Senior Resource Guide Houston (Spring/Summer 2022) by Senior Resource Guide for the Modern Caregiver

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SENIOR

HOUSTON EDITION SPRING/SUMMER 2022

RESOURCE guide your

ULTIMATE GUIDE TO

OVERCOMING GUILT

with senior care decisions

REMINISCENCE THERAPY

An effective memory tool for caregivers

aging care

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2021

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2020

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WE SPECIALIZE IN HOME CARE

O M E CA R E

WE EXCEL IN DEMENTIA CARE

We provide customized care using a Montessori and holistic approach because you deserve the best quality of life. And, our COVID-19 procedures are designed to ensure your safety. Personalized Care Light Housekeeping | Meal Preparation | Grooming/Bathing/Dressing Customized Activities/Hobbies | Hospital/Rehab to Home Companion Care (in-home/facility/appointments) | Errands/Grocery Shopping

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Senior primary care centered on

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“For me, they’ve been fantastic. They are always ready to answer my questions and any concerns I may have.” María, CenterWell patient

A doctor’s office focused on the needs of seniors: C

CMY

Convenient locations

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Schedule a tour at one of our Houston locations: Baytown | Beaumont | Conroe | Downtown East | Gulfgate Hiram Clarke | Humble | Jacinto City | Little York | Pasadena Port Arthur | Sunnyside | Tidwell | Westside Plus 2 locations now open in: Emancipation | Sharpstown Become a patient or schedule a tour today Call 713-728-6698 or visit SeniorFocusedHouston.com Monday - Friday, 8am - 5pm CenterWell Senior Primary CareTM accepts Aetna, Cigna, Humana, Memorial Hermann, TexanPlus and Wellcare of Texas Medicare Advantage plans. Follow us @CenterWellPrimaryCare to learn about activities and events CenterWell does not discriminate on the basis of race, color, national origin, age, disability or sex. ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-877-320-2188 (TTY: 711). 注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-877-320-2188 (TTY: 711). GCHKU9REN

the

CAREGIVING journey Rosalynn Carter says there are only four kinds of people in the world:

Those who have been caregivers Those who are currently caregivers • Those who will be caregivers • Those who will need caregivers • •

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SPRING/SUMMER 2022

aregiving has a way of creeping up on us. As family, friends and neighbors, we all want to be there for our loved ones when they need us. Very few of us see ourselves as a “caregiver,” and most of the time we haven’t had any training on how to be a caregiver, or an understanding of the depth the role requires. For the majority, it takes a “trigger event” such as a fall, hospital admittance or diagnosis of a health condition before there’s full realization of the situation and what plans/actions need to take place. The Senior Resource Guide is designed and geared towards the unique needs of the modern caregiver. We’re here to help take the guesswork out of this challenging role by providing support and knowledge-based information at your fingertips when you need it—both in print and online. As you journey through different stages in your caregiving quest, our hope is that you’ll be able to use the Guide to help create space for flexibility and make well-informed decisions. At the end of the day, feeling good about your care and efforts, as well as seeing your caregiving experience as a positive expansion and transformation, will help you and your loved one live more fully. In the words of our Founder, here’s to your quest!

TRANSITION AND REFLECTION “What do I do now that they’re no longer here? How can I honor my journey? How have I grown?”

LATE PHASE FINDING BALANCE “I’m needing to recharge but there’s not enough time.”

• 5 Vital Tips to Help Deal With Caregiver Stress (see pg. 80)

FINAL PLANNING “How do I make sure they’re taken care of and their wishes are met?”

• Understanding Hospice (see pg. 146)

SHIFTING PRIORITIES “I know this is what’s going on and need to give it attention.”

INCREASING DEMANDS “This is getting bigger and needs more of my attention.”

MAJOR TRIGGER EVENTS “What are our next steps now that this event has happened?”

• Questions to Ask During Hospital Discharge (see pg. 117)

• Home Care versus Home Health Care (see pg. 74)

IDENTIFYING YOUR ROLE “I can help out.”

• Setting Expectations for Your Role as a Caregiver (see pg. 20)

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SENIOR RESOURCE GUIDE

• Signs Not to Ignore: Dementia versus Normal Aging (see pg. 102)

• Getting Connected With Help (see pg. 28) • 5 Must-Have Legal Documents (see pg. 50)

DETECTING CHANGES “Is this part of normal aging?”

“This is not normal aging, what is it and what can I do?”

PLANNING AND PREPARING

HOUSTON EDITION

MID PHASE

CONTENTS HOUSTON EDITION

SPRING/SUMMER 2022

GENERAL INFO 4

The Caregiving Journey

Our Legacy

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THE ROLE

The Senior Resource Guide Team

What to Do When You Need a Break

Get Connected

THE PLAN

How to Handle Anger + Difficult Behavior

30 What Level of Care is Right

Overcoming Guilt with Senior Care Decisions

20 Setting Expectations for Your Role as a Caregiver

5 Steps to Take When Your Parents Require Different Levels of Care

What’s an Adult Day Center?

Volunteering Opportunities

Transition Home Healthcare (see also pg. 32B)

40 Warning Signs of Unsafe Driving in Seniors 42

INITIAL MEDICAL CARE

Ombudsmen are Here to Help

Understanding Medicare: Parts, Plans and Meeting Your Needs

BlueCross BlueShield of Texas

Make the Most of Your Doctor’s Visits

CenterWell Senior Primary Care (see also pg. 3)

Mobile Care

A Guide to Medication Obstacles

CONVERSATIONS

How to Talk with Your Parents About Their End-of-Life Wishes How to Talk with Your Siblings About Caregiver Responsibilities

LEGAL + FINANCIAL

50 Five Must-Have Legal Documents

When Do You Need to Consider In-Home Care?

Fail-Proof Activities Based on Your Loved One’s Care Level

Home Care Versus Home Health Care

Your Dream Remodeling (see also pg. 1)

Home Care Comparison Chart

SENIOR RESOURCE GUIDE

DAILY CARE

HOUSTON EDITION

MID PHASE

CONTENTS HOUSTON EDITION

SPRING/SUMMER 2022

SELF CARE

Meaningful Minutes for Caregivers

80 Five Vital Tips to Help Deal with Caregiver Stress

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DIET + WELLNESS

Why are Seniors More at Risk of Dehydration?

How Can You Stimulate a Senior’s Appetite?

90 Homemade Turmeric Almond Dressing Recipe

MEMORY + DEMENTIA

Steps to Take After a Memory Issue is Recognized

Reminiscence Therapy

Tips for Effective Alzheimer’s Communication

102 Signs Not to Ignore: Dementia Versus Normal Aging 105 Platinum Senior Care (see also inside front cover) 107 Paying for Long-Term Care 109 Caring for a Loved One with Dementia 111

Anthology of Tanglewood (see also pg. 2)

112

133 Questions to Ask When Looking for an Assisted Living Facility

NEW STEPS 112 Care Transitions 114 What Type of Mental Health Professional is the Right Fit? 117 Questions to Ask During Hospital Discharge 119 PAM Health (see also back cover) 120 Choosing the Right Rehabilitation Center

122

137 Questions to Ask When Considering Skilled Care 139 Momentum Skilled Services (see also inside back cover) 140 What’s Skilled Care and Where Do I Start? 143 Looking at Skilled Nursing Options 145 Pillar Stone Healthcare Company, LLC (see also pg. 32A)

SENIOR LIVING

122 Types of Residential Care for Seniors

150 Hospice Options

156 Preparing & Presenting a Eulogy

152 Questions to Ask When Choosing a Hospice Program

158 7 Items to Consider When Planning a Celebration of Life

154 Steps to Take After the Passing of a Loved One

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146 Understanding Hospice

LATE PHASE

HOUSTON EDITION

125 Senior Living Communities

Cora Hobbs 1915-2006

Our

Karyn Dean 1957-2020

LEGACY

SRGTEXAS.COM

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hat began as a simple collection of local resources has blossomed into what we now know as the ultimate guide to aging care. As a caregiver for her grandmother and an eldercare advocate for over 25 years, our Founder Karyn Dean realized she was not alone in the quest for information and resources. It was her dream to create a reliable resource that caregivers, seniors and eldercare professionals could turn to when navigating the many challenges associated with aging—thus was born the Senior Resource Guide. Although Karyn is no longer with us, her dedicated mission of educating family caregivers and senior care professionals as well as her memory lives on. Her beautiful spirit guides every thought and decision throughout our transition into the modern caregiver’s resource. What started out as a passion project with her husband quickly grew into something more when their children united behind the mission and joined SRG. Today, a team of compassionate individuals are part of the SRG family and bring an enthusiastic energy to helping caregivers through their journey.

HOUSTON EDITION Spring/Summer 2022

PUB L I S H ER The Dean Family

CO N T R I B U TO RS Anthology of Tanglewood, John B. Earthman, Mayo Clinic, Momentum Skilled Services, PAM Health, Pillar Stone Healthcare Company, LLC, Sharon Wagner, Texas Health and Human Services, The American Elder Care Research Organization

A RT D I R ECT I O N /G RA P H I C P RO D U CT I O N Erin Suwwan, Jaclyn Threadgill – LuckyYou! Creative

SA L E S Alex Dean – Director of Business Development Morgan Keefe – Campaign Success Manager Caroline Davis – Account Executive Chloé Mathis – Account Executive Mary Berglund – Account Executive

MARKETING Jennifer Dean Stavert – Director of Marketing Winona Vo – Senior Marketing Executive

D I ST R I BU T I O N

C H I E F EX EC U T I V E O F F I C E R Terry Dean

FO U N D E R & C H I E F V I S I O N A RY A M O N G T H E A N G E LS

Disclaimer of Endorsement: Reference herein to any specific products, process, or service by trade name, trademark, manufacturer, or otherwise, does not necessarily constitute or imply its endorsement, recommendation, or favoring by the Senior Resource Guide.® The views and opinions of authors herein do not necessarily state or reflect those of Senior Resource Guide® and shall not be used for advertising or product endorsement purposes.

©2022. Senior Resource Guide is published semi-annually for the Greater Houston, Austin & San Antonio markets by: SRG Services, Inc., 77 Sugar Creek Center Boulevard, Suite 600, Sugar Land, Texas 77478 \\ 281–277–2333 \\ SRGTEXAS.com

SENIOR RESOURCE GUIDE

Karyn Dean

HOUSTON EDITION

Brian Stavert – Manager Myles Moore – Senior Distribution Executive

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EARLY PHASE

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HOW TO HANDLE ANGER + DIFFICULT BEHAVIOR And Not Take It Personally

SRGTEXAS.COM

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ave you noticed that as your loved one has aged, you’re seeing things in them you’ve never seen before? Memory loss? Difficulty managing emotions? Do they make decisions that compromise the safety of themselves or others? Do these troubling behaviors sometimes have a clear trigger and at other times no discernible reason? Difficult aging behavior can take a huge emotional and physical toll on the family member who is providing care. Learning to navigate these changes is critical to developing caregiving endurance. Let’s walk through a few common scenarios that frequently pop up for family caregivers. It’s important to keep in mind the symptoms will vary from one person to the next, and for any given individual, what works one day may not work the next. So, keep these tools in your back pocket.

FRUSTRATION AFTER FORGETTING Beginning early in the onset of dementia, a person may become angry or frustrated when they forget something. They may realize this on their own or when it’s brought to their attention. The key is to try to take the focus off these moments of confusion.

ADJUSTING TO RESIDENTIAL CARE Struggles can also arise with change, such as the transition to a senior living residence. Your loved one may not remember where they are or why they are there. In this situation, your goal should be to validate their concerns while also giving a simple explanation. Try framing it as a temporary situation or agreeing with them and telling them you’ll work on bringing them home soon. This idea, known as a “therapeutic fiblet,” is used frequently in caring for people with memory issues.

SENIOR RESOURCE GUIDE

In most cases, not correcting your loved one is vital to avoiding frustration. Some people living with dementia experience anosognosia (pronounced ANN-uh-sog-KNOW-zha). This means that they have limited or no insight into their deficits. A person living with dementia may acknowledge their disability on some level but perhaps not the full extent of it. When their forgetfulness is brought to their attention, they may become defensive, angry or even frightened. Taking the emphasis off their forgetfulness minimizes the chance of a negative reaction.

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It may feel counterintuitive not to tell the complete truth, but you’re meeting your loved one in their reality. Trying to argue and rationalize will likely cause frustration for both parties. Even if you persuade them, they may subsequently forget, and then you’ll have to relive this difficult conversation. It’s important to keep in mind that you’re not trying to get your loved one to permanently remember something. You’re simply offering comfort and reassurance in the moment.

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PREVENTING TRIGGERS The family member in your care may exhibit outbursts even without any triggers. When they experience anger, agitation, and other challenging symptoms, keep track of them in a journal. Journaling their symptoms can help identify any consistent triggers. Write down what happened leading up to the outburst and record what strategy was successful in de-escalating the symptoms. While the strategies to deal with the situation can help your senior get through a difficult moment, avoiding the trigger in the first place can keep the situation from developing or escalating. However, avoidance may not always be possible, so keep this formula in mind: validate their feelings; provide a simple (even temporary) solution; and redirect to a more pleasant activity.

aid Easier S Than Done

“DON’T TAKE IT PERSONALLY” Aging can cause personality changes or behaviors that can be upsetting and emotional to deal with as the caregiver. It’s not easy to provide such a high level of care for someone who may not notice or appreciate the care, or who may be resentful and angry. At times, it may be necessary to walk away after doing a quick assessment of your loved one’s safety. Whether it’s to recharge emotionally, or for your safety, having a separate space to walk into is important. If you’re providing care and meeting resistance, it’s okay to consider whether that particular task really needs to

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SENIOR RESOURCE GUIDE

HOUSTON EDITION

This

be accomplished at that particular moment. Reapproaching at a later time may be advisable. It’s not uncommon that your loved It’s important to one may at times respond better to keep in mind that someone other than you. Are there your loved one friends, family members or professional doesn’t have care providers to whom your loved control over their one may be more receptive? Is there symptoms, and someone who can physically step in with a different approach or provide a what they say in a distraction over the phone? painful moment is The most challenging behaviors are not personal, nor is often directed at the primary caregiver it a reflection on the simply because you’re the one who has care you provide. the most trusting relationship with the aging family member. It’s important to keep in mind that your loved one doesn’t have control over their symptoms, and what they say in a painful moment is not personal, nor is it a reflection on the care you provide. It’s still valid for you to feel upset. Allow yourself to feel the emotions caused by their behavior. Journal them as you would journal your loved one’s symptoms and triggers. Connect with someone you trust to help you deal with these moments. Most importantly, have patience with yourself. If you respond in the wrong way, chances are you will remember that longer than your loved one will. Giving them some space will help them reset, and you should take that as an opportunity to reset yourself. Difficult aging behaviors aren’t easy to navigate. They can take a lasting toll on the caregiver and the whole family, and positive moments can be hard to find. But take every opportunity to remind yourself of all the things you loved—and still love—about this person you’re caring for. Those thoughts can help carry you through the most challenging times.

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OVERCOMING GUILT WITH SENIOR CARE DECISIONS

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f you’re responsible for deciding care for your elder family member or friend, it can cause a lot of stress. Senior care decisions aren’t easy for anyone to make, especially for a loved one. Are you making the right choice by putting them in a senior living community or personal care home? Will they receive adequate care? Are you capable of being their caregiver? Do they need more care than you can provide? If things go wrong, is it your fault? What could you have done to prevent this scenario altogether? These are all questions you’re probably asking yourself, and you’re not alone—many caregivers feel this guilt, and there is support out there for you. Caregiving can sometimes feel like a demanding, full-time job. Although it allows you to spend more time with your loved ones, it can be quite emotionally and physically draining. One of the most challenging decisions to make is whether or not to seek other care options. These options vary by level, ranging from no assistance to around-the-clock nursing care. The answer as to whether you should pursue senior care options for your loved one is never black and white, often resulting in mixed emotions. Recognizing the feeling of guilt is the first step in tackling those difficult emotions that often accompany eldercare. Ample research and communication play a key role in alleviating guilt and making the best decision for your loved one. It’s important that guilt is addressed as it’s unlikely to go away on its own. Trying some of the following tactics may help in reducing guilt.

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If you continue to beat yourself up for not being able to provide all the care they require, seek forgiveness within yourself. Recognize that you’re doing your best to help your loved one and you still play a valuable role in their care. Guilt can affect your relationship with your loved one and the attention and care you’re able to provide. If you’re struggling to find ways to work through guilt, a therapist, counselor, or support group are additional options to help untangle emotions and find ways to create change within yourself. Prioritizing mental health is vital for both your well-being and your ability to provide the best care for your loved one.

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Openly discussing the situation with your loved one, friends and family can help ease some Sometimes guilt can burdens while also ensuring become so strong everyone feels confident about it’s difficult to get any choices made. through each day. Researching the right care and involving your loved one in the process as much as possible can help alleviate feelings of guilt. Mentally opening the door to let guilt, frustration or regret come in is sometimes needed to address and process the complexity of these emotions. Writing down what you feel or simply observing these feelings without judgment can make them less powerful and lighter. Identifying the source and recognizing where it is coming from is the key to navigating feelings of guilt. Practicing gratitude and shifting your focus to acknowledging any opportunities you’ve gained as a result of your decision about their care. For example, are you able to spend more quality time with your loved one now? What are you more knowledgeable about now having gone through the situation? Consider what you might say to a friend or family member in a similar situation as you. Oftentimes, we’re harder on ourselves. Show yourself some kindness and replace those negative self-thoughts with compassion.

