Articles Posted in Continuing Care Retirement Communities (CCRC)

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My friends tell me I should write a book. At times when I think I have heard everything and would have no new stories to share, the next phone call from a prospective client proves me wrong. Does my heart ever get broken? The answer is Yes. But the following story has left me the most devastated as any I have experienced in the 18 years I have owned this business.

My clients were a woman in her 90’s and her adult son. She had been an active woman who was suddenly stricken with a disease that caused her to become bedridden. Her son lived several hours away. Her wish was to remain in her independent living apartment with a 24-hour caregiver. It was becoming too much for the son to travel back and forth to supervise her situation, so he hired me to supervise his mother’s caregivers, check the mail, and address any immediate concerns with doctor appointments, food, supplies, and any other issues. Unfortunately, the non-medical home care agency that supplied the caregivers on a 24-hour basis was already in place and would not have been my choice. The agency was the “preferred” agency of the retirement community where my client resided, and my repeated appeals to replace the agency were resisted.

I have never experienced a more horrific nightmare than I did with managing our problems with this agency. The first major correction I made was addressing the fact that the agency was billing my client on a 12-hour shift basis. As a result, she was paying for two 12-hour shifts at a rate of 24 hours x $35 per hour per day = $840 per day. I had the agency convert the caregiver to Live-In status, which achieved a rate reduction to $400.00 per day. The only catch was that the caregiver had to be able to sleep uninterrupted for 8 hours a night.

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This year marks the 60th anniversary of Older Americans Month, as President Biden wrote in his recent presidential proclamation on the occasion. Thirty-three years ago, President George Bush, Sr., observed that Americans age 85 and older constituted one of the fastest growing segments of our population and that 1 in 5 Americans would soon be age 65 or older. Indeed, several years ago, I observed some of my friends retiring. Although they seemed happy to do so, I hoped and prayed that I still had many years of working ahead of me. Deep down, I felt that there was a chapter of my life that had not yet been written. I wasn’t certain what the story and adventure might be, and I thought about it for a number of years.

I have been a harp student ever since my husband’s untimely death from cancer in 2015. I had played the harp as a child and yet, as life-responsibilities grew, I had taken a hiatus for many years. Following the loss of my husband and my parents, I decided to take up the hobby again to divert my thoughts and to avoid escaping my grief by watching TV reruns at night. One day, a dear friend asked me to play the harp for her daughter’s wedding. Then, leaders of a retirement community asked me to play for an event for their residents. As the idea started catching on, the pandemic halted the possibility of playing more places. But, as things improved, I eventually was asked to play at more retirement homes, community events, and dance recitals, etc. Voila! I had found the pen to start writing the next chapter of my career by adding harp performances to ADSLA’s menu of services.

As President Bush wrote in 1990, “millions of older Americans are now remaining in the work force past the traditional “retirement age.” Indeed, many are pursuing second careers, while others continue to enrich our communities and country through volunteer work – and/or by quietly devoting their time to family and friends. Not long ago, U.S. News & World Report noted that many older workers move into a new field before retiring. The national magazine listed 15 “In-Demand Jobs for Seniors,” and I was delighted to see musician listed among them.

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My clients were a fascinating professional couple from South Africa. I say fascinating because they told me stories of how they had hidden Nelson Mandela in their home for 2 weeks while they were living there. The couple hired me to find the right senior living community for them because, unfortunately, the wife had memory issues, and the husband had terminal cancer that was expected to claim his life within a year. Both were ambulatory and extremely intelligent.

They had looked at several places on their own. However, none of the places had an assisted living memory unit, which would be critical for the future since the husband was not expected to live beyond another 12 months or so. When he died, the wife would have no one nearby on a daily basis to help with her memory issues. When I pointed this out to them, they had no idea there was no memory care available at the communities they had been considering. Can you imagine if they had moved to such a community, based on their limited assessment? They hired ADSLA just in time!

My clients’ major criteria for choosing a community was proximity to their two sons, both of whom have disabilities and do not drive. A member of the extended family confided to me that the parents had provided condominiums for their adult sons and, effectively, routine transportation as well, even though both men are capable of using publicly available transportation.

