Essential Resources for Senior Citizens and Their Caregivers

(Eldercare Directory) Every state has an Aging Services Division dedicated to providing frail seniors with home and community-based services, so that they can continue living in their own homes, instead of having to enter a nursing home.

A wide range of state assistance programs are generally available to eligible seniors, including home health aides and skilled nursing care, home-delivered meals, help with household chores, transportation to shopping and medical appointments, as well as counseling, advocacy and legal aid.

In addition to these programs that help senior citizens directly, many states also offer caregiver assistance programs that provide family caregivers with information, counseling, and respite services.

Long Term Care Ombudsman

The long-term care ombudsman is a statewide office that was created under the authority of the Older Americans Act. The office of the ombudsman has the responsibility and authority to investigate and resolve complaints from seniors and their family members regarding the quality of care in long-term care facilities, including nursing homes, assisted living facilities, board and care homes, and specialty care facilities, such as dementia day care programs.

Agents from the ombudsman’s office work as advocates for elderly residents, in response to individual complaints, to ensure that residents receive quality care, that their rights are respected, and that they are treated fairly by the long-term care facility, its providers, and staff.

The ombudsman’s office is also available to assist seniors and their family members in their dealings with other government agencies, to ensure that elderly patients and residents receive all of the medical, rehabilitation, legal, financial, and social services that they are entitled to by law.

Food and Nutrition Programs

Congregate and Home Delivered Meals

Eligible seniors can receive free nutritious meals, which are professionally prepared and served daily in congregate settings, such as senior and community centers. Most communities also have programs, such as Meals on Wheels, that offer seniors the option to have meals delivered to them every day in their own home.

Nutrition Counseling

Many local agencies for the aging offer seniors and caregivers nutrition counseling services, to help them make healthy meal choices, and can give advice and recommendations for dealing with the nutritional aspects of various illnesses.

Supplemental Nutrition Assistance Program (SNAP)

The Supplemental Nutrition Assistance Program (SNAP), formerly known as Food Stamps, is a federal program that provides monthly financial assistance to eligible individuals, including the elderly and disabled, who have low income and limited assets and need help paying for food. Although this is a federal program, it is administered at the state level, so you should contact your state’s Agency on Aging to apply for help through this program.

»Read more details about the SNAP program, including income and asset limits, in our article on Federal Programs for Seniors.

Caregiver Assistance Services

The overwhelming majority of in-home care services for the elderly is provided by unpaid family caregivers who give freely of themselves and make it possible for their elderly loved ones to live at home in a family setting for as long as possible.

Family caregivers of the elderly can now get help and support through several programs designed specifically to address their needs.

Caregiver Respite

Most states have some type of caregiver respite program which provides family caregivers with temporary relief from their care giving responsibilities. Through the respite program, caregivers can arrange to have a substitute caregiver come in to their home and provide care to their elderly family member, or the elderly care recipient could be temporarily cared for in an alternative residential care setting, such as a nearby adult care home.

Caregiver Counseling

Caregiver counseling services offered through the state and local agencies on aging provide caregivers with information on how to access government program and services for the elderly, assist the elderly and their caregivers with applying for benefits, and offer guidance and information to enable seniors and their caregivers to make informed decisions about their elder care options.

Medicaid Waiver

Through the Medicaid Waiver program, eligible seniors who require a level of care that would ordinarily require admission into a nursing home can receive in-home care services paid for by Medicaid. The goal of the program is to prevent or delay nursing home admission, and provide frail seniors with the necessary medical and support services to enable them to continue living at home with their families safely and comfortably, for as long as possible.

Adult Protective Services and Elder Abuse Prevention

The division of adult protective services is responsible for investigating allegations of abuse or neglect of vulnerable adults, including the frail or disabled elderly and adults with emotional or mental disabilities as a result of an illness or injury. Suspected cases of neglect or abuse of a vulnerable adult, such as physical abuse, sexual abuse, financial abuse or exploitation, whether in a domestic or institutional setting, should be reported to the state’s division of adult protective services.

Legal Aid

The legal aid program for seniors is administered through state or local agencies on aging. Through the program, qualified attorneys answer seniors’ legal questions, provide legal advice and advocacy, prepare and review legal documents, and represent seniors in legal proceedings.

State Health Insurance Assistance Program (SHIP)

Seniors can contact their State Health Insurance Assistance Program (SHIP) to speak with trained insurance counselors who can provide accurate and objective information and guidance regarding the public and private health insurance options available for the elderly in their state, including Medicare and Medicaid benefits, Medicare Advantage and Supplement Plans, and also state-sponsored prescription assistance programs for the elderly.

»Learn more about Medicare and Medicare Advantage Plans.

Senior Companion and Friendly Visitor Programs

These programs provide seniors with a chance for social interaction with a volunteer, usually another senior citizen, who comes to visit the senior and engage in conversation, or perhaps to read to a visually impaired senior. Volunteers may also take seniors out for recreational activities or help with some light chores around the home. These volunteers can play an important role to help prevent social isolation, and can also watch for signs that the senior is developing a new or worsening health condition that requires medical care.

Chore and Homemaker Assistance

Seniors can apply through their local agency on aging to receive help with their routine household chores, such as shopping, doing laundry, general house cleaning, preparing meals, and yard work such as mowing grass, raking leaves, pulling weeds, and clearing snow.

Transportation Service

In most communities, seniors can call their local office for the aging to arrange for transportation to and from medical appointments, shopping centers, and other locations as required to manage their personal affairs. Seniors who use a wheelchair or have other mobility impairments should call well in advance of their scheduled appointment, to ensure the availability of handicapped-accessible transportation.

Self-Directed Care Options

An increasing number of states are offering seniors the ability to participate in self-directed care programs, which offer seniors a fixed monthly cash benefit that they can use as they see fit, to purchase personal care items for their comfort or convenience, or to pay for services from home and community-based care providers that they choose.

When properly implemented, these programs give seniors greater control over their own care and finances, thus promoting independence and self-determination.

Senior Employment

Seniors who wish to supplement their retirement income and provide useful services to their community may be able to participate in state sponsored senior employment programs. These programs are primarily directed at low-income seniors and offer job training, employment counseling, and job placement services, with many seniors placed in non-subsidized positions working for community service agencies.

