A reverse mortgage is the encumbrance of an existing apartment for the purpose of receiving money from the bank. The mortgage is intended for retirees aged 60+, who need a large sum of money for various needs: helping children, traveling abroad or financing life in old age. With a normal mortgage, people borrow money from the bank for the purpose of purchasing an apartment and must repay the mortgage in monthly interest-bearing payments.
Pensioners at retirement age will have difficulty obtaining a large amount of money in a normal way, therefore they can convert their apartment by working for a bank or other financial body, and receive a large amount of money in return.
Advantages of the reverse mortgage-
A reverse mortgage is a loan for any purpose, which is not limited in time.
There is no need to pay it back in regular monthly repayments.
There is no need to take out life insurance as with a normal mortgage.
Income tests are not done (because without regular refunds, there is no interest in regular income).
You can pay off the reverse mortgage at any point in time and without penalty.
A reverse mortgage helps to finance the needs of the borrowers at the expense of the property.
It is better for retirees who need money to take a reverse mortgage and not sell the house, instead of taking a normal interest-bearing loan and deferring the repayments.
The borrowers continue to own the house and are allowed to live in it.
For him, the bank is calm, because he has a lien on the house. The bank’s profit is from the interest that is accrued and recorded in the bank’s books, but is paid only at the end of the mortgage period.
When the borrower decides to sell the apartment or passes away, the proceeds from the sale of the apartment will cover the loan amount plus the accrued interest.
Helping children-
In light of the high cost of living in Israel and the growing dependence of young people on their parents, the need and desire of parents to help through greater funding has increased and they are working to realize a reverse mortgage. The expectation is that the process of using a reverse mortgage will expand. Many parents want to help their children later in life, than to help through the inheritance, because the children need help now.
Financing the old age-
A reverse mortgage is an effective way for retirees to get a large sum of money that will allow them to finance the rest of their lives after they stop working. Sometimes family members are unable to help their parents and this is the only way out. The amount of money that the pensioners can receive depends on the value of the apartment, the age of the borrower and it can reach half of the value of the apartment, therefore, this financial solution will significantly affect the quality of life of the pensioners and their families.
Who is eligible for a reverse mortgage?
60+ years old, who own a residential property without encumbrances, foreclosures or debts. Even those who have a low mortgage balance may replace a standard mortgage with a reverse mortgage.
The entities that give a reverse mortgage:
Banks and insurance companies.
The Actual Execution Process:
Submit an application to a body that finances a mortgage and receive a sum of money in exchange for pledging the property.
Returning the loan:
There is no need to return money immediately. The money will be returned to the lender through the sale of the property or the payment of the reverse mortgage. If there is a balance left when the property is sold, the surplus will go to the borrower or his heirs.
Due date:
It is possible to pay off the reverse mortgage at any time and without penalties (but it is advisable to verify this when signing the contract).
Restrictions on the use of money:
There are no limitations. The money given in exchange for a reverse mortgage can be designated for any purpose. T
he loan amount that can be received:
The amount depends on the age of the borrowers. It usually reaches up to half of the property’s value. As the age increases, the loan rate in relation to the value of the property increases.
Different routes to a reverse mortgage-
Old age financing – borrowers who want to continue living in their apartment and need money to live on, can request a reverse mortgage, which will be repaid at the end of their longevity or after leaving home.
Nursing home financing – borrowers who need money to move to a nursing home will receive the money until the end of their longevity or until they leave the nursing home.
Covering the debt of the regular mortgage – for those who still have a mortgage on the property, and wish to stop paying monthly payments, can cover the debt by taking out a reverse mortgage and leave more money to live on.
The interest rate used in a reverse mortgage-
The interest rate of a reverse mortgage is slightly higher than a standard mortgage (between 0.3% and 1.3% above standard mortgage interest). Reverse mortgage interest accrues over time.
Additional costs:
Fees for the lawyer, who signs the documents to open the case.
The cost of opening a mortgage portfolio – between 1% and 2% of the value of the property.
Fees for the appraiser, who determines the value of the property.
Insurance on the apartment.
Payment of service fees.
Reverse mortgage flexibility –
The borrower can repay the mortgage at a time that suits him. In addition, the procedure for taking out a reverse mortgage is relatively simple. In most cases, there is no need for guarantees or securities, because the property constitutes the security, therefore the conditions of the banks are more flexible.
Disadvantages of the reverse mortgage –
The interest on the mortgage increases over time. Additional related costs are: hiring an appraiser, paying a lawyer and paying management fees. Also, there is an influence here on inheritance. If there is no ability after the borrower’s death to return the loan money, the apartment will be sold and the inheritance will go down the drain.
Recommended if so:
Check in advance the positive and negative financial implications of taking out a reverse mortgage.
In conclusion-
A reverse mortgage is a safe and available financial solution for those who have difficulty raising money through a loan from the bank or other entities. It contains many advantages and solutions to difficulties, which without it would have been difficult to solve. The ability to raise a sum of money relatively easily can improve the quality of life of the elderly population and the life of the entire family in many respects.
Since it is a financial product with advantages and disadvantages, it is important to check the feasibility of the transaction, to examine the current and future financial situation of the borrowers and possibly also the heirs. For this purpose, it is recommended to contact a professional independent of the banks, and receive advice and a feasibility study.
