Aging Insight 2015 by Aging Insight

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INSIGHT

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2015 | Volume 3

Using Medicaid or VA to Pay for Long-Term Nursing Care

Powers of Attorney:

Resource GUIDE

The Most Complete DIRECTORY Around

The Most Important Document You Will Ever Sign

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id you know there are more people now on planet Earth over the age of 65 than there has ever been in the history of our world? Our modern age has made it possible for multiple generations of families to know and enjoy one another and for seniors to savor their retirement years without the burdens of backbreaking work. However, the joy of those retirement years can quickly vanish if a senior has an abrupt health crisis or illness. Suddenly, issues such as getting the right care and support, paying for such care and avoiding the nursing home, all while not being a burden on others, becomes a top priority for that senior. Also, a sudden health crisis can bring concerns about going broke to pay for needed care or concerns about preserving assets to pass down to the next generation We can help you think about and address these issues. Our goal is to help you plan, prevent and protect: •

Plan to live your retirement years on your terms, without unnecessary interference from others

•

Prevent institutional care if at all possible

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Protect your assets not only from the costs of probate and taxes, but from uncovered long term care and medical costs as well

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 long-term care needs 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!

John K. Ross IV is an Elder Law attorney and senior 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, serves as president for the Alzheimer’s Alliance Tri-State and serves on the board of directors for CHRISTUS St. Michael Rehabilitation Hospital. 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 98.5 FM Texarkana and the Aging Insight television program on KLFI-TV Channel 10 Texarkana. Lisa Shoalmire, J.D., M.Tax. a senior 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 quality of life for themselves or their loved ones. Lisa is also a member of the National Academy of Elder Law Attorneys. Lisa is the co-host of the Aging Insight radio program Saturdays from Noon to 1:00p.m. on 98.5 FM Texarkana and the Aging Insight television program on KLFITV Channel 10 Texarkana.

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Keep control of your assets, your plans and your life. Ross & Shoalmire, Elder Law attorneys and staff are here to guide clients through difficult decisions concerning health, housing, financial and legal issues. Our practice is devoted entirely to • • • • • •

• Advanced Directives Asset Protection • Probate Estate Planning • Powers of Attorney Wills • VA Benefits Trusts Guardianship Medicare/Medicaid Qualifications & Appeals

To learn more about avoiding the nursing home, remaining independent and protecting your life savings contact Ross & Shoalmire, LLP.

Texarkana Office 1820 Galleria Oaks | Texarkana, TX 75503 903-223-5653 (Principal Office)

www.rossandshoalmire.com Paris Office 1007 S. Collegiate Paris, TX 75460 903-905-4436 (By Appointment Only)

Longview Office 1125 Judson Road, Ste. 105 Longview, TX 75601 903-212-7313 (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®

Table of Contents ®

Legal Matter 6 Using Medicaid to Pay for Long-Term Nursing Care 12 Benefitting from VA Benefits 16 Special Plans for Special People 18 Powers of Attorney

2015 │ Volume 3 Publisher John K. Ross IV, Lisa B. Shoalmire

Senior Health

Editor Christal Browning

22 Alzheimer’s Disease From an Elder Law Attorney’s Viewpoint 26 Dementia: Tips for Dealing with Difficult Behaviors 28 The Health Benefits of Tai Chi

Sales & Distribution Christal Browning

30 A Rolling Stone Gathers No Moss

Contributing Writers Jim Aldridge Christal Browning Thomas Callaway Denorise Hamilton Kristen Ishihara Dr. Brian Matthews Dr. Amy Leigh Overton-McCoy Ron Mills John Ross Lisa Shoalmire

Housing & Lifestyle 32 What if Things Don’t Go According to “The Plan” 34 Finally, Someone Understands Me

Financial Facts 38 Estate Planning Basics 40 5 Simple Steps to Feel More Confident About Your Retirement

Radio/TV Advertising Christal Browning KLFI Productions

Aging Insight® Directory 45 45 46 47 49 51 52 53 56

Elder Law Services Adult Daycare Geriatric Behavioral Health Facilities Home Health Services Hospice Services Assisted Living Services Independent Living Services Long-Term Care & Rehab Sitter / Provider Services

Creative Services / Print Lauren Butler Magna IV Principal Office 1820 Galleria Oaks | Texarkana, TX 75503 www.AgingInsight®.com Aging Insight®

@txkelderlaw

O: (903) 223-5653 F: (903) 223- 5658 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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Legal Matters

Using Medicaid to pay for Long-Term Nursing Care by John Ross

ong 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.

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 2015) 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.

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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 2015. 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.

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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 too 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.

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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. 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 2015. 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.

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Legal Matters 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 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, there 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.

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!

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 $5,098.00 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 $5,098.00 (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 return. But this rule is completely separate from Medicaid. Any gift can potentially cause a problem with Medicaid, no matter what amount it is.

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!!!

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

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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 agreements. 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 a 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]. A 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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Legal Matters

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Legal Matters

Benefitting from VA Benefits

by John Ross

The most commonly 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 served in combat. It is merely a requirement that the veteran’s service occur during one of the periods of time where the United States 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 an as yet 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 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 the veteran 12

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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. 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 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 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 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 have been several attempts to pass legislation in Congress that if passed will impose a transfer of assets penalty similar to Medicaid. This

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Legal Matters 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. For 2015, a surviving spouse of a veteran could receive a maximum benefit of approximately $1,149.00 per month, a single veteran could receive a maximum benefit of approximately $1,789.00 per month and a veteran with a dependent spouse could receive a maximum benefit of approximately $2,120.00 per month. Letâ&#x20AC;&#x2122;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. Sallyâ&#x20AC;&#x2122;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 $1,149.00 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. Planning related to obtaining VA benefits is very complicated. Not only must you meet VAâ&#x20AC;&#x2122;s eligibility rules exactly, this type of planning is only a small part of the type of planning 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. Also, it should be noted that as of the time of this writing, the VA has proposed significant changes to the Aid and Attendance program. These changes, if passed, will make pre-planning related to VA benefits even more important. 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. Sincerely; John K. Ross IV Elder Law Attorney, Accredited VA Attorney, United States Marine 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 attorneys. vzvzzBenefits 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.

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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.

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 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

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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.

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.

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.

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 a 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.

PEACE OF MIND

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.

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Legal Matters

Powers of Attorney By Kristen Ishihara

What would you say if I asked you, “What are the most important estate planning documents that you will ever sign?” The typical answer to this question is a Last Will and Testament. But if that is how you answered the question, you would be wrong. Although Wills can be important documents for certain individuals, Powers of Attorney are an absolute requirement for any adult age person. Many people consider themselves familiar with a Power of Attorney but may not fully understand what a Power of Attorney can and cannot do for them and their loved ones. If you have not had the need for one, or you have one that has worked for your needs, you likely haven’t given much thought to what a Power of Attorney actually says, or should say. Many businesses or agencies accept a Power of Attorney without reading it, however, the reality is that a Power of Attorney grants you only the powers specifically outlined in the document. If you exercise a power as the agent not granted in the document, you have breached a fiduciary duty and may be personally liable. If you as the principal fail to give sufficient authority to your agent, you may hinder their ability to handle your business in a manner that serves your best interests and protects your assets. It has been our experience that far too few individuals and businesses pay attention to the language of the Power of Attorney and fully understand the consequences of what that language provides and does not provide, when it is the details of this document that give it its power.

