AGING
INSIGHT
2014 RESOURCE GUIDE
RESOURCE GUIDE
DIRECTORY The Most Complete Resource Around
Q&A
Qualifying for VA and Medicaid
PG 38
Using Special Needs Trusts to Plan for the Disabled
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“I
don’t want to ever be in a nursing home!!” “I want to age in my own home.” We have talked to thousands of seniors and each and every one of them feels the same way. But did you know that for a married couple turning age 65, there is a 70% chance that at least one of them will need long term care? By age 85, the number has increased to nearly 97% of all individuals will need long term care before the end of their life. There is good news however. Through planning for your future health, housing, financial, and legal needs, you have a better chance to remain independent, to avoid becoming a burden on your family and to avoid going broke. Unfortunately, much of the information you need to accomplish these goals has been scattered throughout the community or is mired in rumors and misinformation. Finding one reliable source for all these issues was difficult. That is why we started Aging Insight®. Aging Insight® is an educational and information resource for seniors and their loved ones. Our goal is to help families plan for, pay for and coordinate the longterm care of elderly or disabled loved ones. By providing information related to health, housing, financial resources and legal needs, we want to guide you through the aging process and give you reliable resources to obtain the care you need and maintain the highest possible quality of life. Aging Insight® is designed to assist families who need to respond to the current and future challenges of long-term illness and disability, including care support, estate planning, asset protection, Medicaid planning, care planning and coordination, patient advocacy and more. Live your life on your terms…here is the information to do it!
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John K. Ross IV is an Elder Law attorney and founding partner of Ross & Shoalmire, LLP Elder Law Firm. John holds a degree in Accounting from Texas State University and a Juris Doctorate from Texas Tech School of Law. John devotes his entire practice to assisting individuals with their estate planning and Elder Law needs. He is licensed to practice in Texas, Arkansas, and before the Unites States Tax Court. John is a U.S. Marine Corp veteran and is also an accredited Veterans Affairs attorney, a member of the National Academy of Elder Law Attorneys, a member of the Judge Advocate for the American Legion and a member of the board of directors for the Alzheimer’s Alliance. John is a frequent speaker on both a local and national level, and has been quoted by such national publications as the Wall Street Journal on aging issues. John is the co-host of the Aging Insight® radio program Saturdays from Noon to 1:00p.m on 107.1 FM and the Aging Insight® television program on KLFI-Texarkana. Lisa Shoalmire, a founding partner of the Ross & Shoalmire, LLP Elder Law Firm, is a senior advocate and Elder Law attorney. Lisa’s practice is centered on protecting the rights of seniors and the disabled. She holds a Juris Doctorate and a Masters of Taxation from Baylor University and a Certified Public Accounting certificate from the State of Louisiana. Lisa is licensed to practice law in Texas and Arkansas and she is a member of the Board of Directors for Opportunities, Inc. and the Texarkana Community Foundation. Lisa’s unique knowledge of the interaction between special needs planning, trusts, and asset protection planning has allowed her to assist countless families in maintaining the highest of life for themselves or their loved ones. Lisa was selected as a 2013 delegate to the National Aging and the Law Institute held in Washington D.C. and she is a member of the National Academy of Elder Law Attorneys. Along with her partner, Lisa is the host of the Aging Insight® radio program Saturdays from Noon to 1:00p.m. on 107.1FM and the Aging Insight® television program on KLFI-Texarkana.
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Don’t lose your life savings.
Keep control of your assets, your plans and your life. Catastrphic helath care costscan be an overwhelming issue for you or your family. There is financial assistance out there to help you get the care you need for those who qualify. however, the regulations pertaining to eligibility are complex and confusing, and many people do not know what to do. We can help by designing a plan: • • •
To help you pay for the care you need. To allow you to make your own decisions about the kind of care you want and the way you want your financial arffairs arranged. To ultimately maximize the assets you pass on to your family, free from creditors and government interference.
Texarkana Office 1820 Galleria Oaks | Texarkana, TX 75503 903-223-5653 (Principle Office)
Ross & Shoalmire, LLP can also help you with Wills, Trusts, Powers of Attorney, Guardianship, Advance Directives, Probate and the Administration of Estates
www.rossandshoalmire.com Paris Office 1007 S. Collegiate | Paris, TX 75460 903-905-4436 (By Appointment Only)
John K. Ross IV, Lisa B. Shoalmire and/or Ross & Shoalmire, LLP, by way of this article, is not offering legal advice. This article is intended to be for informational purposes only. Before relying on any information contained herein, the reader should consult an elder law attorney.
Aging Insight®
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Table of Contents ®
Legal Matters 6 Using Medicaid to Pay for Long-Term Care 2014 │ Volume 2
10 Benefitting from VA Benefits
Publisher John K. Ross IV, Lisa B. Shoalmire
14 Special Plans for Special People
Editor Christal Browning
Senior Health 18 Hospice Care... Guilty by Association?
Sales & Distribution Christal Browning
22 Keys to Healthy Senior Living
Contributing Writers Dr. Brian Matthews Dr. Julia Kim Fair Shae Guest Linda Nickerson State Farm - Larry Oxford
Housing & Lifestyle 26 Caring for the Caregiver 28 All about Home Health Care
Radio/TV Advertising Christal Browning KLFI Productions
Financial Facts
Creative Services / Print Lauren Butler Magna IV
34 Retirement Planning & Long-Term Care 36 Preparing for Peace of Mind in Retirement
Aging Insight® Directory 38 Adult Daycare 39 Assisted Living Services 40 Geriatric / Behavioral Health Facilities 41 Home Health Services 44 Hospice Services 45 Independent Living Services 46 Long-Term Care/Rehab Facilities 49 Sitter / Provider Services
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Principle Office 1820 Galleria Oaks Texarkana, TX 75503 www.agingInsight®.com O: (903) 223-5653 F: (903) 223- 5658 Aging Insight®
@txkelderlaw
John K. Ross IV, Lisa B. Shoalmire, Ross & Shoalmire, LLP, and/or Aging Insight LLC by way of this publication, is not offering legal advice. This publication is intended to be for informational purposes only. Before relying on any information contained herein, the reader should consult an elder law attorney. Aging Insight® is a registered trademark of Aging Insight LLC, all rights reserved.
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Accepting New Patients - Call 870-7SENIOR (773-6467)
Specialized Care for Older Adults Building healthy relationships is what the Wadley Senior Clinic is all about. The clinic is equipped with imaging and lab capabilities and staffed with a team of experts who are trained in the care of the older adult with each team member
(L-R) Amy Leigh Overton-McCoy, Ph.D., GNP-BC Jerry Stringfellow, MD - Julia Kim, MD
offering specialized knowledge and skills. With the guiding principle that all patients have unique needs, the healthcare team emphasizes patient-centered care with individualized care plans.
Where
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For patients age 55 years old and above For more information, visit www.wadleyhealth/seniors
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1307 Trinity Boulevard Texarkana, AR 71854 870-7SENIOR - 773-6467
Aging Insight®
5
Legal Matters
Using Medicaid to pay for Long-Term Nursing Care by John Ross
Long Term Care Medicaid is the federally mandated program that provides access to skilled nursing care for individuals who meet certain requirements. Although Medicaid is a federally created program, the actual administration of that program is left to the individual states. Because of this division between federally created rules and state administration, there are many specific differences between the states, although the overall rules are generally the same. Also, the rules change frequently, so from the time a reader starts this article, the rules may change before they even finish the article. As a result, the following information is for general knowledge and should not be relied upon without the advice of an expert in elder law. There are a bevy of misconceptions related to Long Term Care Medicaid. In fact, it is common for families who could be eligible for Medicaid to incorrectly assume that they do not qualify, even before they know the rules. Even more often, individuals and families will attempt to “plan” for their future Medicaid needs by acting on rumor and the advice of family, neighbors and friends. Most often, these people find that not only have they acted incorrectly, but that their attempts at “planning” have actually caused more problems than they solved. Because of the many rumors, misunderstandings and outright lies related to Medicaid, it is necessary to provide a general background to the program’s eligibility requirements before any discussion of planning can occur. The purpose of this article is to provide exactly that general overview with the intent that once the reader is armed with the basic knowledge, he or she will not make the same mistakes as so many of the people who came before them. 6
Q&A
How does one qualify for Medicaid long-term nursing home benefits? In very general terms, in order to qualify for Long Term Medicaid, the applicant must, (1) be a U.S. citizen or an alien lawfully living in the U.S. AND reside in the state where they are applying for benefits; (2) be over 65, disabled or blind; (3) have a “medical necessity” requiring skilled nursing care; (3) meet the income cap which means the applicant cannot make more than $2,163.00 (in 2014) per month in income; and (4) have only limited assets. In addition to these requirements, applying for LTC Medicaid does a person no good unless he or she is at a facility that accepts Medicaid and not all nursing homes accept Medicaid benefits. Of those nursing homes that do, the nursing home may only accept a limited number of Medicaid recipients. Additionally, the Medicaid “bed” generally is in a semi-private room. What if the applicant receives only $1,000.00 per month in income but the other spouse receives $1,700.00 or even $3,000.00 per month in income? The applicant will not have a problem with the income cap because he is receiving less than $2,163.00 per month in 2014. Medicaid only counts the applicant’s income and not the spouses income! If a couple are receiving rental payments from a lease of their land or are receiving note payments, the Medicaid Agency will consider that the income goes to the spouse whose name is on the check. What if the applicant does have too much income? Even if you the applicant has too much income, they can still qualify for Medicaid. If the applicant otherwise qualifies for Medicaid long term nursing home benefits, the applicant) or the applicant’s spouse or duly appointed agent) may create a Qualified Income Trust or “Miller Trust.” This trust allows the applicant to transfer his/her income into the trust and then qualify for Medicaid long term nursing home care benefits. This means that no one should every be disqualified for Medicaid because they have to much income! Either you have less than the income limit and qualify or you have more than the limit, set up a Miller Trust and then qualify. This Miller Trust sounds great, can I transfer my other assets into a Miller Trust to protect them? No. A Miller Trust is ONLY used to overcome the income cap issue. A Miller Trust is NOT a trust used to protect assets (resources). What are the assets that I can keep and still qualify for Medicaid? When applying for Medicaid, the state will look at what they call your “countable resources.” To qualify for Medicaid, an unmarried individual’s countable resources (assets) cannot exceed $2,000.00. If both spouses are applying for long term care nursing home benefits, then their combined countable resources generally cannot exceed $3,000.00.
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If only one spouse is applying for Medicaid benefits, the community spouse will keep more than $2,000.00 in assets. When the Medicaid application is made, all available non-exempt resources of both spouses will be counted as resources, whether the property is classified as community or separate. One half of the couple’s resources will be set aside for the spouse not applying for Medicaid benefits, with a minimum set aside amount of $23,448.00 and a maximum of $117,240.00 in 2014. There may be ways in which to increase the maximum amount that can be set aside for the spouse staying at home but the strategies can be complex and should be discussed with an expert. Are all of a person’s resources or assets counted when determining Medicaid eligibility? No. The following assets are exempt from being included as a resource. • The principal residence of the Applicant up to a value of $543,000.00; • A burial plot held for the Applicant or the Applicant’s family; • Term or burial insurance, if it has no cash value; • Identifiable burial funds in the amount of $1,500.00 or a prepaid irrevocable burial contract regardless of the value; • One automobile is exempt, regardless of value; • Household goods and personal items; • Life insurance policies owned by the Applicant with total face values of $1,500.00 per insured person or less; • Livestock and poultry that are held for business purposes or for consumption; • Business property essential for self-support; and • Non-business property valued at up to $6,000.00, essential for self-support (generally mineral interests). What if I am told that I have to “spend down” resources before I or my spouse qualifies for Medicaid. Should I “spend down” before I make application for Medicaid or after the application is made? Spending down before or after the application is not the key. The Medicaid Agency gives you a credit for all monies spent after you enter a medical facility and ultimately stay for 30 days or more. For example, imagine that a Wife has a stroke and goes into the hospital in September. On October 4, she is moved into a nursing facility and continues to reside there. Her husband makes application for Medicaid benefits for her in December. The Medicaid Agency will determine what their assets were all the way back to September 1 and then again on December 1 to see if they have already spent funds to meet any spend down. When only one spouse is applying for Medicaid, it is best to “spend down” AFTER the Medicaid application is filed. This is generally AFTER a person goes into a nursing home. However, before a person spends anything, they should get the advice of an expert. Many families do not have to spend a single penny before qualifying for Medicaid!
