Posted by Sheri Samotin on Wed, Jul 14, 2010
So, the day you’ve been dreading has come. You have concluded that you simply can’t live in your home a moment longer. If you are like many older adults, you’ve avoided confronting this reality and don’t want to think about moving into a “facility.” I’m happy to report that there are many wonderful options for you. Enjoy my top strategies for choosing your senior living solution.
- Scout ahead of time –There are many options for senior living. If you remember going to look at colleges with your teenager you’ll know exactly what I mean. It can be overwhelming to figure out what you need and what you want. So start the process, even if you can’t imagine that you’ll ever choose to move.
- Understand the math – Money does matter. Your resources will determine the range of available options. For example, if you have equity in your home, are a veteran, or own a long-term care insurance policy you may be in a very different situation from someone whose only resource is a monthly social security check. Crunch the numbers ahead of time to figure out how much can be spent each month and what is included. Most communities provide a worksheet that will help you understand this calculation. Don’t confuse the issue by spending time visiting a place that is outside of your means.
- Narrow the choices to no more than three or four using the “Five S” method – Once you have a list of possibilities that are within your budget and preferred geography, it’s time to narrow the choices to a few where you think you will be happiest. My “Five S” method, considers size, sights, sounds, smells, and services. What you are really doing is looking for a good match based on a sixth “S” – similarities. You are looking for a place where the residents are as similar to you as possible in terms of age, activity level, mental acuity, hobbies and interests, and socio-economic factors.
- Size – Will you be more comfortable in a larger community with many residents or a smaller, more intimate setting? Can you still get around reasonably well, or will a large campus become frustrating? Will you take advantage of the facilities that might be available in a larger community or will these amenities likely go unused? Will the size of the living unit work? To many women having a full kitchen is very important, even if they will receive two meals each day as part of their living package. On the other hand, many men are sure they need a “den” or “office” within their living unit and won’t hear of moving into a space without it.
- Sights – The classic line I hear from people exploring senior living options is, “Everyone here is old!” Sometimes that’s true. Some communities cater to an older crowd with more physical limitations and you’ll see lots of walkers and wheelchairs. Other communities attract younger, more physically active residents where jackets and ties at dinner are expected. You’ll also find that there are distinct differences in the “look and feel” from one residence to the next. Some have a homey feel, while others look like upscale hotels or even cruise ships! And still others give a more clinical or medical impression. Ask yourself whether you can “see” yourself in a particular community. Take the time to notice the details, especially in the public spaces.
- Sounds – When you first enter the community, is there a hush, or do you hear a loud television set? Or perhaps, you hear ringing phones and beepers, much like you would in a hospital. Do you get the impression that the residents are socializing, gathering, and participating in activities?
- Smells – Try to visit about a half hour before mealtime, and notice the smell. Is it appealing? When you are in the living areas, does it look and smell clean? Does there seem to be a strong “air freshener” odor everywhere that might be used to mask less than optimal cleaning? Our sense of smell is a fabulous clue to what’s really going on.
- Services – Some communities offer a continuum of care, so that residents can come into an independent living situation and then move to assisted living, skilled nursing, or a memory unit if needed. This is ideal if you and your spouse need different levels of care or if you suffer from a condition that you know will progress over time. You’ll also want to look at the services available to help with activities of daily living, transportation, physical therapy, etc. Take a close look at the social calendar since interaction with others is one of the huge benefits of community living.
- Ask for and check references – Before you decide that a particular community is on the short list, be sure to ask for and check a few references. Ask for permission to talk with the family members of two or three residents in addition to the residents themselves. When you have these conversations, don’t be shy about asking some tough questions.
Once you have arrived at a decision, it is important that you move ahead with it quickly. As the saying goes, “time kills all deals”, and this one is no exception. You will always be able to come up with a reason why this isn’t the right time to move. But the truth is, if you have reached the point where you have even started visiting communities, you probably know in your heart that this move really is in your best interest.
©2010 LifeBridge Solutions, LLC. All rights reserved.
Posted by Sheri Samotin on Mon, Oct 26, 2009
Senior Move Managers are professionals who specialize in assisting older adults and their families with the emotional and physical aspects of relocation and/or "aging in place." A Senior Move Manager (SMM) can help you develop an overall move or "age in place" plan. This might include helping you decide what modifications need to be made to your current home for you to remain there safely. If you conclude that a move is better for you, your senior move manager can help you determine the optimal community and unit that will best serve your needs.
