FAQs

1. What are some common reasons that elder mediation is needed? Caregiving concerns; housing, living, or residence concerns; guardianship or pre-guardianship conflicts, financial disputes, decision-making, planning options; sibling disputes, or safety concerns about driving or other safety related concerns are all reasons that families seek elder mediation services.
2. What is care management? What does a care manager do? Care managers are the best asset when an individual is unable to care for themselves or their affairs.  We utilize Certified Care Managers to provide in-depth assessments, develop individualized care plans, and monitor client care needs. Here are some examples of care management duties:
   • Assess the current living environment
   • Identify appropriate and safe living environment
   • Hold nursing home/assisted living communities accountable for safe, appropriate care
   • Connect client with needed services, such as home health or physical therapy
   • Act as liaison to healthcare providers and insurers
   • Address immediate, short-term, and long-term needs
   • Provide customized, sustainable solutions
   • Monitor services to ensure the client’s care goals are met
3. Are your care managers certified? Our Care Managers are certified through the National Academy of Certified Care Managers.

1. What does an Elder Care Coordinator do? An Elder Care Coordinator helps bridge the gap between legal guidance and medical care. This individual helps you navigate the complicated web of medical care while ensuring that your wishes are considered, and your best interest are protected. We can help conduct care assessments, help locate additional services, review medical issue and make referrals to specialists, help you plan for the future, and provide education, counseling and support.
2. Does an Elder Care Coordinator make decisions for me or my loved one? Our goal in elder care coordination is to foster cooperation between all health care and long-term care providers and make sure that you and your family understand the questions being asked and the medical context surrounding your care. You likely don’t have the medical expertise to make a fully informed decision. With an Elder Care Coordinator on your team, you will!
3. What kind of training do you have? Lauren has a BA in Psychology from DePaul University and a Master’s in Social Work from Loyola University., as well as certifications in Crisis Prevention, Mental Health First Aid, Dementia care, and Medicare/Medicaid. Her training and experience help her bridge the medical, emotional, and legal aspects of the aging process.

1. How do you know if you need physical therapy? Physical therapy is focused on improving balance, mobility, functional independence, pain management and overall quality of life. If you have any of the signs below, it may be time to consider whether physical therapy might help improve your quality of life. Remember, this checklist is meant to be helpful, but most interventions begin with a referral from your physician, so don’t hesitate to chat with your caregivers about whether these interventions might be appropriate for you.

• I worry I’ll fall
• I sometimes feel dizzy
• I wear glasses
• I’ve fallen in the past 6 months
• I take several prescription medications
• I often feel depressed or hopeless
• I exercise vigorously
• I sometimes feel unsteady walking
• It’s hard for me to get up from a chair or the couch
• I take extra care getting ready in the morning because I feel off-balance

2. How do you know if you need occupational therapy? Occupational therapy is focused on improving your ability to carry out activities of daily living, or ADL’s. If you have any of the signs below, it may be time to consider whether occupational therapy could be beneficial for you. Remember, this checklist is meant to be helpful, but most interventions begin with a referral from your physician, so don’t hesitate to chat with your caregivers about whether these interventions might be appropriate for you.

• I’m weak from illness or injury
• I’m tired, short of breath, or have trouble doing tasks that used to be simple for me.
• I struggle to bathe, dress, eat, or use the restroom without assistance.
• It’s hard for me to get in and out of chairs, in and out of bed, or in and out of the shower.
• I have fallen frequently, or lose my balance doing certain tasks like tying my shoes.
• I can’t see well
• I have pain when I do certain functional tasks, like buttoning a shirt.
• I use an assistive device.
• I am more dependent on a family or caregiver.

3. How do you know if you might benefit from Speech Language Pathology? Speech Language Pathology, or Speech Therapy, can be helpful in assessing, diagnosing, or treating disorders related to speech, language, communication, cognition, and swallowing. If you have any of the signs below, it may be time to consider whether Speech Language Pathology is appropriate. Remember, this checklist is meant to be helpful, but most interventions begin with a referral from your physician, so don’t hesitate to chat with your caregivers about whether these interventions might be appropriate for you.

