FAQs

Caregivers of Older Adults

Many older adults need caregivers to help make life easier as they age. The caregiver’s responsibilities depend on the person’s needs and abilities. For example, some older adults only need help with cooking and light housekeeping. Others may require assistance with most or all daily tasks, such as eating, bathing, and walking.

Cancer Caregivers

A cancer caregiver assists a person through cancer treatment. Along with basic caregiving tasks like cooking and cleaning, a cancer caregiver might:

• help the patient make decisions regarding treatment
• help the patient set aside time for fun, relaxing activities
• help the patient decide whether they should continue a certain treatment
• keep track of the patient’s doctor’s appointments
• inform the patient’s loved ones of any treatment-related changes

Chronic Illness Caregivers

A chronic illness is an illness that lasts at least one year and requires ongoing medical care. Examples include diabetes, dementia, and heart disease. Many people with chronic illness require caregivers to assist with daily tasks they can’t perform on their own due to illness.

In addition, since some chronic illnesses prevent people from getting out of the house and spending time with others, a caregiver can provide much-needed companionship.

Mental Health Caregivers

A mental health caregiver assists people with severe mental illness, such as schizophrenia and major depression. Their responsibilities may include:

• monitoring the person’s symptoms
• transporting the person to therapy and psychiatry appointments
• encouraging the person to engage in self-care activities, such as meditation and journaling
• administering medications
• helping the person with employment and finances

Physical Disability Caregivers

Like chronic illness, physical disability can hinder your ability to complete daily tasks and spend time with other people. Thus, like chronic illness caregivers, a physical disability caregiver helps with daily tasks and provides companionship.

They may also help people complete physical therapy exercises to increase strength and mobility.

If you’re caring for someone with a disability, it’s important to get all the help and support you need. Call the Area Agency on Aging (AAA) at 1-800-252-9240 or 2-1-1 to find out what programs are available in your community. Programs may include respite care (a short-term service that gives you a break from your caregiving responsibilities), educational workshops, counseling, and more.

You can also search this website to find more caregiving information, links to on-line resources, information on topics such as stress management, legal considerations, chronic disease, sensory loss, communication techniques, long-distance caregiving, nutrition, and more.

AARP offers this handy booklet with checklists for cargivers titled, Checklist for Family Caregivers. View it online here:  https://www.aarp.org/content/dam/aarp/entertainment/books/2015-04/Caregivers_Excerpt.pdf

Most adult day care centers are located in urban areas, and many portions of Texas have no centers. To find out if there are any in your area, call your Area Agency on Aging at 1-800-252-9240.

Since adult day care centers are expensive to run, they are rarely found outside of urban areas. The National Day Adult Services nadsa.org has a limited number of centers in north central Texas.

In Texas, visit Take Time Texas: https://apps.hhs.texas.gov/taketimetexas/search.cfm

To search by state, Eldercare Locator: https://eldercare.acl.gov/public/resources/factsheets/adult_day_care.aspx

National Adult Day Care Services Association: https://www.nadsa.org/consumers/

Costs for day care vary with the average cost of $33.00 per hour in Texas. Companies usually require a minimum of 3-4 hours per days. Services are generally private pay. Some people have long term care insurance to help with costs.

Although Medicare will not pay for adult care programs, Medicaid may pay in some cases. Call your managed care organization if you have Medicaid and are interested in attending adult daycare. If you don’t have Medicaid, call your Aging and Disability Resource Center at 1-855-937-2372 to see if there are private-pay facilities in your area.

Because of our public funding, this website does not link to for-profit companies including assisted living centers, personal assistance companies, individuals offering respite in their homes, and other options are available in many communities.

Ask other caregivers, older adults, faith-based contacts, or call the area agency on aging or ADRC. In addition, do an online search using search words such as “adult day care for seniors,” and the name or zip code of your community.

Look at the sites listed below for lists of questions to ask a day care center and for in-home providers. Add or remove questions that do not apply to your situation or to that of your loved one.

• National Adult Day Services Association provides Questions to Ask When siting an Adult Day Center
• Alzheimer’s Association Choosing an Adult Day Center
• National Caregiver Alliance Hiring in-home Help

Falling is NOT a normal part of aging.

What falls prevention education programs are available?

