Home Instead Senior Care sponsors Jim Miller's Savvy Senior column

Dear Savvy Senior,

What kinds of programs are available to help low-income seniors with their Medicare costs and other expenses? My 81-year-old mother has gone through her savings and is having a tough time getting by on her Social Security benefits. What can you tell us?

Worried Son

Dear Worried,

There are actually a variety of under-utilized programs that can help lower-income seniors with their Medicare costs, grocery bills, utility expenses and more. Here’s what you should know.

Medicare Savings Programs

For millions of seniors who are having a tough time paying their out-of-pocket healthcare costs, help is available through Medicare Savings Programs (MSPs). These are Medicaid-administered programs that pay Medicare Part B premiums and depending on your mom’s finances may even pick up the tab on her Medicare copayments and deductibles. To qualify, her income must be under $1,246 per month (or $1,675 for a married couple), and her assets must be below $6,680 ($10,020 per couple) not including her house, vehicle, burial fund, furniture or other household items. To find out if she qualifies, or to apply, contact her local Medicaid office – call 800-633-4227 begin_of_the_skype_highlighting 800-633-4227 end_of_the_skype_highlighting for contact information.

Extra Drug Help

If your mom is eligible for a MSP, she’s also eligible for “Extra Help” in paying her Medicare prescription drug plan costs. If, however, she’s not eligible she can still get Extra Help if her annual income is below $16,335 ($22,065 for a married couple living together), and her cash assets are under $12,640 ($25,260 for married couples) excluding her home and vehicle. For more information, call Social Security at 800-772-1213 begin_of_the_skype_highlighting 800-772-1213 end_of_the_skype_highlighting www.ssa.gov/prescriptionhelp.

Food Assistance

In addition to the Medicare programs, your mom may also be able to get some help with her grocery bills. Food assistance programs like SNAP (Supplemental Nutrition Assistance Program) are available to seniors, age 60 and older, with cash assets under $3,000, and a “net income” below $903 per month ($1,215 for a family of two). Net income is figured by taking your mom’s gross income minus allowable deductions like medical expenses, rent or mortgage payments, utility costs, insurance, taxes and more. The average monthly SNAP benefit is currently around $101 per person. To find out if your mom qualifies, use the SNAP pre-screening tool at www.snap-step1.usda.gov or contact her local SNAP office – call 800-221-5689 begin_of_the_skype_highlighting 800-221-5689 end_of_the_skype_highlighting

Utility Assistance

There are also resources available that can help low-income seniors reduce their utility bills. The Low Income Home Energy Assistance Program, as well as local utility companies and charitable organization help millions of Americans each year with their home heating and cooling costs. To search for help go to energynear.org, a web portal that provides information on all energy assistance programs in each state, along with qualification details, how to apply and who to contact. You can also call the National Energy Assistance Referral project at 866-674-6327 begin_of_the_skype_highlighting 866-674-6327 end_of_the_skype_highlighting

Supplemental Income

Another program to check into is SSI or Supplemental Security Income. Administered by the Social Security Administration, SSI provides monthly payments to very low income seniors (age 65 and older), as well as to those who are blind and disabled. To learn more or find out if she’s eligible, visit www.ssa.gov/ssi or call 800-772-1213 begin_of_the_skype_highlighting 800-772-1213 end_of_the_skype_highlighting

Savvy Tip: To search for other assistance programs go to benefitscheckup.org, a comprehensive web service developed by the National Council on Aging, that contains a database of more than 2,000 federal, state and local programs that can help seniors in need. The site will help you locate programs that your mom may be eligible for and will show you how to apply. This service is only available online.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

Jim Miller, creator of the syndicated Savvy Senior column

About Jim Miller

Jim Miller is the creator of Savvy Senior, a syndicated information column for older Americans and their families that is published in more than 400 newspapers and magazines nationwide. Jim is also a contributor on NBC’s “Today” show, and is the author of The Savvy Senior, The Ultimate Guide to Health, Family and Finances for Senior Citizens, (Hyperion, 2004).

Jim is frequently quoted in articles about issues affecting senior citizens and has been featured in numerous high profile publications, including Time magazine, USA Today and The New York Times.  In addition, he has made multiple appearances on CNBC, CNN, Retirement Living Television and national public television.