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We recruit experienced caregivers so that your experience is a blessing. 323 Hickory Street Texarkana, AR 71854 ph: 870-774-0701 870-772-3868 www.livethedifference.us
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Legal Matters But I heard that if I go into a nursing home, I will lose my house. Isn’t this true? No, you do not need to sell your homestead and spend the money in order to qualify for Medicaid. Nor will a nursing home make you sign your house over to them. These are all just rumors. The Medicaid Agency considers your homestead an “exempt” asset and therefore will not include it when determining your eligibility. You can get Medicaid and keep your house!!! What about after my death? Will the State take the house if either I or my spouse receives Medicaid assistance? Not if you protect it first! When the state pays for your care under the Medicaid program, the money they pay is more like a loan instead of a gift. The way they collect on their loan is a law called the Medicaid Estate Recovery Program. However, is no estate recovery, ever, when the deceased Medicaid recipient has a surviving spouse, minor children, disabled child of any age) or an unmarried adult child who lived in the homestead at least one year immediately prior to death. This is not a lien statute so the state will not “take” the homestead. The statute makes the State a creditor just like a doctor or ambulance company and just like any creditor, if there are no exemptions or waivers from collection, the creditor can require the executor to sell estate assets to pay the debt. But even if one of these exceptions doesn’t apply to you, all hope is not lost. There are many other ways you can protect your home and belongings if done very carefully. Can I give away some of my resources (assets) in order to qualify for Medicaid? Generally, no. If a nursing home applicant makes a transfer of resources for less than fair market value (a “gift”) in order to qualify for Medicaid benefits, the applicant will be penalized for the gift by being ineligible for Medicaid benefits for a calculated period of time (the “transfer penalty”). The Medicaid Agency has determined that the average private pay cost for nursing home care is $156.34 per day for Texas and $4,849.00 per month for Arkansas. To determine the number of months of ineligibility for any gift, the Medicaid Agency will divide the amount of the gift by $156.34 or $4,849.00 (depending on the state). The resulting quotient is the number of days/months of ineligibility for benefits. If a gift is made, the presumption is that it was made in order to qualify for Medicaid benefits. The Applicant would have to prove that the gift was made for a totally different reason, which is a very difficult burden of proof. Also, do not confuse the Medicaid gifting penalty with the federal gift tax law. Under the gift tax rules, a person can give away up to $14,000 per person each year without having to file a gift tax vreturn. But this rule is completely separate from Medicaid. Any gift can potentially cause a problem with Medicaid, no matter what amount it is.
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Can I transfer all of my assets into a Trust and then apply for and qualify for Medicaid long term nursing home benefits? Congress allows a disabled person under the age of 65 to transfer assets to a Supplemental Needs Trust drafted by an attorney or a Pooled Trust (e.g. the Arc of Texas, Master Pooled Trust) without transfer penalties. Both of these trusts require that upon the death of the applicant/beneficiary, all Medicaid expenditures are paid back to the State out of the remaining funds. These trusts are generally irrevocable. Also, if you have a disabled child or other disabled individuals in your family, you can transfer assets into trusts for their benefit if it is done very carefully. If a person is planning ahead, there are additional types of trusts that can potentially be used to protect your assets from the costs of nursing home care. These are very specialized documents and should only be created by an attorney that is familiar with the Medicaid eligibility rules. These are not “living trusts” or “revocable trusts” which are the most common type of trust agreement. Generally, living trusts will not protect your assets from your own costs of care. How can I learn the details about the Medicaid program? When asking a legal question about the Medicaid program or any other legal issue, it is imperative that a person obtain advice from a competent elder law attorney. For example, Texas law prohibits non-attorneys from advising persons about Medicaid qualification and charging fee. • A person who is not licensed to practice law in Texas commits an offense if the person charges a fee for representing or aiding an applicant or recipient in procuring assistance from the Commission [the Texas Health and Human Services Commission’s Medicaid program]. • person commits an offense if the person advertises, holds himself or herself out for, or solicits the procurement of assistance from the Commission. • An offense under this section is a Class A misdemeanor. Section 12.001 of the Texas Human Resources Code. In any case, DO NOT take the advice of anyone other than a qualified elder law attorney. This includes insurance agents, nursing home case workers, DHS employees or even other lawyers who do not specialize in Elder Law. John K. Ross IV, Lisa B. Shoalmire and/or Ross & Shoalmire, LLP, by way of this Medicaid Frequently Asked Questions, is not offering legal advice. This article is intended to be for informational purposes only. Before relying on any information contained herein, the reader should consult an elder law attorney. The vast majority of this document is taken, with permission, from the copyrighted material of Patricia F. Sitchler, an attorney with the law firm of Schoenbaum, Curphy and Scanlan, PC. Our deepest and most sincere thanks to her for allowing us to use this material and for her continued efforts in the area of Elder Law.
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Three chef-prepared meals a day
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Full calendar of activities and events
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Housekeeping and linen service
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9
Legal Matters
Benefitting from VA Benefits by John Ross
Benefits available through the Veterans Administration are the most commonly overlooked benefits available to seniors. Many times, veterans and their spouses make incorrect assumptions related to their entitlement to VA benefits. These individuals will assume that since they did not retire from the military they are not entitled to any benefits from the VA, or the will assume that since they were not injured during their service they are not entitled to any benefits from the VA. While there are in fact benefits available to retired veterans and veterans with service connected disabilities, these are not the only benefits available. The most commonly
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overlooked VA benefit is called the “Aid and Attendance� benefit. Of the people who have heard of this benefit, many have been incorrectly told that they do not qualify. The reality is, this benefit is available to many veterans and their spouses and can prove to be a lifesaver when times get tough. In order to qualify for the VA Aid and Attendance benefit, the veteran must have served at least ninety (90) days of active duty. Of those ninety days, at least one of the days must have been during a designated period of war. This does not mean that the veteran had to have serve in combat. It is merely a requirement that the veteran’s service occurred during one of the periods of time where the United States
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had declared war. Official periods of war include: the Mexican Border, May 9, 1916, to April 5, 1917; World War I, April 6, 1917, to November 11, 1918 (April 1, 1920, if served in Russia); World War II, December 7, 1941, to December 31, 1946; Korean Conflict, June 27, 1950, to January 31, 1955; Vietnam War, August 5, 1964, to May 7, 1975 (February 28, 1961, if served in Vietnam); and the Persian Gulf War, August 2, 1990 to unknown date. In addition to the Veterans active duty service, he or she must have been discharged from the military in some way other than dishonorably. This could include an honorable discharge, an other than honorable discharge, a general discharge or a medical
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Legal Matters discharge. Even if a veteran was dishonorably discharged, it may still be possible to petition VA to have the dishonorable discharge changed to one of the other forms of discharge. A veteran who meets the above noted requirements is considered a wartime veteran. So what about the spouse of a wartime veteran? The surviving spouse of a wartime veterans is also entitled to the Aid and Attendance benefit, if he or she was married to the veteran for at least one year, married to the veteran at the time of the veteran’s death and has not since remarried. There is no requirement that the spouse be married to be veteran during the veteran’s time of service. Additionally, if the widow of a veteran does remarry and his or her new spouse is also a veteran who meets the eligibility requirements, then the spouse can qualify under that second marriage instead.
any unreimbursed medical expenses. Such unreimbursed medical expenses might include insurance premiums, copays, prescription drugs and the cost of in home care or assisted living. For example, a veteran with $4,000.00 in monthly income might not consider himself to have low monthly income. But if this veteran lives in an assisted living facility that charges $3,500.00 a month in rent, then the veteran’s Income for VA Purposes is only $500.00 per month. That would meet the definition of low monthly income. The VA also requires an applicant to have a normal net worth. Unlike other federal programs, the VA does not define normal net worth. Instead, the VA will look at a person’s net worth in relation to how much they are spending and their life expectancy. Therefore, a younger veteran might be entitled to keep more assets than an older veteran. Typically, the VA does not count the
spouse could receive a maximum benefit of approximately $2,200.00 per month. Let’s take Sally as an example. Sally is the surviving spouse of a veteran who served during the Korean conflict. She is seventy-nine years old and her Social Security and retirement income totals $2,000.00 per month. Sally’s health has declined and although she still lives at home, it is becoming more and more difficult for her to take care of herself. Sally looked at one of the local assisted living facilities and really liked what she saw. However, when she was told that the monthly cost would be $2,500.00, she assumed that she could not afford that much expense and continued to live at home in an unsafe environment. But after applying for the Aid and Attendance benefit through the VA. Sally was able to receive the maximum VA benefit of $1,100.00 per month. This increased her income to $3,100.00
Sally was able to receive the maximum VA benefit of $1,100.00 per month. This increased her income to $3,100.00 dollars and she can now afford to live in the assisted living facility that she thought she could not afford.” The reason the VA benefit is termed the Aid and Attendance benefit, is because it is for veterans or their surviving spouses who need assistance with their normal activities of daily living. In order to meet this requirement, the applicant must be over sixty-five (65) years of age or blind or disabled and need someone else’s help with their activities of daily living. Such a assistance might include help with feeding, bathing, getting dressed, meal preparation, financial management and similar items. Finally, in order to qualify for this benefit, the applicants must have what the VA considers to be low monthly income and a normal net worth. However, a person should not assume that they do not meet these requirements without having a full understanding of what these terms mean. For example, when the VA uses the term “low monthly income,” they are referring to Income for VA Purposes (IVAP). IVAP is defined as the total household income minus
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value of a home in its determination of net worth. With a thorough understanding of the rules and the guidance of someone experienced with dealing with the VA, many people can meet this section of the eligibility test. It should be noted that as of the writing of this article, the VA does not impose a penalty for transfers of assets. However, there is legislation in Congress that if passed will impose a transfer of assets penalty similar to Medicaid. This makes it even more important to plan ahead if you might benefit from the VA Aid and Attendance program at some point in the future. So, why is all of this discussion about the Aid and Attendance benefit so important? For those who qualify, the VA will send money that the person can use to help pay for their care. A surviving spouse of a veteran could receive a maximum benefit of approximately $1,100.00 per month, a single veteran could receive a maximum benefit of approximately $1,700.00 per month and a veteran with a dependent
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dollars and she can now afford to live in the assisted living facility that she thought she could not afford. Planning related to obtaining VA benefits is very complicated. Not only must you meet VA’s eligibility rules exactly, this type of planning is only a small part of the type of planning on that is necessary for a person to protect themselves, their life savings, and their dignity. Many elder law attorneys are also accredited VA attorneys. A lawyer must be accredited by the Veterans Administration in order to assist you with VA planning. In addition to elder law attorneys, there are Veterans Service Organizations (VSO) that can also provide assistance with VA benefits. For those who qualify, the VA Aid and Attendance benefit can be the difference between life and death. Anyone interested should seek advice, even if they do not need the benefit yet. Thank you to all the veterans and their family who have given so much for this country.
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13
Legal Matters
Special Plans for Special People BY LISA SHOALMIRE
Using Special Needs Trusts to Plan for the Disabled Caregivers for people who are ill, aged or disabled are the unsung heroes among us. These caregivers are typically on the job 24 hours a day, seven days a week, caring for that special someone in their lives who has limitations which prevents that person from living independently. The subject of this care may be a child with Down’s Syndrome or it may be a spouse with Alzheimer’s disease. Either way, these caregivers stand as a buffer against the world to make sure that their special someone is provided with a safe, clean place to live, nutritious meals to eat, a capable medical team to treat them, and love and affection to enhance their lives. The biggest fear these caregivers often have is a day when, due to their own death or disability, they cannot be there to care for their loved one.
PLANNING IS IMPERATIVE
If someone with special needs depends on you to care for them, it is imperative that you plan for your disabled loved one if you cannot be their caregiver. One important piece of this plan is to consider creating a Special Needs Trust to hold assets for the benefit of the disabled individual. A special needs trust allows you to leave money for the care of your loved one that won’t disqualify them from Supplemental Social Income (SSI) or government healthcare benefits such as Medicaid. The government support programs for the disabled are an important safety net for disabled persons and in many cases may be the only source for healthcare coverage. If a disabled person receives even a small inheritance or gift outright, that person may immediately lose access to medical, housing and cash benefits until the assets are spent. The disabled person then has to reapply for these benefits which may take time to process. However, if assets are set aside for the disabled person using a properly drafted and executed Special Needs Trust (SNT), then assets left by the caregiver or others are not counted as a resource of the disabled person, but yet, these assets may be used to enhance the quality of life of the disabled person, beyond the very modest government programs available to them. Most importantly, assets held in a SNT do not disqualify the disabled person from their health coverage, housing benefits or disability payments.
benefit of a disabled child. The trust document will name who the beneficiary is (the disabled person) and the trust will also name a trustee, who is the person who can manage the assets placed into the trust and make disbursements to the beneficiary.