Reporter: Maxim Weizman – economist, entrepreneur and real estate man, owner and founder of Weizman Consulting and Mortgages!
The subsidy is carried out through the supplementary insurance of the various health funds. The health insurance funds participate in financing hearing aids for those aged 65 and over.
General – the subsidy is done in a perfect general way. Klalit Perfect customers over the age of 18 who need hearing aids will be able to receive them – according to a specified list of device models that appears on the Klalit Perfect website. In order to receive the service, one must have a referral from a doctor of Klalit Health Services, or a doctor approved by Klalit Perfect, or a referral from a Klalit communication clinician. The service can be used after 6 months of joining the perfect college. The reimbursement amount is up to 75% of the cost of the accessories, up to a maximum amount of NIS 1,100 per calendar year.
How can the subsidy be obtained?
Make sure you have the following documents:
A. Tax invoice and original receipts signed by the service provider. Make sure that the details of the buyer and the type of accessory purchased are stated on the invoice. If the invoice/receipt in your possession is computerized/digital, you must attach a statement that the original was not transferred to any other party.
B. A referral from a doctor or communication clinician of General Health Services, confirming the need for the accessory, relevant to the year of purchase.
2. The refund request can be submitted through the website here>>>
3. You can also fill out an application form, a refund form, attach to the application form the required documents listed above, and send it to Kallit Memhol, Claims Department, P.O. Box 2265 Bnei Brak, zip code 5112201
The rest of the checkouts, you can go to the following links or contact us by phone and check-
Maccabi Cooperative, phone- *3555
National Insurance Company – 1-700-507-507
United Cooperative – 1-222-3833
Assistance in financing mobility devices-
The Ministry of Health participates in the financing of rehabilitation, mobility and walking devices.
Assistance in financing walking aids-
Who is eligible? – People with permanent disabilities who need devices, including those who are hospitalized in nursing homes, hospitals and institutions of the Ministry of Welfare.
The insured’s deductible is 25% of the cost of the device, or of the maximum participation ceiling established for him, whichever is lower.
Recipients of the following allowances are exempt from paying a deductible (it is necessary to submit appropriate certificates for the allowance):
People who find it difficult to finance their share, can contact the social worker at the health bureau with income certificates of both spouses (salary slip/pension/allowance, self-employed tax assessment and other documents that will be required).
Social Worker may increase the participation of the Ministry Of Health up to 90% of cost of device in the following cases:
In the same year, another device was purchased.
There are other people in the family who are entitled to assistance in financing a device that year.
That year, the applicant had additional expenses related to his disability, for which he did not receive assistance from another source.
The family finances the stay of a child or other first-degree family member at the institution.
The devices, as stipulated in the third supplement to the State Health Insurance Law, are:
Limb prostheses, gloves to cover a hand prosthesis and stump socks (in the case of replacing a stump or prosthesis).
Special medical shoes.
Waist support belts and orthoses (splints).
The process of exercising the right
You must have a recommendation from an orthopedist or a rehabilitation doctor and contact the guidance coordinator at the health office in the residential area.
For those who stay in institutions, the application can be made through the framework in which they stay.
The orientation coordinator will check the details and refer the applicant to a licensed doctor using a card that will indicate the participation rate of the office.
The applicant can choose a doctor from a list that will be given to him by the orientation coordinator.
The doctor will examine the applicant and determine his eligibility for the device.
The applicant can choose a supplier from a list of authorized workshops.
After receiving the device, the doctor will check its quality and suitability for the applicant’s needs.
National appointment center for Lewis Institute patients
The Lewis Institute in collaboration with the Ministry of Health established a national appointment calling center in order to make it easier for the institute’s patients, and to reduce the length of time waiting for an appointment.
Patients of the Lewis Institute who are entitled to custom-made walking aids can make an appointment through the hotline for licensed doctors in the hospitals where the Institute’s clinics operate.
The hotline, whose number is 03-7575660, operates Sunday-Thursday from 8:30 a.m. to 3:30 p.m.
During the hours when the hotline is closed, the applicant can leave a message and they will get back to him.
Victims of road accidents
In general, traffic accident victims have been insured since 1975 according to the law on compensation for traffic accident victims.
However, as of May 17, 2012, victims of road accidents are entitled to receive rehabilitation and mobility devices from the Ministry of Health after the conclusion of the legal proceedings in their case with the insurance company, on the condition that the judgment/settlement agreement established does not include compensation for the devices in the future as well and does not prevent the Ministry of Health from being reimbursed by the insurance company.
Until the legal decision is issued, the insurance company is responsible for supplying or financing the necessary devices.
For more details, see Medical Administration Circular No. 15/2014 – Approval of rehabilitation and mobility accessories and walking aids for traffic accident victims.
Assistance in financing rehabilitation devices –
The Ministry of Health participates in the financing of rehabilitation devices.
The firm participation of a rate of 25%of price determine accordin to the type of device ,according to the division of two groups:
Devices for which a maximum amount is set (which is not the full price of the device).
Devices to check for 3 quotes. The price of the device will be determined according to the cheapest offer.
