Estate Planning Blog Articles

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How Do I Make a Care Plan for Mom?

Medicare typically doesn’t pay for basic assistance, and families often don’t try to determine how to provide this care until there is a health crisis, which can lead to unnecessary stress, conflicts and escalating costs.

Nerd Wallet’s recent article, “Create a Care Plan for Older Parents (or Yourself),” says that making a care plan well in advance lets families organize, locate appropriate resources and determine ways to pay for care before a crisis hits.

A care plan is thinking through the logistics of what you’ll need as you age, so that you are prepared when the poop hits the fan with aging. A way to cope is to plan for temporary rather than permanent disability. Ask what kind of help you or your loved one might need after a hip or knee replacement. How well is the home set up for recovery? Who would help with household tasks? Contemplating a two- or three-month disability with an eventual return to health is less daunting but involves much of the same planning as a more lasting decline.

Many seniors would like to stay in their current homes as they age, something called “aging in place.” That typically means relying on family members for care, using paid workers, or both. However, if family members will be tapped, discuss the logistics, including whether and how much they will be paid. If home health aides will be hired, consider who will supervise the process.

Look at any savings that can be tapped and whether the senior may qualify for government help, such as veterans benefits, Medicaid, or state programs. Families may want to consult an elder law attorney for personalized advice.

It is important to look at the current home as “aging friendly.” An occupational therapist can suggest adaptations allowing the older person to remain in the home if they’re disabled. The sooner you get this evaluation, the more time you’ll have to prepare. Even if the home supports aging in place, the neighborhood might not. Consider how the older person will socialize, get groceries, and make it to health appointments if they can no longer drive.

An independent living or senior living facility could provide more amenities. However, these typically don’t provide long-term care. Therefore, see if the senior is okay with moving again later or whether they should begin with an assisted living or continuing care facility that can provide more help.

Once you have a plan, capture the details and share it with family members or others who may be involved. Revisit the document periodically as circumstances change. Aging planning is an ongoing process.

Reference: Nerd Wallet (Aug. 24, 2023) “Create a Care Plan for Older Parents (or Yourself)”

Tips on Finding the Right In-Home Aide

About 90% of older adults would prefer to age in place, rather than move into an assisted living facility or nursing home, according to an AARP survey.

WRAL’s recent article entitled “How to choose an in-home health aide” says that, fortunately, you can have good health care and independent living with an in-home health aide. An aide can provide you with care for a short amount of time during the day or can stay with you around the clock. Depending on your needs, an aide can help with many tasks. These include things such as:

  • Chores, such as laundry, cooking and shopping
  • Daily activities, such as bathing, dressing, eating, grooming, moving from one place to another and toileting
  • Monitoring vital signs, like blood pressure, respiration, and pulse
  • Keep an eye on your physical and mental health, including your level of exercise and how much you are eating, drinking, and going to the bathroom; and
  • Assist in emergencies, like an accident, heart attack, or stroke.

There are a number of actions to take when you hire an in-home health aide. Here’s the rundown:

  1. Determine what kind of care, and how much, you need.
  2. Decide if you want to hire through an agency or on your own. The advantages of using an agency are that you will get a prescreened aide and will have backup care when that person is unavailable. You also won’t have to be concerned about offering benefits as an employer because the agency takes care of those.
  3. Consider what you can afford. If you qualify for Medicare or have long-term care insurance, some or all your care may be paid for. If you use an agency, the Mayo Clinic suggests you ask for written, detailed explanations of all services and fees associated with home care. Once you have this from several agencies, you’ll be able to choose the best one for your budget. If you hire a home health aide yourself, remember to think about sick days, holidays, vacation, payroll taxes and Social Security. That is because your aide will be considered a household employee.
  4. After you’ve found your health aide, create a care plan, which may include the following:
  • The days and hours you need assistance
  • The daily tasks that need to be completed
  • A schedule of appointments and medication times
  • A list of contacts, such as your doctor’s information
  • An emergency plan; as well as
  • Any of your personal preferences.

Re-evaluate your care plan every few months. Ask your family to discuss this with you because having loved ones on board will be helpful in the future, when you may need more support as you continue to age in place.

Reference: WRAL (April 17, 2022) “How to choose an in-home health aide”

What Do I Need to ‘Age in Place’?

Home modification is the official term (from the Americans with Disabilities Act) for renovations and remodels aimed for use by the elderly or the impaired. It means physically changing your home, removing potential hazards and making it more accessible, so you can continue living in it independently.

Bankrate’s recent article entitled “The best home modifications for aging in place” reports that home modifications can be pricey—typically ranging from $3,000 to $15,000, with the average national spend being $9,500. However, it can be a worthwhile investment. You can save money by doing the right home modifications. That is because the longer you can safely live in your home, the less you will need to pay for assisted living care.

