TOPICS
   

CARE OPTIONS


Figuring out what care you loved one needs can be confusing. To help sort through the options, consider which of the following are needed, then match you level of need with the care options described below.

____Social activities for elders
____Transportation
____Housework, chores or shopping
____Companionship at home
____Money management, paying bills
____Assistive equipment or devices
____Home modifications to improve accessibility
____Personal care services at home (bathing, for example)
____A safe place to be outside the home during weekdays
____Overnight care at home
____Rehabilitative therapy
____Nursing care (e.g. injections, wound care)
____Medication management
____Alternative housing or residential care

Your Office on Aging can provide help you scout out local resources and services to match your needs.

Respite Care
Respite programs provide volunteers who give full time caregivers some needed time away to relieve the stress of caring for an incapacitated family member. Information is available from your area Office on Aging. Respite for caregivers is also an important and integral part of all hospice programs.

Home Care Services
Special assistance to help seniors live independently is available for many situations. From bathing, to healthcare, social workers work to coordinate services for homebound seniors experiencing difficulties, thus preventing small problems from escalating into situations that put seniors at greater risk of institutionalization. Home care provides individuals with a wide variety of supportive services that enable them to remain in their own home. Services may be medical or non-medical and may include:

  • Nursing care
  • Personal care (e.g., assistance with bathing, toileting, and dressing)
  • Monitoring of medications
  • Physical, speech, respiratory, therapies
  • Strategies to compensate for physical limitations
  • Assistance with meals
  • Housekeeping
  • Companionship and supervision
  • Adult Day Care Services
    Designed to meet the needs of frail elders or cognitively impaired adults (e.g., Alzheimer's disease or stroke), adult day care centers provide a safe and caring setting for individuals who can no longer be left at home alone.
    Services may include:
  • Meals
  • Social interaction with others
  • Social activities
  • Therapeutic recreation
  • Emotional support
  • Transportation to and from home
  • Health monitoring or rehabilitative therapies

  • RESIDENTIAL CARE
    About one in twenty Americans is cared for in a nursing home, and many more live in other types of senior residences, allowing varying degrees of independence. Residential care covers a variety of facility types where the person lives and receives care services.

    While deciding upon residential care is never easy, learning where to aim your search is the first step. Understanding the range of residential options available will help you and your loved one select the most appropriate type of facility.

    Assisted Living Facilities are a relatively new category of residential care designed for people who do not need skilled nursing care, but could benefit from personal care assistance and support services. Living arrangements vary from small group homes with shared rooms to apartment-style units.
  • Board and care model: offers room and board in either a private home or larger building. Meals are in a common dining area. These facilities offer somewhat less independence and privacy since residents do not have the option to cook their own meals and may not have their own bathroom.
  • Hospitality model: offers apartment-style living and hotel-type services with limited personal care assistance for toileting, getting up from a chair, or assistance eating. Residents have a high-degree of independence but may not be able to stay if their care needs worsen.
  • Aging-in-place model: offers apartment-style living with more intensive personal care services which are more likely equipped to assist those in wheelchairs, or residents requiring more help with toileting and incontinence.

  • Your Office on Aging can provide help you scout out local resources and services to match your needs.

    BEREAVEMENT COUNSELORS


    Specially trained professionals or volunteers will help those who are experiencing new or unresolved grief over the death of a loved one. Grief reassurance helps individuals through the many stages and problems associated with the grieving process. Support is offered in a variety of ways: one-on-one assistance, groups, camps, printed materials, and/or referrals to other resources. Your local hospital, Hospice and/or funeral services director may be able to refer you to a local counselor or grief support group.

    DO NOT RESUSCITATE/COMFORT ONE DNR


    Comfort One (DNR) is a program offered by the State of Idaho Emergency Medical Services Bureau. This program gives terminally ill persons who are not hospital in-patients an opportunity to limit their treatment by Emergency Medical Services in a medical emergency. By enrolling and displaying the proper identification, only supportive care will be given in a emergency. A DNR patient is identified by a pre-numbered and signed form or a DNR bracelet with a Comfort One logo. This program applies only to the Emergency Medical Service personnel working on ambulances or Quick Response units.

    Only persons who have been diagnosed with a terminal illness may enroll in this program. The Comfort One DNR form must be signed by themselves and their physician.

    Only an unaltered Comfort One form or bracelet can be honored in the pre-hospital setting.

    Living wills can only be honored in a health care facility setting and are not a substitute for the Comfort One form or bracelet.