Whether you decide to move or age in place, your SMM will help you organize and sort through your belongings, arrange for the profitable disposal of unwanted items, and arrange shipments and storage where needed. If you decide to age in place, your SMM will have knowledge of vendors who can add safety items such as ramps or grab bars and can help you prepare your home for live-in help if that is indicated. If you decide to move, your SMM will create a floor plan for your new home, interview and oversee packers and movers, unpack and set up your new home, and coordinate related services such as cleaning, waste removal, selecting a realtor, or preparing a home for sale.
Senior move managers have expertise in resources and approaches that save money and reduce stress. Imagine how nice it would be to go away for a long weekend and return to your new home with everything unpacked and put away, your pictures hung, the bed made, and the refrigerator full! That sounds like the perfect cure for the exhaustion you fear.
Be sure to choose a senior move manager who is bonded and insured. Also, be sure the person you choose specializes in working with older adults and their families and is not simply a moving company employee. Household transitions are difficult for everyone, but even more so for older adults who have accumulated a lifetime of possessions that often won't fit in their new home. An expert, affordable, and compassionate senior move manager can help you to navigate this important life transition.
© 2009 LifeBridge Solutions, LLC. All rights reserved.
Posted by Sheri Samotin on Mon, Jul 13, 2009
The aging parent who asserts that they will never be "sent" to a retirement home is the parent who fears being abandoned in his or her old age. He usually has expectations that one of his children will take him in. She might expect that she will be able to manage in her own home forever. This parent has rarely purchased long term care insurance and often hasn't thought much about what will happen when he can no longer take care of himself. Most adult children will agree that worrying about this is hugely stressful for them once they start to think about it.
But is it possible that the parent who is determined never to consider an alternative living situation has actually cheated himself out of some meaningful experiences with his kids? Might this mother and grandmother one day regret that while she is living under the same roof with one of her kids that they are never really engaged with her on an emotional level because they spend so much time attending to her physical needs? Is there a positive benefit that comes from adult children caring for their parents from a bit of a distance? While your parent has not been physically abandoned, might their fear of being pushed aside have created a situation where they are emotionally invisible?
Like so much else in life, it's all about balance. Perhaps the ideal situation is when your parents have put the pieces in place so that even if they live in your home, you can afford some caregiving help. Or maybe if they understood that moving to a retirement community doesn't mean that they will be abandoned will make it easier for them to consider that option. When their health or memory begin to fail, the time you spend with your Mom or Dad can be about keeping them company, making them comfortable, and allowing them to participate to the extent that they can in your life and your children's lives. Think about it. Don't let your parents do such a good job of making you feel guilty if you consider an alternative living situation that you forget that they need you on an emotional level.
Posted by Sheri Samotin on Thu, Jul 02, 2009
Jane Gross posted a fabulous discussion in The New Old Age Blog today called "The $500,000 Question." She relates her personal story of caring for her Mom, and wonders whether everyone might have been better off if they had considered a continuing care retirement community. She concludes that it would have been at least a break-even proposition on the money side, and a clear win on the emotional side.
Just as interesting as the post itself are the many comments left by readers. The stories posted by these adult children trying to do their best for their aging parents are both heartwrenching and uplifting.
If you are currently trying to help your aging parents, or planning for their future or your own future, this discussion is well worth your time.
Check it out!
Posted by Sheri Samotin on Mon, Jun 29, 2009
If you are the adult child of an aging parent, you have probably asked yourself, "How do I know what type of help my aging parent needs?" Unless you are a senior resource professional, sorting this out can often seem overwhelming. So, here are six questions to ask to help sort it all out.
- What is my parent's physical condition?
- What is my parent's emotional condition?
- What is my parent's cognitive level?
- What financial resources are available to pay for help?
- What human resources are available to provide help?
- What input has my parent given on the entire topic?
Your parent's physical condition will help you determine such things as whether your parent needs help with activities of daily living (e.g., toileting, dressing, feeding, mobility), with medication management, or with managing medical conditions such as diabetes or using supplemental oxygen. Your answers will help you decide whether your parent's physical condition allows them to be safe in their current living environment without extra help, or whether you need to arrange for in-home help or possible transfer to an independent or assisted living setting. If your parent's physical condition is likely to be short-term, as when she is recovering from surgery, you have other options to consider, such as having physical or occupational therapists come to the home, or perhaps a short stay in a rehab setting.
Sometimes, your parent is physically capable of taking care of himself, but he has become isolated and is not engaging in social interaction with others. This might be simply because he can no longer see well enough to drive or because many of his friends have passed away and he lacks someone to "hang out" with. Whatever the reason, social isolation can often lead to depression or other emotional difficulties. If this is your situation, you might decide to look into available senior centers, adult day care, or companion services for your Dad. Depending upon your answers to the other questions, you might also consider an independent or assisted living arrangement since these environments generally offer a great deal of social interaction and stimulating activities.
