Senior Living

Conventional and Internet surveys agree - the 57 and up population not only represents the largest segment of home ownership but are also the fastest growing age group using computers and the Internet. Your needs going forward require a specialized professional who can help you with answers to the following questions:

Are you facing an empty nest?
Is your home too large for your current lifestyle?
Are you thinking of downsizing?
Should you sell your home or keep it as an investment?
Should you purchase another home or consider alternatives?
Should you relocate?
Is living near your children a concern?
Would you like to learn more about what resources and activities are available that meet your priorities?
Do you need any assistance with estate or tax planning?

YOU ARE NOT ALONE!
I serve a distinguished clientele whose needs may be similar to yours. If you are reading this page perhaps you or someone you know is ready to get professional advice on making this part of life the best it can be. Below are some resources to help better understand your options. Should you require any personal consultation, please feel free to contact me directly, I would be delighted to meet with you personally should you want to do that?

Profile of a Senior

For today's senior citizen, the moniker itself conjures up tired men and women sitting on park benches feeding pigeons, a memory many hold dear as it invokes images of a previous generation. That is simply not a valid description any longer.

Though many of today's seniors began life before there was rock music, air conditioners, microwaves ovens, credit cards, SUV's and computers, they watched all these innovations come to birth and have embraced many of them. In fact, in a 2004 survey, Pew Research reported that nearly 50% of all seniors own computers and are on the Internet.

Today's seniors live active lives. Some are working on second or third careers because working is not something they do just to earn money; it is a way of taking all their accumulated knowledge and applying it to projects they love and believe in.

Some are focusing on their equity portfolios not just to insure provision for their children, but to plan and prepare for their own future in regard to housing, mental and health issues. Some are seeking to advance their education in all things from getting their doctorate in History to golfing and dancing.

Though today's seniors grew up during a time when cigarette smoking was considered fashionable, when Coke was a just a mixture of water, sugar and bubbles, when McDonald's only served a few hundred thousand, today's senior is filled with a wisdom drawn from a life lived during a time when music, art, fashion, space travel, technology and medical renaissances converged.

Today's senior is physically healthier than ever, having grown up doing jumping jacks with Jack LaLanne, Aerobics, Jazzercise and now Pilates. Today's seniors can rely on great medical advancements that make once life threatening events an outpatient treatment. Today's seniors are positively spirited as a result of enhanced physical and dietary regimens, and enriched medical wonders that include such things Viagra.

While today's seniors were born before there was touch tone dial, CD players and the Internet, it was members of today's senior population who invented these things. Many of you are still productive in the work force today, working hard and inventing our future.

When you think of today's seniors, you don't think of white haired old men and women with walkers. You think of Sean Connery, Barbara Walters, Johnny Carson, Michael Douglas, and the millions of amazing resilient men and women that make up the most distinguished members of our population.

Creativity, Activity and Longevity

Creativity is what separates humans for all other species. Its seeds stem from thought with a gentle mixture of talent, inspiration, experience and desire. Creativity holds no boundaries. It comes in all shapes and regards a wealth of applications that include financial planning, painting, music, decorating, writing or inventing.

Today's seniors are generously advantaged by a great assortment of creative activities and outlets. They are encouraged to explore them as therapy for some of the challenges that come with adjustments to daily living that include a greater amount of leisure time and longer lives. As creative expression distinguishes humans, it also provides us with an elixir for dealing with life issues. Whether it's engaging in sports, writing a novel or scrapbooking, creative endeavors keep seniors engaged in life, stimulate memories, while offering choice and control.

Creative involvement appears to have medicinal benefits for those who are challenged with physical or mental issues due to stroke, heart attack, dementia or other factors. For example, studies have shown that those with Alzheimer's open up and communicate well through collage work. One of the leading proponents of the medicinal use of creative activity is Gene D. Cohen, MD, PhD. Director and Professor of Health-care Sciences and Professor of Psychiatry at the Center on Aging, Health & Humanities, George Washington University, Washington, and D.C. He is also the author of The Creative Age: Awakening Human Potential in the Second Half of Life (Harper Collins).

