SPD-IM-03-117

SPD-IM-03-117
Information
Memorandum
Originating Cluster:
Seniors and People with Disabilities
Oregon Department of Human Services
Authorized by: Mary Lee Faye, Administrator
IM Number: SPD-IM-03-117
Date: 12/19/03
Signature
Subject:
"Home for the Holidays" media campaign
Applies to (check all that apply):
All DHS employees
Area Agencies on Aging
Children Adults and Families
Community Human Services
Other (please specify):
County DD Program Managers
County Mental Health Directors
Health Services
Seniors and People with Disabilities
Message:
The Eldercare Locator is launching a "Home for the Holidays" media campaign focused on tips
for family discussions about finances, legal issues, and health care insurance. As part of the
effort, n4a has developed an Informational Guide entitled: Face the Facts: Topics to Discuss
Now with Your Aging parents. It provides a brief overview of key concerns, including Social
Security and pensions, living wills and advance directives, Medicare and Medicaid, and long
term care insurance also with suggested questions to ask in conversations on the topics. These
are among the top requests for information from callers to the EldercareLocator.
An electronic copy is attached. Please, feel free to reproduce and distribute it as needed.
Additional copies of the printed version of the Guide are available in limited quantities
upon request. E-mail requests to [email protected] Another web site to use is
www.n4a.org.
If you have any questions about this policy, contact:
Contact(s): Judy Bowen, SPD Office of Home & Community Supports
Phone: 503-945-6401
Fax:
(503) 373-7902
E-mail: [email protected]
SDSD 0080 (08/03)
Home for the Holidays
Face the Facts:
Topics to Discuss Now with Your Aging Parents
It is said that love is the greatest gift of all. As many families gather together during the holiday season, it may provide a good opportunity to express how much we care through a frank and open discussion with older relatives about
their well-being. As we age and live longer, financial, legal, health care and long term care issues affect families,
not just individuals. The Eldercare Locator, a nationwide service funded by the U.S. Administration on Aging that
links older consumers and their families to local aging services, produced this guide to help families “face the
facts” about these important topics. The overview below addresses some key areas of concern, suggested questions
to ask, and ways in which families might initiate conversations about these often difficult to discuss topics with
their aging parents.
Key Considerations…
1
4
Find out what financial benefits are provided
by your parents’ Social Security and pension.
Determine if they are eligible for other
financial programs.
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Be certain each family member has a
living will. Know where all your parents’
insurance policies, wills, trust documents, tax returns, investment and
banking records are located.
2
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Identify what community services are
available that can help your parents maintain independence in the home for as long
as possible — such as home modification
programs that can install assistive devices
(i.e., bathroom rails and entry ramps),
and home health and chore assistance.
Learn whether housing options are
available to meet their changing needs.
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3
Investigate what type of long term care
insurance coverage may be best for your
parents or for yourself! Generally, premiums
are lower when policies are purchased at
younger ages.
Understand that Medicare generally does not
cover long term care (e.g. nursing home or
extended home care), and Medicaid pays only
for low-income individuals.
5
Family members may not understand how their parents’ estate planning could
impact their own financial status as well as that of their children.
1
Conversation Checklist
Families may avoid potential problems and be in a good position to deal with later life
needs by understanding and being prepared to face the following issues.
Financial Organization
Legal Preparation
There are many financial resources that your loved
one might already be receiving or be eligible for.
Social Security is the federal program that provides
retirees a regular income based on work history,
and benefits to disabled workers. Long-time workers
usually have pensions that are retirement compensation plans either fully managed by the employer, or
involve employee contributions, such as Tax-Deferred
Annuities (TDAs) or Individual Retirement Accounts
(IRAs). Some people have “lost” a pension they
earned, while others forget about a retirement
account set up many years prior. Low-income and
disabled individuals age 65 or older could also
be eligible for monthly cash benefits through
Supplemental Security Income (SSI).
