For the past several months, I have been writing about resources for seniors and their families in the East Bay. Most of the articles have focused on programs that help seniors age in place. Almost all seniors want to remain in their own homes, but some are not able to for a variety of reasons.
During the holidays many families are struggling with the decision about moving their parents or other elderly relatives to a retirement community. It is easy to put off a decision like this when parents live in other locations and their children do not realize how frail they have become. I work closely with Mona Lalchandani of Exceptional Senior Placement to help my friends and clients find appropriate communities for their loved ones. Mona has been providing services to seniors for almost two decades and really knows the retirement communities in our area. Her services are free to seniors.
I invited her to write an article about some of the questions that people have when they are considering moving either themselves or a family member to a retirement community.
Families are overwhelmed with moving their loved ones to a retirement community, especially when seniors are adamant about staying in their own home and when they emphatically refuse to be “put away” or feel they are being institutionalized. This is one the hardest decision an adult child or spouse will make on behalf of their loved ones. Families (of the sandwich generation) are juggling careers, their own children, some degree of long-distance caregiving and struggling with the “guilt” of finding an appropriate placement. But a time comes when the senior cannot live safely and independently at home. Some of the signs that mom or dad cannot remain at home are:
1. Medication-when seniors forget or refuse to take their medication, there is no structure or routine and there is no one to monitor the medication.
2. Meal preparation-when a senior cannot manage to shop and cook for themselves. They are unable to operate the appliance, especially the stove safely. When the senior is losing weight and is too frail or confused to eat nutritious meals.
3. Safety-when the senior is a fall-risk, the home is not equipped with grab bars, ramps if needed and an emergency response system.
4. Personal hygiene-when a loved cannot and will not bathe, groom or dress themselves appropriately.
5. Transportation-when a senior should not be driving, and do not have alternate means of transportation to doctors appointments, the grocery store, etc.
6. Socialization-when the senior is isolated, and has little social interaction or stimulation.
7. Home Management-when the senior can no longer pay bills on time or manage their finances and keep up with home maintenance, yard work etc.
These are signs that the senior needs to think of independent living, assisted living or board and care options. It is better to plan ahead than to have a crisis.
Independent Living-When cooking meals, housekeeping, yard work and home repairs become burdensome, many senior move into Independent Living Communities to enjoy a more carefree lifestyle. They live in their own apartment but are offered a myriad of amenities such as a fitness center, restaurant-style dining, libraries, and social and leisure activities. The community offers peace of mind for seniors and their families yet enable them to enjoy their independence without the hassle of maintaining a home.
Assisted Living-Seniors who live in assisted living communities are unable to live independently but do not need skilled nursing. Assisted living are usually congregate or apartment-style living which provide meals, housekeeping, laundry, medication management, personal care, wellness and fitness programs and social activities in a supportive environment. There are 24-hour caregivers who can provide assistance with ADLs (activities of daily living, bathing, dressing, grooming, ambulation and toileting).
Some Assisted Living communities offer a separate dementia care for residents suffering from memory loss. This is typically a “secure” memory care neighborhood with trained staff who are devoted to providing specialized memory care in a supportive environment.
Board and Care Homes-These facilities are usually 4-8 bed homes which can provide hands-on care for frail seniors and seniors with limited income. They provide meals, housekeeping, laundry, medication management, personal care and include a limited amount of social activities.
Nursing and Rehabilitation Centers-Also known as a Nursing Homes, these facilities provide 24-hour nursing care and rehabilitative services to individuals who need medical supervision. Sometimes seniors require a short stay for rehab and strengthening after a hospitalization before returning home or to an assisted living facility. Others require long-term medical care that cannot be provided in other settings.
Continuing Care Retirement Communities (CCRC)-When an independent living community is connected with an assisted and a skilled nursing home it is called a CCRC. The resident can take advantage of the full range of services and transfer from one part of the building to another when their needs and level of care change.
Cost
The cost of the facility depends on the type of facility you choose and also the level of care that is provided to keep the senior safe and enhance their quality of life.
Board and Care costs range from $1,200-$2,500 for a semi-private room, which includes all room and board as well as all costs for personal care (including medication management and incontinence care). Private rooms range from $2,000-4,000 per month. A few Board and Care homes will accept one client at an SSI rate ($1,050 per month).
Assisted Living communities charge between $2,000-$3,500 for a private studio with a small kitchenette and bathroom. This price only includes rent, 3 meals/day, house-keeping, laundry, activities and transportation. Any personal care like bathing, grooming, toileting, medication management etc. are at an additional cost; the fee for services is either based on a level of care or a point system. A one-bedroom costs range from $2,500-$5,000.
Dementia Care is more expensive, since it is a smaller unit with more trained caregivers. The price range is $2,500-$6,000 per month and some communities charge extra depending on the level of care.
CCRC has a one-time entrance fee which can be costly in addition to a monthly fee. The contracts for CCRC differ in the amount of entrance fee based on the size of the apartment and also on fee for services.
Community Fee: Most Assisted Living and Dementia Care communities charge a one-time community fee which ranges from $500-$10,000. This is not a deposit and the communities use the money for the upkeep of the property, initial assessment of the potential client and to paint and clean the carpets in the apartment. Sometimes this fee is negotiable. There are several aspects of the community a family member must consider before moving their ones. The checklist can be extensive and therefore it is important to do due diligence and get references from current residents or their families.
Some of the important considerations are:
Is the facility licensed, how long have they been in business, what are the qualifications of the administrator or executive director?
Does the facility post a valid license and have written descriptions of resident’s rights and responsibilities?
Ask to see the latest state licensing inspection reports
What is the monthly cost, what services are provided in that fee, what additional services are available and at what cost? What is the Community Fee?
Can the fees/charges be changed based on the level of care?
What happens when the funds run out, what is the notice period for a resident to leave the facility?
Is the facility safe, clean and have trained staff. Does the facility have 24 caregivers and an emergency response system?
Do other residents appear happy, relaxed, well groomed and engaged?
Is the facility wheelchair accessible?
What is the staffing ratio, are the staff engaged with the residents?
Can the facility provide references? Does the facility have respite stay?
As I mentioned that the checklist is long, sometimes families get a “good feeling” when they tour the community and feel their loved one could live there with love, dignity and compassion.
As I mentioned earlier this process can be a stressful experience for families. While there are many options, families may be in crisis and are can easily become overwhelmed with making a decision. I decided to start my own senior placement services 3 years ago when I saw the anguish the families go through. Compassion, respect and dignity are the foundation of my senior placement business. Being raised in a culture where elders are revered for their wisdom and experience, I felt a great passion for starting a consulting service where I would be instrumental in finding the “right” placement for the seniors.
My service is free to the client and I become their advocate and help them narrow down the options based on:
Location
Budget
Medical Condition
Social Environment
Emotional Needs
Physical Needs
My service is FREE to families and I provide:
Confidential Assessment
Research Options for Senior Placement
Contact Facilities and Tour with Clients
Assist with the Necessary Paperwork
Negotiate a Better Rate
Follow-up within a week of placement.
Working with families has been one of the most rewarding experiences in my life. I strongly feel that I can be an advocate and find the best options they deserve and help enhance their quality of life.
I can be reached at (510) 910-0344. My website is www.seniorcareoptions.info
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