Dr. Cohen is the lead researcher of a 25-year study on creativity and aging in more than 200 senior citizens. Regarding the relationship of creativity and health, Dr. Cohen says, "Expressing ourselves creatively can actually improve health, both mentally and physically. Creativity is a natural, vibrant force throughout our lives-a catalyst for growth, excitement and forging a meaningful legacy." Dr. Cohen also makes some other key points regarding the importance of creativity to wellness. They are:

Creativity reinforces essential connections between brain cells, including those responsible for memory.
Creativity strengthens morale. It alters the way we respond to problems and sometimes allows us to transcend them. Keeping a fresh perspective makes us emotionally resilient.
Challenging the brain can relieve sleep and mood disorders.
Reading, writing and word games increase one's working vocabulary and help to fend off forgetfulness.
Capitalizing on creativity promotes a positive outlook and sense of well-being. That boosts the immune system, which fights disease.
Having an active, creative life makes it easier to face adversity-including the loss of a spouse.

(Cohen, Gene D., "Welcome to the Creative Age", Bottom Line/Tomorrow Vol.9, #8 (Aug.2001)

When addressing the longevity of seniors, we need to look at more than the immediate needs of food, shelter, finance and physical health. There is much more to a truly healthy, rounded and fulfilling life than this. These things can be meaningful to a person, especially towards the end of their life. If we remember this, we will be much more likely to have a happy ending to our story.

Long Term Care Insurance

What is Long-Term Care Insurance?

Long-Term Care insurance is a private insurance policy to help pay for some long-term medical and non-medical care. This includes assistance with activities of daily living, as well as paying for sudden, unexpected, large continuing expenses that would deplete or exhaust your financial resources. As Medicare generally does not pay for long-term care, this type of insurance policy may help provide coverage needed in the future. Some long-term care insurance policies offer tax benefits; these are called "Tax-Qualified Policies." Long-Term Care insurance policies are actually designed to and may be the only thing that keeps you out of a nursing home when you need care for an extended period of time. When you are unable to take care of yourself, you need to hire someone to do it.

Paying for Long-Term Care - The Medicare Misconception

Many people think Medicare covers Long-Term Care expenses, such as nursing homes, elderly care and home health services. However, Medicare only provides short-term benefits (a maximum of 100 days) for skilled care in a nursing home following a three-day hospital stay. Medicare pays only for part-time skilled home-health visits and nothing for 8-hour shifts at home. Most Long-Term Care is custodial and not skilled, so you can't count on Medicare to pay for it.

Medicaid pays for nursing home care only after you have spent your assets and become impoverished. It pays nothing for assisted living or home health care. Therefore, Long-Tem Care is an expense that needs to be paid for privately.

Why Do I Need Long-Term Care Insurance?

If you can not take care of yourself, there are plenty of resources from which to choose: home-health services, adult day-care centers, assisted-living facilities, or nursing homes. Finding the money to pay for such help however, presents a dilemma.

What If You Have an Accident or a Stroke?

The average cost of Long-Term Care today is $247 for a private room and $174 for a semi-private room, and the average stay is 2.7 years. That equates to an average of $63,418 per year. Long-Term Care can last for several months or years. The chances are that you will need Long-Term Care at some point in time.

Waiting Can Be a Costly Mistake.

Not everyone qualifies for Long-Term Care insurance. A change in your health can result in increased premiums by as much as 50% for the same protection prior to your health problem. It is possible that a change in your health could make you completely ineligible at any price. If you buy a policy at age 75, the premium can be more than double than if you had bought the policy at age 65.

Are There any Negative Aspects to Long-Term-Care?

Research indicates that for some people, long-term-care insurance can be risky and expensive. As with health insurance, you must keep paying to keep it in force. If premiums rise, you may have to drop the coverage, possibly losing everything that you've paid. The policy's benefits may cover only a portion of the total expense. Many policies are packed with catches that can keep you from collecting. Finally, there's no guarantee that long-term-care insurers, some of which have weak balance sheets, will be around 20, 30, or 40 years from now when you need them to pay. While Long-term-care insurance may not be the greatest deal, right now it is just about the only thing that's available.

Your Insurer May Not be Around for the Long Haul.

Some long-term-care insurers have shaky finances at best. If a company goes under, you could lose your coverage, and some of the money you paid, or face stiff premium increases if the business is bought by another insurer.

HOW TO CHOOSE

Use this established criteria to determine the worthwhile hedge against the costs of long-term care, if you can afford it. If you decide that you want a policy, follow these shopping guidelines.

Consider buying at around age 65

Look for a strong Insurer

Buy a flexible policy

Make sure the daily benefits increase along with the price of care

A four-year benefit plan should be sufficient. Nearly 90 percent of all people over age 65 who enter a nursing home stay fewer than five years. The average length of time for current residents is 2 1/2 years. If you're willing to play the odds, a four-year benefit may be a reasonable gamble. If you do require nursing-home care for a longer period, four years will give you and your family time to prepare for the financial demands of a longer stay.

