IOA Blog - Lifestyle Discussions on Aging, Senior Care & Being a Caregiver
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Institute on Aging and its partner organizations are
dedicated to helping family caregivers however they can, yet for many families,
more help is needed.
In a recent piece by Kaiser Health News published in the New
York Times, a Bay Area couple, Gloria and Arthur Brown of San Mateo, shared
their story. To anyone caring for a family member, it’s a familiar one.
Arthur, 79, is living with Alzheimer’s disease. Gloria, 73, is his primary caregiver. A home health aide comes to their home twice a week, but those visits are only brief respites for her. And the cost of care borders on untenable.
Paying for help isn’t cheap: The going rate in the San Francisco Bay Area, where the Browns live, ranges from $25 to $35 an hour. Ms. Brown estimates she has spent roughly $72,000 on caregivers, medications and supplies since her husband was given his diagnosis four years ago.
Thankfully, it looks like help may be on its way for the
Browns and millions of others in California and across the country. The
California legislature is currently considering a bill authored by Assemblyman
Jim Patterson that would give family caregivers in the state a tax credit of up
to $5,000 annually to offset expenses. Other states around the country are
considering similar measures, as well, including Arizona, Illinois, Nebraska,
New Jersey, New York, Rhode Island, and Wisconsin.
It’s already possible for family caregivers to get paid for their work, but the options are limited. There are existing tax deductions available, as well. Patterson’s proposed tax credit will provide additional help, but according to the AARP, it won’t cover the out-of-pocket costs of caregiving entirely. A 2016 study by the organization found that, on average, family caregivers spend $6,954 annually out of their own pockets. The AARP also estimates there are about 40 million people caring for family members nationwide.
The need for
caregivers is growing fast
With 10,000 Baby Boomers turning 65 every day, it’s no
secret the need for professional caregivers is growing ever more urgent.
California Governor Gavin Newsom went so far as to feature it in his State of
the State Address in February, calling for a “Master Plan for Aging.”
“The Golden State is getting grayer,” he said. “We need to
get ready for the major demographic challenge headed our way.
“For the first time in our history, older Californians will
outnumber young children. Over the next decade, our statewide senior population
will increase by 4 million. In 25 years, it will double. And more than half
will require some form of long-term care.”
Newsom pointed to his experience with his own father, who
was diagnosed with dementia and passed away last year.
“I lost my father over the holidays, after years of
declining physical health and dementia,” Newsom said. “He was determined to
live out his days with dignity. He also happened to be a retired public
official with a pension and a support circle of family and friends.”
Not all Californians have the means to deal with a dementia
diagnosis, Newsom said, and even his family struggled.
“Even with all those advantages, it was a daily
challenge to meet his needs so he could live in place and maintain a good
quality of life,” Newsom said. “Millions of Californians share a similar story,
and the numbers will only grow.”
residents in need can turn to Healthy SF for affordable healthcare coverage,
and if two city supervisors have their way, residents will have guaranteed
mental health coverage, as well.
Hillary Ronen and Matt Haney introduced a ballot measure this week to create a
program appropriately called Mental Health SF. If approved by the voters in
November, it would provide for mental health and addiction recovery services
for San Francisco residents, regardless of their financial standing.
It would go a
step further than Healthy SF, as well – while that program is reserved for the
uninsured, Mental Health SF would be available even for residents who have
Seniors stand to benefit from expanded coverage
strain is one of the major concerns facing older adults, as it affects nearly
everything else. Without money to pay for treatment, many older San Franciscans
simply go without, and their mental health suffers for it.
Health SF, older adults dealing with depression or anxiety could get the help
they need. Seniors having issues with medication, even
addiction, could see a qualified professional.
announcement, reported by the San Francisco Chronicle, Ronen said all San Franciscans are
aware of the problem. Services like IOA’s Friendship Line were born from that need. Now, Ronen
said, is the time to do something big.
Franciscans are ready for a bold and big change. We can’t keep failing.”
calls for the use of state funding as well as a tax increase on companies that
pay their CEOs 100 times more than the median compensation paid to their
employees. It would create a 24/7 service center and an office to coordinate
The supervisors and Mayor London Breed’s office have made mental health awareness in San Francisco a priority. Breed recently appointed Dr. Anton Nigusse Bland, medical director for Psychiatric Emergency Services at Zuckerberg San Francisco General Hospital as the city’s first-ever director of mental health reform. In that role, Dr. Nigusse Bland will evaluate the city’s existing services and identify opportunities for change.