The Savvy Senior column is brought to you by Home Instead Senior Care of Richmond and Tappahannock

Home Instead Senior Care provides extraordinary senior home care, personal care and companionship services to seniors in the Richmond area which includes the counties of Chesterfield, Goochland, Hanover, Henrico and Powhatan.  We also serve all of the Northern Neck out of our Tappahannock office.  For more information, please visit our digital brochure or call our office at 804.527.1100 begin_of_the_skype_highlighting 804.527.1100 end_of_the_skype_highlighting anytime.

Every week, Home Instead Senior Care of Richmond profiles senior living communities in the area as a service to our readers.

Heritage Oaks is near Chippenham Hospital and serves seniors age 65+

This week, we take a look at Heritage Oaks Retirement. Conveniently located two blocks from Chippenham Hospital, Heritage Oaks sits on 12 acres of wooded, landscaped, private land. 

It is a blended community that offers restaurant-style dining, on-site healthcare assistance, transportation services, and spacious apartments decorated with residents’ own home furnishings.

Heritage Oaks' dining offers a restaurant-like experience.

Heritage Oaks boasts a restaurant that “rivals the best restaurants in town and is a chance for residents to indulge” with three delicious meals served daily.

It also plans a host of activities for its residents, including:

• Jazzercise
• Poker
• Exercise Classes
• Matinees
• Undefeated Wii Bowling Team
• Full-time chauffeur
• All-inclusive pricing

Here’s what Heritage Oaks has to say about the high activity level it offers:

Residents at Heritage Oaks are active and social. You’ll find them playing billiards, growing their own vegetables in our outdoor garden, socializing with friends in quiet nooks or participating in discussion groups and tours. When the weather is nice, many of our residents choose to walk around our beautifully landscaped gardens. During those days when it’s best to stay indoors, you’ll find them exercising with our modern equipment or participating in an exercise class.

Our chapel offers a place for quiet meditation on days when you want to slow the pace. Our lofty atrium provides the perfect backdrop for musical presentations. With a full-time Activities Director on-site, there’s always something to do.

For more information on Heritage Oaks,  visit http://www.heritageoaksretirement.com or call them at 804.323.3800. They are conveniently located in Richmond at 1100 German School Road, Richmond, Virginia 23225.

And, for more information on how a Home Instead CareGiver can help keep your loved one living independently in his or her own home, regardless of where he or she calls home,  visit our web site at www.homeinstead.com/richmond-va, view our digital interactive brochure, or call our Richmond office today at 804.527.1100.

Seniors often don’t realize that getting a little help now, when they’re getting a little older, can help them remain living independently for a lot longer than if they try to do everything on their own. 

Following are strategies from Home Instead Senior Care^® and family caregiving consultant Dr. Amy D’Aprix to help family caregivers turn resistance into assistance.  

1. Understand where the resistance is coming from.  Ask your parent why he or she is resisting.  “Mom, I notice that every time I bring up the idea of someone coming in to help, you resist it.  Why is that?”  Oftentimes older adults don’t realize they are being resistant.  
2. Explain your goals.  Remind your loved one that you both want the same thing.  Explain that a little extra help can keep her at home longer and will help put your mind at ease as well.  Have a candid conversation with him about the impact this care is having on your life.  Oftentimes seniors don’t understand the time commitment of a caregiver.
3. Bring in outside help.  If a relationship with a parent is deteriorating, ask a professional, such as a geriatric care manager, for an assessment.  A third-party professional can provide valuable input.  Also, go to www.4070talk.com for tips on how to talk with a loved one.  If you are having problems getting through to your older adult, consider asking another family member or close friend to intervene.  If you’re not making headway, perhaps there’s someone better to talk with your parents.
4. Research your options to find the best resources for your loved one.  Contact your local Area Agency on Aging or a geriatric care manager to research resources in your community.  Or download The Home Care Solution, a guide for family caregivers to help them find the best in-home care for their loved ones.  If you decide outside help is needed, reassure your parents and tell them you have researched caregivers and you are confident you have found the best one you can find to come into the home to help.
5. Respect your parent’s decisions.  Sometimes you won’t agree with your parent’s decisions and that’s O.K.  As long as your loved one is of sound mind, he or she should have the final say.   

A note:  If your senior has dementia, seek professional assistance from a doctor or geriatric care manager.  Logic often will not work and other strategies must be employed. 