Pick a 30-day elimination period. A policy with a 90-day period might cost 15 percent less a year than one with a 30-day period. But with inflation, a nursing home that currently costs $181 a day will cost $538 in 20 years, bringing the total for those 60 additional days to $32,280.

ADDITIONAL OPTIONS

You can pay to get some money back. If you have to cancel your plan, you can recoup money you invested by adding a non-forfeiture clause to your policy. That allows you to collect a daily benefit when you need long-term care based on the amount you paid in. But you can claim only as much as you paid in, and inflation won't be covered even if you opted for inflation protection. The non-forfeiture provision will likely add 30 percent to your premiums.

Your premiums may be partially deductible. So-called tax-qualified plans, which meet federal standards, allow you to deduct your annual premium up to a limit based on your age. But along with other medical expenses, the amount is deductible only to the extent that it exceeds the federal government's 7.5 percent threshold of adjusted gross income. You may be able to deduct only a small portion of the expense.

Hold any group plans to high standards. More than 5,000 employers, including the federal government, offer group long-term-care plans that may give employees a discount and allow them to pay premiums with pretax dollars, further lowering their cost. If your workplace plan does not offer the features recommend, you would be better off buying on your own.

Check Out Partnership Plans.

In four states--California, Connecticut, Indiana, and New York--you can buy a "partnership" plan that protects some or all of your assets from being depleted. In California, Connecticut, and Indiana, you can get coverage equal to the amount of assets you want to shelter. If you want to protect $100,000, you buy a policy that comes close to paying out $100,000. If you become eligible for Medicaid, you can keep $100,000 of your assets above Medicaid's limit. In New York, you can buy a policy with three years of nursing-home coverage and six years of home-health care. You become eligible for Medicaid after exhausting your benefits, but without spending any more of your assets. Such policies protect assets, but you may not exceed Medicaid income limits. If you move out of state, you may keep the plan, but you lose the asset protection. On the plus side, most of these plans cover assisted-living care.

Seniors FAQ's

I Am Looking to Start a New Chapter in my Life, What Should I be Doing? To begin, you must determine what your needs are. This would include such things as:

Have you just retired?
Are you divorced or widowed?
Do you currently own a home?
Do you want to sell the home?
What type of new living situation are you considering?
Do you have children?
Are you active?
Do you require any medical attention?
How Can I Prepare My Safety Net From a Position of Security?

The truth is none of us can predict our personal future or that of a loved one. Early planning provides us ways to protect our property and maintain our well-being. It is better to prepare for your future from a position of health and security than to wait for a crisis and make decisions in grief or haste.

What Issues Should I be Most Concerned With? There are many. A partial list includes:

Health

Be aware of your overall health, your problem areas, and your future risks. Take all necessary precautions, including physical and mental workout as well as diet. Secure a good physician and hospital that you trust with your personal health. Your physician will evaluate your diet and exercise needs as well as other influences on your health. It is never too late to begin an exercise program or to give up bad habits. Working with your trusted specialists can add years of active living.

Finance

Do what you can to become educated on all matters concerning your finances. Some things to consider include:

Current assets
Future assets
Benefits
Various insurance coverage’s.

You cannot rely on Medicare to cover all payments, despite the revisions made in the area of health care coverage. The cost of nursing homes, long term care, assisted living or private nursing care must be considered and planned for. Opportunities available through retirement plans, insurance riders, and state programs should be obtained and studied with a trusted financial advisor.

Legal issues

These should be attended to when you are of sound mind and in full control of your possessions. Protecting your personal property and finances is imperative so that they are available for your care when needed. When you are not competent due to ill health, you may not be able to initiate the legal documents necessary to allow a friend or family member to handle your affairs. Now is the time to explore who will have your power of attorney to execute decisions on your behalf when you are incapable of doing so. You should also consider the implications of a living will.

Housing

Determine what housing alternatives would be acceptable and available to you should your independence be threatened by illness, disability, or loss of income. Visit locations in your community and make your plans known to your family. Safety, security, cost of upkeep, accessibility, types of residents who share the facility, and even geographic location are important considerations. Assuming that someone else will make a decision to your liking when the time comes is unfair to that "someone", and risky to your future peace of mind. Being informed about deposits, waiting lists, nursing standards and eligibility requirements will lead to a good feeling of control over difficult decisions.