Mental health apps soaring in popularity
Awareness Month is about raising awareness, but once you acknowledge you need
help, where do you get it? For many, seeing a therapist in person is difficult,
whether because they aren’t ready to take that step or simply can’t afford it.
That’s where phone apps and online services like Talkspace, Ginger, and
BetterHelp have stepped in, and they are clearly filling a need. This morning, Talkspace announced it had raised an additional $50 million
in funding, for a total of $110 million, and will partner with UnitedHealth
Group to make the app available to 2 million of UnitedHealth’s Optum customers.
While these apps are not aimed specifically at older adults, it’s an audience that will perhaps benefit more than most. Mobility and transportation are common issues for seniors. While they may want to speak to a therapist, they may not have the means to visit one in person. Arranging for transportation on a regular basis to visit a mental health professional may be reason enough for an older adult in need to decide it’s not worth the trouble. The ability to communicate with a therapist from the comfort of their own homes, then, means the removal of a major barrier to service. Talkspace co-founder Oren Frank said he started the company in part because mental health services are woefully lacking. According to federal estimates, about 57 million adults had mental health or substance-use conditions in 2017, and about 70 percent of them received no treatment. Apps like his allow users to text, email or video chat with licensed therapists for a flat weekly or monthly fee.
May 29 is National Senior Health & Fitness Day
doesn’t have a monopoly on the month of May! In fact, for 26 years now, the
last Wednesday of May has been National
Senior Health and Fitness Day,
a nationwide event aimed at keeping American seniors healthy and fit. There are
more than 1,000 fitness events planned all over the country, including Northern
California. This year’s theme is “Live and Thrive with Exercise!” and includes
things like fitness walks and other low-impact exercises, health screenings,
workshops, and more.
it’s a well-researched fact that physical and mental health are intertwined. Exerciseisoftenprescribed as a treatment for depression and
anxiety, and seniors who suffer from loneliness and isolation can turn to group
exercise classes for socialization.
May marks Mental Health Awareness Month in the United States, and it’s important to remember that anyone can suffer from mental health issues, big and small. That includes older adults. From depression and anxiety to dementia, seniors are often expected to be stoic, to keep their mental health issues to themselves, and that’s why Mental Health Awareness is so crucial! It serves to remind us that we are not alone and we should not be afraid to put ourselves out there and be vulnerable.
But what if an older adult family member is suffering silently? Thankfully, there are signs to look for, even if your loved one is trying to hide it.
What does poor or declining mental health look like?
One sure sign to look for is isolating behavior. If an older
adult loved one is uncharacteristically showing little interest in hobbies or
activities they’ve always enjoyed, it could be a sign of depression.
Dr. Patrick Arbore founded IOA’s Friendship Line in 1973 to combat social isolation and loneliness in older adults.
“We were very aware, even then, that loneliness and social
isolation had a relationship to suicide and suicidal ideation,” he says.
The Friendship Line was created with the idea that even a 15-minute phone call can make a noticeable difference.
“It can impact the caller’s thinking about despair or
hopelessness or depression,” Arbore says.
Another indicator that something might be wrong is a change
in routine. That could be an unkempt home that’s always been tidy, suddenly
missing appointments, or even sudden changes in personal care.
Finally, memory issues are something to keep an eye on. It can be tricky to determine what is the sort of forgetfulness that comes as we age, and what could be a sign of something like dementia, so you’ll have to use your judgment. If your loved one is repeatedly asking the same question even though it’s already been answered, misplacing items more regularly, or forgetting important dates or commitments, it might be worth a conversation.
How can you improve mental health?
There are many simple, straightforward ways to improve
mental health, starting with some tried and true methods:
Exercise – Regular exercise has been shown to release chemicals that mitigate depression and anxiety, improves cognitive function, and lessens the likelihood of physical injuries like falls that could lead to deeper depression.
Socialize – One sure sign of depression is isolating oneself, and unfortunately, that only leaves a person more depressed. Simply having the support of a social group can be a huge boost to happiness, and like exercise, can have big benefits for cognitive function.
Learn something new – Taking on a new hobby isn’t just fun; the challenge of learning a new skill helps cognitive function, improves mood, and if it’s a social hobby, has all the benefits of that, as well.
