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									Elder/Adult Dependant Care
The information below was retrieved from the UC Berkeley Work and Family web site
(http://workandfamily.chance.berkeley.edu/)

         Where to Begin
         Setting Up a Care Plan
         Home and Day Care
         Family Homes and Assisted Living
         Retirement Communities and Nursing Homes
         Financial/Legal Concerns & Care Insurance
         Planning for Disasters and Medical Emergencies
         Caregiver Care and Elder Abuse
         Dying, Death, Funerals and Grief
         Resources for Elder and Adult Dependent Care



Where to Begin
An array of elder care programs has sprung up over the last 20 years, funded by the Older Americans Act
and distributed throughout all American communities. Unfortunately, these programs are not always
highly visible or well coordinated.

When elder care issues arise, you need to act as early as you can. You need to know what questions to
ask, what kind of help is available and what is most appropriate. (For example, your elder may not need
to go into a nursing home; all that may be required is to safety-proof his/her own home, or bring in
someone to do household chores, for a fraction of the cost.)
How do you know when to step in? In a medical crisis, it's obvious, but if you're observant, sometimes an
elder will send signals that intervention is needed before something more serious happens. For example,
your elder's house may not be as clean or tidy as it was. Bills may go unpaid. The refrigerator may be full
of outdated foods and the pantry full of weevils. Personal grooming—clean clothes and body—may have
deteriorated. Your loved one may also have had a significant change in weight or eating habits. Changes
in your elder's attitude or behavior (for instance, isolation, depression, memory loss) are key warning
signs, especially if there have been recent losses—of friends, or in "activities of daily living," such as
bathing, eating, cooking, or mobility.

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Within the community, the single best place to begin is your county's Area Agency on Aging (AAA).
Sometimes this office is called the Council or Commission on Aging or Elder Affairs. This federally-funded
program, known as the National Network on Aging, offers free or low-cost services through public and
private agencies. The wide range of services includes domestic help, home health care, transportation,
information and referral, adult day care, and legal advice. The AAA's purpose is to keep elders in their
homes and out of institutions, for as long as possible. To contact the AAA in your area, call 1-800-510-
2020. You can also contact the Elder Care Locator, 1-800-677-1116, which can refer you to the nearest
AAA office. You can call Monday through Friday, between 9 am and 5 pm Eastern Standard Time. Their
website is http://www.n4a.org/locator.cfm and http://www.eldercare.gov/Eldercare/Public/Home.asp.

You can also get information from your elder's doctor or other medical professionals, community mental
health centers, hospital discharge planners or social workers, geriatric care managers, local and national
medical associations, senior centers, family service agencies, adult protective services and rehabilitation
centers. Many private businesses are now involved in facilitating elders remaining independent; check
with pharmacies and grocery stores, for example. Employment services that specialize in older workers
are a good source for companions, drivers and housekeepers for an older person living alone.
Word of mouth is also a valuable resource. Check with religious and civic groups, neighbors and friends.
Many churches and synagogues sponsor volunteer programs to run errands for seniors or visit shut-ins.
Hospitals and geriatric clinics conduct physical examinations and mental and nutritional evaluations;
international organizations provide translation services and referrals. Private organizations and hospitals,
among others, offer support groups.

If you have the funds, but not the time or patience to do the care giving yourself, consider hiring a private
geriatric care manager, a licensed professional who will develop and administer a course of action, and
monitor the care plan for you. This is especially valuable in long-distance care giving. For a referral,
contact the National Association of Professional Geriatric Care Managers, 1604 N. Country Club Road,
Tucson, AZ 85716, 520-881-8008. Their web site is http://www.caremanager.org

More Elder/Adult Dependant Care topics:
Setting Up a Care Plan; Home and Day Care; Family Homes and Assisted Living; Retirement Communities and
Nursing Homes; Financial/LegalConcerns & Care Insurance; Planning for Disasters and Medical Emergencies;
Caregiver Care and Elder Abuse; Dying, Death, Funerals and Grief; Resources for Elder and Adult Dependent Care




Setting up a Care Plan
For any care plan to work, your elder should be included in every possible aspect of the planning process.
This will not only assure that his or her dignity is respected, but also that the plan will be followed.
Whether your elder needs short- or long-term care, allow for flexibility as new challenges arise.

Depending on your relationship with your elder and with other family members, and on the elder's
willingness to admit there's a problem, it may be hard to broach the subject of needing help. It's important
to remember that our parents' generation came through the Depression and a World War; they are proud
and independent, often unwilling to admit to "weakness" or any need for services.

Sometimes you can get around a stubborn or non-communicative elder by getting a trusted friend,
physician or clergy member to bring up the subject. You can also raise the topic by suggesting, for
example, that you need their help with your own financial or estate planning.

One of the first orders of business is to determine who will be the "primary caregiver," the one who will
have the main responsibility either for the actual care, or for putting all the pieces of the plan together and
monitoring them through their inevitable progression. If possible, involve as many family members,
significant friends or neighbors as possible in building a network of caring people who ensure that your
elder is being monitored at all times no matter how small or how large the needs. Make sure each person
knows what is expected and encourage feedback and suggestions for improvements or alterations as the
situation changes.

Be aware that in many families, old sibling rivalries and unresolved emotions toward elders can arise. You
may resent that your brother doesn't do enough, that your parents aren't getting the love they need from
relatives, or that you weren't "mothered" the way you needed. Be realistic, and don't expect 100 percent
agreement on everything. Recognize roles that family members have played in the past and try not to
exclude anyone.

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One of the hardest aspects of care giving is the emotional toll that can arise from unexpectedly having to
assist your elder. For many of America's care providers, duties range from helping with grocery shopping
and doctor's appointments, to having to diaper and bathe an elder. Sometimes these tasks are
challenging.

Care providers commonly have a range of emotions that can make them feel embarrassed and isolated.
The reasons include guilt over feeling that you are not doing enough or that you can't protect your loved
one from further harm, denial of the problem, and anger and frustration over not being able to get your
loved one to do what you think is best.

Establishing a well thought-out but flexible care plan will help relieve stress for everyone involved. In
addition to learning what resources are available, you especially need information about your loved one's
mental and medical status. You need to collect data on health care, and legal and financial affairs. You
need to gather names, addresses and phone numbers of all physicians and specialists, attorneys and
financial planners; lists of medications and health history; locations and numbers of health insurance
policies and legal papers; assets and debts, expenses and income sources. Many financial decisions
need to be made at the planning stage, so they can be implemented when needed. For example,
purchasing long-term care insurance or meeting Medicare eligibility requirements are steps that can affect
plans both at home and in a nursing home.
You need to ask the following questions:
      How much of my elder's dependency is due to illness or infirmity, and how much is attributable to
         personality, habits and coping styles?
      Am I or my family reinforcing dependent behavior while my elder is anxious and able to remain
         independent?
      Have I presumed that certain frailties exist or have they been confirmed medically?
      What problems are a result of natural-aging processes? What problems can be corrected by
         making changes in my elder's living environment, medications, etc.?

