Part 3: How is home care paid for?

Home care companies typically bill on an hourly basis for their services – and that rate varies widely depending on where you live. Paying for home care services is one of the most challenging issues for caregivers because most elders and families must pay for services out-of-pocket. Medicare and Medicaid do not pay for home care in most instances. Here are some other options to pay for care:

Health insurance
Some health maintenance organizations (HMOs) and some health and long-term care insurance plans provide coverage for home health care, so be sure to check benefits statements and policies

Long–term care insurance
Long-term care insurance helps cover the cost of care at home or in a nursing facility. It can cover much of the cost of home care – depending on the policy terms.

Veteran’s administration
If your loved one served in the U.S. military, financial assistance might be available to provide a veteran with home care.

State and local programs
Call your local Department of Aging or Area Agency on Aging. In many states, there are local and state funded programs that offer limited care for seniors who meet certain criteria.

Viatical life settlements
If your loved one has a life insurance policy, there are companies that offer insurance owners the option to sell their policies in exchange for a lump sum payment that is greater than the cash surrender value.

Government funding
For low-income elders, Medicaid programs in most states support home care services as an alternative to nursing homes.


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Part 2: What services are available for seniors living at home

Once you know that there is a problem, how do you know if home care is right for your parent?

Home care is generally defined as non-medical support services delivered at the home of the senior. “The aim of home care is to allow seniors to remain at home longer rather than enter an assisted living community, nursing home or other type of senior care. Home care may be appropriate if a senior prefers to stay at home but needs minor assistance with activities of daily living,” says Sam Almengor, National Accounts Director for Senior Helper, a national company that provides professional in-home assistance services.

“One of the most frightening prospects for seniors is leaving home. Home Instead Senior Care is helping seniors stay in their homes as long as possible,” Hogan says.

What services can your parent get from home care? Home care agencies help with any activities and needs that a person needs throughout the day. Services include:

  • Companionship and conversation
  • Grocery shopping
  • Meal planning and preparation
  • Diet monitoring
  • Hygiene assistance, including bathing and dressing
  • Light housekeeping
  • Walking assistance
  • Errands and transportation
  • Laundry, ironing and vacuuming
  • Change linens and bed making
  • Help with bills and mail
  • Supervise home maintenance and repairs
  • Organize closets and pantries
  • Medication reminders
  • Help with correspondence
  • Wash dishes
  • Appointment reminders
  • Coordinate home services
  • Pick-up prescriptions
  • General shopping
  • Review phone messages
  • Watch movies and play games

How to start the conversation about home care
If you’ve noticed the warning signs, the time to start talking with senior parents sooner rather than later, when a crisis has occurred. But how do you bring up sensitive subjects related to aging, such as the need for home care? Home Instead recommends some conversation starters that might help overcome the awkwardness.

Approach your parents with a conversation. Discuss what you’ve observed and ask your parents what they think is going on. If your parents acknowledge the situation, ask what they think would be good solutions. If your parents don’t recognize a problem, use concrete examples to support your case.

Remember you are talking to an adult, not a child. Patronizing speech or baby talk will put older adults on the defensive and convey a lack of respect for them. Put yourself in your parents’ shoes and think of how you would want to be addressed in the situation.

Tomorrow in part 3 we’ll discuss payment options for home health care


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Part 1: 20 Warnings signs your parent needs help at home

Maybe you’ve noticed that dad’s unopened mail is piling up. Or mom, once meticulous about her appearance, is wearing wrinkled clothes and not doing her hair. Perhaps there are bruises on your aging parent’s arms. When you bring up the subject, you hear, “Everything is fine. There’s no need to worry.”

Admitting they need help would mean they can’t take care of themselves anymore, and no one wants to lose their independence. “Denial is the unrealistic hope that a problem is not really happening and will go away by itself. Admitting they need help and accepting assistance is not easy for people as they age. It represents a loss of independence. Denial plays a major role – and signs get ignored,” says Paul Hogan, Founder and Chairman of Home Instead Senior Care.

The burden often falls on the family to recognize the signs that an aging parent might need help with daily living tasks.

This doesn’t necessarily mean that your loved one has to go to assisted living or a nursing home, but they may need some extra help in their home. If they’re not willing to admit it, how do you know if your elderly parent needs home care?

Here are signs that may indicate your parent needs help at home:

  • Spoiled food that doesn’t get thrown away
  • Missing important appointments
  • Unexplained bruising
  • Trouble getting up from a seated position
  • Difficulty with walking, balance and mobility
  • Uncertainty and confusion when performing once-familiar tasks
  • Forgetfulness
  • Unpleasant body odor
  • Infrequent showering and bathing
  • Strong smell of urine in the house
  • Noticeable decline in grooming habits and personal care
  • Dirty house, extreme clutter and dirty laundry piling up
  • Stacks of unopened mail or an overflowing mailbox
  • Late payment notices, bounced checks and calls from bill collectors
  • Poor diet or weight loss
  • Loss of interest in hobbies and activities
  • Changes in mood or extreme mood swings
  • Forgetting to take medications – or taking more than the prescribed dosage
  • Diagnosis of dementia or early onset Alzheimer’s
  • Unexplained dents and scratches on a car

Tomorrow we’ll discuss Part 2: What services are available for seniors living at home?

