Articles Posted in Assisted Living

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After I have completed the task of finding the perfect senior living option for a senior loved one, many of my clients are faced with selling the senior’s property. I have asked my colleague, Senior Real Estate Specialist (SRES) Roz Byrne, to offer advice on that subject:

It’s an age-old question, and as we age it gets even trickier to determine how much work or money we should put into our homes.

When it’s time to sell the family home, seniors’ homes tend to present themselves in one of three ways:

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While “age 55 and older” seems to be the general definition of an American “senior,” I have never allowed my age to deter me from enjoying two of my favorite activities: tap and jazz dancing. As a senior living advisor and former part-time children’s dance teacher, I am pleased to see so many senior living communities offering dance therapy classes to their residents. I have also taught tap and ballet on a voluntary basis in several senior centers and in some of the assisted living communities that specialize in dementia care. When I was teaching, I was made aware that several of the participants in my class with dementia also had Parkinson’s disease.

Exercising even just several times a week can boost a person’s immune system and make him or her feel better physically and mentally. That is in large part because of the endorphins that are released. Exercise classes provide fun and fellowship while encouraging seniors to move all of their muscles and body parts. If a person moves his or her limbs, it increases hand-to-eye coordination, strengthens the core, and helps balance.

I approached teaching my senior dance classes as I would have any other basic level: I included combinations and repetition to Frank Sinatra and Bobby Darin songs, among others. I found that most of my “students” found ease in doing the tap warm ups, grape vines, and some jazz movements, even if a participant was confined to a wheel chair. Many of the participants said that their joints felt better, their overall movement improved, and, most importantly, their spirits had been lifted. After the class had finished, I always served my students a snack and we’d talk for a while. Some of the residents with dementia would reminisce about where they used to go to dance with their spouses. One resident in particular spoke about a church in Evanston, Illinois that had a Scottish affiliation and offered Scottish dance lessons. She even went so far as to quote me the exact street address. The repetition of certain exercises helps people with Parkinson’s to concentrate on movements that have become difficult for them, such as doing two things at once. People who have suffered a stroke are able to express themselves by moving to the music even though they can’t talk. Sometimes seniors’ medications stop working for them and yet the classes gave them relief from their symptoms.

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Real-Life Story

I recently had a preliminary meeting with the adult son of an 82 year old senior who was diagnosed with dementia. The senior had been living with him for a number of years and was having issues with wandering, falling, and incontinence. In order to alleviate the stress of having the senior in the adult child’s home, a part-time caregiver was hired during the day to meet the senior’s care needs. During our meeting, my client did not want me to meet the senior in order to avoid unnecessary agitation. His mother was not born in this country and spoke a limited amount of English. After learning some facts about the senior’s behavior and financial realities, I informed my client that the senior was a candidate for assisted living with memory care. But, the catch was she needed to be in a Continuing Care Retirement Community that would keep her once her funds were exhausted. Or, she could move to an assisted living that offered memory care. Then, she could be moved to a nursing home that accepted Medicaid when she still had enough funds to move to a decent community.

Right after Christmas, my client called me and said his mother had fallen. The rehabilitation community where she was receiving therapy had set a release date for the following week. My client asked me to come and assess the senior and make suggestions for a long-term care community.

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As a Certified Guardian, I am often asked to act as a senior’s Power of Attorney for Health Care when s/he doesn’t have a family member who is willing or fit to act for him/her. Simply stated, the Power of Attorney for Health Care grants the designated “agent” control over the senior’s decision-making, including end-of-life decisions if the senior lacks the capacity make the decisions on his/her own. As a Power of Attorney For Health Care, you should be thoroughly familiar with a senior’s personal, financial, and medical history before accepting this serious responsibility. Please read the following real life story that makes my point.

REAL LIFE STORY

Five years ago,  I was called at the last minute to act as Power Of Attorney (POA) For Health Care for an 85 year-old  woman.  It was the day before she was to move to independent living at a retirement community. Independent living used to mean that the senior can basically function on their own with some assistance with meal preparation and housekeeping. Now there are a lot of ala carte services that can be brought to the senior’s independent apartment, allowing him/her to remain there without changing to the assisted living level of care. The woman’s former POA had moved out of state and had written her a formal letter of resignation. A trust company had been appointed to act as her Power of Attorney For Finances.

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My client was the son of a 72 year-old woman who had suffered a stroke within the last six months. She had been placed at an excellent assisted living community that I had used for several clients in the past. After the stroke, she needed some help with her activities of daily living. Her son had indicated that he wanted to move her due to the high price being charged at the community. He was bearing most of the expense. He asked that I come and visit with her in order to hear her side of the story.

When I went to assess her in the lobby of the current community (at the son’s request), I found a well-dressed woman who was totally independent and had all of her faculties. When I asked her why she was in assisted living, she told me about the stroke. The physician who practiced at the community originally would not release her to the independent living level of care.  She felt the woman needed medication supervision.  But, my client proved her wrong. Then on review of my client’s case, the physician reversed the decision and approved her her to live in the independent living area.

However, my client didn’t want to remain at the current community. She had met a boyfriend there, and he had recently moved to a competing independent living community. She wanted to move there too.  As the conversation developed, she shared that her boyfriend wanted her to move in with him because his memory was getting bad, and he wanted someone to take care of him.

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“There’s no place like home for the holidays,” sings Perry Como in the Christmas classic composed by Robert Allen and recorded in 1954. But despite the wonderful lyrics of writer Al Stillman, sometimes you can (and maybe even should) reconsider what best constitutes “home sweet home.” For a senior whose health or faculties are failing, or who would benefit from greater socialization and/or daily living support, the holidays can be a good opportunity for family members to bring up life planning for the new year. It is, after all, one of the few times of the year when loved ones gather and may pause to converse leisurely around the kitchen or dining table.

