Transitions in aging 2016

Long-term care Planning

2016

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Medical Equipment

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Assisted Living

Home Care

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Your Local Guide to Aging Well

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2016

LONG-TERM CARE PLANNING

Anyone can make mistakes with estate matters, but you don’t have to

By Nathaniel Sillin

A

dulthood brings certain financial responsibilities like the building of budgets, bank accounts and proper insurance. It’s surprising how few consider a proper estate plan part of that essential mix.

In fact, a recent ABCNews poll found that only about 50 percent of Americans have created a will and significantly fewer have created the supporting estate documents like a living will or a power of attorney.

Preparing now for the end of your life or for illness may not sound like fun, but it is necessary. Having a plan for the future can help bring you peace and even put you on the road to stronger financial security. It can also help those you care most about. We’ve all heard cautionary tales about relatives or friends who did not have a will, and family members who were left with difficult but avoidable situations.

So how do you start an estate plan?

It has a lot to do with carefully drawn documents, but it’s the planning behind them that really counts. I would encourage you to work with a qualified financial, estate and/or tax professional at the earliest opportunity to make sure your plans fit your needs and the needs of your loved ones. Here’s a bit more detail on each.

A will, also called a testament, is the starting point. Wills are generally seen as the umbrella document that drives the rest of an individual’s estate process. A will generally accomplishes the following: • It details how you want to leave your property to specific people or institutions after you die.

• If you have minor children, it allows you to name a guardian to care for them after you die or become inca-

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“A recent ABCNews poll found that only about 50 percent of Americans have created a will.” pacitated. It also indicates who will manage your kids’ assets, including what you leave them.

• It lets you name your executor, the trusted person who will carry out all your wishes in the will.

If you die without a valid will, your state’s court system may get involved in distributing your assets depending on intestacy laws on the books.

A living will, also known as an advance directive, allows you to define how you want to be medically treated under specific situations, including irreversible injury or terminal illness. Depending on your state laws, living wills allow you to express your exact wishes about feeding, breathing assistance and other life-sustaining procedures in addition to how you want them carried out at certain decision points in your care. A living will may also provide information on pain or infection medications you either want or don’t want administered, as well as specific instructions about your remains, including release to your family or donation for medical research.

Powers of attorney are legal documents that allow you to name a specific person to take care of your money or health care wishes if you are incapacitated. It is particularly wise to seek professional counsel from a qualified trusts and estates attorney in writing these documents. The person you designate as health care power of attorney will be speaking with doctors and executing your wishes on various forms of treatment; your financial power of attorney will be in charge of

paying your bills and depending on the range of responsibilities you outline for that person, handling your investment and business affairs. Both are extremely important jobs that should be carried out by people you trust, and that’s why they need to be people in the know.

Make their preparation part of your estate planning so they know how to

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step in and carry out the assignments you’ve given them efficiently.

Estate planning is the final, responsible step in all good financial planning.

While it may be unpleasant to do, it is essential in taking care of family, loved ones and causes you support after you’re gone.” ■

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Transitions in aging

4

AGING IN PLACE

Common sense upgrades for a safer bathroom

By Lynn Pribus

A

lthough kitchens are a top candidate for remodeling and upgrading, “Remodeling Magazine” sees bathroom remodels as being an even better investment from a financial standpoint.

An important consideration these days is enhanced bathroom safety, including features like grab bars, roll-in showers and good lighting. It makes little difference in the cost of a remodel, but can be a valuable factor increasing the marketability of a property or the ability of residents to age in place.

2016

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It’s time to change the image of these safety features as being just for seniors.

For example, people need to see grab bars as safety bars that can also provide children or any-aged persons with disabilities gain an extra ounce of security with a steadying bar.

These days grab bars come in designs that provide architectural interest as well as safety. Materials include teak, various metallic finishes and even glowin-the-dark acrylic. An interesting new gizmo is a grab bar with built-in LED lighting, which creates an all-in-one night light/grab handle. These can be

“An important consideration these days is enhanced bathroom safety, including features like grab bars, roll-in showers and good lighting.”

especially useful for folks with poor eyesight.