• I can’t chew or swallow properly
• I often cough when I eat or drink
• I don’t have much appetite anymore
• I’ve lost quite a bit of weight
• I struggle with carrying on a conversation
• I don’t communicate as much anymore
• I feel confused and have trouble remembering
• My voice is much higher or lower than before
• I have a hoarse or harsh sound to my voice

1. I’ve noticed that my elderly loved one may need some assistance managing their finances. How do I know when to intervene? Talking with an elderly loved one about their finances can be difficult as they may feel embarrassed or defensive. They belong to a generation that was taught to keep their information private and not to share their concerns openly. Even if they need help, they may be unwilling to talk to you because it's "none of your business," or because they're afraid to give up control over their own financial affairs. However, delaying the conversation could prove costly if you see warning signs of cognitive decline or an inability to manage their affairs.
2. How do I talk to my elderly loved one about their finances? If they're reluctant to talk to you, make it clear that you respect their needs and concerns. However, don't be afraid to express your own needs and concerns as well. Their financial situation may impact you also, particularly if they become unable to support or care for themselves. At the very least, you should find out where they keep their personal records; discuss housing, health care, and budgeting issues; and find out what steps they have taken to plan their estate. What if they still refuse to talk to you? If they're capable of managing their affairs for now, you may want to drop the matter and reapproach them later. Or you may suggest that they talk to another family member, a trusted friend, or an attorney or financial professional. However, if you feel that they're no longer competent to manage their own affairs, or that their financial situation is precarious, you should seek out professional advice right away.
3. Do I need a financial planner? If you recently stepped into the role of caregiver for an elderly loved one, or are helping manage their day-to-day affairs, a financial planner can help organize their finances and develop a plan to meet their financial obligations. A financial planner can help you assess their overall financial situation and determine if you need to make any adjustments to their investments or take steps to protect their assets.
4. Will a financial planner help me set up a personalized plan for my loved one? Yes, each plan is developed according to the individual needs of the client. A comprehensive plan includes goal setting, cashflow and budgeting, risk management, tax and investment planning, and estate planning.
5. Will a financial advisor help with more than investments? Yes, a financial planner helps make decisions about what you should do with your money. In addition to investment advice, financial plans include savings, budget, insurance, and tax strategies.
6. Is a financial planner a fiduciary? Financial planners who hold the designation of Certified Financial Planner Professional® (CFP) must always act as fiduciaries when providing financial advice to their clients.
7. Do I need a financial planner if I don’t have a large estate? Everybody can benefit from the advice of a financial planner and many CFPs® welcome clients of all economic backgrounds.

1. When are people eligible to enroll in Medicare? Typically, eligibility begins three months prior to your 65th birthday. Coverage will begin on the first day of the month that you turn 65. 
2. Does Medicare cover Long-Term Care? Medicare does not cover long-term care, but like most things in life, it’s complicated. It is strongly advised that you have a long-term care policy for that coverage, but everyone’s situation is unique. Give Mike a call to talk about your specific situation.
3. What are the different parts of Medicare? There are 4 parts to Medicare: Part A - Hospital Insurance, Part B - Medical Insurance, Part C - Medicare Advantage, and Part D - Prescription Drugs. Each of these has a different purpose, and all of them can work together, depending on your individual situation.
4. When is the Annual Enrollment Period for Medicare? October 15th through December 7th each year. During this window, you are able to change your plan, which then becomes active on January 1st of the following year.
5. What is the difference between Medicare Supplements and Medicare Advantage? Medicare Supplements, aka Medigap, pays for the gaps in Medicare not covered by Parts A and B. The supplement plan will only pay for and cover whatever Medicare pays for and covers. These plans are managed by private insurance companies. Medicare Advantage plans are “all in one” plans that cover all of Parts A and B and some plans include Part D as well. Most plans will also provide benefits that are not included in Medicare, such as Dental, Vision, Hearing, Silver Sneakers, transportation, and more.
   
6. I don’t take any prescription drugs. Do I still need Part D? Yes! Medicare beneficiaries need to purchase a Part D plan whether or not they are taking prescription drugs. If they only have Parts A/B or have a Medicare supplement plan, then they need to purchase a stand-alone prescription drug plan (PDP). The only exception is that those who have Medicare Advantage will not need to purchase a PDP, as long as their Medicare Advantage plan includes a PDP benefit.
7. Can I ever lose my Medicare coverage based on my health? No! You will not be denied coverage for Medicare based on your health.
8. How much does Medicare cost me? As long as you have worked at least 40 quarters in the US, there are no monthly premiums for your Part A coverage. For 2022, there is a monthly premium for Part B that can range from $170.10 - 578.30. Your monthly premium is determined by your income tax return from 2 years prior. Click here to view the current Part B Cost table. These monthly premium rates are evaluated and published annually.
9. What happens to my Medicare plan if I move? If you have a Medicare Advantage plan and you move outside of your plan’s service area, you will have 60 days to choose another plan in your new area. This does not apply if you have Original Medicare (parts A and B) or a Medicare Supplement because they do not have “service areas.” 
10. What happens if I do not apply for Medicare when I am first eligible? If you didn't sign up for Part B when you first became eligible, your monthly premium may go up 10% for each 12-month period you could have had Part B, but chose not to enroll. In most cases, you'll have to pay this penalty each time you pay your premiums, for as long as you have Part B. Further, the penalty increases the longer you go without Part B coverage. Part D also has a penalty if you do not enroll when you are first eligible. The cost of the late enrollment penalty depends on how long you went without Part D or creditable prescription drug coverage. Medicare calculates the penalty by multiplying 1% of the "national base beneficiary premium" ($33.37 in 2022) times the number of full, uncovered months you didn't have Part D or creditable coverage. These penalties can be avoided by either enrolling when first eligible or maintaining “creditable coverage.”

