Do You Need to Hire a Senior Care Worker?

need to hire a senior care workerIt’s never easy to realize a senior loved one can no longer live completely independently and needs some assistance. But in order to provide the best quality of life possible, some seniors will need a companion or other caregiver to help them stay in their own home. Seniors may also require help with maintaining their home, especially if they are aging in place in their own house. Here are some possible signs that you need to hire a senior care worker.

Signs Your Senior Needs Help at Home

  • Spoiled food that does not get thrown away
  • Missing important appointments
  • Unexplained bruising
  • Difficulty getting up from a seated position
  • Difficulty with walking, balance, and mobility
  • Uncertainty and confusion when performing once familiar tasks
  • Forgetfulness
  • Unpleasant body odor
  • Infrequent showering or bathing
  • A strong smell of urine in the house
  • Noticeable decline in grooming habits and personal care
  • Dirty house, extreme clutter, and dirty laundry piling up
  • Stacks of unopened mail or an overflowing mailbox
  • Late payment notices, bounced checks, and calls from bill collectors
  • Poor diet or weight loss
  • Loss of interest in hobbies and activities
  • Changes in mood or extreme mood swings
  • Forgetting to take medications, or taking incorrect dosages
  • Unexplained dents and scratches on a car

Whatever type of help your senior needs, family caregivers cannot do it alone. That’s where we come in. Our senior care companion services are available 24 hours a day, 7 days a week. We offer on-call, temporary, part-time, or full-time options to meet your specific needs.

Contact us at (518) 348-0400 and let us know how we can make your life easier.

Meeting the Growing Senior Care Demand

meeting the growing senior care demandAccording to the U.S. Administration on Aging (AOA), in 2015, 14.1 percent of the U.S. population was aged 65 or older, or one in every seven Americans. By 2020, 54 million people in the U.S. will be over the age of 65; by 2040, that number will top 82 million. People reaching age 65 today have an average life expectancy of 85.8 years (male) to 87.8 years (female), according to the Society of Actuaries MP-2016; which will result in a staggering number of seniors over the age of 80 in the next 20 years, many of whom will need some kind of care. Already, we can see the growing demand for senior care is critical in our lives and so it will continue.

Senior care is essential to our expanding elderly population. Some senior care is short-term, following an accident or injury that generally resolves itself. Most, however, is long-term care which involves a variety of services which help meet both the medical and non-medical needs of seniors with chronic illness, disability, or advanced age who have difficulty caring for themselves. Long-term care can be assistance with activities of daily living (ADLs) like dressing, bathing, meal preparation, and using the bathroom, or medical care that requires the expertise of skilled practitioners to address chronic conditions.

Senior care relates to a wide range of care but commonly refers to extended services for seniors who need help with ADLs. Senior care can be provided in a senior’s home, as well as the home of a family member (such as a son or daughter), in the community, or in various facilities like adult day care centers, fixed communities, assisted living facilities, and skilled nursing homes.

In-home senior care is usually provided in three ways:

  1. By a home health care agency that employs the worker to work in the family’s home, and sees to payroll, taxes, and human resources. (The agency employs the senior care provider in the home and maintains control of the worker’s job duties.)
  2. By a referral or placement agency (like A New England Nanny) that finds and recruits the senior care worker on behalf of the family, charging a fee to do so, but then withdraws direct responsibility and transfers control for the employment over to the family. This type of agency may provide advice, support, and replacement services, if needed.
  3. By hiring independently, whereby the family or friend finds, hires, and employs the senior care worker according to all federal, state, and local requirements as a household employer, on behalf of the senior needing care (sometimes the senior is also the one employing the caregiver directly).

To achieve an effective and practical balance between your career and your family—making your private and professional lives enjoyable, fulfilling, and manageable—you decided to hire an in-home caregiver for your parent or elderly relative and, therefore, to have your senior or yourself become a household employer. And we’re here to help! In addition to companion caregivers, we can also provide personal care aides and Certified Nursing Assistants. Caregivers in those fields can assist seniors with bathing and toileting, tasks that companion caregivers don’t generally perform.

Contact us at (518) 348-0400 and let us know how we can meet your senior care needs.

