The Handbook of Elder Care Resources for the Federal Workplace

Today, people are living longer, healthier lives and the elderly population is rapidly growing. With diversity and longevity becoming two terms that describe America's workforce and population, the Federal Government is addressing the issues of aging and its impact on our families, work environment, and productivity.

The statistics on aging are overwhelming. As of 1999, there are more than 34 million individuals age 65 or older living in the United States. By the year 2030, it is expected that this number will exceed 70 million, more than double the present number. The average age of the Federal full-time employee is 45.6 years. Moreover, an increasing number of these employees face the challenges and responsibilities of caring for an aging family member or friend. Approximately 25.8 billion Americans spend an average of 18 hours a week caring for an ailing relative. Women, the traditional caregivers to elderly persons, today make up 44.4 percent of our workforce.

Given these demographics, it is important that the Federal Government offer elder care programs, policies, and initiatives to assist employees who are currently, or who will be caregivers with family and work/life demands.

The Handbook of Elder Care Resources for the Federal Workplace was developed to introduce you -- the employer and employee caregiver -- to the various services and resources that are available to help you make informed elder care decisions. From choosing an assisted living arrangement to dealing with the complexities of social security income, this Handbook provides practical tips and solutions to these complicated aging issues.

The Handbook describes a variety of community resources that are offered around the country to help older adults function independently and discusses housing options, financial and medical considerations, nursing homes, and home health care agencies. It also provides a listing of:

• Federal and National Elder Care Organizations;
• Area Agencies on Aging; and
• State Long-Term Care Ombudsman Offices.

The U.S. Office of Personnel Management (OPM) is committed to helping employees who care for elderly parents and older persons to meet their obligations to their families, personal responsibilities and the job.

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Table of Contents

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Elder care is a broad field that recognizes the role of the adult caregiver as one that provides essential services to a parent or older person. Often employees do not recognize their role as a caregiver nor do they realize that help may be available in the community to assist an older person. Sometimes it is difficult for an employee to remember that he or she has needs that should be met. Ask yourself the following questions:

Am I concerned about the safety or welfare of an aging relative or friend?

Do I help an older person from time to time with household tasks such as grocery shopping, paying bills, or house cleaning?

Am I providing personal care -- bathing, feeding, grooming -- to a parent or older person who needs assistance in these areas?

If you answered YES to any of these questions, you are a caregiver. Caregiver is a term describing a person who is concerned about or provides assistance to another because of physical or mental limitations. A caregiver can help anyone -- a child, a disabled person, or an aging individual. However, this handbook is intended to help people who are employee caregivers of a parent or older person.

Your agency's Employee Assistance Program (EAP) may be helpful in assisting you with problems or concerns you may be experiencing as a caregiver. An EAP counselor also can direct you to the appropriate resources that will help your parent or older person. In addition to the listings in this book, there are many other resources available to help caregivers do their jobs. If you would like to receive a fact sheet on caregiving, a pamphlet titled "Caregiving: 1st Line of Defense," or a resource list of national organizations that offer free or low-cost resources, contact the Older Women's League (OWL) at 1-800-TAKE OWL from 9:00 a.m. - 5:00 p.m. (Eastern Standard Time). The OWL is a non-profit organization that seeks to educate the public about issues affecting middle-aged and older women.

Employee caregivers can find other services, sources of help, and emotional support on several World Wide websites created by national caregiving and home care associations. Some of these include:

This section of the Handbook was written with the assistance of the Older Women's League.

Many people associate the aging process with the need for nursing home care. In fact, most persons do not need nursing home care. Instead, many parents or older persons can remain independent, but frequently need assistance with various daily living tasks. Communities throughout the United States offer varied services for their aging populations. Check with the social services office of your parent or older person's local government to determine which services are available in his or her area. Utilizing these community resources can help your parent or older person live more comfortably and remain independently in his or her home. In addition, a parent or older person who have chosen an alternative living arrangement, such as congregate housing, can use these services as an additional tool to make daily living simpler. The list below will familiarize you with some of the community resources that may be available in your parent or older person area and suggest the general availability of these services across the country. Remember, you must contact the local government where your parent or older person resides to determine if these services are available in his or her area.

Adult Day Care

Adult day care centers offer a variety of health care and social services for people who need assistance with personal care such as grooming or toileting, but not around-the-clock care. Round trip transportation may be provided to the center where people may spend a few hours or all day.

Availability - Adult day care center availability varies. The centers may be operated by hospitals, nursing homes, religious organizations or privately owned care centers. Contact your parent or older person's Area Agency on Aging for information.

Area Agencies on Aging

Area Agencies on Aging (AAA) provide access to a variety of services to older persons in communities throughout the United States. These services include: information and referral, homemaker/home health aides, transportation, congregate care and home-delivered meals, chores, and other supportive services.

Availability - AAAs are located in every State. The types of services they offer will differ. A partial listing of AAA addresses and telephone numbers are provided in the Resource and Referral Services section of this Handbook.

Assistive Products

Assistive products are services and devices that can be purchased or rented to help people function better at home. These may include devices for persons with hearing and/or visual impairments and those who need help in walking or moving about.

Availability - Assistive products may be available from medical equipment rental stores or electronic product retail stores. Several States have assistive products and devices distribution programs operated by the State rehabilitation agency for the disabled.

Case Management

Case management is a method of assessing a person's total care needs, arranging for necessary services, and coordinating the delivery of services. Since care problems rarely occur one at a time and services may be fragmented, this service can be used by caregivers to coordinate a care plan.

Availability - While availability varies, case management services are becoming more widely available. Contact your parent or older person's AAA for information.

Friendly Visitors

Friendly visitors are volunteers who regularly visit older persons who may need companion- ship. They may read, write letters, run local errands, etc. for the older person.

Availability - Friendly visitors are usually provided by a religious or volunteer organization. Contact your parent or older person's church or synagogue or the Visiting Nurses Association to see if the service exists in their community.

Home Adaptation

Home adaptation means making changes to your parent or older person's home to accommodate his or her changed needs. Adaptation may include small changes like installing grab bars, or major changes such as widening doorways for wheelchairs or installing a bathroom on the first floor of the home.

Availability - You need a good contractor and a good idea of what your parent or older person wants done. Seek advice from professionals you know you can rely on, such as an occupational therapist, before hiring anyone to do major jobs.

Home Chore Services

Home chore services offer minor household repairs, household cleaning, and yard work.

Availability - Home chore services are widely available. Contact your parent or older person's AAA for information.

Home-Delivered Meals

Home-delivered meals or "meals-on-wheels" is a service that delivers hot, nutritious meals once or twice a day, usually five days per week. Most home-delivered meal programs can accommodate special diets.

Availability - Home-delivered meals are widely available. Contact your parent or older person's AAA for information.

Home Health Care

Home health care covers a wide variety of medical services provided by such professionals as nurses or physical therapists.

Availability - Home health care is widely available. Contact your parent or older person's Visiting Nurses Association or AAA. Refer to the Practical Tips for Elder Care section for a helpful checklist on selecting a home health care agency. Also, see the Resource and Referral Services section for a listing of home health care resources.

Home Maintenance and Repair Programs

Home maintenance and repair programs (usually sponsored by nonprofit organizations) provide home maintenance, home repairs, and help with emergencies such as frozen pipes. No major improvements or cosmetic changes are included. Some programs will help you work with contractors.