Mindfulness – Whether through yoga or meditation or something else, taking the time to practice mindfulness is an easy way to improve mental health. Even just a few minutes of deep breathing has been shown to provide a noticeable boost. It calms the mind and body and helps us put stressors – a major source of anxiety – into perspective.
It’s no secret that as we age, we become increasingly at risk of falling, and fall-related injuries are more significant for older adults. What researchers recently learned, however, is potentially significant: a definitive link between cognitive slowing and fall risk, and an opportunity to provide better care for those living with dementia.
Manuel Montero-Odasso, M.D., Ph.D., from the University of Western Ontario in London, Canada, and his colleagues set out to study the role of cognition in falls, with the hope of managing and even preventing them in older adults.
Their study, published in the Journal of the American
Geriatrics Society last year, measured the relationship between gait and
cognition in aging adults. The study showed that low performance in attention
and executive function was associated with “gait slowing, instability, and
future falls.” In addition, older adults with dementia who experience a fall
are five times more likely to be admitted to long-term care facilities. They
are at higher risk for fractures, head injuries compared to older adults
without dementia who experience a fall.
Montero-Odasso and his team concluded that older adults living with dementia should have cognitive training specifically related to their motor function. Montero-Odasso also said he is optimistic about the role virtual reality might play as a therapeutic tool.
Fall risk is more common than you think
According to the U.S. Department of Health & Human Services, more than one in three people age 65 years or older falls each year. There are many factors at play, the HHS says. As we age, our eyesight, reflexes, and hearing aren’t what they used to be. Common health issues older adults face, such as thyroid or nerve issues, can also make a person more prone to a fall. In addition, some medications cause drowsiness, which might be enough to cause someone to catch their foot on the end of a rug and be unable to catch themselves before falling.
It’s no secret that natural light can transform a space, or
that it has a tangible effect on the people who live and work there. The
difference between a basement office with no fluorescent lights and a corner
apartment with floor-to-ceiling windows is – please forgive the pun – like
night and day. Simply put, natural light makes people feel better!
It was on the basis of this idea that University of Southern
California Assistant Professor of Architecture Kyle Konis created a study to
explore the effect of natural light even further.
Konis, who received his doctorate from the University of California, Berkeley, knew that people who work in spaces that have daylight exposure are more content and productive, while those without much exposure to daylight, such as nightshift workers, are more prone to obesity and Type 2 Diabetes. The logical next step, he said, was to think about groups that might be hardest hit by “poorly functioning indoor environments.” That’s how he came up with a pilot study looking at the impacts of daylighting on older adults living with dementia.
Daylight first, medication second
Konis and his team looked at about 80 participants across
eight dementia communities in Los Angeles and Orange counties. His study showed
that early morning exposure to natural light improved the mood of residents,
reducing depression and psychoactive symptoms, which are common side effects of
the neurodegenerative disease.
The hope is to use the pilot study results to kickstart more research on the subject. He said dementia treatment is often, and rightfully, focused first and foremost on delaying memory, learning, and language degradation. What is often overlooked is the depression, agitation, and difficulty sleeping that often comes along with a dementia diagnosis. Lack of exposure to daylight leaves people feeling moody and sluggish, a feeling similar to jet lag. While depression can be treated pharmacologically, there are other options, like mindfulness and meditation. Konis hopes that his study and further research will allow some dementia sufferers to live happier, healthier lives without the need for medication.
Other research backs Konis up
Konis isn’t alone in his pursuit, either. In the Netherlands, there is a village-like community for older adults with dementia called Hogeweyk. They live in houses just like their old homes, they have gardens, and they shop at the local grocery using special currency. And in the United States, the Green House Project is taking a similar approach. The Green House Project, a national non-profit dedicated to creating alternative living environments to traditional nursing home care facilities, also mimics the feeling of home by giving their campuses the look and feel of a residential neighborhood. “This is a disease or problem that’s been almost totally focused on pharmaceutical cures. There are lots of other things we can do to make a difference,” said Victor Regnier, a professor who has dual appointments in gerontology and architecture at USC. “If you can create a setting [like Hogeweyk or Green House] that’s more normalized — less rules and more improvisational attitudes — it’s just better.”
Environment clearly has an impact
While Regnier and others look at the broader environmental
impact on dementia patients, Konis said he hopes to continue his research on
the effects of natural light. As the dementia population is predicted to
dramatically increase in the coming decades, Konis’ research could be hugely
“There’s a huge demand now for housing people with dementia,” he said. “Dementia care, in terms of the companies that operate them, they’re buying existing medical facilities or hotels and repurposing those buildings. They’re not always thoughtfully designed from the ground up.”