• 8 Tips for How Seniors Can Protect Themselves from Money Scams
• 22 Senior Scams You Must Know and Avoid  – An article by the National Council on Aging
• Five Ways to Detect a Phishing Email – an article defining this type of cybercrime (with examples) and how to avoid it.
• New Scams That Seniors Need to be Aware of – an article on the SenorsMatter.com website
• Preventing Home Improvement Fraud – an article by HomeAdvisor.com
• Top 10 Financial Scams Targeting Seniors
• Top Frauds and Scams – an article by AARP
• What to Do Next – if you fall for a cyber scam

Assisted Living is paid by the individual, long term care insurance, and some other options.  https://dailycaring.com/how-to-pay-for-assisted-living-6-options/

Does Medicare pay for assisted living?

Medicare does not cover any cost of assisted living.

It will pay for most medical costs incurred while the senior is in assisted living, but will pay nothing toward custodial care (personal care) or the room and board cost of assisted living. Some Medicare Advantage plans may pay for personal care assistance for persons residing in assisted living or memory care, but will not contribute towards the cost of room and board.

Nursing homes are defined by Medicare as skilled nursing care. Medicare Part A hospital insurance covers inpatient hospital care, skilled nursing facility, hospice, lab tests, surgery, home health care. Medicare pays for skilled nursing care.  Medicare covers up to 100 days of care in a skilled nursing facility (SNF) each benefit period. To be eligible for a new benefit period, and additional days of inpatient coverage, you must remain out of the hospital or SNF for 60 days in a row. The patient pays for more than 100 days  care in a benefit period.

When the patient is no longer about to pay the costs, the patient can apply for Medicaid. Although Medicaid if federally funded, each state manages how Medicaid is providing. If you have a Medicare health plan, your plan may cover them.

What is not paid by Medicare Part A or Part B Some of the items and services Medicare doesn’t cover include:

• Long-term care (also called custodial care )
• Most dental care
• Eye exams related to prescribing glasses
• Dentures
• Cosmetic surgery
• Acupuncture
• Hearing aids and exams for fitting them
• Routine foot care

The American Geriatrics Society (AGS) has released its latest update to one of geriatrics’ most frequently cited reference tools: The AGS Beers Criteria^® for Potentially Inappropriate Medication Use in Older Adults. With more than 90% of older people using at least one prescription and more than 66% using three or more in any given month, the AGS Beers Criteria^® plays a vital role in helping health professionals, older adults, and caregivers work together to ensure medications are appropriate.

Since 2011, the AGS has been the steward of the criteria and has produced updates on a regular cycle. The AGS Beers Criteria^® is an explicit list of PIMs (potentially inappropriate medications) that are typically best avoided by older adults in most circumstances or under specific situations, such as in certain diseases or conditions. For the 2023 update, an inter-professional expert panel reviewed the evidence published since the last update (2019) and based on a structured assessment process approved a number of important changes including the addition of new criteria, modification of existing criteria, and formatting changes to enhance usability. The criteria are intended to be applied to adults 65 years old and older in all ambulatory, acute, and institutionalized settings of care, except hospice and end-of-life care settings.

Published in it’s entirety in Journal of the American Geriatrics Society (JAGS), the AGS Beers Criteria^® serves as a comprehensive list of medications that older people should potentially avoid or consider using with caution because they often present unnecessary risks for this population.

For the 2023 update, an expert panel reviewed more than 1,500 clinical trials and research studies published between 2017 and 2022. The resulting 2023 AGS Beers Criteria® include:

• Over three dozen individual medications or medication classes to avoid for most older people.
• 40+ medications or medication classes to use with caution or avoid when someone lives with certain diseases or conditions.

The AGS Beers Criteria® is also available as a mobile app and as a pocket reference card, both of which can be accessed via GeriatricsCareOnline.org. As with past updates, the AGS has also created a suite of public education materials that are available at HealthinAging.org.

• The intention of the AGS Beers Criteria® is to:
  • reduce older adults’ exposure to potentially inappropriate medications (PIMs) by improving medication selection
  • educate clinicians and patients
  • serve as a tool for evaluating the quality of care, cost, and patterns of drug use in older adults
• The target audience for the 2023 AGS Beers Criteria^® is practicing clinicians and others who utilize the criteria including healthcare consumers, researchers, pharmacy benefits managers, regulators, and policymakers.
• The criteria are intended to be applied to adults 65?years old and older in all ambulatory, acute, and institutionalized settings of care, except hospice and end-of-life care settings.