The best aging-in-place home modifications align with “universal design,” an architectural term for features that are easy for all to use and adaptable, as needs dictate. This includes additions and changes to the exterior and interior of a home. Some of the simplest home modifications include DIY jobs:

  • Adding easy-grip knobs and pulls, swapping knobs for levers
  • Installing adjustable handheld shower heads
  • Rearranging furniture for better movement
  • Removing trip hazards; and
  • Installing mats and non-slip floor coverings.

Next, are some more complex home modifications. These probably would need a professional contractor, especially if you want them up to code standards:

  • Installing handrails
  • Adding automatic outdoor lighting
  • Installing automatic push-button doors
  • Leveling flooring; and
  • Installing doorway ramps

There are also home modifications that can be done by room:

  • In the bathroom, installing grab bars and railing, a roll- or walk-in shower/tub, or a shower bench
  • In the kitchen: adding higher countertops, lever or touchless faucets and cabinet pull-out shelves
  • For the bedroom, use a less-high bed, non-slip floor, walk-in closets and motion-activated lights
  • Outside, you can add ramps, a porch or stair lifts, and automatic push button doors.

Finally, throughout the house, keep things well-lit and widen hallways and doorways; add a first-level master suite, elevators or chair lifts, “smart” window shades/thermostats/lighting and simpler windows.

Note that some home modifications may qualify as medical expenses. As a result, they are eligible for an itemized deduction on your income tax return. A home modification may be tax-deductible as a medical expense, if it has made to accommodate the disabilities (preferably documented by a physician or other health care provider) of someone who lives in the home, according to the IRS.

Reference: Bankrate (March 30, 2022) “The best home modifications for aging in place”

What Upgrades Can I Make to ‘Age in Place’?

With our aging population, we need more solutions to help seniors live well. That’s where universal design comes in: it’s a concept that tries to make products and structures usable by everyone, regardless of age, ability, or other factors.

Money Talks News’s  article entitled “8 Essential Home Features for Aging in Place” says that aging in place requires homes that accommodate our needs as we age. The article sets out a list of eight design features buyers focused on accessibility are looking for based on survey data from the National Association of Home Builders’ 2021 “What Home Buyers Really Want” report.

  1. Lower countertops. The kitchen is the center of most homes, and it’s an important part of universal design. Countertops that are three inches lower than the standard height of 36 inches lets seniors and those with limited mobility to fully participate in meal prep. You can round all countertop edges and corners because fewer 90-degree angles may reduce bumping and bruising and minimize injury in the event of a fall.
  2. Lower kitchen cabinets. According to Aging in Place, upper kitchen cabinets that are three inches lower than standard height lessens the tendency to overreach and potentially lose balance. Lower cabinets that feature pull-out shelves, “lazy Susan” corner cabinets and easy-pull handles offer additional convenience for seniors and those who rely on a wheelchair or mobility scooter.
  3. Bathroom aids. For seniors, using the bathroom safely can a challenge. Aging-in-place design recommends these features to make bathrooms more practical and convenient:
  • A walk-in tub or a shower with non-slip seating
  • An adjustable or hand-held showerhead
  • A comfort-height toilet
  • Ground-fault interrupter (GFI) outlets that reduce the risk of shock; and
  • Grab bars near the toilet and shower.
  1. A Stepless entrance. To age in place safely, AgingCare recommends that a home’s main entrance not have steps and should have a threshold height of no more than a half an inch. Here are a couple of ways that an entryway without steps can make life better for seniors:
  • It facilitates smooth entrance/exit by wheelchair, scooters, or walker
  • It decreases the risk of falls, particularly in snowy or icy conditions; and
  • It makes it easier to get deliveries and enter the home carrying groceries.
  1. Non slip floors. According to the CDC, more than 35 million older adults fell at least once in 2018, and 32,000 died from fall-related injuries. To help, non-slip surfaces like low-pile carpet, cork and slip-resistant vinyl can minimize the risk.
  2. Wide hallways. Wide hallways (defined as at least four feet wide) let seniors access every space in their home with a walker, wheelchair, or scooter, or with the assistance of a home health aide.
  3. Wide doorways. A standard doorway can be as narrow as 24 inches, which is a tight fit for seniors who rely on wheelchairs, scooters, or walkers. Seniors like wide doorways, defined as at least three feet wide. According to the ADA, doorways should have at least 32 inches of clear width. To help with an easy transition from room to room, thresholds should be as flush to the floor as possible.
  4. Full bath on main level. Not just convenient, it’s a critical safety feature for seniors. Besides eliminating the need to go up and down stairs several times a day, main floor bathrooms also allow the elderly to (i) respond to incontinence issues more quickly; (ii) practice regular self-care; and (iii) access a private space when required.

Reference: Money Talks News (Aug. 5, 2021) “8 Essential Home Features for Aging in Place”

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