Aging in place (AIP) costs considerably less than assisted living care, but it’s not free.

Though funds are dwindling for many senior-related programs (Medicare, Medicaid and Social Security have all spent ample time on the chopping block lately), there are still a number of federal, state, local and private organizations that offer financial support to seniors who want to stay where the heart is.

To begin – because first you might need to sell the idea to skeptical family members, or just figure out what modifications are needed before getting the capital to do it – get to know what services and resources are offered in your home state via these helpful sites:

• Search for home repair and modification resources in your region at Eldercare.gov.
• HomeMods.org is a national information clearinghouse on all things related to home modifications. Professionals and consumers alike can peruse an extensive resource directory on the site.
• Not sure if your own home or a senior loved one’s residence is adaptable for AIP? Most are, but the WellCome Home site helps you clearly see the potential and know where to direct your energies and efforts when it’s time to transform the home.
• Download this Home Safety Checklist from Rebuilding Together, Inc. to remove fall hazards and resolve accessibility issues, many of which may be implemented without spending a dime.

Should the need arise for assistive equipment (such as power chairs or stair lifts) or home modifications (like wheelchair ramps or door-opening systems), here are a few ways to ease the burden of purchasing or installing these costly components.

Claim a deduction. Russell Glickman, a DC-based home design and remodeling expert, recommends conferring with a Certified Public Accountant (CPA) to find out whether you or a loved one is eligible to deduct the cost of home modifications on your federal income tax. You need a written recommendation from your doctor as proof that the modifications are medically necessary. Glickman also states that you can claim a deduction for the costs of operating and maintaining the modifications, whether or not the stair lift, ramp, or other equipment qualified as a medical expense. Home improvements (or capital expenses) that may be deducted per the IRS.gov are as follows:

• Constructing entrance or exit ramps for your home.
• Widening doorways at entrances or exits to your home.
• Widening or otherwise modifying hallways and interior doorways.
• Installing railings, support bars, or other modifications to bathrooms.
• Lowering or modifying kitchen cabinets and equipment.
• Moving or modifying electrical outlets and fixtures.
• Installing porch lifts and other forms of lifts (but elevators generally add value to the house).
• Modifying fire alarms, smoke detectors, and other warning systems.
• Modifying stairways.
• Adding handrails or grab bars anywhere (whether or not in bathrooms).
• Modifying hardware on doors.
• Modifying areas in front of entrance and exit doorways.
• Grading the ground to provide access to the residence.

Note: You can only itemize these deductions if the main purpose of installation is medical care for you, a spouse or dependent (modifications made for aesthetic, architectural or other personal reasons do not qualify). Permanent improvements that boost your property’s value may be partially included as a deduction; in this case, the cost of the home modification is reduced by the amount of the property value increase (whatever the difference is what your qualified medical expense to deduct will be). If the home modification does not increase your property value, you can deduct the whole cost as a medical expense.

Visit the Area Agency on Aging. Every state offers different incentives, programs, and benefits to their senior residents. The best way to learn about them all, in addition to any tax credits or federal monies available through Medicare, Medicaid (in some states, you may be able to qualify for funding via the Medicaid HCBS – home and community-based services – waiver), HUD, the VA, or the USDA that would be disbursed through the state, is at your local Area Agency on Aging. The AAA is a one-stop-shop neighborhood branch of your state’s department that handles senior care (i.e. Department of Aging, Department of Public Welfare, etc.). Go to Eldercare.gov or N4A.org to find your AAA by zip code, city or county.

Apply for grants or take advantage of state assistive technology projects to make your home wheelchair accessible. According to HomeMods.org, funding is available for this specific modification through the Department of Veteran Affairs (call 800-827-1000 or your local VA for more details) and via the United Cerebral Palsy Association (call 800-872-5827). The IRS also permits those with disabilities to claim some of these expenses as a tax deduction. Check in with the National Council on Independent Living Center (call 703-525-3406) to get local funding information and referral services.