Now in its 36th year, Dinner à la Heart
represents a perfect marriage between two of San Francisco’s favorite things:
incredible food and giving to a good cause. After all, what better way to
support Institute on Aging’s work with older adults and adults living with
disabilities than by celebrating in the city’s world-class dining with family
and friends? And this year, Dinner à la Heart will also celebrate Dr. James
Davis, a very special person who has done a great deal to support Institute on
Aging and the community over the years.
What is Dinner à la Heart?
Dinner à la Heart gives Bay Area residents an opportunity to
select from one of many chosen a Bay Area restaurant enjoy a unique dining
experience, for either dinner or lunch, while supporting the Institute on
Aging’s programs and services. Diners enjoy a prix-fixe meal along with wine
and coffee or tea, for a price ranging from $85-$250 per person.
Inspired, then involved
Dr. Davis’ experience with Institute on Aging comes through
Mt. Zion Hospital, where he was chair of the Mt. Zion Health Fund and was
introduced to IOA through one of its board members. Hearing about IOA’s work,
he says, “Got me very inspired to get more involved.” The more he worked with
IOA, he says, the more he embraced its mission.
For more than a decade now, Dr. Davis has continued to
support IOA as a member of its board; his internal medicine and rheumatology
practice, his work with the Arthritis Foundation, and his work as a clinical
professor of medicine at the University of California San Francisco, are all
worthy of recognition.
When Dr. Davis learned he was to be honored at Dinner à la
Heart this year, he says he was “very flattered.” It’s a treat, he says, in
part because the event is one that’s always been near and dear to his family.
“Starting when I first came back to San Francisco, my
parents and my aunt were very active in IOA, and the whole family would gather
together every year,” he says. “Then when I moved back to San Francisco, myself
and my cousins as the next generation started coming. Now my kids and my cousin’s
kids come. It’s this big family gathering every year now.”
Dr. Davis says Dinner à la Heart is a perfect example of
what makes IOA special.
“That’s really part of the beauty of IOA, is this generation
to generation connection,” he says. “Cable Car Caroling is great for that now,
too. Multigenerational families have been coming to these events for years, and
they have a wonderful legacy to them.”
Honoring the past, looking ahead
For an event that goes back nearly four decades now, it’s no
surprise the planning and execution of the event is multigenerational, too.
Sandra Simon, co-chair of the Dinner à la Heart Auxiliary Board, has been
involved for 25 years, and her mother was involved for many years before that.
“My mother passed away in 1994, and one of her friends on
the board called and said ‘you need to come on and take her place,’” she says.
“I couldn’t say no!”
Simon says one of her favorite aspects of Dinner à la Heart
is the connections it forges.
“There are people who are always together,” she says.
“They’ll call to make a reservation for their group and instantly you remember
Simon says she is particularly looking forward to honoring
“Oh, I’ve known Jim Davis since we were kids,” she says. “He’s
been so involved and has given a ton to the community. Many of our supporters
were his patients! Everyone thinks he’s a great guy, so it was an easy
Davis will be honored and will speak at a special event at the Presidio Golf
& Concordia Club that evening. A social hour begins at 6:30 p.m., with
dinner to follow at 7 p.m.
Preparing for the occasion
Simon says planning for the event begins in August, and
picks up steam in December, when the list of participating restaurants is
finalized. Some of the restaurants have participated for years, but they always
try to bring in new venues, as well. On the day of the event, Simon says,
things get really hectic.
“We try to make it festive as part of the experience, so
every restaurant gets decorations,” she says. “And we also bring them gifts
from IOA’s day center’s program – they make notecards for this occasion. Then
our ladies deliver all these items to the restaurants.”
As for the popularity of the event itself, Simon says it’s
an easy sell.
“We’re asking people if they want to go out to dinner with
their friends,” she says. “People say, ‘Yeah, why not?’”
Carolers young and old will gather Saturday, December 1st for one of Institute on Aging’s most beloved events, the 34th Annual Cable Car Caroling. This multicultural songfest brings holiday cheer to isolated older adults and adults living with disabilities at assisted living centers, skilled nursing facilities and individual homes across San Francisco.
