Plan now for long-term living
Staying at home as you age
By DOTTIE BYRD, CLTC

For several years, I have been teaching a course called "Senior Options for Independent Living" in senior education programs. As the number of senior citizens steadily increases, there are more and more choices available to remain independent when our life situations change. Age, loss of a spouse or companion, health problems or just a desire to make life simpler, safer and less stressful can trigger a need for change. I recently changed the name of the course to "Planning for Long Term Living" to better reflect what most of us are facing and should be planning for now.

The first question I ask the participants is "What does independence mean to you?" Ninety-nine percent say independence means staying at home as long as possible. I then ask them if they have made any changes or modifications in preparation to remain in their homes. Most have not and that reflects the findings of an important AARP study released last year that found even though a majority believed in planning, only about half of the respondents have made, or anticipate making, any modifications that could help them stay in their homes.

In planning to stay in your own home, or perhaps even moving to a smaller, more manageable dwelling, such as an apartment, condominium or small one-story home, there are four major factors to be considered. Number one is a Safe Environment. Use caution and common sense. Make sure locks are secure, but you can get out in an emergency. Don't answer the door to strangers. Register with your local fire and police departments if they have programs to check on older citizens.

Number two is nutrition - can you get out on your own, buy groceries, get them back to your kitchen and prepare good nutritious meals for yourself?. The third factor is availability for exercise, both physical and mental. Do you have a safe neighborhood or nearby mall for walking or transportation to a fitness center. Mental exercise is being emphasized more and more as a key to well-being and independence. Reading, making lists, taking courses in senior education programs, word games, puzzles and card games can help maintain brain function. The fourth factor, which can be related to the first two, is socialization or interaction with a variety of people. Conversation, especially positive, meaningful interaction promotes a feeling of optimism and well-being.

When assistance is needed at home, the first line of defense is family, friends and neighbors - someone to check on you daily. Medical alert monitoring devices should be considered a necessity for emergency situations. This device is a necklace with a button that you push to alert someone at a company that you need

help. You are immediately contacted on the monitor in your home, so that even if you cannot get to a phone, you are in contact with someone who can send help immediately. Also, the company makes periodic calls to check on you and your device. The cost is about $35 per month.

When modifying your home, such simple alterations as removing unused furniture, scatter rugs and obstacles in traffic areas can be helpful. Also, handrails bathroom accessories and better lighting can make a big difference in safety and comfort. Home medical equipment such as walkers, hospital beds, wheelchairs, etc. is an obvious choice.

You may have an unpaid informal caregiver such as a family member or spouse, but recent studies indicate that untrained caregivers frequently impair their own health and well-being as well as that of the person they are caring for.

Professional home care falls into two categories. The first is non-medical care; sometimes referred to as personal care, companion care or homemaker services. An agency sends a caregiver to assist with daily activities such as meals, light housekeeping, some grooming, driving, and medication reminders. This type of service locally costs about $12 to $15 per hour

The second category is medical home health care provided by licensed professionals.

This care includes both skilled and unskilled care with activities such as bathing, dressing, eating, ambulating, transferring (from bed to chair, chair to toilet, etc.), administering medication and therapy. Medicare pays for only skilled care on a short term basis until the patient is able to care for themselves. Medicare does not pay for custodial or personal care.

What happens when staying at home becomes impractical, unsafe or too expensive? In the long term care industry, when a person requires assistance 4 or 5 hours a day or overnight, it's time to look for alternatives.

Senior Housing Options

The term "Aging in Place" is becoming familiar and describes a facility or living arrangement where a person chooses to live out the rest of life. Retirement communities are springing up everywhere. These can be independent living in apartments, condos or homes. Some are quite interesting built around hobbies and mutual interests or as elaborate as resorts. Others are simple and affordable, but all offer a safe environment, conveniences, exercise facilities and socialization.

Assisted living facilities are decidedly the wave of the future. These facilities offer several levels of assistance and settings that vary widely from independent living to total care. residents use their own furniture and belongings in a private apartment or studio. The cost is

usually based on room and board, plus a menu of health care needs paid for as needed. Like retirement communities, these facilities offer a host of services and activities for all levels of participation to keep residents safe, healthy and active.

Continuing Care Retirement Communities (CCRC's) are campus-like settings with residences determined by choice of size and cost. This is a true "aging in place" community where residents buy in while still independent and remain for life. The community offers a continuum of housing, services and health care systems from independent living, assisted living and nursing home care. in facilities on campus.

Two excellent websites with information about all of these senior housing choices nationwide are www.senioroutlook. com. and www.retirementhomes. com

With more choices available, hopefully nursing homes as we know them today will be simply end-of-life facilities. Medicare covers some skilled nursing care, however, Medicare does not cover long term care, but short term restorative care only. For this reason alone, people need to plan now for long term care and know the choices available.

The question of how to finance one's long term living is crucial to making wise decisions about the future. Long term care insurance (LTCI) is

by far the best choice for the majority of people. A comprehensive long term care policy covers all the options in this article starting with informal care and including total care to bedridden and hospice.

A popular misconception is that because the cost of long term care is expensive, the insurance is also. When, in fact, policies are designed and affordable for most people.

As a long term care insurance specialist certified in long term care, I receive information daily about developments in the LTCI industry. The US Dept. of Health and Human Services and the Centers for Medicare and Medicaid Services have jointly funded an LTC Consumer Awareness Campaign in five pilot states. It is the first effort by the Federal government to make the public aware of the importance of planning for long term care. This campaign is aimed at 50 to 70 year olds. While long term care insurance should be purchased while a person is still healthy enough to qualify, in today's competitive market, even people in their 70s and 80s can qualify. A qualified independent insurance agent specializing in LTCI can present several policy choices and explain the many different benefits available from dependable companies.

The writer is an LTCI specialist licensed in Georgia, Florida and North Carolina. She may be reached at 706- 835-1718.