Get a loan to add a room. If Mom is moving in and she has health needs or disabilities, you may be eligible for government funding. FannieMae offers the HomeChoice program, Home Keeper program, and the Home Equity Conversion Mortgage (get more details at http://www.efanniemae.com, or visit the local office). In Texas, New Mexico, California and Illinois, residents can apply for a Home Modifications Loan for Homeowners (with fixed interest rates and low minimum loan amounts) via Bank of America, under the “Access Loans” category. For more information, call 800-843-2632 (in CA, IL) or 800-900-9000 (in TX, NM).

Contact local foundations and non-profit organizations. Some may offer financial assistance or services referrals for those providing care for someone with disabilities or diseases like Alzheimer’s, multiple sclerosis, or rheumatoid arthritis. Easter Seals and Rebuilding Together both offer low- or no-cost community-based home modification and repair programs.

Take out a second/reverse mortgage. If you have the equity, this is a good way to secure a loan for a home modification, which, if done well, should add value to the home as more people will be seeking homes where aging in place is possible. You must be over 62 to secure funding via a reverse mortgage. (Learn more about reverse mortgages here.)

Check your insurance policies and healthcare plans. The National Association of Home Builders says that some programs – auto insurance, worker’s compensation, long term care policies (some will cover the cost of major modifications in lieu of a transition to a long-term care facility), state catastrophic accident insurance plans, and medical trust funds – might cover the costs of a home modification.

If you have a Medicare Advantage Plan, check with your care/case manager to find out if some home modification costs may be covered in the plan (note: those that do generally require participation in a care management program).

Move your parents in. If you have decided it’s best for Mom and Dad to just move in with you so you can provide care more readily, Glickman says you may be able to use proceeds from the sale of their home to make an accessible suite at your residence. He adds that adult children can avail themselves of the space in the future too, as their own care needs change.

Ready to consider a home modification for a family member’s residence, or your own? 101 Mobility has a full line of products (stairlifts, auto lifts, ramps, and more) and a team of highly-trained professional installers standing by to get AIP construction underway. Learn more about their services and find the local office serving you at http://101mobility.com/locator/.

Additional Sources:

• http://www.homemods.org/FAQ/index.shtml
• http://www.nahb.org/generic.aspx?genericContentID=89799

My mind quickly became overwhelmed as she shared the rapid pace of her husband’s decline in terms of his health and the way in which he had been “handled” by the health care system and moved from place to place, from ER to hospital to rehab to acute long term care to long term care.  Betty shared her saga with amazing clarity but also with great emotion.

Through her tears, she shared her love for her husband, dismay at the health care system, and  astonishment at the differing quality of care and attitude of physicians.  One thing she said to me several times, “Dale, please tell people the information they need to know about their loved ones (before hospitalizations), and the conversations they need to have NOW.”  Betty is so right! This is the foundation we need to have in place in order to be the best advocate for our loved one.  Advocating for a loved one in an often complex healthcare system “requires” that we have the facts and know the wishes of our loved one.

To that end, I have listed below key information we need to know about our aging loved ones. And one other important point … as my Elder caring attorney -friend, Doug Germann, reminds me.  It’s not enough to know information and have legal documents in place.  You also need to have a discussion with your loved one about their wishes (healthcare and end of life.)  I encourage everyone to make this a priority in the new year.  We never know when illness or accident will occur.  Recognize that this is a gift of love!

Before your parent’s next Emergency Room (ER) visit, here are 5 things you should know about them: 

