(Frequently Asked Questions)
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What services may be available?
Every community is different and offers different services. To figure out what’s available in your community, call 2-1-1 to be connected with an information and referral specialist. Phones are answered 24 hours a day, seven days a week. You can also call 1-800-252-9240 during normal business hours to speak to your local Area Agency on Aging, or call 1-855-937-2372 to speak to your local Aging and Disability Resource Center.
There are some basic social services that are available in nearly all Texas communities. These include transportation, nutrition, housekeeping, personal care, medical equipment and adaptive aids, financial assistance, help with housing costs, hospice care, respite and caregiver support, legal help, mental health services, and independent living skills training.
What are area agencies on aging (AAAs)?
Area agencies on aging (AAA) are a network of nationwide organizations dedicated to addressing the needs of older people and their family or informal caregivers.
How do I find my local area agency on aging?
North Central Texas Area Agency on Aging serves these counties:
Collin, Denton, Ellis, Erath, Hood, Hunt, Johnson, Kaufman, Navarro, Palo Pinto, Parker, Rockwall, Somervell, or Wise https://www.nctcog.org/aging-services/older-adults/resources-and-additional-information
Dallas Area Agency on Aging serves Dallas County https://www.ccadvance.org/seniors/
Tarrant County Area Agency on Aging serves Tarrant County https://www.unitedwaytarrant.org/aaatc/
Also see the Texas Area Agencies on Aging (state-wide) Directory
What programs do the area agencies on aging offer for caregivers and for older adults?
Do I have to have a low income to get help through the area agency on aging?
Who can I call?
Important Phone Numbers for Texas Residents:
- 2-1-1 Dial 211, a 24/7 information referral line for community and social services
- Medicare: 1-800-633-4227
- Texas Aging and Disability Resource Centers: 1-855-YES-ADRC (1-855-937-2372)
- Texas Area Agencies on Aging: 1-800-252-9240
- Texas Department of Family and Protective Services: 1-800-252-5400
- Texas Department of Housing and Community Affairs: 1-800-525-0657
- Texas Department of Insurance: 1-800-252-3439
- Texas Department of State Health Services: 1-888-963-7111
- Texas Health and Human Services Commission (Medicaid): 2-1-1
- Texas Legal Services Center: 1-800-622-2520
- Texas Veterans Commission: 1-800-252-8387
- U.S. Veterans Administration: 1-800-827-1000
Am I a caregiver?
- Drive to and from medical appointments.
- Communicate with health care professionals.
- Contact community service organizations such as the Area Agency on Aging, Meals on Wheels, or the Alzheimer’s Association.
- Help arrange for home health care or hospice services.
- Assist someone to pay bills.
- Help someone clean their home or arrange for housecleaning.
- Do home repairs or arrange for someone else to do so.
- Do yard work or hire someone else to do so.
Types of Caregivers
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.
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.
Where can I find caregiver support?
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.
Where can I find materials on caregiving?
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
Day Care for Adults
What is adult daycare?
Adult day care centers are designed to provide care and companionship for older adults who need assistance or supervision during the day. These centers provide respite to family members, allowing them to go to work, handle personal business, or just relax while knowing their relative is well cared for and safe. Adult day care is used to relieve the caregiver of his or her duties for the day while ensuring that the care recipient will still receive the proper care in a safe, friendly environment.
In most cases, people who go to adult day care centers must be able to take care of their own personal care. In contrast, some centers may provide more care.
Adult day care can be an affordable alternative to in-home care.
How can I find adult day care?
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/
How do I pay for adult day care?
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.
What questions should I ask when I am evaluating adult day centers?
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.
What are home health aides and personal care services?
Medicare pays for home health aides in some cases. Aides can do things like help you get dressed, take a bath, and so on. But Medicare will pay only if you meet all of the eligibility criteria below:
- You are under the care of a doctor who has developed a plan of care for you;
- Your doctor has ordered skilled care, such as nursing, physical therapy, occupational therapy, or speech therapy;
- Your doctor has ordered home health care;
- Your doctor has certified that you’re homebound, which means that you can’t leave your home unless you get some help; and
- You receive home health services from an agency that has a contract with Medicare.
Medicare usually pays for personal care services on a temporary basis, as long as you require skilled care. Medicare will not pay for help from aides with bathing, dressing, and using the bathroom when this is the only care you need.
Texas Health and Human Services have programs such as Family Care that provide personal care services on an on-going basis. To qualify, you must have low income and limited resources. Specifically, your income can be no greater than $2,349 per month if you’re single or $4,698 per month if you’re married. In addition, you can have no more than $5,000 in resources if you’re unmarried or $6,000 in resources if you’re married. In addition, you must have some kind of medical condition that makes it difficult for you to care for yourself. Keep in mind that HHS has interest lists for most programs. Even if you qualify, you will need to wait until a slot opens up.
