This month, I am celebrating the 11-year anniversary of the opening of Andrea Donovan Senior Living Advisors. I am hoping that I have at least another 11 years of rewarding work ahead of me. I have to chuckle because I have had so many unusual requests over the past decade, not to mention finding that special apartment for the senior who has the 90 pound Labrador that must continue to attend its current doggie day care, requests for caregivers who speak a special dialect of Indian or Farsi, accommodations for religious preferences, transportation to senior symphony practice for a senior cellist, and finding a nursing home that would allow my senior loved one with dementia to store and play her piano in her room. I figure that I have evaluated more than 450 senior communities in the Chicago metro area over the past decade and completed over 6,000 hours of research. I know that sounds like an insanely large number of hours, but how else would I be able to get the answers for my clients? Admittedly, in some cases there may only be one right answer, as I share in this month’s REAL LIFE STORY.
My clients were the child (and her husband) of a 94 year old gentleman. He had been a white collar professional, an avid musician (stringed instruments) and recently lost his spouse. He underwent some very serious cancer surgery several years ago and had recovered very well. He and his late wife had been living in a luxury condo owned by the child. Since it was located in the middle of the downtown area, it allowed them easy access to their doctors, the symphony, and shows they deeply loved. After the death of his wife, he remained in the condo with several caregivers who came in at 2 different intervals during the day. He remained in the condo alone in the evening. However, the child told me he had recently been hospitalized with pneumonia, wasn’t drinking enough fluids or eating 3 meals a day, and had fallen. The child no longer wanted him to live in the condo alone. I was also told that the senior was “putting on a good act,” and that his need for more help was being well hidden. I was told that I would need to duplicate his environment in order for a move to occur. The environment could not have an “assisted living or nursing home feel.”
When I assessed the senior in the condo, I was overwhelmed by the beautiful view of the city from its large windows and perceived that, in addition to excellent care, aesthetics would play a huge part in the selection of his senior living community. He was very neat and well dressed. But, he was very hard of hearing, and somewhat unsteady on his feet. I felt that he was playing Poker with me in regard to his answers to my questions, and keeping his cards very close to his chest. One of the caregivers was present during the meeting and told me that he provided escorts for doctor appointments and errands, prepared meals, for privacy was only allowed to stand by for showers, and helped the senior to exercise. The caregiver told me as we were riding down the elevator that his client was becoming forgetful and didn’t use his walker. In my assessment, the client was in need of some standby assisted living.
After calling the viable continuing care retirement communities in the downtown area, I found that most of the assisted living areas were full. I did find one community that had spectacular views of the downtown area. The apartments were dually-licensed for independent living/assisted living. For seniors who are borderline, like my client, ala carte services could be ordered until the full array of assisted living services were needed. Best of all, he won’t have to change apartments as his needs change. He will be able to age in place in the same apartment.
One More Thought for Today
The term “Assisted living” has become a huge “catch all” phrase. When you use it, be aware of what you are asking for.
Generally, the term “assisted living” refers to a long-term care community or area of a continuing care retirement community that is licensed by the state to provide standby or hands-on care with activities of bathing, dressing, transferring, walking, eating, and toileting. Assisted living communities are licensed to do different things. Some are based on a social model of assisted living, meaning the assistance is lighter, or standby, and heavily emphasize socialization through activities. Others are based upon a medical model, meaning the assistance could be heavier or hands on. A nurse could be present for a set number of hours each day or on a 24-hour basis. The nurse provides medical oversight of the residents and may administer medications. The resident receives 24-hour supervision and three meals in assisted living. This is a very general and not all-encompassing definition.
The lines between independent living and assisted living have become very blurred. This is due to the number of ala carte services that are available for additional purchase in many of the independent living options, such as shower assistance, help with dressing, and companionship visits.