Month: April 2024

Caring for a loved one with dementia can be rewarding, but it has its challenges. Knowing what to do after a dementia diagnosis can be daunting, and before you can take care of other people, you have to take care of yourself. Dementia caregiver support groups can help you connect with others in similar situations and receive additional support. It can be therapeutic to know that you aren’t alone and talk about improving your and your loved one’s quality of life. Here, we discuss several ways to participate in dementia caregiver support groups that fit your family’s needs and schedule so you can care for your loved one while receiving the support you need. 

In-person dementia caregiver support groups

In-person support groups allow you to talk to like-minded people face-to-face, which can help you feel more connected to others going through the same difficult situation. These meetings may appeal to someone who likes to get out of the house and socialize. Caring for others, especially in a home setting, can be lonely for everyone involved. Getting out of the house to attend a meeting in person can help alleviate the feelings of isolation. 

If you’re unsure how to find a local in-person dementia caregiver support group, you can start on the Alzheimer’s Association website, where you can search by your zip code to find a support group in your area. Trained individuals lead all groups. You can also search for local Alzheimer’s Association support groups using the Community Resource Finder.

Virtual or video conference meetings

While some prefer in-person support groups, others may benefit from virtual or video conference meetings. These online meetings occur on the telephone or via video conferencing apps like Zoom or Skype, which may be helpful to people with scheduling constraints or who cannot find an in-person support group in their area. Some conferences hold informative workshops and presentations to help you learn more about how to take better care of your loved one and yourself. 

You can attend these support groups from the comfort of your own home. A virtual or video conference meeting is great for those seeking more information on how to improve care for themselves and their loved ones but who face time or geographical limitations. 

The Alzheimer’s Association facilitates virtual support groups in addition to the in-person meetings mentioned above. The Alzheimer’s Foundation of America also hosts regular telephone and Zoom meetings for caregivers and loved ones of those living with dementia.

Peer-to-peer dementia caregiver support groups

If you enjoy the feeling of community, a peer-to-peer support group may be for you. In peer-to-peer meetings, you gather with other individuals going through similar situations. A trained peer support specialist typically oversees these meetings, but the attendees run the meeting. Here, you will offer support to other caregivers and discuss personal experiences, struggles, and challenges. 

Some meetings you might find via the sources above may be peer-to-peer groups. If this is your preference, check with the meeting you choose to see if it’s the right fit. The Family Caregiver Alliance also runs an unmoderated email-format support group for caregivers and loved ones of people living with dementia.

Professionally led meetings

Some people prefer a guided hand when it comes to support groups. When your support group is led by a professional, they can direct the conversation and offer insight. They are trained to offer compassion, build confidence, and provide guidance and information to the caregivers attending the meetings. 

Professionally led meetings can also help connect the attendees to formal services, resources, and referrals if needed. The professional group leader can help resolve any conflict that may arise in the group and keep the group on track when discussing specific topics. 

Some of the groups you might find using the above resources may be led by professionals. If you would prefer to attend dementia caregiver support groups led by professionals, you should check with the meeting host to see if it suits your needs.

Online communities and message board groups

Talking about your feelings can be difficult. Not everyone enjoys talking about their feelings aloud, whether in person or over video chat, and some may struggle to speak in front of large groups. Utilizing an online community or message board group can help even the shyest individuals reach out and gain support from a like-minded community. 

An added benefit of an online community or message board is that you can talk, chat, and contribute on your own time. There is no designated meeting time, so you can add your experience, struggles, and challenges as little or as often as you like. You can do this anywhere at any time, as there is no need to be in a quiet, isolated location. 

Memory People is a Facebook group that, while private, is open to anyone who would like to join. This group focuses on the reality of a dementia diagnosis and offers a space for support and advice for anyone affected by Alzheimer’s or dementia, including caregivers.

Support groups for caregivers of people with specific types of dementia

Dementia is an umbrella term for the loss of cognitive abilities such as memory, language, problem-solving, and other thinking abilities. While many people can experience these symptoms from something as average as the aging process, there are more specific types of dementia that require advanced care, such as Lewy body dementia. 

Specific types of dementia can come with their own sets of problems that other caregivers may not relate to. Finding a support group for your loved one’s specific type of dementia can help you feel seen and connected to others, as they will likely know more about what you’re going through than others. 

You can search online to find a support group that focuses on specific types of dementia. For example, the Lewy Body Dementia Association allows you to search its website for local support groups for caregivers and loved ones of people with Lewy body dementia. 

How to choose a dementia caregiver support group

It can be difficult to decide what type of support group to attend, especially when you have caregiving and other life responsibilities. Here are a few questions you can ask yourself to help determine which type of group is best for you:

• Can you attend meetings at a specific time each week or month? This will help determine whether a scheduled in-person, virtual, or phone support group can work for you. Remember that you may not have to attend every meeting, but your schedule may need to be reliable enough to attend as regularly as would benefit you. If not, consider message boards or groups on social media platforms, which allow for 24/7 access to support and messages.
• Do you thrive on talking face-to-face with people? An in-person support group could be helpful if you are a people person or want to get out of the house and into a different environment. If not, you may benefit just as well from virtual or message board groups.
• Would you prefer talking with people whose loved ones have the same type of dementia? If you feel you would get the most out of a support group of people who are dealing with caring for someone with the same type of dementia, such as Alzheimer’s or Lewy body, then you might want to look for a support group for those caregivers. Remember, though, that it’s not necessary: Dementia is a broad term for many types of conditions, so hearing different stories can be beneficial as well.

Finding a support group that can help you through this challenging time can be a great benefit to your mental health. Some caregivers may want a place to get tips and advice on coping with caregiving duties. Others may want to vent their frustrations. At the root of it all, if you’re looking for a support group, you likely want to feel less alone. Caregiving can be lonely, even when you have family members and health care providers around you. If you’re the primary caregiver, you may simply want to feel cared for yourself. In that case, realize that just about any support group you choose will help because it’s full of other caregivers who want the same connection.

If you’re covered by Medicare or soon will be, you may have noticed that you can still be responsible for some significant charges even with the coverage Medicare offers. Some health care services could be cost-prohibitive with these out-of-pocket costs. This is where a Medicare Supplement Insurance (i.e., Medigap) policy can help. It is important to understand what Medigap is, what these plans cover, and how much they cost to help you determine whether you need the additional supplemental coverage.

What is Medigap?

Medicare Supplement Insurance helps fill in many of the out-of-pocket costs, or “gaps,” in original Medicare (Parts A and B) coverage, such as copayments, coinsurance, and deductibles. This is why Medicare Supplement Insurance is often called “Medigap.” Medigap plans can help with hospitalization deductibles and skilled nursing facility (SNF) expenses, among other costs, depending on the plan. Private health insurance companies sell Medigap policies to help cover some out-of-pocket costs not covered by original Medicare.

It is important to keep in mind that while their names sound similar, Medicare Supplement and Medicare Advantage are not the same. Medicare Advantage — also known as Medicare Part C — is an alternative to receiving original Medicare Part A and Part B benefits. Medicare Advantage plans may also cover additional benefits not covered by original Medicare, such as vision and dental care. Many Medicare Advantage plans also include prescription drug coverage. (Those enrolled in original Medicare must purchase prescription drug coverage separately through a Medicare Part D plan.) 

Private insurance companies sell Medicare Advantage plans. Those enrolled in Medicare Advantage may not also have Medicare Supplement Insurance; Medigap is available only to those on original Medicare. 

What do Medigap plans cover?

There are ten different Medicare Supplement Insurance plans to choose from (in 2024). These plans are each referred to by a letter of the alphabet, with Medigap Plan A offering the most basic set of benefits. 

All Medigap plans cover some or all of Medicare Part A coinsurance and hospital costs for an additional 365 days after original Medicare hospital benefits are used up. They all also offer coverage for Medicare Part B coinsurance or copays, blood (first 3 pints), and Part A hospice care coinsurance or copays. 

Some Medigap plans also cover skilled nursing facility coinsurance, Medicare Part A deductibles, Medicare Part B deductibles, Part B excess charges, and emergencies during foreign travel.

As an example, Medicare Part A pays very little — if anything — for skilled nursing facility care. Even if you qualify for coverage, costly out-of-pocket charges could exceed $16,000 in just the first 100 days ($204 per day ✕ 80 days = $16,320).

Medicare skilled nursing facility coinsurance (in 2024)

Some Medigap plans cover some or all skilled nursing facility coinsurance charges, which can add up quickly. This coverage could save you a lot of money

In some states, you may be able to purchase another type of Medicare Supplement policy called Medicare SELECT. These plans require insured individuals to use specific hospitals and, in some cases, specific doctors (other than in emergencies) to be eligible for full benefits. In return for these restrictions, the plan may charge lower premiums.

How much do Medigap plans cost?

The cost of Medicare Supplement plans can vary widely depending on which option you choose and where you purchase it. For example, Medicare Supplement Plan A typically costs less than Medicare Supplement Plan F because the latter covers more benefits. 

It is important to note that all Medigap plans of the same letter must provide the same benefit structure, no matter which insurance carrier offers them. So, for instance, all Medigap Plan C policies cover the same list of benefits, regardless of where the plan is purchased. However, the premium could differ from one insurance company to another, so it is critical to compare the cost of Medigap plans from several different carriers before you commit to one. 

When can I sign up for a Medigap plan?

Generally, you can sign up for a Medicare Supplement plan during your Medigap open enrollment period, the six-month window when you turn 65 and initially get Medicare Parts A and B. 

The Medigap open enrollment period begins the first month you have Medicare Part B coverage. During this time, you may enroll in Medicare Supplement Insurance without going through the medical underwriting process. You could keep your Medigap premium cost down by purchasing a plan during this initial eligibility window because insurance carriers are not allowed to conduct medical underwriting and in turn charge higher premiums for those with adverse health issues. You also will not be denied for a plan.

However, if you wait to sign up for Medigap until after your open enrollment period for Medicare Supplement has ended, you could pay a higher premium or even be denied for a plan altogether due to preexisting conditions. 

How can I find a Medigap plan in my area?

If you are turning 65 soon or are already enrolled in original Medicare but do not have Medicare Supplement Insurance, you can find a Medigap plan in your area by searching for your zip code on Medicare.gov. 

You can also research private insurance companies that offer this type of coverage. Plans may also be offered through various organizations, like AARP. For example, for the AARP Medigap plan — underwritten by UnitedHealthcare — you can enter your zip code on AARP’s website and find more details about the available plans and their premium costs. 

Because there are many different Medigap plan options, it can help if you discuss your specific health care coverage needs with a professional who can assist you with finding the best option for you.

Even with the coverage that original Medicare offers, individuals may find themselves owing high out-of-pocket costs for their health care. Medigap plans can alleviate some of these costs. By researching the different Medigap plans available, you can potentially lower some costs and avoid any surprisingly large medical bills.

Nursing home care is expensive, with the cost reaching $100,000 or more per year in some areas of the U.S. When assets run out, it may be necessary to turn to government programs like Medicaid to help pay for care. Because qualifying for Medicaid requires an individual to have low income and few assets, many people have concerns about what will happen to their assets, income, and property — particularly when one spouse goes to a nursing home and the other lives at home. So, what happens when one spouse goes to a nursing home that is paid for by Medicaid?

Here, we briefly go over what Medicaid is and how it helps people pay for nursing home care. Then, we explain what to anticipate if one spouse must apply for Medicaid nursing home benefits and how it can impact the healthy spouse, too.

What is Medicaid?

Medicaid is a program run jointly by the federal and state governments that provides health care and long-term care services for people with low incomes. While the federal government is responsible for the overall supervision of Medicaid, each state’s government has wide latitude in running its Medicaid programs. Applicants must meet certain financial requirements to qualify. These requirements can differ from state to state, but they typically require a person to have low income and dollar amount of countable assets in order to be eligible to receive benefits.

Note that while the names sound similar, Medicaid is not the same as Medicare. While Medicaid exists to provide coverage to people with low incomes, Medicare provides health insurance coverage to people age 65 and over and individuals under age 65 with certain disabilities regardless of income and asset levels. Medicare pays very little (if anything) for long-term care services, covering only medically necessary services and only for a limited time.

Financial considerations when qualifying for Medicaid nursing home benefits

Medicaid may cover the cost of nursing home care if the person meets financial eligibility requirements and needs a nursing home level of care. Financial eligibility for Medicaid can differ from state to state. Generally, the program takes several factors into consideration, including:

• Cash, including savings and other assets.
• Social Security benefits.
• Veterans benefits.
• Employment wages.
• Pension payments.
• Interest/dividend income.

The individual may keep assets considered exempt, such as a small cash allowance, a vehicle for personal use, and a prepaid funeral.

If an individual is currently receiving Medicaid benefits for health care services or meets the criteria for eligibility for nursing home coverage based on health and financial factors, coverage is generally effective either on the date of Medicaid application or on the first day of the month of application.

On the other hand, if an individual is not currently receiving Medicaid or cannot yet qualify due to their current income and assets, they may be required to “spend down” before qualifying for Medicaid’s nursing home benefits. This means paying for their own care out of pocket until their assets have been spent down to a level that meets their state’s eligibility threshold. Assets and income must be spent on care and necessary items, though, as Medicaid prohibits gifting.

What happens when one spouse goes to a nursing home and needs Medicaid coverage

The qualification criteria can also differ somewhat based on whether an individual is single or married. The asset limits are higher for spouses than for single individuals if one spouse is applying for Medicaid and the other is not. In this instance, in most states, the at-home spouse is permitted up to $154,140 in countable assets (in 2024). This is in addition to the assets the spouse in the nursing home is allowed to keep.

With a married couple, all countable assets are considered jointly held, and therefore, they are available to be spent on the institutionalized spouse’s care, subject to certain spousal allowance limits. It does not matter if the funds are held in a joint account or in separate accounts with only one spouse’s name. All the accounts will be considered.  

The healthy spouse’s assets are considered countable, even if there is a premarital agreement or they were never contributed to by the spouse in the nursing home. However, spousal impoverishment provisions allow the healthy spouse to retain a certain amount of assets and income.

