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Help for Caregivers
Caregivers are wonderful people! Many caregivers serve selflessly in caring for their loved ones, and in the process, they provide millions of dollars of service at no cost to society. This does not mean, however, that there is no cost to providing this care. Unfortunately, the cost is often borne by the caregiver, not only in lost income, but with the caregiver’s health as well. In fact, a study published in the Journal of American Medical Association (December 15, 1999) found that caregivers under stress were 63% more likely to die than non-caregivers with the same demographics. This is why the staff at Keystone often refers to caregiving as a “Team Sport.” Stress for caregivers increases with the decline in function, both physical and mental, of the loved one for whom they are caring. While a caregiver may be able to provide all help needed early-on in caring for a loved one, the stress will become overwhelming as time goes on. A previous brochure listed some of the reasons caregivers are reluctant to get the help they need. This brochure will review some of the help that is available.
Office of Aging- Different counties use different names, but all of them will have the word “Aging” in the name. Due to funding limitations they cannot provide as much help in the home as they used to provide, but they have other programs and services such as the “Family Caregiver Support Program.” They also provide information and referral for senior adult services provided through other agencies and organizations.
Adult Day Programs- The central feature of these programs is that the older person needing care or supervision goes to a center during the daytime, up to five days per week, giving the caregiver at home a respite from the demands of caregiving.
LIFE Program The website for the PA LIFE program gives the following description. “Living Independence for the Elderly (LIFE) is a managed care program that provides a comprehensive all-inclusive package of medical and supportive services. The program is known nationally as the Program of All-Inclusive Care for the Elderly (PACE). All of the PACE providers in Pennsylvania have the name ‘LIFE’ in their name.” With this program people go to a day center for up to five days per week, and receive supplemental help at home instead of being placed in a nursing home. The cost is less than a nursing home would cost, and these programs also accept Medicaid for payment. Cumberland, Franklin, Lancaster, and York Counties currently have LIFE programs.
Alzheimer’s Association- Not only do they provide information on dementia and how to help someone with dementia, they also operate a 24/7 Helpline (1-800-272-3900). In addition to these services they have information on support groups for caregivers of adults with dementia.
Respite Care- Many Personal Care Homes and Nursing Homes provide respite care on a space available basis. This can give a caregiver a needed break from caregiving, or allow a caregiver to take a vacation or participate in a family get-together such as a reunion, or wedding, or the birth of a grandchild.
Private duty help- There are a number of agencies which provide private duty care. The Directory of Services on Keystone’s website, www.keystoneelderlaw.com, has a listing of these agencies under the heading of “Home Care Agencies.” This help is normally an out-of-pocket expense. However, some long-term care insurance policies will cover private duty help. Wartime veterans and their surviving spouses may be able to get financial help from the VA. Other people use reverse mortgages to get the funds needed to pay for private duty help.
Community Organizations- It is good to find out what local community groups do. For instance, Jewish Family Services of Harrisburg provides a variety of services for older adults. Many religious worship centers have volunteer help for those who are a part of their community.
Support Groups- Many individual caregivers feel isolated and alone. This compounds the stress these caregivers experience. A support group can provide a wonderful release because you find out you are not alone in what you are feeling and experiencing as a caregiver. Your local Aging office is likely to have information on support groups. Some newspapers print listings of support groups. Many organizations that focus on a particular disease have information on support groups relating to that particular disease. A support group can be a key to helping you be a more effective caregiver.
On-line resources- There are many on-line sites that have good information for and about caregivers, but space will only allow the listing of a couple of them. www.caregiving.org is the website for the National Alliance for Caregiving. They have helpful publications and links to other sites for additional information on resources. www.learningcenter.pahomecare.org provides courses on how to provide care for older adults. It is open to both family caregivers and professional caregivers.
Family and friends– Of course, it should go without saying to include family and friends as a resource for caregivers. Probably what holds most caregivers back is that they do not want to admit to their friends and family that they need help with caregiving, but there is no shame in admitting we are not superhuman. Often what family and friends need to know are the specific ways help is needed: for instance, someone to stay with your loved one while you go shopping, to the doctor’s office, to the beauty/barbershop, to do errands, or just to have some time to call your own. Maybe it will be with household tasks that are hard to get done with the amount of time caregiving requires. The important thing is that you do not allow some sense of embarrassment to keep you from getting help with your loved one’s caregiving needs.