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SETTING EXPECTATIONS FOR YOUR ROLE AS A CAREGIVER

Getting Prepared for the Position

SRGTEXAS.COM

SPRING/SUMMER 2022

t’s not always easy watching a loved one age. This can become especially hard when they reach the point of no longer being able to take care of themselves. And, if you didn’t already find yourself providing some level of assistance before a major life event occurs, you may now find yourself in the role of being the caregiver. You may have intentionally elected to become a professional caregiver or a caregiving volunteer to help those in need. In any case, if you’re new to this journey, here are some helpful tips to keep you prepared as you embark on this path.

THE ROLE OF CAREGIVER This is a role you can find yourself in rather quickly without knowing it happened. A serious health event is typically the catalyst for this type of situation. However, this change can also happen gradually, and the role of caregiver might be taken on without even realizing it until you're deep into the process. For instance, you may initially stop by just to check on your loved one. Gradually, the number of visits increase, and

SENIOR RESOURCE GUIDE

progressively those visits turn into helping prepare meals, assisting with lawn maintenance, light housekeeping, and managing medical appointments. Before you know it, they’re heavily relying on you and unable to do many of these things themselves. Whether you had a conversation about it or not, at a certain point you realize you’ve accepted and taken on the role of caregiver. Although you're now taking on the responsibility to care for someone else, you may already have quite a lot of responsibilities of your own (perhaps children or a full-time job). It’s important to know and understand the responsibilities that come with your new caregiver role. This way you're better able to care for them with confidence, empathy, preparedness and love throughout this journey.

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Your caregiver quest doesn't come with a manual, so here are some examples of tasks you can anticipate in your new role: • • • • • • • • •

Help with finances such as paying bills, credit cards, managing rent and utilities or home care fees Buy groceries, clothes and toiletries Arrange medical appointments and provide transportation to and from Be a companion or arrange for companion care Help cook and clean Assist with pet care Ensure legal documents such as wills, trusts, guardianships, power of attorney are addressed Keep other family members apprised Make hard medical decisions

PREPARING FOR THE ROLE It can be easy to become overwhelmed and stressed when taking on this role for the first time. Here are some tips that can help you and the person you’re caring for feel more at ease.

BE SURE to have all physicians’ information on hand and establish yourself as the primary caregiver for the person. You may need to have them sign paperwork allowing you to see their health information under HIPAA or have a medical power of attorney document

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HAVE A CONVERSATION about you becoming their official caregiver and establish responsibilities and boundaries

MAKE A LIST of all medications they’re taking as well as allergies and hospitalizations in the last 10 years

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SPEAK to them about how their financial obligations will be resolved TALK about where they want to live out their remaining years ASK if possible to be added to their bank account, which will allow you to easily pay bills BE SURE to determine whether they have a power of attorney or other legalities in place FIND SUPPORT for both yourself and your loved one as neither of you are alone in this process CREATE a catalog of experts that you’ve interacted with. You never know whose expertise you might rely on in the future

Ways to Cope

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• Taking care of yourself

• Seeking mental health assistance when needed • Getting enough sleep • Building a strong support system • Drinking plenty of water • Exercising • Eating clean

SETTING EXPECTATIONS It’s important to take care of yourself. Being a caregiver can easily take over your life if you’re not mindful. While you want to be there for your senior loved one, you also need to be there for yourself. When you’re struggling, seek help. When you’re unable to do something, it’s okay to say no. When you take care of your mental and physical self, you’re better able to care for your loved one. We are here with additional resources as needed. Remember, you are not alone as it takes a great deal of strength to be a caregiver.

Serving Aging Texans in counties:

Austin, Brazoria, Chambers, Colorado, Ft. Bend, Galveston, Liberty, Matagorda, Montgomery, Walker, Waller & Wharton

Meals: Provide nourishing meals with socializing in senior centers and deliver to eligible homebound seniors.

Medicare & other Benefits Assistance: Trained benefits counselors assist Texans over 65 or disabled understand, shop plans and apply for assistance programs for Medicare. Help with Medicaid, health insurance and legal assistance also available. In-Home Services: Help seniors maintain independence with

personal care assistance, health maintenance, home modifications/ accessibility and case management.

Caregiver Support Services: Help family caregivers through a care system of respite care, support groups, and education. Targeting those with greatest economic needs, living in rural areas and caring for those with moderate impairments. Nursing Home Advocates: Trained ombudsmen (advocates) visit nursing homes and assisted living facilities to ensure the quality of care and quality of life of residents. They inform residents of their rights and investigate and resolve complaints. Information & Referrals: Link older Texans and disabled to

community resources.

800-437-7396

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WHAT TO DO WHEN YOU NEED A BREAK

Finding a solution you’re comfortable with

SRGTEXAS.COM

SPRING/SUMMER 2022

ven though you have a loved one you care for dayin and day-out, it’s likely you have other duties and responsibilities outside of providing for your elderly or disabled loved one. This overflow of obligations is a classic recipe for exhaustion and shattered nerves, especially when you tack on the emotional burden of these obligations being something you care deeply about. Many caregivers experience burnout simply because they cherish (and stress over) the well-being of loved ones so much. When you’re burnt out, you’re not able to provide the same amount of attention and care because, in most cases, you’re completely drained mentally and physically; your glass is empty. And an empty glass has no way of quenching the thirst of those in need. That’s why it’s so important for caregivers to fill their own glass first with self-care and a respite plan.

WHAT IS RESPITE? Respite care is a way for those experiencing caregiver burnout to rest and recharge. There are many services to utilize in Texas. Essentially, caregivers always have to be on guard and ready to respond when needed, preventing you from turning off completely. Respite care gives you consecutive time off ensuring you can completely switch out of working mode for hours or

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Don’t get Burnt Out

Discover different kinds of respite care available in Texas as well as typical costs in the full article, visit srgtexas.com/getcaregivertoolkit

SENIOR RESOURCE GUIDE

Dive Deeper

WHY IT’S ESPECIALLY NEEDED FOR DEMENTIA CAREGIVERS Additionally, caring for someone with dementia, memory issues or Alzheimer’s can feel overwhelming. On top of scheduling and keeping track of things for your loved one’s life, you have to remember everything for your own day-to-day, which can be challenging. Studies show that informal and familial caregiving shares strikingly similar characteristics with chronic stress. Both informal caregiving and chronic stress eat at you over a long period of time, having psychological and physical effects that may seem subtle to those not aware. Other areas of life, such as relationships, hobbies or work, are also strained in response. This stress accumulates and may simply turn into your lifestyle. Since taking care of a loved one usually goes unpaid, some providers forget that what they’re doing is actually work. And just like your average 9-5 job, you need to take time away from that work to make it sustainable. As a caregiver, be on the lookout for mental and physical signs of stress and exhaustion, and when spotted, realize it’s time to look into care facilities or in-home respite care in Texas.

HOUSTON EDITION

It’s so important for caregivers to fill their own glass first with self-care and a respite plan.

days at a time. These services provide a professional caregiver or facility to take your place so that you can completely unplug from your duties.

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GET CONNECTED Familiarizing Yourself with Local Resources That Can Help

TEXAS HEALTH AND HUMAN SERVICES The agency offers a wealth of information to connect you to resources, health care providers and services that can help you and your aging loved one live healthier. In the menu bar on their website is a dropdown for “Services,” which provides a wide range of helpful resources for people with medical, physical, intellectual or developmental disabilities; older adults; and caregivers who need a break from their duties. If you’re unsure how they can help, or even if you may not qualify for a program or service, Texas Health and Human Services’ trained professionals can help steer you in the right direction.

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Call 1-855-937-2372 or visit hhs.texas.gov

2-1-1 TEXAS As a trusted state resource available for free 24/7, 211 Texas is a connector for all Texans to critical, community-based services. Whether it’s a sudden medical bill, a natural disaster, a veteran trying to return to civilian life, or a concern about an aging parent—people from all walks of life can find themselves in need of assistance and confronted with a maze of agencies and programs that are challenging to navigate. Their trained helpline specialists are good listeners, blending understanding and expertise to provide information and referrals drawn from a comprehensive database of social services. Call 2-1-1 or visit 211texas.org

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UNITED WAY OF GREATER HOUSTON United Way seeks to ensure that all older adults can live vibrant lives. They offer resources to a number of programs that focus on older adults’ health, financial security and engagement.

EARLY PHASE

An Overlooked Resource

Support groups are an excellent resource and there are many specifically for caregivers. See srgtexas.com to find support groups in your area.

SENIOR RESOURCE GUIDE

Harris County Area Agency on Aging Call 832-393-4301 or visit houstontx.gov/health/Aging

Houston-Galveston Area Agency on Aging Call 1-800-437-7396 or visit h-gac.com/area-agency-on-aging

AREA AGENCY ON AGING Serving over 250,000 people annually, Texas’ 28 area agencies on aging offer help to Texans age 60 and older, their family members and caregivers to locate and access local services, including benefits counseling, legal assistance, care coordination, caregiver support services, in-home support and the ombudsman program.

HOUSTON EDITION

Visit referral.unitedwayhouston.org for a searchable directory that offers information on several community programs covering an array of categories including transportation, housing options, benefits screenings, dementia evaluations and elder abuse.

EARLY PHASE

THE PLAN

WHAT LEVEL OF CARE IS RIGHT

Understanding the Care Continuum ADULT DAY CARE An ideal option for older adults who wish to age at home but need daytime supervision. Adult day care centers provide services which typically include meals and activities that provide social interaction. Some centers specialize in services for individuals with Alzheimer’s and dementia.

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HOME CARE/HOME HEALTH For seniors living independently but require assistance. Nonmedical care (home care) or skilled medical care (home health) aim to allow an individual to remain at home by filling any gaps in care. These care services can range from specialized such as wound care to generalized like companionship and housekeeping. CONTINUING CARE RETIREMENT COMMUNITY A housing option whereby a spectrum of aging care can all be met within one community. Beginning with independent living, moving to assisted living and finally skilled nursing as needed. All are typically located together on one campus. INDEPENDENT LIVING A housing option for individuals who require little or no assistance with activities of daily living but enjoy access to dining, medical, hospitality and entertainment services. Also known as 55+ apartments or independent/retirement communities.

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Medicare

These types of care typically accept Medicare: • Skilled Nursing Continuing Care • Skilled Nursing Rehab • Home Health Care • Hospice Care

ASSISTED LIVING A housing option similar to independent living but for those who require more assistance and have difficulty with daily living activities.

SKILLED NURSING/ REHABILITATION FACILITY Ideal for those individuals who require constant nursing care. These facilities are licensed and equipped to provide residents with health care that meets the needs of more involved medical conditions.

For a more detailed look at each of these levels of care, visit srgtexas.com.

HOSPICE CARE End-of-life care for the terminally ill, usually via visits in the home or facility of residence.

SENIOR RESOURCE GUIDE

ALZHEIMER’S/DEMENTIA CARE Provides special programs and assistance for those with memory loss. Some facilities may provide special security measures.

HOUSTON EDITION

PERSONAL CARE HOME Assisted living in a home-like setting and typically has fewer residents.

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Mont Belvieu rehabilitation & healthcare center

14000 Lakes ofBlvd. Champions Blvd. • Mont Belvieu, TX 77523 14000 Lakes of Champions 14000 Lakes of Champions Boulevard • Phone: 832-669-3900 • Fax: 832-669-3890 www.MontBelvieuRHC.com MONT BELVIEW • 832-669-3900 Mont Belview • 832-669-3900

The Park at Bay Area Enhanced Assisted Living 5000 Space Center Blvd. • Pasadena, TX 77505

www.parkatbayarea.com • PH: 281-721-2500 • Fax: 832-770-4362 5000 Space Center Boulevard 5000 Space Center Blvd.

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Trinity rehabilitation & healthcare center

314 East Caroline 314 E. Caroline St. • Trinity, TXStreet 75862 314 East Caroline Street TRINITY • 936-744-1300 Trinity • 936-744-1300

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THE PLAN

EARLY PHASE

5 steps to take when

YOUR PARENTS REQUIRE DIFFERENT LEVELS OF CARE

SENIOR RESOURCE GUIDE \\

r e b m e m e R

HOUSTON EDITION

ne parent requiring advanced care sooner than the other is a probable situation as women and men aren’t statistically equal health wise. When parents require different levels of care, it can be hard trying to balance these circumstances. For example, what if Mom has dementia and needs to move into a memory care community? What is Dad to do? This is similar in some ways to a divorce. However, in this instance, both parties typically want to be together, yet the Prioritize your separation is necessary to maintain health and welltheir health and safety. being too. Taking With the separation, feelings time to refuel of loneliness and social isolation will allow you to can arise. continue supporting The following are ways to help your parents support a healthy relationship through this new and quality of life for both turn in their journey. parents despite their change in environment.

EARLY PHASE

Step

THE PLAN

CREATE A SCHEDULE

A schedule offers routine and structure and will not only benefit your parents but also you. It can help ensure that each parent doesn’t go too long without a family member or friend visiting. Make time for Sunday brunch, biweekly game night or a monthly movie marathon. If a loved one doesn’t live nearby, then schedule virtual visits where the possibilities are endless.

Step

PLAN FOR TRANSPORTATION

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Transportation may be required for various reasons such as taking one parent to visit the other, doctor’s appointments, shopping/ errands, etc. It’s often difficult to arrange for last-minute service, especially if both parents require transportation on the same day. Consider creating a schedule of availability with other loved ones willing to help drive each parent. You could also hire a private companion or care aid who can come spend some time with your parent(s) as well as drive to necessary appointments. For other options, see “Get Connected” in the Guide to discover local resources that can help.

Step

TAKE ADVANTAGE OF TECHNOLOGY

Smartphones, tablets, computers and more allow the opportunity to interact with people even when they’re not physically nearby. With apps such as Zoom and FaceTime, you can quickly connect with loved ones via video. If your parents aren’t tech-savvy, walk them through the process and show them how easy it is to reach their spouse and other loved ones whenever they desire.

THE PLAN

Step

EARLY PHASE

ENCOURAGE A HEALTHY LIFESTYLE

A positive aspect of living apart is that each parent may have more time to focus on themselves. This offers a wonderful opportunity to build good habits that promote happiness. For example, Mom can enjoy Zumba and chair yoga at the community while Dad sharpens his golf or tennis skills at home. As a result of working on themselves independently, they can cultivate their own strengths and be a better team when they’re together.

Transitioning from levels of care can be physically and mentally draining for everyone involved, but with the tips we’ve outlined and a support system in place for both parents, it should make this phase easier.

SENIOR RESOURCE GUIDE

Check in often with each parent to see how they’re doing both emotionally and physically. Consider that your parents may not want to burden you and voluntarily come to you to voice their thoughts. Try asking yes or no questions like “Do you like how often you’re seeing Mom/Dad?” or “Are you happy with your current daily routine?” to help determine if things need to be adjusted. Creating a standard of open communication can increase the level of comfort and their willingness to share any concerns.

HOUSTON EDITION

COMMUNICATE FREQUENTLY

Step

EARLY PHASE

THE PLAN

WHAT’S AN ADULT DAY CENTER? How it Can Help Caregivers

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dult day care provides care and companionship to older adults in a structured setting, allowing primary caregivers an opportunity to work, catch up on personal items or simply relax. Are adult day centers the same as my community’s senior center? While senior centers are intended for healthy, independent and physically capable older adults, adult day services are for individuals with physical or cognitive limitations. Adult day centers are an ideal option for older adults who wish to age at home but need some supervision. Different programs and services can be found at each adult day center. For example, some centers may specialize in Alzheimer’s or dementia care while others may offer therapeutic exercise, mental interaction, social activities and assistance with personal care. Some centers offer weekend or evening hours, but most operate weekdays during daytime hours. Many provide daily activities, nutritional meals and transportation to and from the center at no cost or on a per-ride basis. Depending on the services offered, costs for adult day care can range from $25 to over a $100 a day, according Visit srgtexas.com to the U.S. Administration on Aging. to further your Texas has one of the lowest average understanding and learn: daily rates around $35. • When exactly is the right To find adult day care programs time for adult day service in your area, type your zip code into • What questions to ask the National Adult Day Services when vetting centers Association’s searchable online directory • How to help your loved (found on their website) or contact your one adjust to the new care local Area Agency on Aging.

More to Know

Helping Bridge the GAP for a Secure Future

Brazos Bend Guardianship Services assists incapacitated and disabled adults and their families with legal guardianship, money management and adult guardianship education. To learn more about Guardianship Services call 281-232-7701 Ask about our monthly group Information Sessions!

www.brazosbendguardianship.org 830 3rd St. #209, Rosenberg, Texas 77471

EARLY PHASE

THE PLAN

VOLUNTEERING Volunteering can be a rewarding use of your loved one's time. Consider these questions before recommending a volunteer opportunity for them: What are their skills, interests and personal priorities? How much time do they have to volunteer? • What's the best use of their talents? • Considering the distance, do they have reliable means of transportation? • •

in the on st u o H r te Grea Area

SOME ORGANIZATIONS LOOKING FOR VOLUNTEERS Catholic Charities Volunteer opportunities at their various sites in Houston, Galveston and Fort Bend County. 713-874-6563 catholiccharities.org

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Fort Bend Care Center Volunteers can help in the office, at their community food fair, rebuild homes and tutor. 832-539-4846 fortbendcarecenter.org

Fort Bend Seniors Meals on Wheels Volunteer opportunities include administrative assistance, help with “Welcome Bags,” delivering meals and more. 281-633-7719 fortbendseniors.org

Houston Methodist

There are many volunteer opportunities such as administrative assistance, patient and unit involvement, hospital greeting and hospitality and more. 832-667-5816 houstonmethodist.org/giving/ volunteer

Interfaith Ministries for Greater Houston Many opportunities for volunteering. See their website or call for more information. 713-533-4900 imgh.org

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Mainland Medical Center Auxiliary, Inc.

