What's the best way to find a good in-home caregiver for my elderly mother?

Finding a good in-home caregiver that is dependable, likeable, trustworthy and affordable can be challenging. Here are some tips and resources that can help.

Know Your Needs

Before you start the task of looking for a caregiver, your first step is to determine the level of care your mom needs. If, for example, she only needs help with daily living activities like preparing meals, doing laundry, bathing or dressing, then a "personal care aide" will do.

However, if she needs health care services, there are "home health aides" who can provide the same support as personal aides but who also have training in administering medications, changing wound dressings and other medically-related duties. Home health aides often work under a nurse's supervision.

Once you settle on a level of care, you then need to decide how many hours of assistance she will need. For example, does your mom need someone to come in just a few mornings a week to help her cook, clean, run errands or bathe? Or, does she need more continuous care that requires daily visits or a full-time aide?

After you determine her needs, there are two ways in which you can go about hiring someone. You can either hire through a home health agency or you can hire someone directly on your own.

Home Health Agencies

Hiring a certified home health agency to supply and manage your mom's care is the easiest but most expensive option of the two. Costs run anywhere from $12 to $40 an hour depending on where you live and the qualification of the aide. This is usually a better choice if your mom requires a lot of in-home health care.

The agency will handle everything, including an assessment of your mom's needs, assigning appropriately trained and pre-screened staff to care for her and finding a fill-in staff member on days her aide is unavailable.

However, there can be a few drawbacks. You may not be able to provide much input into the selection of the caregiver and the caregivers may change or alternate, which can cause a disruption in care and confusion.

You also need to know that Medicare does cover some in-home health care services if it is ordered by a doctor, but it will not cover personal care services, such as bathing and dressing. However, if your mom is low-income and qualifies for Medicaid, some personal care services are covered.

To locate and compare Medicare-approved home health agencies visit www.medicare.gov/hhcompare or call 800-633-4227 and request a free copy of the "Medicare and Home Health Care" (Publication #10969), which explains coverage and how to choose an agency.

Hiring Directly

Hiring an independent caregiver on your own is the other option. It is less expensive with costs typically ranging between $10 and $20 per hour. Hiring directly also gives you more control over who you hire so you can choose someone who you feel is right for your mom.

But, be aware that if you do hire someone on your own, you become the employer. Therefore, there is no agency support to fall back on if a problem occurs or if the aide does not show up. You would also responsible for paying payroll taxes and compensating any work-related injuries. If you choose this option make sure you check the aide's references thoroughly and conduct a criminal background check.

To find someone, you can ask for referrals through friends, doctor's offices or hospital discharge planners. You can also check online job boards like craigslist.org, carelinx.com or carescout.com. Some states offer registries (phinational.org) to help you locate quality caregivers.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living” book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization’s official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

Are there any services you know of that check in on elderly seniors who live alone? My 84-year-old father won't wear a lifeline help button and I worry about him falling or having a medical emergency and not being able to get to the phone to call for help.

Depending on where your dad lives, there are check-in call services, volunteer visiting programs and a variety of technology options you can turn to that can help you keep tabs on him. Here are several to check into.

Daily Check-in Calls

To make sure your dad is okay every day, consider signing him up for a daily check-in call service program. These are telephone reassurance programs run by police or sheriff's departments in hundreds of counties across the country and are often provided free of charge.

Here's how it would work. A computer automated phone system would call your dad at a designated time each day to check-in. If he answers, the system would assume everything is fine. But if he doesn't pick up, or if the call goes to voicemail after repeated calls, you (or whoever his designee is) would get a notification call. If you are not reachable, calls are then made to backup designees who have also agreed to check on your dad if necessary. If no one can be reached, the police or other emergency services personnel will be dispatched to his home.

To find out if this service is available in your dad's community, call his local police department's non-emergency number. If the police or sheriff's department in your dad's community does not provide a daily check-in call program, there are a number of companies you can turn to that offer similar services directly to consumers for under $15 per month. A few programs to check into include the CARE senior calling program (Call-Reassurance.com), CareCheckers (CareCheckers.com) and IAmFine (Iamfine.com).