    The Emergency Medical Service provider will provide comfort and palliative care such as:
  • Manually open the airway
  • Remove obstructions in the airway
  • Provide oxygen
  • Control Bleeding
  • Make the patient comfortable
  • Provide emotional support to the patient and family
  • The Emergency Medical Service provider will NOT:
  • Perform cardio-pulmonary resuscitation (CPR)
  • Perform cardiac monitoring and defibrillation
  • Administer resuscitation medication
  • Perform endotracheal intubation
  • Perform positive pressure ventilation
  • For more information about DNR, contact your personal physician or State of Idaho EMS at 208-334-4000.

    ESTATE PLANNING SERVICES


    Your estate includes all of the property you own, or any part of property in which you might have a stake. Your estate also includes direct financial assets such as stocks, mutual funds, insurance, benefits from retirement, IRA's and bank accounts. Your estate consists of your personal possessions as well, such as cars, valuables, furniture, etc. In order to find the value of your estate, add the fair market value of all the items in your estate and then subtract the liabilities you might have, such as mortgages or other loans and debts. Knowing the value of your estate will help you understand the potential taxes your estate might be subjected to upon your death, as well as the type of estate plan that can help you preserve as much of your wealth as possible.

    Here is a list of things effective estate planning can do for you:
  • Ensure that you retain control of the distribution of your estate according to your wishes
  • Protect your wealth from potentially large estate taxes
  • Help guarantee that your heirs are taken care of after you die
  • Avoid the expensive and time-consuming process of going through probate
  • Keep your affairs private, confidential and out of the public domain
  • Dictate the care you want and oversight of your estate if you become incapacitated for any reason
  • Allow you to create special trusts for children, grandchildren or others who are important to you
  • Here are a few things to consider when creating your estate plan:
  • If you die while your children are still young, who should become their guardian?
  • How should you and your spouse distribute your assets in case one of you dies?
  • Who should receive your life insurance settlement, pension or other retirement benefits?
  • If you cannot care for yourself, who will care for you?
  • If you cannot manage your estate, who will oversee your day-to-day affairs?
  • If you end up owing estate taxes at your death, who will ensure they are paid for?
  • Many different professionals may be able to assist you in the formation of an estate plan that fits your specific needs. This may include an attorney, certified public accountant, financial planner or insurance agent. If you don't think that you are ready for a professional to help you review and plan your estate, there are
    a number of resources that can help you understand and plan certain aspects of your estate.

    Adapted from Careguide - Elder Care Services. You will find tools at this site for calculating the size of your estate, links to related articles, and an Estate Planning Quiz to test your knowledge of estate planning.

    FAMILY CAREGIVERS SUPPORT GROUPS


    Support groups are generally educational and supportive in nature, lead by a health care professional. Caregiver's stress, practical advice and ideas regarding nutrition, safety and relationships are usually addressed.

    FINANCIAL ASSISTANCE


    Long term care can be ruinously expensive, but research and planning will help relieve the stress of paying for your care, or a loved one's care, and make difficult situations more manageable.

    Retired and on a fixed income?
    Find out what coverage Medicare provides, or how to find the right Medigap policy.
    Still working, but thinking about the future?
    Learn how long term care could affect your retirement.
    Are you assisting a parent?
    Learn what costs are involved.
    Visit Careguide - Elder Care Services for a wealth of resources.

    FUNERALS & MEMORIAL SERVICES
    There are many respectful and meaningful options to traditional funerals.
  • Direct cremation with a memorial service.
  • Immediate burial with a memorial service.
  • Donating a body. The Idaho State University Office of Biological Sciences accepts donations of bodies for use in their Family Practice physician education program. For information, contact Dr. Trent Stevens, 208-282-3993.
  • The family can make arrangements for disposal of the body without the services of a mortician. Information is available from the Funeral Consumers Alliance.
  • National Funeral Directors Association
  • HOSPICE PROGRAMS


    Hospice is a special concept of care designed to provide comfort and support to patients and their families when a life-limiting illness no longer responds to cure-oriented treatments. Generally, this care is provided in the patient's home or in a home-like setting operated by a hospice program. Hospice care neither prolongs life nor hastens death. Hospice staff and volunteers offer a specialized knowledge of medical care, including pain management. The goal of hospice care is to improve the quality of a patient's last days by offering comfort and dignity. Hospice care is provided by a team-oriented group of specially trained professionals, volunteers and family members. Hospice addresses all symptoms of a disease, with a special emphasis on controlling a patient's pain and discomfort. Hospice deals with the emotional, social and spiritual impact of the disease on the patient and the patient's family and friends. Hospice offers a variety of bereavement and counseling services to families before and after a patient's death.

    Medicare, private health insurance, and Medicaid in most states cover hospice care for patients who meet certain criteria. In addition, many hospices depend on charitable contributions to cover the costs of care for terminally ill patients who cannot afford to pay for their care.

