I am still convinced that assisted living is the best place for her, and we are trying to work together with the staff to tweak her daily experience. Can they pull her and another one or two residents aside for Scrabble? Games of Hearts? Her vocabulary and math skills are quite impressive - let’s tap into those every day to keep her mind sharp, and, let’s face it, to keep her from being bored. Can she spend part of the day on the non-memory assisted living wing? Some of their programming is more engaging. And how about getting her to the gym or the pool for physical therapy for those painful arthritic hips? We are in the midst of these conversations with the Newbridge staff, and from the care and attention I have seen them give to each resident, I am sure that we will work out some new daily rhythms for her that she will like much better.

And there’s a lot to be said for having your best friend on campus! My grandmother’s best friend Bea lives in the independent living building. (Newbridge is a continuing care style campus.) Yesterday I took my 5 year old and we found a wheelchair (it would have been a very long walk for her with her walker and those pesky hips) and brought my grandmother to one of the campus restaurants for a long, leisurely, laughter-filled and hug-filled lunch with her wonderful pal and another woman from their old “supper club.” A group of about ten women used to go out every week to the “pancake house” (I think it was IHOP, but they all call it the pancake house). In recent years that group dwindled as driving became more difficult. But now several of those women are moving to Newbridge, and the supper club will rise again.

But her hips have awful arthritis and she’s been having more and more trouble getting herself up and down and walking around. We finally got to the point where we’ve become worried about her trying to get to the bathroom in the middle of the night. At the same time, we’ve become less enamored with her day program. And it’s just too difficult for her to navigate the stairs getting in and out of her apartment building every day. So we all - the whole family, including my grandmother - decided it was time for assisted living.

And what a place we found! She is in the memory program assisted living at Newbridge on the Charles. All I can say is WOW. The staff is incredible, so thoughtful and kind, and watching their residents so closely. I am beyond impressed. And the building! Well, it’s beautiful. And the food! Fresh and delicious.

Here is a hot tip - they had us arrive for move-in at 11:30, so the very first thing that happened was we were escorted to the dining room for lunch. Well, my grandmother could not have been happier! To sit in a lovely dining room, being waited on, eating scrumptious food - she kept looking at us, saying “I get to live here?!” And from there they swept her up into the day’s activities and Myrlene and I went to set up her room.

Her first day could not have been better! She didn’t ask for Myrlene and me at all that whole afternoon. We were worried about her going to bed alone and being confused by the new room, and maybe waking up in the morning and not knowing where she was, so Myrlene slept over with her. The report is that they kept her busy with activities until 8 pm and then she slept all night!

I am headed back over on Friday morning to visit with my two-and-a-half year old. I’ll be chronicling how my grandmother is doing and how the rest of us are adjusting to the change.  So far, things are looking great!

Bob Thomson, Lic. Ac., practices in Hingham. I know several people who swear by his skills. He is a great listener, and he really takes the time to think up the most appropriate treatment for each client. Lucky for us, he is conducting group sessions at our local senior centers. He has the group sit in comfortable chairs, and he applies treatments to the calfs and forearms - and from those locations, the acupuncture works its way to the rest of your body, to find the places that need the healing.

Afraid of needles? They don’t hurt. They shouldn’t call them needles, that word scares too many people. Although I admit that I close my eyes and don’t look at them for my entire session.

Here is where you can find Bob and begin your path towards feeling better:

Hanover Council on Aging: Friday 1/29 & Friday 2/5, both from 8:00 - 10:30 a.m. (Ongoing)

Hingham Department of Elder Services: Thursday  1/28 from 9:00 - 11:00 a.m. (Fourth Thursday of every month)

And if you aren’t quite ready for a treatment but would like to meet Bob and learn more about acupuncture, he will be presenting an introductory seminar at the Braintree Council on Aging on Thursday 2/18 from 10:30 - 11:30 a.m.

The fee is $25 per treatment, and the fifth session is free.

Spice up your winter and try something new!

So far the societal responses to these needs have been minimal. Take transportation - the Ride is, well, a long ride. The senior centers have vans, but you need to set up your appointment in advance, and their funding allows them to transport seniors only for certain types of activities. Poor transportation options as an elder or disabled person have been the flip-side to the choice of living the quiet life in the suburbs.

As for remaining at home for as long as possible, there is more help available here, and I help my clients access the resources available to them as best as possible. There is veteran’s funding, MassHealth money, and then good old fashioned creativity - like setting up a contract with a child that allows her to leave her job in order to care for her parents, yet be paid so that she can still meet her own obligations at home. Or, another example would be two or three elderly neighbors sharing the services of a personal shopper or a personal chef so that the grocery shopping and cooking is taken care of.

As a society, we expect to be taken care of in our old age, yet we encourage our children to cross the county in search of their dreams, so we don’t have a built-in support system. And we don’t like to pay taxes. So who will care for the Boomers? I think the coming decades will see a blossoming of the American “creative spirit” - neighbors banding together to develop shared living arrangements, new businesses developing to serve seniors at home at prices they can afford. And in the mean time, each aging Boomer should be saving up funds for what they hope will be a long retirement. Meeting with a trusted financial advisor would be a very good first step.

For anyone who will need MassHealth to pay for nursing home care, it is usually a good idea to try to set aside some funds to serve as a cushion to provide those necessary items that MassHealth won’t cover. For single elders,  the way to set aside a reserve fund is usually to deposit some amount of money with a “pooled trust.” A pooled trust is a trust fund, operated by a nonprofit organization, that pools together the deposits of its many elder and disabled members in order to streamline costs and maximize interest earned. The staff at the pooled trust keeps a separate running balance of each individual’s deposits. We have four pooled trusts in Massachusetts.