More Elder/Adult Dependant Care topics:
Where to Begin; Home and Day Care; Family Homes and Assisted Living; Retirement Communities and Nursing
Homes; Financial/LegalConcerns & Care Insurance; Planning for Disasters and Medical Emergencies; Caregiver
Care and Elder Abuse; Dying, Death, Funerals and Grief; Resources for Elder and Adult Dependent Care




Home and Day Care
It's a natural human desire to stay in familiar surroundings and remain involved with community and
family. This desire to "age in place" is making home care one of the fastest-growing segments of the
health care industry.

Many social service agencies and other health care organizations provide a variety of medical, nursing
and personal services to help people stay out of institutions. Home care is also usually more cost-
effective. Those who use home care services include people who are discharged from a hospital or
nursing home but need additional care; the terminally ill who want to die in the comfort of their own
homes; those with short-term skilled medical needs; and those who need assistance to live independently
at home due to age, chronic illness, or disability.

Home services include any combination of health care, medical equipment, respite care, nonmedical
homemaker and chore services (housekeeping, bathing, meal preparation), home-delivered meals,
nutrition management, home repairs or weatherization, companion services, counseling and
rehabilitation, telephone reassurance, and emergency response systems. These "custodial" services can
be hourly, weekly, monthly or any other arrangement.

Home health care can also mean skilled services such as nursing, physical therapy, occupational therapy
and speech therapy. Medicare will pay for skilled health care in the home when it is medically necessary
to treat an illness or injury if the care is furnished by a participating home health agency; if the care
needed includes intermittent skilled nursing, physical, or speech therapy; and if the patient is homebound
and under the care of a physician who sets up a home care plan. Custodial care is not covered under
Medicare when it is the only kind of care needed; that care is primarily for helping with activities of daily
living and not considered skilled.
You can find home care through friends and relatives, family service agencies, AAAs, hospital personnel,
physicians, nursing registries and medical organizations, especially if the need is a result of illness or
disability.

An elder's ability to remain independent may depend on services that seem simple, but are critical. The
least intrusive are volunteer services in which people make weekly visits, for example, or daily telephone
calls. Check out home services such as the Department on Aging Assets Senior Companion Program,
510-238-3080, which offers telephone reassurance and friendly visiting services; and look into the
"gatekeeper" program, which uses community agencies (like the Tri-Cities Elder Coalition) to look for
signs of neglect in elders.

Home Health Agencies
Home care is also provided by private home health agencies, through physician referrals by way of the
hospital discharge planner, and through public health departments. Workers can be registered nurses,
therapists or home health aides. Homemakers and chore workers may provide services that preserve the
dignity and confidence of your elder, preventing a slide into depression that can precipitate a decline and
subsequent need for a nursing home.

If you go to a referral agency (home health care, visiting nurses), ask how long it has been in business
and insist on references. Ask how the agency screens employees and monitors workers, and if there are
substitutes when needed. Ask about the qualifications and training of workers, and whether the agency
insures against misconduct. (Agency home health aides are certified and must complete a training course
and pass a state test.)

Find out exactly how much you will be charged and how much the worker is paid. Insist on references
and check them carefully. Get the phone number, address, driver's license and Social Security number of
the prospective aide, and don't be afraid to complain to the agency if you are dissatisfied with the work.
Home health agencies will consult with your elder's doctor and prepare a written plan of care. The
supervising nurse will visit with you concerning this plan, and will discuss costs. If you are not satisfied,
keep looking.

Home Modification
Sometimes all it takes for an elder to remain at home are some modifications in the house itself. These
can range from more lighting to installing grab bars in the bathroom. Financial assistance for energy bills
can also help; PG&E has a program for eligible seniors called HEAP/LIRA through the Department of
Community Services and Development (1-800-433-4327). They are open Monday through Friday, 8 am
to 4:50 p.m. SBC can provide telecommunication devices.

Common adaptations might include:
    Raising toilet seats or installing hand-held shower heads and bath benches.
    Rearranging furniture for easy passage or hiring a contractor to widen hallways or cover steps
     with a ramp.
    Replacing doorknobs with lever-type devices.
    Covering light switches with foam to make the lever longer and easier to reach or grab.
    Installing a security system if it will make your elder feel safer.
    Checking that doors and locks are easy to use and replacing them if they are not. (Doors should
     have dead bolts.)
    Removing all throw rugs and installing non-skid strips in bathrooms, on stairs, and other well-
     tracked areas.
    Setting up an emergency response system, especially if your elder lives alone. (Your Area
     Agency on Aging should know which hospitals have such systems.)
    Setting up a support system with neighbors, relatives and friends, postal workers, grocers, utility
     readers, bank tellers and others whom your loved one comes into contact with regularly. Some
     communities have these "gatekeeper" programs already in place.
Adult Day Care
One of the fastest growing segments of the aging network is adult day care or adult day health care.
Sometimes these services are known as respite care, because they give the caregiver a break while
allowing an elder to remain involved in the community.

At adult day care, your elder will have some combination of social and art activities, a hot lunch, and a
place to be cared for while you are at work. Rates average $40-$100 a day, with discounts for those who
qualify due to low income. Adult day care is not covered by Medicare but is covered by Medi-cal.

Adult day health care is a more structured setting that includes medical monitoring, occupational and
physical therapy, counseling, support groups for families, etc. For those who qualify, Medicare or
Medicaid (Medi-Cal in California) subsidizes these costs.

There are specialty day centers for those with Alzheimer's and related dementia; they can be sponsored
by hospitals, nursing homes, churches, mental health facilities, and city park and recreation departments.
There are also more specialized facilities in "assisted living" communities.

You may find that your elder is resistant at first to going out of the house or to a new place. This isn't
uncommon; make a deal to try it for two or three weeks. Usually by that time you'll know whether it works
out; more often than not, it will.

If you're looking for adult day care:
      Decide what level of activity and care your elder wants or needs.
      Decide what you need (occasional free time, coverage while at your job, transportation, support,
         help in developing a care plan).
      Find a center by asking the doctor, checking the Yellow Pages under "Adult Day Care," "Aging
         Services," or "Senior Citizens Services," or calling your local Area Agency on Aging. Also check
         with social service agencies such as Catholic Charities, Family Services, and Jewish Family and
         Children's Services.
      Call the centers and ask for fliers or brochures, eligibility criteria, costs and discounts, a monthly
         activity calendar, menu and application procedures.
      Find out who is the owner or sponsoring agency, how long the center has been operational, hours
         and days of operation, staff credentials and ratio to clients.
      Discuss all aspects of respite or day care with your elder.
      Find out if the center is certified, if your elder relative can begin on a trial basis, and if the service
         is regulated by the state.
      When you visit, look to see if staff members seem cheerful, helpful and competent, if there are
         unpleasant noises or odors, if the clients are enjoying themselves, if there are safety features all
         around (such as handrails), and if there are any medical or therapy services.

