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One Senior Place OneSeniorPlace.com
Brevard/Space Coast: 321-751-6771 8085 Spyglass Hill Road, Viera, FL 32940
Greater Orlando: 407-949-6733 715 Douglas Ave, Altamonte Springs, FL 32714
PERSONAL PLANNING RESOURCE GUIDE
Opening the Lines of Communication Hope is not a plan when it comes to determining your long-term care needs. It is important to start the conversation early, BEFORE health changes force your hand. These are the topics for discussion:
Preferences/Concerns What is your biggest concern in planning for your future? How do you feel about moving to assisted living or a nursing home? If it was possible, would you like to stay in your home? Do you have legal provisions in place if you become ill or incapacitated? Have you made those wishes known to your designated person?
Home Safety Do you feel safe in your home? Are you willing to do the things necessary to stay safely at home? Would you be willing to accept help with your everyday activities? Does your hearing or eyesight affect your safety at home? Do you still feel safe driving? Have you had any recent car accidents? Are you worried about being a crime or fraud victim?
Health
Do you have any chronic health conditions? Do they affect your ability to do your everyday activities? Do you take medications and can you take them without assistance? When was your last physician’s appointment?
Health Care
Do you know what kind of medical coverage you have? Do you know the provisions of your medical insurance- co-pays, deductibles etc.? Do you feel your health care coverage meets your needs?
Nutrition
Are you able to shop and cook safely? Are there any physical problems affecting your appetite?
Finances How will you pay for your long-term care? Do you worry about outliving your money? Do you have any long-term care insurance? Are you able to pay your bills without assistance? Are all your bills paid up-to-date?
Legal
Do you have a DNR? Do you have a living will, a will, a power of attorney, a trust, a health care surrogate or proxy? Does your designated person have access to your financial and legal information?
Call Today for a Free Consultation 866 -751-6771
8085 Spyglass Hill Road, Viera, FL 32940 321-751-6771 715 Douglas Avenue, Altamonte Springs, FL 32714 407-949-6733
Playing it Safe
It is important to make sure you know where all your important documents are stored. Use the space below to let your designated family member know who to contact for those documents and where they are kept.
Personal Information for
Street address
City State Zip
Phone No. Cell Phone
Social Security No. Driver’s License No.
Emergency Contact Phone
Veteran? Yes No If yes, Service No.
DD-214? Yes No Location of DD-214
Health Information
Primary Care Physician Name
Street address
City State Zip
Phone No.
Other Physicians/Specialists/Dentist:
Name
Specialty Phone No.
Name
Specialty Phone No.
Name
Specialty Phone No.
Name
Specialty Phone No.
Call Today for a Free Consultation 866 -751-6771
8085 Spyglass Hill Road, Viera, FL 32940 321-751-6771 715 Douglas Avenue, Altamonte Springs, FL 32714 407-949-6733
Chronic Health Conditions
Hearing Aids
Audiologist/Hearing Aid Specialist
Manufacturer
Warranty Contact information
Health Insurance
Company Name
ID No. Phone
Secondary Insurance
ID No. Phone
Prescriptions
Pharmacy Phone
Pharmacy Phone
Medication/Dosage/Prescribing Physician:
Drug Allergies
Call Today for a Free Consultation 866 -751-6771
8085 Spyglass Hill Road, Viera, FL 32940 321-751-6771 715 Douglas Avenue, Altamonte Springs, FL 32714 407-949-6733
Financial
Name of Bank
Type of Account Account No.
Names on the Account
Location of Statements
Name of Bank
Type of Account Account No.
Names on the Account
Location of Statements
Name of Bank
Type of Account Account No.
Names on the Account
Location of Statements
Location of Safety Deposit Box and Key
Pension/401K/IRA/Survivor’s Benefit Plan
Employer Name
Benefit Coordinator Phone No.
Employer Name
Benefit Coordinator Phone No.
Employer Name
Benefit Coordinator Phone No.
Call Today for a Free Consultation 866 -751-6771
8085 Spyglass Hill Road, Viera, FL 32940 321-751-6771 715 Douglas Avenue, Altamonte Springs, FL 32714 407-949-6733
Life Insurance
Company
Policy Owner Policy No.