The Foster Grandparent Program (FGP)

Volunteers needed to help with guest services, the gift shop, admissions, human resources and more. 409-938-5758

Volunteers serve as mentors, tutors and caregivers for children and youth with special and exceptional needs. 713-595-8198 erjcchouston.org

This organization can connect you with volunteer opportunities to fit your time and interests. 713-595-8157 rsvpvolunteers.com

Second Mile Mission Center Fort Bend Volunteers enjoy working in the food pantry, helping with merchandising items and listening to those in need. 281-261-9199 secondmile.org

Sire Therapeutic Horsemanship

United Way of Greater Houston Deliver meals to home-bound seniors, paint, make repairs and more. 713-685-2300 unitedwayhouston.org

Volunteer Houston Offering a flexible volunteering model with no long-term commitment, they offer a variety of activities that conveniently fit your schedule and interests. Sign up online. volunteerhou.org

SENIOR RESOURCE GUIDE \\

These are only a few of the many organizations regularly seeking volunteers. Check srgtexas.com for more volunteer opportunities.

Find More

Volunteers 55 and older provide one-on-one emotional support, mentoring and tutoring children with exceptional needs. 281-344-3515 hhs.texas.gov

Opportunities available in several locations. Volunteers assist riders in a variety of ways, both inside and outside the riding arena. 281-356-7588 sire-htec.org

The Foster Grandparent Program (HHS)

HOUSTON EDITION

RSVP of Southeast Texas

EARLY PHASE

THE PLAN

WARNING SIGNS OF UNSAFE DRIVING IN SENIORS and When it’s Time to Address

hether warning signs surface gradually or because of a recent change in health, they shouldn't be brushed aside or overlooked. Even minor changes that manifest individually can quickly lead to a more substantial problem. For example: •

• • •

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•

Neck pain or stiffness can make it tough to properly check mirrors and look out for other vehicles. Leg pain or stiffness can make it difficult to switch between the pedals. Diminished range of motion and arm strength can make it challenging to turn the steering wheel. Slowed reaction time can impact braking or honking if needed quickly. Reduced ability to multitask makes it tricky to effectively divide attention between multiple activities. Impaired vision or hearing can be troublesome to see traffic lights or street signs and hear emergency sirens or honking horns. Declining memory can be problematic for regularly driven trips and cause an individual to become lost or confused.

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Something to Ask

• • • •

•

• • •

Do they remember/are able to fasten their seat belt? Do they sit comfortably at the wheel or lean forward? Do they appear tense or distracted easily? Is there any difficulty moving their feet between pedals? Do they often confuse the gas and brake? Are they able to properly observe traffic lights, road signs, pedestrians, and the reactions of other motorists? Do they drive too close to other vehicles or drift into other lanes often? How’s your loved one’s reaction time in general? Is there any confusion in unexpected scenarios? Are they consistently waiting too long to brake or accelerate at traffic lights? Has your loved one retained a good sense of direction? Do they complain that vehicles or people appear suddenly to them?

If you notice any of these warning signs or others, it may be time to share your concerns, talk with their doctor, and/or have a driving assessment done. Whether your loved one is still driving, driving with limitations, or having to give up driving altogether, being aware of the warning signs can help you to play a valuable role in their safety.

SENIOR RESOURCE GUIDE

•

Has your loved one’s car insurance rate gone up? This may be a sign that they’ve had recent driving infractions. Consider giving their driving condition more attention.

HOUSTON EDITION

WHAT SHOULD YOU BE LOOKING FOR? When joining your loved one for an errand or an outing, encourage them to drive and observe the following:

EARLY PHASE

THE PLAN

OMBUDSMEN ARE HERE TO HELP Courtesy of Texas Health and Human Services

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long-term care ombudsman not only enforces, but also helps nursing home residents to understand their rights. Living in a nursing home doesn’t mean giving up your freedom. If you feel someone is violating you or your loved one’s rights, the Texas Health and Human Services Commission’s long-term care ombudsman can help. Nursing home residents have the same rights and protections of their health, safety and welfare that we all share. For nursing home residents, these rights include the right to vote, voice complaints, exercise personal choice, the opportunity to make medical and social decisions, visit with anyone they wish, and to be lawfully discharged and leave the facility. One of the most common issues one might face when being discharged is to potentially lose their spot in the nursing home they were initially admitted to. This practice, known as “patient dumping,” is among the top five frequent complaints Patty Ducayet, Texas long-term care ombudsman, sees. The long-term care ombudsman will make sure the individual knows their rights, including the right to appeal and return to the nursing home after a hospital stay, and can represent them during that appeal.

Important Number

THE PLAN

EARLY PHASE

Call 800-458-9858 to report suspected elder abuse or neglect that occurs in nursing homes, assisted living facilities, day activity and health services. You can also report care concerns about home health and hospice agencies.

Often the most direct and expedient way to ensure your issue is addressed is to inform the skilled nursing facility’s management team, but the Texas Health and Human Services Commission stands by ready to help if needed. According to Texas Health and Human Services, some of the ways long-term care ombudsmen help nursing home and assisted living residents include:

“An ombudsman can help bring the resident’s concerns to management and offer ideas to address the concern,” Ducayet said. “An ombudsman can give everyone information about the nursing facility’s requirements about residents’ rights and will tell the resident about the option to report a complaint to HHSC LongTerm Care Regulatory Services.”

Find out more For more information on the ombudsman in your area: 800-252-2412 hhs.texas.gov (search for ombudsman)

HOUSTON EDITION

•

SENIOR RESOURCE GUIDE

•

Listening to residents and family members when they have concerns or issues. Telling residents about their rights. Protecting resident health, safety, welfare and rights. Helping families learn about nursing homes and how to pay for them. Working to solve problems and making sure state regulations and laws protect residents.

•

EARLY PHASE

CONVERSATIONS

hat w w o n K nt they wa

how to talk with

YOUR PARENTS ABOUT THEIR ENDOF-LIFE WISHES

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he conversation involving your parent’s or loved one’s end-of-life wishes is a difficult one. Consider, though, that prolonging this discussion could lead to your mother or father’s inability to share their wishes should they become sick or injured. Without some type of advanced planning, you may be left to make decisions for them, and these decisions could lead to conflict, especially with siblings or other family members involved.

OVERCOMING THE HESITATION TO TALK The fear of saying the wrong thing, or even validating the tender realities of your loved one’s state of being, can lead to hesitation on your part when initiating this very important end-of-life conversation. One way to overcome this hesitation is to share with your parents your thoughts on why it might be important to address these issues sooner rather than later. Perhaps you might share that you’re currently addressing your own future considerations and that it would be sensible to discuss theirs, stressing the idea that lacking a plan could result

CONVERSATIONS

EARLY PHASE

For a list of must-know important documents and to read the full article, visit srgtexas.com/getcaregivertoolkit

SENIOR RESOURCE GUIDE

Important Documents

There’s more of this article in our Caregiver Toolkit which offers tips on how you can open a dialogue, what questions to ask, and the important documents and resources to consider when it comes to end-of-life conversations.

SOME QUESTIONS YOU SHOULD CONSIDER ASKING 1. Have you thought about who you want to make medical decisions for you if you’re not able to make them for yourself? 2. Do you know what kind of medical treatment you want if you become sick or injured? 3. If you need long-term care, do you want to be cared for at home or would you prefer to move? 4. Do you know who you want to handle your finances if you’re not able to? 5. Have you created a will, power of attorney or advanced health care directive?

HOUSTON EDITION

in larger issues down the line. By opening up a dialogue about these issues in general, it’s easier to start talking about what your parents want. Ideally, your parents have already begun to consider their end-of-life wishes, but it’s important to understand what those wishes are and what type of plan might be in place already.

EARLY PHASE

CONVERSATIONS

how to talk with

YOUR SIBLINGS ABOUT CAREGIVER RESPONSIBILITIES Keeping the Conversation Positive and Productive

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ften there is more than one family member involved with taking care of a parent or aging loved one. If you’re fortunate enough to have a sibling—or more—to rely on when you find yourself in a caregiving role, consider this as a blessing. Unfortunately it’s not always the case that siblings are willing or even able to help. A family can become estranged over the years, a sibling may be physically or financially unable to provide assistance, or perhaps they simply live too far away. Whatever your situation is, we’ve provided a few tips to begin the conversation with your siblings and to get the support needed for ensuring the best care for both the caregiver and the person they’re providing care for.

SIBLINGS AND ROLES Regardless of whether you are the primary caregiver or your sibling is, caregiving can come with feelings of guilt, frustration and many times helplessness. Personal emotions can sometimes get in the way of making decisions for what’s best for your parent or aging loved one.

CONVERSATIONS \\ EARLY PHASE

Remember the Why

Have the conversation in person if possible. These discussions can be sensitive by nature and are often hard to successfully carry out over the phone or by text. Schedule a time for you and your sibling to meet, and preface the meeting with the topic so everyone has some time to think about what they want to say prior to sitting down together.

•

If your sibling hasn’t seen your parent or aging loved one in a while, they may not be aware of the current situation. In this case, bring any helpful documentation such as medical visits, diagnosis paperwork, and medication prescriptions to show your sibling your loved one’s current condition.

•

SENIOR RESOURCE GUIDE

Try to begin the conversation while your parent or aging loved one is still healthy and without cognitive challenges. Being proactive will help to ensure that everyone involved will enjoy less stress, and a plan can be put in place for when the time arises.

•

HOUSTON EDITION

What’s most important is to try and keep in mind that it’s all about caring for your parent(s) or aging loved one and ensuring they have a great quality of life.

HOW TO APPROACH SIBLINGS When we put our differences aside and come to the conversation prepared and without judgment, we place ourselves in a better position of getting the help we need for ourselves, our siblings, and the person for which we’re providing care. Here are a few tips to keep the conversation with your sibling positive and productive:

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EARLY PHASE

CONVERSATIONS

•

Discuss all upcoming needs. If it’s time for your parent or aging loved one to move out of their home, make sure to share this information with your sibling to avoid anyone feeling left out or blindsided. Discuss costs and location and determine whether you can agree on a place, and be sure to share your parent or aging loved one’s wishes.

•

If you find that the conversation begins to feel contentious, take a break to allow emotions to settle down. When resuming the conversation, remind everyone that this is an opportunity to make caregiving decisions cooperatively, and agree to move forward by focusing on the tasks at hand.

•

Ensure that you remain emotionally available and supportive to one another. It’s often unrealistic to assume that the responsibility should lie with one sibling. If you are the primary caregiver, make it known that you will need help and how and when they can best assist you. If you are not the primary caregiver, offer your help when possible. It can be hard to ask for help in these situations, however failure to do so ultimately can lead to resentment. No matter which role you are in, empathy and the courage to ask for and offer help will be vital.

Be sure that everyone involved is aware of present circumstances, who the primary caregiver is going to be, and where important documents can be found and accessed. These can be challenging and emotional times, so if you find you’re unable to get everyone on the same page, it may be necessary to seek a professional mediator. In the end, when tackling the caregiving process, remember that the whole is greater than the sum of its parts. Defined roles, communication, empathy and perseverance will see you through.

EARLY PHASE

LEGAL + FINANCIAL

FIVE MUSTHAVE LEGAL DOCUMENTS

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hether you’re a caregiver yourself, or perhaps interested in getting your own affairs in order, we’ve identified five recommended legal documents that every adult should have. There are many available online resources that explain each document in greater detail. Some will provide a free template for you to create your own documents for instance. If you have an attorney, be sure to ask them about these types of documents. Don’t wait until it’s too late—take a moment now to get organized.

1. ADVANCE DIRECTIVE Also known as a living will or health care declaration/directive, this document outlines your wishes for medical treatments and life-sustaining measures, in the case that you’re not able to communicate them verbally. Details might include a “do not resuscitate” order (DNR), the use of breathing machines, tube feeding or organ donation. Making these decisions in advance lets medical professionals know what measures to take and grants your loved ones peace of mind should they have to communicate these decisions for you. 2. DURABLE POWER OF ATTORNEY FOR HEALTH CARE While an advance directive is limited to end-of-life concerns, a durable power of attorney for health care accounts for all

LEGAL + FINANCIAL

EARLY PHASE

Online Resources

health care decisions in the case that you’re incapable of making decisions for yourself. In this document, you can outline how your designated power of attorney should act. Their authority to make these decisions ends when you’re once again capable of making your own decisions.

• eldercareteam.com • legalzoom.com

• nlm.nih.gov/medlineplus/ advancedirectives.html • texasnaela.com • texasprobate.com/ professional-forms

5. FINANCIAL POWER OF ATTORNEY This document designates someone (principal) to do business on your behalf should you be unable to take care of necessary matters yourself. Tasks designated might include paying bills, selling property, managing assets or applying for medical benefits. Unlike a living trust, a financial power of attorney terminates upon the death of the grantor.

SENIOR RESOURCE GUIDE

4. LIVING TRUST A living trust designates someone (trustee) to help manage and distribute your assets rather than going through the court system, as in a last will. This often prevents your last wishes from becoming public record. This document also designates terms in which the trustee would set into action should you be unable to make decisions regarding your assets during and after your life.

HOUSTON EDITION

3. LAST WILL AND TESTAMENT Many people know this document simply as a “will.” It outlines how your property (including digital property such as email accounts and blogs) should be distributed and to whom. Different states have different requirements for one’s will. In Texas, your will must be signed by two witnesses.

EARLY PHASE

INITIAL MEDICAL CARE

UNDERSTANDING MEDICARE:

Parts, Plans and Meeting Your Needs Courtesy of Sharon Wagner, seniorfriendly.info

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any Americans who enter into Medicare do so with a sketchy understanding of how the system works. That’s rather alarming considering how much older Americans rely on Medicare for their health care needs. It’s essential that seniors and their caregivers understand how the program works to avoid missing out on important benefits and paying unnecessarily high costs. Sometimes, the best approach is to start from the beginning when unraveling a complex subject like Medicare.

PARTS OF MEDICARE When you sign up for Medicare at age 65 you’re automatically enrolled in Plan A, which is hospital coverage, and Plan B, which covers outpatient coverage. Part A covers room and board in a hospital or skilled nursing facility, while Part B covers things like doctor visits, surgeries, lab work, equipment and diagnostic tests. Prescription drugs are covered under Part D, which provides a card that allows you to buy prescription medications at a significantly lower cost than retail. Part D insurance is voluntary coverage but it’s a key part of the system because paying out-ofpocket for medications can be extremely expensive.

MEDICARE ADVANTAGE Choosing the right supplemental coverage is one of the most important decisions you’ll make as a Medicare enrollee.

SENIOR RESOURCE GUIDE

HOW THE PARTS WORK Your Medicare Part B coverage is based on income, with enrollees starting at a base rate of $135.50 while higher-income enrollees pay an “income adjustment” (meaning they pay more for Medicare). Part B is a necessity; you can’t purchase supplemental insurance unless you have both Part A and B. If you’re working for a large employer, your health insurance there continues as your primary with Medicare playing a secondary role, meaning you can delay enrolling in Part B if your group insurance already includes outpatient benefits. Part B covers 80% of medical services, with your share being the remaining 20%. Certain treatments and procedures can be quite expensive, which means you could end up with a hefty co-pay. Part D has built-in co-pays for medications, so you won’t need supplemental insurance for the cost of needed medications.

HOUSTON EDITION

EARLY PHASE

INITIAL MEDICAL CARE

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INITIAL MEDICAL CARE

Fortunately, you can select plan options based on your budget. Medicare Advantage, also known as Part C, offers plans that provide a low-cost alternative to Medicare. These plans have their own local network of providers and usually have lower premiums than Medigap, though there are co-pays for hospital stays, doctor visits and other approved services. Medicare Advantage also has a folded-in version of Part D, though it’s important to remember that it may not include the specific medications you need.

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MEDIGAP As mentioned, Medicare pays 80%. A Medigap plan pays the other 20% of your Part B outpatient expenses. Some Medigap plans also cover Part A and B deductibles, though you purchase your own stand-alone Part D coverage since Medigap doesn’t cover prescription medications.

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Questions about Medicare Insurance Plans? Get answers at a free Blue Cross and Blue Shield of Texas educational seminar. Virtual and in person sessions are available. Reserve a spot: By Phone: Call toll-free 1-866-427-7497, For accommodations of persons with special needs at meetings, call 1-866-427-7497 (TTY 711).

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EARLY PHASE

INITIAL MEDICAL CARE

DECIDING WHETHER MEDICARE ADVANTAGE COULD BENEFIT YOU Check to make sure your doctor is in-network and accepts Medicare Advantage (some accept original Medicare instead). Keep in mind, most Advantage plans are good about pairing you with a specialist if your doctor is out of network. You’ll also want to make sure any medications you take are covered. If you take several prescriptions and have reached the “donut hole,” the annual limit on what Medicare Advantage will cover (between $3,820 and $5,100 on covered medications), bear in mind that Part D enrollees get a 75% donut hole discount on brand-name drugs starting at $3,800. Consider also your out-of-pocket costs if you anticipate health care expenses. You can always choose a plan with lower out-of-pocket costs. Check out the plan finder at Medicare.gov to find Medicare Advantage plans in your area that meet your needs. Note that plans such as Humana Medicare Advantage have extensive benefits, including vision and dental coverage as well as an innovative fitness program called SilverSneakers, which provides access to over 13,000 fitness centers. It’s important to understand the Medicare system so you can find the coverage you need. As you compare and contrast plans, carefully check network provider and covered prescription medication lists. And stay abreast of the changes which frequently occur with Medicare. It also helps to know that if your plan doesn’t work for you this year, you can change it next year.