More than 500 volunteers aboard 15 motorized cable cars will traverse the city, visiting about 60 locations over the course of the day. The holiday season is a joyous time of year but for those who are lonely it can be difficult, and that’s where the carolers come in, bringing smiles and laughter to those who may not have another opportunity.
‘A profound experience’
Few can speak to the impact of Cable Car Caroling better than Ken Donnelly, CEO of the Heritage on the Marina retirement center and a member of the Cable Car Caroling board. Donnelly says Heritage on the Marina has been participating in the event since 2013 and he has no plans to stop.
“It’s a wonderful event, for both carolers and recipients,” he says. “Not only do the carolers feel that they are bringing joy to their older neighbors, but they also see the various environments they live in and the frailties they deal with each day.”
As the CEO of a facility and a caroler himself, Donnelly says it’s a particularly moving day for him, but he says it truly is the older adults who benefit the most.
“They appreciate people from the greater community taking time to come and spread good cheer,” he says. “I think the carolers’ singing oftentimes reminds them of a happy time for them.”
Uplifting holiday atmosphere
“We see more than 1,000 seniors in a day,” says Tamara Cameron, IOA’s Events Manager. “For a lot of them, this is the only holiday celebration they get. It’s really special to do that for someone you know isn’t going to have anything else.”
Cameron says the participants represent every segment of the community.
“We have a ton of families, we have a group of Brownies who come out,” she says. “We have a woman who does this as her holiday celebration every year, then she and her friends meet at her home for dinner afterward. Everybody is represented. Some of our IOA employees come out, too!”
Cameron says the joyous atmosphere on the day of the event is infectious.
“The holiday spirit it creates is my favorite thing about Cable Car Caroling,” she says. “People show up in their holiday clothes, they are so excited to be there – it’s just a very uplifting day.”
The older adults at the facilities are always touched by it, as well.
“It’s a win-win because it is such a gift on both ends,” Cameron says. “It’s a gift for them to have us sing to them and it’s a gift for us to get the opportunity.”
Festive fun for a good cause
Imagine a world where you are alone – isolated and vulnerable; feeling hopeless, invisible, worthless, and unloved. For too many seniors and adults living with disabilities, this is a reality. Isolation and loneliness plague too many and it is extremely detrimental not just to the quality of life but overall health. Research shows that lacking social connections is as damaging to our health as smoking 15 cigarettes a day (Holt-Lunstad, 2015).
Friendship Line provides a literal lifeline to these isolated individuals. Friendship Line, founded in 1973 by Dr. Patrick Arbore, Director of IOA’s Center for Elderly Suicide Prevention, makes and receives almost 150,000 calls per year to reach out to those feeling alone. By providing a warm voice to speak to and a person to connect with, this service provides an ally, a friend, and most importantly a human connection. The calls made at Friendship Line fill these secluded individuals with hope, purpose, and meaning. After the calls, they feel seen and heard – acknowledged in a way they haven’t for a very long time. It restores a light within that had dwindled. At its core, Friendship Line provides the human connections that bind us to life.
Last year, Cable Car Caroling raised more than $100,000 for this vital service.
A family tradition since day one
One of the most enthusiastic supporters of Cable Car Caroling is Zak Arbore, Patrick’s son, who has participated every year since the very beginning. Now in his second year as co-chair of the event alongside his wife, Renee Russo, Arbore says he can still remember the inaugural year.
“I was 4 or 5 years old when it started,” he says. “My early memories are of the smells, sights and sounds of the places we visited. The cable cars were so fun. Some of the cars used to have a bell in the back and I remember ringing them a lot.
As he’s grown older, so has his appreciation for Cable Car Caroling, both the event itself and what it means for the Friendship Line his father started. The sense of community the event creates, he says, is why he keeps coming back.
“When all the carolers come back together and share a meal together, there is an incredible sense of accomplishment,” he says.
To be sure, Arbore says, Cable Car Caroling is a family affair.
“My Dad started the Friendship Line and I have grown up in and around his work,” Arbore says. “My mom has always been a part of it, too; she is usually our song leader on our car. And now my wife and a lot of her family are staunch cable car carolers.”
How to take part
Cameron says the event always sells out, so if you want to carol, you should sign up as soon as possible. Those who can’t or don’t wish to participate can also donate online at give.ioaging.org/ccc. You can also sign up to take the Cable Car Challenge, wherein every $200 you raise earns you a ticket to the event (with a minimum donation of $200).
Anyone on the fence about caroling, Arbore says, should go for it.
