Articles Posted in Independent Living

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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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Sometimes, the last person a senior wants advice from is his or her own child. After all, a senior loved one is the person who may have changed your diaper. The role reversal that occurs as a senior ages can be psychologically painful for him/her as the child now takes on the parental role. As a result, the senior may not want to listen to what the child has to say.

I am often hired to intercede in situations where a senior is reluctant to move or an independent senior is “sitting on the fence” as to whether now is the time to move or stay at home.

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Real-Life Story

I was hired by the child of a senior whose parents were taking a trial stay at a local Continuing Care Retirement Community (CCRC). I was hired after the trial move had occurred. The parents had lived in their own home, which was located two hours away from their two children. Although independent at this point, each parent had health problems that would require attention in the future. Both adult children had health issues of their own and admitted to me that travelling to the parents’ home to take care of housecleaning, errands, and well-being checks was getting to be too much for them to handle. One child had taken on more of the responsibility for their needs and was failing rapidly from a health perspective. I was informed that both parents had come to rely upon this particular child and were totally oblivious to the fact that it was becoming a burden to her. In addition, I was told that the neighborhood where the parents lived was changing, and the windows to the house had been shot out twice over a two-year period. Due to the neighborhood decline, home care wasn’t an option. The entire family was fighting, the parents would not list to their children, and one child told me they were considering family counseling. In addition, the 30-day trial at the CCRC was coming to an end, and the parents had their bags packed to move back home.

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When I started in the senior industry over 15 years ago, “independent living” at a senior living community meant that the senior could take care of him or herself. He or she might require some assistance with meal preparation and housekeeping; however, the senior had to be able to ambulate on his/her own. In the worst case scenario, a walker might be used. The resident also had to bath, toilet, eat, transfer, and dress without help. With today’s emphasis on having a senior “age in place” in their his or her own apartment, I’ve witnessed independent living become the new assisted living.

While this change has been evolving for years, I have noticed that the process of assessing the a prospective resident for independent living has become much more lenient. There are so many ancillary services that can be brought into the senior’s independent living quarters apartment that it resembles assisted living or a nursing home without the licensure. Here are some examples of the services that can be brought into independent living and the typical costs:

Morning and evening assistance – $18.00 per 20 minutes – includes getting the senior out of bed, helping with hygiene and dressing (not bathing)
Bathing – $24.00 per 30 minutes
Escorts to meals and activities – $9.00 per escort
Medication Set-up – $37.00 per week, Medication Reminder – $8.00 each
Laundry – $9.00 per load
Routine safety checks – $6.00 each
Other services such as live in companions can be hired starting at about $200 per day.

But if a senior needs additional help with activities of daily living (bathing, dressing, toileting, walking, eating, and transferring), the price increases. Extra housekeeping and additional meals can be purchased (in independent living, one meal is usually provided).

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As the former Admissions Director of a retirement community that offered independent living, assisted living, and intermediate nursing care, I often had to convince the senior that it was time for him/her to move. Some of the seniors (and their children) knew that it was time to move. Other seniors were extremely resistive. One circumstance stands out in my mind that may offer you some tips on how to convince the senior to move. As a senior living advisor and Certified Care Manager, I find my past experiences to be invaluable to share with my clients.

Real Life Story
My prospect for the retirement community was a seventy-eight year old senior who I will call Mary. Mary was living alone in her own home. She had Parkinson’s disease but could perform all of her activities of daily living on her own. She was the perfect candidate for independent living! The house was located in a changing neighborhood. Her daughter, Lynn, brought her to the home for a tour because Mary’s home had been burglarized. Mary was mugged during the burglary.

During the entire tour and interview, Mary cried piteously and kept repeating that she didn’t want to leave her home. The daughter and I kept insisting that Mary’s safety was at risk. Lynn was also the only relative in the Chicago metropolitan area, and lived in a suburb that was over 25 miles from where Mary lived. I also stressed during the interview that Mary’s Parkinson’s disease would become worse at some point in time. The community would offer additional assistance as well as being closer to Lynn.

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Happy Holidays to you and your loved ones!

While the holidays can be a time of joy, they are also a time when extended family gatherings may provide us with occasion to notice that an older loved one’s health is deteriorating. As families reunite, celebrate the season, and take stock of the year gone by, they sometimes reflect on the passage of time – and begin to recognize how it might be affecting a senior member.

A sense of fear or worry — exacerbated, perhaps, by the darker winter weather – can then lead families to make rushed and hasty decisions about senior care or senior living options. Later, they hire me when they realize they have made an error.