For more information, call the Department of Social Services, Community Care Licensing Division, 916-
229-4530, Monday-Friday, 8 am-5 pm. You can also go to their web site at www.dss.cahwnet.gov.

More Elder/Adult Dependant Care topics:
Where to Begin; Setting Up a Care Plan; Family Homes and Assisted Living; Retirement Communities and Nursing
Homes; Financial/LegalConcerns & Care Insurance; Planning for Disasters and Medical Emergencies; Caregiver
Care and Elder Abuse; Dying, Death, Funerals and Grief; Resources for Elder and Adult Dependent Care




Family Homes and Assisted Living
Leaving home can be traumatic for an older person. It can end special life patterns, including friends and
routines, producing great anxiety and feelings of loss. However, if an elder is socially isolated, if it's too
hard to finance upkeep or home repairs or if the home design cannot accommodate disability, then you
should consider alternate housing arrangements.
There are more options than ever as a new "seniors housing" industry jumps into full swing. As the U.S.
population ages, there has been a shift away from institutional settings toward "assisted living"—homes or
large communities that offer independent living with limited health and personal care services.

Here are some options to consider:

Living with Family Members
Some elders are able to move in with their adult children and family, or vice versa, perhaps after some
home reconstruction. If you consider this option, be sure everyone in your family is involved in the
process. Be aware of the possibilities of lifestyle conflicts, the physical demands of 24-hour oversight, and
changes in marital and familial relationships. Be sure to work out the finances and living arrangements
before the move, especially if it's long distance. On the plus side, multi-generation households offer a
special quality of life, especially if there are grandchildren, and it is much easier to monitor diet and
medications with your elder in sight.

Sometimes children move into their parent's home, perhaps after modifications. Be sure you consider all
the financial and lifestyle ramifications, as well as issues of control and interdependence.

By making some changes in the house, a separate self-contained unit called an accessory apartment can
be created - if zoning laws allow. Entrance is usually separate from the main house.

Sharing a home is also a common solution. In this situation, your elder can be matched with another
applicant who may split housing and utility costs in exchange for services. There are also social
advantages, especially if your elder lives alone. An extra bedroom can be rented or your elder can join a
group residence. Check with your local Area Agency on Aging or shared housing service for details. Word
of mouth, newspaper ads, and community bulletin boards can also be helpful. Before making any change,
however, be sure that the responsibilities and expectations of all parties are clearly defined, such as how
household duties and finances will be split, how disputes will be handled and what happens if your elder's
housemate becomes ill.

Assisted Living
No longer is a nursing home the only alternative to living at home. If your elder does have to move, there
are several "in-between" options, depending on your elder's medical and mental condition. Many of these
facilities have requirements, including what levels of care are provided, what happens if your elder
deteriorates or is no longer ambulatory, and under what conditions your elder will be forced to find
another facility if his or her care can no longer be maintained at current conditions. Make sure all
requirements are thoroughly spelled out.

Age-segregated apartments or "independent living”
This setup is often referred to as "senior housing" and is apartment living with age peers, usually 55 and
up. Check with your local Public Housing Authority or AAA for details.

"Congregate living" or "assisted living”
These are mostly rental units that offer a moderate level of support services in addition to meals. The
range of services might include housekeeping, transportation, health and wellness programs and
emergency response systems. These homes typically provide private living quarters with a central dining
room. Transportation, shopping and housekeeping services are often provided, as well as professional
staff such as social workers, counselors and nutritionists. In some cases, costs are subsidized by the U.S.
Department of Housing and Urban Development under Section 8. Call your local Housing Authority for
details.

“Board and care" or "residential care for the elderly" (RCFE)
These homes offer room and meals and some level of supervision or personal assistance, but not skilled
medical care. They are bridges between living independently and living in an intensive medical setting.
This rental housing system provides housekeeping and personal care services for as few as three or four
people to as many as 150 or more. The larger homes offer more activities and services. California puts
serious restrictions on what levels of care RCFEs can provide. They are not required to have nursing staff
and are not allowed to care for clients who need that level of service. Check the phone book under
Homes | Residential Care for listings.

In board and care homes, administration and staff are required to report significant health changes to the
resident's doctor and family. Assessments must be made regularly, and residents must have access to
medical and dental services.

Some board and care homes are specifically for those with a dementing disease. Others will not accept
anyone who causes disruptions or who wanders. In some cases, a resident must leave when a medical or
mental condition worsens beyond the home's ability to care for him or her. All states require these homes
to be licensed; check with the State Department of Social Services for the record of any home you are
looking into. In California, call the Community Care Licensing Division at 916-229-4530.

Questions to Ask When Looking for Assisted Living
When considering a board and care or residential care home, find out the following:
   1. Is the facility licensed? If not, it means the care is not being monitored.
   2. Is it adequately staffed? Are staff members cheerful, helpful, clean, energetic?
   3. Are the meals nutritious and adequate?
   4. What is the level of activity? Do residents just sit around, or are there planned outings, reading
       materials, music, etc.?
   5. Is the facility clean, tidy, odor-free?
   6. Is the contract clear? Make sure all the services you have arranged for, as well as the fees and
       levels of care, are spelled out clearly in the contract.
   7. What are the restrictions on medical conditions under which a resident can be admitted and
       continue to live there?
   8. What are the facility's home inspection records? Check with the state Department of Social
       Services, Community Care Licensing Division, 916-229-4530.
   9. How much privacy will your elder have? Are pets allowed? How much personal furniture, etc., will
       be allowed? Is the bathroom shared?
   10. What are the real costs, including add-ons? Most facilities are not covered under Medicare
       though in some cases Medicaid or Supplemental Security Income qualifies. Check with our local
       office of the Social Security Administration, or call 1-800-772-1213.
   11. Do the residents have outings, go to religious services? Do they seem well-groomed, happy,
       active?

More Elder/Adult Dependant Care topics:
Where to Begin; Setting Up a Care Plan; Home and Day Care; Retirement Communities and Nursing Homes;
Financial/LegalConcerns & Care Insurance; Planning for Disasters and Medical Emergencies; Caregiver Care and
Elder Abuse; Dying, Death, Funerals and Grief; Resources for Elder and Adult Dependent Care




Retirement Communities and Nursing Homes
Continuing Care or Life Care Retirement Communities
"Life care" or "continuing care retirement communities" (CCRCs) contract to take care of your elder for life
for an entrance fee and monthly payments. These communities often contain, on one site, a range of
housing from individual apartments to skilled nursing facilities. Some communities contract with nearby
nursing homes to fulfill this agreement to provide "care for life." These sites usually have dining rooms
and a full range of lifestyle options. There's a great variation, however, so you should ask enough
questions to feel comfortable.