“The holiday spirit has never been as tangible as when you are participating in Cable Car Caroling,” he says. “You are riding a motorized cable car through a world class city, you are vising elderly people who do not get many visitors ever and you are the star of the show. You can throw your voice into the group’s song and wait to see those elders’ eyes light up with joy and hope for the future.”
2030 seems like the distant future, but it is only 12 years from the writing of this article—just as close in time as 2006. That year is going to mark a milestone in US demographics: for the first time, people 65 and older will outnumber those 18 and younger. Indeed, 1 out of every 5 Americans will be at or past retirement age.
Those numbers, from the US Census Bureau, are fairly staggering, and represent some fairly enormous social changes over the last few generations. Better medical care, improved awareness of what is and is not healthy, and declining birth rates mean that America is aging (though slower than Europe or parts of Asia).
By 2035, there will be 78 million people 65 and over
By 2060, that number will jump to 98 million
By 2060, people 65 and older will make up 24% of the population
None of this is bad, of course. For one thing, it means people are living longer and have more time to explore and learn and live their lives to the fullest. And this isn’t the demographic disaster or the “end of America” more hysterical media types like to imagine it is; the rate of immigration will keep the US population growing at replacement rates, with the happy outcome of making this country much more diverse.
That being said, of course, an aging population brings with it its own set of social and economic challenges. One will be social benefits, like paying for Medicare and Social Security. That’s a political issue, of course; there is more than enough money in the GDP to handle this. But a larger problem looms in the medical and health care needs of an aging population.
This happy explosion in the older adult population means that there is a growing need for doctors, nurses, and professional caregivers, especially in home-based care. Indeed, it is one of the most important areas of economic growth.
The population is changing. But what isn’t changing is the need for committed, compassionate, and professional care that helps older adults live their best lives. Understanding that market can help younger people find jobs that will be challenging, interesting, fulfilling, and filled with love.
“The Future of Employment”
It’s not just us saying this. Writing at Quartz, Dan Kopf calls jobs involving personal care of older adults the “future of employment.” Indeed, the Bureau of Labor Statistics, as he points out, says that this will be the fastest area of employment growth from 2016-2026 (and, one can surmise, beyond that, but the latest numbers are through these years).
To back that up, Kopf gave some more impressive numbers. Over the next decade:
Personal care jobs will grow by 750,000
Home health aides will grow by 425,000
These jobs will grow from 2.3 to 3.4 million jobs overall
These jobs will grow 37% and 37%, respectively, the 3rd and 4th fastest growing jobs in the US
(Even those last percentages are misleading, since the 1st and 2nd place jobs will only add 17,000 workers.)
So it is pretty clear that the aging population is going to have a direct impact on what work will be like in the future.
This work isn’t all uniform, of course. There are many different jobs, including working at hospitals and at nursing care facilities. But more and more, the bulk of jobs is moving toward senior home health care as the result of cultural and sociological shifts.
Senior Home Health Care Leads the Way
In the last few decades, we’ve seen a cultural move toward aging in place. While many nursing care facilities are amazing places staffed with wonderful, dedicated people who work hard to build a true community, more and more people want to stay in their homes or with a loved one in place of starting over.
That’s not easy, of course. While there are programs to help, such as home-delivered meals for older adults in California, it can be challenging to age in place. It can be hard to care for yourself, and it can be hard to care for a loved one, especially if you have a full-time job and family of your own.
That’s where a caregiver comes in. Whether you have a full-time caregiver who might specialize in your specific health needs or a part-time one who can come in and handle things like medicine or bandages or basic chores like cooking, caregivers are an enormous help. They are companions and nurses, friends and chefs, someone to talk to and someone to laugh with and someone to lean on. They are people who help older adults age in place, with the comfort and dignity they deserve.
There are reasons for this. For one, not everyone knows that this is a growing industry. And there are some unfair structural reasons. For one thing, the average pay is low, often under $15 an hour depending on the state. Few jobs come with benefits, and few have consistent hours. That makes people reluctant to take a job.
But that could change. Indeed, the shortage of workers, combined with the growing need, will demand that changes. When labor becomes necessary, wages and benefits go up. It seems almost inevitable.
That’s why we think that not only is this job growing in importance, but as more people realize its importance and the shortage of workers become more apparent, this is a position that will be able to provide a stable and steady income for anyone with the dedication and the heart to take it.