Activities and Lifestyle

As studies have shown, one of the secrets to longevity and health is a peace of mind found through renewed or continued interest in the world and its activities. Whatever your passions or hobbies, seek out furthering your education, get involved in artistic endeavors, correspond with a pen pal, or start a new business.

Support Systems

This is a general term for surrounding yourself with friends, relatives, and resource persons that will serve to inspire you, keep you vital, entertain you, and who will be available when help is needed. This is an area often neglected by seniors, especially after the passing of a spouse. Making plans for your future in later years deserves the same attention, excitement and positive outlook you gave to choosing a college, planning for children, and your career. A safety net of information about health, finances and legalities while continuing to develop personal interests and friendships will support and sustain you through times of difficult decision making.

What are the Different Types of Living Facilities Available for Seniors?

Facilities are organized into the following categories:

Independent Living
Nursing Homes
Continuing Care Retirement Communities
Adult Active Communities
Alzheimer's Care
Assisted Living
Independent Living

Often referred to as Retirement Communities, Congregate Living or Senior Apartments, this is a residential living setting for elderly and senior adults that may or may not provide hospitality or supportive services. Under this living arrangement, the senior adult leads an independent lifestyle that requires minimal or no extra assistance but offers the security and conveniences of community living. Independent living also includes rental assisted or market rate apartments or cottages where residents usually have complete choice in whether to participate in a facility's services or programs.

Some independent communities offer organized social and recreational programs as a part of everyday activities (Congregate Living or Retirement Communities), while others provide housing with only a minimal amount of amenities or services (Senior Apartments).

Cost/Payment

Prices for units in these communities generally depend upon local market conditions. Most communities that provide services are market rate, but some subsidized senior apartments cater to seniors with limited incomes. Private Funds are most often used, although some senior apartments are subsidized and accept Section 8 vouchers. Medicare and Medicaid do not cover payment since no health care is provided.

Care

Since independent living communities are independent, health care is not provided as part of the fees. However, many communities will allow you to pay for a home health aide or nurse to come into your apartment to assist you with medicines and personal care.

Nursing Homes

These facilities are licensed and regulated by the State Departments of Public Health and are individually certified by the State for Medicare and Medicaid. They are available to seniors who do not require acute hospitalization but do need 24-hour skilled care. Some of what is provided includes:

Regular medical supervision
Rehabilitation therapy
Personal care
Personal protection
Assistance for most or all daily living activities such as bathing, dressing and toileting
Regular medical supervision and rehabilitation therapy are mandated to be available, and nursing homes are eligible to participate in the Medicaid program. These facilities are State Licensed.

The Nursing Home's medical staff sets them apart from other types of senior housing as care is provided by registered nurses, licensed practical nurses, and nurses aides at all hours of the day. Facilities include:

Trained medical staff
Medically planned meals
Professional service staff-activity director
Social workers
Furnished rooms with housekeeping services
Physician and physician services (on call)
Physical, respiratory, and speech therapists
Medications
Personal care items
Laundry service
Depending on the facility, some of these services may have extra charges associated with them.
Questions to Consider

When selecting a nursing home, ask the following questions of the administrator or admissions coordinator:

What levels of care do they offer?
Do they accept Medicare or Medicaid?
Are there any restrictions on the type of patients they admit?
What is provided in the basic daily rate?
What services cost extra?
Is there a volunteer program?
Is there an adequate staff?
How long do nurse call lights stay on?
Do the patients look clean and are they dressed in clean clothes?
Are staff members kind and responsive when they talk to residents?
Is the food good? Ask a resident how it tastes. See if it looks good and if it is served hot.
Do the patients seem to get enough to eat? Are they offered second servings, diet permitting?
Does the home serve snacks?
Is the dining room clean and well furnished?
Are patients assisted with eating when required?
Is there an activity program?
Is there a full-time activity director?
Is a list of activities posted?
Is there something for patients to do who are confined to their rooms?
Are there many patients sitting around with nothing to do?
Does the facility have community TV with good reception?
Is there a volunteer program?

Cost/Payment

Nursing Home facilities generally charge a basic daily or monthly fee. In most cases, however, residents and or their families will have purchased long-term care insurance in anticipation of the cost or seek alternative forms of financing. These facilities do accept a variety of Medicare, Medicaid, private insurance carriers, and private funds.

Care

There are three care programs. They are:

Basic Care - These are services required to maintain a resident's activities of daily living. Basic Care includes personal care, supervision and safety. A nurse aide, practical nurse or a family member can provide this care.

