alright not to love retirement. Just because the grass seemed greener in someone else’s yard, doesn’t mean it always turns out to be that way. It is OK to accept that maybe retirement isn’t entirely what you expected and to make changes that can enable the experience to be better. •

Turning your retirement dreams into reality through proven, time-tested investment solutions.

712.256.4856 Portfolio management beginning at $100,000.

Senior Living and Care Guide 2012 9

Supporting your loved ones A

move to assisted living, even if all parties are in agreement, can be a stressful time. Your loved one will need your support. Here are some of the ways you can help: Acknowledge your loved one’s feelings of loss: Even in the best of situations – where your loved one willingly chose assisted living – grief and feelings of loss are to be expected. Leaving one’s home is a huge decision. Don’t minimize their feelings or focus excessively on the positive. Sympathize and respect feelings of loss and give them time to adjust. Call and visit as often as you can: Regular contact from friends and family will reassure your loved one that they’re still loved and cared for. Continue to include your loved one in family outings and events whenever possible. If your loved one lives far away, regular calls or emails can make a big difference. Work through concerns together: While your loved one will likely go through a period of adjustment after moving into an assisted living facility, don’t automatically assume that complaints are just part of the transition process. If your loved one has concerns, take them seriously. Talk about what steps you can take together to resolve the issue. And if the problem turns out to be a big one with no apparent solution, be prepared to look at other facilities. Help your loved one personalize their living space: Help your loved one choose and bring over the meaningful possessions and decorations that will give the new living space the feeling of home. But be careful not to take over. Let your loved one take the lead. He or she is going to be the one living here, after all. •

DOs for friends and relatives • If requested, help with the sorting, packing, and moving • Listen as your loved one talks about what they left behind • Be helpful even if you do not agree with the decision to move • Recognize that moving to a new home represents a major change • Call and visit often during the first few weeks • Be positive

DON’Ts for friends and relatives • Make all the decisions or take over the sorting, packing and moving process • Focus only on yourselves. This is about the resident moving, not you • Criticize the decision to move into assisted living • Make light of the transition • Immediately talk about selling the resident’s house • Make promises that you cannot keep • Be negative

Monday-Friday 9am-5:30pm , Saturdays 10am-2pm 2701 W. Broadway , Council Bluffs, IA 51501 (712) 328-2288 Fax: (712) 328-2299 Toll Free: (888) 798-2288

Making Life Accessible

10 Senior Living and Care Guide 2012

A checklist for choosing an assisted living facility

When you are looking for an assisted living or residential care setting, please consider the following checklist to help you make the best choice to meet your individual needs. Licensure • Does the home have a current state license? If the answer is "no," do not use the home. Certification and quality Review • Does the home have a formal quality assurance program? • Does the facility belong to a state care association? • Does the staff regularly attend educational programs to maintain or enhance there skills? Moving in • What does the moving in process entail? What are the paperwork requirements and the timeframes involved? • How is the initial personal needs assessment managed? Who completes the assessment? • Is the residence affiliated with a hospital or nursing home should acute or long-term care be needed? If so, is there a priority admission process? • If you need hospital or nursing home care, is your room held? What are the associated fees? Is there a discount for unused services (e.g. meals)? • Does the residence subscribe to a set of resident rights and responsibilities? Is a printed copy available? Service planning • Are the family and the resident involved in the service planning process? How often are resident’s needs assessed? Who completes the assessment? • Are there special programs for memory impaired residents and residents suffering with dementia? Are there accommodations for memory-impaired residents to be outside and exercise? • Are there special programs for residents with disabilities? • How are emergency situations managed? What is the protocol for such events? Is a physician available in an emergency? • Will the facility assist in arranging for other medical services?

• Will the resident’s personal physician be notified in an emergency? • Does the home have a transfer arrangement with a nearby hospital? Is emergency transportation readily available? • What happens if the health care needs of a resident change? Under what conditions are residents asked to move if there is a change in health status? Services and activities • Does staff assist residents in administration of medication? If so, what kind of staff? • Must the resident use the residence’s pharmacy? Does the pharmacy provide a yearly review and consultation services? • Are there professional nursing services on site? If not, does the staff assist residents and families in making arrangements through a home health agency? • Are the services of a physical, occupational or speech therapist available or arranged? • Does the residence provide bed linens and towels? • Does the residence provide laundry service? • Are there beauty and barber shop services available on site? • Is assistance in bathing and personal grooming available? • What recreational and spiritual activities are available? Request or review a copy of the activities calendar. • Are arrangements made for residents to worship as they please? • Are activities planned around each resident’s individual preferences and life pattern? • Are group and individual activities available? • Are residents encouraged to participate? • Are outside trips planned? • Do volunteers work with residents? • Are the activity supplies available for resident use outside of scheduled programs? • Is transportation provided for medical appointments and recreational purposes? • Is there a resident council? How often does it meet?


Proud d too bee partt off thiss community BETHANY HEIGHTS 11 Elliott St. 712-328-8228 Alzheimer’s Support Group Meetings offered at 6:30 pm the last Tuesday of each month at Bethany Lutheran Home. Open to public. Call 712-328-9500 for details.

BETHANY LUTHERAN HOME 7 Elliott St. 712-328-9500

#1 Fitness Center in Council Bluffs!

Thee Center. Livee Yourr Life. Classes and activities include land and water exercise, resistance training, swimming, fall prevention classes, dances, card clubs, travel, art classes, health fairs, holiday celebrations and more!

Make new friends, learn new skills, get healthy, feel better have fun!

Where People 50 and Over Meet for Fitness & Fun!

You’re invited! Three Free Visits! Guest must be 50 years of age or older and complete a guest registration card. Signed Waiver and Release of Liability required for guest to participate. All Center policies, guidelines and procedures apply to all using facility. One coupon per person. Expires 11-30-2012

714 S. Main Street • Council Bluffs, IA 51503


12 Senior Living and Care Guide 2012

CHECKLIST/Continued from page 10

• What are the suggestion, complaint, or grievance procedures? • Are social services available to assist residents and families? Staff • Inquire about the residence’s staffing patterns and philosophy. • What training and qualifications are required for staff? Are there on-going training programs provided for staff? • Observe staff and resident interactions. Are they positive? Courteous? • Does staff show interest in and respect for individual residents? Do they know residents by name? • Is staff trained to protect resident dignity and privacy? • Does staff handle resident requests in a timely way? • Does the residence have a volunteer program? If yes, what types of activities do the volunteers perform? • Does the administrator/ director practice an “open door” policy to answer questions, hear complaints, or discuss problems? Costs and fees • What is included in the basic daily/monthly cost? Ask for a printed copy. • Does the residence have a written schedule of fees for extra services? If so, request a copy. • Under what circumstances might the fees change? How much notice is given if there is a fee increase?