What are the five Beers criteria?

The American Geriatrics Society uses specific criteria to list potentially inappropriate medications for adults over age 65. The five sections of the Beers Criteria are:

1. Medications to avoid if you’re over 65 years old and not in a hospice or a palliative care setting.
2. Medications to avoid among people with certain health conditions.
3. Medications to avoid that cause drug interactions when combined with other medications.
4. Medications to avoid due to harmful side effects that outweigh the benefits.
5. Medications to use at limited doses or avoided due to their effects on kidney function (renal impairment).

What medications are on the Beers Criteria list?

There are close to 100 medications or medication classes on the Beers Criteria list. The following table isn’t a comprehensive list of all of the medications listed. Rather, it gives an example of a drug in each category and the reason why it’s harmful.

Although the AGS Beers Criteria^® may be used internationally, it is specifically designed for use in the United States and there may be additional considerations for certain drugs in specific countries. Whenever and wherever used, the AGS Beers Criteria^® should be applied thoughtfully and in a manner that supports, rather than replaces, shared clinical decision-making.

Sources: National Library of Medicine; The John A. Harford Foundation; the Cleveland Clinic

If you — or someone you care for — hasn’t lived at home for a while or has had a recent change in functioning, you may be interested in independent living skills training. Skills training can help you master the basics of cooking, using public transportation, keeping up with your bills, using a computer, and other things.

Activities of Daily Living (ADLs) affect a person’s level of independence and ability to care for themselves. How each ADL affects an individual to care for themselves can help determine whether a patient needs daily assistance.

Limited ADLS are not covered by Medicare since they do not require skilled nursing care.

ADLs  include

• Ambulating:
  The extent of an individual’s ability to move from one position to another and walk independently.
• Feeding:
  The ability of a person to feed oneself.
• Dressing:
  The ability to select appropriate clothes and to put the clothes on.
• Personal hygiene:
  The ability to bathe and groom oneself and to maintaining dental hygiene, nail, and hair care.
• Continence:
  The ability to control bladder and bowel function
• Toileting:
  The ability to get to and from the toilet, using it appropriately, and cleaning oneself.

Instrumental ADLs – those that require more complex thinking skills, including organizational skills.

• Transportation and shopping:
  Ability to procure groceries, attend events Managing transportation, either via driving or by organizing other means of transport.
• Managing finances:
  This includes the ability to pay bills and managing financial assets.
• Shopping and meal preparation:
  ie everything required to get a meal on the table. It also covers shopping for clothing and other items required for daily life.
• Housecleaning and home maintenance:
  Cleaning kitchens after eating, maintaining living areas reasonably clean and tidy, and keeping up with home maintenance.
• Managing communication with others:
  The ability to manage telephone and mail.
• Managing medications:
  Ability to obtain medications and taking them as directed.

Causes & Symptoms

Signs of an overactive bladder include urinating eight or more times a day or getting up more than twice at night to go to the bathroom.Most bladder control problems are caused by weak pelvic muscles. These muscles support the bladder and help control urine flow. Other problems may be caused by damaged nerves or effects of medications. Understanding they type os bladder control problem you have is the first step toward treating it.

Here are the primary types of Urinary Incontinence

• Stress Incontinence – Urine leakage when coughing, sneezing, laughing, exercising or straining (causing stress on the bladder), are symptoms of stress incontinence.
• Urge Incontinence – Leakage after sudden strong urges to urinate is a symptom of urge incontinence.
• Functional Incontinence – Difficulty getting to the bathroom “in time” due to problems walking or undressing is a sign of functional incontinence.
• Overflow Incontinence – Overflow incontinence happens when small amounts of urine leak from a bladder that is always full. A man can have trouble emptying his bladder if an enlarged prostate is blocking the urethra. Diabetes and spinal cord injuries can also cause this type of incontinence.
• Mixed Incontinence – Mixed incontinence is a combination of symptoms based on stress and urge.

You are not alone

• As many as 1/3rd of community-dwelling adults age 65 and over experience bladder control problems, or incontinence.
• Although it is more common in women, men also experience bladder control problems.
• As many as half of older women say they have had urine leakage at one time or another.
• Younger women may experience urine leakage while they’re pregnant or after giving birth.
• Female athletes of all ages sometimes leak urine during strenuous activities.