    Directory of Idaho Hospice programs

    National Hospice Helpline 1-800-658-8898.

    LETTER OF LAST INSTRUCTION


    From important numbers like your social security number and your medicare number, to the name of your pet's veterinarian; from a list of your investments to your wishes for burial, this form guides you through the process of gathering the information your family will need when you die. There is a helpful form you can download.

    MEALS ON WHEELS


    Meals on Wheels typically provide regular lunch time meals at a senior meal site. They also deliver prepared meals to homebound seniors in need of nutrition services.

    MEDICAL CONSENT LAW


    ORGAN AND TISSUE DONATIONS


    A designation can be put on your driver's license which indicates that you are willing to be a tissue and/or organ donor. This is an excellent first step. However, it is your next of kin who will be making that decision on your behalf when you die, so you need to talk about your wishes and put it in writing.

    In addition to organs (heart, kidneys, liver), various tissues can be donated also. Skin tissue can be used for burn victims and cartilage and bone is used in reconstructive orthopedic and orthodontic surgeries. For more information, contact Life Center Northwest Donor Network toll free 1-877-275-5269.

    PALLIATIVE CARE


    In recent years, many hospice care programs added "palliative care" to their names to reflect the range of care and services they provide. Hospice care and palliative care share the same core values and philosophies. Defined by the World Health Organization in 1990, palliative care seeks to address not only physical pain, but also emotional, social, and spiritual pain to achieve the best possible quality of life for patients and their families. Palliative care extends the principles of hospice care to a broader population that could benefit from receiving this type of care earlier in their illness or disease process. To better serve individuals who have advanced illness or are terminally ill and their families, many hospice programs encourage access to care earlier in the illness or disease process. Health care professionals who specialize in hospice and palliative care work closely with staff and volunteers to address all of the symptoms of illness, with the aim of promoting comfort and dignity.

    SENIOR SERVICES


    Senior citizens and their families can get comprehensive information on services and resources available in their town or county by contacting an area Office on Aging.
     

    TELEPHONE REASSURANCE


    Volunteers call homebound and/or disabled elderly each weekday morning to assure their safety and well-being. Other programs check on seniors who fail to call in each day on a pre-determined schedule.

    TRANSPORTATION


    Whether for a medical appointment, to shop for groceries or to a Senior Center, transportation is available to seniors. Contact your area Office on Aging.

    VOLUNTEERS


    Frequently, volunteers who assist seniors in their homes are available by contacting your area Office on Aging or an RSVP program. The Retired Senior Volunteer Program provides an opportunity for those seniors interested in volunteering their time to improve the lives of others in their community. Senior volunteers may serve as mentors to low income youngsters, deliver meals on wheels, volunteer as part of hospice programs, or perform a myriad of other important community services. If you are interested in being a volunteer, many worthwhile and fulfilling opportunities exist.

    WILLS


    Although wills can be very complicated, they are fairly simple in the grand spectrum of legal instruments. A will is essentially a legally valid document that outlines how one's money, property or other assets are transferred when he dies. There are different types of wills, but most wills are referred to as "simple wills."

    A will can usually be drawn up by an attorney for a reasonable fee, unless the estate is very large or the instructions are very complex. It is also possible for you to draw up your own will using standard forms or software. Be aware of the laws governing wills in your state of residence. If you draw up your own will, be sure that anything your state requires is included or the will could easily be judged invalid.

    Some things to know about wills:

  • A living will is really not a will at all because it doesn't provide for the disbursement of property. Instead, it allows you to state what medical treatment you would want to receive if you become terminally ill and are unable to communicate.

  • Wills generally don't govern assets in trusts, jointly owned property or assets already specifically directed to someone through other legal documents or instruments, such as an IRA or insurance policy.

  • The most important thing to remember about wills is that they save your family members and friends from painful disputes over your belongings. If not for yourself, consider creating a will for their sake.

  • Additions to wills, known as letters of instruction, can be created for items that might not merit inclusion in a will, but nonetheless need to be distributed. These letters, which can be very detailed, might arrange for the disposal of old files, instructions for tasks like the upkeep of a home or what to do with a loyal canine companion. Take note that letters of instruction are not legal documents so, items of personal importance or high value should be included in a will.

  • Return to Top

    HOME | TOPICS | ON OUR OWN TERMS l PBS l Thirteen

    Funding for this landmark PBS series and the companion outreach campaign is provided by The Robert Wood Johnson Foundation; The Fetzer Institute; The Nathan Cummings Foundation; The Kohlberg Foundation, Inc.; The Laurance S. Rockefeller Fund; The John D. and Catherine T. MacArthur Foundation; and Mutual of America Life Insurance Company.