First: What is a Power of Attorney? There are two types of Powers of Attorney (POA) that this article will discuss: (1) a Durable Power of Attorney; and (2) a Medical Power of Attorney. With any Power of Attorney, there is a principal who grants authority to an agent to act on their behalf. However, the principal remains in charge and is able to revoke a Power of Attorney at any time. We will discuss both a Durable Power of Attorney and Medical Power of Attorney in detail. Durable Power of Attorney. A Durable Power of Attorney is a written instrument, defined by Texas law, which designates another person as attorney in fact or agent for the person granting a POA and is signed and acknowledged by that person in front of a notary public. The authority of the agent is limited to only the specific powers listed in the POA. A POA may be effective immediately or may be a “springing” POA that becomes effective upon the principal’s subsequent incapacity. Very simply, a Durable POA allows someone to act on your behalf with third parties to handle your business. The most commonly known type of POA is a Statutory Durable Power of Attorney. The form for such is found in Section 752.051 of the Texas Estates Code and is often used by individuals that have searched and found the terms on the Internet. The Statutory Durable Power of Attorney allows you to check a number of powers that can be granted to the agent that relate to financial matters. The Statutory Durable Power of Attorney is generally sufficient for actions such as handling daily banking

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activity on behalf of the principal and corresponding with providers contracted with the principal (utilities, phone, etc.). However, the Statutory Durable Power of Attorney does not grant authority to the agent that may become necessary in a comprehensive estate plan, particularly in providing for long term care. The Statutory Power of Attorney does not provide for the creation of trusts and it also limits the amount of a gift to an individual to not exceed the amount of annual exclusions allowed by the federal gift tax. These, and other omissions in the Statutory Durable Power of Attorney, do not appear alarming initially but can quickly become so if the principal that granted the POA becomes incapacitated and can no longer make those decisions on their own and have not granted the authority to do so to a trusted agent. You can easily protect yourself in this situation by having an Elder Law attorney draft a Durable Power of Attorney for you that takes into consideration your specific circumstances and needs. This POA will be much lengthier than a Statutory Durable Power of Attorney and provide for a much greater depth of individual situations, including those that would allow for long term care planning and asset protection. Medical Power of Attorney. A

Medical Power of Attorney is a written document that gives the agent the power to make health care decisions on behalf of the principal. An agent does not have the authority to make any medical decisions on behalf of the principal until a physician certifies in the principal’s medical record that the

principal is incompetent to make his or her own medical decisions. Very simply, a Medical POA allows an individual to make medical decisions for you once you become unable to do so. To be effective, a Medical POA must be executed with the appropriate formalities. A Medical POA must be signed in the presence of two ascribing witnesses, or acknowledged by a notary. The appropriate language for the Medical POA is found in Section 166.164 of the Texas Health and Safety Code and must be executed in conjunction with the Disclosure Statement found in Section 166.163. A Medical POA may also include personal requests for an intimate and important time in your life. An Elder Law attorney can help you consider your individual situation and draft a Medical POA that is appropriate. In addition to the traditional

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Medical POA, there is another element that must be considered. There is a federal law called the Health Insurance Portability and Accountability Act, referred to as HIPAA, that governs the privacy of your health information. To make sure that the person you have appointed as your agent on the Medical POA can access your medical records, it is necessary to include very specific language in the Medical POA or in a separate document that grants the agent authority to access medical information under the HIPAA privacy law. This type of information is commonly omitted by many Medical POAs, but it is the kind of information that an Alder Law attorney will insure is included in your documents. Second: What’s the Rush? Many don’t feel a sense of urgency to put important estate-planning tools into place, such as a Durable and Medical Power of Attorney. However once you or someone you know has a situation where they needed a POA or had a POA that was poorly drafted, you will quickly

develop that sense of urgency. We run across that situation far too many times in our practice and hope you will heed the warning to meet with an Elder Law attorney sooner rather than later to discuss these important documents, as well as other documents that are important to your estate planning and protection of your assets.

A client named Sarah learned about the importance of having comprehensive estate planning and powers of attorney in place the hard way. Sarah had been happily married to her spouse for over ten years when he suffered a number of significant health care crises in a short period of time. These crises rendered Sarah unable to care for her spouse, Walter, at home and after he left the hospital he was admitted to a skilled nursing facility. Prior to his marriage to Sarah, Walter had executed a Medical Power of Attorney giving authority to his adult sibling, Jean, to make medical decisions on his behalf if he became unable to do so. After Sarah and Walter married, they visited an attorney that updated their wills and did a statutory power of attorney, but no other estate planning documents. Because Walter had not updated his Medical POA, nor revoked the Medical POA granted to his sister Jean, even though he was married to his spouse Sarah, it was Jean that the medical care providers had to ask for medical decisions. This turned into a conflict between Jean and Sarah and the situation escalated quickly. Sarah found herself in the position of not being

able to make medical decisions for her spouse, not being able to provide for his financial affairs or get him qualified for Medicaid which he desperately needed and the stress of the situation took away from her ability to provide Walter with the love and support that she as his wife wanted to provide. We were able to help Sarah right this situation, however it was a lengthy and expensive process that could have been easily avoided by a visit to an Elder Law attorney that would have discussed the importance of having appropriate estate planning documents in place. Sarah experienced what so many of our clients experience: an unexpected health crisis, which turns into a housing crisis after that individual cannot return to their home, which turns into a financial crisis when that family realizes the cost of a long-term care facility is upwards of $4,500.00 per month. We assist clients everyday that find themselves in this type of urgent situation, however with some planning in advance, an Elder Law attorney can make the best plan to provide protection for your assets and your legacy. Third: What now? We hope by learning more about powers of attorney and the role that they can play in your comprehensive estate plan you are interested in getting the appropriate documents put into place for you and your loved ones. So what is the first step? Contact an Elder Law attorney to set up a consultation to discuss your individual needs, concerns and situation. That attorney can tailor a plan to meet your needs. That attorney will be glad to go over each document and its importance with you. You do not need to gather personal information prior to making the appointment, the attorney can help you through that process and almost all the necessary information you will know, or will have readily accessible. The biggest mistake you can make is putting off this type of planning because you feel you don’t understand the documents, don’t think you have time to gather the information, or most commonly don’t want to think about a

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potential health crisis, or assume that you and your loved ones will not be impacted by a health crisis. An Elder Law attorney can help give you and your loved ones peace of mind. Don’t delay in taking the necessary steps to protect yourself and your family, contact an Elder Law attorney today.

Kristen J. Ishihara has been a practicing attorney in Longview, Texas since 2006. She graduated from Baylor Law School with honors and is licensed to practice in Texas, Arkansas and Oklahoma. Kristen was elected to the Longview City Council as representative for District Four in 2014 and enjoys serving the community in that capacity. Kristen was honored to be selected as an Emerging Young Leader in 2013 by the Longview Chamber of Commerce. Kristen is also an active member with the Junior League of Longview and the Zonta Club of Longview. Kristen is happy to assist clients with elder law issues, asset protection and estate planning issues to include: • Trusts and wills; • Estate Planning Documents such as Power of Attorney and other directives; • Medicaid Applications and Medicaid Estate Recovery; • Veteran Aid & Attendance Applications; • Guardianships; and • Probate. Kristen is an accredited Veterans Affairs attorney, as well as a member of the National Academy of Elder Law Attorneys.

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Alzheimer’s Disease from an Elder Law Attorney’s Viewpoint by John Ross Several years ago I began volunteering with the Tri-State Alzheimer’s Alliance and am currently serving as President of the Board of Directors. I have given many hours to this organization and I’m proud of all that the Alliance has accomplished. But why do I do it? There are certainly many worthwhile charities that I could assist. Is it because of a family connection? No. Luckily, there has not been any case of Alzheimer’s disease in my family. Then why serve? Because as an Elder Law attorney, I have a unique insight into how this disease ravishes a family and years of experience have shown me that no other illness presents such a devastating result on the person, their family and society as a whole. In the United States, nearly thirty six million people suffer from Alzheimer’s disease and related dementias. Unlike other diseases like cancer, Alzheimer’s has no cure and is a life ending illness 100% of the time. But it is not necessarily the effect on the patient that makes Alzheimer’s so

bad, rather it is the effect on the families and community that differentiates this disease from others. Again, unlike cancer, heart disease and other serious illnesses, Alzheimer’s robs the patient’s ability to care for themselves often years before there is any effect on their physical health. This leaves the person with the disease unable to manage day to day affairs and puts that burden on their surrounding family and the community as a whole. It is estimated that the cost of caring for people with Alzheimer’s tops $220 billion each year, just in the United States. Included in that cost is an estimated 17 billion hours of unpaid care provided by families annually. And Alzheimer’s doesn’t discriminate. It affects all races and genders, although it does affect women at a slightly higher rate. So by now I’ve probably convinced you that Alzheimer’s is a significant issue, but that is not really the point of this Article. As an Elder Law attorney, my professional practice is centered on addressing the health, housing, financial and legal issues of people as they age to hopefully allow that person to age on their own terms, without institutional care, without becoming a burden on their loved ones and without losing their life savings in the process. And after many years of working at this, I have learned that no other disease spans the full range of my practice like Alzheimer’s.

Decision Making Authority Becomes More Important

I work closely with many hospice organizations to assist their patients, many of whom are very close to the end of their life. In some of these cases, just day or hours away. But in most of these cases, I am able to sit with the person while they explain their personal situation, wants and desires.

