Introduction 1
About This Book 1
Foolish Assumptions 3
Icons Used in This Book 4
Beyond the Book 4
Where to Go from Here 4
Part 1: Getting Started With Navigating Your Later Years 5
Chapter 1: Looking Ahead: The Big Picture 7
Planning for the Future Starts with You 7
Navigating the Roadblocks of Planning 8
Reasons for resistance 9
The benefits of planning 9
Unraveling the Meaning of Long-Term Care 10
Defining long-term services and supports 11
Understanding what Medicare covers 12
Discovering How Your Options Are Changing 13
Looking at why changes are being made 13
Keeping up with insider language 15
Meeting Your Changing Needs 16
Location, location, location 17
Timing and flexibility 18
Getting Professional Advice 19
Chapter 2: A Personal Inventory: Past, Present, and Future 21
Looking at the Present - and the Future 22
Healthcare needs 22
Family, friends, and professionals 24
Personality characteristics 25
Attitudes about money 26
Creating a Plan Based on Your Profile 28
Drawing a CareMap to Visualize Your Profile 29
Chapter 3: Finding Services 31
Where to Turn for Help 31
Organizing your research 33
Federal government programs 34
State and local programs 36
Community-based organizations 38
Taking Your Research to the Next Level: Site Visits for Housing 40
Tips for your tours 40
Federal and state regulations 41
Chapter 4: Making Decisions: A Family Affair 43
Holding Family Meetings 44
Who should be included? 44
When should you get together? 45
What should be on the agenda? 45
Being Considerate of Others 47
Allocating responsibilities 48
Bringing in the outer circle 50
Dealing with Conflict 51
Mediators and counselors 51
Consensus and compromise 52
Part 2: Choosing Where to Live 53
Chapter 5: Staying in Your Home 55
Staying at Home in Your Community 55
Dealing with Two Major Hazards 56
Preventing falls 57
Preventing burns 59
Modifying a Home 60
Categorizing types of home modifications 60
Checking out accessibility 61
Finding a contractor 63
Getting help paying for home modifications 63
Seeking Help at Home 65
Allocating tasks to family 65
Searching for services 66
Finding help for other chores 66
Putting technology to use 67
Preparing for an Emergency 68
Creating a support network 69
Making an emergency plan 69
Putting together a disaster kit 71
Chapter 6: Under One Roof: Generations Living Together 73
Multigenerational Living: Everything Old Is New Again 74
Why different generations are living together 74
Defining family households by generation 75
Considering family reactions before making a decision 76
Where Should We All Live? Considering the Options 78
Having a relative move in with you 79
Preparing to move into your parent's home 81
Making fair financial arrangements 82
Making the Move 84
Getting started 84
Planning ahead 85
Sorting and packing 85
Settling in 86
Checking In over the Long Haul 86
Chapter 7: Downsizing for Now and Later 87
The Emotional Aspects of Downsizing 88
Downsizing and Home Renovations 89
Getting Started 90
Putting together important papers 90
Sorting and decision making 90
Donating or selling items 92
Hiring professional help 93
Making the Move 93
Chapter 8: Assisted and Independent Living and Other Group Settings 95
What Is Assisted Living? 96
Interpreting industry and government language 96
Getting to know what assisted living offers 98
Checking out healthcare services 100
Finding more information on assisted-living facilities 100
Evaluating the Cost of Assisted Living 102
Choosing from the menu of cost plans 103
Asking questions to create a monthly budget 104
Beyond the Brochure: What to Look for When You Visit 106
Making notes about the common areas 106
Checking out the residential units 107
Investigating continuing care 107
Pitfalls to Avoid 108
Unnecessary trips to the ER 108
Additional costs or a move after a hospital stay 108
Exclusion from social activities or dining room seating by other residents 109
Failing to read the contract 109
Independent Living and Other Options for Group Living 110
Independent living for seniors 110
Affinity or niche communities 110
Cohousing arrangements 111
House sharing 112