Independence & Safety
How can I make an old adult's home safer?
General Home Modification Tips
If you want to stay in your home as long as possible but find it difficult to get around, there may be things you can do to make your home safer and more accessible.
To get ideas for improvements that are specific to your home and your needs, you may want to hire an occupational therapist. This is a health professional who is trained to take into consideration your balance, coordination, endurance, strength, and vision relative to your home environment, and give you recommendations about making your home safer and more usable. To find an occupational therapist in your area — as well as quality data about agencies that provide occupational therapy — you can go to Medicare’s Home Health Compare website, at http://www.medicare.gov/homehealthcompare/search.aspx
You can make several changes yourself, at little or no cost. For example, make sure you have plenty of light and walkways that are free of obstructions. If your bathtub is hard to use, consider using a handheld shower wand and shower chair or transfer bench.
Other modifications — such as widening bathroom doorways or installing grab bars, handrails, and wheelchair ramps — may be more costly and better left to professionals.
If you’re looking for a professional to make accessibility modifications to your home, ask if he/has a tax ID, insurance coverage (including bonding), ability to meet construction standards of the Americans with Disabilities Act, and references. You can also contact the Better Business Bureau to see if he or she is a member and has any complaints on file. It’s a good idea to check with at least three contractors so you can compare cost and quality. Another way to find profession to is to check home improvement stores, friends, or the Texas Association of Builders at 1-800-252-3625.Download thie Home Fall Prevention Checklist for Older Adults
Check out these articles for more home improvement safety tips:
- 10 Safe Gardening Tips for Seniors
- 10 Smart Home Features to Help You Age in Place
- A Home Fall Prevention Checklist for Older Adults
- Preparing Your Home for a Loved One with Alzheimer’s: A Caregiver’s Guide
- Preventing Falls at Home
- The Most Common In-Home Injuries for Seniors and How to Prevent Them
- How to Prevent Fires in Your Home Cómo prevenir incendios en su casa Spanish both English and Spanish
- Keeping Safe in Case of Fire Cómo mantenerse a salvoen caso de incendios Spanish both English & Spanish
How can I prevent falls?
Falling is NOT a normal part of aging.
What falls prevention education programs are available?
Where can I learn more about creating safety and maintaining independence for my care receiver?
How should I prepare for emergencies?
What frauds and scams should I be aware of?
- 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
Insurance & Financial Issues
How can I get help paying for care?
Is it a struggle to pay your bills every month? If so, you may want to see if you qualify for state and federal programs that provide income and on-going help with utility, healthcare, and housing costs. Here are some programs that are available to people with very low incomes:
- Supplemental Security Income (SSI) is a program for people who are at least 65 years old or blind or disabled and have low incomes and limited resources. The 2020 income limit for a single person is $783 per month — not counting the first $20 per month of most income you receive, the first $65 per month you get from working, and half of the wages over $65. The 2020 income limit for a couple is $1,175 per month. People who qualify for SSI get a monthly check, in addition to Medicaid benefits. Call the Social Security Administration at 1-800-772-1213 for more information.
- Medicaid is a health insurance program that is automatically approved for people who have been approved for SSI (see above). In addition, people who require nursing home care may also qualify for a type of Medicaid even though their income is above the allowable limit. In addition, pregnant women and parents of children may qualify for Medicaid if they have low incomes and limited resources. To see if you qualify for Medicaid, call 2-1-1 or go to a local Medicaid office.
People who qualify for Medicaid can receive medical services from doctors and other healthcare providers who have contracts with the Medicaid program. In addition, Medicaid can pay for things like eyeglasses and hearing aids.
People who receive both Medicare and SSI/Medicaid don’t have to pay Medicare premiums, deductibles, or copayments.
- Medicare Savings Programs are available to people who get Medicare benefits, have low incomes, and limited resources. There are three different Medicare Savings Programs — QMB, SLMB, and QI — that have three different income limits. In 2020 you may qualify for a Medicare Savings Program if your income is below $1,456 (not counting the first $20 in wages) and you are single, or if your monthly income is below $1,960 and you are married. In addition, you must have less than $7,860 in savings, investments, and property (other than your home and car) if you are single and $11,800 if you are married. If you qualify for QMB, the program will pay your Medicare Part A and B premiums, Medicare Part A and B deductibles, and Medicare Part A and B copayments. If you qualify for SLMB or QI, the program will pay your Medicare Part B premiums. To see if you qualify for a Medicare Savings Program, call 2-1-1 or 1-800-252-9240 and ask for a benefits counselor.
