,good evening and thanks for watching PBS Fort Wayne.

I think you're going to like our LIFE Ahead show this evening.

>> We've got some very interesting and informative guests for you this evening and a very good topic.

>> I'm the host of the show Sandy Thomson but the real stars are sitting over here.

So let me introduce you this evening.

>> You might recognize David Anthony .

He's been with us here on life I had before.

Thank you for coming back.

>> Absolutely.

It's we didn't scare you the first time.

Not too bad.

Be gentle on him and he is an attorney specializing in elder law or yeah.

>> Do Wills trusts powers of attorney help folks with the estate planning and long term care planning and all that?

>> OK so a big area that you might want to have some questions about and if so you can give us a call here and David will help you out on the legal front and we have with us the enrollment manager director direct enrollment director for the PACE Program PKC.

>> Now you're probably wondering what that's about.

It's very exciting news for us in northeastern Indiana and is going to share that information.

>> So now here's kind of a deal to to give you an idea of what we're going to be talking about as people begin to age or perhaps they have a medical condition and you're thinking about long term care of some sort perhaps nursing homes or assisted living might be the first thing that comes into your mind about what we're going to talk about tonight or some other alternatives for you to consider.

>> And this is exciting I think because you want I don't know, 10, 20 years ago these kinds of things didn't exist in the people really only had a choice of nursing homes or well actually even assisted living wasn't available a long time ago.

>> So it was like assisted living I mean a nursing home or nothing kind thing.

>> Well, one of the things I know is that because we've talked about this many times with your legalists associates that people tend to age better if they're medically able to if they stay at home rather than going somewhere else.

>> So let's kind of look at that topic as well.

What are what are some things involved, David, that we need to think of when we talk about people aging at home, aging well at home?

>> Yeah, well, you know, I was looking on the Internet and I saw that the statistics there are over fifty six thousand people over 100 hundred years old in this country.

>> Are you serious and huge and the numbers are looking like people will you know, next generation after me might be living up to one hundred and fifty years.

So when we think about what does it mean to be retired and how do we do that?

Well, you know, it becomes a bigger question because you know, 70, 80 years old isn't really that old anymore.

>> So you know, when we try to cover home care costs and think about that plan if we retire still in our mid to late 60s, we've got a long period of time that we need to cover .

And so, you know, you can consider do we pay it out of pocket or do we have long term care insurance?

Some of our veterans would have some assistance through the VA and then of course Medicaid has some programs that help pay for home care.

One of them is the PACE program.

Yeah, And the other program would be they would send home care workers to your house and so in private pay well and Medicaid would actually there's programs to help pay for home care through Medicaid, you know.

>> Yeah.

Those statistics for how long we might live like that scary but it's encouraging, you know.

>> So we'll see you right here when I'm one hundred and fifty.

Yeah well I mean that's the case.

So I mean look at well right now Social Security looking at the possibility of raising it to 67 I think is what they're looking at as a possibility.

>> So yeah, you may be working longer but again you might have a lot more years that you need to find somewhere or someone to take care of .

So now as David mentioned, we're going to talk about private pay, long term health insurance, veteran's benefits and Medicaid waiver.

So let's kind of get into each one of those individual.

>> Let's talk about the reality of paying for home health care.

Are there a lot of options in Fort Wayne that you know, a place where people can get home health care they would privately pay for ?

>> Oh yes.

Probably one hundred maybe.

Oh, there's many, many companies in Allen County and Fort Wayne specifically that offer in-home care and private pay is usually always an option.

>> Sure.

Are there any parameters I mean I've heard somebody that I know at home health care and and it was wonderful for them but they had to be there like three hours that typical.

>> Yeah.

And part of that is just to make it feasible for the worker because a lot of the a lot of workers are doing this.

>> Yeah yeah.

To get their pay and and make it a reasonable block they typically want to do about three hours and the costs are twenty to forty dollars an hour for that home care which can quickly add up.

So as long as you have the funds you can hire as much home care as you need but people think you know, maybe home care would be a cheaper option.

>> But by the time you know that what you're telling yeah.

By the time you compare it to, you know, a nursing home stay might cost you, you know, six thousand ten thousand dollars a month and that's a pretty big number.

But if you're paying for twenty four hour care at home and you're paying twenty to forty dollars an hour for that, you're you're into the tens of thousands maybe twenty thousand dollars a month just to pay for home care.

