Helping A Senior Downsize? Pack Your Patience!

Hello All, 

It's snowing again....It's march 3...ugh, Wanted to share with you a story about downsizing a senior.

When my aunt was getting up in years it became apparent that living alone in her house was no longer a good thing. She was not really sick, it was more of a financial burden for her to keep her house and the neighborhood she lived in was getting to be more dangerous for someone living alone. With the help of my mother the decision was made for her to move into a subsidized senior apartment building. She did not have a large house, but still it was a big downsize for her.

I was young at the time and so I volunteered to help her go through everything and I do mean everything in her house so she could pack up what she wanted to take and say good by to the rest.

Thank heavens I was a patient person. I remember going room by room, drawer by drawer, closet by closet sorting and sorting every scrap of paper, every plastic bag every stack of paper, I thought it would never end.

So here’s the thing. Older folks and probably many younger ones too collect a lot of stuff.  When we live in the same place for any length of time we, like birds fill our nests with thousands of bits and pieces of STUFF. Whether it’s books, papers, clothes, nick knacks, food, whatever we have lots of stuff! This holds true for the majority of the population with the exception of those who are minimalists like my sister in law ( she does not even have a junk drawer ) who doesn’t have a junk drawer or 10? 

For those of us who are younger, when we decide to move what do we do? We load up dozens and dozens of boxes with all our STUFF! We don’t take time to sort it all out ( at least most don’t ) we just shove it in a box label it “Office” and load it on the van, only to be unloaded at our new digs and shoved back in the drawers from whence it came.  And so the process goes each time we move from the time we leave our parents home till the time we find ourselves old and have to relocate to a smaller nest. 

Now you see this move is not like the others. We cannot take all our stuff with us. But how do we decide? Our nest has been so comfortable for so long, how will we live without ALL our stuff. It’s hard let me tell you. And the older you are the harder it is. I worked with my aunt helping her sort through her stuff for over a month. Some days it was painstakingly slow. We would perhaps get through only a dresser or a closet. I watched as she handled each and every item she owned and had to make the choice, take or abandon.  I could see how hard it was for her. Things that I thought were meaningless seemed so important to her. In my heart I knew I had to let her make the decisions and could not rush her to much.  We finally got through everything in the house and boxed up the things she was taking with her only to find, it was to much stuff. So we had to pare it down a bit more. The move went smoothly and soon she was settled in her new nest surrounded by the things she has chosen as most important to her. She lived in that apartment for several years until the time came when she had to move to a nursing home. This move was very different as she had developed dementia and so now it was my mother and I deciding what she could take. That was very hard, but in the end we chose the things we thought would bring her a sense of home, photos, a favorite clock, a little purse to keep some odds and ends in. I think we chose wisely, she seemed happy and this move meant getting rid of most of her stuff, that was a sad day. 

In the end I learned some very valuable lessons. 

• Giving up our Stuff is hard and with all the other things older folks may have already lost like their independence, their home, their car, their health, and now this….it only adds to their pain.

• Downsizing before you are forced to do so is a good thing. Perhaps we should all take a look around as I am right now. Look at all the stuff we have. Do I need to thin in out a bit? Maybe 5 junk drawers is enough instead of 10 or maybe pare it down to 1!

• In the end things aren’t  what mean the most in life. I know it’s cliché but family, friends, relationships that is what matters in life, all the rest is just fluff.  

So if you are helping a parent or another loved one or friend downsize be patient. Stop and think “what if it were me” how would I feel about emptying out my nest . That will help you help them though this very tough and often painful process.

Have you helped someone downsize? I’d love to hear about your experience and how you survived the process.  We are on this journey together and learn from each other so please feel free to share.

Until Next Time

Nancy

When Searching For Assisted Living Beware of Hidden Fees

Hello everyone, 

I hope you are enjoyed your weekend. I had my granddaughter here today, she is almost two years old and she wore me out, but it's a good kind of worn out. Children bring out the best in us and keep us young - or so I hope.