It is difficult in a short a brochure to cover all the possible sources of help for caregivers, but this review of some of the helps available will let caregivers know they do not have to sacrifice their health in order to provide the care their loved ones need. There is help available!
Power of Attorney
A Power of Attorney can be used to give another person the right to sell a car, home, or other property in the place of the maker of the Power of Attorney. A Power of Attorney might be used to allow another person to sign a contract for the maker of the Power of Attorney (the person who makes a power of attorney is called the “principal”). It can be used to give another person the authority to make health care decisions, do financial transactions, or sign legal documents that the principal cannot do for one reason or another. With few exceptions, Powers of Attorney can give others the right to do any legal acts that the makers of the Powers of Attorney could do them themselves. A General Power of Attorney gives the “power of attorney Agent” or simply “Agent” (the legal name of the person who is authorized to act for the principal) very broad powers to do almost every legal act that the principal can do. When Elder Law Attorneys draft general Powers of Attorney, they still list the types of things the Agent can do but these powers are very broad. People often do general Powers of Attorney to plan ahead for the day when they may not be able to take care of things themselves. By doing the General Power of Attorney, they designate someone who can do these things for them.
Normal Powers of Attorney terminate if and when the principal becomes incompetent. Yet many people do Powers of Attorney for the sole purpose of designating someone else to act for them if they cannot act for themselves. It is precisely when persons can no longer do for themselves that a Power of Attorney is most valuable. To remedy this inconsistency, the law created a Durable Power of Attorney that remains effective even if a person becomes incompetent. The only thing that distinguishes a Durable Power of Attorney from a regular Power of Attorney is special wording that states that the power survives the principal’s incapacity. Even a Durable Power of Attorney, however, may be terminated under certain circumstances if court proceedings are filed. Most Powers of Attorney done today are durable.
Yes. At the time the Power of Attorney is signed, the principal must be capable of understanding the document. Although a Power of Attorney is still valid if and when a person becomes incompetent, the principal must understand what he or she is signing at the moment of execution. That means a person can be suffering from dementia or Alzheimer’s Disease or be otherwise incompetent sometimes but as long as they have a lucid moment and are competent at the moment they sign the Power of Attorney, it is valid even if they do not remember signing it at a later date. At the time it is signed, the principal must know what the Power of Attorney does, whom they are giving the Power of Attorney to, and what property may be affected by the Power of Attorney.
Any competent person eighteen years of age and older can serve as an agent. Certain financial institutions can also serve. There is no course of education that agent must complete or any test that Agent must pass. Because a Power of Attorney is such a potentially powerful document, agents should be chosen for reliability and trustworthiness. In the wrong hands, a Power of Attorney can be a license to steal. It can be a big responsibility to serve as an agent.
Medicare is health insurance and covers medical services such as physician appointments, therapy, blood tests, x rays, medical procedures and hospitalization. Medicare will sometime pay for rehabilitation in a long-term care facility for a period of 20 to 100 days, but not longer. In long-term care, Medicaid covers the cost of ongoing support services for daily functioning, such as room and board in a nursing home.
Medicaid is a federal program that is overseen by the Center for Medicare and Medicaid Services (CMS). In Pennsylvania, Medicaid is called Medical Assistance and is administered by the Department of Human Services (DHS).
In Pennsylvania, Medicaid funds are not available to pay for assisted living or personal care.
For Medicaid to pay for care in a nursing home, an individual recipient must be determined to need a nursing home level of care by a physician and the local Office of Aging. An individual whose income is not greater than three times the poverty level may keep up to $8,000 of total resources, but may otherwise keep only $2,400. The cash value of life insurance counts as a resource, but one car and a residential home does not count as a resource.
Empowering Clients with Holistic Planning at
Keystone Elder Law
At Keystone Elder Law, we believe that the physical, social, legal, and financial considerations of our clients all intertwine. We utilize an interdisciplinary approach to evaluate each area, which allows for the creation of a plan that addresses the concerns of the individual as a whole as well as the family. To this end, our model of practice includes a Care Coordinator (usually a nurse or social worker), whose expertise complements our team of attorneys.
When the road of life is smooth, decisions about legal and financial matters are easy to push aside for “a rainy day.” Planning ahead, however, will allow for more options as you view the map of where you’ve been and where you want to go. Don’t let a crisis limit your choices or derail your plans.(717) 697-3223