- The Medicare Low-Income Subsidy is available to people who get Medicare benefits, have low incomes and limited resources, and who are enrolled or want to enroll in a Medicare prescription drug program. In 2020 you may qualify for a Medicare Low-Income Subsidy (also called “Extra Help”) if your income is below $1,615 per month (not counting the first $20 in wages) and you are single, or $2,175 per month and you are married. If you’re working, the first $20 in income does not count. In addition, you may have no more than $14,610 in savings, investments, and property if you are single, or $29,160 if you are married. People who qualify for the Low-Income Subsidy pay no more than $3.60 for each generic drug and $8.95 for each brand-name drug.
- The Supplemental Nutrition Assistance Program (SNAP) is a new name for food stamps. It is a federal program that helps low-income families buy nutritious food from local food stores. SNAP is available to families, older people, and single people who have low incomes and limited resources. To see if you qualify for SNAP, call 2-1-1 or go to a local Medicaid office.
Are you having problems managing your bills because it’s hard to see the bank statements or keep up with the math? If so, you may want to see if there are any money management programs that serve your community. Money management bill payer services help clients balance checkbooks, prepare checks, and stick to monthly budgets. For clients who need more help, money managers may be able to serve as representative payees — receiving checks on behalf of clients and paying their bills.
If you’re looking for emergency assistance or do find out if your community has a money management program, call 2-1-1 to see what’s available in your community.
What are Medicare & Medicaid?
What is Medicare?
Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, or people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant – ESRD). For more information visit: https://www.medicare.gov/ or download the Medicare Preventive Care fact sheet.
Medicare Prescription Discount Information – Search by drugs through the Pharmaceutical Assistance Program – Some pharmaceutical companies offer assistance programs for the drugs they manufacture. For more information download the Medicare Part D prescription fact sheet.
What is Medicaid?
Medicaid is an assistance program.
It serves low-income people of every age. Patients usually pay no part of costs for covered medical expenses. A small co-payment is sometimes required. Medicaid is a federal-state program. It varies from state to state. It is run by state and local governments within federal guidelines.
For more information visit Medicaid.gov
To see if you qualify for your state’s Medicaid see: https://www.healthcare.gov/medicaid-chip/eligibility/
For Texas programs visit the Health and Human Services website: https://hhs.texas.gov/services/health/medicaid-chip
Where can I get help with utility bills?
Comprehensive Energy Assistance Program
TDHCA’s Comprehensive Energy Assistance Program (CEAP) is designed to assist low-income households in meeting their immediate energy needs and to encourage consumers to control energy costs for years to come through energy education. The CEAP is administered through sub-recipients, which collectively cover all 254 counties of the state. For a list of local Program Administrators visit http://www.tdhca.state.tx.us/texans.htm and select “Utility Bill Payment Help” or call 1-800-525-0657.
Weatherization Assistance Program
TDHCA’s Weatherization Assistance Program (WAP) is designed to help low-income customers control their energy costs through the installation of weatherization materials and education. The program’s goal is to reduce the energy cost burden of low-income households through energy efficiency. The WAP is administered through sub-recipients, which collectively cover all 254 counties of the state. For a list of local program administrators visit http://www.tdhca.state.tx.us/texans.htm and select “Weatherization” or call 1-800-525-0657.
Where can I get assistance with a home loan in Texas?
TDHCA administers several programs to help Texans with low and moderate incomes buy homes.
Texas First Time Homebuyer Programs
TDHCA administers three homebuyer assistance programs: My First Texas Home (MFTH), My Choice Texas Home, and Texas Mortgage Credit Certificate (TX MCC).
The My First Texas Home option offers mortgage loans at 30-year, fixed interest rates, and down payment and/or closing cost assistance to eligible Texas first time homebuyers. The My Choice Texas Home option offers mortgage loans at 30-year, fixed interest rates, and down payment and/or closing cost assistance to income-eligible first-time and repeat homebuyers. TX MCC offers tax credits up to $2,000 per year based on the annual interest paid on a mortgage loan. For more information go to http://www.tdhca.state.tx.us/homeownership/fthb/index.htm or call 800-792-1119.
Texas Bootstrap Loan Program
TDHCA administers the Owner-Builder Loan Program, also known as the Texas Bootstrap Loan Program (Bootstrap). The Texas Bootstrap Loan Program is a self-help housing construction program that provides very low-income families (Owner-Builders) an opportunity to purchase or refinance real property on which to build new housing or repair their existing homes through “sweat equity.” Owner-builder’s household income may not exceed 60% of Area Median Family Income. The maximum Bootstrap loan may not exceed $45,000 per household. For further information go to http://www.tdhca.state.tx.us/oci/bootstrap.jsp
Home Sweet Texas Home Loan Program
The Texas State Affordable Housing Corporation (TSAHC) Home Sweet Texas Home Loan Program serves Texas home buyers with low and moderate incomes. It provides a 30-year fixed interest rate mortgage loan and down payment assistance of up to 5% of the loan amount. You don’t have to be a first-time homebuyer to qualify, and you don’t have to live in the home for any set period of time. The down payment assistance is a gift that never needs to be repaid.