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Many of my clients ask me, “Andrea, is it ever too early to plan for a senior’s future care?” My answer is, “It is never too early.” Approximately, 90% of my clients contact me when there is a crisis with a senior loved. That includes situations where there was a life-changing event with the senior, or the children of the senior made an incorrect decision about the senior’s type of care. In light of the Coronavirus pandemic, I can only imagine how many people wished they had contacted a senior living professional to create a care plan for a loved. Despite the fact that the Center for Disease Control has issued guidelines that suggest that no one be allowed to visit senior loved ones except for essential employees, I would be less stressed knowing that my loved one was being cared for in a safe environment. Picture a situation where the senior may be living at home alone. The children may experience stress because they don’t know if the loved one is safe, receiving the right care, and eating properly. With the emphasis on social distancing, the tasks that the child must perform on behalf of the senior become all the more difficult. If the right plan of care was in place and acted upon prior to the pandemic, the stress involved with a crisis could be alleviated.

Most of the long-term care communities, including independent living, assisted living, memory care, and the skilled nursing homes have been abiding by the guidelines issued by the Center for Disease Control. Some of the senior living communities have elected to stay open, continue to do tours, and admit new residents. And while it is painful  not to be able to see a senior loved one face-to-face, those communities that have abided by the guidelines have innovative ways of connecting the senior to his/her family. Many of the activity directors have gone door to door, arranging virtual meetings via Skype, Facetime, or Zoom between the seniors and their families. Don’t forget that if your loved one is in a skilled nursing home, you always have the right to request a care plan meeting with the nursing home staff to ensure that your loved one is receiving the appropriate care. If you have a special relationship with a Certified Nurses’ Assistant, you can ask him/her to connect you with a senior loved one via a cell phone.

At Andrea Donovan Senior Living Advisors, our process always includes a face-to-face assessment of the senior to determine his/her physical and mental capabilities. We will discuss whether placement in a senior living community or help at home is appropriate. The cost of senior care is astronomical so you cannot afford to make a mistake. That’s where we come in. Since we have toured and evaluated over 450 senior communities in the Chicago metropolitan area according to cost and method of payment, level of care, quality of care, staffing, food, and cleanliness, we direct you to no more than 3 or 4 senior housing options that fit your senior’s big picture! And since we are Certified Geriatric Care Managers, we will create and implement a care plan if the senior is to remain at home. And most importantly, we don’t accept any commissions from the communities or services that we present as options. We work for you and your loved one. Please stay safe!

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Even in the best of circumstances, the holidays can feel like a Keystone Kop comedy or a carousel spinning at a high rate of speed as each of us tries to keep up with shopping, cleaning, cooking, traveling, and engaging in social events and religious observances. When caring for an elderly relative, especially a person with dementia (PWD), the sense of fatigue – and sometimes farce – can feel almost double-fold. That is why I wish to share a few tips for surviving the holidays. Indeed, these tips are valuable no matter what one’s age or circumstances might be!

First, a tip borrowed from the commercial airlines: Be sure to put on your own oxygen mask before attempting to assist others. Self-care is an essential part of being able to help a person with dementia: At this hectic time of year, be sure that you are getting enough sleep, good nutrition, exercise and emotional support as you tend to the needs of your loved one with dementia. The commandment to “Love thy neighbor as thyself” implies that there is such a thing as a just love of self — no, not selfishness, but a proper regard to maintaining the strength and equilibrium that you will need in order to share those gifts with others. Prioritize what really matters, and don’t sweat the small stuff. Take breaks when you need them, and call on friends and other family members to pitch in and help when you feel overloaded. Often, others are happy to have the opportunity to assist.

When communicating with a person with dementia, recognize that emotional reactions and a tendency to judge are naturalhuman. However, they need not control you or a situation. As a PWD’s ability to verbalize deteriorates, he or she often will rely on body language to convey his or her emotions and wants and — conversely – to assess your mood, intentions andor sincerity. Ask yourself, what is their body language saying? What is yours saying? Clues to reading another’s mood and intentions include the following:

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I am often amazed at the number of clients who call me and say they are looking to place a loved one in a senior living community because their loved one is falling. When it comes to senior falls, please remember the following very general guidelines:

No senior living community provides one-on-one care. Placement in a senior living community is never a guarantee that an older loved one won’t fall. If a senior is in independent living, that level of care is not licensed. There are no nurses or nurses’ assistants. If a senior falls in independent living, 911 will be called to help the person stand or to take them to the nearest hospital. When a senior resides in assisted living or a nursing home, there will not be enough staff to prevent the senior from falling unless the staff witnesses the fall taking place and they can act on time. Don’t forget that your loved one will be sharing a certified nurse’s assistant with many other residents.