• Is there a security deposit? What is the refund policy? Are advanced payments returned if the resident leaves the home? • Can service agreements and/or contracts be amended or modified? Location • Is the facility and environment pleasing to the resident? • Is the facility convenient for frequent visits of family and friends? • Is the location of the residence convenient to shopping, medical services, and entertainment areas? • Is the facility convenient for the resident’s personal physician? • Is the facility near a hospital where the resident’s personal physician practices? Cleanliness • Is the facility as clean as you set your personal standards? Lobby • Is the atmosphere welcoming? • Is the furniture attractive and comfortable? Are certificates and licenses on display? • Hallways • Are halls large enough for two-way traffic to pass easily? • Are halls well lighted? Living space and accommodations • Are there adequate community areas for resident use? Is equipment (such as hobby supplies, easels, yarn, etc.) available? Are residents using equipment? • Are the resident rooms furnished or unfurnished? What is the policy about personal belongings? • What is the policy for overnight guests? Are there guestrooms available? What are the guest fees? Is outdoor furniture available for residents and visitors? • Is additional storage space available? Is there an extra fee? • Does the residence meet the rules for people with disabilities? • Can residents have automobiles? Is there assigned parking? Is there an extra fee? • Are there patios and courtyards available for resident use? Is there an area for resident gardening? • Is exercise equipment available? • Does the residence provide security? • Are pets allowed to reside in the residence? If so, are

We Bring The Care To You

Medicaid Waiver Approved

• Housekeeping • Respite • Personal Care • Errands

(800) 991-7006

Helping People Remain Independent

Senior Living and Care Guide 2012 13

• Are pets allowed to reside in the residence? If so, are there additional fees and or deposits? If not, are pets allowed to visit? Toilet facilities • Are toilets convenient to bedrooms? • Are they easy to use for a resident with physical challenges? • Is there a sink conveniently available to each bathroom or bedroom? • Do bathtubs and showers have non-slip surfaces and handgrips? Dining room and meals • Is the dining area attractive and inviting? • Are tables convenient for those with physical challenges? • Are personal food likes and dislikes taken into consideration? • Are special diets accommodated? • Does a dietician or nutritionist review the menus? Request or review copies of the menus • Is food tasty and attractively served? Ask to try a meal. • How often do the menus rotate? Are residents and families involved in the menu planning? • Are residents allowed to have guests for meals? Is there a separate guest dining room? • Are there reasonable choices of dining times? • Is there plenty of time allowed for each meal?

• Are snacks available? • Is food delivered to residents unable or unwilling to eat in the dining room? • Are those needing help receiving it? Kitchen • Is the food preparation area separate from the dishwashing and garbage areas? • Is food needing refrigeration not standing on counters? • Does kitchen help observe sanitation rules? Your part • If you are selecting a facility for someone else, are you: • Involving this person in the choice? • Prepared to ease the resident’s transition to the home by being with them on admission day and staying a few hours to get them settled? • Ready to visit the resident frequently and to make sure those friends make similar visits? • Willing to provide the resident with the same amount of love in the facility that you would if they were at home? Waiting for placement • After you have identified an appropriate facility, you may find there is no vacancy. Put your name on the waiting list. In the meantime, check alternatives such as day care, night care, home health agencies and other community resources that might help meet immediate needs. •

Our Services:

Dr. Farid Sadr

• • • • • • • • • • •

Internal Medicine and Family Medicine Same day appointments available Extended hours In-house laboratory services Immunizations for adults and children Flu shots Laceration repair Diabetic Education Smoking Cessation Allergy Testing Cholesterol/Hypertension screening

• Electrocardiogram • Physicals (General, DMV, Sports, Schools, Employment) • Cardiac and Diabetic Risk Screening • Well Woman Exams • H-Pylori Testing • Aortic Aneurysm Screening • Incontinence Screening • Well Child Exams • Mole Removal

Office Hours: Monday 9am to 7pm Tuesday 9am to 6pm Wednesday 9am to 6pm Thursday 9am to 6pm Friday 9am to 6pm

801 Harmony Street, Suite 202 | Council Bluffs, IA 51503 | 712-308-1563

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Veteran benefits available for seniors


he Department of Veterans Affairs (VA) offers a benefits package that provides hospital and outpatient medical care and treatment. VA’s priority system ensures that veterans with service-connected disabilities and those below the low-income threshold are granted top priority for receiving care. There is no monthly premium required for VA care. However, depending on the veteran’s situation, co-payments may be required. The Uniform Benefits Package available to all enrolled veterans includes: • Inpatient hospital care

• Ambulatory care • Adult Day Health Care • Home Health Care • Respite care • Hospice Care • Prescription drugs, pharmaceuticals and durable medical equipment, such as wheelchairs and hospital beds • Emergency care in a VA facility Although many veterans qualify for free healthcare services, based on a compensable service-connected condition or other qualifying factor, most are required to complete an annual financial assessment to determine if they qualify for free services.

Veterans whose household income and net worth exceed the established threshold must agree to co-payments to become eligible for VA health care services. The financial assessment determines the enrollment priority group and the co-payments, if any, that apply. Call VA Health Care at (877) 222VETS or go to for more information.

Eligibility and qualifications • Veteran must be enrolled in the VA health care system • Most veterans required to report household income and net worth annually. •

Your home.Your care. Your pace.

Your home is best and Immanuel Pathways can help you continue living there for as long as possible. Our program provides a comprehensive system of health care. The model of service is PACE: Program of All-inclusive Care for the Elderly. Our program includes primary, acute and long-term health care as well as adult day services and transportation. Services are provided in the home, in the community and at our PACE Center. PACE participants may be fully and personally liable for the costs of unauthorized or out-of-PACE program services. Emergency services are covered. Participants may disenroll at any time.