Prescription Assistance Program

Most states have some form of prescription assistance program to help low income elderly and disabled residents pay for their prescription medications. The details of these programs vary from one state to another, but in most cases they provide comprehensive prescription drug coverage for seniors without other prescription insurance coverage, and also supplement the coverage and reduce the out-of-pocket expenses for eligible seniors who have coverage through a Medicare Drug Plan.

Senior Housing Assistance

A variety of government housing assistance programs are available to help seniors with their housing needs. The majority of these programs are sponsored by the federal government, however they are administered through the state and local agencies on aging.

Senior Housing Apartments

Many communities use federal funds to maintain a stock of public housing apartments for low income senior citizens and persons with disabilities. The demand for these senior apartments is very great, and there is usually a waiting list for available apartments. You should contact your state Agency on Aging, listed below, for information about the eligibility requirements and instructions on how to apply for a senior apartment in your area.

Section 8 Housing

Section 8 housing is a federal program administered by the states, which provides a rent subsidy to eligible seniors to allow them to rent a home or apartment from a private homeowner.

»Read more about the Section 8 Program in our article on Federal Programs for Seniors.

Home Repair and Modification Assistance

Various types of financial aid, ranging from grants that do not have to be repaid, to low interest loans, are available to eligible seniors who need help paying for necessary home repairs, or who need to make modifications to their home in order to make it handicapped-accessible.

Demand for home repair and modification grants is high, and funds are very limited, so you should apply as soon as possible when the yearly application period opens in your area.

Heating and Energy Assistance

The federal government makes funds available to the states to help low income seniors pay for a portion of their winter heating and summer cooling costs. Although this is a federal program, it is supervised at the state level, and usually administered at the county or local level. The income limit for receiving energy assistance varies from state to state, based on state median income and the federal poverty level, and also depends upon your family size.

Contact your state agency on aging listed below for information about how to apply for this program.

Program of All Inclusive Care for the Elderly (PACE)

The Program of All Inclusive Care for the Elderly (PACE) is a special program, available in just 28 states, which offers integrated Medicare and Medicaid benefits and provides medical, social, and long-term care services to the frail elderly, in order to improve their quality of life and ensure that they have the professional support and care that they need, in order to remain in the community and in their homes for as long as possible.

Burial Assistance

Many states offer a small amount of financial assistance to help families pay for the funeral, cremation, and/or burial costs of deceased seniors who were receiving certain low-income benefits, such as SSI or Medicaid, at the time of their death, and whose estate is insufficient to pay for their final expenses. If the deceased has living relatives who were legally responsible for their support while they were alive, then the legally responsible relatives must also lack sufficient resources in order to qualify for burial assistance.

State Agencies for the Aging

The following table provides links to every state’s Aging Services Division, where you can find complete details about your state’s aging assistance programs, including eligibility requirements and application procedures.


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Alzheimer’s Disease: Anticipating End-of-Life Needs

(Mayo Clinic) As an Alzheimer’s caregiver, you might be your loved one’s most powerful voice. Make decisions that ensure dignity and comfort for your loved one.

In the early stages of Alzheimer’s disease, caregivers often focus on keeping loved ones safe and comfortable. As the disease progresses, however, you might face difficult end-of-life questions. When is it time to choose comfort care over lifesaving care for your loved one? When does medical care merely prolong a person’s dying? Here’s help considering these and other end-of-life questions.

Create Advance Directives

Advance directives are written instructions regarding your loved one’s preferences for medical care at the end of life. Ideally, discuss these preferences in the early stages of the disease with your loved one. Later, make sure copies of advance directives are included in your loved one’s medical charts. This is important if your loved one moves to a nursing home or other facility for long-term care or needs care in a hospital or emergency room. The advance directives will help the staff know what is — and isn’t — to be done in medical emergencies.

Focus on Comfort, Not Life Extension

As Alzheimer’s progresses, your loved one might not be able to communicate that he or she is in pain. Look for clues, such as a sudden increase in disruptive behavior or trouble sleeping. Physical signs might include sores, swelling, and feverish or pale skin. Speak to the medical team about adjusting your loved one’s treatment plan to ensure his or her comfort.

Eventually, you might need to weigh your loved one’s comfort against the benefits of prolonged life. In some cases, efforts to prolong life — such as dialysis, tube feeding and antibiotics to treat bacterial infections — might result in unnecessary suffering for people who could otherwise reach the end of life in relative comfort and peace.

Consider Hospice or Palliative Care

Hospice care focuses on pain management and comfort care at the end of life. Hospice care is typically reserved for people who have less than six months to live. Because this time frame can be difficult to predict in end-stage Alzheimer’s, hospice care is generally considered appropriate when a person who has end-stage Alzheimer’s:

  • Has lost the ability to communicate
  • Can no longer walk
  • Is experiencing urinary and fecal incontinence
  • Has at least one dementia-related medical complication, such as aspiration pneumonia, infection or weight loss

Hospice care can be provided anywhere, including a nursing home. If your loved one lives longer than six months after starting hospice care, the benefit can be extended. Likewise, you can choose to stop hospice care at any time.

Palliative care — which aims to improve quality of life for people who have advanced illnesses — also might be appropriate. Unlike hospice care, palliative care is available at any time during a serious or life-threatening illness. It’s offered in conjunction with other medical treatment and is meant to help ease symptoms, relieve pain, address spiritual and psychological concerns, and maintain dignity and comfort.

Connect Through the Senses

Even if your loved one doesn’t recognize you or can’t communicate verbally, you can still show reassurance and love. To maintain a connection, use your loved one’s senses:

  • Touch. Hold your loved one’s hand. Brush his or her hair. Gently massage your loved one’s hands, legs or feet.
  • Smell. The scent of a favorite perfume, flower or food might be comforting.
  • Sight. Show your loved one a video with scenes of nature and soft, calming sounds. Or take him or her to look at a garden or watch the birds.
  • Hearing. Read aloud, even if your loved one can’t understand the words. The tone and rhythm of your voice might be soothing.