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Senior Health Conversely, I have been brought in by families to assist with their family member who has Alzheimer’s, but the patient themselves can no longer competently discuss their situation with me. Often times this person is years away from death. This is where the Powers of Attorney come in. There is a whole separate article in this guide about Powers of Attorney and their importance. But Alzheimer’s disease demonstrates the importance better than any other. If you cannot make your own decisions, someone must be able to do that for you. If you have Powers of Attorney in place, the person you choose will make those decisions. If not, a court will make those decisions for you. Those are the only two options and I have never had a person tell me they would rather have a court governing their life if given the choice. However, I have had hundreds who have found out the hard way that the lack of a Power of Attorney, or even more frustratingly a Power of Attorney that was incorrectly drafted, has forced their family into the long, arduous and expensive court Guardianship process. Given that Alzheimer’s has an estimated ten to fifteen year life expectancy, the Powers of Attorney that a person signs while they are still competent must last and flow with an ever changing legal and societal environment. They must be so thorough as to attempt to address every possible scenario that might arise both now and in the future. As I often describe it to clients, think of everything you can do as a free American and then put that in writing so that when you are incompetent, someone else would be able to do any of those things too.

Planning for the Surviving Spouse Becomes More Important

One of the most shocking statistics with Alzheimer’s disease is not about the person afflicted with the illness, but rather about their spouse. As mentioned earlier, a person with Alzheimer’s has a ten to fifteen year life expectancy. However, the spouse of the person with Alzheimer’s only has a three to five year life expectancy. It is so difficult and stressful to care for a spouse with Alzheimer’s that more often than not, the caregiver dies first. I have spoken to hundreds of spousal caregivers as an Elder Law attorney. These wonderful individuals sacrifice their entire existence to provide for their loved one and epitomize the concept of “through sickness and in health.” And because of their gallant attempts to provide that care, their spouse with the disease is able to live at home where they are comfortable. But if that spousal caregiver dies before their ward, the spouse with the disease is often left with no caregiver and yet their care needs have not gone away. In order to maintain the person in the home or place them in a facility, the family can often expect costs that vary from $3,000.00 per month to over $10,000.00 per month. Since this is unaffordable for most people, special planning must take place to prepare for the death of the caregiver spouse.

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Senior Health The scenario described above is often addressed by what I refer to as the two-step. Most married couples own all of their marital assets jointly. This presents a problem though when we are talking about one of the spouse’s being unable to provide for themselves. Step one of my two-step plan is to get all of the marital assets in the name of the caregiver spouse. Then step two is to set up the estate planning for the caregiver spouse so that if they die before their spouse with Alzheimer’s, all of the marital assets will be held in a special needs trust for the benefit of their surviving spouse. There is also an article in this guide about special needs trusts, but essentially they are designed so that a person can have assets and still be eligible for need based government benefits such as Medicaid. If the above plan were implemented, then the caregiver spouse would own all of the assets and then upon their death, all of the assets would go to their spouse with Alzheimer’s, but in a way that protects those assets for their surviving spouse’s benefit. If done correctly, this can allow the person with Alzheimer’s to receive assistance from programs like Medicaid for their basic care and still have plenty of resources to supplement that care to provide the best quality of life available.

Preplanning is More Important

Something like 75% of people die without ever doing any sort of estate planning. And in many of these cases, the lack of estate planning has no discernable effect on the family. These are the people who one day were perfectly healthy and the next day are no longer with us. This easy transition for such a large percentage of the population makes many people think of estate planning as optional. However, when they think this, they are actually thinking about what will happen when they die and not what will happen when they become incapacitated. The real value of estate planning is the ability to provide for yourself while you are alive.

If this is done correctly, the issues that come with transfers at death will take care of themselves. Alternatively, if a person’s only focus is on what happen when they die, it’s possible that all of their assets get spent paying for long term care during their incapacity leaving nothing left to distribute at death. Over the last several years I have seen many families who have used up hundreds of thousands of dollars paying for long term care and in the end have very little to pass on. Unfortunately, figuring out the best way to protect and preserve assets for the future is complicated and involves a thorough review of a person’s income and assets. With that done though, developing a plan for how to pay for long term care can begin to develop. However, many of the resources available to assist with long term care expenses require that any plan to preserve assets be done well in advance. For example, Long Term Care Medicaid, which is the most commonly used long term care benefit, provides that if you have taken steps to protect your resources within the last five years, there could be a period of time that Medicaid will not pay for you. Likewise, while VA does not currently have such a restriction, the VA has proposed adopting a similar provision which I expect will become law soon enough. This does not mean that you should give away all of your assets so

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that you can get Medicaid in the future. Quite the opposite, in fact. There are many tools available to protect assets while maintaining use and control of your assets. And when you do your planning for the future, you want to be able to utilize every tool available. Unfortunately, if you have waited until the middle of a crisis, many of those tools will no longer be available because you don’t have the time it will take for the plan to take effect.

Learning About the Illness Becomes More Important

I have visited with many families who are caring for a loved one that has fallen ill with some disease. In many of those cases, the family can tend to the needs of that loved one without knowing a lot about the illness. For example, if a person has cancer and is receiving chemotherapy, all the family really needs to know is that their loved one will be weak and will need help and support following the treatments. Alzheimer’s disease is different. A person with Alzheimer’s still looks like the same person they were before the disease. However, the disease can cause them to act differently, get confused during ordinary situations, and forget ordinary items and the people they were once close to.

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Senior Health

Tips for Dealing with Difficult Behaviors by Denorise Hamilton

Dementia, what is it? Dementia is a term that describes a collection of symptoms that include decreased intellectual functioning that interferes with normal life functions and is usually used to describe people who have two or more major life functions impaired or lost such as memory, language, perception, judgment or reasoning; they may lose emotional and behavioral control, develop personality changes, and have problem solving abilities reduced or lost. Early, accurate diagnosis of dementia is important for the patient and their families because it allows early treatment of symptoms. Virtually all patients will develop changes in behavior and personality as the disease progresses. The nature and frequency of symptoms vary over the course of the illness. It is important that caregivers of the patient with dementia are educated about the disease process, the manifestation of various behaviors, and the appropriate intervention. Of the many challenges for caregivers of patients with dementia, unquestionably the most challenging are behavioral disturbances. These symptoms can include agitation, restlessness, depression, wandering, and difficulties with activities of daily living, sleep problems, delusions, and hallucinations. Such symptoms are further complicated by the cognitive and memory deficits so characteristic of dementia. As the caregiver of a loved one with dementia, it is important to keep in mind that the person is not acting that way on purpose. By learning how to identify problem behaviors for what they are and by making simple tweaks to the home environment and a caring approach, you reduce stress, possibly minimize problem behaviors, and increase the quality of life for you and your loved one. The following are an overview of the most common dementia â&#x20AC;&#x201C;associated behaviors and suggestions that may be helpful in handling them.

Agitation Agitation refers to a range of behaviors associated with dementia such as, irritability, sleeplessness, verbal or physical aggression. These behaviors can be triggered by a variety of things such as environmental factors, fear, or fatigue. Reduce noise, clutter, or number of persons in the room. Maintain structure by keeping the same routine. Reduce caffeine intake, sugar, and junk food. Try gentle touch, and speaking in a calm tone. Increase daytime activities, discourage inactivity and napping during the day, this promotes a better sleep pattern. Identify warning signs of possible physical aggression; they can occur suddenly, with no apparent reason. Signs of impending physical aggression are, increased swearing, loud voice tone, pacing, clenched fist, making threats, ect. Know when to back away and seek assistance Resisting Activities of Daily Living Refusing or great resistance to personal grooming such as bath, brushing teeth, combing hair, changing clothes, or toileting. If your loved one is agitated or resistive, leave them alone until theyâ&#x20AC;&#x2122;re calmer. Identify possible changes needed for the environment (warmer, cooler, time of day, ect.). Talk about pleasant and non threatening topics. Choose loose fitting comfortable clothes with easy zipper and minimal buttons. Be aware of and respond promptly to non verbal cues of toileting needs. Promote privacy.