For more information or to get answers to your questions, please contact your local Home Instead Senior Care office.  In Richmond, we can be reached — anytime day or night – by calling 804.527.1100.  Or you can visit our digital web brochure at http://hisc189.digbro.com.

Dr. Dale Atkins was featured on the Today Show this morning talking about the idea of “role reversal” when faced with caring for an aging parent, which she says is really not so much about that. “Your parents are always your parents,” she says.

Taking care of yourself as a caregiver is important and getting a team together to help you is beneficial, too.

Visit msnbc.com for breaking news, world news, and news about the economy

Atkins adds that having an online support group as well as family members available to help you discuss the critical and emotional issues will help relieve the stress often associated with caring for your elderly Mom or Dad.

Check out the video above and Dr. Atkins’ book entitled “I’m OK, You’re My Parents: How to Overcome Guilt, Let Go of Anger, and Create a Relationship That Works.”

Home Instead Senior Care provides many resources to family members facing caring for an aging parent, including a website with educational videos at CaregiverStress.com. If you or your elderly loved ones are in the local Richmond or Northern Neck areas, we can help you with your unique and individual situation by simply calling our Richmond home care office at 804.527.1100. Our office line is open 24 hours a day, 7 days a week to help you with your senior care needs.

And if you need assistance outside of the Central Virginia area, simply visit http://homeinstead.com for additional locations.

If you’re a senior and you are living at home in Richmond or Northern Neck, or if you have an aging parent or relative who is, this summer is a great time to assess whether you need extra help around the home.  Below is a short survey to determine your senior home care needs:

Please check all that apply:

1. Are you having trouble walking?
2. Have you fallen, or are you afraid of falling?
3. Are you not eating as well as you should be?
4. Are you forgetting to eat?
5. Are you afraid of falling in the shower or bathtub?
6. Do you need help getting to your medical appointments?
7. Do you need help grocery shopping and running errands?
8. Do you need assistance getting dressed?
9. Do you need help getting to the bathroom in time?
10. Do you forget to take your medications?
11. Are you afraid to be home alone?
12. Does your family worry about you while you’re home alone?
13. Are you able to properly maintain your home?
14. Have you lost interest in activities that used to make you happy?
15. Are your regular, daily activities more difficult than they used to be?

If you can answer “yes” to any of these questions about your activities of daily living (ADL), then Home Instead Senior Care may be able to help.  Our trusted CAREGivers provide non-medical companionship and homecare services to help seniors remain as independent as possible in the comfort and safety of their own homes – wherever they call home.

To learn more about how we may be able to help you, please call our Richmond home care office at 804.527.1100 or our Tappahannock home care office at 804.443.4885.  Or visit us online at http://www.homeinstead.com/richmond-va.

Need some additional caregiving help for an elderly loved one?   Want to make sure your Father or Mother get some additional help around their home to help them remain independent?  Always wanted to know more about how Home Instead can help reduce stress and lighten your caregiving load if you’re the family caregiver?

Well, there’s no better time than now to make your appointment for our free, no-obligation home care assessment and to start having those conversations.  For a limited time, you’ll receive a free copy of Stages of Senior Care: A Step-by-Step Guide to Making the Best Decisions as our thank you for your time and for meeting with us in person.

Simply call our office at 804.527.1100 to make your appointment and mention the offer code “STAGES” when you call.  While our offices are open during the week, our phone lines are open 7 days a week for your convenience including Saturdays and Sundays.

The just-released Stages of Senior Care: Your Step-by-Step Guide for Making the Best Decisions

Stages of Senior Care is more than a book.  It is a reference guide for family members or seniors who want to gain a better understanding of all the many care options available to seniors. 

It explains the various options and the advantages and disadvantages of each.  You’ll keep it nearby and will refer to it again and again as senior care needs change from independent living to assisted living to hospice care and everything in between.

Again, Stages of Senior Care is our free gift to you for simply meeting with us in person to review your senior care needs whether those include light housekeeping, meal preparation, medication reminders, transportation, personal care or companionship services. 

Just call our Home Instead office at 804.527.1100 and mention offer code “Stages.”   Offer good while supply lasts so don’t delay.  Offer available in Greater Richmond and Northern Neck areas served by our Home Instead Senior Care offices in Richmond and Tappahannock.