TWO TYPES OF SPECIAL NEEDS TRUST
There are two main types of SNTs: a First Party SNT and a Third Party SNT. A first party SNT is funded using the beneficiary’s own assets. A common example of this type of trust is a Court created trust for the disabled beneficiary funded with money from a legal settlement from a personal injury lawsuit which was the cause of the individual’s disability. The most common type of SNT is the Third Party SNT. This is a trust set up by third parties, such as parents of a disabled child. The parents can create the trust today, even while they are living, or they can put a provision in the Last Will and Testament that creates the SNT at their death to hold assets for their disabled child. An important distinction between the two types of trust is that, when the disabled beneficiary dies, assets which remain in a First Party SNT must be paid over to the State that provided any government support to the individual during his or her lifetime. This is called a “payback provision.” In contrast, any assets which remain in a Third Party SNT at the disabled person’s death may be disbursed to other surviving family members or other named beneficiaries. There is no payback requirement for a Third Party SNT.
WHAT IS A TRUST?
A trust is simply a legal entity that can hold assets for the benefit of someone else. For instance, a parent may create a trust by signing a trust document creating a trust for the
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HOW TO SET UP A TRUST
A special needs trust is definitely not a do-it-yourself project. There are numerous federal and state laws, as well as administrative rules, which must be carefully followed in setting up and running a SNT. A misstep, even an unknowing one, can cause the trust to be “busted”, and the assets drained out without benefiting the disabled individual. An attorney who specializes in SNTs will know best how to create the trust for your individual circumstances and build in as much flexibility as allowed under the current laws and rules which affect SNTs.
Heal-In
FUNDING THE TRUST
If you are setting up a Third Party SNT, you will need to estimate how much assistance the beneficiary will need over their lifetime and determine what the source of those funds may be, both while you are living and able to care for them, and after you are deceased. This may mean you name the trust as a beneficiary of life insurance policies, retirement accounts or even place your residence in the trust for the benefit of your disabled family member. If you create a Third Party SNT while you are living, you can even encourage other family members making gifts to the trust, either while they are living or through their own estate planning.
A special needs trust allows you to leave money for the care of your loved one that won’t disqualify them from Supplemental Social Income (SSI) or government healthcare benefits such as Medicaid.”
OPERATING THE TRUST
The Trustee is responsible for managing the assets of the trust, filing tax returns if required, and disbursing assets for the benefit of the disabled person. SNTs can be challenging to operate properly because of all the rules which have to be followed. Some family members are simply not equipped or are unwilling to learn to be good trustee. Many people who create a SNT appoint a professional trustee, such as a bank trust officer, to be the trustee to make sure all the rules are followed and the trust is not “busted”. The trustee makes sure that the assets in the trust are maintained and kept safe and that the needs of the beneficiary are met. The Trustee may use funds in the trust to pay for medical expenses not otherwise covered such as special medical equipment or in-home caregivers. The trustee may also pay for quality of life enhancements for the disabled individual such as cable television, tablet computers, vacations and entertainment.
Dr. Oz has stated the new medicine is “energy medicine.” Why? Because it is totally natural, relaxing, low-cost, proven through use for thousands of years, and good prevantative practice. Many people report a relaxing effect, and no side effects! Energy treatments are given with a soft touch to different areas of the body, fully clothed. For those able tand willing ot relax on a table, mild stretching is an added plus which oimproves range of motion and also strength. Health topics are promoted in this calm setting , including reminders for all the facets of vital living. It’s one-on-one attention which takes and all-natural apprach to relieving fears or anxieties. The alpha level of relaxation enables persons to more easily selfregulate their bodies with a balanced approach. Every increment of improvement for your residents improves their quality of likfe, whether that is being flexible enough to preform morning care more easily or having the interest for conversation with others. Acceptance at each stage of life is key, allowing all the joys possible at each and every stage.
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By utilizing a SNT, caregivers get peace of mind that, even after they are gone, their disabled loved one will have resources at their disposal to enhance their lives while still maintaining eligibility for disability and medical benefits. You should speak to an Elder Law attorney about your situation if you are caring for a special needs person and create a plan of care.
Aging Insight®
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My Thoughts on Senior Care by David Carl
I was excited to be asked to participate in an article for Aging Insight®. Our agency was licensed in July 2012 by the Department of Aging and Disability of Texas. We are also a member of Texas Home Care and Hospice of Texas. Our mission and goal is for Texarkana seniors to stay home, stay healthy, and stay happy. We have many clients that will attest to the fact that we accomplish our goals, which makes us happy, happy, happy.. I realized the need for home care while being the primary caregiver for my 92 year old grandfather. I also realized it was much more than I had previously thought. America is aging at an alarming rate; some statistics say that our seniors are moving into the 65 year old age group never before seen in history. This is due in large part to the baby boomers. In 1900 America had 3.1 million, in the year 2000, 35 million more will join the 65 year olds, and it is projected to hit an astonishing 72 million seniors in the year 2030. I find this amazing on one hand and alarming on the other. What will happen to them? Will our federal and state government be ready for this shift in aging? During our present economic situation will families be prepared to take on the task of caring for their loved ones? It is disappointing to note that most of our client’s sons and daughters are taking on the task. The families that I know have children entering college. Most couples are both working. The added stress of taking care of mom and dad or both is sometimes overwhelming. This is why Advantage Senior Care exists. We are here to help. I have found that some of our clients, not the seniors we care for, but the sons and daughters of our seniors, call us when caregiving reaches a crisis. It is important to note another statistic. Primary caregivers die before the patients. Caregiving can be quite stressful, more so if it’s a relative that
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they are caring for. The problem compounds when the various forms of dementia, Alzheimer’s, and the degenerative diseases set in that accompany aging. Advantage Senior Care offers a 4 hour minimum visit to relieve the family member, give them time to run errands, or just relax. You aren’t at your best when stressed and overwhelmed by caring for your senior, in fact, you’re everyone including yourself a disservice. So take a break, recharge your batteries and let us help.
Currently, we have clients that require 24 hour care due to hospitalization. We also care for Alzheimer patients, and sadly, those who are just plain lonely and need a caring person to help with a bath, prepare a meal, pick-up prescriptions, take to the beauty salon, run errands, do light housekeeping and the list goes on. I am fortunate to have a group of hardworking and experienced caregivers that enjoy seeing a smile on the faces of our clients. It has been said that we do anything that Medicare and Medicaid do not cover and for that reason we are private pay. My responsibilities include putting the right caregiver with the right client, and I visit families to ensure that we are providing quality care. I take this very seriously, so much so that I have a client myself. You see, I like to stay close to the business of caregiving. Every Tuesday and Thursday I spend the day with my client, who has
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Parkinson’s disease. I first met him when he called our agency and requested a caregiver. My assistant and I went out to interview him as we do with all new clients, just to find out what type of care is needed and get an idea of which caregiver would be best suited for the job. He stated he didn’t want a female caregiver, and at the time I had no male caregivers on staff, so I offered to help. He seemed relieved and I was happy to have a new client. We go to lunch, pick-up dry cleaning, do some shopping, whatever he wants to do for the day, it is his day! That was almost 2 years ago, and I am so thankful to be a part of his life. Parkinson’s comes in many forms from mild to advance. Some of the many symptoms are depression, lack of mobility, loss of motor skills, cognitive problems, etc. In the past, I was in business and it was always about money, chasing the dollar, working hard, and trying to get ahead. On one afternoon , after being with my client that day and watching him struggle to overcome this debilitating disease , I remembered his smiling and laughing at one of my corny jokes. It dawned on me that this is really what it’s all about. My most rewarding times have been spent caring for others and trying to bring some happiness into their lives. I hope I always have a client to care for. It’s more rewarding and fulfilling than anything I have ever done. So stay home, stay healthy and stay happy, we care about you at Advantage Senior Care. I would like to hear from you, my office number is 903280-7072.
David is the co- owner / administrator for Advantage Senior Care, located in Texarkana, Texas. David grew up in Mississippi and graduated from Mississippi State University in 1980. After graduation he worked for Crown Leasing Corporation as market manager, regional manager and President. While working for Crown Leasing he lived in Houston, Indianapolis, and Chicago. He moved to Texarkana in 1985 opening his own business 1992 and settled in Pleasant Grove, where he currently resides. He and partner, Trina Campbell opened Advantage Senior Care in July of 2012.
Aging Insight速
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Senior Health
HOSPICE CARE... guilty by association? BY Dr. Brian L. Matthews
Too “Good” To Be True?
Although the first hospice program originated in Connecticut in the early 1970s, end-of-life care was viewed with minimal interest amidst the predominant fight to find plausible cures for cancer5. The word hospice has been a taboo subject that rears it uninvited head when death and dying are the topic of conversation. The negative connotations, such as pain, fear, uncertainty, loneliness, among other descriptors associated with hospice, have so far removed the concept from the minds of so many that the mere mention of the word provokes an angered and rejected response. Historically, while death and dying was socially and culturally forbidden and even avoided by clergymen, family, and physicians, the boundary of hospice care has rapidly expanded even as late terminal illnesses continually persist. If
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hospice was a painting that represented a “utopic” paradise, it would be painted with the following brush strokes: • To know when death is coming and understands the disease trajectory. • To be able to retain control of the end-of-life process. • To be treated with dignity and respect. • To have control over pain relief and symptom control. • To have a choice and control over the location where death occurs. • To have easy access to information and expertise when needed. • To have access to spiritual and emotional support. • To have access to hospice care at any location besides a hospital.
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• To have control over social interaction and who shares the end-of-life experience. • To be able to initiate advance directives to ensure that final wishes are granted. • To have time to say goodbye and have control over other aspects of time. • To be able to leave at the appropriate time and not prolong life pointlessly2. Hospice reflects this serene utopia, or good death experience, where life is reflective of religious, social, and cultural experiences and where death is free from pain and suffering. Here, death is seen as a natural process and an active phase of life that is filled with hopes, dreams, and goals that patients and their caregivers aspire to accomplish before death occurs. Considered the ideal or perfect place, utopia helps patients elude or avoid pain and suffering and provides an environment where the cultural, social, and personal disposition of the patient take precedence and the connection to the true meaning of life is discovered. Now, while there is no such thing as the perfect place, perfection in regards to death and dying can be physically, socially, spiritually, and psychologically within reach. To help reach this “utopia”, hospice strives to minimize as much pain and suffering as possible and provide a good death experience by virtue of a palliative and healthcare delivery system. So, if that’s the case,
Senior Health how has hospice care that promotes such freedom and escape from pain and suffering struck great fear in the minds of patients and their caregivers? Even more, what does hospice really look like? What is so scary about it?
What is Hospice...Really?
Contrary to its residential origin, hospice provided in a home setting is now relative because the pathways to hospice care are now utilized in acute care, community, as well as residential aged care sectors8. Hospice is more of a conceptual and holistic practice that represents a philosophy that describes a standard of care and a systematic form of healthcare delivery. In addition, hospice care also provides bereavement counseling for surviving family members who have difficulty coping with the death of a loved one. The purpose of hospice is not to view dying as a set of medical problems that needed to be solved4. The idea of delivering emotional, physical, social, and spiritually comfort in a palliative setting became the premise and narrative for suitable end-of-life care. Focusing on the holistic view of the patient instead of the nature of the terminal illness, hospice care targeted quality-of-life in a multidimensional capacity, consisting of physical, emotional, social, cognitive, and spiritual components. Through an interdisciplinary approach and a pain management system, the sole purpose of hospice care is to maximize comfort and dignity in addition to improve quality-of-life for terminally-ill patients1. Moreover, using
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this approach, patients and caregivers become readily prepared for impending death through psychological and spiritual counseling, frequent communication about the disease process, accessibility to medicines, medical devices required for maximized care, and assistance with activities of daily living5. The hospice team flexibly applies energy to free patients from suffering and functional limitations so that they can travel, visit with family, reconcile personal differences, prepare a legacy, and reflect on their lives1. This employment of comprehensive care by the hospice team makes the reality of a good death more attainable and less burdensome.
