Caregiving & Partnering with 
Aging Loved Ones

The Benefits of Preventive Care Planning

Preventive planning for elder care offers significant benefits by enabling early detection of health issues, allowing for timely intervention, maintaining independence, and improving overall quality of life by preventing further complications and unnecessary hospitalizations. This ultimately enables seniors to live more active and fulfilling lives, and includes identifying potential risks like falls, managing chronic conditions, and addressing mental health concerns proactively.  

Key benefits of preventive planning for elders: 

• Early detection and treatment: Regular check-ups and screenings allow healthcare providers to identify potential health problems at their earliest stages, enabling prompt treatment and better management of chronic diseases like diabetes, heart disease, and arthritis. 
• Maintaining independence: By addressing health concerns early, seniors can maintain their ability to perform daily activities and live independently for longer. 
• Improved quality of life: Proactive care can significantly improve overall well-being by preventing unnecessary pain, discomfort, and complications from untreated health issues. 
• Reduced risk of falls: Assessments and interventions focused on balance, strength, and gait can help prevent falls and related injuries, especially important for older adults. 
• Mental health support: Regular check-ins with healthcare providers can identify potential mental health concerns like depression or anxiety, allowing for early intervention and treatment. 
• Lifestyle management: Preventive planning can encourage healthy lifestyle choices like regular exercise, balanced diet, and adequate sleep, which are crucial for overall health in older adults. 
• Care coordination: A well-developed preventive plan can facilitate coordinated care between different healthcare providers, ensuring all aspects of an older adult's health are addressed. 
• Advanced care planning: Discussing future care needs and preferences early on can help ease decision-making for family members in case of a medical crisis. 
  • What age-related Medical Issues should we watch out for? 

Advance Care Planning 

Planning ahead for end-of-life care,  advance care planning, helps to ensure that aging adults get medical care that is a good fit for their preferences and health situation. In other words, good planning can help you figure out which care is unlikely to be helpful; understanding this is a powerful factor in what people want and don’t want.

Completing a legal form such as an advance directive or a MOLST form is an important part of advance care planning, but there’s much much more to good planning ahead. It’s especially important for family caregivers to be involved in planning, if possible, because most older adults will need family — or someone else — to help with medical decision-making during a hospitalization, or an emergency.

•  Advance Care Planning - Here’s a helpful slideshow that delves deeper into the details of this process. See more
   

Special Topics

What Do I Do If My Elderly Parent Refuses to Go to the Doctor?  LINK 

Love Loss and Laughs:  Let’s Talk About Aging Parents - A Real Life Guide to Solving Problems with 27 Essential Conversations, by Laura Tamblyn Watts 

• What do we do about my parent’s hearing problem? 
• What do we do about my parent’s vision loss? 
• What do we do about my parent’s incontinence? 
• Does my parent have an issue with alcohol? 

 How to Care for My Parent when they Are Hospitalized 

For additional information on Hospital Care Management 

see Crisis Care Management - LINK 

Dementia & Anesthesia 

To limit the impacts of anesthesia on dementia, the most important steps are to consult with a healthcare professional before surgery, discuss the patient's specific cognitive status, and opt for the least invasive anesthetic options like regional anesthesia when possible, while avoiding medications that can worsen cognitive function, particularly benzodiazepines and anticholinergics; additionally, meticulous post-operative care with close monitoring and cognitive stimulation can help manage potential cognitive decline. 

When illness causes couples to separate 

Researchers examined how the onset of four serious physical illnesses – cancer, heart problems, lung disease and stroke – affected marriages. They found that overall 31 percent of the marriages ended in divorce over the period studied. Specifically divorce was more likely when the wife was sick. 

At the same time, caring for ill parents can have an impact on the caregiver’s marriage.  Be attentive, open and communicative of what is happening and seek support when necessary. 

Dehydration

How to Prevent, Diagnose and Treat Dehydration -  https://betterhealthwhileaging.net/qa-how-to-prevent-diagnose-treat-dehydration-aging-adults/

Avoiding Falls

The number one action driving seniors from independence is a fall. Each year 1 in 4 older adults experience significant falls with approximately 50% of these occurring in their homes. With current trends and falls the leading cause of injury-related hospitalizations among older adults, we can expect 7 fall deaths every hour by 2030. (CDC). Look for information on making modification to homes in Aging in Place.  Below are some articles speaking to some of the medical causes of falls.

• Preventing Falls in Aging Adults - https://betterhealthwhileaging.net/falls-topic/
• 8 Things to check after a person falls - https://betterhealthwhileaging.net/8-things-to-check-after-fall-in-aging/

Grief & Loss 

Bereavement Support Group: Held at St. Eulalia’s. Topics include an overview of the bereavement process, signs and symptoms of grief, feelings associated with bereavement, and the uniqueness of each person’s grief experience. - 50 Ridge St. Winchester, MA - Phone: (781) 729-8220 Ext. 16 - LINK 

The Children's Room: Grief support services for children, teens, and families. Services are aimed at children ages 3-18 who have lost a parent or sibling, as well as for their caregivers. Runs support groups, teen programming, and referrals. -  1210 Massachusetts Ave. Arlington, MA - Phone: (781) 641-4741  - E-mail: info@childrensroom.org - LINK 

Self-care, Fitness & Exercise 

The Jenks Center offers programming Monday -Saturday in person and virtually to keep seniors active, balanced and engaged.  Check out the Jenks website for a calendar of low- or no- cost weekly and monthly activities, including: 

• Balance classesAerobics and Muscle Fitness 
• Tai Chi 
• Dance Cardio 
• Step Aerobics 
• Mindfulness Practices 
• Yoga and Meditative Movement 
• Reiki Healing 
• Therapy Dog 

Look for physical activity programs that can be accessed through technology at home, such as doing an online group fitness class through SilverSneakers or the YMCA. Jenks offers several of their programs virtually. 

