We all want the best for the senior loved ones in our lives. For many seniors, living independent lives at home is their main desire. Seniors are able to do so provided they are physically and mentally able to care for themselves. Sometimes, depending on their situations, seniors need help and guidance from friends and relatives, or from even caregivers who can facilitate the potential of seniors living home alone for as long as possible.

The key to seniors maintaining independent lifestyles depends on many factors and most importantly their safety in doing so. With that being said, it should be noted that one of the most common dangers older seniors face is falling. In fact, research shows that injuries and subsequent complications due to falls are the leading causes of death in seniors who are 65 and older. Furthermore, one out of three seniors in this age group fall each year. While not every tumble guarantees an injury, these statistics should prompt you and your senior loved ones to make every effort to prevent falls occurring within their homes.

The first place to evaluate is the bathroom. While this is the smallest room in the house, bathrooms potentially offer the most opportunities for falls to occur. Bathtub edges may be hard to step over for some seniors. Once in the shower or tub, wet surfaces can cause seniors to slip. Some seniors may not be able to stand steadily while bathing. Others may have trouble sitting down on toilets or standing up again after using them. Wet floors after showers or baths and even bath mats can cause seniors to slip and fall.

Comfort Keepers offers these ideas and solutions for safety in the bathroom:

Bathtubs and Showers
Install grab bars in proper places to aid in safe entry and exit of tubs and showers. Consider replacing a bathtub with a walk-in shower for seniors who have trouble stepping over high bathtub sides. Non-skid mats or decal applications should be applied on the floors of showers and tubs to help prevent slipping while bathing. Seniors who have trouble standing to bathe should use sturdy shower chairs made specifically for this purpose. Make sure soap, shampoos, towels and other bathing necessities are within easy reach.

Toilets and Floors
Seniors who have trouble sitting and standing up can have raised toilet seats installed to make this process easier. Grab bars should be installed for additional support. Make sure the toilet paper dispenser is easily accessible. Use a bathmat for the bathroom floor just outside the shower or tub to prevent slipping on slick floors after bathing. Place a non-skid material between the bathroom floor to prevent the mat from sliding or creasing.

While none of these safety features guarantees a no-fall zone, they certainly add layers of protection and aid for seniors at risk for falling. Your local home improvement store or durable medical equipment company carries safety devices made for specific purposes, and to ensure the safest results these items should be used instead of homemade devices. Another crucial element is installing safety aids properly and also teaching your loved ones how to use them. The discussion may be a bit hard to broach but the end result fosters safe, independent living for seniors in their own homes for as long as possible.

What can help me stay at home?

You may be used to handling everything for yourself, dividing up duties with your spouse, or relying on family members for help. But as circumstances change, it’s good to be aware of all the home care services available that might be of help. What you may need depends on how much support you have, your general health, and your financial situation.

Household maintenance

Keeping a household running smoothly takes a lot of work. If you’re finding it hard to keep up, you can look into laundry, shopping, gardening, housekeeping, and handyman services. If you’re having trouble staying on top of bills and appointments, financial and healthcare management may also be helpful.

Transportation

Transportation is a key issue for older adults. Maybe you’re finding it hard to drive or don’t like to drive at night. Investigating transportation options can help you keep your independence and maintain your social network. You may want to look into local transportation such as buses, reduced fare taxis, and senior transportation options to appointments.

Home modifications

If your mobility is becoming limited, home modifications can go a long way towards making home more comfortable. This can include things such as grab bars in the shower, ramps to avoid or minimize the use of stairs, or even installing new bathrooms on the ground floor.

Personal care

Help with activities of daily living, such as dressing, bathing, feeding, or meal preparation, is called personal care or custodial care. You can hire help with personal care, ranging from a few hours a day to live-in care. People who provide this level of care include personal care aides, home care aides, and home health aides. Home health aides might also provide limited assistance with things such as taking blood pressure or offering medication reminders.

Health care

Some health care services can be provided at home by trained professionals, such as occupational therapists, social workers, or home health nurses. Check with your insurance to see what kind of coverage is available, although you may have to cover some cost out of pocket. Help on Medicare coverage can be found in the Resources section below.  Hospice care can also be provided at home.

Day programs

Day programs, also called senior daycare, can help you keep busy with activities and socialization during the day, while providing a break for caregivers. Some day programs are primarily social, while others provide limited health services or specialize in disorders such as early stage Alzheimer’s.

Reprinted with permission for personal or non-profit use. Visit www.helpguide.org to see the article with links to related articles.  This material is for information and support; not a substitute for professional advice.

“Why can’t I just pay for my own long term care?”

I get that question frequently, and the answer is: you can.