Aging at Home in the Bay Area
The need for senior home health care jobs is of particular importance to us here in the Bay Area. In fact, San Francisco and nearby Sacramento are both in the top 10 for employment growth in in-home senior care (#1 is Nashville, and there are probably some good country songs to be written about that).
This region has been leading the way for cultural changes in how we age. At Institute on Aging, we fully believe that growing older doesn’t mean life is over, or that you have to settle down and stop exploring. We know that you are still you, at any age, and have the same rights and expectations for a decent life as any age group.
To do so, though, there is a need for home health care. That need is growing, and the profession is changing and getting the esteem and respect it has always deserved. Ideally, wages and other benefits will grow accordingly.
That’s not just a matter of basic economics. It’s not just supply and demand. It comes from recognizing what is important as the nation changes and recognizing what we need to make it happen. That’s why senior home health care jobs are the fastest growing in the country: we’re catching up to what makes life truly important.
Many people look forward to retirement for years. But when the time comes, they trade their old sources of stress for new ones. This is particularly true when it comes to finances. Stress itself can lead to significant declines in a senior’s emotional and physical health and even accelerate the aging process. And, of course, your elderly parents’ financial stress can affect you as well. Whether some of the financial burden falls on your shoulders or not, it can be very unsettling to face compounding bills and other expenses without knowing how you will manage together.
The good news is that there are more helpful financial resources for seniors than you might expect. In California, there are programs to help aging adults and their families with many necessary living expenses, from family caregiver support to home utility relief. If you’re looking for financial assistance for your elderly parents, this is a good place to start. With a combination of federal and California state benefit programs, you can help them to rebuild some stability and to refocus on their special freedom in the later years. In a lot of cases, even a little bit of financial help for seniors goes a long way.
What Financial Assistance Is Available for Your Elderly Parents?
When your parents are retired and on a fixed income, they may find that they have a lot less flexibility than they are used to. The spending habits that supported their previous lifestyle may become impractical or even impossible. In some cases, low-income seniors may struggle just to cover their basic necessities of life.
This is why California has a number of programs that offer financial assistance for the elderly, including:
Health Care and Prescription Drugs
Medicare is a common benefit that can help cover the costs of many of your parents’ health care needs. Depending on their income level, they may be eligible for Medi-Cal benefits, which make medical costs even more affordable. Among the benefits, these programs offer prescription drug discounts and assistance for home care services. You can visit the Social Security Administration website for more information about eligibility and benefits.
State Property Tax
Based on age and income, your parents could be eligible for property tax assistance in California. This can be a relief when facing the whole range of bills and daily expenses on a fixed income. Contact your county assessor to find out more and to access application forms.
Many seniors struggle to feed themselves, let alone to feed themselves healthy, balanced meals. If your elderly parents are subsisting on a low income, they may be eligible for Supplemental Nutrition Assistance Program (SNAP) benefits through CalFresh. If eligible, they’ll receive funds through a debit card system that they can apply toward their regular groceries. Find out how you can get started applying for nutrition assistance here.
Social Security assistance is based on an individual’s work history and whether they paid into Social Security in the past. Supplemental Security Income (SSI) is an additional benefit for senior citizens who currently meet the low-income threshold, helping recipients further relieve financial stress. Click here to calculate your parents’ estimated Social Security benefits, and learn more about SSI benefits here.
Overcoming the Barriers to Financial Help and Stability for Seniors
With the range of programs and opportunities for relief available, it’s unfortunate that many aging adults do not realize the benefits of these resources. Common reasons seniors do not participate in federal and state assistance programs include:
They don’t know what’s available or what they qualify for.
The benefits and services are difficult to access.
The application processes are too complicated.
But, with your help, your elderly parents can overcome these barriers and create their own personalized financial strategy for the years to come. If new expenses arise that appear to be unmanageable, you’ll know that you can reach out to see if financial assistance is available.
Whether your parents are living on a limited income to begin with or the expenses simply pile up and outweigh the resources of retired living, the financial assistance in California is designed to help fill in these holes. With the right money management strategies and diversified, purposeful income sources, your elderly parents can move into their later years with confidence and freedom.
These empowered strategies will lighten your parents’ load and yours too. When your parents have meaningful tools and resources, you can feel more assured of their independence and security, and the time you spend together can be more about enjoying each other’s company than about financial worries and problem-solving.