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Wandering Wandering can be potentially dangerous, leaving the house alone, walking into intersections, ending up miles away from home with no communication. Wandering occurs as a result of restlessness and disorientation. Pay attention, monitor behavior over time and carefully watch for pacing, redirect restless behavior. Have a plan in place if your loved one does wander away. Notify your local police about your loved one condition and ask to be notified if they are found in the community alone. Paranoia and Suspicion Memory loss and confusion may cause your loved one with dementia to perceive situations in unusual ways. Sometimes the person may become paranoid that they are being watched or plotted against. Do not take offense to the accusation, listen to what’s troubling the person and try to understand their reality. Reassure them that you are there to help them, let them know that you care. Don’t argue; allow them to express their opinion. Attempt to redirect them, shift their attention and engage them in an activity that promotes healthy behavior.

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Denorise Hamilton is the Community Educator/Pre-Admission Screener for Wadley Regional Medical Center Behavior Health Unit. She received her Associate Degree in Nursing at Texarkana Community College. Denorise has over 25 years of psychiatric nursing experience. She’s held numerous postions during her tenure as a psychiatric nurse. She has worked on adolescent, adult, and geriatric units and even spent time working on a chemical dependency unit. Denorise served as Director of Senior Care unit for a number of years, and later served as Marketing Coordinator. Her love for helping people is what makes her job rewarding on a daily basis.

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Hallucinations and Delusions Hallucinations (seeing or hearing things that others don’t) and delusions (false beliefs that someone is trying to hurt or kill another). Simply and calmly verbalize your perception of the situation, but avoid trying to convince them that their perception is wrong. Sexually Inappropriate Behaviors This includes behaviors such as undressing in public, making sexually inappropriate remarks, masturbating, and unreasonable sexual demands. Develop an action plan to follow before behaviors occur (what you will say and do if the behavior happens at home, around other adults, or children). If possible identify what triggers the behavior. Talk to your doctor about a possible treatment plan.

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Aging Insight®

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“Tai Chi Senior Health

Tai Chi forms take approximately 10 to 20 minutes to finish, can be practiced just about anywhere, and need no special equipment.”

The Health Benefits of

by Dr. Amy Leigh Overton McCoy

Each year there are increasing numbers of older adults within the United States. By the year 2030, one out of every five Americans will be 65 or over. Older adults want to be healthy, functional, and independent. With the rising cost of health care, it is important for all of us to explore ways to achieve optimal health. Cardiovascular/aerobic physical activity has been accepted for some time as a part of preventive medicine to reduce the occurrence of hypertension, strokes, diabetes, and other cardiovascular diseases, such as elevated cholesterol. The literature supports the belief that cardiovascular/ aerobic physical activity is associated with better and improved cognitive function in older adults. As we age, our bodies change physically and cognitively. As early as the age of 30, physical changes are occurring in the body. Older adults experience more chronic illness and, therefore, movements may become more difficult. Another area that presents challenges to older adults is the decrease of mobility due to pain and stiffness related to the disease process of arthritis. Arthritis is the second major physical change that often leads to disability and causes a decline in activities of daily living, including bathing, cooking, dressing, and toileting.

Because of these physical and when cardiovascular/aerobic activities cognitive changes, some older adults become too difficult because of other may be hindered from participating in physiological conditions. Tai Chi has been shown in medical cardiovascular/aerobic-type physical activities. Physical activity that is not research to be a beneficial nonconsidered aerobic should be explored pharmacological intervention for as an alternative activity for older numerous conditions that often affect adults when cardiovascular/aerobic older adults. The benefits range from activities become too difficult because improved sleep, mood, memory, of physiological and debilitating cholesterol, blood pressure control, conditions. Tai Chi is a great exercise immune system as well as reducing option that should be considered as an falls. Tai Chi is a way for all of us to stay active and healthy as we age. alternative physical activity for older adults. Dr. Amy Leigh Tai Chi is typically done in Overton-McCoy, slow motion while maintaining Ph.D., GNP-BC a relaxed and peaceful mind. Tai received her BSN Chi is executed with the neck, and MNSc from shoulders, chest, spine, stomach, the University lower back, buttocks, and groin of Arkansas for muscles completely relaxed. The Medical Sciences. knees should be slightly bent, She received her Ph.D. allowing weight to sink into from Capella the thighs, which increases the University in muscular workload. Tai Chi Psychology. forms take approximately 10 With a doctoral to 20 minutes to finish, can be dissertation on the association between tai chi practiced just about anywhere, and memory in older adults, she is an instructor and need no special equipment. of tai chi. With 13 years of experience, she is a Tai Chi can even be altered for board certified Geriatric Nurse Practitioner. individuals who may need to She serves as the Associate Director for the perform these activities sitting or Texarkana Regional Center on Aging. Dr. Overton-McCoy is a member of the American lying. Because of the slow, lowGeriatric Society, Sigma Theta Tau - Gamma Xi impact movements, this type of Chapter, American Nurses’ Association among mind–body physical activity may other community groups. be an alternative for older adults

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Housing & Lifestyle

Arthritis is that rust trying to get into your joints. When you stop moving, that arthritis rust consumes the joint and limits your ability to move without pain. â&#x20AC;&#x153;

A Rolling Stone Gathers No Moss by Jim Aldridge, PT, DPT, MHA,

Being a physical therapist for the past 15 years, people ask me some very interesting questions. Why am I here? Who are you again? When will you leave? One of the most common questions is â&#x20AC;&#x153;what can I do about my arthritis pain?â&#x20AC;? I have my standard spiel depending on which joint is involved about using ice, anti-inflammatories, weight control, and gentle exercises. People balk immediately about the ice. Arthritis is an inflammation of the joint. If you put heat on inflammation it makes it hotter. Ice, especially after a long hard day at work or at the house, is the optimal choice. The standard antiinflammatory drugs like naproxen, aspirin, or ibuprofen set at the suggested scheduled time period for a week will help jump start that exercise program. Weight control is also a major issue. Excessive weight exponentially increases the pressure on your joints. Losing a few extra pounds can help alleviate that pain. Using all of the above information to control your pain with arthritis is the first step. The next step is even more important. Moving and keeping active with all of your normal activities will keep the pain from setting in permanently. Adding a few more activities would help, too. Once you succumb to allowing arthritis to control your daily life, arthritis consumes you. The best comparison of arthritis

is rust. A movable joint in an automobile does not rust if that automobile is still maintained and running. When that same automobile stops running and seizes to be maintained, all of those joints become consumed by the rust. Arthritis is that rust trying to get into your joints. When you stop moving, that arthritis rust consumes the joint and limits your ability to move without pain. Even though it may be painful to move with arthritis, arthritic pain is made worse by not moving. Therefore, truly a rolling stone gathers no moss. Keep moving, keep exercising, and keep living a full life.

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Jim Aldridge, PT, DPT, MHA, is Program Manager at Christian Care Center for the past 2 years and a Physical Therapist for the past 15 years. He is a proud father of two little girls, Zoe and Mia.

“Giving Quality to Life through Compassionate Care” Ray Johnson, LVN

Kim Keith, LNFA

Clinical Liaison

Executive Director

Brittanie Stone Community Relations

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Laura Cantrell, SLP Morgan Bennett, OTR Kahla McMahen, COTA Lesa Shipp, PTA Jim Aldridge, PT, DPT, MHA Program Manager

Aging Insight®

Housing & Lifestyle

What If Things Don’t Go According To “The Plan” by Christal Browning

Burns G. Barr had a plan - to live one day longer than his beloved wife of 63 years who was ill and confined to a wheelchair. Even at the age of 83, Mr. Barr was relatively healthy and throughout his life had managed a successful career and household, so he believed he had the situation under control. He never considered that he would be the one to die suddenly on that warm June day or things would have been different–or would they? Of course, no one knows when that day will come, that thing called death, all that we do know is that death is inevitable for each of us and the timing is not our own. If we did know, wouldn’t we want to take the necessary steps to protect our family and our assets? But what if we didn’t know what we needed to do? Mr. Barr’s story is a common one. No one wants to be a burden on their family, and often the family has promised never to place their loved ones in a facility, so they continue “doing the best they can do”. Sometimes this is a viable option, but even so, every family needs to have an estate plan in place – a plan that takes into consideration your family, health, housing, finances and future needs. These things that appear very simple can quickly become complicated (you are healthy today, but what happens if you have a

stroke tomorrow?) Where do you turn? A law firm specializing in elder law whose focus is to protect the family members and their assets can put that plan together. Attorneys who have helped countless families through crisis situations and have first hand knowledge and experience in assessing the various outcomes, often unforeseen by the family. Governmental assistance, in the form of Medicaid or VA benefits, may or may not become a necessity, but the plan should definitely include those options as the rules are complex and the appropriate steps must to be taken to insure maximum protection of a family’s assets. So what happened to the beloved wife? The kids had to step up and help mom out physically and financially.