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INITIAL MEDICAL CARE

EARLY PHASE

MAKE THE MOST OF YOUR DOCTOR’S VISITS A checklist of what to do before, during and after your loved one’s appointment. BEFORE THE APPOINTMENT

ARRIVE early to fill out paperwork or complete the paperwork online (if available).

SENIOR RESOURCE GUIDE

BRING their updated insurance cards and valid ID. Certain aspects of their insurance policy may have changed despite having the same insurance company for years.

CALL to confirm the appointment. During this time, ask if your loved one needs to fast for blood work.

WRITE down all the symptoms and problems your loved one is having, along with questions you have for the doctor. Prioritize the problems and questions in case you don’t get to address everything due to time constraints. A follow-up plan to address additional problems can be developed (consider making time for multiple appointments).

HOUSTON EDITION

TAKE a photo(s) on your phone or write down all of your loved one’s current medications, supplements and vitamins. Bring the list with you to the appointment, or if you elect to bring all the medications in a bag, that works as well.

EARLY PHASE

INITIAL MEDICAL CARE

KNOW which pharmacy you want prescriptions to be sent to and have their contact number on hand.

DURING THE APPOINTMENT SHARE with the doctor the symptoms (when they started, how long they last, how they feel, and where they are) your loved one is having, and ASK questions. Reference your prioritized list. BE HONEST. Don’t let your loved one leave out any details that appear to be “minor” or embarrassing. You want an accurate diagnosis and the only way to accomplish this is to be comprehensive with the physician.

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LISTEN and WRITE down what the doctor says. From important information to prescriptions, you want to remember everything they told you. You can either bring something to write on, or you can request a printed review of the doctor’s assessment and plan, which typically includes medication instructions, diet adjustments, plan of action, etc. REPEAT back what you heard to ensure your understanding and to prevent any miscommunication if you must relay information to other family members. SCHEDULE another appointment before you leave (if possible), whether it’s a follow-up appointment or their next checkup. As mentioned, if you were unable to get through all of your questions, this would be a good time to schedule another appointment as well.

For the full checklist with more valuable tips to prepare you for before, during and after a doctor’s appointment, visit srgtexas.com/getcaregivertoolkit

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EARLY PHASE

INITIAL MEDICAL CARE

MOBILE CARE TELEMEDICINE PROVIDERS

HOUSE CALL PHYSICIANS

The following offer a “digital visit” via an app, cell phone or computer.

There are times when getting to the doctor’s office is prohibitive or not practical. For those times, consider a physician who makes oldfashioned “house calls.”

Houston Concierge Medicine 713-333-6464 houstonconciergemedicine.com

DispatchHealth

Houston Methodist Virtual Urgent Care

720-647-5329 dispatchhealth.com

713–790–3333 houstonmethodist.org/virtualurgent-care

Geriatric Home Care Physicians 281-491-6767 ghcphouston.com

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SPRING/SUMMER 2022

M. Sandra Scurria, MD 281–661–5901 mdvip.com/doctors/sandrascurriamd

Harris Health House Calls and Palliative Care Program

Texas Center for Lifestyle Medicine

713-566-6832

713–690–1991 texascenterforlifestylemedicine.org

713-234-7057 drjulielester.com

Village Medical

Quentin Mease House Call Program

Julie Lester, DPM (podiatry)

713–461–2915 villagemedical.com

Visiting Physicians Association 713-532-6884 visitingphysicians.com

713-566-6832 harrishealth.org

UT Physicians Center for Healthy Aging House Call Program 713-486-5150 uth.edu/aging

Denotes Telemedicine Providers who also offer house call visits.

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EARLY PHASE

INITIAL MEDICAL CARE

A GUIDE TO MEDICATION OBSTACLES “I was discharged from the hospital with so many new medications and don’t even know what I’m taking them for.” As your senior’s health changes, medication requirements often change as well. Oftentimes, hospital stays result in several medication changes, including adjustments in dosages, removal of some, and the addition of new ones. This cumbersome process can leave room for errors. Fortunately, there are steps you can take that may help prevent errors when medication changes occur. Prior to being discharged, ask the nurse to review the updated list of medications with you. It’s important for you and your loved one to understand the reason they’re taking Repeat back what each medication. each medication is You’ll also be given a list with and what they treat. this information on the discharge This tactic will help paperwork. If any of this information in becoming familiar looks inaccurate or confusing, ask the with each. nurse to check with the doctor or other health care providers to confirm accuracy. If possible, have a family member or friend with you during this time. There’s typically a lot to take in at once and they can assist with asking any clarifying questions as well as taking notes. Follow up with their primary care provider after any hospitalization. The provider can review the discharge medications with you and update their medical records. This is

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Discharge Tip

INITIAL MEDICAL CARE

Create a List

Make Checkpoints

SENIOR RESOURCE GUIDE

Another obstacle is running out of medication. Making a plan of how your loved one will access medications is essential and may help prevent missed doses. If transportation is an issue, look into mail delivery options, which can bring medications right to their doorstep or seek assistance from family members or friends. Home caregivers, aides or companions are also available to provide transportation to the pharmacy. Keeping a schedule with estimated refill timeframes for each medication will help keep them on track and prevent missed doses. Try to make it a habit of refilling medication a few days or a week before they’re out. Perhaps the medications are too expensive, and your senior loved one can’t afford them. If they are struggling to pay for medications, ask the primary care provider about alternate medication options or the pharmacy for recommended resources. The medication obstacles your loved one faces can be difficult but remember there’s a lot of help available. Your health care team, family and friends are all important resources who can work together with Your loved one may you to ensure your loved one takes have spilled some their medications as prescribed. With pills, misplaced the support of everyone involved, it’s the bottle, or possible to overcome any obstacle accidentally taken and maintain excellent medication an extra dose. compliance.

HOUSTON EDITION

Include each medication with an explanation of what it treats. Doing so may bring to light any medications that are duplicating efforts or no longer necessary. Keep the list—a printed and digital copy—easily accessible in case of emergency.

“I’ve been out of my medication for three days. I’m not sure how to get more.”

EARLY PHASE

also a great opportunity to discuss any further questions you or your loved one may have after leaving the hospital.

MID PHASE

DAILY CARE

FAIL-PROOF ACTIVITIES

Over ten ideas!

Based on Your Loved One’s Care Level

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ou make regular visits to your aging mother or father, grandmother or grandfather, aunt or uncle, but whether they still live in the home or are in a senior living community, you can get caught up in the logistics of caregiving. Housekeeping, medications, meals, appointments, bills—the list goes on. You may feel as though you’re not truly spending quality time together because things have changed. The activities that you both used to enjoy now seem challenging, if not impossible. The key to making the most out of your visits is finding engaging, meaningful and purposeful activities that are unique to your senior loved one’s care level. Time spent visiting can be difficult but going prepared with something to do provides an anchor. If a family member who lives in a senior care facility becomes confused or wants to go home, you can redirect to the activity. The task at hand can also serve as a timer if you have trouble leaving: The end of the activity signals the end of the visit. When choosing an activity to do with your loved one, keep in mind the types of activities they may have previously enjoyed. Someone who didn’t like art museums before probably won’t like one now, but perhaps a recorded concert of their favorite singer will get them up and dancing. Here are a few activity ideas you can do together to create enjoyable moments among the day-to-day necessities of caregiving.

•

Cooking and baking are great ways to inspire memories of favorite recipes, aromas, tastes, and times. Mom and dad may need more supervision and help these days, but cooking utilizes all of our senses, which are powerful prompts to memory and conversation as in, “Do you remember that Thanksgiving when…?”

•

Legacy projects such as scrapbooks with family photos or biography projects such as Storyworth can help tap into long-term memories. In the process, you may learn something new about your loved one.

•

Small crafts such as yarn projects or flower arrangements can engage interest and creativity. These activities are fun, have a start and an end, are easy to clean up, and leave a nice memento for both of you.

•

Family favorite board games, card games, crosswords and the like can help keep aging minds, and younger ones, active. Many of these can be done independently or with a partner and are available in large print for people with visual impairments. Puzzles with large-size pieces are available for hands that no longer have the dexterity of youth, or even middle age.

•

Seniors with mobility issues can benefit from movement. Many great exercise programs, like yoga or chair exercise classes, are online. If “exercise” isn’t your family member’s favorite word, consider subtle ways to get them up and around. Seeing you get active can often act as a cue for your loved one to participate.

Household tasks such as organizing a closet, sorting tools or folding laundry are familiar and can help someone feel engaged—in a purposeful way—in their own care.

SENIOR RESOURCE GUIDE

•

HOUSTON EDITION

MID PHASE

DAILY CARE

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•

Enjoy virtual escapes. The pandemic expanded the options for online programs that can transport you from the comfort of home! Getting out virtually, you can explore local museums, zoos or cities, anywhere in the world.

•

Get active in your community together. Explore local senior centers to find fun social or educational activities. For individuals dealing with memory loss, consider checking out Memory Cafes, which are designed to give people living with dementia a place to come together in appropriate environments and offer each other company and support.

•

If your family has religious or spiritual beliefs and traditions, consider ways you can continue to practice them together. Prayers, songs and other rituals can bring familiar, comforting feelings and foster a deeper intimacy between you.

•

If mom or dad is in a senior living community, participate in activities offered there. This can give you insight into what their days are like when you’re not around, and allowing them to share pieces of their lives with you can strengthen your relationship.

No matter your loved one’s care level, active engagement is vital in maintaining a positive, loving relationship and making the most of the time you have together. Be mindful that activities may take longer to complete, and you may need to provide more guidance than previously. But even if you’re leading the project, the activity is still providing your loved one with important stimulation and connection. The goal is to adapt to meet their current abilities rather than allowing age to strip meaning from your lives.

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DAILY CARE

MID PHASE

WHEN DO YOU NEED TO CONSIDER IN-HOME CARE?

It May Be Time to Look for Assistance

SENIOR RESOURCE GUIDE

HOUSTON EDITION

s we age, there are certain issues that we, or those we love, may eventually face when doing simple household chores, such as laundry, cleaning or grocery shopping. These issues tend to arise from normal changes in our physiology including lack of mobility, vision changes, and physical dexterity to name a few. With these changes, we often find that there's an increased need for help with necessities like bathing, dressing and meal preparation. When this happens, it may cause you to wonder if it’s time to hire in-home care or move to an assisted living. Irrespective of your search for a caregiver for yourself or for a loved one, in-home care could be the ideal option. Though research shows that most older adults prefer to age in place in their own home, there are many questions raised by older adults or their informal caregivers regarding home care. In this article, we provide answers to a few questions you may have regarding in-home care.

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MID PHASE

DAILY CARE

It may be time to look for assistance when signs of decline begin to appear during various activities of daily living. Many adult children who are caregiving may cohabitate with their parents. However, working adults may also have responsibilities that don’t allow them to provide care during the day. As time carries on, the dishes begin to stack up in the sink, the laundry piles up, and your parent is found in the same chair you left them in when you return home. Then the realization hits—your parent hasn’t had a shower in a long period of time. Perhaps even more tricky is when your loved one lives alone, and you notice a similar situation as noted above with the dishes, laundry and hygiene. You might notice that the mail has piled up and bills aren’t being paid or medication refills go unfilled. There’s also the scenario where your aging parents are living independently, however you begin to notice a decline in the health of the parent who typically provides care for their spouse. The stress of providing care can take a physical and mental toll on even the most experienced caregivers. In-home care can provide respite for the caregiver, which can allow for some muchneeded rest and time for self-care. Give yourself permission to take a break! These are just a few examples of when to consider exploring in-home care options. Moreover, receiving care assistance enables you to focus on spending quality time with your loved ones and less time worrying or stressing over daily care needs.

From the Experts

Learn what aging signs you should be on the lookout for in the full article: srgtexas.com/getcaregivertoolkit

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MID PHASE

DAILY CARE

HOME CARE VS HOME HEALTH CARE

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HOW CAN I DETERMINE IF HOME CARE IS NECESSARY? When self-care at home becomes difficult and/or family caregivers are not available to assist, home care may be the answer. Home care often relieves family members of basic caregiving functions and makes it possible to spend quality time, rather than the functional caregiving time. Home care is often easier and faster than moving to an institutional care setting and allows the senior to stay at home in familiar surroundings. WHAT IS HOME HEALTH CARE? When the need exceeds what home and personal care can provide, a home health care agency may be required. Home health care provides skilled medical services (such as administration and adjustment of medication levels, monitoring and dressing of wounds, etc.) in the home by trained medical personnel. Home health care is always ordered and supervised by a physician. WHAT IS HOME CARE? Simply put, home care is non-medical personal assistance provided in the home. Home care may include help with bathing, dressing and personal hygiene. It may include a wide range of services: taking and recording vital signs, assistance in the bathroom, light housekeeping, meal preparation, companionship, grocery shopping and pharmacy errands, home safety supervision, medication reminders, bill-paying, laundry and transportation.

DAILY CARE

MID PHASE

GREATER HOUSTON AREA

713-686-2233

Platinum Senior Care 281-306-6615

Encore Caregivers

SENIOR RESOURCE GUIDE

HOME CARE / HOME HEALTH OPTIONS

HOUSTON EDITION

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WILL MY INSURANCE COVER THE COSTS? Medicare, Medicaid and private insurances are sources of payment for receiving home and home health care. Home health care services are typically medically necessary. They are paid for by Medicare or other health insurance, and have been ordered by a physician. Private duty home care services are typically paid for privately, or using long-term care insurance, reverse mortgage proceeds, Veterans aid and attendance pension benefits, or some combination of any of these programs.

MID PHASE

DAILY CARE

CAREBUILDERS AT HOME OF KATY

HOME HEALTH RESOURCES

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ENCORE CAREGIVERS

PLATINUM SENIOR CARE

SPEECH THERAPY

PROVIDER

PHYSICAL THERAPY

Greater Houston ns Area optio

WOUND CARE

HOME CARE COMPARISON

DAILY CARE

MID PHASE

SENIOR RESOURCE GUIDE

HOUSTON EDITION

COMPANIONSHIP

MEAL PREPARATION

LIGHT HOUSEKEEPING

For a full comparison chart that includes accepted forms of payment, criminal background checks, medication reminders, respite care, plus more, visit srgtexas.com

TRANSPORTATION

OCCUPATIONAL THERAPY

MID PHASE

SELF CARE

MEANINGFUL MINUTES FOR CAREGIVERS

Creating Space for Yourself to Recharge

aking time for yourself may seem impossible, but try carving out 5 minutes in your day to press pause. It can make a world of difference. Consider turning your phone on silent mode and stepping away to:

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GET FRESH AIR. Open your windows or simply step outside to take in a new environment. A fresh atmosphere is excellent for resetting your mind and body, which can help you feel calmer. If you have the time, go for a walk or run to boost endorphins. MAKE A GRATITUDE LIST. Write down 10 things you’re thankful for. Shifting your mind to appreciation and finding the positive in your day cultivates a new perspective. The 10 items can be relatively small or large. Try to be as specific as possible and give thought to the reason you’re grateful for each of them. For example, you may be grateful you were able to pick up dinner for your mom because you received a huge smile from her. Or you could be thankful for your bed, pet, laughter, alarm clock, etc. In the words of Oprah Winfrey, “Be thankful for what you have; you’ll end up having more. If you concentrate on what you don’t have, you will never, ever have enough.”

SELF CARE

MID PHASE

JOT DOWN YOUR THOUGHTS TO CLEAR YOUR MIND. If you’re feeling overwhelmed or as if your tasks and demands are never ending, grab a piece of paper (or open a notetaking app on your phone) and unload your thoughts. Don’t attempt to organize them. Simply write them out as they pop up in your mind—things you’re worried or happy about, obligations, items on your to-do list or projects. Decluttering the mind and slowing down spiraling thoughts can help sort out a frazzled mind, but also may help clarify emotions. Additionally, the act of writing down any bright spots in your caregiving journey encourages calm and may help store it in your memory.

• Make yourself a cup of tea or coffee • Five-minute breathing exercise • Meditate (or just close your eyes and relax) • Read a short article of interest • Stretch

Music is a fantastic way to relieve stress. While some types of music such as classical and ambient have been studied for their calming effects, listening to your personal favorite song or genre also has its benefits. Whether it’s been a stressful day or you’re just looking for some good vibes, take a moment to turn on Spotify or queue Alexa to play “Dancing Queen” by ABBA. Listening to music that makes you feel good will help put a smile on your face. Additionally, research has shown that music can help reduce burnout and help you fall asleep. However you spend your five minutes, make the most of it. Fully dedicating time for yourself allows your mind and body the opportunity to recharge.

SENIOR RESOURCE GUIDE

• Chat with a friend or family member

HOUSTON EDITION

• Take a power nap

lower our heart rate and cortisol levels • release endorphins and improve our sense of well-being • distract us, reducing physical and emotional stress levels •

More 5-minute ideas:

LISTEN TO A FAVORITE SONG. According to Psych Central, a 2020 overview of research into music and stress suggests that listening to music can:

MeTime

MID PHASE

SELF CARE

FIVE VITAL TIPS TO HELP DEAL WITH CAREGIVER STRESS

And Recognizing Unhealthy Stress Levels

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ccording to the National Alliance for Caregiving and AARP, around 34.2 million Americans have provided unpaid care to an adult age 50 or older in the last 12 months. Many of these caregivers also care for other family members, such as children, and work outside the home. Without assistance from others and appropriate self-care, it’s a recipe for caregiver stress, fatigue and eventual burnout. In this article, we’re going to talk about recognizing when your stress levels are getting too high and some tips for dealing with caregiver stress.