Group homes 112
Chapter 9: Beyond Your Home: Living in a Community 113
Understanding Why Community Matters 114
Defining age-friendly communities 114
Looking at livable-community initiatives 115
Taking a Walk Around Your Community 116
Looking at sidewalks and surrounding areas 117
Checking for places to stop, shop, and chat 118
Rating your community 118
Finding Community Services 119
Considering NORCs and Village Networks 121
Navigating NORCs 122
Joining a Village 123
Chapter 10: Getting Around: Transportation Options 125
Judging Whether Driving Is Still Safe 125
Watching for warning signs of unsafe driving 126
Starting the conversation 127
Making Your Car Fit You 128
Increasing safety with new technology 129
Choosing a new vehicle 130
Modifying vehicles 131
Knowing When It's Time to Give Up the Keys 132
Finding Alternatives to Driving 133
Public transportation and paratransit options 134
Private options 135
Part 3: Legal and Financial Planning 139
Chapter 11: Unraveling the Rules of Medicare and Medicaid 141
The Distinction between Medicare and Medicaid 142
Looking at Medicare Basics 143
Are you eligible for Medicare? 143
What's included in Original Medicare 145
What you get with Medicare Advantage plans 147
Prescription drug coverage 148
Durable medical equipment coverage 150
Home healthcare services 151
Medicaid Ground Rules 152
Are you eligible for Medicaid? 153
What services Medicaid offers 155
How Medicaid works with home- and community-based programs 156
Medicaid managed long-term care 157
Coordinating Benefits 158
PACE programs 159
Coordination with other health insurance 160
Chapter 12: Paying for Care: Long-Term Care Insurance and Other Options 161
Reviewing the Ups and Downs of Long-Term Care Insurance 162
Traditional long-term care insurance 164
Group and employer-based long-term care insurance 165
Hybrid long-term care insurance 165
Short duration long-term care insurance 166
Asking questions when considering any type of long-term care insurance 167
Continuing to pay rising premiums 168
Getting your claims paid for 169
Receiving Money through Annuities 170
Using Disability Insurance 172
Selling Your Policy: Life Settlements 172
Considering a Reverse Mortgage 174
Chapter 13: Financial Matters: Money Management, Wills, Trusts, and More 177
Managing Money 178
Opening joint bank accounts 178
Granting financial powers of attorney 180
Where There's a Will 182
Taking inventory of your assets 183
Considering types of wills 184
Choosing the executor 184
Taking the final steps 185
Settling the Estate with Probate 186
Reviewing the Rules on Estate Taxes 188
Establishing a Trust 189
Pros and cons of living trusts 190
Special-needs trusts 191
Considering Guardianship 191
Part 4: Managing Your Healthcare 193
Chapter 14: Choosing Good Medical Care 195
Checking on the Special Medical Needs of Older Adults 196
Identifying common chronic conditions 196
Dealing with multiple ailments 197
Finding the Right Specialist to Manage Care 198
Considering the need for a geriatrician 199
Finding a geriatrician 200
Navigating Hospitals 201
Where to go for emergencies and non-emergencies 201
Being admitted to the hospital 203
Planning for a hospital stay 204
Polypharmacy: Too Many Drugs? 206
Using caution with certain drugs 207
Getting medications right 208
Other risks and questions 209
Chapter 15: Demystifying Home Care 211
Examining Varieties of Home Care 211
Surveying Services from a Home Healthcare Agency 213
Defining different kinds of home care agencies 214
Choosing a home care agency 215
Paying for Home Care 216
Looking at Medicare's rules for eligibility for home healthcare services 216
Understanding Medicaid home care 220
Other kinds of insurance 221
Hiring home care workers on your own dime 222
Working with Home Care Aides 223
Paying Family or Friends to Provide Care 224
State programs 224
Long-term care insurance 225
Caregiver contracts 225
Is There a Doctor in the House? 226
Chapter 16: Understanding the Different Roles of Nursing Homes 227
Beginning with Nursing Home Basics 228
Defining nursing homes 228
Moving from a hospital to short-term rehab 229