These questions might include:
    What is the entrance fee? Is the monthly fee reasonable and affordable?
    What are the health care obligations and is there adequate staff?
       What services are covered by the monthly fee? Is the admission fee refundable?
       What is the CCRC's financial status? Is it solvent? What is the track record?
       Do the fees increase with level of care? Who decides when the resident is no longer able to live
        independently and must move to the " assisted living " quarters?
       Are there enough nursing home beds to accommodate everyone? Are nonresidents admitted to
        the skilled facility?
       If possible, go over a CCRC contract with an attorney before signing. The terms should be
        checked through the State Department of Insurance, 1-800-927-HELP (927-4357), and contracts
        for several communities should be examined.

Nursing homes, also called convalescent homes, are licensed by the Department of Health Services, 1-
800-554-0352, to provide both skilled nursing and custodial care. Residents may be recovering from a
hospital stay and in need of rehabilitation and personal services such as grooming and bathing, or may
be admitted because of a terminal illness or debilitating disease such as Alzheimer's, when 24-hour care
is needed. These homes are traditionally called Skilled Nursing Facilities (SNFs), which provide 24-hour
nursing care, or Intermediate Care Facility (ICFs), which provide similar services to SNFs but not around
the clock.

The traditional image of nursing homes brings unease, but these facilities have changed dramatically over
the past 50 years. Although half of those aged 65 and older stay in a nursing home at least once in their
lives, these facilities are no longer just places where people go to die. For example, nursing homes
handle patients discharged from hospitals who don't need an acute level of care but are not yet ready to
return home.

There are two primary considerations about nursing homes when this becomes the only sensible option
for the well-being of your elder. The first is emotional; the importance of the transition from family home to
nursing home is not always acknowledged. The change can represent a series of losses, and support
systems should be in place before this move is made. Secondly, it is important to do strong financial
planning beforehand. Public programs such as Medi-Cal pay for nursing home care, but if your elder is
not qualified for this government entitlement, then typically most of the costs will be out-of-pocket.
Medicare only covers the "skilled" aspects of nursing home care, not custodial services.

Choosing a Facility
Choosing a nursing home is a difficult proposition at best, both physically and emotionally. Ideally, you
would have time to plan ahead, but that is not always possible. You can find nursing homes through your
local senior information and referral office, and the State Ombudsman Office, 916-419-7510
(Ombudsmen are trained professionals who advocate for patients and families in long-term care facilities;
they answer complaints, investigate facilities, etc.). Ask hospital discharge planners, social service and
family service agencies, friends and neighbors, and check the Phone Book under "Nursing Homes" and
"Homes-Residential Care."

Four important factors in choosing a facility are: what kind of care is needed, what financial resources are
available, what location is best, and what kind of lifestyle is desired. California Advocates for Nursing
Home Reform (CANHR), 415-974-5171, is also a good resource for questions and concerns about
nursing homes. They can be reached Monday through Friday from 9 a.m.-12 p.m. and between 1 p.m.
and 5 p.m.

Consider other options before placement in a nursing home. Sometimes all an elder needs is personal
care services at home, closer monitoring by a physician (diet, hydration, medications) or home repair and
modification. Consult with as many professionals as you can before making a placement.
Payment options and finances are especially critical to understand long before nursing home placement
is considered. Familiarize yourself with long-term care insurance policies, also known as "nursing home
policies," and Medi-Cal eligibility rules before considering placement. One source is the California
Partnership for Long-Term Care, 1-800-CARE-445 (227-3445), or CALPERS, which offers insurance
policies for state employees.
There are many excellent sources for learning about Medi-Cal eligibility. One is your local HICAP office,
or Health Insurance Counseling and Advocacy Program which offers free counseling to Medicare
beneficiaries about health insurance options. Ask about "spending down" assets to required levels
(around $2,000, though the amount varies by state); eligibility requirements, application procedures and
processing time; the possibility of liens on real estate after the death of the person in the nursing home;
"spousal impoverishment," or the ability of the well spouse to remain in the family home with a certain
level of assets; and other forms of health insurance such as "Medigap" policies, which supplement
Medicare coverage. Your local Social Security office can also help you.

Location is critical because it can make the difference in your loved one's ability to have visitors
frequently, and your ability to visit as often as needed or desired. Take into account your elder's social
situation before deciding to relocate. A sense of loss of friends and familiarity can be more devastating
that the move itself.

Lifestyle preferences can influence the choice of a convalescent facility. Some of them are geared toward
active residents; some have special ethnic menus and activities. Size of the facility is also important. The
smaller ones may be more intimate but with less to do and larger ones will be more stimulating, but may
provide less personal attention.

Medicare Coverage
Care in a skilled nursing facility (SNF) is the only type of nursing home care that Medicare covers. It does
not pay for services that are primarily custodial (bathing, grooming, housekeeping). There are three parts
of Medicare coverage: Part A (hospital insurance), Part B (medical insurance) and Part C (prescription
drug benefit). Part A can help pay for care - inpatient hospital care, post-hospital skilled nursing care,
post-hospital home health care, and hospice care - at a SNF under five conditions:

    1. The medical condition requires daily skilled nursing or skilled rehabilitation services that can only
       be provided in an SNF.
    2. The individual has been in a hospital at least three days in a row before being admitted to an
       SNF.
    3. The individual is admitted to the facility within 30 days after leaving the hospital.
    4. The care in the SNF is for the same condition treated in the hospital, or for a condition that arose
       while receiving care in the facility for a condition treated in the hospital.
    5. A medical professional certifies that the individual needs, and is responding to, skilled nursing or
       rehabilitation services on a daily basis.

Some of this coverage can also transfer to care in the home.

Part B has annual deductibles (about $124 a year) and co-insurance, and can be signed up for during
special enrollment periods. It pays about 80 percent of physicians' services, other medical services and
supplies, home health care services, outpatient hospital care, diagnostic tests, ambulance, second
opinions and durable medical equipment. To find out about the monthly premium, call your local Social
Security office.