First-time buyers can also apply for a Mortgage Credit Certificate. It offers a dollar for dollar savings of up to $2,000 every year as a special tax credit. It’s available statewide through a network of approved lenders. For more information, contact TSAHC at 1-877-508-4611.
Who pays for assisted living?
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.
Who pays for nursing home care?
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:
What is subsidized housing?
Finding and keeping safe, affordable, and accessible housing can be hard, especially when you have a limited income. There are a number of programs, financed by the federal and state government, that provide housing assistance. Not sure where to start? You can contact the Texas Department of Housing and Community Affairs’ Housing Resource Center at 1-800-525-0657. Or you can call your Aging and Disability Resource Center at 1-855-937-2372.
The following are major housing programs and providers.
Housing Choice Vouchers – The Housing Choice Voucher program (sometimes called Section 8) is funded by the U.S. Department of Housing and Urban Development (HUD) and administered by public housing authorities (PHAs). It’s the federal government’s major program for helping people with low incomes pay rent at private properties.
Participants choose their own housing — which can include single-family homes, townhouses, and apartments. The properties must meet certain health and safety standards, and landlords must agree to accept the vouchers.
Participants pay 30% of their income toward rent. The voucher pays the landlord the difference between the unit’s fair market rent (as determined by HUD) and the participant’s contribution. For example, someone who has a Housing Choice Voucher receives $800 a month in income. She finds an apartment that rents for $850 a month (an amount that HUD determines is a fair market value), and the landlord agrees to accept the voucher. She pays $240 per month, and the voucher pays the balance of $610 per month.
To get more information about Housing Choice Vouchers, contact your local PHA. You can get contact information for your local PHA at https://www.hud.gov/sites/dfiles/PIH/documents/ PHA_ Contact_Report_TX.pdf
Some small cities and rural areas don’t have their own PHAs. In those cases, the Texas Department of Housing and Community Affairs ( TDHCA) serves as the PHA. To qualify for a Housing Choice Voucher through TDHCA, eligible households can have no more than half of the Median Family Income (MFI). However, TDHCA gives priority to those with incomes at or below 30% of the MFI. For more information on eligibility and availability of Housing Choice Vouchers, contact TDHCA’s Section 8 Division at 1-800- 237-6500 or go to http://www.tdhca.state.tx.us/section-8/
Project Access – TDHCA’s Project Access Program makes Section 8 Housing Choice Vouchers available to people who live in institutions and need affordable housing in order to return to the community. Qualifying individuals must be residents of nursing facilities, Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IIDs), or state psychiatric hospitals. A nursing home relocation specialist or case manager is often available to help fill out the Project Access paperwork, find a property that accepts the voucher and arrange other community-based services.
For more information on Project Access, contact the TDHCA Section 8 Division at 1-800-237-6500 or go to http://www.tdhca.state.tx.us/section-8/contacts.htm
Tenant-Based Rental Assistance – TDHCA provides funding to local governments, PHAs, and nonprofit organizations for the Tenant-Based Rental Assistance (TBRA) program, which can be used for rental subsidies, security deposits (up to two months’ rent), and utility deposits for low-income renters. TBRA funding is available for up to 24 months while the participating household engages in a self-sufficiency program. If available, additional funds may be set aside to provide assistance beyond 24 months for individuals meeting certain program requirements.
You can find a general overview of the TBRA program at http://www.tdhca.state.tx.us/home-division/tbra.htm. The TBRA program is not available in all parts of Texas.
Family Unification Vouchers – The Family Unification Program (FUP) provides targeted vouchers to families who are at risk of having their children placed in out-of-home care because of lack of decent, safe, and sanitary housing; and youth at least 18 years old and not more than 21 years old who left foster care at age 16 or older and who lack adequate housing. FUP vouchers for families have no time limit, but FUP vouchers for youth are limited to 18 months of rental assistance.
FUP vouchers are not available statewide. To see if they’re available in your community go to https://www.hud.gov/sites/documents/FUPBASELINES011314.PDF
Section 8 Project-Based Rental Assistance – Section 8 Project-Based Rental Assistance (PBRA) program allows people with limited incomes to rent modest units at affordable prices. It provides rental assistance only at participating properties. If a program participant moves out of that property, he/she no longer qualifies for the program. In this way, the PBRA program is different from the Section 8 Housing Choice Voucher program, which allows the participant to move to any property that will accept the voucher and still receive rental assistance.
Private owners, including both for-profit and nonprofit entities, own and manage the Section 8 PBRA properties. Tenants pay no more than 30% of their income toward rent, and federal funds pay the landlord the difference between the tenant’s contribution and the fair market rent. You can find properties that participate in the Section 8 PBRA program at http://www.hud.gov/apps/section8/
HUD 202 – The Section 202 program helps expand the supply of affordable housing with supportive services for the elderly. It provides very low-income elderly with options to live independently, but with access to support services such as cleaning, cooking, and transportation.