Some of the toughest decisions come when your parent is memory impaired. If your parent wanders outside of the house and gets lost, or leaves the stove on overnight, she needs closer supervision. If she becomes agitated due to the cognitive impairment, she may require someone around all of the time to keep her calm. If your parent suffers from Alzheimer's disease, there are often physical considerations as well, especially in the later stages of the disease. As is always the case, safety should be your first concern.
When it's time to figure out what help to put in place, there is no way to escape thinking about the financial side of the decision. While some home care is covered by health insurance such as Medicare, most care related to activities of daily living is not. If your parent has long term care insurance, it will generally begin paying for services once your parent meets the policy guidelines, which typically state that a physician must certify that they have difficulty with two or more ADLs and that this state will continue for at least three months. Some long term care policies provide for "first day" coverage for in-home assistance or services within an assisted living facility. You need to know whether the care you seek will be covered by Medicare, and if so, you must use a Medicare certified home health agency. If you are paying privately, then you have the flexibility to use any agency or to use a private caregiver who is not associated with an agency. Be sure to take the time to decipher your parent's insurance policies in advance so that you have some idea about what will be covered.
Many families are able to take care of their aging parents themselves. This is especially true when there are many adult children who live nearby and who can take turns or divide up the duties. If this is the case with your family, it is helpful to sit down before a crisis strikes to figure out who has the capabilities and the time to do what. In that way, the entire family will function as a team, and if supplemental resources need to be hired, everyone on that team will understand why that needs to happen. Some families set up care contracts so that the family caregiver is paid by the parent for whom they are providing the care.
Last but not least, if your parent is able to provide input to this discussion, it is a good idea for them to do so. It is helpful to understand what your parent's desires are, and if practical, to honor at least some of them. This is not always possible, but when it is, it is an important step in the process of a smooth transition.
Posted by Sheri Samotin on Thu, Jun 25, 2009
Yesterday, I had the opportunity to participate in a health fair in a local assisted living community. I was able to engage with several residents and I couldn't help but think about some of the striking differences I observed.
Let's start with the residents themselves. The first lady I spoke with was very sweet, but completely out of touch with what was going on around her. She was calm, polite, and immaculately dressed and if you saw her at the cosmetics counter in Saks Fifth Avenue you wouldn't have thought for a minute that she was anything other than a sweet older lady. That said, upon spending just a few minutes chatting with her, it became clear that she was happily in her own world.
Along came a gentleman who, with the exception of a pronounced limp, looked and acted like he belonged on the golf course. He was charming, articulate, and I was wondering to myself why exactly he was living there, but I'm sure it made sense for him.
A few moments later, a gentleman stopped by in a blue blazer, a crisp dress shirt and trousers and dress shoes. He spoke in French for a few moments, and gave me the two minute version of his life story. And then, he gave it to me again, word for word. When he started in for the third time, it was clear that looks are definitely decieving.
Finally, a woman came in riding a scooter. She was the self-appointed leader of the book group and was concerned that she couldn't find her "flock". She had a mission, and that was to get her fellow residents to read and discuss great works, and to write their autobiographies as a legacy for their families. She and I spent quite a while talking about her frustration that so many of her peers didn't seem to think that anyone would be interested in their life stories. This lady was as together as most people half her age, and it was her body, not her mind that caused her to be there.
If you are a caregiver or a professional advisor for a senior, please remember that each of them are individuals. Don't assume that because their bodies have failed them that their minds are slow. And don't assume that if someone "looks fine" that they will be able to process everything that you are telling them. Each of these individuals is a blessing, and we all need to stop and spend the time to see that, even when we're busy doing what we do with and for them.
Posted by Sheri Samotin on Tue, Jun 23, 2009
For many seniors, the move to an assisted living residence is emotionally very difficult. If they are lucky enough to be "with it", they know that the move is required because they are no longer able to safely live on their own. That realization is very sobering and is a step along the lifecycle that is often not welcome. The other scenario is when the new resident is not completely aware of what is happening and that can be just as difficult when they suddenly find themselves in new surroundings without a full understanding as to why things have changed. In either case, there are simple ways to make an assisted living residence feel like home.
Be sure to bring along some familiar items. It might be tempting to buy a new bedspread for your Mom, much like you would do for your daughter who is heading off to college. However, Mom might much prefer that familiar old spread that makes the new space feel like HER bedroom, and not a hotel. Similarly, while your Dad probably can't move his entire condo into his new assisted living home, you can make room for his favorite chair and footstool. Make sure to place lots of familiar and favorite knick-knacks around the new space too, and don't forget about cherished family photos. Remember that this move is not an exciting time for your parent, and is probably not something he or she is looking forward to, even if she recognizes its necessity.