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Senior Health
What Makes Hospice So Scary? Good death aspirations can be quite unattainable if patients and their caregivers lack the physical, emotional, and spiritual capacities to pursue personal goals and when suffering seems imminent through the entire disease process without any other community support7. Patients and caregivers not only deal with the disease itself but the reality that there are no curative treatments to treat the disease. This statement puts the element of fear into a more horrific perspective. Of course, death is a universal human experience that is unavoidable. By nature, humans elude the things that make them uncomfortable, helpless, fearful, and vulnerable. In her book, On
care because no one likes to talk about it. For some, denial inadvertently creates a wonderful euphoria where the journey to inevitable death is entrenched with curative interventions, an existential reliance on a higher being, strong social interactions, and an utter avoidance of the looming disease that forces one’s hand to face a harsh reality. There is a certain level of gratification and peace that comes with prolonging the inevitable. Moreover, anger adds fuel to the denial flame. Patients and caregivers proceed to fight as warriors to the very end. The goal is to fight death at all costs, even if it means eventually losing the battle but having the peace of trying without giving up. This battle either ends in late referrals to hospice care
Death and Dying, Dr. Elizabeth KublerRoss described the sequential process of grief to include: (1) denial, (2) anger, (3) bargaining, (4) depression, and (5) acceptance. The presence of denial seems to be a common stigma associated with hospice care which only breathes life the stigma of a scarier death3, 6. This avoidance creates discomfort when discussing hospice
or a bad death caused by inadequate medical, nursing, social, and/or spiritual support. It is not that patients and caregiver fail to understand what the word terminal means; it is that they are not yet willing to accept the reality that they will eventually lose someone they truly love. And, this is what makes hospice such a scary word.
Dr. Brian L. Matthews is the Director of Marketing/Admissions at Edgewood Manor Skilled Nursing and Rehabilitation at 4925 Elizabeth Street in Texarkana, Texas. Dr. Matthews holds a Bachelor of Business Administration in Marketing and a Master of Business Administration in Management from Harding University. He also holds a Doctor of Business Administration in Marketing from Argosy University. He has lived in Texarkana for 11 years and has been a resident of Texarkana, Texas for 6 years where he serves as city councilmember for Ward 4. Dr. Matthews has over 12 years of marketing experience. He is very active in the community, serving as a board member for the Texarkana Area Community Foundation, Alzheimer’s Alliance Tri-State Area, CHRISTUS St. Michael Rehabilitation Hospital, and the Diversity Awareness Committee for Texarkana Independent School District. He also serves as a member TRAHC’s African-American Executive Committee, a member of the Quality Assurance and Improvement Committee for Spring Lake Park Elementary School, and a member at Texas High School and OPTIONS Academic Alternative High School.
References: ● Abrahm, J. L., & Hansen-Flaschen, J. (2002, January). Hospice care for patients with advanced lung disease. Chest, 121(1), 220-229. ● Archer, K. C., & Boyle, D. P. (1999). Toward a measure of caregiver satisfaction with hospice social workers. Hospital Journal, 14(2), 1-15. ● Borbasi, S., Wotton, K., Redden, M., & Chapman, Y. (2005, August). Letting go: A qualitative study of acute care and community nurses’ perceptions of a ‘good’ versus a ‘bad’ death. Australian Critical Care, 18(3), 104-113. ● Byock, I. (1996). Beyond symptom management. European Journal of Palliative Care, 3, 125-130. ● Jennings, B., Ryndes, T., D’Onofrio, C., & Bailey, M. A. (2003). Access to hospice care: Expanding boundaries, overcoming barriers. Hasting Center Report, S3-7, S9-13, S15-21. ● Kim, S., & Lee, Y. (2003). Korean nurses’ attitudes to good and bad death, life sustaining treatment and advance directives. Nursing Ethics, 10(6), 624-637. ● Matthews, B. L. (November, 2012). Hospice informal caregivers’ perception of a good death experience: Using dimensions of the SERVQUAL Analysis to measure service quality and overall customer satisfaction. (Unpublished doctoral dissertation). Argosy University, Arizona. ● Phillips, J. L., Halcomb, E. J., & Davidson, P. M. (2011, May). End-of-life care pathways in acute and hospice care: An integrative review. Journal of Pain and Symptom Management, 41(5), 940-955.
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Waterton Plaza AT COWHORN CREEK
5524 Cowhorn Creek Drive Texarkana, Texas 75503 Waterton Plaza at Cowhorn Creek offers quality, individualized care by a dedicated and caring staff. We specialize in rehabilitation and physical therapy to help residents regain their strength and independence. Weather your looking for extra help to get back home or looking for long term solution to meet your individual goal, Waterton Plaza at Cowhorn Creek is your home away from home.
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Senior Health
Keys to
Healthy Senior Living BY
Dr. Julia Kim
and natural detoxification systems efficient and healthy. Our immune systems are exposed to numerous bacterial, viral, fungal, and parasitic pathogens daily. A healthy immune system will keep many of these pathogens from infecting the body. The key to staying active is to integrating exercise, brisk walks, into one’s daily plans and personal lifestyle. Proper rest should also be planned with increased activity and fitness to help your body adjust to the increased metabolism required by increased activity.
• • • • • • •
•
Here are some of the benefits of regular exercise and keeping active:
Improves longevity and healthy living Relieves symptoms of depression and anxiety and improves mood Improves heart-lung and muscle fitness Improves sleep length and sleep quality Helps prevent the insidious loss of bone known as osteoporosis Reduces the risk of falling and improves cognitive function among older adults Helps in preventing heart disease and stroke or its precursors, high blood pressure and undesirable blood lipid patterns Helps the immune system to combat certain cancers, including colon and breast cancer, and possibly lung and endometrial (uterine lining cancer Helps prevent type 2 diabetes and metabolic syndrome Prevents weight gain, promotes weight loss (when combined with a lowercalorie diet), and helps keep weight off after weight loss
Healthy eating and regular ... sustained exercise such physical activity are essential for as aquatic exercises and helping the human body deal with • underwater movement classes the daily stress that life brings on the cardiovascular system. Our can also improve cardiovascular • cardiovascular system depends health with less risk of gravity upon healthy heart muscle tissue causing injury to joints or and elastic blood vessels that muscle tissue.” can tolerate changes in blood Studies suggest that older people, those pressure and heart rate. There who are out of shape, or those with disabilities, may get as are many things in life that can cause our heart rate to increase dramatically as it is a natural response of our much benefit from 30 minutes of slower walking or other autonomic nervous system also known as the fight or flight exercise as younger, more fit people get from the same amount response. Even the caffeine in a daily cup of coffee or tea in of more-intense activity. In our clinic we have regular classes the morning will increase our heart rate for short periods of Tai Chi Chuan to help older people stay active for longer by time. Sometimes a bad dream or anxiety caused by a periods with benefits to joints and circulation and decreased bad memory will make our heart race and ignite a systemic risk from higher impact bursts of exercise that can injure the response in our cardiovascular system. By keeping active joints or increase the risk of falling. Other forms of sustained and exercising daily, we can help strengthen the muscles exercise such as aquatic exercises and underwater movement of our cardiovascular system to accommodate the regular classes can also improve cardiovascular health with less risk fluctuations in heart rate often experienced with the hustle of gravity causing injury to joints or muscle tissue. Any form of regular movement with proper rest and recovery can help and bustle of modern life. Regular exercise help keep our bodies’ excretion, immune, create healthy habits for improving quality of life.
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Dr. Julia Kim graduated from the New York University and attended medical school at the Saba University School of Medicine. She completed her family medicine residency program at the Overlook Hospital – Atlantic Health System and pursued the fellowship of Geriatric Medicine in New York – North Shore University Hospital. On completion of training, she practiced medicine at the Rowan University School of Medicine as an assistant professor in the geriatric department and the team physician at the Lighthouse Hospice. Dr. Kim began her full-time practice in Texarkana at the Wadley Senior Clinic in November of 2013. Her special interest is in the management of the elderly with Alzheimer or dementia. Dr. Kim is married to Timothy Chung and they have a 5 month old daughter, Makayla.
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1. Choose activities you enjoy doing 2. Exercise with a friend for motivation and
HOME HEALTH
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3. Try taking lunch on the move at a park or a public area within walking distance
4. Sign up for a class or social exercise group you would look forward to attending regularly
5. Take the parking spots that are further away
from your destination to add some extra steps to your trip
6. Wearing a pedometer to track how many steps you take throughout the day
7. Plan out set breaks or times for 10 to 15 minutes of activity throughout your day
8. Reward
yourself with non-food related incentives for accomplishing activity goals
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“Our family serving yours” ...is the heart to what Texarkana Funeral Home proudly stands behind. Family owned and operated since 1939, we have grown in many different directions and locations. Texarkana Funeral Homes services local residents on both sides of the stateline with locations in Texarkana, Texas and Texarkana, Arkansas as well as Chapelwood Funeral Home in Nash, Texas, Bates-Rolf Funeral Home in DeKalb, Texas and Bates-Rolf Funeral Home in New Boston Texas. Our licensed funeral directors and their assistants serve families in their greatest time of need; providing warmth, reassurance, and compassion during the most difficult time in life. Our family’s beliefs have been words of comfort to the generations. Specializing in complete funeral, burial and cremation services with cemetery monuments and aftercare Texarkana Funeral Homes continue to be the low cost leader in the region. During all stages of life, we methodically plan for the events we consider to be major milestones like purchasing a first home, planning a wedding, having children, and saving for retirement. Planning for final arrangements however, is arguably one of the most important life events that is all too often neglected. Since 1970, Texarkana, Chapelwood, and Bates-Rolf Funeral Homes have offered pre-planning as a better way to serve your family. Pre-planning allows families to make rational decisions now, so that they are not forced to make emotional decisions later, which in return gives peace of mind to the person that pre-planned, as well as their loved ones. It is a wonderful feeling for a parent to know that they will not leave the burden of their final arrangements for their children to bare, not to mention the peace of mind in knowing that ones final wishes will be taken care of in each and every aspect. With pre-planning comes many advantages, including: personal selection of the type of service. Pre-arrangement freezes today’s prices, which means the price you pay today never changes, even if the cost of the chosen plan increases in the future - interest free.
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Uniquely, we handle our own claims in house through our insurance department, Family Liberty Life Insurance Company, which enables claims to be processed in our administration office and in a timely manner, never leaving our care. Our agents are personable, knowledgeable and experienced in caring for you and your family during your time of greatest need, they are there to answer any questions for you concerning pre-arrangement contracts and can be reached for an appointment at any of our locations. In addition to the various funeral home locations and pre-planning options, the Texarkana Funeral Home organization offers complete cemetery services through Hillcrest Memorial Park and Monument Company. The original cemetery, that is now Hillcrest, was established July 1, 1929 and is one of the Texarkana area’s most distinguished landmarks. The original 15 acres property has been expanded and now covers 39 acres of gently rolling hills and native shade trees. The cemetery became a Perpetual Care Cemetery in 1946, which means it is maintained and cared for by cemetery staff, and is operated under the State Banking Laws of Texas. Some of the features that Hillcrest has to offer include: companion sections, veteran discounts, family lots, and private mausoleums. As a dual monument company, Hillcrest specializes in bronze and granite memorials, as well as granite monuments and markers. Hillcrest offers many options to consider when making your cemetery property selection, ensuring the possibility to meet individual preferences and needs. With the fastest growing segment of the funeral industry being cremation, Texarkana Funeral Home made the decision to develop the area’s first cremation center located adjacent to Hillcrest Memorial Park in the latter part of 2013. The addition of Hillcrest Crematory ensures that your loved one will never have to leave our care. Some of the advantages of cremation include the flexibility and personalization of the process. Not all family members are able to meet for a funeral service at the time of need, but cremation allows a service or
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memorial to be held at a later date. Families can then choose to keep the ashes safely in a beautiful keepsake urn. One may also choose to request their ashes to be scattered in a favorite place, or several different locations that were once meaningful to the passed loved one. The benefits of cremation allow you to make the entire ritual a unique, personalized tribute, which truly reflects the personality of the deceased. To further extend the full service experience, Texarkana Funeral Homes presents the aptly named, Unique Flowers and Gifts, located next to Texarkana Funeral Home in Texarkana, Arkansas. With a wide selection of potten plants, silk and fresh floral arrangements, gifts, gourmet baskets, candles, and beautiful home decor, Unique Flowers offers the highest quality of flowers and service that only a local flower shop can provide. We make it easy to order for any occasion with same day delivery (in Texarkana) and online ordering at uniqueflowersandgifts. com. Texarkana Funeral Home has been a staple in the community for many years. We plan to continue serving our area resident’s in the future while focusing on providing the utmost care to families during some of their most vulnerable and difficult times, as pleasing the families we serve is the most important thing we do.