Senior Care Tips: Estate Planning

senior care tipsThere are many issues that arise when it comes to senior care – one of the senior care tips to keep in mind regards estate planning. You’ve likely been repeatedly advised to ensure for your own estate planning, but as you take on caring for your elderly loved ones, you may also need to become familiar with their estate plan.

If your elderly loved one has not put his or her affairs in order, it should be done immediately, so you can be sure about his or her wishes before he or she becomes too incapacitated to communicate those wishes to you. Wills need to specify not only wishes for “handing on” precious keepsakes and possessions but also written directives as to how your elderly loved one wishes his or her remains disposed of, funeral and burial plans, and so on. Advance directives include the senior’s living will, which states his or her wishes in case he or she is near death and wants no life-saving, artificial measures taken to restore or preserve life, and medical power of attorney, also known as a health care proxy, enables the senior to designate a loved one as the decision maker for medical concerns in case he or she is unable to do so. A power of attorney allows the senior to give another the power to act on his or her behalf if he or she is in unable.

Be sure your senior caregiver is aware of where these important papers are kept (or has copies of them) and can access them in order to provide medical professionals with these critically important instructions during medical emergencies . For instance, emergency medical professionals in an ambulance or at a hospital emergency room will request copies of a patient’s  do not resuscitate order (DNR) or medical power of attorney.

Advance directive

This is a legal document that specifies that you do not want to be kept alive on artificial life support and can direct other aspects of health care if the elder is unable to speak for him- or herself. As with most legal documents, this needs to be as specific as possible, providing instructions regarding respirators, feeding tubes, and pain medication, among other things. Advance directives usually include a DNR, a living will, and a durable power of attorney.

  • Do Not Resuscitate: known as a DNR, is a written order directing health care professionals to not resuscitate a patient in case of cardiac or respiratory arrest. DNRs are generally given when resuscitation would only delay the inevitable and leave the patient severely and permanently incapacitated.
  • Durable power of attorney: enables a senior to authorize a specific person to make financial or health care decisions for him or her. Durable powers of attorney are most often effective when a doctor certifies that the patient is incapacitated; however, a durable power of attorney could begin upon signing the document. It will depend on the document’s wording as to when the powers begin.
  • Living will: a document that states in detail acceptable medical procedures and life-sustaining measures. It does not name someone to act on a senior’s behalf like a health care proxy, or medical or durable power of attorney. Living wills should be made available upon admission to any health care facility and to doctors, as well as kept on hand in the elder’s home. (A living will is not necessarily legally binding—state laws vary widely. Some hospitals and physicians may refuse to honor a living will in an attempt to keep the senior patient alive.)

Legal guardianship

A guardian is appointed by the court to have custody of another. Legal guardians may be appointed on a temporary basis (for a fixed period, i.e., one year) and for a senior’s medical consent. In short, a guardian may make medical decisions for the senior and work directly with medical professionals.

Living trust

According to AARP, a revocable living trust is a written agreement designating someone to be responsible for managing the senior’s property. It is called a living trust because it is established while the senior is alive. It is “revocable” because, as long as you are mentally competent, the senior can change or dissolve the trust at any time at his or her own discretion for any reason. Typically, a living trust becomes irrevocable (cannot be changed) when the person dies. As a trustee, you (as the senior’s designated relative or friend) can manage the assets, including selling or investing them.  You may also name your spouse as your co-trustee. If every asset is transferred into the living trust while the senior is alive, a living trust may substitute for a will. A pour-over will can be written to ensure that at the time of death any property not in the living trust is poured over into the trust.

Will

This is a legal document in which the senior declares who will manage his or her estate after he or she dies. The estate can consist of anything he or she owns—it may be as big as the senior’s home and as small as the deceased’s grandmother’s cameo pin or even a photograph.

There are professionals, namely attorneys and financial advisors, who specialize in elder law and estate planning. Since laws vary by state and are often subject to change, it is advisable to contact one. New York State’s legal services department may offer help at its Division of Elder Law, or you may access AARP’s prescreened list of attorneys.

For more information about how we help families with senior care issues, contact us at (518) 348-0400.

Hiring Senior Care

hiring senior careIn 2011, the first of America’s baby boomers—78 million people born between 1946 and 1964—reached their 65th birthday. These baby boomers began to turn age 65 at a rate of 8,000+ per day. According to the U.S. Administration on Aging (AOA), people reaching their 65th birthday today can expect an additional 18.6 years of life, creating a staggering number of seniors over the age of 80 by 2026. Already, senior care has become more and more critical in our lives, and the data available supports that it will continue to be so.