The deductible is at a rate of 25% of the amount determined by the Ministry of Health (except in cases where an exemption is granted and will be detailed later).
Who is eligible?
A person with a permanent disability who needs a rehabilitation device and lives in the community.
According to the determination of the High Court of Justice, the state is responsible for funding for those who stay in out-of-home care of the Ministry of Welfare.
Who is not eligible?
Work accident victim
casualty of hostilities
Disabled IDF
Holocaust survivors receiving compensation from the Ministry of Finance
The disabled from the war against the Nazis
Holocaust survivors who receive an allowance for camp and ghetto survivors from the Ministry of Finance
Exemption from payment of deductible-
No deductible is required for the following rehabilitation devices:
Regarding the rest of rehabilitation,the following populations are attempt from paying from deductible device:
Recipients of an income supplement supplement for an old-age pension
Recipients of an income supplement supplement for a survivor’s pension
Recipients of a full disability allowance that includes a family allowance
Recipients of an income guarantee benefit
Families whose net income is the amount of an old-age benefit with an income supplement supplement (net income is after deductions for income tax, the National Insurance Institute, health insurance, pension fund and workers’ council have been reduced).
To receive the exemption from the payment, it is necessary to submit appropriate certificates, depending on the qualifying reason.
People who find it difficult to finance their share, can contact the social worker at the Ministry of Health with proof of income from both spouses (salary slip/pension/allowance, self-employed tax assessment and other documents that will be required).
The social worker may increase the participation of Ministry of Health up to 90% cost of the device in the following cases:
In the same year, another device was purchased.
There are other people in the family who are entitled to assistance in financing a device that year.
That year, the applicant had additional expenses related to his disability, for which he did not receive assistance from another source.
The family finances the stay of a child or other first-degree family member at the institution.
List of rehabilitation devices-
The list of devices, established in the third supplement to the State Health Insurance Law, includes:
Eye prostheses and scleral prostheses (lenses) for all ages. The Ministry of Health finances the full cost (no deductible is required).
Facial prostheses – nose/ear/orbital. Breast prosthesis, once every two years. The Ministry of Health finances the full cost or the established participation ceiling (whichever is lower). Bra for a breast prosthesis – funding is given only once. The Ministry of Health finances the full cost (no deductible is required). Assistive and alternative communication devices – systems that allow the user the ability to communicate through recorded or typed messages that replace speech. The use of devices allows people without the ability to speak or with poor speech intelligibility to express themselves, thus communicating with their environment in an optimal and independent way, as much as possible.
The equipment that has been financed includes:
Dedicated computers on which dedicated software will be installed. In cases of a physical limitation in operating the computers, accessibility accessories to operate them (such as a special mouse or activation switches) will also be financed.
Supportive and alternative computerised communication systems that are operated through gaze focusing, and the aids that accompany them (such as a column or an arm for the computer’s adjusted position).
The process of exercising the right-
You should contact the relevant doctor at the health fund to receive a recommendation.
The Document required for the assistance request:
For hearing aids – a referral from an audiologist and a speech therapist’s recommendation along with an audiological examination
For visual aids (including eye prostheses) – an ophthalmologist’s recommendation
Breast prostheses – recommendation of a family doctor/ internist/ oncologist/ surgeon
ID photo
The submission of the documents to the health bureaus can be done by the health funds or directly by the applicant/representative on his behalf.
The request is submitted to the device coordinator in the department of chronic diseases and rehabilitation at the nearest health office.
The documents can be submitted on reception days in the department, by mail or by fax.
A local committee will discuss the request and the committee’s decision (approving or rejecting the request) will be sent in a reply letter to the applicant.
Instructions regarding the continuation of the process will be detailed in the reply letter that will be sent to those whose application has been approved.
Those who have received confirmation of eligibility of self purchase,will submit the following documents to Health Office to receive refund :
Confirmation of eligibility
Device receipt confirmation form (signed)
Invoice and receipt – original documents
Bank account details for bank transfer of the refund (using a copy of a canceled check)
Appeal:
Those whose request for assistance was rejected may appeal the committee’s decision.
The appeal shall be submitted in writing through the Health Bureau.
The appeal committee hearing will be held within 30 days from the date of receipt of the appeal and its handling at the health bureau.
Important Information:
The authorisation to finance the device will be valid for six months.
The list of mobility equipment that is subsidized by the Ministry of Health-
The Devices are stipulated in the third supplement to the state health insurance law :
Manual wheelchairs
strollers
Buggy chairs
motorized wheelchairs
Wheelchairs for toilets
Special cushions for wheelchairs
Inserts (seating systems) for wheelchairs
Full Fowler + HI-LOW hydraulic and electric beds
Electric air mattresses (standard) to prevent pressure sores
Electric and hydraulic domestic cranes
Rear walkers
Rollators
Treadmill will die
Canadian crutches
Crawlers/portable stairlifts – in exceptional cases
Fully funded devices for pension recipients:
The following devices are financed only for the recipient of allowances mentioned above(without the need for a deductible) :
Normal treadmills
Walking sticks of all kinds
Sponge cushions to prevent pressure sores
Standard sponge mattresses (“egg pattern”)
The process of exercising the right:
You should contact the family doctor at the health fund.