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Housing & Lifestyle
Caring for the
Today, there are approximately 5 million individuals in the United States and 26 million worldwide currently living with a diagnosis of Alzheimer’s disease. For every one of these individuals, there are 2.5 other “victims”---a husband or wife --- son or daughter--inlaw or friend--- whose entire life changes because of the constant and isolating demands of caregiving. The progression of Alzheimer’s causes tremendous stress for the caregiver(s) and heartbreak for the entire family. To successfully survive the Alzheimer’s journey, caregivers must arm themselves with all the information, knowledge and skills available. Local organizations focusing on education, care and support of caregivers are an invaluable resource to caregivers. In this service area, Alzheimer’s Alliance Tri-State is the only organization focusing on the needs and concerns of caregiving. Resources for caregivers are available in many different forms, including workshops, conferences, printed materials, DVDs, assistive devices, one on one coaching/counseling, individualized training, support
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For more information on Alzheimer’s disease please contact: Alzheimer’s Alliance of the Tri-State Area 100 Cypress StreetPO Box 7812 office: 903.223.8021 toll free: 877.312.8536
Caregiver by Linda Nickerson
groups, home assistance and respite care. While respite may be a new word for some people, it is not a new phenomenon: it emerged late in the 1960’s with the deinstitutionalization movement. One of the most important principles of this movement was the belief that the best place for a loved one with special needs was in the home and community. Families with loved ones with a special need know the commitment and intensity of care needed. The level of dedication and care becomes part of daily life, part of the family routine, but this same commitment can make stress routine also. Caregivers can become accustomed to having no time for themselves or other family members. The need for support in general and respite in particular has emerged as one of the important issues to be addressed by policymakers, service providers, and researchers in the field of disability support services. Respite care is an essential part of the overall support that families need to keep their loved one with a disability or chronic illness at home. Respite care is temporary care to persons with disabilities or special health care needs, including individuals at risk of abuse or neglect, or in crisis situations. Temporary means anything from an hour to two weeks. It may mean periodically or on a regular basis. It can be provided in the family’s home
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or in a variety of out-of-home settings. Respite services are intended to provide assistance to caregivers and to prevent “burn-out” and family disintegration. Since not all families have the same needs, respite care should be geared to individual family needs by identifying the type of respite needed and match the existing need to services currently available. Once identified, it is also important for families to have access to that type of respite in an affordable form. Regardless of the type of respite program utilized, the emphasis should be on orienting services toward the entire family. The following quote is from a caregiver’s point of view and experience with respite care: “Did we need respite? You bet we did. This was particularly important when caring for a loved one with special needs such as Alzheimer’s. “During this time either my husband or I always had to be with Dad while the other ran errands, did the grocery shopping, or attend to family needs. Our friends disappeared from our lives, and our relatives lived far away. The world of normal family life in which family members live, work, play together and take joy in each other’s accomplishments, activities and outing vanished. Our respite time was the most wonderful gift we could have given our family. It was truly a blessing. It gave us an opportunity to stand outside the situation and view it from a distance. It enabled us to spend time with others and
with each other, review what had gone on before, to put things into perspective, to think and to plan. We were physically and emotionally restored, and were able to go with much more strength.” Respite is most frequently identified as the primary need for families who have family members, children or adults requiring support services. Respite can be a help for your whole family….each member may benefit from the support respite care services can provide. It means more time with other family members and a chance to have some time to yourself, something everyone needs now and then. Our Place Day Respite Center in Texarkana is a program of Alzheimer’s Alliance Tri-State designed to provide much needed rest and relief for
caregivers of persons with Alzheimer’s and related dementias. It also provides socialization for those diagnosed with the disease. Our friends benefit from the socialization and cognitive stimulation of being in a safe, supportive, engaging environment where they can interact with others while participating in enjoyable activities designed to match personal abilities and needs. Activities and programs are designed to brighten their day by revitalizing the joys, accomplishments, strengths and comfortable habits of the past and present in a homelike environment. Caregivers are provided with peace of mind knowing their loved one is spending the day in a safe environment and engaged in worthwhile activities
with compassionate, trained volunteers and staff. As a caregiver, first and foremost, take care of yourself. Your loved one needs you. You need to stay healthy both physically and mentally. Providing the care you give is the hardest yet most rewarding endeavor you will experience. With over 15 years of experience both professionally and personally with Alzheimer’s disease, it is my personal mission to help resolve the daily challenges faced by families coping with Alzheimer’s disease. By helping caregivers, we can make life better for those with the disease. -Linda Nickerson
1008 Citizens Trail Texarkana, TX 75503 903 838 9526 “If it hadn’t been for Ross & Shoalmire… I just don’t think I could have made it” “There is a huge difference from an elder law attorney and just an attorney…you must understand the difference. - You are in the BEST of hands when working with Ross & Shoalmire!!” -Emily Sabo
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Ray Johnson 903 280 2897 Amber Lawrence 903 276 5833
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Housing & Lifestyle
All about Home Health Care by Fair Shae Guest, RN
Home Health Care is a personal and private form of care provided in the comfort of a patient’s home. Each patient is assessed and then an individual plan of care is developed according to the patient’s needs. Since the care is provided in the comfort of the patient’s own home, the health care provider is able to improve the patient’s health while also making the patient more independent. Since time spent in the hospital is expensive, making it a burden to patients and their families, the primary goal of Home Health Care is to provide quality medical support at home in order to avoid spending a superfluous amount of time in the hospital. This is accomplished by educating both the patient and caregivers on how to properly attend to medical needs at home. The patients and the families are very involved in the treatment plan developed for the patient, which includes education for the patient, family, and caregivers. Educating the patient is a vital part of home health that must be accomplished in order for the patient to remain independent. There are many skilled treatments offered by home health care. All of the treatments provided must be ordered and directed by the patient’s physician. Each skilled treatment is provided by a highly skilled and trained professional. Services offered are Nurses, Physical Therapists, Occupational Therapists, Speech/Language Pathologists, Home Health Aides, Medical Social Workers and Dietitians. Skilled Nursing is offered by registered nurses and licensed vocational nurses. Nursing care is provided for all types of medical conditions and needs. The nurse implements a plan of care, under physician supervision, with the input of all other skilled providers according to the needs of the patient. This plan is followed and amended as needed according to changes in the patient’s condition. Some of the skills that a nurse may perform with a patient include wound care, diabetic teaching, education of disease processes and ostomy care and education. Physical Therapy is offered by physical therapists and assistants. Physical therapy is provided for patients who need assistance in regaining physical function and range of motion. Some activities that a physical therapist may perform with a patient include gait training, assistance
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with medical equipment, artificial limbs and pain control. Physical therapists also perform a safety evaluation and educate the patient regarding safety measures. Occupational Therapy is offered by occupational therapists and assistants. Occupational therapy is provided for patients who need to learn new ways to perform activities of daily living and upper body strengthening. Some of the activities of daily living that are addressed by an occupational therapist include personal care, eating, dressing, toileting and meal preparation. Speech Pathology is offered by speech pathologists. Speech therapy is offered to patients who have difficulty with speech and communication, cognitive skills and eating or swallowing. Speech therapy usually includes an extensive evaluation to gather all of the information needed for the proper treatment plan. Sometimes the patient has a swallow study performed in the home. Home Health Aides are provided to patients on a temporary basis when the patient is unable to perform activities of daily living including bathing, dressing, meal preparation, grooming and light housekeeping. Home health aides must be provided under the care of a licensed professional. Patients who receive home health aide services are taught ways to perform the needed activities so that they can return to their independence. Medical Social Workers are provided to patients and families who need assistance with issues involving their care. Some of the issues addressed are community programs available, assistance with wills, power of attorney and out of hospital DNR.
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Texarkana: Held Every Fourth Thursday of the Month from 8:30 - 10:00 am at Trinity Baptist Church ◉ 3115 Trinity Blvd. Paris: Held Every First Tuesday of the Month from 8:30 - 10:00 am at Calvary UMC ◉ 3105 Lamar Ave. www.edwardjones.com
Markets Change. Are You Prepared? Dietitians are provided to patients who need assistance with nutrition and dietary needs. Many medical conditions can be improved with a proper diet. Durable Medical Equipment and Supplies that are assessed as a need by the licensed health care provider are requested to the physician. If the physician agrees, the medical equipment order is sent to a DME provider of the patient’s choice and delivered to the patient’s home. The DME’s trained staff will set up and educate the patient and caregiver on use of the equipment. Home health care is paid for by a number of payor sources. There are different requirements by each payor source in order for a patient to qualify for home health. Medicare is the largest payor source of home health care. Listed are the requirements in order for a patient to qualify for home health that will be paid by Medicare: services are determined medically necessary and ordered by a physician, the patient is homebound due to illness or injury and the patient needs part time or intermittent skilled
When you stop and look back at what’s happened in the markets, it’s easy to realize how quickly things can change. That’s why we should schedule some time to discuss how the market can impact your financial goals. We can also conduct a free portfolio review to help you decide if you should make changes to your investments and whether you’re on track to reach your goals.
Stop by or call today to schedule your free review.
Stephen L Gerrald, AAMS® Financial Advisor .
350 N Collegiate Dr Suite 300 Paris, TX 75460 903-784-6696
MKT-5163A-A-AD
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Housing & Lifestyle nursing care, physical therapy or speech language pathology. Occupational therapy, dietary and home health aides services are only covered if the patient is also receiving skilled nursing care, physical therapy or speech therapy. The patient must have a face-to-face visit with a physician 90 days prior to the admission to home care or 30 days after the admission to home care. Medicare Part A (Hospital Insurance) will pay for 100 home health care visits if the patient has had a hospital or skilled nursing facility stay of at least 3 days within the past 14 days. There are no co-payments. Medicare Part B (Medical Insurance) will pay for home health care visits when the patient has not had a qualifying hospital or skilled nursing facility stay or the patient requires more that the 100 visits paid by Medicare Part A. If the patient has only Part A or Part B, all of the home health visits will be covered by the Part that the patient has. Medicaid also pays for home health depending on which type of Medicaid the patient has. The Medicaid provided services are limited to skilled nursing, physical therapy, occupational therapy and home health aide services. Patients who are private pay can pay for home health services as well. Private Insurance may pay for home health services if offered by the patient’s plan. These are each on an individual basis. Qualifications for home health services paid by private insurance are all based on the patient’s individual health plan. Patients may contact their insurance company to verify if home health is covered. Most insurance companies require a co-pay for services offered. Many people of all ages use home health care. Some examples of when a person may need home care are as follows: a patient who is discharged from a hospital or skilled nursing facility who is not fully recovered, patients with acute/chronic conditions such as diabetes, COPD, wound care, cancer, kidney disease and HTN that require frequent monitoring by a skilled health care provider or that can no longer meet their needs alone, patients who have limited mobility who needs assistance with ADLs and patients who need education of a new disease process and how to remain independent with their care. Home Health Care allows patients to remain in their own homes and live independently even if they have medical issues. It also allows for patients to be discharged home to their own environment even when they are not fully recovered. The licensed professionals provided by home health care can be the “eyes and ears” of the patient’s physician. Home health care can postpone a patient from being placed in a nursing home or other facilities and also assists the patient’s family in efforts to care for a patient at home. Home health care is much more cost efficient than hospital and nursing facility stays. Most of all, home health care allows the patient to be proud and independent. Choosing a home health care provider can be difficult
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for patients and their family members. Research done before choosing a home health can be proven to be time well spent. A patient has the right to choose any home health provider that is qualified to meet their needs. Patients who have managed care or private insurance may be limited to those agencies that are enrolled with that plan. Here are a few topics that should be considered when choosing an agency: how long has the agency been in business, are they qualified to meet the patients needs, does the physician know the agencies reputation, is the agency able to provide literature regarding the services offered, how does the agency select their employees and ensure that they are well educated and professional, does the agency care for anyone that the patient may know so that a reference check may be performed and is the agency associated with any organizations. When selecting an agency, make a visit to that agency’s office to assess the neatness, cleanliness and organization of the office staff and employees. A patient may schedule an interview of the nurse who would be providing their care, prior to selecting the agency to make sure they are making the right decision. If a patient is unsure if they qualify for home health, they should contact the agency of their choice and discuss with their physician. Home Health Care provided in the patient’s home is most successful when the patient, licensed professional, patient’s physician, family and caregivers are all involved in the treatment plan for the patient. Home health is designed to keep the patient out of the hospital or facility and assist them in returning to their independence to care for themselves in their own home. Information in this article was obtained from the Texas Association for Home Care and Hospice website at www. tahch.org. For more information regarding home health, you may contact TAHCH at (800) 880-8893.
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Fair Shae Guest, RN, Director of Care Coordination at Cypress Home Care with 14 years of nursing experience, 8 years in home health including case management, branch management & director of care coordination, also hospital & dialysis experience. Fair Shae lives in Pattonville, TX with husband Jerad Guest and their two children; McKenna and Brecken.