SIGNS THAT YOU MAY BE TOO STRESSED Everyone copes with stress differently, but if you find yourself experiencing any of the symptoms below then your stress might be progressing to unhealthy levels. • • • • • • •

Feeling run-down or tired often Difficulty sleeping Trouble concentrating Resenting obligations Not taking care of your own health Smoking, drinking or eating too much Cutting back on activities that you usually enjoy

SELF CARE

MID PHASE

The good news is there are ways to deal with caregiver stress and keep it in check.

Tip

DECIDE WHAT‘S IMPORTANT THEN SAY “NO” TO THE REST.

Very few people can do everything alone. Tap into the network of friends, family and social services around you to lighten your own load. Even if they live far away or can’t help with hands-on care, you can delegate tasks that can be done online or over the phone. Many state, local and religious organizations also have resources available to help senior adults and caregivers. Why not task a helpful friend or family member to look through what’s available and pick out the most promising services? They can also assist with applications and coordinating services.

SENIOR RESOURCE GUIDE

TAP INTO THE RESOURCES AROUND YOU.

Tip

HOUSTON EDITION

No caregiver is perfect and it’s impossible to do everything all the time. Prioritize what you or your family member needs that is most critical and break that down into small, easier-tomanage steps. It’s okay to say “no” or even just “not right now” to tasks that drain you. You don’t have to cook a homemade meal every single night, host holiday get-togethers or have the most well-kept yard in the neighborhood. Focus on what matters and cut the rest, especially in times of stress.

MID PHASE

Tip

SELF CARE

SIMPLIFYING COMMUNICATIONS.

If your loved one has experienced unstable health lately, you may find yourself on the phone giving multiple updates to friends and family. While they mean well, it can get exhausting for you to rehash the same information and answer the same questions repeatedly. You can cut back on your update workload considerably by employing a phone tree (where you update one person and they pass the information to other designated people) or using private websites that allow you to post updates but still have privacy controls like CaringBridge or PostHope.

Tip

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SET AND FOLLOW YOUR PERSONAL HEALTH ROUTINE.

It’s easy to forget about your own health when you’re busy caring for someone else. Research has shown that caregivers, particularly female caregivers, have lower levels of self-care and higher rates of health problems than non-caregivers. Developing your own simple routines to get enough sleep, water and exercise can help to improve your health and lower stress. Don’t put off recommended health screenings and checkups. You’ll be a more effective and less-stressed caregiver if you make taking care of your own health a priority as well.

Interfaith Senior Services promotes independent living to senior adults 62 and older From young people to senior adults, if there is a need, Interfaith of The Woodlands is here to help. We offer many services to our senior neighbors, including: Financial Assistance Prescription Drug Assistance Information & Referral Transportation Numerous Wellness Programs Interfaith answers the needs of senior adults in South Montgomery County. As our name suggests, Interfaith of The Woodlands fosters the belief that all faiths can work together to address critical human needs. If you or someone you know are in need of assistance, a helping hand is waiting.

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MID PHASE

Tip

SELF CARE

TAKE CAREGIVING BREAKS REGULARLY.

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Schedule time for yourself and do not waver. These breaks can be small, like a walk around the block or coffee with a friend while your loved one sleeps. Consider asking a family member to visit for the weekend so you can take time away to recharge. If you don’t have anyone in your personal circle who can take over caregiving duties on occasion, there are also networks of professionals available. Many communities have resources such as in-home respite care, adult day care centers or programs or senior living communities with short-term stays available.

FINAL THOUGHTS Taking care of a senior adult can be very rewarding, however there’s no doubt that at times it can also be stressful. Unrelieved stress can build up over time and damage your own health and your ability to care for your loved one. By prioritizing activities, reaching out for assistance, simplifying communications with friends and family, taking regular breaks from caregiving, and sticking to your own personal health routines, you can reduce the amount of caregiver stress that you feel. In the long run, this will help both you and your loved one to thrive during potentially difficult times.

MID PHASE

DIET + WELLNESS

WHY ARE SENIORS MORE AT RISK OF DEHYDRATION?

eniors are not only at an increased risk of lacking proper hydration, but also the serious health complications from being dehydrated. Severe or untreated chronic dehydration can lead to several conditions that caregivers should be aware of: Urinary tract infections, kidney stones or kidney failure Electrolyte problems that can lead to heart trouble or seizures • Low blood volume (hypovolemic shock) that can be lifethreatening • Heat exhaustion or heat stroke • Confusion, anxiety and disorientation •

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•

There are a number of factors that make older adults more susceptible to suffer from dehydration.

LESS TOTAL BODY FLUID The amount of fluid in your body decreases with age. Since you have fewer water reserves available for your body to use, any further decrease in water intake has a larger effect. DECREASED THIRST RESPONSE The feeling of thirst decreases with age. Older adults’ bodies may not let them know when they need to drink more water.

DIET + WELLNESS

Pro Tip for Hydration KEEP WATER HANDY.

A study from the U.S. National Academies of Sciences, Engineering, and Medicine determined the following levels to represent adequate fluid intake, however, individual needs may vary. MEN: About 15.5 cups (3.7 liters) of fluids a day WOMEN: About 11.5 cups (2.7 liters) of fluids a day These recommendations are for total daily fluid intake which covers water, food and any other drinks. They also estimated that about 20% of fluid intake comes from food each day. Maintaining hydration is a serious concern for caregivers of older adults. The good news is it can be easily managed and worked into a daily care routine.

SENIOR RESOURCE GUIDE

HOW MUCH WATER SHOULD AN OLDER ADULT DRINK IN A DAY?

HOUSTON EDITION

This might sound basic but don’t underestimate how effective this simple measure could be. For seniors who experience mobility issues, it can be hard to get up, walk to the kitchen and refill a drink. Keeping a water bottle convenient and nearby means water is always within reach. It also provides a visual cue to consume more water.

MEDICATIONS AND UNDERLYING HEALTH CONDITIONS Senior adults are more likely to have underlying health conditions that require them to take medication. Some medications can cause increased urination and water loss. There’s no set formula to tell you how much a senior adult should drink in a day. This varies depending on their health status, activity level and the climate they live in.

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DECREASED KIDNEY FUNCTION Some seniors can experience decreased kidney function with age. They may lose more water with urination than when they were younger.

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HOW CAN YOU STIMULATE A SENIOR’S APPETITE?

roper nutrition is imperative as you age. It not only helps an aging individual stay strong and healthy, but also aids recovery from any ailments. But what do you do when your older loved one has lost their interest in eating and isn’t getting the nutrition they need? A senior with no desire to eat can prove to be a difficult challenge. We’ve rounded up some savvy ideas for you to try to help increase a waning appetite. •

Create a routine: If your loved one doesn’t have a regular eating schedule, encourage them to start eating at a specific time daily. This will help train their bodies and mind to look forward to a meal every day.

•

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Get them to eat with others: Loneliness and depression are associated with an increased loss of appetite in older adults. Seniors may enjoy eating more if they view it as a social activity instead of a chore. Savvy suggestion: Plan dates with friends, family or neighbors. Also consider your local senior center or faith-based community for meal opportunities.

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Savvy suggestion: Identify the point in the day when their appetite is strongest and any factors that may have influence (i.e. sleep, mood, activities, etc.).

•

Include more finger foods: Seniors experience loss of coordination and shaky hands, making it difficult to use utensils. This may lead to them rejecting their meals due to embarrassment or frustration. Consider items like fruit,

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chicken nuggets and sandwiches as they can eat these with their hands. Savvy suggestion: Don’t shy away from variety. Changing up the menu not only prevents them from getting bored, but also allows you to analyze which foods they’re able to handle best. Also, be sure you’re incorporating vital minerals such as calcium and vitamin D for bone health. When providing protein, seniors require between 1 and 1.3 grams for each kilogram of their body weight. •

Combat medication side effects: Medications can come with nasty side effects such as dry mouth and metallic taste. Besides being uncomfortable, these can lead to loss of appetite. Encourage seniors to brush their teeth, use a mouth rinse or chew sugar-free gum before eating to treat dry mouth. Doing so gets saliva flowing, enhances their ability to taste, and reduces discomfort, which may help boost their appetites. Savvy suggestion: If their food tastes “off,” consider adding fruits or herbs to make a flavor more prominent. For example, try infusing water with lemon, mint or cucumber.

Savvy suggestion: Start with ingredients they already love. Mix in healthy flavor boosters such as cinnamon, turmeric, ginger, cocoa and unsweetened matcha powder.

Discover more powerful tips + tricks to handle diminishing appetites at srgtexas.com/getcaregivertoolkit

Drink the food instead: Many seniors have difficulty with chewing and/or swallowing. In such cases, go with smoothies, soups or bottled nutritional drinks.

SENIOR RESOURCE GUIDE

•

Savvy suggestion: Start a meal off with a small portion of their favorite snack or appetizer.

HOUSTON EDITION

Let them choose: Help make your loved one feel more empowered by including them in the decision-making. Let them get involved in what they will eat and how it will be prepared.

•

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HOMEMADE TURMERIC ALMOND DRESSING Courtesy of epicurious

his creamy dressing is great drizzled over your favorite salad, grain bowl or cooked veggies. Bonus: Turmeric offers improved brain function and anti-depressant benefits.

TURMERIC ALMOND DRESSING RECIPE

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INGREDIENTS • 3 (2-inch) pieces fresh turmeric, peeled and roughly chopped, or 2 teaspoons ground dried turmeric • 1 (1-inch) piece fresh ginger, peeled and roughly chopped

DIRECTIONS • 1 garlic clove, roughly chopped • 1/4 cup plus 2 tablespoons fresh lemon juice • 3 tablespoons natural almond butter • 1 tablespoon honey • 1/4 teaspoon kosher salt

Makes 3/4 cup. Combine all ingredients with 3 tablespoons water in a blender and purée until smooth, about 3 minutes. Taste and adjust salt or lemon juice, if desired.

Find more recipes on srgtexas.com

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MEMORY + DEMENTIA

steps to take after

A MEMORY ISSUE IS RECOGNIZED

he days following a loved one’s dementia or Alzheimer’s diagnosis can be difficult and filled with emotion. For many, the lack of knowledge is often scarier than the diagnosis itself as you have no idea what to do, what to expect or how you’re supposed to help. We’ll examine this topic and discuss those critical first steps to take following this type of diagnosis, as well as how you can provide the best care possible.

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STEP 1: CONSULT A SPECIALIST.

Alzheimer’s and dementia diagnoses are often made at the hospital following a significant event or at a primary care physician’s office after the onset of some cognitive symptoms. However, if you or your loved one haven’t spoken to a neurological specialist, it’s highly recommended. This is because dementia isn’t always caused by unstoppable neurological degeneration. It can result from several medical conditions, such as heart disease, intracranial pressure, or a mass located at certain spots within the body. It can also be the result of certain medications, such as anticholinergic and bladder antimuscarinic (bladder suppressant) drugs. If this is the case, you’ll want to know so you can obtain the most effective treatment.

STEP 2: CONSIDER YOUR OPTIONS.

Alzheimer’s and dementia don’t currently have cures, but there are treatments and medications available to help improve

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symptoms. Make sure you talk this possibility over with your loved one’s doctor and keep up to date on new findings and treatment options. Questions to ask your loved one’s doctor: • • • • • • •

What tools or tests were used to determine a diagnosis? What were you measuring? What is causing the illness? What are the treatment options available? What symptoms are alleviated by each medication and are there any side effects? Are there any clinical trials available and where can I find additional information on those? How will the disease progress? What forms of care are available to help my loved one live with the disease?

There’s more of this article in our free Caregiver Toolkit. To learn more critical first steps, visit srgtexas.com/getcaregivertoolkit

SENIOR RESOURCE GUIDE

Six More Steps

Receiving a degenerative memory diagnosis is never easy, and it’s important to recognize and cope with any emotions you may have. Although your loved one is still around, feelings of loss, anger and fear are common. Coming to terms with the diagnosis will help you and your loved one move forward and discover new ways to live a positive and fulfilling life.

STEP 3: TAKE CARE OF EMOTIONAL NEEDS.

HOUSTON EDITION

You should also be considering what long-term care may look like. For most adults with a memory-targeting illness, longterm care often involves professional at-home caregivers or a specialized 24-hour facility.

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REMINISCENCE THERAPY:

How It Can Help with Memory Issues

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iving in the past is often viewed with negative connotations and discouragement. However, when it comes to patients with Alzheimer’s or dementia, reminiscing can be a healthy and beneficial way to feel connected, valued and heard. Reminiscence therapy or a “life review” was first proposed by Dr. Robert Butler, a psychiatrist specializing in geriatric medicine, in the 1960s as a new way to look at aging and the natural process of memory. This was counter to what the other leading psychologists and psychiatrists promoted as they felt that one should focus on the present and the future rather than try to relive broken or disconnected memories. For caregivers working with patients who have cognitive difficulties, reminiscence therapy can be an effective tool for engaging in conversation, making the patient feel valued and heard, and dealing with difficult emotions. There are several easy and effective ways for even non-trained professionals to participate in this form of therapy.

WHAT IS REMINISCENCE THERAPY? The practice of reminiscence therapy involves exchanging memories from one’s past as a way to remember more things. Its main goal is to stimulate the brain and improve overall well-being. Professional clinicians and family members can use this approach in both a clinical setting as well as an informal setting.

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There are three main types of reminiscence therapy: Simple: reflecting on the past in a natural and enjoyable way Evaluative or Life Review: examining life and sometimes addressing hard memories • Life Story: a narrative approach of past, present and future • •

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REMINISCING VS REMEMBERING When asking patients to remember something on command, many can become frustrated or embarrassed as they may not be able to remember certain information right away. Patients may also try to read the expressions or tone of the caregiver to see which response is appropriate and may say that they do remember when in fact they don’t. There are a few key differences between simply remembering something instead of reminiscing. Remembering is the recall of specific things such as where you were born or where you parked your car. Reminiscing is walking through past events or memories but doesn’t always entail analyzing them. The goal of reminiscence therapy is not to get someone to remember something from the past, but instead to create an atmosphere that allows memories to arise organically. The difference between these two can be tricky to understand at first, but when done correctly, this approach can help foster a deeper understanding and emotional connection between caregiver and patient.

HOUSTON EDITION

The strategy one uses will depend on the patient and the intended result. It’s also important to note that one method may not work every time, and the caregiver may need to use one or more methods over time. Some methods may not work at all while others may work quickly. If one type doesn’t work, don’t simply give up. Consider trying another day or maybe at a different time of day.

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REMINISCENCE THERAPY IDEAS FOR CAREGIVERS You don’t have to be a trained clinician or professional caregiver to participate in reminiscence therapy. Here are a few easy ways for caregivers and family members to begin: •

Use a variety of mediums: Photographs, smells, music, food or objects can be a great first step to begin the conversation.

•

Ask open-ended questions: As with any conversation, questions that result in a simple “yes” or “no” can be challenging to expand upon, so be sure to continue with follow-up questions if you ask a yes-or-no question.

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BENEFITS OF REMINISCENCE THERAPY Reminiscence therapy can be especially useful for patients who also deal with depression and anxiety as it helps to be reminded of past accomplishments, joys and struggles endured through the years, and how their past has defined who they are today. Studies have also suggested that it can help improve a patient and caregiver’s relationship. Many caregivers are often focused on a needs level instead of an interpersonal level and reminiscing on both positive and hard memories.

MEMORY + DEMENTIA

Important to Note

•

Begin early in the day: Many patients with Alzheimer’s or dementia report the best time for recall is early in the morning. Working with them at a time that works best for them can lead to better results.

•

Revisit special settings from one’s past: If possible, taking someone to an environment that is significant to them from their past can trigger these responses. Places like old homes, schools, religious places of worship, and workplaces are easy to visit if close by.

Reminiscence therapy is just one approach to help patients who suffer from cognitive related diseases. One must consider the patient’s personal and medical history before starting this form of therapy, and it may not be suitable for all individuals.

Be open to emotional responses: Some memories can be hard or painful, but that doesn’t mean they’re bad. Encourage these emotions as it can provide a therapeutic response.

SENIOR RESOURCE GUIDE

•

HOUSTON EDITION

Even though there is no research to show any negative effects of reminiscence therapy, recalling old memories can be difficult. Ensure you’re supporting them with an open and nonjudgmental mind.

Use your observational skills: Are there objects or photographs they keep in a special place or tend to look at regularly? Look for conversation starters in the environment or home that can help trigger a conversation.

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•

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TIPS FOR EFFECTIVE ALZHEIMER’S COMMUNICATION

lzheimer’s disease presents many challenges, and communication is a big one. Despite the challenges, you can communicate effectively with a loved one who has Alzheimer’s. Consider these tips provided by the Mayo Clinic staff:

SPEAK CLEARLY Introduce yourself. Speak in a clear, straightforward manner.

SENIOR RESOURCE GUIDE

KEEP IT SIMPLE Use short sentences and plain words. As the disease progresses, yes-no questions may work best, and only one question at a time is best. Break down requests into single steps.

AVOID DISTRACTIONS Communication may be difficult—if not impossible—against a background of competing sights and sounds.

STAY PRESENT Maintain eye contact, and stay near your loved one so that he or she will know that you’re listening and trying to understand.

HOUSTON EDITION

SHOW RESPECT Avoid secondary baby talk and diminutive phrases, such as “good girl.” Don’t assume that your loved one can’t understand you, and don’t talk about your loved one as if he or she weren’t there.