Barrier-free homes are also important. Removing shower sills, widening doorways and installing accessible handles on doors, sinks and faucets allows owners to remain in their home as they age.

It also increases the value of the home. More and more the public is seeing the advantages of a barrier-free home, whether it is new construction or a renovation project.

For instance, many people are replacing those aging fiberglass all-in-one shower/tub combinations with tiled, walk-in showers with no sill. This means easier access for persons with disabilities as well as older people.

A shower seat is another nice feature. While a removable plastic seat is useful, it may not be completely stable and also has a hospital feel to it. Instead, why not install a spa-like seat of tile or teak wood? A tile bench, of course, is permanent. Teak is waterproof and elegant, and the bench

could either be built in or one that folds up.

It’s smart to put the shower controls right by the entrance so users can stay dry while the water is warming up. In addition, technology has made some very nice advances in user-friendly fixtures. A hand-held shower option is a worthwhile investment and there are single-handle mixers offering easier control over flow and temperature for sinks, tubs and showers. There are even touchscreen-operated showers.

Finally, it’s prudent to have bathrooms well lit. Even during sleep hours, it’s important to have sufficient lighting between bed and bathroom. Illuminated light switches are easy to find in the dark and those illuminated grab bars are perfect. Another tactic would be a sensor light that goes on automatically when someone enters a room. A third option would be attractive nightlights that provide adequate light. They come in a variety of styles from purely practical to whimsical. ■

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MEDICAL SERVICES

Exploring options for managing pain

M

aybe your knees aren’t what they once were and a leisurely walk around the block has become a painful ordeal.

Perhaps too much time hunched in front of the computer has left your shoulders an aching mess.

Young or old, you’re in good company. More than 11 percent of Americans suffer from chronic pain, according to the National Institutes of Health, and are looking for ways to rid themselves of those aches, even if just temporarily, so they can enjoy life without wincing and groaning.

“People can experience chronic pain for a number of reasons,” said Dr. Ronald Shapiro, medical director of Physicians Technology, LLC. “They may have had an injury. They may have arthritis.

Sometimes just sitting too long at the computer without a break can lead to shoulder problems.”

Although anyone can experience chronic pain, a National Institutes of Health (NIH) study showed that women, older people and non-Hispanics were more likely to report pain. Asians were less likely.

Shapiro said there are a number of options patients can turn to for treating pain. Some of those include: • Pain-relieving medication. Both over-the-counter and prescription medications are used by millions of Americans. Those medications do provide relief, although the Centers for Disease Control recently urged physicians to cut down on the amount of opioids they prescribe because of the risk that patients can become addicted to these narcotics, as well as the alarming increased incidence of fatal prescription-medication overdose.

• Physical therapy. A good physical

therapist can do wonders for helping alleviate a patient’s pain and assist them in achieving a more active lifestyle than they might have imagined. The downside is that the cost of those weekly visits can add up.

• Complementary health approaches. The NIH study says that many people turn to alternative approaches to pain relief, such as yoga, massage and meditation. The NIH says those may be able to help with managing pain and other symptoms that are not consistently addressed by prescription drugs and other conventional treatments.

• Technaceuticals. Technology is emerging as an alternative option for temporarily relieving pain, especially as a replacement for medication.

Shapiro has been involved in research in that area and co-invented with David B. Sutton a device for home use called the Willow Curve, a low-level smart device that treats joint pain.

Because it’s also a smart computer, the device assesses the condition of the joint and delivers a targeted digital treatment to temporarily relieve pain. A variety of ailments can be treated with such technaceuticals, including arthritis, general joint pain, knee pain, tennis elbow and rotator cuff injuries, among many others.

For more information on the Willow Curve, visit www.willowcurve.com.

