1. Where should I begin?
A. Suggestions on where and when to begin discussing long-term issues:
Plan a family meeting that lets everyone know what is in place, what your wishes are and where you need help now and in the future.
Review your options and needs with a trusted advisor.
Determine your current assets and liabilities.
Determine costs in your area for various levels of nursing and intermediate custodial care so that you can properly evaluate your resources and your capabilities.
2. Who is primarily responsible for long-term care issues?
A. Long-term care is a family issue. When one person in a family needs long-term care, it affects the entire family:
• The lifestyle of the spouse changes dramatically:
• An adult child may have to spend more time helping an older parent; or
• Parents must focus on helping their temporarily or permanently disabled child.
3. What are the primary concerns when a family member needs long-term care?
In most situations, the family’s financial picture changes, sometimes drastically, along with the emotional stressors on the family and the health of the caregiver, which often begins to suffer.
4. What are the odds that initial care can and will be received at home and/or from family members?
A. Most people who need long-term care assistance receive care at home for some period of time. Although, it is important to be realistic about what kind of family support wi4ll be available to you or other members of your family when the need for long-term care arises.
5. Who specifically should address the issues of long-term care, the child/children or the parent/s?
A. Children need to be respectful of their parents' wishes, while at the same time being realistic about their parents' capabilities and needs. They must educate themselves about their parent's issues, enabling them to help their parents understand the specifics of their situation.
6. Are there any guidelines that may help when addressing the issues concerning aging parents?
A. The following guidelines may help when talking about these issues with your parents.
Realize that at some point your parents will need some assistance, if just for grocery shopping, house cleaning, etc.,
Be alert to changes in your parents’ physical, mental and emotional situation:
When you sense that your parents are ready and prepared to talk about the subject, be willing to listen and have and open, honest dialogue about their short-term or long-term care needs:
Call on professional advisors to help you understand the ramifications of decisions about long-term care for the whole family, and to learn about various alternatives.
7. Are there States with laws that hold adult children responsible for the debts of their destitute parents?
A. Yes, there are 30 states that have such laws.
8. What is a HC (Health Care) agent authorized to make decisions regarding?
A. A Health Care Agent is authorized to make decisions regarding:
• Medical Providers
• Medication and Tests
• Food, Water and Resuscitation
• Personal Care
• Access to Medical Records
• Consent or Withdraw Consent
• After Death Decisions.
9. Who would have the knowledge and experience to address the possible multiple issues concerning aging parents and eldercare?
A. A Geriatric Care Manager (GCM). A Geriatric Care Manager is a health and human services professional such as a gerontologist, social worker, counselor, or nurse, with a specialized body of knowledge and experience related to aging and elder care issues.
10. Is there a difference between a GCM and a PGCM?
A. A Professional Geriatric Care Manager is a geriatric care manager who is a member of the National Association of Professional Geriatric care managers and has committed to adhering to the GCM Pledge of Ethics and Standards of Practice.
11. Are there specific questions to ask or guidelines to follow when looking for a geriatric care manager?
A. A geriatric care manager recognizes the following certifications as being “certified care managers”: CMC, CMM, C-ASWCM and C-SWCM. The most important questions to ask should include:
Are you a member of the National Association of Professional Geriatric Care Managers?
Are you certified as a care manager?
Do you hold other professional licenses or certifications?
How long have you been providing care management services?
Does your company also provide home care services?
How will you communicate information to me?
Can you provide me with references?
12. Are care managers specialized in all areas and issues concerning elder care?
A. No. Care managers do not and are not specialized in all areas.
13. What are the expectations for the care manager when found?
A. Once you have found a care manager he or she should:
Do an on-site assessment, give an overview of the reason you are seeking help and introduce all parties involved. You should ask:
• What resources will it take to resolve this situation?
• Are there any alternative courses of action?
• What are the advantages and disadvantages of each alternative?
• Who will be working with you?
• How many professionals may be involved?
• What about off-hours and back up?
• How are fees computed?
• How are travel time and mileage handled?
• How are services terminated?
14. If the geriatric care manager is referred from an agency are there specific questions I should ask regarding the agency itself?