The family doctor or other specialist doctor will forward the referral to a physical therapist or occupational therapist (who has a certificate of authorization to recommend), for the purpose of checking eligibility for participation in the financing of the device.
The professional officials at the health fund will guide the applicant regarding the documents he must submit and the process of submitting the application to the Ministry of Health.
Documents to be submitted:
Current medical/nursing report signed by a doctor and a nurse
Specification and/or recommendation of a physical therapist or therapist in the occupation of the insuring health fund
A social report signed by an attorney from the health fund or the social services department in the locality (recommended in the case of motorized/electric mobility devices or as required by the bureau)
ID photo
The submission of the documents to the health bureaus can be done by the health funds or directly by the applicant/representative on his behalf.
The request is submitted to the device coordinator in the department of chronic diseases and rehabilitation at the nearest health bureau.
The documents can be submitted on reception days in the department, by mail or by fax.
A local committee will discuss the request and the committee’s decision (approving or rejecting the request) will be sent in a reply letter to the applicant.
Complex devices (a bed with an electric mechanism, a motorized wheelchair, an auxiliary motor for a manual wheelchair, a crane with electric operation and a caterpillar) are transferred to a district committee for discussion.
Instructions regarding the continuation of the process will be detailed in the reply letter that will be sent to those whose application has been approved.
Those who have received confirmation of eligibility for self-purchase, will submit the following documents to the health office in order to receive a refund:
:
Confirmation of eligibility
Device receipt confirmation form (signed)
Invoice and receipt – original documents
Bank account details for bank transfer of the refund (using a copy of a canceled check)
Submitting an application for those aged 70 and over:
In the Application of those age 70 and over there is a option to submit application for financing mobility devices in one of the following way :
Sending the request to the email address: shikum_natali@moh.gov.il
Sending the request to the fax number: 03-9135864
These inquiries are handled by the Ministry of Health through an external company.
Appeal-
Those whose request for assistance was rejected may appeal the decisions of the committees.
The appeal shall be submitted in writing through the Health Bureau.
The appeal committee hearing will be held within 30 days from the date of receipt of the appeal and its handling at the health office.
Repair of mobility devices:
The Ministry of Health finances the repair of mobility devices after the end of the warranty period given by the supplier.
As of April 1, 2017, all populations are given full funding for repairs of manual mobility devices (such as manual wheelchairs and toilet wheelchairs), as previously only for repairs of electric mobility devices. For more details, see the circular of the Medical Administration dated 05.04.2017.
The Ministry may collect participation in the financing of the repair in the event of a malfunction resulting from negligence, from unreasonable use, or from use contrary to the instructions of the manufacturer, the supplier or the Ministry of Health.
Mobilitiy Device supplied untill 2014:
After the end of the warranty period, do not contact the suppliers directly in order to receive a repair service.
If a repair is required for the device, please contact the “Voice of Health” hotline by phone: *5400, 08-6241010.
Most of the repairs are carried out through the national unit for rehabilitation and mobility devices.
Mobility Device supplied as of 2014:
In the case of devices supplied by authorized suppliers (in a tender), contact the authorized supplier that supplied the device directly.
The following device will return to the Health office at the end of use:
Manual wheelchairs (all types)
Wheelchairs for toilets
motorized wheelchairs
Wheelchairs with auxiliary motors
strollers
beds
levers
Caterpillars/portable stairlifts
special walkers (rollers)
The recipient of the device and an additional guarantor (or guarantor only), must sign when receiving the device a commitment form and promissory note guaranteeing the return of the device at the end of its use.
Important Information:
The authorization to finance the device will be valid for six months.
The specification of the recommendation that will be approved by the health bureau, includes functional and medical information that is transmitted, if necessary, to suppliers for price quotations. A person who wishes to maintain confidentiality in the transmission of information, should contact the health bureau in his area of residence.
From November 2018, the new reform in nursing, shared with the Ministry of Health, the National Insurance and the Ministry of Welfare, was launched. This article comes to explain the new situation in accordance with the reform and to give tools for choosing between the various options. And:
Chapter I- Basic definitions:
When we come to examine what are the main changes in the new reform in nursing, we must define a number of main issues on which it is based.
1. Nursing allowance-
An allowance provided by the National Insurance Institute. Until October 2018, it was possible to receive the benefit in one of the following 2 ways:
A. Employers of Israeli workers – through a nursing company or directly to the bank account (this if the recipient of the benefit has the opportunity to prove that he receives the service of an Israeli nanny for 6 days a week and 12 hours a day).
B. Employers of foreign workers – through a nursing company (see my previous article), or with a direct benefit to the beneficiary’s bank account.
2. A.D.L. test
This is the functional test performed by the National Insurance through nurses coming to the home of the benefit recipient. The test consists of 6 main tests:
A. Getting up and lying down.
B. Mobility.
C. Bathing
D. Dressed.
3. Eligibility levels – 6 established levels:
A. Level 1 – between 5.2 and 3 points
B. Level 2 – between 5.3 and 5.4 points
C. Level 3 – between 5 and 6 points
D. Level 4 – between 5.6 and 5.7 points
E. Level 5 – between 5.7 and 9 points
F. Level 6 – from 5.9 points and above.
Chapter II – The main changes in the reform:
There are 2 main changes in the nursing reform
1. Change in nursing hours according to each level:
Until October 2018, there were 3 levels in receiving the nursing allowance.