Dying with Dignity

Helping someone who has Alzheimer’s through the last years of life is a difficult journey. As the disease progresses, you’ll make more decisions for your loved one. Among the most profound are decisions that ensure respect, dignity and physical comfort until the end of life.


© 1998-2017 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved.


‘Making the Best of It’: Families Face the Heavy Burden of Alzheimer’s

(HealthDay News) For Marilyn and Tom Oestreicher, their golden years were within reach.

After more than four decades of marriage, the Illinois couple had fashioned a comfortable daily routine. The parents of two grown children, she was a bank teller, while he was a school teacher and a published Civil War scholar.

But in 2013, Tom was diagnosed with Alzheimer’s at the age of 65. And all of their plans were thrown into disarray.

“It’s certainly not how we saw the end of our journey,” admits Marilyn.

“My grandma died at 93 with dementia. And my mom has it now at 93. But it’s a whole different ballgame when it’s your spouse. You just have to go forward and do what you can do.”

For Marilyn, that meant coming to terms with her new and often daunting role as the caregiver for a loved one struck by progressive dementia.

She has plenty of company.

“When you look at Alzheimer’s statistics, we know that there are now more than 5 million Americans being cared for by 15 million unpaid caregivers,” said Monica Moreno, national director of the Alzheimer’s Association’s division of Early Stage Initiatives and E-Services.

Absent new treatments for a disease with no known cure, those figures will likely triple by the middle of the century, Moreno added.

“Which means that an escalating number of families are going to be facing the challenges of caregiving for a devastating disease,” she noted.

“So, what we want to do is make sure that we understand exactly what these challenges are, so we can make sure that there are programs and support services in place that can help them through every step of this disease.”

Gauging the Burden

To that end, the Alzheimer’s Association has just completed a new survey that asked more than 1,500 adults to share their fears and concerns about getting older, getting sick and/or caring for a family member struggling with dementia.

Roughly 70 percent of non-caregivers said they are afraid of ultimately becoming a burden to their spouse, partner or children. A similar number said they feared becoming unable to support and care for themselves.

That might explain why nearly 60 percent of non-caregivers said they were specifically afraid of getting Alzheimer’s, more than the 46 percent who said they were afraid of simply dying.

Still, the vast majority (85 percent) said they would want their spouse or partner to be their main caregiver if the need arose. Nearly three-quarters said they would want professional caregivers, exceeding the roughly two-thirds who said they would want their children to shoulder that responsibility.

Among people already caring for someone with Alzheimer’s, nine in 10 cited emotional stress as the biggest challenge, while about 80 percent said physical stress and time management were big problems. Nearly 70 percent felt financial strains, and about two-thirds said they felt ill-informed about the disease.

And while eight in 10 caregivers agreed that it ideally “takes a village” to care for someone with Alzheimer’s or dementia, more than 80 percent said they had insufficient help from other family members. Almost two-thirds of caregivers said they felt isolated or alone, and roughly half said they had no one with whom to discuss their hardships.

Caregiving a Lonely Business

“Part of it is that people don’t understand,” explained Marilyn.

“Not your girlfriends, not your sisters. Nobody. And really, if they’re not going through it themselves they can’t understand, or they don’t want to because they don’t want to think it can happen to them,” she added.

“In fact, some caregivers end up totally losing touch with family or friends, almost out of a fear that they can catch this themselves. Now, we haven’t had that happen. But we have very, very good friends,” she said.

Marilyn has also found solace in an Alzheimer’s support group, a regular caregiver gathering that she describes as a “sisterhood.”

“These are people who are dealing with this day to day,” she said.

“They understand the struggle. I’m not, but some are on meds because of depression, or to help them sleep, or to help them keep going. And that’s something you can talk about. You can talk about anything with them, because they’re going through the same thing. You get information, and you get support. And that helps you to understand that there is life after a diagnosis.”

The ‘Unsung Heroes’

Alzheimer’s patient Mike Belleville, a Massachusetts resident, couldn’t agree more. Caregivers are “the unsung heroes of this whole thing,” he stressed.

“People with dementia are losing a piece of ourselves and our identity every day. But the people who care for us are also losing a piece of their identity every day as well. And that’s not recognized enough. So ‘caregiver,’ for me, doesn’t even [express] enough respect for what they do,” added Mike, who was diagnosed with Alzheimer’s in 2014 at the age of 52.

Instead, he calls his wife his “life-giver,” pointing out that it was she who took the first critical steps to get him back on his feet after his diagnosis.

“We were stunned,” Mike recalled.

“I was a telecommunications technician for Verizon for almost 20 years, which was a pretty demanding job. But when I started to forget things I had trained others to do — when I would start getting lost coming home from work — we went to see a doctor,” he said.

“But it was a complete shock to us. We didn’t even know you could get it when you’re that young. We had no idea what to do. We were clueless,” Mike explained.

“I had been a very active person. But, to be honest, I went into a deep depression for the first five to six months.”

It was his wife who finally reached out to the Alzheimer’s Association, beginning the process of “getting educated about the disease,” he added.

“So, now we’re plugged in,” Mike said.

“We understand what’s going on. And we don’t feel like we’re trying to do this all on our own. And I’m retired, and I can still function pretty well. But my wife now has all the stress of managing all the finances. And caring for our 19-year-old son, who has Asperger’s. And still working a full-time job. And taking care of me. And we’re the lucky ones,” he chuckled.

‘We Have Our Children and Friends Who Pitch In’

Marilyn considers herself lucky as well. With great difficulty, Tom was able to slog through a final year of work, post-diagnosis, to secure his pension. She was able to retire with social security and Medicare in place. “If we had been younger, it would’ve been a big problem. But we’re fortunate,” she said.

“Of course, it can still be really tough,” she added, noting that hired help is likely not in the offing given that Tom had no long-term disability insurance.

That fact places them among an estimated 100 million American workers who have no such coverage, according to Council for Disability Awareness.

“But Tom is still very functional,” Marilyn said.

“And we have our children and friends who pitch in. So, we don’t need help yet. And when we get to the point when we do, we’ll just have to see how that works out. You just have to make the best of it.”

More Information

There’s more on Alzheimer’s and caregiving at the Alzheimer’s Association.