Looking for a Nursing Home
Here are some tips to consider when looking for a nursing home:

       How will your family meet expenses? What are the base costs? What are add-on costs (e.g.,
        laundry, bandages, beauty salon)?
       Is the facility Medicare- or Medicaid-certified? What rehabilitation services are provided?
       Is the home clean and odor-free? Are requests for assistance responded to quickly?
       Does the nursing home require that a resident sign over personal property or real estate in
        exchange for care?
       Are the residents happy, alert, groomed, clean, well-fed, healthy? Are they restrained to
        wheelchairs, lethargic?
       What levels of care are available, and are they appropriate to your elder's needs?
       What is the staff-to-resident ratio?
       How often are meals repeated? Are alternatives available, as required by law? Are there any
        ethnic-specific diets?
       Can residents bring their own furniture and personal effects to decorate the room? Is there a safe
        for valuables and money?
       Do activities cover a broad range? Is there an activities coordinator?
       Is there a family council for residents? When does it meet and who coordinates it?
       What is the procedure for leaving the facility temporarily, such as hospitalization or vacation? Will
        your elder's place be held?
       Is the ombudsman program's phone number listed?

You should visit each nursing home under consideration more than once—unannounced and at different
times. Talk to residents and staff, ask what they like and don't like. Take a guided tour, then come back
on your own.

More Elder/Adult Dependant Care topics:
Where to Begin; Setting Up a Care Plan; Home and Day Care; Family Homes and Assisted Living;
Financial/LegalConcerns & Care Insurance; Planning for Disasters and Medical Emergencies; Caregiver
Care and Elder Abuse; Dying, Death, Funerals and Grief; Resources for Elder and Adult Dependent Care



Financial/Legal Concerns & Care Insurance
Financial and Legal Concerns
As Americans age, more people are going to need long-term care. In fact, the fear is that people are
going to outlive their assets. Whether or not this fear is justified, it is always smart to do as much advance
planning as possible, especially to secure a legal and financial foundation that is in place if and when a
crisis does hit.

What catches most caregiving families unprepared is the fact that most of the ravages of old age are not
covered by Medicare or other forms of health insurance. A new legal field has grown up recently to help
families negotiate the complex labyrinth of legal and financial planning for elder care. These elder law
services include setting up living trusts, wills and probate management, estate planning, advance
directives, Medi-Cal planning, investigation into financial abuse, and conservatorship or guardianship.

Some of the documents you should consider are:
    "Advance directives." These are the most common legal documents that attorneys recommend to
       families. They include:
            A durable power of attorney. This is a legal document that gives another person the right
                to act on your elder's behalf financially if he or she becomes temporarily or permanently
                incapacitated. Otherwise, a family member may have to go to court to obtain
                conservatorship or guardianship, which is time consuming and expensive, and strips the
                elder of rights.
            A durable power of attorney for health care. This is a document that allows your elder to
                name another person to carry out preferences in treatment (or no treatment) should he or
                she become unable to communicate or make decisions, especially at the end of life. This
                document also explains how decisions are to be made.
            A will or living trust. If there is a will, the estate will go through probate, a court procedure
                that determines how assets will be distributed. Trusts are agreements that determine how
                assets will be managed in life, and by whom, and how they will be distributed after death.
                Trusts do not go through probate.
    Estate planning means creation and conservation of an estate, post-death estate administration,
       and disposition and distribution of the estate to beneficiaries. It can also mean deciding who will
       get property, avoiding probate and reducing taxes if the assets are substantial. Different states
       have different laws. Consult an elder law attorney for details. For a local referral, contact the
        National Academy of Elder Law Attorneys, 1604 N. Country Club Road, Tucson, AZ 85716 (520-
        881-4005). Their web site is http://www.naela.org

Legal and Financial Records
You should have the following information on your elders handy, or know where to locate it:

       Full legal name
       Social Security and Medicare numbers
       Date and place of birth
       Names and addresses of spouse and children (or location of death certificate if any are
        deceased)
       Location of birth certificate and certificates of marriage, divorce, citizenship, pre-nuptial
        agreements
       Names and addresses of close friends, relatives, doctors, lawyers
       Requests, preferences, pre-arrangements for burial instructions, burial plot deed
       Copy of military discharge papers, military record
       Keys to the house, car, safe deposit box, etc.
       Information about house maintenance, contracts, utilities, etc.
       Sources of income and assets (pension funds, interest income, savings bonds, etc.)
       Property deeds and tax amounts
       Health and life insurance policies, names, and numbers (including supplemental health and long-
        term care insurance)
       Household, boat, auto insurance and titles
       Names and numbers of policies or accounts for stocks, bonds, Keogh, IRA plans, property
        (investment income)
       Employer/retirement asset information such as profit-sharing, stock options, credit union, ESOP
        or TRASOP benefits, annuities, medical insurance for surviving spouse
       Bank accounts (checking, savings, credit union, IRAs, 401Ks, stocks, bonds, money markets);
        names, phone numbers, amounts
       Copy of most recent income tax return
       Liabilities (what is owed to whom, when payments are due)
       Mortgages and debts (how and when paid)
       Credit card and charge account names and numbers
       Names and telephone numbers of financial advisers, brokers, insurance agents, bank officers,
        and money management services
       Estate documents: wills, trusts, powers of attorney, health care proxies

Long-Term Care Insurance
When considering long-term care insurance, know that premiums are age-related: The longer you wait,
the more costly they are. It's a good idea to determine whether the policy is affordable; you need to
discuss age, health status, overall retirement objectives, and income. Know, also, that if your elder has
Alzheimer's or Parkinson's, for example, or other existing health problems likely to result in the need for
long-term care, he or she may not be able to buy a policy. (Consult a financial planner, your local Health
Insurance Counseling and Advocacy Program, or local Area Agency on Aging. Call several insurance
companies and agencies to compare policies and provisions.)

Some tips on shopping for long-term care insurance:

       Is the premium affordable now and in the future?
       Is there a clause that will allow benefits to increase along with inflation?
       Does the policy cover nursing homes, care in the home, or both? Is there coverage for adult day
        care or other community services or facilities?
       How long a benefit period will your policy cover? Catastrophic events last longer, and have longer
        benefit periods and higher costs.
       What are the death benefits?
       Is the policy renewable for life?
       Are Alzheimer's disease, senility and other " organically based mental conditions " covered?
       Is coverage limited to Medicare-certified nursing homes?
       Must you have a hospital stay before entry into a nursing home to get benefits?
       Do the premiums go up as you get older?
       Is there a grace period for late payment?
       What is the deductible? When are benefits payable?
       What is the daily benefit rate? How does it compare to actual charges where your elder lives?
       Are insurance premiums and benefits tax deductible?