Self-insuring, or simply deciding you’ve got enough money on hand to pay for your own long term care needs, is a perfectly acceptable strategy. But, this assumes that you know what you’re getting yourself into, and that you understand what self-insuring means. Let’s talk about a few things that you need to consider before you decide to self-insure.

Most of us know, within a few thousand dollars, how much it would cost us to replace our car, or even our house. That’s a predictable expense, something you can put a fairly accurate price tag on. How much will your long term care services cost you? You can’t say. It might be a few thousand dollars, but it could just as easily be half-a-million dollars. There’s just no way to predict it. That makes it hard to say “Okay, I’ve put aside X amount of dollars; this should cover my long term care needs.” That’s the first problem  – will the money you’ve identified as your long term care fund be enough? Most people drastically underestimate how expensive long term care can be.

The second problem is this – are you sure that money’s not going to be needed for anything else, before you need long term care? If you dip into this every time you go on a vacation, or every time you need to buy a new appliance, it’s not going to be there when you need long term care. Your long term care fund has to be used for nothing but long term care, so you need to put it aside and forget it. Again, not always as easy as it sounds.

Finally, what if you have enough money, but it’s not that easy to get to? I’ve had several clients who are very wealthy on paper, but all of their wealth is in real estate. If they needed cash, they’d be hard pressed to get it without either borrowing it or selling a piece of real estate. What if you happen to need it in the middle of a real estate market like the one we’re in now? Uh-oh. What if your money is kept in retirement accounts or investments? You’re going to be taxed on that when you take it out, right? Suddenly, if you’re drawing more than your normal income from these accounts, your taxes are going up. What if your money’s in the market, and the market is down when you need it? Using your own money is often more expensive than the actual care, because of the costs you incur in getting to it.

Self-insuring is a valid approach, but it’s not necessarily an easy or realistic one. Insurance provides you with leverage and access – you turn your relatively small premium into a much, much larger benefit that will be there when you need it. If you’re going to self-insure, make sure you know what you’re up against. Thanks!

And Happy New Year! Kerry Peabody, LTC insurance specialist, Clark Insurance

Maybe you’ve thought about long term care, and you’ve decided that you have enough money tucked away to take care of it when it happens to you. We insurance nerds call that “self-insuring.” You’ve decided that you’ll rely on your own assets to protect you, and that is a perfectly valid approach – as long as you realize what that means.

For instance, did you realize that a year in a private nursing home room in Maine right now costs a little bit over $100,000 on average?  That’s a lot of money. Now maybe if you’re single, and you’ve got some cash tucked away, and you don’t mind selling your home, you can cover this and not worry about it. Again, that’s perfectly okay – it’s your money. But what if that’s not the case? What if you have a spouse who still needs an income? What if you have a family you wanted to give that house or money to? You need to understand that the financial impact that long term care can have is significant, and that it may impact more than just you.

If you are determined to self-insure, you need to make sure that you have money set aside that’s tagged for nothing but long term care. It can’t be the money your spouse is going to need to live on. It can’t be the money you use to pay for your grandson’s first year of college. It can’t be the money you’re going to use to replace that old Buick that’s sitting in the driveway. Your long term care money has to be protected, so it will be there when you need it. If you use it for something else, you’ll be in a hard spot when you do need LTC services.

You can do this by simply leaving the money in a CD or a savings account. It may be part of your “bigger” accounts, but if so, make sure anyone who may be in a position to spend that money (powers of attorney, etc.) knows about your LTC fund. You may want to consider using one of the new “asset-based” LTC insurance plans that use a lump sum to fund a much larger benefit pool using your money as the base. They let you keep control of the money, so you haven’t lost it if you need it later. Wherever you put that money, make sure that it’s preserved for your LTC needs.

Self-insuring is a valid approach to planning for long term care, and for many people, it will work. But before you decide that it’s the right approach for you, you must consider the impact it will have on those around you, and that the money will actually be there when you need it. As you know, I’m a phone call away if you want to share your thoughts. Kerry Peabody, Clark Insurance

Maybe you’ve thought about long term care, and you’ve decided that you have enough money tucked away to take care of it when it happens to you. We insurance nerds call that “self-insuring.” You’ve decided that you’ll rely on your own assets to protect you, and that is a perfectly valid approach – as long as you realize what that means.

For instance, did you realize that a year in a private nursing home room in Maine right now costs a little bit over $100,000 on average?  That’s a lot of money. Now maybe if you’re single, and you’ve got some cash tucked away, and you don’t mind selling your home, you can cover this and not worry about it. Again, that’s perfectly okay – it’s your money. But what if that’s not the case? What if you have a spouse who still needs an income? What if you have a family you wanted to give that house or money to? You need to understand that the financial impact that long term care can have is significant, and that it may impact more than just you.