Let us help you put your financial house in order. Sometimes the things that are most important are the things easiest to put off. Like most people, maybe you could use some help getting your financial house in order. That’s where Citizens National Bank and our financial partners can help. The combined experience of CFG Citizens Financial Group Investments, and the Trust Department of Citizens National Bank can be a strong ally in helping you make the most of your future. Why wait? Call 903-657-8521 for an appointment today!
CFG Citizens Financial Group Investments Partners with
Danny Copeland
Vickie Boggio
Investment Executives
Gordon Northcutt Trust Administrator
CFG Citizens Financial Group Investments is a marketing name of Cetera Investment Services LLC, member FINRA/SIPC. Securities and insurance products offered through Cetera Investment Services LLC. Cetera Investment Services LLC is not affiliated with the financial institution where investment services are offered. Investments are: • Not FDIC insured • May lose value • Not financial institution guaranteed • Not a deposit • Not insured by any federal government agency. Aging Insight® 31
Financial Facts
Retirement Planning & Long-Term Care
No retirement plan is complete without a plan for long-term care. For many seniors, it is the only thing they have not planned for that could completely wipe out their entire life’s work and retirement savings. Long-term care is the term used to describe a variety of services in the area of health, personal care, and social needs of persons who are chronically disabled, ill or infirm. Depending on the needs of the individual, longterm care may include services such as nursing home care, assisted living, home health care, or adult day care. Long-term care is not just for the elderly. Of those receiving long-term care today, over 40% are under the age of 65. Here are some interesting statistics: the odds of your home burning are down in your lifetime is about three out of 100(30%), but nearly every homeowner has homeowners insurance. The odds of you totaling your car during your lifetime are about 18 out of 100(18%), yet most responsible automobile owners carry auto insurance. The odds that you will need some form of long-term care during your lifetime are about 72 out of 100(72%). 32
However, less than 30% of Americans over age 45 have purchased long-term care insurance. An even more alarming statistic shows that two out of three (67%) of single people and one out three (33%) of married people exhaust their savings after just 13 weeks in a nursing home. Within two years 90% will be bankrupt. To make matters worse by the year 2030, the average cost of one year nursing home care is expected to be about $207,000. Medicare Supplement Plans or long-term Disability plans are not designed to cover expenses for ongoing long-term care services. Medicare pays for a limited amount of skilled care to help you recover from an acute condition as long as you are improving. It has limited benefits for custodial care for short periods of time. Medicaid is a welfare program funded by federal and state governments, designed to provide health care for the truly impoverished. For most people providing for long-term care is a choice between paying out of pocket, depending on family members or buying long-term care insurance. Most people prefer to live at home as long as possible
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and go to a nursing home only when necessary. Longterm care insurance for most people is the best choice. It could be the only thing that allows them to stay at home while receiving care. You cannot just buy a long-term care policy. You have to qualify for it with your health. You cannot wait until you have a serious medical condition or you are unable to take care of yourself. The time to consider long-term care insurance is when you are in good health. For that reason most people apply for long-term care insurance between the ages of 45 to 65. No retirement plan is complete without thinking about and planning for long-term care. For many people the best choice is Long-Term Care Insurance. *Footnotes: Kaiser Commission on Medicaid and the Uninsured Medicaid and long-term care services and Supports, February 2009 The 2010 Sourcebook for Long-term care insurance, American Association for Long-term care insurance, data by Millman Consulting(2010) Long-term Care Insurance: Protection for Your Future. American Council of Life Insurers. Washington, D.C. 2007. American Association for long-term Care Insurance, 2008 LTCI Sourcebook **Disclaimer: This information is for educational purposes only. You should contact your own tax or legal advisor for advice regarding your personal circumstances.
Larry Oxford is a native of Texarkana and has been in the insurance and financial services business for over 40 years. He has a BBA from the University of North Texas and holds three professional designations ChFC, CLU, and CPCU. Mr. Oxford is involved in the community serving on the board of Texarkana Area Community Foundation and is past president of TISD board of trustees, Wilbur Smith Rotary Club, and Four States Association of Insurance and Financial Advisors. He is married and has two grown sons, on eikn Dallas and one in Nashville Tennessee.
Non-profit since 1985.
803 Spruce St. Texarkana, TX 75501
3605 Jefferson Ave. Texarkana, AR 71854
903.794.4263 870.216.0046
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Advance Funeral & Cemetery Planning Bereavement Travel Compassion Helpline® National Transferability For your Personal Planning Guide or more information, please call us today.
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602 Olive Street, Texarkana, TX 75501 2807 Moores Lane, Texarkana, TX.75503 903-793-3141| eastfuneralhome.com www.prepaidfunerals.texas.gov THE DIGNITY MEMORIAL NETWORK: AMERICA’S LEADING FUNERAL HOMES, UNITED TO BRING YOU THE SERVICES YOU NEED WHEN IT MATTERS MOST.
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Financial Facts
Preparing for
Peace of Mind in Retirement (BPT) - Everyone’s vision for retirement is different - for some it involves trips across the globe, while for others it means relocating to a new city or picking up a new hobby. Regardless of what your retirement goals might be, preparing to achieve them financially should include a plan that anticipates both the expected and unexpected events and expenses that may arise before or after leaving the workforce. Planning for retirement is challenging - only 46 percent of Americans feel certain that they will be able to afford the essential expenses after retirement, according to a survey by Ameriprise Financial. Breaking retirement planning down into simple steps, as shown in the new Confident Retirement(R) approach recently introduced by Ameriprise Financial, can be an easy way for those nearing - or in retirement to begin planning. The approach takes into account four fundamental areas:
guaranteed or stable income (e.g. Leaving a legacy. social security or a defined benefit After accounting for essential and plan, among other options). anticipated lifestyle expenses, and preparing for potential unexpected Ensuring your lifestyle. expenses, create a legacy plan In addition to covering the essentials, for any of your remaining assets. many people have lifestyle goals they Having a plan in place for your want to pursue such as travelling, loved ones and the causes that are or learning a new skill or hobby. important to you is a key part of Developing a strategy that can help planning for the future and will cover the expenses that come with give you control of your assets in these goals can help you feel more your golden years. -It is important to recognize the possibility that as confident about achieving them. you age, your physical and mental health could decline. To help ensure that your assets are used according to your wishes, consider working with an attorney who can advise on, and prepare legal documents such as a health care directive and power of attorney. Also make sure your beneficiary designations are up to date and that you begin putting an estate plan in place.
Covering essentials.
Unanticipated events such as a catastrophic medical event or chronic illness, supporting a family member and loss of a spouse can have a devastating impact on retirement plans and goals. Developing a plan to cover the unexpected can help you navigate these bumps on the way to your financial goals.
The foundation of any retirement strategy, essential expenses, includes ongoing necessities such as food, housing, taxes and some medical expenses. Economic conditions may always be a little uncertain and as a result, your goal should be to fund essential expenses with sources of 34
Preparing for the unexpected.
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The Confident Retirement approach uses the four principles outlined above as a framework to help advisors work with their clients toward their retirement goals. It’s never too early - or too late - to start preparing for retirement. Consider working with a financial professional to define and work toward your unique retirement goals. For more information, visit Ameriprise.com.
EDITOR’S NOTE:
The Retirement Check-In survey was created by Ameriprise Financial utilizing survey responses from 1,000 employed Americans ages 50-70. All respondents have investable assets of at least $100,000 (including employer retirement plans, but not real estate) and are planning to retire at some point. The survey was commissioned by Ameriprise Financial, Inc. and conducted via telephone interviews by Koski research from October 31-
November 14, 2012. Guarantee, as used in this material, depends upon the ability of the issuing entity to honor and pay the amount you may be entitled to. U.S. Government bonds are backed by the full faith and credit of the U.S. Government. Certificates of deposit are FDIC-insured up to $250,000 per depositor. Insurance and annuity products are not governmentinsured, and are backed only by the continued claims paying ability of
the issuing company. It is possible that an issuing entity may not be financially able to meet income guarantee obligations. Confident Retirement is not a guarantee of future financial results. Brokerage, investment and financial advisory services are made available through Ameriprise Financial Services, Inc. Member FINRA and SIPC.
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PAID ADVERTISEMENT Heal-In at Windsor Cottage
Natural Living… Natural Healing By Penny Compton
Once upon a time, natural living and healing were a natural part of family life. Changing times often creates greater stress for our senior relatives and friends as they use more energy and resources taking care of their daily living needs. Natural living can progressively become too difficult to maintain without assistance. Windsor Cottage is a privately owned assisted living facility that has created an intimate style atmosphere for the feeling of being home. Windsor Cottage encompasses all of the elements for its residents to experience life, happiness, and longevity in their retirement years. This peaceful, idyllic setting strives to provide the support to be comfortable, socially engaged, optimally healthy, and active. Being home at Windsor Cottage means you are assisted by the strength and wisdom of an experienced and loving longterm staff member. Windsor Cottage provides independent living with the ability to age-in-place. Management and staff are passionate about the importance of choices in this community-based setting, just like each person makes choices in their own home. Residents also enjoy helping with special event decorations and voting on special menus. Administrator Melissa Green smiles warmly as she walks through the French doors waving a list. “The residents have chosen bacon -wrapped chicken fillets in cream sauce,” she said. Plans are now being discussed for another activity room to host special home kitchen activities.
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This team enjoys working together to provide independent retirement living wholeheartedly supporting the residents need for quality of life. Delicious nutritional smoothies made from whole foods are also offered in addition to home-cooked meals made from scratch each day. These smoothies return us to the basics of natural food healing. Made with fresh fruit, vegetables, and coconut oil, smoothies provide phytochemicals as well as vitamins and minerals which support and enhance physical and mental vitality. Wellness visits from Jan McCabe, RN offer one-on-one time to residents. Energy treatments are both relaxing and promote improved balance. McCabe has over a decade experience in energy work and over 25 years in conventional care. She actively promotes wellness activities with an understanding of traditional pathology. “Our residents are free to enjoy many different activities without worrying about painting the house or mowing the yard. We take care of those details,” said Carla Hill Assistant A d m i n i s t r a t o r. We provide the safety and security according to the individual needs of each person so they can enjoy life.” We have an in-house
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4110 Jefferson Avenue │ Texarkana, AR 71854 Phone: 870-773-0417 www.livethedifference.us beauty shop with spa pedicure. We offer organic gardening, covered patio area, and walking path. In addition to these amenities, the library area provides a place to read and relax or enjoy music. As if on cue, a local chorus and piano player arrive to provide entertainment to the delight of residents filling the comfortable living area. “It’s home-living, not hotel-living… and love,” says one of our residents. “Love is what brings it all together and makes it work.” Windsor Cottage offers age-inplace support including on-site church services and other daily activities. Sitter services are also available through Senior Living Services. Sitters may be scheduled for special needs such as appointments, temporary illnesses or 24/7 companionship. Begin to live the difference! Call Melissa or Carla today at 870-773-0417 to schedule a convenient appointment. They will show you around the lovely campus with private accommodations both studio and suites. You are also invited to join us for a home cooked meal. Windsor Cottage may be exactly what you or someone you know is looking for.
Resource Directory
2014 Resource Directory Our convenient directory is broken into 8 categories and then alphabetized by city.
Adult Daycare EL DORADO, AR Elder House Day Care
615 W. Cedar
El Dorado, AR 71730
870-875-1711
311 W. Main
Magnolia, AR 71753
870-234-4530
Pace Opportunities Center
106 Morgan St.
Mt. Pleasant, TX 75455
903-717-8951
The Covenant House
106 S. Johnson Ave.
Mt.Pleasant, TX 75455
866-291-3017
Opportunities, Inc.