“The opportunity is out there to improve the quality of life for anyone who suffers from chronic pain,” Shapiro said. “A person shouldn’t feel that they just have to endure it. Whether it’s technology, physical therapy or something else, they have options that can make their day-to-day living a lot better.” ■

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2016

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Senior Homecare by Angels

HOME CARE

New methods to pay for home care

By Ora Lee

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amilies need to understand their options when it comes to paying for care. First, it’s important to understand the level of care you need. Senior care can range from a couple of hours a week to 24-hour skilled nursing care.

You may think that Medicare is the only option to pay for long-term care, but Medicare only covers nursing and clinical care for acute conditions, usually following a stay in a hospital or rehabilitation, or skilled nursing facility.

Rates vary on how much care will cost. Generally 24-hour care in a nursing home will be much more expensive than private in-home care. However, those rates also vary depending on how many hours a caregiver’s services are needed.

Luckily, there are more options to assist you in paying for long-term care.

Medicaid covers a limited amount of long-term, in-home care for those who qualify. Medicaid will only pay for in-home care if provided by a Medicaid-certified home care agency, not by an independent, paid caregiver or family member. To find out about Medicaid eligibility and coverage for in-home care, call 1-800-221-3943 or visit www.colorado.gov. You can also contact the Area Agency on Aging in Mesa County at 248-2717, and Region 10 in Delta and Montrose at 249-2436.

PACE, Program of All-Inclusive Care for the Elderly provides comprehensive home and community care for frail elders who would otherwise require nursing home care. PACE is only available in certain areas and eligibility is restricted to low-income seniors, usually those eligible for both Medicare and Medicaid.

Veterans benefits - Veterans and the surviving spouses of veterans may be eligible for some in-home care assis-

tance from the Department of Veterans Affairs, either through health benefits offered to veterans or in the form of a monthly cash benefit. If your loved one is housebound, these benefits may be even higher.

Long-term care insurance - If you have a long-term care insurance policy, it may include coverage for in-home care.

Life insurance policy - Convert your life insurance policy into cash to help pay for in-home care.

Personal and family assets - There are several ways personal/family assets can be used to help pay for in-home care, including tapping into the equity in your home and gathering contributions from family members who aren’t actively helping with daily care.

Reverse mortgage is a special type of home equity loan that allows you to receive cash against the value of your home without selling it. For most, you can choose to receive a lump sum payment, a monthly payment, or a line of credit. You continue to live in your home and you retain title and ownership of it. You don’t have to repay the loan as long as you continue to live in the home. Instead, the amount you owe, based on loan payouts and interest on the loan, becomes due when you or the last borrower, usually the last remaining spouse, dies, sells or permanently moves out of the home.

Uranium workers’ benefits - If you or a family member incurred a lung illness, kidney cancer or fibrosis silicosis within the last 60 years (even if the family member is deceased) and they worked as a uranium miner, uranium miller, worked at a processing plant or transported uranium between 1942 and 1971, they may qualify for $150,000 to $275,000 tax free.

This compensation can include in-home care. ■

2016

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Will Medicare cover a home health aide?

By Teresa Ambord Generally, no but it might, if you meet the requirements.

1) You must be homebound. In other words, to leave your house you must require the use of a wheelchair or walker or other device.

2) You have a plan of care approved by your doctor, showing that you need part-time skilled nursing care or skilled therapy services from a physical or speech therapist. Your doctor may also specify that you need a home health aide (or occupational therapist) to assist with activities of daily living such as bathing, dressing and using the bathroom.

This plan of care is good for 60 days and must be renewed to remain in force.

Note: Be aware that if you do not need skilled therapy or skilled nursing services, Medicare will not pay for an aide to provide help with activities like bathing, dressing, etc.

• • • •

3) The home health agency you choose must be certified by Medicare. If you meet all these requirements, Medicare may pay for home health care up to 28 hours per week. But Medicare will not pay for homemaker services like shopping, cleaning and meal prep. What other options do you have if Medicare won’t cover it?