Wills and power of attorney may not be topics your
relatives want to discuss. However, these issues
need to be addressed before it’s too late to make
sure that their assets are properly taken care of
and that their medical treatment preferences are
known. A will directs how a person wants property
to be distributed after death and appoints a trusted
person to be the executor; and a durable power of
attorney provides written authorization for a person
you name to act on your behalf for whatever financial
or health care purpose you spell out. An advance
directive is a legal document that provides directions
for your health care if you are unable to speak for
yourself.
Ask…
Ask…
❏
What type of retirement income
do you receive?
❏
Are pension savings from all jobs
over the years being collected?
❏
Is there a need to apply for Supplemental
Security Income benefits?
❏
Who can access your important financial
information in case of emergency?
❏
Where do you keep these important
documents?
“Thirty percent of adults do not know where their
parents keep important papers such as their health
insurance card, financial statements or will.”
— Family Circle and Kaiser Foundation
2
❏
Do you have a will?
❏
Have you executed a durable power of
attorney or considered who you might
want to handle your finances or health
care decisions in the event that you are
unable to so?
❏
Are important legal documents up to date?
❏
Where are these important
documents kept?
❏
What other legal matters are you
concerned about ?
Conversation Checklist
Health Insurance
Community Services
Health care is a high-cost necessity, so it is crucial to
know what is available to meet your family member’s
needs, and what they are eligible to receive. Most
adults over age 65 are covered by Medicare, the
federal health insurance program that helps pay medical expenses for older Americans and younger people
with disabilities. But Medicare does not cover all needs,
and Supplemental Insurance (also called Medigap
insurance) might be necessary to cover additional
health costs. Medicaid, on the other hand, is the
federal and state insurance program that helps pay the
health care costs of low-income individuals of any age.
Long term care insurance is available through the
private market to assist individuals to cover the cost
of long term care services such as home health and
nursing home care. These policies are often expensive,
however, premiums are usually lower if the policies are
purchased at a younger age. Having a long term care
insurance policy ensures that your loved one can make
their own choices about what long term care services
they receive and where they receive them.
One of the most useful forms of help that adult
children can provide for their parents is information
about community resources that are available to
enhance their independence. Services like home
modification are available to help reduce the risk
of accidents and make daily household activities
more comfortable to per form. Emergency Response
Systems not only summon emergency help quickly,
but can also increase the feeling of security within
the home. Transportation services may be available
to assist older adults who need help getting to
appointments with their doctor. There are many
community resources to help older persons by
providing information or a needed service. Find out
about these and other services available through
your state, area agencies on aging, and local aging
services providers by contacting the Eldercare
Locator at 1-800-677-1116 or www.eldercare.gov.
Ask…
❏
❏
❏
❏
❏
Ask…
As your health status changes, are
you prepared to meet your long term
health care needs?
❏
Are there house repairs or modifications
needed that will help you, such as installing bathtub railings, an emergency response
system, or other assistive devices?
❏
Are you comfortably able to pay for
prescription drugs and other out-ofpocket health care costs?
Do you need assistance with housekeeping,
shopping or personal care activities?
❏
If you become homebound, would you need
home-delivered meals?
Who are your doctors and how can
they be contacted?
❏
Do you need transportation? What services
are available in your community?
❏
Do you anticipate needing other living
arrangements in the future?
Do you have proper health insurance
coverage (not too much or too little)?
Where do you keep your insurance card,
Medicare information, and other important
health care documents?
3
Contact the Eldercare Locator at 1-800-677-1116 Monday through Friday, 9:00 a.m. to
8:00 p.m. EST or through the Web site at www.eldercare.gov. The Eldercare Locator is a public
service of the U.S. Department of Health and Human Services Administration on Aging and is
administered by the National Association of Area Agencies on Aging in cooperation
with the National Association of State Units on Aging.
1730 Rhode Island Ave., NW, Suite 1200
Washington, DC 20036
Tel: 202-872-0888 • Fax: 202-872-0057
— Home for the Holidays, 2003 —
Contact the Eldercare Locator at 1-800-677-1116 Monday through Friday, 9:00 a.m. to 8:00 p.m. EST or
through the Web site at www.eldercare.gov. The Eldercare Locator is a public service of the U.S. Department
of Health and Human Services Administration on Aging and is administered by the National Association
of Area Agencies on Aging in cooperation with the National Association of State Units on Aging.