Agent’s Name Phone
Amount Beneficiaries
Company
Policy Owner Policy No.
Agent’s Name Phone
Amount Beneficiaries
Long-term Care Insurance
Company
Policy Owner Policy No.
Agent’s Name Phone
Auto/Renter’s/Homeowner’s Insurance
Company
Policy Owner Policy No.
Agent’s Name Phone
Company
Policy Owner Policy No.
Agent’s Name Phone
Call Today for a Free Consultation 866 -751-6771
8085 Spyglass Hill Road, Viera, FL 32940 321-751-6771 715 Douglas Avenue, Altamonte Springs, FL 32714 407-949-6733
Company
Policy Owner Policy No.
Agent’s Name Phone
Company
Policy Owner Policy No.
Agent’s Name Phone
Property Ownership
Do you have a Veteran’s Certificate of Eligibility?
Where is it located
Property Address
Mortgage Co Account No.
Location of Title
Property Address
Mortgage Co Account No.
Location of Title
Outstanding Financial Obligations
Name Account No.
Name Account No.
Name Account No.
Name Account No.
Name Account No.
Call Today for a Free Consultation 866 -751-6771
8085 Spyglass Hill Road, Viera, FL 32940 321-751-6771 715 Douglas Avenue, Altamonte Springs, FL 32714 407-949-6733
Legal
Attorney Name
Address
City/ST/Zip
Phone Date Will Executed
Location of Will
Executor of Estate
Power of Attorney
Name Phone
Location of POA
Trust
Name of Trust
Name of Grantor/Trustee Phone
Living Will
Date Executed Document Location
Funeral Planning
Name of Funeral Home/Crematorium
Funeral Planner Name
Funeral Home Phone No. Prepaid information
Call Today for a Free Consultation 866 -751-6771
8085 Spyglass Hill Road, Viera, FL 32940 321-751-6771 715 Douglas Avenue, Altamonte Springs, FL 32714 407-949-6733
Miscellaneous Important Information:
Location of Birth/Adoption Papers
Location of Marriage/Death/Divorce Documents
Security/Garage Door Code(s)
Memberships/Subscriptions
Computer Passwords
Online Accounts/Memberships
Provisions for Pets
Notes
Call Today for a Free Consultation 866 -751-6771
8085 Spyglass Hill Road, Viera, FL 32940 321-751-6771 715 Douglas Avenue, Altamonte Springs, FL 32714 407-949-6733
Moving: Are YOU ready?
Decision Tree for Senior Retirement Options
Assess personal, physical and medical needs for yourself and your loved one.
Review income, assets, investments, value of home in order to determine what you can afford.
Review possible payment assistance benefits or programs that you might be eligible for: Long
Term Care Insurance, Veteran’s Benefits, Medicaid Waiver/ Diversion Program?
Evaluate your support network to determine where you want to be located: Stay in the same city?
Are you active in your church, have many friends? Move closer to adult children?
Educate yourself on the options available to you and schedule a lunch or dinner tour.
Things to look for when touring and inquiring about a facility:
Menu: Food choices
Staff: How do they interact with the residents? How long have they worked there? Is there
frequent staff turnover?
Residents: Do they seem happy? Do they make you feel welcome?
Activities and programs: Do they offer things that are of interest to you?
Transportation: If you no longer drive or are unable to, can they provide adequate transportation
for you?
On-site providers and services: Hair salon/barber shop, physicians, podiatrist, hearing specialist,
eye doctor?
Levels of Care Offered: Can they accommodate your needs as you age?
Selling Your Home: Senior Real Estate Specialist
Obtain a free market analysis to determine value of your home, seek suggestions to help improve
the value without spending a lot (painting neutral colors, reduce clutter, remove excess furniture,
plant new flowers in yard, power wash driveway).
Decide which furniture and belongings that you want to keep, what will fit in your new apartment.
Contact an estate sale expert to determine the best approach to getting rid of your excess
furniture and belongings – do you have antiques or valuables that should be sold separately?
Ask your family members if they are interested in any items that you no longer want or need.