Treatment Strategies

80% of people with bladder control problems can be helped! In most cases, a combination of exercises and a few changes in daily habits will make the difference. Common therapeutic strategies include:

• Pelvic muscle exercises exercises
• Diet/nutritional/Lifestyle changes
• Timed voiding
• Biofeedback
• Medication or creams
• Electrical stimulations
• Surgery

For More Information on Urinary Incontinence
Visit the National Institute of Diabetes and Digestive and Kidney Diseases for more information on

• urinary incontinence in men
• urinary incontinence in women

Different types of facilities provide different levels of care, depending on the person’s needs. Learn about the different types of residential care to determine which one best fits the needs of the person living with dementia here: https://www.alz.org/help-support/caregiving/care-options/residential-care

• Fact sheet listing of housing types: https://www.alz.org/media/Documents/alzheimers-dementia-choosing-residential-care-ts.pdf
• Booklet https://www.n4a.org/files/HousingOptions.pdf, provided by the National Association of Area Agencies on aging, is a comprehensive guide that describes the different types of housing options for older adults and ways to evaluate the choices.

“I want to stay in my own home!”

Staying in your own home as you get older is called “aging in place.”  Many complex issues have to be considered, especially health and mobility. Assessment and, planning, and honesty with health care providers and family are essential  https://www.nia.nih.gov/health/aging-place-growing-older-home

Assisted living communities are a unique option for older adults who are mostly independent but require some assistance with day-to-day living. It combines housing, support services, and health care, as needed.

Nursing homes are generally designed for seniors who require 24-hour medical supervision due to physical or mental conditions that leave them unable to care for themselves.

Memory care is a distinct form of long-term skilled nursing that specifically for patients with Alzheimer’s disease, dementia, and other types of memory problems. Also called Special Care Units (SCUs), memory care units usually provide 24-hour supervised care within a separate wing or floor of a residential facility.

HUD Homeless Assistance Programs

The U.S. Department of Housing and Urban Affairs (HUD) administers a Continuum of Care (CoC) Program that helps people who are homeless move into short-term and permanent housing. HUD awards CoC funds to non-profit agencies for activities that may include the following:

Legal decisions and completed legal forms not only protect the person you care for, but they also protect you, the family caregiver.

Legal documents provide guidance from an older adult about medical care they would like to receive and designates someone to make medical and financial decisions. Completion of legal forms is the only way to ensure that an older adult’s wishes are followed.

As a caregiver, you have no legal authority just because your care receiver tells you what they want. Saying “but he/she told me what to do” does not mean anything without signed legal documents.

These forms need to be stored somewhere that you or the person you care for can get to them 24 hours a day/seven days a week. Copies are acceptable, in most instances. Caregivers need to have copies with them at all times. Remember, banks with a lock box are not open all day or the entire weekend and you may be away from home when the care receiver needs you.

Important Forms – Texas State Law Library For other states, do an internet search entering the name of your state and the name of the form. Form titles vary by state. Contact local area agency on aging, which may have a list of elder law attorneys and those who may do pro bono work. 

• Will: allows you to determine how your property will be distributed after you die.  There is no will template but learn about the types of wills, what you need to consider writing them, and the importance of conferring with a licensed attorney, whenever possible. See below for how to find an attorney.
• Transfer on Death Deed: Like a will, but designed to avoid probate and Medicaid estate recovery. If someone receives long-term care services paid for by Medicaid, the state of Texas has the right to ask for some money back from the estate after the individual dies. To help pay for long-term care services, such as skilled care facilities, every state must have a Medicaid Estate Recovery Program (MERP). There is a review period of financial records for the 60 months/5 years that Medicaid paid for long-term care services before the person died. After review, the state may or may not ask for money back. The state will never ask for more money back than it paid for Medicaid services.
• Statutory Durable Power of Attorney (SDPOA): This form allows you to designate someone to make financial decisions for you.
• Medical Power of Attorney (MPOA): This form allows you to designate someone to make medical decisions for you. Note: This form is not what is usually known as a “living will.” See Directive to Physicians and Family or Surrogates below.
• Directive to Physicians and Family or Surrogates – AKA a “Living Will”: This form documents your wishes in the event you are unable to make your own decisions and you suffer from a terminal or irreversible condition. This form states your wishes if you do not want extraordinary measures taken to keep you alive. Without this form, physician training, hospital, and nursing home policies often dictate the use of “heroic means” to sustain life. For example, “reviving” a very ill person after a stroke, and using a respirator for someone deemed medically “brain dead,” are standard procedures in many hospitals.
• HIPAA authorization to disclose Protected Health Information (PHI) – HIPAA Release (Health Insurance Portability Act), By signing of a HIPAA release form, the patient gives permission to health professionals to talk to anyone other than the patient regarding medical-related issues. Caregivers need to be listed on your care receiver’s medical records. Ask for this form from a physician or at the hospital. You can use the signed HIPAA release with any doctor or in any hospital in Texas. Carry a copy of this everywhere you go.
• Texas Do Not Resuscitate (DNR) form – Informs emergency medical personnel that a person does not wish to receive emergency lifesaving treatment if their heart stops or if they stop breathing. This information is provided for your information only. An Out Of Hospital DNR Order is executed by a doctor and must be kept with the person at all times.  Caregivers should also carry a copy.