A. Yes. Ask lots of questions before choosing a care manager referred by an agency or other institution. You should ask:
What are the primary services provided by this agency/business?
What other services does this agency/business provide?
How many care managers are there in this agency/business?
Is there a fee for the initial consultation and, if so, how much is it?
Given the nature of you problem, what information should you bring with you to the initial consultation?
Should other family members/friends/caregivers come to the initial consultation?
What will the initial consultation include?
Do they have knowledge about long-term care policy claim procedures and the tax consequences of the services they are providing?
15. Are there issues to be concerned with regarding the caregiver of a person with long-term care needs?
A. Yes. As the caregiver of a person with long-term care needs the temptation is to try to provide everything. It is crucial to realize that there is a limit to what you can provide and it is best for everyone involved not to take on too much of the effort. It becomes difficult to give good advice to your loved one, or to make sound decisions, when you are overwhelmed with his or her day-to-day needs.
16. Why is tax information so important when planning for long-term care needs?
A. The tax information is important when planning for long-term care needs because it is critical to making the right decision at this particular time, information on income taxes, estate taxes, and on-going income flow. Without this information the wrong financial decisions could be made by a person stepping in as caregiver, unaware of the ramifications of different investments, insurance coverage, or other planning previously established.
17. Should I expect my employer to understand my plight as caregiver to elderly parents or a disabled spouse or child?
A. In early 1993, President Bill Clinton signed the Family and Medical Leave Act (FMLA) that would allow people to take time off work to care for their family or themselves.
18. What does the FMLA (Family and Medical Leave Act) address specifically?
A. The FMLA guarantees employees of companies with more than 50 employees up to 12 weeks of unpaid leave per year, to care for a newborn, or a newly adopted child, to care for certain seriously ill family members and/or to recover from their own serious health condition.
19. Does everyone qualify for family and/or medical leave?
A. No, not everyone is covered. There are generally three conditions:
• Your employer must have 50 or more employees on the payroll for 20 workweeks during the current or preceding calendar year.
• You can count employees at different work sites within 75 miles to reach the 50-employee threshold.
• You must have worked for your employer for at least 12 months and for at least 1,250 hours during the last year. If you worked 25 or more hours for 50 weeks in a year you would have worked the required total of 1,250 hours.
20. Are the rules applicable to all employees?
A. No. Specific rules apply to teachers and some highly paid “key” employees.
21. How can it be determined whether the law applies to specific employer?
A. To determine whether the law applies to your employer, find out how many employees are on the payroll, including those on leave and working part-time. To be covered 50 employees must work within 75 miles of your work site.
22. Does the law guarantee time off with pay?
A. No. The FMLA only requires unpaid leave. However, the law permits an employee to elect, or the employer to require the employee, to use accrued paid leave, such as vacation or sick leave, for some or all of the FMLA leave period. When paid leave is substituted for unpaid FMLA leave, it may be counted against the 12-week FMLA leave entitlement if the employee is properly notified of the designation when the leave begins.
23. Regarding geriatric care managers, what and who determines the need for a care manager?
A. Geriatric Care Managers are usually required when an individual’s health needs are determined to be chronic. Often a family member with Durable Power of Attorney (DPAHC) for Health Care determines the need.
24. Once it is determined that a care manager is needed and a care manager is chosen should there be documentation of the agreement/s and arrangements?
A. Once the decision is made to hire a care manager, ask that your arrangement be put in writing. The writing can be a letter or a formal contract.
25. What items specifically should the contract address?
A. It should spell out what services the care manager will perform and what the fee and expense arrangements will be. What is important to remember is-even if your agreement remains oral and is not put into writing, you have made a contract and are responsible for all charges for work done by the care manager and his/her staff.
26. Is there a resource or referral and/or information service that addresses specifically eldercare issues?
A. Yes, a nationwide toll-free information and referral service can give access to telephone numbers of programs in all areas of the United States. The toll-free telephone number for the Eldercare Locator is 1-800-677-1116.
27. What are greatest challenges family members will confront concerning eldercare?
A. When people are forced to go on Medi-Cal it’s a huge shock for them and for family members. Some families argue about who is going to be responsible for the family member. Many are afraid that if they sign the paperwork they will be financially responsible for their loved one, although that isn’t the case.
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