Comparing nursing homes for a long stay 231
Visiting Nursing Homes 232
Checking off important points 233
Noting policy details 236
Checking Out New Models of Nursing-Home Care 237
Eden Alternative 238
Green House Project 238
Beatitudes 239
Responding to Residents' Problems in Nursing Homes 239
Chapter 17: Getting the Healthcare You Want (And Avoiding What You Don't Want) 241
Talking about Future Healthcare Decisions 242
Realizing the importance of advance planning 242
Making wishes known with advance directives and living wills 243
Dealing with the Rules of Advance Directives 243
Finding the forms for advance directives and living wills 244
Putting all your wishes down on paper 244
Choosing a healthcare proxy 245
Adding do not resuscitate (DNR) orders 246
Keeping your advance directive accessible 246
Choosing Physician Orders for Life-Sustaining Treatment (POLST) 247
Understanding Care Options for Serious Illness: Palliative Care and Hospice 248
Palliative care 248
Hospice 249
Part 5: Services for Special Groups 253
Chapter 18: LGBT Older Adults 255
Recognizing LGBT Aging and Health Issues 255
Physical conditions 256
Mental health risks 257
Knowing Legal Protections and Their Limits 258
The U.S Supreme Court and same-sex marriage 259
Obama presidential memorandum on hospital visitation 261
Keeping Legal Documents at the Ready 263
Finding LGBT-Friendly Providers and Facilities 264
Finding healthcare providers 265
Considering independent- or assisted-living facilities and nursing homes 266
Looking at LGBT-specific options 267
Chapter 19: Services for Veterans 269
Getting into the VA System 270
Comparing the VA to other healthcare systems 270
Understanding eligibility for VA healthcare 271
Supporting Veterans and Their Families 273
Shared decision making 273
Caregiver support 274
Noting VA Options for Older Veterans 275
Receiving pensions 276
Using Aid and Attendance and Housebound programs 277
Finding the Right Residential Setting or Nursing Home for Veterans 279
Veterans' medical foster homes 279
Community living facilities (nursing homes) 280
State-operated veteran homes 280
The domiciliary program 281
TRICARE for Life 281
Using Other Resources to Navigate the VA System 282
Chapter 20: Family Caregivers 283
Defining Family Caregivers 284
Family caregivers by the numbers 284
What family caregivers do 286
Family caregivers' rights and obligations 287
Becoming a Family Caregiver 290
Identifying yourself as a family caregiver 290
Readying yourself for negotiation 291
Checking Out Different Types of Family Caregivers 292
Family caregivers who are employed 292
Long-distance family caregivers 295
Multicultural caregivers 296
Looking at Your Caregiving Experience through a CareMap 297
Looking for Help 299
Family and friends 299
Federal programs 300
State programs 302
Community-based organizations 302
Internet resources 303
Part 6: The Part of Tens 305
Chapter 21: Ten Myths about Aging and Future Care 307
Serious Memory Lapses Are Normal in Older Adults 307
Older People Fall: Not Much You Can Do about It 308
Antibiotics Are the Best Drugs for Older Adults with Coughs and Colds 309
Americans Dump Their Older Relatives in Nursing Homes 310
Medicare Pays for All Long-Term Care 311
Hospice Is Just a Place Where People Go to Die 312
Millionaires Take Advantage of Medicaid 313
If I Need Care, I'll Wind Up in a Nursing Home 314
Assisted-Living Facilities Are Regulated Like Nursing Homes 315
Long-Term Care Insurance Covers All Your Needs 316
Chapter 22: Ten Resources with State-by-State Information 317
Identifying Local Services through Area Agencies on Aging 318
Assessing Assisted-Living and Rehabilitation Facilities 319
Finding Services and Housing Options through Eldercare Locator 320
Getting Support for Family Caregivers 320
Modifying Your Home with Rebuilding Together 321
Getting Information on Medicaid in Your State 321
Calculating Costs 321
Finding Your State's Advance Directives 322
Solving Problems through an Ombudsman 322
Resolving Complaints through BFCC-QIOs 323
Part 7: Appendixes 325
Appendix A: Glossary 327
Appendix B: Resources 339
Index 347