• For low-income people, Medicaid might pay. All states offer some form of Medicaid coverage for in-home care.

• Long-term care insurance or possibly a life insurance policy may pay for in-home care.

• Veterans may be able to get coverage for in-home care in some communities. It’s called Veteran-Directed Home and Community Based Service, and it allows veterans a flexible budget to pay for in-home care. Wartime veterans and their spouses may qualify for additional in-home services, or assisted living or nursing home care.

To qualify you must meet certain income and assets limits. Learn more at www.va.gov/geriatrics or call 800827-1000. ■

Transitions in aging

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Transitions in aging

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RESOU

LONG-TERM CARE PLANNING When planning for your long-term care you should start saving for retirement at birth. But who has that kind of foresight? Your projected retirement savings will have a great deal to do with your long-term care choices and now is a great time to sit down with a good attorney, a good financial planner and your insurance agent.

Center for Independence.......................................................241-0315 A nonprofit agency offering free services to seniors with disabilities and age-related conditions. Services include help with housing, benefits, low vision, hearing loss, health and wellness.

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Colorado Injury + Pain Specialists….....................................242-0162

Val Begalle, Cherry Creek Mortgage…................................ 245-6404

Colorado Injury + Pain Specialists is a free-standing, multi-disciplinary pain management center dedicated to profoundly changing the way patients experience the journey through injury and pain.

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AGING IN PLACE The experts agree that the best place for you to live as you grow older is in your own home. But in order to do so, you may need to change your house to fit your changing needs. It could be as simple as adding a grab bar in the shower or as involved as adding an elevator if you’re having trouble getting up and down the stairs.

Tile Meister............................................................................ 244-8453 Tile Meister specializes in tile for complete remodels in Western Colorado. We install skylights, solid surface countertops and handicap accessible fixtures for your shower and bath. Aging in place specialist.

HOME CARE You should live long enough that someday your kids will say to you, “Ew! I’m not doing that.” When that happens or when you need assistance around the house, consider calling someone to help you out.

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Our services ensure you or your loved one will have the highest quality care at home.

Nuclear Care Partners.....................................................888-525-5111 Visiting Angels...................................................................... 254-8888

MEDICAL EQUIPMENT

Visiting Angels is a non-medical home care service that assists people by maintaining the independence of their daily routines and familiar surroundings. We help people age and stay at home.

As you age, you may need tools to help you walk, such as a cane, walker or a wheelchair. Modern technology has made great advancements in helping people hear and see more clearly.

AAA Hearing......................................................................... 243-6440 AAA Hearing is a locally owned company with friendly faces eager to help you hear your best. Using the latest advances and products, we provide comprehensive, compassionate and cost-effective hearing care.

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MEDICAL SERVICES Some medical services, like foot surgery, will keep you mobile while other medical procedures can keep you looking younger. Whatever you need, we have local experts that can help.

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Transitions in aging

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At The Oaks Assisted Living, enjoy the freedom of living in safety and comfort. With private rooms and daily activities, you’ll become family, with staff available when you need them.

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You’re ready to move but not yet into assisted living. Would you like to live in a place where other people your age live? A senior living community might be just the ticket. Is it time to downsize? These experts can help.

When you need more assistance and some medical care.

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ASSISTED LIVING

BeeHive Homes..................................................................... 549-6554 Home away from home, focused on providing quality assisted living services, including medication monitoring, healthy home cooked meals, housekeeping, furnished private rooms with private 3/4 bath, activities, and 24-hour security.

Brookdale Sunrise Creek (Montrose)................................... 240-0600 Purposeful living with breathtaking views at our independent, assisted and memory care senior living. It’s the perfect retirement destination for active seniors who seek tailored opportunities for living an optimum life.

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HopeWest is dedicated to profoundly changing the way our community experiences serious illness and grief—one family at a time. The organization provides care in Delta, Mesa, Montrose, Ouray and Rio Blanco counties.

BEREAVEMENT When it’s time to go you can always go in style.