1. What is aging in place? Aging in place is a term used to describe a person living in whatever residence they would choose, for as long as they are able as they grow older. This includes being able to have any services or supports they need over time as their needs change.  
2. What do I need to consider about aging in place? There are many aspects to think about—if staying in your home is important to you, it’s still vital that you consider how to stay safe, get around, and manage your daily activities. Consider the following:
   • How will you get around at home? Are you having trouble walking or moving around the hose? Could that be made better by something like a walker or electric scooter? Is your home layout compatible with these kinds of devices? Our team can help you evaluate your situation and your home environment.
   • How will you get around town? If you’re no longer driving, do you have access to public transportation, taxis, or ride-sharing services? Are you comfortable using these services? Do you have a friend, relative, or neighbor who can help you complete errands or make it to doctor’s appointments? Let’s talk about your situation and your options.
   • Is your environment safe? Are there concerns about crime in your neighborhood? Do you live alone and worry that if you’re sick or hurt there won’t be anyone around to help? Is an emergency alert system appropriate for you? Our team will talk to you about these issues and more, to make sure your plan is sound.
   • Are there changes you can make to your current home that would make your home easier and safer to live in? Don’t underestimate the value of simple changes like a ramp at your door, grab bars/handles in the bathtub or shower, non-slip flooring options, or comfortable handles on doors or faucets that make it easier to go about your day-to-day life. We can make recommendations for small changes that can go a long way, and help you find the right resources to have this work completed.

It might feel like this is a list of reasons NOT to Age in Place, but that’s not true! By considering these options and planning for them, our team can help you find the ideal plan for you, your loved ones, and your environment.

3. How much will it cost to age in place? It’s important to think about how you plan to pay for the help you need. Some types of assistance may cost a lot, but others may be free. Some could be covered by Medicare or private health insurance, and others will not be. Every individual’s situation is unique, but it’s certainly possible that paying for a few services out of pocket could cost less than moving into an independent living, assisted living, or long-term care facility. Reach out to our team to talk about your goals, wishes, and options.

1. What is a professional fiduciary? A person or entity, typically a trust officer, guardian or agent that has the legal responsibility and duty to act in your best interest. We provide critical financial services to seniors, persons with disabilities and children.
2. Why do I need a fiduciary anyway? There inevitably comes a time when your health or lifestyle dictates that you cannot or do not want to be actively handling all aspects of your financial estate.  Often an unexpected illness is the culprit.  When it isn’t illness, it is a lifestyle change that requires a different level of planning for the future.  Either way, having a corporate fiduciary lessens the burden on you and your loved ones and puts the financial work in the hands of professionals.  Only when your situation calls for it, we can step in and immediately begin handling your financial estate, including receiving all income to which you are entitled, paying your bills, managing a home or other real property, managing and safeguarding your investment and retirement accounts, and planning for your future financial needs. Often this level of work is daunting for a family member, who might also be trying to provide for your care and personal well-being.
3. What is the difference between a trustee, an executor, a guardian, and an agent under a power of attorney? With the help of an estate planning attorney, you can give the authority to a person or entity to legally act on your behalf, including managing your financial estate. A trustee has a duty to carry out the wishes and instructions as set forth in a trust document and is typically chosen by you during your estate planning process. A trustee can and often does manage your financial affairs during your lifetime, when you can longer do so yourself because of illness or other unforeseen circumstance. An executor is a fiduciary who carries out your wishes as expressed in your last will and testament, and steps into this role after you have passed. A guardian is a person or entity appointed by a court of law when you have been declared unable to handle your own affairs.  This circumstance usually arises if you fail to set forth your wishes in a properly executed estate plan. An agent under a power of attorney can also handle your affairs while you are living and has a legal duty to act on your behalf and in your best interest. This situation typically arises when you have failed to set forth a complete estate plan, but you have granted someone the power to legally manage one or more of financial or medical issues through a legal document called a power of attorney. 
4. What does this service cost? All professional fiduciaries vary, but most trust departments charge a percentage of total assets under management.
5. What do you mean by “assets under management? Your financial estate, including but not limited to your right to receive income from ANY source, your banking account(s), your investment account(s), your home, your personal belongings, your 401k or other retirement plans.
6. How can I be sure you are carrying out my wishes? A fiduciary has obligations under the law.  A professional fiduciary must adhere to certain standards established by state law (and sometimes other rules such as banking regulations) to manage your affairs as a prudent investor would.  Working with an estate planning attorney to set forth your wishes in a trust or other document, helps ensure that we have a clear understanding how we are meant to manage your financial estate.
7. But won’t a stranger be making decisions about the product of my lifelong work? Hopefully not!  By meeting with and establishing a relationship with the trust officer of Hometown National Bank, you will begin to know us, and we will begin to know you and your care network.  Our goal is to spend time getting to know you and learning how you would like your affairs handled, so that when the time comes we will be well prepared. When an illness or unforeseen event arises, we want to know the people and families on the other end of the equation so that we can serve you to the best of our abilities.
8. What if I don’t have a huge financial estate? We work with people and families of all financial sizes.  It isn’t only the extremely wealthy who need corporate fiduciaries.

