Author: Debbie McDonald

Senior Tax Help for Free

3 Free Senior Tax Tips That Will Make You Feel Really Smart

All of a sudden, I was responsible for my dad’s taxes in addition to my own. I didn’t even know how he usually did them or where to find his detailed paperwork.

He was living with trauma-induced dementia in a small family care home, and couldn’t help answer questions. I sleuthed out the name of his tax preparer, but felt sure it had to be simple enough to file on my own. After completing his taxes for $100 with online filing software, I realized that I could have done it for free with expert help.

With the tax deadline looming, jump on these free tools that are currently available for elder tax assistance.

1. The IRS offers Tax Counseling for the Elderly (TCE). Just enter your zip code to find someone near you to help.

2. AARP Foundation Tax-Aide also provides free tax preparation in different ways – in-person, low-contact, or contact-free – depending on what service is available in your area. Some sites can provide service in one or two visits, or you may not need to visit a site at all, with all interactions taking place online. Brief descriptions of each service type offered at Tax-Aide sites are available by selecting the “Service Types” tab on this AARP page.

3. You can also choose to prepare your tax return yourself, with the use of the free OnLine Taxes software. Its availability can vary by year.

Senior Tax Credit

Check in to the Senior Tax Credit for the Elderly and Disabled. If your senior qualifies, you could take up to $7,500 directly off their tax bill. To qualify, a person must be 65 years of age by the end of the tax year. The IRS also establishes income guidelines for each tax year. Check with a tax professional.

The April 18  deadline is coming up, so don’t wait to reach out to counselors at the IRS and AARP Foundation for questions about your senior’s taxes. If you are caring for a senior in your home, talk to a tax counselor about deductions for related costs and about claiming them as a dependent. The time is now to utilize these free resources for your senior’s taxes.

You know all about your senior’s habits,
but you don’t have to know
all about how to do their taxes.

Debbie McDonald is the Founder of Ways & Wane, an online platform that helps you help your aging parent. She lives in Northern California with her husband.

Paying for Long-term Care

How do you pay for assisted living
(or in-home care)?

Author Cameron Huddleston discusses surprising ways to pay for assisted living, in-home care or a nursing home. She includes topics like hidden resources and converting life insurance.

Interviewer Elizabeth Dameron-Drew highlights the Digital Social Worker that walks you through various pay options.

How much does it cost to care for an elderly person?

Nursing homes, assisted living, wheelchairs, walkers, prescription copays—the costs add up.

The Alzheimer’s Association estimated end-of-life care costs in 2016 were between $217,820 and $341,651. 

Sometimes, otherwise healthy loved ones need a short dose of care as they recover from an acute medical episode like a broken leg. Other times a fall triggers a path of steady decline with cascading assistance needs. Skilled nursing or assisted living can become necessary, which can be expensive.

If your senior’s health is faltering, costs not covered by insurance add stress to an emotionally charged situation.

There are three key “aging shocks” that surprise families: 

  • uncovered costs of prescription drugs, 
  • the costs of medical care that are not paid by Medicare or private insurance, 
  • the actual costs of private insurance that partially fills in the gaps left by Medicare, and the uncovered costs of long-term care.
    –Health Services Research: The 2030 Problem: Caring for Aging Baby Boomers

For the estimated 7 million individuals who provide long distance care, actual out of pocket expenses amount to almost $5,000 per month. For caregivers who have, or are considering leaving the workforce to care for an ailing parent, the costs are even greater—over $650,000 in forfeited salaries, benefits and pensions.

  • 70% of adults who are 65 years old will require some level of long-term care throughout the rest of their life,
    2018 – U.S. Department of Health and Human Services
  • 2 years: Average number of years that individuals age 65 and older will have a high long-term care need during their lifetimes.
  • $350,174: The average lifetime cost of care for an individual who has dementia,
    2018 – Alzheimer’s Association
  • 1 in 4: The number of adults who are 45 years old or older who are financially unprepared for long-term care expenses,
    2015 – AARP
  • 13% percent of adults will pay at least $150,000 in lifetime long-term care expenses out of their own pocket.
    2018 – U.S. Department of Health and Human Services
Discover hidden ways to save money

looking at cost of nursing home on computerYou can decrease the personal and economic costs of caregiving through careful research and planning. Think about what happens when you go to the grocery store with and without a shopping list. You will feel much better when you know your options and develop back-up plans before you absolutely need to help your senior make a long-term care decision. 

