Articles Posted in Independent Living

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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.

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According to the American Health Association, every 34 seconds, someone in the United States experiences a myocardial infarction (heart attack). The U.S. Centers for Disease Control and Prevention note that heart disease is the leading cause of death for both men and women in the United States. Each year, about 715,000 Americans experience a heart attack. Of these incidents, 525,000 are a first heart attack, and about 190,000 are a second heart attack. Risk factors include high blood pressure, high LDL cholesterol, smoking, diabetes, overweight/obesity, and physical inactivity.

Rates of death from heart attack and cardiovascular disease are highest in persons age 65 and older. Therefore, it is important that those of us who care for seniors understand why and recognize the warning signs.

According to a summary fact sheet compiled by one retirement agency, the human heart starts to lose pumping power as people age. By the time a person reaches the age of 80, the heart’s resting capacity typically has been reduced by half. Depending on factors such as diet, lifestyle, and family history, over time the coronary arteries may develop a build-up of plaque, restricting blood flow and the supply of oxygen to and through the heart. Other chronic conditions associated with aging and physical inactivity might increase a person’s risk of heart disease too. A heart attack occurs when part of the heart muscle dies or gets damaged because of reduced blood supply. A myocardial infarction (heart attack) can happen at any age, but risks generally begin to increase for men beginning at age 45 and for women at age 55.

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In the past several weeks it seems like I have been deluged with cases involving senior citizens who need to give up there driving privileges. My own Mother is 91 and still independent. Yet, she had enough common sense to relinquish the keys when she realized her age and the effects of her medications could cause her to have an accident. We live in such an auto-dependent society that most seniors don’t take charge of the fact that memory impairment coupled with the effect of medications can impair visual -spacial abilities, reaction time, and concentration behind the wheel.

As a senior living advisor, I have collected copies of the transportation schedules from over 400 communities. Many of the retirement communities offer transportation options that are quite flexible and could be a saving grace in a child’s quest to encourage a parent to stop driving. My REAL LIFE STORY exemplifies how retirement community transportation may help in that regard.

REAL LIFE STORY

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The weather in Chicago has fooled us again! Last week, we suffered from the sweltering heat. For the past few days it has been like fall. Tomorrow, it will probably snow. Just as the weather can change on a dime, so can “Seasonal Affective Disorder (SAD) ,” cause depression in a senior at any time of the year.

What is Seasonal Affective Disorder? At is a form of depression that affects seniors (and other people) at the same time of the year every year. My Father started experiencing the symptoms at it at about the same time he was diagnosed with dementia. He had been a “sun worshipper” all of his life and spent hours outside during the summer months reading books. Once the winter months would set in and he was unable to spend time outside, he would experience depression, loss of interest in activities he enjoyed, sleepiness, anxiety, a heavy feeling in his arms and legs, weight gain, and social withdrawal. The symptoms would manifest themselves at the same time of the year. While most people suffer from SAD during the onslaught of fall and winter, some people actually exhibit symptoms in the spring and summer! People who have SAD during those months experience some of the reverse symptoms meaning weight loss, loss of appetite, insomnia along with anxiety, irritability, and agitation. As a Certified Care Manager, it makes sense that I observe so many seniors who (like my Father) experience the disease in the fall/winter. Inclement weather may inhibit a senior’s ability to drive, walk, and attend the activities that make him/her the most happy.

What causes SAD? As with other forms of depression, the causes are unknown. It is suspected that age is a factor along with the an individual’s genetics. Changes in the brain chemical or neurotransmitter, Seratonin, are also though to trigger SAD. This brain chemical affects mood. A reduction in sunlight may cause a drop in Seratonin which increases depression. When the seasons change, the levels of Melatonin may change as well. Melatonin is a hormone that helps with sleeping patterns. SAD is also diagnosed more often in women, but men often experience much more serious symptoms. People who have clinical depression or bipolar depression seem to be prone to SAD. If a person lives far north or south of the equator, the decrease in sunlight during fall or winter may increase the occurrence of the disease.

