Articles Posted in Continuing Care Retirement Communities (CCRC)

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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 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.

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.”

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When I started serving in the senior living industry over 15 years ago, all communities included three meals in the rent. Three meals were just part of the senior’s care package, whether the level of care be independent living, assisted living, or skilled nursing home.

While that still holds true today for assisted living or nursing home care, the meals/food picture has changed in the independent living landscape. Most independent living communities are offering one main meal per day, with the choice of paying for 2 extra meals on an ala carte basis. Other independent living organizations are offering “flex dollar” arrangements, where the senior is given a fixed dollar stipend on a monthly basis. The flex dollars can be used to purchase meals, haircuts in the salon, or other amenities the community has to offer.

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About one-half of the clients who engage me for my services do so after they have already selected a community for a loved one. Then, when a problem arises, they call me to help fix the problem. Unfortunately, no one has a crystal ball and can anticipate some of the unusual circumstances that can arise. Most of the time, clients are so pre-occupied with fixing the senior living problem that exists now, they do not consider what can happen in the future. Clearly no one is to blame, as it is always what we do not anticipate that causes a problem.

Real-Life Story

My clients were the children of a senior aged 78. She had been placed at a Continuing Care Retirement Community (CCRC) that offered Independent Living, Assisted living, Assisted living with a memory care unit, and Skilled Nursing care. She had a lovely apartment in the independent living area that required an entrance fee of more than $200,000 when she moved in.

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Many seniors have a tendency to keep private their financial realities. However, if your senior loved one purchased long-term care insurance to cover the costs of a stay in a community or to hire non-medical home care, you will want to ask if you can look at it. I say this based on the experience I had with my mother, and I share our story lest you should have the same experience.

My mother purchased a long-term care policy 25 years ago. I was amazed that the insurance carriers were able to underwrite her at age 70. Thankfully, she was well enough to pass the underwriting since she had no serious medical issues at the time. However, the agent who sold the policy to her (and who had bragged that she was the number one producer at her company) was not exactly prudent when designing the structure of the plan for a claim that could occur in the far future. The plan that was sold to my mother included a 90-day waiting period before any benefit would be paid. Such waiting periods are common. The plan maximum paid up to $100 per day. That, too, was all right for a plan that was purchased 25 years ago. However, the agent neglected to sell my mother her an inflation guard benefit which would increase her plan’s benefit by 3-4% per year. If an inflation guard benefit had been included, the benefit she would receive would be much more in line with the currents costs charged by her senior living community. The bottom line is, based on the plan purchased 25 years ago, my mother will receive a benefit that will cover $3,000 of her $6,000 monthly cost.

While I am thankful she had the policy, it would have been more valuable if the inflation coverage had been included at its inception. If you know or suspect your aging loved one has purchased a long-term care policy, ask if you can sneak a peek at it!

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I remember fifteen years ago when I started as an Admissions and Marketing Director in the senior living industry, my future boss took me on a complete tour of the community. Or so I thought.

The community included independent living, where most of the seniors were well off mentally and ambulated with, at worst, a cane. The next level of care was assisted living, which at the time was an extension of independent living. But, the residents at that level received “standby” assistance with bathing, dressing, toileting, transferring, eating, and walking. At worst, seniors there ambulated with the help of a walker. No wheel chairs were allowed. Last, there was nursing home level, or the dreaded fifth floor that was reserved for residents who could no longer function at the independent living or assisted living level. Most were in wheel chairs and needed total assistance with their activities of daily living. Or, some suffered memory impairment and were at risk for wandering. The fifth floor was equipped with a security code for the elevator and an alarm for those residents who might attempt to leave unattended.

When my boss conducted the tour, he showed me the independent living and the assisted living areas, both of which were places where the residents appeared to be happy. However, after I began working there, I was sent to complete a task on the fifth floor where the residents needed total assistance with everything. Being new to the industry, I was like many of my clients taking a tour of a nursing home for the first time. I was nervous and terrified! I rushed down to my boss’s office and told him that I was exceedingly upset that I was not told that the fifth floor existed. As time went on, I grew to love the residents on the fifth floor. There we were encouraged to take a break from the regular tasks of the day, attend scheduled activities, or just talk.

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Here are five easy steps to help convince your loved one who needs to move:

1. Enlist the child, sibling, or friend who is closest to the senior to initiate the conversation. The senior needs to hear the message from the right person.

2. ​Plant the seeds in very short, non-threatening messages. For example, “Gee, I noticed that you are having a little trouble getting yourself dressed. Don’t you think you would benefit from a little help?” Change the message at the right moment at the next attempt. “I noticed you have been eating a lot of cold cereal instead of a meal. Wouldn’t it be nice to have someone cook your meals for you?” Space out the messages and deliver them at the opportune times. It may take months for a senior to decide you are right.

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When you have completed the daunting task of choosing the right senior living community for your loved one, your next mission will be to prepare for his/her move. It is very likely that the senior will be moving to an apartment or room that will be much smaller than his/her current living arrangement. Decisions will need to be made as to which items the senior will discard, donate or keep. All of us tend to have difficulty parting with “keepsakes” to which we have emotional attachments; accordingly, it may be a wise decision to utilize the services of a professional organizer when your senior moves.

Sue Becker is a Certified Professional Organizer in Chronic Disorganization. She has worked side by side with my senior clients (including those with dementia) to help them with the highly emotional task of sorting through years’ worth of keepsakes and papers and deciding which items to keep.

Keepsakes: Turn Your Muddled Mess into Meaningful Memories

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My clients are a couple ages 78 and 80. The couple’s daughter had called me and tearfully related the story of how her parents were looking at senior living options, most of which would not fill their long-term needs. Like many of my clients, they had lost a significant amount of money in the most recent economic crisis, and they were living in a condominium where they could not afford to stay. The daughter feared that they would run out of money and be forced to move to a Medicaid community in the future. She pleaded with me to call her mother and set up an appointment to talk to them.

When I called, her mother curtly told me that they were still driving, had their faculties, and were able to evaluate the senior living communities on their own. Furthermore, they couldn’t afford services like mine. I assured her that I have lots of flexibility with the way my services are structured, and I could design a consultation that fit their budget. She said “no thanks,” and hung up.

When I relayed the situation to the daughter, she said that she would convince her parents to set up an appointment with me. To this day, I don’t know what the daughter said to her parents, but within a few days, I had an appointment set.

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Many times my stories revolve around the child of a senior who hires me to solve a parent’s senior living problems. The terms of my real life story are a little bit different this time.

My clients were a couple ages 80 and 78, respectively. They lived on the east coast, but grew up in the Chicago metro area. Like many grandparents, they wanted to move back to the Chicago suburbs to be closer to their children and grandchildren.

When I met with this couple, I was pleased to find two very polished, excessively independent individuals. One member was still working in an artistic capacity. They were more than open to sharing their financial realities with me. Their annual income was more than ample, and their net worth was well in excess of $1 million. They also had long-term care insurance.