9. What expertise do you have to be managing my money? Our team consists of investment and trust officers, as well as support staff to keep your financial affairs running as smoothly as possible.  Our investment committee is constantly researching and meeting to make adjustments to maximize growth or income, according to your needs, and minimize risk. In 2022, we had close to 600 million in assets under management and still growing. Our trust officers include a retirement specialist, an elder law attorney, and a special needs planning specialist.

1. Does Medicare pay for long term care (i.e. Assisted Living)? Medicare does not cover the cost of any long-term residential care, such as assisted living, memory care, or nursing homes. If you are a resident of one of these facilities, Medicare-covered health services provided by the facility are covered as they would be in any living situation. Medicare does not, however, cover any of the costs of residency or any day-to-day care costs to help with things like dressing, bathing, or eating. Services may be covered for short-term stays, but only under specific circumstances and for certain facilities that provide skilled care, such as nursing homes or skilled nursing facilities.
2. Can I bring my pets to senior living? The majority of senior living communities allow pets, including assisted living, nursing homes, and independent living communities. It’s not unusual for the community to have rules or restrictions on the size or type of pets accepted. For example, some facilities may not allow certain dog breeds, or may require pets to weigh less than 20 pounds. Exotic animals such as certain birds or snakes may not be allowed in every building. If you’re looking to bring a pet into your new living arrangement, talk to your Senior Advisor about your furry friend to make sure that we find a community that’s compatible.
3. Where and how do I start downsizing? If you have the luxury to plan ahead, it’s always great to start as soon as possible. Six months or even a year prior to moving into a senior living space is an ideal timeframe to begin making plans—even if you’re still deciding where you will end up. If you don’t have that much time, that’s okay, too. Our team can help advise you on how to organize, what to plan to bring, and how to handle what’s being left behind. Moving is stressful at any stage of life, but with a Senior Advisor on your side, you’ll know exactly what to do. Let us help you get a plan together.
4. Can I furnish/decorate my apartment as I wish? Nearly every community or facility will allow you to decorate your space, but there are often some restrictions in place. It’s not uncommon to hear that you can’t put holes in the walls or to be required to use certain window treatments. You may be restricted on what kinds of electronics can be used in the space for safety reasons. That being said, you can make your apartment feel like home by adding more of your personal style—consider bringing a favorite furniture piece, decorating with framed photos, or bringing your favorite artwork or paintings to make the space feel like your own.
5. When is the best time to look into senior living? There are many pieces to consider, but chances are, if you’re thinking about senior living options, it’s probably time to start looking. There are many of aspects to consider—social health, physical well-being, and safety all play a part. For example, does your loved one need more encouragement to participate in activities or socialize with others? Are you or a family member struggling to get sufficient nutrition? Would they benefit from a lifestyle without maintenance like vacuuming, doing the dishes, or laundry? Do they need assistance with activities of daily living (ADLs) like bathing, eating, or dressing? Would they benefit from medical care coordination as their medical picture gets more complicated? We’d love to talk with you about what your options are, what could be beneficial for you or your loved one, and how we can find the right kind of facility or community for your situation.
6. How can I afford Senior Living? Most families use their own money to pay for assisted living—this money could come from personal savings, pension payments, or retirement accounts. It’s not uncommon for family members to contribute, in addition to the resources you or your loved one have saved for this stage of life. Insurance generally does not cover assisted living, but may cover short-term stays in a skilled nursing facility in certain situations, depending on your policy. Long term care insurance (LTCI) can be used for some types of senior living, but most policies must be purchased before age 80. If you’re not sure how to pay for Senior Living, we’d be happy to discuss your options with you or connect you with a financial advisor who can help you plan for what comes next.
7. What are the different types of senior living options? Senior living comes in many different flavors, and one size does not fit all. You might consider any of the following options: Aging in place, where the older adult stays at home or lives with family. Independent living describes a housing situation designed just for seniors. This includes things like retirement communities, senior apartments, and other senior developments. Residential care homes are smaller facilities that provide care to a small, select group of senior adults; these typically provide a higher level of care than assisted living, but lower level than a skilled nursing facility. Another option is a Continuing Care Retirement Community or CCRC. These communities have space set aside for independent living, assisted living, and skilled nursing, so they can provide a stable home in one location for the rest of your life—you may start in independent living and graduate to assisted living when you need a bit more help with day-to-day activities. The next level of care comes in the form of an assisted living community. These are typically small apartments that offer some assistance with activities of daily living, but are for older adults who are still somewhat independent. Nursing homes, or skilled nursing facilities are best for older adults who need 24-hour supervised care. Each resident receives treatment from an on-site physician and nursing staff, and physical therapy or occupational therapy are often available within the facility. Some facilities have special services for residents with Alzheimer’s or dementia.