For complete program details and beneďŹ ts, please call 712-256-PATH (7284).

1702 N. 16th Street

Council Bluffs, IA 51501


16 Senior Living and Care Guide 2012

Long-Term Care Insurance Primary Source: The American Association for Long-Term Care Insurance


ong-term care is becoming an increasingly important issue in this country. The aging baby boomer population in the United States is approaching 80 million. As of January 1, 2011, there were 10,000 baby boomers turning 65 every day and this is expected to continue for the next 19 years! As Americans continue to live longer, millions will face the prospect of needing or providing long term care at some point in their lives.

What is Long-Term Care (LTC)? Long-Term Care encompasses a wide range of medical and support services for people with a degenerative condition (say Parkinson’s; or those that occur after a stroke), a prolonged illness (cancer) or a cognitive disorder (Alzheimer’s).

If these make you think of conditions that affect older individuals, you are right. Most people need longterm care in their later years (typically their 80s). But, younger people may also need long-term care as a result of accidents (falling off roofs and motorcycle accidents especially for men) or illnesses that tend to inflict younger people like multiple sclerosis. Long-Term Care is not necessarily medical care but rather “custodial care.” Custodial care involves providing individual assistance with activities of daily living or the supervision of someone who is cognitively impaired. To better understand Long-Term Care, think of the activities that you performed when you woke up this morning. You probably stepped out of your bed … walked to the bathroom … used the toilet … took a shower … got dressed … ate breakfast.

When you are healthy it is easy to take for granted these Activities of Daily Living (ADLs). However, when you or a loved one is stricken with a degenerative condition such as a stroke or Alzheimer’s, performing these ADLs becomes impossible without the assistance of another

Our kind, caring, hospice experts can assist with: Improving Quality of Life Accomplishing Your Goals Pain and Symptom Management Medications and Medical Equipment Emotional & Spiritual Support Keeping You Home

Iowa Hospice, it’s your choice. 1-800–HOSPICE (467-7423)

Senior Living and Care Guide 2012 17

person. As we age, performing these simple functions becomes difficult; often impossible. This type of care is what “LongTerm Care” means. It is the same type of care that a parent must provide for their new baby. This type of care is chronic (full-time) and thus becomes very expensive. LongTerm Care can be provided in many settings including nursing homes, your own home, assisted living facilities and adult day care. I’m Never Going To A Nursing Home; Why Am I Reading This? Say the words “long-term care insurance” and chances are you think nursing home. Today, that could not be farther from reality. Today, long-term care insurance really means home care coverage. It is true that the earliest policies issued in the 1980s generally paid for nursing home care. But, today, one of the most significant benefits of long-term care insurance is the ability to receive care in your own home. And, almost half of all longterm care insurance benefits pay for home care. Here are some current facts:

There are some 7.6 million individuals currently receiving care at home. And, 43 percent of all individual long-term care insurance policy benefits went for home care.

Another 1.0 million Americans live in assisted living communities. And, 32.9 percent of all individual longterm care insurance policy benefits went for assisted living care and costs.

Some 1.8 million Americans live in nursing homes. Many are there because Medicaid (the federal poverty program) pays for care in nursing homes. Only 24.1 percent of longterm care insurance policy benefits paid for nursing home care. * Source: 2008 LTCi Sourcebook, American Association for Long-Term Care Insurance).

What Are My Real Chances of Needing Long-Term Care? We’ve asked the nation’s smartest actuaries (those are the mathematicians who price insurance policies by calculating the risk you’ll need care) and here’s the reply. Your chances of needing long-term care are either going to be zero (0%) or 100 percent. We can share with you a ton of great statistics provided by government and independent researchers (and we will). But none of it is really relevant to predicting whether you are going to need long-term care. Your chances are going to be zero … or 100 percent. As Clint Eastwood would say, “are ya feeling lucky?” We’d rather say, “isn’t it smarter to do a little planning … just in case.” But, for those who like statistics, here’s one of the best studies we’ve found. Estimated Years Of Needing LongTerm Care After Turning Age 65 More than 5 years: 20% 2 to 5 years: 20% 1 to 2 years: 12% 1 year or less: 17% % None: 31% If you are thinking about long-term care insurance, here are the most important things to know: 1. You must health-qualify for longterm care insurance. Not everyone can. Because health changes, especially as you grow older, it’s smart to

look into this well before you reach retirement age (your 50s are generally the best time to start). 2. Long-term care insurance can be far more affordable than most people think. Cost is an issue; so you need to know there are many ways to make this protection affordable. 3. Rates (Premiums) can vary significantly from one insurer to another. Each insurer has pricing “sweet spots” based on your age when applying. Available discounts and options can vary too. It’s a reason to work with someone with access to policies from multiple insurers. 4. Health qualifications can also vary from one insurer to another. If you’re in great health, don’t use tobacco products, take no medications — then every insurer will accept you. Each insurer sets their own health-qualifications and they change from time to time. Be prepared to share information with an insurance professional. You want them matching you with the company offering the best protection for the best price. 5. You’re only going to buy longterm care insurance once. Deciding to buy long-term care insurance is a financial and emotional decision. But, it’s different than buying car or home insurance, which people switch from time to time. It’s almost never economically advantageous to switch (primarily because costs are based on your age at application). Many people sell long-term care insurance so make sure you work with

18 Senior Living and Care Guide 2012

Many people sell long-term care insurance so make sure you work with someone who really knows this business. It will save you money and yield benefits for many years to come. The Biggest Mistakes To Avoid? Making a mistake we’ll regret is perhaps our biggest fear when making a purchasing decision. So, when it comes to long-term care insurance, what are the biggest mistakes to avoid?

1. Waiting too long to start planning. You don’t have to buy insurance pro-

tection today; but at least find out what a policy will cost. If you take prescription medications or have health conditions, find out if you can health qualify. Ask what health changes might make you ineligible to health qualify.

between insurers and acceptable health conditions vary. You want to work with an experienced and knowledgeable professional who stays current and can get you the best coverage for the best price.

2. Believing it won’t happen to you. Denial is the best reason not to plan. And, honestly, we hope you live a long life … never have an accident or illness. Yes, we hope you never need longterm care. We also hope you never have a car accident. But hope is not a strategy. Planning for the future is.