More Elder/Adult Dependant Care topics:
Where to Begin; Setting Up a Care Plan; Home and Day Care; Family Homes and Assisted Living;
Retirement Communities and Nursing Homes; Planning for Disasters and Medical Emergencies;
Caregiver Care and Elder Abuse; Dying, Death, Funerals and Grief; Resources for Elder and Adult
Dependent Care



Planning for Disasters and Medical Emergencies
We all hope that emergencies or disasters will not happen. However, planning and preparation are key
elements of positive outcomes in times of emergency. We present two elements of emergency/disaster
planning here:
     Suggestions for emergency information letters and a consent form for emergency illness or injury
     Family Emergency Preparedness Plan and Checklist

Emergency Information Letters and Consent Forms
If your child, elder, or adult dependent should have a medical emergency while in someone else's care, it
is important that the caregiver know how to respond and have the means to do so. Most care providers
have an emergency care authorization form that parents or caregivers sign before their child or elder
receives care at that setting. If you were not asked to sign such a form, please inquire with the provider.
The information here applies to more informal care provision, such as babysitters and relatives. Please
check with your child or elder's health care provider to ensure that the letter you prepare fulfills their legal
requirements for emergency care provision.

One person in the University of California Berkeley Parents Network suggests the following approach for
their children. This can also be applied to elders or other adult dependents:

"We have several pages which we leave with caregivers, whether they are friends, family, or babysitters.
We give them the following information:

A) Emergency Information
     Location of medicines
     Location of emergency/earthquake supplies
     Location of fire escape ladders
     Names and numbers of friends and neighbors to call in an emergency
     Out of state contacts

B) How to find us and our schedules
     Our schedule for the evening/weekend
     Our cell phones and other contact numbers
     Notes about kids' schedules, food, etc. [Note: this can also apply to elders/adult dependents]

C) Emergency Medical Information
       Children's full names and Kaiser #'s
       Any allergies or pre-existing medical conditions
       Names, addresses, phone numbers, and hours of kids' doctor and dentist.
       Driving directions to Kaiser

"We then sign the following statement:
'We hereby authorize _______ to obtain all necessary and appropriate X-ray examinations, anesthetic,
medical, or surgical diagnosis or treatment and hospital care which is deemed advisable by, and is to be
rendered under, general or special supervision of any physician or surgeon licensed to practice medicine
under the laws of the state of California. Best efforts shall be made to contact us before such
authorization, but in the case of urgent care, it is understood that the authorization of this is given in
advance of any specific diagnosis, treatment or hospital care but is given to provide authority and power
on the part of _____ to give specific consent to any physician in the exercise of their best medical
judgment is deemed advisable, and is in the best interest of the child(ren). This authorization is valid until
________ (date).' "

There are also forms available from Nolo Press concerning medical authorization for treatment of minors
and child care contracts. To view Nolo's offerings in this area, go to their web site at
http://www.nolo.com/all_products_cat.cfm/cat/5/#view. Once again, verify any form you choose with your
children's health care provider to ensure that it meets their requirements.

Family Emergency Preparedness Plan and Checklist
We are well aware of the need to be prepared for unexpected disasters or emergencies. Establishing a
family preparedness plan may help to avoid injury and panic during an earthquake or other emergency
situation. Planning is vitally important since many working people and their families spend their days in
different locations and may not be reunited for some time if transportation routes are damaged.

Steps Your Family Can Take to Prepare
Locate community sources for information regarding:
    List of supplies to have on-hand at home, school, and in the workplace.
    First aid and CPR training for family members.
    What to do when an earthquake occurs.

The mission of the Office of Emergency Services (OES) is “to ensure the state is ready and able to
mitigate against, prepare for, respond to, and recover from the effects of emergencies that threaten lives,
property, and the environment” (OES website). You can contact them at 916-845-8510 or go to their
website www.oes.ca.gov for more information on emergency preparedness planning. You can also go to
http://bepreparedcalifornia.ca.gov/epo.

Family Plan If Separated When a Disaster Occurs
If you haven't yet done so, formulate a family plan for handling emergencies and include children in the
planning process, as is age-appropriate. Pre-school age children who have never experienced a quake
may be confused or frightened by talk of what can occur, but benefit from a general reassurance that you
will never give up trying to locate them if you are separated.

       Delegate responsibilities for specific tasks to each family member.
       Formulate a plan for reuniting your family after an earthquake.
       Make a list of three or four places the family can go if you are separated and unable to return
        home (neighbors, relatives, local schools, or community centers). Post this list in a prominent
        place in the home.
       Select an out-of-state relative or friend as your "family contact center".
       Establish a list of key addresses and telephone numbers for all family members.
       If you must leave your home after an emergency, leave a message indicating where you will be.
       Learn what your child's school/child care program's emergency plan is regarding holding and
        releasing children after a quake, and safety information/training in the classroom.
       Share your family plan with your child's care providers/school or your elder's caregivers. Sign a
        medical treatment consent form for minor children to avoid delay in emergency hospital care,
        should that become necessary.
       Learn what the University's or other employer's emergency plans are for holding/releasing
        employees after a quake and assignment location during restoration efforts.

Family Emergency List
Click here for a Family Emergency List to assist your family in its emergency preparation planning. This
file is in a PDF format.

An Additional Resource
The web site of the American Academy of Pediatrics has a very good section entitled "Family Readiness
Kit: Preparing to Handle Disasters." This kit includes steps for family disaster planning and guidelines for
helping children cope in times of emergency. You can reach their web site at http://www.aap.org/.

More Elder/Adult Dependant Care topics:
Where to Begin; Setting Up a Care Plan; Home and Day Care; Family Homes and Assisted Living; Retirement
Communities and Nursing Homes; Financial/LegalConcerns & Care Insurance; Caregiver Care and Elder Abuse;
Dying, Death, Funerals and Grief; Resources for Elder and Adult Dependent Care




Caregiver Care and Elder Abuse
Here are some tips for caring for the caregiver—yourself:

Admit your feelings if you're tired, isolated, helpless, angry, resentful or guilty. Talk to someone, join a
support group and share concerns, especially with your elder, if possible. Support groups are also great
places to get tips and resources. You can find them through hospital senior services, religious service
organizations such as Jewish Family and Children's Services and Catholic Charities, the United Way,
hospices and Area Agency on Aging offices. Also check with the Family Caregiver Alliance and
Alzheimer's Association. Most groups are free or very low cost and meet weekly, or at least regularly. See
the Eldercare Community Resources in this Guide.

Set reasonable expectations for yourself. Don't think you have to be all things to all people at all times.
Set limits with your family, friends and parents, and stick to them.

Take care of yourself physically. Eat right, get exercise, use relaxation techniques. Try to keep regularity
in your life. You are entitled to the same good care you are giving to other people.

Avoid destructive ways of coping such as alcohol, overeating or drug misuse.

Seek help when you need it, from family and friends, professionals and employers. You don't have to do it
all yourself.

Maintain as many social activities and contacts as you can. Make personal time and plan occasions for
your own pleasure and renewal.

Allow yourself a full range of feelings and don't be hard on yourself. Begin to acknowledge your own
aging process, the losses and gains in your own life. Most of all, remember that there's no right or wrong
way to do this work.