1. Is there a difference between home care and home health? Yes, home care is non-medical.  This means that caregivers will help with the activities of daily living (ADLs) such as bathing, toileting, and dressing.  Home health deals with medical issues, such as wood care, medication administration, and more.  Home care is not paid for by Medicare; home health is covered by Medicare
2. I have Medicare.  Does that pay for home care? Unfortunately, it generally does not.  All home care is private pay. Unless you have long term care insurance or veteran’s benefits, home care must be paid for by the individual, not insurance.  There are certain Medicare Advantage programs that will offer limited home care benefits.
3. What are the benefits of using an agency? Agency caregivers are experienced, trained and insured. They have received at least 8 hours of training as required by the state of Illinois.If an accident occurs the agency or caregiver will be responsible for damages. Additionally, if you hire an agency the agency will find a replacement if your caregiver gets sick or goes on vacation
4. What does the caregiver do? In addition to helping with bathing, toileting, dressing and eating, the caregiver can provide companionship and medication reminders.  They can also drive individuals to appointments, grocery shopping, take out the garbage, laundry, and light housekeeping.  All of these activities are necessary for someone to live independently.
5. What is the minimum number of hours I can have a caregiver? Typically, the caregiver works between 4-6 hours.  The reason for this is most seniors require additional time to accomplish an activity.  What might typically take a healthy individual one hour to accomplish can take two hours for someone who has health issues.  Additionally, the additional time allows the caregiver and the client to establish a rapport.  
6. I am receiving OT, PT, and home health. Why would I need home care? Those are wonderful services.  But they will not be there every day for an extended period of time. Caregiving takes much more time than people realize.

1. How is hospice paid for? Most people receiving hospice care are covered by the Medicare Hospice Benefit. The Medicare Hospice Benefit covers 100% of the cost for hospice. Medicaid and most private insurances cover 100% of hospice care as well.   
2. What are the services provided with hospice?
   • Visits from the hospice team who will manage the patient’s pain and symptoms
   • Assists the patient with the emotional and psychosocial and spiritual aspects of dying
   • Provides needed drugs, medical supplies, and equipment
   • Coaches the family on how to care for the patient
   • Provides bereavement care and counseling to surviving family and friends.

Note: The hospice team is available 24/7.

3. Who qualifies for hospice care? Hospice care is for any person who has a life-threatening or terminal illness. Most reimbursement sources require a prognosis of six months or less if the illness runs its normal course in order to cover the expenses associated with hospice care.
   
