Professional Assistance May Be the Solution—No Matter What the Problem Is
When it comes to life’s biggest decisions, most challenging transitions, and largest opportunities, we generally turn to professionals for help. From planning a move to planning for the financial future, there are professionals who can help with every step of life’s journey. With an increasing number of credentialed professionals specifically trained to meet a diverse array of needs, there is generally a professional for that—no matter what that is. Many of these professionals work directly with Aging Life Care Managers to help clients achieve their best quality of life and to deliver the best possible results for families. In fact, in many instances, care managers will recommend professionals who become a vital part of a client’s care team. No matter what stage of life you find yourself in or what your age, there is never any reason to face life’s changes and challenges alone. Enlist the help of a professional and get the help you need. Some of the more prominent categories of professionals are detailed below. The tables on the following pages list dozens of options that are available in these and other categories. For specific information on available services, please contact the individual providers. Aging in Place Solutions Need to update your home to meet your changing needs? Want some help running errands? Have medical needs that require special equipment? There are individuals and businesses available to meet all your needs and allow you to remain safely in your home. Successfully aging in place frequently requires additional assistance from professionals to ensure that all daily needs are met and the home environment remains safe. Assistive Technology In today’s connected world, we are all accustomed to turning to technology for solutions. Help managing the challenges that come with aging or disability is no different. There are many technologies that can help you with all types of needs—from staying in contact with family to hearing better. Technology professionals can help clients find specific technologies that can improve their living environments and their lifestyles. Downsizing/Moving Solutions Moving is one of life’s most monumental tasks. Add in the fact that many seniors have been in their homes for two, three, or more decades, and moving becomes even more daunting. Whether you need to de-clutter and downsize in preparation for a move to a retirement community, or just have your home deep cleaned to provide a safer living environment, there are professionals available to help. When it comes time to sell the family home, there are also professionals available to prepare the home and ensure that you get top market value. Medical Solutions Sometimes medical needs require the help of a specialist or a business that caters to specific conditions or illnesses. Professionals can help you with a wide range of needs—from vision services to hospice care to mental health care and everything in between. Planning Solutions Planning ahead for financial and legal needs is important at every stage of life, but never more so than during retirement. Financial and legal needs frequently become more complex with age. You may need help with tasks ranging from paying bills and managing paperwork to estate planning and managing Medicaid. Professionals are available who specialize in each of these areas and can make meeting your financial and legal needs easy. Solutions for Professionals From Aging Life Care Managers to Elder Law Attorneys to assisted living and homecare providers, all professionals who work with senior clients and their families need specialized training to ensure that they have the most up-to date information and education. Professionals who train their peers help to ensure that all seniors get the best possible assistance with all their needs.
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By Phyllis Mensh Brostoff, CISW, CMC, Aging Life Care AssociationTM Member, Fellow of the Leadership Academy
If you took a poll of older adults and asked each person if they wanted to remain in their own home until the end of their life, most people would say, “of course.” That is a wonderful goal, which often takes a lot of sound planning to be successful. Anything can get in the way—accidents, illness, lack of energy, declining physical abilities—of achieving your desired independence. It is hard to give up even a little autonomy, but asking for assistance can help keep you where you want to be—in your own home. What if You Become Homebound? If you are recovering from an acute illness, you may be eligible for home health services that are paid for by the Medicare program. An Aging Life Care Manager™ can help you access licensed home health services by facilitating a conversation with your physician about your need for skilled nursing services, physical therapy, occupational therapy, and/or speech therapy in your home. This is an important conversation to have with your doctor and discharge planner if you are in the hospital or a nursing facility and need to decide on and plan for services in your home once you are discharged. However, Medicare will only pay for these services if you are “homebound.” Homebound is defined as only leaving your home for “medical treatment or short, infrequent absences for nonmedical reasons, like attending religious services.” You may also receive help from a home health aide under the supervision of a professional nurse or therapist. A physical or occupational therapist can evaluate your home and recommend equipment (such as guard bars in the bathroom) that will improve your safety. Accessing services These services must be obtained from a state licensed home health agency certified to provide Medicare-reimbursed services. They may be freestanding agencies, or they may be part of a large, hospital-based organization. Licensed home health services are