Tags Posts tagged with "aging in place"

aging in place

METRO photo

By Leah S. Dunaief

Leah Dunaief

A woman I know is now a widow. She has two adult children but lives many miles from them. In order to visit her home and her town, which are located in a beautiful part of the country, they are required to take two flights, then drive a couple of hours to reach her.

The relationship she had with her late husband was not so different from many couples: she took care of the shopping and cooking, and he paid the bills and balanced the checking account. They both loved their house and how they lived.

But life for her has taken a turn.

Not only is she now alone, she is approaching 80 and has trouble walking. She manages the aisles of the supermarket with difficulty, and so hasn’t had any fresh produce or other perishables in a month. As a result, she is not eating well. Her son is coming shortly to manage her finances and fix whatever might need repair in the home, but he has to leave his own children and his job to do that. As a result, the number of visits he can make is limited. Her daughter, who lives in a big city and has a demanding job, has yet to come. Another relative, who lives across the country, recently offered several days of help but cannot do that with any regularity.

Unsurprisingly, all are urging her to move closer to one of them.

“I want to stay in my own home!” is her adamant reply. She wants to age in place. The U.S. Centers for Disease Control and Prevention defines aging in place as “the ability to live in one’s own home and community safely, independently and comfortably, regardless of age, income, or ability level.”

She is no different from 90 percent of adults over the age of 65 who say they prefer to stay in their current residence as they age.This is a major issue. Can this woman remain in her home? Can any of us, as we age, plan to remain in our homes?

Some considerations include home preparation. Can she avoid falling? Among the greatest threats to older people is falling, a leading cause of injurious death. That may be prevented by installing grab bars in the shower, railings on the stairs, avoiding loose throw rugs and obstructed pathways. Increased lighting, walk-in bathtubs, sliding shelves,  even walk-in showers can greatly aid all of us, whether we are aged or not yet there.

Technology can also be a help. This woman’s son can pay her bills remotely, if appropriate arrangements are made with her bank. He can also order various items she may need over the internet, including food from the local markets. The reaction to COVID-19 is to be thanked for the ease and wide-spread availability of remote purchasing plus delivery. And, with a little patience on the part of the younger generation, she might be taught to use the computer to order for herself.

To help her walking, she might get hiking poles or an electric wheelchair or even an electric scooter to ride to her friends in the neighborhood if she doesn’t want to use a cane or a walker. Some 32 percent of those over age 65 have difficulty walking, so this is not so strange.

Cognitive problems, which she doesn’t have but, according to statistics, 1 out of 5 people over 55 will experience, can be mitigated by some help from local social services. Research by her family would be required. But this presents a more severe need that may involve moving into an assisted living facility in the community.

Older adults should not have to leave the towns and school districts they have paid taxes to help maintain over the years and the familiarity and daily support system that has built up around them during their long residence.

We need to give more attention and planning to this segment of the people. And we need to follow their lead rather than demand they change their lives.

METRO photo

People want to grow old gracefully and maintain their independence as long as possible. There are many decisions to make as well as information to wade through to ensure needs are met and proper care is received through one’s golden years. Individuals, caregivers and families may find that a few helping hands along the way can be invaluable.

Numerous elder care resources are available for those who don’t know where to look. Start by researching the National Council on Aging (www.ncoa.org). This is a national leader and trusted association that helps people age 60 and older. The council works with nonprofit organizations, governments and businesses to organize programs and services at the community level. This is a good place to find senior programs that can help with healthy aging — emotionally, physically and financially. 800-201-9989

At the local level in the United States, the federal government has mandated Area Agency on Aging (www.n4a.org) facilities in every county/city. These agencies can provide information on service programs available to the seniors in the area, as well as financial resources. These facilities give seniors access to volunteers who can take seniors around by car, and some provide meals-on-wheels services. 631-853-8200

AARP (www.aarp.org) is yet another organization dedicated to helping seniors. The comprehensive AARP website offers a host of information on everything from senior discounts to products to health and other information specific to seniors. The AARP also has an affiliated charity that works to help low-income seniors procure life’s necessities. 888-687-2277

The Administration for Community Living (www.acl.org) was established to help older adults and people of all ages with disabilities live where they choose. A network of community-based organizations helps millions of people age in place. 212-264-2976

This article first appeared in TBR News Media’s Prime Times supplement on Jan. 28, 2021.

Stock photo

By Nancy Burner, Esq.

Nancy Burner, Esq.

Concerns about accessing long-term care in the community is something we often discuss with our clients. How will they access the care? Who will pay for it? Is the care reliable? Can I safely and affordably age in place? 

The positive news is that there are many options for care in the community. We are fortunate to live in an area where care is accessible, reliable and affordable. Many of our clients are surprised to learn that Community Medicaid is a way to access care in the community. 

Unlike Chronic Medicaid, which requires a five-year financial look back as a prerequisite for eligibility, Community Medicaid does not have any look back. This means that with some relatively simple planning (in most cases) the financial eligibility requirements can be met with little to no waiting time.

It is important to note there are strict asset and income limitations for applicants for Community Medicaid. An applicant is permitted to have $15,150 in liquid nonretirement assets in his or her name (in New York for 2018). They can have an unlimited amount of qualified (retirement) accounts in their names so long as they are taking the required distribution as set out by the local Medicaid program. 

The primary residence is also an exempt resource, provided the Medicaid recipient remains in the home. It is advisable for all Medicaid recipients to do some estate planning with their home to ensure that it will remain protected should a need arise for care in a facility. Additionally, such planning can ensure that the home is protected from potential estate recovery after the death of the applicant. The applicant is also permitted to have an irrevocable prepaid prearranged funeral account.

With respect to income a single Medicaid applicant is permitted to retain $862 in monthly income. Any income amount over this allowance is considered “excess income.” The good news is that all of the Medicaid applicant’s excess income can be redirected into a pooled income trust, which is a type of special needs trust established and managed by nonprofit organizations for the benefit of disabled beneficiaries. The excess income transferred into a pooled trust can be used to pay the Medicaid applicant’s monthly household and personal expenses.

As you can see, with some relatively straightforward planning most people can qualify for Community Medicaid benefits. Once you have applied and been accepted under the Community Medicaid program, you can access a variety of services that will help you to remain in the community. 

For most of our clients the greatest benefit is the availability of a care provider who can come into their home and provide assistance with activities of daily living such as dressing, bathing, light housekeeping and meal preparation. 

Community Medicaid will also cover the cost of certain approved assisted living facilities and some adult day care programs. The availability and accessibility of care in the community is oftentimes far more available than most of our clients think. 

The community-based Medicaid program is invaluable for many seniors who wish to age at home but are unable to do so without some level of care and certain supplies the cost of which would be otherwise too expensive to sustain on their own. With some careful planning aging in place is certainly a viable option for most clients we meet.

Nancy Burner, Esq. practices elder law and estate planning from her East Setauket office.