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Mr. & Mrs. Barr had lived on a very modest income before his death and her monthly expenses tripled upon moving into an assisted living facility. Their son, who lives locally, heard of the Ross & Shoalmire law firm and their events like the Eggs & Issues program. He decided to make an appointment and believes it was the best decision he could have made. During the initial free consultation, he learned of the Aid & Attendance benefit available to the spouse of a Veteran. He, like most VA families, had not heard of that benefit before. Ross & Shoalmire assisted the family to establish a VA Asset Protection Trust in order to get her qualified. What the son realized before he left that initial appointment was “that this would be an investment but worth every penny”. Once Mrs. Barr was approved she started receiving the benefit which is a tax free monthly income to help pay for her expenses at the assisted living facility. This helped her children who had been paying the bulk of the expense. “The knowledge that John Ross has is powerful information and is truly invaluable!” as quoted from the son, Burns A. Barr. Burns also said, “Sometimes when you are in the middle of the crisis you may never find these things out that can help and I’m just grateful that I did. What I have also learned is that I need to take care of all my personal planning before there is a crisis. I love my wife and kids and want things to be easier for them!” Find out what options are available to establish a plan to

Dignified Care. Distinctive Living.

best take care of you and your family by visiting with one of the elder law attorneys at Ross & Shoalmire where they can help you by understanding your personal situation.

Christal Browning is the Business Development Executive for Ross & Shoalmire, LLP. Christal has a BA in Communications from Stephen F. Austin State University and has 14 years of experience in the healthcare arena. She is the proud editor of Aging Insight, the president of Twin City Marketing Alliance and Healthcare Connections. She is a board member for Hands on Texarkana and is also a member of P.E.O. Philanthropic Educational Organization. Married to Kevin, she has 3 kids- Spencer, Garrett, Avery and a step-daughter Madison.

Waterton Plaza AT COWHORN CREEK

Waterton Plaza at Cowhorn Creek offers quality, individualized care by a dedicated and caring staff. We specialize in physical and occupational therapy to help residents regain their strength and independence. Whether you are looking for extra help to get back home or a long term solution to meet your individual needs, Waterton Plaza at Cowhorn Creek is your home away from home.

Services Provided

Physical Therapy ◉ Occupational Therapy ◉ Speech Therapy 24-Hour Nursing Care ◉ Wound Care ◉ Respite Care Healthy Home-cooked Meals ◉ Medication Administration Dedicated Housekeeping Staff ◉ Activities ◉ Beauty/Barber Services

For more information please call: (903) 223-1188 5524 Cowhorn Creek Drive Texarkana, Texas 75503 Aging Insight®

Housing & Lifestyle

Finally, Someone Understands Me: The Perspective of the Caregiver

Dr. Brian L. Matthews

As the baby boomers continue to progressively age, older adults will eventually become informal caregivers. A question of physical decline and increased mortality becomes questionable regarding the ability of older adults to withstand the complexities of caregiving without being physically healthy to maintain a substantive balance of avoiding stressors that quicken physical and cognitive decline. Older adults who are healthy can become and sustain their role as caregivers, resulting in less stressors and a good death experience1. Furthermore, healthier caregivers are more prone to achieve physical and cognitive health and elude the complexities of physical decline or the stress of cognitive performance. The difficulty embedded in the physical activity of the caregiving role would accelerate potential negative effects related to intensive care over a long period of time, leading to a decline in physical health outcomes for older men and women and increases mortality 1. The myriad of tasks related to the caregiver role

ranges from completing personal care, facilitating service coordination, financial management, managing pain relief, and symptom management to administering medications, providing emotional and spiritual support, effectively communicating with healthcare professionals, and providing transportation to and from physician appointments and treatments 2,6,8,9. Of these, pain management can pose a challenging task for caregivers while trying to successfully navigate the provisions of other needed medical services. Aside from the primary stressor of effective pain management, the modern role of the caregiver can entail everyday duties and responsibilities such as work, family, work performance, and social obligations, that must be fulfilled which become secondary stressors 1. This addition of stressors creates tension among existing roles which leads to a dissatisfying outcome riddled with physical and emotional problems. A lower quality of life, intensified symptom frequency, and depression exhibited by the patient contributed to

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caregiver burden. This wear and tear is referred to as reciprocal suffering which is dually experiencing physical, emotional, and social needs and issues that exist when caring for a dying patient and displaying an accelerated decline in quality of life as the physical and psychological changes of the patient amplifies7. As a result, the caregiver experiences â&#x20AC;&#x153;caregiver breakdownâ&#x20AC;? 7. Accordingly, healthcare professionals refer to caregivers as second-order patients 7 because they require psychological and palliative support through interactions with the hospice interdisciplinary team. Likewise, some physicians view caregivers as they do patients in that they feel that caregivers should be protected and safeguarded rather than at the helm of problem solving. However, if control is stripped partially or completely from the caregiver, this may signify vulnerability on the part of the caregiver which infers a lack of control within the caregiving paradigm4. On the other hand, when caregivers are given control through problem solving, they become masters

of managed care, in turn, contributing greatly to life satisfaction in addition to physical and mental health 4. More so, if the caregiver’s burden is reduced, the subsequent result would include improvements in mental and physical health outcomes would lead to satisfaction and altruistic fulfillment. A caregiver facing the rigors of caring for a loved one can become overwhelmingly burdened when the patient’s needs exceed their physical, emotional, and financial resources 7. What is more, as chronicallysick patients live longer as a result of medical advances, caregivers are subjected to longer durations of caring which may result in encountering insufficient resources to effectively fulfill the multiplicity of role obligations. For example, with older adults comes physical decline, decreased opportunities to socialize

outside of the immediate family, and lower earning capabilities. Physical and psychological symptoms became aggressively intense for caregivers at the advanced stages of the terminal

relinquishing care to someone else, attributing this hesitation to losing control of caring for their loved one. Some caregivers receive little help from friends and family who may not be aware, due to a high degree of privacy, that such debilitating circumstances even exist. Therefore, no support is given. Some caregivers find it extremely difficult to handle the routine tasks of providing care for their loved ones. Here, the adaption to physical and behavioral changes was complicated and the caregiving experience became emotionally demanding and draining. Sentiments like “slowly and surely you start to suffer yourself ” and “I see caring as my duty but it produces feelings of frustration rather than any good feelings” become statements of resentment and anger rather than joy and selflessness. These types of grueling

Likewise, some physicians view caregivers as they do patients in that they feel that caregivers should be protected and safeguarded rather than at the helm of problem solving. illness due to the acceleration of functional and cognitive impairments in addition to the increased frequency and difficulty of care 7. Caregivers typically find that caring for their loved one is physically and emotional demanding and that is difficult to insert their own activities into their caring regimen 5. Oddly, while caregiving can be very difficult, some caregivers are apprehensive in

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Aging Insight®

Housing & Lifestyle statements characterize the stress of being overtaxed, isolated, physically and emotionally drained which directly contributes to physical decline and lower life satisfaction. Because of the intense nature of caregiving, those who take on this task are subject to fewer social contacts, limited opportunities to socialize, and deteriorating health along with depression, loss of identity, stress, strain, fatigue, and mortality as conjoining factors. They also experience exhaustion and dramatic lifestyle changes. Role strain affects the role of parent, friend, or employee. As these role obligations increase, the caregiver may be forced to relinquish other roles due to a lack of resources necessary to effectively carry out its duties and responsibilities. Roles that are generally affected included spouse, parent, housekeeper, employer, employee, coworker, and friend 2. Moreover, the unpredictability of the disease process delays finalizing future plans, time for recreation becomes nonexistent and caregivers experience physical, mental, and emotional exhaustion. Also, caregiving has the propensity to affect areas in which role strain greatly impacts the

family dynamic which can include decreased family intimacy, lack of family support, and family tension. It is that imperative the healthcare professionals safeguard existing coping strategies and prevent the dismantling of familiar coping mechanisms during this limited duration of care between pre-bereavement and post-bereavement. Due to caregivers’ integral part of the healthcare system, understanding initial needs and concerns of the caregiver can help reduce stressors and creates a positive caregiver experiences.