usually timelimited, ending when you have met the goals of treatment and the need for the skilled care has ended. If you have enrolled in a Medicare Advantage program, you may also have access to additional services such as home visits after a hospitalization. Other Home Care Services Many other care services are provided in the home but are not licensed or paid for by Medicare. An Aging Life Care Manager can help you understand what they can offer, access reputable services, and monitor them on an on-going basis. Non-Medical Aides, Companions and Homemakers There are many types of paid care giving services available—often called non-medical aides, companions and homemakers—who many people hire privately. If you do, you or your family should check at least two work-related references, develop a specific set of tasks and expectations for the caregiver, arrange to pay all appropriate taxes, and have the required insurance coverage. Caregiver services can also be arranged through an agency. While this may cost more per hour than hiring an aide yourself, hiring an agency assures you of coverage when the aide is sick, on vacation or quits. The agency also carries liability insurance and is responsible for all employment taxes and employee bonding. An Aging Life Care Manager can help you find a reputable agency and get important questions answered, such as: do they check police and driver license records; do they provide supervision; how do they handle cancellations; and how long have they been in business? Your family can come together and construct a plan for supporting you in your wishes to remain in your home. If it becomes clear that you all need help in doing that, hiring an Aging Life Care Manager is a wise investment. The Care Manager can facilitate a family understanding of the situation and help everyone recognize what your needs are, help bring on board important services, and provide caring support to you and your family on an ongoing basis. Phyllis Mensh Brostoff, CISW, CMC, is a social worker and co-founder of Stowell Associates – a care management and home care company in Milwaukee, Wisconsin. She has written numerous articles and presented seminars across the country. More information is available at www.caremanagedhomecare.com. Follow Phyllis on Twitter, Facebook, or email her at [email protected]. Thank you to the Aging Life Care Association™ for permission to share this information. You may learn more about Aging Life Care™ at aginglifecare.org.
Receive Assistance While Enjoying the Comforts of Home
Home care can include a wide variety of healthcare and supportive services—from professional nursing and home health aide services to physical, occupational, respiratory and speech therapies. Options in Home Care An incredibly diverse field, home care includes companion care, home healthcare or skilled nursing. COMPANION CARE is provided by caregivers or companions, who serve as surrogate family members, performing many of the tasks that family members would typically complete. Assistance from companion caregivers can include meal preparation, medication reminders, laundry, light housekeeping, shopping, transportation and assistance with exercising. The overall goals of companion care providers are to ensure that the home environment remains safe and that the individual has a companion to spend time with when family is not available. HOME HEALTHCARE is for those who are no longer able to perform all of the functions of daily living by themselves but who do not require skilled medical services. A home health aide can help with activities of daily living (ADLs), which include bathing, dressing, transferring, eating and toileting. Additional services generally include meal preparation, mobility exercises, housekeeping, laundry, medication reminders and transportation. SKILLED NURSING CARE is prescribed by a physician and is administered by a registered nurse. The services provided by skilled nurses include: administering injections, administering medications, wound care, IV monitoring, blood tests, catheter care, respiratory therapy, physical therapy, feeding tube administration and more. Finding a Provider After determining the type and amount of services needed along with payment options, consumers should begin interviewing potential providers. This is a highly important decision, since finding a qualified, reliable and compassionate individual is essential to the health and happiness of patients and their families.
The Alzheimer’s Association Provides Some Common Signs
Every individual may experience one or more of these signs in different degrees. If you notice any of them, it is recommended you see a doctor. 1. Memory loss that disrupts daily life One of the most common signs of Alzheimer’s is memory loss, especially forgetting recently learned information. What’s typical? Sometimes forgetting names or appointments, but remembering them later. 2. Challenges in planning or solving problems Some people may experience changes in their ability to develop and follow a plan or work with numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. What’s typical? Making occasional errors when balancing a checkbook. 3. Difficulty completing familiar tasks at home, at work or at leisure People with Alzheimer’s often find it hard to complete daily tasks. Sometimes, people may have trouble driving to a familiar location, managing a budget at work or remembering the rules of a favorite game. What’s typical? Occasionally needing help to use the settings on a microwave or to record a television show. 4. Confusion with time or place People with Alzheimer’s can lose track of dates, seasons and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there. What’s typical? Getting confused about the day of the week but figuring it out later. Information from the Alzheimer’s Association website. Visit www.alz.org or call 1.800.272.3900 for information, referrals and support.