Long-term care is relatively new and that’s simply because we’re living longer lives, into our 80s, our 90s and even 100s. When you live a long life, chances are you’re far more likely to need long-term care. The average life expectancy in the United States did not reach 65 until about 50 years ago. The average life expectancy now is well over 70 for both men and women. And, the fastest growing group in the United States is people over the age of 85. Experts estimate that by the year 2040, we will have over a million people in the United States over the age of 100.

3. Counting on government programs. If you are 50 or 55, are you really ready to count on Medicare and Medicaid being able to pay for the care you want in 15 or 20 years? Everyone wants someone else to pay the bill. If you prefer having choice, options and independence, then you’d better have a plan in place … just in case. 4. Not working with a long-term care insurance professional. Costs vary between insurers, discounts vary

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deal with. But, if you live a long life … you’re going to need to have a plan for the risk of needing long-term care. Your Life Expectancy At Age 65 As people age, their life expectancy actually increases. Each year you live, you have survived all sorts of causes of death. If you were born in 1943 (65 years ago at this writing), your life expectancy at birth was about 68 years. Once you reached 65, you can expect to live another 18.4 years. Your current life expectancy is now 83.4 years. Your Life Expectancy At Age 75 If you make it to age 75, your life expectancy increases to 86.8. It’s not funny math, its just one of the weird things that statistics does. What Do Long-Term Care Services Cost? Obviously Long-Term Care services are very expensive. Quality nursing homes are always filled to capacity and they are consequently able to command a hefty fee for services. Home care is also expensive. Bringing a home

health aide into your home every other day for a 4 hour visit can easily cost $1800 per month. When the home care approaches 8 hour visits every day, the costs rise to $7,200 per month. At this point, the care recipient begins to receive facility based care simply for economic reasons. It’s important to consider long-term care insurance when you are still able to “health qualify”. Insurers offer individuals in good health discounts that are locked in. So, even when your health changes, and everyone’s does, you’ll still enjoy the savings. More important, you’ll have locked in your insurability. Wait too long, and a health condition could arise that makes you uninsurable. Each insurance company sets their own acceptable health standards — a reason you want to start by talking to a long-term care insurance professional with access to multiple insurance companies. For more information, log-on to The American Association for Long-Term Care Insurance website: •

Council Bluffs Long-Term Care Estimated Costs Home Health Aide: Average Hourly Rate: $17 Homemaker: Average Hourly Rate: $15 Assisted Living: Lowest Monthly Cost: $1,555 Assisted Living: Highest Monthly Cost: $4,675 Assisted Living: Average Monthly Cost: $2,400 Nursing Home: Semi-Private Daily: $115 Nursing Home: Private Average Daily: $150 Primary Source: The American Association for Long-Term Care Insurance

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20 Senior Living and Care Guide 2012

When to start receiving retirement benefits


ne of the most frequently asked questions at local Social Security offices is “What is the best age to start receiving retirement benefits?” The answer is that there is no one “best age” for everyone and, ultimately, it is your choice. You should make an informed decision about when to apply for benefits based on your individual and family circumstances.

Your decision is a personal one: Would it be better for you to begin receiving benefits early with a smaller monthly amount or wait for a larger monthly payment later that you may not receive as long? The answer depends on a number of factors, such as your current cash needs, your health and family longevity, whether you plan to work in retirement, whether you have other retirement income sources, your anticipated future financial needs and obligations, and, of course, the amount of your future Social Security benefit. Weigh all the facts carefully and consider your own circumstances before making this decision.

Monthly payments differ substantially based on when you start receiving benefits: If you live to the average life expectancy for someone your age, you will receive about the same amount in lifetime benefits no matter what age you start them. However, monthly benefit amounts can differ substantially based on your retirement age. Basically, you can get lower monthly payments for a longer period of time or higher monthly payments over a shorter period of time. The amount you receive when you first get benefits sets the base for the amount you will receive for the rest of your life, though you do receive annual cost-

of-living adjustments and, depending on your work history, may receive higher benefits if you continue to work Retirement may be longer than you think: When thinking about retirement, be sure to plan for the long term. Many of us will live much longer than the “average” retiree, and, generally, women tend to live longer than men. About one out of every four 65-year-olds today will live past age 90, and one out of 10 will live past age 95. Social Security benefits, which last as long as you live, provide valuable protection against outliving savings and other sources of retirement income. Your decision could affect your family: Your spouse may be eligible for a benefit based on your work record (spouse benefits are reduced if claimed before the spouse’s full retirement age). If you die before your spouse, he or she may be eligible for a survivor benefit based on your work record, particularly if you have earned more than your spouse over your lifetime. If you begin receiving Social Security benefits early, we cannot pay your surviving spouse a full benefit from your record. Also, if you wait until after the full retirement age to get benefits, your surviving spouse – if he or she is at least full retirement age – generally will receive the same benefit amount that you would have received. Your children may also be eligible for a benefit on your work record if they are under age 18 or if they have a disability that began before age 22. For them to receive benefits, you must be getting benefits, too. You can keep working: When you reach your full retirement age, you can work and earn as much as you

want and still receive your full Social Security benefit payment. If you are younger than full retirement age and if your earnings exceed certain dollar amounts, some of your benefit payments during the year will be withheld. This does not mean you must try to limit your earnings. If Social Security withholds some of your benefits because you continue to work, Social Security will pay you a higher monthly benefit amount when you reach your full retirement age. In other words, if you would like to work and earn more than the exempt amount, you should know that it will not, on average, reduce the total value of lifetime benefits you receive from Social Security – and may actually increase them. Here is how this works: after you reach full retirement age, we will recalculate your benefit amount to give you credit for any months in which you did not receive some benefit because of your earnings. In addition, as long as you continue to work and receive benefits, we will check your record every year to see whether the additional earnings will increase your monthly benefit. Don’t forget Medicare: If you plan to delay receiving benefits because you are working, you should sign up for Medicare three months before reaching age 65, regardless of when you reach full retirement age. Otherwise, your Medicare medical insurance, as well as prescription drug coverage, could be delayed, and you could be charged higher premiums. •

– Information from the U.S. Social Security Administration


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22 Senior Living and Care Guide 2012

SSA cruising in cyberspace TIM JOHNSON


he Social Security Administration is delivering an increasing number of services in cyberspace.