With married couples, qualifying for Medicaid’s nursing home coverage can impact both spouses — not just the one who needs care — with regard to income and assets, including the couple’s home. Therefore, items to consider when one spouse needs Medicaid nursing home benefits include:

• Expenses of the stay-at-home spouse.
• Other individuals residing in the couple’s home.
• Future potential health care and long-term care needs of the healthy spouse.

Medicaid estate recovery

Another item to be mindful of when a spouse (or other loved one) has their nursing home care paid for by Medicaid is estate recovery. This refers to the process of state governments recouping money that the Medicaid program spent on care for the recipient if they are permanently institutionalized or after they have passed away.

If there is money in the recipient’s estate after they pass away, the state may attempt to recover the cost of care from there. For example, the state could place a lien on the individual’s home or other property to ensure the satisfaction of the “debt.”

It is important to note, though, that if the individual’s surviving spouse still resides in the home, it will be exempt from the estate recovery process. However, if the stay-at-home spouse passes away first, then Medicaid may require that the home be sold to pay the expenses of the spouse in the nursing home. Once these funds have been spent down, this spouse may reapply for Medicaid. 

Where to go from here

Medicaid planning — including spend-down strategies — can be complex. It is important to have a good understanding of how the process works as well as resources to access, such as a Medicaid planner or an elder law attorney, if you have additional questions or concerns as you move forward. Knowing what happens when one spouse goes to a nursing home and the other does can help prepare you for what you need to do to to ensure your spouse gets the coverage and care they need.

State Health Insurance Assistance Programs (SHIPs) help people understand Medicare, Medicaid, and state and federal assistance programs for seniors. These programs are complex, and people often need help understanding the programs and coverage that can help them with their needs. Every state has a State Health Insurance Assistance Program, which is a free resource to help people learn how to make the most of these programs. Here, we’ll explain what SHIPs do and how they can help you understand the insurance and financial options that are available to you that can help cover living expenses and medical costs.

SHIP was created through the Omnibus Budget Reconciliation Act of 1990. Under this law, the Centers for Medicare and Medicaid Services was allotted money to create health insurance advisory programs in every state and U.S. territory. States may refer to their programs differently, but each state has one. 

SHIP’s main purpose is to ensure that Medicare-eligible seniors understand the benefits they might have access to and to educate seniors, their families, and their caretakers about how to start receiving Medicare benefits.

What services do State Health Insurance Assistance Programs provide?

SHIP offers Medicare counseling to people who are or soon will be eligible for Medicare. Family members and caregivers can use SHIP services to help their loved ones understand how to apply for Medicare and receive health insurance coverage.

SHIP counselors are trained to assist Medicare beneficiaries. Every counselor is required to participate in an extensive 8-to-10-hour training process. SHIP counselors have been trained to help seniors understand different components of Medicare, including:

• How to enroll in Medicare benefits.
• Medicare terms and options for coverage.
• What Medicare does and does not cover.
• The ins and outs of Medicare Parts A, B, C, and D, Medigap, and other supplemental insurance benefits.
• Medicare enrollment penalties.
• The appeals process.
• Medicare Savings Programs.
• Extra Help (or Low-Income Subsidy) program.
• Long-term care insurance coverage options.

Depending on your need, a SHIP counselor might refer you to Medicaid offices or the Social Security Administration to pursue additional benefits.

SHIP counselors also participate in outreach programs that notify people who could potentially benefit from the service. SHIP outreach programs can include:

• Community events.
• Health fairs.
• Senior fairs.
• Informative presentations to seniors, their families, and their caregivers.

What State Health Insurance Assistance Programs can’t do

SHIP offers counseling about health insurance, but it does not offer medical insurance coverage. Working with SHIP does not mean you are enrolling in a health insurance program. SHIP also does not enroll seniors in Medicare. SHIP’s services are limited to helping seniors and their caretakers understand Medicare and their options for health care coverage.

When to use your State Health Insurance Assistance Program

SHIP was established to assist seniors who are approaching a significant milestone in their lives. Many people who use SHIP’s services are at retirement age and need to understand their options for health care coverage. Below are a few scenarios in which you might benefit from the services SHIP offers.

Getting help with Medicare open enrollment

The Medicare open enrollment period (which runs annually from October 15 to December 7) can be confusing for someone applying for Medicare. SHIP counselors offer help by hosting seminars where seniors and their families can get individualized counseling and answers to their questions. 

Appealing a Medicare denial

SHIP helps seniors understand their right to appeal a Medicare denial. Not complying with Medicare appellate procedures can result in you losing your right to receive benefits. SHIP can connect you with a trained counselor who can provide one-on-one counseling services if you find yourself in the appeals process. 

Getting financial assistance

Lower-income seniors might have special offers regarding Medicare enrollment. Depending on your income, you might be eligible for the Extra Help program from Medicare to help pay for prescription drugs, for example. A SHIP counselor can evaluate the situation and help you determine if you are eligible. SHIP can also help with any recertification paperwork.

Prepare to meet with your State Health Insurance Assistance Program counselor

When you speak to a SHIP counselor, they will need some personal information to best serve you. Before contacting a SHIP counselor, be prepared with the following information to get the most out of your initial meeting:

• Medical conditions and medical history.
• Prescription medications.
• Income and asset information.
• Medicare card (if you are currently enrolled).
• Information about other health insurance you might carry.

How to find your local State Health Insurance Assistance Program

SHIP offices are located in all U.S. states and territories, including Puerto Rico, Guam, the U.S. Virgin Islands, and the District of Columbia. The official name for your area’s SHIP services may differ. You can find a local SHIP counseling service by visiting shiphelp.org. Click on “Find Local Medicare Help” in the top right corner and follow the link to the office in your state or U.S. territory. You can also get help finding your local SHIP by calling the national hotline at 1-877-839-2675. 

Understanding your health insurance options and services can be difficult, as the topics are complex. State Health Insurance Assistance Programs are there to get you help with the nuances of Medicare and other resources that may be available to you. With the help of trained counselors, you can be sure you are making the most out of these resources.

Mental health issues affect almost half of all military Veterans, making access to mental health services a true necessity. Senior Veterans are not excluded from those who face mental health challenges, as they also contend with issues that can come with the aging process. The Department of Veterans Affairs (VA) offers mental health services to support Veterans’ mental health, serving 1.7 million Veterans in 2023. Here, we’ll describe some of the common mental health issues that senior Veterans face, some of VA’s helpful programs, and how to get started. 

Common senior Veteran mental health challenges 

The majority of people experience mental health challenges at some point in their lives. However, senior Veterans’ mental health crises can look a bit different. Some common mental health challenges among senior Veterans can include but are not limited to:

• Depression.
• Anxiety.
• Grief.
• Post-traumatic stress disorder, or PTSD.
• Effects of exposure to hazardous materials.
• Substance use disorder.
• Suicide.

Although many Veterans experience the aforementioned mental health challenges, senior Veterans can experience them on a different level. The impact of their service-related mental health challenges can be exacerbated by the physical and cognitive changes that come with aging. Even when receiving help from home care services or moving to a senior living community, past experience with military-related situations can significantly alter mental health and day-to-day functioning. 

Considering all the factors that affect the mental health of senior Veterans, VA has developed mental health services to help those who may face the emotional challenges of aging and of having served in the military. Below are some mental health resources offered by VA.

VA mental health services

VA provides mental health services for a variety of psychological needs that Veterans may have. There are opportunities through peer support, individual and group counseling, therapy, medication, or a combination to assist Veterans with addressing their mental health challenges and enabling them to improve their quality of life. Veterans may be able to use some services even if they’re not enrolled in VA health care.

In addition to the traditional services mentioned above, VA offers various virtual tools and services to supplement the Veteran’s mental health care plan or to provide alternatives to those who may not be able to access help in person. Below, we discuss some of the other resources available to Veterans struggling with mental health challenges.

Veteran Training online self-help portal 

If the senior Veteran can utilize online services, the Veteran Training online self-help portal is an excellent resource for improving mental health. Self-help can be a great way to boost mood and self-esteem and give purpose. The portal provides easy access to helpful information and can be utilized from the comfort of home.

The VA Veteran Training website offers a variety of useful programs, including courses on the following: 

• Sleep issues.
• Anger management.
• Problem-solving skills.
• Moving forward.
• Recovery plans.

These self-help courses can greatly improve the Veteran’s overall well-being. Veterans of any age can utilize this service.  

VA telehealth for mental health services

Telehealth is an innovative strategy that can reach seniors wherever and whenever needed. VA offers telehealth services for senior Veterans who need quick access to mental health services from the comfort of their homes. 

Veterans can access high-quality mental health care from any location, including home, the clinic, or the hospital. You will meet virtually with your VA provider and connect with specialists to collaborate and improve your mental health. To access these services, locate your nearest VA center and see if they offer in-network community care providers in your area. 

Mental health apps for Veterans 

VA has developed a variety of mental health apps designed specifically for Veterans. Some Veterans may not feel comfortable openly discussing their thoughts and feelings with a professional; therefore, mental wellness apps may be a good alternative, although it’s important to note that they cannot replace the level of care and support they would receive from a mental health professional.  

Veterans mental health apps include but are not limited to the following: 

• ACT (Acceptance and Commitment Therapy) Coach offers exercises, tools, and information to help Veterans “live with unpleasant thoughts, feelings, and impulses without avoiding them or being controlled by them.”
• AIMS (Anger and Irritability Management Skills) for Anger Management provides tools and information for people coping with anger issues.
• Annie for Veterans gives automated text message reminders for a Veteran’s self-care.
• Beyond MST (Military Sexual Trauma) provides tools and features to support survivors of military sexual trauma. 
• CBT-i (Cognitive Behavioral Therapy for Insomnia) Coach is an app that supplements the care of someone receiving cognitive behavioral therapy for insomnia. 

These apps are effective and easy to use. Simply visit the VA app store website to see all the available mental health apps. 

PTSD treatment programs

Post-traumatic stress disorder (PTSD) can be a serious mental health issue. Studies have shown that older adult Veterans seek help coping with PTSD less often than other age groups due to a stigma around facing mental health challenges. Still, there are resources to help older adults coping with PTSD. Though an older adult Veteran can seek help through a therapist on their own, VA also offers PTSD treatment programs through all VA medical centers.

Most Veterans can qualify to receive treatment in a local program. The services include individual mental health assessments, medications, and individual, family, and group therapy. Veterans can also receive therapy with other Veterans who experienced similar conflicts or trauma.

The first step to getting involved with these programs is to use the VA services locator or call VA’s Health Benefits Hotline at 1-877-222-VETS (8387) to find local services.

How to get started with VA mental health services 

Mental health should always be prioritized — especially for military Veterans who may experience mental health issues exacerbated by their military service. If you or a loved one is a senior Veteran and requires mental health services, the resources mentioned above can provide you with the peace of mind you deserve. 

If a senior Veteran is struggling with anger, has trouble sleeping, or is readjusting to life outside the military, these VA services can be life-changing and lifesaving. From peer support groups to one-on-one counseling to online self-help tools, these resources can help improve the Veteran’s mental health, thus offering a better quality of life. 

If you are interested in these services, contact your local VA medical center to discuss your mental health care needs. Please note that these services may still be available even if the senior Veteran isn’t enrolled in a VA health care plan. 

As older couples age, their long-term care needs often differ. These situations can be hard to navigate, especially when one partner requires significantly more assistance than the other. When that happens, exploring various senior living options, including assisted living, is essential to ensure both receive the care and support they need. Read on to explore ways assisted living helps couples navigate the senior living landscape, including situations when each partner’s needs vary.

What is assisted living?

Assisted living is a residential living arrangement for seniors who require assistance with activities of daily living (ADLs) but do not need the skilled medical care that nursing homes provide. Unlike independent living communities, which don’t provide personal care support, assisted living communities offer a combination of housing, personalized support, activities, and health care services to promote resident independence and enhance their quality of life. Couples may find that assisted living can be a great senior living solution, especially when one or both people need help with activities of daily living, such as bathing, dressing, feeding, transferring from one position to another, or moving around.

How does assisted living help couples with different care needs?

When one partner requires a higher level of care than the other, assisted living communities offer customized solutions to address the couple’s unique needs. Here are some of the ways providers address the different care needs of assisted living couples: 

Individualized care plans

Based on an initial assessment, assisted living communities create personalized care plans for each resident to address their needs and preferences. This process allows couples with varying care needs to receive support tailored to each partner’s unique requirements.

Specialized services

When one partner requires a higher level of care, assisted living communities can provide specialized services, such as memory care or dietary assistance, to meet their specific needs. This customized approach ensures both individuals receive the appropriate level of support while living together in the same community.

Care coordination

Assisted living communities often employ or partner with specialists, including care managers and social workers, who can coordinate care services for couples with different needs. These staff members can help schedule appointments, communicate with health care providers, and perform various other duties, ensuring that both individuals receive the care and support they need.

Flexible living arrangements

Many assisted living providers offer different housing options to accommodate couples with varying care needs. For example, couples may choose to live together in a shared apartment or separately in another apartment within the same community, empowering each to receive individualized care services based on their specific requirements.

Respite care services

Assisted living communities may also provide respite services for couples with different care needs. Respite care allows one partner to receive temporary care and support, for example during an illness or recovery, while the other partner continues to live in the apartment and receive their usual level of care and support.

Supportive environment

Assisted living communities promote independence, social connection, and inclusion for all residents. This supportive environment can be notably beneficial for couples with different care needs, allowing each partner to take advantage of various activities, services, and amenities within the community while maintaining their relationship and quality of life. 

Basic services at assisted living that help all couples

For a monthly fee, assisted living communities cater to seniors, including couples, who wish to remain independent but may require minimal daily living assistance. In addition to an apartment, that monthly fee typically covers these basic services for residents: 

• Personal care assistance: Assistance with ADLs, such as bathing, dressing, grooming, and medication management.
• Meal services: Nutritious meals prepared and served in a communal dining area.
• Housekeeping: Assistance with maintaining a clean and tidy living space. Note that some providers charge extra for some of these services at some facilities. For example, laundry may have a per-load or per-month cost.
• Transportation: Scheduled transportation for medical appointments, shopping, and social outings.
• Social and recreational activities: Opportunities for social engagement, exercise, entertainment, and community involvement.
• 24-hour security and emergency response: Continuously ensured safety and well-being of residents.

