Articles Posted in Assisted Living

Published on:

by

Only two things in my life have terrified me. The first was laying my husband of 33 years to rest after watching him suffer dreadfully from cancer of the appendix. I can at least take some comfort in the fact that I know he is at peace. The second thing was having to place my mother in a long-term care community.

You might be surprised and be asking yourself, “Why was she terrified? She does that sort of work as a beloved Calling and for a living!” My reply to such a reasonable question is this: As a highly trained and experienced professional, I have absolutely no problem dealing with my clients’ parents or loved ones. But when it comes to one’s own mother, the process takes on an added dimension that is – as you can imagine – very personal and emotional.

My mother is 95 years old and has lived on her own up until this point. Our family was fortunate enough that one of my siblings took on the role of companion and “go to” person for her. But my mother suffers from a rare blood disorder, severe arthritis, and heart issues, to name but a few. She has been prescribed 17 different medications, none of which she was taking correctly. She was not eating properly and had fallen on several occasions. She would only accept very minimal help with bathing and dressing.

Continue reading
Published on:

by

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

Continue reading
Published on:

by

Assisted living communities that have a memory care unit are supposed to be adequately staffed with assistants and aides who are educated to deal with the behaviors of dementia residents. The habits of these residents can often be repetitive and endanger the resident if they are not closely watched. Many residents “sundown” in the evening, meaning they may often become more confused and agitated at this time. In my opinion, the caregiver ratio in these sorts of units at night should be no less than 1 aide to 8 residents, when residents with dementia, whether ambulatory or not, can become very agitated and even combative. The “powers that be” at some senior living communities will dispute my ratio, contending that they only need to staff according to long-term care regulations. This month’s real life story will outline the consequences of understaffing.

Real-Life Story

I was recently hired by a client who was forced to place her memory-impaired relative in an assisted living community’s memory unit. The relative had been living in another retirement community that was not equipped to care for residents with memory issues. When the staff at the original community witnessed the relative dragging a bag of laundry up the hallway in the wee hours of the morning, the staff arranged to have her taken to the local hospital’s behavioral unit for evaluation. Apparently, this had not been the first incident of questionable behavior. When the evaluation of the relative was complete, my client was informed that the retirement community could not handle the relative’s behaviors. Therefore, my client had to place the relative in an assisted living community that had a bed available in its specialized memory unit.

Continue reading
Published on:

by

I was recently hired by a family whose loved one was taking an experimental drug for cancer. The cost of the drug was more than $8,000 a month. Because the drug is experimental, it is not covered by private insurance, Medicare, or Medicaid. The drug was being paid for by a grant that required re-application every year.

The senior was at risk for falling, had a catheter, and had been admitted to a rehabilitation community covered by Medicare. However, one of the children informed me that finding a community that would accept the loved one (due to the experimental status of the drug) was a challenge. Their first choice in rehabilitation communities declined to offer the senior a bed since the drug wasn’t covered by Medicare. The administration at the community did not want to incur any liability for absorbing the cost of the drug. The second choice in rehab. communities admitted the senior, but required the children to purchase the drug and bring it to the home for administration to the senior.

When the senior’s Medicare days were exhausted, it was time for me to find a permanent home for him. While a family member told me that it was probable that the grant would be re-issued to cover the drug for another year, I had to bear in mind that at some point the grant may stop paying for the prescription. Thankfully, this senior had enough money to pay for long term care, and the prescription for several years, before applying for Medicaid. However, all the communities that I approached for his placement required that the children would still have to pay for and deliver the prescription. Since the senior had progressed during rehabilitation, I was able to secure placement in a Continuing Care Retirement Community (CCRC) that offered high level, assisted living that was lower in cost than a nursing home, but could address issues with the catheter via their medical in-home care services. The senior eventually would be able to apply for Medicaid and transfer to the CCRC nursing home on the same property. However, should the senior convert to Medicaid status, the experimental drug will not be covered.

Continue reading
Published on:

by

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.

Continue reading
Published on:

by

Every once in a while I am confronted with a situation that requires me to think out of the box a little bit more than usual. Recently, I was asked to find placement for a “young” senior who had a traumatic brain injury. This case involved many calls to different social service agencies. Unfortunately, due to my client’s age, lack of need for hands-on care at this point in time, and certain cost factors involved, some of the information I obtained was not usable. I had to dig deeply beyond the options that first emerged.

Real-Life Story

My client is 63 years old. Unfortunately, my client was hit by a motorcycle when a teenager and suffered a traumatic brain injury. After rigorous rehabilitation, the client was able to lead a normal life. However, after a series of personal disasters including a fall, the client experienced a number of physical setbacks that resulted in needing to use a walker for ambulation and needing to move in with an elderly parent. The parent and the child shared a caregiver from a private, non-medical home care agency for standby assistance with activities of daily living. At this point, my client needed only standby assistance with dressing. The arrangement was only temporary for my client, as independence and socialization were major factors. My client was doing well from a cognitive stand point. Therefore, I was hired by the client’s Power of Attorney for Health Care to find alternate living arrangements for the client. Here are the results of my research:

Continue reading
Published on:

by

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:

Continue reading
Published on:

by
loadimage

I recently had a conversation with a family whose loved one was diagnosed with terminal cancer. The loved one was taking a drug that caused some very severe reactions including nose bleeds, diarrhea, and skin outbreak. The person’s primary care physician encouraged the family to keep the patient on the drug, as it could add some precious time to her life. In contrast, the physician at the nursing home where she was completing her rehabilitation encouraged the family to place her on hospice, rather than prolong her life. As this raises very emotional and controversial issues, I have asked the experts at Rainbow Hospice to provide an explanation of hospice care, what it is and is not.

Understanding Hospice

Valerie Nikolas
Marketing & Communications Specialist
Rainbow Hospice & Palliative Care

What is hospice?

  • Comfort care
  • Support and encouragement
  • A celebration of life

Hospice is physical, emotional and spiritual support for patients and families living with serious illness. The goal of hospice care is to provide pain and symptom management as well as comfort, but not to offer a cure.

Continue reading

Published on:

by

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.

Continue reading

Published on:

by

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.

loadimage

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.

Continue reading