SOURCES: Monica Moreno, national director, Early Stage Initiatives & E-Services, Alzheimer’s Association, Chicago; Marilyn Oestreicher, Alzheimer’s caregiver, Genoa, Ill.; Mike Belleville, Alzheimer’s patient, Bellingham, Mass.; June 1, 2017, Alzheimer’s Association Survey

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New Technology Could Allow You or Your Parents to Age at Home

(AARP) Devices give older people the opportunity to avoid or delay the nursing-home decision.

En español | Phil D’Eramo used to call his parents four or five times a day to make sure they took their medication. An only child from upstate New York, D’Eramo was worried, especially about his 89-year-old father, who has Alzheimer’s disease. Were Mom and Dad eating often enough? When his father went out for short drives, was he getting home safely?

But D’Eramo has found peace of mind in a sleek system called Lively. It has six sensors that D’Eramo has placed on his parents’ pillboxes, the refrigerator, the microwave, the bathroom door and his father’s key chain.

Now he logs onto a website to check their activity, captured via cellular connection, and remotely monitors their medication. He sees the number of times Mom opens the refrigerator, and when Dad goes into the bathroom or heads out the door. The company can alert D’Eramo by text, email, Web or phone if something is out of the ordinary.

“Using this new technology allows me to feel emotionally confident and secure that my parents can stay in their home longer,” said D’Eramo, 44, a printing company salesman.

A dazzling array of new technology is giving older people more confidence in their ability to live alone, and it’s helping many families avoid the wrenching decision to move an aging parent from his or her home to a nursing facility. “Smart” technology such as sensors, voice activation, GPS, Bluetooth, cellular connectivity via mobile phones, smartphone monitoring apps and sophisticated computers are making aging in place a viable option for an increasing number of people.

“Technology is allowing me to stay on my own as long as I can — I would like to die right here in my condo,” said Phyllis Bek-gran of Venice, Fla., who turns 90 this month.

There are devices to track medication and Alzheimer’s wandering, activity — or inactivity — in the house, falls and real-time health information. With mobile push-button personal emergency response systems, called PERS, and GPS location tracking, you can monitor parents or aging friends at home, or while they play golf or go on long walks.

“We’ve entered the era of low-cost, miniaturized, technological capabilities that enable smarter caregiving and greater independence,” says Laurie Orlov, an aging-in-place technology analyst. It’s currently a $2 billion industry, and Orlov expects it to rise to $30 billion by 2020.

Katy Fike, an engineer and gerontologist, has met with “over a thousand entrepreneurs from around the world” since cofounding Aging2.0 less than two years ago. The San Francisco-based business advises start-ups in the aging and boomer fields. Fike is seeing a lot of what she calls “connected independence” technologies, which include activity sensors that give adult children insight into their parents’ daily activities and tools that let family caregivers be part of doctors’ appointments remotely.

Bek-gran is one of the 40 percent of U.S. adults age 85-plus who live alone (as do one-third of those 65-plus). With more than 4 in 10 U.S. adults caring for an adult or child with major health issues, and 5 million to 7 million long-distance caregivers, the potential tech market is vast.

And just wait for the deluge of boomers who will need care.

“Device stigma” is also vanishing. In some cases, the tracking devices are becoming cool. A child might have a GPS watch that keeps tabs on him in the mall, while adults proudly sport activity wristbands to track their exercise and food. So what’s the big deal about Grandpa wearing a GPS watch or pendant if he tends to wander or fall? So far, the government and insurance companies have balked at paying for some of the devices.

“While Medicaid may reimburse for some aging-in-place technologies, Medicare, unfortunately, does not,” says Majd Alwan, executive director of the nonprofit Leading Age Center for Aging Services Technologies.

But that hasn’t stopped the boom in new devices, as more and more people and families embrace the lifestyle choices they offer.

1. MedMinder

Who uses it: Laura Reeves’ father-in-law, who has Alzheimer’s disease, takes 18 pills a day. He had been skipping some doses or popping too many.

“We didn’t want to take his independence away but had to protect him,” says Reeves, who moved with her husband from Portland, Ore., to Green Forest, Ark., to be near his parents.

Skipping doses or taking too many pills, at the wrong time or not at all, has serious consequences. Many older people need multiple medications multiple times a day; a memory issue compounds the task.

What it is: A digital pill dispenser that looks like a regular seven-day model. One type is locked until it’s time for medication; the other is unlocked.

How it works: A caregiver fills the medicine tray that goes into the device. The adult child logs onto the Web, remotely programs the schedule and can see if the user has complied. The dispenser flashes (if locked, it unlocks) when it’s pill time, then beeps if the medicine’s not taken. Still no luck? A prerecorded voice from, say, a grandchild, reminds Grandma to take them. If she doesn’t, she gets a call, and a family member receives an email, text or call. The system helped Reeves’ father-in-law take his medications on time, and his health improved dramatically.

2. Reminder Rosie

Who uses it: Mike Beadles’ mom, 85, who has Parkinson’s disease and dementia, lives with him in Lawton, Okla. She finds her son’s voice on the clock soothing. Now Mike, 61 and a disabled vet, is using the low-tech gadget, too.

“Rosie reduces my stress because I don’t have to be nervous either one will miss a dose,” says Beadle’s wife, Heyyoung, who is 43.

What it is: A voice-activated talking clock that tells you to take your medicine at a certain time. You can use it for other reminders, too (feed the cat, take a short walk).

How it works: A family member programs the clock (perhaps “I love you, Mom. It’s time to take two blue pills and one yellow pill”). Once the medicine is taken, the person either says “reminder off” or touches it to turn it off.

3. Philips Lifeline With AutoAlert

Who uses it: Telling her parents they needed an emergency button

“was a hard conversation to have,” says Susan Morrell, 50. “Nobody likes to admit they’re getting older and need help.”

But she and her five siblings had that conversation last year when her father, Larry Beighey, 75, and her mother, Carole, 76, who uses a walker and has chronic obstructive pulmonary disease (COPD), both wound up in the hospital at the same time. Now fully recovered, they use personal emergency response devices in their homes in Amelia Island, Fla., and Hubbard Lake, Mich.

What it is: A personal help button for home use that is worn around the neck or wrist and can detect if you’ve fallen.