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6 Fun Activities That Count As Exercise



When you’re caring for someone else, it seems there aren’t enough hours of the day to get everything done. Of all the things you want to do in your “spare time,” exercise might be the last activity on your list. Yet out of all the activities you could do, exercise may be the most beneficial because it can keep you from getting sick, help you sleep better, and increase energy throughout the day.

But if it feels like one more chore or routine that you don’t look forward to, you are less likely to follow through on your good intentions. The good news is, you don’t have to work out at the gym 5 days a week to get in shape. Although all exercise takes some effort, it doesn’t always have to feel like work. So find some help watching mom or dad for a few hours a week, and take care of yourself.

Here are 6 ideas for ways to help make exercise feel more like fun, and less like work:

1) Enlist a friend

Find someone to be your exercise buddy. Don’t choose just anyone: Pick someone who is full of energy, fun and who you look forward to spending time with. That way, you’ll want to exercise just to be with your friend. Look for someone who’s more committed than you, so they can keep you motivated.

2) Group Fitness

Group classes are a way to meet new people, and be motivated to go each time. Local Parks and Recreation departments or Community Centers offer low-cost group exercise programs, such as yoga, tai chi, step aerobics and water exercise classes. They are a great way to improve flexibility, muscle tone and relaxation.

3) Take a Lesson

Get outside and learn a new skill. Book a golf or tennis lesson, and get to swinging. You’ll not only burn calories, you’ll also learn new skills and have fun.

4) Dance

Dance your way to better health. Square dancing or ballroom dancing are excellent ways to increase endurance and improve balance. The latest dance exercise craze is Zumba, a combination of Latin dance and exercise moves. Dancing enhances cardiovascular function and endurance, while practicing muscle memory routines effectively exercises the whole body. And simply put, it’s fun.

5) Hang Out With the Kids

Drag the kids away from their cell phones and computers, and start a game of basketball, soccer or baseball. Form teams, make it a weekly competition, hold practice sessions, and maybe even come up with some prizes for the winners at the end of the “championship series.”

6) Play Games

Think hanging out in front of the TV with a remote in your hand doesn’t qualify as exercise? It does if you’re playing a fitness game, like Wii Sports. Wii tennis consumes 179 calories per hour, and Wii boxing 174. Of course, those numbers are a fraction of the real-world activities (tennis is 318 calories per hour, and punching a boxing bag is 382) but its better than if you had lounged on the couch munching on a bag of chips.

Exercise is Crucial for Caregivers

Of course, playing Wii doesn’t really count as a balanced exercise regimen. Your goal is 30 to 40 minutes of moderately intense exercise three or more times a week – but every bit counts. So give yourself credit for seemingly small accomplishments, cut yourself some slack and have fun!


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Give Thanks!




What’s Cooking?

Stuffed Pepper Soup

Bell peppers, chopped tomatoes and lean ground beef are simmered in broth with onions and garlic, then topped with brown rice – everything you love about stuffed peppers, in a soup!

This is a hearty bowl of soup that will fill you up and warm you on a chillynight. I guess you can call this a lazy stuffed pepper because it tastes just like a stuffed pepper without all the extra work. Topped with brown rice it’s a satisfying meal. Heck, if you wanted you could even make this with ground turkey, and top it with shredded cheese. Have fun with this one!

Servings: 6 • Size: about 1 1/2 cups soup, 1/2 cup rice • Old Points: 5 • Points+: 7 pts
Calories: 261 • Fat: 5 g • Carb: 37.5 g • Fiber: 5 g • Protein: 17.6 g • Sugar: 6 g
Sodium: 606 g  (without salt)


  • 3 cups cooked brown rice
  • 1 lb 95% lean ground beef
  • 1/2 cup chopped green bell pepper
  • 1/2 cup chopped red bell pepper
  • 1 cup finely diced onion
  • 3 cloves garlic, chopped
  • 2 cans (14.5 oz each) cans petite diced tomatoes
  • 1 3/4 cups tomato sauce
  • 2 cups reduced sodium, fat-free chicken broth
  • 1/2 tsp dried marjoram
  • salt and fresh pepper to taste


In a large pot or dutch oven, brown ground meat on high heat and season with salt.Drain fat if any, reduce heat to medium-low, then add peppers, onions and garlic.Cook about 5 minutes on low heat.