Level A- It provided its recipients with 9.75 hours of nursing per week.
Level B- Granted its recipients 19 nursing hours per week when employing an Israeli caregiver and 16 nursing hours for employers of foreign workers.
Level C-Granted its recipients 22 nursing hours per week when employing an Israeli caregiver and 19 nursing hours for employers of foreign workers.
As of November, there are 6 levels for the benefit as written above. (In the rest of the article, the levels will be detailed according to the services that can be received in each of them).
2. Payment amounts when receiving the benefit or a portion of it directly, the amount of money paid to those entitled to the nursing benefit at each level has increased significantly.
Additional nursing services:
Laundry (0.25 hours per week for 5 kg),
club (2 weekly sessions per day),
Emergency button (0.25 hours per week)
Absorption products
Level B:
hours or a caregiver from a nursing company for 10 hours or a caregiver through a nursing company for 6 hours in combination with a financial allowance of NIS 820 per month.
Level C:
A caregiver through a nursing company for 15 hours or a caregiver from a nursing company for 11 hours in combination with a financial allowance of NIS 820 per month.
Exceptionally and according to the decision of a social worker referred by the National Insurance Institute, it will be possible to get a caregiver from a nursing company for 10 hours in combination with a financial benefit of 1025 NIS per month.
Additional nursing services:
club (2 weekly hours per day),
emergency button (0.25 hours per week),
Laundry (0.25 hours per week for 5 kg),
Absorption products
Level D:
Caregiver through a nursing company for 19 hours. or a nanny from a nursing company for 15 hours combined with a financial benefit of 820 NIS per month, exceptionally and based on the decision of a social worker referred by the National Insurance Institute, it will be possible to receive a nanny from a nursing company for 12.5 hours combined with a financial benefit of NIS 1300 per month. Additional nursing services:
• Laundry (0.25 hours per week for 5 kg),
• Club (2.75 NIS per day)
• Emergency button (0.25 hours per week)
• Absorption prod
Level E:
Caregiver through a nursing company for 23 hours. Or a caregiver from a nursing company for 19 hours combined with a financial allowance of NIS 820 per month. Exceptionally and according to the decision of a social worker referred by the National Insurance Institute, it will be possible to get a caregiver from a nursing company for 15.5 hours combined with a financial benefit of NIS 1570 per month. Additional nursing services:
• Laundry (0.25 hours per week for 5 kg),
• Club (2.75 per week per day),
• Emergency button (0.25 hours per week)
• Absorption products.
Level 6:
Caregiver through a nursing company for 28 hours. Or a caregiver from a nursing company for 24 hours combined with a financial benefit of NIS 820 per month. Exceptionally and according to the decision of a social worker referred by the National Insurance Institute, it will be possible to get a caregiver from a nursing company for 18.5 hours, combined with a financial benefit of 1910 NIS per month.
Additional nursing services:
Laundry (0.25 hours per week for 5 kg),
Club (2.75 per week per day),
Emergency button (0.25 hours per week)
Absorption products.
Chapter 3 – The services that can be received at each of the levels for benefit recipients who need 24-hour supervision.
Benefit recipients who employ foreign workers (and/or benefit recipients who employ Israeli workers for 6 days a week, for 12 hours a day), can choose whether to receive the money through a nursing company or through a direct benefit. In my previous article on this matter, I showed that there is a gap expressed in thousands of shekels per year between the employers who choose to receive the benefit directly, and those who receive the benefit through the nursing companies, therefore, we will not focus on that in this article. However, it is important to note the amounts of money paid by the National Insurance Institute to direct benefit recipients as follows:
Chapter 4 – Holocaust survivors 9 nursing hours
Holocaust survivors recognized by the Authority for the Rights of Holocaust Survivors and/or the Claims Conference are entitled to an additional 9 hours of nursing care per week beyond the nursing benefit provided by the National Insurance.
Eligibility for receiving these 9 hours is meeting a rating of 6 ADL points (level 3 as above) in the dependency test and in addition, in that the nursing allowance is not reduced due to income.
According to the new reform, those Holocaust survivors, who are entitled to this supplement, can receive this benefit financially directly to their bank account, which will add 1842 NIS to them every month.
The option to choose a direct benefit is only given to those who employ a 24-hour caregiver.
Chapter 5 – Considerations for receiving compensation in money or directly:
When it comes to receiving part or all of the benefit directly, we must take into account a number of factors that influence the decision:
1. Bureaucracy-
The nursing companies claim more than once that a benefit recipient is directly “alone” with the employees he employs. This assumption is devoid of any foundation since the corporations and private bureaus are responsible for the employment of the foreign workers. The nursing company has no responsibility towards the foreign worker. With the exception of the payment of the salary, she has no connection with him, even though she is considered his employer, the recipient of benefits and the holder of the license is the main employer. Therefore, he must manage the employment of the caregiver regardless of the nursing company.