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DON’T INTERRUPT It may take longer than you expect for your loved one to process and respond. Avoid criticizing, hurrying and correcting. USE VISUAL CUES Sometimes gestures or other visual cues promote better understanding than words alone. Rather than simply asking if your loved one needs to use the toilet, for example, take him or her to the toilet and point to it. DON’T ARGUE Your loved one’s reasoning and judgment will decline over time. To spare anger and agitation, don’t argue with your loved one. STAY CALM Even when you’re frustrated, keep your voice gentle. Your nonverbal cues, including the tone of your voice, can send a clearer message than what you actually say.

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SIGNS NOT TO IGNORE:

DEMENTIA VERSUS NORMAL AGING

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f you’ve found yourself worried about whether or not a loved one might be showing signs of dementia, you aren’t alone. Distinguishing between dementia indicators and normal aging factors can be tricky, and it’s important to know the difference to avoid adding any unnecessary stress or worry to the situation. Afterall, is rushing mom off to the doctor because she called you your sibling’s name—maybe even the family dog’s name once…or twice—the right next step or even a cause for alarm?

DEMENTIA OR AGING: THE SIGNS

The Alzheimer’s Society notes six different abilities and how they may be impacted by normal aging compared to possible changes due to dementia. We’ll cover all six and highlight a few of the differences between the impact of dementia or aging on those abilities.

1. SHORT TERM MEMORY & LEARNING NEW INFORMATION Normal aging can impact short-term memory and the learning process by causing one to falter or struggle to remember

2. DECISION MAKING & PROBLEM SOLVING As we age, many people struggle to juggle multiple tasks at once, take a bit more time to process decisions or information, and occasionally make mistakes when completing everyday tasks. People who are impacted by dementia, however, might make

SENIOR RESOURCE GUIDE

something commonplace. Forgetting about an appointment or misplacing the phone are all traditionally normal occurrences for many as they age. Dementia can impact short-term memory in a bit more comprehensive way. Forgetting the names of loved ones or close friends or being unable to recall who you had lunch with earlier that day can be cause for added concern. Similarly, misplacing the phone or keys in illogical places, like the bathroom cabinet or freezer, may be signs worthy of more attention.

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frequent mistakes when completing tasks like cooking or cleaning, struggle to concentrate for very long, and get confused more often. If your loved one finds it difficult to comprehend finances or gauge the severity of everyday risk, these may be signs of a more serious issue.

3. LANGUAGE Struggling to remember the right word or keep up with a conversation where many people are talking at once is pretty normal for people of all ages, especially those who are older. Though if any of these things happen on a frequent basis, it could be a sign of dementia. Regularly referring to items using words like “that” or “this” may signal to you that something more serious is at play.

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4. ORIENTATION If your loved one occasionally needs to be reminded of the date or day of the week, this isn’t necessarily cause for worry. But if they struggle to recall what the season is or need daily reminders about the date, it may be time to address these issues. Another common characteristic of those impacted by dementia is feeling unsure of their surroundings when in an otherwise familiar place—like at home. 5. VISION & PERCEPTUAL SKILLS A common complaint among older adults is they have difficulty seeing as well as they used to, often impacted by cloudy vision or worsened eyesight. But struggling with depth perception when doing things like reaching for a door handle or climbing the stairs should be addressed by a doctor as these challenges go beyond the boundaries of worsened eyesight.

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MEMORY + DEMENTIA

6. MOOD & BEHAVIOR Feeling stressed out or blue about life’s challenges or getting upset when plans don’t play out as expected is normal, especially as we age. If your loved one seems to be becoming withdrawn or uninterested in their hobbies and friends, this could be a signal for greater concern. Similarly, being extremely sad or scared for seemingly no reason, or as a result of relatively ordinary challenges, could be related to dementia.

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WHEN IN DOUBT, TRUST THE PROFESSIONALS

As your loved ones age, it’s likely you’ll face challenges discerning whether or not their behavior is a symptom of something more drastic than old age, and that’s no easy task. While we often feel responsible for the well-being of those around us, remember it isn’t your job to diagnose them beyond your capabilities—unless, of course, you’re a neurologist. Not the case? Trust a professional to give your loved one the best care possible and address the needs that cause concern.

Take Five

Feel less stressed in minutes. Set a timer for 5 minutes and close your eyes. Take a few deep breaths releasing any tension in your body and imagining it melt away. Focus on a fivecount breath: • Slowly inhale from the belly • Then into ribs • Then into chest • Up into crown of the head • Then gently hold the breath for the fifth count On the exhale, reverse for another count of five. This time start from the top of your head and move down to the chest, ribs, belly, pausing on that last bit of breath out of the body, and then repeat from the beginning.

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PAYING FOR LONG-TERM CARE

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Ways to Pay

HOUSTON EDITION

ong-term care is a type of personal care service older adults may need if they become unable to care for themselves because of a prolonged physical illness, a disability or a cognitive impairment, such as Alzheimer’s disease. Long-term care can be expensive. Long-term care insurance is designed to cover medical and personal services in a number of settings such as your home, adult day care, skilled nursing facility or assisted living community. Most long-term care insurance policies are individual policies and can differ from one company to the next. According to medicare.org, long-term care may be divided into three levels: Skilled care is continuous “around-the-clock” care designed to treat a medical condition and performed by skilled medical personnel, such as registered nurses or professional therapists. Intermediate care is intermittent nursing and rehabilitative care provided by registered nurses, licensed practical nurses, and nurse’s aides under the • Medicaid supervision of a physician. • Medicare Custodial care is designed to assist with one’s activities of daily living • Long-term care insurance (such as bathing, eating and dressing). • Long-term care It can be provided by someone without riders attached professional medical skills but is to a life insurance supervised by a physician. policy or annuity Texas created the Long-Term Care • Accelerated death Partnership Program, which is a joint effort benefits from life insurance between private insurers and the state. For a list of companies participating in the • Personal cash or savings program visit: tdi.texas.gov/consumer

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CARING FOR A LOVED ONE WITH DEMENTIA

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HOUSTON EDITION

hen a loved one is living with a memory impairment, the caregiver role can be a complicated one. The World Health Organization reports that more than 55 million people around the world are currently living with some form of dementia, with an additional 10 million cases diagnosed each year. There are many different forms of dementia, including Alzheimer’s disease, which may account for up to 70% of cases. All forms of dementia are progressive in nature, and each one leads to deterioration in cognitive function. Dementia affects thinking, orientation, memory, calculation, learning capacity, language, comprehension, and judgment, as well as mood and emotional control. The mental disorder can also have social, economic, physical, and psychological impacts on both the patient and their caretaker. Fortunately, a variety of dementia resources are available to rely on and provide assistance to seniors and families in this phase of aging. This article will help you discover some of the best activities for individuals with dementia and caregiver tips to create a positive, supportive environment for everyone.

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TIME-TESTED CAREGIVER TIPS No matter where a loved one with dementia is living, there are solid methods that can make the situation easier for everyone. For example: • • • • • • • • •

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•

Comforting to Know Evidence shows that the right exercises, activities and therapies can help to slow the progression of dementia.

Keep your loved one involved in decision-making Learn how to communicate appropriately with them Limit potential frustrations Reduce distractions Stay flexible Maintain a daily schedule Promote connection to avoid isolation Create a calm, soothing environment Focus on safety Remove excessive furniture or rugs, and use safety locks on necessary doors to keep the home safe

As you seek to understand the different aspects of dementia care, consider reaching out to experts in memory support and joining a local support group to meet other caregivers you can relate to. You’ll find they can be a valuable resource to you throughout your journey.

Dive Deeper

Learn the must-know safeguarding tips for your loved one’s home as well as more dementia-friendly activities in the full article, visit srgtexas.com/getcaregivertoolkit

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NEW STEPS

CARE TRANSITIONS

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hen it comes to long-term care, people often use more than one solution over time. As people switch from one type of care to another, there is a transition period. A care transition may occur when someone leaves the hospital and needs support to heal at home after they’ve been discharged from the hospital, or it might happen when someone who is receiving in-home care decides to move into a supportive community, such as assisted living or senior housing. The goal is to avoid a gap in care for the individual as they pivot between different care types. When someone leaves the hospital or a rehab facility for home, their doctor or nurse can’t go with them and a family or professional caregiver might be needed as they continue to heal at home. For example, someone might need help with using the bathroom, taking new medications, or going back to see the doctor for follow-up appointments. An even longer and different type of transition may occur when someone decides to move from their current residence to a

SENIOR RESOURCE GUIDE

new one—whether that’s from a stand-alone home into a senior housing apartment, assisted living facility or in with family across town or another state. A caregiver—whether a family member or a professionallytrained one—can help to make these types of transitions smooth. If they’re transitioning to an assisted living facility, a caregiver can inquire about opportunities to join in meals and activities prior to moving in. This type of engagement can help the individual feel more relaxed about their new surroundings and making a big change. When making changes in long-term care options, aim for a continuity of care during the transition so risks for setbacks are minimized and chances for success are increased.

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WHAT TYPE OF MENTAL HEALTH PROFESSIONAL IS THE RIGHT FIT?

hen exploring a potential therapist or psychiatrist, inquiring about their approach to treatment can be helpful in determining if they’re a good fit. For some, a medication-based treatment through a psychiatrist or other qualified medical professional might be best, whereas a combination of medication and therapy, or just therapy on its own, might be more appropriate for others. If seeking traditional talk therapy, also known as psychotherapy or • Inquire counseling, there are a number of as to the experience possibilities, including clinical or level in counseling psychologists, social treating workers, counselors or family individuals therapists. The terms “therapist” with similar and “counselor” are often used problems interchangeably and sometimes highlight • Make sure the level of education or credentialing. they’re Psychotherapy might not work licensed to for everyone, and alternative methods practice in your state including animal-assisted psychotherapy or somatic therapy might be healing

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Must ask!

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Types of Counseling

Psychotherapy versus Psychological Counseling Counseling is often more short-term than therapy and focuses on specific issues—it’s designed to help a person address a particular problem, such as stress management. The focus may be on problem solving or on learning specific techniques for coping. Psychotherapy is more long-term and focuses on a broader range of issues.

options to consider. Another alternative is e-therapy via video conferencing or through services on an app, such as Talkspace which essentially puts a licensed therapist in your pocket.

SENIOR RESOURCE GUIDE

HOUSTON EDITION

Jot down any reminders, questions or findings.

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*$19.95 is the monthly price of subscription to a MobileHelp Classic at home only system. There is a one-time $49.95 processing fee and $15 shipping fee required to subscribe to this plan. Equipment may vary as shown. System featured in photo above is the MobileHelp DUO available at an additional monthly cost. Call or see terms and conditions for further details. 50% off Fall Detection Promotion valid when Fall Detection Service is added to your monitoring system and MobileHelp Connect Premium service is included with the order. Offer is valid for the first year of service only. This offer is for new customers only and cannot be combined with any other offers. Promotion available for select plans only and for a limited time. During the promotional term, you will receive $5 off the $10 full retail price of Fall Detection service. After first year, Fall Detect pricing reverts to discounted price of $7.50/ month when combined with MobileHelp Connect Premium. Fall Button does not detect 100% of falls. If able, users should always push their help button when they need assistance. Fall Button is not intended to replace a caregiver for users dealing with serious health issues. Service availability and access/coverage on the AT&T network is not available everywhere and at all times. Current GPS location may not always be available in every situation. MobileHelp is a registered trademark. Patented technology. MobileHelp is an FDA registered company. MHPN-00939 Rev. 1

NEW STEPS

questions to ask

MID PHASE

hat w w o n K to ask

DURING HOSPITAL DISCHARGE

y asking the right questions and taking an active role in your loved one’s care, you can bridge the gap that patients typically experience when transferring from one care setting to another, which is one of the top causes for hospital readmission.

What is the average length of recovery time? Which doctor appointments are needed after discharge and when should they be scheduled?

HOUSTON EDITION \\

4 5

SENIOR RESOURCE GUIDE

Can you show me how to do tasks that require special skills? i.e. changing a bandage, giving a shot, wheelchair transfers, etc. If we need help with these tasks, who do we contact?

Will my loved one be safe at home upon discharge or will someone need to be with them 24 hours a day? Keep in mind dressing, bathing, cooking and housework.

117

What care or therapies are needed after discharge? i.e. home health, outpatient therapy, rehab/skilled nursing, etc.

MID PHASE

6 7

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9 10 11 12

NEW STEPS

What problems, symptoms and side effects should we watch for? May we have the latest list of prescribed medications? What does each medicine do and why is it needed? What are the medication dosages, conflicts and side effects? Who should we contact with questions about the medications? What medical equipment is needed? i.e. walker, oxygen, etc. Who will arrange for this? Are there any activity restrictions and for how long? Are there any dietary restrictions? What are our options for when/where my loved one is being discharged?

My Questions

Jot down any questions or thoughts.

We We We We Care Care Care Care

THE MOST TRUSTED SOURCE FOR POST ACUTE CARE THE THE MOST MOST MOST TRUSTED TRUSTED TRUSTED SOURCE SOURCE SOURCE FOR FOR FOR POST POST POST ACUTE ACUTE ACUTE CARE CARE CARE INTHE EVERY COMMUNITY WE SERVE IN INEVERY INEVERY EVERY COMMUNITY COMMUNITY COMMUNITY WE WE WE SERVE SERVE SERVE SPECIALIZED REHABILITATION PROGRAMS • OUTPATIENT THERAPY CLINICS

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SPECIALIZED REHABILITATION PROGRAMS: SPECIALIZED SPECIALIZED REHABILITATION REHABILITATION REHABILITATION PROGRAMS: PROGRAMS: PROGRAMS: • SPECIALIZED Amputee • Spinal Cord Injuries

•• •Amputee •Amputee Amputee • ••Spinal •Spinal Spinal Cord Cord Cord Injuries Injuries Injuries Aquatic Pulmonary Disease Our Focus is providing • • Aquatic • Aquatic Aquatic • • Pulmonary • Pulmonary Pulmonary Disease Disease Disease Our Our Focus Focus Focus is isproviding isproviding providing • Our Brain Injury • Hip Fracture • •Brain •Brain Brain Injury Injury Injurypost-acute• care •Hip•Hip Fracture Hip Fracture Fracture high quality, that • Stroke • Outpatient Therapy high high quality, quality, quality, post-acute post-acute post-acute care care that that that • high •Stroke •Stroke Stroke • care •Outpatient •Outpatient Outpatient Therapy Therapy Therapy • Trauma Services fosters meaningful improvement and • • Trauma • Trauma Trauma Services Services Services fosters fosters fosters meaningful meaningful meaningful improvement improvement improvement and and and Orthopedic Conditions Parkinson’s Disease, •• •Orthopedic •Orthopedic Orthopedic Conditions Conditions Conditions • ••Parkinson’s •Parkinson’s Parkinson’s Disease, Disease, Disease, OUTPATIENT recovery for people with injuries, illnesses and disabilities. 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110 E. Medical 655 Medical Center u uCenter u Blvd., uu tu t t Blvd. uTX uCenter t 110110 E.110 Medical E.Webster, Medical E. Medical Center Center Center Blvd. Blvd. Blvd. 655655 E.655 Medical E. Medical E.Webster, Medical Center Blvd. Blvd. Blvd. 77598 TXCenter 77598 110Webster, E. Webster, Medical Center Blvd. 655 E.Webster, Medical Center Blvd. Webster, TXTX 77598 TX 77598 77598 Webster, Webster, TXTX 77598 TX 77598 77598 832.224.9500 281.286.1500 Webster, TX 77598 Webster, TX 77598 Main: Main: Main: 832.224.9500 832.224.9500 832.224.9500 Main: Main: Main: 281.286.1500 281.286.1500 281.286.1500 Main: 832.224.9500 Main: 281.286.1500

18839 McKay u u tu t t Blvd. uMcKay t 18839 18839 18839 McKay McKay Blvd. Blvd. Humble, TXBlvd. 77338 18839 McKay Blvd. Humble, Humble, Humble, TX TX 77338 TX 77338 77338 281.964.6600 Humble, TX 77338 Main: Main: Main: 281.964.6600 281.964.6600 281.964.6600 Main: 281.964.6600

Certificate Certificate Certificate of of of Certificate Certificate Certificate of Distinction of Distinction of Distinction Certificate Certificate Certificate of Distinction of Distinction of Distinction Distinction Distinction Distinction for for Stroke Stroke Stroke Certificate offor for for Stroke for Stroke Stroke andand Pulmonary Pulmonary Pulmonary for for Stroke for Stroke Stroke andand Pulmonary and Pulmonary Certificate ofand Distinction Certificate ofPulmonary Distinction Rehabilitation Rehabilitation Rehabilitation Distinction for Stroke Rehabilitation Rehabilitation Rehabilitation Rehabilitation Rehabilitation Rehabilitation Stroke and Pulmonary for Stroke and Pulmonary Opening Soon 1917forAshland St., 4th Floor 7622 Branford Pl. Rehabilitation Rehabilitation ◆ Outpatient ◆ ◆ Therapy Therapy Therapy ▼Therapy Outpatient ▼Rehabilitation Outpatient ▼Outpatient Outpatient Pulmonary Pulmonary Pulmonary Rehab Rehab Rehab KEY:KEY: u KEY: Outpatient uOutpatient Outpatient uOutpatient Outpatient Therapy Therapy t t t Outpatient Outpatient Pulmonary Pulmonary Pulmonary Rehab Rehab Rehab

19770 Kingsland Blvd. Houston, TX 77008 Sugar Land, TX 77479 Therapy ▼ Outpatient Pulmonary Rehab Rehab Katy, TX 77094 713.814.9100 KEY: ◆uOutpatient Outpatient Therapy t Outpatient Pulmonary 281.766.9002 postacutemedical.com postacutemedical.com postacutemedical.com ForFor more For more more information information information onon any on any of any of our of our locations, our locations, locations, visit visit visit PostAcuteMedical.com PostAcuteMedical.com PostAcuteMedical.com postacutemedical.com pamhealth.com For more information on any of locations, visit PostAcuteMedical.com Post Post Post Acute Acute Acute Medical Medical Medical is committed is is committed committed toour to providing to providing providing patients patients patients with with with thethe best the best best care care care and and and outcomes. outcomes. outcomes. WeWe off We off eroff er both er both both inpatient inpatient inpatient and and and outpatient outpatient outpatient therapy. therapy. therapy. Find Find Find a location athe location a location near near you. you. you. Post Acute Medical is committed to providing patients with bestnear care and outcomes. We offer both inpatient and outpatient therapy. Find a location near you.