Caring for an elderly Mom or Dad can be daunting. Talk to them about their wishes.

If you have an aging parent, you probably have received advice from friends and experts to start talking with your parent now about issues such as finances, health and safety concerns. 

You know you shouldn’t delay any longer, and you definitely should not wait until a crisis occurs. 

However, it is tough to know how to get started.  You respect your parent’s privacy.  You have had no experience or training for this.  It is downright uncomfortable.

You may be thinking,

How do I find out what my parent really wants and what he/she expects from me?

How do I broach sensitive subjects?

What if they get upset with me?

What if they refuse to talk with me?

It’s important to realize it takes just one event to change your parent’s world and yours.  My mother’s health deteriorated rapidly in a 3-month period due to a viral infection.  A seemingly simple fall can result in a broken hip or brain injury.  An aneurysm can result in a coma. 

None of us can predict the future.  But, we certainly can start the conversations with our parent now.  Let me share some tips.

1. Start with an understanding of how your motivation and your parent’s motivation differ.  David Solie in his book, How to Say It To Seniors, tells us that the primary driver in the elderly is to “maintain control.”  That makes sense when you think about the losses they are experiencing; the loss of strength, health, and friends.  As adult children, our primary driver is “safety”!  We have to learn to assist, not insist.
2. Plan a special visit of 2 or 3 days with your parent.  During this time, just plan to be present, listen and walk beside your parent in their daily routines.  This means putting your laptop, blackberry and phone away.   The first time I did this, I was amazed.  I gained insight into my mother’s world, and the experience also helped me transition from my fast-paced world to hers.  A natural result of the visit was a deepened trust and openness between my mother and me.
3. Broach sensitive discussions with thoughtful wording, such as using the phrase, “What If”.  “What if your arthritis gets worse and you need help in your home” or “What if one day you need full-time care?” If your parent doesn’t want to talk about it at that time, know that you’ve planted a seed.  It also helps to share these conversations with your other siblings (who may live states away from you and your parent). Try to get family members on the same page.  

So, start with a sincere desire to understand your parent, their fears, needs and wishes.  Put yourself in their shoes, and listen, non-judgmentally.  Build a foundation of trust and sharing.  That foundation is what will help guide you through the conversations you need to have with your parent now and in the future. 

Want to learn more about communicating with an aging parent and siblings?

Obtain Dale Carter’s entire Ecourse, “Five Essential Strategies to Help Your Aging Parent Face Change” at http://www.transitionagingparents.com/

About Dale Carter

The above article was written by Dale Carter and published with permission.  Dale Carter is the founder of Transition Aging Parents, providing information and insight for adult children of aging parents so they can “thrive and find joy” in every stage of life.  Besides her blog, articles, and newsletter, she hosts a weekly radio show, interviewing authors and experts.  Her book, “The 6 Steps to Guide an Aging Parent through Change & Crisis” will be published later in 2010.

At Home Instead Senior Care

Home Instead Senior Care has many additional resources to help you with having those often difficult conversations with your aging parent.  There is a 40-70 Rule booklet which you can download at this link:  The 40-70 Rule.  You can also reference the website and book, The Stages of Senior Care.  And, lastly, you can preview our Richmond digital brochure here:  Home Instead Senior Care of Richmond.

And, remember, we’re here to help.  Just call our Richmond senior care offices at 804.527.1100 — we’re here for you anytime, day or night, whenever you need assistance.

Home Instead CAREGivers can be there to help elderly loved ones when family can't

According to the American Association of Neurological Surgeons (AANS), simply falling at your own home is the leading fatal injury for people 65 and older. Nearly 50 percent of all fall-related fatalities are caused by traumatic brain injury. 

In 2008, nearly 8.6 million Americans of all ages suffered accidental falls. 

Gail L. Rosseau, M.D., AANS spokesperson and a Chicago neurosurgeon, states “Many head injuries occur at one’s residence – whether it is a home or a nursing home facility – and involve falling and bumping one’s head, resulting in mild concussions to severe and even fatal traumatic brain injuries.” 

Among people ages 55 and older, most head injuries were related to flooring, wheelchairs, canes, crutches and walkers. But falls can happen in so many ways — stumbling on stairs, slipping in bathtubs, falling off ladders and step stools, and tripping over garden hoses, dog leashes, and household appliance cord. It’s really easy to accidentally fall — at any age. 

