Articles Posted in Independent Living

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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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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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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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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.

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One of my current clients is a former medical professional who has decided to donate her body to science upon her death. She therefore enrolled as a member of a local anatomical gift association. As her Power of Attorney for Health Care, I was assigned the task of pre-arranging for the disposition of her body. My client’s enrollment card stated that arrangements needed to be made in advance with a funeral director to transport the body to the location of the anatomical gift association when the time comes.

Upon making a telephone call to a local funeral home to get a price for transportation of the body, I was shocked to be quoted a price for more than $1,600, along with a $350 cremation fee. Since the quote sounded high, I called the anatomical gift association to be certain that I understood all of the stipulations. When I had a discussion with the association’s representative, I was informed that every funeral home has the right to charge differently for its services. I was also informed that if the anatomical association accepts the body, then cremation of the remains is free. If the body is not accepted, i.e., is diseased or in unacceptable condition, the association would charge $370 for the cremation of the remains. The association’s representative gave me the name of two other funeral homes and recommended that I get quotes from them.

When I called the second funeral home, I was informed that the cost to transport the remains would be $1,150, with a $350 cremation fee. Although the price was better, the funeral director’s demeanor was so unfeeling that I wrote him off immediately. The second funeral director quoted me a fee of $850, and there was no cremation fee whether the anatomical society accepted the body or not. The deal sounded a little too good, so it made me wary. Last, I contacted the funeral director who handled by late husband’s services, because he was a very easy going man who made my life easier during a very difficult time. His price was $650, plus a $350 fee for cremation if the body was rejected. While his transportation quote was even lower than $850, I knew that I need not be wary based on my firsthand knowldege of his services and demeanor.

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There are many occasions when my clients hire me as a second set of eyes and ears once they have completed the first round of tours at senior living communities. Most of the time my clients are in emergency situations. Sometimes they have selected a community and are prepared to act upon their decision, but they use me as a sounding board for their concerns. Here are two example situations where my clients were unaware of the types of questions they should have been asking:

Real-Life Story 1

My client was looking to place a loved one in a Continuing Care Retirement Community (a community that has independent living, assisted living, and a skilled nursing home all on one campus). In my client’s opinion, the senior was currently at the independent living level. I had not yet met the senior, so therefore I was unable to verify that assessment. However, during our conversation, there were indications of some health concerns that made me suspicious that the senior was more appropriate for assisted living. The client had toured a large number of senior living communities and was leaning toward selecting one in particular. I indicated to my client that if the senior was to enter at the independent living level, that was fine. But, I had knowledge that the assisted living area had a ratio of Certified Nurse Assistants to Residents of 1 to 20. Such a ratio is not acceptable for a community that is delivering a large amount of hands-on care to its residents. I advised my client to question the Admissions Director about the ratio I shared with my client.

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After a long and often gray winter, it is wonderful to start seeing green again – whether it is the lively colors of St. Patrick’s Day celebrations, the first signs of daffodils and tulips, or early Easter decorations.   Spring is rightly associated with fresh starts and new beginnings, and so it might well be a good time to discuss senior living options for the older individual or couple in your life.

Many families have seen a senior loved one’s health decline over the course of winter, or watched with concern as “the house seems to be getting away from Mom and Dad’s ability to keep up with it.”  Hence, spring might be the time to suggest a fresh look at senior living options available in your area.

Here are three tips to keep in mind if you are trying to convince a senior to move or are merely attempting to bring up this sometimes-delicate subject:

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089I remember when I received a phone call from an 82-year-old client who was crying piteously. She needed to move to a senior living community because the upkeep on her house was just too burdensome. She was terrified that she could not take her 80-pound Labrador with her. In addition, she wanted to continue to send the dog to the same doggy day care organization on a daily basis because the dog loved the socialization with the other dogs.

Although my initial phone calls to area senior living communities were met with some raised eyebrows from several of the Admissions Directors, I was able to find my client a beautiful apartment with a sliding back door and a backyard. She could lead the dog straight out the back door. In addition, it was within the specified distance so the doggy day care bus could still pick up the dog!

Generally, here are the rules regarding pets at senior living communities:

  1. Although a dog weighing under 40 pounds is typically not an issue, you can use some bargaining power for dogs that are bigger. Many independent living communities are not full. Most Admissions Directors will be willing to accept a dog as long as the senior can take care of it and it is well-behaved. Cats are not a problem.
  2. Assisted living communities (non-memory care) are willing to accept a dog or cat as long as some provision is made to take care of the animal. Many places charge an annual fee, up front, to assist with taking care of the pet.
  3. If your loved one needs to move to a nursing home, you need to make other arrangements for a pet. Many nursing homes have a community dog or cat. But, you will have to make arrangements to have your loved one’s dog visit.

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