MID PHASE

NEW STEPS

ur o y w Kno options

This content is proudly provided by

See their ad on the Back Cover

CHOOSING THE RIGHT REHABILITATION CENTER

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any families aren’t aware that they have choices regarding where to complete rehabilitation and that it can take place in a variety of settings, including in the home. The most important factor in determining where to complete rehabilitation is to find a setting that will reduce the risk of hospital readmission while helping your loved one regain their strength and confidence as quickly as possible.

THINGS TO CONSIDER WHEN SELECTING A REHABILITATION CENTER • Determine whether the rehab center can provide short- or long-term rehabilitation as needed. Some only provide short-term. • Try to visit several to be able to compare and contrast. • Ask to see patient rooms and common living spaces to evaluate the levels of cleanliness, comfort and privacy that residents have.

NEW STEPS

MID PHASE

•

Ask if both private and shared rooms are available.

•

Check out the dining options and menus.

•

Visit the community areas to find out about social events and activities designed to keep residents engaged and entertained.

•

Ask for information about your loved one’s specific rehab program.

•

Ask if the person who is administering the rehab program is an employee or outsourced and if possible, try to meet them.

•

Ask about the availability of specialized staff, with regard to you or your loved one’s specific needs.

•

Inquire about a personalized care plan and get actual details about it in advance.

•

Ask to see their most recent “Satisfaction Survey” results and statistics on benchmarked outcomes.

SENIOR RESOURCE GUIDE

HOUSTON EDITION

Jot down any reminders, questions or findings.

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Notes

MID PHASE

SENIOR LIVING

TYPES OF RESIDENTIAL CARE FOR SENIORS INDEPENDENT LIVING

ASSISTED LIVING COMMUNITIES

DESCRIPTION

Single family homes or townhomes for self-sufficient seniors that offer the security and social activities of a community living environment.

Communities, typically of 2-3 story apartments, that provide 24 hr assistance with activities of daily living such as eating, bathing, and using the bathroom, but not 24 hr medical services.

SERVICES

• • • •

• • • • • • • • •

Laundry/linen service Meals Transportation Social activities

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NOTE – there are more luxury communities that have all the amenities of country clubs.

Laundry/linen service Meals Transportation Social activities Bathing/Dressing Toileting Housekeeping Medication assistance Security and emergency calls

REGULATION

Not Regulated

State Regulations

ALSO KNOWN AS

Retirement Communities, Retirement Homes, Senior Apartments, Senior Housing, Senior Living Communities, Active Adult Communities

Assisted Living Facilities, Personal Care Homes, Eldercare Facilities, Domiciliary Care, Board and Care, Residential Care Facilities, Community-Based Retirement Facilities, Adult Living Facilities, Adult Foster Care, Sheltered Housing, Community Residences, Group Homes, Adult Family Homes

APPROXIMATE Market rate to rent or buy a COSTS home plus community fees from $700 – $6,000/month.

$2,844 – $9,266/month Avg cost in Texas is $3,795 – source Assisted Living Research Institute

SENIOR LIVING

MID PHASE

Information courtesy of The American Elder Care Research Organization

SKILLED NURSING (NURSING HOMES)

CONTINUING CARE RETIREMENT COMMUNITIES

Communities, typically private and shared rooms, which provide 24 hr assistance with activities of daily living and medical care by nurses and therapists.

Campus-like communities that provide a continuum of care, from private residences to assisted living and skilled nursing care; designed for individuals with declining conditions and those that want to remain in a single location.

• • • • • • • • • • • • •

$4,639 – $12,623/month

Varies with breadth of services required.

HOUSTON EDITION \\

Skilled Nursing Facilities, SNF, Nursing Home CCRCS, Continuing Care, Retirement Facilities, Care and Rehabilitation, Convalescent Life Care Facilities, Life Care Communities, Life Hospital, Rest Home Plan Community

SENIOR RESOURCE GUIDE

Some State Regulations

State & Federal Regulations

Laundry/linen service Meals Transportation Social activities Bathing/Dressing Toileting Housekeeping Medication assistance Security and emergency calls 24 hr nursing care Condition specific care Hospice/end of life services Doctors on call

123

ASSISTED LIVING

MEMORY CARE

INDEPENDENT LIVING

HOME CARE

Rose Find the right senior living option for your mom or dad with our free personalized process 1

Connect with a local advisor

Review a tailored list of recommendations

Evaluate, tour and decide with confidence

A Place for Mom helps thousands of families like Rose’s each year and simplifies the process of finding senior living with customized guidance at no cost to your family. Our service is free, as we’re paid by our participating communities and providers.

Connect with us at 1-866-491-0076

ASSISTED LIVING

MEMORY CARE

INDEPENDENT LIVING

HOME CARE

SENIOR LIVING

MID PHASE

SENIOR LIVING COMMUNITIES in the Greater Houston Area AL ADL Assisted Living

55+ Arella on Jones

AL ADL Assisted Living

SNF Baywood Crossing

AL ADL Assisted Living Elena Estates

SNF Cypress Creek Rehabilitation & Healthcare Center

Key

AL Evergreen Cottages Bridgewater MC

21715 Bridgewater Village Dr 77449 281-670-9810

55+ Active 55+ Community SNF Skilled Nursing

IL Independent Living

AL Assisted Living

MC Memory Care

HOUSTON EDITION

504 Bering Dr 77057 832-426-3167

IL Anthology Senior Living Tanglewood

13600 Birdcall Ln 77429 713-724-3268

SENIOR RESOURCE GUIDE

710 N Main St 77562 713-298-5098

5020 Space Center Blvd 77505 713-575-1800

3903 Canterbury Dr 77521 713-298-5098

12840 Jones Rd 77070 832-500-5477

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3604 Autumn Ln 77521 713-298-5098

MID PHASE

SENIOR LIVING

AL Evergreen Cottages Jasmine MC

SNF Park Manor of Humble 19424 McKay Dr 77338 281-961-0954

21609 Provincial Blvd 77450 281-670-9810

SNF RollingBrook Rehabilitation & Healthcare Center

AL Evergreen Cottages Magnolia MC

750 Rollingbrook Dr 77521 832-572-7575

21605 Provincial Blvd 77450 281-670-9810

AL The Landing at Augusta Woods IL

SNF Fall Creek Rehabilitation & Healthcare Center

7727 Augusta Pines Dr 77389 346-707-3867

14949 Mesa Dr 77396 713-882-1905

AL The Park at Bay Area

AL Kingwood Memory & Assisted Living MC

911 Southern Hills Rd 77339 281-892-1400

MC The Reserve at Braeswood 7800 N Stadium Dr 77030 713-714-6269

SNF Mont Belvieu Rehabilitation & Healthcare Center

AL The Reserve at First Colony

14000 Lakes of Champions Blvd 77523 832-669-3900

13825 Lexington Blvd 77478 281-946-2944

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5000 Space Center Blvd 77505 832-574-5523

Key

55+ Active 55+ Community SNF Skilled Nursing

IL Independent Living

AL Assisted Living

MC Memory Care

Libbie’s Place Senior Day Program Day Activity and Health Services for Seniors

Day Serving Activityseniors and facing memory loss, physical ealth Services for challenges Seniors & loneliness.

409-741-2538

5402 Avenue U • Galveston

www.libbies.org 409-741-2538

5402 Ave. U • Galveston www.libbiesplace.org

Transportation available for Island and Mainland Participants 409-741-2538 Transportation available for Island & Mainland Participants

5402Licensed Ave. U • Galveston by Texas Department of Health & Human Services Vendor #100536 Licensed by Texas Dept. of Aging & Disability Services Vendor #100536 www.libbiesplace.org

nsportation available for Island & Mainland Participants

ensed by Texas Dept. of Aging & Disability Services Vendor #100536 VA Approved VA Approved

SECC Campaign Participant

MID PHASE

SENIOR LIVING

AL The Reserve at Katy

AL Total Loving Care Inc III

21601 Provincial Blvd 77450 281-524-3736

23315 Johnson Rd 77357 281-543-5037

AL The Reserve at Pasadena

SNF Trinity Rehabilitation and Healthcare Center

4004 Vista Rd 77504 713-714-6263

314 E Caroline St 936-744-1300

AL The Reserve at Pearland

SNF West Houston Rehab & Healthcare

2940 Cullen Pkwy 77584 281-357-9885

13428 Bissonnet St 77083 713-351-4300

MC The Reserve at Royal Oaks 11395 Richmond Ave 77082 281-305-1719

AL Woodlands Memory & Assisted Living MC

AL Total Loving Care Inc

26311 Oak Ridge Dr 77380 281-892-1400

23370 Johnson Rd 77357 281-399-3718

AL Total Loving Care Inc II

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23374 Johnson Rd 77357 281-399-8377

Key

55+ Active 55+ Community SNF Skilled Nursing

IL Independent Living

AL Assisted Living

MC Memory Care

LUXURY ACTIVE SENIOR LIVING

Scan for amenities!

NOW OPEN! BE THE FIRST TO UNCOVER A SERENE LIFE STYLE AT ARELLA ON JONES

( 8 3 2 ) 5 0 0 - 5 47 7 • WIDE AIR-CONDITIONED HALLWAYS • FULL-SERVICE SALON & SPA • POOL WITH SWIM-UP BAR

• FULL-SIZE WASHER AND DRYER INCLUDED • POWER FLUSH TOILET WITH BIDET • PHONE & INTERNET SERVICE INCLUDED* *FIRST 12 MONTHS

12840 Jones Rd, Houston, TX

77070

ArellaJones.com

ArellaJones@adaracommunities.com

55+ ACTIVE SENIOR LIVING

CALL TO SCHEDULE A TOUR TODAY! U P TO O NE M O N T H F R E E! INTERNET & CABLE INCLUDED!

COMMUNITY AMENITIES • À la Carte Chef-Prepared Meals Served In Our Elegant Dining Room or Privately in Your Home

• Screened in Pool Design for Protection, Comfort, and Mosquito Control • Walk-In Showers Available*

• Senior Focused Resident Activities and Programs • On-site Full-Service Salon • Art-room and Event Space

*In Select Homes *Certain Restrictions Apply. Ask For Details

545 FM 1488, Conroe, TX 77384

(713) 574-8873

. ArellaForestAtWoodland.com

EXPERIENCE THE NOT-FOR-PROFIT DIFFERENCE Not-for-profit providers of aging services offer a commitment to quality that stems from a mission of service and a history of compassion

LOCATE PROVIDERS IN YOUR AREA

HIRING ALL OVER THE STATE

leadingagetexas.org/directory

careers.leadingagetexas.org/jobseekers

LeadingAge Texas is a trade association representing the full continuum of missiondriven, not-for-profit aging services providers. Providers can learn more & apply for membership at www.leadingagetexas.org/memberships

info@leadingagetexas.org

www.leadingagetexas.org

(512) 467-2242

Here to love. Here to serve. Here for you and yours.

•Spacious Apartments & Suites •Chef-prepared Meals •Comprehensive Wellness Programs •Award-winning Assisted Living & Memory Care SUGAR LAND 281.277.0900

PEARLAND 281.997.2500

Lic. #030191

Lic. #12776

13825 Lexington Blvd. Sugar Land, TX 77478

2940 Cullen Parkway Pearland, TX

WESTCHASE MEMORY CARE

281.759.2900 11395 Richmond Ave Houston, TX 77082 Lic. #010308

KATY 281.578.2222

PASADENA 713.941.4663

Lic. #121252

Lic. #000951

21601 Provincial Blvd. Katy, TX 77450

4004 Vista Road Pasadena, TX

BRAESWOOD MEMORY CARE

713.799.8200 7800 N. Stadium Dr. Houston, TX Lic. #030311

COLONIALOAKS.COM

ASSISTED ASSISTED LIVING LIVING IN IN AA HOME HOME ENVIRONMENT ENVIRONMENT

Owned by by a a Registered Registered Occupational Occupational Therapist, Therapist, Owned Owned by Registered Occupational Therapist, our our type B assisted livings are licensed by the state Owned by aa Registered Occupational Therapist, our type B assisted livings are licensed by the state type B assisted livings are licensed by the state and provide and provide 24 hour hour care. We have by a Visiting Visiting our type B assisted livings areWe licensed the state and provide 24 care. have a 24 hour care. We have a Visiting physician, Visiting physician, Visiting podiatrist and provide 24 hour care.and Weprovide have a long-term Visiting physician, Visiting podiatrist and long-term podiatrist and provide long-term careprovide or care.as care or respite respite care. Hospice care is respite provided physician, Visiting podiatrist and provide long-term care or care. Hospice care is provided as Assisted Assisted Living Living Hospicethrough care is provided as needed through agencies. needed agencies. Our facilities will allow care or respite care. Hospice care is provided as Assisted Living needed through agencies. Our facilities will allow Our facilities will allow your loved one to AGE IN PLACE. your loved one to to AGE AGE IN PLACE. needed your through agencies. Our IN facilities will allow loved one PLACE. your one toBaytown AGE IN PLACE. Lane,TXBaytown TXloved 77521 |Dr, 3903 Canterbury Dr, N Baytown TX 77521 36043604 AutumnAutumn Lane, Baytown 77521 | 3903 Canterbury TX 77521 | 710 Main St, Highlands, TX 77562

ADL ADL

3604 Autumn Lane, Baytown TX 77521 | 3903 Canterbury Dr, Baytown TX 77521 | 710 N Main St, Highlands, TX 77562 SECURE COMMUNITY MEMORY CARE: 710 Main| 710 St, Highlands, TX 77562 3604 Autumn Lane, Baytown TXOFFERING 77521 | 3903 Canterbury Dr, Baytown TXN77521 N Main St, Highlands, TX 77562 For more information, please call Virginia Campbell at 713-298-5098

For more information, please call Virginia Campbell at 713-298-5098 For call Virginia VirginiaCampbell Campbellatat713-298-5098 713-298-5098 Formore moreinformation, information, please please call

Navigate the challenges of an aging loved one with the right tools.

Start Here

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srgtexas.com/getcaregivertoolkit

Find the right senior living option for your mom or dad with our free personalized process Our service is at no cost to you, as we’re paid by our participating communities and providers.

1-866-491-0076

SENIOR LIVING

questions to ask

MID PHASE

hat w w o n K to ask

WHEN LOOKING FOR AN ASSISTED LIVING FACILITY

If there is a waiting list, how many are on it and what is the policy? What are the billing and payment policies and procedures? Is there a security deposit and is it refundable?

Is there an initial assessment prior to admission?

HOUSTON EDITION

What kind of experience and training does the staff possess?

SENIOR RESOURCE GUIDE

2 3 4 5 6

What is the staff-to-resident ratio during the day, at night and on weekends?

133

tart with a visual assessment of both the inside and outside. Also, note if the residents are engaged in activities or just sitting.

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MID PHASE

7 8 9 10 11 12 13 14 15 16 17 18 19 20

SENIOR LIVING

What and how much are additional services not included in the monthly fee? What additional services are available if resident’s needs change? What is the discharge policy? What off campus excursions are provided and how often? Are happy hour activities provided? Is Wi-Fi available and if so, where on the campus? Are there safety locks on the doors and windows? Is there an emergency generator or alternate power source? Are transportation services provided or a parking lot for the resident’s vehicle? What is the pet policy? Is rehab offered on campus? Can special dietary needs be accommodated? What is the meal program? Does the residence offer worship services?

Hands, Helping Hands, Loving Loving Hearts Hearts

We provide Alzheimer’s certified Assisted Living, specializing in providing the highest level of care as well as hospice and respite care.

We’re here to provide you and others We provide Alzheimer’s living with aging disabilities, Alzheimer’scertified Assisted Living, in providing and other dementias or diseases, the specializing quality care you deserve with love and compassion. the highest level of care

as well as hospice and in respite care. Three convenient locations New Caney 23370 Johnson Road | 281-399-3718 Three convenient locations in New Caney 23374 Johnson Road | 281-399-8377 23370 Johnson Road | 281-399-3718 2331523374 Johnson Road | 281-543-5037 Johnson Road | 281-399-8377 23315 Johnson Road 281-543-5037 Call us today or|come visit

non-institutionalized, Call usour today or come visit our nonhomelike environment. institutionalized, homelike environment. totallovingcareservices.com totallovingcareservices.com

Peace • Love • Comfort Giving patients and families a sense of comfort during end of life. We treat patients from a holistic point of view, emphasizing the importance of the whole person (mind, body, and spirit) and family interdependence.

23315 Johnson Rd | New Caney, TX 77357 | 832-723-0420

Learning the ABCDs of Medicare can be confusing. We can help.