•  Names of their doctors and their contact information.  This was critical in the diagnosis and treatment of my mother when she was rushed to the hospital with a supposed stroke, close to death.  I was the one who called her long-time specialist and alerted him to her condition and hospitalization.  Without his timely help, I don’t know what the outcome would have been.
• Birth dates and insurance information.  If an aging parent loses consciousness, you will need to provide their birth dates, name and phone number of their insurance provider.  If you think you would just reach for the card in their wallet, think again.  In the chaos of an emergency, that may not be so easy.
• Allergies and other medical conditions.  It is important to know allergies to medications, as well as major medical issues and past surgeries.  We hear about the new EHR (electronic health record) with a patient’s history following him/her through the health care system.  This is NOT yet in place for most of us!  Even if your loved one is conscious, they will likely be in a state of pain, confusion and stress.  You need to know their medical history.
• Medications and supplements.  Every adult should have a list of their medications (prescription and over-the-counter), including vitamins and supplements.  Vitamins and herbal supplements can interact with medications given in an emergency situation.  You can Google for “medication tracker.”  Print it out, work with your parent to complete it, give one copy to your parent to post on the frig and one copy for you to keep.
• Advance directives.  This document outlines your parents’ wishes in the event they cannot make medical decisions for themselves.  In many retirement communities, each resident keeps this posted inside their door.  Not a bad idea for any older adult.  In case of emergency, ambulance personnel would know whether to resuscitate.  And, then the document is critical later, as you, your family and the physician discuss and determine care.

There may be other things that you have found are important to know.  I encourage you to continue this conversation at our ‘Transition Aging Parents’ Facebook page.  Click here.

(Source:  “Aging Parents:  During emergency, details counts”, MayoClinic.com)

Not surprising, the most popular was a post I wrote about how to help an aging parent who refuses help.  As family members and caregivers, I imagine we’ve all faced this situation, and may likely face it again in the future.

I encourage you to take a few minutes now to read these short blog posts, reflect and gain insight on some of the key issues that you may face now or in the coming year.

1.  How to Help an Aging Parent Who Refuses Help

One question I hear over and over goes something like this, “We see our parents struggling with their living situation, and we have tried every way possible to talk with them about it, but they refuse to accept help in their home.  What can we do?” In this post, I explore the situation from our parents’ perspective, and then provide some suggestions.  Click here.  

2.  Transitioning An Aging Parent to Assisted Living – When & How

Although our aging parents may wish to age-in-place in their homes, the day may come when we need to think about a move to Assisted Living.  In this post, I provide key criteria that would indicate consideration of a move to Assisted Living.  As always, I encourage us (adult children and families) to be thinking ahead and to become knowledgable about local options in our community now.  Don’t wait for a crisis to occur when you have to abruptly choose an Assisted Living facility for your parent.     Click here.

3.  Safety and Innovation – Bathroom Design for the Elderly

If you’re a caregiver to an older adult, you know that bathing is a difficult challenge.  In this post, you’ll read about innovative bathroom equipment for older adults.  You don’t have to have a huge budget or grand remodeling scheme to consider some of these items.  Open your mind to some of the new possibilities (in showers, tubs, toilets) supporting safety, independence and quality of life for your aging parents.  Click here.

4.  Validation Technique – Communicating with Those with Dementia

The Validation technique, created by by Naomi Feil 30 years ago, is a tested method of communication with disoriented elderly that helps reduce stress, and enhance dignity and happiness.   In this post, I share the principles behind the Validation Technique and key benefits.  Both families and professionals can utitlize this powerful technique and ensure that older adults in their care never reach a vegetative state.  Click here.

5.  How to Deal with a Difficult Sibling in Decision-making for an Aging Parent

Why is it so hard for a family to listen to Mom or Dad, consider the options and then, in a unified way, make the right decision in Mom or Dad’s best interest?  In this post, I share key reasons I believe to be true and then a few possible strategies.   Click here.

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NOTE:

If you’re new here, you may want to request my Free eCourse, “Five Essential Strategies to Help Your Aging Parent Face Change”.  Click here.

If you’d like to continue this conversation, please join us on Facebook at our ‘Transition Aging Parents’ page. Click here.

Many of us live across the country from “aging in place” parents. A lot can happen in one year, in terms of your parent’s health and home. If you find yourself in a home that’s in disarray or facing someone who is in frail health, you may find yourself in a reactive mode, wanting to jump at a solution. You may want to immediately ask direct questions. But that will likely put the your parent on the defense. There’s a better way to approach the situation.