Dr. Brian L. Matthews has been a citizen of Texarkana since 2003. He graduated cum laude with a Bachelor of Business Administration from Harding University in Searcy, AR in Marketing. He went on to attend Harding University and graduated summa cum laude with a Master of Business Administration in Management in 2002. On September 21st, 2012, Dr. Matthews successfully defended his dissertation and received a Doctor of Business Administration in Marketing from Argosy University in December, graduating magna cum laude with a 4.0 GPA. During his doctoral tenure, he was also inducted into the National Society of Collegiate Scholars Dr. Matthews currently serves as a Texarkana, Texas city councilman for Ward 4 and is also the Director of Marketing and Admissions for Edgewood Manor Skilled Nursing & Rehabilitation Center. He also serves as a board member for CHRISTUS St. Michael Rehabilitation Hospital, Alzheimer’s Alliance-Tri-State, The Healing Place, Texarkana Area Community Foundation, Ark-Tex Council of Governments, Vice-President of the Diversity Awareness Committee (TISD), the Executive Committee for TRAHC’s African-American Committee (TAAC), and the Campus Quality Assurance Committee for Spring Lake Park Elementary School. He is the proud father of his 8 year old son, Bradley Matthews.

References 1. Andershed, B. (2006). Relatives in end-of-life care - Part 1: A systematic review of the literature the five last years, January 1999-February 2004. Journal of Clinical Nursing, 15, 11581169. 2. Bernard, L. L., & Guarnaccia, C. A. (2003, December). Two models of caregiver strain and bereavement adjustment: A comparison of husband and daughter caregivers of breast cancer hospice patients. The Gerontologists, 43(6), 808-816. 3. Burton, A. M., Haley, W. E., Small, B. J., Finley, M. R., Dillinger-Vasille, M., & Schonwetter, R. (2008, June). Predictors of well-being in bereaved former hospice caregivers: The role of caregiving stressors, appraisals, and social resources. Palliative & Supportive Care, 6(2), 149-158. 4. Houts, P. S., Nezu, A. M., Nezu, C. M., & Bucher, J. A. (1996). The prepared family caregiver: A problem-solving approach to family caregiver education. Patient Education and Counseling, 27, 63-73. 5. Kraijo, H., Brouwer, W., de Leeuw, R., Schrijvers, G., & van Exel, J. (2011). Coping with caring: Profiles of caregiving by informal carers living with a loved one who has dementia. Dementia, 11(1), 113-130. 6. Kurtz, M. E., Kurtz, J. C., Given, C. W., & Given, B. (2005, August). A randomized, controlled trial of a patient/caregiver symptom control intervention: Effects on depressive symptomatology of caregivers of cancer patients. Journal of Pain and Symptom Management, 30(2), 112-122. 7. Waldrop, D. P., & Meeker, M. A. (2011). Crisis in Caregiving: When home-based end of-life care is no longer possible. Journal of Palliative Care, 27(2), 117-125. 8. Washington, K. (2011). Commitment to care: A grounded theory of informal hospice caregivers’ development as symptom managers. Qualitative Social Work, 1-14. 9. Washington, K. T., Demiris, G., Oliver, D. P., Wittenberg-Lyles, E., & Crumb, E. (2011). Qualitative evaluation of a problem-solving intervention for informal hospice caregivers. Palliative Medicine, 1-7.

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Aging Insight速

Financial Facts

Estate Planning Basics By Ron Mills

In this article we will look at some general estate planning concepts and strategies. While there’s no such thing as a “one size fits all” estate plan, this overview may assist you in thinking about your own estate planning needs, and may help you determine whether you might benefit from working with a financial planning professional. First, what is an estate plan? It is simply a map of how you want your personal and financial affairs to be handled in case of incapacity or death, and the subsequent implementation of the strategies that will fulfill those objectives.Who needs an estate plan? It’s highly likely that you do. You may think estate planning is just for the wealthy, but it’s not. In fact, an estate plan may actually be more important if you have a smaller estate, because your final expenses will have a much greater impact on your estate and there’s a much greater possibility that your loved ones could suffer from a lack of financial resources. The simple fact is that you cannot control what happens to your property if you die or become incapacitated if you don’t have an estate plan in place. Generally, people create estate plans because they want to make sure their wishes are clear in order to avoid family disputes. Also, they care about preserving their property for their loved ones and want to make sure that their loved ones are properly provided for as well. Some of the following scenarios are valid reasons for establishing an estate plan: •

Your spouse isn’t comfortable handling financial matters • You have minor children • Your net worth exceeds the federal transfer tax exemption amount ($5,430,000 in 2015) • You own property in more than one state • Financial privacy is a concern • You own a business There are several basic estate planning concepts that you should know before you start your plan:

Planning for Incapacity

Incapacity describes a condition in which you are legally unable to make your own decisions. As much as we don’t want to think about it, anyone can be stricken at any time. What would happen, for example, if you were the victim of an accident that puts you in a coma for several months. How would your doctor know what medical treatments you would or would not want if you can’t speak for yourself? How would your personal business be transacted if no one is authorized to sign documents for you?

Without an estate plan, someone would have to go to court and get legal permission to do things for you. That person or entity is called a guardian. It might be a close family member or a financial institution. This process, though it serves its purpose, may very well not be the way you want your estate to be handled. There are several tools available for you to plan for incapacity. Among them are:

Living Will

A living will lists the type of medical treatments you want or do not want under certain circumstances. For example, it might state that you do not want life support if you fell into a permanent vegetative state. You list the specific actions to be taken under possible scenarios so that those reading will clearly understand your wishes.

Joint Ownership

If you grant joint ownership of your property to another person, that person will have the same access to the property as you do. If you become incapacitated, that person would simply act instead of you. The most common example of

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Durable Power of Attorney

Also known as a health care proxy, a durable power of attorney lets you designate an agent to make decisions on your behalf while you are competent or incompetent. You are simply granting authority to your agent to make decisions for you.

Do Not Resusciate Order

Also known as DNR Order, this tool ensures that your end-of-life wishes regarding life support are your own. A DNR Order is a legal form, signed by both you and your doctor, that is posted by your bed to give health care workers the permission needed to carry out your wishes. These are a few of the steps you can take to provide for the proper transfer of your property and make your last wishes known. However, estate plans can be more complex and involved, so it always is a good idea to discuss your situation with an experienced estate planning attorney to make sure your desires are being conveyed properly to those who will be handling your affairs while you are incapacitated or at your death.

Ronald L. “Ron” Mills Senior VP, Regional Trust Manager at BancorpSouth A New Boston, Texas, native, Ron has more than 24 years of experience in trust and wealth management and almost 30 years with BancorpSouth. He is a baord member of the Texarkana Symphony Orchestra, Texarkana Museums System, Texarkana Public Library Foundation and the Texarkana Area Community Senior VP, Regional Trust Manager | BancorpSouth Foundation. In addition, Ron is an adjunct instructor | Texarkana, TX 75505 P. O. 5608 | 3000 New A&M Boston Rd ofBox Finance at Texas University - Texarkana. He Ron.Mills@bxs.com is also a Paul Harris Fellow and an avid volunteer in | c. 903.227.8997 | f. 903.334.7599 o. 903.334.7501 the Texarkana Community. also holds a BBA Finance from Texas At Ron BancorpSouth, we’ve beenin helping individuals, familiesA&M and institutions grow-for almost 140 years. Ourfrom wealthTexas management University Commerce, a MBA A&M division includes- Texarkana, a seasoned team advisors and University and ofis afinancial graduate of the a suite of tested and trusted products and services, including Texas School of Trust Bank in, Texas Personal Trust investment management, trust administration, retirement planAdministration School and the Graduate ning and the creation of endowments andNational foundations. Trust School.

Experience You Can Trust

a joint ownership asset is a checking account. Both parties can make deposits and write checks. If one party went into a coma, for example, the other person would still be able to transact business for the account.

Ronald L. “Ron” Mills

A New Boston, Texas, native, Ron has more than 24 years of experience in trust and wealth management and almost 30 years with BancorpSouth. He is a board member of the Texarkana Symphony Orchestra, Texarkana Museums System, Texarkana Public Library Foundation and the Texarkana Area Community Foundation. In addition, Ron is an adjunct instructor of Finance at Texas A&M University - Texarkana. He is also a Paul Harris Fellow and an avid volunteer in the Texarkana community.