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When medicine can no longer offer you a cure, hospice care can provide you comfort and support when you’re terminally ill. But what’s really cool is that hospice care can offer that support to your family and friends as well. While they can’t offer you a miracle drug, what they do offer is a miracle.

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Pet euthanasia, hospice and pain management. Please contact us to help with your pet’s end-of-life journey. Convenient and peaceful services provided in the comfort of home.

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Transitions in aging

2016

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SENIOR LIVING

When housing needs change, what are your options?

By Teresa Ambord

W

hether you’re considering new housing for an elderly relative, or thinking ahead to your own needs, the task of choosing the right place to live can be overwhelming. On the other hand, the choices are so much better than they once were. Creating safe, homey, pleasant residences for seniors is a strong industry in the U.S. these days. Instead of waiting till the need is immediate, think over the possibilities while there’s time. Here are some of the most common options.

INDEPENDENT LIVING People who are able to live on their own and don’t have specific medical care needs may be best served by an independent retirement community. For the most part these communities appear no different than another neighborhood, except they generally have age restrictions, such as 55 and up, and possibly enhanced security.

A retirement community could consist of individual homes, mobile homes, townhouses or condos. Some communities are set up for renters and others for home ownership. This type of arrangement brings resources together so seniors can live independently, but if they want or need additional services, such as help with housekeeping, laundry, group meals or prepared meals, transportation, security, and social and cultural activities, they are readily available.

ASSISTED LIVING You’ve probably seen assisted living facilities springing up everywhere. They provide some medical care for those who need a little more, but still allow residents to feel independent. These residences generally have the ability to help with managing prescriptions,

bathing, dressing and grooming if needed. They may provide or arrange for transportation and assist those who need help with personal mobility. Some assisted living arrangements are like small, private apartments, with health care personnel on the premises at all times, or at least on call.

In most facilities you can opt for other services, for an additional fee, such as housekeeping help, personal laundry service, Alzheimer’s care, etc.

NURSING HOMES Nursing homes are available for those who require round-the-clock care but don’t need to be in a hospital. In the recent past, many of these homes were known as rigid, rule bound and driven by tight schedules. Over time they have become more focused on the needs of the residents, so they can begin to feel at home. Some nursing homes are developed to be like small households, where a group of people live under one roof, share meals and engage in activities together. Some have dogs or cats living there, or allow residents to bring their own pets with them.

IS IT STABLE FOR THE LONG TERM? When you are checking out an option, you’ll need to be armed with specific questions. The first area of concern should be the stability of the facility. You can start looking into this by calling the local Area Agency on Aging (Mesa County: 248-2717 and Delta-Montrose: 249-2436).

Here are some questions to ask: • Is the facility experiencing legal or financial problems?

• Are there pending lawsuits or state inspection issues against the facility?

• Is it able to maintain an adequate and qualified staff?

2016 • Does it have current state and local licenses?

• Does it have adequate liability and malpractice insurance?

Also ask your physician, nurses and other health care professionals, hospital discharge planners, and social workers. The reputation of a housing facility for seniors and the disabled gets around fast among those who deal with the elderly, so don’t hesitate to ask.

Once you know a facility is sound, get more personal. Visit the place at least twice, during different hours and days of the week to see for yourself what the quality of life is for residents.

Talking to the staff can reveal a lot about how they feel about residents and can give insight into how you or your loved ones will be cared for.

When I visit my aunt in the rest home where she lives, the desk attendants ask who I am there to see. I mention her name and although it is a large facility, they know who she is, where her room is, whether she had visitors recently, and anything unusual about her day.

As I walk to her room I notice staff members interacting with the residents and I’m always impressed.

Transitions in aging

www.BeaconSeniorNews.com MORE RESOURCES Seniorliving.org suggests when you visit a facility, have these questions in mind.

• Is the staff respectful and friendly?

• Is the nursing home clean?

• Do they offer social, recreational, religious and cultural activities that interest you or your elderly relative?