And so while again if you have the money that can be a very great option for you but it's even if you have a significant nest egg as your care needs increase, so will those costs and so private paying for home care can be challenging for a lot of people.

>> Sure.

And as you mentioned as people age a little longer as we move along here, there may be many more years and months for them to have to consider a private pay option.

>> Lisa, I want to ask because I know you deal also with a lot of people in the medical vein of that.

>> When does someone and David you can chime in with this too when when does someone know when they can seek assisted living or a nursing home or when they can utilize some sort of home health care?

>> Are their medical diagnosis or what type of situations?

So in order to enter a nursing facility or and assisted living facility, sometimes you have to meet what is called a nursing home.

The level of care OK, which is a type of assessment that helps the staff know how much help you really need and it has to meet a certain level so that that is one way to know if you might need to go into a facility but otherwise it might just be based on how well you're doing at home if you're still safe there, if you have any support people coming in to help you.

>> Yeah, you know that's good.

David, anything you want to chime in here?

Yeah, just you know, people might be surprised what the facilities are like these I think there's a real negative thought from how maybe the facilities of the past were finitely very sterile hospital settings but a lot of especially assisted living and independent living very much like an apartment and spacious rooms and increasing amenities.

My uncle who is just sixty keeps joking by the time he needs care they're going to have to have a microbrewery in the place for him.

>> So and they probably they probably with a wine bar in the cafeteria.

>> Absolutely.

Yeah well I mean that's certainly something you have to think about what fits your needs and you know how not you know it's not all about payment.

>> It's like what's important to you.

Right.

All right.

Let's talk about in terms of private pay you said the general cost could be I'm just a general because I know this could change from place to place well for private pay for home care specifically you're talking like I said about 20 to 40 dollars an hour usually right now the prices change and they could probably going to go up in the future.

But currently you're looking at twenty five thirty five dollars an hour for home care assisted living ranges anywhere from 15 or independent living anywhere from fifteen hundred six thousand again depending on what those care needs are.

And of course that is always going up and one of the ways to help offset that can be long term care insurance.

>> Let's talk about that.

You know, that's a big thing people have to decide, you know, should I get it?

>> That's a big question and if so, when should I get it?

>> Do you have some guidelines, David?

Yeah, I think conventional wisdom is if you're thinking about long term care insurance, you probably want to start thinking about that when you're in the late forties, early fifties and the older you get later you buy it, the larger those premiums are going to be.

But it can be really good if you have if you have again it's kind of a resources what you have coming in versus what you're willing to pay for that insurance.

>> It can be a really good fit for people because it it can pay out one hundred two hundred three hundred dollars a day depending on what you're buying and some of that's going to be based on if you go see an insurance agent they might look at well how much income are you expected to have in retirement and what are those costs going to be and how do we fill the gap?

>> Yeah, this might be what you need so it's going to vary from person to person.

They do get long term care insurance and the options of what it might cover I suppose just like any health plan, you know, there are so many out there to choose from and you have to decide what's important to you.

>> I mean do I need a lot of medical care?

Do expect hospital bills?

>> Do I think that I'm going to need dental or vision or multiple things?

>> So a lot of things to consider when you're choosing long term care.

You talked about maybe thinking about getting it when you're in your 40s or 50s and I've heard it can get if you wait till your in your 60s and 70s the cost for you for premiums gets really high and at some point maybe at some point you say hmm, I don't think it's worth it now because I'd be paying too much.

>> It can be yeah.

I mean and there are there are other planning options like I said with Medicaid or V.A.

benefits that can that could help offset those costs as well .

>> And again, just the right kind of planning or based on your resources you got to you know, talk to professionals and say what what are my options and what are the best going to meet my needs?

>> And I mean I think that's what people do when they select their auto insurance or their home insurance.

They're they're trained.

They have to think looking at a lot of things what is the value of my home or how much would it cost me to replace these things or how much of my income can I devote to insurance?

>> So a lot of parameters.

>> All right.

I want to talk about just for a moment home health care in terms of needs and we talked just a little bit about this lease in terms of when you medically might need something else.

>> I know someone who needed some home health care but they were physically able to stay at home and they, you know, do their shows and and feed themselves and that sort of thing.

>> But a little bit of dementia confuse them enough that they weren't always certain about their medications, you know, and either taking them twice or not taking them and home health care provided a wonderful opportunity for them to come in a few hours every day.

Just make sure the meds were right, make sure they were eating that kind of thing and then go by the wayside.

Now eventually that person needed a little more care medical care and had to move into another facility.

