Even with the best planning and efforts, sometimes we still may need support to age our best. Knowing about statewide and local services and programs can help you decide what is best for you. In an urgent situation, the last thing we want to do is start learning about resources and processes for getting help.
Take time now to learn about what services, supports and programs are available; who provides the services; and some basic eligibility information – that way if you or a loved one need support, locating it won't add to your stress.
How to Be Informed
It is estimated that by 2030, there will be 132 million older adults in the United States. There is not enough affordable housing to meet the needs of this growing population. During the past 10 years, the number of older adult households affected by worst-case housing needs has increased.
The Department of Housing and Urban Development defines worst-case needs as renters with incomes below 50 percent of the area median income who do not receive government housing assistance and who pay more than 50 percent of their income for rent.
A White House Conference on Aging study shows that since the Great Recession, the number of households with worst-case housing needs has decreased; however the number of older adult households with worst-case housing needs has increased. Another study by AARP and the Joint Center for Housing Studies of Harvard University shows a gap between older adults who are eligible for housing assistance (3.9 million), and older adults who are actually receiving assistance (1.4 million). Stable, affordable housing is a key component to aging and living well when older adults have to pay high housing costs, they often cut back on their medications, food, and savings.
- This Older Adults and Housing issue brief (PDF) gives an overview of the importance of stable housing for older adults.
- This Housing Resource (PDF) gives an overview of the low-income housing resources that are available to older adults.
- U.S. Department of Housing and Urban Development: Information on staying in your home, finding rental properties, and protecting yourself against scams and housing discrimination
- Texas Department of Housing and Community Affairs: Vacancy clearinghouse search engine
- Elder Options of Texas: Search engine
- 2-1-1 Texas search engine
- Area agency on aging or call 800-252-9240
Long-term care refers to a variety of programs designed to help people with daily living tasks such as bathing, dressing, personal care, housekeeping and preparing meals. It is estimated that 70 percent of people 65 and older can expect to use some form of long-term care during their lives. The most common LTC supports are:
- Home health organizations provide care to people in their own homes.
- Day Activity and Health Services provide daytime services to people on weekdays (and sometimes weekends). Services address the physical, mental, medical and social needs of participants.
- Independent living, such as senior apartments, provide some assistance with meals and light chores; residents are largely independent.
- Assisted living offers some assistance with daily living, such as laundry, medication and meals; staff are on-call 24-7.
- Nursing homes provide care to people with significant physical or behavioral health needs. Nursing home residents generally need round-the-clock supervision.
Many people think that Medicare will pay for their long-term care expenses, but this usually is not the case. Instead, people have to rely on their savings, long-term care insurance or Medicaid to cover these costs. While Medicaid will pay for long-term care services, to qualify your income assets must be below a certain level and you must meet the minimum state eligibility requirements. To find out if you might be eligible for Medicaid or to apply for benefits, visit the Your Texas Benefits website.
- The Long-term Care Provider Search Online database can help you identify residential or community-based LTC options.
- Area agencies on aging staff can assist you in finding LTC services for which you may qualify. Call toll-free 800-252-9240 to find the AAA near you.
- Aging and disability resource center staff can help you locate LTC providers in your community. Call toll-free 855-937-2372 to find the ADRC near you.
Medicare, Medicaid and Long-term Care Insurance
Medicare is the federal health insurance program for people 65 or older, certain younger people with disabilities, and people with end-stage renal disease.
There are several variations of Medicare, including:
- Medicare Part A (Hospital) – Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care and some home health care.
- Medicare Part B (Medical Insurance) – Part B covers certain doctors' services, outpatient care, medical supplies and preventive services.
- Medicare Supplement Insurance (Medigap) – This can help pay some of the health care costs that Medicare Part A & B do not cover, like copayments, coinsurance and deductibles.
- Medicare Part C (Advantage Plans) – Part C is a health plan offered by a private company that contracts with Medicare to provide Part A and Part B benefits. This type of plan also may provide drug benefits.
- Medicare Part D – Part D adds prescription drug coverage to Medicare Part A and B.