In fact, the nursing company is a body that stands in the way between the recipient of the benefit and the employee, thus hindering the transaction. Therefore, the recipient of the benefit must know that, in any situation in which he employs a caregiver, he must treat it as a full employer and, therefore, must manage the employment as required by law. The nursing company will not give him the help he needs once the employee ends the employment. On the contrary, in most cases the recipient of the benefit learns that the nursing company did not give him the information he required as an employer and he is left alone in front of the workers’ organizations, led by “Ko Le Oved”.
2. Sharing family members-
As a result of the fact that the employment of a 24-hour caregiver requires the benefit recipient to manage the employment, it is very important for the family members to participate in this employment. This sharing can often be the difference between a successful deal and a failed deal. The family member managing the employment will be the one who deals with all bureaucratic matters in front of the employee and the various authorities. Any problem of the employee will be directed directly to the family member and the patient will be able to be the one who receives the service without disputes or conflicts regarding wages, conditions, vacations, etc.
3. The ability to use the payment received directly to finance nursing care-
According to the new reform, those Holocaust survivors who are entitled to this supplement can receive this benefit in monetary form directly to the bank account, which will add 1842 NIS to them every month.
The option to choose a direct benefit is only given to those who employ a 24-hour caregiver.
Unfortunately, many elderly people in the country do not “finish the month”. In such a situation, every amount of money, even the smallest, that goes directly to the bank account of the benefit recipient, is used for day-to-day financing and not for nursing care. Be and the family members are involved in the administration of the benefit, after all, they must act wisely and not use the money to buy products from the grocery store.
It must be taken into account that when the benefit recipient reaches a nursing situation, in most cases the situation is not reversible but only worsens and as a result, the nursing expenses increase. Various devices, medicines, hiring a 24-hour employee, receiving a private consultation from a specialist doctor, etc. cost a lot of money. Therefore, the more the family members involved save the money received directly and save it for the day they need it, the better off they will be.
A number of examples are given:
per month, the cost of employing a foreign worker is currently around NIS 9,000 per month. A private home visit by a specialist doctor (NIS 1,000-1,500 and double that in some areas). A wheelchair privately, 5000-3000 NIS. A benefit recipient who receives care from a nursing company and combines with the care a monetary benefit and saves the amount he receives directly actually prepares the ground for a better future for him.
Chapter 6 – Summary:
The new nursing reform gives the recipients of the nursing allowance many new options. There is no doubt that much thought was put into the reform in order to give more to the recipients of the nursing allowance. The change in treatment levels and the increase of hours at each level allow the recipient of the benefit to calculate and plan his steps forward – which was not part of the options until today. Correct planning and making the appropriate personal decision for each benefit recipient are a cornerstone in reaching the third age or a nursing situation. It is possible to ask whether the new reform is sufficient and the answer is likely to be no and there are many other things that need to be done, but there is no doubt that the new reform is an important first step in creating a comprehensive solution for seniors who are in nursing care.
The post was written by: Mordechai Seig, CEO of the SLA company – Aid, counseling and guidance for the elderly.
Different functional states in a person are determined in relation to his ability to perform basic actions called day-to-day actions. These actions are: dressing, eating, controlling braces, bathing, moving around and making transitions between positions (for example from lying down to sitting) independently at home.
These actions that seem “basic” to us begin to take on a different meaning when we reach old age. Also, with the elderly I take care of, they are not basic at all.
There are six functional states in the elderly based on the definitions and laws in the State of Israel. These definitions will determine which of the authorities is responsible for financing the out-of-home living arrangement of your parent or relative. In other words, according to the functional status, it is possible to determine where the person will live and what the conditions of his care will be.
Therefore, the importance of understanding these functional situations is very great.
1. Functional modes: independent-
Self-employed is someone who does not need help at all in day-to-day activities. Those who function on their own in an optimal way in each and every one of the activities. Therefore, he does not need the help of a person or a device (such as a walker, etc.) to maintain his lifestyle. Independent people, live without difficulty among the community in which they live, or if they chose to do so within the framework of sheltered housing.
If the older family member who is independent, feels lonely and is interested in a nursing home suitable for the independent. However, he does not have the financial ability to pay for the institutional housing, he must contact the office responsible for the elderly at the bureau of social services in his city.
He must ask her to help him begin the process of financing his stay in the institutional housing where he wishes to live.
To start the process, you will need to bring documents detailing the income of the older family member and his children. If the older family member owns an apartment, the cost of renting it will be taken into account. The welfare services usually transfer all the income of the older family member to them by standing order.
So he has about NIS 500 left in his account for monthly pocket money during his stay in the nursing home. The children will also be charged a participation amount based on the calculation of their income scale. It is important to know: there are nursing homes under the supervision of the Ministry of Welfare today that accept elderly people at the request of the Ministry of Welfare.
2. Functional conditions: exhaustion or body exhaustion-
When the level of functioning decreases and the ability to function independently in day-to-day activities is impaired, the elderly person moves to a new functional state called exhaustion, or body exhaustion. In this situation, the elderly no longer function completely independently, sometimes needing the assistance of a walker for mobility, help with bathing, etc.