• Can you choose your waking, bedtime and bathing time?

• Can you get food and drinks any time? Is the food good? Ask to try it.

• Can you have visitors anytime?

• Can you have a pet?

• Is transportation provided?

• How much privacy is there?

• Can you decorate your room how you like?

• Is the temperature comfortable?

• Is there good natural lighting?

• Do you have a telephone and TV in the room? ■

THE COSTS OF LONG-TERM CARE Every year, Genworth Financial does a survey of the average costs of various services around the country. Here’s the information for the Grand Junction area in 2016.

Homemaker Services.........................................................$125 per day Home Health-Aide Services...............................................$125 per day Adult Day Health Care.........................................................$62 per day Assisted Living Facility .............................................. $3,795 per month (private one bedroom, single occupancy) Nursing Home....................................................................$220 per day (semi-private room) Nursing Home....................................................................$282 per day (private room).

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NURSING HOME

Strategies for paying for long-term care

P

eople pondering their retirement years often conjure images of spending more time on a favorite pastime or traveling around the country or the world.

Health concerns can intrude on those idyllic scenes, though, not only affecting enjoyment of life but also punching a heavy dent in retirement savings.

“As we age, usually our medical or long-term care expenses increase, sometimes depleting our assets to a level of crisis,” Financial advisor Jake Lowrey said. “It’s important for retirees, and anyone planning for retirement, to become educated about what the pitfalls

focus on people

our residents

their lives

their families

are and what they need to do to avoid losing their life savings.”

Long-term care can especially burn a hole in savings accounts. In 2012, for example, nursing home care averaged $74,800 a year, according to a report by the Henry J. Kaiser Family Foundation.

Meanwhile, assisted living facilities averaged $39,500 per year, and home health services averaged $21 per hour.

More than 10 million Americans need some sort of long-term care, the Kaiser report said. That number covers all ages, even children, but about half are people 65 and older.

“Those older Americans had looked

forward to enjoying their golden years,” Lowrey said. “They should be able to have actual golden years instead of what can end up being scary years, both personally and financially.”

Certainly, being able to maintain good health is a key factor in protecting savings and making retirement enjoyable and satisfying, he said.

But life doesn’t always work out that way. Fortunately, there are strategies seniors can use to lessen the impact of expenses brought on by long-term care needs. According to Lowrey, some of those include: • VA benefits. Military veterans may be able to offset nursing home or assisted living expenses through benefits provided by the U.S. Department of Veteran Affairs. A veteran’s eligibility for long-term care services would be determined based on his or her need for ongoing treatment, personal care and assistance, as well as the availability of the service in the area where the person lives, according to the Department of Veteran Affairs.

2016 Other factors, such as financial eligibility, a service-connected disability, insurance coverage, and/or ability to pay may also come into play.

• Medicaid compliant SPIAs. A SPIA is a single-premium immediate annuity.

Typically, a SPIA is a contract with an insurance company where you pay the company a sum of money up front (the premium), and the company promises to pay you a certain amount of money periodically for the rest of your life.

A Medicaid compliant SPIA is a specially designed annuity that pays out over the person’s “life expectancy” and has other specific characteristics. A couple who put money in a Medicaid annuity are able to avoid having the income from that annuity count against the financial assistance a spouse receives for nursing home care.

• Setting up a trust. Trusts can help shelter wealth from the look-back periods in Medicaid requirements and assist in qualifying for VA programs, among other advantages. ■

2016

www.BeaconSeniorNews.com

Transitions in aging

A wellness transition to home: Learn about your rehabilitation options

By Auni Anderson, Larchwood Inns

A

s we age, the likelihood that we will end up in the hospital increases, whether it’s because of a planned admission for procedures, such as hip or knee replacement, or an unexpected, emergent stay following a fall or acute illness.

Hospital stays are much shorter than they were 30 years ago. But oftentimes, additional time is needed for recuperation and rehabilitation. Therapy is needed to improve strength and mobility, and nursing care is required for medication, pain and wound management.