How it works: The base station is plugged into the wall. Sensors in a button are connected wirelessly to the base station and distinguish between a fall and other movement. If it senses a fall, you’re connected to the response center.

4. GrandCare Systems

Who uses it: Gladys Jules lives in Atlanta and has used GrandCare to check on her aunt and mother in South Carolina and to keep them socially connected. Jules’ daughter recently had twins and streams daily photos to her grandmother. Last September, Jules, 62, had colon surgery and now also uses GrandCare daily. She takes biometric readings, organizes her prescriptions and stores her medical information for her kids “just in case.”

What it is: A multipurpose system that tracks daily activity, has medical monitoring (glucose, oxygen, blood pressure, weight) and can display anything: diets, discharge plans, exercises. An interactive touch screen lets Dad watch videos, view family or Facebook photos, listen to music, play games, read the news and video chat with family.

How it works: It uses an Internet connection that communicates with wireless sensors you’ve placed around the house. Caregivers log on to a website to see their loved one’s activity, write them messages and make rules (“Alert me when …”).

5. GreatCall 5Star Urgent Response

Who uses it: Faith Simon’s father started falling, and her mother has vision problems and can’t use the phone. They were an hour away in Auburn, Calif. So she signed them up for an urgent response system. Her dad, now deceased, “pressed it a dozen times,” says Simon. Her 96-year-old mother has yet to trigger it, but Simon says “it gives me peace of mind.”

What it is: A mobile personal emergency response system for use at home or while traveling.

How it works: GPS technology allows CPR-trained agents to find location and assess the situation.

6. MobileHelp

This company has an on-the-go mobile PERS device with GPS satellite location tracking as well as an in-home base station. Press the help button and, after the response team seeks medical help, it calls and emails your family and tells them where you are, including the hospital. In January, MobileHelp unveiled a fall-detection system that gets you help even if you’re unable to push a button or speak.

7. Connect America

Through a base station in the house, this PERS summons help from a monitoring team, informing EMTs of existing medical conditions. The company also offers a mobile PERS that travels with you outside your home, connecting your SOS to 911 or a family member.

8. Life Alert

Remember “I’ve fallen and I can’t get up?” This is that company. You wear a pendant or wristband that has a help button. An interesting feature: Life Alert will program your own cellphone so that it speed-dials the monitoring center. There’s a special app for smartphones.

Sally Abrahms writes about boomers and aging. She is based in Boston.


19 Free Services for Seniors or Their Caregivers

( with Tony Rovere) Most seniors these days are living on limited incomes from sources that may include Social Security, a small pension or maybe some other form of government assistance. With few resources at their disposal, finding services for free or discounted prices is vital.

There are likely many of these types of services available through your local Office for the Aging (the name of this government agency may be different in your local area, i.e. Division of Senior Services) or local charities such as Lions Club or Meals-on-Wheels, or on the Internet through sites like

However, in my opinion, the most rewarding of these freebies for seniors and their caregivers – things like free hearing aids and free dentures – will be more difficult to come by. From my experiences as a caregiver, I have compiled a list of these types of services and provided a roadmap and examples for how to find them.

1. Benefit Counseling

How many times have you, either as a senior or as a caregiver, wrestled with trying to figure out what type of help was available to you? There is free counseling available through your local Office for the Aging that can provide this type of assistance and point you in the right direction to receiving the help you need.

You can get answers regarding health insurance, food stamps and other services through these counselors.

2. Adult Day Care

Adult day care centers can be run by a government entity, or through a local charity or house of worship. The purpose of these senior centers is to provide a safe place to socialize and have a hot meal in a protected setting. These adult day care centers are ideal for seniors who cannot remain alone, but are not in need of the care that a nursing home provides.

If you go through your local Office for the Aging, they will probably be able to direct you to such a day care center, let you know if there is a charge for the facility and what the eligibility requirements are.

As for the fees associated with these facilities, if the facility does in fact charge a fee they are normally quite nominal and are just there to help the center cover its own costs for meals and operating costs like utilities.

As for the eligibility requirements, that will depend upon the capabilities of the staff at each individual facility. As an example, some adult day care centers will only accept those who are continent because they will not have the supplies to change adult diapers. Other facilities may require a certain amount of mobility for those attending (i.e. they are able to get out of a wheelchair on their own or with minor assistance). It is really ‘hit or miss’ because each facility will have their own requirements.

When initially contacting the Office for the Aging or the local charity, give them as much information upfront regarding both the fees (if you are only looking for a free facility) and the physical condition of the applicant. This way they can act as a filter to point you in the right direction.

3. Dentists That Accept Medicaid

Due to the problems of billing and getting paid by the government, there aren’t many dentists that accept Medicaid, but a few do. This means that a senior with no dental insurance may still be able to get the dental care needed…you just might have to travel to get it.

To find a dentist in your state that accepts Medicaid, contact your state Department of Health, but keep in mind that you may have to travel out of your way to get these services. For example, in my home state of New York, the state Department of Health website lists about 40 dentists that accept Medicaid. That’s not a great number for a state with a population of 19,500,000. On Long Island, where I live, there are only two.

4. Free Dentures

As incredible as it may seem, it is possible for low-income seniors to receive a free set of dentures. In addition to calling your Office for the Aging to see if they know of a source, here are two additional places to look into:

  • Your State Dental Association: here you will be able to access free or low-cost dental programs. As an example, one of my customers contacted the Ohio Dental Association and was then directed to Dental Options (in Ohio). She discovered her mother was eligible and will soon be getting the help she needs. While these services will vary based on your location, the place to start is with your state dental association.
  • Dental Colleges: while not free, if there is a local dental college in your area you could get a substantial discount on dental care.

5. Elderly Pharmaceutical Assistance Program (EPIC)

EPIC is the name of the State Pharmaceutical Assistance Program in New York. New York is one of the 23 states that have such a program (the other 27 canceled their programs after the Federal government instituted Medicare Part D). If you live in Colorado, Connecticut, Delaware, Idaho, Illinois, Indiana, Massachusetts, Maryland, Maine, Missouri, Montana, North Carolina, New Jersey, Nevada, New York, Pennsylvania, Rhode Island, Texas, the U.S. Virgin Islands, Virginia, Vermont, Washington State or Wisconsin, you have access to another means of assistance to obtain your prescription medications.