If you need general information on basic legal documents, you can contact your local area agency on aging by phone or online or call 211 for help in locating experienced attorneys, some forms, and other information.

Advance Directives – Documents that allow a person to state their health care treatment preferences and to designate someone who can make decisions if they should become incapacitated. A family member or other caregiver has not authority to tell health care staff the patient’s wishes without the legal authorization. These include Directive to Physicians and Family or Surrogates ES, and Out-of-Hospital Do-Not-Resuscitate (OOH-DNR) Order.

Also see Frequently Asked Questions for Mental or Physical Disability – discusses forms listed above as well as other concerns family caregivers often have about legal issues.

Resources – Use the resources listed below or contact local area agency on aging or call 211

• Legal Aid of Northwest Texas –  Choose a Texas County for the local phone number to call.
• Texas Legal Services Center (TLSC) or call 1-800- 622-2520. TLSC may be able to help if you can’t afford to pay an attorney. It provides legal information and referrals.
• Texas State Bar Lawyer Referral Service or call 1-800-252-9690. Based on your legal needs, it will connect you with an attorney who specializes in your subject area and agrees to provide a half-hour consultation at a minimal cost.
• NAELA – National Association of Elder Law Attorneys – Enter a zip code to find a list of attorneys. These attorneys specialize through training and experience in elder law and special needs law.

• Contact your local County Bar Association – ask if any of the members are elder law specialists providing pro bono (free) services, at least for a consultation.
• Some large churches can help people find lawyers who are willing to provide limited pro bono advice to persons with low incomes.
• Ask family and friends for recommendations of attorneys they have used. Remember, not all attorneys specialize in elder law, even if they state they specialize in probate law.

Ask questions

No matter how you find a prospective lawyer, the following questions can help you compare experience and cost:

• How long have you been in practice?
• Do you specialize in a particular area (e.g., estate planning or elder law)?
• How long have you been specializing in this area?
• What are your fees?
• Do you offer free consultations?
• What is the average charge for the type of consultation I need?

These discussions with the person who you care for are not easy. Emphasize that the purpose is to follow their wishes and take care of important medical, legal, and financial issues only when they are unable to do that for themselves.

Disclaimer: No documents or information provided here or anywhere on www.familycaregiversonline.net should be considered legal advice, or intended to replace a formal discussion with a licensed attorney with experience in elder law.

Thanks to attorney Greg Zambie, Texas Legal Services, for review and edits.

Edited by Zanda Hilger

You might check with family and friends. You might also contact the Texas State Bar Lawyer Referral Service, at 1-800-252-9690. Based on your legal needs, it will connect you with an attorney who specializes in your subject area and agrees to provide a half-hour consultation at a cost of $20.

No matter how you find a prospective lawyer, the following questions can help you compare experience and cost:

• How long have you been in practice?
• Do you specialize in a particular area (e.g., estate planning or elder law)?
• How long have you been specializing in this area?
• What are your fees?
• Do you offer free consultations?
• What is the average charge for the type of consultation I need?

If you can’t afford to pay an attorney, the Texas Legal Services Center (TLSC) may be able to help. It provides referrals to lawyers — often within the legal aid network — legal information and legal advice. Its attorneys have expertise in topics including public benefits, private pensions, crime victims’ rights, health insurance, nursing home regulations, kincare, consumer protections, and veterans’ issues. To contact TLSC, call 1-800- 622-2520.