Skilled Care - This is the level of care which requires the regular services of a registered nurse for treatments and procedures. Skilled care also includes services provided by specially trained professionals, such as physical and respiratory therapists.

Sub-Acute - This is comprehensive inpatient care designed for someone who has had an acute illness, injury, or chronic illness. Sub-acute care is generally more intensive than traditional nursing facility care and less than acute care, requiring frequent (daily to weekly) recurrent patient assessment and review.

Continuing Care Retirement Communities (CCRCs)

Generally, CCRCs are communities which provide several levels of continuum of care for elderly persons. This continuum of care is sometimes referred to as the levels of care and may include the following:

Independent Living - Residents live independently in their daily activities in their independent living units. Some services are generally provided to these residents such as housekeeping, meals and laundry service.

Assisted Living - Residents need some assistance with the activities of daily living such as bathing, dressing, eating or taking medications.

Skilled Nursing Care - Residents generally require round-the-clock nursing service in a nursing facility.

CCRCs are different from other housing and care facilities for seniors because it usually provides a written agreement or long-term contract between the resident (frequently lasting the term of the resident's lifetime) and the community which offers a continuum of housing, services and health care system, commonly all on one campus or site.

Questions to Consider

If you are thinking about a CCRC, the following are some questions you might want answered:

Who owns the CCRC?
Are the owners financially stable?
What are the CCRCs long term plans?
Will the CCRC be around to deliver services as long as you need them?
Who manages the CCRC?
How long have they been managing it?
Are they likely to continue?
What is the turnover rate among the staff with whom you will be interacting on a daily basis?
If the CCRC is a condominium, individual housing unit or a co-op, are there any restrictions on selling it?
Is there a waiting list? If so, how long do they estimate it will take for you to be admitted?
What services are you getting for your monthly fee?
Are more services available if you need them? At what cost?
Is transportation available? At what cost?
How often and for what reasons can the monthly rate increase?
Is the increase predictable and is it tied to something like the consumer price index?
Is there a basic entry fee? How much is it and how long do you have to pay it? Is the entrance fee refundable and under what circumstances?
How much care will you get for your monthly fee?
What care is available and who chooses the care provider, you or the CCRC?
What care is available at additional cost and at what cost?
Will it cost extra to use your own doctor?
What happens if you can no longer afford to stay in the CCRC?
Are they certified for Medicare and Medicaid?
How are medical emergencies handled?
Is a hospital close by and what services does it offer?
Will your cost rise if you need assistance with daily living or you need to move to assisted living or skilled nursing care?
What if you are a couple and only one of you moves?
What happens if you get Alzheimer's disease?
Can the CCRC provide care for you on the premises?
If not, where can you obtain the care?
Who pays for all of this? If it's you, how much will it cost?
Is there anything that gives the CCRC the right to ask you to leave?
If so, what is it, and what happens to the money you paid as an entry fee?
There are always rules for residents. Can you live happily with them?
Can the CCRC handle your dietary needs and your tastes in food?

CCRCs offer a variety of residential services, including the following:

A maintained apartment, townhouse, or other unit
Cleaning and laundry service
Meals in common dining areas (number of meals per day may vary)
Grounds maintenance
Security
Social, recreational, and cultural programs
Health care services
Care is covered for contracted services
Personal care and help with daily activities
Nursing care
Rehabilitative care
Respite & hospice care
Alzheimer's & special care clean, furnished rooms

Cost/Payment.

The agreements or contracts used by CCRCs differ, but are generally based on the health care provided. The three most common types of health care coverage in the CCRC agreement are listed below.

Extensive agreements - These include housing, residential services and amenities, and unlimited, specific health related services with little or no substantial increase in periodic (monthly) payments

Modified agreements - These include housing, residential services and amenities, and a specific number of long term nursing care days with no substantial increase in periodic (monthly) payments. After you have used your allocation of nursing care, you are then charged the daily rate for each additional day

Fee-for-service agreements - These include housing, residential services and amenities for the fees stated in your agreement. You also pay for any health related services as you use them, at the current rate, either daily or monthly.