Upon leaving the hospital, you have two primary options.

1) Home care with home health services 2) A short stay at a skilled nursing facility

The discharge planner at the hospital can discuss these options with you, and give you information on companies from which you may choose.

NO PLACE LIKE HOME Most of us would likely prefer to be able to go directly home. Home health is a service provided to patients who do not need 24-hour care, or who can be cared for by family or private caregivers.

Typically, home health services include visits by nurses and therapists two to three times per week for a couple of weeks. There are several wonderful companies to choose from in the Grand Valley, but keep in mind that some of them do not accept certain Medicare Advantage Plans.

TRANSITION IN COMFORT When 24-hour care is recommended, due to secondary to limited ability to

perform activities of daily living, safety concerns, and/or limited support at home, a short stay in a good skilled nursing facility is the best place to be.

Skilled nursing facilities provide 24/7 nursing care. A licensed nurse administers medications, cares for wounds as directed by your physician, and assesses pain and overall health while communicating with your physician.

Therapists work with the patient an average of five days per week on strengthening, safety, transfers and other daily living activities, and will often assess your home for needed adjustments to accommodate your return. Speech therapists assist patients who have difficulty with swallowing or speech.

Skilled nursing facilities employ a full-time dietician to assist patients with

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diabetic or other special diets, weight loss or gain, malnutrition and other concerns. The facility has an entire team of professionals whose goal is to provide a comfortable, friendly environment that promotes rehabilitation for a safe transition to home as soon as possible. Sometimes this team includes professionals in social services, activities, housekeeping, laundry, maintenance and medical records. Some facilities even have a beauty shop.

SCHEDULE A VISIT You are welcome to visit most rehabilitation facilities prior to making a choice for yourself or a loved one. Make an appointment with the admissions coordinator, take a tour and ask any questions you may have. Being knowledgeable can alleviate undue stress. I think you’ll be pleasantly surprised at the homelike atmosphere you will find in most homes. â–

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Transitions in aging

www.BeaconSeniorNews.com

HOSPICE

Understanding hospice care and Medicare coverage

By Ron Pollack WHAT IS HOSPICE CARE? Hospice care is a program of care and support for patients who are terminally ill. These patients may no longer want to try to cure a terminal illness, or their doctor may have determined that efforts to cure an illness are not working.

To qualify for hospice care, the patient’s regular doctor and a hospice medical director must certify that the patient is terminally ill and has six months or less to live.

The goal of hospice care is to help patients who are terminally ill live comfortably. Hospice services may include physical care, counseling, drugs, and other treatments that can help a person feel more comfortable physically

and emotionally.

Hospice care can include doctor and nursing services, home health aide and homemaker services, social work services, grief and loss counseling, and short-term care in a medical facility for pain and symptom management. Care can be provided at home or an inpatient facility.

WHAT MEDICARE BENEFITS ARE AVAILABLE? Medicare hospice benefits are available to patients who are eligible for Medicare Part A (hospital insurance) and who are certified as having six months or less to live (if the illness runs its normal course). Patients must sign a statement choosing hospice care instead of other Medicare-covered ben-

efits to treat the terminal illness.

Medicare will still pay for covered benefits for any health problems not related to the terminal illness.

Once a patient is certified as having six months or less to live and has proactively chosen hospice care, Medicare covers a full package of related services. There is no deductible or upfront amount the patient must pay before coverage begins. The copayment or charge for each prescription drug, and products for pain relief and symptom control cannot be more than $5.

Services a patient receives while in hospice care are covered under original Medicare, even if the patient has a Medicare Advantage plan (like an HMO or PPO). If the patient has original Medicare and a Medicare supplemental policy (Medigap), the Medigap policy covers copayments and charges for drugs and respite care. The Medigap policy covers health care costs not related to the terminal illness.