The use of full bed rails is not allowed in Illinois. They are considered to be a restraint. They can only be used if a doctor writes an order for them. The most that can be used without a doctor’s order is a half rail. A resident cannot be restrained with chemicals without a doctor’s order. There are grab bars available that attach to seniors’ beds to help them steady themselves when they rise. Many times, a mattress is placed close to the floor to lessen the distance of any potential fall.

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I was fortunate enough to be interviewed for a blog post by my colleagues at Lexington Square regarding caregiving tips for a spouse. I would like to share them with you.

When it comes to caregiving to a spouse, there may come a time when additional help and support are needed.

In this helpful Q & A with Andrea Donovan of Senior Living Advisors of Inverness, she offers expert insight on how to best handle this situation, how to overcome caregiver guilt and how to create a social and wellbeing experience for both the caregiver and spouse.

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I recently had the wonderful opportunity to be interviewed on the Silver Solutions Radio show. It airs on WMRN 1410 AM in Elgin, Illinois. It is hosted by Jeanette Palmer, Jim Wojchiechowski, and Kathleen Wetters, who each independently own a Right At Home non-medical home care agency. During the interview, they graciously gave me a chance to explain how I started my career in the senior housing industry as the Admissions and Marketing Director of the St. Andrew Life Center (Now Glen St. Andrew) in Niles, Illinois. It was a faith-based community that offered three levels of care, including independent living, assisted living, and a nursing home on one campus. I was receiving so many telephone calls (mostly from the children of seniors who were calling me from the Yellow pages) from people who didn’t know how to solve their senior loved ones’ problems. I saw a niche for a consulting business. So in 2006, much to my husband’s dismay, I opened Andrea Donovan Senior Living Advisors in 2006.

I started my senior housing placement consulting business by touring and evaluating over 150 senior living communities in the Chicago metro area. I looked at cost and methods of payment accepted, levels of care, staffing, and quality of care. Then I also evaluated quality of life factors such as cleanliness, menus, activities, and apartment and room layouts. So, when a family needs my services, I make a face to face evaluation of the senior, their financial realities, and the location preferences of the family. Then, I select the options that fit the senior’needs so families aren’t wasting time touring places that simply won’t work long-term.  At this point I have toured and evaluated close to 500 senior communities in the Chicago metro area.

We also shared a very frank discussion about the costs of placement in a senior living community versus the costs of staying at home in the Chicago metro area.  We talked about the advantages and disadvantages of each option.

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The holidays can be a profoundly stressful time for a Person With Dementia (PWD) and his/her family members. To avoid even more stress and any potentially awkward or embarrassing situations, family members who don’t know about the PWD’s diagnosis should be made aware of it. That way, you will avoid any shock and/or inappropriate remarks when your Uncle Fred decides to pipe up and exclaim, “Hey, why are you acting so weird?!”

Many years ago, I was driving my parents to Wisconsin to visit my maternal grandmother. My dad was sitting in the front seat of the car with me. He used to read the daily newspaper from cover to cover. So, I wasn’t surprised to look over and see him reading the paper during our trip. Dad also had a marvelous sense of humor. So, when I glanced over and saw him reading the newspaper with his sunglasses on, and upside down, I giggled and said, “Very funny, Dad!” But then I saw that he really wasn’t comprehending what I was saying. When we arrived in Wisconsin, I noticed that he needed a lot of help to get out of the car and eventually to the hotel room. I addressed my mother indignantly and asked, “When were you planning on telling me about this?” She replied, “I just didn’t want you to worry.” So, what would have been a better approach? Was it better to cover up the situation and let it rear its ugly head at a time when I didn’t expect it? Or should she have told me?

This season, if you intend on taking your Person With Dementia to a holiday party, plan to keep the visit short. Parties with a lot of people, flashing lights, noise, and kids, etc., can be very overwhelming. It is a good idea to have a family member assigned to stay with the PWD so that he or she stays engaged and does not withdraw. Look for a quiet room where the person can retreat to if he or she becomes overwhelmed. Or you may want to avoid parties all together and have family members visit the person at home in smaller numbers. If you have recently moved your loved one to a long-term care community, it probably is not advisable to take the PWD out of the environment to which he or she is just getting accustomed. All of the communities will have some sort of holiday get-together that family members can attend. Dementia is an unpredictable disease, so it is best to avoid behavioral issues from the get-go.

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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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