A Special Care Residence May Be the Right Option
Special care units are a relatively new concept, so certification standards for nursing homes and adult care residences do not specifically address these programs. You will need to rely on your own judgment when considering a special care unit. Visit more than one special care unit and compare them. Use all your senses when you visit — sight, smell and hearing are all important. Be sensitive to the overall atmosphere and how the staff interacts with the residents. Ask about the number of staff on duty at all times and find out about any special training they have had. Generally, the more staff available, the higher the quality of care. Some reports find a daytime ratio of six residents to one staff person to be adequate in a special care unit; others feel that a ratio of eight to one can also result in quality care. At night, when residents are in bed, a higher patient to staff ratio may be fine. Get a written description of the services and programs offered by any special care unit along with the charges or fees associated. This description should clearly explain to you how the special care unit differs from the rest of the nursing home or assisted living facility. It should emphasize special training the staff receives and describe the environment. Before choosing a special care unit, you should be confident that the higher price charged for care in the unit will actually result in better care for your relative. You may find that your relative can be adequately cared for in a regular unit. Finally, talk with someone about special care units. Your state ombudsman, your local chapter of the Alzheimer’s Association or your local Area Agency on Aging are all good resources. They may be able to provide you with a more detailed consumer checklist to help you compare special care units. All dementia special care units should focus on the individual needs of the resident. Care plans should be developed, implemented and reviewed often. All patients should be treated with respect and dignity in a physical environment that encourages independence while promoting safety. Researching special care residences can ensure your loved one will receive the proper support he/she needs.
Use This Checklist to Find the Right Facility
• Is the facility Medicare-certified and/or Medicaid-certified? • Are the home and its current administrator licensed? • What type of education and training do staff members have? • How many Registered Nurses (RNs) and Certified Nursing Assistants (CNAs) are on staff? • Are background checks conducted on all staff members? • Is there a care plan developed for every resident? • Are care plans reviewed and updated by providers and family members? • Is the interaction between residents and staff members warm and respectful? Are public areas and resident rooms clean and comfortable? • Are there a variety of activities available for residents? • What is the staff to patient ratio at night and on weekends? • Do staff members respond to residents’ requests for assistance promptly? • Are there enough staff members available to assist residents during meals? Does the food in the dining room look and smell appealing? • Are there handrails in hallways and grab bars in bathrooms? • Are exits clearly marked? • Is the facility outfitted with smoke detectors and sprinklers? Adapted from Medicare’s Nursing Home checklist. For more information, see www.medicare.gov.
Specialized Care for Individuals Who Need Daily Assistance
While some individuals are able to continue running their households with little assistance, there are those who may have debilitating physical or emotional conditions that require care beyond what family or professional home care aides can provide. What is Nursing Care? At a nursing home, care is administered by professionals under the direction of a physician. Many facilities also offer sub-acute, respite, rehabilitation and other short-term care. Rehabilitation services can be especially helpful for individuals who are recovering from surgery, an illness or any other life-changing event. These homes serve as permanent residences for individuals who are too sick or frail to live at home or as temporary facilities during a recovery period after a surgery or illness. Who Pays for Nursing Care? Medicare, Medicaid, private insurance and personal assets are all used under various circumstances to pay for services in a nursing care facility. If a facility is not certified by Medicare and Medicaid, the care will have to be paid for entirely with personal funds. In general, Medicare pays for skilled nursing care following hospitalization for the same illness or condition at 100 percent of the cost for days 1 – 20. Some long-term care insurance pays for nursing home care; insurance payments are usually a fixed amount for a specified number of qualified days. The basic daily rate is the standard charge the nursing home bills to all residents, which covers the fundamental services every resident receives, including rent for the room, housekeeping, meals and general nursing care. It is important to understand all the services and amenities that are not included in the basic daily rate. What to Look for in Nursing Care Before choosing a home, contact the Long-Term Care Ombudsman Program of your Area Agency on Aging. Ombudsman programs promote the highest quality of life and care for residents of nursing facilities and can help families and staff with inquiries and complaints. Tell the ombudsman which options you are considering and request any information they may have. Visit your prospective communities at different times of day. Talk with residents. Be persistent about getting your questions answered.