Whether you are currently faced with the dilemma of how to pay for long-term care or are planning for the future, these are the steps to systematically approach the challenge: 

  • Review your senior’s assets
  • Determine potential long-term care cost
  • Evaluate ways to cover long-term care

Step One: Review Your Senior’s Assets

  • Identify all sources of income and expenses for your senior by filling out this Asset Calculator. It will help you determine their eligibility for Medicaid.
  • Find and review insurance policies, including life, medical, home, car, etc.
  • Find a financial professional to advise you on managing your senior’s assets.  The Senate Committee on Aging recommends looking for someone with a financial gerontology certification; however the Securities and Exchange Commission does not endorse any financial advisor titles, like elder specialist. 
    • Ask your employer if they offer financial counseling services.

    Step Two: Determine potential long-term care cost.

    You can estimate the cost of your senior’s long-term care using this online calculator. When we researched options for my father, this calculator was pretty accurate for where we live in California.

    Step Three: Evaluate ways to pay for long-term care.

    There are three options to pay for or reduce the cost of long-term care:

    • government programs,
    • insurance programs or
    • personal assets

    We will start with reviewing government programs to find out which costs they cover.

    Find out what Medicare or Medicaid covers.

    video on how much long-term care costsAccording to the U.S. Dept. of Health and Human Services . . . 

    Medicare only pays for long-term care if skilled services or rehabilitative care are required:

    • In a nursing home for a maximum of 100 days, however, the average Medicare covered stay is much shorter (22 days).
    • At home combined with skilled home health or other skilled in-home services. Generally, long-term care services are covered for only for a short period of time.
    • Does not pay for non-skilled assistance with Activities of Daily Living (ADL), which make up the majority of long-term care services.

    Medicaid (program name varies by state):

    • Does pay for the largest share of long-term care services, but to qualify, your senior’s income and assets must be below a certain level and they must meet minimum state eligibility requirements.
    • Ask about federal or state funds available to pay caregivers by contacting the Eldercare Locator. Reach them online or by calling 800-677-1116, Monday – Friday, 9am – 8pm EST. Find your local office number on their website by adding your zip code. They can also inform you about other local caregiving services, like those provided under the National Family Caregiver Support Program. 
    • Call your State Health Insurance Program (SHIP) for FREE advice about Medicare programs. Find the number for your state.
    Time to review your senior’s insurance programs. 
    • If your senior has long-term care insurance, call your senior’s long-term care insurance provider to ask about guidelines for paying a caregiver.
    • If you are wondering if they should get long-term care insurance, check estimates with this online calculator. Advanced age and physical health can affect one’s ability to qualify for long-term care insurance.
    • If your senior has life insurance, call your senior’s life insurance provider and ask about the following options.
    • Ask about converting life insurance to a Long-Term Care Benefit Plan Account. By exchanging a life insurance policy for a long-term Care Benefit Plan, the benefits go toward long-term care including assisted living, home health care, and nursing homes. Benefits are deposited into a FDIC-insured benefit account that follows federal and state banking regulations and is held by a nationally chartered bank and trust company. The benefit payments are then made directly to the health care facility on a monthly basis.
    • Ask about an Accelerated Death Benefit, in which your senior would receive a tax-free advance on the life insurance death benefit while they are still alive.
    • Ask about the present value of the policy and if it is an option to sell it to pay for long-term care.
    • Ask about selling the policy to a third-party, called a viatical settlement. This option is only available if the insured is terminally ill with a life expectancy of two years or less.
    Time to review their personal assets.
    • If your senior owns a home, search for an authorized reverse mortgage counselor in your state. A reverse mortgage is a special type of home equity loan that allows you to receive cash (to pay for long-term care) against the value of your home without selling it. There are no restrictions on how you spend the money and you can receive it monthly or in one lump sum. You have to be 62 or older. Here is a helpful Consumer Financial Protection reverse mortgage guide.
    • Call a financial advisor and ask about a charitable remainder trust. This trust allows you to use assets to pay for long-term care services while contributing to a charity of their choice and reducing your tax burden at the same time. You can set up the trust so that they receive payments from the trust to use for long-term care services while they are alive.
    • Talk to your employer about covering your senior’s expenses pre-tax on a Flexible Spending Account plan. 

