How You Can Avoid Nursing Home Care – Part Two

In our last blog post, we discussed five creative ways to avoid nursing home care.  For more tips and tricks, check out the rest of our suggestions.

6.  Make a Move

If in-home care is unreasonably expensive in your area, consider relocating to a less costly location.  Cost of living is often more expensive in urban areas, as well as along the east and west coasts.  With a little research, you may find a new location with affordable homecare.  Is there a relative in another city or state that could help share responsibilities?  This often helps make a major move more sensible.

7.  Get Financial Help

If you consider a lack of cash as the main reason your loved one can’t remain at home, check out two often-overlooked sources of funds:

  • Cash for life insurance.  Some life insurance policies can be cashed in with the insurance company for 50 to 75 percent of the policy’s face value.  A “life settlement” may also be possible, but the amount you get will depend on the policy benefit amounts, premiums, and the policyholder’s age and health.
  • Reverse mortgage.  For those who own their own home, a reverse mortgage might raise enough money to pay for a significant amount of in-home care.   The money from a reverse mortgage is available for homecare as long as the homeowner lives in the home.

8.  Check out Assisted Living

If you’ve exhausted the possibilities for homecare, look into your community’s assisted living facilities.  These facilities are beneficial for seniors who need regular monitoring, but not round-the-clock care.  Assisted living offers basic supervision and services – such as meals, housekeeping, and help with daily tasks – while some facilities even offer specialized care for people with advanced illnesses.

Seniors often enjoy assisted living because they can associate with other seniors in the common areas, and still have privacy in their own apartment.

9.  Call Medicaid

In recent years, Medicaid has begun to recognize that the alternative to unaffordable in-home care is nursing home care, which Medicaid covers.  As a way of allowing Medicaid recipients to stay at home (saving Medicaid nursing home costs), some states have established Home & Community Based Services (HCBS).

These services offer Medicaid coverage for a limited amount of in-home care and adult daycare.  Not every state offers HCBS, so contact your local Medicaid office at to check out your eligibility.

10.  Ask About Veteran Benefits

If your family member is a veteran or spouse of a veteran, he or she may qualify for Veterans Affairs (VA) benefits.  The VA may offer in-home care and adult daycare benefits, homemaker services, community living centers, or cash benefits – just to name a few.  To get free information regarding your potential benefits, call the VA’s Vet Center in your state.

Avoiding nursing home care may mean utilizing several of the suggestions we’ve provided.  You may also want to contact a geriatric care counselor for more practical ways you can safely and affordably stay in your home.

How You Can Avoid Nursing Home Care – Part One

Home is where the heart is.  There’s a reason this saying has retained its popularity throughout the years; simply because it’s true.  For most of us, our homes represent security and stability that we are unlikely to find anywhere else.  This, combined with other factors, results in the majority of seniors preferring to remain at home during their golden years.

There’s no question that nursing homes provide quality care to countless individuals.  Most nursing homes employ caring workers who try hard to make elderly ones feel as comfortable as possible.  In spite of this, most of us want to avoid nursing homes if at all possible.  Whether you are considering your own future, or thinking of a loved one, here are a few good tips on how you can stay out of a nursing home.

1.  Pool Resources

Hiring a paid caregiver can be expensive.  Even with a combination of professional homecare and family caregiving, the costs may be more than one family member can handle.  Caregiving is also extremely stressful and tiring.  For families who want to help their parents or grandparents remain at home, responsibilities need to be shared.  Pooling resources can take some of the sting out of expensive homecare, while sharing daily tasks will ward off stress and exhaustion.

2.  Share Care

Is there someone in your parent’s apartment building or neighborhood who also needs in-home care?  If so, it may be possible for them to share caregivers.  Bringing the neighbor into your parent’s home or taking your parent to the neighbor’s means that one caregiver can provide care to two seniors at once.  This is a great way to cut costs in half while providing companionship at the same time.

3.  Use Adult Daycare

Despite the somewhat childish connotation of the term ‘daycare,’ these facilities are actually a really great way to keep your loved ones out of nursing homes.  Adult daycare centers offer meals, transportation, exercise, and social interaction.  It’s a nice change of pace for seniors, and most centers charge considerably less per hour than in-home caregivers.

4.  Consider Free or Low-Cost Care

Ask yourself what type of care is really necessary.  Many seniors require assistance only part of the day – typically first thing in the morning and at night.  If you don’t need a full-time professional caregiver, check out what low-cost or free options are available in your area.  Many communities have volunteer church groups, senior-to-senior programs, and college kids who provide free local services like companion care.

5.  Look at Your Backyard

Ever heard of an ECHO or ADU?  A small, separate living unit in a backyard or other open space is sometimes called an Elder Housing Cottage Opportunity (ECHO) or Accessory Dwelling Unit (ADU).  The addition of such a unit is not cheap, but overall costs may be significantly less than nursing home care.

Stay tuned for our next post with five more “out of the box” tips!