These multi-family apartment complexes were built and managed by non-profit organizations with HUD funds. Search for these properties and other “affordable housing” options at https://www.hud.gov/states/texas/renting. Apply for this housing by contacting each property.
USDA Rural Development Multi-Family Housing Rentals – The U.S. Department of Agriculture has multi-family apartment complexes in rural areas of the state. To find multi-family apartment complexes in your area visit https://rdmfhrentals.sc.egov.usda.gov/RDMFHRentals/select_state.jsp for rental assistance. Apply for this housing by contacting each property.
Additionally, Texas’ Aging and Disability Resource Centers are required to develop affordable housing inventories, including properties that are not funded by TDHCA. You can get a list of properties in your area by calling 1-855-YES-ADRC (1-855-937-2372).
Section 811 Project Rental Assistance Program for Persons with Disabilities – The Section 811 Project Rental Assistance (PRA) program provides project-based rental assistance for extremely low-income persons with disabilities linked with long term services. The program is made possible through a partnership between TDHCA, Texas Health and Human Services (HHS), and eligible multifamily properties.
The program is limited to individuals who are part of the Target Population and receiving services through one of the HHSC Agencies participating in the program.
To see the current list of target populations, go to https://www.tdhca.state.tx.us/section-811-pra/index.htm
Each eligible household must have a qualified member of the target population who will be at least 18 years of age and under the age of 62 at the time of admission. All three target populations are eligible for community-based, long-term care services as provided through Medicaid waivers, Medicaid state plan options, or state-funded services and have been referred to TDHCA through their service provider or coordinator.
Individuals must be referred to the program by a Qualified Referral Agent.
The Section 811 PRA program provides rental assistance at participating properties only. For program information, including a list of participating properties, go to http://www.tdhca.state.tx.us/section-811-pra/index.htm.
Health & Wellness
What is hospice?
For people who are in the late stages of life-threatening diseases, hospice care offers medical services, emotional support, and spiritual resources. It doesn’t focus on prolonging life, but on controlling pain and enhancing quality of life. Hospice services include basic medical care that manages symptoms, medical equipment and supplies, counseling and social support, volunteer support, and respite care for family members.
Many insurance programs, including Medicare, Medicaid, and the Veterans Health Administration, pay for hospice care. Most — but not all—private insurance programs, also have hospice benefits. In addition, Texans who don’t have health insurance can often receive hospice services from hospice agencies’ charity care programs.
To qualify for hospice, you must have an incurable medical condition and your doctor must certify that you have no more than six months to live if your illness runs its normal course.
For more information about hospice, you can call the Texas Association for Home Care & Hospice at 1-800-880-8893 or your local Aging and Disability Resource Center at 1-833-937-2372.
What is the Beers List or Criteria?
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:
- Medications to avoid if you’re over 65 years old and not in a hospice or a palliative care setting.
- Medications to avoid among people with certain health conditions.
- Medications to avoid that cause drug interactions when combined with other medications.
- Medications to avoid due to harmful side effects that outweigh the benefits.
- 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.
Where can I find independent living skills training and tools?
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.
If you’re interested in skills training, contact your independent living center, or ILC. ILCs provide a broad range of services, including skills training and peer support groups, to people of all ages who have disabilities. They provide these services at no cost.
If you or your loved one has an intellectual or developmental disability, contact your Local Intellectual/Developmental Disability Authority (LIDDA) to see what services are available in your community. Community centers provide support such as residential services, supported home living, supported employment, and vocational services. Most programs have lengthy waiting lists. To find out which LIDDA serves your area, go to https://www.dads.state.tx.us/contact/la.cfm
Tools for Independent Living
The State of Texas provides a wide range of services for Texans with disabilities. Its rehabilitation programs include the following:
- Independent Living Services:
support self-sufficiency. For more information, call 1-877-787-8999 or go to https://hhs.texas.gov/services/disability/independent-living
- Deaf and Hard of Hearing Services:
serve Texans with hearing loss, providing information and training, communication strategies, and assistive technologies. To find out more go to https://www.hhs.texas.gov/services/disability/deaf-hard-hearing
- Specialized Telecommunications Assistance Program:
helps pay for specialized phones for people with disabilities that interfere with the use of standard phones. For more information call 1-877-787-8999.
- Vocational Rehabilitation Program:
helps Texans with disabilities prepare for, find, and keep jobs. For more information call 1-800-628-5115.
In addition, the Texas Workforce Commission has a Division for Blind Services that provides information, counseling, and training for individuals who are interested in working. For more information call 1-800-628-5115.
What are the activities of daily living (ADLs) and does Medicare help with them?