6101 North Stateline
Texarkana, TX 75503
903-791-2270
Our Place Respite Care Center
100 Memory Lane
Texarkana, TX 75503
903-223-8021
MAGNOLIA, AR The Caring Place of Magnolia MT. PLEASANT, TX
TEXARKANA, TX
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Resource Directory
Assisted Living Services ASHDOWN, AR Pinecrest Retirement Lodge
2048 Rankin St.
Ashdown, AR 71822
870-898-8383
1102 S. William St. #143
Atlanta, TX 75551
903-796-6300
500 W. 23rd St.
Hope, AR 71801
870-777-8655
Heritage Park Village
1714 N.Edwards Ave
Mt.Pleasant, TX 75455
903-577-0759
Mt. Pleasant Assisted Living
2007 N. Edwards Ave
Mt.Pleasant, TX 75455
903-572-8123
Mt. Pleasant Hospitality House
804 West 16th St.
Mt.Pleasant, TX 75455
903-572-9893
ATLANTA, TX Wesley House of Atlanta HOPE, AR Hope Haven Retirement Home MT. PLEASANT, TX
PARIS, TX Paris Oaks 2905 N. Main Paris, TX 75460 903-784-3243 Pine Tree Ranch Assisted Living
2990 Pine Mill Rd.
Paris, TX 75460
903-783-0652
Spring Lake Assisted Living
750 N. Collegiate Drive
Paris, TX 75460
903 785-1110
Sterling House of Paris
2410 Stillhouse Rd.
Paris, TX 75462
903-784-8800
SULPHUR SPRINGS, TX Hopkins House
890 Camp St.
Sulphur Springs, TX 75482
903-439-1202
Wesley House Assisted Living
1044 Church St.
Sulphur Springs, TX 75482
903-439-0529
TEXARKANA, AR The Gardens
1625 E. 42nd St.
Texarkana, AR 71854
870-772-0689
Winsor Cottage
4110 Jefferson St.
Texarkana, AR 78154
870-773-0417
Colonial Lodge Assisted Living
5001 Elizabeth St.
Texarkana, TX 75503
903-792-0838
Cornerstone Assisted Living
4100 Moores Lane
Texarkana, TX 75503
903-832-5515
Independent Living Center The Magnolia
3120 Smith St.
Texarkana, TX 75503
903-831-3911
4205 Richmond Meadows
Texarkana, TX 75503
903-838-7319
The Oaks Assisted Living
4317 McKnight Rd.
Texarkana, TX 75503
903-838-5001
The Retreat at Kenwood
210 N. Kenwood
Texarkana, TX 75501
903-336-6134
Sterling House
4204 Moores Lane
Texarkana, TX 75503
903-838-3562
Whispering Pines
5002 Elizabeth St.
Texarkana, TX 75503
903-792-8014
TEXARKANA, TX
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Resource Directory
Geriatric/ Behavioral Health Facilities GREENVILLE, TX Glen Oaks Hospital
301 East Division
Greenville, TX 75401
800-443-1109
Greenville, TX 75401
903-408-1500
Hope AR 71801
870-722-2420
1301 East Lincoln Rd.
Idabel, OK 74745
580-286-7623
615 Clinic Drive75605
Longview TX 75605
903-212-3105
311 Morrow St.
Mena, AR 71953
888-394-7300
820 Clarksville St.
Paris, TX 75460
903-737-3491
2601 Cornerstone Drive
Sherman, TX 75090
903-416-3000
1006 Highland Ave
Shreveport, LA 71033
318-678-7500
Hunt Regional Medical Behavioral 4215 Joe Ramsey Blvd. HOPE, AR Golden Care at Wadley Hope Hosp. 2001 South Main St. IDABEL, OK McCurtain Memorial Gero Psych LONGVIEW, TX Audubon Behavioral Health MENA, AR Mena Senior Behavioral Health PARIS, TX Senior Transitions at PRMC SHERMAN, TX TMC Behavioral Health SHREVEPORT, LA Brentwood Hospital TEXARKANA, AR
Riverview 701 Arkansas Blvd Texarkana, AR 71854 870-772-5028 TEXARKANA, TX Wadley Behavioral Health
1000 Pine St.
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Texarkana, TX 75501
903-798-7300
39
Resource Directory
Home Health Services ASHDOWN, AR Hospital HH
450 W. Locke St. # A
Ashdown, AR 71822
870-898-4120
Atlanta Memorial Home Health
106 N. East St.
Atlanta, TX 75551
903-799-3000
Kelton HH
102 C. West Hiram St
Atlanta, TX 75551
903-796-4040
ATLANTA, TX
BAGOTA, TX Lewis HH 157 N Main Bagota, TX 75417 903-632-2173 CLARKSVILLE, TX Country Home Care
1505 West Main St.
Clarksville, TX 75426
903-427-8366
Cypress HH
389 US Hwy 82 West
Clarksville, TX 75426
903-427-4598
DEKALB, TX Cypress HH 111 Bowie St. Dekalb, TX 75559 903-667-4588 DEQUEEN, AR Amedysis Home Health
307 West Stillwell Ave.
DeQueen, AR 71832
870-642-4214
Cypress HH
111 Northeast Bowie St.
DeQueen, AR 71832
870-667-4588
431 West Oak
El Dorado, AR 71730
870-862-2631
104 W. Cass St
Gilmer, TX 75644
903-843-2841
EL DORADO, AR South Arkansas Home Care GIILMER, TX First Choice HH
Kingsman HH 102 Buffalo St Gilmer, TX 75644 903-680-2220 Heritage HH
100 E. Jefferson St, Ste 3
Gilmer, TX 75644
903-680-2349
Hospital HH
1615 N.Harvey St
Hope, AR 71801
870-722-2025
Hempstead HH
100 E. 20th St# E
Hope, AR 71801
870-777-9424
Gentiva Home Health
804 E. Jackson
Hugo, OK 74743
580-326-8376
Millinium HH
1090 US Hwy 271
Hugo, OK 74743
580 317-8079
35 FM 250 S
Hughes Springs, TX 75656 903-639-1011
124 North Main St
Linden, TX 75563
HOPE, AR
HUGO, OK
HUGHES SPRINGS, TX Advantage HH LINDEN, TX Cypress HH 40
www.AgingInsight.com
903-756-8895
Resource Directory
MT. PLEASANT, TX At Home HH
806 N. Jefferson Ave.
Mt. Pleasant, TX 75455
903-577-9877
Chambers HH
801 N. Madison Ave.
Mt. Pleasant, TX 75455
903-572-9700
Cypress HH
1318 S. Jefferson
Mt. Pleasant, TX 75455
903-577-5111
412 Hwy. 37 South
Mt. Vernon, TX 75457
903-537-2445
Howard County Health Unit Howard County Hospital HH
201 E. Hempstead St.
Nashville, AR 71852
870-845-2208
220 South 2nd St.
Nashville, AR 71852
870-845-5118
Southwest Ark HH
900 W. Leslie St. #4
Nashville, AR 71852
870-845-8206
312 North Center St
New Boston, TX 75570
903-628-7807
At Home HH
2775 NE Loop 286
Paris, TX 75462
903-785-5467
Critical Provisions
1705 E. Houston St.
Paris, TX 75460
903-739-9090
Cypress HH
5020 Loop 286 SE
Paris, TX 75460
903-737-8727
First Choice HH Guardian Homecare
1651 Clarksville St.
Paris, TX 75460
903-739-2616
3158 Clarksville St.
Paris, TX 75460
903-737-9865
Jordan Health Services
3745 Lamar Avenue
Paris, TX 75460
903-785-4326
MT. VERNON, TX Jordan Health Services NASHVILLE, AR
NEW BOSTON, TX Cypress HH PARIS, TX
Mays HH 385 Stone Ave. Paris, TX 75460 903-785-6297 On-Call HH
135 N. Collegiate Dr.
Paris, TX 75460
903-784-6300
Platinum Home Health
140 S. Collegiate Dr.
Paris, TX 75460
903-739-8070
Premier HH 2160 Lamar Ave. Paris, TX 75460 903-737-9010 Red River HH
6345 Lamar Rd.
Paris, TX 75462
903-785-4070
Signature HH 420 N. Collegiate Paris, TX 75460 903-785-4900 SULPHUR SPRINGS, TX Cypress HH
1304 Church St.
Sulphur Springs, TX 75482 903-438-8400
Cooper HH
121 Oak Ave.
Sulphur Springs, TX 75482 903-885-5606
Exceptional Home Health
1330 Church St.
Sulphur Springs, TX 75482 903-885-5566
First Choice Homecare
1091 Church St.
Sulphur Springs, TX 75482 903-439-4773
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Resource Directory
TEXARKANA, AR Hospital HH
1305 Arkansas Blvd. #101
Texarkana, AR 71854
870-898-4920
Integrity Home Health
East 9th Street, Suite 12
Texarkana, AR 71854
870-773-4900
Jordan Health Services
4425 Jefferson Ave.
Texarkana, AR 78154
870-772-0958
Miller County HH 503 Walnut Texarkana, AR 71854 870-773-2108 Southwest Arkansas HomeCare
132 Medical Cir.
Texarkana, AR 71854
870-845-8206
At Home HH
5495 Summerhill Rd.
Texarkana, TX 75503
903-792-3006
Bethany Home Health
3002 Moore’s Lane
Texarkana, TX 75503
903-793-2447
Christus Homecare
1400 College Dr. Ste. 201
Texarkana, TX 75503
903-255-5100
TEXARKANA, TX
Cypress HH 5520 Christus Dr. Texarkana, TX 75503 903-832-2728 Encompass HH
5331 Summerhill Rd.
Texarkana, TX 75503
903-793-0264
Guardian Homecare 5401 Plaza Dr. Texarkana, TX 75503 903-255-0782 Healthsouth Texarkana Home Care 515 W. 12th Street
Texarkana, TX 75501
903-735-5070
Homebound HH
1705 N.Bishop St.
Texarkana, TX 75503
903-838-4941
Healthback HH
2501 Summerhill Rd.
Texarkana, TX 75501
903-793-0282
Heritage HH 4939 Elizabeth St. Texarkana, TX 75503 903-793-4900 Jordan Health Services
600 W. 16th St
Texarkana, TX 75503
903-794-3102
Mays HH 4144 McKnight Rd. Texarkana, TX 75503 903-334-6980 Regency HH 3002 Moores Lane Texarkana, TX 75503 903-793-2447 Theracare HH 3501 Stoneledge Texarkana, TX 75503 903-832-4663 WINNSBORO, TX Cypress HH
42
1005 E. Coke Rd.
Winnsboro, TX 75494
www.AgingInsight.com
903-342-3232
Resource Directory
ASHDOWN, AR
Hospice Services
Little River Hospice
450 W. Locke St.
Ashdown, AR 71822
870-898-4105
Kelton Hospice MAGNOLIA, AR
301 West Main St.
Atlanta, TX 75551
903-796-3030
Serenity Hospice
1316 Main St. Ste# 102
Magnolia, AR 71753
870-901-0500
Cypress Basin Hospice, Inc.
207 Morgan
Mt. Pleasant, TX 75455
903-577-1510
Heart to Heart Hospice
201 W. 20th St.
Mt.Pleasant, TX 75455
903-575-9111
201 E. Hempstead St.
Nashville, AR 71852
870-845-2058
Cypress Basin Hospice
707 Lamar Ave
Paris, TX 75460
903-905-4574
Heart To Heart Hospice
350 N. Collegiate Drive
Paris, TX 75460
903-737-0847
Legacy Hospice
3110 Lamar Ave.
Paris, TX 75460
903-784-1147
ATLANTA, TX
MT. PLEASANT, TX
NASHVILLE, AR Howard County Health- Hospice PARIS, TX
Mays Hospice 3057 Clarksville St. Paris, TX 75460 903-739-2427 Platinum Palliative & Hospice Care 140 S. Collegiate #100 Paris, TX 75460 903-783-1818 Premier Hospice 750 Clarksville St. Paris TX 75460 903-737-9010 Waterford Hospice
420 N. Collegiate
Paris, TX 75460
903-785-1800
950 Main St.
Sulpher Springs, TX 75482 903-951-1194
Dierksen Hospice
4425 Jefferson Blvd.
Texarkana, AR 71854
870-773-4353
Hospice of Texarkana
501 East 6th St.
Texarkana, AR 71854
870-216-0046
Serenity Hospice
210 N. Stateline # 301
Texarkana, AR 71854
870-773-2621
SULPHER SPRINGS, TX Cypress Basin Hospice TEXARKANA, AR
TEXARKANA, TX CIMA Hospice 3505 Summerhill Rd. Texarkana, TX 75503 903-794-2462 Dierksen Hospice 6500 Summerhill Rd. Texarkana, TX 75503 903-793-6350 Heritage Hospice 4939 Elizabeth Texarkana, TX 75503 903-792-0716 Hospice of Texarkana 803 Spruce Texarkana, TX 75501 903-794-4263 Serenity Hospice
5604 Summerhill Rd. #3 Aging Insight速
Texarkana, TX 75503
903-255-0430
43
Resource Directory
Independent Living Services
I
DABEL, OK
IDABEL, OK Colonial Lodge Independent Cntr. 1307 SE Adams St.
