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Published in U.S. 1 Newspaper on June 14, 2000. All rights reserved.
Options in Elder Care
Program directors of clubs and business organizations
can schedule a presentation on the hot topic for the boomer generation,
elder care. Carol Johnson of the Lawrenceville-based Senior
Options offers just such a program, called "Navigating the Maze."
She sorts out the alternatives available, including home health care,
live-in custodial help, nursing home placement, assisted living communities,
and continuing care retirement communities (CCRCs).
Senior Options, established a couple of months ago, provides professional
nursing assessments and care planning, care monitoring, and assistance
in choosing living alternatives (609-620-9682; fax, 609-620-1836,
www.home.net~cmjpp). "Our goal is to preserve the dignity and
independence of the individual," says Johnson.
To the business of helping people choose alternatives, Johnson brings
a varied set of experiences. The daughter of a master sergeant in
the U.S. Air Force, she grew up in Baltimore and has two grown daughters.
After 10 years as a registered nurse, she went into real estate, managed
the Princeton Junction branch office of Richardson Realty, and then
worked at two continuing care retirement communities (Presbyterian
Homes at Meadow Lakes and Monroe Village) and was marketing director
at Morris Hall, St. Mary’s residential and assisted living community.
Johnson is licensed in New Jersey as a registered nurse, an assisted
living administrator, and a real estate associate-broker.
"I cannot believe the calls I am getting," says Johnson. "Discharge
planners call me to help clients decide what their options are. If
someone is discharged to their family’s rather than their own home,
I tell them about their options. A lot of people don’t understand
the advantages and the limitations of the assisted living facilities."
Though there are other geriatric counselors in the area, Johnson brings
the experience of an R.N. and an administrator to her work. At an
hourly rate of $55 she helps individuals and families decide whether
to try to stay home or get placed in a facility. "New Jersey provides
some counseling assistance, but what I do is narrow it down locally
and to a particular facility. I specialize in Mercer, Bucks, Yardley,
South Middlesex — I know those facilities backwards and forwards."
For $300 she can also do a full nursing assessment and report that
can be used for an application to a facility. "The facility will
have a better idea of whether that person meets the requirement,"
she says. "The average assessment takes two to three hours."
"Many people want to be reassured they are doing the right thing
for their parents," she says. "I have worked hands-on and
know how the facilities operate."
Most people don’t realize that — unlike nursing homes — each
assisted living facility can have its own admission and discharge
criteria. "In one assisted living home you could be incontinent
and be able to stay. In another, if you became incontinent, they could
discharge you," she says. Another common misconception is that
Medicaid can pay for assisted living stays. "There are no assisted
living communities in Mercer County currently accepting Medicaid,"
says Johnson. Most people also don’t know:
assisted living is not covered by Medicare.
than nursing homes. For example, assisted living staff ratios —
in most instances — are left to the provider to determine.
will have to find other placement. And though you may financially
qualify for a nursing home under Medicaid, you may not medically
qualify for a nursing home.
end up costing more than a nursing home. This still will not be the
24-hour skilled nursing supervision that a nursing home provides.
options is difficult. and many people don’t know how to do it.
obtainable. Facilities are required to make them available upon request.
of my calls are from women in their 70s and early 80s. They are taking
care of a spouse, or they realize their home is becoming too large
to take care of, with the yard work and the steps, and they starting
to feel overwhelmed. They are researching for the future."
— Barbara Fox
08648. Carol Johnson. 609-620-9682; fax, 609-620-1836. Home page:
High tech companies are in vogue, and Velvet G. Miller’s
new company — My Parent’s Concierge — does have some high
tech aspects. But you can’t take good care of an elderly person without
having some old-fashioned person-to-person encounters.
"Some have called us a high touch company," says Miller. "I
am proud to be that. We are a personal brokerage service for those
making decisions on behalf of elder and dependent relatives. We emphasize
sensitivity in whomever we deal with, across all cultures." Her
"concierge" service can take care of anything from paying
household bills to making health care arrangements.