Cost considerations for assisted living couples with different care needs

Addressing a couple’s differing assisted living care needs can impact the overall cost of their living arrangements. An assisted living community’s pricing structure is typically based on each resident’s level of care and required services. When one partner needs a higher level of care, such as specialized medical services or additional daily living assistance, the cost of their care may be higher than that of the partner who requires less intensive support.

Additionally, couples may have the option to choose different accommodation types within the assisted living community based on their individual care needs. For example, one partner may opt for an apartment with around-the-clock care and support while the other may choose a standard unit with basic living assistance. In this scenario, the first partner’s monthly bill will probably be higher than their partner’s.

Because these housing and care options can affect the overall cost of assisted living, couples with differing care needs must carefully consider the financial implications before signing on the dotted line. Seniors should always discuss their living options with others, including family members, an attorney, or a financial advisor, before making such a life-changing decision.

Final thoughts about assisted living couples with different care needs

As one possible long-term care solution, assisted living can be a viable option for couples with different care needs, offering a range of services and support to meet the requirements of each partner. Choosing an assisted living provider that can accommodate varying levels of care empowers couples to stay together in a supportive and inclusive environment — one where they can receive the professional assistance they need to maintain their quality of life with dignity and respect. 

Finding an assisted living community that can cater to the unique care needs of couples is essential for ensuring a comfortable and fulfilling living experience for both partners. Researching each community’s services, support, and cost structure empowers older couples to make better-informed senior living decisions, promoting their health, happiness, and independence as they age gracefully together in their new home.

It is common for one spouse to have different care needs from the other as they age. Figuring out how to get services for each person can be challenging because long-term care options may involve moving to a residential facility, and all options have significant costs. Sometimes the couple has time to determine the best choice for their situation, and sometimes an injury or unexpected circumstance requires the couple to make a choice quickly. In either case, there is a solution for every couple. Here, we offer factors to consider when deciding and options for getting the care you and your partner need.

What type of help does each spouse need?

The first consideration for a couple deciding on long-term care is the level of care needed for both people. The difference between their needs may be small or large, which will determine where the couple lives and whether they can remain together. For example, if one person is healthy and the other has Alzheimer’s disease or another form of dementia, there may come a point when they need memory care. While some facilities allow couples to live in memory care together, it’s not always allowed or even advisable.

On the other hand, if the couple’s care needs are closer together, for example with one needing help with activities of daily living and the other not needing assistance, they may be able to remain in the home together with the help of home care services or they may move to assisted living together, depending on the facility’s guidelines.

Decide whether it’s possible to remain living together

The couple must also consider each other’s wishes while keeping in mind that the ideal scenario might not be available. Their biggest desire may be to remain together, and this could be possible depending on the long-term care setting necessary for the person with higher care needs. It also may be possible that one wishes to remain in the home even if the other must move to a facility to receive the care they need. 

It could be possible to remain living together if home care services can meet the needs of the spouse who needs a higher level of care. Typically, home care providers are with their clients for a few hours per day. If the spouse needs round-the-clock assistance, the cost of 24-hour home care may be so great that the couple needs to consider another option that requires one spouse (or both) to move to a long-term care facility.

Estimate how long you or your spouse needs long-term care

When considering long-term care options, you should consider how long you or your spouse will need care. For example, if you are confident that your or your spouse’s care needs are temporary, choosing a care option you can easily change may make sense. You might use a combination of home health and home care at your residence to get the care needed without moving into a facility. If you or your spouse eventually requires a higher level of care than can be provided at home or if your care needs are more permanent, you could consider assisted living for one or both of you.

Assess your household’s financial situation

Financial constraints can limit your options, especially because long-term care can be expensive. Your financial situation will likely be a large part of your decision about long-term care and may dictate where you can receive this care and whether both people in the couple can move to long-term care together. 

Also, if one spouse needs care while the other doesn’t necessarily need the help, the couple may need to move to assisted living (even when one spouse doesn’t need care) so the couple’s home can be rented or sold to help pay for the care. If you need to move right away, you can also use financial products like a bridge loan to help pay for care while you wait for your home to sell.

Determine each partner’s caregiving capacity

A common dilemma is when one partner overextends themself while caring for the other, whether at home or in the same apartment in assisted living. When this happens, it can result in caregiver burnout and significantly affect the caregiver’s physical and mental health. Separation during recovery or even in long-term care may be best for the caregiver’s health and well-being while the other partner gets the assistance they need.

Even if the couple can continue to live together, getting the right care for the spouse who needs assistance can positively impact the mental and physical well-being of the healthier spouse and the relationship itself.

Find out how much family members and friends can help

Families often help aging parents by assuming caregiving duties that augment professional support services. If you and your spouse don’t have nearby family or another support system to assist, the partner in need may benefit from a more intensive care setting, especially if one is struggling to care for the other. 

Consider the amount of support your extended family and friends can provide. Hiring help or moving to senior living might be necessary if the tasks are too complicated, physically involved, or time-consuming for untrained caregivers to perform. 

Long-term care options for couples

Below are different care options that may suit both of your needs. These senior living options offer flexibility to meet different care needs under one roof.

In-home care

Home care can work well when one or both people have care needs, such as assistance with activities of daily living. One of home care’s advantages is that you can remain in your home as a couple. However, if one person requires intensive nursing, home care will not be adequate, and a higher level of care might be needed. Also, home care can get expensive, depending on the required number of hours of care.

Independent senior living

Independent senior living covers various housing settings, including cottages, free-standing apartment buildings, and independent living in assisted living communities. Some communities will allow a couple to remain in independent living and add additional care services as needed without a move. Other communities will require a move to an assisted living apartment to receive a higher level of care.

Assisted living

Assisted living for one or both people is an option. In most communities, there is a base price with an additional add-on fee for the second person. Other care costs can be split if needs differ significantly. In the case of a tiered system, one person may be at level 4 (higher care needs) while the other is at level 1 (few care needs). Talk with the admissions coordinator to get a good idea of your costs so you can make a prudent decision.

Continuing care retirement community

Continuing care retirement communities (CCRCs) offer a range of care levels on one campus, including independent living, assisted living, memory care, and nursing care. If one of you needs assisted living and the other doesn’t, it may be possible for you to move to assisted living in a CCRC together, or one of you may stay in independent living while the other moves to a higher level of care on the same campus. 

The above senior care options can meet a couple’s varying and evolving needs while they still live together. Though home care and independent living require the individuals to manage the care services on their own, they are realistic solutions to allow each partner in the couple to live safely and comfortably while continuing to live together. While moving to a senior living community like an assisted living or CCRC requires the couple to pack up their belongings and move to a facility, they can continue to live together while having all the care either of them will need and living low-maintenance lives. No one option is the best fit for all couples, so discussing the factors listed above can help determine the best way for individuals to receive the long-term care services they need.

Because long-term care services can be expensive, many people must turn to Medicaid for help paying the tab. Before you can qualify for Medicaid, certain financial criteria must be met. For some, this means having to “spend down” assets to lower their resources to meet Medicaid’s financial requirements. When one spouse needs nursing home care, Medicaid’s spend-down rules can impact both spouses. If your spouse requires nursing home care and is applying for Medicaid, how can you protect the assets you’ve worked so hard to build up?

The good news is that some assets are considered less vulnerable to Medicaid than others. This guide will explain Medicaid’s financial limitations for married couples and provide strategies to protect your assets if your spouse goes to a nursing home.

Medicaid financial requirements

Medicaid is a joint federal and state program providing health care and long-term care services for low-income individuals. While specific criteria must be met to qualify for Medicaid’s nursing home benefits, these can differ from state to state. 

In general, though, an individual — whether single or married — must have insufficient assets to pay for their own care. In some cases, they may have to spend down some assets to qualify. Simply gifting these assets to a loved one, including the healthy spouse, is prohibited. In fact, for married couples, both spouses’ assets are considered, even if they are jointly titled or held only in the healthy spouse’s name. 

Which assets count toward Medicaid eligibility?

For the purpose of spending down assets, Medicaid divides assets into countable (i.e., available) and non-countable (exempt) assets. Countable assets include personal financial resources, such as:

• Cash.
• Stocks, bonds, and other investments.
• Pensions (if the applicant is retired).
• Annuities (if not converted to an income stream).
• Cash-value life insurance (above a stated death benefit amount).
• Investment properties.

A married couple’s primary residence may also be considered countable if the value exceeds a certain amount unless the healthy spouse still lives in the home. 

Non-countable assets are generally not used when determining an individual’s eligibility, so they are typically considered “safe” from Medicaid. These include:

• A small sum of money (or “cash allowance”).
• Some personal items (such as clothing and jewelry).
• A prepaid funeral and burial plot.
• Term life insurance (i.e., death-benefit-only coverage). 
• A vehicle for personal use.
• Property (real or personal) essential to the applicant’s self-support, regardless of its value.

Protections in place for a person whose spouse goes to a nursing home

A healthy spouse can keep half of the couple’s total assets up to a maximum cap, which varies depending on the state. This is referred to as the Community Spouse Resource Allowance, or CSRA.

In addition, Medicaid has a set of spousal impoverishment protections that allow the healthy spouse to keep enough income and assets to live on. For instance, the healthy spouse may keep all their own income, and they may even be allowed to keep some of the other spouse’s income if it is needed for financial support. 

While this monthly maintenance needs allowance varies by state, the federal government has a set minimum and maximum. In 2024, these figures range from a low of $2,465 per month to a high of $3,853.50. Medicaid will also allow for a monthly family income allowance if other family members live in the household. 

Strategies to protect your assets if your spouse goes to a nursing home

A healthy spouse can protect their assets if their spouse moves to a nursing home in a few legitimate and legal ways. Remember that all of these are complex legal and financial matters, and to use the strategies properly, it’s best to work with a licensed expert, like a Medicaid planner or an elder law attorney.

One misconception is that the only way to reduce the value of a Medicaid applicant’s assets is to spend them on their medical care. However, there are actually many ways that assets could be spent that will still allow for Medicaid nursing home coverage eligibility.

For example, in many states, the following are allowable expenditures when spending down assets:

• Payment of legitimate debt.
• Purchase of non-countable assets (such as a new home, a car, and household goods) and payments for these assets.
• Caregiving services (particularly if care at home helps keep the applicant spouse at home or out of a more expensive nursing home facility).

Other ways to protect assets for an individual whose spouse gets Medicaid to pay for nursing home care include: 

• Irrevocable or Medicaid asset protection trusts: In some states, trusts may be used to preserve assets. Any assets over the Medicaid financial limits may be transferred into such a trust. While these trusts may require giving up control of assets, they can still provide a way for the needy spouse to qualify for Medicaid without fully depleting the couple’s entire estate. 
• Transferring the home out of the Medicaid recipient’s name: When the spouse who receives nursing home care passes away, Medicaid may attempt to collect payment from their estate. This process is called estate recovery. One way Medicaid does so is by placing a lien on the surviving spouse’s home. However, if the Medicaid recipient had legally transferred the property out of their name — including into their spouse’s name or an irrevocable trust — before their passing, the house cannot be taken by Medicaid.
• Medicaid annuity: Assets could be used to purchase an annuity designed to comply with Medicaid rules. This can help shield the amount of money contributed to the annuity. 

Paying for nursing home care can be challenging, but Medicaid may be able to help. It is important to remember that Medicaid qualification criteria and resource limitations can differ from one state to another. The Medicaid application and asset protection process can also be complicated. Working with the appropriate professionals, such as Medicaid planning attorneys, elder law attorneys, and estate planners, is a good idea. Otherwise, Medicaid benefits could be delayed or possibly even denied altogether. With the proper knowledge and assistance, you can learn how to protect your assets if your spouse goes to a nursing home.

An Alzheimer’s or dementia diagnosis in a loved one can bring many emotions. Shock and dread are common as families consider an unknown future. Relief is surprisingly frequent, too, as suspicions are confirmed, and it becomes time to take action. Many family members feel confused and overwhelmed, unsure where to start getting their affairs in order. This article will walk you through the next steps now that your loved one has a dementia or Alzheimer’s diagnosis so you can feel confident as you embark upon your journey.

Long-term care planning after a dementia or Alzheimer’s diagnosis

Because dementia worsens over time, patients eventually need long-term care as the disease progresses. Long-term care can be provided in multiple settings. Your loved one can remain living at home for as long as it is safe for them. If they need help, family members can help care for them, or home care services can offer the necessary support. Some home care providers may offer specialized at-home dementia care. When the home care provider is not with your loved one, you can consider adult day care programs or respite care to give family caregivers a break in their caregiving duties.

If your loved one can no longer live at home, moving to a senior living community can allow them to access the care they need. Assisted living can be a good option for a person who may need some help with activities of daily living but can maintain some independence. An adult foster home can offer similar types of support but in a smaller setting than assisted living, which may better suit your loved one’s preferences. A nursing home may be a better fit for a person who needs significant help managing many activities of daily living or chronic medical conditions that require skilled nursing care. 

Some senior living communities offer memory care services, which could be important to your loved one’s care as the disease progresses. These services are catered toward individuals with Alzheimer’s disease or other forms of dementia to meet the specific cognitive, physical, and emotional challenges that come along with the disease. Senior living communities may have memory care wings in the buildings, or you may even find a stand-alone memory care community for your loved one. These communities focus on providing care solely to individuals with memory care needs.

The right option for your family depends on many factors and may change over time.

What to consider in long-term care planning

• Which settings could meet your loved one’s needs for a safe, therapeutic environment with opportunities for social interaction and meaningful activities?
• What kind of at-home Alzheimer’s and dementia care would you need to meet your loved one’s medical and care needs at home? 