Many services are now available online, confirmed Denise Jones, district manager. A person can apply for retirement, spouse’s, Medicare and disability benefits online at Nearly 1 million people used the agency’s online retirement application service in 2011, according to the SSA. About the same number of online disability applications were received in 2011. Applicants can now appeal a decision denying them disability benefits at, according to materials from Jones. Social Security now offers a Benefit Eligibility Screening Tool so people can see if they are eligible for any of the programs SSA administers, including retirement, survivors, disability, Supplemental Security Income, Medicare and special veterans benefits at People can also estimate the retirement benefits they will someday receive at There are planners online for different kinds of benefits and what factors affect them at Almost 4 million used online planners in 2011, the agency stated. People can use the website to find the nearest Social Security office. Beneficiaries can set up direct deposit

of benefits, request a replacement Medicare card, change the address their benefits are sent to and make other changes. At the same time, Social Security has been cutting back on the printed materials it sends to taxpayers. In October 1999, Social Security began automatic mailings of annual, individualized statements to workers 25 and older not receiving benefits. In April 2011, the automatic mailings were suspended because of budgetary constraints. According to the SSA, this saved them $30 million in fiscal year 2011. In February 2012, SSA resumed automatic mailings, but only to people 60 and older not receiving monthly benefits. These are generally timed to reach people about three months before their birthday month. Beginning May 1, 2012, statements were made available online for workers 18 and older. In July, the SSA began mailing one-time statements to workers in the year they turn 25. Those who prefer not to use a computer to access the agency’s services can call the local office at (866) 5728381; visit the office at 20 Arena Way, Suite No. 1; or use the national toll-free number, 1 (800) 772-1213. •

Southwest 8 Senior Services is the area’s one-stop shop for all aging related issues such as housing options, elder abuse, nutrition and meals, services to help the elderly stay in their home, Medicare and insurance information, and more. We also have comprehensive programs to support family members who care for an aging loved one. Please contact us for information, assistance or to learn more about options for aging with dignity and independence.

Staff photo/Tim Johnson

The Council Bluffs Social Security Administration office is in the plaza across from the Mid-America Center, 20 Arena Way, Suite No. 1.

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Senior Living and Care Guide 2012 23

Tips for long-distance caregivers

aring for a friend or family member who has cancer is not easy. It may only get more difficult when a caregiver lives far away. Long-distance caregiving may not be ideal for the patient or the caregiver, but it’s sometimes the only option. Long-distance caregivers can expect their out-ofpocket expenses to be higher, as the cost of travel alone is likely to be considerable. While long-distance caregiving may not be ideal, the American Cancer Society offers the following tips to help men and women entrusted with caring for a cancer-stricken friend or family member from afar. • Make sure your loved one’s home is safe. When you get the chance to visit your loved one’s home, make the most of that visit and ensure his or her home is safe. If the illness has made things more difficult around the house, address any of these issues before you return home. Patients who receive chemotherapy are often weakened after treatment, so it can help to install some grab bars in the bathroom or purchase a shower seat to reduce the risk of falling in the shower. In addition, make

sure handrails inside and outside the home are secure. If they’re loose, tighten them so they provide adequate support. • Clean up around the house. Cancer patients may also be too weak to keep up with their chores around the house. A dirty home can be depressing to men and women battling cancer, so clean up around the house to brighten the home and reduce the risk of an insect or rodent infestation. • Be ready for a crisis. No one wants to imagine a situation in which his or her loved one suffering from cancer has an emergency, but caregivers need to do just that. Have someone you can count on nearby to check on your friend or family member if you suddenly cannot reach the cancer patient. Introduce yourself to your loved one’s next-door neighbor or meet a close friend who lives nearby that you can contact should your friend or family member prove difficult to reach. • Make a list of medications and update it regularly. Cancer patients often take certain medications as part of their treatment and recovery, and caregivers should make a list of these medications, periodi-

cally updating the list as the treatment and recovery process progresses. • Make sure your loved one has a cell phone. Though it might seem hard to believe, some people, especially the elderly, still do not have cellular phones. When serving as a long-distance caregiver, it’s imperative that you can easily and routinely reach your cancer-stricken friend or relative. Cancer treatment might make it difficult for him or her to get to a land line, so be sure he or she has a cell phone that he or she can carry with them at all times. Program important numbers, including your own number, as well as his or herphysician’s and a neighbor’s or nearby relative’s number, into the phone. • Stay in touch with the patient’s physician. While a physician might not be able to share all the details of your loved one’s condition, you can keep in touch with him or her to stay abreast of how the treatment and recovery process is going. A physician can help you tailor your caregiving to best manage the patient’s needs, adjusting that plan as the treatment and recovery process evolves. •

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24 Senior Living and Care Guide 2012

When you become the parent of your parent


edical advancements have enabled people to live longer. Though everyone wants to live longer, some people outlive their ability to care for themselves. In such instances, family members must make a decision regarding how best to care for an elderly relative. According to “Aging in Place in America,� a commissioned study by Clarity(R) and the EAR Foundation, 63 percent of Baby Boomers are actively involved in providing some kind of help or assistance to their elderly parents. Whether this is due to the rising cost of elder care or simply a feeling of obligation on the part of the child, many middle-aged men and women are responsible for caring for aging parents and young children. The emotions that might result from caring for an aging parent are often mixed. Some people are happy to do their part to help make life a lit-

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tle easier for a person who devoted so much of his or her energy to raising them. Others in the sandwich generation can feel like this is a burden or guilty that they’re not doing enough for a parent. Signs an elder needs help When an older relative stops driving, this is often indicative that he or she needs assistance with daily living. There also may be signs that support and care is needed, such as if the house seems untidy, if he or she is having trouble maintaining personal hygiene, if the parent is getting hurt attempting to do things around the house or if he or she seems malnourished due to the inability to cook meals. Limited mobility or loss of mental faculties also may be indicative that it is time for a loved one to receive care.