Volunteer Visiting Programs

Another option you may also want to consider is finding a volunteer visiting program. These are usually run by churches, community groups or social service agencies.

These programs provide volunteers who will visit older adults in their homes usually for an hour or two once a week. The volunteers provide companionship as well as the reassurance that someone is checking in on a regular basis. They can also alert you if they notice your dad's health or living conditions start to decline.

To find out if these services are available, check with local churches or call the Eldercare Locator at 800-677-1116 to find groups or agencies near your dad.

Technology Solutions

There are a number of different technologies that will help keep your dad safe at home and help you keep an eye on him from afar. For example, for safety and peace of mind there are medical alert systems, which provide a wearable "help button" that would allow your dad to call for help anytime he needed it. Some of these systems also offer wall-mounted buttons that can be placed near the floor in high-risk fall areas, like the bathroom or kitchen, if he will not wear a help button.

If you want to keep daily tabs on your dad, there are wireless sensor-monitoring systems that he can put in his home that will notify you if something out of the ordinary is happening. There are also video monitoring cameras that have built-in motion and sound detection to let you know when something is detected and two-way audio that will let you talk and listen to him.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living” book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization’s official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

What exercises are best suited for people with arthritis? I have osteoarthritis in my neck, back, hip and knee and have read that exercises can help ease the pain and stiffness, but I do not know where to start and I certainly do not want to aggravate it.

Many people who have arthritis believe that exercise will worsen their conditions, but that is not true. Exercise is actually one of the best treatments for osteoarthritis.

Proper and careful exercises can help reduce joint pain and stiffness, strengthen muscles around the joints and increase flexibility. It also helps manage other chronic conditions that are common among seniors with arthritis, such as diabetes, heart disease and obesity. Here are some tips to help you get started.

Recommended Exercises

Determining exactly which types of exercises that are best for you depends on the form and severity of your arthritis and which joints are involved. It is best to work with your doctor or a physical therapist to help you develop a personalized exercise program. The different types of exercises that are most often recommended to seniors with arthritis include:

• Range-of-motion exercises: These are gentle stretching exercises that can relieve stiffness and improve the ability of your joints to move through their normal range of motions. These exercises should be done daily.

• Strengthening exercise: Calisthenics, weight training and working with resistance bands are recommended (two or more days a week) to maintain and improve your muscle strength. Strengthening your muscles will help support and protect your joints.

• Aerobic exercises: Low-impact activities like walking, cycling, swimming or water aerobics are all recommended three to five times per week to help improve cardiovascular health, control weight and improve your function overall.

It is also important to keep in mind that, when you first start exercising, you need to go slow in order to give your body time to adjust. If you push yourself too hard you can aggravate your joint pain. However, some muscle soreness or joint achiness in the beginning is normal.

To help you manage your pain, start by warming up with some simple stretches or range of motion exercises for five to 10 minutes before you move on to strengthening or aerobic exercises. Another tip is to apply heat to the joints you will be working before you exercise and use cold packs after exercising to reduce inflammation.

If you experience significant pain while you are exercising, you may need to modify the frequency, duration or intensity of your exercises until the pain subsides. Alternatively, you may need to try a different activity (e.g., switching from walking to water aerobics). It is important to note that if you are experiencing severe, sharp or constant pain, large increases in swelling or your joints feel hot or red then you need to stop and see your doctor.

Exercising Aids

To help you exercise at home, the Arthritis Foundation offers a variety of free online videos (see Arthritis.org/living-with-arthritis/exercise/videos) to guide you through a variety of exercises. There are also arthritis exercise DVDs that you can purchase for a few dollars through Collage Video (CollageVideo.com, 800-819-7111) or the Arthritis Foundation Store (AFstore.org).

Also see Go4life.nia.nih.gov (or call 800-222-2225), a National Institute on Aging resource that offers a free exercise guide that provides illustrated examples of different exercises.