Today I thought to share with you some of my findings on the HIDDEN FEES that are lurking in some if not all Assisted Living Facilities' pricing structures. This came to mind after I was reviewing a checklist that AARP put out for people who are searching for an Assisted Living facility. What was it that was so surprising?

Procedure for Setting Up VA Fiduciary Account for Mom's Benefits

"It Really Was Quite Easy and Painless. "

Hello All,

Today we finally had the meeting with the rep from the VA to set up the Fiduciary Account for mom's Aid and Attendance Benefits. As promised I will tell you all how it went and what I found out about the process. 

The meeting was very informal. We met at the Adult Family Home where mom is now living. The rep needed to meet with my sister who was to become the fiduciary and my mom, in order to assess her abilities to handle her own money. I went along to see how the process worked and just in case there where any questions about her application since I was the one who filed the initial forms.

The rep was very nice. She asked my mom the usual questions when checking for dementia; Do you know what year it is? Do you know who is president? Do you know where you are? Have you been in the hospital in the past year? Mom was able to answer some of the questions but with further conversation and my mom's own admittance, it was obvious that she needed help and could not manage her money on her own. 

The rep then gathered required information. She needed copies of my mother's financial  statements, bank accounts and any other sources of funds. She needed verification of my mother's current monthly income - social security and any other sources besides the VA benefits. A list of her current medical expenses was also needed - medicare supplement premiums, and lists of medications and cost of care at the Adult Family Home. Then she asked for two references from my sister who would testify to my sisters trustworthiness. She also asked for my sisters approximate yearly income.

After gathering all the information she went over the process for setting up the account. My sister will receive a letter of approval from the VA after they complete a background and credit check on her.  She then needs to take the letter along with a direct deposit form which the rep gave her to the bank and have them set up the account. The account will be in my mother's name with my sister's name listed as fiduciary. She said any bank can be used. Once the account is set up the back payment that is owed to my mother will be deposited into the account and her regular monthly payments will start going into that account.  

Here are a few rules about how the account is to be handled:

•  My sister will have to write checks from this account directly to the Adult Family Home, she cannot transfer the money into mom's other account and write one check, she will have to write two checks every month.
• There is never to be any commingling of funds with any of my sisters own money. The money is to be used only to pay for mom's  care ( already knew that ).
• My sister must keep records of all expenses in case they were to ever audit the account. Not hard since it's money in money out kind of situation.
• We are to notify the VA if mom moves or goes on medicaid anytime in the future. 

Other than that it was pretty straight forward. The meeting lasted about 30 minutes and she wanted to see my mother's room before she left. We were glad to get this piece of the puzzle in place so that from here on out things should be straight forward. 

By the way, if someone has ever filed for bankruptcy they cannot be a fiduciary for another under the VA rules. 

Hope this helps you if you are facing this procedure in the future. It really was quite easy and painless. We are very grateful to have these benefits for mom as they allow us to have her in a nice quiet place with some wonderful people looking after her. Without the VA we would have had to apply for medicaid and then the uncertainty of where she would end up would have been an issue. We will have to apply for medicaid in the future if she out lives what she has left but at least this buys us some time (about 4 years) to see what our options are without having to make a hasty decision we may regret. 

If you are in a situation like ours, I suggest that you take the time to research medicaid facilities, as I will be doing, over the course of the next several months. Find out what facilities take medicaid and if there is a waiting list. I find being proactive makes things easier and less stressful for all. 

Until Next Time
Take Care All,
Ruth Anne

Meeting with VA for Fudiciary Account Posponed a Week

Happy Saturday to all,

Our meeting with the VA rep to set up mom's fiduciary account was suppose to be yesterday. The rep called in sick so now the meeting is set for next Friday 2/19/2016. I was disappointed as I hoped to have information to share with you on how the process works, but this extra week with give you more time to send in your questions about VA Aid and Attendance Benefits. You can use the link at bottom of article or you can email me at ruthann@palcaregivers.com.