   
4. How is hospice different from palliative care? Hospice care is appropriate when curative measures are no longer available or when a person has opted out of further curative measures; at this stage, the focus is on comfort. Palliative Care focuses on symptom management while one is receiving aggressive treatments.
5. Where is hospice and palliative care given? The Hospice and Palliative teams come to your home wherever you call home. Including nursing homes, assisted living communities, hospitals, and care centers.
6. Can I keep my Physician? Yes, your primary care physician plays a key role in your care. 
7. Does hospice mean I will die soon? Although your physician and the hospice medical director will have to certify that you have a life-limiting illness that could take your life in six months or less if left untreated, utilizing hospice care does not mean you will die within that time frame. In fact, studies have shown that people actually live longer on hospice care, compared to those that have not accepted hospice care. 
8. Do I need to be homebound to receive hospice? No, hospice concentrates on your life. Hospice patients are encouraged to get out and live as much as they safely can. Some individuals under hospice care even take extended vacations.
9. Does hospice provide caregiver services? No, Hospice will provide Hospice Aides for limited personal care visits like bathing, but they are not available to provide custodial care or sitter services. 
10. Who makes up the hospice team? The interdisciplinary team usually consists of:

• The patient’s personal physician
• Hospice physician (or medical director)
• Nurses
• Hospice aides
• Social workers
• Spiritual care providers or other counselors
• Bereavement professionals
• Speech, physical, and/or other occupational therapists
• Trained volunteers

• What is mental health and what do I do if I’m worried about mental health? Mental health is a catch-all term that refers to our emotional, psychological, and social well-being. A person’s mental health will affect how they think, feel, and act, a and can be reflected to the world in how they relate to others, make decisions, and handle stress. While people are often reluctant to seek help with. Mental health issues, particularly older adults, talking with a clinical professional about the challenges you’re facing can immediately improve your quality of life. As a clinical psychologist, Dr. Olesia Shalayska has a wide range of tools in her toolbox to help you or your loved one live their best life.
• How can I prevent mental health problems? There are a number of steps you can take to help avoid or prevent mental health problems, but know that no one solution will work for every individual. Eating healthy, staying in contact with friends and loved ones, or participating in activities that bring you peace and joy are small steps you can take, but many people need the help of a professional, and that’s okay! Ultimately working with a doctor or therapist to understand your mental health challenges and develop coping strategies and exploring treatment options will be most helpful.
• What do I do if I’m worried about a family member’s mental health? There are a lot of reasons you might be worried about a family member or loved one’s mental health. Changes in behavior or attitude can be obvious and immediate or happen more gradually. The best thing you can do if you’re worried about a family member’s mental health is to encourage them to seek help from a professional. If your loved one is in crisis and in danger of hurting themselves or others, please treat that as an emergency and seek professional assistance immediately.
• I’ve noticed functional changes in my parents, what do I do? It can be overwhelming when you start to notice changes in your older loved one, but it is a natural part of the aging process. There’s a lot to consider and it’s easy to feel overwhelmed yourself. It may help to consider that when you’re facing what feels like an endless chain of decisions, if you consider thoughtfully with a focus on what’s best for your loved one, there aren’t any “wrong” choices, just the best choice that you could make at the time. The team at Aging Care Solutions is a great place to start—let’s talk about your situation, your parent’s situation, and what the best possible outcome would be. We’ve brought together a team of experts with knowledge in everything from legal to medical to social wellness to mental health. Our goal is to provide a whole suite of solutions and help you consider your options from all angles.
• How do I deal with anxiety or depression? Depression and anxiety are serious issues that can affect the way you feel, act, and think. True depression and anxiety are medical conditions that require treatment from a doctor. While family and friends can help you find treatment or support you through the journey, your friends and family cannot solve the issue completely. There are many options for treatment, including psychotherapy and medications, but to know what’s right for you or your loved one, we recommend that you speak with a professional. Contact Dr. Olesia Shalayska to talk about how you or your loved one are feeling and discuss treatment options. While depression and anxiety are common among older adults, neither should be written off as “just a normal part of aging.” We can help.
• What is psychological vs neuropsychological assessment? You may hear these terms used interchangeably in conversation by the average person, but psychological assessments and neuropsychological assessments are two different kinds of assessments with different approaches and purposes. Psychological testing involves an evaluation by a clinical psychologist, and relies on the psychologist’s evaluations of behaviors, medical history, mental health history, answers to questions and other factors to either diagnose a condition or clarify a diagnosis. Neuropsychological testing is a specialized type of testing that covers a wide range of cognitive and behavioral assessments to determine cognitive abilities, sensory perceptions, motor function, executive function or problem solving, language abilities, information processing and more. To determine the type of evaluation or assessment appropriate for your or your loved one, contact Dr. Olesia Shalayska to learn more.
• What are some of the warning signs of mental illness? More and more of us are helping to care for older adults, so it’s important to understand some of the warning signs of mental illness in this group. It may be different than what you’ve come to expect from television or movies. When you think about your loved one and their behaviors, consider the following: Has your loved one shown an increase or decrease in appetite (or the accompanying weight loss or weight gain)? Are there any changes in how they approach personal care? If Grandma has a years’ long habit of getting her hair done every week and then starts skipping those appointments, it could be a sign that something is wrong. Are there signs that your loved one is withdrawing from social activities or becoming more isolated? When your father stops attending his regular poker game or withdraws from his church community, it could be a sign that more is going on behind the scenes. Are you seeing signs of memory loss? While a certain amount of cognitive decline is normal, serious and escalating memory problems, like misplacing belongings, not recognizing people known to your loved one, or asking questions again that they just asked can all be signs of a more serious issue. Ongoing and increasing depression or anxiety is another sign to look out for; if untreated, depression or anxiety in older adults can become severe. If you or your loved one are noticing some of these warning signs, know that you don’t have to accept any of these signs as irreversible or an inevitable part of aging. Olesia Shalayska has experience in treating older adults and is committed to helping you or your loved one live their best life. You’re not alone; we’re here to help.
• What are the warning signs of dementia? Whether you’re concerned about your own mental health or someone you care about, it may be helpful to consider the warning signs of dementia. Here are some signs to keep an eye out for:
• Difficulty performing daily tasks: Is your loved one forgetting how to do part of their typical routine, like preparing a meal or playing a game they play often?
• Day-to-day memory loss: While it’s normal to forget an appointment or phone number every now and then, when this begins to happen regularly, it may be a sign of a larger problem.
• Disorientation of time or place: We all have days when we forget that it’s Thursday or walk into a room and forget why we’re there, but this sign goes beyond that. When normal memory challenges escalate to dementia, your loved one might get lost in a familiar area or not know how to get home from a friend’s house that they visit often.
• Impaired judgement: Again, we all make questionable choices from time to time—maybe you know you should go see the dentist for that tooth sensitivity, but you’ve been putting it off due to scheduling or expense. A person living with dementia may experience broader changes in how they make decisions, such as wearing winter clothes on a hot day or making a conscious decision to ignore a pressing medical issue.
• Misplacing things: Anyone can misplace their phone or car keys—that’s not unusual. Like many of these signs, an occasional misstep is not necessarily indicative of a larger issue. But someone living with dementia is significantly more likely to misplace items because they’ve put them in an inappropriate resting place. For example, putting cans of soup in the refrigerator instead of the pantry, or putting the TV remote in the microwave.
• Changes in personality: Are you or your loved one behaving in a way that’s out of character? Suddenly becoming confused, suspicious, or withdrawn from activities or settings that previously created a feeling of excitement or engagement? A person living with dementia may experience striking changes in personality such as these.
• Changes in mood and behavior: We all have a bad day sometimes, and it’s perfectly normal to have an “off” day from time to time. A person living with dementia, however, is more likely to experience large mood swings, from tears, to anger, to calmness, for no apparent reason.
• Difficulty understanding visual or spatial information: This sign can include things like double vision, or problems navigating a space, like avoiding the edge of the coffee table or struggling to place a notebook on the side table accurately. Like many of the warning signs in this list, dementia isn’t the only reason a person might struggle with these tasks, but it’s worth ruling out.