If you need some motivation or do not like exercising alone, ask your doctor about exercise programs in your area for people with arthritis. Hospitals and clinics sometimes offer special programs, as do local health clubs and senior centers.

The Arthritis Foundation also conducts exercise and aquatic programs for people with arthritis in many communities throughout the U.S. Contact your local branch (see Arthritis.org/local-offices or call 800-283-7800 for contact information) to find out what may be available near you.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living” book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization’s official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

My father receives over 100 pieces of junk mail every week and I just discovered that he has given away nearly $5,000 over the past few months to many of the solicitors who mail him this junk. Can you offer any tips on how I can stop this?

Millions of Americans get bombarded with unwanted junk mail these days, including "mail fraud" schemes that you and your dad should be careful to guard against. Here are some tips that may help.

Mail Fraud Alert

While junk mail comes in many different forms—credit card applications, sweepstakes entries, magazine offers, coupon mailers, donation requests, political fliers, catalogs and more—the most troublesome type is mail fraud. This type of junk mail comes from con artists who are trying to take your money.

Mail fraud can be tricky to detect because there are many different types of schemes out there that may seem legitimate. Some of the most common mail scams targeting seniors today are phony sweepstakes, foreign lotteries, free prizes, vacation scams, fake checks (see FakeChecks.org), donation requests from fake charities or government agencies that do not exist, get-rich chain letters, work-at-home schemes and inheritance and investment scams.

If your dad is getting any type of junk mail requesting money in exchange for a free gift or if he's receiving checks that require him to wire money, you need to call the U.S. Postal Inspector Service at 877-876-2455 and report it.

Unfortunately, once a person's name and contact information is included on these mail fraud lists, also known as "suckers lists," it is very difficult to be removed from the list. This is because criminals regularly trade and sell mailing lists of people who they believe to be susceptible to fraud and the scammers will not remove names when they are requested to do so.

Knowing this, a good first step to help protect your dad is to alert him to the different types of mail fraud and what to watch for. The U.S. Postal Inspection Service can help you with this. They offer a list of the different mail fraud schemes at PostalInspectors.uspis.gov.

Another option is to see if your dad would be willing to let you sort through his mail before he opens it so you can weed out the junk. You may want to have the post office forward his mail directly to you to ensure this.

If your dad feels compelled to donate to certain charities, ask him to let you check them out first to make sure they are legitimate. You can do this at charity watchdog sites like CharityNavigator.org and Give.org.

Reduce Junk Mail

While scam artists are not likely to take your dad's name off their mailing lists, most legitimate mail-order businesses will. Start with the Direct Marketing Association, which offers a consumer opt-out service at DMAchoice.org. This won't eliminate all his junk mail, but it will reduce it. The opt-out service is $2 for 10 years if you register online or $3 if you register by mail.

To put a stop to the credit card and insurance offers he gets, call the consumer credit reporting industry opt-out service at 888-567-8688 and follow the automated prompts. He will be able to choose to either opt out for five years or to opt out permanently. Be prepared to give his Social Security number and date of birth. You can also do this online at OptOutPrescreen.com. If you choose the permanent opt-out, you'll have to mail in a form.

You should also make sure your dad's home and cell phone numbers are registered with the National Do Not Call Registry (DoNotCall.gov, 888-382-1222) to reduce the number of telemarketing calls he receives.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living” book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization’s official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