If you are determined to self-insure, you need to make sure that you have money set aside that’s tagged for nothing but long term care. It can’t be the money your spouse is going to need to live on. It can’t be the money you use to pay for your grandson’s first year of college. It can’t be the money you’re going to use to replace that 1983 Buick that’s sitting in the front yard with pieces falling off of it. Your long term care money has to be protected, so it will be there when you need it. If you use it for something else, you’ll be in a hard spot when you do need LTC services.

You can do this by simply leaving the money in a CD or a savings account. It may be part of your “bigger” accounts, but if so, make sure anyone who may be in a position to spend that money (powers of attorney, etc.) knows about your LTC fund. You may want to consider using one of the new “asset-based” LTC insurance plans that use a lump sum to fund a much larger benefit pool using your money as the base. They let you keep control of the money, so you haven’t lost it if you need it later. Wherever you put that money, make sure that it’s preserved for your LTC needs.

Self-insuring is a valid approach to planning for long term care, and for many people, it will work. But before you decide that it’s the right approach for you, you must consider the impact it will have on those around you, and that the money will actually be there when you need it. 

Call with questions. Kerry Peabody, Clark Insurance 

“Long term care insurance is too expensive.” Is it, really? How much does it cost? You don’t really know, do you, until you sit down with an LTC Specialist to discuss what sort of plan makes sense for you. LTC insurance is an extremely flexible product, and before a good agent starts throwing numbers out, he or she will sit with you and find out what you need for coverage. This is done by talking with you about your needs, your family, your finances, and your expectations. When you’ve talked through all of that, then the agent can recommend a plan, and that plan will drive the price.

Most clients are simply looking for an affordable safety net plan – something that will supplement their other assets, and help them stay out of the nursing home, while taking the burden off of their family. A safety net plan, if properly designed, will be quite affordable – especially when you consider the alternative – a very costly long term care bill. One major insurance carrier recently announced that they’re paying $1,500,000 per day in long term care insurance benefits. I’m guessing that the people getting those checks aren’t complaining that they paid too much for their insurance.

Now, this doesn’t mean you may not have heard some horror stories about ridiculously expensive policies. I can show you one of those policies, but chances are you don’t need it, you don’t want it, and won’t buy it. You’ll be unprotected because I tried to sell you an inappropriate plan. Or, we can design a good, solid, safety net plan that would be very reasonable in cost, and it would provide you with a lot of protection and the peace of mind you’re looking for.  

Be smart, and do your homework. Don’t “assume” yourself into a tight spot. Good luck! Kerry Peabody, Clark Insurance

I’m excited about being part of Maine Senior Guide. As an expert in LTC (long term care) insurance, any opportunity to help educate you about this topic is valuable, because there’s so much inaccurate and misleading stuff floating around out there. Since about 70% of us will need long term care services at some point, you need to know the facts. I’m going to provide you with clear, concise information on the risks you face and what your options are to protect yourself.  A single long term care event can quickly wipe out a lifetime of savings, and tear up a family. Fortunately, it doesn’t have to be that way, but you need to take steps now to get ready for it.

Most of us have a story about long term care. We’ve seen it in both my family and my wife’s. My grandmother, Eileen, spent the last two years of her life in a Medicaid bed in Downeast Maine. Although the staff was professional and attentive, she wanted to be at home, but she couldn’t. We visited her frequently, but I confess – there were times I put it off, just because I felt so helpless to do anything for her. (If I had been in the LTC business ten years earlier, this wouldn’t have happened.) She didn’t have the money to pay for the services she needed, and ended up on MaineCare, in a nursing home.

My wife’s grandmother, Elizabeth, on the other hand, received daily home care services for several years before she finally had to go into the nursing home, where she spent a few months before she passed. The difference was that she had the resources to pay for basic care services in her own home for as long as they were sufficient, and the private money to get into the nursing home of her choice. This made her final years much more tolerable. It’s unfortunate, but it boils down to this – if you have money to pay for care, you’re in control. If not, you’re at the mercy of someone else – your family, your friends, or “the system.”

I want to help you avoid that. Do you have a stable income? Do you own your home, or have other assets? Do you want to make sure that your family doesn’t bear the burden of care? Do you want to be calling the shots when you need care? If you answered “yes” to these, then you need to at least explore your options. For some families, long term care insurance isn’t the answer, but for many others, it can be.