Before you leave for to visit your aging parents, here is a simple checklist and suggestion on how to approach concerns with your parents.  And, by all means, if you face a deteriorating or emergency situation with your parent, take a step back (and some deep breaths)…and try to frame the situation with an empathetic and loving approach.

Here are the main points of the checklist:
1. Look in the frig (is there outdated food in it?)

2. Drive their car (check the state of the tires, oil, antifreeze)

3. Take a peek at the mail (keep an eye out for unpaid bills)

4. Investigate the bathroom (check for cleanliness)

5. Take a note of how the pets are doing

6. Talk to the neighbors (a bonus is establishing a relationship with the neighbors and also someone to keep an eye on their home and them, even if just from the outside)

7. Identify some benchmarks ( consider marked declines from the previous year)

8. Go to the source. This is probably the most important ‘next’ step. Take the time to sit down with your parent, listen to their concerns, worries and perceptions. Ask what you can do to help. As when dealing with any of life’s difficult problems, oftentimes an individual (young or old) needs time to process a conversation, suggestions, etc. Give your loved one time to let your conversation sink in. Then, after the holiday, you can (as a family and ‘team’) engage in devising plan for solutions that meet your parent’s needs.

If you’d like to continue this conversation, please join us on Facebook at our ‘Transition Aging Parents’ page. Click here.

Dale Carter (left) before presenting. On the right, host Brenda Torres

Give Me Just 3 Hours … and I’ll Share my ADAPT framework for caregiving so you can be the guiding force in your family, bring your family together, save precious time, money & your health while respecting your aging parent’s dignity and independence.

Join me for 3 evenings in November (one hour each evening over the phone) when I show you exactly how to help your aging parent, regardless of the challenge.  I will provide you with the same roadmap I used in helping my mother.

Based on sound principles of communication, project management, and gerontology, you’ll learn the innovative ADAPT tool that you’ll be able to use time and time again.

Why take the time now to learn about ADAPT and how it can help your family?  The holidays are fast approaching and are often the first time in months or perhaps a year (or more) when family gathers and realizes there are changes in Mom or Dad’s health or living conditions.  It can throw a family into a panic.  I know!  The information and insight I provide in this 3 hour seminar will serve as a roadmap and provide you with guiding principles … so you are not caught up in the panic.  You will know what to do!

Why this seminar and my ADAPT approach?  Let me share feedback from two other people who completed my seminar.  One young man told me (months later) that when his grandfather became ill and faced end of life, that because of what the young man learned in my seminar, he was able to guide his mother (primary caregiver) through the difficult decisions and care during his grandfather’s last weeks of life.

Another attendee, a director of a hospice organization, later told me that “one concept” I shared made all the difference at the end of her father’s life.  She told me it helped her family give her father ‘quality of life” and gave the family peace.

This 3 part seminar will give you both the tools (the ADAPT framework and a host of resources) and insight into your relationship with your aging parent, your family and your community.

We’ve often heard “it takes a village to raise a child.”  It also takes a village to care for an aging parent.  After my seminar, you will be able to find your village.

This special seminar begins November 15, 8pm Eastern.  If you cannot one or more of the calls, you will still receive the recordings and hand-outs.

For more information and to register, click here.

• Do you have an aging parent?
• What would help you at time of the next crisis or transition?
• How about several key resources & tools at your fingertips?

Then, there is a no-cost teleseminar just for you!  Tuesday, November 8th at 8pm Eastern.  You’ll be able to listen over the phone in the comfort of your home!

I’ll share

• 3 key resources to turn to in the event of any crisis or challenge
• AND
• a preview of my upcoming 3 evening seminar … featuring the simple but powerful ADAPT framework for caregivers and families.

So, come and join us!

Find out how you can

• become the guiding force in your family
• bring your family together,
• find the right resources and professionals to help your parent
• and, create and sustain balance in your own life.

One of the first questions we always ask each other is, “how is your mother doing?”  Our mothers have each had their share of medical problems as they aged and have made very different choices in where and how they will live.  Neither has a college education, neither is wealthy, and both are quiet ladies.  Val’s mother chose to stay in her own home with her younger daughter living with her.  My mother chose to move to a senior community. So, what is it that has caused these two women to thrive through crises and the challenges of aging?  I think Val and I ponder this question not just out of friendship and caring for each other, but we too are thinking about our own aging.  We are all on this journey of life together!