    Find more answers to your long-term care questions with the help of a Digital Social Worker. Step-by-step you will uncover more answers to pay for your senior’s long-term care so it doesn’t dramatically affect your own accounts.

    May you have peace at all times in every way as you help your senior in their waning phase of life.

    Debbie McDonald is the Founder of Ways & Wane, an online platform that helps you help your aging parent. She lives in Northern California with her husband.

    How to Quickly Decorate An Assisted Living, Nursing Home or Hospital Room

    How to invite healing joy into your senior’s room

    Does your senior’s nursing home room feel depressing? Did the balloons deflate and the flowers die after a day in the hospital? Does their room in the assisted living facility still look kind of generic even after adding a few photos on the bedside table?

    If you feel that way walking in, think how they feel living there.

    Sometimes we hesitate to decorate, giving these excuses:
    • My senior won’t be in this room very long.
    • The facility restricts what we add to the walls or room.
    • I don’t want personal items to get in the way of medical staff and equipment.

    Overcome your internal excuses and create an atmosphere for healing and joy, even in a nursing home or assisted living facility!

    Choose one of these simple products and ideas to transform your senior’s room.

    1. Removable “sweet dreams” decal on the wall in front of the bed wishes them good night
    2. Huge paper flowers/decals or removable potted plant decals (these don’t need water) fill a space
    3. Make a custom placemat with photos of people they love to use on a tray or at the table 
    4. Inspire conversation with this “Who I Am” poster and hang it with damage-free wall clips
    5. Wall mounted or desktop adjustable sunlight lamp may improve the mood
    6. Have a photo blanket made, even just lap size
    7. Put up a suction cup window-mounted outside bird feeder
    8. Put up sparkle lights around a window or door frame
    9. Set up a digital picture frame with rotating pictures 
    10. A diffuser with essential oils offers aromatherapy and a warm light. (Not recommended for shared room situations.) 
    11. Tack a beautiful  poster on the ceiling above their bed. This scene makes you feel as though you are laying in a forest looking up through the trees on a sunny day.
    12. Hanging a quilt on a wall can fill a big blank space and helps create a cozy atmosphere. These quilt hangers attach with removable adhesive strips
    13. The management of a real fish tank is too much, but can be relaxing, so why not try a lamp/virtual ocean fish tank?
    14. This temporary stick-on wall quote is a reminder to spread joy
    15.  Window suction plant pot brings the outside in
    16.  Rugs are trip hazards, but these peel and stick tiles can look like a rug.
    Consider some of the benefits of temporary decorating:
    • Gives you something to do “together.” Bring some paint chips and ask which colors they like. Psychology Today says, “Some colors, like shades of yellow, are like the sunshine. They can boost one’s mood and create a sense of optimism. Shades of blue can be calming. Others, like red or a secondary color such as orange, can be jarring.” Use those colors as you choose decorations. Or ask them which quote they like better for their temporary decal or about their favorite pictures for the lap blanket.
    • Becomes a conversation starter for staff or visitors.
    • Creates a welcoming atmosphere. If the decor makes staff and visitors smile, that brings more joy to your senior’s room.

    Decorating your senior’s room fills it with personalized brightness and joy. Even if you just choose one of the items above, it can have a compounding effect, which is needed in a nursing home, hospital or assisted living facility.

    Want other gift ideas for your senior? Check out these 7 thoughtful presents.

    Debbie McDonald is the Founder of Ways & Wane, an online platform that helps you help your aging parent. She lives in Northern California with her husband.

    Your Parent Forgets Your Birthday

    You didn’t expect your parent to show up on your birthday with a gift and a card.

    After all, you sometimes wear a name tag so they remember your name. And yet, the first time your elderly parent

    parent with dementia forgets birthday :(forgets your birthday, well, it can be painful. It amplifies the loss happening right in front of you and is a very personal reminder of the new relationship with your parent. For many people, this strikes a painful chord.

    To support you in this, here are 5 ideas to help you weather the next forgotten birthday.