Questions to ask Although taking on the care of an aging parent may seem like the best idea possible, particularly for a senior who is very afraid of losing his or her independence, it may not always be in either party’s best interest. Before anyone determines what will be done to help a relative, it’s best to answer a few questions as straightforwardly as possible. • What type of care does my parent need? • How soon into the future is that type of care bound to change? • Can this care be handled by

someone who comes into the house, such as a visiting nurse? • Will my parent feel comfortable with an outside person helping with day-to-day care? • What are my parent’s limitations? • Am Icapable of handling this on my own? • Can I afford an adequate care facility? • What are my local facility options? • Will this type of care affect my own personal well-being? • Can Ihandle this emotionally and physically? Any person facing the prospect of caring for an aging parent can realize that there is help available, as well as many different people who can help guide a decision. The first resource is to ask siblings, aunts, uncles, and cousins to weigh in on the situation to help the family come to a consensus.

There are also social workers who specialize in this sort of thing, as well as financial consultants who can spell out the pros and cons of different types of care and help determine the most affordable option. This can also go a long way toward helping determine the course of action. The burden of caring for a parent can take a physical and mental toll on a person. Knowing there is a support circle available can ease one’s mind and enable caregivers to make rational decisions that are in everyone’s best interest. Caring for a loved one who can no longer care for him- or herself is something that many Baby Boomers are facing on a daily basis. Although it may be a touchy subject, it is worth exploring what you will do before the situation becomes urgent. •

26 Senior Living and Care Guide 2012

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How It Works Model hobby kits assist soldiers who are on the mend in re-focusing their energies on positive accomplishments and improving their fine-motor skills as part of their therapy.

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Glossary of senior housing terms This list can help you navigate commonly used terms and the different senior housing and care choices available. Accreditation: A seal of approval given by an autonomous governing body to a community or service provider. To become accredited, the community or provider must meet specific requirements set by the accreditation entity and is then generally required to undergo a thorough review process by a team of evaluators to ensure certain standards of quality. The accrediting organizations are independent, not government agencies or regulatory bodies. Some examples of accreditation bodies for the senior housing and care industry include CARF (Commission on Accreditation of Rehabilitation Facilities), CCAC (Continuing Care Accreditation Commission) and JCAHO (Joint Commission on Accreditation of Healthcare Organizations). Activities of Daily Living (ADLs): Bathing, eating, grooming, dressing, toileting and other day-to-day activities. ADA (Americans with Disabilities Act): Passed by Congress in 1980, this law establishes a clear and comprehensive prohibition of discrimination on the basis of disability. Administrator: In most cases, a licensed professional who undertakes the duty of managing the day-to-day operations of a care facility such as a nursing home or assisted living facility. Adult Day Care: Structured programs with stimulating social activities and health-related and rehabilitation services for the elderly who are physically or emotionally disabled and need a protective environment. The participant is usually brought to the care facility in the morning and leaves in the evening. Advantage list: List of health service providers that agree to give particular insurance company policyholders a preset discount.

Aging in place: A concept that advocates allowing a resident to choose to remain in his/her living environment regardless of the physical and or mental decline that may occur with the aging process of aging. There is a wide range of home care services that can help you maintain your independence within the comfort of your own home. Alzheimer’s care center: A treatment center that specializes in providing care for those with Alzheimer’s disease with more of the care geared towards supervision of the patient in a safe and controlled environment. Alzheimer’s: A progressive, neurodegenerative disease characterized by loss of function and death of nerve cells in several areas of the brain, leading to loss of mental functions such as memory and learning. Alzheimer's disease is the most common cause of dementia. Ambulatory: The ability to walk freely and independently, not bedridden or hospitalized.

Assessment: An evaluation, usually performed by a physician, of a person's mental, emotional and social capabilities.

Assisted living: It is a special combination of housing, personalized supportive services and health care designed to meet the needs – both scheduled and unscheduled – of those who need help with activities of daily living. Services provided in assisted living residences usually include: • Three meals a day served in a common dining area • Housekeeping services • Transportation • Assistance with eating, bathing, dressing, toileting and walking • Access to health and medical services • 24-hour security and staff availability • Emergency call systems for each resident's unit • Health promotion and exercise programs • Medication management • Personal laundry services • Social and recreational activities

28 Senior Living and Care Guide 2012

Caregiver: The primary person in charge of caring for an individual with Alzheimer's disease, usually a family member or a designated health care professional.

Home Health Care: Provision of medical and nursing services in the individual's home by a licensed provider. Hospice Care: Philosophy and approach to providing comfort and care at life's end rather than heroic lifesaving measures, it can include medical, counseling, and social services. Most hospice care is furnished in-home, while specialized hospices or hospitals also provide this service.

Case management: A term used to describe formal services planned by care professionals. Charge Nurse: An RN or LPN who is responsible for the supervision of a unit within a nursing facility. The charge nurse schedules and supervises the nursing staff and provides care to facility residents.

Congregate Housing: Is similar to independent living except that it usually provides convenience or supportive services like meals, housekeeping, and transportation in addition to rental housing. (from ALFA)

Continuing Care Retirement Community (CCRC): Is a community that offers several levels of assistance, including independent living, assisted living and nursing home care. It is different from other housing and care facilities for seniors because it usually provides a written agreement or long-term contract between the resident (frequently lasting the term of the resident's lifetime) and the community which offers a continuum of housing, services and health care system, commonly all on one campus or site. (from ALFA) Continuum of Care: Care services available to assist individuals throughout the course of a disease. This may include Independent Living, Assisted Living, Nursing Care, Home Health, Home Care, and Home and Community Based Services. Convalescent Home: See Nursing Home. Dementia: The loss of intellectual functions (such as thinking, remembering, and reasoning) of sufficient severity to interfere with a person's daily functioning. Dementia is not a disease itself but rather a group of symptoms that may accompany certain diseases or conditions. Symptoms may also include changes in personality, mood, and

behavior. Dementia is irreversible when caused by disease or injury but may be reversible when caused by drugs, alcohol, hormone or vitamin imbalances, or depression. Developmental Disability (DD): Affliction characterized by chronic physical and mental disabilities, which may include: cerebral palsy, retardation, thyroid problems, seizures, and quadriplegia. Director of Nursing (DON): A DON oversees all nursing staff in a nursing home, and is responsible for formulating nursing policies and monitoring the quality of care delivered, as well as the facility's compliance with federal and state regulations pertaining to nursing care. Financial Counseling Programs: Help seniors with managing their finances, bills, and completing Medicaid, Medicare or insurance forms.

