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Seminar for Savvy Seniors and their Families: Questions Answered

December 4, 2018

 It was truly a pleasure to speak to Great Falls older adults and family members last weekend at the Seminar for Savvy Seniors and Their Families event!  Thank you Bill Canis and the Great Falls Citizens Association for coordinating another terrific program!  We had an exceptional turnout for a cold and rainy morning!  Unfortunately, due to time constraints we were unable to answer every question, so I have decided in follow up to post some answers to questions posed on my blog today!

 

Questions and Answers:

 

Houses in GF are often bigger than what seniors need, often with several levels accessed by stairways. What would you recommend to them about adapting their homes and is that an expensive choice?


A care Manager as a part of their initial assessment will inspect the home environment for appropriateness and safety.  they will also make recommendations and suggestions for cost effective modifications and changes to support aging in place.  Most homes can be changed to accommodate aging in place.  

 

Stair lifts can be an easy and cost effective modification for one's home

that will make navigating stairs no longer a problem!  

 

Medicare Part B or a Medicare Advantage C Program- WILL COVER seat lift mechanism only- about $300 dollars for a chair lift.  You will need to obtain physician prescription and a certificate of medical necessity for this.  

 

A stair chair lift is classified as a “home modification” by Medicare instead of a “durable medical equipment”.

 

Straight stair lifts with installation start at $2,000 (refurbished units) or as little as $49.50/month with no down payment for qualified buyers, which includes warranty and in-home consultation.  They have back up batteries for power outages also!  

 

The average cost of a new stair lift is $3000.00 - 4000 , depending upon whether you have straight or curved stairs.  Curved stairs will cost an additional amount.  

 

Stair lifts can also be rented for allow monthly fee - Freedom lifts is one company offering rentals.  Feel free to contact me for a list of reputable vendors! 

 

Homes in GF are far apart.  What steps do you recommend so that seniors can become less isolated?

 

Getting involved in your local senior center, local memory cafes, volunteer activities, local schools, fitness center or gym, library, and more can be a terrific way to reach out, meet new people, and feel fulfilled.  

 

Volunteer match is a terrific program that will match you to appropriate volunteer activities: https://www.volunteermatch.org

The site will ask you several questions to ensure that they are matching you to areas of interest and within the specified area!  

 

Please contact me if you require additional 
guidance!  

 

What does GF lack in senior services and facilities that other communities around us have?

 

A true senior center physical location for meetings and to house all the historical items, etc!!!  This needs to happen!!!!  I hope that individuals will reach out to the Great Falls Senior Center and provide support for this!  

 

Access to transportation services for private duty caregivers is also a huge challenge - so it is difficult at times to obtain consistent in home help.  

 

Who can help seniors with small chores and repairs around the house --at a reasonable cost--that they might have once done themselves?  

 

The Shepherd Center has volunteers available to help with simple repairs and chores for older adults.  

 

Many services and many provide senior discounts for larger projects and needs!  

 

Fairfax County also has a home repair program where they can receive up to $500.00 towards repairs too.  https://www.fairfaxcounty.gov/housing/home-repair-elderly-program

 

 

Transitioning from a job to retirement means new financial considerations.  Are there some suggestions for steps that should be considered?  

 

Meet with a trusted financial planner, care manager,  and elder care attorney.  Pre-planning is key and will put your mind at ease!  No matter what your financial situation is an effective plan can be put in place to support your needs!!!   

 

What critical legal documents should a senior have in place.  From your experience, what might be the repercussions of not having them?   

 

A Will- Everyone should have a will as without one you are leaving up to a judge after your passing to decide on were your possessions will go in probate!  

 

Living Trust-  This allows an individual to bypass the expensive and long process of probate and protects your privacy.

 

A will although important only takes effect after you die and the will is probated and managed by the executor.

 

The living trust can take effect immediately upon your death without probate, or can take effect if you are incapacitated and unable to manage your financial and legal affairs.

 

A successor trustee manages the living trust instead of an executor, but the roles and responsibilities the similar.

 

A living trust is most  beneficial and appropriate for individuals who have complicated financial and. /or personal situations.   For example, individuals who have a complex family dynamic,  a blended family, own a business,  or own property in more than one state.  The fee for setting up a living trust can vary depending upon the elder care attorney used and complexity of financials.  It is safe to budget $1000-$4000 and is a worthwhile expenditure for many.