Here are some next steps for thinking about long-term care planning

• Learn about your options for memory care.
• Start touring care communities in advance, if possible.
• Evaluate your home safety. Checklists are available online, but a professional assessment may be beneficial.

Health care planning after a dementia or Alzheimer’s diagnosis

Start a conversation about future care wishes as soon as possible after a dementia diagnosis so your loved one can participate to the greatest extent possible. It can feel difficult to talk about, but these conversations bring peace to all involved. As medical events occur and decisions must be made, they’re invaluable to guiding the decision-making process. Resources are available online to help guide these conversations.

What to consider for your health care planning

These decisions are very personal, and your loved one may not have the answers right away. Here are some questions to consider in this decision-making process:

• What makes for a good quality of life?
• What are the goals of care (length of life vs. quality of life)? 
• Which health challenges is your loved one most likely to face in the years to come?
• Would they want CPR, intubation, or other advanced but traumatic lifesaving measures?

Next steps in your health care planning

• Ask your loved one about their wishes for future care. 
• Complete advance directives (living will) and a medical power of attorney.
• Complete HIPAA authorization forms for each health care provider.
• Learn why hospitalization is so hard on people with dementia.
• Learn about medication safety in dementia and how to identify and reduce side effects.
• Learn about fall safety and take steps to reduce the risk of falling.
• Ask the doctor about medical order forms (such as a practitioner order for life-sustaining treatment or a do-not-resuscitate order) if advanced lifesaving measures are not desired.

Legal and financial planning

Your loved one will need support with day-to-day finances and planning for future financial needs. Long-term care expenses can add up, so your loved one will want to ensure they have the funding available to pay for care services they will need in the near future and down the line.

Legal and financial considerations after a dementia or Alzheimer’s diagnosis

Working with your loved one to plan the legal and financial aspects of their future is ideal. Decisions and actions about your loved one’s finances and legal matters are extremely difficult without their signature and consent. It’s important to finalize as many of these documents and decisions as possible. Here are some of the considerations you should take into account when it comes to your loved one’s legal and financial situation:

• What is their financial situation, including income, savings, investments, and debts?
• What financial support might they be eligible for through government benefits?
• If they have long-term care insurance, what limitations exist on their policy?
• What home modifications might be necessary?

Next steps for legal and financial planning

• Establish consent to manage legal and financial affairs with a durable power of attorney for finances (or general durable power of attorney).
• Consult with a long-term care planner to determine your best options for paying for memory care and other needs.
• Learn how to manage money for a person with dementia or hire a professional bill-pay service or money manager.
• Take steps to protect your person from scams and fraud.
• Create a personal care agreement for any caregiving duties.
• Consult with your tax professional regarding tax considerations of caregiving.
• Review life insurance policies and financial accounts and update beneficiaries as needed.
• Ensure a will or trust is complete.
• Make final arrangements for funeral services and cremation or burial.
• Gather important documents in a safe place and ensure a trustworthy person can access them if needed.

Caregiver planning

Planning to become a caregiver is discussed much less often than legal, financial, and advance care planning, but it’s just as important.

Supporting someone with dementia requires more energy as time goes on. At first, they may not need much support. However, it adds up, slowly draining energy reserves. Family members often find they’re sacrificing much more of their needs than they realized to support their loved one and may experience caregiver burnout. 

At the same time, dementia increasingly affects a person’s abilities and behavior, especially when they have unmet needs. It can be hard to tell what someone with dementia needs because communication becomes challenging. Tough emotions and tricky situations become more frequent. Falls, medical events, emergencies, and close calls become more common.

Many family members don’t think of themselves as caregivers until they’re exhausted, and their options are limited. By taking action now, you can drastically alter your caregiving experience (and your loved one’s experience of needing care). It will likely still be challenging — but much less so than stumbling through unprepared. 

Caregiving considerations

• What can be done to ensure everyone’s physical, mental, emotional, and social needs are consistently met over time?

Next steps for caregiver planning

• Develop a good self-care plan that realistically enables you to meet all your needs.
• Learn about behavior and communication in dementia online, in family caregiver training classes, or from a dementia care coach or geriatric care manager.
• Start developing a sound support system of friends and professionals who can provide practical assistance and help you navigate tough times.
• Look into helpful ways to manage sharing caregiving duties with others. Use a care coordination app to share care tasks with others.

As emotionally complex as a new dementia or Alzheimer’s diagnosis can be, experts agree: You’re in a better position now that you know. You’re able to start planning and building support systems. This puts you in a powerful spot. The caregiving journey is a lot different with the right support. Supporting someone with dementia is a marathon, and getting ready for it empowers you to set up a sustainable and rewarding experience.

For most people, rising out of bed and walking to the bathroom to perform their morning routines requires minimal thought and effort. However, for those 65 and over and others with mobility problems, the bathroom can be an intimidating place filled with potential hazards that make getting ready in the morning far from routine. With the help of in-home caregivers, seniors can safely navigate their bathrooms and maintain their independence with renewed confidence. Read on to explore four essential ways professional home care services promote senior bathroom safety, empowering clients to lead more active and fulfilling lives.  

Bathroom safety challenges for older adults

Seniors may encounter numerous challenges while using the bathroom due to age-related physical and cognitive changes. Mobility issues, decreased balance, reduced muscle strength, and vision impairment can make simple tasks like getting in and out of the bathtub or using the toilet difficult and dangerous. Additionally, environmental factors, such as slippery surfaces, sharp corners, trip hazards, and inadequate lighting, can further increase the risk of bathroom falls and accidents.

According to data compiled by the Centers for Disease Control and Prevention (CDC), roughly one in four seniors experience a significant fall annually. A large percentage of those falls occur in their home’s bathroom, resulting in injuries ranging from hip fractures to head contusions. Some seniors never fully recover as a result. Furthermore, a fear of falling can keep seniors from practicing proper hygiene, which can impact their health and well-being. 

What is professional in-home care?

Though some confuse the two, home care and home health care are different types of in-home assistance. Home care involves nonmedical assistance and support that allows seniors to accomplish their aging-in-place goals. Home care agencies employ caregivers trained to assist seniors with activities of daily living (ADLs) in the comfortable and familiar surroundings of their private residences.

In-home caregivers are equipped with the knowledge and skills to address the unique needs of seniors, including bathroom safety concerns. Most home care providers offer a wide range of services, from personal care assistance and medication reminders to companionship and homemaker services, tailored to meet each client’s unique needs and preferences.

How senior home care services promote bathroom safety

While serving as extended support in the home, professional caregivers can help seniors and their families optimize bathroom safety in these ways:

Bathroom safety assessments

In-home caregivers are trained to conduct thorough assessments of the bathroom environment to identify and eliminate potential hazards. Working with family caregivers, they can recommend and implement various bathroom safety modifications, such as installing grab bars, nonslip mats and strips, shower chairs, and raised toilet seats to enhance safety and streamline daily routines.

In-home caregivers can show clients how to create a senior-friendly bathroom environment by improving the lighting, reducing clutter, and removing trip hazards.

Mobility assistance 

In-home caregivers provide hands-on assistance to seniors with mobility issues, empowering them to navigate the bathroom safely and confidently. Depending on the older adult’s needs, caregivers can help clients perform routine bathroom tasks, such as transferring to the toilet or getting in and out of the shower or tub, reducing the risk of falls. In-home caregivers can also help seniors safely get around the bathroom when experiencing medication-related side effects. These essential services can help prevent bathroom emergencies.

Personal care support 

Using individualized care plans, in-home caregivers can assist older adults with various personal care tasks, including bathing, grooming, and toileting. Providing reliable and compassionate one-on-one support allows caregivers to help seniors maintain their daily hygiene routines with dignity and respect.

Emergency response

In-home caregivers are trained to handle emergencies promptly and effectively. They can quickly respond to bathroom accidents or incidents, providing first aid and contacting medical professionals and family members if needed. Home care providers can also deploy advanced in-home medical alert systems, ensuring their clients’ safety throughout the home. 

Final thoughts about how home care improves seniors’ bathroom safety 

The challenges aging-in-place seniors face in the bathroom can limit their lifestyles. However, with the right support, these challenges can be effectively managed, empowering seniors to maintain their independence and quality of life. As one possible senior care option, professional in-home caregivers can significantly enhance senior bathroom safety by providing a safe and supportive environment, allowing seniors to thrive in the comfortable and familiar surroundings of home. 

If you or a loved one is considering home care, start by researching reputable home care agencies nearby to explore the services they offer. When working with a reliable home care provider, seniors and their families can have peace of mind knowing their loved ones are receiving the daily living assistance they need to navigate the bathroom safely. If you or your loved one is facing bathroom safety challenges, consider the many benefits of professional home care services.

Adult Protective Services (APS) is a social services agency that tends to the needs of vulnerable adults. Every state has APS offices, typically run at the local or county level. APS offers invaluable services to the nation’s most easily preyed-upon adult populations, such as older adults and adults with disabilities. The purpose of APS is to protect adults at risk of experiencing different types of neglect or abuse and to ensure they have recourse and a source of relief from these problems. Learn how Adult Protective Services can help vulnerable seniors and adults with disabilities.

What issues can Adult Protective Services help older adults with?

APS helps older adults respond to a variety of issues, including various forms of elder abuse. Unfortunately, the problems explained below are prevalent among senior populations across the country. Some of the most common issues that trigger a response from APS include the following:

Physical abuse

Seniors are particularly susceptible to physical abuse. As people age, they become less able to protect themselves from physical harm and may lose their ability to vocalize any threats of abuse they might receive. According to statistics published by the National Intimate Partner and Sexual Violence Survey, 1 in 10 seniors over age 70 fell victim to some form of abuse. Of the number reported, 1.7% of victims suffered physical abuse.

Neglect and abandonment

Many older adults need a caregiver to help them with basic needs. Under those circumstances, a care provider, whether a loved one or a hired professional, assumes responsibility for their well-being. Neglect happens when a caregiver fails to provide a senior with basic needs. Abandonment occurs when a caregiver deserts the senior whose care they assumed responsibility for, leaving them unable to care for themselves and at risk of health and safety issues.

Domestic violence

Domestic violence is when a romantic partner or family member behaves in a way that hurts, manipulates, or terrorizes someone. The abuser uses these tactics to gain control of the victim. Incidents of domestic violence can be common among the older adult population. 

Emotional abuse

Emotional abuse can significantly harm a senior’s quality of life. Emotional abuse is nonphysical abuse that happens when a person faces mental anguish, emotional pain, and stress at the hands of another person. The abuser may threaten, humiliate, or intimidate the older adult and cause emotional trauma in order to control them.

Self-neglect

Self-neglect is reportable to APS. Per the definition provided by the United States Department of Health and Human Services, self-neglect is any “behavior of an elderly person that threatens his or her own health or safety.” Self-neglect can show up as the senior failing to provide themselves with shelter, food, clothing, water, medications, hygiene, and safety precautions.

Financial abuse and financial scams

Seniors are often the victims of financial crimes. Financial abuse happens when someone leverages their relationship with an older adult to take advantage of them financially. Depending on the relationship between the senior and the abuser, financial abuse can be a form of domestic violence.

Seniors are also particularly vulnerable to financial scams. Caretakers should help older adults remain vigilant to help them avoid scammers. Adults who have been scammed can file a report with APS or have a report filed on their behalf.

Sexual abuse

Sexual abuse is any sort of nonconsensual sexual contact. Any older adult can become a victim of sexual assault, especially if they suffer from physical injuries or limitations, memory problems, or mental impairment.

What services does Adult Protective Services provide to older adults?

APS offers protective services to seniors who experience or are at risk of experiencing these different types of abuse, neglect, or exploitation. They receive and investigate reports of the above issues and may intervene when appropriate and with the older adult’s consent. To ensure that vulnerable adults who may live in dangerous situations receive the care and safety they need for a good quality of life, APS offers these resources and services:

• Emergency shelter.
• Legal assistance, which may include representation in court for seniors facing criminal charges or referrals for elder law attorneys.
• Access to food.
• Law enforcement protection.
• Resources for medical care and benefits.

In addition to the above practical services, Adult Protective Services does the following for vulnerable seniors:

• Evaluating the client’s risk of mental illness or impairment and physical harm.
• Investigating reports of abuse.
• Developing a care plan for the senior.
• Providing ongoing monitoring of services provided to the senior.

Who qualifies for APS services?

APS agencies have slightly different qualifications for services depending on the state, but generally, any vulnerable adult aged 18 or older can receive protection from APS, with “vulnerable” indicating that the person is an older adult or has a significant mental or physical disability. Some states’ APS agencies assist only older adults and have age limitations. Adult Protective Services does not have an income requirement. 

Does APS help older adults residing in senior living communities?

Adult Protective Services always responds to reports of abuse for adults living in their communities, meaning in their private homes or non-institutional settings. APS also responds to reports of potential abuse of older adults who reside in senior living communities in about half the states across the nation. If your state’s APS does not respond to reports of abuse in a long-term care setting, you should contact your long-term care ombudsman.

What is an APS investigation like?

An APS investigation starts after someone makes a report to the agency. Before the investigation begins, the APS investigator must inform the senior of their right to deny answering questions or refuse any intervention.

An investigator meets the senior in their home and conducts interviews with the senior and potential witnesses. If the investigator finds evidence of potential abuse, they offer senior protective services. Depending on the severity of the situation, APS might assign a case manager to help the older person receive essential services. In cases of criminal activity, APS could report the alleged abuser to local authorities.

The results of an APS investigative report are private record in most states. The person or agency that reports any potential abuse cannot expect to receive follow-up information from APS.

How can I make an APS report?

Anyone can report an incident of potential elder abuse, including facility employees, family members, and seniors themselves. If you suspect that a senior is experiencing some form of abuse, neglect, or exploitation, report it to a local APS office. You can find your state or county’s branch of APS on the National Adult Protective Services Association website.

When a spouse moves into a nursing home, they require a high level of care. That alone is stressful, but the changes a nursing home placement brings are considerable. You are living alone now without your spouse and may worry about what the future holds. If you were your spouse’s caregiver before placement, the nature of your relationship likely had already changed. Increased dependency and a change in roles can lead to stress, conflict, and confusion about the changes in your relationship. A move to a nursing home can provide some relief and a chance to reset your relationship despite new challenges. We have some tips to strengthen your relationship and stay connected with your spouse in a nursing home.