Availability - These programs are widely available. Contact your parent or older person's AAA for information.

Homemaker Services

Homemaker services include assistance with grooming and dressing, and help with meal preparation, food shopping, or light housekeeping.

Availability - Homemaker services are widely available. Contact your parent or older person's AAA for information.

Hospice Care

Hospice is a special kind of care for terminally ill people and their families. It does not focus on recovery through medical treatment, but instead helps people cope with the physical and emotional pain of dying from a clearly terminal illness. Hospice care may be given at home or in a hospice facility, and may be provided by or supplemented by trained volunteers, as well as by family members. Insurance coverage for hospice care varies. Medicare will provide benefits to patients who are diagnosed as being terminally ill, but patients receiving hospice benefits waive their regular Medicare coverage while they are under hospice care.

Availability - Availability varies from State to State. Contact your parent or older person's AAA for information. You can also contact your parent's State hospice or home care association, the Foundation for Hospice and Homecare at (202) 547-6586, or the Hospice Association of America at (202) 546-4759.

Nutrition Services

Nutrition services provide people with inexpensive, nutritious meals in group settings such as senior centers, churches, synagogues, or senior housing. Nutrition sites may provide transportation.

Availability - Nutrition services are widely available. Contact your parent or older person's AAA for information.

Personal Emergency Response Systems (PERS)

PERS are emergency alert button devices that are placed in the home and can be pressed to summon help from emergency response centers such as hospitals or 800 numbers.

Availability - Approximately ten national companies manufacture PERS. They may not be readily available in all areas. Contact your parent or older person's AAA for information.

Respite Care

Respite care provides short-term relief to people who care for a parent or older person at home. The respite can be for a few hours or several days. It may be provided at home, at adult day care centers, or at hospitals overnight.

Availability - Respite care services are widely available. Contact your parent or older person's AAA for information.

Senior Centers

Senior centers offer older people an oppor- tunity to socialize and a place to meet. They offer a wide variety of social, educational, and recreational programs. Some senior centers provide transportation services.

Availability - Senior centers are widely available. Contact your parent or older person's AAA for information.

Telephone Reassurance

Telephone reassurance is offered by volunteers who arrange to talk to older persons daily to ensure that "all is well." This service is especially helpful to people who live alone.

Availability - Availability varies in communities. Contact your parent or older person's AAA, church or synagogue, or Visiting Nurses Association.

This information is reprinted with permission from the AARP's publication Tomorrow's Choices.

Many people assume that a nursing home is the only option for parent or older persons who can no longer live alone in their own homes. However, there are many housing alternatives available. The information listed below will familiarize you with some of these options. The questions that follow each section suggest what you, your parent, or an older person might consider before selecting an alternative living arrangement. Please note that although this section refers to "parent," it applies to both parents.

Having a Parent Move in With You

For many people, having a parent move in with them is the best choice when living alone is no longer possible for the older person. For other people, it can be a difficult choice. If you are considering such an arrangement, you need to talk seriously with your immediate family and your parents to understand how each one of them feels. You also need to be sure to express all of your feelings about the situation. Talk with friends whose parents live with them and try to understand what it's like for them. Think through the questions listed below for both parents and children and discuss the issues together before agreeing to this living arrangement.

Questions for the Adult Child

• Do you want your parent to move in? Have you been honest in expressing your feelings about it?
• Are you aware of local services that could help you through difficult situations?
• If you don't want your mother or father to move in, but it must happen anyway, will you be able to handle it?
• How much time can you spend with your parent? Have you explained what your weekdays and weekends are like?
• Do you expect your parent to do chores around the house? Is this a reasonable expectation? Have you talked to your parent about what to expect and why?
• Can you afford it?

Questions for the Parent

• Does your son or daughter want you to move in? If not, and you move in anyway, will the emotional strain be too much on you?
• How will living expenses be shared?
• What will you use for transportation? Will you have easy access to shopping, a place of worship, friends, and other interests of your own?
• Do you have friends in the area where your children live? Are there people close by with whom you can create friendships?
• Will you be able to accommodate your child's lifestyle?
• Will you be able to live with your children's children?
• Can your children afford to have you live with them?
• How will your presence affect family relationships?
• How much time will you expect your child to spend with you?

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Foster Care

Foster care is a social service that places an older person who is in need of a modest amount of daily assistance into a warm home environment. The costs vary, and may be covered by the State social services program. The older person may be expected to contribute to the stipend paid to the family providing the foster care. The availability of this program is limited. Contact your AAA for more information.

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Home Sharing

As an alternative to moving into your home, your parent may want to consider sharing their home with others, moving into someone else's home, or finding a new house that can accommodate them and several other people. Shared households can be arranged either by sharing expenses or by exchanging services for rent. For example, a homebound homeowner might prefer having someone do housework, shopping, yard work, or other errands in exchange for free lodging. This sort of arrangement should be put in writing, so there are no misunderstandings later

Consider these issues:

• Do local zoning laws in your parent's community permit two or more unrelated people to share a house? Check with your local zoning or planning board.
• Will your parents want to share their home or move to share another's home?
• How will your parent's personality fit with a potential housemate's?
• Do a background check with the local law enforcement agency and be careful about giving the person(s) sharing the home access to the home owner's financial information.
• How will sharing affect your parent's finances?
• How will your parent resolve differences that arise?
• What will new income do to your parent's eligibility for certain public benefits like Supplemental Security Income and Food Stamps?
• What will your parent's responsibility be if his or her housemate becomes ill?

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Adding an Accessory Apartment

Another way your parent can remain at home is to add a separate, self-contained apartment unit to his or her house, called an accessory apartment. This allows your parent to stay in his or her house but not be alone, and the rental income will provide him or her with additional living resources. Creating a new kitchen, bath and access are usually the most expensive changes to be made; however, your parent's home may only require minor changes to accommodate an accessory unit.

Before your parent starts building, you might consider:

• Do zoning laws allow accessory apartments? Check with your parent's local zoning or planning board before making plans.
• Will the cost of the renovation, increased utility bills, higher taxes, and insurance premiums be covered by the rent your parent receives?
• Will the benefit of having someone nearby be worth the expenses?
• Will your parent expect his or her tenant to be a companion or will your parent have a landlord/tenant relationship?
• Is sufficient parking available?
• How will your parent divide costs like taxes and utilities between himself or herself and the renter?
• Will your parent be able to manage the responsibilities of a landlord?
• Will your parent be able to find tenants?

Before your parent searches for a tenant, consider whether he or she wants a companion, someone who provides home services, or just a renter. If your parent needs help around the house, some tenants may be willing to exchange services for rent. Any arrangement for exchange of services in lieu of rent should be put in writing as part of the rental agreement. Also, it is important to be alert to any tax consequences in this type of exchange services.

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ECHO Housing

If you and your parent don't wish to live together, having your parent live in a cottage on your property might be a workable alternative. Elder Cottage Housing Opportunity (ECHO for short) units are small, self-contained, portable housing units that can be placed in the back or side yard of a single family house. They were first manufactured in Australia to enable parents to remain near their adult children and families. ECHO units provide closeness, while retaining privacy for both parties. The cost of ECHO housing is less than a new home. For example, companies in California and Pennsylvania offer completely installed one-bedroom units with more than 500 square feet of living space for around $25,000.

Consider these issues:

• Do zoning laws restrict this type of structure? Check with your local zoning or planning board.
• Is there adequate yard space for both structures?
• What will the local tax treatment be? Will it add to the value of your property?
• Are utility hook-ups available?