So here are my thoughts and insights that I shared with Val about what I believe have been the keys to my mother’s health and happiness.  

When Val asked me that question, “how is your mother doing?”, of course, I thought about her physical health, but I immediately realized it was so much more.  Our aging parents are whole persons with physical, emotional, social and spiritual needs.

• Physical. My mother faced death in 2001 and again in 2008 due to a rare-autoimmune disease.  Now, for the first time in 10 years, that disease is in remission, and her doctor declares her to be healthier than he has ever seen her.  Surely the right medical care and medications were important factors, but a critical factor was her referral to physical therapy last year.  It did wonders for the chronic pain in her legs, and for the first time in her life, she is on a regular exercise program with a trainer at her community.  We joke that she’s the only one in the family with a personal trainer!

• Social.  Social interaction is a huge part of my mother’s life.  She often tells me, “I never have to eat alone again!”  She loves to share about the lives and backgrounds of her new friends.  When once she was always the giver (helping every family member that came her way), she is now also a receiver of friendship and a person in her own right.  As she shares this over the phone, I can almost feel her hold her head high with pride.

• Mental.  You know the old adage, “use it or lose it?”  This is so key for mental health.  Mom tells me she puts on CNN every morning when she wakes up.  She asks, why do some of the people around here not care about what’s going on in the world?, and declares, “I want to know.”  She will often want to analyze some world issue when we talk.

• Cultural.  She loves the lectures and musical programs that are brought in, especially the young children.  Last week a music teacher brought in her young students to give a piano recital.  Mom was delighted watching them perform.  She picked up on every nuance.  As she shared, it took me back to the many recitals Mom had driven me to …  the richness of memories for us both.

• Spiritual.  Mom’s faith continues to be a big part of her life.  Sunday service, the old hymns, connecting with her church family and friends each week and visits from the pastor.  Again, that deep sense of community and connection.

But, there is one thing we each can do that will change our caregiving experience in a very profound way.

Interestingly enough, I realized ‘this one thing’ as I was reading an unrelated article about entrepreneurs.  The key point of the article is that entrepreneurs try so very hard to hide what’s going on.  But, successful founders understand/confront their weaknesses and fill those gaps with people from their network.

The light bulb went on for me!  How often, as caregivers, do we consciously or unconsciously hide what’s going on?

It may be due to one or more of the following:

• some distorted sense of personal responsibility – “I’m my parent’s child. I have to be the one who cares for our parent”
• sense of guilt - “My parent refuses to let a stranger in their home.  They only want me there to help”
• lack of knowledge what to ask for or who to reach out to – “I’ve never been a caregiver before.  But, I can figure this out on my own.”
• perhaps simply taking the path of least resistance at a given moment in time – “I am so tired and don’t have any extra time or money, so I’ll just manage and deal with problems as they arise.”

Can you see yourself or perhaps a sibling in one of the statements above?  Whenever I am coaching a caregiver and I hear a sentiment such as those I’ve listed above, I remind them that “caregiving is a marathon, not a sprint.”  A caregiver cannot sustain the kind of long-time care that will be a reality for so many of us with our aging parents.

We need to become “transparent.”  Share our needs and seek out those who can help and support us.  This past week, I wrapped up a 3 part seminar with the final evening focused on community-based and national resources.  We spent 2 hours discussing the incredible resources available to caregivers, many of which are no-cost.  Every time I share this type of information, I see looks of surprise.  I see attendees start to relax, and then it’s as if a dam has broken.  Everyone starts sharing resources that have been most powerful for them.  And, it’s all because, in that room, at that time, they are “transparent” in sharing their situation and their experience.

My advice to each caregiver out there.  Don’t wait!