    1. Expect your senior to forget and mourn the loss that represents, but don’t stay in that sad place too long.
    2. Print the letter below, put it in an envelope and give it to yourself—from your parent. 
    3. Gather all the memories of times your birthday wasn’t forgotten and take time to savor those memories. Maybe take a few minutes and write them down. 
    4. Put an extra candle on your dessert, from your parent.
    5. Remember that you are loved, today, tomorrow and yesterday. 

    Celebrate YOU by sending yourself this card!

    The Unsent Birthday Card. . . From Your Parent

    You transformed my life with your birth. Hidden in the recesses of my mind, I know it’s the anniversary of your birthday. Somewhere in my mind, I remember your birthday parties, your smiles, your fingers in frosting, the brightly colored cards, your gifts, the yellow crepe streamers, the balloons bouncing, the flickering candles. My love for you was on full display in the way we celebrated your birthday. 

    Today is the same as two yesterdays ago or two days from now—I don’t know. I count on you to know what day it is. I want to celebrate this birthday for you, but I don’t know where the candles are. So will you find them for me? Will you put an extra candle on—from me to you? (You should probably light it for me too since people get nervous when I have the matches.) And then, when your wish-breath blows the candle out, know that in that hidden place in my mind, my love for you is on full display.

    Happy Birthday!

    May you find joy in loving one another well today and tomorrow and tomorrow. 

    Elizabeth Dameron-Drew is the Co-founder and President of Ways & Wane. She walked closely with her own father through his years of waning. She lives near Seattle with her two teenage sons, husband and two rescue dogs. When she’s not working on this platform she’s probably creating books, doing research work or planning a dinner party while listening to the rain and thinking about her next creative endeavor.

     

    Her mom’s surgery became a caregiving trial run

    Exercises all the time, great home designer, smart as a whip . . . her 79-year-old mom embraced the knee surgery as a ticket to more action. Being the daughter and her mom’s best friend, Cheryl prepped to provide post-surgery care . . . and then the side effects began . . . Listen to the lively interview. You’ll love these two 🙂

    The One Thing You Need in Order to Always Smile at Your Mom (or Dad or MIL)

    A caregiver’s super power

    Why am I talking about super powers here? Because being a family caregiver is hard. You not only need healthy habits— you deserve them—in order to show up as the best version of yourself.

    A key study

    Dr. Robert Emmons, professor of psychology at the University of California at Davis, researcher, author and perhaps the world’s leading scientific expert on gratitude, argues that gratitude has two key components: 

    1. It’s an affirmation of goodness. We affirm that there are good things in the world, gifts and benefits we’ve received.
    2. We recognize that the sources of this goodness are outside of ourselves. We acknowledge that other people—or even higher powers, if you’re of a spiritual mindset—gave us many gifts, big and small, to help us achieve the goodness in our lives.

    Dr. Emmons performed a study where all the participants were asked to write a few sentences each week, focusing on particular topics. One group wrote about things they were grateful for that had occurred during the week. The second group wrote about daily irritations or things that had displeased them. The third wrote about events that had affected them (with no emphasis on them being positive or negative). 

    After 10 weeks, those who wrote about gratitude were more optimistic and felt better about their lives. Surprisingly, they also exercised more and had fewer visits to physicians than those who focused on things that irritated or disappointed them.

    Claim gratitude as your super power

    I’m thrilled that my 80-year-old mother-in-law agreed to join me in a joint gratitude list this year! (It’s just a google doc. that we can both access.) My secret goal is to get to a list of 1,000 “gratitudes” before the end of the year, but I’m holding that loosely since I don’t want to weigh down the activity with rules. 

    Read Ann Voskamp’s 1000 Gifts for beautiful writing and more inspiration about WHAT to be thankful for.

    Have you ever made a point of practicing gratitude?

    If not, maybe this is your nudge. There are many journals and apps which provide some structure. Some just have a spot for the date and then a few lines while others have inspiring prompts and adjectives boxes to check which may be helpful if self-awareness is difficult for you. 

    I’ll tell you who is grateful for you. Your senior. Even if they cannot or will not express it, they are grateful for your kind-hearted, imperfect care in their season of waning.

    So what are you grateful for today and . . . will you join me in focusing on gratitude this year?