Here are some services that can assist your family members:
Adult Day Care
Social, recreational and health services provided in a
protective setting to individuals who cannot be left alone
because of health care need, confusion or disability.
Home Health Services
Includes such activities as changing wound dressings,
checking vital signs, cleaning catheters and providing
tube feedings.
Information and Referral/Assistance
Information Services (I&R/A)
Specialists provide assistance and linkage to available
services and resources.
Legal Assistance
Advice and representation is available to persons aged
60+ for certain legal matters including government program benefits, tenant rights, and consumer problems.
Case Management
Case managers work with family members to assess the
needs of seniors and arrange for services to assist them to
remain independent.
Personal Care
Services assist functionally-impaired individuals with
bathing, dressing, walking, supervision, emotional security, and eating.
Elder Abuse Prevention Programs
Allegations of abuse, neglect and exploitation of senior
citizens are investigated by protective service specialists.
Intervention is provided in substantiated cases of abuse,
neglect or exploitation.
Respite Care
Offers caregivers a break from constant supervision and
personal care of a person with a functional impairment.
Emergency Response Systems
Provides in-home 24-hour electronic alarm systems that
enable homebound persons to summon emergency help.
Employment Services
Helps older adults explore employment opportunities.
Financial Assistance
Benefit programs include energy assistance, financial
management counseling, food stamps, prescription drug
assistance and Social Security.
Nutrition Services
Nutritious home delivered meals (known as “Meals on
Wheels) are provided to older persons who are homebound. Congregate Meals provide the opportunity for
older persons to enjoy a meal and socialize with other
seniors in the community.
Home Chore Services
These services include housekeeping, shopping and home
maintenance.
Senior Housing Options
The variety of options available include: assisted living,
retirement communities, nursing facilities, government
assisted housing, and shared housing.
Senior Center Programs
Offers a variety of recreational and educational programs, seminars, events and activities for older adults.
Telephone Reassurance
Trained volunteers provide regular contact and safety
check to reassure and support homebound senior citizens and disabled persons.
Transportation
Services are available for older or disabled individuals
who do not have private transportation, or who are unable to utilize public transportation to meet their needs.
Volunteer Services
Volunteers provide daily telephone reassurance, friendly
visiting and insurance counseling to older adults.
Conversation Approaches
Prepare yourself to be open, honest and not argumentative.
Be ready to listen and hear what is being said to you.
Have some knowledge about the topic you’re talking about.
Direct
If the care recipient is a ‘no-nonsense, get-to-the-point’ personality, openly express your concerns and ask questions
for information you need to address specific situations that might arise.
Educational
For the relative who might need a delicate push, you might begin by sharing an experience of another caregiver
you know about their own personal situation, and explain how it made you realize the importance of discussing issues now that will help you be of better assistance to them in the future.
Expert
For the relative who refuses to talk about personal issues or tends to accuse their children of trying to take
control of their life, seek to make them the expert by asking for their advice about a particular issue — for example,
“what type of long term care plan should I look into,” or “can you recommend someone to help me prepare my
will.” This strategy is non-threatening and could lead to them sharing personal details, or at least letting you
know where they stand on the subject.
Resources
Organizations/Publications
Eldercare Locator
www.eldercare.gov
1-800-677-1116
WISER
5 Questions to Ask your
Mother or Grandmother
www.wiser.heinz.org
202-393-1990
Medicare
www.medicare.gov
1-800-Medicare
Kaiser Family Foundation
Talking with Your Parents about
Medicare and Health Coverage
www.kff.org
650-854-9400 or 202-347-5270
American Bar Association
Commission on Law and Aging
Health and Financial Decisions:
Legal Tools for Preserving Your
Personal Autonomy
www.abanet.org
312-988-5000 or 202-662-1000
Pension Benefit Guaranty Corp.
Finding a Lost Pension
(on Web site, see publications/
Pension Participant Publication)
www.pbgc.gov
202-326-4000
Social Security Administration
www.ssa.gov
1-800-772-1213
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