[music] 00:04 speaker 1: welcome to aging insightwith your hosts, john ross and lisa shoalmire. this program is brought to you by... 00:36 lisa shoalmire: welcome back to anotherepisode of aging insight. i'm lisa shoalmire and this is my colleagueand partner, john ross. and we're elder law attorneys based righthere in the ark-la-tex area. aging insight is a television program thatwe want to bring into your living rooms, the information that you need as you look forwardto those retirement years and those years of enjoying that time of life where you canenjoy your friends and family, and get to
do some of those things you would like todo. but we want you to be informed and have theinformation you need to make choices about this time in your life. 01:20 john ross: yeah. really, the key in living on your own termsis not just randomly saying, "well, here's what's never gonna happen to me." and you'd be surprised how many times i havesomebody in my office and they'll say, "well, john, you know what? i'm just never going to a nursing home.
not gonna happen. i'm never gonna do it." well, we don't always get to say never. in fact, i learned from a small child thatwhen i would say i was never gonna do something, that was almost a guarantee that whateveri said was gonna be the one thing that happened. but, one thing we do know is that while noteverybody under every circumstances can avoid nursing home care, there are lots of otheroptions where you can get the same or similar type care outside of the nursing home. and that's really what we wanted to talk abouttoday, was alternatives to nursing home care.
02:24 lisa shoalmire: well, that's right,because a lot of times as we grow older or we have a health crisis, sometimes we needa little bit more intense care during those times as we recover and regain strength. and then sometimes, our health condition just... it leaves us at a point where we just can'tlive as independently as we used to. and the one thing we hear over and over againis, "i want to avoid nursing home care." and that's a wonderful goal, and we're hereto give you some information on how to meet that goal, but you have to have some informationabout what services and alternatives are out there to help you get the care that you needinside your home or at another alternative,
to an institutional type nursing home. so john, i guess i'd like to start with onething that seems to come up is if a parent needs additional care and they have an adultchild who is maybe available to look in on them, at some point, just popping in onceor twice a day becomes not enough. 03:43 john ross: right. yeah, the main thing here is that at somepoint in time, you end up needing some extra care in that home environment. and so the first thing is to figure out whatoptions do you have as far as in-home care providers.
and this can get really confusing really fast,because you hear about agencies that call themselves home health companies, you havehospice agencies, then you have in-home assistance, which is not necessarily medical care, andso, it can get really confusing really fast. so the first thing is to learn what differentoptions are out there for that in-home care. the second part of that is then figure outhow to pay for 'em, but we'll figure that out a little bit later. 04:32 lisa shoalmire: okay. yeah, so when you're looking at those differenttypes of agencies and things that talk about providing some support in your home, john,you mentioned home health, home health is
typically service that is prescribed by aphysician, and it's also typically a short-term type service. it addresses an immediate issue through arecovery, perhaps wound care, perhaps central line management, perhaps certain heavy dutymedications through iv therapies. those type things can be done at home througha home health service, but that type of service is not a long-term solution, and that typeof service is not something that's going to generally spend hours per day in the homeproviding care. 05:25 john ross: yeah, i would say that ina typical situation, you're probably looking at a couple of times a week where a nurseor a nurse's assistant, a cna-type person
comes out and provides some basic services,medical-type services and likely talk about, wound care and different things like that. but it's not the day-to-day, hour by hourcare that somebody might need. for example, if you just need a help gettingoff of the couch and getting down the hall to the bathroom or to the bedroom, home healthis not the right provider for that. so home health provides medical type care,and very similarly, you have hospice. hospice also has some home assistance benefit,but again, it's gonna be typically medical-type care. it's gonna be there to assist the person withsome of their medical needs as they go through
the aging or in a hospice case, through thedying process. but again, it's not an hour by hour, day-to-daycare, that is provided by non-medical in-home care providers. 06:41 john ross: and notice i say, 'non-medical'. so we're talking about people who may havesome caregiver training, but these are not nurses. these are people who are there to do lighthousekeeping, cooking, transferring, so maybe helping you get from that couch to the bathroom,attending to personal needs and things like that.
and again, that's a service that's generallygonna be paid for out of pocket by the individual on an as needed basis. 07:14 lisa shoalmire: right, and so that isa difference between the three services we just mentioned is often times, home healthservice and hospice service can be services that medicare may cover a benefit for thoseservices for a certain period of time, but that in-home care assistance service, thatnon-medical service is typically always a private pay where you're really writing thechecks to cover that person coming into the home to provide that non-medical assistance. 07:47 john ross: right, and of course, itdoesn't have to be an agency, so to speak.
most in-home caregiving is provided for byimmediate family members. whether it's a spousal caregiver, whetherit's children, whether it's just other family or friends that have gathered around to providefor that in-home care. i guess our point is, if you intend on stayingat home, you got to figure out how. 08:20 lisa shoalmire: that's right. so, we're gonna take a break and when we comeback from the break, we're gonna talk about ways to pay for care in the home, and alsosome other alternatives that are a little bit newer in our community. so, stick with us.