How will we recognize that an elderly person has gone from a state of independence to exhaustion or physical exhaustion? When he needed help with 2-3 ADL activities (daily). For example – needs a walker and supervision in the bath. If your family member who is defined as debilitated or physically debilitated, is interested in a nursing home for the debilitated. In addition, he needs financing for his stay in a nursing home for the elderly, the process for receiving the financing is exactly similar to the process that takes place with an independent elderly person
3. Functional situations: nursing-
Only when the elderly is unable to function and needs full help in most ADL activities (activities of daily living) is he defined as nursing. That is, when he is confined to a wheelchair, does not control the braces, needs full help in bathing and dressing, he is defined by the authorities as nursing.
It is important to note that there is no connection between the physical state and the mental-cognitive state and an elderly person can be nursing and also completely lucid. In order to get help and make it easier for the elderly, long-term care health insurance should be taken out so that the expenses are reduced and the help is greater.
In addition, if the nursing family member needs help financing his stay in a nursing home, it is necessary to contact the website of the Ministry of Health. Forms must be downloaded from this website in order to obtain the Ministry of Health code. In addition, there is a list on the website of all the forms required to obtain the code for the Ministry of Health.
Collect all the required documents and submit them to the Ministry of Health as soon as possible. The process usually takes about two months until you can get the hospitalization code. If there is no choice and the family member must be rushed to a long-term nursing home, there are nursing homes that provide the option of pre-cod. That is, a partial payment given to the nursing facility for two months until the code is received from the Ministry of Health.
4. Functional situations: temporary nursing – a person in a rehabilitation situation –
Sometimes when an elderly person becomes nursing due to medical activity (for example surgery) but has rehabilitative abilities. For example, after the medical activity and with the help of proper guidance and training in a rehabilitation institution – he may return to a higher level of functioning. The definition of this functional state is temporary nursing.
In order to receive funding for a rehabilitation institution, it is necessary to contact the health insurance office in the area of residence or the office at the hospital where the elderly is hospitalized. The social security office will help in finding a rehabilitation institution according to the area of residence and the health fund of the elderly.
5. Complex nursing-
Patients who are nursing based on their function and in addition to that, special medical treatment is necessary for them. Below are some examples of medical conditions that may lead to hospitalization in a complex nursing setting:
1. Pressure sores of severity level 3-4.
2. Need for fluid infusion and/or intravenous drug therapy for an extended period of time.
3. Respiratory problems that require respiration, inhalations or inhalations more than once a day.
4. Dialysis or hemodialysis, a person suffering from a malignant disease and needs close medical monitoring and/or pain management.
If you wish to go to a complex nursing department in a nursing home, permission is required from the geriatrician responsible for this issue at the health fund. The referral to the geriatrician is made through the family doctor for the person living in the community or through the social service of the hospital if the person is hospitalized.
6. Exhaustion-
The definition of mental exhaustion does not concern the physical condition of the elderly at all, but the degree of his clarity. A person is diagnosed with dementia, when his level of dementia increases and his orientation in time, space and person decreases. The decrease in orientation levels is such that he needed constant supervision.
It is important to note that a debilitated person is not a mentally ill person but someone whose cognitive level is impaired due to diseases related to old age (Alzheimer’s for example). Although various tests to check the soundness of an elderly person (mini mental tests for example) are conducted by various parties, a qualified diagnosis accepted by the authorities is given by a psychiatrist who specialized in geriatrics only.
If the elderly person lives in the community, his family members should contact the family doctor in order to receive a referral to a psychogeriatrician. Also, if the elderly is hospitalized, a psychogeriatrician at the hospital performs a diagnosis in order to determine the functioning of the family member as a mental retardation.
After determining that the elderly person is mentally ill, the family must contact the health insurance office if the elderly person lives at home, or the hospital office. This is in order to help find a suitable institution for the mentally ill and to help start the process of receiving a hospitalization code from the Ministry of Health. The body that finances institutional arrangements for the mentally ill is the Ministry of Health, below is the link to the website of the Ministry of Health
In conclusion-
The different functional situations require different preparation of the elderly and his family members in order to continue the routine of life as much as possible. This, in order to enable the best and most appropriate care for each elderly person.
Article: Irit Rabinowitz, attorney M.A. degree in health and rehabilitation.
A Holocaust survivor for whom the following conditions are met:
Receives rewards from the treasury and financial assistance due to being in a nursing home,
recognized as needy,
diagnosed with dementia
may be entitled to participate in the financing of the nursing home.
In addition, if it is a Holocaust survivor, who:
lives in the community
does not receive any nursing hours from the National Insurance,
He has an Israeli therapist,
is entitled to assistance in financing the caregiver.
Participation in nursing expenses due to the dementia disease-
A Holocaust survivor, who is required to receive the assistance of a foreign worker, or to be hospitalized in a nursing facility due to dementia, is entitled to participate in the costs of the treatment or hospitalization at the rate of the relative part in which he was diagnosed with this disease.
This benefit is particularly relevant to those suffering from dementia (dementia) and it is highly recommended to submit an application for participation in nursing expenses.
Ways of participating in the expenses for dementia (dementia):
Assistance in participating in the financing of hospitalization in a nursing facility in the amount of 1400 NIS.
Assistance in financing the maintenance of an Israeli employee in the framework of realization of nursing hours from National Insurance in the amount of 740 NIS per month.