Online: bcbstx.com/medicare/seminars These events are only for educational purposes and no plan-specific benefits or details will be shared.

Blue Cross Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association Y0096_TBSRGAD20_C

753378.0520

SENIOR LIVING

questions to ask

MID PHASE

hat w w o n K to ask

WHEN CONSIDERING SKILLED CARE

What amenities are private pay? Is Wi-Fi available and if so, where on the property? Are there safety locks on the doors and windows?

HOUSTON EDITION

What happens when the Medicare reimbursement runs out?

3 4 5 6

Does the same team of nurses and certified nursing assistants (CNAs) work with the same resident all week?

SENIOR RESOURCE GUIDE

What is the staff-to-resident ratio during the day, at night and on weekends?

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tart with a visual assessment of both the inside and outside. Also, note if the residents are engaged in activities or just sitting.

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Is there an emergency generator or alternate power source? What is the evacuation plan should it be necessary? What is the pet policy? Can special dietary needs be accommodated? Do residents have a choice of food items at each meal? Are the meals prepared on-site or off-site? What is the policy for residents eating in their rooms? Does the residence offer worship services? Is there a functioning security system? Are there pharmacy, lab, dental or x-ray services available on-site? Are they Medicare and/or Medicaid certified? Is abuse prevention training and background checks a requirement for all staff? How often are residents bathed? What special services can be provided if needed, such as on-site rehab, therapeutic whirlpool baths, ventilators, hospice, etc.?

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Looking for long-term or post-acute care? Momentum Skilled Services can help you in your time of need. We operate skilled nursing facilities in the Greater Houston area. Whether you’re in Humble, Baytown, Cypress or Houston, we have a facility for you. For more information or to schedule a tour, please contact Casey Mosley at (832) 431-1777.

Tips From Experts in the Industry

SKILLED NURSING FACILITY DEFINED It’s an in-patient rehabilitation and medical treatment center staffed with trained medical professionals. They provide the 24-hour medically necessary services of licensed nurses, physicians, physical and occupational therapists, speech pathologists, pharmacist, dietitians and more. • A short-term care and long-term care center that is aimed to help care for your loved one. • Also referred to as SNF (pronounced sniff )

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•

SELECTING A SKILLED NURSING FACILITY Picking a skilled nursing facility can be hard. It’s a big decision to make. There are a lot of options out there and many things to consider. To help make this process easier, we got inside information from industry professionals on what they personally look for and what they tell their friends to look for when considering skilled care. Let’s take a look at some of their insightful suggestions.

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TOUR ANY FACILITY YOU ARE CONSIDERING. Tour multiple buildings so you can get a feel of the entire building or campus. If inperson touring is unavailable due to COVID-19, ask for a virtual tour, the facility’s website, any pictures they have, and their social media handles.

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Expert Advice For an in-person tour, make sure to go twice with one of the visits being during a mealtime.

WATCH THE INTERACTION between staff members and the residents who live there. It shouldn’t be robotic. Residents should be happy and talking to the staff like they are friends.

There’s more of this article in our free Caregiver Toolkit. For the full list of what to know when considering skilled care, visit srgtexas.com/getcaregivertoolkit

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More Insider Insight

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LOCATION IS IMPORTANT to consider. While most people want the closest option to them for visiting purposes, remember at the end of the day you can drive away but your loved one cannot. Pick the better facility even if it is farther away. Your loved one will thank you for it.

HOUSTON EDITION

LOOK FOR CLEANLINESS. While most buildings will look clean, you can tell if they deep clean by looking for dust on the picture frames. While most people think smell is an inevitable part of nursing facilities, it is not. Smell is a sign of poor cleanliness.

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SIGHT • Is the curb appeal and grounds well-kept and is the facility clean? • Do the residents look well-groomed? Do the residents look happy? • Were residents engaged in activities during your visit?

HOUSTON EDITION

significant tool for caregivers searching for a skilled nursing facility? Your five senses. Often unrecognized, our senses are hard at work gathering powerful information from our environment. Tapping into this when touring a facility can help you make informed decisions about which is the best fit for your loved one. Whether you’re planning ahead or need to make an unexpected decision, this tip sheet from Pillar Stone Healthcare Company will help heighten your awareness by breaking down exactly what questions you should be asking yourself when selecting a skilled nursing facility.

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SMELL • Are you greeted with unpleasant odors as you enter the facility? • Does the facility smell clean and fresh? • Do you smell food being prepared, cookies, popcorn and other pleasant smells? HEARING • Are you hearing joyful sounds in the facility? (singing, music, positive staff interactions) • Are call lights being answered timely? • Is the facility calm and peaceful sounding or is it unsettling and flooded with noise?

For the full list of questions to ask yourself when selecting a skilled nursing facility, visit srgtexas.com/getcaregivertoolkit

We embrace and appreciate the opportunity to care for your loved one.

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rehabilitation & healthcare center 5020 Space Center Blvd. • Pasadena, TX 77505 www.baywoodcrossing.com • Phone: 713-575-1800 • Fax: 713-575-1801

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All Centers comply with applicable Federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability or sex.

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UNDERSTANDING HOSPICE

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ospice care is a philosophy of care that accepts dying as a natural part of life. When death is inevitable, hospice seeks neither to hasten nor postpone it. Hospice provides care, comfort and support for persons with life-limiting conditions as well as their families.

HOW DOES HOSPICE WORK? Hospice care is for any person who has a life-threatening or terminal illness. All hospices consider the patient and family together as the unit of care. Most reimbursement sources require a prognosis of six months or less if the illness runs its normal course. Patients with both cancer and non-cancer illnesses are eligible to receive hospice care. The majority of hospice patients are cared for in their own homes or the homes of a loved one. “Home” may also be broadly construed to include services provided in nursing homes or hospitals. Typically, a family member serves as the primary caregiver and when appropriate, helps make decisions for the hospice patient. Members of the hospice staff make regular visits to assess the patient and provide additional care or other services. Hospice staff is on call 24 hours a day, seven days a week. Medicaid or a private insurance company, hospices will work with the person and their family to ensure needed services can be provided.

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HOW IS HOSPICE PAID FOR? Hospice is paid for through the Medicare Hospice Benefit, Medicaid Hospice Benefit and private insurers. If a person doesn't have coverage through Medicare, Medicaid or a private insurance company, hospices will work with the person and their family to ensure needed services can be provided.

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WHO IS THE HOSPICE TEAM? Hospice care is a family-centered approach that includes, at a minimum, a team of doctors, nurses, social workers, counselors, and trained volunteers. They work together focusing on the patient’s needs; physical, psychological or spiritual. The goal is to help keep the patient as pain-free as possible until death. The hospice team develops a care plan that meets each patient’s individual needs for pain management and symptom control.

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WHO IS ELIGIBLE FOR MEDICARE HOSPICE BENEFITS? Hospice care is covered under Medicare Part A (hospital Insurance). You are eligible for Medicare hospice benefits when you meet all of the following conditions: You are eligible for Medicare Part A (hospital insurance) Your doctor and the hospice medical director certify that you are terminally ill and probably have less than six months to live • You sign a statement choosing hospice care instead of routine Medicare covered benefits for your terminal illness • And you receive care from a Medicare-approved hospice program. • •

Please note: Medicare will still pay for covered benefits for any health problems that aren’t related to your terminal illness.

WHAT DOES MEDICARE COVER? Medicare covers these hospice services and pays nearly all of their costs:

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• • • • • • • • •

Doctor services and nursing care Medical equipment (like wheelchairs or walkers) Medical supplies (like bandages and catheters) Drugs for symptom control and pain relief Short-term hospital care, including respite and inpatient for pain/symptom management Home health aide and homemaker services Physical, occupational and speech therapy Social work services and dietary counseling Grief support to help you and your family

Please note: You will only have to pay part of the cost for outpatient drugs and inpatient respite care.

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Hospice Resources

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RESPITE CARE AND MEDICARE Respite care is care given to a hospice patient by another caregiver so that the usual caregiver can rest. As a hospice patient, you may have one person who takes care of you every day, like a family member. Sometimes your caregiver needs someone to take care of you for a short time while they do other things that need to be done. During a period of respite care, you might be cared for in a Medicare-approved facility, such as a hospice residential facility, hospital or nursing home.

HOUSTON EDITION

THE MEDICARE HOSPICE BENEFIT DOES NOT COVER THE FOLLOWING: • Caring Connections • Treatment intended to cure your caringinfo.org terminal illness. You should • Hospice Link talk with your doctor if you 1-800-331-1620 are thinking about potential • National Hospice and treatment to cure your illness. Palliative Care Helpline • Medications not directly related 1-800-658-8898 to your hospice diagnosis. • Texas and New Mexico Hospice Organization Hospice team members will 1-800-580-9270 consult with the hospice physician and will inform you and your family which drugs and/or medications are covered and which ones are not covered under the Medicare Hospice Benefit. • Room and board aren’t covered by Medicare. You may receive hospice services wherever you live, even in a nursing home, however, the Medicare Hospice Benefit does not pay for nursing home room and board.

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HOW DO I BEGIN RECEIVING HOSPICE? Anyone can inquire about hospice services. You or your loved one may call a local hospice and request services. The hospice staff will then contact your physician to determine if a referral to hospice is appropriate. Another way to inquire about hospice is to talk with your physician, and he or she can make a referral to hospice. Hospice can begin as soon as a ‘referral’ is made by the person’s doctor. As a hospice patient, you always have the right to stop getting hospice care and receive the “traditional” Medicare coverage you had before electing hospice. All care that you receive for your illness must be given by your hospice team.

GREATER HOUSTON AREA

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HOSPICE OPTIONS Faith Community Hospice 281-422-0414

Living Waters Hospice 832-723-0420

Local options!

“To Comfort Always”

Baytown Area’s First Locally Owned and Operated Freestanding Hospice

Faith Community Hospice, LLC Serving Harris, West Chambers, Liberty, Brazoria and Galveston Counties 4721 Garth Rd., Suite H, Baytown 281-422-0414 • 1-877-422-0414 • www.faithcommunityhospice.com

THE BEST

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See the

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Discover the senior care organizations, businesses and people who were deemed the best in our annual Readers’ Choice Awards.

HOUSTON EDITION

in your area

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questions to ask

hat w w o n K to ask

WHEN CHOOSING A HOSPICE PROGRAM

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3 4 5 6 7

What services are provided? What kind of support is available to the family/caregiver? What roles do the attending physician and hospice play? How does hospice work to keep the patient comfortable? How are services provided after hours? How and where does hospice provide short-term inpatient care? Can hospice be brought into a nursing home or long-term care facility?

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Do physicians visit the patient in the home? What is the staff-to-patient ratio? Are any alternative therapies provided to manage symptoms? What extras does the hospice provide?

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Jot down any questions or thoughts.

My Questions

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Are any of the staff members certified or credentialed in hospice?

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STEPS TO TAKE AFTER THE PASSING OF A LOVED ONE

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hen a loved one passes, it can often seem like the world has fallen off its axis. You no longer know which way is up or down, and while coping with grief, you’re forced to address pieces of their life that must be closed out. The process of taking care of final affairs after the death of a parent, spouse, friend or other loved one who you provided care for can seem overwhelming. We understand, which is why we’ve created a checklist outlining step by step what to do after someone passes, so you can spend more time focusing on healing. In the weeks following the death, you’ll want to begin closing out accounts and buttoning up any unfinished affairs. Tackle the tasks that are most meaningful for you and be comfortable delegating the rest to others.

STEPS TO TAKE WITHIN A FEW WEEKS: • Procure certified copies of the death certificate when it becomes available. You’ll need at least 10-15 copies to provide to entities such as banks and government agencies. •

Find the will (if there is one) and figure out who the executor is. This will be the person in charge of settling the estate in the days going forward, and they’ll need to be involved in all estate decisions hereafter.

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•

Take the will to probate so it can be executed appropriately.

•

Cancel any services that your loved one may have had, such as magazine subscriptions, regular house deliveries, Netflix, Hulu, etc. You’ll also need to close out any credit card accounts and cancel their driver’s license so it can no longer be used. Make sure to also cancel any insurance services, such as home or car insurance.

•

Close out any remaining online accounts, such as social media pages (these can be memorialized if you’d like) and email inboxes.

There’s more of this article in our free Caregiver Toolkit. To discover more critical steps, visit srgtexas.com/getcaregivertoolkit

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Next Steps

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As part of the financial steps after the death of a parent, A court-supervised contact necessary agencies proceeding designed such as a CPA (certified to officially prove a public accountant) and will’s validity estates attorney. These aren’t necessarily required, but they do smooth the process and make the legal side of things more manageable.

HOUSTON EDITION

Probate

•

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PREPARING & PRESENTING A EULOGY By John B. Earthman

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he purpose of a eulogy is to acknowledge and share information about a person’s life. It’s a great honor for someone to present and it’s an important part of the grieving process for the presenter, as well as the audience. A good place to start is to make a list of thoughts and memories you’d like to share. While others might not be comfortable or able to give their own eulogy, they might find great comfort in sharing memories with you that you could incorporate into the eulogy. Things you might include are stories, quotes, expressions of love or prayers—all of which can be delivered in a serious or humorous manner depending on what you feel is appropriate. In an effort to have the audience connected and involved in your tribute, the eulogy can be compiled from private memories that your audience might not be aware of as well as personal traits and details of the loved one that all will remember. You’ll want to include any accomplishments or honors no matter how big or small that were especially important to your loved one. Memories shared should always acknowledge the person in a positive manner and recognize them for who they were accurately. Once you’re ready to write the eulogy, decide on how you’ll begin, then pick the main thoughts and memories that you wish to share and finally determine how you’ll close. You need to

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Remember

properly introduce yourself when you begin and have a summarizing statement to share when you close. You can read from your notes, but practice Nothing has to giving the eulogy and change make sense right any part that doesn’t feel like natural conversation in your now, you have time own words. to process what’s Presenting a eulogy can happening. cause great anxiety. Stopping at any time to collect your thoughts or emotions and then continuing when you’re ready is understandable and acceptable. If you decide that you can’t continue, simply skip to your final statement. It’s the message about the impact of your loved one that’s important, not the delivery, so just be yourself.

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Thoughts

Is there a story about your loved one you’d like to tell? Jot down any ideas, reminders or notes.

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7 items to consider when

PLANNING A CELEBRATION OF LIFE

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eing in charge of planning your loved one’s end-of-life tribute is an important undertaking. How can you honor a person very dear to your heart— and the hearts of others—in a special way without it being a somber occasion? Hosting a celebration of life. This style of observance focuses on the joyous memories of how your beloved touched countless lives throughout their years. If you’re planning this type of celebration for your loved one who has recently passed, or you simply want to plan ahead for the future, here’s a list to ensure you check off all the boxes!

1. CREATE AN INVITE LIST + DISTRIBUTE IT. Think of family, friends (new and old) and others in their life that they loved. Once the list is created, consider sending out the information via email, private Facebook event, printed invitation or phone call. 2. BOOK A VENUE. Choosing the right location can be challenging. Consider hosting the celebration at a park, faith-based community center or a place that held special meaning to your loved one. Then, decide if there’ll be a virtual aspect of the event to allow attendance from those who aren’t in close proximity to the location.

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3. SET A TIME. Will this take place during the week or on the weekend? Will it be in the evening after work or early in the afternoon? Pick a time that works best for you and your family and understand that it doesn’t have to take place right after the passing of your loved one. If you’re wanting to wait a few days, weeks, or months, that’s okay. 4. INCORPORATE PERSONAL TOUCHES. Adding features that are unique to your loved one will make the celebration even more memorable. This could be having a special theme such as a luau because they loved Hawaii or wearing purple because it was their favorite color. The number of ideas is endless, and the sentimental factor will touch everyone in attendance.

SENIOR RESOURCE GUIDE

Remember, it’s a celebration for your loved one. Share wholesome experiences, laugh at funny stories and cry if you need to. Don’t hold back your emotions; be comforted knowing that your loved one is leaving this world with a beautiful commemoration.

7. GATHER PHOTOS AND CREATE A SLIDESHOW. Sharing a slideshow of images and videos of your loved one can be impactful. Pull together the memories with family and friends and have your loved one’s favorite songs playing in the slideshow background.

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6. SERVE REFRESHMENTS. You don’t have to provide an entire meal; however, serving some appetizers and drinks is appreciated. Whether you choose to do this buffet or potluck style, create a spread that fits within your budget. Also consider offering alternative options for those with dietary restrictions.

HOUSTON EDITION

5. DESIGNATE SPEAKERS. Asking a few people to share stories about your loved one is the focal point of the celebration. After all, storytelling can be the best way to make everyone feel connected. Encourage opening the floor to others once the designated speakers are done.

SENIOR

HOUSTO N EDITION SPRING/SUMMER 2022

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Senior Resource Guide Houston (Spring/Summer 2022)

Articles inside

Steps to Take After the Passing of a Loved One

Understanding Hospice

Types of Residential Care for Seniors

What’s Skilled Care

Looking at Skilled Nursing Options

Paying for Long-Term Care

Reminiscence Therapy

Tips for Effective Alzheimer’s

Signs Not to Ignore Dementia Versus

Steps to Take After a Memory Issue is Recognized

Homemade Turmeric

Meaningful Minutes for Caregivers

How Can You

Why are Seniors More at Risk of Dehydration?

When Do You Need

Home Care Versus

A Guide to Medication

Ombudsmen are

Make the Most of

Volunteering Opportunities

Five Must-Have Legal Documents

Understanding Medicare: Parts, Plans and Meeting Your Needs

What’s an Adult