• Tips for Getting and Staying Active as You Age - LINK 
• How to Promote Physical Health While Aging: The Healthy Aging Checklist Part 2 https://betterhealthwhileaging.net/how-to-promote-physical-health-for-healthy-aging/

Dental, Foot, Vision and Hearing Care 

• Part 4 - Love, Loss and Laughs - Let’s Talk About Aging Parents - A Real Life Guide to Solving Problems with 27 Essential Conversations, by Laura Tamblyn Watts 
  • What should we do about my parent’s hearing problems? 
  • What so we do about my parent’s vision loss 

Physical and Occupational therapy 

• Understanding Physical, Occupational, And Speech Therapy In Senior Rehabilitation n- LINK 
• Occupational therapy services - Medicare.gov - LINK  

Flu and Other Vaccines 

Substance & Addictions 

• 12 Step Education Program: A place where individuals can go to share their experiences with alcohol use with one another and support each other in the ongoing effort of maintaining abstinence. - 171 Cambridge Rd Woburn, MA - Phone: (781) 932-8711 - LINK 
• Gamblers Anonymous: A group that comes together to share their experiences, strengths and hopes with each other regarding their gambling problems. Meetings on Mondays from 7:00-8:30 PM. - 100 Winthrop St. Medford, MA - LINK 



Cognitive impairment or dementia 

• How to Promote Brain Health: The Healthy Aging Checklist, Part 1, Learn more
• Part 2 - Mental Capacity, Power of Attorney, and Safety - Let’s Talk About Aging Parents - A Real Life Guide to Solving Problems with 27 Essential Conversations, by Laura Tamblyn Watts 
  • How do I know if my parent has cognitive impairment or dementia? 
• When Your Aging Parent Needs Help, A Geriatrician’s Step-by-Step Guide to Memory Loss, resistance, Safety Worries and More, by Leslie Kernisan, MD, MPH and PAul Spencer Scott 
• How to Talk with a Parent with Dementia - LINK
 

Daily Care

• Do you need to enlist the help of a professional caregiver, a home companion or a home maker to help you make some time for yourself? 
• Does your loved one need in-home medical care? 
• Do you need help in determining what daily care services could best help your loved one? 
  • Best Practices for Effective Elderly Medication Management - LINK 

A Daughter’s Guide to Hiring the Right Aging Care Professional - LINK - https://daughterhood.org/a-daughters-guide-to-hiring-the-right-aging-care-professional/ 

Hiring a Care Manager in your Area - Learn the Landscape of Resources - LINK - https://aginglifecare.org 

Aging Life Care Association - LINK - http://www.aginglifecare.org/ALCA 

Geriatric Care Managers - LINK - http://www.caring.com/local/geriatric-care-managers 

In-home medical equipment 

There are several low-cost or no-cost sources, if you are in need of temporary or more permanent in home medical equipment:  

• Jenks Center, Home Medical Equipment Loan Program 781-721-7136 
• Assistive Technology Regional Centers -  Run by the Easter Seals, this program allows you to borrow equipment, free of charge, from the inventory of the Assistive Technology Regional Centers (ATRCs). - 89 South St. Boston, MA - Phone: (617) 226-2640 Email: - ATRCBoston@eastersealsma.org - LINK 
• HELP PROGRAM: Free Masons, 500R Cummings Park, Woburn, Ma- Open Saturdays 9 -1: https://smd-help.org/SMD-HELP_Woburn_2017.pdf 
• Hospital Equipment Loan Program - Free medical equipment loan program operated by the masonic lodge, appointment preferred for hospital bed or commode. Open Saturdays 9 -12 only. - West Cummings Park (Right Side) - Suite 1150. (Washington Street) Woburn, MA - Phone: (781) 322-1052 - LINK 
• Medicare.gov Supplier Directory: www.medicare.gov/supplierdirectory 
• REquipment - A donation-based program that provides free refurbished durable medical equipment (DME) to adults and children with disabilities and elders in MA. - PO Box 311 Methuen, MA - Phone:(800) 261-9841  - Email:info@dmereuse.org - LINK 

Organizations 

• Winchester Health Department - Provides a variety of vaccines to all ages, including flu, pneumonia, and TB testing as well as information on many topics. - 109 Skillings Rd. Winchester MA - Phone: (781) 721-7121 - LINK 
• Massachusetts Department of Public Health - LINK 
• United States Department of Health and Human Services: The US Department of Health and Human Services (HHS) addresses the needs of aging seniors through the Administration on Aging (AOA), which implements the Older Americans Act (OAA) and provides services like information and referral, meals, and in-home care. - LINK 

Housing 

The Continuum of Senior Living: From Independence to Hospice 

When considering housing options, seniors can consider options like selling their house outright, moving in with family, downsizing to a smaller home, moving into an assisted living facility/nursing home, joining a retirement community, selling to a family member, or exploring "aging in place" solutions with home modifications to support their needs depending on their health, financial situation, and desired lifestyle.   The following are some of the broader stops along the continuum. 

Aging in Place 

Aging in Place refers to the ability of a person to remain in their own home while receiving the necessary support and services to maintain their independence and quality of life. 

Given the choice, 90% of adults would prefer to age in place independently and comfortably.  Aging in place can provide an enhanced quality of life with seniors remaining in familiar surroundings which contribute to emotional well-being and life satisfaction.  Staying in one’s community also allows for continued engagement more often with established social networks. And finally with the average Massachusetts assisted living residence and private nursing home costing $6400 and $13,400 per month respectively, investments in modifications to stay at home can be cost effective. 

Continuous Care Retirement Communities (CCRC) 

A continuing care retirement community (CCRC) is a senior living option that provides seniors with the opportunity to live in one location for as long as they need. Typically they offer Independent and Assisted Living options with some level of on-site healthcare services, and access to doctors and nurses.  Some, not all, CCRCs offer Memory and skilled nursing care with 24/7 access to medical professionals.  The benefit of CCRCs is that they allow residents to choose what level of help they want through the various stages of the aging process, without the necessity of moving from one location to another.   