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The blistering Chicago heat arrived last week. That means it is time to review some tips to keep your senior loved one safe. Our elderly loved ones are more sensitive to the effects of heat and are more prone to dehydration. Remember that they do not adjust well to rapid switches in temperature. If they have a medical condition, it may change the way his/her body reacts to the heat. Prescriptions s/he may be taking also affect the way his/her body adjusts.

I am fortunate enough to have a brother who is able to check on my 91 year old mother on a daily basis, and another brother who stays with her at night. I am blessed and I don’t know what I would have done without either of them. If you aren’t as lucky as I am, you will need to designate a trustworthy individual to check in on you elderly loved one. Whether your senior lives at home or in a senior living community at the independent, assisted living, or skilled nursing level, the following are tips that you can use to cope with the heat:

-Try not to take a senior outside during the hottest parts of the day. This sounds like common sense but when you are under the duress of taking care of a senior and your own family, common sense flies right out the window!

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I was an advocate for “person-centered care,” long before it became part of elder care terminology. “Person centered care” simply means that a community, or another entity, adapts and delivers care or amenities according to the habits of the senior. As the former Admissions Director of a community that catered to residents at the independent, assisted, and intermediate nursing home level, I knew that flexibility was the key to keeping the place full. Most importantly, it kept the residents happy.

The organization that I represented had not changed much aesthetically or administratively since it was built in the early 1950’s. Consequently, I broke just about every rule in the book (often to the dismay of the religious order that had once reigned there in the past) in order to keep the place filled. At one point, I admitted a cheerful, boisterous, resident who asked me if he could bring his extremely loud, talkative, Cockatiel to live with him when he moved in. I said, “of course,” even though the community had a strict no pets policy. The bird absolutely delighted the residents and I often saw a group of them congregating in the owner’s room before dinner. Another resident’s daughter told me that her Father was a sports fanatic and that he often watched as many as six different events at the same time. Bear in mind, we are talking about events that occurred 15 years ago, and the building was not yet cable friendly. I said, “That’s no problem, we’ll just install a satellite dish outside his window.” You can imagine how many eyebrows I raised when the satellite dish company pulled up and started to hammer away.There was also a long-term resident who confided to me that she had an illness that would eventually cause her to need a feeding tube. She said that above all, she wanted to live out her final days at the community rather than be moved to a nursing home where they could accommodate her needs. I was very touched by her request. I approached the Administrator and asked if there was something we could do for her. He was able to petition the State on a one time basis to allow the feeding tube, and her request was granted! Thankfully, times have changed since then. As a senior living advisor, I have learned that some but not all of the nursing homes are delivering “person-centered care.”

Real Life Story

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I just turned 55 on my last birthday. Although some people consider 55 as the official age of becoming a senior, I have never allowed my age to deter me from participating in my hobby of tap and jazz dancing. As a senior living advisor, (and a former, part-time children’s dance teacher of 13 years, hobby only) I am also pleased to see so many of the senior communities offering dance therapy classes to their residents. I have also taught tap and ballet on a voluntary basis in some of the assisted living communities that specialize in dementia care and several senior centers. I was made aware that several of the participants also had Parkinson’s disease.

Exercise that is performed several times a week can help to elevate a person’s immune system and make them feel better about themselves. That is because of the endorphins that are released. The exercise classes provide camaraderie while encouraging seniors to move all of their body parts. If a person moves their limbs, it increases hand to eye coordination, strengthens the core, and helps balance.

I approached the classes as I would have at any other basic level. I included combinations and repetition to Frank Sinatra and Bobby Darin songs. I found that most of my “students,” found ease in doing the tap warm ups, grape vines, and some jazz movements, even if they were confined to a wheel chair. Many of the participants said that their joints felt better, their overall movement improved, and most importantly their spirits had been lifted. After the class had finished, I always served them a snack and we’d talk for a while. Some of the residents with dementia would reminisce about where they used to go to dance with their spouses. One resident in particular spoke about a church in Evanston, Illinois that had a Scottish affiliation and offered Scottish dance lessons. She even went so far as to quote me the exact street address.The repetition of certain exercises helps people with Parkinson’s to concentrate on movements that have become difficult for them, such as doing two things at once. People who have suffered a stroke are able to express themselves by moving to the music even though they can’t talk. Sometimes peoples’ medications stop working for them and the classes give them relief from their symptoms.

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