Answers for the journey of aging

SAGE (Senior Advocacy Guidance and Education) is a community of senior-care professionals serving the Puget Sound region. Our Leaders work in hospice, in-home care, elder law, guardianship and fiduciary services, senior housing placement, and senior real estate transitions. Instead of searching for each expert separately, families reach one connected group that already works together.

We aren't a directory. SAGE Leaders know one another, meet regularly, and coordinate on real families' situations. When your needs cross specialties, such as a move that also needs a power of attorney, we connect you directly.

No. Reaching out to SAGE and attending our community events is free. If you decide to work with an individual professional, such as an attorney, fiduciary, or real estate broker, that professional will explain any fees for their services directly with you.

We serve seniors and families across Kitsap, Pierce, King, Mason, Jefferson and Clallam counties in Washington, including Bainbridge Island, Bremerton, Port Orchard, Poulsbo, Silverdale and Gig Harbor. See our full Areas Served list.

Yes. Many of the families we help are adult children coordinating from a distance. We can talk by phone or video and help you build a local team you can trust. You're also welcome to contact us on behalf of a parent, and we'll include them when they're ready.

Choose an event on our Events page and select "Reserve a seat." Community groups, churches and senior centers can request a presentation on topics like hospice, elder law or downsizing.

No. If someone is in immediate danger or has a medical emergency, call 911. If you suspect abuse, neglect or exploitation of a vulnerable adult, contact Washington Adult Protective Services.

Change usually shows up in small ways first. Consider getting support if you notice any combination of:

• Falls, bruises or near-misses
• Weight loss, spoiled food or skipped meals
• Missed medications or doctor appointments
• Unpaid bills, unopened mail or new scam calls
• A messier home, or less personal care and hygiene
• Pulling away from friends, church or hobbies
• Getting lost while driving, or new dents on the car

Start with any SAGE Leader; we'll point you to the right first step.

Contact any SAGE Leader. In one conversation we'll ask about health, safety, money and legal readiness, then tell you which one or two steps matter most right now. Send us a message to get started.

Lead with their goals, not your worries: "What would make it easier to stay in your home?" Talk early, before a crisis, and in short conversations rather than one big one. A neutral professional at the table often lowers tension.

Many families wait until the final days, but hospice helps most when started early. Patients with a life expectancy of six months or less are eligible. Signs to watch for include repeated hospital visits, recurring infections, increased pain or weakness, and weight loss alongside a serious illness such as cancer, heart, lung or kidney disease, dementia or Parkinson's.

Medicare Part A covers hospice care related to the terminal illness, including the care team, medications, medical equipment and supplies. Most families pay little out of pocket; there may be small copays for medications and respite care. Medicare does not cover room and board in an assisted living or nursing home. Medicaid, VA benefits and many private plans also cover hospice.

Wherever the person lives: a private home, adult family home, assisted living or nursing home.

Yes. You can leave hospice at any time, for example to try a new treatment, and come back later if you choose.

Yes. The hospice team works alongside the primary care doctor and any other providers your family wants involved.

No. Hospice shifts the goal from cure to comfort, dignity and time well spent. It also supports the whole family, including grief support after a loss.

A POLST (Portable Orders for Life-Sustaining Treatment) is a medical order, signed by a clinician, that records a seriously ill person's wishes about resuscitation and other treatments. Unlike an advance directive, emergency responders can act on it. Ask the doctor or hospice team about one.

Non-medical in-home caregivers help with daily life: bathing, dressing, meals, light housekeeping, medication reminders, errands, transportation and companionship. Care can be a few hours a week or around the clock.

In-home care is non-medical help with daily living. Home health is short-term skilled care (nursing or therapy) ordered by a doctor, usually after a hospital stay. Hospice is comfort-focused care for someone with a terminal illness. Many families use more than one.

Generally not for ongoing non-medical care. Families usually pay privately, or use long-term care insurance, VA benefits, or Washington Medicaid programs for those who qualify. Washington's WA Cares Fund may also help eligible residents; ask us for the current eligibility rules.

Assisted living offers apartments with help on hand and shared dining. Adult family homes are residential houses caring for a small number of residents, often with a higher staff-to-resident ratio. Memory care is a secured setting designed for people living with dementia.

Start with care needs, budget and location, then visit at different times of day. Ask about staff turnover, how care levels and prices change, and recent state inspection reports. A placement advisor can narrow choices quickly.

Start early and go room by room. Decide what moves, what goes to family, and what's sold or donated. A senior transition specialist can manage the sorting, the move, setting up the new home, and selling the house.

It depends on cash flow, taxes and timing. Talk with a real estate professional who specializes in seniors, and with your tax or legal adviser, before listing.

• Will or trust
• Durable power of attorney for finances
• Health care power of attorney
• Health care directive (living will)
• POLST, if seriously ill

Review them every few years and after any major life change.

A power of attorney lets someone you choose act for you if you can't. It must be signed while the person still has capacity, so the time to do it is now, not after a diagnosis of dementia.

The family may need to ask a court to appoint a guardian or conservator. Courts also consider less restrictive options first. This process takes time and money, which is why planning ahead matters.

A professional fiduciary is a certified, court-accountable professional who can serve as guardian, conservator, trustee or agent under a power of attorney when no family member is able or available.

Options include savings, long-term care insurance, home equity, VA benefits, and Medicaid for those who qualify. Medicaid eligibility has strict rules on assets and transfers, so talk with an elder law attorney before moving money.

Watch for new "friends," sudden changes to accounts or wills, and missing money. Set up account alerts, limit card access, and keep a trusted contact on bank accounts. Report suspected exploitation to Washington Adult Protective Services.