There’s a well-known phrase, attributed to Ben Franklin (but in reality a little older), which is that the only certain things in life are death and taxes. It’s not a fun phrase, but there’s a certain shoulder-shrugging wryness to it because there are some things in life one has to accept.
But even if you accept them both, it might be hard for you to wrap your head around the idea that death and taxes aren’t always separate and that you still have to understand tax implications for your estate after you pass away.
That’s why estate planning is so important for older adults. You want to be able to control your legacy and make sure that the money you’ve earned and the property or possessions you want to leave go to the right people in the right amount.
Of course, taxes are just one thing you have to prepare for when it comes to estate planning: there are a host of other issues that you need to take into account. Not doing so can make it challenging for your family after you pass away, but following these estate planning tips for older adults means you will make things easier on those who are left.
In fact, you could say that’s another certainty.
Estate Planning Tips For Older Adults
When you start thinking about your estate, there are some logistical and emotional hurdles to overcome. Here’s how you get moving:
Talk to the People In Your Life
Ultimately, the decision on what to do with your money is up to you, but you can also talk to your children and other loved ones about your estate. This doesn’t mean soliciting their opinions or asking for advice, but it can be good to say why you are making the decisions you are making. You can clear the air so there aren’t disputes after you pass away. You don’t want to be worrying about that.
Understand What Kind of Estate Planning Is Right For You
It’s no secret that there are vast amounts of inequality in the world, and especially in America. There will be different levels of red tape and different requirements for different levels of wealth. For instance, only about .2% of people pay the federal estate tax (or roughly one out of every 500). But if estate tax applies to you, you should understand how to make sure your money is taken care of.
It’s important to know all the tax and legal obligations that come with your level of assets. Ask yourself questions like, “What options do I have to help my loved ones avoid probate?” and, “What are the implications of continual non-wage wealth after death?” Making sure you know all your obligations is the best way to meet them.
Plan for Long-Term Care
The good news is that people are living longer than ever these days. The bad news is that money doesn’t enjoy that same extended longevity. Money can be spent and run out before you pass away, even when you still have medical bills and the costs of living in a facility or aging in place.
When estate planning, make sure that you have taken into account the need for long-term health and habitation needs, not to mention entertainment or travel expenses. You don’t want money locked away somewhere where you can’t access if you need it. Think realistically and actuarially.
Create a Living Trust
One way to protect your assets while leaving them accessible is by creating a living trust, which you can dip into when you need. When you pass away, your assets still go to your designated heirs, but you yourself won’t be caught in a bind. A trust also designates someone to manage your affairs for you if you are incapacitated. Make sure that you have designated someone as executor to ensure your wishes are followed.
There is no question that this stuff is hard. It can be extremely challenging to keep in mind all the rules and regulations and to have a firm grasp on all your assets and the best ways to protect and distribute them. Getting a reputable financial planner can make a world of difference.
The benefit of having a professional financial planner is that, well, they are professional. They’ll work with you to understand what you want and what you need in your later years. They will make offer you advice based on what they think is best for you and your needs. It’s compassion and professionalism.
Keep Your Documents Safe and Accessible
It seems anachronistic in the electronic age that you might need to rely on actual physical documents, but you often do. Wills, living trusts, living wills, medical care information—all of that relies on an actual signature. If these documents are destroyed in a fire or earthquake, or you pass away without telling anyone where they are, or you can no longer remember, it can be a real hassle.
So keep them safe, make sure you can grab them if you need to, and tell your designated executor where they are. It’s not just bookkeeping; it is truly safekeeping for your future.
Review and Revise
These aren’t set in stone. Your situation may change, your ideas of what you want to do with your money may change, the world itself may change. You aren’t bound to your first thoughts, especially if you are materially depriving yourself of financial flexibility (which again strengthens the need to have a revocable trust).
Make sure that you revise in the aftermath of divorces, weddings, deaths, or births. Make sure your wishes reflect the nearest current reality. After all, the point is to pass on what you have to those you love with ease and grace and without conflict.
Avoiding Conflict In Your Estate
Having your estate and financial affairs settled means being able to give of yourself, but it is also a gift to yourself: you’re giving yourself peace of mind. You’re able to know that what you have will live on after you while allowing you to live in comfort in the present.
Making sure that you have an estate plan means being able to live your life. It means that you don’t have to worry about a sudden disaster or slow sickness harm your family. It means that you are continuing to show love and take care of those you have loved and cared for all your life. Your love has always been the true certainty in life: make sure it keeps on living.