What resources can you refer me to for long-term care financial help? My 84-year-old mother needs assisted living or nursing home care, but we do not have a lot of money and she does not have long-term care insurance.
If your mother does not have a long-term care insurance policy there are several resources you should look into that may help pay for her care depending on her particular circumstances.
Medicaid: The first thing to understand is that Medicare (the government health insurance program for seniors 65 and older and individuals with disabilities) does not cover long-term care. This includes nursing home care, the costs of assisted living facilities and home aide services (unless your mom is receiving skilled nursing or therapy services too). Medicare only provides limited short-term coverage, which includes up to 100 days for skilled nursing or rehabilitation services after a hospital stay.
However, Medicaid (the joint federal and state program that covers health care for individuals who have very low income) as it currently stands, does cover long-term care facilities and in-home care. To be eligible for coverage, your mother must have a very low level of income. Her countable assets cannot be more than around $2,000, including investments.
Note that most people who enter a nursing home do not qualify for Medicaid at first, but pay for care out-of-pocket until they deplete their savings enough to qualify. Contact your state Medicaid office (see Medicaid.gov) for eligibility details.
Veterans aid: If your mom is a wartime veteran, or a spouse or surviving spouse of a wartime veteran, there is a benefit called "Aid and Attendance," which can help pay between $1,153 and $2,127 a month toward her long-term care.
To be eligible, your mom must need assistance with daily living activities like bathing, dressing or going to the bathroom. In addition, her yearly income must be under $13,836 as a surviving spouse, $21,531 as a single veteran or $25,525 as a married veteran (after her medical and long-term care expenses). Her assets must also be less than $80,000 excluding her home and car.
To learn more, see Benefits.VA.gov/pension or contact your regional Veterans Administration office or local veterans service organization. Call 800-827-1000 for contact information.
Life insurance: If your mom has a life insurance policy, find out if it offers an accelerated death benefit that would allow you to receive a tax-free advance to help pay for her care.
Another option to consider is selling her policy to a life settlement company. These are companies that buy life insurance policies for cash, continue to pay the premiums and collect the death benefit when she dies. Most sellers generally get four to eight times more than the policy cash surrender value.
If she owns a policy with a face value of $100,000 or more and is interested in this option, ask for quotes from several brokers or life settlement providers. To locate some, use the Life Insurance Settlement Association member directory at LISA.org.
Tax breaks: If you are helping out your mom financially, you may also be able to claim her as a dependent on your taxes. This could potentially reduce your taxable income by $4,050, which you could use for her care. To qualify, you must pay at least half of your mom's yearly expenses and her annual income must be below $4,050, excluding Social Security. For more information, see IRS Publication 501 at IRS.gov/pub/irs-pdf/p501.pdf.
If you cannot claim your mom as a dependent because her income is too high, you may still be able to get a tax break if you are paying at least half her living expenses and they exceed 7.5% of your adjusted gross income. These expenses include her medical, dental and long-term care costs. You can include your own medical expenses in calculating the total. See the IRS Publication 502 (IRS.gov/pub/irs-pdf/p502.pdf) for details.
Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living” book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization’s official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

My dad is interested in downsizing his smartphone wireless plan and is looking for the best low-cost options. He uses his phone primarily for talking and texting, but also wants to have some cellular data for checking email when he does not have WiFi access. Do you have any recommendations? There are several great low-cost deals I can recommend for older smartphone users who are looking to save some money by paring down their cell phone plan. Here are three possible options to consider.

Republic Wireless

If your dad is an Android smartphone user, Republic Wireless (RepublicWireless.com) offers one of the cheapest deals available for light data users. Republic uses a mixture of Wi-Fi and cellular networks—Sprint and T-Mobile specifically—to transmit calls, texts and data. This patented technology automatically offloads as much as possible to WiFi networks when available, so he will consume less data than he would with traditional carriers. Republic's no contract service plans start at $20 per month for unlimited talk, text and one gigabyte (GB) of data. If your dad needs more data, their $30 per month plan provides 2GB, and $45 per month buys 4GB. How much data will your dad need? The best way to find out is to check his current phone bills. The average smartphone owner uses between 2GB to 3GB of data each month, but most seniors use less than 1GB. To use Republic Wireless, he will need a compatible Android phone (iPhones are currently not compatible) or your dad can buy a new phone through the company. It currently offers eight Android phones with prices starting at $99.