Many people today find themselves as part of the “sandwich generation” – not only are they caring for their own children, but for their elderly parents as well. This type of household is becoming increasingly common in the United States. With elderly parents living longer and families choosing to care for them in the home, as well as having a family of their own, families are tasked with managing the care of their dependents around their careers. With so many different pressures on them, this type of family can save a lot of time and hassle from understanding the correct way to look after their household workers from the start. With more and more available senior care options for the home environment, a sandwich-generation family can hire a senior caregiver to achieve a successful work/life balance that benefits everyone in their family.

Senior caregivers include medically trained professionals like physical therapists, registered nurses, and nutritionists, but can also include those who simply run errands, do the laundry, cook meals, and provide companionship. Regardless of what type of senior care you need, it is crucial that you use due diligence when it comes to hiring a caregiver for your loved one.

For more information about the senior care companions that we provide, please contact us at (518) 348-0400.

Long Term Care Insurance to Help with Senior Care

long term care insurance to help with senior careWhile often purchased through independent means, long term care (LTC) insurance as an employee benefit is being offered more often by employers. Under this LTC policy, services to meet LTC needs such as adult day care, home health, skilled nursing care, and custodial care are available to employees, their spouses, and sometimes parents or parents-in-law.

According to AARP, addressing caregiver support issues in the workplace is smart business. AARP noted that companies are finding senior care help to be advantageous because both the employer and employee benefits when workers have options that make caregiving more manageable. According to AARP, about 33 percent of large companies offer basic senior care benefits, as do 25 percent of all businesses. Most are in the form of resource materials and referral services, unpaid leave, dependent care flexible spending accounts, counseling, or back-up senior care. More progressive companies offer subsidized in-home emergency care or adult day care, on-staff geriatric care specialists, and allowing older relatives on health insurance plans.

Many employers are sympathetic to the demands of those providing senior care for their loved ones.  Via the Family and Medical Leave Act, eligible workers may access up to 12 weeks of unpaid leave for family caregiving without the loss of job security or benefits. But many unions and employers have gone beyond that mandate and negotiated the following programs to help employees address their senior care needs:

  • resource and referral services that match providers with appropriate senior care resources and services;
  • pretax programs that establish a tax-free flexible spending account for senior care expenses (as well as child/dependent care expenses);
  • elder care funds that provide direct cash payments or reimbursement for senior care expenses;
  • support services that offer information and support services for retired employees and their families;
  • long term care insurance that helps employees pay for long term care for themselves and their dependents including spouse or parent; and
  • sick time for family members and flex time options  which both allow workers to use their accumulated sick leave to care for sick dependents.

Check with your company to determine if you have workplace benefits for senior care help.

Many families opt to try to save money by becoming their senior’s caregiver themselves, as opposed to hiring help to provide care to their loved one, or using a nursing home. Costs to companies with employees acting as senior caregivers can be high: according to AARP, one study showed that 75 percent of employees caring for adults experience negative health concerns of their own, including stress, depression, panic attacks, headaches, loss of energy and sleep, weight loss, and physical pain. AARP cited a study by the MetLife Market Mature Institute and National Alliance of Caregiving that said U.S. companies paid between $17.1 billion and $33.6 billion annually on lost productivity, equaling $2,110 for every full-time worker who cares for an adult.  Other AARP figures showed a cost to business of $6.6 billion to replace employees (9 percent left work or took early retirement); nearly $7 billion in workday interruptions (i.e., coming in late, leaving early, taking time off during the day or spending work time on senior care matters); and, $4.3 billion in absenteeism.

See some alternate payment methods for senior care, or contact us at (518) 348-0400 for more information.

Need Senior/Companion Care? We Can Help!

 

Companion & Senior Care

Senior Care Payment Options

senior care payment optionsAccording to Paying for Senior Care, nearly all money spent on long term senior care comes from government programs (like Medicaid, Medicare, veteran’s benefits, and Social Security); insurance (like long term care and health insurance); personal property; and, private assistance (including nonprofits, foundations, and pharmaceutical companies). No coverage—including health and long term care insurance—will  fully cover the complete needs of your elderly loved one, and the senior and his or her family will need to cover many aspects of care themselves.