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.
The extent of an individual’s ability to move from one position to another and walk independently.
The ability of a person to feed oneself.
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.
The ability to control bladder and bowel function
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.
Where can I get medical equipment and adaptive aids?
If you have problems doing everyday tasks—like getting dressed, taking medicines, or taking a bath, consider the use of durable medical equipment or adaptive aids. Durable (or reusable) medical equipment consists of things like wheelchairs, bath chairs, and walkers. Adaptive aids include adaptive light switches, communication equipment (e.g., TTY phones), computer devices (e.g., special keyboards), home modifications, mobility aids (e.g., staircase lifts), and more.
To get more information on what assistive technology might be able to do for you — and sources of assistive technology — call Abledata at 1-800-227-0216. Abledata is a federally funded clearinghouse that provides information about assistive technology. You can also call your Area Agency on Aging (AAA) at 1-800-252-9240.
Medicare may pay for durable medical equipment, such as wheelchairs, walkers, electric scooters, hospital beds, and oxygen tanks. To qualify you must have Medicare Part B, get a doctor’s authorization for use of the equipment at home, and order the equipment from a company that has a contract with the Medicare program. In most cases, Medicare will cover 80% of the cost, and you (or your supplemental insurance) will be responsible for 20% of the cost.
As a general rule, Medicare does not pay for equipment that’s used in the bathroom, such as raised toilet seats, bath chairs, and transfer benches.
The Veterans Administration (VA) may also provide medical equipment for qualifying veterans. Call the Texas Veterans Commission hotline at 1-800-252-VETS (8387) to see if you qualify for medical equipment, in-home services, and/or pensions from the VA.
What is mental health and what services are available?
Nearly one in four Americans will experience a mental health condition at some time in his/her life. Although most mental health conditions are treatable, approximately two-thirds of those who are affected don’t seek treatment. In many cases, untreated mental health conditions can interfere with recovery from physical illnesses.
If you’re experiencing problems or changes with your mood or mental status, don’t assume that’s a normal part of growing old and/or dealing with a disability. Talk to your doctor or a mental health professional.
Medicare will cover mental health services, generally paying 80% of the cost once you’ve met your Part A or Part B deductible. For inpatient treatments, it pays for up to 190 days during your lifetime, after you’ve met your Part A deductible.
Medicare Part B may also pay for partial hospitalization — or a structured program of outpatient active mental health treatment that is provided during the day and doesn’t require overnight stays. In order to qualify for partial hospitalization, a doctor must certify that you would otherwise need inpatient treatment, and the doctor and partial hospitalization program must agree to accept Medicare payments.
If you don’t have insurance or don’t know where to get started, you can contact your local mental health authority. To find out which authority serves your county, go to https://www.dshs.state.tx.us/mhservices-search/
What are meal programs?
If you have problems buying or fixing food, there are state and local programs that may be able to help.
If you can’t afford to buy all the food you need, see if you qualify for Supplemental Nutrition Assistance Program, or SNAP, benefits (which used to be called food stamps). In order to qualify, you must have a low income and limited resources. To apply, call 2-1-1. The call taker can also let you know if there are food pantries nearby.
If you have a disability that makes it hard to fix food, you may qualify for home-delivered meal programs through the Area Agency on Aging (AAA), Texas Health and Human Services (HHS), or managed care organization if you receive full Medicaid benefits (instead of QMB, SLMB, or QI only). The AAA serves people who are at least 60 years of age, regardless of their income. HHS provides home-delivered meal services at no cost to people who are older or disabled, have low incomes, and have limited resources. Keep in mind that AAA and HHS home-delivered meal programs may have waiting lists. If you receive full Medicaid benefits, speak to the service coordinator with the managed care organization that you’re assigned to.
If you’re at least 60 years old, ask if your AAA offers congregate meals. If so, you can go to a meal site and get a noon meal at no charge. Often, the AAA can help arrange a trip to and from the meal site. Congregate meal sites include senior centers, recreation centers, and churches.
To find out what meal programs are in your community, call 1-855-YES-ADRC.
Where can I get help with transportation?
Most communities have public transportation services that can meet the needs of people with and without disabilities. To find out who your local public transportation providers are, you can contact the American Public Transportation Association. This site contains links to transit agencies for cities, towns, and counties across the United States.
If you have a disability, ask about paratransit services. Paratransit services use vans or buses that pick people up at their homes (or other starting points) and take them to specific destinations — such as a senior center, grocery store, or doctor’s office.
How do you qualify for paratransit services?
In most cases, you need to fill out an application and prove you have a disability. This is usually done by getting a statement from your doctor, explaining why your medical condition makes it difficult for you to use regular transportation.
Public transportation services are available to people of all income levels. They usually require riders to pay fares, but the fares are kept low (e.g., a few dollars for each one-way trip) because the government helps pay the cost.