- The Centers for Medicare and Medicaid Services (CMS) provides enrollment information, eligibility guidelines and frequently asked questions about Medicare and Medicaid programs. Call toll free 800-MEDICARE (800-633-4227) or visit medicare.gov.
- AAA staff can answer Medicare benefits questions and help you enroll and walk you through insurance questions. They also can provide referrals to other organizations that work with Medicare and Medicaid, as well are help submit contested claims. Call toll-free 800-252-9240 to find the AAA near you.
- 2-1-1 Texas staff can refer you to organizations that can help with Medicare, Medicaid, and other insurance program. Dial 211 or visit www.211texas.org/.
- Texas Legal Services Center staff provides free legal information about medical services to qualifying low-income Texans. Call toll-free 800-622-2520 or visit www.tlsc.org.
Medicaid is a jointly funded federal-state health insurance program that covers more than 72.5 million Americans, including children, pregnant women, partners, older adults, people with disabilities and people who are eligible to receive federally assisted income maintenance payments. People who have both Medicaid and Medicare are called dual eligible, and in most cases all healthcare will be free to people who are dual eligible.
Long-term Care Insurance
Long-term care is a skilled care or personal care service you might need if you are unable to care for yourself because of an illness, disability or cognitive impairment. Long-term care services can be provided to you at home or in hospice, at a day activity and health services center, a nursing home, or assisted living facility. These services can be costly and many people use long-term health insurance to protect their assets and help pay for services.
- 2-1-1 Texas staff can refer you to organizations that can help with Medicare, Medicaid and long-term care services. Call 211 or visit www.211texas.org/.
- The Own Your Future program explains the different types of long-term care insurance and provides information about the benefits and costs to consumers.
- Learn about the Aging services provided by HHS.
Trying to find information and services when a need arises can be overwhelming. Community supports – such as 2-1-1, ADRCs and AAAs – can help you get the services you need to age and live well. Communities can help clear up the confusion and raise awareness of the services and supports available for older residents through a number of methods including hosting community events like health fairs or speakers series.
By hosting health fairs to highlight organizations that provide community-based services, communities can raise awareness of the services and supports available to older adults.
- 2-1-1 Texas is a free, anonymous social service hotline available 24/7 that helps Texans connect with the services they need.
- AAAs help Texans 60 and older, their family members and/or other caregivers access information and locate services that can help them live in their homes and communities for as long as possible. Call toll-free 800-252-9240 to find the AAA near you. This Evidence-based Programs (PDF) issue brief provides an overview of how evidence-based programing, often offered at AAAs, can help improve overall health and wellbeing.
- ADRCs serve as a single point of contact to long-term care services. Call toll-free 855-937-2372 to find the ADRC near you.
- Elder Options of Texas helps older adults and their caregiver find care services.
- Communities and worksites are encouraged to use the Age Well Live Well Be Informed Template to highlight local resources and supports. Email AgeWellLiveWell@hhsc.state.tx.us to request a copy.
- Texas Veterans Commission is the state-appointed advocate for Texas veterans.
- U.S. Department of Veterans Affairs oversees and administers services and programs for military veterans.
- This Aging Awareness (PDF) issue brief provides an overview of aging and more information on programs and services that can help older Texans remain healthy and independent as they age.
According to a CMS survey, 19 percent of all Medicare beneficiaries who live in the community have given up driving. When someone no longer drives it increases the need for public transportation and other accessible and affordable methods for getting around.
Accessible transportation includes not only the means of transportation, but the environment to get the person to and from the transportation. For example, safe, accessible, well-lit routes to public transportation that offer shade protection and benches. Reducing the cost of transportation is important when creating comprehensive transportation options (such as bicycling or ride-sharing programs).
Even with public transportation, many people are not comfortable or knowledgeable about how to access it. Partnerships between public transportation agencies and older adult service providers offer a way to develop system familiarization programs and materials that help make older adults feel safer and more comfortable with public transportation. For communities that do not have public transportation (approximately 40 percent of rural county residents nationwide) coordinated efforts that pool resources across agencies to span a larger region may be necessary.
