Articles Posted in Assisted Living

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My clients were a very pleasant, alert, 90 year old woman and her son. The son had been gainfully employed by a major corporation and had been transferred to a state out west. He liked the new location very much and remained there once he was retired. His mother had lived here in the Chicago area all of her life. When she could no longer take care of herself, the son chose to move her to an assisted living community here. She had lived in the suburbs all of her life and wanted to be in close proximity to the cemetery where her husband was buried. She had an excellent support system here, consisting of many personal friends who visited her and members of her church who came to give her communion at least once a week. In addition, the son hired me to act as her advocate for several hours a week. His long-term plan was eventually to find a senior living community for her out west where he was living. In the interim, he wanted me to monitor the visits from the nurse who was tending to a wound on his mother’s leg, ensure that her hearing aids were charged, make certain she arrived at her ophthalmologist appointments, and see that her mind was being occupied by decent activities and going outside.

At first my elderly client was rather wary of me. But we developed a wonderful relationship. She was very frank with me with regard to the staff at the local community. She was in the assisted living area of a Continuing Care Retirement Community (CCRC), including independent, assisted, and nursing home living, because she needed standby assistance with bathing, dressing, and putting in her hearing aids. On occasion she needed to use a wheel chair for long distances, and was in need of 24-hour supervision. However, she complained of long waits when she pushed her wrist pendant for summoning help. She said that when she did get help, some of the staff members were nice and others were not. She often mentioned to me that the activities were not very interesting. She told me she didn’t complain to staff or to her son because her son tried so hard to do a good job. She did mention that the food was wonderful. Overall, I got the impression that she was just putting up with things and would like to be happier with better staffing and activities.

The son eventually contacted me and said he found a new community for his mom out west and gave me the dates of her departure. I met with the son and his mom to say good-bye. The son told me that his mom was going to be living in an independent living/assisted living/memory care community. He explained to me that the independent living and assisted living residents lived in the same area in the new community because state law prohibited them from being separated. He expressed concern over the potential wait time involved when she pushed her pendant button. I asked him if he had asked what the ratio of staff to residents was and he replied “No.” I asked if he had checked the activity schedule for the types of things that might make his mom happy. I did not receive a clear affirmative answer. Since his mother loved the food at her original, local community, I asked if he had tried the food at the new community out west. Again, the answer was no. When I asked why he went with a community that lacked a nursing home component, he said he was told that any of the services she needed could be brought into her apartment. I’m not certain he was aware of how astronomical the costs of ordering ala carte services into an assisted living apartment can be.

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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.