Visit often

This suggestion may seem obvious, but frequent visits will have a twofold effect: They will give you time to connect with your spouse and assess any care problems. When appropriate, bring other family members and friends, but make sure you have alone time together as well. Ask your spouse how you can improve their comfort by personalizing their room. Having personal items in a room can be more conducive to connection.

Share meals with your spouse

Share meals with your spouse in the dining room or their room when possible. You can bring home-cooked meals or takeout for variety from the facility’s meal programming. If your spouse can leave the nursing home, take them to a restaurant. Going to a restaurant may involve using a wheelchair, so ensure that you feel confident and safe taking your spouse out of the nursing home. Joining your spouse during meal times can also improve their appetite, which will help them receive the nutrition they need and benefit their overall well-being.

Consider topics of conversation before visits

In a nursing home, it is easy to slip into conversations about care needs and health concerns, which can be valuable and necessary, but be prepared with other topics. Perhaps your spouse wants updates on family or news events, or maybe you can discuss television shows or books you both enjoy. If your spouse has dementia or another form of cognitive decline, talk with the activities director about ways to engage and appropriate conversation topics.

Celebrate special occasions

Special occasions such as birthdays and holidays can be lonely in a nursing home. If your spouse can’t leave to attend family gatherings, celebrate with them in the nursing home. You can bring other family members to the nursing home and request a separate room (sometimes available in certain facilities) for a private gathering. Consider bringing decorations, gifts, and food items to help brighten the celebration.

Use physical touch

Intimacy in a nursing home is challenging, and physical or cognitive decline may have significantly impacted the desire and ability to have intimacy. Still, physical touch is an important aspect of closeness. Consider holding hands, hugging, massage, and kissing. Simple gestures of intimacy can strengthen your bond with your spouse.

Engage in activities together

You can attend group activities together at the nursing home, such as musical programs or lectures. Group activities provide entertainment and an opportunity to connect with other residents, which can benefit your spouse in the long run and help them feel less isolated when you cannot be there. You can also consider playing games, doing puzzles, or watching movies in your spouse’s room. Activities encourage laughter, improve mood, and promote conversation and connection.

Share feelings 

Sharing feelings is a significant part of fostering and maintaining a connection with your spouse. Frustrations, fears, and anxiety can interfere with your ability to connect as a couple. It is important to listen and validate these feelings and advocate if necessary to resolve any problems. If you feel that you need to talk with someone about your spouse being in a nursing home, don’t hesitate to reach out to friends and family or even mental health professionals to express and work through your feelings.

Bring or send care packages

Nursing home life can be tedious, and your spouse may long for the pleasures of being at home. Bring small gifts or reminders of home, such as photos, books, music, a bedspread, a favorite lotion, or aftershave. Ask your spouse about any particular items that might help them feel more comfortable. Doing so shows you care.

Remain involved in care decisions

Your spouse may have limited ability to participate in care decisions. It is challenging to keep track of care providers and see the big picture. Your involvement in care plan meetings and communication with daily providers can give your spouse confidence and reassurance that you are taking care of them while ensuring they receive the care they need.

Long-distance connection

Sometimes, it isn’t possible to visit often due to distance or time, but there are ways to stay connected. Consider using technology to stay connected and ask the nursing home staff if they can assist your spouse in accessing any devices they aren’t familiar with. An iPad or smartphone can be a great way to stay in touch virtually. If you have children or grandchildren, encourage them to call and stay connected. They may need some prodding but will likely respond positively.

Connecting with your spouse in a nursing home

Nursing home placement is a significant event that can cause upheaval, uncertainty, and fear about the future. The events that preceded placement likely added stress to your relationship and possibly changed it. However, with a commitment to doing what you can to connect with your spouse and accept where you are now, you may become closer than ever before.

For most aging adults, prescription medications are a line item on their household budget. With the Centers for Disease Control and Prevention reporting that about one in five older adults take at least five prescription drugs daily, it is no wonder that some seniors worry about finding the money they need to cover their next pharmacy bill. The average out-of-pocket prescription drug cost for adults aged 65 to 79 is about $456 annually. For those on a fixed budget, that expense is troubling. Fortunately, there are prescription assistance programs and other ways to offset the costs of prescription medications. Here are some avenues to explore when looking for how to get help with prescription costs.

Medicare

Medicare benefits can sometimes feel confusing, especially since there are so many parts with different names and costs. However, you can find some financial relief for prescriptions through Medicare.

Medicare prescription drug plans

Eligible seniors can enroll in Medicare drug plans, also called Medicare Part D, which add prescription coverage to original Medicare. Note that you have to opt into Part D coverage. To opt in, you must have Medicare Parts A and B.

Medicare Advantage plans with prescription drug coverage

You can also enroll in Medicare Part C (Medicare Advantage), which will give you Part D benefits to help cover your prescription medications in addition to Parts A and B coverage. You can enroll on the Medicare Plan Finder to get the process started.

Extra Help program

Medicare’s Extra Help program can help people with limited resources pay for prescription drugs. Some individuals are automatically enrolled, such as those with Medicaid benefits, those who have a Medicare Savings Program through their state, and those who receive Supplemental Security Insurance (SSI). Others can still qualify for Extra Help: If your income and resources don’t exceed the limits set by Medicare for the calendar year, you can apply.

Limited medication coverage through Medicare Part B

Medicare Part B also covers a small amount of prescription drugs when used under certain conditions, most often for drugs you wouldn’t normally administer yourself. For example, a new intravenous drug designed to slow symptoms of Alzheimer’s disease is covered, as are medications associated with the use of durable medical equipment like infusion pumps and some injectable osteoporosis drugs.

Part B might also cover some support with medication management via a home health care visiting nurse as long as it is prescribed by a physician and used on a short-term basis. Check with your physician to see if you might benefit from this service.

Medicaid

Medicaid, a program jointly run by the federal government and each state, can provide relief for eligible seniors looking to offset the costs of prescription medications. Medicaid coverage is based on financial need, and not all seniors who apply will be eligible.

Currently, federal law makes Medicaid pharmacy coverage optional for each state. However, all states provide coverage for outpatient prescription drugs to eligible individuals. For example, Illinois covers all prescription drugs and some over-the-counter ones filled at pharmacies that have signed a rebate agreement with the Centers for Medicare and Medicaid Services. Similarly, the state of Virginia covers prescription medications fully. Check your state’s Medicaid coverage to see how they can help with prescription costs.

Veterans assistance

For eligible Veterans, enrollment in the VA health care system is considered creditable coverage for Medicare Part D purposes. If you are eligible for Part D coverage, you can take advantage of the VA prescription drug coverage and be confident it is at least as good as the coverage offered under Part D. Only Veterans can receive this benefit, so dependents and family members need to find coverage elsewhere.

Contact your VA caseworker to learn more about your eligibility, as well as to find out how much your copays might be and if you must fill your prescriptions through VA-approved pharmacies or VA facilities.

Other state and county prescription assistance programs

Depending on your state, county, and city, you might also be eligible for additional funds to offset the costs of the medications you need. These prescription assistance programs are typically available due to grant funding, meaning benefits might be limited or not renewable each year.

In New Jersey, for example, older adults who meet age and income criteria and are enrolled in Medicare Part D can qualify for the Pharmaceutical Assistance to the Aged & Disabled (PAAD) program, significantly reducing prescription costs to as little as $5 per medication. 

Other programs in the state of New Jersey are available to all residents regardless of their age or income. The New Jersey Drug Card program offers discounts to state residents through the participation of medication partners and pharmacies in the state.

You can find out which grants and programs are available in your area by contacting your state’s Division of Human Services or Office on Aging or looking on their websites. You can also contact your local Area Agency on Aging or your local senior services organization.

GoodRx coupons and prescription discounts

You don’t have to rely solely on benefits from federally funded programs to get further help with prescription costs. Apps and platforms like GoodRx allow users to search for the lowest prescription prices in the neighborhood and then direct them to that location. The platform states they can save consumers up to 80% on FDA-approved drugs, both brand-name and generic.

The GoodRx app offers free services to users, though there is an option to upgrade to a monthly plan for more benefits. For $9.99 per month, users can also get discounted telehealth visits and free home delivery plans for prescriptions.

Even better, you can use GoodRx regardless of your insurance status, so you might save even more money on your Medicare-covered prescriptions.

Store membership prescription discounts

You might already have corporate or store memberships that can help with prescription costs. Costco, for example, offers prescription medication discounts with a Costco membership. The discounts apply to Costco members, eligible dependents, and pets. You can find a participating pharmacy and show your Costco card to receive the discount.

You can get help with prescription costs

Reducing prescription medication’s monthly or annual costs can require a multifaceted approach, combining health care benefits with state-funded relief programs or apps that look for the lowest pricing available. A little research can help you find the best combination that works for your budget.

Adults aging in their neighborhoods can find many resources and support systems within their town or city designed just for older adults. For example, many towns feature a senior service division, and recreation departments often have a special events calendar for adults over 55. Another common resource is senior centers, a community hub that provides socialization, education, and more for older adults. Here’s why you should look into your local senior center to find support and recreational opportunities for yourself or your loved one.

What are senior centers?

According to the National Council on Aging, senior centers are community focal points designed to provide services and resources to older adults. It is estimated that more than 11,000 senior centers nationwide serve more than 1 million older adults daily. These centers are valuable resources that provide local older adults with educational, entertainment, and socialization opportunities and connect seniors with other helpful resources in their communities.

Senior centers aim to provide events and resources that support seniors as they work to meet their health and wellness goals. You’ll find seniors who live at home without support, seniors who need some in-home support from caregivers, seniors who live with an adult child, and even seniors who live in independent living communities — all seniors are welcome at the senior center.

Senior centers are typically open five to six days per week, with hours fluctuating based on the needs of their community. Business hours are common, but you might also find a senior center that stays open later a few evenings a week to serve their patrons.

Where can I find a senior center near me?

A simple internet search should provide you with the nearest senior center. Also, senior centers often work closely with community organizations, so contact your town’s senior services or recreation department for information about senior centers. Some senior centers partner with hospitals, so check there, too.

What happens in senior centers?

Perhaps the best part of senior centers is that they offer programming, support, and resources tailored to the needs of the participants and community. For example, what you see happening in a neighborhood senior center in Chicago might be different from a senior center’s programming in a rural town in Alabama. This customized approach ensures the seniors who visit the center get exactly what they need when they need it.

While each senior center offers unique programs, you can find similar offerings in most centers throughout the country. Each resource and event is designed to enhance quality of life and empower seniors to remain as independent as possible. Below are some examples of the kinds of programs senior centers commonly offer.

Socialization events

Connecting with peers is a foundational component of wellness for older adults, but it can be difficult to find new friends. Senior centers are vibrant, social community hubs offering programs and events designed for healthy socialization. You might find happy hours, entertainer performances, or other special events to encourage conversation. These events provide fun opportunities for meeting new people with common interests or connecting with old friends.

Health and wellness screenings

Your community senior center is a place where you can take advantage of health and wellness resources. You might find bone density screenings, vision and dental clinics, wellness fairs, and presentations given by local health experts on the calendar at a senior center. Most of these events will be free or at a reduced cost.

Fitness classes

Staying active as you age is important for maintaining your health and well-being. Many senior centers offer free or low-cost fitness classes to support seniors’ physical health. You might find balance classes, chair yoga, tai chi, and other classes designed specifically for seniors. For example, the Senior Center of West Seattle offers several different types of fitness classes per week, so older adults can find something they enjoy that suits their mobility level. 

Financial assistance

Do you have questions about Medicare choices, or are you wondering if you might meet the qualifications to get reduced electric bills? Your local senior center likely has the information you need. Many senior centers even invite experts to give presentations or host free clinics where you can bring your information and receive personalized advice. They also often offer assistance with tax preparation, such as at the Community for Positive Aging in Portland, Oregon. They provide free sessions to help older adults with tax preparation and to answer tax-related questions. 

Community meals

While home-delivered meals through organizations such as Meals on Wheels are an excellent resource for many older adults, enjoying a meal with others also has benefits. Many senior centers are community meal sites where seniors can gather for a free or reduced-cost meal catered by a local restaurant or organization. Seniors can get together to meet others in their community while receiving nutritious meals that support their well-being.

Community connections

Senior centers are connected to all the resources in the surrounding area. They can bring in local experts to give educational lectures, lead art workshops, or facilitate fitness classes. In addition, they can connect patrons to other community resources, such as vetted handyman services, senior-experienced moving services, and more.

Costs associated with senior centers

Depending on the senior center, you might expect to pay a yearly or monthly membership fee to access all events and resources. This is typically offset through grants or other government funding, but the membership payments help to ensure excellent programming and events.

If your senior center doesn’t have a membership option or if you just want to attend an event or two every once in a while, you might pay a nominal fee for each one. An event that includes dinner and entertainment, for example, will cost more than an event that doesn’t feature food. You might also pay for special trips, such as excursions to the new museum in town or to catch a classic film at the theater with the group.

Exploring your senior center

When you’re ready to learn more about your senior center, get on their mailing list to receive their newsletter and monthly calendar. This way, you can see upcoming events that interest you. Contact them to schedule transportation assistance if you need a ride to and from the center. Many senior centers work with the city’s senior transportation division and can give you a scheduled ride at a low cost.

Contact your local senior center with any questions. You’ll find that the staff is helpful on the phone and even more welcoming in person. Enjoy the friendships and opportunities that come with regular visits to the senior center.

When your spouse moves to a nursing home, it can feel like a colossal change, and in many ways, it is. There is a disruption of routine; you are alone in your house without your companion and may be worried about their well-being and chances for recovery and returning home. Your worry can quickly become stress, but there are positive ways to cope. Here, we go over tips for how to cope so you can ease the transition and ensure the well-being of yourself and your spouse in a nursing home.