If you’re concerned about any of these signs, contact Dr. Olesia Shalayska to discuss your options for assessment and diagnosis. Early diagnosis and intervention of dementia can be extremely helpful in maintaining the best possible quality of life for yourself or your loved one.

9. How do I know if I or my loved on should be tested for dementia? If the issues outlined in question number 8 sound familiar, it may be time to consider an evaluation. You may be tempted to chalk up the changes you’re seeing as a normal part of aging, but when these symptoms go beyond typical age-related changes you should seek out an evaluation to determine what treatments or interventions might be appropriate. Contact Dr. Olesia Shalayska to discuss your concerns.
10. What treatment options are available to improve mental health? Through Peace of Mind Psychological Services, Dr. Olesia Shalayska provides a wide range of services to her patients, including older adults.

• Direct Cognitive Assessments
• Facility Partnerships (Long-Term Care or Skilled Nursing Facilities)
• Patient-Centered Care
• Reduction of Disruptive Patient Behaviors
• Improvement of Patient Quality of Life
• Addressing Mood & Personality Disorders
• Treatment for Depression & Anxiety
• Support for Life Transitioning
• Neurological Testing
• Psychological Testing
• Chronic Illness Support
• Emotional and Psychological Support to Family and Caregivers

In addition to assessment and diagnosis, Dr. Olesia is able to provide ongoing treatment through psychotherapy and medication management.