You don’t need to spend a lot of money to get a good long term care insurance safety net. Most of my clients are surprised by how affordable it can be, if properly designed. And the best part – it’s free to learn about it. All it costs you is a couple of hours of your time, and that’s a small price to pay for knowing what you’re up against, and how you can avoid it.

Talk to you soon!

Kerry Peabody, CSA (certified Senior Advisor) CLTC (certified Long Term Care insurance advisor) Clark Insurance

Like many of you I grew up with the innocent “don’t let the bed bugs bite” mantra before being sent off to bed as a kid. Heck, we all knew there were no more likely “Bed Bugs” than monsters under the bed. Or did we?

Bed bug infestation in the United States is increasing at an alarming rate, especially in the Northeast. Some pest management firms have reported more than a 10-fold increase in bed bug treatments in recent years.

Why? A number of theories exist:

• the rise of international travel
• recycling of furniture
• the ban of some of the more potent insecticides such as organophosphates and carbamates

Identification of infestation can occur in several ways. Common signs include blood spotting on bedding and a characteristic sickishly sweet odor. Certainly allergic reactions to bug bites are a sign hard to ignore. The insects are very good a flattening their bodies and can be very difficult to find because they can run very quickly. Pest control professionals are usually required to make positive identification and speciation. They use physical inspection which is relatively difficult compared to the use of canines. Yes canines (dogs)! These specially trained dogs are very good at identification, especially useful in larger buildings such as dormitories and hotels, since they can identify infested rooms individually to avoid overtreating the entire building.

Remediation historically used a variety of insecticides but a new method is becoming increasingly popular: thermal remediation.

Thermal remediation consists of warming the interior of the house and/or infested furnishings and contents to approximately 135 deg F for a period of approximately five to six hours. During this heating process the interior temperatures are monitored and logged continuously to assure a thorough kill. Room heaters powered by either a remotely connected electric generator or gas-fired heaters are typically used to generate the heat in various sections of the building and supplemented with high velocity circulating fans to homogenize the temperature. The goal is for all contents that could harbor bugs and/or eggs to reach the desired temperature for the bake out period. Sometimes, especially in hotels or dormitories, the contents of the room are removed and placed in a large box truck outdoors equipped with a high-powered heating system. This is easier than “cooking” the room depending upon the number and size of the infested rooms.

This is where Thayer Corporation comes in. As experts in the field of heating, cooling and ventilation, we were consulted to offer methods of improving this heating process.  We have already identified several improvements to the process and are currently working on even more comprehensive enhancements.

Thermal Remediation has several advantages over traditional methods. While use of chemicals remains the most popular method, it requires a significant quantity of insecticide and it may be necessary to perform multiple applications as well over a period of time. It isn’t unusual for applicators to dismantle furniture in order to get the chemical to all bugs and egg laying places. The chemical approach requires the applicators be licensed and well trained.

Vacuuming and steaming is yet another method of remediation. The affected areas are both steamed to kill the bugs and eggs and removed with HEPA vacuums. This method isn’t as effective as other methods since the critters are very good at hiding in the smallest cracks and crevices. The other concern with the method is the potential damage may have to furnishings and the wetting that can lead to mold and/or microbial growth.

And since we’re a company working with many alternative energy sources, let me add that sometimes clothing and smaller furnishings can be removed to the outdoors, bagged in black plastic bags and allowed to bake in the sun.

Regardless of the method(s) used to remediate an infested space the most important thing to remember is that the process is only as good as the weakest link. The kill must be thorough or the space will soon become reinfested.

So the next time you send the grandkids off to bed a loving “good night, sleep well” might suffice.

Each day in the United States, 6,000 people turn 65 years of age.  One in five Americans will be older than age 65 by the year 2030 (American Association of Retired Persons, 2003). This increase of U.S. seniors translates into a staggering increase of people looking for assistance with daily living activities.

Ask most seniors where they would prefer to age, and the majority will say they want to stay in their own home.  The preference to age at home along with an increasing senior population has led to incredible growth in the in-home care service industry.  In-home care is a care solution that can help seniors fulfill on the preference to stay in their home, but not all in-home care is the same.  There are a number of in-home care options available, but before you select an individual or an organization to provide care for a loved one, make sure you research providers and ask the right questions.

In-Home Care Services  

In-home caregivers provide a range of care services and assistance that allow seniors and other adults to remain in their own homes. The majority of agencies offer a mix of the following care:

• Homemaking and Companionship Care – This includes meal preparation, running errands, incidental transportation, light housekeeping, companionship, medication reminders, and a variety of other services.
• Personal Care – Personal care includes bathing, grooming and hygiene care, toileting and incontinence care, feeding and special diet or meal preparation and other services.
• Specialized Services – 24-hour emergency response and, oftentimes, care for clients with Alzheimer’s and other dementia issues.