CCRCs allow families and residents peace of mind, knowing that loved ones will have all the support they require no matter their ongoing needs. Often by the time a senior makes the decision to move from their home, they are already facing a complex but not fully realized profile of needs, and a CCRC allows for a menu of services to be utilized. 

Level 1: Independent living 

Independent living or senior 55+ residences cater to seniors who are largely self-sufficient and can manage their daily activities independently, but may prefer to leave behind the burdens of homeownership and enjoy amenities such as prepared dining options and social or recreational opportunities. Older adults who are active and healthy enjoy the continuing care retirement community facilities and maintenance-free advantages while living alone in their preferred home. 

Level 2: Assisted living 

If a loved one’s level of care requires greater assistance, assisted living can provide round-the-clock custodial and medical services. Staff members are available to assist with activities of daily living, such as bathing, dressing, or medication administration, for residents to be as independent as possible. Assisted living may be provided in the form of apartment-style housing, either entirely private or semi-private. 

Level 3: Memory care 

Seniors who are experiencing memory loss as a result of dementia, Alzheimer’s disease, or other cognitive disabilities may choose to move to the on-campus memory care facility at the continuing care retirement community. Residents are cared for by specially trained staff who prioritize comfort, engagement, and safety. 

Level 4: Skilled nursing care 

Skilled nursing care, like assisted living, involves medical and custodial services 24 hours a day, seven days a week. However, skilled nursing pertains specifically to rehabilitation services and short-term care. For instance, residents requiring post-surgical wound treatment, physical or speech therapy following a stroke, or IV medication administration might stay in the skilled nursing facility of a community care retirement complex. 

Hospice Care 

Hospice care focuses on comfort and quality of life for terminally ill individuals, with a life expectancy of six months or less. Hospice care is provided by a team of professionals, including doctors, nurses, social workers, counselors, and volunteers, who work together to meet the patient's physical, emotional, and spiritual needs. Hospice care also provides support for the patient's family and caregivers, helping them cope with the emotional and practical challenges of end-of-life care and bereavement support for up to one year. 

Hospice care can be provided in various settings, including homes, nursing homes, and specialized facilities. Services include: pain and symptom management, medical supplies and equipment, counseling and spiritual support, respite care and specialized therapies. 

Exploring Options and Transitions with your Aging Loved Ones 

• When Should Elderly Parents Stop Living Alone? - LINK 
• How to Talk to Elderly Parents About Assisted Living - LINK 
• 13 Tips to Help a Parent Transition into Assisted Living with Care & Respect - LINK 
• 7 Ways to Help Your Parents Smoothly Transition to Assisted Living - LINK 
• Is it Time for My Parent to Move Into Independent Living or a retirement Home? Let’s Talk about Aging Parents - A Real Life Guide to Solving Problems with 27 Essential Conversations, by Laura Tamblyn Watts 
• How To Move Your Parents. - Marty Stevens-Heebner the president of NASMM - LINK 

Downsizing & Decluttering 

6 Tips to Help Senior Parents Declutter and Downsize - LINK 

Hoarding & Seniors: What Families Need to Know - Hoarding among seniors is more than clutter—it can impact their health and safety. This video shares practical tips to help older adults manage hoarding behaviors compassionately. Learn how to spot hoarding, understand its causes, and approach decluttering with care. If you’re navigating this challenge with a loved one, this guide offers actionable steps to ensure a safer home and better quality of life. LINK 

Selling, Transferring the Family Home 

5 Things to Consider when Selling a Home to Pay for Assisted Living g - LINK 

Moving Parents In With You 

For more resources and information, see section on Caregiver support - LINK 

Guides as you prepare to move in a parent: 

• 10 Factors to Consider Before Moving Your Elderly Parents In - LINK 
• What to Consider Before Moving Your Senior Loved One into Your Home - LINK 
• 8 ESSENTIAL Tips for Moving a Senior Parent Into Your Home | A Place for Mom - LINK 

Here's a breakdown of other helpful resources and considerations: 

Government and Local Resources: 

• Eldercare Locator: This is a great starting point to find local resources, including services for older adults and their families, such as home care, transportation, and caregiver support. Eldercare Locator (.gov) - Phone: 800-677-1116 
• National Family Caregiver Support Program (NFCSP): This program provides grants to states to fund supports for family and informal caregivers.  Website: Administration for Community Living (ACL) (.gov) 
• Aging and Disability Resource Centers (ADRCs): These centers can help older adults and those with disabilities, and their families, make decisions about long-term care and access services. Website: LINK 
• Medicaid Home and Community Based Services (HCBS): This program offers opportunities for older adults and people with disabilities to live in their homes with support. 

Considerations for Moving an Aging Loved One In: 

• Assess Needs: Determine the level of care your loved one requires and what support you can realistically provide.  
• Home Modifications: Consider necessary modifications to your home to ensure safety and accessibility. For more information about how to make home modifications, see the safety section in Aging in Place , LINK 
• Assistive Devices: Explore the use of assistive devices to help your loved one maintain independence and safety in the home.  
• Financial Planning: Explore options for covering caregiving costs, including government programs, long-term care insurance, and other financial resources. 
• Professional Help: Consider hiring in-home care professionals or consulting with geriatric care managers or social workers.For more information about in home services, see the safety section in Aging in Place , LINK
• Family Communication: Have open and honest conversations with your family about caregiving responsibilities and expectations.  Don’t be afraid to have the crucial conversations.  See Let’s Talk About Aging Parents, by Laura Watts on how to approach some of these more difficult discussions with older family members. 
  • Checklist for Moving Elderly Parents: 6 Practical Things to Consider When Moving an Aging Loved One, by A Place for Mom - LINK 

Considerations for the Moving Process 

Helping elderly parents move can bring them closer to family, ensure a safer home environment, and lead to a more active lifestyle. Whether your parent is transitioning to an assisted living community, moving into your home, or downsizing to a senior apartment, these six tips can help you plan. 

• Senior Move Managers:  Consider hiring a senior move manager to help with the packing, moving, and settling in process. Website: National Association of Senior Move Managers (www.nasmm.org) 

Researching New Housing 

Monthly Assisted Living Residences. Lunch and Tour

The Jenks Shuttle is on the road, visiting local assisted living and senior living residences in the area. We will visit a different place each month. - Contact Suzanne Norton for more information. snorton@winchester.us. 

Certified Senior Advisors

There is a network of Certified Senior Advisors who offer free referral services to seniors seeking out information about independent, assisted living and memory care residences in your areas.  Provital is one such service in the Winchester area, but other Certified Senior Advisors in your area can be found HERE. 

Researching Memory Care Residences- 10 Questions to Ask When Considering a Memory Care Facility - LINK 

Resources 

• Medicare Nursing Home Compare: - LINK 
• Assisted Living Locators: Jon Younger 978-553-1130 
• Care Patrol (781) 496-2600 
• Provital Services (781)262-8309 
• A Place for Mom (866) 671-3802 
• Your Local Council on Aging 
• Mass ALA( Massachusetts Assisted Living Association) (781) 622-5999 
• Housing Navigator Ma- https://housingnavigatorma.org/ 
• Massachusetts Association of Residential Care Homes (MARCH): MARCH (Massachusetts Association of Residential Care Homes), established in 1991, is the only organization solely representing rest homes and the residential care community. MARCH is a 501(c6). The mission of the organization is to encourage financial viability, support and advocacy and increased visibility and recognition of the cost-effective quality of care offered residents in a home-like setting within the long term care continuum. - Phone: 978-502-9561 - LINK 

Assisted Living and Nursing Homes in Winchester & Neighboring Communities 

The Gables: Independent and assisted living facility for seniors. Offer entertainment and recreation activities, assistance with medical care, daily living activities, and rehabilitation services.  - 299 Cambridge St. Winchester, MA - Phone: (781) 756-1026 - LINK 

New Horizons at Choate : Independent and assisted living facility for seniors. Offer entertainment and recreation activities, in addition to assistance with on-site medical care, daily living activities, and memory care services. -  21 Warren Ave. Woburn, MA - Phone: (781) 932-8000 - LINK 

Winchester Mount Vernon House: Assisted living facility, offering meals service, on-staff nurse, and assistance with activities of daily living. -  110 Mount Vernon St. Winchester, MA - Phone: (781) 729-0497 - LINK 

Aviva Country Club Heights, Woburn - Assisted lIving with Memory Care - 3 Rehabilitation Way Woburn, Woburn. 

Youville Place, Lexington - Assited Living with Memory Unit 

OTHERS - Suzanne Norton 

Legal & Financial Services 

Activities at the Jenks 

• Tax Assistance: Volunteers provide tax assistance to seniors and prepare income taxes. The program runs from February until April. This is for standard tax returns that would not require an accountant. By appointment.  Contact the Jenks to schedule. (781) 721-7136, Email: info@jenkscenter.org 
• Benefits Checkup, Fridays by Appointment: Millions of older adults and people with disabilities connect with benefit programs that help with health care, medicine, food, utilities, and more.   Contact Jenks Center social worker for a confidential appointment to see what’s available in your area. snorton@winchester.us, 781-721-7136 x 15 
• SHINE (Serving the Health Insurance Needs of Everyone) The program provides free health insurance information and counseling to all Massachusetts residents with Medicare and their caregivers.  SHINE counselors are available regularly at the Jenks. Call the Jenks Center (781) 721-7136 to schedule your appointment. Phone: (800) 243-4636 for Mass support 

Financial Planning 

The Cost of Care 

Aging Americans are struggling to pay for assisted living, home care and other forms of long term care. The cost of care for the elderly varies greatly depending on the type of care needed, location, and level of assistance, but generally ranges from around $5,500 per month for in-home care to upwards of $10,000 per month for a private room in a nursing home, with assisted living falling somewhere in between; costs can be significantly higher in certain regions, especially the Boston, New York and California urban and suburban areas. This does not include other insurance, living or medical costs. 

PayingforSeniorCare.com offers tools and national information, tools and creative ideas which help families and caregivers discover the means to care for their elderly loved ones. Topics include paying for memory care and adult daycare, reviewing products lie walk in tubs, and discussing prescriptions and assisted living costs by state. 

The Cost of Housing 

Entry fees vs monthly rent payment -  In some cases senior residences will require an entrance fee. An entrance fee is a large ($30k - $1 million or more), sometimes refundable, cost at the time of move-in. These are typically charged by continuing care retirement communities and ensure access to care as residents' needs increase. 

Entrance fees are typically refundable (often 100%, 90%, or 50% of the original amount) and are sometimes used by a community to offset lower monthly rent payments. For instance, with a $100k entrance fee the community may charge $4,700 per month in rent, but with a $200k entrance fee the community may charge $4,000 per month in rent. 

The refundability of an entrance fee is dependent on several factors including the amount of care the resident consumes, when he or she leaves the community, the monthly amount paid in rent, or the community's ability to rent/sell the space after the resident has moved out. It is important that you and your estate planner explore all of the scenarios in which you will receive a refund and whether it is a worthy investment.  With senior residences increasingly privately owned, there is not always a guarantee that services will remain at the same level two or five years out regardless of any initial payment. 

Hidden Costs of Care 

Hidden costs of senior care include not only visible expenses like medical bills, but also lost wages, missed career opportunities, and the emotional and physical strain on caregivers, impacting their financial stability and well-being. It is important to consider the impacts on you and your family in your planning. 

• Job/Income Loss of Caregiver 
• Increased Personal Health Care Costs of Caregiver 
• Lost College & Retirement Savings 
• Insurance-related Costs 
• Indirect costs, transportation, meals, etc 
• Direct Costs 
• Expenses for well spouse and dependents 
• Pet care 
• Equipment - ramps, walk in showers, health aides, 

Resources for assistance with caregiving costs 

• Benefits Check Up:  - LINK 
• Paying for Senior Care.com - LINK 
• Minuteman Senior Services: Care Options Counseling 781-272-7177 

Types of Advisors 

Financial advisor: Plans for life events like retirement, disability, long-term care, and estate distribution. For information on how to find an advisor or choose an advisor see this Forbes article. LINK

Daily Money Managers: A daily money manager (DMM) is a person who performs the day-to-day financial tasks of another individual. Daily money managers offer services like paying monthly bills, assisting with tax records, balancing bank records, decoding medical bills, and negotiating with creditors. Other services may include notarization, payroll management, or healthcare advocacy. There’s a whole profession dedicated to helping  parents manage their money. It’s called Daily Money Managers (DMM). You can search for one in your area LINK.   

Investment advisor: Investment advisors are primarily concerned with the growth and returns of your investments based on the priority purpose of your investment selections. (income, growth, balance, etc).  To find a registered investment advisor look to the National Association of Personal Financial Advisors. LINK 

Preparing for Financial Planning 

Have you taken care of your loved one’s finances by:  

• Accumulating your loved one’s essential papers and records 
• Establishing a list of important financial information 
• Organizing contact information for financial and legal professionals 
• Creating a Financial Power of Attorney? 

The Complete Eldercare Planner - Where to start, which questions to ask and how to find help, by Joy Louvered 

• Money Matters: Cost of Caring, Buying Time, Eldercare Budget Worksheet 
• Legal Matters: Estate Planning, Justice for All, Financial Literacy 
• Insurance: Insurance Coverage for a Longer Life, Beyond Medicare 
• Low-cost and No-Cost Resources, Action Checklist, Worksheets 
• AARP Financial Resources & Guides: LINK 
• Unemployment Assistance 
• Vetarans Benefits (VBA) 
  • Create an account to learn about benefits and track applications. LINK 

Social Security 

If you need to coordinate your elderly parents' Social Security benefits, you'll likely need to become a representative payee, which allows you to receive and manage their benefits on their behalf if they are unable to do so themselves. In order to do so you will need to take 4 steps: 

1) Make sure that your name is on the account to which the social security checks are being deposited; 

2) Change your parent’s address to your address for social security documents and mailings online, including all email and phone numbers; 

3) Have your parent’s primary doctor write a letter declaring them incompetent (permanently) and incapable of managing their own benefits; and 

4) Make an appointment at your local Social Security office to complete the necessary paperwork and be interviews. You will need your passport or drivers license and the letter from the doctor. A durable power of attorney is not necessary.


• Social Security Administration - LINK 
• Understanding the benefits- LINK 
  • Social Security Survivors Benefits 
  • Social Security Disability Benefits
  • Social Security Supplemental Income

“Making sure elders have adequate insurance can be a 

matter of economic survival for the entire family.” - Joy Loverde 

Insurance 

Medicare & Medicaid, & Beyond 

Medicare is health insurance for:  People 65 or older, people under 65 with certain disabilities, or people of any age with End-Stage Renal Disease (ESRD) (permanent kidney failure requiring dialysis or a kidney transplant) or ALS (also called Lou Gehrig’s disease). There are 3 Parts to medicare: Part A- Hospital Insurance; Part B -Medical Insurance; and Part D- Drug Coverage.  Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are Medicare-approved plans offered by private companies that must follow rules set by Medicare. 

Medicaid is a joint federal and state program that may help pay health care costs if you have limited income and (in some cases) resources and meet other requirements. Medicaid offers benefits that Medicare doesn't normally cover, like nursing home care and personal care services. The rules around who’s eligible for Medicaid are different in each state. If you qualify for Medicaid in your state, you automatically qualify for Extra Help. Extra Help is a program to help people with limited income and resources pay Medicare drug coverage (Part D) out-of-pocket costs. 

• AARP - Essential Tips Caregivers Must Know About Medicare - Learn how to navigate the system to get the best coverage for your loved ones. LINK 
• A Quick Guide to Medicare and Medicaid: LINK 
• Caregivers: Why Understanding Medicare Insurance for Aging Parents is Important - LINK 
• How to Learn About Medicare Programs to Pay for Caregivers - LINK 
• How to Avoid Paying for an Elderly Parent's Nursing Home Bill - LINK 

Homeowners or Renters Insurance 

Renters insurance can be a good option for seniors living in assisted living facilities because it protects their belongings and provides liability coverage. Homeowners is essential if their belongings are damaged due to theft or disaster and rebuilding and replacement are necessary to staying independent. 

Auto Insurance 

Auto Insurance can account for more than one fifth of ongoing car insurance. Car insurance rates for seniors can vary depending on age, health, and driving history. However, seniors don't always have the highest rates.  Seniors can take defensive driving courses and tests to qualify for lower car insurance rates. These courses can help drivers compensate for age-related changes and improve driving skills. 

• AAA RoadWise Driver: Teaches the latest vehicle technology, including lane-departure warning systems and adaptive cruise control - LINK 
• AARP Smart Driver: Helps drivers learn how to reduce distractions, maintain following distance, and use safety features like anti-lock brakes and airbags - LINK 
• Senior Driving Discount of America (SSDA): Offers online classes and tests that demonstrate safe driving skills  LINK 

Life Insurance 

Life Insurance helps elders who want to prevent dependents from suffering financially upon the policy holders death and/or to cover the costs of funeral arrangements. 

Long term Health Insurance 

• National Council on Aging: How Much Does Longterm Health Insurance Cost and Is It Worth It?: LINK 

Tax Preparation & Resources 

• Senior Citizen Tax Abatement Program: Utilize your skills to enjoy property tax relief.  Requirements for participation includes: Winchester homeownership, age 60 and older, maximum AGI of $67,701 (Individual) or $102,608 (Joint) or less and home value of $1,596,315. For more information contact Phillip Beltz. pbeltz@winchester.us 
• Free or Reduced Tax Filing and or Preparation Software for Elderly: Eligible seniors have many free tax filing options.  Whether they prepare and file their own tax returns or get in-person help, there are easy, secure and free tax filing options for seniors. 
•  IRS provides details. LINK 
• AARP programs nationally. LINK 
  • VA Caregiver Support: www.caregiver.va.gov/ 

Veterans Benefits, Disability Benefits, etc. 

For senior veterans seeking information and resources from the Veterans Administration (VA), the official website is VA.gov Home | Veterans Affairs.This site offers a comprehensive overview of VA benefits, services, and resources, including those specifically tailored for elderly veterans. - LINK 

• Also, check with you Local Veteran Agent Greg Quill gquill@winchester.us 

Legal & Estate Planning 

Seniors should focus on estate planning to ensure their assets are distributed as desired, someone can make decisions on their behalf if incapacitated, and their wishes are honored, including wills, trusts, and powers of attorney, while also considering long-term care planning and tax implications. 

Estate planning is important because it provides peace of mind for seniors, ensuring that wishes are honored and minimizing conflicts among family members. It also facilitates financial stability by ensuring that loved ones have access to resources and assets that have been protected from probate, creditors and potential disputes. 

Solo Agers - What if You Don’t Have a Healthcare Agent or Power of Attorney? Lean more 

Elder Law Attorneys

A good elder law attorney will help your parent clarify his or her financial and health care wishes in detail and then ensure that those wishes are protected, as much as possible, by legal contracts and documents. Elder law attorneys help clients plan for long-term care needs, sort out their advance directives and wills, and make sure the financial power of attorney is in place. They can be a big help understanding the eligibility rules for Medicaid in your parent’s state. Plus, more and more lawyers are teaming up with GCMs to offer one-stop shops. To find an attorney, check out the National Academy of Elder Law Attorneys’ website which has an elder lawyer locator. - LINK 

Elder Law Attorney Andrea Witt, partner at Spano, Dawicki & Witt, LLC offers free consults with Jenks members. Call the Jenks to schedule a free session and ask questions about strategizing or drafting estate plans, asset protection, tax minimization, probate avoidance, trust administration, among other topics.   

• Massachusetts Bar Association - LINK   

Key Documents

Wills: A will is a legal document that outlines how your assets should be distributed after your death. 

Trusts: Trusts allow you to transfer assets to a trustee to manage them, offering flexibility and control, and potentially avoiding probate. 

Powers of Attorney: These documents grant someone the authority to make financial or healthcare decisions on your behalf if you become unable to do so yourself. 

Advance Directives: These documents, like a living will, outline your wishes regarding end-of-life medical care. MOLST is the Medical Order for Life Sustaining Treatments. It cover more than just a DNR ( a legal document instructing healthcare providers  their wishes regarding end-of-life care, specifically in situations of cardiac or respiratory arrest.) 

Beneficiaries: Clearly identify who will inherit your assets, ensuring they receive them as intended. 

Long-Term Care Planning: Consider the costs and needs of potential long-term care, including financial planning and insurance. 

Tax Planning: Consult with a tax professional to minimize potential estate taxes. 

Estate Executor: Choose a trusted individual to manage your estate after your death. 

The five important documents to have for advance care planning are: 

• F = Financial agent - www.eforms.com 
• M = Medical agent - www.masshealthdecisions.org) 
• H = HIPAA release form - www.caring.com 
• W = (Living) Will (www.fivewishes.org OR www.ourcarewishes.com) 
• M = MOLST (www.molst-ma.org) 
• POA FORMS- Printable Forms 

Estate Planning with Children with Special Needs

Estate planning when families have children with special needs can be especially challenging.  Seek out references in your community for specialists who can advise on wills and plans to make accommodations for their future needs.

• Local Referral - Fred Misilo, Fletcher Chilton Law Firm in Worcester, Massachusetts. 508-459-8000.

Advanced Advance Care Planning 

Planning ahead for end-of-life care,  advance care planning, helps to ensure that aging adults get medical care that is a good fit for their preferences and health situation. In other words, good planning can help you figure out which care is unlikely to be helpful; understanding this is a powerful factor in what people want and don’t want.

Completing a legal form such as an advance directive or a MOLST form is an important part of advance care planning, but there’s much much more to good planning ahead. It’s especially important for family caregivers to be involved in planning, if possible, because most older adults will need family — or someone else — to help with medical decision-making during a hospitalization, or an emergency.

•  Advance Care Planning - Here’s a helpful slideshow that delves deeper into the details of this process. See moreDNRs, and Health Care Proxies & MOLSTs 

Divesting of Homes: 

When seniors want to get rid of their homes, they can consider options like selling their house outright, downsizing to a smaller home, moving into an assisted living facility, joining a retirement community, selling to a family member, or exploring "aging in place" solutions with home modifications to support their needs depending on their health, financial situation, and desired lifestyle. 

• Selling and Finding Realtors 
• Gifting Homes to Children or Relatives 
• How to protect your Retirement When Selling A Home 

Family Trusts & Power of Attorney 

Massachusetts power of attorney forms legally permit a person (“principal”) to select another person (“agent”) to make decisions on their behalf. Under State law, an individual may grant medical, financial, parental, tax, vehicle, or any other responsibility to a selected person. If the form is durable, the designation will remain in effect even if the principal can no longer mentally think for themselves (e.g. Dementia, Alzheimer’s, etc.). Once a power of attorney document is written and signed in accordance with State law it is immediately available for use. 

By Type (9) 

• Durable (Financial) Power of Attorney 
• General (Financial) Power of Attorney 
• Limited Power of Attorney 
• Medical Power of Attorney 
• Minor (Child) Power of Attorney 
• Real Estate Power of Attorney 
• Revocation of Power of Attorney 
• Tax Power of Attorney (Form M-2848) 
• Vehicle Power of Attorney 

Crucial Conversations 

Housing 

• How to Talk to Elderly Parents About Assisted Living - LINK 
• Is it Time for My Parent to Move Into Independent Living or a retirement Home? Let’s Talk about Aging Parents - A Real Life Guide to Solving Problems with 27 Essential Conversations, by Laura Tamblyn Watts 

Transportation 

• When is it time for seniors to give up driving & how to have the conversation with parents - LINK 
• How to Know When Your Parents Should Stop Driving - LINK 
• Aging Parents and Driving: How and When To Broach the Subject With Sensitivity and Understanding - LINK 

Nutrition 

• Have a Parent with Type 2 Diabetes? Here's How to Set Them

  Up for Success, Abbot Pharmaceuticals - LINK 
• 11 Tips for Caregivers with an Aging Parent with Diabetes,

  Holiday by Atria retirement Guide - LINK 
• Seniors and Nutritional Concerns - LINK 

Financial Planning and Legal Services 

• What if Aging Parents Refuse to Plan? | 4 Reasons Aging Parents Refuse to Plan - LINK 

Caregiver Support 

Resources at the Jenks 

Respite Program at the Jenks-  The Council on Aging supports caregivers by offering a brief respite once per month from 10-12pm.  This non-medical weekly program aims to provide a safe and nurturing environment for adults with various types of impairment such as: Mild Cognitive Impairment (MCI), Alzheimer’s Disease, Parkinson’s Disease, and other forms of dementia. Different activities will be offered like chair exercise, music, storytelling, and games. A light lunch will be served. Please contact Colleen, Jenks Nurse, at 781-721-7136 for registration, eligibility, and participant criteria screening. 

Do you need caregiver training? 

Alzheimer’s Association Care Training Resources - LINK 

American Red Cross- Family Caregiver Training Program: - LINK 

Minuteman Senior Services- Caregiver Programs- Savvy Caregiver 781-272-7177 - LINK 

Caregiver Training and Support - Healthy Living Coordinator - One Burlington Woods Dr., Suite 101 - Burlington, MA  - Phone: (781) 221-7095 - MassRelay: 711 or 800-439-2370 - LINK 

Caregiving Consultants and Coaches. 

There are individuals offering consulting and coaching to caregivers, sometimes under one of the professional designations mentioned above and sometimes not. Professional patient advocates are another group you can hire to help navigate health care for an aging parent. Some even specialize in certain diseases (like cancer). 

One company trying to do something new and original is called Wellthy. Super friendly and caring, this group deploys a national network of foot soldiers to help  find, vet and coordinate care – AND they do it for a fixed monthly fee so clients don’t have to worry about hourly billing rates.

Visit the Daughterhood  resources page for a roadmap to help guide you through the process. 

Creating a Care Team/Community 

Caregiving is both rewarding and challenging. It's important to ask for the help and break that you and the individual you’re caring for need. When friends and family ask what they can do to help, accept their offer. 

By doing this you will be building your care team. It can be difficult to coordinate helpers in a way that meets your needs and the needs of a person with dementia or other illnesses. 

A planning calendar may be the most important thing you can do to get organized. This makes it easy to share activities and information with your care team. You can post items for which assistance is needed and care team members, can sign up for specific tasks. Color coding can help to easily pick out doctor appointments and other important activities. Another type of caregiving calendar allows requests for help with particular duties. Friends can claim items, which can be tracked online.   

Here are a few examples of some online tools: 

• Care Team Calendar: www.alz.org/help-support/care-options/care-team-calendar 
• Care Calendar: www.carecalendar.org 
• Lotsa Helping Hands: www.lotsahelpinghands.com 
• Caring Bridge: www.caringbridge.org  
• Care Zone: www.carezone.com 
• Caring Village: www.caringvillage.com 
• Communication and Care Coordination: 
• Share the Care: How to Organize a Group to Care for Someone Who is Seriously Ill by Cappy Caposella and Sheila Warnock (2004) - LINK 

TIP: It's important to also involve all family members including those who live at a distance. They may help arrange appointments, manage finances and visit to have time with the person needing care, giving the primary caregiver a break. 

• Caregiver Help: Sibling Agreements to Care for Aging Parents - LINK - 
• Long Distance Caregiving - LINK  
• How can I work with family members to coordinate my parent’s care? Let’s Talk about Aging Parents - A Real Life Guide to Solving Problems with 27 Essential Conversations, by Laura Tamblyn Watts

   

Challenges & Support for the Caregiver 

It can happen so slowly that you don’t even notice it as you push your own social needs aside. Studies show that caregivers who used adult day care services for relatives with dementia had lower levels of stress, anger, and depression, and increased well-being after three months than those who didn’t.  Even something as simple a friendly phone call can reduce distress in caregivers. Enhanced social support can also help with caregiver depression. Taking some “me time” isn’t a selfish act. When you feel better, you’re a better caregiver, too. 

• Managing the Stress of Being a Caretaker - LINK  
• I Wish Someone Told Me: The 10 Things All Caregivers and Aging Adults Should Know About Caregiving - LINK  
• Caregiving: How to Know When You Can't Do it Anymore - LINK - 
• Why Does Being A Caregiver Make Me Feel Angry or Mean? - LINK - 
• Hard Truths About Caring for Aging Parents - LINK - 
• The Financial Burden of Caregiving on Family Members - LINK - 

Caregiver Support Groups 

Do you need a break from your role as a caregiver, so you can take care of yourself and have more energy to be an effective caregiver? Is caregiving causing you to feel isolated? 

If yes, look for caregiver support groups in your local area or online. These can be great support networks for you to share what you are experiencing. Here are some resources to get you started: 

AARP: Offers resources, support groups, and information on caregiving, including a HomeFit program for home modifications. Website: AARP 

Adult Children of Aging Parents: Provides information, resources, and support for adult children caregivers. - LINK 

Alzheimer’s Association Support Groups: LINK 

Caring.com Support Groups: - LINK 

Caregiver Action Network: Works to improve the quality of life for family caregivers. - Help Desk - Phone: (855) 227-3640 - Office Phone: (202) 454-3970 - LINK 

The Jenks Center: Caregiver Support, See side note 

Family Caregiver Alliance (FCA): Provides education, advocacy, and services for family caregivers, including online support and resources. Website: Family Caregiver Alliance 

National Alliance for Caregiving: Works to promote a society that values, supports, and empowers family caregivers. Website: National Alliance for Caregiving 

Seniors Helping Seniors Support Group: Family Support Group – Online via Zoom - Seniors Helping Seniors: Greater Boston & Metrowest (shsboston.com) 617-877-3163 One Tuesday a month, 7 – 8:30 Pm : Virtual - LINK 

AFTD-Affiliated Caregiver Support Group -  Join members of the MGH FTD Unit Caregiver Support Team and AFTD-Affiliated Support Group Leaders for online caregiver support groups every Tuesday. Support groups are for family members caring for a loved one with FTD, Alzheimer’s Disease or a related condition to learn about resources, ask questions and receive peer support for the journey of caregiving. Email ftd.boston@gmail.com to learn more, register and receive Zoom links for attendance. 

Daughterhood - Very few people plan for the all-encompassing role of family caregiver. When it hits, the impact affects everyone. Daughterhood strives to help family caregivers feel supported and not alone. With almost a decade of personal interactions with family caregivers, we understand every step of caregiving and all of the emotions that come with it. Daughterhood sees firsthand the struggles of finding affordable and reliable resources and offers free, virtual, and easily accessible “circles” where caregivers can take a ‘deep dive’ into specific areas, including dementia, care transitions, navigating resources and aspects of care to share and learn from each other in a more flexible format about all aspects of caregiving. 

Juggling Work and Caregiving 

Are you concerned with balancing employment with caregiving? 

Amy Mariani, Vice Chair of Minuteman's Board of Directors, talked with the Boston Globe about the challenges of balancing a career while caring for a parent with Dementia. The Boston Globe offered family caregivers going through a similar situation to Amy, tips on how to utilize caregiver support resources available through local Aging Services Access Points, ways to balance your personal life while being a sole caregiver, and ways to support your own mental health through these times of transition and uncertainty.  Click here to read the full story in the Boston Globe - LINK 

Other Resources: 

• How to Balance Caregiving and Work, by WebMD - LINK 
• Balancing Career and Caregiving, by Caregivers Alliance - LINK 

Sandwich Generation Challenges & Solutions 

Are you part of the Sandwich Generation, concerned with the unique challenges of caring for both parents and children in your home at the same time? 

The sandwich generation refers to adults who are “sandwiched” between two caregiving roles, for those younger and older. A common scenario is people bringing up their own children while also caring for their aging parents. 

This dual role can create stress and emotional strain. The responsibilities can feel never-ending, and you may feel like there’s no time left for yourself. This is particularly true for people who don’t have siblings to share in parental caretaking tasks. It’s also difficult for those caring for parents who live far away. 

Balancing these demands can feel like a juggling act, and it’s common to feel pulled in many directions at once. It’s a tough situation, but there are ways to make it more manageable. 

• 6 Tips for Overcoming Sandwich Generation Burnout, by Caring Bridge - LINK 
• How to Manage Financial Stress: Balancing Care for Kids & Elderly Parents - The Sandwich Generation - LINK 

National Advocacy Organizations 

• Caregiver Action Network (CAN) - Formerly known as the National Family Caregivers Association (NFCA).  Free resources, education, and peer support. Provides checklists, videos, and other tools to help caregivers. Addresses the needs of caregivers for chronically ill, disabled, or aged loved ones. -  LINK 
• National Alliance for Caregiving - Focuses on improving the quality of life for caregivers and those in their care, conducts research, policy analysis, and advocacy, works with the CDC, the National Institute of Aging, and AARP. - LINK 
• Family Caregiver Alliance - Provides information, education, and support groups for family caregivers, Offers a state-by-state list of services and assistance, Supports caregivers for loved ones with chronic illnesses, disabilities, or the frailties of old age. - LINK 
• AARP: Offers free care guides, legal checklists, and an online community 
• Alzheimer's Association: Has a map feature to find local support groups 
• National Stroke Association: Has a support group finder resource 
• Parkinson's Foundation: Has a locator to find local chapters and resources 
• Mental Health America: Provides local support for people with mental health conditions and their caregivers  

Organizations Supporting Caregivers: 

• AARP: Offers resources, support groups, and information on caregiving, including a HomeFit program for home modifications. Website: AARP 
• Adult Children of Aging Parents: Provides information, resources, and support for adult children caregivers. - LINK 
• Alzheimer’s Association Support Groups: LINK 
• Caring.com Support Groups: - LINK 
• Caregiver Action Network: Works to improve the quality of life for family caregivers. - Help Desk - Phone: (855) 227-3640 - Office Phone: (202) 454-3970 - LINK 
• The Jenks Center: Caregiver Support, See side note 
• Family Caregiver Alliance (FCA): Provides education, advocacy, and services for family caregivers, including online support and resources. Website: Family Caregiver Alliance 
• National Alliance for Caregiving: Works to promote a society that values, supports, and empowers family caregivers. Website: National Alliance for Caregiving 
• Seniors Helping Seniors Support Group: Family Support Group – Online via Zoom - Seniors Helping Seniors: Greater Boston & Metrowest (shsboston.com) 617-877-3163 One Tuesday a month, 7 – 8:30 Pm : Virtual - LINK 
• AFTD-Affiliated Caregiver Support Group -  Join members of the MGH FTD Unit Caregiver Support Team and AFTD-Affiliated Support Group Leaders for online caregiver support groups every Tuesday. Support groups are for family members caring for a loved one with FTD, Alzheimer’s Disease or a related condition to learn about resources, ask questions and receive peer support for the journey of caregiving. Email ftd.boston@gmail.com to learn more, register and receive Zoom links for attendance. 
• Daughterhood - Very few people plan for the all-encompassing role of family caregiver. When it hits, the impact affects everyone. Daughterhood strives to help family caregivers feel supported and not alone. With almost a decade of personal interactions with family caregivers, we understand every step of caregiving and all of the emotions that come with it. Daughterhood sees firsthand the struggles of finding affordable and reliable resources and offers free, virtual, and easily accessible “circles” where caregivers can take a ‘deep dive’ into specific areas, including dementia, care transitions, navigating resources and aspects of care to share and learn from each other in a more flexible format about all aspects of caregiving.