Independent Living: Is a residential living setting for elderly or senior adults that may or may not provide hospitality or supportive services. Under this living arrangement, the senior adult leads an independent lifestyle that requires minimal or no extra assistance. Generally referred to as elderly housing in the government-subsidized environment, independent living also includes rental assisted or market rate apartments or cottages where residents usually have complete choice in whether to participate in a facility's services or programs. (from ALFA) See Senior Apartments.

Instrumental Activities of Daily Living (IADLs): Secondary level of activities (different from ADLs, such as eating, dressing, and bathing) important to daily living, such as cooking, writing, and driving.

Kitchenette: Each facility may have its own definition of a kitchenette, but generally one includes a sink, cabinet space, and a mini-refrigerator, maybe a microwave. In contrast, a full kitchen would usually have a burner unit, sink, cabinets, full-size refrigerator, and possibly a microwave or stove.

HIPAA (The Health Insurance Portability and Accountability Act of 1996): This act became a law on January 1, 1997. The act states the requirements that a long term care policy must follow in order that the premiums paid may be deducted as medical expenses and benefits not paid be considered as taxable income.

Licensed Practical Nurse (LPN): LPNs are trained to administer technical nursing procedures as well as provide a range of health care services, such as administration of medication and changing of dressings. One year of post high school education and passage of a statelicensing exam is required.

HMO: A Health Maintenance Organization (HMO) is an organized system for providing comprehensive health care in a specific geographic area to a voluntarily enrolled group of members.

Life Care Community: A Continuing Care Retirement Community (CCRC) that offers an insurance type contract and provides all levels of care. It often includes payment for acute care and

Senior Living and Care Guide 2012 29

physician's visits. Little or no change is made in the monthly fee, regardless of the level of medical care required by the resident, except for cost of living increases. Living Will: A written document, which states the wishes of an individual in advance concerning the use of life saving devices and procedures in the event that the person is terminally ill or has suffered an injury and is no longer competent. Long-Term Care: Care given in the form of medical and support services to persons who have lost some or all of their capacity to function due to an illness or disability. Long-term Care Insurance: The insurance which pays for a succession of care giving services for the elderly or chronically ill. This care may be provided in a facility (nursing home, mental hospital, etc.) or in the individual's home with a nurse or aide. Managed Care: Can best be described as the partnership of insurance and a health care delivery system. The basic goal of managed care is to coordinate all health care services received to maximize benefits and minimize costs. Managed care plans use their own network of health care providers and a system of prior approval from a primary care doctor in order to achieve this goal. Providers include: specialists, hospitals, skilled nursing facilities, therapists, and home health care agencies. Medicaid: Public assistance funded through the state to individuals unable to pay for health care. Medicaid can be accessed only when all prior assets and funds are depleted. There are income eligibility criteria that must be met to qualify for Medicaid. Medicaid accounts for about 52 percent of the nation's care costs, and is the source of payment for almost 70 percent of residents in nursing homes. Medicaid can reimburse Nursing Facilities for the long-term care of qualifying seniors, and in some states, Medicaid pays for Assisted Living care through Medicaid waivers. Medicare: A federal health insurance program for people age 65 and older and

for individuals with disabilities. (from AA) The Social Security Administration regardless of income administers Medicare. It also provides for hospital and nursing facility care (Part A) and physician services, therapies, and home health care (Part B). Medical Director: The medical director coordinates with an individual's personal physician to ensure that the facility delivers the care that is prescribed. In some instances, the medical director may be a resident's primary physician. A staff medical director assumes overall responsibility for the formulation and implementation of all policies related to medical care. Medications Management / Medication Administration: Formalized procedure with a written set of rules for the management of self-administered medicine, as in an assisted living setting. A program may include management of the timing and dosage for residents, and could include coordination with a resident's personal physician. The resident must take the medication him or herself. For instance, the facility can remind the resident that she needs to give herself the medicine injection, but the facility cannot perform the actual injection itself.

organization made up of state officials who are in charge of regulating insurance. They have considerable influence and strive to promote national uniformity in insurance regulations.

Medigap Insurance: Private health insurance that is used to pay costs not covered by Medicare, such as deductibles and co-insurance.

Non-Ambulatory: Inability to walk independently, usually bedridden or hospitalized.

National Association of Insurance Commissioners (NAIC): A national

Not-for-Profit: Status of ownership and/or operation characterized by gov-

30 Senior Living and Care Guide 2012

ernment by community-based boards of trustees who are all volunteers. Board members donate their time and talents to ensure that a not-for-profit organization's approach to caring for older people responds to local needs. Not-for-profit homes and services turn any surplus income back into improving or expanding services for their clients or residents. Many not-for-profit organizations are often associated with religious denominations and fraternal groups. Not-forprofits may also interact with Congress and federal agencies to further causes that serve the elderly. Nurse Assistant: Nurse assistants work under the supervision of a Registered Nurse or Licensed Practical Nurse. A Nurse Assistant provides the most personal care to residents, including bathing, dressing, and toileting. Must be trained, tested, and certified to provide care in nursing facilities that participate in the Medicare and Medicaid programs.

Nursing Home: Provides 24-hour skilled care for the more acute patients. Patients generally rely on assistance for most or all daily living activities (such as bathing, dressing and toileting). (from ALFA) One step below hospital acute care. Regular medical supervision and rehabilitation therapy are mandated to be available, and nursing homes are eligible to participate in the Medicaid program. These facilities are State Licensed. Also referred to as Nursing Facility or Convalescent Home. See also Skilled Nursing Facility.

Occupational Therapy: A creative activity prescribed for its effect in promoting recovery or rehabilitation. This is done to help individuals relearn activities of daily living and is generally administered by a licensed therapist.

attain and maintain their highest level of mental, physical, and psychological function, in a dignified and caring way.

occupational, or speech therapy in order to restore to the patient to a former capacity.

Real Estate: These housing options offer home ownership opportunities for adults 55 years of age and older, or sometimes 62 years and older. Some communities offer rental programs and rent-to-own options. The types of residences you may find are: Single Family Homes, Cottages and Patio Homes, Condos and Townhouses, Manufactured Homes, Gold Communities and Gated Communities.

Residential Care: See Assisted Living.

Physical Therapy: The treatment of disease or injury, by physical and mechanical means (as massage, regulated exercise, water, light, heat, and electricity.) Physical therapists plan and administer prescribed physical therapy treatment programs for residents to help restore their function and strength.