Hope to hear from some more of you as this is a great chance to get you questions answered by a expert, the rep, not me.....


Until Next Time
Take Care
Ruth Anne

Meeting With VA For Fiduciary Account This Week

Hello Everyone, 

Well the Super Bowl is over tomorrow is Fat Tuesday and the weather is still not that bad here in Michigan. All this means we are marching ever forward toward spring...hooray !

This week we finally will be meeting with the person from the VA to set up the fiduciary account for my mother's Aid and Attendance Benefits. Now mind you she has been getting monthly benefits since June of last year so that tells you how far behind the VA is in getting stuff done. 

For those of you who are working with the VA setting up a fiduciary account may be in your future too. Just what is a fiduciary and why do we need to go through this process? I will try and explain to the best of my knowledge.

When we applied for mom's benefits she was, because of her dementia, deemed unable to manage her finances by the VA. We already knew this as she no longer could remember to even ask about her finances which was quite a change for her. All her life she was sharp as a tack when it came to money. She worked hard and saved her money wisely. She knew where her money was and when things came due etc... Because of her failing eyesight myself or my sister have been helping her with her bills for years but she always knew exactly what was what. Then about a year and a half ago she just stopped showing interest in it. By this time she was living at my sisters and my sister was a signer on her accounts so I guess mom knew in her mind everything was taken care of. 

Adult Family Care Homes What Does Your State Call Them?

Hello Everyone,

Well yesterday it was 50 here and today it's snowing, but that's Michigan for you! 

I know many of you have been following my posts and I thank you for that. If you have you know I have talked a lot about Adult Family Care Homes. This is the type of home my mom is in. Let me describe it for you. It's a beautiful home in beautiful wooded area. The family that runs the home lives there. They use the upstairs of the home as their residence and have a beautiful lower level walk out that is designed for the seniors they care for. The house is licensed  by the state of Michigan to take up to 6 residents. Similar home are set up for residents only and the owner does not live there, caregivers are hired for round the clock care. 

The nice thing about these homes, I have seen many of them, is that it's like a family. The residents who have dementia benefit greatly from these homes because they do not have to get use to different caregivers all the time and because the area is smaller they get use to the layout and routine easily. My mom is doing wonderfully at her new home.

What I was wondering is what other states call these type of homes. I know some call them Board and Care Homes, however with the inconsistency of terms when it comes to senior care across the US I was hoping some of my readers could help me put together a list of states and the term they use for these homes. 

If you are in a state other than Michigan and know what your state calls these homes I would love to hear from you. You can leave a comment at the bottom or email me at ruthanne@palcaregivers.com

I am off to help a fellow caregiver find a home for her mom. If you need any help let me know. I will do what I can to assist you. 

Until Next Time
Take Care
Ruth Anne

Moving Mom Into An Adult Foster Care Home For the Aged

Hello Everyone,

After another fall and a return to rehab for several weeks my sister and I have finally taken the steps to move mom to and Adult Foster Care Home ( also called Homes for the Aged ) on a full time basis. This was one of the hardest,  heartwrenching decision we have ever had to make, but it was best for all.

AFC - a house like you or I would live in, only with some modifications inside to accommodate the residents.

My mom as you may know from my previous posts has lived with either myself or my sister since 2001 when dad passed away. She is now almost 92 and has started to develop dementia. My sister and I are not getting any younger and the increased care my mother required was making it very difficult. She could no longer be left alone even for a few hours to go shopping so we had to have someone with her around the clock and night time care literally meant no sleep for my sister, who has and needs to keep her daytime job as her husband was laid off after 27 years, leaving them with one income.

We therefore decided it was time. Time to make things better for all involved, especially mom. We searched and searched and finally found a wonderful Adult Foster Care Home only 10 minutes from both of us.

Should Parents Pay Their Children For Care?

Do you have loved ones you are caring for? How about grand children? If you are here reading this blog, chances are you are a caregiver.

