The Nugget Newspaper - News and Opinion from Sisters, Oregon

As the pages of the calendar keep turning, and months become years, and years become decades, planning for the future takes on a different look. Instead of saving for retirement — you are in it, carefully spending the money you hopefully put aside earlier, or depending on your Social Security to live. Medicare has kicked in and annually you are trying to find the best deal for supplemental gap insurance and drug coverage, or perhaps switching to a Medicare Advantage plan.

The big questions now are: Should I downsize or can I stay in my current home? Where am I going to live if I move? If I become incapacitated or need help with some activities of daily living, who will help? How do I find help and how will I pay for it?

There are numerous resources out there to help make these decisions. Educate yourself about what’s available before you need it. Some housing choices may require getting yourself on a waiting list or paying a deposit. Familiarize yourself with the websites that are full of valuable information and resources to help you.

Aging and Disability Resource Connection of Oregon (ADRC) is a treasure trove of information to aid in accessing information, tools, and guidance to help plan for future needs before they arise, or to explore options to meet current needs. Find them online at http://www.adrcoforegon.org or call 1-855-673-2372 where professional options counselors will speak with you. Their services are free and available to everyone. The website has direct links to everything from housing options and long-term care services to information about Oregon Project Independence and community-based services.

If you elect to stay in your current living situation, be sure you can afford to do that. Do you have enough money to cover the rent or a mortgage, property taxes and insurance, and maintenance of the property AND deal with any potential major medical costs? Is your house manageable for you as you age — are there stairs, for instance?

If you can afford it, modifications can be made to a home to make it more elder friendly and safe. Possible changes might include adding grab-bars, ramps, replacing twist water faucets with levers, changing to linear door handles instead of round knobs, widening hallways, and converting a downstairs room to a bedroom.

Visit the consumer help section of the Oregon Construction Contractors Board website or contact Central Oregon Builders Association for information on hiring a contractor to make those changes.

Available online at http://www.aarp.org is the free AARP Home Fit Guide, which contains information and tips for a comfortable, safe, and livable home. It also provides guidelines for hiring a contractor.

Another possibility would be to consider selling your home if you own it, and moving to a smaller house, a condo, a retirement community, an apartment, or move in with family or friends.

When choosing where to live, here in Central Oregon it is important to consider accessibility to medical care (how far it is from where you live) and availability of other long-term services and supports in the area like home health care, transportation, adult daycare, meal programs, and home medical equipment.

As the ability to live independently begins to decline, it may be time to find some in-home help. Friends and family may be available to assist you, or you can hire a professional homecare worker or contract with a licensed agency that will provide their workers to be of assistance.

Should you decide to privately hire your caregiver, one source is the Oregon Home Care Commission that maintains a statewide registry of potential home-care workers and a guide for hiring and working with the care provider (www.or-hcc.org). You can also utilize their Homecare Choice program, which takes care of paying the workers (with the client’s money), withholding and reporting payroll taxes, and providing workers’ compensation coverage for their caregivers. To learn more, call toll-free 1-844-494-4227 and speak with a Homecare Choice Specialist.

When hiring a home care worker through a local in-home care agency, a caregiver(s) is assigned by the agency that also schedules visits and is responsible for employer taxes. Services vary depending on a person’s needs and abilities and can be short-term while recovering from an injury or illness or long-term over months or years. The service can be as simple as regular welfare checks to much more in-depth services like bathing, dressing, preparing meals, shopping and transportation.

Most in-home care is paid for by the client, although some long-term care insurance plans cover these services. The client pays the agency, not the caregiver.

Oregon Project Independence (OPI) serves seniors and people with physical disabilities by providing services while they are living in their own homes. OPI traditionally serves those who are 60 years of age or older or who have been diagnosed with Alzheimer’s or a related disorder, and meet the requirement of Oregon’s long-term care services priority rule dealing with the level of impairment. They cannot be on Medicaid but can be receiving food stamps and supplemental Medicare beneficiary benefits. A majority of OPI recipients are 125% of the Federal poverty level.

If living independently is not feasible or desired, there are many facility-based options that provide different levels of support, services, and amenities.

Adult foster care homes are licensed single-family settings with care for up to five people. Adult foster home settings serve a range of needs in a home setting and are rated 1, 2, or 3 depending on the care they are able to provide. Not covered by Medicare.

Assisted-living and residential-care facilities are licensed settings providing housing and care services to six or more people. A registered nurse is on staff or under contract but does not have to be there 24/7. Caregivers do not need to be certified, but they are trained in providing care services. Not covered by Medicare.

Nursing facilities give licensed 24-hour supervised nursing care, and their caregivers must be certified as nursing assistants. The State Board of Nursing must approve their training. Nurses and certified nurse aides provide personal, therapeutic, and nutritional care. A certain number of days are covered by Medicare.

Memory-care communities are environments where staff cares for people with dementia who have needs that require a more secure setting. Each setting is licensed by the state as a residential-care, assisted-living, or nursing facility. The state also requires memory-care facilities to train staff to care for residents with dementia and provide specialized services. These facilities are not covered by Medicare.

Long-term care insurance plans cover all these options; how much and for how long depends on the provisions of the policy. If you have limited income and resources, there may be state programs that help cover some of your costs in some long-term care choices. Call your Medicaid office for more information.

ARDC and private placement agencies are among the organizations that can answer questions and give you resources to locate the facility that is right to meet your care needs. Make visits, ask questions, and get references before making your decision.

This provides only a brief overview of services available and the types of issues to be addressed as we age. While you are still able, do your homework, talk with family members about your desires, and make visits to a variety of housing options in the community where you want to live.

If you plan to age in place, start making small modifications to your home so it won’t require a great deal of work if or when you need adapted surroundings. Planning for the final chapter of your life is every bit as important as all the other plans you have made throughout your life.