1. What is the difference between an estate planning attorney and an elder law attorney? Many attorneys can help you plan your estate, but an elder law attorney like Mary Kay and her team at AZ Health and Elder Law are experts in not just estate planning, but Life Care Planning, which encompasses so much more. In addition to the traditional asset-focused elder law services you would expect, our team specializes in providing a wide range of services to support you through legal challenges, asset management, medical care, and family support.
2. What does Life Care Planning mean? A Life Care Plan defines, organizes, prioritizes, and mobilizes every aspect of an elder's care. In addition to traditional asset-focused elder law services that help elders qualify for public benefits while preserving family wealth to the greatest extent possible, a Life Care Plan typically includes provisions legal services, care coordination, health care advocacy, and Medicare and insurance support.
3. Why do I need more than a Will? A will lets you outline your wishes about who gets your assets, from cares to family heirlooms, and who cares for your minor kids if you’re no longer around. But a will won’t let you leave instructions about certain joint assets (like your home that you own with your spouse), assets that have a beneficiary (like life insurance policies) or assets held in a trust. We coordinate these decisions as part of your larger estate plan, which include a will but may also place assets into trusts to make sure that your estate is divided up the right way—your way.
4. What’s the difference between a Will and a Trust? Wills become effective after death, while some trusts take effect as soon as they're signed. Wills direct who receives property, appointing a legal representative to oversee the process. Trusts can be used both during life and prior to your death. Trusts cover only property placed in the trust, while wills cover anything owned by you, the creator of the will. Wills are public record, whereas generally a trust remains private. Guardians for minor children are appointed in a will. It's important to note that trusts and wills can serve together as teammates in a comprehensive estate plan.
5. How do I know when it’s time to act under the Power of Attorney? Powers of attorney grant legal rights to another person if you're unable to make decisions for yourself, such as if you were suddenly on a respirator. When you define your powers of attorney, you will assign tasks concerning your financial affairs and other matters to a person of your choice instead of relying on the courts to appoint a person.
6. What’s the difference between Powers of Attorney for Health and Financial? While the phrase “powers of attorney” refers to the grant of legal rights to another person if you’re unable to make decisions for yourself, there are two primary types of power of attorney: financial power of attorney and health care power of attorney. Under the first type, you will grant legal rights over your financial and other legal affairs to the person you choose should you be incapacitated or unable to make decisions for yourself. Under the second type, you will set forth your health care and end of life medical decisions and name a health care agent to make medical decisions that you can no longer make. A “durable” power of attorney means that the power of attorney remains in effect even while you’re incapacitated.
7. What does a Health Care Advocate do and do I need one? A Health Care Advocate is an individual with experience in health care, social work, and legal work who can help oversee the coordination of your loved one’s health and long-term care. The health care system is complex and being guided through decisions by an experienced advocate can be invaluable. Whether you or your loved one are living at home, in an assisted living facility, or in a nursing home, it’s incredibly comforting to know that his or her care is being coordinated by a team of professionals with extensive knowledge about the costs, quality, and availability of resources in the community.
8. How can you prevent family members from contesting your will? How do you avoid probate? You can make the arrangements more likely to be upheld by ensuring your will is properly executed by working with an experienced attorney. Explain your decisions to your family in the hope you can defuse any problems in advance. Probate is the legal process of administering the estate of a deceased person by resolving all claims and distributing the deceased person’s property. Without proper estate planning, a person’s estate will likely need to be probated, but this can be avoided by proper estate planning with a qualified attorney.
9. What’s the difference between Medicare and Medicaid? While they may sound alike, Medicare and Medicaid are actually two different programs. Both can help you pay for healthcare and medical expenses. Medicaid is a federal public assistance healthcare program based largely on financial need that works differently in each state. Medicare, on the other hand, is an age-based federal health insurance program that guarantees coverage for individuals ages 65 and over and some younger people with disabilities.
10. What is Medicaid Crisis Planning? Long-term illness can quickly deplete an individual’s life savings. There are several ways to afford long-term care, which allows for the preservation of an existing estate plan. Medicaid is one of these options. While Medicare can be used to provide health care services, Medicaid is the only program designed for long-term care assistance. A Crisis Care Plan gives family caregivers the guidance needed to protect the legal, financial, and personal well-being of elderly loved ones who need immediate care outside the home in order to keep them safe. People who benefit from Crisis Care Planning typically fall into one or more of the following categories:

• They are dependent on others for self-care.
• They are in need of long-term care outside the home.
• They are completely reliant on family or professional caregivers.
• Immediate action is needed to pay for care without bankrupting the family.