The three general types of payment or fee arrangements are:

Entry fee and monthly fee
The entry fee is a one-time, up-front fee that is combined with monthly fees to cover the living unit, services and care items covered in your resident agreement. CCRCs may charge an entrance fee that depends on the individual CCRC. The entrance fees charged can be minimal to several hundred thousand dollars. This is the most common type of fee arrangement offered. The entry fee may or may not be refundable. If it is refundable, it will be under certain conditions as specified in the mandatory disclosure statement

Monthly-fee-only or rental
There is no lump sum entry fee. The cost of your living unit, services and care are covered in your monthly fee payment. Sometimes, however, there is a small up-front fee or deposit charged

Ownership or equity (condominium, cooperative or membership).
These types of CCRC agreements involve the actual purchase of real estate and/or a membership. The purchase of the real estate can be an expensive undertaking, especially if a large down payment is required. Additionally, there can be a mortgage associated with the transaction. The service and health care package is generally separate from the real estate transaction and is covered through monthly fees or assessments.

Services

Monthly fees generally cover the following:

Meals (numbers may vary)
Scheduled transportation
Housekeeping services
Unit maintenance
Laundry
Health monitoring services
Some utilities
Organized social activities
Emergency call monitoring
Security

Active Adult Communities

The terms "Active Adult", "Senior" or Resort Communities, refer to rental communities where you must be 55 years or older and sometimes 62 years or older to live. These options are designed specifically to attract "age qualified" retired persons and those nearing retirement age who wish to get a start on owning a place where they will eventually retire and who desire the maintenance-free lifestyle. They offer an independent lifestyle in addition to social and recreational activities with older adults.

Services

These communities may offer facilities and amenities such as:

Golf
Tennis
Views
Walking and biking trails
A swimming pool
Exercise rooms and a variety of clubs and interest groups.
Many are gated communities that offer a high level of security and some have health care facilities on site
Classes such as art, dancing, woodworking, ceramics, chorus, yoga, etc.
Many will have a clubhouse or country club with dining facilities, and depending on location, a marina and beach.
Residents may live in individual single-family homes, condominiums, town houses or suites in high rise towers.

Alzheimer's Care

At some point, the needs of the Alzheimer's patient may be too great to continue home care or prior care in an Assisted Living Facility. Transferring to an Alzheimer Care Facility presents the patient with a treatment center whose focus is geared toward supervision. These facilities are part of a new trend to provide specialized care for those with Alzheimer's. Some of what differentiates these facilities from Nursing Homes or Assisted Living Facilities are elements like design features within the facility that assist with the problems associated with this disease such as: color-coded hallways, visual cues, and secure wandering paths for additional security.

Questions to Consider

Inquire about the facilities specialties - This should include information about dementia training (both past and on-going) for employees, specialized activities and a calm environment.

Inspection Report - Request to see the most recent facility inspection report. This document is public information, must be posted in a visible area, and highlights the kind of care provided.

Staff - Inquire about the size of the staff and what their availability is throughout the days, evenings, nights and weekends. This will help determine how much individual attention your family member will receive.

Determining your individual needs - Inquire about whether the facility offers a cognitive assessment as part of the screening. Such an assessment helps assure the family and the facility that the residence is capable of meeting the individualized needs of the resident.

Security - This pertains to the facility's ability to safeguard potential wandering of their patients.

Long Term Care - Learn about the staff's ability to care for your loved one as the disease progresses. Not all facilities provide care throughout the progression of the disease.

Learn about your families’ involvement - Identify the facility's plans for maintaining and involving family in the care, support, and problem-solving of the patient

Care/Facility

Similar to Assisted Living communities, most provide assistance with dressing, grooming, bathing, and other daily activities. Assistance with medications differs according to state regulations. Meals, laundry and housekeeping are usually provided within private and semi-private rooms in a residential type setting.

Assisted Living Facility (ALFs)

Assisted Living Facilities are privately owned facilities which provide room, board and limited personal services (such as help with bathing and dressing) as well as access to available community services. ALFs can range in size from a few residents to a facility housing as many as several hundred older adults. ALFs also vary considerably in monthly rent, types of services offered, and physical amenities. Some ALFs accept certain low-income adults who are certified eligible for state-supported assistance as determined by the Department of Children and Families. ALFs usually are appropriate for persons in the early to middle stages of Alzheimer's disease.

Services

ALFs will generally provide a range of services that promote resident quality of life and independence, including:

Personal care services (help with eating, bathing, dressing, toileting, etc.)
Various health care services
Social services
Supervision of persons with cognitive disabilities
Social and religious activities
Exercise and educational activities
Arrangements for transportation
Laundry and linen service
24-hour supervision
Three meals a day plus snacks in a group dining room
Housekeeping and maintenance.