It's been a few days since I have posted and I am sorry for the delay. I have been caught up in my caregiving duties as well as enjoying time with my precious 16 month old grand daughter, she is such a delight and a welcome refreshment to help make it through the tough times!

Do you visit and post in the online forums such as caring.com or agingcare.com? I have also been doing a lot of reading and posting on these forums lately and find there are so many wonderful people out there doing what we do, caring for a loved one with all that entails and just trying to put one foot in front of the other on the journey we travel.

One subject that has been coming up quite a bit in the forums lately is the debate on whether or not it is proper to ask your parents to pay you to act as their caregiver, provide housing and the like. And the opinions run the gamut. So I thought I would share some of my thoughts as well as how the government feels about the subject.

Consider: What type of care are you providing? What have you had to give up to provide this care? And how do your parents feel about the services you provide?

Many of you have given up so much to care for your parents and do so willingly, out of love. When your parents need intense care or supervision as my mom now needs, you may have moved them into your home in order to provide that care. Many of you have also had to give up outside employment to stay home 24/7. 

Some feel that no matter what you have to give up, you should never charge your parents for care, after all they raised you and provided for you for many years. If that is your opinion and you have the financial resources to do so that is fine and I applaud you for your devotion and love. Some however do not have the financial resources to not work. So when their parents need care they have a few options. They can hire a caregiver, put their parent in an assisted living or nursing home or they can work for their parents and provide the needed care. If given the options most parents would likely prefer to have their own family caring for them for as long as that is possible.

Consider what it would cost to put a parent in an assisted living facility. If they need anything other than basic assistance such as meals and general supervision the costs can be $5 to $6 thousand dollars a month. If they need to go to a nursing home the costs can skyrocket to $8 thousand and above. If you were to hire an in home caregiver the cost would be anywhere from $20 to $30 dollars an hour depending on how much care is need and what area of the country you live in. These costs can eat up even a healthy retirement account in no time. 

If you are the one providing the care, you may as many people feel, it is only reasonable that you get paid. How much is something you and your parent can work out, which in my experience is very reasonable and so much less than what they would have to pay for outside care. No one should take advantage of their parents and charge them outrageous amounts of money just because they feel they can, this is a form of elder abuse. However no one should question a reasonable amount. 

Caring for a parent who is aging is a very tough sometimes full time job. If you have siblings who do not participate in the care they may question you getting paid. In that case you need to make them understand just how much you have given up and how much you do for mom or dad or both. If they are worried about their inheritance, remind them of how fast that will disappear if mom goes to a nursing home.

And the government too feels it reasonable for a family member to be paid for services. Many do not know that Veterans Benefits can be used to pay family members. In most states a medicaid waiver can be uses to pay family caregivers. The government is beginning to realize something that has been obvious for years, and that is, that keeping the elderly at home with family is much more cost effective. They are finally starting to get it. 

So if you are caring for mom or dad, grandma or grandpa and you need to be paid, in this person's opinion that is fine. You are working hard, maybe harder than you ever have before. You are also making a better life for your family member, because they are being cared for by someone they know and love. You are doing a good thing. Don't feel guilty!

One important note for paid family caregivers - please have a caregiver contract in place. This is especially important if you are using government benefits to pay your wages. Also this will protect you if in the future your loved one has to go on medicaid and the money to pay you was used during the 5 year look back period.  (The Deficit Reduction Act of 2005 expanded the look back period from 3 years to 5 years.  Almost every state has adopted this or is in the process of adopting this rule).  If you do not have a contract the government may look at those payments as gifts and require them to be paid back. The contract will save you in that case. Another good reason to have a care contract in place is if there are any disputes between family members regarding inheritance, we all know how nasty greedy relatives can be. For information on how to structure a care agreement you may want to check out this link click here . 

Dear Ruth Anne, Here's what I think...

I hope this information helps those of you who are wrestling with this subject. And I would love your feedback. How do you feel about it? What side do you come down on? Please share your thoughts. 

Until Next Time
Take Care
Ruth Anne