Retirement Communities Offer Something for Everyone
Offering everything from low-maintenance homes to luxury apartments, retirement communities in the Mid-Atlantic Region are as distinctive as their residents. Local retirees have a seemingly endless array of options to choose from when selecting their new home. However, before they can select the appropriate community, retirees and their loved ones should be sure to fully understand all the options. Learning the basic terminology used in the retirement living industry will help consumers begin to consider and compare options. The chart after this article features a list of communities that offer a variety of retirement living options. Continuing Care Retirement Communities The wide range of retirement living options starts with Continuing Care Retirement Communities (CCRCs), which generally feature care options ranging from independent living to long-term nursing care on one campus. Residents can transfer to higher levels of care as needed and enjoy a wide array of amenities and activities. CCRCs offer long-term contracts that guarantee lifelong shelter and access to specified health care services. Most CCRCs establish requirements for incoming residents based on age, financial assets, income level and physical health. Residents are typically expected to move in while they are still independent to get to know the community. In return for guaranteed lifelong shelter, amenities and health care, residents usually pay a lumpsum entrance fee and regular monthly payments. Independent Living Communities For seniors who want to leave the burdens of home maintenance behind, Independent Living Communities may be the ideal option. In addition to property upkeep, these communities also generally offer 24-hour security and activities to keep residents engaged. Independent Living Communities are similar to any apartment, condominium or single-family development, except that they provide special services including security and activities. These communities typically offer a full range of activities such as shopping trips, outings to cultural events and organized gatherings that promote socialization. Many communities also feature tennis courts, swimming pools, activity rooms and other amenities to keep residents active and engaged. Assisted Living Communities Individuals who need assistance with the activities of daily living—including eating, dressing, walking, transferring and toileting—may want to consider an Assisted Living Community. In addition to daily assistance, these communities also offer activity programs to fit the interests of almost any resident. As opposed to Independent Living Communities, health care services are available at Assisted Living Communities. Residents of assisted living generally need some assistance with at least one of the activities of daily living. They may also need transportation assistance and help with housekeeping and laundry, all of which are typical offerings. Additional amenities can include private units, state-of-the-art facilities, beautifully decorated common areas, barber shops and beauty parlors, pharmacies, physical therapy services, recreation rooms, libraries, gardening areas, fitness centers, and many others. Nursing and Rehabilitation Centers Finally, whether for a short-term rehabilitation or a long-term medical stay, Nursing and Rehabilitation Centers are a vital senior living option. These centers are equipped to help residents heal and/ or maintain their best quality of life and often feature a full schedule of activities. At a Nursing and Rehabilitation Center, care is administered by professionals under the direction of a physician. Many facilities also offer sub-acute, respite, rehabilitation and other short-term care. Rehabilitation services can be especially helpful for individuals who are recovering from surgery or an illness. Choosing a Community After selecting the type of community that best fits their wants, needs and budget, retirees should start calling individual communities to request additional information. Communities will also likely have detailed websites, as well as staff members who will be happy to answer questions about the property. When researching potential communities, retirees should be sure to ask about admission and discharge criteria. Prospective residents should fully understand the entrance and monthly fees, as well as any additional fees that may be incurred. Finally, potential residents should ask about amenities, activities and resident involvement. Once they have narrowed their search down to a few communities, potential residents should plan on-site visits with friends or relatives. Only by visiting a community in person can individuals get a true feel for the lifestyle residents enjoy.