Ron also holds a BBA in Finance from Texas A&M University Commerce, a MBA from Texas A&M University - Texarkana, and is a graduate of the Texas School of Trust Banking, Texas Personal Trust Administration School and the National Graduate Trust School.

About Us Founded in 1876, BancorpSouth has grown into one of the South’s leading financial institutions with a presence in eight states and assets exceeding $13 billion.

The Right Solutions. The Right Partners.

BancorpSouth’s Wealth Management officers are dedicated to helping you — or your business — grow and protect wealth and assets. To fulfill this promise, we build on our expertise and insight, combined with a wide range of trusted solutions and services.

3000 New Boston Road | Texarkana, TX 75501 | P: (903) 334-7501 | F: (903) 334-7599 | BancorpSouth.com BancorpSouth.com Investment and insurance products and services are offered through INFINEX INVESTMENTS, INC. Member FINRA/SIPC. BancorpSouth Wealth Management is a trade name of the bank. Infinex and the bank are not affiliated. Products and services made available through Infinex are not insured by the FDIC or any other agency of the United States and are not deposits or obligations of nor guaranteed or insured by any bank or bank affiliate. These products are subject to investment risk, including the possible loss of value.

Investment Management | Trust & Estate Administration | Endowments & Foundations | Custody & Safekeeping Services | Retirement Plan Services Bank Deposits are FDIC insured. BancorpSouth Wealth Management is a trade name of BancorpSouth. Infinex and the bank are not affiliated. Securities offered through INFINEX INVESTMENTS, INC., Member FINRA/SIPC.

Aging Insight®

Financial Facts

Steps to Feel More Confident about Your Retirement

It’s natural to have mixed emotions about retirement – it’s a huge life change that people spend most of their working life preparing for. While the thought of retirement is exciting, the options and advice available can sometimes seem overwhelming and complex. There are several simple things you can do if you’re feeling unprepared for your retirement years. Check out the following steps to help you get ready for this milestone.

Determine your vision. One of the most enjoyable parts about planning for retirement is deciding how you’ll spend your time. Though you could just be looking forward to relaxing, you may also decide to move to a different area of the country, travel, volunteer or spend more time with family and friends. Your plans can always change, but creating a list of activities you may want to pursue is a valuable and fun part of the planning process.

www.AgingInsight.com

Retirement living made simple. Cowhorn Creek Estates takes care of life’s daily details so you can focus on what matters most. As a resident, you’ll enjoy: •

Three chef-prepared meals a day

•

Full calendar of activities and events

•

24/7 live-in managers

•

Housekeeping and linen service

•

Scheduled transportation

•

Pets warmly welcomed

• Peace of mind for you and your loved ones! • And much more!

Please call us at 903-306-2197 to schedule your personal visit and complimentary meal today! Welcome to Holiday. Welcome home.

Cowhorn Creek Estates Independent Retirement Living

5415 Cowhorn Creek Road, Texarkana, TX 75503 903-306-2197 | cowhorncreekestates.com Aging Insight®

Financial Facts

Start with the basics. Developing a written plan is the first important step, but before you get caught up in the numbers, determine what you will absolutely need to cover expenses that are truly essential. Include basics like groceries, mortgage payments, healthcare costs and other financial obligations. You may want to make a list of areas where you could cut back and reduce your expenses if you hit a financial roadblock in the future.

Make your plans concrete. Many people get hung up on this step, as it can come with a tough reality check. To begin, calculate how much money you’ll need to cover your essentials over the course of a 30 year retirement, and then add discretionary expenses that accompany activities and lifestyle goals – such as travel and hobbies. Be honest with yourself and try to account for cost-of-living increases and

rising healthcare costs in your projections. This will give you a rough estimate of how much “income” you’ll need in retirement to replace your paycheck and achieve your desired lifestyle. Then consider all the sources you can draw this income from – such as a 401(k), annuities or cash savings. Also consider breaking this amount down into smaller goals that you can more easily prioritize, manage and track.

Protect your plan and your legacy. Ensure the beneficiary information on your accounts is upto-date and that you have the right insurance and protection plans in place to safeguard your income and assets now – and for the long-term. Also begin thinking about the legacy you want to leave – to your family or to organizations that are important to you. Involve your loved ones in these conversations and clearly communicate your intentions and expectations.

www.AgingInsight.com

Track your progress. As with all goals, it’s important to set milestones, check-in and reflect as you go. Keep in mind that a little time and organization goes a long way. Set aside one day each month to sit down with your finances, and also consider meeting with a legal and financial professional annually. Even if your goals still seem far away or if you’ve experienced a setback, you won’t regret spending the extra time to review your progress. This also provides a good opportunity to make adjustments if your situation or plans for the future have changed.

Thomas A. Callaway CRPC®, is a Financial Advisor with Ameriprise Financial Services, Inc. in Paris TX. He specializes in fee-based financial planning and asset management strategies and has been in practice for 22 years. To contact him you can go to www. ameripriseadvisors.com/thomas.callaway or call (903)785-7000, office located at 2219 Lamar Ave Paris, TX 75460.

Retirement planning can be a complicated, emotional and overwhelming process. Consider seeking objective advice from a professional financial advisor who can guide you through it and ensure you’re aware of all your options. It’s important to keep in mind that the surest way to feel confident about what’s to come is to do everything you can to prepare for it.

Ameriprise Financial and its representatives do not provide tax or legal advice. Consult your tax advisor or attorney regarding specific tax issues.

James M. Callaway

Ameriprise Financial Services, Inc. 2219 Lamar Avenue Paris, TX 75460 (903) 785‐7000

Financial Advisor CA Insurance #0F05226 ameripriseadvisors.com/james.callaway

Thomas A. Callaway, CRPC®

Financial Advisor ameripriseadvisors.com/thomas.callaway

Aging Insight®

Call

(903) 794-1300 for Details

Don’t Leave Your Family with the Burden of your Funeral Expense...

Pre-Plan Today!

It’s never too early to plan for your future. Pre-planning Benefits Your Entire Family In Many Ways... ● ● ●

Saves Your Family the Emotional and Financial Burden of Planning your Final Arrangements Personal Selection of the Type of Service ● Price Locks In at Today’s Cost Flexible Payment Plans ● Interest Free

You’ll Love the Peace of Mind

www.AgingInsight.com

Resource Directory

2015 Resource Directory Our convenient directory is broken into 9 categories and then alphabetized by city.

Elder Law Services LONGVIEW, TX Ross & Shoalmire, LLP

1125 Judson Road, Ste 105

Longview, TX 75601

903-212-7313

1007 S. Collegiate

Paris, TX 75460

903-905-4436

1820 Galleria Oaks

Texarkana, TX 75503

903-223-5653

PARIS, TX Ross & Shoalmire, LLP TEXARKANA, TX Ross & Shoalmire, LLP

EL DORADO, AR Elder House Day Care

Adult Daycare 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

Aging Insight速

Resource Directory

Geriatric Behavioral Health Facilities GREENVILLE, TX Glen Oaks Hospital

301 East Division

Greenville, TX 75401

800-443-1109

Hunt Regional Medical Behavioral

4215 Joe Ramsey Blvd.

Greenville, TX 75401

903-408-1500

2001 South Main St.

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

701 Arkansas Blvd

Texarkana, AR 71854

870-772-5028

1000 Pine St.

Texarkana, TX 75501

903-798-7300

HOPE, AR Golden Care at Wadley Hope Hosp. 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 TEXARKANA, TX Wadley Behavioral Health

www.AgingInsight.com

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

157 N Main

Bagota, TX 75417

903-632-2173

Country Home Care

1505 West Main St.

Clarksville, TX 75426

903-427-8366

Cypress Home Health

389 US Hwy 82 West

Clarksville, TX 75426

903-427-4598

111 Bowie St.

Dekalb, TX 75559

903-667-4588

Amedysis Home Health

307 West Stillwell Ave.

DeQueen, AR 71832

870-642-4214

Dequeen Medical Center HH

1007 N. 14th Street

Dequeen, AR 71832

870-584-0277

431 West Oak

El Dorado, AR 71730

870-862-2631

ETMC Home Health

711 N. Titus St.

Gilmer, TX 75644

903-843-4320

Guardian Angels Home Health

1113 St. Hwy 154, Ste 105

Gilmer, TX 75644

903-680-2330

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

316 N.Polk

Jefferson, TX 75657

903-665-2142

124 North Main St

Linden, TX 75563

903-756-8895

833 N. Washington

Magnolia, AR 71753

ATLANTA, TX

BAGOTA, TX Lewis Home Health CLARKSVILLE, TX

DEKALB, TX Cypress HH DEQUEEN, AR

EL DORADO, AR South Arkansas Home Care GIILMER, TX

HOPE, AR

HUGO, OK

HUGHES SPRINGS, TX Advantage HH JEFFERSON, TX Jordan Home Health LINDEN, TX Cypress HH MAGNOLIA,AR MRMC Home Health