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Board and Care Homes

Board and care homes go by many names (including personal care homes, residential care facilities, assisted living, and domiciliary care). In exchange for rent, generally they provide room, meals, laundry and house-keeping, and regular contact with staff to ensure that "all is well." The daily contact with staff is what distinguishes "board and care" homes from the more familiar boarding houses. Your parent would share this home, of course, with a number of other residents.

Visit the home with your parent before a decision is made. Look at the private room your parent may occupy. Ask lots of questions about the services and evaluate the staff. Ask for references and check the home's record with the local or State licensing agency.

Consider these issues:

• Will your parent have privacy and independence?
• Is common space available?
• How much will it cost, including add-ons to the rent?
• Is it near public transportation, places of worship, and shopping?
• Can your parent's special dietary needs be met?
• Does the home comply with local licensing, fire, and zoning laws? Is it licensed by the State?
• What are the arrangements for sharing bathrooms?
• Will your parent have to climb stairs?
• Are there security locks on each room?
• Will your parent have access to a telephone?
• Are pets allowed? Who will care for them?

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Congregate Housing

Congregate housing is usually an apartment complex that provides each tenant a full apartment, serves meals in a central dining room, and provides housekeeping services. It is different from board and care homes because the individual units include kitchens and because it provides a professional staff that may include social workers, counselors, or nutritionists.

Today, most congregate housing facilities are sponsored by non-profit agencies and range in size from 35 to 300 living units. You may find congregate housing facilities listed under "Retirement Communities" in your local telephone directory.

The rents vary, and Federal subsidies often help cover a portion of rental fees.

Consider these issues:

• Is transportation to stores, places of worship, and other services available?
• Can the facility accommodate your parent's special dietary needs?
• Is there adequate security for your parent's personal belongings?
• What in-house services are available? Look for services such as occupational and physical therapy, counseling, recreational and social activities, a library, and daily telephone monitoring.
• Do services like physical therapy cost extra? Be sure to check for all costs in advance.
• What is the policy on bringing personal furniture?
• Are pets allowed?
• How does your parent feel about the overall atmosphere of the facility?

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"Life Care" or Continuing Care Retirement Communities (CCRCs)

Continuing care communities offer the benefit of independent living in apartments and houses, but with health care services and a nursing facility on the premises. Payment for nursing care and many other services is sometimes made in advance.

The cost of a continuing care community can be high. The entrance fee can range from $50,000 to $250,000 (which may or may not be refundable) and you must also pay monthly fees (that can increase while you are a resident).

The difference between a continuing care community and board and care homes or congregate housing is that continuing care communities provide a commitment to take care of residents regardless of any changes in their health, for as long as they reside in the community.

If your parent is considering a move to a continuing care community, BE CAUTIOUS. Some continuing care communities have financial problems. You may wish to review the facility's financial statement with an attorney or accountant and note its cash reserves and its policy for using them. Check with the local or State Long-Term Care Ombudsman and the Better Business Bureau or the Consumer Protection Office in the CCRC's locality to be sure it has not generated complaints of any kind.

Consider these issues:

• How complete is the nursing facility? What services does it provide?
• What medical costs does the contract cover?
• What is the policy for transferring residents between apartments and the nursing facility?
• Is the management open and responsive to resident concerns?
• Do the fees cover all of your parent's costs?
• Does your parent have to pay extra for anything (such as laundry)?
• Are places of worship nearby?
• Is transportation to needed services, like grocery stores, available?
• Is there access to a telephone?
• What is the refund policy for deposits and entrance fees? How is the amount of the refund calculated? When is your parent entitled to receive a refund?

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Nursing Homes

Nursing homes are for people who need extensive and extended health or personal care. Many people live in nursing homes unnecessarily because they thought they had no other alternatives. Nursing homes are intended only for those who are seriously ill--not for people who feel they have no other options.

There are two levels of care:

Skilled Nursing--is for persons who need intensive care, 24 hour-a-day supervision, and treatment by a registered nurse under the direction of a physician.

Nursing Facility--is for persons who need 24 hour-a-day supervision under the direction of a registered nurse and a physician.

The level of care required is determined by a person`s physician. In addition, many States require and conduct pre-screening of potential nursing home residents to determine the level of care needed. Your parent`s local social service agency or the admissions person at any nursing home can direct you to the agency that makes this determination.

There are about 20,000 nursing homes in the United States, serving about 5 percent of the older population. The chances are about one in four that an individual will need to reside in a nursing home at some time in his or her life. The cost for staying for one year in a nursing home generally ranges between $20,000 and $48,000. Medicare and private medigap insurance plans reimburse very little of the cost. An extended stay in a nursing home can wipe out a family`s savings, so advance planning for this eventuality is critical. Only when a nursing home patient becomes impoverished, does Medicaid begin to pay the cost of nursing home care.

Before entering a nursing home, ask yourself:

• Have you explored thoroughly with your parent the home and community-based options described in this book?
• How will your parent meet the expenses?
• How will your parent cope with the institutional atmosphere? The loss of independence?
• Is the home convenient for visiting by family and friends?
• Is the home clean and odor free?
• Can the home ensure the security of your parent's possessions?
• What levels of care are available? Are they appropriate to your parent's needs?

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Ombudsman

To help you in selecting the right nursing home for your parent, consider contacting the local ombudsman. The ombudsman program is a significant part of the nursing home system. Federal law requires each State Agency on Aging to have an Office of the Long-Term Care Ombudsman, and more than 500 local ombudsman programs now exist nationwide.

These offices provide help and information to older Americans, their families, and friends regarding long-term care facilities. The local ombudsman also can help to ensure that your parent receives good care throughout his or her stay. Keep in mind that the ombudsman cannot advise you on one particular nursing home, but will supply current information regarding nursing homes near you or your parent.

Ombudsman functions include:

Visiting nursing homes on a regular basis;

• Receiving and investigating complaints made by or on behalf of nursing home residents and working to resolve the problems;
• Referring un-resolvable problems or findings of serious violations of standards in a nursing home facility to State Health Departments for action; and
• Providing information on licensed long-term care facilities in the State or local area including the number and nature of complaints against a facility, results and conclusions of the investigation into these complaints, and advice on what to look for as tell-tale signs of good care in facilities.

Refer to Resource and Referral Services for a list of State long-term care ombudsman offices.

Refer to Practical Tips for Elder Care for a list of helpful suggestions and a checklist that can be used when you visit nursing homes.

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Nursing Home Telephone Interview

Once you identify what you want and need in a home, simply telephoning some of the nursing homes on your list may eliminate the need to visit them. Some of the key questions that you may ask over the phone to facilities are:

• Is the nursing home certified for participation in the Medicare or Medicaid programs?
• What are the facility`s admissions requirements for residents?
• What is the "typical profile" of a resident in the facility? For example,if a family member requires temporary rehabilitation services and the nursing home specializes in Alzheimer`s disease care, it`s probably not a good match.
• Does the nursing home require that a resident sign over personal property or real estate in exchange for care?
• Does the facility have vacancies, or is there a waiting list?