Consumer Cellular

Another excellent low-cost option for lighter data users, and one that caters to older adults, is Consumer Cellular (ConsumerCellular.com). Rated the number one wireless service by Consumer Reports seven years running, Consumer Cellular offers a variety of "pay for what you need" talk and connect plans that will allow your dad to choose exactly what he wants. Consumer Cellular's talk plans start at $10 per month plus 25 cents per minute, which may be an option if your dad is an infrequent caller. Otherwise they offer $15 per month for 250 minutes, $20 per month for 1,500 minutes or $30 per month for unlimited minutes. Consumer Cellular also offers connect plans for text messages and cellular data. These plans cost $2.50 per month for 300 texts and 30 megabytes (MB) of data, $5 per month for 2,000 texts and 200MB data, $10 per month for unlimited texts and 500MB, $20 per month for unlimited texts and 1.5GB, $30 per month unlimited texts and 3GB or $40 per month for unlimited texts and 5GB of data. Consumer Cellular, which offers 5% monthly fee discounts to AARP members, also allows customers to utilize their own smartphones by offering free SIM cards. Alternatively, customers can purchase a wide variety of Android and Apple iPhones or the senior-friendly Doro 824 SmartEasy.

Lifeline Program

If your dad's income is low enough, another option to check into is the Lifeline Assistance Program. This is a federal program that provides a $9.25 monthly subsidy that can go toward your father's smartphone service. To qualify, your dad will need to show that his annual household income is at or below 135% of the Federal Poverty Guidelines (which is $16,281 for one person or $21,924 for two people) or that he is receiving a government benefit, such as Medicaid, food stamps, SSI, public housing assistance, veterans pension or survivor's pension benefits or that he lives on federally recognized tribal lands. To apply, he can contact a wireless provider in his area that participates in the Lifeline program (see LifelineSupport.org or call 800-234-9473) and ask for an application form. He will want to check all wireless providers in his state because some offer better services than others.Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living” book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization’s official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

Opioid addiction is a national problem that is hitting people of all ages, including millions of older Americans. Here is what you should know and do to help your mom.

The Cause

The main reason opioid addiction has become such a problem for people over age 50 is because opioids have become a commonly prescribed (and often overprescribed) medication by doctors over the past two decades. It is being used to treat many different types of pain and diseases, including arthritis, cancer, neurological diseases and other illnesses that become more common in later life. Nearly one-third of all Medicare patients—almost 12 million people—were prescribed opioid painkillers by their physicians in 2015. That same year, 2.7 million Americans over the age of 50 abused painkillers. Taken as directed, opioids can manage pain effectively when used for a short amount of time. However, because nearly 5% of those treated will develop an addiction or abuse the opioid medication, people should be screened and monitored when using an opioid for a long period of time.

Signs of Addiction

Your mom may be addicted to opioids if she cannot stop herself from taking the drug and her tolerance continues to increase. She may also be addicted if she keeps using opioids without her doctor's consent, even if it is causing her problems related to her health, money, family or friends. If you think your mom has an addiction, ask her to see a doctor for an evaluation. Go to a family doctor, her prescribing physician or find a specialist through the American Society of Addiction Medicine (see ASAM.org) or the American Academy of Addiction Psychiatry (AAAP.org). It is also important to be positive and encouraging. Addiction is a medical matter, not a character flaw. Repeated use of opioids actually can change the way the brain functions.

Treatments

Treatment for opioid addiction is different for each person, but the main goal is to enable your mom to stop taking the drug and avoid using it again in the future. To help her stop using the drug, her doctor can prescribe certain medicines to help relieve her withdrawal symptoms and control her cravings. These medicines include methadone, buprenorphine and naltrexone. After her body detoxifies, behavioral treatments such as individual counseling, group or family counseling and cognitive therapy can help her learn how to manage depression, avoid the drug, deal with cravings and heal damaged relationships. For assistance, call the Substance Abuse and Mental Health Services Administration (SAMHSA) confidential help line at 800-662-4357 or visit SAMHSA.gov. The SAMHSA has individuals who can connect you with treatment services in your mom's state. Also, if you believe that your mom has a doctor who prescribes opioids in excess or without legitimate reason, you should report him or her to the appropriate state medical board. For contact information visit FSMB.org.Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living” book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization’s official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.