08:40 larry sims: hi, there. i'm larry sims. it's been my privilege for the past severalyears to be a volunteer board member of hospice of texarkana, and there i'm able to representcommunity members like you. we continually customize our end-of-life careto better meet the needs of our community. as an example, our medical director and nursepractitioner still make visits to homes and facilities. call today to learn more about the help wecan give your family. hospice of texarkana, the non-profit hospiceestablished in 1985 for the community, by
the community. 09:16 speaker 5, male: as things get olderthey require more care. this car and i have seen a lot of miles together,but because i take care of her, she runs just like she did in 1955. that's why i chose the wadley senior clinic. with an individualized care plan designedjust for me, and a convenient location off jefferson avenue, they have everything tokeep me running like new. it's not about the miles, it's about the journey. let the wadley senior clinic keep you happy,healthy, and cruising down the road of life.
09:46 john ross: hi, i'm john ross, elderlaw attorney and board member for the alzheimer's alliance, and welcome to our place. our place is a day program designed to providerest and relief for the caregivers of people with alzheimer's and related dementias. our place is a safe environment where ourfriends benefit from socialization in a home-like environment. alzheimer's is devastating, and affects over17,000 families in our area. to find out how our place can benefit you,please visit our website. 10:16 speaker 6, male: with my dad, it wasin a hospital setting.
and in his situation, he fell into renal failure. he also helped us make decision to be on hospice. i have to admit, it took a huge weight offour shoulders for him to be willing. that offered us a lot of comfort, along withthe hospice company itself. but it gave us closure and it helped us throughthe entire process. 10:43 speaker 7, female: cima hospice, comfortand care when it matters most. 10:51 john ross: welcome back to aging insight,i'm john ross and this is lisa shoalmire, and today we're talking about alternativesto nursing home care. something we hear all the time is our clientssaying that, "i just don't wanna go to a nursing
home if i can avoid it." and that's great, but what you need to knowis, "okay, if you wanna stay in that home, how?" and we talked about in the first segment,your options as far as home health, hospice, but then also non-medical in-home care assistance,and that can be quite helpful. there are some other things, maybe you onlyneed a break every so often, so maybe you do have that family member. maybe it's a spouse or maybe a child who isthat primary caregiver, and they're in the home, they're with you maybe on a 24-houra day basis.
but, it doesn't matter how much your heart'sin it and how much you're willing to devote every hour of the day to being a caregiver,sometimes you just need a break. and whether it's to go to the grocery storeor get a little shopping done, or maybe you need to go to your own medical appointments. sometimes, there's just no alternative tothat, and so, there are some day options. 12:16 lisa shoalmire: well, right. well, oftentimes, if you're the person whoneeds care and you're relying on that family caregiver that's with you all the time, atsome point that caregiver, they're gonna wear out.
and in order for you to stay home, we needthat caregiver to get recharged and rested. and so, as the person who needs care, youhave to be able to let go a little bit so that that caregiver can get that rechargethey need. and we do have a couple of newer programsin our community that will help provide that time for that caregiver to recharge, and acouple of those programs: one is through opportunities inc., who's a non-profit, that a lot of folkshere are very familiar with. they don't just have programs for childrenand developmentally-disabled adults, they also have a senior day center, where fivedays a week a senior can come and get meals, can get medical supervision.
for instance, if you have something like adiabetes or something that needs to be managed throughout the day, you can also... there's socialization and opportunities, tojust visit and have a home away from home, and that's a daytime program. so, if you have an adult child who's caringfor you, you could spend some time at that daytime program, while that adult child worksor takes care of their own personal business. so that's one program, and john, tell us aboutanother one. 14:00 john ross: yeah, and then of coursethe other alternative you have here in town is with the alzheimer's alliance.
in the last year or so, the texarkana alzheimer'salliance opened a day respite center and all respite means is rest. and a day respite center over at the alzheimer'salliance, is called our place. and our place is some place that you can takethat loved one where they're gonna be entertained throughout the day, they're gonna have lotsof events and stuff going on, and they're gonna play games, they're gonna have fun,there's dancing, there's food, there's games, there's all kinds of stuff. and so, it gives the person with alzheimer'sor some other related dementia, a place to go, but more importantly, it gives that caregiveran opportunity to get out and do those things
that they've been needing to do, that groceryshopping, that doctor's visit, or maybe just that time to get a break, because the lifeexpectancy of a caregiver is actually pretty short. it's very hard to be a caregiver. but one day of rest from being a caregiverwill add 36 days to that caregiver's life expectancy. so, take advantage of programs like opportunitiesand our place over at the alzheimer's alliance and use those as alternatives. and that way, the better the caregiver is,the longer the person stays in that home environment.
so use these services that are out there. 15:35 lisa shoalmire: well, that's right,john. very frequently, we've met with caregiverswho are just really at the end of their rope, and they're worn out, and they don't feellike they can do it anymore, and they're just beat down. and in their heart they want to, but physicallythey're just to a point they can't and they're for the first time considering nursing homeor institutional care, which they know that's not what their loved one wants, but they justfeel overwhelmed. so, one way to avoid institutional care isto make sure your care plan with your caregivers
accounts for some down time for those caregivers. 16:14 john ross: yeah, and using some of theseday programs can be a great way to do it. the impact on a caregiver, it's doesn't justaffect that caregiver, but it affects all of us as a community. these caregivers are unable to work, they'reunable to go to their own doctor's appointments, they end up having their own problems. which again, this just reverberates throughthe community. people miss work, they miss opportunitiesthat are out there. and so, utilizing these day centers alongwith your other in-home care providers and
things like that can be a great tool. now, you may be watching and say, "well, john,i just don't need that," or "i don't have anybody in my family that needs that." well, i got a solution for you, too. volunteer. both of these organizations are non-profitorganizations and they would love to have somebody come up and help be a volunteer atone of these day centers. and you may not be able to help somebody inyour own family, but you could help somebody else by putting in a few volunteer hours.
so, consider that as well. 17:17 lisa shoalmire: that's true. so, we're gonna take our last break. when we come back, we're gonna talk abouthow to pay for some of these alternatives including the day centers and also the programsthat might be out there where you can get some assistance to stay at home. so, come back and see us. 17:40 speaker 7, female: all our moments shouldbe cherished. cima hospice provides comfort care when youneed it most with compassion, dignity and
respect. along with jordan health services, cima hospiceprovides compassionate continuity of care. cima hospice, comfort and care when it mattersmost. 17:55 larry sims: hi there. call today to learn more about the help wecould give your family. 18:30 john ross: hi, i'm john ross, elderlaw attorney and board member for the alzheimer's 19:00 speaker 7, female: from our first momentsto our final days, life's journey should be remembered free of burden and worry. family should be cherished.
cima hospice provides comfort care, dignityand respect. learn more about cima hospice at cimahospice.com. 19:18 lisa shoalmire: welcome back to aginginsight, i'm lisa shoalmire and i'm here with john ross. and today's topic, we're talking about avoidinginstitutional care, and thinking about a plan in advance of some alternatives to nursinghome or institutional care if you get to a point, or a family member of yours, gets toa point where they just need some more intent supervision and care. we've talked about some day center programsthat are out there.
we've also talked about home health, and hospice,and in-home non-medical care. but you know what? one of the biggest concerns for every familyis, "how do you acquire the resources to either get this type of care paid for, or be ableto pay for it out of pocket?" that's a big concern. 20:15 john ross: right. 'cause in-home care, non-medical type in-homecare, the cost of that can range anywhere from $10 to $20 an hour, which that can addup real fast. and essentially, when you're paying for long-termcare, you have three options.
you can pay cash, well, that's one option. and some people are blessed with enough resources,that paying $10 or $15 dollars an hour, even for 24-hour a day care is within their realm,but not very many people can afford to do the other option is to have long-term careinsurance, but if you're one of those folks that has long-term care insurance and you'reconcerned about the future and about staying at home, one thing to be sure and check, doesyour policy cover in-home care? not every long-term care insurance policywill cover in-home care. some of them will, some of them won't. if you want to stay at home and you're usinglong-term care insurance, you've got to make
sure that that long-term care insurance willpay for in-home care, not just nursing home after that, you get into various forms ofgovernment assistance, like veterans benefits, which we've talked about before on the show,and medicaid. now this is one... 21:40 lisa shoalmire: this is different thanmedicare. [chuckle] 21:42 john ross: which is different than medicare. and this is one that a lot of people, whenmost people think of long-term medicaid, they think of nursing homes.
21:50 lisa shoalmire: that's right, that'sall they think of, that medicaid only pays for that institutional at a nursing home typecare. and actually, that's just not the case. medicaid these days, governments are recognizingthat care at home in the community is frankly cheaper on government budgets... 22:11 john ross: it is. 22:11 lisa shoalmire: than care at an institutionalor a central facility. so, there are a number of programs that arecropping up to help families keep their loved one at home with utilizing some medicaid financing.
22:29 john ross: right, on the texas side,we have a program called "the community based alternative", and most people just refer toit as the cba program. and on the arkansas side, the same type programbut for the arkansas residents, is called "elder choices." and these two programs have roughly the sameeligibility criteria as nursing home medicaid. so you do have to have relatively limitedassets, but again, looking down the road and trying to figure out, "how are you going topay for care?" that maybe an option, although, there maybe things that you need to do ahead of time so that when the time comes, you will be eligiblefor those programs.
23:10 lisa shoalmire: and john, what thoseprograms look like is that those programs can include paying for a certain number ofhours a week for that in-home assistance that we were talking about earlier. so, it may pay for 20 hours or 40 hours. i met with a lady recently, and the cba forher family member ran 100 hours a week of third-parties, nurses aids, cnas coming intothe home to assist her to care for her family member. and so, it was a great program to keep thatfamily member at home. these programs can also cover things suchas adaptive medical devices that, whether
it's that four-point walker or whatever adaptivedevices might be needed for your family member or yourself to stay at home, and so thoseprograms can pay for that as well. 24:13 john ross: right. and then of course, the other thing that wetalked about were these day respite centers like the opportunities senior center, andlike the our place at the alzheimer's alliance, and although these are private, non-profitorganizations... for example, the alzheimer's alliance hasa fund paid for by donors who have provided their own money to the alzheimer's allianceto provide scholarships so that people who can't afford that, that they can now becauseof these generous donors out there in the
community. 24:54 lisa shoalmire: oh, wow! and i know that the opportunities programcan accept cba and elder choice monies for the care that's rendered there. 25:05 john ross: right, so there's lots ofdifferent options. so what we want you to do is look down theroad. the first question is, are you one of thesefolks that says, "hey, i don't wanna have to go to a nursing home"? and if you are, great.
but that's not the end of the discussion,that's the start of the discussion. the second thing is, how are you gonna stayat home? what programs might you use? would you want in-home care providers? do you have family that can do it? and how are you going to pay for all of these? and, how are you gonna do that without goingbroke in that process? and of course, we don't have enough time todayto cover all of that, but we do want you to think that there are some alternatives tonursing home care.
they are available out there, you've justgotta know where they are, who they are, and how to get 'em. 26:00 lisa shoalmire: that's right. we so often run into folks where they havea family member, a husband that says, "i don't ever wanna go to a nursing facility," andthen we have a spouse that is just wearing themselves out to the bone, trying to keepthat promise... 26:16 john ross: that's right. 26:17 lisa shoalmire: to their husband orwife. and all the person who needs the care eversaid was, "i'm never going to a nursing home.
don't ever do that to me," but they didn'tmake any plans. and so, what we're talking about today ismake those plans. think about it and figure out how you're notgonna burden that caregiver who's going to be managing your care or looking after youwith a promise that they're killing themselves trying to keep. 26:50 john ross: that's right. and of course, if you have more questionsabout this, you can always listen to us on the radio every saturday at noon on 107.1. you can find us on the internet at aginginsight.com,and of course, if you've got specific questions
about say, the medicaid or the va benefitsthat we talked about, look for a copy of the aging insight magazine in your local doctor'soffice, or hospital, or even swing by and pick one up from us. but, of course, if you do have questions,you can always just keep tuning into aging insight tv. 27:24 lisa shoalmire: alright. well, we'll see you next time. 27:26 john ross: bye bye. 27:28 speaker 1: thank you for joining usfor this week's aging insight program with
john ross and lisa shoalmire. this program is made possible by...
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