Here are three tips to consider this holiday if you are trying to convince a senior to move or even simply trying to bring up this often delicate subject:

Do not use words such as “nursing home” or “facility” or “institution” during a conversation with the senior. Instead, use the words “retirement community,” “continuing care retirement community,” or “alternative living option.” A lot of seniors have awful memories of a loved one living in an old-time nursing home, with few to no amenities, and little sophistication with regard to geriatric needs. Your older loved one might not realize how senior living communities have changed. They are not your Grandma’s nursing home anymore!

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20171031_141154-2-300x225How in the world are busy professionals who also have growing children supposed to find the time to handle their aging parents’ issues – both health and living arrangements?

More and more of them are turning to experienced professionals who have experience in the field and can assist with everything finding the most cost effective and person-centered elder care, to interviewing potential home caregivers, to dealing with legal and financial specialists, to acting as a liaison to Medicare and long-term care insurance companies and even to paying bills.

Chicago Senior Living Advisors, based in Inverness, provides personalized Geriatric Care Management which is designed to assist family members or other unpaid people who are caring for an elderly or cognitively impaired loved one, according to Andrea Donovan, president.

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As I have mentioned in the past, the lines between the levels of care provided by long-term care communities have become very blurred. As the number of assisted living communities providing specialized memory care seems to increase every week, here are some of the things you need to look out for if you are contemplating moving a loved one to one of them:

Last month, I was hired by a family to advocate for their grandfather who had recently turned 100 years old. He was living in an assisted living community that specialized in memory care. Please note that the level of care offered was assisted living only and did not include a third higher level of care, i.e., skilled nursing. When he entered the community a year ago, he had been totally ambulatory and able to take care of all of his activities of daily living with cueing. Shortly after he entered, the community physician decided to take him off of all of his memory-related medications (without the consent of the family), because the doctor felt the medications were adversely affecting the patient’s kidneys. The grandfather went into withdrawal and ended up in a wheel chair needing total assistance with all activities of daily living.

In addition, the absence of using one of the dementia medications made the grandfather combative. The staff at the community claimed that he was at times in need of a three-person assist. Normally, a two-person assist and beyond indicates that person should be in a nursing home. The staff requested that the family look elsewhere for a new community for their grandfather. The staff also requested that the family hire a private caregiver to assist Grampa with his activities of daily living and prevent him from getting out of bed. The cost of his care in assisted living was $8,300 a month, just as much as a nursing home, plus the cost of a caregiver. Since the grandfather was already 100 years old, the grandchildren did not want to move him. Upon the request of the grandchildren, I was asked to attend the quarterly care plan meeting (attended by the Administrator and representatives of dietary maintenance, social work and nursing). Here is what happened:

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Elder abuse is a crime. It can occur whether your loved one is at home, attending adult day care, or living in a senior living community. And like any other crime, you have an obligation to report it. This month, I have asked one of my trusted partners, Mike and Mary Doepke of Home Helpers Home Care of Hinsdale, to share some information on Elder Abuse:

From all outside appearances, 80-year-old Shirley seemed well cared for by the niece who had moved in with her a few months earlier. She even told her friends how she was enjoying the company and the help around the house.

Shirley had always been frugal with her credit cards, using them only when needed. So when the bank called to ask her about some recent, unusual charges on her account, she was alarmed. She was even more surprised to find out that the purchases were made by the niece she had welcomed into her home.

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This week, I was overjoyed when a former client called me to tell me about her mother’s progress. Her mother was a young 70 when they became my clients less than a year ago. When I first met the elder during an assessment, she was at a short-term rehabilitation community and was covered under Medicare. She had been living in an independent living community with a 24-hour caregiver. A stroke had left her unable to use her left side. Then, the caregiver dropped her while she was transferring her in the bathroom and broke my client’s leg. That is how she ended up in a nursing home receiving short-term rehabilitation.

My client’s 100-day allotment under Medicare rehab was coming to an end, and she soon would have to begin paying privately. Although the care was satisfactory at the current community, she wanted a private room. This nursing home didn’t offer any private rooms. She did have the personal funds to pay privately for quite a while, even though the rate for a private room was over $300 per day. I knew, however, that since she was a young 70, and the cost of nursing home can run $9,000 and above for a private room, she would need the safety net of Medicaid if her money ran out. Because the stroke and the broken leg had left her totally disabled, she had to be transferred in and out of bed, bathroom and shower with the use of a Hoyer lift. I sent the senior’s adult children to tour a half dozen selected communities with the needed equipment, but nothing seemed to pass muster in their eyes. Either the rate for a private room was way too high, they didn’t like the Admissions Director, or the aesthetics were not what they wanted. They were being very specific about their location preference. Finally, I identified a community that was half-way in between for both daughters and had several Hoyer lifts available for the residents’ use. I was also very selective about the physical therapy that would be available to my senior client, as the daughters stated that she may want to pay privately for additional therapy. The therapists at the community were actually employees of the nursing home, not a separate agency. As a result, I knew she would have a better chance at receiving therapy from the same therapists.

When I recently spoke to the daughter, she said, “I have been meaning to call you. My mother has been moved from the nursing home (needing full assistance with bathing, transferring, toileting, dressing, walking and eating) to the assisted living area (some hands-on assistance with the aforementioned activities) of the nursing home. She can transfer in and out of bed and bathroom without the assistance of the Hoyer lift. The cost of her care was also reduced! And it is all because the therapists at this community worked so closely with her to improve her condition. Thank you!”