The birds are chirping, the sun is shining, and you are strolling along, enjoying the day, when suddenly you slip on a piece of cardboard someone left on the sidewalk. You break your hip, the operation doesn't go so well (after all, you are a woman in your late 80s with low bone density). For the first time in your life, you need help with everything: getting up, going to the bathroom, taking a shower, dressing, cooking... and little by little, things get worse. That's what happened to my mom – a long time ago. Fortunately, while she was in rehab, an agency contacted us and offered the help of a caregiver from the Philippines. In some countries, mom might have had to move into nursing care; instead, she stayed home, cared for 24 hours a day by a wonderful woman. However, as you will have learned from reading last month's column, help is expensive. Fortunately, in 1986 the Knesset passed the Nursing Care Law (Hok Siud). As a result, at least 160,000 Israeli senior citizens and residents who are either wholly or partially dependent on others are receiving financial assistance for home care and other crucial services through the National Insurance Institute. Indeed, according to Orna Zamir, the institute's director of long-term care (LTC) at home, relatively fewer people are found in Israel's nursing care institutions than their counterparts in many other countries. The law's provisions are meant for people who have reached retirement age and are dependent on someone else in order to carry out routine daily activities. The law offers four types of assistance: 1) Home care services: Five to 22 hours per week; people with 24-hour-a-day caregivers can get this type of assistance as a direct monetary subsidy; 2) Delivery of absorbent undergarments to your doorstep; 3) Laundry services; 4) Daycare in special facilities. To be eligible for benefits under the Nursing Care Law, one must: • Have arrived in Israel before retirement age (62 for women, 67 for men); • Have a monthly income that doesn't exceed a specified sum (see below); • Reside either at home or in assisted living (diur mugan); • Be dependent on someone else to help you in your daily life. Determining eligibility FINANCIAL: Monthly income refers only to regular income that you receive each month, such as pensions, stipends from NII, and property rentals. Holocaust survivor stipends from foreign countries are not included in the calculations. Zamir points out that even people with considerable savings – including stock and securities, here and abroad – may still be eligible for assistance through the law if their monthly income falls below the limit. In order to receive a full benefit, a single person may have a regular monthly income of up to NIS 9464 – a couple, NIS 14,196. Singles with an income of up to NIS 14,196 are eligible for a 50% benefit; so are couples whose monthly income reaches a ceiling of NIS 21,294. NEED FOR CARE: Once you have been declared financially eligible by the NII, a nurse, physical therapist or other professional will visit you at home and establish the extent of your dependence on others. That professional's evaluation plus your financial eligibility determine how much help you will get from the NII and what that help will be. Many elderly people who become dependent on others still insist on looking their best and may even try to show off their mental faculties in an attempt to prove what good shape they are in. Indeed, my mom – who was wearing make-up and had her hair done when the evaluator came – smiled so winningly that the professional doing the evaluation could have been misled. That's why Zamir stresses the importance of an additional person being present at the evaluation. That person, generally a family member, will be able to give the professional evaluator crucial information on both the cognitive deterioration and physical disabilities of the person needing care. There must be an opportunity for this additional person to speak privately with the professional, so that the person needing care is not hurt or insulted by what must be said. You (or the person who assists you) may be unhappy with the process of the home visit or the conduct of the evaluator. In the past, says Zamir, there really was no one to talk to about it and if you felt the decision of eligibility or non-eligibility was based on a faulty home visit, you had no recourse but to appeal. Zamir claims that those days are over. If you write a letter to the LTC Home Care Unit, she says, someone will call and you can discuss your concerns about the home visit. “We are making a strong effort to listen to what you have to say,” notes Zamir (see below). If you are over 90 years old, you may choose to have your dependency evaluated by a specialist physician in geriatrics as part of his work in a public institution – i.e. you cannot pay privately for the forms. If you or someone you care about/for needs parttime or full-time care, you can file a claim for assistance under the Nursing Care Law. Entitlement (zakaut) begins on the first of the following month. You no longer have to go to a branch of the NII to file a claim; today you can do this through a form you receive online. However, the forms are not yet available in English, nor is the short video explaining how to fill them out. For assistance, once you get the form, ask a friend, contact the Seniors' Advice Bureau at the NII or, another possibility, your local Citizens' Advice Bureau (see below for both numbers). Better yet, connect with one of the many agencies in your area that provide foreign and Israeli workers as caregivers: they will help with the forms, give you advice, and generally steer you on your way. There is no fee for this service; the agencies hope you will continue with them once you are found eligible for assistance. The NII Hebrew website lists agencies under their supervision; the list is not yet available in English. For assistance, or questions about your rights at the NII, call the Seniors' Advice Bureau. Should all else fail, and you believe you are eligible for assistance under the Nursing Care Law, or think you deserve higher eligibility than you received, you can appeal the NII's decision with a fax or email to Zamir's department at the NII. You may wonder who decides exactly what kind of assistance you need. Zamir notes that a social worker from your municipality comes to your home during the first month after the entitlement is approved (and once or twice a year after that) to go over the different possibilities with you. This is to make sure that the services you receive suit your needs. • For more information, see the website (in English) dealing with long-term care at the NII: https://www.btl.gov. il/English%20Homepage/Benefits/LongTerm%20Care/ Pages/default.aspx Seniors' Advice Bureau: *9696; for English: (02) 646- 3404. Leave your number and someone will call you back. For information on employing foreign workers, see my previous column of January 22 (Metro) or January 29 (In Jerusalem). Note: I can't solve your personal problems (for this, please call the Welfare Ministry's central number – 1-800-506-060 and ask for the number of your local citizens' advice bureau (Shil). However, please do write with comments on my articles or issues you would like to see raised in the future. Next month's article will be on consumer law and relevant issues. Contact me at: consumerjpost@gmail.com