Call Today for a Free Consultation 866 -751-6771
8085 Spyglass Hill Road, Viera, FL 32940 321-751-6771 715 Douglas Avenue, Altamonte Springs, FL 32714 407-949-6733
Senior Retirement Living Options
Independent Senior Housing: Condos, 55+, mobile home park, apartment, single family home. No services
or amenities unless provided by private business or agency.
Independent Senior Retirement Communities: Meals, housekeeping, transportation, activities all included
in the monthly fee. Services and assistance often available onsite as your needs increase.
Continuing Care Retirement Community (CCRC): Usually a “buy in” fee, promotes “aging in place” since
they offer Independent, Assisted, Skilled Nursing, and often Memory Care and guarantee that you can
remain on the same campus until your death. Move in while considered Independent.
Assisted Living – provides assistance with activities of daily living and services distinguished by licensure:
o Standard (STD) basic assisted living license
o Limited Nursing Services (LNS) some nursing services provided
o Extended Congregate Care (ECC) highest level of care provided under ALF license
o Limited Mental Health (LMH) specific licensing and training to provide assistance to residents with
mental health diagnosis
Skilled Nursing Facility (SNF): offers short term, sub acute rehabilitation and long-term nursing care.
Who Pays for All This?
Medicare pays for “skilled care” by a nurse, occupational, speech or physical therapist, in a person’s home or
living facility. The amount of time this care will be paid for is defined by Medicare and will vary by
situation. Skilled care in a nursing facility or rehab is limited to 100 days, but may be less depending upon
the patient’s progress in rehabilitation. Medicare also covers hospice care.
Medicaid pays for skilled nursing care for people that are financially qualified. This may be both short-
term and long-term care. Medicaid will also cover hospice care, and on a limited basis, assisted living.
Long-term Care Insurance pays for care received in the home or in a facility based on the particular
provisions of the individual policies. Policy owners should be aware of the policy triggers, daily limits and
maximum policy limits.
Veteran’s Aid and Attendance Benefits pays for home care and care in a facility. Veterans and their spous-
es must meet eligibility requirements.
Private Health Insurance and Supplements may have skilled care benefits. Check with your health insur-
ance to find out the limitations of these policies.
Revolutionizing the way America shops for Elder Care and Services
8085 Spyglass Hill Road, Viera, FL 32940 321-751-6771 715 Douglas Avenue, Altamonte Springs, FL 32714 407-949-6733
OneSeniorPlace.com
In-Home Care Options:
Private Duty Care provides non-medical care and assistance with activities of daily living such as meal prepa-
ration, bathing, grooming , dressing, transportation and light housekeeping. Private duty care is almost
always private pay but may be paid for by Medicare when bundled with skilled services ordered by a phy-
sician. Long-term care insurance policies may also pay for in-home care. You CAN use Veteran’s Aid and
Attendance Benefits to pay for private duty care.
Skilled Home Health Care is care given by nurses, occupational, speech or physical therapists. Medicare
pays for this care with an order from a physician. Most private insurances also pay for skilled home care.
Hospice Care can be given in a patient’s home, including residence in assisted living or skilled nursing facili-
ties. Patients must have a terminal diagnosis. Medicare and Medicaid, as well as private health insurance
(subject to terms of policy), will pay for hospice care.
Still have questions? One Senior Place is here to help. We invite seniors and interested family members to
take advantage of the free consultation process that helps connect you to the right service or product for
your individual needs. Call 866-751-6771 today and schedule your free consultation!
Revolutionizing the way America shops for Elder Care and Services
8085 Spyglass Hill Road, Viera, FL 32940 321-751-6771 715 Douglas Avenue, Altamonte Springs, FL 32714 407-949-6733
OneSeniorPlace.com
Full Range of
In-Home Care
Services Bathing, Dressing Personal Care
Meals, Housekeeping, Laundry
Transportation
Registered Nurse On Call 24/7
Alzheimer’s and Dementia Care
Geriatric Care Management
Medical Care Coordination
Medication Management
Placement Assistance
Transitional Care
Lic # 30211049 A One Senior Place Company
321-253-6336 24 hours