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People To Talk To

• Your family (or a trusted advisor) about their reactions to the plans your parent is making;
• At least one person who lives in the type of facility your parent is contemplating;
• The Better Business Bureau and Consumer Protection Office in the area where the facility or service is located, to check on its reputation;
• An attorney if your parent will be required to sign a contract; and
• State and local Long-Term Care Ombudsman Programs that are set up to investigate complaints and mediate disputes between residents and/or their families and nursing home facilities. You can find them through your State Agency on Aging.

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Housing and Nursing Home Resources

A number of resources are available that may be of help when considering housing options.

Write to AARP to obtain a free copy of the following publications. Include the title and publication number.

AARP Fulfillment
601 E Street, NW.
Washington, DC 20049

• Staying at Home: A Guide to Long-Term Care and Housing -- Publication No. D14986
• Tomorrow`s Choices: Preparing Now for Future Legal, Financial, and Health Care Decisions -- Publication No. D13479
• Nursing Home Life: A Guide for Residents and Families -- Publication No. D13063

Write to the American Association of Homes for the Aging to receive a copy of the following publications:

American Association of Homes for
the Aging (AAHA) Publications
901 E Street, NW., Suite 500
Washington, DC 20004-2037

• Continuing Care Retirement Community: A Guidebook for Consumers
• The Continuing Care Consumer Brochure: A Life Style Offering Security and Independence
• Living Independently: Housing Choices for Older People (brochure)
• Choosing a Nursing Home: A Guide to Quality Care(brochure) -- Publication No. CF015
• The Nursing Home and You: Partners in Caring for a Relative with Alzheimer`s Disease

Write to Department of Health and Human Services at:

HHS - Centers for Medicare and Medicaid Services
6325 Security Boulevard
Baltimore, MD 21207

For a free copy of

• Guide to Choosing a Nursing Home -- Publication No. HCFA-02174

With the exception of the Nursing Home Telephone Interview information, the housing alternative information was borrowed from two AARP publications, Tomorrow`s Choices and Nursing Home Life: A Guide For Residents and Families, and is reprinted here with permission from AARP.

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When an aging family member suddenly needs help with daily living tasks or must enter a nursing home, the emotions of such a change can interfere with a family`s ability to make decisions. The decision making process can seem overwhelming, particularly if legal concerns are involved. While dealing with your parent`s legal concerns may seem difficult, you need not feel overburdened. The best defense against confusion and uncertainty in coping with legal issues is to prepare in advance of change. The information in this section offers some suggestions for preparing you and your parents for the day they may need your assistance in handling their legal affairs. "Getting Your Affairs in Order" provides an easy process for aging parents to organize their legal affairs should they need assistance later on. The second part of this section defines legal terms that relate to the aging field. Regardless of your circumstances, everyone should read this section and become familiar with the legal issues that affect many aging adults and their children.

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Getting Your Affairs in Order

 Relatives and friends sometimes must help older people manage their legal or financial affairs temporarily or even gradually assume these responsibilities. Often the person who provides care has little knowledge of vital information and records. If papers are in order, the task is much simpler.

Although each situation is different, the following suggestions can help most people begin creating a financial and personal records file.

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Personal Records File

A personal records file should include the following information:

• Full legal name;
• Social Security number;
• Legal residence;
• Date and place of birth;
• Names and addresses of spouse and children (or location of death certificates if any are deceased);
• Location of will or trust;
• Location of birth certificate and certificates of marriage, divorce, and citizenship;
• List of employers and dates of employment;
• Education and military records;
• Religious affiliation, name of church or synagogue, and names of clergy (if desired);
• Memberships in organizations and awards received;
• Names and addresses of close friends, relatives, doctors, and lawyers or financial advisors; and
• Requests, preferences, or prearrangement for burial.

A family member or friend should know the location of this personal records file and the location of all important papers and  documents, although it is not necessary to reveal the contents of wills or trusts.

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Financial Records File

In making a financial records file, list information about insurance policies, bank accounts, deeds, investments, and other valuables, using this outline:

• Sources of income and assets (pension funds, interest income, etc.);
• Social Security and Medicare information;
• Investment income (stocks, bonds, and property);
• Insurance information (life, health, and property), with policy numbers;
• Bank accounts (checking, savings, and credit union);
• Location of safe deposit boxes;
• Copy of most recent income tax return;
• Liabilities--what is owed to whom and when payments are due;
• Mortgages and debts -- how and when paid;
• Credit card and charge account names and numbers;
• Property taxes; and
• Location of personal items such as jewelry or family treasures.

Having this information available can help you or a family member plan for any change in later years--retirements, a move, a death in the family--and can help you or a family member make wise decisions.

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Legal Definitions

Many communities offer legal services. For those elderly who are unable to manage their own affairs appropriately, legal and/or protective services may be needed. Such services are designed to safeguard the rights and interests of older persons, to protect them from harm, to protect the property of older persons, and to provide advice and counsel to older persons and their families in dealing with financial and business concerns. Older persons and their families should become familiar with the following legal terms.

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Power of Attorney

This is a legal device which permits one individual (the Principal) to give to another person (the attorney-in-fact) the authority to act on his or her behalf. The person with power of attorney is then authorized to handle banking and real estate, pay bills, incur expenses, and handle a wide variety of legal affairs for a specific period of time. This can continue indefinitely as long as the person granting power of attorney remains competent and is capable of granting power of attorney. This kind of power of attorney expires when the Principal becomes comatose, mentally incompetent, or dies.

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Durable Power of Attorney

Most people feel more secure knowing that, in the event of incapacity, a trusted person and not the courts will make decisions and carry out their wishes. A Durable Power of Attorney gives a specified person this right despite the physical or mental incompetence of the elder. It terminates only upon the death of the grantor (Principal) or if revoked by a legally appointed guardian or by the grantor if he or she remains competent.

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Guardianship or Conservatorship

A guardianship or conservatorship, arranged through an attorney, blocks a person from acting on his or her own behalf. This arrangement is useful when a person is incapable of managing financial and/or personal affairs, or does not know that he or she is managing poorly, and this incapability poses a major threat to his or her well-being. All guardianships must be approved by a court and actions taken by a guardian are overseen by the court.

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Social Security Representative

In the event a parent or older person cannot sign a Social Security check, the Social Security office will appoint a person, institution, or community association as representative payee. The name on the Social Security check is changed from the direct beneficiary`s to the payee`s, and the payee is then responsible for distributing the money on behalf of the beneficiary. Social Security checks can also be directly deposited in most situations.

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Will

A will is a legal declaration of how the deceased wants his or her money, property, and other possessions disposed of after death. A will also can be used to determine guardianship of minor children and to set up trusts for heirs who may have an inadequate knowledge of how to manage inherited money or property.

Without a doubt, every person with property of any value should have a will. However, many people delay thinking about death and then die intestate, that is, the State distributes their estate according to the laws of the State. When drawing up a will, a parent and older person should make a list of his or her resources and clarify and write down his or her wishes. The parent and older person must choose an executor and witness to the will. The parent and older person also has the responsibility to review it periodically, to keep it up-to-date, and to see that it is stored in a safe place. You should know where your parent or older person`s will is kept.

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Living Will

A living will is a document that allows people to state, while they are still able, their wishes regarding the use of extraordinary measures or procedures to keep them alive when it is evident that they are dying. The living will may also appoint someone else (a relative, friend or attorney) to direct health care if the person signing the living will is unable to do so.

In most cases, people who sign living wills want to be certain that they will not receive unwanted or unwarranted treatment if death is near and they have no reasonable expectation of recovering. Others may want to make clear that they want to be at home when death is imminent, or that they want to donate their organs after death. Currently, 38 States and the District of Columbia have recognized the Living Will as legally binding under most circumstances.