Differences in In-Home Care Providers

Independents

There are three fundamental business structures of providers who offer in-home care for seniors and other adults:  independents, registries, and employment based agencies, which include local/regional/national corporations or franchise organizations.  Each is substantially different in how they staff and charge for services as well as who assumes the role of employer and the associated responsibilities of the employer.

Independents are as the name suggests; an individual, or individuals, not part of a larger organizational structure providing in-home care.  An independent may be someone you know personally or from the community, or it may be someone who advertises in-home services in the classified section of the newspaper.  No matter the source of the independent caregiver, there are implications surrounding hiring an independent that should be considered before securing the relationship.

The biggest “plus” in hiring an independent is the hourly rate.  Generally, you pay the caregiver less than what you will pay a registry or an employment based agency.  However, a lower hourly rate does not always translate into the most cost efficient solution.  If you secure an independent to provide in-home care, you are now the employer.  That means you are responsible for all employment taxes and deductions for your employee, the caregiver.  You also become responsible for securing the appropriate insurance coverage such as Workers’ Compensation in case the caregiver is injured while providing care in the home and general liability insurance in the event the caregiver causes property damage.  Most homeowners’ policies do not cover the expenses associated with an injury or damages sustained while a caregiver is in your employ.  Additionally, while not required it is important for your own safety and security that you procure appropriate background checks and validation that the candidate is a capable, appropriately trained, and quality care provider.   Beyond the finances, is there a backup caregiver in the event the primary caregiver is ill or unable to care for the individual?  Is the individual trained or does he/she have access to training, to accommodate the changing care needs of a client?  If care is provided in a licensure state, is the caregiver licensed or certified to provide the care services?  On the surface, a lower hourly rate can appear to be the sensible decision, but as you begin to understand what an independent caregiver can or cannot provide, a clear message begins to emerge. A lower rate does not always translate to a more cost efficient, or highest quality, care solution.

Registries

Registries are organizations that build and manage databases of caregivers, but do not actually employ the caregivers.  The caregivers often act as 1099-contract labor, but the employment arrangements can vary. If you opt to hire a caregiver from a registry, one of the first questions you should pose is who assumes the role of employer and who is responsible for employment tax withholdings and the appropriate insurance coverage?  Some registries do provide Workers’ Compensation coverage, but make sure you understand the extent of the coverage to ensure the caregiver is actually covered while working for you.

Quality registries typically complete background checks on the caregivers in their database.   Generally, they do not provide training, nor do they ensure a level of caregiving proficiency prior to placing the caregiver.  Registries act as a “match maker” and provide viable caregiver personnel options for consumers to consider.  In the event a caregiver falls ill or an event materializes that precludes the caregiver from caring for the client, the registry can provide alternative caregiver solutions.     If you choose a registry to provide an in-home caregiver, make sure you understand:

• Who employs the caregiver
• Who is responsible for employment tax withholdings
• What kind of background checks have been run on the caregiver and the outcome of the checks
• Any and all insurance coverage that may apply to the caregiver in the home
• The type of training the caregiver may have received and certifications the caregiver may have secured
• How the caregiver is paid
• The type of caregiver oversight

Employment Based Agencies

The third option is an employment based agency which may be a corporation, or part of a corporation, or a franchise organization.  The greatest benefit to hiring a caregiver from an organization that employs its caregivers is the oversight provided and convenience for everyone involved.  It is a turnkey care solution and once you have met with the company and made the decision to work with the company, the “back office” details are not your responsibility.  The biggest distinctions with these organizations are:

• They employ the caregiver and clients are not burdened with the laws and requirements associated with being an employer
• Typically, employees have undergone rigorous background checks, interview process, and reference validation
• Caregivers are covered by Workers’ Compensation, general liability, and bonding insurance
• Caregivers are typically trained prior to being placed in a client’s home and there is ongoing training to ensure caregivers are educated and prepared to deliver quality care
• Certification and  licensure requirements are understood and adhered to
• A large roster of caregivers are available and prepared to “step in’ in the event the regular caregiver is unavailable
• Ongoing oversight and involvement from the corporate staff or franchisees

In-home care for seniors and other adults is gaining in momentum as the preferred care solution.  Who wouldn’t prefer to stay in the privacy of their own home, surrounded by cherished belongings and memories, and maintaining a level of independence?  Today, there are more care options available to seniors and their families, and in-home care can be that solution, but families need to ask the right questions.  If you are seeking a care solution for yourself or someone you love, take control of the situation and leverage the information that is available to you.  Ask good questions and stay involved!

©Comfort Keepers 2010