And, you must be extra careful with any head injury. What seems like no big deal can turn out to be something much more. Consider actress Natasha Richardson, who fell during a skiing lesson in March 2009. Her fall was not “big” or unusual, and her head hit snow. Although she did not appear to be injured at the time, she died soon after from a fatal brain injury. 

Some easy changes around the home can help Seniors prevent falls and head injuries: 

• Secure loose electrical cords
• Remove articles on the floor that someone could trip on (rugs, footstools, grandchildren’s toys)
• Buy bath mats and rugs with slip-resistant backing
• Install grab bars and handrails for the frail and elderly
• Improve lighting in the home (this is so very important as vision worsens as we age)
• Check all stair railings and steps
• Wear proper shoes with slip-resistant soles
• Do not wear clothing that can interfere with your vision

Another way to help Seniors avoid falling is through fall prevention programs, which typically include a review of the person’s medications, reduces risk factors in their home and provides safety modifications, education, and an exercise program. Studies show fall prevention programs reduce falls by 30-50%. 

Tai Chi, a martial art using slow movements, also helps Seniors lower the risk of falling. Tai Chi teaches people to relax, slow down, coordinate their mind and body, and improve posture. The strength and balance that Tai Chi and other exercises make seniors feel stronger and more confident as they move.  You can read more about how Tai Chi can help at this article:  Tai Chi May Combat Seniors’ Fear of Falling 

Home Instead Senior Care provides in-home care to Seniors in the Richmond and Northern Neck areas.    While we can’t always be there to prevent a fall, we can help Seniors live more independently by being there when they need a hand, by helping them with meal preparation or light housekeeping so they don’t have to, by driving them to a doctor’s appointment or shopping so that they don’t have to go alone.  

And we can be there when it’s just not possible for family members to be there and that can easily reduce stress on the family caregiver(s).  If you are caring for an elderly loved one — or if you perhaps are a Senior yourself — and you could use an extra pair of caring hands, simply call our Richmond senior care office at 804.527.1100.  We’ll be there when you can’t because…  to us, it’s personal.

What is hospice?  Probably no form of senior care is as little understood as hospice.  People often have misconceptions about it and almost always questions such as:

• Is it a building, like a hospital? 
• Who are the professionals who will take care of my mother in hospice care? 
• How much, or how little, will they do for her? 
• If nursing home costs have impoverished her how will she, or we, pay for hospice care? 
• What role does the family play in hospice care?

Hospice care is sometimes thought of as a synonym for palliative care.  That’s not too far wrong, but hospice care is really a particular kind of palliative care.  Palliative care is a form of treatment that does not attempt to cure the patient’s underlying disease.  Rather it focuses on alleviating the symptoms of the disease, especially reducing the pain.  People of any age can undergo palliative care, among them children suffering from cancer. 

Eliminating Pain

Palliative care does not preclude other medical care.  It is possible, for example, to have one team of doctors alleviating the pain of a child with leukemia, in other words, practicing palliative care, while other specialists focus on curing the child’s disease.

In contrast, hospice care is limited to those who are judged by medical professionals to be at the end of their lives, generally, but not exclusively, the elderly.  The purpose, as with other forms of palliative care, is to eliminate or at least control pain and suffering. 

The promise to the individual who is placed in hospice care is that she will be able to spend her final weeks and days with as much dignity and as little pain as possible.  Hospice care professionals assist the patient with the emotional and spiritual aspects of death as well.

SUMMARY:  Hospice Care and Palliative Care:  What’s the difference?

• Palliative care is designed to alleviate symptoms, especially reducing pain.
• People of any age can receive palliative care, including those who simultaneously receive healing care.
• Hospice is a particular kind of palliative care, limited to those who are judged by medical professionals to be at the end of life but are still in need of pain relief and comfort.

While in hospice or palliative care, your elderly loved one may need companionship care or personal care during this difficult time.  Home Instead Senior Care of Richmond can provide those services and more so that you can have a few less things to worry about.  Simply call our Richmond office at 804.527.1100.  We serve Greater Richmond and Northern Neck, too.

Excerpted from the book, Stages of Senior Care:  Your Step-by-Step Guide to Making the Best Decisions by Paul & Lori Hogan.  Also, credit to National Hospice and Palliative Care Organization.