One fact is true—at-home care for an elderly loved one is labor intensive and is provided mostly by trained individuals. Therefore, it can quickly become very expensive. Some senior care payment options have recently become available for elders and their families to consider.

Accelerated Death Benefit

This is a life insurance death benefit paid in cash in advance, tax-free. An accelerated death benefit is available to people needing long-term care for an extended period of time. Also known as a “living benefit,” accelerated death benefits may include all or part of the total life insurance death benefit.

Charitable Remainder Trust

This allows people to use their own assets for long term care while reducing their taxes. Generally used by well-off people who donate specific asset types to a public charity at fair market value, the trust enables people making donations to receive a tax deduction on the amount gifted. The donor receives payments from the trust that then can be used for long term care. When the donor dies, the balance of the funds in the trust go to the charity.

Deferred Long-term Care Annuity

This is available to people up to age 85, this annuity allows people to create two funds—one for long-term care expenses and the other to be used as they like. The long term care fund may be accessed immediately and if not used may be passed to  heirs, but eligibility depends on the annuity holder’s health. There are many health criteria and the fund could be taxed.

Life settlement

This is a fairly recent financial option in which the owner of a life insurance policy sells an unneeded policy to a state-licensed third party (or investor)l for more than its cash value and less than its face value. Until recently, if a policy owner opted out of a policy by surrendering the policy or allowing it to lapse, the additional value was relinquished back to the issuing life insurance company. In some cases, an insured’s health may have declined since the policy was issued and the policy may be worth considerably more than the surrender value. A life settlement is an alternative to a surrender or policy lapse, or when the owner of a life insurance policy no longer needs or wants the policy, the policy is under performing or can no longer afford to pay the premiums.

Reverse mortgage

This is a loan based on home equity that enables older homeowners to convert part of their home equity into tax-free income without having to sell the home, give up the title, or incur a new monthly mortgage payment. According to the Federal Trade Commission, with a regular mortgage, policyholders make monthly payments to the lender. In a reverse mortgage, policyholders receive money from the lender and generally don’t have to pay it back for as long as they live in their home. Instead, the loan is repaid when they die, sell their home, or when their home is no longer their principal residence. The proceeds of a reverse mortgage generally are tax free, and many reverse mortgages have no income restrictions.

Viatical Settlement

This allows people to sell their life insurance to a third party and use the money to pay for their care. In viatical settlements, cash payments may be up to 85 percent of the policy’s face value. Such a settlement is only possible if the policyholder is terminally ill (a life expectancy of two years or less). Money received from a viatical settlement may be tax-free. Viatical settlements may potentially affect Medicaid eligibility.

Other income

While the majority of people over age 65 receive their largest source of retirement income from Social Security (ssa.gov), some may also access Supplemental Security Income (SSI),which provides monthly cash payments to help pay for food, shelter, and clothing. Like Social Security, SSI is derived from payments workers put in during their working years and is available to people with limited incomes age 65 or older, or are blind or disabled. Local Social Security Administration offices can help determine eligibility. Outside of Social Security, employer-sponsored retirement pensions are the next largest income source for people age 65 or older. (The Pension Rights Center at pensionrights.org provides pension counseling.)

For more information, contact us at (518) 348-0400.

Senior Care Issues: Home Modification for Seniors

home modification for seniorsHealth and safety in the home is an important issue to consider when the home is where the caring of your loved one takes place. Also, it has become a workplace for your employee. Whether your senior loved one decides to stay in his or her home or to live in your home, the home must be made and kept safe. Up to half of all home accidents could be prevented with home modifications and repair. Home modifications for seniors enable safety and allow people to stay in their homes longer.

Adapting homes for safer and friendlier senior environments can encompass some quick and easy fix measures, as well as full renovations. Modifications can include installing: lever-style door and sink handles; bathroom grab bars (shower and toilet); improved lighting and installing night lights; handrails (on both sides of stairs and ramps); wider doorways for wheelchair access; stairway chair lifts; walk-in/low curb or curbless showers; and, a bath/bed room on the first/main floor.  They may also include removing all loose rugs and clutter. Other useful tools include kitchen utensils like automatic openers and other kitchenware that offer built-up handles for easier gripping (as with hair brushes and combs, too), and bowls and plates with nonskid bottoms.