Elder Abuse
There is no universally accepted definition of the phrase "elder abuse, " and state statutes vary
considerably. However, it is generally agreed that elder abuse can involve any of the following: physical
abuse, psychological/emotional abuse, financial abuse, neglect, and abandonment. For more information
on elder abuse, contact the Adult Protective Services office in the county where the elder resides. If the
elder is in a board and care home or long-term facility, contact the Ombudsman in the county where the
home or facility is located.

More Elder/Adult Dependant Care topics:
Where to Begin; Setting Up a Care Plan; Home and Day Care; Family Homes and Assisted Living;
Retirement Communities and Nursing Homes; Financial/LegalConcerns & Care Insurance; Planning for
Disasters and Medical Emergencies; Dying, Death, Funerals and Grief; Resources for Elder and Adult
Dependent Care



Dying, Death, Funerals and Grief
Just as there is a trend toward home care and aging at home, there is a trend toward dying at home and
away from institutions. More and more families are turning to hospice services when their loved ones
come to the end of life. These services are available in the home or in a nursing home.

Hospice means “waystation," a term taken from medieval times when pilgrims needed a rest on their
journeys. It is a form of comfort care, rather than aggressive medical treatments to cure the illness or
prolong its course. A Medicare benefit, hospice services combine a team of professionals including
doctors and nurses, volunteers and aides, clergy and social workers for both patient and family members.
There is 24-hour emergency phone service, education and counseling for patient and family, and follow-
up bereavement support for a year if needed.

Medicare's rule of thumb for admission to a hospice program is that a physician has determined the
patient has six months or less to live. The advantage of this program, no matter how much time the
patient has, is that he or she can remain in familiar and comfortable surroundings with loved ones nearby.

The family is encouraged to become involved in education and patient care the entire time, to whatever
degree desired. The hospice worker's mission is to help the entire family deal with death and dying
issues, aging and illness, in a way that makes the process less fearful, less mysterious and less stressful.

Funerals
If your elder dies at home, you will need to contact someone to remove the body. If you have been in
touch with a funeral home ahead of time, the director will know what to do. If you don't have a funeral
director, a religious community may be helpful in recommending someone.

It is possible to pre-plan funerals and if you are able to do so, ask about prices or ranges for typical
services. This information must be available over the phone, according to federal law. Ask about the costs
of caskets, burial prices, cemetery plots, memorial services, use of a hearse, graveside services,
embalming and cremation.

When you meet with the funeral director, you must be given a "Statement of Funeral Goods and Services"
that includes an itemized list of all goods and services agreed to—even if you have bought a funeral
package.

Notification of friends and relatives is an important task in the first few hours after your elder's death. The
immediate family should be notified right away. Make a list of whom to call and decide who will make the
calls, so that the immediate stress can be mitigated.

An obituary or death notice in the local paper is customary; these are prepared by the funeral home,
ideally in conjunction with family members. The funeral director will have standard forms for death
notices, but you may want to include any special awards and accomplishments, memberships and
charitable organizations to which memorial donations may be made.
It is said that the cost of dying may be one of the largest expenses that we will have in our lifetime.
Funerals cost an average of $7,200, a sum that is not always covered by the deceased's insurance or
burial plan.

Grief
The loss of a loved one is something that life can't prepare us for. Yet if grief is unaddressed, denied,
glossed-over, it can simmer for years and emerge in self-destructive ways.

There is no time-line for "getting over" the loss of a parent or loved one. A rule of thumb is that it takes
two years to assimilate the death of a parent: one year to go through all the anniversaries, birthdays, etc.,
and one year to begin the personal healing process. There are no obvious signposts that can tell you
when you should be feeling this or that; grief is personal because each relationship has been unique.

Depression, fatigue, loss of sleep and appetite, apathy, separation—all these are normal feelings, and
coming back into an active life takes as long as it takes. Sometimes grief can be pathologically disruptive,
however, and in those cases, professional help should be sought.

If you can join a support group or talk with others who have experienced a similar loss, your grief process
will be more amenable. Check with social service agencies, your local AAA or hospice agencies to find
these groups.

More Elder/Adult Dependant Care topics:
Where to Begin; Setting Up a Care Plan; Home and Day Care; Family Homes and Assisted Living;
Retirement Communities and Nursing Homes; Financial/LegalConcerns & Care Insurance; Planning for
Disasters and Medical Emergencies; Caregiver Care and Elder Abuse; Resources for Elder and Adult
Dependent Care