Aging Insight速

870-235-3598

Resource Directory Home Health Services, Cont. MARSHALL, TX Marshalls Homecare & Hospice

111 E. Burleson

Marshall, TX 75670

903-923-8154

Thompson HH

304 University Ave #104

Marshall, TX 75670

903-938-6590

Good Shepard Homecare

401 S. Bolivar St.

Marshall, TX 75670

903-927-1144

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

201 E. Hempstead St.

Nashville, AR 71852

870-845-2208

Howard County Hospital HH

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

1651 Clarksville St.

Paris, TX 75460

903-739-2616

Guardian Homecare

3158 Clarksville St.

Paris, TX 75460

903-737-9865

Jordan Health Services

3745 Lamar Avenue

Paris, TX 75460

903-785-4326

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

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

MT. PLEASANT, TX

MT. VERNON, TX Jordan Health Services NASHVILLE, AR

NEW BOSTON, TX Cypress HH PARIS, TX

SULPHUR SPRINGS, TX

www.AgingInsight.com

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

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

1005 E. Coke Rd.

Winnsboro, TX 75494

903-342-3232

TEXARKANA, TX

WINNSBORO, TX Cypress HH

Hospice Services ASHDOWN, AR Little River Hospice

450 W. Locke St.

Ashdown, AR 71822

870-898-4105

301 West Main St.

Atlanta, TX 75551

903-796-3030

2301 Champagnolle Rd

El Dorado, AR 71730

866-378-0388

Life Touch Hospice

1707 Eastridge Drive

Magnolia, AR 71753

870-234-9112

Serenity Hospice

1316 Main St. Ste# 102

Magnolia, AR

870-901-0500

ATLANTA, TX Kelton Hospice EL DORADO, AR Life Touch Hospice MAGNOLIA, AR

Aging Insight®

71753

Resource Directory

Hospice services, Cont. MARSHALL, TX Heartsway Hospice

205 E. Austin St.

Marshall, TX 75670

903-938-5200

Marshall HH & Hospice

111 E. Burleson

Marshall, TX 75670

903-923-8154

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

707 Lamar Ave 350 N. Collegiate Drive 1305 Lamar Ave. Ste C 3057 Clarksville St. 140 S. Collegiate #100 750 Clarksville St. 420 N. Collegiate

Paris, TX 75460 Paris, TX 75460 Paris, TX 75460 Paris, TX 75460 Paris, TX 75460 Paris TX 75460 Paris, TX 75460

903-905-4574 903-737-0847 903-784-1147 903-739-2427 903-783-1818 903-737-9010 903-785-1800

Cypress Basin Hospice

950 Main St.

Sulpher Springs, TX 75482

903-951-1194

Legacy Hospice

301 Gilmer Street Suite A

Sulpher Springs, TX 75482

903-335-8901

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

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

Legacy Hospice

2407 Moores Lane

Texarkana, TX 75503

430-200-2830

Serenity Hospice

5604 Summerhill Rd. #3

Texarkana, TX 75503

903-255-0430

MT. PLEASANT, TX

NASHVILLE, AR Howard County Health- Hospice PARIS, TX Cypress Basin Hospice Heart To Heart Hospice Legacy Hospice Mays Hospice Platinum Palliative & Hospice Care Premier Hospice Waterford Hospice SULPHER SPRINGS, TX

TEXARKANA, AR

870-773-2621

TEXARKANA, TX

www.AgingInsight.com

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

1700 E. Short Hillsboro St.

El Dorado, AR 71730

870-875-2524

Wesley House

231 Quail Drive

Gilmer, TX 75644

903-734-1784

Bradford House

1704 N. Bradford S.

Gilmer, TX 75644

903-8437601

500 W. 23rd St.

Hope, AR 71801

870-777-8655

Oak Wood House

Main 2907 Victory Drive

Marshall, TX 75672

903-935-6263

Reunion Inn

2801 E. Travis St.

Marshall, TX 75672

903-927-2242

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

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

Brookdale Paris

2410 Stillhouse Rd.

Paris, TX 75462

903-784-8800

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

The Gardens

1625 E. 42nd St.

Texarkana, AR 71854

870-772-0689

Windsor 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

3120 Smith St.

Texarkana, TX 75503

903-831-3911

ATLANTA, TX Wesley House of Atlanta EL DORADO, AR Ella Manor GILMER, TX

HOPE, AR Hope Haven Retirement Home MARSHALL, TX

MT. PLEASANT, TX

PARIS, TX

SULPHUR SPRINGS, TX

TEXARKANA, AR

TEXARKANA, TX

Aging Insight速

Resource Directory

Assisted Living Services, Cont. The Magnolia

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

Brookdale Texarkana

4204 Moores Lane

Texarkana, TX 75503

903-838-3562

Whispering Pines

5002 Elizabeth St.

Texarkana, TX 75503

903-792-8014

Independent Living Services EL DORADO, AR Hudson Senior Center

900 Greet Street

El Dorado, AR 71730

870-863-7393

1307 SE Adams St.

Idabel, OK 74745

580-286-3757

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

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

IDABEL, OK Colonial Lodge Independent Center PARIS, TX

TEXARKANA, AR

TEXARKANA, TX

www.AgingInsight.com

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

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

870-875-1580

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

Gilmer 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

ASHDOWN, AR

ATLANTA, TX

BROKEN BOW, OK

CLARKSVILLE, TX

DANGERFIELD, TX Windsor Place Nursing Center DEKALB, TX The Ponderosa/ Sunny Acres DEPORT, TX Deport Nursing Center DEQUEEN, AR DeQueen Therapy & Living Center DIERKS, AR Dierks Health & Rehab EL DORADO, AR

GILMER, TX

Aging Insight速

Resource Directory

Long-Term Care & Rehab, Cont. GLADEWATER, TX 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

Hughes Spring Nursing Center

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

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

Marshall Manor Nursing Center

1007 S. Washington Ave.

Marshall, TX 75670

903-935-7971

Marshall Manor West

207 W. Merrit St.

Marshall, TX 75670

903-938-3793

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

HONEY GROVE, TX Honey Grove Nursing Center HOPE, AR

HUGHES SPRINGS, TX

HUGO, OK

IDABEL, OK

JEFFERSON, TX

LINDEN, TX Linden Healthcare Center MAGNOLIA, AR

MARSHALL, TX

MT. PLEASANT, TX

MT. VERNON, TX Mission Manor Nursing Center

www.AgingInsight.com

Resource Directory

MURFREESBORO, AR Murfreesboro Nursing Center

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

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

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

Heritage Plaza

600 W. 52nd St.

Texarkana, TX 75503

903-792-6700

NASHVILLE, AR

PARIS, TX

PITTSBURG, TX Pittsburg Nursing Center PRESCOTT, AR

SPRINGHILL, LA Fountainview Care & Rehab STAMPS, AR Homestead Manor SULPHUR SPRINGS, TX

TEXARKANA, AR

TEXARKANA, TX

Aging Insight速

Resource Directory Long-Term Care & Rehab, Cont. 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

Wispering Pines Nursing Home

910 S.Beech St.

Winnsboro, TX 75494

903-342-5243

Trinity Nursing & Rehab

502 E. Coke Rd.

Winnsboro, TX 75494

903-342-6951

WINNSBORO, TX

Sitter / Provider Services EL DORADO, AR Superior Senior Care

515 E. Faulkner Street

El Dorado, AR 71730

870-863-0012

162 Private Rd.

New Boston, TX 75570

903-314-0301

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

Superior Senior Care

4425 Jefferson St 112

Texarkana, AR 71854

888-423-8154

Senior Living Services

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

NEW BOSTON, TX Helping Hands Sitter Service PARIS

TEXARKANA, AR

TEXARKANA, TX

www.AgingInsight.com

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