Idabel, OK 74745
580-286-3757
PARIS, TX Colonial Lodge Ret. Community
4530 Lamar
Paris, TX 75462
903-785-8877
Golden Acres Ret. Community
3414 Clarksville St.
Paris, TX 75460
903-739-2739
Paris Retirement Village
1400 W. Washington St.
Paris, TX 75460
903-737-0736
The Residences on Stillhouse Rd.
2810 Stillhouse Rd.
Paris, TX 75462
903-785-4074
Arbor Point Apartments
600 Oats St.
Texarkana, AR 71854
903-216-2300
Housing Opportunities
600 E 43rd
Texarkana, AR 71854
903-791-2297
TEXARKANA, TX Cornerstone Ret. Community
4100 Moores Lane
Texarkana, TX 75503
903-832-5515
Cowhorn Creek Estates
5415 Cowhorn Creek Rd.
Texarkana, TX 75503
903-223-6666
The Oaks Independent Living
4317 McKnight Rd.
Texarkana, TX 75503
903-824-8823
The Palms
4913 Elizabeth St.
Texarkana, TX 75503
903-293-0650
Winfield Estates Apartments
3535 S. Lake Dr.
Texarkana, TX 75501
903-792-1062
TEXARKANA, AR
“The best source for elder care information in the Ark-La-Tex!”
Tune in to 107.1 FM Saturdays from noon to 1:00 pm.
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Hosted By John Ross & Lisa Shoalmire Sponsored by: Advantage Senior Care, Barnette Agency, Inc., Christus Health, Cowhorn Creek Estates, Curt Green & Co., Dierksen Memorial Hospice, Edgewood Manor, Flanagan Financial Group, Guaranty Bond Bank-Guaranty Trust Wealth, Texarkana Funeral Home, Riverview Behavioral Health & Lonny Winters Financial Advistor
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Resource Directory
Long-Term Care & Rehab ARKADELPHIA, AR Courtyard Gardens Health & Rehab 2701 Twin Rivers Dr.
Arkadelphia, AR 71923
870-246-5566
Twin Rivers Health & Rehab
3021 Twin Rivers Dr.
Arkadelphia, AR 71923
870-246-6337
Little River Health & Rehab
418 N. 2nd St.
Ashdown, AR 71822
870-898-5101
Pleasant Manor
950 Homestead Dr.
Ashdown, AR 71822
870-898-5001
ASHDOWN, AR
ATLANTA, TX Golden Villa 1104 S.William St. Atlanta, TX 75551 903-796-0290 Rose Haven
200 Live Oak Dr.
Atlanta, TX 75551
903-796-4127
Broken bow Nursing Home
700 Jones St.
Broken bow, OK 74728
580-584-6433
McCurtain Manor
1201 Dierks St .
Broken bow, OK 74728
580-584-9158
Clarksville Nursing Home
300 East Baker St.
Clarksville, TX 75426
903-427-2236
Regency Nursing Home
2407 US Hwy 82 West
Clarksville, TX 75426
903-427-3821
507 E. Watson Rd.
Daingerfield, TX 75638
903-645-3915
12520 FM 1840
DeKalb, TX 75559
903-667-2572
126 Hwy 271 S
Deport, TX 75435
903-652-4410
322 W. Collin Ray Dr.
DeQueen, AR 71832
870-642-3562
402 Arkansas Ave.
Dierks, AR 71833
870-286-3100
Courtyard Rehab
2415 W. Hillsboro St.
El Dorado, AR 71730
870-875-2524
Grace Point Health & Rehab
1700 Short East Hillsboro St. El Dorado, AR 71730
870-862-5124
Hudson Memorial Nursing Home
700 N. College Ave.
El Dorado, AR 71730
870-863-8131
Oak Ridge Nursing & Rehab
501 Hudson St.
El Dorado, AR 71730
870-862-5511
Timberlane Health & Rehab
2002 S. Timberwood Dr.
El Dorado, AR 71730
870-863-8090
BROKEN BOW, OK
CLARKSVILLE, TX
DANGERFIELD, TX Windsor Place Nursing Center DEKALB, TX The Ponderosa/ Sunny Acres DEPORT, TX Deport Nursing Center DEQUEEN, AR Brookwood Nursing & Rehab DIERKS, AR Dierks Health & Rehab EL DORADO, AR
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Resource Directory
Long-Term Care & Rehab, Cont. GILMER, TX Bradford House
1704 N. Bradford St.
Gilmer, TX 75644
903-843-7601
Gilmore Care Center 703 Titus St. Gilmer, TX 75644 903-843-5529 Upshur Manor Nursing Home
623 State Hwy 155 North
Gilmer, TX 75644
903-797-2143
Legends Oaks Healthcare
2101 FM 2685
Gladewater, TX 75647
903-845-2175
Texan Nursing & Rehab
300 Money St.
Gladewater, TX 75647
903-845-2101
1303 E. Main
Honey Grove, TX 75446
903-378-2293
Heather Manor Nursing & Rehab
400 W. 23rd
Hope, AR 71801
870-777-3448
Laurel Place
1901 S. Laurel St.
Hope, AR 71801
870-777-8855
704 Taylor St.
Hughes Springs, TX 75656 903-639-2531
Thereon Grainger Nursing & Rehab 215 FM 161 S. Hughes
Hughes Springs, TX 75656 903-639-2561
GLADEWATER, TX
HONEY GROVE, TX Honey Grove Nursing Center HOPE, AR
HUGHES SPRINGS, TX Hughes Spring Nursing Center HUGO, OK Homestead Health & Rehab
1001 Heritage Way
Hugo, OK 74743
580-326-7771
Baptist Village of Hugo
1200 West Finely St
Hugo, Ok 74743
580-326-8383
Memorial Heights Nursing Center 1305 SE Adams St.
Idabel, OK 74745
580-286-3366
Hill Nursing Home
808 NW MLK Ave.,
Idabel, OK 74745
580-286-5398
Pine Hill Nursing & Rehab
1307 MLK Drive
Jefferson, TX 75657
903-665-3951
Magnolia Manor
510 E. Bonham St.
Jefferson, TX 75657
903-665-3903
1201 W. Houston St.
Linden, TX 75563
903-756-5537
Magnolia Health & Rehab
2642 N. Dudney Rd.
Magnolia, AR 71753
870-234-7000
Wentworth Place
26 Warnack Springs Rd.
Magnolia, AR 71753
870-234-1361
IDABEL, OK
JEFFERSON, TX
LINDEN, TX Linden Healthcare Center MAGNOLIA, AR
46
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Resource Directory
MARSHALL, TX Marshall Manor Nursing Center
1007 S. Washington Ave.
Marshall, TX 75670
903-935-7971
Greenhill Villas of Mt.Pleasant
2530 Greenhill Rd.
Mt.Pleasant, TX 75455
903-572-0974
Mt. Pleasant Healthcare
1606 Memorial St.
Mt. Pleasant, TX 75455
903-572-3618
Pleasant Springs Healthcare
2003 N. Edwards St.
Mt.Pleasant, TX 75455
903-572-5511
501 Yates St.
Mt.Vernon, TX 75457
903-537-4424
110 West 13th St.
Murfreesboro, AR 71958
870-285-2186
Minecreek Health & Rehab
1407 N. Main St.
Nashville, AR 71852
870-845-2021
Nashville Nursing Center
810 N. 8th St.
Nashville, AR 71852
870-845-4600
Sunbridge Care & Rehab of Omaha 205 Giles St.
Omaha, TX 75571
903-884-2358
Brentwood Terrace Health & Rehab 2885 Stillhouse Rd.
Paris, TX 75460
903-784-4111
Heritage House of Paris Health & Rehab Center
150 SE 47th St.
Paris, TX 75460
903-784-3100
Legend Healthcare & Rehab
520 SE 8th St.
Paris, TX 75460
903-737-9820
Paris Healthcare Center
610 Deshone Drive
Paris, TX 75462
903-784-6638
Stillhouse Rehabilitation & Healthcare Center
2900 Stillhouse Rd.
Paris, TX 75462
903-785-1601
123 Pecan Blvd.
Pittsburg, TX 75686
903-856-3633
Hillcrest Care and Rehab
1421 W. 2nd St. North
Prescott, AR 71857
870-887-3811
Prescott Manor Nursing Home
700 Manor Rd.
Prescott, AR 71857
870-887-6639
215 1st St. NE
Springhill, LA 71075
318-539-3527
826 North St.
Stamps, AR 71860
870-553-4444
MT. PLEASANT, TX
MT. VERNON, TX Mission Manor Nursing Center MURFREESBORO, AR Murfreesboro Nursing Center NASHVILLE, AR
OMAHA, TX PARIS, TX
PITTSBURG, TX Pittsburg Nursing Center PRESCOTT, AR
SPRINGHILL, LA Fountainview Care & Rehab STAMPS, AR Homestead Manor
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Resource Directory
SULPHUR SPRINGS, TX Carriage House Manor
210 Pipeline Rd.
Sulphur Springs, TX 75482 903-885-3589
Rock Creek Health & Rehab
1414 College St.
Sulphur Springs, TX 75482 903-439-0717
Sulphur Springs Health & Rehab
411 FM 2285
Sulphur Springs, TX 75482 903-885-7668
Bailey Creek Nursing & Rehab
1621 E. 42nd St.
Texarkana, AR 71854
870-774-3581
Linrock Nursing & Rehab
1100 E. 36th St.
Texarkana, AR 71854
870-773-7515
Arkansas Nursing & Rehab
2107 Dudley
Texarkana, AR 71854
870-772-4427
Christian Care Center
8 Robinson Place
Texarkana, TX 75501
903-838-9526
Cornerstone Nursing Center
4100 Moores Lane
Texarkana, TX 75503
903-832-5515
Edgewood Nursing & Rehab
4925 Elizabeth St.
Texarkana, TX 75503
903-793-4645
TEXARKANA, AR
TEXARKANA, TX
Heritage Plaza 600 W. 52nd St. Texarkana, TX 75503 903-792-6700 Reunion Plaza 1401 Hampton Rd. Texarkana, TX 75503 903-792-7994 Texarkana Nursing Center
4920 Elizabeth St.
Texarkana, TX 75503
903-792-3812
Waterton Plaza
5524 Cowhorn Creek Rd.
Texarkana, TX 75503
903-223-1188
Sitter / Provider Services PARIS On Call Elder Care
147 N. Collegiate Drive
Paris, TX 75462
903-905-4975
Visiting Angels of Paris
1849 Lamar Ave. #200
Paris, TX 75460
903-784-3902
4425 Jefferson St 112 T
Texarkana, AR 71854
888-423-8154
323 Hickory St.
Texarkana, AR 71854
870-774-0501
Advantage Senior Care
4116 McKnight Rd
Texarkana, TX 75503
903-280-7072
Home Care Assistance
2011 Mall Dr.
Texarkana, TX 75503
903-306-0335
Visiting Angels- Texarkana
2405 Moores Lane
Texarkana, TX 75503
903-831-5555
TEXARKANA, AR Superior Senior Care Senior Living Services TEXARKANA, TX
48
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Rehabilitation is all we do.
When you choose HealthSouth Rehabilitation Hospital of Texarkana for your recovery after an illness, injury or surgery, you’re choosing a higher level of care. That’s because rehabilitation is all we do, supported with the latest technologies, certified rehabilitation specialists and comprehensive programs to help patients reach maximum independence. • Physical, occupational and speech therapy departments • 24-hour registered rehabilitation nurses • Frequent physician* visits • Individual program with at least three hours of therapy a day, five days a week • Outpatient and home health services available for continued support When it comes to your rehabilitation, get the higher level of care you deserve. Call 903 735-5011
* HealthSouth provides access to independent private practice physicians, specializing in physical medicine and rehabilitation.
2006, 2010, 2011, 2012
The Joint Commission Disease-Specific Care Certification in Stroke Rehabilitation and Hip Fracture Rehabilitation
515 W. 12th Street • Texarkana, TX 75501 903 735-5000 healthsouthtexarkana.com ©2014:Healthsouth Corporation:477293-04
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Senior Day Center Opportunities Senior Day Center is designed to maintain independence for seniors and provide respite for family and caregivers. It is a cost effective alternative to longterm or in-home care. For almost 50 years, Opportunities has provided vital services in our community. The Senior Day Center offers families peace of mind. They feel secure in knowing that their loved one is receiving special care, in a spacious facility designed specifically for adult day care. Accessible transportation is also available to and from the Center. Seniors receive: • Nutritious meals • Exercise & wellness • Activities • Socialization • Medical monitoring • Caregiver respite • Family support • Transportation Opportunities Senior Day Services 6101 N Stateline Ave Texarkana, TX 75503
903.791.2286 www.oppinc.org
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