What moving to a nursing home means for you and your spouse

A move to a nursing home suggests that your spouse has care needs that exceed what any other setting can provide, including living at home and receiving your help or that of a home care provider. This may mean that your loved one has a serious, chronic medical condition or a complication from an accident that has led to the need for nursing home care because 24-hour nursing and aide care is available in this type of facility. 

With this circumstance, it’s likely the case that the spouse of the individual in need of care is extremely stressed. You may have been caring for your spouse and are either burning out or the responsibilities have increased beyond your skill set. In either case, you’re maxed out. Utilizing nursing home care means that your spouse will receive the care they need, and you’ll also get the relief you need.

Coping strategies for when your spouse moves to a nursing home

Caregiving for your spouse may have been a part of your life before their move to a nursing home. Although many of those responsibilities are relieved, you are still a caregiver, and the stress of having your spouse in a nursing home is a different type of challenge. 

Some nursing homes may seem to have unappealing environments. You may fear that the nursing home will not provide the same level of care you did. This fear can cause a great deal of anxiety about how your loved one is doing psychologically, and you may worry whether the nursing home is meeting their health needs. Managing your emotions and using coping strategies are critical to maintaining your own health and having the energy to advocate and be with your partner in a meaningful and supportive way during their nursing home stay.

Acknowledge your feelings

You may have various feelings, including anger, disappointment, fear for the future, loss, loneliness, guilt, sadness, and helplessness. As difficult as these emotions are, you should recognize they are a normal response to the upheaval a nursing home admission can cause. You may feel as though you have given up on your spouse and feel shame about the decision to place them in a nursing home. It will be hard, but try to accept your feelings without judgment, and know that even though your decision was challenging for both of you, it was the right one at the time.

Seek emotional support

You will need emotional support during this time of transition. Reach out to friends and family who will listen and can often offer valuable advice. You may be surprised to find out you aren’t the only one who has gone through this experience. If you feel you would benefit from professional help, don’t hesitate to seek the support of a therapist or counselor. 

Stay involved with others outside the nursing home

In your desire to improve your spouse’s stay in a nursing home, you may neglect your friends and family. A full-time job can add even more urgency to the situation, as there are only so many hours in a day. However, even calling friends on the phone or arranging a video chat can help you stay connected and engaged. Close relationships can provide support and care, improving your mood and helping you feel less alone while your spouse is in a nursing home.

Practice self-care

Caregiver burnout is possible when your spouse is in a nursing home. To recharge your emotional battery, continue to engage in activities that bring you pleasure and relaxation. Hobbies, exercise, listening to music, yoga, and meditation are all restorative practices. Don’t feel guilty about the self-care practices necessary for you to manage a challenging situation while maintaining your well-being.

Be proactive and advocate for your spouse in nursing home care

Advocating for your spouse in a nursing home benefits both of you. Being proactive and engaged in care decisions will give you a sense of control over the situation, and your loved one will benefit from better care and from knowing you are involved in their care. Do what you can to make your spouse’s experience more pleasant by personalizing the room and bringing friends and family to visit.  

Spend quality time together

Arranging quality time together can be challenging, especially if your spouse is in a shared room. However, there are ways the two of you can be together, even if it may feel awkward at first. Try to be positive and go outside the nursing home if your spouse can leave safely. Plan topics to discuss and activities that can pass the time and bring enjoyment for you both. You might also consider attending some of the nursing home’s activities or events together. This can help you connect and the other residents, which can be especially helpful if your spouse is in the nursing home for the long term.

Take care of financial or legal matters

As practical as this may seem, attending to financial and legal matters can reduce stress. Nursing homes are expensive, and you want to protect your assets and estate. Consult an estate planning attorney to tie up any loose ends. Make sure you have health care power of attorney and living will documents. If you already have them, update them as needed. Keep your spouse informed and involved in all decisions if they can do so.

Moving a spouse or partner to a nursing home may be the last thing either of you wants or expects. You will experience some emotional upheaval, but remember you are in this together. Caring for yourself will bring a steady hand to a difficult situation, so your spouse in a nursing home can get the help they need to remain healthy and safe.

There may be no more challenging conversation to have with a parent than telling them they need to move to a nursing home. You may be familiar with hearing your parent say the phrase, “Promise me you will never move me to a nursing home.” But care needs change, and it may become necessary. Your promise may need to be revised so your parent can get the care they need. Here, we offer ideas about how to prepare to talk with your parent about moving to a nursing home, approach the conversation, and mitigate potential issues to minimize conflict.

Prepare for the conversation about a move to a nursing home

You may not know how this conversation will go, so prepare for strong emotions at first. Your parent may blame you and express anger and resistance. Recognize that these emotions reflect their fear of disempowerment and losing independence. Your goal is not to try to fix or rectify these emotions but to accept them and acknowledge their valid feelings. 

A legitimate question your parent may have is why a nursing home is required. Discuss the value and benefits of nursing home care in the context of your parent’s care needs. Remember that nursing homes offer the highest level of care besides those offered in a hospital setting. Therefore, your parent’s needs may be too great for an assisted living community or require an amount of time from a home care provider that would make the home care cost unaffordable to you. A nursing home may be their only option. Be as specific as you can about how this level of care is necessary for recovery and safety.

Choose the right time and place

Your parent may currently be in the hospital, a rehab, an assisted living facility, or at home, but consider the timing and place for the conversation regardless of the setting. Choose a time when your parent is more alert and calm. For some people, this will be in the morning, and for others, it will be in the afternoon. Ensure that the location is quiet and calm without distractions. Having a sibling with you or another family member may be helpful. A group of people can feel overwhelming and threatening, so keep the group small.  

Address fears and misconceptions about nursing homes

Invite your parent to talk openly and honestly about their feelings and fears. Their feelings are valid, but fears may be based on nursing home myths. You can try to address concerns head-on with solutions and facts. For example, provide solution-based reassurance if your parent worries about the quality of care or privacy. Let them know the types of staff members who can assist them with certain care needs and that there are multiple shifts to ensure that help is available at every hour.

Reassure your parent that you will visit

Your parent may be concerned that if they move to the nursing home, they’ll get lonely and have no visitors. After all, if you have been their caregiver and now the nursing home will take your place, will they stop seeing you? You can address that concern by considering your schedule beforehand and offering a tentative visitation plan. The schedule can evolve to suit both of your schedules, but outlining specific days and times when you’ll visit may put them at ease.

Also, you can tell your parent that the time you spend together moving forward will be quality time instead of focused on caregiver tasks. In fact, they may find the time you share to be more enjoyable since you can focus on catching up and bonding with one another.

Consider involving other professionals

If it is helpful, consider asking for assistance from other professionals. You might talk to their physician, a geriatric care manager, or someone from their religious community. Sometimes, another person’s objective perspective can reinforce the need to move to a nursing home in ways that are more acceptable to your parent. 

If you attend doctor appointments with your parent, consider asking their general practitioner or specialist to talk with them about the advantages and positive health outcomes of moving to the nursing home. If your parent can hear directly from their health care provider how the nursing home’s services can help them better manage their chronic condition, they may be more open to the idea.

Provide as much information as possible

Often, fear is based on not knowing what to expect. Provide as much detailed information as possible, such as what your parent can bring with them, the schedule of care, activities, visiting hours, and meal preferences.

Cost may come up, which is a valid concern. Be prepared to discuss ways to pay for nursing home care.

If your parent refuses to go to a nursing home, discuss the consequences of that decision, such as health and safety concerns.

Emphasize the positives of a move to a nursing home

Offering hope while keeping expectations reasonable can be a tricky balance. Achieving this balance will depend on your parent’s personality and your relationship with them. If recovery is possible, emphasize how round-the-clock care can support that goal. If recovery is unlikely, staying positive and making the experience valuable is still important. Work with your parent to identify which family and friends they’d like to visit with, and offer to schedule frequent visits with these individuals. 

Focus on your relationship

Sometimes, the relationship gets lost in the chaos and confusion of significant care decisions. Decline, disability, and dependence are challenging for parents and their adult children to navigate. There is no road map for preserving a long-standing relationship that has now changed. Try focusing on the heart of the relationship whenever possible, and include humor, stories about grandchildren, and topics of interest to your parent. Remember that relegating your parents’ care to the hands of professionals will give you more time to focus on your relationship and spend quality time together.

Approaches to avoid

The goal of discussing a move to a nursing home should be preserving your relationship with your parent while ensuring their health and safety. Although your parent’s reaction isn’t in your control, how you conduct yourself is. Here are some recommendations on approaches to avoid:

• Don’t be forceful. No one likes being told what to do, so avoid being forceful. Try an inclusive and cooperative approach to help your parent come to a place of acceptance.
• Avoid fear tactics. Perceived or real threats can cause lasting harm to a relationship and are unlikely to work anyway. Your parent has the right to make their own decisions, even if you disagree with those decisions. 
• Don’t distort the truth. There may be damaging repercussions if you aren’t truthful about nursing home care. If you don’t have answers to specific questions, be honest and say you don’t know but will try to find out. 

Talking with a parent about moving to a nursing home won’t be easy. Accept the outcome, knowing you have approached the conversations with reasonable expectations, compassion, flexibility, and respect.

Creating an estate plan is essential to long-term planning as we age. Having your affairs in order will ensure that your wishes are carried out and that your loved ones have peace of mind in knowing your preferences. As important as having an estate plan, it is equally important to keep it updated as your life changes. Some common events should remind you to update your estate plan. The following are some examples of when to change your estate plan.

If you move to a long-term care facility

Seniors who move to senior care facilities that Medicaid pays for, such as many nursing homes, should consider the Medicaid Estate Recovery Program when updating their estate plans. The Medicaid Estate Recovery Program is a federal requirement that states collect reimbursement for the cost of benefits they paid out during the beneficiary’s lifetime, including long-term living arrangements.

Medicaid recovers its costs through the probate process from your estate after you die. If there is not enough money in your estate to cover the cost of care that you received, the program might sue your family to recover its losses. Some families may be involved in a lawsuit where the program attempts to take property like a family home and other major assets.

Seniors should also ensure that copies of their important estate planning documents, specifically a living will and an advance directive, are accessible to their senior living community. The best way to ensure all your affairs are in order is to speak to an estate planning attorney before moving into a senior living community. If you need to update these documents or create them for the first time, doing so upon moving to a senior living community is a great time.

If you move to another state

Let’s say you relocate to another state to live closer to your family members. Or perhaps you move to another state for its senior-friendly tax advantages. If you move to another state for any reason, it is time to revisit your current estate plan because probate and estate laws can vary from state to state. There may be some state-specific laws in your new location that can invalidate your current estate plan, even if the details were valid in your previous state. Examples of seemingly minor things that can negate your current estate plan include:

• Differences in the number of witnesses required for a last will and testament. 
• Variations in signature requirements.
• Marital property law.
• Forms required to create a valid living will or advance health care directive. 
• Who can legally serve as the executor of your last will and testament.

When there is a change in your assets

One of the primary purposes of an estate plan is to dispose of all your property after your death. You need an updated estate plan if you have an increase or decrease in your assets. So, let’s say you sell your home in order to move to a senior living community. You will need to update your will to reflect the change in your assets.

The size of your estate will determine your tax exposure. The bigger your estate, the more likely your heirs will owe estate taxes. Estate taxes vary by state. An estate planning attorney can help you understand your rights and obligations regarding estate taxes and help you potentially reduce the final estate tax bill.

After a marriage, divorce, or death

A marriage, divorce, or death are the most common life changes that require an update to your estate plan. You’ll need to update your estate plan if you are married or divorced or if a death impacts your beneficiaries. For example, a new spouse may bring you stepchildren and step-grandchildren, and you might want to include the new members of your family in your last will and testament. Also, after a divorce, you might want to ensure that your ex-spouse is no longer named as your health care agent or power of attorney. You will also likely need to make updates if someone currently a part of your estate plan passes away.

When you make changes to beneficiaries

You should update your estate plan to include any changes in your beneficiaries. As mentioned above, your family may continue to grow with time, and your estate plan should reflect those changes. In addition to family members and other heirs changing, your values might change. Perhaps you find yourself passionate about a certain charity and want to leave the organization money for support; you will need to update your estate plan to reflect this desire.

When a trustee, guardian, or executor cannot serve

People make estate plans to stay in charge of their legacies. Part of maintaining control is naming the person or people who will serve as a trustee, guardian, or executor of your estate. The person who serves in one of these roles is responsible for ensuring that your wishes are carried out after your death. It is important to choose people that you trust to accomplish this. If someone whom you previously named can no longer complete their duties in this role, it is time to update your estate plan to name someone who can.

What documents do I need to update my estate plan?

A last will and testament alone might not be enough to complete your estate plan. The instructions listed in a last will and testament do not become effective until after you pass away. Other estate planning documents that can help you manage your affairs during your lifetime include the following:

• HIPAA authorization form: HIPAA laws prevent medical providers from sharing patients’ private information without their consent. You might decide to add a HIPAA authorization form to your estate plan to allow someone you trust to speak to your health care team on your behalf.
• Revocable living trust: Revocable living trusts allow family members to avoid probate taxes by removing your property from your total estate, thus avoiding taxes. One of the greatest benefits of a revocable living trust is that it helps heirs avoid probate taxes after you die and allows you to continue to access the property placed into the trust during your lifetime.
• General durable power of attorney: A general durable power of attorney grants an agent of your choice the ability to make financial, business, and other decisions to help you manage your life as you age or if you become unable to complete these tasks on your own.
• Living will: A living will directs physicians and health care agents regarding your health care preferences if you become incapacitated and cannot communicate your desires regarding medical treatment.
• Advance directive: An advance directive is a form that instructs family, caregivers, and doctors about your desires for end-of-life care. The provisions of an advance directive are not applicable unless you are terminally ill.

Talk to an elder law attorney about estate planning

Life changes might require updates to your current estate plan. Speaking to an estate planning attorney could offer much-needed relief to you and your loved ones in a stressful situation. If you are considering updating your estate plan, contact an elder law attorney in your area with your questions and concerns.