Registered Nurse (RN): Graduate trained nurse who has both passed a state board examination and is licensed by a state agency to practice nursing. A minimum of two years of college is required in addition to passage of the state exams. The RN plans for resident care by assessing resident needs, developing and monitoring care plans in conjunction with physicians, as well as executing highly technical, skilled nursing treatments.

Quality care: Term used to describe care and services that allow recipients to

Rehabilitation: Therapeutic care for persons requiring intensive physical,

Respite Care: Services that provide people with temporary relief from tasks associated with care giving (e.g., inhome assistance, short nursing home stays, adult day care).

Senior Apartment: Age-restricted multiunit housing for older adults who are able to care for themselves. Usually no additional services such as meals or transportation are provided. Similar to Independent Living.

Senior Citizen Policies: Insurance policies for those over the age of 65. In many cases these policies are in combination with coverage provided by the government under the Medicare Program.

Support group: Facilitated gathering of caregivers, family, friends, or others affected by a disease or condition for the purpose of discussing issues related to the disease. •

Senior Living and Care Guide 2012 31

Living at home: Tips for a safer environment


ost people prefer to remain in their own homes and consider alternatives only if their care needs cannot be met at home. Modifying the home is an important option that can improve safety and help with performance of daily activities such as bathing and cooking. Home modifications range from grab bars in the bathroom and improved lighting to handrails and wider doorways for wheel chair access, or even adding a bathroom on the first floor of a two-story home for someone no longer able to climb stairs. Food preparation and home delivery is a great help Many companies now exist that can deliver pre-prepared home meals that are nutritious and easy to warm up or cook – two major concerns for the elderly. Consider moving your loved one to a more suitable environment Perhaps moving to a new home will best help meet physical and safety needs. Consider the variety of options such as moving to a house, condominium or apartment that is all on one level, or that has elevators instead of stairs. Consider a small, easy-to-care-for apartment with basic modifications already in place. Nagging repair problems When you get the phone call that a light switch isn’t working or the gutters need cleaning, or your loved one or friend is unable to cut the lawn or shovel the snow, that doesn’t mean they mean to move out of the house. It just means that some help is needed. As so many of us live far from parents or loved ones, there’s still a way to arrange help for them in their home, and many of these service companies can by consulting local directories. •

Minor modifications and in-home services can help seniors stay in their own home

Staying at home is possible, but may require modifications, such as grab bars in the bathroom or wider doorways for wheelchairs, or long-term care, such as physical therapy.

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Senior Living and Care Guide 2012 33

Assisted living financial worksheet Use this itemized worksheet in estimating the monthly cost of needed services. Not all items may be applicable to your specific situation. $_____ Entrance and/or Initial Assessment Fee $_____ $_____ $_____ $_____ $_____ $_____ $_____ $_____ $_____ $_____ $_____ $_____ $_____ $_____ $_____ $_____

Selected Unit and Basic Service Package Cost for Meals Cost for Housekeeping Cost for Personal Laundry Service Cost for Linen Service Cost for Medication Management or Assistance Cost for Personal Care Assistance (bathing, dressing, eating, etc.) Cost for Recreational Field Trips Cost for Transportation Cost for Telephone Service Cost for Cable Television Beauty Shop Charges Other Charges Other Charges Other Charges Total Estimated Monthly Charges

Make sure you are aware of the following: ____ Know what the basic service package includes ____ Know all costs associated with your service package ____ Know about additional services and their associated fees (e.g., medication management) ____ Know the circumstances why fees might change and how much notice is given to families and residents ____ Understand the services planning process ____ Understand the service contract ____ Know about the criteria and policies associated with discharge ____ Understand resident rights and responsibilities ____ Know the residence’s grievance policy and procedure ____ Understand how many staff are available and their qualifications ____ Have the name and telephone number of the staff contact person

34 Senior Living and Care Guide 2012

Hobbies for the golden years


hether retirement is on the horizon or has already begun, more free time equates to an increased opportunity to fill your days with enjoyable activities. Individuals facing busy schedules are often forced to push hobbies to the sidelines, as more pressing things, such as a job, household responsibilities, and parenting tasks, are accomplished. Once retirement arrives, a newfound freedom in your schedule may occur, and there can be plenty of hours to devote to the hobbies and pastimes you find enjoyable. According to research, hobbies can have many benefits. They may serve as an emotional outlet or a way to relax. Hobbies can keep the mind and hands active. They also allow for quiet time and mind wandering — which can free up creative thinking. Hobbies can also serve as a means to connecting with people and opening up new groups of friends. There are many hobbies you can consider, depending on physical health and abilities. These may be hobbies you once enjoyed in the past or new activities to expand your horizons. And hobbies need not be crafty in the traditional sense, just about any activity — even being a mentor — can be a form of a hobby. Starting a hobby When deciding on a hobby, you can first take an inventory of your skills and interests. If you have always been handy around wood and construction, perhaps a woodworking hobby will be enjoyable and also may work as a source of income revenue. Other activities that require the use of the hands and mind include

Sewing can be a hobby that seniors do after retirement when they have ample free time. knitting, needlepoint, painting, puzzles, quilting, scrapbooking, and crocheting. These can keep the mind active and improve dexterity and fine motor skills. Next, you may want to consider the costs surrounding a hobby. While something like taking photos may have relatively low costs, collectibles, exotic sports, sports cars, and travel could become expensive. It’s important to weight the costs against your finances to ensure that you will be financially comfortable while engaging in this particular hobby. Explore what your friends are doing. If you want to get into a new hobby, ask neighbors and friends what they do to keep busy — and try it out. You just may find that you’re naturally inclined to do this type of activity and enjoy it. Visit a local hobby shop or craft

store and browse through the aisles. See where your attention is drawn and give that activity a try. From building model trains to cultivating an herb garden, there are dozens of ideas to try.

Other pastimes A hobby can take the form of volunteer work, teaching, mentoring, joining a martial arts class, taking classes at a college, and even caring for a pet. If you are the type who likes to interact with other people instead of engaging in a solitary hobby, consider one of these types of activities instead. Once a hobby is started, it is not set in stone. If you find you do not feel motivated to do this hobby, try something else. Remember, the days are now yours to fill, so maximize time spent with activities you can enjoy. •

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