Income requirements vary from state to state, so you will have to check with your state administrators to determine your level of eligibility, but this can be a great way for seniors to save on their prescription drug costs.

6. Low Cost Prescription Drugs

Despite the advent of Medicare Part D, and certain state run assistance programs such as EPIC (outlined above), there are still many seniors that cannot afford their medications.

This is why most manufacturers of prescription drugs provide assistance for those who cannot afford their medications. A comprehensive list of these programs is provide by the Partnership for Prescription Assistance as well as the steps to follow to apply for assistance.

Another cost saving strategy is to make the switch to generic drugs.

As the Food and Drug Administration says:

Generic drugs are important options that allow greater access to health care for all Americans. They are copies of brand-name drugs and are the same as those brand name drugs in dosage form, safety, strength, route of administration, quality, performance characteristics and intended use.”

Generic drugs cost about 50%-80% less than their brand name equivalents, so it makes all the sense in the world to speak with your doctor about making the switch.

7. Family Caregiver Support Programs

These programs are often offered through the government, or volunteer organizations. Either way, as a caregiver, you can be provided with respite care by volunteers, as well as counseling and Support Groups to ensure your physical and emotional wellbeing. These services are designed to supplement, not replace, the efforts of the family in caring for a loved one.

8. Free Cell Phones or Discounted Phone Service

LifeLine is a federal government program for qualifying low-income consumers designed

“to ensure that all Americans have the opportunities and security that phone service brings, including being able to connect to jobs, family and emergency services.”

LifeLine assistance provides one free or discounted phone (either landline or wireless cell phone) per household. To qualify, seniors will likely have to be on some form of government assistance, such as:

  • Medicaid
  • Food Stamps
  • Supplemental Social Security
  • Temporary Assistance for Needy Families
  • Low Income Home Energy Assistance Program

Visit to see if you qualify and to find participating companies in your state.

I was able to get my mother a free cell phone within five days of her being approved for Medicaid, after providing a picture of my mother’s Medicaid award letter (yes, I know it is shocking for the government to move that quickly). The only drawback to the program is the type of phone that you are sent. My mother can use it but it has smaller buttons that can make it confusing. I would prefer for her to have a larger handset with larger buttons, but this is working for the moment.

9. Free Phone for Hearing Impaired

A new service that is (at least temporarily) being funded by the FCC, called CaptionCall, provides free phones to those with medically recognized hearing loss.

The way that this phone works is simple. A screen on the phone instantly takes the words being spoken and puts them onto a screen on the phone so that hearing impaired individuals can read what is being said.

You can learn more at (and click on Promotions) for more information.

10. Supplemental Nutritional Assistance Program (SNAP)

This used to be called Food Stamps, but is now known as the Supplemental Nutritional Assistance Program (SNAP). You can apply through your state Office for the Aging, or Elder Affairs Department.

Each state has slightly different requirements based upon income, but what I have found is that most states have a website ( in my home state of New York) where you can set up an online account and, based upon your age, zip code, income and residence status, you are then directed to all of the benefits that you are eligible for.

Once you are approved, the maximum monthly benefit depends upon the size of your family, from $200 all the way up to $1,500.

11. Other Free Food Services

In addition to programs such as SNAP, there are many nutrition programs, offered either by local charities or local governments that can provide seniors with a nutritious meal (typically lunch) and the opportunity to socialize.

Check with your local Office for the Aging to see what programs are available in your area. In my county, there are 33 such nutrition sites that seniors can attend and, in some cases, transportation is provided.

There are also websites that have listings of local food banks where qualifying individuals can receive free food. The best food bank search engine is at Simply plug in your state and a listing of locations and the types of services offered at each food bank will pop up.

12. Free Hearing Aids

Buying a new hearing aid can run into the thousands of dollars, so it’s no wonder that seniors are hard pressed to pay for these devices. But I have found that there are a few ways to obtain free hearing aids. Some will be new, and others may be used, but they will all be free.

First, try your local Lion’s Club. Most chapters either operate or know of a local hearing aid bank that can match needy seniors with recycled hearing aids.

Another approach is to seek out clinical trials of new hearing aids. Contact hearing aid manufacturers and see if you can volunteer for a trial. When the trial is over, you typically get to keep the hearing aid. I recently saw a commercial from one hearing aid manufacturer that was advertising for people to participate in trials, so they are open to this idea.

You will have to medically qualify for the trial and you may have to contact several manufacturers until you find one that works for you. You may also get put on a waiting list. Regardless, this can be a powerful way for very low income seniors to receive a free hearing aid.

13. Free Legal Help

When my mother had her heart attack and I started the Medicaid application process, I quickly realized that there would not be any money to pay our mounting bills. So I called my local Office for the Aging and they put me in touch with a local law school that operated a Senior Law Center for low income seniors like Mom.

They wrote a letter to the creditors on my behalf asking for the debts to be forgiven. With this letter I attached a letter from the nursing home detailing Mom’s prognosis. That was 14 months ago, and I haven’t heard from the creditors since, so I guess that ‘no news is good news.’ I did receive one confirmation letter, from Wal-Mart, that the debts were forgiven. The others have not contacted me yet, so I am hopeful that they’ve written the debts off as bad debt.

These types of law centers won’t represent you in a large scale, but they can be invaluable in drafting a simple will, certifying a POA or health care proxy, or drafting a letter to creditors.

If your Office for the Aging is unaware of a local resource for such help, another place to look would be the Lion’s Club. Many of the members of the Lion’s are attorneys and local business leaders who may be able to help you find a pro bono attorney to handle something like this.

14. Free Medical Alert System

We have all seen the television commercial with the elderly woman in the bathroom saying, “Help, I’ve fallen and I can’t get up!” That’s what a medic alert system is for. It is a waterproof pendant that is worn around the neck or wrist, that works in conjunction with a wireless phone attachment. In an emergency, the wearer presses the button to be connected with the monitoring service and speaks into the pendant.