    Grateful for you,
    Elizabeth

    Five Creative Ways to Advocate for Your Parent in a Nursing Home

    Understanding the world of assisted living and nursing homes can be like learning a new language. Add a bit of dementia and a worldwide pandemic to the mix and the recipe becomes messy. Advocating for your senior under these circumstances requires creativity and perseverance!

    5 strategies to advocate for your senior in an assisted living facility or nursing home

    1. Make use of “compassionate care visits”, available under certain circumstances. These may include end-of-life situations, but those are not the only circumstances that qualify. According to the Department of Health & Human Services Centers for Medicare & Medicaid Services, compassionate care situations include, but are not limited to:
    • A resident, who was living with their family before recently being admitted to a nursing home, is struggling with the change in environment and lack of physical family support.
    • A resident who is grieving after a friend or family member recently passed away.
    • A resident who needs cueing and encouragement with eating or drinking, previously provided by family and/or caregiver(s), is experiencing weight loss or dehydration.
    • A resident, who used to talk and interact with others, is experiencing emotional distress, seldom speaking, or crying more frequently (when the resident had rarely cried in the past).

    Allowing a visit in these situations would be consistent with the intent of “compassionate care situations.” Also, in addition to family members, compassionate care visits can be conducted by any individual that can meet the resident’s needs, such as clergy or lay persons offering religious and spiritual support.

    2. Don’t hesitate to speak up as your senior’s advocate. This is not the time to worry about being “liked”. Just remember to be courteous. Dozens of times I specifically spoke up about an IV. I usually say something like, “I appreciate you, but he’s an impossible stick so we need the specialist.” I imagine how I’m going to feel if I don’t stand up and ask for what my senior needs.

    woman in nursing home looking outsideIn general, try to understand the situation before you begin expressing your concerns. Let’s say you are concerned that your senior isn’t getting their physical therapy. Bring it up with the most appropriate person by commenting in a neutral way: “My dad said something about not having PT. I’m curious to understand his current PT schedule and how that’s going.” You’ll likely get a much better response than, “Why is my dad not getting his PT?!”

    3. Establish one point of contact at your senior’s residence. Discover the best time of day for them to talk with you regarding their updates and observations. Specifically ask, “Do you see any changes that concern you?” If you can regularly talk to the same person, consider setting up a 1-5 scale regarding how your senior is doing overall. This way you can more objectively compare day to day. Keep good notes about these conversations with dates and the names with whom you’ve spoken.

    4. Set up a time to talk to your parent using video technology. It’s very hard to advocate for your senior if you cannot see them. When you see them (even if it’s just over video call) you can pay attention to things like: is their hair combed, have they lost weight or simply do they look like themselves or not. Nursing home or assisted living staff should be able to assist you with setting up these calls. Some places have a tablet for video calls that can be sanitized and shared between residents.

    5. Should you have concerns about the care your senior is receiving, first ask to talk to the director of the nursing home. Keep good notes about what exactly was discussed. If you feel that the issues or concerns are not being addressed despite your continued attempts, contact the Long-Term Care Ombudsman Program in your state to assist you.

    What is a Long-Term Care Ombudsman? 
    An ombudsman (pronounced aam¡buhdz¡muhn) is a trained volunteer who acts as an advocate for residents of nursing homes, adult family homes, and assisted living facilities. Their purpose is to protect and promote the Resident Rights guaranteed these residents under Federal and State law and regulations. They are trained to receive complaints and resolve problems in situations involving quality of care, use of restraints, transfer and discharge, abuse and other aspects of resident dignity and rights.

    May you find joy in loving one another well, even if it has to be from afar!

    Elizabeth Dameron-Drew is the Co-Founder & President of Ways & Wane. She walked closely with her own father through his years of waning. She lives near Seattle, Washington with her two teenage sons, husband and two rescue dogs. When she’s not working on this platform she’s probably creating books, sewing, or vacuuming, or cooking while listening to the rain and thinking about her next creative endeavor.

    How to Balance Work With Your Parent’s Medical Procedure

    woman waiting for senior having medical procedureDo you take PTO at work to help your aging parents? Medical procedures like joint replacements, heart procedures and cancer treatments are common among those over age 65. 

    Your aging parent may exude health, especially for their age. But it is likely they will experience a serious medical procedure.

    Do you need to take time off work in order to help? 

    Potentially, yes. But you may be able to show up for your parent while getting some work done using the tips below.