Partnering our way through happily ever afters and the occasional horror story
By Buckley Fricker, J.D., CMC Elder Law attorneys focus much of their time on drafting documents to ensure for quality of life through Advance Directives. They also make sure the financial picture is handled according to the client’s needs. From revocable or irrevocable trusts to Power of Attorney documents (POAs) to naming joint or successor agents, Elder Law attorneys can handle all the legal needs of seniors and their families. Some Elder Law attorneys also act as a variety of agent-types, just like family members of clients. They can serve as Guardians Conservators, POAs, and Trustees (hereafter simply known as “agents”). Sometimes the client’s family members are available to serve as agents, and do a great job. There are plenty of happily ever afters out there. Other times, though, there are no suitable family members available, either because there actually are none, or because they aren’t “suitable.” “Un-suitable” can result in a wide variety of scenarios, some of which are sadly comparable to either dark comedies or horror stories. Enter the Aging Life Care Manager also known as Care Managers or Geriatric Care Managers (GCMs). Aging Life Care Managers are professional guides and advocates for families who are caring for older relatives or disabled adults. On the national level, these professionals are represented by the Aging Life Care Association. Elder Law Attorneys Hiring Care Managers One common joint effort between Care Managers and Elder Law attorneys occurs when the Elder Law attorney is the agent for an individual client. The attorney agent hires and directs the Care Manager to assess the client and come up with a care plan. Once the attorney approves the care plan, he or she hands the Care Manager the power of implementation. The Care Manager sets off on their gallant horse to ensure the best possible care for the client over sometimes quite treacherous terrain. Care Managers are often called upon to mediate family feuds, locate the best placement or secure home care for a client. They also make sure that care plans continue to be the best fit over time, as well as change course when needed. They make and attend appointments and procedures. Finally, they are the advocates in all sorts of circumstances: medical, entitlement benefits, social and emotional wellbeing and more. Planning Ahead for Care Management Needs A growing trend is for people who are having Estate Planning and Advance Directives drafted by an attorney to include language in anticipation of needing a Care Manager in the event of incapacity. For instance, a Care Manager may be needed if there is an illness or disability that leaves an individual unable to manage his or her own care. Many people realize that their “agent-family-memberin- charge:” a) likely has a job and a family of their own, and b) doesn’t happen to be an expert on elder care. Planning for the inclusion of a Care Manager’s assistance, if needed in the future, can be accomplished through elder law documents. Some documents can “direct” the agent to hire a Care Manager (meaning the agent pretty much has to hire one), and some documents state the agent “may” hire one. This distinction can have to do, for example, with whether the document is a POA, with “may/ suggest” type language, or a Trust, with “may, direct, or shall type language.” The estate planning client who may be interested in including Care Management planning should discuss reasons for differences in wording with their attorney. Scenarios where such a discussion may be necessary could include: the Client’s level of confidence in the agent (will they really do what I want them to?), or the client’s confidence in the future care budget (will my funds support making my agent hire a Care Manager, or should I just suggest it)? The Client-Centric Approach Whether through planning documents to arm the client with tools like Care Management Experts, or by hiring one themselves in their capacity as an agent, Elder Law attorneys can literally save the day. The Aging Life Care Association has a cavalry of Care Managers ready to make that happen. Thank you to the Aging Life Care Association™ for permission to share this information. You may learn more about Aging Life Care™ at aginglifecare.org.
Easy Steps for Maintaining Balance as a Caregiver
By Linda Fodrini-Johnson, MA, MFT, CMC, Aging Life Care Association™ Member and Fellow of the Leadership Academy As adult children caring for our parents, we may not be able to reverse the inevitable end-of-life issues our parents are facing, but we can prepare ourselves with information ahead of time so there are fewer surprises. Tackle the challenges that come with caregiving and create a more balanced life by following these easy steps. 1. Establish Connection Through Honest Conversation The goal here is to gather information about your parents regarding the present and the future. The first conversation about these important issues may be uncomfortable; it may take a few conversations before your parents are willing to give up a little control and plan with you for their future. Your goal is to get your parents’ answers to all the “what if ” questions now, so you can all reduce any confusion and indecision during an actual crisis. • Planning the Conversation - Make a list of your concerns. Base them on your own observations and those of others who are close to your parents’ situation. Prioritize the list with what you see as the most important issues at the top. • Starting the Conversation - The approach you take with your parents is key to having a successful conversation. Think through your points very carefully and write them down to help you keep on track and grounded. The goal is to engage your parents in a meaningful conversation about what supports they might accept now and what they might consider in the future. • Goals by Necessity - As mentioned above, it might take a few conversations before your parents are ready to be co-planners with you. The following are the most important issues to cover in that first, or a subsequent, conversation: • Insurance information, • Medical information, • Legal information, • Financial information, • Day-to-day issues, • Emergency call information, • Social information, and • Cognitive information. 