>> So it's going to be different for every person.

Do you find there's a certain diagnosis that where people might be more inclined to need help?

>> Lisa?

So for the space program the most common diagnoses we see are congestive heart failure.

Oh yeah.

COPD diabetes, dementia just diagnoses that if gone unchecked if you don't have some sort of nurse or help at home to kind of keep an eye on your condition that they can quickly go out of control.

So those are the most common that we see in our program.

>> You said that they need to have a medical reason who decides that the physician or whom we do in in home nursing assessment to determine the level of care.

OK, and so it's how many activities of Daily Living ADLs do you need help with ADLs?

>> All right.

We're going to talk to real professional term terms and those are really important because the the activities of daily living they are and I'll let you go into what exactly they are you probably have that a little bit better off top of your head.

But those are important for getting your long term care insurance started getting VA benefits and getting Medicaid benefits so you have to have they're not just going to hand you the money, right?

>> They're not just going to hand you a support or or give you get you onto a program.

You have to prove what those are and so they are important being able to show that and having that medically documented is important for a variety of benefits is exactly that makes a lot of sense.

Hey, we have a phone call coming in here and I do want to remind all of you viewing tonight that this is really your show.

That's what public broadcasting is about and attempt to provide you with information and education that will help you with some choices you have to make in your LIFE Ahead now.

>> So it's your show.

OK, so I've been asking questions but I would love for you to call if there's something you're wondering about or you have a question about again legally or with the PACE program that one of our cast here this evening can answer for you the numbers on the bottom of the screen and that'll be up regularly here during the rest of the show.

>> So give us a call.

>> Meanwhile we have Jane James I think that just called in and he has a question for them.

He says What would be some reasons that a healthy person would opt out of at home care or home health care?

Huh?

Anybody have an idea on that?

Some reasons that they would opt out.

>> I guess, you know, if you're healthy you might not need as much assistance.

>> But I think if you're you know, if you're thinking about what your lifestyle wants to be sure those are the options for the assisted living or the independent living.

One of the nice things about that is it provides a community and that's true and that's the other nice thing about the space program is it also provides a community setting.

So with you if you're thinking about home care as somebody comes to me yeah.

>> And to your home and you in the home help.

Right.

Or most likely it can still be a little bit isolating especially if they don't have a big support group whereas the the assisted living or the the long term care facilities or the space program they provide other people to interact with and they have I believe I believe you guys have meals in those kinds of things.

>> We're going to talk specifically here in a moment about that space program and much like I guess you know your own interest or whatever might determine whether or not you get lawn care or insurance or whether you get home health care assisted living.

>> You know, some people might be fine.

They like to be alone.

Right.

And home health care might work for them.

And if if it can provide their medical needs but other people that might be more social would like to have companions at lunch or something else to do or go down the hall and visit with somebody.

But I've had clients who were very capable and they decided that they again they just liked the community and a lot of facilities have very nice on there.

They have big campus and they have everything from villas and independent living and assisted living.

So so that might be why you would opt into a facility versus staying at home even if you were healthy.

>> Yeah, I was visiting somebody once at one of the local complexes that had different levels of assisted living.

>> They had like you said the Bela's which were like a little ranch house really it was lovely.

>> And then if your medical needs were more than maybe you'd move to another area that had somebody coming in every day a nurse or somebody to come in and check on you every day and then maybe eventually you'd be in the main room or the main building with more more of a hospital setting depending on your needs.

But I met some people I was having lunch with these friends a friend that was in the nursing home and I met this lovely couple who were in their late fifties and they had been touring different facilities because they wanted to make a decision themselves of where they would go and they were going to go into one of these apartments, if you will, so they could still have their car.

>> They were still able to keep a pet.

You know, just a lot of things.

All right.

Let's talk about we've talked about long term care.

Let's talk about veterans.

>> Give us some guidance there if you can, David.

Well, the the most important thing is that you have to have certain periods of service and so you mean time of service.

>> Yeah.

So VA benefits there are a lot about when did you serve how long did you serve and the circumstances for your discharge.

OK and so the most important document if you're looking for veterans benefits, probably the most important thing you can do is hold on to your deed to 14 days to to to 14 is the document that has in one place how you served, how long you served the period of service and how your discharged and so you do it in military service.

>> Yes you do OK and if you lost that I would encourage you to go to your go to the veterans service officer in town, go to the VA and get a copy because that's going to be your starting point for any benefits.

But there are quite a few different kinds of benefits.