Questions to consider

If you decide that assisted living is the right solution, consider the following when evaluating the assisted living choices in your area:

Is the management experienced?
Do they have genuine concern and respect for the residents?
Are the residents and families happy and satisfied?
Is staff friendly and caring?
What is the staff to resident ratio?
Is the community clean and comfortable?
Is this a place children would like to visit?
Are meals appealing and well balanced?
What health and wellness services are available?
Is the location convenient to friends and family?
What activities are planned for residents?
Will the prospective residents like these activities?
Will the prospective resident enjoy the daily life as compared to the other options?
Do services and quality of living meet your standards?
Is the value comparable to cost?
What are the residency criteria?
Considering all...will assisted living improve the quality of life for a resident?

Cost/Payment

While costs vary across the nation, assisted living generally costs less than home health services or nursing home care. The following factors should be considered:

Types of services
Size of accommodation
Location of community, etc.

Most assisted living residences charge monthly rates and do not usually have an entrance fee. Many also have daily rates for short-term stays (respite care).

What should I Know Before Choosing a Senior Housing Facility?

Perform a thorough review of the services, operations and finances of the establishment, including a review of their audited financial statements.

Consult an attorney and/or a financial advisor to determine if the establishment is appropriate for your lifestyle and financial situation.

Spend as much time as you can visiting the establishment and try to participate fully in its activities.

Compare Establishments. Do as much research as possible. Make sure that whatever place you choose, your choice is right for you.

Interview residents and staff. Objectively evaluate the services and amenities based on your lifestyle and your condition.

Share the details with someone you know and trust. They might be able to be more objective than you and assist in your evaluation.

What Should I Know About Private Insurance Policies?

Some insurance companies offer private insurance policies specifically for long-term nursing home care. These policies vary widely in coverage and cost, and it is important to understand precisely what kind of policy you are purchasing.

Make sure the policy being considered does not duplicate skilled nursing facility coverage provided by any coordinated care plan such as Medicare or Medicaid or other coverage already received. Check for any prerequisites required before the company will pay benefits. For example, ask if the company requires that a patient have prior hospitalization before any benefits are paid out. Some diseases such as arthritis-related problems and Alzheimer's do not require hospitalization before the need for nursing care arises.

If possible, seek an insurance policy that pays benefits immediately upon entry into a nursing care facility. Many insurance policies, which are purchased prior to the need for nursing care, require a waiting period after entry into a nursing care facility before payments are made. It is highly unlikely that nursing care insurance can be purchased after a person has entered a nursing care facility.

Another private insurance policy, Medigap supplemental insurance, is designed to close the gap between medical costs and amounts paid by Medicare. However, both Medicare and Medigap are primarily designed for short term, acute care and, consequently, are unlikely to meet the long-term needs of nursing care residents.

Reverse Mortgage

A Reverse Mortgage Defined

A reverse mortgage is a special type of loan used by senior homeowners to convert part of the equity in their home into cash or tax-free income without having to sell the home, give up title, or take on a new monthly mortgage payment. The money from a reverse mortgage can provide seniors with the financial security they need to enjoy their retirement years to the fullest.

The reverse mortgage is aptly named because the payment stream is "reversed." Instead of making monthly payments to a lender, as with a regular first mortgage or home equity loan, a lender makes payments to you.

While a reverse mortgage loan is outstanding, you continue to own the home.

You Will Never Be Forced Out of Your Home

Borrowers will never, under any circumstance resulting from the reverse mortgage, be forced to leave their homes providing they pay their real estate property tax and insurance premiums.

Borrowers can choose to receive the reverse mortgage funds as a lump sum, monthly income (for up to life), or a line of credit, or as a combination of monthly income and line of credit. No mortgage payments are due during the life of the loan. Borrowers can use the funds anyway they wish. Borrowers make no monthly payments on a reverse mortgage during its term. The loan becomes repayable when the borrower sells the home or permanently moves out. In addition, the repayment amount can not exceed the value of the home.

What can the Money Be Used For?

The money from a reverse mortgage can be used for ANYTHING, including the following:

Daily living expenses
Home repairs and home modifications
Medical bills and prescription drugs
Pay-off of existing debts
Continuing education
Travel
Long-term health care
Prevention of foreclosure, and other needs.

If your home needs physical repairs (mandatory repairs) in order to qualify for a reverse mortgage, a portion of the proceeds will be set aside for this purpose.

To qualify for a reverse mortgage, you must be at least 62 years old and own your own home. There is no income or medical requirements to qualify. You may be eligible for a reverse mortgage even if you still owe money on a first or second mortgage. In fact, many seniors get a reverse mortgage to pay off a first mortgage.