The actual system is totally free, even the shipping. The monitoring service does have to be paid for, but that is normally around $30 a month.

One thing I would advise you to consider when choosing a medic alert company. Make sure that the company you choose does NOT outsource its central station monitoring service. When your loved one hits that button, you want a trained, competent professional who can calmly contact emergency services and stay on the line with your parent until help arrives.

There are many medical alert products out there, such as, LifeStation and Rescue Alert, that offer this type of service.

15. Free Walkers or Rollators

A walker will run you around $40 (rollators are a little more expensive). That can be a lot of money for a cash-strapped senior. If you are looking for a discounted or free walker, here are places you should start your search:

a) Thrift stores such as Goodwill, which operates outlet stores throughout the country and has very reasonable prices

b) Hospitals and nursing homes may periodically dispose of reliable, used equipment that may be ideal for you.

16. Home Energy Assistance Program (HEAP)

Through your local or state Office for the Aging, you can apply for assistance either in the form of weather upgrades to your residence – such as added insulation in the attic to improve the energy efficiency of your home (this is known as the Weatherization Assistance Program) – as well as direct cash assistance based upon your income level.

One not widely known fact about HEAP is that it is available to both homeowners and renters, making it more widely accessible for low-income seniors.

17. Ombudsman Services

For caregivers of nursing home patients, the state ombudsman’s office is there to address issues with the care of their loved ones. You can think of the ombudsman as similar to a union rep. They will investigate complaints on your behalf to insure that nursing home residents are being treated fairly.

I previously wrote about my own experience with nursing home neglect against my mother and how I brought in the state ombudsman to investigate the issue.

If you feel there is an issue of neglect or abuse of a nursing home resident, getting the contact information is easy. This information must be prominently displayed in the lobby of all nursing homes, along with the website and phone number to call for help.

18. Residential Repair Services

Need some minor work done around the house, but can’t afford the labor? Many Offices of the Aging run a residential repair service where seniors can have minor work done to their home or rental at no labor cost.

NOTE: You will have to pay for supplies, but the labor is free from the volunteers.

19. Silver Alert Program

Caregivers of seniors with dementia are often concerned about a loved one getting lost while wandering – especially if they are driving with dementia. There are many ways to combat this. One way is through a Silver Alert program, which (as defined on Wikipedia)

“is a public notification system in the United States to broadcast information about missing persons – especially seniors with Alzheimer’s Disease, dementia, or other mental disabilities – in order to aid in their return.”

Silver Alert and similar programs vary greatly by state. The way the Silver Alert program works in my local area is as follows:

The caregiver will contact the local police department and fill out a form identifying the senior, giving a physical description, as well as any medical information you wish to disclose.

Your parent will then be issued a Silver Alert bracelet that will have a unique ID number and instructions for anyone who locates them to call a police non-emergency number. This way they can be safely returned home without compromising any personal information on the part of the senior or caregiver.

Check with your local Police Department for more information.

I have used many of these services to assist me in my role as a caregiver and hope that this list of free or discounted services is useful to you and your family as well.

~ Tony Rovere,

Do you know of other free services for seniors that we can add to the list?


Tony Rovere became involved with seniors and caregiving after his mother’s heart attack forced him to navigate the government bureaucracy that comes with caregiving. His website,, is a resource for seniors and caregivers who can benefit from his personal experience as a caregiver.

©2016 AgingCare, LLC. All rights reserved.


Elder Orphans: How to Plan for Aging without a Family Caregiver

(AARP) When you can’t lean on family and friends to help take care of you, here’s what you can do.

Carol Marak was a caregiver for both her parents: Her mom had congestive heart failure and her dad had Parkinson’s disease. After they died and she turned 60, she says,

“It occurred to me … oh, my goodness, I am not married. I do not have children. Who is going to do that for me?”

Marak, 65, of Waco, Texas, is considered an “elder orphan” — someone who is aging alone with no family available to address their caregiving needs. More than 1 in 5 Americans older than 65 are — or are at risk of becoming — elder orphans. And 23 percent of boomers will eventually be without family caretakers, according to Maria Torroella Carney, who has studied the issue and is chief of geriatric and palliative medicine at Northwell Health of Great Neck, N.Y.

And those figures don’t include the countless parents whose adult children are not available or able, for various reasons, to assist them.

The American Geriatrics Society recently developed guidelines for how public policy and the health care industry might assist elder orphans. (The authors refer to them as “unbefriended” older adults.) Experts warn of a potential crisis as the population ages and even fewer family caregivers are available for each person.

A 2015 AARP Public Policy report titled “Valuing the Invaluable” concluded that while there were 7.2 potential family caregivers for every person 80 and older in 2010, that ratio is likely to fall to 4 to 1 by 2030, and could sink to 3 to 1 by 2050.

But even with already high numbers of elder orphans set to skyrocket, there’s still a widely held assumption in the health care industry that everyone has a family caregiver in the wings.

“When you go in for a colonoscopy, they won’t even do the procedure if you don’t have someone to take you home,” Marak points out.

“Everyone thinks we all have family. Well, we don’t.”

Here are some tips for planning ahead if you don’t have a family caregiver.

Consider where — and how — you might like to age. While you’re still healthy, evaluate your living situation and try to make a plan.

“Identify where the best place is for you to live,” Carney says.

“Should you move to an area that’s more walkable, or has mass transportation or access to taxis?”

You might also consider communal living options, such as taking on roommates, or moving to a senior community or assisted living facility — often an ideal option for some who can afford it.

Get your paperwork in order. Make all legal documents accessible and your intentions clear. That includes deciding upon a health and financial proxy: Who’s going to make crucial decisions for you if you become incapacitated? If you don’t have anyone in your personal life to fill that role, you might look into elder care resources in your region. Or your doctor may be willing to step in, Carney says.

“I’ve had patients who’ve had no one and have asked me or my colleague to be their health care proxy,” she adds.

(If a physician agrees to be your proxy, he or she can’t continue as your health care provider.) You might consult an elder care lawyer to discuss your situation and help you plan.