Resources for Elder and Adult Dependent Care
Community and National Resources
After you browse through these local and national resources, don't miss the collection of internet
resources at the bottom of this page.
Adult Protective Services
County Contact List
Investigates complaints of elder abuse.
Alzheimer's Association
24-hour Help Line: 1-800-272-3900
Find your local Alzheimer’s Association
Information, support groups and referrals.
American Association of Retired Persons (AARP)
AARP California State Office
200 S. Los Robles Avenue, Suite 400
Pasadena, CA 91101-2422
Phone: 1-866-448-3615 (toll-free)
Fax: 1- 626-583-8500
E-mail: calosangeles@aarp.org
Website: http://www.aarp.org/states/ca/
Booklets on caregiving, housing, long-term care insurance, planning for retirement, etc.
American Cancer Society
Phone: 1-800-ACS-2345 (or 1-866-228-4327 for TTY)
Hours: 24 hours a day, 7 days a week
Website: http://www.cancer.org
Arthritis Foundation
Northern California Chapter
657 Mission Street, Suite 603, San Francisco CA 94105
Phone: 1-800-464-6240
E-mail: info.nca@arthritis.org
Website: http://www.arthritis.org/chapters/northern-california/
Northeastern California Chapter
3040 Explorer Drive, Sacramento, CA
Phone: 800-571-3456
E-mail: info.neca@arthritis.org
Website: http://www.arthritis.org/chapters/northeastern-california/
Southern California Chapter
800 West 6th Street, Los Angeles, CA
Phone: 800-954-2873
E-mail: info.sca@arthritis.org
Website: http://www.arthritis.org/chapters/southern-california/
San Diego Area Chapter
9089 Claremont Mesa Boulevard, Suite 104, San Diego, CA
Phone: 800-422-8885
E-mail: info.sd@arthritis.org
Website: http://www.arthritis.org/chapters/san-diego/
California Advocates for Nursing Home Reform
650 Harrison Street, 2nd Floor, San Francisco, CA 94107
Phone: 415-974-5171 or 800-474-1116
E-mail: mis@canhr.org
Website: http://www.canhr.org/
Annual "Report Card" on State facilities.
Publishes "So You Think You Need a Nursing Home" guide ($18).
California Association of Area Agencies on Aging
980 Ninth Street, Suite 240
Sacramento, CA 95814
Phone: 916-443-2800
Website: http://www.c4a.info/LinksHP.html
Free information and assistance for seniors, families, in finding services.
California Foundation for Independent Living Centers, Inc.
1029 J Street, Suite 120, Sacramento, CA 95814
Phone: 916-325-1690 (or 916-325-1695 for TTY)
Fax: 916-325-1699
E-mail: CFILC@cfilc.org
Website: http://www.cfilc.org/site/c.ghKRI0PDIoE/b.695113/
In-home care services referrals for developmentally disabled adults.
California Partnership for Long-Term Care
MS 4100, Suite 71.3052, 1501 Capitol Avenue, Sacramento, CA 95814
Phone: 916-552-8990
Fax: 916-552-8989
E-mail: cpltc@DHCS.ca.gov
Website: http://www.dhs.ca.gov/cpltc
Information on long-term care insurance policies.
California Senior Legal Hotline
444 North Third Street, Suite 312, Sacramento CA, 95811
Phone: 916-551-2140 or 1-800-222-1753
Website: http://www.seniorlegalhotline.org/
Legal assistance for Californians over 60
Department of Aging, Senior Companion Program
1300 National Drive, Suite 200
Sacramento, CA 95834-1992
Phone: 916-419-7500 (or 1-800-735-2929 for TDD/TTY)
Fax: 916-928-2268
E-mail: webmaster@aging.ca.gov
Website: http://www.aging.ca.gov/programs/senior_companion.asp
Friendly visitors, telephone reassurance.
Help Line
Phone: 1-800-273-6222
General information and referrals to non-profit and governmental agencies, including adult day care,
senior activity centers, emergency medical services, and counseling.
HICAP (Health Insurance Counseling & Advocacy Program)
Phone: 1-800-434-0222
Website: http://www.aging.ca.gov/information_on/hicap.asp or
http://www.cahealthadvocates.org/HICAP/index.html
Long-Term Care Ombudsman
1828 L Street, NW, Suite 801, Washington, DC 20036
Phone: 202-332-2275
Fax: 202-332-2949
E-mail: ombudcenter@nccnhr.org
Website: http://www.ltcombudsman.org/
Meals on Wheels Association of America
203 S. Union Street Alexandria, Virginia 22314
Phone: 703-548-5558
Fax: 703-548-8024
Email: mowaa@mowaa.org
Website: http://www.mowaa.org/index.asp
National Association for Continence
P.O. Box 1019, Charleston, SC, 29402-1019, United States
Phone: 1-800-BLADDER or 1-843-377-0900
Fax: 1.843.377.0905
E-mail: memberservices@nafc.org
Website: http://www.nafc.org/home/
Low-cost educational leaflets, books, audiovisuals.
"Resource Guide" of products and services. Referrals to local support groups.
National Academy of Elder Law Attorneys Inc.
1604 N. Country Club Road, Tucson, AZ 85716
Phone: 520-881-4005
Website: http://www.naela.org/
Local referrals. Free "Questions & Answers When Looking for an Elder Law Attorney.'
National Association of Private Geriatric Care Managers
1604 North Country Club Road, Tucson, AZ 85716-3102
Phone: 520-881-8008
Fax: 520-325-7925
Website: http://www.caremanager.org/
Information, local referrals.
National Family Caregiver Alliance
180 Montgomery St, Suite 1100, San Francisco 94104
Phone: 415-434-3388 or 1-800-445-8106
E-mail: info@caregiver.org
Website: http://www.caregiver.org/caregiver/jsp/home.jsp
Clearinghouse for memory loss and brain injury. Extensive literature, publications list, services. Publishes
"Directory of California Support Groups for Caregivers of Brain-Impaired Adults," Statewide clearinghouse
Senior Care Connection
Phone: (866) 239-2273
E-Mail: info@seniorcareconnection.com
Website: http://www.seniorcareconnection.com/index.html
Social Security
Office of Public Inquiries, Windsor Park Building, 6401 Security Blvd., Baltimore, MD 21235
Phone: 1-800-772-1213 (or 1-800-325-0778 for the hard or hearing)
Website: http://www.ssa.gov/
Find your local office
Visiting Nurse Association & Hospice of Northern California
Administrative Offices
Sutter VNA & Hospice, 1900 Powell St., Suite 300, Emeryville, CA 94608
Phone: 1-800-698-1273
E-mail: svnahospice@sutterhealth.org
Website: http://www.suttervnaandhospice.org/
Visiting Nurse Association & Hospice of Southern California
Claremont
150 West First Street, Suite 270, Claremont, CA 91711-4750
Phone: 1-800-266-3574 or 909-624-3574
San Bernardino
412 East Vanderbilt Way, Suite 100, San Bernardino, CA 92408-3502
Phone: 800-556-0219 or 909-384-0737
E-mail: pmeinhardt@vnasocal.org
Website: http://www.vnasocal.org/index.htm

Internet Resources
     Administration on Aging web site. Useful information for caregivers, including list of State
        Agencies on Aging, Eldercare Locator, State resource directories for information and referral
        services. http://www.aoa.gov/
     Alzheimer's Disease Education and Referral Center provides information, research, and care
        giving suggestions. http://www.nia.nih.gov/Alzheimers/
     Benefits Checkup is a free, confidential service is offered by the National Council on the Aging.
        It identifies and explains federal and state benefit programs that older adults may qualify for and
        how to apply for them. www.benefitscheckup.org
     California Registry is a referral agency for seniors and their families who are looking for
        alternative housing or companion care. http://www.calregistry.com/
     The Elder Care Locator website helps seniors, caregivers, and professionals find local eldercare
        resources. http://www.n4a.org/locator.cfm
     Elderweb offers information on topics like Aging, Elder law, and Diseases.
        http://www.elderweb.com
     Family Caregiver Alliance site on care giving resources, fact sheets, San Francisco Bay Area
        resources, online support group and care planning consultation and policy alerts.
        http://www.caregiver.org
     The National Council on the Aging web site has a special section on caregiving. New
        information is posted regularly. http://www.ncoa.org/caregiving
     Senior Resource is “the “E-cyclopedia" of housing options and information for
        retirement, finance, insurance and care.” http://www.seniorresource.com/house.htm
     ThirdAge for active seniors includes aging news and information, national and local resources, a
        caregiver chat line. http://www.thirdage.com/care/


More Elder/Adult Dependant Care topics:
Where to Begin; Setting Up a Care Plan; Home and Day Care; Family Homes and Assisted Living; Retirement
Communities and Nursing Homes; Financial/LegalConcerns & Care Insurance; Planning for Disasters and Medical
Emergencies; Caregiver Care and Elder Abuse; Dying, Death, Funerals and Grief

								
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