Assistance in participating in financing the maintenance of a foreign worker in the amount of 1000 NIS per month.
Assistance in participating in a stay in sheltered housing/ department for the debilitated in the amount of NIS 740 per month.
Participation in the maintenance of an Israeli worker-
Those who have been recognized as receiving compensation based on income according to the Nazi Persecution Disability Law and do not receive any nursing hours from National Insurance. In addition to this, he is assisted by an Israeli worker, he is entitled to participation in the amount of 740 NIS per month from the Authority for the Rights of Holocaust Survivors.
Where should I go to exercise the right?
In each of the requests, the Authority for the Rights of Holocaust Survivors belonging to the Ministry of Finance must be contacted for assistance. The payment will be made starting from the date of applying for the assistance.
In order to exercise this right, you can contact us and we can help you exercise this right.
When a person from the locality is asked “What do you know about dementia?”, those who have little or no experience in treating a dementia patient, usually answer something along the lines of “Oh… it’s just a disease of forgetfulness”. This is probably one of the most outrageous answers an experienced person can imagine.
Caring for an adult diagnosed with this debilitating disease at home is a task full of stress and anxiety. Until the word “forget” does not even come close to a correct description of the situation.
Caregivers must devote every minute of their time to caring for the adult.At all times they take care of his safety.They have no time for themselves.There is no need to even explain what this means about working and taking care of children at the same time.
Caring for a dementia patient at home changes the whole family dynamic. This brings a flood of conflicting emotions such as resentment, guilt, anger and unrelenting stress. In this article, we will try to explain why.
How dementia affects the person
Dementia is a debilitating disease that damages the brain and causes forgetfulness. Imagine your elderly father forgetting that he retired over twenty years ago. He forgets that his parents died thirty years ago. that he moved two years ago, his young wife got married…
And then there are the dangerous little forgetfulness. He forgets that his little granddaughter cannot yet chew or swallow solid foods when he gives her chocolate. He forgets to turn off the oven (and is sure to turn it off). He forgets to lock doors, how to eat, dress, use the phone and dozens of other things every day.
Imagine caring for a dementia patient at home. A person who raised you all his life and now has difficulty with the most basic actions and needs and needs close supervision and help in everything.
Home care for a dementia patient
The role of caregiver steadily takes over your entire life. This is the point where the stress and negativity starts. Dementia patients can ask questions “Can I move in with my friends?”. A question after which you will have to gently explain to them that their friends are already adults and cannot live alone without the help of others.
The patient can nod his head and understand this, but after five minutes he will forget about the conversation and repeat the same question again.
The cyclical cycle of actions is constantly in action when dealing with a dementia patient. Imagine repeating the same sentence 10 times a day, every day. When there is a pile of paperwork to handle in the office. When the children need to be picked up from school. And when you haven’t had time to eat since morning.
The caregivers begin to feel resentment and then guilt because they are aware that it is not the patient’s fault – they are experiencing resentment towards the person who has cared for them all their life.
This is the reason why most family members choose home care. Out of love, respect and commitment. But, it is only when they begin to carry out the task that they realize the enormous amount of work that is required.
The effects of treating a dementia patient at home
When a family member begins to spend more and more time caring for a dementia patient, it is only natural that this will affect other aspects of their lives. Especially children can feel neglected after the sudden change in the direction of attention towards the adult.
Once the child’s needs were above all else; Caring for a family member with dementia is in many ways like caring for another child. Therefore, when treating a dementia patient at home and bringing such a situation to the family, it is necessary to explain the situation to everyone in advance. Family members need time to prepare for the change.
And even then, the change itself will exceed their expectations and they will struggle to cope.
Behavior patterns of a dementia patient
There are dementia patients who suffer from aggression, which increases the stress level at home. They may become nasty and even violent, very different from their personality structure before they got the disease. In one case, the father suffering from dementia was cared for by his loving home;
As the disease progressed, his behavior began to change and he became more and more unpredictable. When the cat they raised at home died, his home was struck with grief. Instead of sympathizing with the loss, he started laughing and said “Blessed that we got rid of him!”
In other cases, people with dementia may withdraw from guests who come to their home and refuse to talk to them. They can become stubborn about meals. Maybe even refusing to eat until they get a certain portion they want, and then refuse to eat that too.
All these actions, which take place on a daily and consistent basis, can easily take a toll on the therapist and cause them (the therapists) to break down emotionally.
Friends and relatives of the caregivers may stop wanting to come to their home. Caregivers have less and less time to work, and little, if any, time for themselves. The therapists become “silent patients” who slowly begin to suffer from depression, stress, anxiety and other frustrations.
On top of all this, they suffer from a lack of sleep hours after waking up enough times to take care of a patient who has wet his bed and the sheets have to be cleaned and changed. This is just another addition to the pressure that is accumulating and growing.
Summary and advice for home care for a dementia patient
There are dozens of books, blogs and advice from people who, like us, document and share their experiences of caring for a person with dementia and advise others on how to do the same. The task is not easy and requires more patience than raising your children.
If you are also caring for a dementia patient, don’t take the whole burden on yourself. Share it with others and remember to take care of yourself too. If you need advice, please call me at 0547758564.