Develop a social network. You may not be able to rely on friends for serious, long-term care, but they can help you — and you them — in many ways, such as bringing meals when you’re ill or recovering, and doing errands such as picking up prescriptions or groceries. Sometimes it’s hard to make new friends late in life, and old ones may not live nearby or are caught up in their own health issues. Consider joining clubs, taking a class, volunteering — anything that will offer you repeated exposure to a new group of people.

Find support from like-minded people. Marak started a Facebook group for elder orphans in February 2016 so

“people have a place just to feel like they’re not alone, so they can identify with others.”

Think creatively. Among other possible ways to plan for a future without a family caregiver, Marak has considered adopting a family. They’d agree to care for her, and she’d bequeath her assets to them. Other innovative ideas, Marak says, include joining other elder orphans in a living situation with space for a live-in caregiver

“so the residents, as they age, can count on this caregiver to help them at home. They provide the space for the person to live, and that person provides the services they need.”

If you have ideas for how elder orphans might prepare for aging without a family caregiver, join the conversation at AARP’s online community.


Christina Ianzito is a features editor at AARP Media.

Copyright 2016 AARP


Alzheimer’s Disesase: Managing Personality and Behavior Changes

(National Institute on Aging) Alzheimer’s disease causes brain cells to die, so the brain works less well over time. This changes how a person acts. This tip sheet has suggestions that may help you understand and cope with changes in personality and behavior in a person with Alzheimer’s disease.

Common Changes in Personality and Behavior

Common personality and behavior changes you may see include:

  • Getting upset, worried, and angry more easily
  • Acting depressed or not interested in things
  • Hiding things or believing other people are hiding things
  • Imagining things that aren’t there
  • Wandering away from home
  • Pacing a lot
  • Showing unusual sexual behavior
  • Hitting you or other people
  • Misunderstanding what he or she sees or hears

You also may notice that the person stops caring about how he or she looks, stops bathing, and wants to wear the same clothes every day.

In addition to changes in the brain, other things may affect how people with

Alzheimer’s behave:

  • Feelings such as sadness, fear, stress, confusion, or anxiety
  • Health-related problems, including illness, pain, new medications, or lack of sleep
  • Other physical issues like infections, constipation, hunger or thirst, or problems seeing or hearing
  • Problems in their surroundings, like too much noise or being in an unfamiliar place

If you don’t know what is causing the problem, call the doctor. It could be caused by a physical or medical issue.

Keep Things Simple…and Other Tips

Caregivers cannot stop Alzheimer’s-related changes in personality and behavior, but they can learn to cope with them. Here are some tips:

  • Keep things simple. Ask or say one thing at a time.
  • Have a daily routine, so the person knows when certain things will happen.
  • Reassure the person that he or she is safe and you are there to help.
  • Focus on his or her feelings rather than words. For example, say, “You seem worried.”
  • Don’t argue or try to reason with the person.
  • Try not to show your frustration or anger. If you get upset, take deep breaths and count to 10. If it’s safe, leave the room for a few minutes.
  • Use humor when you can.
  • Give people who pace a lot a safe place to walk.
  • Try using music, singing, or dancing to distract the person.
  • Ask for help. For instance, say, “Let’s set the table” or “I need help folding the clothes.”
  • Talk with the person’s doctor about problems like hitting, biting, depression, or hallucinations. Medications are available to treat some behavioral symptoms.

For More Varegiving Tips and Other Resources

  • Read “Caring for a Person with Alzheimer’s Disease”: www.nia.
  • Visit
  • Call the ADEAR Center toll-free: 1-800-438-4380


See the Person, Not the Disease, with Alzheimer’s Caregiving

(Mayo Clinic with Angela Lunde) Last time, we spoke about wandering, a label we often attach to a person living with Alzheimer’s.

It’s natural to attach a label to something we don’t completely understand or like. Think of other labels we use and apply in the context of dementia.  We label a person as a way to explain their so called “behaviors” with words like: resistive, hoarder, screamer, pacer, or sundowner.

To identify the person, some may refer to them as a patient, sufferer or victim. We describe a place of residence as a unit, facility or memory wing.  We talk in terms of deficits and losses and may think about the person as child-like, incompetent, less-than or no longer there.

No wonder so much fear and stigma surround Alzheimer’s. The labels and words not only send a message to those who hear them, but they also reinforce stereotypes and perceptions in our own mind that then influence our attitudes and our behavior.

If we use the word patient in our everyday interactions when referring to people living with dementia, then we see a medical diagnosis before we see a person. We focus on the deficits without seeing a whole person.

Similarly, if we refer to people victims then we think of them as a victim and we react by treating them as if they’re helpless and without the capacity for quality living.

If we say someone has behaviors then we think of the person or their disease as the problem. When we assume a person is no longer capable based on a diagnosis, we start taking over. When we believe in our mind that a person with dementia is child-like it changes how we communicate with them.

A study published in the American Journal of Alzheimer’s and other Disorders demonstrated that “restiveness to cares” in those living in a nursing home was significantly higher when staff communicated using “elderspeak” as opposed to normal adult communication.

Elderspeak refers to infantilizing and patronizing communication, similar to baby talk. It includes simplified grammar and vocabulary, as well as overly intimate terms of endearment.

Because many folks living with dementia can’t effectively communicate their needs (concerns, grievances) verbally, they compensate with non-verbal communication. This often gets labeled as “resistive.”

Bottom line, they’re simply trying to communicate in the best way they can, and in this case, it’s the need to be treated as an adult —  further evidence that persons living with dementia know when they’re being treated with dignity and respect or not.

Every person living with dementia embodies a unique history along with personal values, preferences, strengths and abilities.

And although it can sometimes be difficult to always know what someone with dementia is capable of, and it can change from day to day, they can often do much more than we think.

Some of what contributes to “problem behaviors” in persons living with dementia is their need to contribute, to feel useful and to function independently

Sometimes all it takes is to break a task down into smaller steps, offer some cues to help them get started, and then allow a bit more time. Each of us has a basic need to be engaged in meaningful activities and in life.

There are justified explanations for why a person living with dementia behaves or reacts in a particular way. If we believe that everything has meaning behind it, then our relationship to the person living with dementia dramatically changes. We see a person, not a disease. And that person will tell you everything you need to know once you pay attention with your eyes, your ears, and most of all your whole heart.


By Angela Lunde