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Legal Aid

There are a few programs that will provide low-cost legal services to a parent or older adult. Legal aid offices are set up to provide low income individuals with legal services if they meet eligibility guidelines. A parent or older person can sometimes receive help with government forms, tax forms, wills, etc., from retired attorneys, volunteers from the Bar Association, or paralegals who are supervised by an attorney. Some States have toll free telephone numbers that a parent or older person can call and talk with an attorney. Contact your local AAA or senior center for further information on these programs.

These definitions were borrowed from The Partnership Group, Inc. and are reprinted here with their permission.

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Will

The information in this section briefly discusses financial considerations that you and your parent or older person may wish to consider. The information is in no way intended as financial advice nor as a comprehensive overview of parent or older person financial concerns. Instead, this section is intended to introduce you to or remind you of some common financial topics that concern parent or older persons.

Most of the information concerns Social Security income. To receive additional information on any topics listed below contact the Social Security Administration. The Social Security Administration can answer many questions about the Social Security system and can send you free informative brochures on its programs. Refer to the resources listed at the end of the Social Security and Health Insurance sections for a partial listing of these publications.

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Social Security

Social Security--The General Idea

The basic idea behind Social Security is a simple one. An individual pays taxes to the system during his or her working years, and the individual and members of his or her family receive monthly benefits when he or she retires or becomes disabled. Or, survivors collect benefits when an individual dies.

Here's An Important Point: Social Security is not intended to be an individual's only source of income. Instead, it is meant to be used to supplement the pensions, insurance, savings, and other investments accumulated during the working years.

There are three types of Social Security benefits:

• Retirement Benefits provide retirement income to retired workers and their families
• Survivors Benefits provide income security to family members upon the death of a breadwinner
• Disability Benefits provide protection against the loss of family income due to the disability of a breadwinner.

What is Supplement Security Income?

SSI is short for Supplemental Security Income. The SSI pays monthly checks to people who are 65 or older, or disabled or blind and who have low incomes and few assets. SSI isn't just for adults. Monthly checks can go to disabled and blind children, too. People who get SSI usually get Food Stamps and Medicaid, too.

The amount of SSI money your parent or older person receives depends on where they live. The basic SSI check is the same nationwide. However, many States add money to the basic check. Call the Social Security Administration's toll free number -- 1-800-772-1213 -- to find out the amounts for your parent's or older person's State.

Signing Up

For disability, survivors, and SSI benefits, your parent or older person should apply as soon as he or she is eligible. When signing up for retirement, Social Security asks that an individual do so about three months before he or she wants the benefits to start.

When Individuals Need Help Handling Their Benefits

Sometimes Social Security or SSI recipients are not able to handle their own financial affairs. In those cases, the Social Security Administration turns to a relative, a friend, or another interested party to handle a person's Social Security matters. This person becomes the "representative payee." All Social Security or SSI benefits due are made payable in the payee's name on behalf of the beneficiary. Contact the Social Security Administration for more information.

Booklets Available

The Social Security Administration produces many publications and fact sheets designed to help explain these programs to you or your parent or older person.

To obtain free copies of the following, call or write the Social Security Administration:

Dept. of Health and Human Services
Social Security Administration
Baltimore, MD 21235
Toll Free 1-800-772-1213

• Retirement- A guide to Social Security retirement benefits
• Disability- A guide to Social Security disability benefits
• Survivors - A guide to Social Security survivors benefits
• Medicare- A guide to the Medicare program
• Supplemental Security Income- A guide to the SSI program
• Understanding Social Security- A comprehensive explanation of all the Social Security Programs
• A Guide For Representative Payees - A guide for representative payees

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Additional Financial Resources for Women

To receive a copy of the book, Women and Money: The Independent Woman's Guide to Financial Security for Life, by Frances Leonard, write to the Older Women's League at the address below and include a check or money order for $12.95.

OWL
666 11th Street, NW., Suite 700
Washington, DC 20001

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Tax Information

The following list of tax publications may be useful in understanding the often complex tax laws that govern an parent or older person's money. You may need to contact a lawyer to receive additional assistance.

Contact the Internal Revenue Service (IRS) toll free at 1-800-829-3676 to order the following free tax guides:

• Tax Information for Older Americans- Publication No. 554
• Social Security Benefits and Equivalent Railroad Retirement Benefits - Publication No. 915
• Credit for the Elderly or the Disabled-Publication No. 524
• Tax Information for Survivors, Executors, and Administrators - Publication No. 559
• Pension and Annuity Income - Publication No. 575
• Child and Dependent Care Expenses-Publication No. 503
• Tax Rules for Children and Dependents -Publication No. 929
• Tax Counseling for the Elderly Handbook- Publication No. 1114
• Guide to Free Tax Services - Publication No. 910

Tax Assistance

Contact the IRS toll free at 1-800-829-1040 to  receive assistance in filling out tax forms for older persons. The IRS will refer you to a volunteer tax assistant in your area.

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The information listed below briefly describes government funded and other health insurance programs for parents or older persons. To receive further information on any of these programs contact the Social Security Administration toll free at 1-800-772-1213 or contact your local Social Security office.

Medicare

Medicare is our country's health insurance program for people 65 or older, certain disabled people under 65, and people of any age who have permanent kidney failure. It provides basic protection against the cost of health care, but it doesn't cover all medical expenses.

Medicare has two parts: Hospital Insurance (Part A) and Medical Insurance (Part B). Hospital Insurance helps pay for inpatient hospital care, skilled nursing facility care, home health care, and hospice care. It is paid for by the payroll tax Federal Insurance Contribution Act (FICA) that also pays for Social Security. Medical Insurance helps pay for doctors' services, outpatient hospital services, ambulance services, diagnostic tests, therapies, durable medical equipment, medical supplies, and prosthetic devices. Medical Insurance is financed by monthly premiums paid by people who choose to enroll.

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Medicaid

Many people think that Medicaid and Medicare are two different names for the same program. But actually, Medicaid is a State-run program designed primarily to help the elderly and others with low income and little or no resources. Each State has its own rules about who is eligible and what is covered under Medicaid. However, all States cover basic inpatient and outpatient medical services, and various additional services may be provided at the option of the individual States.

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Qualified Medicare Beneficiary

If your parent or older person gets Medicare, and has little income or resources he or she may be eligible for the "Qualified Medicare Beneficiary" -- or QMB -- Program. If your parent or older person qualifies,  the State he or she lives in will pay their Medicare premiums, deductibles, and co-insurance. If you think your parent or older person may qualify, contact his or her State or local medical assistance (Medicaid) agency, social services office, or welfare office for information.

Medigap

Medicare provides basic health care coverage, but it doesn't pay all medical expenses, and it doesn't pay for most long-term care. For this reason, many private companies sell insurance to fill the gaps in Medicare coverage. This kind of insurance is often called "Medigap" for short. Contact the Health Care Financing Administration's Medigap Hotline toll free at 1-800-638-6833 for more information on Medigap.

When Individuals Need Help Handling Their Benefits

See the section Financial Matters for an explanation of the representative payee system.

Booklets Available

The Social Security Administration (the organization that provides information about the Medicare program) and the Centers for Medicare and Medicaid Services (the organization that administers the Medicare program) produce many publications and fact sheets designed to help explain these programs to you or your parent or older person.

For a free copy of the following publications, write or call the Social Security Administration at:

Social Security Administration
Public Information Distribution Center
Public Affairs Office, P.O. Box 17743
Baltimore, MD 21235
Toll free 1-800-772-1213

• Medicare- A straight-forward guide to the Medicare program.
• You Should Know About QMB- A guide to the QMB program.
• A Guide for Representative Payees - A guide for representative payees.

To obtain a free copy of the publications, write or call the Health Care Financing Administration at:

Medicare Publications
Centers for Medicare and Medicaid Services
6325 Security Boulevard
Baltimore, MD 21207
Toll Free 1-800-638-6833
8:00 a.m. - 8:00 p.m.
Eastern Standard Time

• The Medicare 1996 Handbook - A handbook of the Medicare program.
• Medicare: Hospice Benefits- A guide to the medical and support services available to Medicare beneficiaries with terminal illnesses.
• Medicare and Advance Directives - A guide to what action elders need to take to make sure that decisions made now - in advance of becoming ill - will be followed in the event they become physically or mentally unable to communicate their wishes about the type of treatment they wish to receive or who can make those decisions.

Medigap Resources

For a free copy of the 1999 Medicare and You, write or call the Health Care Financing Administration at:

Medicare Publications
Centers for Medicare and Medicaid Services
6325 Security Boulevard
Baltimore, MD 21207
Toll Free 1-800-638-6833
8:00 a.m. - 8:00 p.m.

Write to AARP for a free copy of the following publications. Include the title and publication number.

AARP Fulfillment
601 E Street, NW.
Washington, DC 20049

• Medigap: Medicare Supplemental Insurance - A Consumer's Guide -Publication No. D-14042
• Before You Buy: A Guide to Long-Term Care Insurance - Publication No. D-12893.

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Establishing An Elder Care Support Group

A Guide for Group Coordinators, Employee Assistance
Program Counselors and Work/Life Managers

As an increasing number of employees face the responsibilities of caring for an aging family member, many employers are searching for ways to help their employees balance the demands of caregiving and work. One effective and useful tool is the work-site support group. Support groups bring together people who have similar concerns or difficulties and enable participants to share personal stories and helpful information. Members often find it comforting to learn that their problems are not unique. Establishing a support group is inexpensive and relatively simple. The information provided below explains how to start a support group in your agency. These suggestions can be modified to suit the needs of your employees.

Employee Needs Assessment:

Establishing a support group should be based on a sufficient employee need and desire for one. One way to determine this is to conduct an employee survey to assess the extent to which employees have elder care responsibilities or concerns and would like agency help meeting them.

Many employees with elder care responsibilities may not even realize that they are caregivers. A needs assessment survey should describe the term "caregiver." Caregivers of the elderly are concerned about or provide assistance to elderly relatives or friends who have physical or mental limitations. Such care may include any number of tasks such as making regular telephone checkups, providing transportation, meals, medical care, or personal care, managing finances, or assisting with shopping and other errands. A survey should emphasize that caregiving includes any support no matter how small the task and may be provided by a caregiver who lives far away from the elderly person. Include questions about anticipated elder care concerns in the near future and employee interest in participating in a support group.

If the survey results reveal an interest in starting a support group, consider the remainder of these steps. Keep in mind that a support group can be as small as five people and may grow as employees learn of its existence.

Support Group Coordinator:

Because attendance at support group meetings may be sporadic at times, the consistent attendance of an employee assistance program (EAP) counselor or work/life manager at the meetings can help to maintain the group. The group coordinator can be  responsible for advertising future group meetings, arranging meeting space, and maintaining a current list of group members and their telephone numbers. (See Meeting Time and Place below.) An EAP counselor or work/life manager also can offer group members elder care resource and referral information and explain personnel flexibilities available in their agencies that may help employees balance work and caregiving demands.

There also may be interest in starting a support group newsletter that could include newspaper and magazine articles on caregiving and aging issues, resource and referral information, and the date and time of the next support group meeting. A newsletter is especially helpful to members who temporarily lose contact with the group.

If a counselor or work/life manager is not available to attend meetings on a regular basis, a leader may emerge from the group. This individual could be responsible for arranging the meetings or writing a newsletter. These tasks also could be shared by members on a rotating basis. Each group will conduct itself differently.

Meeting Time and Place

Establish the time, place, and frequency of the support group meetings. Generally, employees like to meet at lunch time and will bring their lunches. Participants will decide how often they want to meet.  Usually, a meeting room must be reserved in advance. Contact the agency building services office to find out how to reserve a room. Once a meeting time has been established, advertise the meeting at least two weeks in advance by placing announcements in a location where employees are certain to see them (bulletin boards or employee newsletters, for instance).

Goals/Purposes/Expectations:

It is important to explore what members wish to accomplish at the meetings. Members should discuss the goals of the support group at the first gathering. The goals may change as new members are added or as problems or concerns change. These goals and purposes should be considered each time the group meets. Members also may wish to explain what they hope to gain from attending the meetings.

Confidentiality:

Support group members must agree not to discuss the personal aspects of the meetings they attend. Certainly it is appropriate to share resource information outside the group, but the personal problems and concerns of members should remain private. This agreement of confidentiality should be stated at the first meeting.

Open or Close Ended Group:

Support groups can be open-ended or close-ended. An open group accepts new members at any time while a closed group establishes a group but does not add new members for a specified period of time. The person that establishes the support group may make this decision or the members at the first meeting may decide. An agency elder care support group may be better suited to an open-ended format since many employees experience the onset of elder care problems suddenly.

Resource and Referral Information:

In addition to emotional support, caregivers often need information about elder care resources and services available in the community. As mentioned above, an EAP counselor or work/life manager can often provide such information. However, these professionals may not be readily available to the group on a regular basis or may have limited access to such information.

Employees can call the Eldercare Locator, a toll-free telephone number (1-800-677-1116) operated by the National Association of Area Agencies on Aging, to learn how to contact the appropriate AAA in their parents' or  older person's community. The 670 AAAs located in communities across the United States can help employees locate services for their parents or older persons, even if they live in another State.

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Nursing Home Checklist

• Keep these suggestions in mind when visiting a nursing home:
• Visit a nursing home more than once and during different times of the day.
• Make an appointment to meet with the administrator or admissions director for your first visit and ask for a guided tour of the facility.
• Make sure that you are given the opportunity to talk to residents and observe conditions in the nursing home by yourself.
• Meet with members of the nursing home family council, which is composed of family members of the facility's residents. If the nursing home doesn't have a family council, ask to speak with family members of residents of the facility.
• Review the facility's fire safety training program.

When you visit a nursing home, you should carry this checklist with you. It will help you to compare one facility with another, but remember to compare facilities certified in the same category; for example, a skilled nursing facility with another skilled nursing home. Because nursing homes may be licensed in more than one category, always compare similar types of service among facilities.

Home A _______________________________________________

Home B _______________________________________________

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Selecting a Home Health Care Agency

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A number of Federal and national organizations can provide you with information about elder care issues such as housing, health care, and legal matters.

Many such organizations are listed below; however, this is not an exhaustive list. Each organization's mission, address, and telephone  number is included. Many of the organizations offer free publications that address numerous aging issues. There may be a charge for some materials. Contact the organizations to obtain a list of available publications.