Questions to Ask Potential Caregivers

Deciding on a caregiver for your loved one may seem challenging.  With elder abuse and fraud on the rise, the thought of leaving your mother or father in another’s care might fill you with apprehension.  However, armed with the right information you can make a sound decision and hire a suitable caregiver.

Factors to Consider

Because hiring a caregiver is largely an emotional issue, sometimes the more practical aspects are overlooked.  “Families need to be aware of all the implications when considering hiring home help for their aging parent or loved one,” says Cheryl Smith, President and CEO of Kansas City Home Care, Inc.  She adds, “Most people don’t think about the potential tax or liability issues when researching home health care.”

These issues need to be addressed before you decide on hiring a private caregiver or going through an agency.   Homecare poses the risk for injury, so make sure your caregiver has workers’ compensation insurance.  If there is no policy in place and the caregiver is injured, you will be responsible for all medical and disability payments.

Many families find that hiring a home care agency directly eliminates financial and legal worries and eases the stress of the entire process.

Questions to Ask

Not all homecare agencies are created equal.  Some agencies offer limited supervision of their providers, and not all caregivers have the necessary skills to provide quality care.  Rosemarie Tamunday, owner of RIGHT ACCORD Private Duty-Home Health Care in Sarasota, Florida, says, “Training, or lack of it, is the issue. We’ve always insisted on a standardized training program for our caregivers. But we’re an exception. Many companion care companies, some of them franchises, offer very limited caregiver training.”

To overcome this potential problem, interview at least two or three agencies.  Make your expectations clear, and ask as many questions as you need to help you understand the agency and their policies.

When meeting with agency directors, ask:

  • How long they’ve been in business
  • How quality control is monitored and ensured
  • If their workers are bonded and insured
  • For a list of references
  • How extensive are their background/criminal checks
  • Are there limitations as to what the caregiver can and cannot do
  • What is the company’s replacement policy or guarantee
  • Are rates negotiable
  • How much training do the caregivers receive

This is just a basic list of questions you should have answered.  If you think of more, by all means, ask them.  Your loved one’s safety and health is on the line so it is vitally important to find a caregiver you trust.

Reduce the Risk of Falls

While many of us chuckled when we saw the famous “I’ve fallen and I can’t get up” commercial, falling is certainly no laughing matter.  Every year, one-third of Americans over the age 65 fall.  Twenty to thirty percent of those who fall suffer injuries that reduce their mobility, such as a hip fracture.  50 percent of those who’ve suffered a hip fracture never return to their previous level of independence.

Most falls have multiple causes, and while anyone can fall accidentally at any age, our risk factors increase as we age.  While most accidents are not serious, falls are still the leading cause of injury and injury-related death among seniors.  Stay safe by following these five tips.

1.  Clean Up Your Environment

Your kitchen, living room, bedroom, bathroom, hallways and stairways may be littered with hazards; so to make them safer:

  • Move furniture, boxes, plants, cords, and decorative items away from entrances, stairways, and other high traffic areas.
  • Remove loose rugs, or secure them with slip-resistant backing.
  • Have broken or loose floorboards fixed immediately.
  • Clean up spills right away.
  • Store frequently used household items where you can easily reach them.
  • Use nonslip mats in your bathtub, and install a grab bar if you have difficulty getting in and out.

2.  Light up Your Home

Keeping your home brightly lit will help you avoid objects that might make you trip.  Always:

  • Have nightlights in your bathroom, bedroom, and hallways
  • Turn on the lights before going up or down stairs
  • Remove obstacles in front of lamps or light switches
  • Place lamps by your armchair, couch, and bed.
  • Keep a flashlight within easy reach for power shortages.

3.  See Your Doctor

Working together with your doctor will help identify situations where you may be at risk for falling.  Your doctor can take a comprehensive look at your medications to see if there are potential side effects or interactions that put you at risk.

Your doctor will ask if you’ve experienced any eye or ear problems, which can affect your balance. He will also want to know if you’ve had any dizziness or shortness of breath when walking.  Details like these can help your doctor develop specific fall-prevention strategies.

4.  Wear the Right Shoes

Wearing sensible shoes is a great way to prevent slips and spills. You will need to:

  • Have your feet measured each time you buy shoes.
  • Wear sturdy shoes with nonskid soles – but not extra-thick.
  • Give up all floppy slippers and shoes with high heels.
  • Always keep your laces tightly tied.

5.  Exercise

After discussing it with your doctor, begin a regular exercise program.  Walking, swimming, and other physical activity reduces your risk of falling by improving your strength, balance, flexibility, and coordination.

Multiple studies indicate that exercise, especially programs including balance training, reduce falls among the elderly.  If exercise is difficult for you, consider working with a physical therapist.  Simple movements will increase your strength and improve your balance.

If necessary, have your doctor refer you to an occupational therapist.  He can give you more suggestions on preventing falls and staying safe.