    Six Tips to Waiting Room Productivity
    • Prepare to be your parent’s medical advocate.

    Before the procedure, discuss what role they would like you to play in different scenarios, both if it goes smoothly and if there are complications.

    • Create a medical document planner with your parent.

    Ensure you have copies of their driver’s license, insurance cards, advance directive, medical history and medication list. Make sure you know which pharmacy they use. Both digital and paper copies are useful. A planner like this one is helpful. 

    1. Recognize post-surgery support will take more time than you expect. Transportation to follow-up appointments, support through medication reactions and personal assistance may be needed. Enlist other family members to help ahead of time. If you are providing the physical follow-up care yourself, remember self-care so that you can show up as your best self.
    2. Research outside help, even if you think you won’t use it. 

    Knowing where and how you would get additional care support gives you peace of mind and allows you to meet your other work and family commitments. Consider getting a home health aide or checking into a rehab facility. Either one takes the physical burden off family members and offers built-in physical therapy. Research providers and read reviews at the unbiased Care Compare.

    Many employers offer caregiver support as a part of your benefit package. Ask your HR department to offer the Ways & Wane benefit.
    • Be present in order to honor your parent.

    Try to avoid scheduling critical meetings on the day of the procedure, even if you are working in the waiting room. You don’t want to be on an important call when the doctor comes out to give an update. 

    • Prepare your hospital “go” bag. 

    Take your work with you. Procedures can be delayed or prolonged. Make sure you have power cords, earbuds, snacks, water and a sweater or light blanket in case your waiting time gets extended.

    Download a free guide “How to Balance Work with Your Parent’s Medical Procedure” to share on your company’s Slack or with your HR team.

    Care well; work well.

    Debbie McDonald is the founder of Ways & Wane, simplifying eldercare decisions for working professionals. She lives in Northern California with her husband.

    How to Help Your Senior Dress with Success: These Shoes Won’t Let Me In!

    Age-related health challenges like arthritis and reduced mobility mean that many seniors struggle with getting dressed.

    Adapting your senior’s clothing for their current capabilities creates a win-win situation. The ability to dress themselves reduces frustration, helps maintain their independence and gives them a sense of control.

    senior in assisted living trying to get shoe on
    Surprising Options

    The world of adaptive clothing offers things like:

    • Pants with side zippers which are easier to use than front zippers
    • Magnetic belt buckles 
    • Front-closure bras
    • Extra wide slippers that velcro completely open/shut, accommodating swollen feet
    • Socks with extra wide tops are easier to put on
    • T-shirts that snap in the back so they are put on from the front without arms being having to be raised above the head
    • Snap back duster-style dresses, eliminate the challenges pants can pose
    • Non-binding elastic waistbands on roomy and stretchy pants allow for fewer adjustments after transfers
    • Wheelchair pants with discreet flaps on the backside make bathroom trips and incontinence easier to manage
    • A wheelchair blanket that snaps to the arm handles so it won’t slip off
    Adaptive Clothing Companies

    Several companies specialize in adaptive clothing:
    1. Canadian-based Silverts allows you to shop based on your senior’s specific condition and has a wide range of colors and patterns.
    2. Buck and Buck, a 40+ year old U.S. based company, features items with simple, basic styling.

    Do-It-Yourself

    Alternatively, a tailor or alterations person (usually drycleaners have this service) modifies your senior’s current clothes. For example, buttons become permanently sewn to the outside of a shirt/pants and velcro attachments are hidden right behind them.

    Altering existing clothes proved the best option for my dad. He donned the same kind of button-up shirt for 40 years and didn’t like pullover shirts. Adapting his favorite shirts so that he could velcro the buttons maintained his independence and made him feel “like himself.”

    If you are up for a simple sewing adventure or have a friend who is, here’s a tutorial showing how to replace buttons with velcro. 

    Simple Solutions

    Lastly, these 3 tips help a senior get dressed by themselves:

    1. A dressing stick makes putting on shoes, socks, shirts and pants less of a struggle.
    2. A visit from an occupational therapist maximizes your senior’s current strengths and abilities.
    3. A paperclip looped into the hole in a zipper handle makes it much easier to grasp and pull.May your new year be filled with joy, your zippers zipped and your velcro firmly attached!