The Area Agency on Aging (AAA) often helps with transportation. To qualify for services through the AAA you must be at least 60 years old. In addition, the AAA may give priority to certain groups of older people (e.g., those with low incomes, those who have recently been in the hospital, those who need medical transportation, and so on). To find out if your AAA pays for transportation, call 1-800-252-9240. Keep in mind that the AAA’s transportation providers usually schedule trips on a first-come, first-served basis, so it’s important to call several days before you need a ride.
The State of Texas provides medical transportation for people who have Medicaid benefits. If you have Medicaid and need to go to the doctor, hospital, or drug store that participates in the Medicaid program, call the following number to set up a ride:
- If you live in the Dallas area, call 1-855-687-3255
- If you live in the Houston/Beaumont area, call 1-855-687-4786.
- If you live in any other part of Texas, call 1-877-633-8747 (TTY: 1-800-735-2989).
If you can’t get a ride through public transportation, the Area Agency on Aging, or the Medicaid program, call 2-1-1 and ask what local transportation programs are available. There may be volunteer groups that help out with transportation or businesses that can provide transportation for a fee.
If you have your own transportation but have a disability that limits how far you can walk, you can apply for a temporary or permanent handicap parking placard. You will need to fill out an application, and your doctor will need to sign a statement that you have a disability. For information, call your county tax office.
Is there help for urinary incontinence?
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.
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
- Medication or creams
- Electrical stimulations
For More Information on Urinary Incontinence
Visit the National Institute of Diabetes and Digestive and Kidney Diseases for more information on
Where can I get help with vision Issues?
Housing, In-Home Resources
What are the different types of housing for older adults, like nursing homes, assisted living, and others?
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.
What is assisted living?
- Balancing a checkbook
- Medication reminders
- Housework, etc.
What is aging in place?
“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
What are the differences between assisted living, nursing home care, memory care, and skilled nursing facilities?
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.
Skilled nursing facilities – Although they have traditionally been called “long-term” care centers, skilled nursing facilities today just as frequently provide transitional care. Transitional care is just what it says—interim medical and nursing treatment designed to help people transition back to everyday life following an illness or injury. Most often, that means post-acute care following a hospital visit.
What programs are available for homeless people?
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:
- Permanent Housing, which can consist of Permanent Supportive Housing or rapid-rehousing (help with finding rental housing and short-term rental assistance)
- Transitional Housing, which can cover the cost of up to 24 months of housing
- Supportive Services that link clients with housing or other necessary supports
- Homelessness Prevention, which may include housing relocation and stabilization services in addition to short- and medium-term rental assistance.
For more information go to https://www.hudexchange.info/homelessness-assistance/
Emergency Solutions Grants Program
Funding through the Emergency Solutions Grant (ESG) program is allocated to states, counties, and cities for street outreach, emergency shelter, essential services, and rental assistance for households experiencing homelessness or who are at risk of homelessness. The Texas Department of Housing and Community Affairs (TDHCA) receives federal ESG funding and, in turn, awards ESG funds to units of local government, nonprofit organizations, and domestic violence providers.
To learn more about HUD’s ESG program services go to https://www.hudexchange.info/programs/esg/.
ESG services are not available statewide. To see if services are available in your community, you may search the HUD website at https://www.hudexchange.info/grantees/ or go to TDHCA’s website at http://www.tdhca.state.tx.us/texans.htm and search “Emergency and Homeless Services.”
Where can I get assistance with home repair or modifications?
There are several programs that may be able to help repair, rehabilitate, and modify homes for Texans with low incomes.
Amy Young Barrier Removal Program
TDHCA’s Amy Young Barrier Removal Program (AYBRP) funds accessibility modifications to increase accessibility and eliminate hazardous conditions in the homes of Persons with Disabilities. The program can cover modifications such as adding handrails and ramps, widening doorways, adjusting countertops and cabinets to appropriate heights, installing buzzing or flashing devices for persons with visual or hearing impairments, and installing accessible showers, toilets, and sinks.
The program provides one-time grants for up to $22,500 per home, for renters or owners who earn no more than 80% of the Area Median Family Income. The Department implements the AYBRP through multiple nonprofit organizations and local governments who process intake applications, verify eligibility, and oversee construction. Not all portions of the state have program administrators. For a list of local program administrators visit http://www.tdhca.state.tx.us/texans.htm and select “Home Repair/Accessibility Modifications” or call an AYBR Program Administrator in the TDHCA Housing Trust Fund division at 1-512-936-7799
Homeowner Rehabilitation Assistance Program
Homeowner Rehabilitation Assistance (HRA) Program helps repair homes owned and occupied by qualified homeowners. The HRA Program funds local governments, PHAs, and non-profit organizations to provide the rehabilitation services and is not available statewide. For a list of local program administrators visit http://www.tdhca.state.tx.us/texans.htm and select “Home Repair/Accessibility Modifications,” email email@example.com or call 1-512-475-2135.