Making Your Home Arthritis-Friendly

Coping With Arthritis


Arthritis is the most common disease in individuals aged 65 and older, with half of the United State’s senior population suffering from some form of the condition.  Arthritis, a degenerative disease of the joints, is not actually one disease but a group of more than 100 different conditions that cause swelling, pain, and interference with normal movement.

Most (if not all) arthritic seniors have the desire to “age-in-place” at home, but some question their decision when arthritis symptoms start to worsen.  Even simple tasks become a challenge – often causing frustration, depression, and pain.  Fortunately, there are a variety of ways seniors can make their homes more “arthritis-friendly.”

  1. Add lights and de-clutter.  This goes for all seniors, not just those suffering from arthritis.  Installing additional lights makes it easier for seniors to see, while eliminating unnecessary clutter clears walk-ways and prevents painful falls.
  2. Replace doorknobs with levers.  Doorknobs can be painfully difficult for arthritic seniors to turn, so switching to levers can make a considerable difference.
  3. Install grab bars and hand rails.  If arthritis symptoms make it difficult for you to navigate through your home, installing grab bars and hand rails will help significantly.  They can be placed along hallways, in bathrooms – virtually anywhere you need assistance walking or rising from a seated position.  Thanks to the popularity of such hardware, you can likely find just the right color and style to match your home.
  4. Purchase a shower seat.  Sitting while showering reduces stress on your joints and makes the entire experience less tiring.  If stepping into a bathtub is hard on your knees, consider installing a walk-in tub and shower.
  5. Minimize steps.  Arthritic knees and ankles can make walking up and down stairs incredibly painful.  Many seniors who live at home eventually have to move into a single-story dwelling as a result.  Another way to eliminate stair steps is by installing an indoor chair lift and outdoor ramps.  These assistive devices can be pricey but most seniors agree they are well-worth the investment.
  6. Remodel your kitchen.  If your budget allows for renovations, the kitchen is the best place to do so.  Most work in the kitchen is done with your hands – which is also where arthritis may plague you the most.  Cabinet and drawer handles should be replaced with D-shaped handles which are easier to grasp.  Buying a refrigerator with side-by-side doors reduces the need for bending and twisting, while lowering cabinet shelves decreases strain from reaching.

These are just a few of the ways you can make your home more arthritis-friendly.  Check with your doctor, arthritis-support group, or local senior center for more suggestions.

5 Signs a Senior Needs More Help at Home

young woman helping senior lady with the housework

It’s our natural tendency as humans to avoid asking for help.  This is especially true for most seniors, who fear that reaching out for help will lead others to conclude he is unable to care for himself and should be placed in a care facility.  It’s also difficult for older ones to ask for help because they’ve spent most of their lives caring for not only themselves, but spouses and children as well.  Since it is unlikely to be solicited, it is vitally important that adult children watch for signs that their aging parents need help.  Here are a few common signs that indicate when a senior needs more help at home.

1.  The house is unkempt.  When you visit your parent’s home, do you notice more than the usual amount of dust and disarray?  Are dishes constantly piled up in the sink?  Of course, every home has a little dirt and disorganization once in a while, but if you notice a steady decline in housekeeping quality, it could mean the senior is having difficulty keeping up with such duties.

2.  Bills are going unpaid.  When seniors struggle to keep their finances in order, it may be time for others to step in.  If mail is unopened or the checkbook isn’t properly balanced, your loved one may feel that taking care of the finances is too overwhelming.  It’s important that you offer assistance before the senior incurs late fees or has the electricity turned off.

3.  The senior is losing weight.  Unexplained weight loss may be a result of the elderly person failing to make healthy, nutritious meals for himself on a regular basis.  Take a look in the senior’s refrigerator.  If you notice insufficient supplies of food (or spoiled and outdated food), grocery shopping may be the problem, or it may mean the senior has a lack of self-interest or is suffering from depression.

4.  Reduced self-care efforts.  We all have “off” days where we don’t feel like doing our hair, showering, or even getting out of our pajamas.  However, if you notice that your parent is consistently ignoring personal hygiene, there could be a problem.  Seniors who avoid bathing or brushing their teeth may be depressed or even could be developing dementia, so it’s critical to seek medical help right away.

5.  Senior has unexplained bruises.  Signs of injury – such as bruises, cuts or scrapes – could be evidence of falls.  Some seniors try to keep such injuries a secret, fearing that their family will rush to the conclusion that he needs to be in a nursing home.  He may also be embarrassed, or even have forgotten falling in the first place.  Be diligent about checking after your loved one.  Seniors who have fallen in the past are at greater risk for falling again, which can result in serious injuries.

When it comes time to talk to your loved one about her situation at home, be kind and patient.  If you begin the conversation with your parent by insisting she needs more help because she’s incapable, the discussion will not end well.  It’s a good idea to ask a geriatric care manager or social worker for advice before you bring up the idea of extra help with your loved one.  The more information you have and the way you present the information will ensure a much better outcome.