• Reach out to your family members, share your concerns and challenges.  Ask for their ideas and support!
• Reach out to organizations (such as the Alzheimer’s Association) and take advantage of their education classes and support groups
• Check out the many online resources that can help!  eCareDiary is a fabulous resource, helping families stay in touch and on the same page with their ‘medication & appointment management tool’ (and private calendar.)  This is a great aid for families who are spread across the country!.
• A terrific go-to resource is your Area Agency on Aging.  Funded by the federal government and staffed by senior advisors, help with your caregiving questions and challenges is just a phone call away.  You can find them online at www.eldercare.gov

Have you found a way to help your aging parent?  Please share it with our community of caregivers at our Facebook fan page, ‘Transition Aging Parents’

But, what about the resident who has never used a computer?  My mother has no interest in email, Google search or online games.  But, there are definitely things she’d love to be able to do, such as video chat and share photos.  It is neat to hear her discover these things.  She told me the other day that her physical therapist skypes with her family once a week … and they are in the Phillipines.  You can well imagine her next thought.  My mother wants to “skype” with her family scattered across the country, Indiana, Arkansas, Seattle, Chicago.  She wants to watch to her great-grandchildren as they grow!

Here’s our challenge.  In the past, I’ve tried to help my mother learn 2 different ‘senior friendly’ programs for sharing email, photos, …  My mother’s greatest difficulty is in using the mouse.  And, of course, the other problem is that when I leave and return home, she has no one to help her with her questions. But, she continues saying, “someday I’d love to have a computer.”

Until now, I have unable to find the “right” technology for my mother.  I am looking for a total solution:

• a computer, software & personal support
• easy for my mother to navigate (no mouse and it’s got to be intuitive)
• at a good price point

Last month, I found the product, Telikin, and had the pleasure of interviewing Telikin’s sales and marketing directors (Nancy Allegrezza and Cheryl Lewis) on my radio show.  It your time permits, I encourage you to listen to our 30 minute interview, click here.

Nancy and Cheryl shared the many benefits of Telikin for older adults.  First and foremost, it helps older adults stay connected with their friends and family.  Telikin provides easy-to-use video chat, email, photo sharing, and web access that can reduce the social isolation often associated with aging, as well as cognitive stimulation, increased independence and life-long learning opportunities for seniors.  Telikin’s goal is to “simplify the computing experience for seniors, and anyone else who is frustrated by, or intimidated by conventional computer use.”

Here are a few of the key features:

• Touch screen capability ( a stylus or finger tips can be used)
• Screen is easy-to-read (large buttons, fonts, with ability to enlarge text with magnifiers)
• Easy navigation is ensured by the ‘list of features’ always visible to the user on the left hand side of the screen
• Features are simplified (3 clicks to do video-chat)
• The Home screen provides a well-organized ‘at a glance’ view

There are certain features that I especially like, as a long distance caregiver.

• The video chat will also help me see first-hand how my mother is doing.  I can have a ‘virtual visit’ with her and observe her and her environment.  It’s so much more helpful seeing someone versus hearing them describe how they are over the phone.
• She’ll have her calendar and address book at her finger tips, something she currently struggles with.
• I’ll be able to use the ‘Tech buddy’ feature of Telikin to have remote access to Mom’s computer so I can be her first line of support.

Setup and support are 2 critical factors in choosing the right technology for an older adult.

• Telikin’s software is pre-installed.  There is no monthly software fee, and software updates are f.ree and automatic. You will need to obtain a high-speed internet connection and then plug in the computer’s power cord. Voila!
• Support comes in the form of online help, help via email and support via telephone to a “live person.”  That last point is huge.  Nancy emphasizes their Support Team is local, cheerful and patient.

Nancy and Cheryl wrapped up our radio interview by sharing that Telikin has been positively ‘ life changing’ for many of their senior customers who have had little or no computer experience, and who didn’t know what they were missing in terms of communicating with others and being in touch with the world.  For some, Telikin is their first computer!  Our family is planning on giving my mother a Telikin for Christmas.  I can’t wait to see her reaction

You can see Telikin for yourself in this excellent short video.  Click here.