This section highlights five Federal agencies that have instituted elder care programs for their employees over the past few years. It describes the best examples of diverse Federal elder care programs that demonstrate exceptional commitment, dedication and promotion of family-friendly programs. The agencies include: the Departments of Labor, State, and Energy, the National Security Agency, and the Social Security Administration. They were past Awards Winners or Honorable Mention recipients of OPM's annual Director's Awards for Outstanding Work and Family Programs. Although we have singled out these agencies, other Federal agencies not mentioned have that should also be commended for their efforts in promoting elder care and aging programs.

Department of Labor

200 Constitution Avenue, NW
Washington, DC 20210
(202) 219-6741
http://www.dol.gov

The Department of Labor (DOL) serves American workers as a leader in creating progressive programs to deal with the diverse issues and needs that confront working men and women. The DOL was one of the first Federal agencies to negotiate a comprehensive menu of available alternative work schedules for their employees. Their WorkLife Center assists employees in managing their work and family responsibilities. The WorkLife Center clearinghouse offers referral services, websites, literature, and videos on family-friendly topics and personnel flexibilities such as dependent child and elder care, leave options, telework, and employee assistance programs.

In October 1998, DOL contracted with the Dependent Care Connection (DCC) Life Care Counseling, Education, and Referral Services which provides resource and referral services to employees nationwide via website or through toll-free numbers.

In promoting elder care programs, the Department of Labor offers two support groups. The first is the Alzheimer support group which meets every third Thursday of the month. The second is the newly established Elder Care Support Group which meets on the second Wednesday of each month. DOL sponsors annual elder care fairs with representatives from national and local adult dependent care organizations. In addition, the Department holds brown bag seminars for those who care for aging parents or relatives. DOL also has published and issued the Helping Balance the Needs of Work and Family brochure to all employees. This publication is also available on the DOL intranet, LaborNet.

Department of State

Work and Family Programs
PER/ER/WFP SA-6, Room 431
2101 C Street, N.W.
Washington, DC 20520
(703) 516-1735
http://www.state.gov

The State Department sponsors the American Association of Foreign Service Women (AAFSW) Interagency Eldercare Forum. The Forum consists of work and family specialists from the Central Intelligence Agency (CIA), Federal Bureau of Investigation (FBI) and U.S. Aid to International Development (USAID) who answer questions and discuss issues on elder care. AAFSW and the Office of Employee Relations also coordinate a working group that identifies elder care issues.

The State Department's Family Liaison Office conducted a survey and report for relatives who reside on post with Foreign Service members. The State Department offers a variety of elder care services such as counseling and referrals, the use of overseas health units for elderly dependents, and an elder care seminar series to address dependent care needs and responsibilities.

Department of Energy

Office of Human Resource Management
1000 Independence Avenue, SW
Washington, DC 20585
(202) 586-4054
http://www.doe.gov

The Department of Energy (DoE) provides counseling, guidance and referral information to caregivers of elders. The DoE sponsors support elder care group meetings that are held monthly to assist employees with aging and adult dependent care needs. In 1997, DoE established an Eldercare Library that maintains current information on national and local elder care services.

The DoE also sponsors elder care and care- giver fairs, workshops and seminars. The agency provides work and family services such as extensive Dependent Care Directory, various alternative work schedules, job sharing and part-time employment, leave sharing and options (Family-Friendly Leave Program and Family and Medical Leave Act), telework, and Employee Assistance Programs.

National Security Agency

Work/Life Services
9800 Savage Road
Ft. George G. Meade, MD 20755
(301) 688-4283
http://www.nsa.gov

The National Security Agency (NSA) offers their employees elder care resources and re ferral services to State and national organi zations that serve seniors. The NSA Work/Life Services sponsors a biannual elder care expo in May for employees to learn about senior services and programs. As part of their assistance to caregivers, the NSA works with the Anne Arundel County Senior Health Insurance Counseling and Advocacy Program (HICAP) to offer workshops to help em ployees understand Medicare/Medicaid, Medigap Insurance, interpreting health insurance policies, and understanding medical bills.

The NSA offers "lunch and learn" seminars and lectures on topics such as elder caregiving, how to minimize stress, and community resources that are available to family members and caregivers. Panel presentations such as "The Myths and Facts of Aging" are also offered for senior service professionals, managers, employees and caregivers.

The NSA established a Work and Family Resource Group (WFRG), a private organization of employees to discuss aging and elder care resources and services. The WFRG sponsors guest speakers from the Maryland Department of Aging and established a support group for grandparents raising grandchildren. In addition, the NSA's Employee Assistance Services have reconvened its Elder Care Support Group which meets once a week for 10 weeks. The Government Employees Benefits Association held an Eldercare Symposium in January 1999 that presented information on elder law issues, care management, and long term care insurance.

The NSA also offers an Employee Assistance Service that is open to all agency civilian and military employees and their dependents. Various forms of alternative work schedules are utilized by the majority of the agency's workforce. This flexible policy allows employees to work a reduced schedule by adjusting the requirements of the position or by permitting more than one individual to perform the duties and meet their family demands.

Social Security Administration

West Highrise Building
6401 Security Boulevard
Baltimore, MD 21235
(410) 965-0479
http://www.ssa.gov

The Social Security Administration (SSA) offers a comprehensive work/life program that provides many benefits to its workforce of over 65,000 employees nationwide. SSA conducts ongoing activities such as lunchtime seminars, fairs, bimonthly newsletters, support groups, and information phone lines.

The SSA networks with local area agencies and senior care associations to keep up-to-date on new eldercare services in the community. For example, the Easter Seals and Employees' Activities Association of the SSA and the Centers for Medicare and Medicaid Services (CMS) opened a local adult day care center to give seniors a positive place to get appropriate medical care and therapy and participate in stimulating social activities with peers. In addition, the SSA sponsors a Grandparents Raising Grandparents Support Group that offers monthly lunch time meetings. This support group conducted a one hour satellite broadcast that featured information about legalities, rights, community assistance, and services to grandparents and grandchildren. Still, further SSA partnered with CMS to produce a 30 minute videotape entitled, "Medicare From a Caregivers Point of View" that is available to all SSA/CMS employees.

In terms of resources, the SSA Career/Life Resource Center offers programs, services, access to the Internet, videotapes, books on family services, and seminars pertaining to various family needs. The SSA conducted 20 eldercare interactive broadcasts on the SSA National Satellite Network, with tapes available in Resource Center.

As for personnel flexibilities, SSA employees are provided information on how to use Family-Friendly leave policies and volunteer leave transfer programs, and flexible and compressed work schedules to assist with their dependent care responsibilities.

Area Agencies on Aging

Area Agencies on Aging (AAA) are located in approximately 300 communities throughout the United States and are there to assist you in obtaining services for your elderly parent or older person. A state directory of websites can be found at http://www.n4a.org/

Among the variety of questions the AAA staff can answer for you are:

• What types of day care or nursing care are available in my parent's community?
• How can I arrange to have meals delivered to my parent's home?
• Can transportation be provided to bring my parent to medical appointments?
• How can I find someone to help my parent with household chores and home maintenance?
• Where can my parent get financial counseling?
• Where can my parent get legal counseling?
• How can I arrange for my parent's Social Security check to be deposited directly into his or her checking account?
• How can I learn whether my parent is covered by Medicaid, and what types of services are covered?

To keep the handbook to a manageable size, we have listed only those AAAs in metropolitan areas which have more than one thousand Federal employees.