Options on How to Receive Money from a Reverse Mortgage.

All at once (lump sum)
Fixed monthly payments (for up to life)
A line of credit
A combination of these
The most popular option - chosen by more than 60% of borrowers - is the line of credit, which allows you to draw on the loan proceeds at any time

The size of the reverse mortgage you can receive depends on:

Your age at the time you apply for the loan
The type of reverse mortgage you choose
The value of your home
Current interest rates
And - sometimes - where you live.

In general, the older you are and the more valuable your home (and the less you owe on your home), the larger the reverse mortgage can be.

What Costs are Associated With a Reverse Mortgage?

They include the origination fee (which can be financed as part of the mortgage), an appraisal fee, and other charges similar to those for regular mortgages.

The money provided to you from a reverse mortgage is tax-free, and does not affect regular Social Security or Medicare benefits. However, the funds received from a reverse mortgage may affect your eligibility for certain kinds of government assistance, such as Medicaid or state assistance programs. So, you should check into this before getting a reverse mortgage. To do this, you may wish to consult with your local Area Agency on Aging (to locate, call 1-800-677-1116, or visit www.www.eldercare.gov), a reverse mortgage lender, or a tax attorney.

How Do I Begin the Process?

Before applying for a reverse mortgage, you must first meet with a reverse mortgage counselor. You may, however, first approach a reverse mortgage lender, who can provide you with the names of approved counseling agencies in your area. A list of approved counseling agencies nationwide is posted on the Internet by the U.S. Department of Housing and Urban Development. www.hud.gov

The counselor will educate you about reverse mortgages, and inform you of other alternative options given your situation, as well as assist you in determining which particular reverse mortgage product best fits your needs.

No payments are due on a reverse mortgage while it is outstanding. The loan becomes due and payable when you cease to occupy your home as a principal residence. This can occur if you (the last remaining spouse, in cases of couples) pass away, sell the home, or permanently move out.

Where can I get a Reverse Mortgage?

They are offered by banks, mortgage companies, and other financial institutions.

In the U.S., the most popular reverse mortgage is the federally-insured reverse mortgage, called the FHA Home Equity Conversion Mortgage Program (HECM). The other major product is the Home Keeper reverse mortgage, developed in the mid-1990s by Fannie Mae, a private national mortgage company. One "jumbo" private reverse mortgage product, designed to accommodate seniors living in higher-priced homes, is offered by Financial Freedom Senior Funding Corp. of Irvine, CA. This is the Cash Account Plan. The HECM and Home Keeper products are available in every state, while Financial Freedom's product is offered in 21 states and the District of Columbia.

Purchasing a Second Home

Purchasing a Second Home:

There's a growing trend among late baby boomers and young seniors who are experiencing empty nest to invest in second homes that serve as a getaway, an investment and as well as a possible new permanent residence down the road.

Making An Investment: For many Americans, investing means real estate. For many late age boomers and young seniors, this includes purchasing a second home. This could be:

Vacation getaway
An income property
A second residence

Today, these options are increasingly becoming one in the same as they provide numerous opportunities for the owners to reap a multitude of benefits over time.

With today's growing population of aging baby-boomers who are retiring with record levels of equity income, tax-free profits of up to a half million dollars from the sale of homes, poor performing stock investments, many homeowners aged 46 to 65 are seeking the security of reclusive retreats and viewing them as great investments as well as wise lifestyle choices.

You are not Alone. The facts are:

Over half of all second-home owners consider their second home as a family retreat.
One in six second-home owners over 55 plans to make their second home their primary residence after retirement.


Picking The Right Property:

The trend today is to locate property and areas where the pursuit of an active recreational lifestyle is abundant and where the property can also be shared by and with children, many of whom are young adults and or young, married and with rowing families. The critical lure to certain areas are driven by proximity of family and secondly by desired activities that rank in this descending order of needs:

Beach/Lake and or Water Sports
Boating
Hunting/Fishing
Golfing
Winter Recreation
Shopping
Exercising
Biking Hiking Horseback riding
Tennis

If you are interested in learning more, or would just like to talk about any of the above, please feel free to contact me at any of the contact information provided bellow. It would be a pleasure to hear from you.

Very Truly Yours,

Paul C. Ryan, CRS, e-PRO, GRI
Broker – Owner
Ryan & Associates Realty
San Francisco, California
(415) 584-6160
www.sfproperties.net
ryanre@pacbell.net