But the VA is going to give you if you could get approved for your benefit through them.

Usually when we're talking the long term care we're talking about the aid and attendance pension and and that is a pension benefit based on certain financial criteria and again those activities of daily living.

Sure.

And and you have to have that the medical need but it is it's a it's a cash benefit.

So what they're going to do is they're going to say you have health care needs that exceed your ability to support yourself.

>> I see.

And if you do then they'll say OK, we'll give you up to four a veteran it's up to about twenty three hundred dollars a month.

>> Yeah.

And you can use that on anything.

It's cash benefit but they assume that you need it because your health care costs are so high.

>> Yeah.

So they kind of put those factors together and determine that so you would need to go to the Veterans Office.

>> Yeah yeah.

>> So I said Turnitin also yeah the the you can go to the veterans the veterans website for VSOE Veterans Service Officer in your area they will help find they will help you with your your benefit requests and then also there are attorneys like myself who will help with veterans benefits applications.

They're very, very strict about what you can do and can't do that you can't charge for an application so it's know but realizing that you know this as well.

>> Yeah, I remember Robert many of you might remember was on LIFE Ahead.

He was an attorney and we're probably ten twelve years he was on, you know, regularly and he had been a veteran himself so he was a real specialist at veterans benefits.

So it's nice that you know a lot about that too.

Lisa, I want to get to you to talk about the space program.

>> Pacey, what does it stand for and what is it pays stands for our program of all inclusive care for the elderly and it's a program that could be a good alternative for somebody that maybe could live in an assisted living or a long term care facility like they could live there but they don't want to OK their goal is to remain in their home for as long as possible as long as it's reasonable to stay at home and our program brings services to them that you might find at an assisted living or nursing facility like medical or what about daily things housekeeping, laundry.

>> Could you help with that too?

We do a variety of different services.

We do provide in-home care throughout the week so we help out with things like dressing, bathing, OK using the restroom, housework those are a deal's a deal.

Yes.

Activities of daily living.

So we do that during the week in your home and then we have a facility where you can come into our building throughout the week and inside we have a primary care clinic, physical and occupational therapy.

We have an adult activity center where we serve lunch every day.

You were talking about this a huge social aspect to it and we also provide transportation to your doctor's appointments and back and forth from our building.

So we kind of bring those services that you might receive in a facility.

We bring them to you instead and then we also try to get you out of the house and bring you into our building so that you can be around other people and receive care and receive that that extra care if you will.

>> At least working people find out more information about that or you mentioned with veterans where they should contact is there an agency here in town where people could find out yes, our facility is here in town on Lake Avenue.

We also have a website Pace and E I n yes.

>> Or you can find more information on Enga the Indiana website The Sims Centers for Medicaid and Medicare.

>> They can't not find you.

Yeah yeah.

There's there's many different websites that talk about peace programs in aging and in-home services.

>> I know is is a really I consider it sort of the nine one one or four one one four especially elderly people they can kind of direct you to different resources.

>> So if you need you can call them and say hey how can I get a hold of Lisa?

>> That's right.

And you'll be direct directed right to OK. >> All right.

That makes sense.

I want to go back to you again here.

David.

>> Talk about specific services in terms of don't mean specific services.

>> Are there things people need to know from a legal point of view that might connect somewhat with the services they need that we should consider we only have just a couple of minutes.

>> So yeah, I mean I think that if you're looking at long term care the baseline is always do you have power of attorney and I say this enough that people probably get tired of hearing me say it but can't say enough if you have a power of attorney document I think I'm losing my happens all the time of business if you if you don't have power of attorney people that you rely on can't help you.

Yeah.

And then from there you can look at trusts and wills and all that stuff but if you get a power of attorney you won't regret it.

It's affordable and it's just good for most things in your day to day life .

>> Exactly.

And and we get that reminder well at least once a month first Wednesday of the month we always have a legal show and a lot of your associates are here with us as well and they all say the same thing get your power of attorney, get your health care representative right a living well and put it all in a place where somebody else can find that's what everybody in the family well, I have certainly learned a lot myself here talking with Lisa and David and I hope you have as well.

>> We're going to be with you every Wednesday night, by the way, right here on PBS for weighing new topics every week.

Again, the first show of the month is legal but we have a lot of different topics.

>> So check in with us and you guys for you to know and the rest of you this show will air three times through the weekend and you can check your local TV listings for when that will be by Monday you're going to be signing autographs.

>> Thank you all for watching.

Good night