Until now, MassHealth has allowed elders to set aside some funds in a pooled trust to serve as a cushion for those uncovered “extras” that will inevitably be needed during a nursing home stay. MassHealth has permitted this transfer without imposing the usual transfer penalty.

But we just learned that this month, MassHealth plans to close this door and will no longer allow elders to set aside reserve funds in this manner. Therefore, if you are an elder or are caring for an elder who you think will need MassHealth nursing home care soon - whether that be in the next few months or the next year - you should speak with an elder law attorney this week about setting up a pooled trust account. In order to preserve a cushion to sustain a person through a nursing home stay, all of the paperwork for enrolling in the pooled trust must be completed before MassHealth changes the regulation, and they intend to make the change some time this month.

If someone you love will need MassHealth to pay for nursing home care soon, and they would like to set aside a reserve fund to pay for those items and services that MassHealth doesn’t cover, then you need to speak with an elder law attorney now. Time is of the essence.  

In my phone, I have a few people listed - I have ICE1, ICE2, and ICE3.

Many children become part-time or even full-time caregivers for their aging parents. Sometimes a child needs to be paid for this - usually that is the only way she can afford to leave her job in order to stay home and care for Mom. And in some families, the parent insists on paying the child, or at least contributing to groceries and utilities - because she doesn’t want to feel she is taking advantage of anyone or being a burden.

Earlier posts describe why a written caregiver contract is important to prepare for the possibility of a future MassHealth nursing home application, but here is something that would apply more immediately:  in addition to drafting a good contract, an elder law attorney will also set the family up with a payroll service that will make sure the child receives the benefits of an employee. Namely, the child will have two special protections.

The first is worker’s compensation coverage. Have you ever helped a frail elder with a shower? How easy is it to hurt your back? Very. With a proper caregiver contract arrangement, that child can collect worker’s comp from her injury.

The second protection is the unemployment benefit. Sometimes, no matter how good a job a child does of keeping Mom at home, there comes a time where the care Mom needs exceeds what the child can provide, and she must move to a nursing home. Now the child is unemployed.

For so many families, paying a child to care for the parent is the best solution. Having informal, unwritten understandings is typical, but leaves both the parent and child open to too many pitfalls. By working with an elder law attorney to craft a good caregiver contract and to set up a payroll service to take care of the deductions and taxes, both the parent and child will be much better protected in the long run.

On Veterans Day 2009, Governor Patrick signed into law a range of new or increased benefits for veterans. One component is additional “welcome home” bonuses for soldiers completing multiple tours of duty. Until now, they received a bonus only upon returning home from the first tour.

A forward-thinking provision is to allow veterans to use some of the education and training they received in the military to count towards state requirements when seeking certain state permits or certifications.

The law also allows the state to be more proactive in preventing veteran homelessness, by working with vets before they become homeless and by providing more housing.

Perhaps one of the most important provisions is increased social support to returning veterans and their families. Spotting needs due to mental health issues or physical impairments – and many of both can go undetected for some time – is critical to keeping vets and the families caring for them from unraveling. I hope that the state makes some real advances in social services and can become a model for other states.

The US Census, conducted every ten years, is underway. You can count on scammers to use the opportunity to try to rip people off.

A Census worker will be coming to your door. They will have an identification badge, a copy of the letter that was previously sent to you by the Census Bureau, a bag or laptop with the Census Bureau insignia, and a hand-held device.

They will ask you for your name so that they can verify your address.

Legitimate census workers will NOT ask for your Social Security number, your credit card number, bank account numbers, or any other confidential information.

If anyone does claim to be with the Census and asks you for your Social Security number, credit card, or bank information, ask them to leave.

Also note that the Census will not contact anyone by email. If you receive an email claiming to be from the Census, it is not legitimate.

Keep an eye on your neighborhood, especially the homes of elderly neighbors. Seniors are particularly susceptible to scam artists.

Most of my clients need a little extra help at home but aren’t sure how to pay for it. When we look at their savings and project how long those funds will work for them, the bottom line is usually this: if the client had just a little more cushion, they could stay at home, with the proper supports, for longer. But where to find the money?

For many of the Greatest Generation, the answer lies in Veterans Benefits. There is a fantastic program that few seniors and their families know about: Aid & Attendance. Once you qualify, the VA will send a monthly check that you use to pay caregivers, buy medical equipment, remodel a bathroom to be wheelchair accessible, pay rent at assisted living – whatever you decide is the best and most effective use of that money. This is the most logical, pragmatic long-term care program I know of. It helps seniors stay at home or in an assisted living – and out of a nursing home – for longer. All without limiting you to certain home health aide agencies, rolling deductibles, and a lot of the impediments that come with other support programs.

The application process for the A&A program is not for the faint of heart. There are reams of papers to fill out (of course), and it can take at least six months to receive approval. More to the point, the VA regulations are hard to find, and if you can find them, impossible to understand. More than almost any other government program, you will need an elder law attorney or a qualified veterans representative to walk you through the planning process. Without this help, it is very difficult to obtain the maximum benefits you are entitled to.

In order to assist you, an attorney must be “certified” by the VA and take requisite training. I have made it my business to become certified and receive the necessary education so that I can help my clients stay at home for longer.