 

Durable Power of Attorney and Advanced Medical Directive - Everyone should have an advance medical directive including a durable power of attorney.

 

A durable power of attorney goes into effect if you become incapacitated for some reason including mental capacity.

 

A regular power of attorney becomes invalid if the grantor becomes mentally incapacitated, so a durable power of attorney is needed.

 

I cannot stress enough to choose carefully and do not choose out of guilt or a feeling of obligation!!!!!!  Choose a trusted friend or family member to be named as agent in the durable power of attorney. You will then be  the “principal” in the document.

 

The agent could be your spouse, but you may want to name a backup, as your spouse may be in the same condition you are so choosing a younger individual is important and recommended!  

 

The role and responsibilities of this person would be to take care of paying your bills, and managing your health care and your money if you cannot do so.  It is an important job!!!!!

 

If you have no durable power of attorney and you become incapacitated, your relatives will have to go to court to get the authority to take care of your finances and health care.  

 

In terms of an Advanced Medical  Directive (or Healthcare Directive), these documents allows one to name a health care agent and fully describe the medical treatments wanted or not wanted.

 

Generally the health care agent is the same person who is the agent in the durable power of attorney, but can be a different individual.  

 

When forming this document think again about who you would want to carry out your sizes!!!  They are not real making decisions for you they are carrying out your wishes!!!!  

 

In addition, also think about what kind of medical treatments you truly desire and what treatments you are not willing to have. Although this may be difficult, consider quality of life and comfort along the way.    Without these types of documents completed you may be given treatments that you do not desire or be kept alive under circumstances you do not prepare.  Some individuals want all treatments no matter what the circumstances are while others prefer not to have ventilator treatment or tube feedings.  

 

So, whatever your wishes are ensure that they are heard clearly!  The Advanced Medical directive is the best place to state all your wishes and ensure that your decision makers carry out your wishes!  

 

Remember that one must be of sound mind to execute these documents!!!  If a person has advanced Alzheimer’s disease, they will not be able to execute a durable power of attorney for this reason!  
 

Pre planning and having these items in place it critical and should not be delayed!  Feel free to contact me for guidance if needed!!!  


 

How Long Does Medicare pay for rehab?

 

After you have been in a hospital for at least 3 days, Medicare will pay for inpatient rehab for up to 100 days in a benefit period. Ensure that if you are admitted for observation status that this is changed in the hospital system to inpatient asap!  The observations days do not count and can deter one from having rehab covered by Medicare!   This is critical and often missed by many resulting in issues!  

 

 A benefit period begins when an individual goes into the hospital. It ends when one has not received any hospital care or skilled nursing care for 60 days.

 

 

Medicare and durable medical equipment (DME):

 

DME that Medicare covers includes, but isn't limited to:

 

Air-fluidized beds & other support surfaces (these supplies are only rented)

Blood sugar monitors

Blood sugar test strips

Canes 

Commode chairs

Continuous passive motion machines

Continuous Positive Airway Pressure devices & accessories

Crutches

Enteral nutrition supplies & equipment

Glucose control solutions

Hospital beds

Hyperbaric oxygen (HBO) therapy

Infusion pumps & supplies

Lancet devices & lancets

Nebulizers & nebulizer medications

Oxygen equipment & accessories

Patient lifts 

Suction pumps

Traction equipment

Walkers

Wheelchairs & scooters 

 

If your supplier accepts assignment, you pay 20% of the Medicare-approved amount, and the Part B deductible applies.

 

Medicare pays for different kinds of DME in different ways.

 

This depends upon the type of equipment so:

You may need to rent the equipment.

You may need to buy the equipment.

You may be able to choose whether to rent or buy the equipment.

 

Important points:

 

Medicare will only cover DME if your doctors and DME suppliers are enrolled in Medicare.

 

Doctors and suppliers have to meet strict standards to enroll and stay enrolled in Medicare!!!

 

If your doctors or suppliers are not enrolled, Medicare won’t pay the claims submitted by them, so understand this aspect of care!   

 

It’s also important to ask your suppliers if they participate in Medicare before you get any DME.

 

If suppliers are participating suppliers, they must accept assignment, confirm this before moving forward.

 

If suppliers are enrolled in Medicare but aren’t “participating,” they may choose not to accept assignment.

 

If suppliers don't accept assignment, there’s no limit on the amount they can charge you so ensure that another vendor is found if possible! 

 

source: https://www.medicare.gov/index

 

 

 

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