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2016 Once a patient chooses hospice care, Medicare will no long cover treatment or prescription drugs intended to cure the terminal illness. However, patients always have the right to stop hospice care at any time. At that point, health care for the terminal illness and services not related to that illness are covered as usual under Medicare.

Medicare does not cover room and board if a patient is receiving hospice care in the home, in a nursing home, or in a hospice inpatient facility. If the hospice team determines that the patient needs short-term inpatient care (or if the patient’s caregiver needs respite services) and the hospice provider arranges the stay in a facility, Medicare will cover the ambulance transportation and stay.

Respite care for the caregiver is covered for up to five days and can be provided on an occasional basis only, and may require a small copayment For more information about Medicare rights, visit Medicare.gov/appeals or call 800-633-4227 (MEDICARE). ■

2016

www.BeaconSeniorNews.com

BEREAVEMENT

When someone dies, you need to do…what?

By Teresa Ambord

A

loved one has died, the pronouncement of death has been made, the body transported away. You know there are things you need to do, people to talk to and details to take care of, but where to begin?

Notify these people • Assuming the doctor was not present or involved, let the physician know of the death. If there was no physician, Consumer Reports says to let the county coroner know.

• You’ll want to let family and friends know. You may call a few key people and ask them to call others for you.

• If the person was still working, let his or her employer know.

• If the person was an active member of groups like a lodge, senior center, or club, notify them of the passing.

The funeral and obituary The deceased may have made a prepaid plan for burial or cremation. Was the person a member of the military, religious group, or fraternal organization? They may have burial benefits or conduct funeral services.

You may need to prepare an obituary. This is basically just a notice of the death, but you may like to mention the surviving family members, and churches or organizations the deceased belonged to. Also, if the deceased had a favorite charitable cause, like an animal shelter, you could mention this in the obituary for people who would rather send a donation than flowers.

Death certificates and the will Consumer Reports says within 10 days of the death, ask the funeral home for multiple copies of the death certificate. Then you will need to contact: • The bank.

• The life insurance carrier.

•

Social Security and pension services that pay benefits to the deceased.

They will need to stop benefits paid to him or her, but also this is the time to ask if there are survivor benefits.

• The investment advisor.

• Utility companies and the post office to stop service or forward mail.

• A trust or estate attorney who will advise you about transferring assets and help you with probate.

If there is a will, take it to the appropriate county or city office to begin probate.

Executor of an estate? Me? If you are the executor of the decedent’s will, there are tasks to be done.

Let’s say the deceased is your elderly widowed father. You may need to rifle through his bills and other paperwork to see what is owed to keep from incurring late fees and interest charges.

You’ll need to find the assets he owned to pay his debts.

If there is not enough money and other assets to pay what is owed, chances are the debts will be written off. However, if there are assets to be inherited they need to be sold to pay his debts. Consult an attorney before you do anything.

For large debts, like a mortgage, there may be insurance to pay it off, such as a life insurance policy.

Before any remaining funds can be distributed to heirs, the executor will need to see to it that income tax returns and estate tax returns, if necessary, are filed, and the taxes due are paid. If you, the executor, do not ensure this gets done, the IRS can hold you personally liable for taxes that were owed, including penalties and interest.

More about taxes Even after death, the IRS wants to hear from the decedent. A final tax re-

Transitions in aging

turn covering the period from January 1 through the date of death needs to be filed. It is due on April 15 the year following the death. If the person was married, the husband or wife will file as a surviving spouse, and the filing is not much different than if there had been no death.

If the person was unmarried, the return will be filed as usual, up to the date of death. If the tax return includes large medical expenses, which will not be covered by insurance, the accountant needs to know this, along with other medical expenses incurred during the year. This is true even if the expenses have not yet been paid.

Is an estate tax return needed?

This is a question to ask your accountant to be certain, however, in general, in 2016 an individual’s estate has to be worth more than $5.43 million before estate tax would be due.

If you are the executor of a sizeable estate, even if you believe no estate tax is due, talk it over with an attorney to be sure legalities are covered. ■

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