Medicaid Waiver Programs
Texas Medicaid waiver programs, including the STAR+PLUS, Community Living Assistance and Support Services (CLASS), Texas Home Living (TxHmL), Deaf-Blind with Multiple Disabilities (DBMD), and Home and Community Services (HCS) programs, can make home modifications that are necessary for health and safety in some cases. If you’re enrolled in a Medicaid waiver program, check with your case manager or service coordinator to see if you’re eligible.
Medicaid waiver services are available to people with low incomes and limited resources who qualify for institutional care. For more information about Medicaid waivers, call 1-855-937-2372.
Area Aging on Aging
Some Area Agencies on Aging have minor home repair programs that assist eligible people age 60 and over. They cannot do major repairs, such as work on roofs and foundations. To find out whether your Area Agency on Aging has a minor repair program, call 1-800-252-9240. It can also let you know if there are other local home repair programs.
Single-Family Housing Repair Grants and Loans
The U.S. Department of Agriculture, through its Section 504 Home Repair program, provides loans to very-low-income homeowners to repair, improve or modernize their homes or grants to elderly very-low-income homeowners to remove health and safety hazards. To qualify you must live in a rural area (generally a city with a population of no more than 35,000); be the homeowner and live in the house; be unable to obtain affordable credit elsewhere, and have a family income below 50% of the area median income. To qualify for a grant you must be age 62 or older and not be able to repay a repair loan.
Since the program serves rural areas, it’s not available in all parts of Texas. To see whether the program is available in your area, go to https://www.rd.usda.gov/programs-services/single-family-housing-guaranteed-loan-program
Where can I get help with housekeeping?
Keeping up a home is a lot of work — especially if a disability makes it hard to get around. There are programs that can help eligible people with chores around the house, such as cooking, cleaning, and doing laundry.
If you have Medicaid and a qualifying medical condition, you may be able to get help through the Primary Home Care or STAR+PLUS program. Contact the service coordinator with your managed care organization to see if you qualify.
If you don’t have Medicaid — but do have a low income, limited resources, and a disability — you may qualify for programs administered by Texas Health and Human Services (HHS), such as Family Care and Home-Delivered Meals. Specifically, your income can be no greater than $2,349 per month if you’re single or $4,698 per month if you’re married. In addition, you can have no more than $5,000 in resources if you’re unmarried or $6,000 in resources if you’re married.
HHS also provides Community Attendant Services to people with low incomes and very limited resources. To qualify, a single individual can receive no more than $2,349 in monthly income and have no more than $2,000 in resources. Couples can receive no more than $4,698 per month and have no more than $3,000 in resources. Those who qualify can receive escort, home management, and personal care services.
HHS also pays for home-delivered meals and emergency response services.
Even if you qualify for HHS non-Medicaid services, you’ll probably have to wait. Because of limited funding, some HHSC non- Medicaid programs may be “frozen” (i.e., not able to accept new applications) and/or have long interest lists that are managed on a first-come, first-served basis. Once you qualify for services through HHS, you can usually keep getting those services as long as you’re eligible.
Many Area Agencies on Aging (AAAs) offer housekeeping services. To qualify, you must be at least 60 years of age. In addition, the AAA may give priority to older people with low incomes, little family support, risk of going into a nursing home, and difficulty caring for themselves. AAA services are usually short-term in nature, lasting six months or less. Contact your local AAA at 1-800-252-9240 to see what programs are available and whether you qualify.
Housekeepers who are paid by HHS and AAAs aren’t allowed to provide any kind of personal care, like helping you take a bath or get dressed.
If you don’t qualify for any of the housekeeping services above, refer to the section on “Choosing an In-Home Provider” for tips on finding a qualified housekeeper.
What legal documents do I need?
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.
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
How can I find a qualified attorney?
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.
Although TLSC provides legal information, it does not represent people in lawsuits. Instead, it makes referrals to local attorneys.
What are Veterans Administration healthcare benefits?
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/
What is the Texas Veterans Commission?
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/
What housing resources are available for veterans?
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
What financial assistance is available for veterans?
- 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/
What is Operation Healthy Reunions?
Services provided by Operation Healthy Reunions include confidential mental health services; individual and family needs assessments; referrals to community resources; support groups; education; and advocacy.
To be eligible for this program:
- Be a returning Veteran of a foreign war
- Be a romantic partner, parent, grandparent, child, sibling, or individual the Veteran considers his/her support system
- The Veteran mush have permanent residency in one of the following North Texas counties:
- Van Zandt
What resources are available for employers?
What discounts are available for older adults?
Check out our Resource Directory for organizations, websites, and phone numbers.
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