2. Assemble Your Team A family member who tries to fly on their own as a family caregiver can bring on some unintended dangers to their own health and the health of their parents by not knowing the right approaches to take or resources to use. You need a “home team” approach to reduce the likelihood that you will suffer from “burn out,” lose wages, sacrifice your career or your marriage, or miss out on activities that you hold dear and that keep your own engine revved. A team can help you maintain balance in your life and can include: • Family and sometimes friends, • Skilled caregivers, • An Elder Law Attorney, and • An Aging Life CareTM professional. If your parents have a low income, you can look for services through nonprofit and government agencies including: • Catholic Social Services; • Jewish Family Services; • Lutheran Family Services; • Your Local Area Agency on Aging –www.eldercarelocator.gov will lead you to an office near your parents; and • Community organizations and services for low-income residents. 3. Protect Your Health Without a sound body, successful family caregiving can be seriously derailed. The stress from caring for older parents can challenge every aspect of your life – work, parenting, exercising, partner relationships and more. Here are some simple guidelines for caring for you: • Have annual physical examinations; • Stick to, or adopt, a healthy diet; • Sleep well; and • Get moving. 4. Maintain Positive Mental Health Everyone on the team who is helping and caring for your parents needs to have a good sense of self and be open to working well with each other. You all possess different gifts and skills, so sorting out who can/will do certain things helps everyone. But even cooperation doesn’t shield us from many of the feelings that arise when caring for others. Even if we see ourselves as mentally healthy, and our lives as well balanced, we need a way to express our emotions to maintain a positive existence. It’s normal to experience times when we feel a little sad, confused, angry, depressed, or disappointed in ourselves or in others. Here are some helpful skills to cultivate: • All of your emotions are valid. Acknowledging how you feel is the first step toward overcoming negative feelings or accepting occasional negative feelings as part of the caregiving process. • Learn to accept those negative or difficult feelings as normal and temporary. • If the burden of sadness is overwhelming for you, it might be time to see an Aging Life Professional or a Licensed Mental Health professional. • It can be easy to get swallowed up in the pain of loss and become isolated. Life is both joy and loss, not just one or the other. Reach out to friends and skilled professionals to help you “right your ship” and sustain you through the journey. • Those caregivers who ask for help are better able to balance caregiving, family, career and self-care than those who do not. • Support groups provide an extra layer of support as a place to listen to others in a similar situation. 5. Use Mindfulness to Create and Sustain Balance Mindfulness activities are those exercises that help you get your mind to a place of relaxation, temporarily disconnected from the thoughts of everyday living. The exercises are purposeful and done with the intention of renewing your mind and body. Some of the exercises take just a few moments, while others might last an hour or more. Some different ways to practice “Mindfulness” include: • Meditation; • Prayer; • Yoga; • Nature walks; • Guided meditation (you can purchase or download CDs and DVDs online); • Relaxation Exercises; • Some forms of massage can be accompanied by “mindfulness” exercises; • Using a simple “mantra” – something you say internally as you take a sip of any fluid, such as, “peace is filling my mind and body;” and • Breathing exercises. 6. Maintain Your Gains Hopefully you have reached some significant milestones: 1) You have had meaningful conversations with your parents and created an equitable plan with them, 2) you have assembled your care team and set your plan in writing, and 3) you have learned the tools you’ll need to keep yourself healthy and your life in balance. Your newest task is to maintain all your gains. Like any new habit or program we start in our lives, it’s easy to slip up and fall back into old habits if we don’t make a conscious effort to stay on course. A crisis can happen with your parents at any time. It might be a medical incident; an environmental issue, such as a blizzard, hurricane or earthquake; or a financial stumbling block. Avoid the escalation of problems and stress by maintaining control and being ready to act in any emergency. Periodic check-in visits with an Aging Life Care Professional are very helpful to keep things stable. If your parent suffers with extreme memory loss or disorientation, remember that dementia is a bit of a moving target; you need professional oversight to make sure that you are addressing small issues as they come up, instead of waiting for a crisis. An Aging Life Care Professional will look for signs that might topple your progress, and address them before they become amore serious threat. Linda Fodrini-Johnson, MA, MFT, CMC, is the Founder and President of Eldercare Services in Walnut Creek, CA. She is also a partner of the VillagePlan. Linda is a Fellow of the Leadership Academy and past-president of the Aging Life Care Association. Linda has over 30 years experience working as a Care Manager. You can reach her at [email protected], or connect with her via social media: Facebook, Twitter, and LinkedIn. Thank you to the Aging Life Care Association™ for permission to share this information. You may learn more about Aging Life Care™ at aginglifecare.org. |
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A publication produced by the Aging Life Care Association - Mid-Atlantic Chapter