They are listed alphabetically by State. If the AAA in your parent's community is not listed in this directory, you can phone the Eldercare Locator toll free at 1-800-677-1116, the State AAA office, or the AAA in your own local community to obtain the phone number of the AAA in your parent's community.

AL - AK - AZ - AR - CA - CO - CT - DC - DE - FL - GA - HI - ID - IL - IN - IA - KS - KY - LA - ME - MD - MA - MI - MN - MS - MO - MT - NE - NM - NV - NH - NJ - NY - NC - OH - OK - OR - PA - RI - SC - SD - TN - TX - UT - VT - VA - WA - WV - WI - WY

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State Long-Term Care Ombudsman Offices

Note

Under Federal Law, the U.S. Office of Personnel Management (OPM) is prohibited from ranking, endorsing, or promoting agencies or organizations listed on its website.

AL - AK - AZ - AR - CA - CO - CT - DC - DE - FL - GA - HI - ID - IL - IN - IA - KS - KY - LA - ME - MD - MA - MI - MN - MS - MO - MT - NE - NM - NV - NH - NJ - NY - NC - OH - OK - OR - PA - Puerto Rico - RI - SC - SD - TN - TX - UT - VT - VA - WA - WV - WI - WY

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Elder Care Publication Guides

Unless otherwise stated, you can obtain one free copy of each publication listed below by contacting the author and/or organization listed. To order a publication in bulk, contact the organization to obtain the cost, if any, for multiple copies.

Community Services

Write:

AAHA Publications
901 E Street, NW., Suite 500
Washington, DC 20004-2037

Include the title, publication number, and a self-addressed, business-size, stamped envelope.

• Community Services for Older People Living at Home - Publication No. CF015.

Write:

Foundation for Hospice and Homecare
519 C Street, NW.
Washington, DC 20002-5809

Include a self-addressed, 52. cent stamped envelope.

• All About Hospice: A Consumer's Guide

Financial

Phone:

Toll Free 1-800-772-1213 to receive the free Social Security publications listed below.

• Understanding Social Security
• Retirement
• Disability
• Survivors
• Supplemental Security Income
• A Guide For Representative Payees

Phone:

Toll Free 1-800-829-3676 to receive a free copy of the IRS tax guides listed below.

• Tax Information for Older Americans- Publication No. 554
• Social Security Benefits and Equivalent Railroad Retirement Benefits- Publication No. 915
• Credit for the Elderly or the Disabled- Publication No. 524
• Tax Information for Survivors, Executors, and Administrators - Publication No. 559
• Pension and Annuity Income- Publication No. 575
• Child and Dependent Care Expenses-Publication No. 503
• Tax Rules for Children and Dependents- Publication No. 929
• Tax Counseling for the Elderly Handbook- Publication No. 1114
• Guide to Free Tax Services - Publication No. 910

Write:

OWL
666 11th Street, Suite 700
Washington, DC 20001

• Women and Money - The Independent Woman's Guide to Financial Security for Life, by Francis Leonard. Include a check or money order for $12.95.

Health Insurance

Phone:

Call Toll Free 1-800-772-1213 - to receive the free Medicare publications listed below.

• Medicare
• You Should Know About QMB
• Medicare: Hospice Benefits Medicare and Coordinated Care Plans
• Medicare: Coverage for Second Surgical Opinion
• Medicare Coverage of Kidney Dialysis and Kidney Transplant Services: A Supplement to Your Medicare Handbook

For the publications listed below write or call:

Medicare Publications
Centers for Medicare and Medicaid Services
6325 Security Boulevard
Baltimore, MD 21207
Toll Free 1-800-638-6833
8:00 a.m. - 8:00 p.m.

• The Medicare 1999 HandbookDepartment of Health and Human Services
• 1999 Guide to Health Insurance for People With Medicare
• Medicare and Advance Directives - A guide to making sure the elder's wishes about the types of medical treatment received are followed and the person designated is allowed to make decisions on the elder's behalf should he or she become physically or mentally unable to communicate those wishes.

Write:

AARP Fulfillment
601 E Street, NW.
Washington, DC 20049

Include the title and publication number.

• Before You Buy - A Guide to Long-term Care Insurance - Publication No. D12893
• Medigap: Medicare Supplemental Insurance - A Consumer's Guide - Publication No. D13133

Home Care

Write:

The National Association for Home Care
519 C Street, NE.
Washington, DC 20024-5809

Include the title, publication number, and a self-addressed, stamped envelope.

• How to Choose a Home Care Agency: A Consumer's Guide and Home Care Bill of Rights- Publication No. C005
• All About Home Care: A Consumer's Guide

Write:

AARP Fulfillment
601 E Street, NW.
Washington, DC 20049

Include the title and publication number.

• Staying at Home: A Guide to Long-Term Care and Housing - Publication No. D14986

Housing

Write:

AAHA Publications
901 E Street, NW., Suite 500
Washington, DC 20004-2037

Include the title and publication number for the three AAHA publications listed below. Include a self-addressed, business-size, stamped envelope for the two brochures.

• Continuing Care Retirement Community: A Guidebook for Consumers-Publication No. CF012 - $4.00 per copy (payable by check )
• The Continuing Care Consumer Brochure: A Life Style Offering Security and Independence -Publication No. CF013
• Living Independently: Housing Choices for Older People (brochure) - Publication No. CF0154

Write:

AARP Fulfillment
601 E Street, NW.
Washington, DC 20049

Include the title and publication number.

• Staying at Home: A Guide to Long-Term Care and Housing - Publication No. D14986

Long Distance Caregiving

Write:

AARP Fulfillment
601 E Street, NW.
Washington, DC 20049

Include the title and publication number.

• Miles Away and Still Caring: A Guide for Long-Distance Caregivers - Publication No. D12748

Long Term Care

Write:

AARP Fulfillment
601 E Street, NW.
Washington, DC 20049

Include the title and publication number.

• Care Management: Arranging for Long Term Care -Publication No. D13803
• Making Wise Decisions for Long Term Care - Publication No. D12435

Nursing Homes

Write:

AARP Fulfillment
601 E Street, NW.
Washington, DC 20049

• Nursing Home Life: A Guide for Residents and Families - Publication No. D13063

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AARP Fact Sheets on Nursing Homes:

Note

Under Federal Law, the U.S. Office of Personnel Management (OPM) is prohibited from ranking, endorsing, or promoting agencies or organizations listed on its website.

Write:

AAHA Publications
901 E Street, NW., Suite 500
Washington, DC 20004-2037

Include the title, publication number and a self-addressed, stamped envelope for the brochure.

• Choosing a Nursing Home - A Guide to Quality Care(brochure) - Publication No. CF015
• The Nursing Home and You: Partners in Caring for a Relative with Alzheimer's Disease - Publication No. CF016 $6.00 per copy (payable by check)

Write:

Health Care Financing Administration
6325 Security Boulevard
Baltimore, MD 21207

• Guide to Choosing a Nursing Home Department of Health and Human Services - Publication No. HCFA-02174

General Overviews

Write:

AARP Fulfillment
601 E Street, NW.
Washington, DC 20049

Include the title and publication number.

• Tomorrow's Choices: Preparing Now For Future Legal, Financial, and Health Care Decisions - Publication No. D13479

Phone:

National Institute on Aging
Department of Health and Human Services
Toll Free 1-800-222-2225

• Resource Directory for Older People

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