If you’re a veteran, you may be eligible for the Veterans Administration’s (VA) healthcare benefits, community-based home care, or disability pensions.

The VA provides healthcare benefits (treatment/medication, etc) to veterans that have a service connected medical condition or meets the income limits under poverty levels. This is verified by filling out VA Form 10-10EZ (Enrollment Application for Health Benefits). Once the veteran is approved, they can contact their nearest VA hospital for care.

Aid & Attendance — VA Aid and Attendance or Housebound benefits provide monthly payments added to the amount of a monthly VA pension for qualified Veterans and survivors. If you need help with daily activities, or you’re housebound, find out if you qualify. Learn about eligibility and how to apply here: https://www.va.gov/pension/aid-attendance-housebound/

The Texas Veterans Commission is a state government organization that provides assistance to all veterans regarding benefits at federal, state, and county levels. For more information regarding types of services provided please visit the following website: https://www.tvc.texas.gov/

The VA provides housing resources to veterans under the VASH voucher program. Veterans need to apply by calling the Fort Worth Office at 817-255-7150, this program is designed mainly for homeless veterans. VA also provides financial assistance for housing modifications in order to assist veterans with certain disability needs.

• U.S. Department of Housing and Urban Development – Veterans Assistance Supportive Housing
  The U.S. Department of Housing and Urban Development – Veterans Assistance Supportive Housing (HUD-VASH) Program is a joint effort between HUD and the VA to move veterans and their families out of homelessness into permanent housing. HUD provides housing assistance through its Housing Choice Voucher Program (Section 8) that allows homeless veterans to rent privately-owned housing. The VA offers eligible homeless veterans clinical and supportive services through its health care system.
  The HUD-VASH Program is administered by public housing authorities (PHAs), and the VA provides dedicated case managers to help secure stable, permanent housing and appropriate support services. Not all PHAs participate in the program. You can find a list of participating authorities at https://www.hud.gov/sites/dfiles/Main/documents/HUD- VASH_grant_chart.pdf
• Veterans Home Improvement Program
  The Texas Veterans Home Improvement Program provides below-market interest rate loans to qualifying Texas veterans who need to make repairs to their homes. For more information go to http://www.glo.texas.gov/vlb/loans/home-improvement- loans/index.html
• Homes for Texas Heroes Home Loan Program
  The Homes for Texas Heroes Home Loan Program provides home buyer assistance for Texas veterans. Program benefits include a 30-year fixed interest rate mortgage loan and down payment assistance, provided as a grant (never needs to be repaid) or repayable second lien loan. For more information go to https://www.tsahc.org/homebuyers-renters/homes-for-texas- heroes-program
• Veterans Housing Assistance Program
  The Veterans Housing Assistance Program helps veterans buy a home with a low-interest loan with little or no down payment. For more information go to http://www.glo.texas.gov/vlb/index.html
• Veterans Land Loan Program
  The Veterans Land Loan Program allows veterans to purchase land at competitive interest rates. Find more information at http://www.glo.texas.gov/vlb/loans/land-loans/index.html
• Veterans Land Board
  The Texas Veterans Land Board provides a broad range of services, including low-interest land, home, and home improvement loans; and skilled nursing care in state Veterans homes. For more information go to http://www.glo.texas.gov/vlb/index.html

• Served during a Wartime Period at least one day.
• Did not receive a Dishonorable Discharge.
• Served more that 90 months during a wartime period before September 8, 1980/24 months afterwards, with at least 1 day during wartime.
• Veteran is at least 65 yrs old or has a permanent and total disability

For more information, please visit https://www.va.gov/pension/eligibility/

Working caregivers are adult children, spouses, or other relatives who help older adults.

Resources:

• Texas Attorney General Website – HIPAA form
• Neala.org – Elder Law Attorneys
• For a list of Texas State Agencies and national resources visit the Legal section of our Resource Directory.

Check out these trusted websites for a list of discounts available to older adults.

The Senior List: Biggest list of Senior Discounts

AARP: 10 Places to Ask for a Discount

AARP: Amazing Dining Deals (56 restaurant discounts)

Bonus…

AARP: Score Birthday Freebies