The cost of receiving long-term care at home or in a senior living community is rising, making it more difficult to cover senior care costs. Older adults can find it challenging to pay for the help they need to perform daily living activities, especially if they are on a fixed budget or have limited resources. The Department of Veterans Affairs (VA) offers the Aid and Attendance benefit to qualifying Veterans to help pay for care.

Fortunately, this benefit is not just for Veterans of the United States military. VA also awards the Aid and Attendance benefit to qualifying spouses, who can use this additional monthly income to help pay their long-term care expenses. Here, we’ll explain how Veterans’ spouses can qualify for Aid and Attendance, the spousal benefit amounts, and how to apply.

What is the Aid and Attendance benefit?

Aid and Attendance is a VA benefit available to eligible military Veterans and their surviving spouses. Beneficiaries receive this tax-free monthly income to help pay for care. Due to the health requirements that beneficiaries must meet to qualify, they typically have significant expenses for care services that help them perform activities of daily living, such as bathing, dressing, feeding, toileting, and transferring (moving from one position to another). Hiring help to perform these fundamental personal care tasks can be costly; Aid and Attendance aims to help beneficiaries cover these additional costs.

How to qualify for Aid and Attendance as a Veteran’s spouse

All Aid and Attendance applicants, including Veterans’ spouses, must fulfill requirements in specific areas. The areas include the Veteran’s military service, the health status of the person who requires care, and the income and net worth of the person who requires care. When the Veteran’s spouse hopes to receive the benefit, they must also meet marital status criteria. We’ll go over all these requirements now.

The Veteran meets military service requirements

Military service requirements for Aid and Attendance apply to all applicants, whether the hopeful recipient is the Veteran or the spouse. The Veteran to whom the spouse was married must have served in the military, and their service must meet these requirements:

• The Veteran must have served at least one day of active duty during dates of a wartime period, such as World War II, the Korean Conflict, the Vietnam War era, or the Gulf War.
• If the Veteran started active duty before September 8, 1980, they must have served at least 90 days of active duty in a U.S. military branch. The days of service do not have to be consecutive.
• If the Veteran started active duty after September 7, 1980, they must have served 24 months of active duty.
• The Veteran cannot have received a dishonorable discharge.

Here are some helpful tips to remember about the Veteran’s service eligibility:

• The Veteran’s service can still qualify even if they did not serve in an active combat zone. 
• The Veteran’s service can qualify even if only one day of their service was during wartime. If, for example, 89 of the 90 days were served during peacetime and one day was during a wartime period, they can still qualify. 
• The Veteran’s service can be in any U.S. military branch that existed during the approved wartimes, including the Army, Marine Corps, Navy, Air Force, Coast Guard, National Guard, and Merchant Marines. Veterans who were Reservists can qualify if they were called to active duty.

The spouse meets health criteria

This benefit intends to provide additional income to individuals with significant daily living needs. Therefore, VA requires that the applicant meets at least one of the following:

• They need help with at least two activities of daily living, such as feeding, bathing, dressing, or transferring (such as to and from bed).
• They have a physical or cognitive issue, such as Alzheimer’s disease, another form of dementia, or another health or medical issue.
• They have vision impairment, such as macular degeneration, or are diagnosed as legally blind.

The spouse’s income and net worth don’t exceed the limit

The Aid and Attendance eligibility criteria also include a maximum net worth limit that applicants must not exceed. This is because VA aims to provide additional income through this benefit to individuals who have significant personal care needs (as listed above) and limited income or resources to cover those costs. In 2024, qualifying applicants must not exceed the net worth limit of $155,356.

VA reviews this maximum net worth amount toward the end of each calendar year and may increase the amount. When VA changes this amount, it is typically related to the cost of living increase in the United States.

An applicant’s financial status is assessed based on their assets and annual income. Assets include essentially all property except the applicant’s car, primary residence, and basic home items, which VA states are “appliances that you wouldn’t take with you if you moved to a new house.” For example, some of the items VA wouldn’t count include furniture, jewelry, or family heirlooms.

Annual income is the applicant’s retirement income and includes other income, such as investment income. Certain expenses, including medical costs such as assisted living and home care for which the applicant is not reimbursed, are deducted from the income amount. The remainder is considered the applicant’s annual income.

The total amount of annual income and total assets cannot exceed the maximum limits for the applicant to meet this area of criteria.

The spouse and Veteran’s marital status meets the requirements

While Veterans who apply for this benefit need to meet all the above areas, spouses must meet the above criteria as well as marital status requirements to qualify:

• The spouse must currently be married to the Veteran, or the spouse must have been married to the Veteran for at least 365 days and was married to the Veteran at the time of their death.
• The spouse does not need to have been married to the Veteran during their time of qualifying service.  
• VA recognizes common-law marriage if the state in which the spouse lives recognizes it.

Aid and Attendance benefit amounts for spouses

VA determines maximum benefit amounts, and it may adjust them on an annual basis. As with the financial requirements, VA reviews them annually and may adjust them for the following 12 months. 

There are two situations in which a spouse can be eligible, and these situations have different maximum benefit amounts:

• The Veteran is alive and married to the spouse; the spouse needs care: The Veteran’s maximum monthly benefit in this situation is $1,806 per month in 2024.
• The Veteran is deceased and was married to the spouse at the time of death; the surviving spouse needs care: The spouse’s maximum monthly benefit in this situation is $1,478 per month in 2024.

It’s important to note that these are maximum monthly benefit amounts, which means spouses might receive less than the dollar amounts listed above. VA considers income and care costs to determine the exact amount it awards the spouse each month.

How spouses can apply for Aid and Attendance

The application is complex and requires significant financial, health, and military service documentation. There are many rules, and there are also many exceptions to rules, so it can feel like a daunting process. But that shouldn’t stop a Veteran’s spouse from applying for Aid and Attendance. This benefit can make a big difference in the life of a Veteran’s spouse, especially when it adds income to help you pay for the care you need to live each day comfortably and safely. 

Let’s review some application basics, including how a spouse should apply, the documentation they need, and options for applying.

Determine whether the spouse or Veteran applies

If the Veteran is alive, the Veteran must submit the application (even if the spouse has health-related needs). In this case, the Veteran submits the application under the classification that the Veteran is married and their spouse needs care. VA looks at all household incomes and household care expenses in making the determination. 

The only circumstance under which the spouse is the actual applicant is if the Veteran is deceased. In that case, the spouse submits the application under the classification that the Veteran is deceased and the surviving spouse needs care.

Aid and Attendance application documentation checklist

Applicants need to gather a number of documents that prove they meet each of the criteria areas. You’ll need to gather:

• Military service documents: To demonstrate that the Veteran meets the military service requirements, you’ll need the Veteran’s discharge paperwork (DD Form 214). You can order a copy through the National Archives. AidandAttendance.com, an online application solution for the benefit, also helps applicants obtain copies of this paperwork.
• Medical and care provider documents: You must also have your health care provider sign VA paperwork confirming you meet the health-related criteria. You and your doctor and long-term care provider will sign this form. If you live in a senior living facility, a representative from the facility can be considered the care provider, for example. These signatures confirm that you meet the health-related requirements.
• Financial documents: You must prove that your income and net worth do not exceed the annual maximum threshold. This documentation should include your income, unreimbursed medical expenses, and net worth. VA has a three-year look-back period: If you have given away any funds, VA has the right to look back at the gifts from the past three years. 

Filing the Aid and Attendance application

As you can see from the extensive list of documents you’ll need, the application process is complex. You can choose to submit your application on your own; many applicants also choose to work with third-party companies that help them file their applications. 

File on your own

If you choose to file your application on your own, keep a few things in mind: First, ensure that you fill out the appropriate forms. You’ll complete one form if the Veteran is alive and applying for the spouse to receive benefits and a different form if the Veteran is deceased and the surviving spouse is applying for the benefit. 

If you are not fully prepared to file an application, you’ll need to access a different form, an Intent to File, which helps protect the initial date of your application. If and when you are awarded the benefit, you will receive monthly payments starting the first month after your claim is opened, which can be done with an Intent to File form submission or a fully developed claim. Because it takes significant time to review the application and submit revisions in the event that VA asks for more information, you will continue to incur long-term care costs during that time. It’s critical to file a complete application or submit the Intent to File to ensure you receive benefits for as much time as you intend.

Also, keep in mind that, based on your circumstances, you may need to complete and submit other forms. 

When gathering the Veteran’s military service documents and your health and financial documents, make sure you obtain proof of all necessary details. When VA reviews your application, it will delay your approval and receipt of benefits if you need to submit more information. The complete application may be 30-plus pages long, and you will fax or mail it to VA.

You also have another option for filing your application. You can get help, which we’ll discuss next.

File online with help

Because the application is complex, third-party companies have emerged to help Veterans and their spouses apply for the Aid and Attendance benefit. You can usually choose services with different levels of assistance. For instance, AidandAttendance.com offers two levels of service: The basic service allows you to use its online application solution on your own. It guides applicants through the forms and alerts them to mistakes before they submit the application. Applicants can also get a PDF copy of their application to keep. The premium service includes those features and others, like support in entering the application data and a final review with a specialist.

Whichever method a spouse chooses, becoming an Aid and Attendance beneficiary can make a big difference in a person’s ability to receive the long-term care they need. Those who qualify require help with daily personal tasks and have limited resources to cover the cost of getting that care. VA steps in to help through its Aid and Attendance benefit, offering qualifying spouses much-needed additional income.

As we age, our relationships with those closest to us shift. For adult children who care for their parents, a change in relationship dynamics becomes especially prevalent. When a parent moves to a nursing home, the relationship shifts even more. Finding ways to stay connected through such a tumultuous time can be difficult. Here, we’ll explore six ways that you can continue to bond and connect with your parent despite a move to a nursing home. We’ll suggest ways that you can spend quality time together and overcome the obstacles presented by the change in living situation. With thoughtful planning, you’ll find new ways to deepen your relationship with your parent in a nursing home so you can have meaningful time together. 

Set reasonable expectations

When thinking about creating meaningful experiences with your loved one, be sure to maintain reasonable expectations. Consider how your parent’s physical or cognitive abilities may have shifted and how that might impact your plans. Determine if there is a better time of day for you to spend time with them and a maximum amount of time that the visit should last. For some older adults, late morning may be the optimal time for a visit, but they might grow tired after an hour. Keeping this in mind will help you have the right mindset for an impactful visit. 

Utilize nursing home amenities

Think about what the nursing home has to offer and how you can make the most of its services and amenities. Nursing homes have communal areas that you can utilize to bring your visit out of your loved one’s room to give them a change of scenery and pace. Consider spending time in areas like the following:

• Public living room: These communal areas have plenty of seating. You’ll likely have windows to look out of and books or magazines to leaf through while you chat.
• Outdoor patio: Weather permitting, getting outdoors is a great change of scenery. Sunlight can help boost mood, and feeling a nice breeze or hearing birds chirp can be grounding.
• Dining room: Changing the venue from their room to the communal dining room can offer enough of a change of pace, and if you’re visiting between meals, it can offer a quiet space to chat along with table space to look through photos or do other activities.
• Private conference room: If one is available, you can visit in a room like this to enjoy some one-on-one private time there if your parent has a roommate in a semiprivate room.

You can also check with the activities director about available games or activities for residents and family members. You might ask about:

• Board games: Great for a lighthearted way to spend time that offers a topic of conversation in the games themselves.
• Puzzles: Choose a puzzle your loved one would enjoy, whether it’s a number challenge in a sudoku or a word challenge in a word search or crossword puzzle, and you’ll not only spend quality time with your loved one, but they’ll get a cognitive workout, too.
• Art activities: Even simple art activities are great, and they also offer an opportunity for conversation while you create your art.
• Scheduled activity programming: Attending one of the facilities’ planned events requires no planning on your end. Just arrive prior to the start of the activity, go to the activity room with your loved one, and enjoy.

In keeping your visit to the nursing home, you’ll reduce the stress your loved one may feel by traveling or going to an unfamiliar place. This lets you both relax and focus on what matters most — spending time together.

Schedule regular, realistic visits

Here, we mention two important aspects of visiting with your loved one: Aim to make your visits both regular and realistic. Regular and realistic visits will look different for each family and can evolve as time passes and circumstances change. Give thought to both, and reassess your visiting schedule often to ensure it aligns with your lives.

To create a regular and realistic visitation schedule, consider your life obligations. Remember that you have your own life to live. While adding spending time with your loved one to your routine, be sure to devote time to your personal responsibilities, hobbies, and social schedule. Those who live far from their parent’s nursing home may find it challenging to make the drive on a daily or weekly basis. On the other hand, those who live close by may feel like they should visit so often that it can take up much of their free time. 

Only you can determine what is a comfortable regular schedule. Identifying what works for you and knowing what to expect about how often you’ll visit can put both you and your parent at ease.

Bring familiar activities

When you’re considering what to do together, familiar activities can often be comforting and encourage reminiscence. Activities your loved one is familiar with, such as looking at photo albums, listening to familiar music, or watching favorite shows, will help your loved one feel comfortable. Think about activities your loved one previously enjoyed and how they could be adapted to meet their current abilities. 

If you’d like to spark interesting conversation, consider watching a TV show that airs during your scheduled visits or bringing a tablet to stream a show you’d both like to watch. You can also show your parents pictures of you and your family members. Did you recently rearrange the furniture in your home? Snap a few photos and show them the before-and-after pictures. These seemingly small conversations and activities can serve as bonding opportunities and promote conversation from one visit to the next. 

Find opportunities to experience something new

One of the best ways to bond with anyone in your life is to experience something new together. This encourages deeper emotional connection and conversation. Consider trying new activities or learning something new together with your loved one. Travel videos, virtual tours of museums, crafts, and poetry are all great ideas to consider. 

Some may worry that nursing homes are lonely, isolated environments, but in reality, they maintain a vibrant activity calendar to keep residents engaged and connected. Visitors are often invited to participate in these events. Find out the activity schedule in the nursing home and, if possible, visit when there’s an event you can attend. Your participation will likely inspire your parent to do the same. You can connect with other residents and staff members as well as encourage your parent to form new bonds. 