Miller has been a nurse, a teacher, a social activist, and a policy
maker. A native of Reading, Pennsylvania, with degrees from Wagner,
Temple, Harvard, and Boston University, she was executive director
of a program for Robert Wood Johnson Foundation and deputy commissioner
of the state department of human services (U.S. 1, February 3, 1999).
With Miller in the business are her husband, Cal Davis, an administrator
at the University of Medicine and Dentistry, and Judy Denby,
with more than 20 years experience in home health and a former editor
of the American Nurses Association’s magazine.
Corporations are finding that their employees are taking a lot of
time away from work in order to help with their parents’ care, says
Miller. "Helping with elder care can be a recruiting and retention
"Adult children say that they are being squeezed with competing
commands. We think this is the right niche at the right time,"
says Miller, whose company emphasizes diversity. "We know that
there are populations of color that also have money, and we will pay
attention to that population, too. We have a cadre of colleagues who
are culturally competent in several ethnic groups. If your aunt speaks
Lithuanian, we will send someone who speaks Lithuanian."
"We try to do more than provide information and referrals. We
can take some of the frustration out of decision-making," says
Miller, who considers her client to be the adult child with an aging
parent. "Our job is to help find the full array of services available
— whether finding transportation or a hair dresser, or making
social or living arrangements. We match the needs and present the
Using the services of Mark Feffer of Tramp Steamer Media, she
plans to put up a website that lets each client see the parent’s page
at any time of day or night to find out just exactly what is going
on with that parent. The report might say, for instance, "That
we have spoken with Annie Smith three times this week, have spoken
with three vendors, and the search is going well, that she doesn’t
like the mah jongg club she is with, and we will work to find some
other outlet, and so on," says Miller.
Another potential high tech piece of the interactive communication
system is a hookup via television or computer to allow for videoconferencing.
"I have seen that work and it is glorious," says Miller. "You
can pick up the phone and see your mom and it is like visiting."
"We are not high tech enough for venture capital money," says
Miller. "We are too high touch. But we like the blend."
08618. Velvet G. Miller, CEO. 609-394-7104; fax, 609-394-6501. www.myparentsconcierge.com.
Social workers, health professionals, and others concerned
with the elderly — including the senior citizens themselves —
are invited to two workshops at the Residence at Forsgate. One on
June 15 is free and deals with elder fraud, one on June 21 (for which
a fee is charged) talks about various mental health problems for elder
Always be skeptical of unsolicited calls, says Alyson M. Cook,
who works for the Elder Fraud Investigations Unit in the department
of law and public safety. Cook speaks on Thursday, June 15, at 1:30
p.m. at the Residence at Forsgate in Jamesburg. The talk is free by
reservation; call 732-656-1000.
Frauds range from shady telemarketers, untruthful sales people, bank-based
scams, bad investment advice, and even sweepstakes scams. Cook’s advice:
legitimate . No matter how the appeal tugs at your heartstrings,
check with the Consumer Affairs Charities Hotline.
shipping, or handling.
numbers — to people with whom you haven’t done business before.
to send someone to pick up your money, hang up.
or 800-242-5846 at the Elder Fraud Action Line.
"Always get something other than a verbal spiel for your own records,"
says Cook. Elderly people can lose $5,000 or more per incident of
fraud, yet many seniors fail to admit they have been swindled. They
fear they will be ridiculed or that someone will say they should not
be living alone.
Barbara Andrews LCSW, a psychoanalyst based on
Bunn Drive, leads one of the workshops for the Gerontology Institute
of New Jersey on Wednesday, June 21, at 8:30 a.m. in "Post Traumatic
Stress Disorders." Andrews talks about how up to 10 percent of
the population show symptoms of severe trauma, including depression,
low self-esteem, hyper vigilance, flashbacks, or even pain symptoms.
Up to 60 percent of women, says Andrews, have experienced some form
of childhood sexual abuse.
The all-day seminar costs $60 for seniors who are in the industry,
$30 for those who are not. Call Beverly Sacharow at 732-257-4380,
E-mail: email@example.com. Sacharow says that the institute was founded
20 years ago in Milltown and focuses on educational seminars for which
continuing education credits are available. It also has an extensive
library of video tapes on the subject of gerontology.