There are many companies that offer home medical supplies and equipment ranging from shower chairs, grabs bars, and raised toilet seats to less obvious but equally helpful and practical products that assist with dressing, eating, hearing, seeing, walking, writing, and almost all activities of daily living. Even motion detectors may be used to signal when a senior is near the top of the stairs or slipping out the front door.

If you are looking for contractors who specialize in home modification for seniors, The National Association of Home Builders and AARP offer a certification for an aging in place specialist, called CAPS. Builders and remodelers (and an increasing number of general contractors, designers, architects, and health care consultants) take a three-day course to learn how to remodel for seniors and create an aesthetically enriching, barrier-free living environment. According to NAHB, CAPS training extends beyond design to address codes and standards, common remodeling expenditures and projects, product ideas and resources needed to provide comprehensive and practical aging in place solutions.

Also, physical and occupational therapists can offer many recommendations on remodeling, as well as assistive devices and durable medical equipment.

For more information, contact us at (518) 348-0400.

Senior Care Payroll and Tax Guide

senior care payrollHave you hired a senior care employee to work in your home? Follow this senior care payroll and tax guide to ensure you are compliant with employment laws.

Step 1 – Determine if you have an employee or independent contractor

The main difference between an employee and a contractor is that an employee operates under the control and supervision of his/her employer (you), and a contractor retains all control over themselves and their services.

Step 2 – Research Tax Laws

The IRS states that anyone paying an individual $1,900 or more in gross wages during the calendar year, legally employs a household employee and must comply with all state and federal tax laws pertaining to household employer status.

Step 3 – Follow Payroll Regulations

According to the Federal Labor Standards Act (FLSA), all senior care employees must be paid at least minimum wage, however, benefits such as room and board can account for a portion of that wage. There is no limit to the number of hours an employee can work – provided there is a mutual agreement. Overtime may be required in your state. Paid vacations, holidays and sick days are not required by law.

Step 4 – Submit Federal and State Forms – can be downloaded from our affiliate partner GTM Payroll’s website

  • Complete SS4 Form for an Employer ID #
  • Register for State Unemployment ID #
  • Register for State Withholding Tax ID #
  • Complete your State New Hire Report
  • Have employee complete W-4 Form
  • Have employee complete I-9 Form

Step 5 – Add Workers’ Compensation to Your Insurance Policy

New York State requires household employers to carry a workers’ compensation and/or disability policy if you employ someone on a full or part-time basis. These policies will protect you from lawsuits and liability in the event that your employee is injured on the job.

Step 6 – Set Up Dependent Care Assistance

You can pay your senior care employee with pre-taxed funds through an employer-sponsored Dependent Care Assistance Program (DCAP), if your employer offers this plan. A plan of this type would allow you to set aside up to $5,000 per year “tax free” money that you can use to pay for senior care. Contact your employer’s Human Resources department for more details.

Step 7 – Calculate Withholding Taxes

Our affiliate partner GTM Payroll Services offers a free wage calculator on their website.

Step 8 – Distribute Paychecks Regularly

You have the option of paying your employee weekly, biweekly, semi-monthly, monthly, or at any other agreed upon interval. Wages should always be paid via check so both parties have a record, and the amount should always be net (after all applicable taxes are withheld). You can also offer the option for direct deposit (check with your bank for details).

For more information, contact us at (518) 348-0400.

Our Featured Nanny: Alicia!

photoWe are excited to introduce you to a member of our talented team, Alicia P.! Alicia joined A New England Nanny this past spring, and she has been a valuable addition to our staff. She is part of our temporary services team, caring for children of all ages and providing companion care as well. The most telling sign of her success? She keeps getting requested by families to come back!

Born and raised in Saratoga County, Alicia graduated from Ballston Spa High School and is currently taking classes in early childhood education. Her hobbies are reading, scrapbooking, and being outdoors as much as possible. Currently residing in Malta with her family, Alicia had this to say about why she enjoys working with A New England Nanny:

“I enjoy helping people – I think that’s why I like this job so much! Whether it be an elderly person or a child, I like to help. Children are so much fun and I enjoy helping them grow and learn. I have two children of my own, ages 6 and 7, and they are my world!”

If you would like to request Alicia for child care or companion care services, please contact us at (518) 348-0400.