Take time for yourself

It may come as a surprise, but in order to feel open to connecting with your loved one, it’s vital that you have time for yourself. Maintaining time to relax and unwind will help you avoid caregiver burnout and feel more emotionally available when visiting your parent in a nursing home. To start, it could be as simple as taking a few deep breaths before going into the nursing home before your visit. 

It’s normal to feel a strain in your relationship after a parent moves to a nursing home, and it’s okay to grieve the loss of your previous relationship. However, by being intentional about your visits, you can find new ways to bond with your parent in a nursing home.

Moving to a nursing home can be a tough change, but luckily there are ways to make your loved one’s nursing home room welcoming and comfortable. Since nursing homes offer the highest level of care besides hospital care, your loved one’s physical or medical situation is likely difficult to manage; the stress they feel about their health along with moving to a new residential environment can be overwhelming. Here, we’ll describe what you can expect in a nursing home room, give tips on how to personalize it, and offer details to consider or discuss with the facility manager before decorating and enlivening your loved one’s nursing home room.

What does a typical nursing home room look like?

Nursing home room setups and styles vary depending on payor source, company ownership, and facility management, but since the Centers for Medicare and Medicaid Services (CMS) works with each state to regulate nursing homes, you can expect some common features. Let’s go over some of the typical features of a nursing home room now.

Shared (semiprivate) or private room

Your loved one will likely live in a shared (also known as semiprivate) room unless they pay for a private room. If they live in a shared room, a curtain often separates each resident’s space, similar to the privacy curtain you might see in hospital rooms. 

Each resident’s living space in the shared room might be small, but keep in mind that each state determines the square footage requirements for nursing home rooms. For example, California requires 80 square feet per bed in shared rooms. 

Furniture typically provided for each nursing home resident

• Bed: The bed is likely motorized so the resident and staff can raise and lower it vertically, tilt the top up and down to allow the resident to sit up easier, and tilt and lower the foot of the bed as well.
• Television: If provided, the TV typically has a remote control that may be integrated with a nurse call button, or it may have a separate TV remote that allows the resident to control the channels and volume without needing to walk over to the TV. 
• Closet space or dresser: Each resident will have private closet space, which may be a closet in the wall, a dresser, or a wardrobe, where they can store extra clothes.
• Bedside table: The bedside table may have a set of drawers inside for additional storage.
• Chair: The chair usually has a cushioned seat and backrest, which the resident or a guest can use during a visit.
• Adjustable, rolling tray table: The rolling tray table usually has an adjustable height and is lightweight so it can be moved around easily.

Other features of a nursing home room

• Bathroom: Most nursing home rooms will have a bathroom that the room’s residents share. The bathroom is likely wheelchair accessible with a wide door and floor space to accommodate a wheelchair. Next to the toilet are usually built-in grab bars and a pull cord to call for help if needed. You’ll find a mirror, hand soap, and paper towel dispenser near the sink. There may not be a shower in the room’s bathroom.
• Window: Each nursing home room will have at least one window. The window treatments are usually vertical or horizontal blinds, and there may be curtains and a valance across the top of the window.
• Call button: Each resident has a call button, like in a hospital room. The call button is located near the bed so the resident can press it to receive assistance without getting out of bed. Pressing the button illuminates a light outside the room and may set off a sound at the nurses’ station, indicating which resident is requesting assistance.
• Privacy curtain: As mentioned above, most nursing home rooms are semiprivate, meaning two residents share one room. To maximize privacy, you’ll find a privacy curtain between the two beds attached to a track in the ceiling. Residents can pull it closed or leave it open when in conversation with one another.

Ideas to make a nursing home room personalized and inviting

Now that you have an idea of what to expect in a nursing home room, let’s go over how you can make it feel more homelike and comfortable.

Involve your loved one

We mention this tip first because involving your loved one will help them feel they have agency over aspects of their life. When moving to an environment where you receive help with many personal tasks and do not have many sources of independence, having the agency to express your preferences for your living space can go a long way.

Talk with your loved one about items they may want to bring, being mindful of space limitations, rules about things like hanging pictures on the wall, and safety. Although it rarely happens, things sometimes disappear from nursing home rooms, so avoid bringing expensive objects, heirlooms, or items with significant meaning.

Visit the room prior to move-in

Before moving in, visit the room to get an idea of what you have to work with before deciding what to bring. Be mindful of the space required by care staff to attend to your loved one’s needs and any equipment they’ll need to use, such as oxygen or a wheelchair. If you’re not sure what equipment they’ll use regularly, you can ask the admission director, the head of nursing, or the director of therapy.

Ask about decoration limitations

Talk with the admission director to learn about restrictions on hanging decorations on walls, furniture that is not allowed, and any other rules the facility has. Ask about the acceptable methods to hang pictures on walls so you can purchase the right products to hang the photos without damaging the walls.

Display personal mementos

Personal mementos can make all the difference in how someone feels in their nursing home room. Mementos evoke positive and comforting feelings that can lift mood and improve well-being. Some suggestions:

• Family photographs: You will need to check with the facility on whether you can place anything on the walls and, if so, what method to use. If wall hangings are not permitted, you could use a digital photo frame, like one from Aura, which you can place on the dresser or bedside table. You can choose between tabletop and wall-hanging frames.
• Personalize the nightstand: Consider adding a personal reading lamp to the nightstand. The overhead fluorescent lights commonly found in nursing homes can be harsh, but the warm glow of a lamp can be comforting. This lamp comes in multiple colors to suit your loved one’s preferences, uses a pull cord to turn on and off, and even has a charging port to keep their cell phone or tablet charged. You can also get an eyeglass holder stand to keep on the nightstand so they do not lose their glasses.
• Knickknacks: Use the top of the dresser for personal items such as figurines or small framed artwork.

Add homelike details

A homey atmosphere can be a challenge to create in a small space, but some ideas include:

• Fresh flowers or plants: Fresh flowers and plants can bring the outside in with fragrance and color. Remember to replenish fresh flowers when they begin to wilt. If live plants aren’t allowed, consider silk.
• Chair: If the facility permits it, bring a favorite chair for visitors to sit in, as long as it doesn’t clutter the room too much.
• Calendar: It is easy to lose track of time in a nursing home. A wall calendar with important dates, including when to expect visitors, can be comforting. Again, check facility regulations about hanging a calendar on the wall.
• Holiday decor: If holidays are important to your loved one, consider decorating the room for holidays.
• Curtains: If the facility allows, replace the room’s curtains with ones your loved one likes.
• Throw blanket and accent pillow: Add a throw blanket to the room decor. The blanket offers extra temperature control, and the cozy fabric can comfort your loved one. While they’re not using it, it can drape over the back of their chair or lie across the foot of their bed for an added homelike feel. Adding an accent pillow is a simple way to incorporate personal aesthetic choices and make the room feel more homelike.

Customize bedding and linens

Considering that your loved one may be spending many hours in bed, using personal bedding can make a significant difference. Check with the facility to learn whether they wash linens you bring from home, and label them to prevent loss.

• Pillow: Bring your loved one’s pillow from home or purchase a better one than the facility provides.
• Sheets: Facility sheets are made for longevity and not necessarily comfort. Bring sheets from home or purchase new ones.
• Bedspread: Consider bringing a personal bedspread or throw for the bed.
• Towels: You may want to bring towels from home if they are better than the ones in the nursing home, making sure you label them.

Noise-canceling headphones or earbuds

One of the more unsettling aspects of sharing a room with another resident is being able to hear them. Noise-canceling headphones that allow your loved one to listen to their favorite music or watch shows on their tablet can block out unwanted noise, improve mood, and have a calming effect.

Personalizing a nursing home room can benefit everyone by making your loved one feel settled in their new living space, encouraging more extended visits from family and friends, and making those visits more familiar and meaningful. Nothing can replace the feeling of home, but your efforts to make things as comfortable as possible will help your loved one adjust and improve while getting the assistance they need.

Maintaining a healthy diet can be challenging for older adults living at home. Although many seniors wish to age in place and experience the benefits of this living situation, they may struggle to get proper nutrition without support. The right foods and nutrition fuel our body, boost our immune system, improve brain function, and keep chronic conditions at bay. Here, we’ll describe some of the common mealtime challenges that older adults face while aging in place and offer ways to overcome them to maintain proper nutrition.

You may have noticed that your aging loved one is unintentionally losing or gaining weight. The National Institutes of Health reports that older adults who are both under- and overweight are at an increased risk of mortality and that malnutrition in older adults is now recognized as a challenging health concern for adults over the age of 65, resulting in physical decline and decreased quality of life. These concerns are caused or exacerbated by some challenges due to aging, especially for older adults who live at home alone or with a spouse who needs care. Here are the most common nutritional challenges facing older adults living at home and tips to maintain healthy eating for seniors.

Meal prep, freeze, and reheat when cooking for one

For many older adults living at home alone, cooking for only one person three times a day can seem overwhelming or even unrealistic, especially if they have spent much of their lives cooking for tables full of children, grandchildren, and guests. Learning how to shrink their favorite recipes to only one serving can feel like quite a difficult task.

Older adults in this situation might benefit from meal preparation, which is making large batches of meals and storing portions for easy reheating later on. Help your loved one select recipes that store well and learn how to refrigerate or freeze individual portions of those favorite recipes so they can grab them later. Invest in containers that hold the perfect portion for different types of meals so they can change the recipe every week. With meal preparation, your loved one can cook in the proportions they are used to but only have to do so every week instead of several times a day.

Instead of relying on processed foods of convenience, meal plan

Many seniors rely on the convenience of processed foods or take-out food from their favorite restaurants as their primary source of meals. While convenience foods certainly can be handy in a pinch, they aren’t a good foundation for a healthy diet. They are often high in calories, salt, sugar, or preservatives and lack the nutrients necessary for your loved one’s well-being.

Again, meal preparation could help seniors who regularly turn to convenience foods. Work with your loved one on developing a healthy meal plan of homemade foods ready to grab in the freezer, fridge, or cabinets. This approach might involve asking family members to assist with meal preparation for the week. You also might consider experimenting with meal subscription services that deliver ready-to-prepare ingredients. These services cut down on shopping and preparation time, allowing your loved one to eat a healthy home-cooked meal without as much trouble.

Meal delivery programs help beat cognitive challenges

Planning and preparing meals can be especially challenging for adults with cognitive decline. Meal preparation and planning are instrumental activities of daily living, or IADLs, which are the functional tasks everyone must do to maintain their household and routine. Meal preparation is one of the first IADLs to go when dementia enters the picture. Without being able to plan and prepare meals at home properly, the senior could end up eating too much or too little throughout the day.

If your loved one struggles with meal prep and planning, consider enlisting a meal delivery program like Meals on Wheels. Contact the senior services department in your loved one’s town to learn more about available services. You also might look into traditional meal delivery services that deliver prepared meals to your loved one’s home. Some delivery services send meals ready to pop in the microwave, so the older adult doesn’t have to do any shopping or detailed preparation. 

Adjust cooking methods to accommodate mobility needs

Moving around the kitchen while preparing a meal is a lot of work, whether you realize it or not. You use gross and fine motor skills as you bend to get a pot, chop carrots and onions, and stir ingredients together. Seniors with mobility or balance challenges may find preparing a meal in the kitchen exhausting or even dangerous, as they might worry about falling or spilling hot food or liquid on themselves.

Help your loved one find a layout in the kitchen that works best for their needs. For example, can you move their most-used pans to the cabinet that is easiest to reach? Can you place a few easy-to-use appliances, like the toaster or air fryer, on the counter so that cooking meals becomes less taxing? 

If you aren’t sure where to start, consider requesting an occupational therapy home visit from your loved one’s physician. They often have recommendations that make instrumental activities of daily living, like meal preparation, easier and safer, which can make healthy eating for seniors more attainable.

Use nutrition programs and budgeting to help pay for food

Adults living on a fixed income often worry about their budget, and with grocery prices increasing, your loved one might choose to buy less food at the store or eat less food in general. Unfortunately, undereating can quickly lead to nutritional complications.

Work with your loved one to determine what percentage of their income should go toward food. Consider coming over weekly to help them clip coupons or look for sales in local stores as they develop their grocery list. Other ways to save money include shopping in bulk or using recipes that incorporate less expensive ingredients. 

Also, consider looking into government assistance programs, such as SNAP or the Senior Farmers Market Nutrition Program, that can help your older adult loved one access nutritious food.

Set a meal and exercise schedule to manage appetite changes

Some older adults find themselves not hungry enough throughout the day to eat at consistent times. This change in appetite can result from different aspects of aging, such as decreased taste, lowered physical activity, and the side effects of medications. Reduced appetite can lead to undereating or even binge eating at the end of the day.

Help your loved one set a meal and snack schedule. Add alarms to their smartphone or digital assistant device to remind them to eat at the specified times. If your loved one still isn’t hungry throughout the day, determine if they spend most of their time sedentary. If so, encourage them to incorporate a walk or some other physical activity into their routine. The activity could stimulate their appetite, which would, in turn, increase their nutritional intake.

Hire home care services to help grocery shop and meal prep

Your loved one might benefit from working with professionals and experts who are trained in healthy eating for seniors. For example, consider setting an appointment with a nutritionist experienced in senior health to lay out a meal plan tailored to your loved one’s preferences and needs. You can use their meal ideas to develop a grocery list that your loved one can use to make planning even more manageable. The nutritionist can also provide snack options high in protein and other nutrients, so your loved one has easy but nutritious food to turn to when they don’t feel like preparing a full meal.

For seniors who have more significant needs with meal planning and preparation, home care might be the best solution. Nonmedical home care agencies often offer meal planning and preparation services. These services involve a caregiver shopping for groceries, coming to the home to plan and prepare meals, and even portioning and labeling leftovers.

Healthy eating for seniors can be challenging but attainable. If you’re concerned about your older adult loved one’s dietary habits, consult their physician and experiment with different approaches to see which ones impact their overall health most. Knowing the different causes for nutritional difficulties seniors may experience can help you figure out how to ensure best that your loved one remains healthy while living at home.