Add tomatoes, tomato sauce, chicken broth, marjoram and season with salt and pepper to taste. Cover and simmer on low heat for 30 minutes. Serve about 1 1/3 cups of soup in each bowl and top with 1/2 cup cooked brown rice.

Makes about 9 1/2 cups

Recipe courtesy of



What’s Cooking?

Blueberry Banana Oatmeal Smoothie


A smoothie is a great way to get a nutrient packed meal or snack that is portable!  This recipe is very easy to customize to your needs. You can use dairy milk, soy milk or almond milk. You can also use gluten free oats if you are gluten sensitive.

Servings: 2 • Size: 1-3/4 cup • Old Points: 4 pts • Weight Watcher Points+: 5 pt
Calories: 180• Fat: 2 g • Carb: 38 g • Fiber: 4 g • Protein: 3 g • Sugar: 8 g
Sodium: 52.5 mg • Cholest: 0 mg


  • 1/2 cup raw quick oats*
  • 2 cups water
  • 1/2 cup unsweetened almond milk, soy milk or dairy milk
  • 1/2 cup blueberries
  • 1/2 ripe medium banana
  • 1/2 tsp vanilla extract
  • 2 tbsp raw sugar
  • 1/2 cup ice


1. Cook oats and water in a small pot for about a minute or two, stirring often until it becomes thick and bubbly. Remove from heat and let it cool a few minutes.

2. In a blender add almond milk, blueberries, banana, cooled oats, vanillas, sugar and ice. Blend on high until very smooth. Pour in a glass over ice. Enjoy!!

Makes 3 1/2 cups.


Recipe courtesy of

A question many “Baby Boomers” are asking

Where did everyone go?

By Joanne R Kanute, BCMCLS, CSA

     Have you ever caught yourself thinking, where did everyone go? Then you pause for a minute to think about it: co-worker comradery is no longer a part of your daily routine, you are now retired. Parenting responsibilities are no longer, the kids are grown and gone. (Now they are telling you what to do.) Your kids have formed their own routines, careers, families and schedules; they don’t have time to fit you into their schedule. Friends; many of your friends have retired and moved out of the area to be closer to their families or sadly, some have passed away.

If you plan to survive loneliness; you need to stay active; socially & physically. Though you are retired, one should continue to set goals for yourself. Without goals it is far too easy to pass things off until tomorrow. Make your physical goals: specific, realistic and important to you.

1. Identify Your Starting Point – think about your typical weekday and weekend day; pick activities that are comfortable and enjoying to you.

2. Figure Out Your Fitness Level – keep track of how much you exercise or are physically active.

3. Set Short-term goals – this will help you make physical activity a regular part of your daily life.

4. Long-term goals – once you establish your short-term goals, focus on where you want to be in a year or so on.

5. Write an exercise plan – write the what, when, where and how much to your physical/exercise plan. Be specific and realistic.

Remaining socially active is very important to your physical and mental health. One may have to stretch themselves out of their comfort zone to meet new friends and find things of interest. Many ask how and where can I meet new people, make new friends in my later years. Here are a few suggestions of how to move on and get past that lonely feeling and bring purpose back into your life:

1. Learn to become more self-sufficient – don’t be afraid to give something a try, being self-sufficient increases your self-esteem.

2. Hobbies – having a hobby not only passes time but it also gives you something to share with others.

3. Join a group – find a group that has many of the same interests that you have.

4. Volunteer – there are many organizations that rely on volunteers to function but also help a neighbor.

5. Get out of the house everyday – even if that means getting outside and sitting on the porch, push yourself out of those four walls.

6. Challenge your mind – do crossword puzzles, jigsaw puzzles, take a class to learn something new.

7. Journal – journaling is the new word for diary! Write down your feelings, your thoughts, and your goals.

8. Physical exercise – if you have an organized exercise plan it gives you something to look forward to. If you join others to exercise, it provides you with some social interaction.

9. Seek help – it’s okay to connect with a life coach, counselor, physiatrist; that is not a sign of weakness or that you’re crazy! Sometimes we need a little push to get us going on the right path to a fuller lifestyle.

One must be a friend and then you will gain many friends. Be a person others want to be around, a positive upbeat person is more fun to be with than one who is continually negative. There is more to life than “doctors’ appointments”, aches and pains, spread your wings! Sitting back and waiting for something to change or improve is not going to happen without some effort on your part. There is always a chance of rejection when you reach out to someone, expect it and don’t take it personal. Take responsibility for your life; don’t wait for someone else to fix it for you!

In today’s society we must be our own greatest advocate! Don’t be afraid to express your feelings or concerns to your family, doctor or friends; it’s always good to talk with others, you gain another perspective to issues.


To contact Joanne for coaching or speaking services please call:

Aging with Distinction at 520-405-6787

or go to: