1. Aging in the Livermore Valley
Planning Ahead
Jessica Reay, Certified Senior Advisor
1/22/2013

2. Where do I start?
Step One: Choose where you want to live

3. What are my housing options?
Option 1- Stay at Home
Hire a caregiver that can come work in your home and take
care of daily activities such as:
• Meal Preparation
• Transportation
• Light Housekeeping
• Medication Reminders
• Personal Care
• Toileting Assistance
• Respite (family / friend caregiver relief)
• Companionship
Estimated monthly cost: $1296 (12 hrs/week)-$8000 (full-time)

4. Housing options, cont.
Option 2- Move to senior community
1. Senior Apartments- Apartment style living. Community
activities. Housekeeping at an additional cost. No hands-on
care or meals provided. Ages 62+.
Example: Heritage Estates
Estimated monthly cost: $1300-$2800
2. Independent Living- Apartment style living. Community
activites. Shuttle transportation. Meals, housekeeping, and
activities included in cost.
Example: Heritage Estates
Estimate monthly cost: $3500-$5000

5. Housing options, cont.
3. Assisted Living- Apartment style living. Shuttle
transportation. Meals and housekeeping included in cost.
Hands on care and medication management available for an
extra charge.
Example: Heritage Estates, Rosewood Gardens
Estimated monthly cost: $3500-$5500
4. Memory Care- Apartment style living. Meals, housekeeping,
hands on care, medication management and resident
supervision included in cost. For memory impaired
individuals with some kind of dementia or Alzheimer’s.
Example: Rosewood Gardens
Estimated monthly cost: $5,500 and up

6. Housing options, cont.
5. Board and Care- Residential home that can house anywhere
from 4-12 residents depending on size. Meals, housekeeping,
personal care, medication management included in cost. Smaller
facility, more “home-y”, less expensive. Residents in this type of
community usually need a considerable amount of care.
Estimated monthly cost: $2500-$4000
6. Skilled nursing facility- Nursing home setting, high level of care.
Nursing assistants, registered nurses, and doctor oversee care in a
medical setting. Meals, housekeeping, hands on care, medication
management and administration, personal care included in cost.
Can handle complex medical issues such as tube feeding, insulin
injections, etc.
Estimated monthly cost: $8400 (at approx $280 per day)

7. Housing options, cont.
7. CCRC “Continuing Care Retirement
Community”- A CCRC has different levels
of facilities within 1 large community. For
example, it would have senior
apartments, independent living, assisted
living, memory care, and skilled nursing.
Main benefit of living in a community like
this is the ability to transfer to a different
level if needed without entirely leaving
the community. Stoneridge Creek will be
the only CCRC in this area when it is
completed in fall 2013.

8. Do your homework!
Thoroughly research whatever home care agency or facility you are
considering as your provider. Each company runs differently. Try to get
references.
Home care agencies:
- Not regulated in the state of California; only a regular business license is necessary
- No set standards, unless member of National Private Duty Association
- Make sure the caregivers are:
- Direct employees and not independent contractors
- Bonded and insured
- Covered under worker’s comp insurance
- Fully background and reference checked
- Trained and supervised
- Payroll: who is responsible?

9. Put it in writing
Step Two- Getting your paperwork
in order
Meet with an attorney who specializes in estate planning. They
can help you with:
- Will writing
- Living Trusts (very popular these days, as there is no probate)
- Financial power of attorney: who will manage your money in
the event you are unable?
- Advance Health Care Directives: Designate a person to make
medical decisions on your behalf if you are unable

10. How will I pay for all of this?
Step Three- Financial Planning
- Medicare/Medi-Cal will not cover
- Meet with a financial planner who can help make
your investments last
- Invest in Long Term Care Insurance
- VA Benefits: Are you a veteran?

11. LONG TERM CARE INSURANCE
Long-term care goes beyond medical care and nursing care to include all
the assistance you could need if you ever have a chronic illness or
disability that leaves you unable to care for yourself for an extended
period of time. You can receive long-term care in a nursing home, assisted
living facility, or in your own home, depending on your policy. Though
older people use the most long-term care services, a young or middle-
aged person who has been in an accident or suffered a debilitating illness
might also need long-term care.
Long term policies usually have an “elimination” period where the client
needs to pay out of pocket for a certain amount of days before the policy
takes effect. Each policy is different, so it is very important to look over
each patient’s policy to see how much money is available towards their
care. It is necessary to make sure the claim is approved through the LTC
insurance company by going through a patient qualification process. LTC
companies are selective with what types of home care agencies they will
approve as a qualified provider, most will only use “full-service agencies”.

12. LONG TERM CARE INSURANCE
When should a person sign up for long term care
insurance?
The best time to sign up for a long term care policy is in your
mid-fifties, before any serious medical conditions arise.
This way you can guarantee acceptance, and get a lower
price rate.
Some companies who provide long-term care insurance are
Genworth, MetLife, New York Life, CalPers, Bankers Life &
Casualty, and John Hancock.

13. VA BENEFITS
The VA Aid & Attendance & Housebound Pension is designed to provide qualified veterans and
their un-remarried surviving spouses with financial benefits outside of the traditional VA residential
system. This pension benefit, which was established in 1952 under title 38USC, provides a direct,
tax free monthly pension to help defray the cost of long-term care.
2009 Maximum Monthly Benefit Amounts Aid and Attendance Housebound Two Veterans /
Spouses $2,582* Two Veterans / Spouses $2,582* Married Veteran $1,949 Married Veteran $1,510
Single Veteran $1,644 Single Veteran $1,204 Surviving Spouse $1,056 Surviving Spouse $808 * May
be higher depending on rating
Eligibility Requirements:
• Must be 65 years old and/or unemployable.
• Must have an Honorable or General discharge (any other than Dishonorable discharge).
• Must have served at least 90 days of active Federal duty with at least one day during an official
period of conflict.
• Must have a medical necessity requiring care
• Must meet income and countable asset criteria established by the VA*
The approval process of VA benefits can be lengthy so there are companies available to help with
the approval that my speed up the process.

14. VA Benefit Resources
• There are companies that can help navigate system
and get claim together for individuals
• Average approval process for VA Benefits under this
program is around 9 months.
• It is illegal to charge Veterans to help with this
paperwork

15. Available Health Programs
Home Health Care:
- Intermittent skilled care that
could consist of nursing, physical
therapy, occupational therapy,
speech therapy, social work,
home health aid
- Ordered by your physician
- Covered by Medicare, Kaiser or
other insurance
- Home health can be provided in
a private residence or any kind of
living facility except for skilled
nursing

16. Available Health Programs, cont.
Hospice:
- Nursing support for a patient that is terminally ill, or is
projected to live 6 months or less
- Patient can come off of hospice at any time if there is
improvement
- Equipment and medications are covered
- Additional support of chaplains, social workers, volunteers
and home health aids for bath visits
- Providing this kind of “comfort care” manages your loved ones
pain level and keeps them comfortable

17. Thank you!
Please contact me if you have any questions. I
would love to help!
Jessica Reay
(925) 200-9333