Here are several ideas for improving transportation options:
- Offer free classes and opportunities for community members to become familiar and practice taking public transportation.
- Determine who in the community has funding for transportation services and explore partnering.
- The Association for Driver Rehabilitation offers referrals to professionals who are trained to help people with disabilities, including those associated with aging. Visit their website or call 608-884-8833.
- ADRCs can help you find transportation providers in your community. Call toll-free 855-937-2372 for the ADRC near you.
- Medical Transportation Program can help you assess if you or someone else qualifies for non-emergency medical transportation services. Call toll-free 877-633-8747.
- AAAs can provide assistance in finding out what transportation services you may qualify for. Call toll-free 800-252-9240 to find the AAA near you.
- Find a local transportation provider by searching the American Public Transportation Association Texas Transit Links website.
- AARP provides driver safety courses.
- Use this checklist to assess your transportation needs (PDF)
- The American Automobile Association website provides resources for older drivers, including self-assessments and training for improving performance.
- This Aging Texas Well Transportation Issues for Older Adults (PDF) issue brief takes a look at some of the barriers older adults experience trying to access public transportation and resources for enhancing existing programs to better serve older adults.
While some older adults keep working because they enjoy it or because they want to receive more benefits from a defined contribution retirement plan, many continue to work because they need the income. In February 2017, the Bureau of Labor Statistics reported that almost 19 percent of adults 65 and older reported working either full- or part-time. Older workers can provide the educational and experiential background that many organizations want; however, a person's physical health is directly correlated their ability to continue working.
For the older person, the opportunity to work also depends on the local employment environment and culture of the workplace. While it is illegal to discriminate against people because of their age, it still happens. Older women in particular often encounter age discrimination in layoffs and hiring practices. Job loss has clear financial implications for older adults, but it can also put added stressors on their physical health. Research has found that people who lose their job between the ages of 57 to 61 have a reduced life expectancy of three years, on average.
- If you feel you have been discriminated against in the workplace or in the application process because of your age, contact the Texas Workforce Commission.
- If you are looking for a job, visit a staffing agency, find a job-seeker club or visit the Senior Job Bank search engine.
- Visit the work section of the AARP's website for information and tips for older workers.
- If you are a low-income worker over age 55, you may qualify to receive training or help finding a job through the Senior Community Service Employment Program.
- If you are an employer, use fair hiring practices and keep in mind the value that older workers can add to the workplace with their years of knowledge and experience. Go one step further and sign the AARP Employer Pledge Program.
The U.S. Equal Employment Opportunity Commission enforces federal laws that make it illegal to discriminate against a job applicant or an employee because of the person's race, color, religion, sex, national origin, age, disability or genetic information. Call the San Antonio Field Office at 800-669-4000 if you would like more information.
Knowing what we should plan for legally can help relieve our fears and the fears of our loved ones. It's not always something we plan for (or an easy conversation to have with your family members) but the awareness of potential legal challenges and developing a plan for addressing any legal issues is a good step to aging well. Issues that can affect older adults' legal health include:
- Benefits programs such as Social Security and Social Security Disability Benefits, Supplemental Security Income, state financial programs, veteran's benefits, and employee pensions and retirement benefits
- Medicare and Medicaid
- Long-term care
- Property (ownership, transfers and taxes of real property) and personal affairs (financial and health care decisions)
- Estate planning
- Consumer protection
- Age discrimination
- Family relationships (marriage, divorce, custody etc.)
- Crime and abuse
- Death (personal representative)
Texas Health and Human Services oversees financial and assistance supports for eligible people.
- AAA staff and volunteer benefits counselor can help navigate Medicare and Medicaid benefits related questions. Call toll-free 800-252-9240 to find the AAA near you.
- ADRCs help provide information about local legal resources. Call toll-free 855-937-2372 to find the ADRC near you.
- Texas Legal Services Center provides legal services and resources to people with low-income and others who meet qualifying criteria. Call toll-free 800-622-2520.
- State Bar of Texas can help you find a lawyer, answer questions of you have a problem with an attorney and provide you with free legal resources.