Also in the program is Joseph McBride MSW, who focuses on bereavement,
chronic illness, and family issues. In "Death in the Family,"
he explains how to work with families in the grief process — exploring
death and facilitating systematic intervention. Gwenelle S. O’Neal,
on the faculty at West Chester University and a visiting professor
at Rutgers, will discuss "Engaging Clients in Groups," how
helping networks can be effective in treatment.
More important than drafting a will is granting power-of-attorney
to someone to act as your agent should you become disabled, says Marilyn
Askin, an attorney (973-731-2355) and new president of the New
Jersey State AARP. "As far as I’m concerned, a power-of-attorney
is far more important than a will because it protects the quality
of life while you’re alive," says Askin, who discusses "Legal
Tools for Financial Management" on Thursday, June 22, from 1 to
3 p.m. at the New Jersey Law Center in New Brunswick. Martin Cramer
of Ruden and Cramer, another elder law attorney, will also join in
the discussion. Call 800-FREE-LAW.
Roughly 90 percent of people Askin speaks with have wills but only
30 percent have power of attorneys — a legal instrument that authorizes
a person to handle the affairs of someone who is sick, disabled, or
deemed incompetent. Without a power of attorney, says Askin, "somebody
has to institute guardianship, a very lengthy, expensive, and demeaning
process because it strips the person of every civil liberty that they
have. Once guardianship is imposed, the person can’t decide on their
own whether to marry, write a will, or vote — their life is in
the hands of the guardian."
Petitioning for guardianship can also be an expensive process —
involving as many as two doctors and two lawyers to petition for the
guardian. "It may very well be that one of the children wants
to be a guardian and they may come into court and bring their own
attorney," says Askin. "You’re hiring all these people to
do something that could have been done by seeing a lawyer and getting
a good power of attorney drawn up."
In practice since 1970, Askin is an associate professor of law, teaching
elder law seminars, at Rutgers in Newark, where she received her law
degree during the `60s. She’s been working with the senior population
since 1978, when she began directing a free legal service program
for senior citizens in Essex County funded through the Older Americans
Act. "I was part of the generation in the 1950s where Chief Justice
Warren said `If you want to change the world, become a lawyer,’"
says Askin. "I went to law school to help people, not to make
money. Some of the problems with the senior community that we came
across involved these very issues — we wanted to make sure that
people had the proper documents so that they didn’t have to have guardianship
imposed upon them." Askin, who runs a private practice, recently
stepped down from the New Jersey Women Lawyers Association to become
president of NJ AARP.
A power of attorney for a joint bank account can be drafted at the
bank, but for a general durable power of attorney — which covers
all of a person’s assets — see a lawyer. Askin recommends these
you appoint should be the person nearest you," says Askin. "A
parent may favor the older child who lives in California but it’s
much more reasonable to have the person nearest, assuming they’re
trustworthy and capable."
the option to make certain cash gifts to heirs, relatives, or others
in order to reduce the estate’s value to an amount specified by the
IRS as non-taxable. "This year everybody can die with $675,000
and not pay one cent in federal taxes," says Askin. "Let’s
say a person has $800,000. The person who has power of attorney should
have the option to make certain gifts to reduce the estate to under
$675,000." According to tax code, a person can leave any number
of people $10,000 without filing it on their return. "If a power
of attorney does not have a provision to make gifts, often the IRS
can come in and say we’re going to assume that the principal did not
want the agent to make gifts, therefore all the money that was given
away we want back in the taxable estate."
"Sometimes the beneficiary on an insurance policy has to be changed
after a person has become disabled — let’s say the beneficiary
is not there anymore," says Askin.
are deposited directly into an account over which somebody has a power
of attorney, says Askin. Otherwise, should you become disabled, somebody
is likely to get entangled in red tape trying to collect those benefits
on your behalf. "That’s a bit more bureaucratic," says Askin,
"and not as reliable as being able to choose the person you trust."
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