Decorate the new space so that it doesn't look or feel institutional or generic. Many assisted living communities will allow a new resident to specify a paint color at no charge, or will allow you to have the space painted a non-standard color as long as you leave a deposit to cover the repainting later on. Warm colors on the walls will help make the new space feel cozy. Likewise, be sure to bring any favorite wall art or lamps along, and don't hesitate to have some window treatments made up. They are not expensive, and go a long way toward customizing a space.
When you are considering what should be moved to the new residence, remember to make sure that you have a place for everything. You don't want too much clutter that will collect dust and get in the way. There is a delicate balance between having enough of those familiar items to make it feel like home, and trying to stuff too much into what is almost certainly a smaller space than the new resident is used to.
At the same time, be sure that there is a simple way for Mom or Dad to keep everything in its place. They will feel much more in control of their environment when it is easy for them to find what they are looking for in their home. Take the time to organize the closets and invest in storage solutions such as baskets or bins as necessary. Make sure that your parent knows where things are, even labeling cupboards and drawers if that helps. When you visit, take the time to look around and make sure that things are where they should be.
Advocate! One of the best ways to make the assisted living residence feel like home is for your Mom or Dad to have social connections there. If your Dad is entirely "with it", make sure to ask the administration to introduce him to others who are too. Make sure that he's not seated at dinner with three people who are in various states of memory loss, as that is a sure way for him to dislike his new surroundings. On the other hand, if your Mom has some memory issues but is still physically very active, be sure to request that she not be seated that first night with a group who are all mobility impaired. I promise that if you do, she'll notice and tell you that everyone else is "too old" for her to socialize with. In short, as with any other transition, it's important that your parent immediately finds a few people with whom he or she can relate, who are "just like them". This will make the move into assisted living go much more smoothly for all.
Posted by Sheri Samotin on Wed, Jun 17, 2009
While no two family situations are the same, there are several common scenarios that baby boomers face as their parents come to the point where it is no longer possible for them to live in their own home without assistance. The first is to have the parent move in with one of his or her children or another relative. The second is for a caregiver (family or paid) to provide in-home assistance. And the third is for the parent to move to another living situation entirely. We will focus on the third scenario.
Let's assume that someone has decided that it is time for your parent to move to a retirement community. Sometimes, your parent will come to this conclusion on his or her own. That is probably the best case scenario, and also the less frequent one. More often, the adult children have reached the decision, but their parent doesn't see things quite the same way. Under each of these situations, what are the steps that you need to take to make that move happen?
Perhaps the most difficult aspect of helping your aging parent transition to retirement living when they don't see the need to do so is overcoming your own guilt. It is natural for you to ask yourself if you are doing the right thing, but if you are convinced that you are, then the most important action is to ACT! The longer your parent stays in his or her current living situation, the more likely it is that a crisis such as a fall will occur, making the move ever more urgent. It is always better to transition calmly than to do so in crisis mode. So, what can you do to help your parent accept the decision that you have made?
One of the best ways to help your parent to see the benefits of a move is to allow them to see what they are moving to. Many communities will allow short stays for prospective residents (and others). If your chosen community allows this, it can be a great way to introduce your parent to the new environment, while still letting them "come home again" before making the move permanent. A week or so is a good length of time for a short stay. Perhaps you can do this if you will be away for a vacation of your own or have a business trip planned. I've actually heard of aging parents who decide not to return to their former residence once they've tried out their new community!
Another possibility is to engage your parent in the process of choosing what furniture, household items, and personal treasures to take to their new home. One of the hardest things for your parent is parting with all of those things he or she has accumulated over a lifetime, and moving to a retirement community usually means downsizing and parting with some of those things. Perhaps there is a favorite chair or dresser that will make the new space feel more like home and help your Mom or Dad get over having to get rid of the rest. Maybe some special window treatments or new bedding can be made for the new space that will make it feel fresh. Hanging favorite photos or art on the walls and making sure the place is all set up for your parent will help to make the whole move less overwhelming. If you are good at imagining an empty room as a home and have the time and energy to set up the new space, then by all means you should take this project on yourself. If not, you might consider engaging a senior move manager who can coordinate the entire project.
Senior move managers specialize in helping people downsize their homes and transition to retirement living. A senior move manager provides services ranging from coordinating the move itself (selecting, negotiating, and supervising the packing and moving staff) to helping decide what to take to the new home and where to put it once it's there. In addition, many senior move managers will unpack and set up your parent's new home and help address the items that are not moving along with them through sale, auction, consignment, or donation, as appropriate. The National Association of Senior Move Managers (http://www.nasmm.org/) provides more detailed information about these professionals including where to find one. For more information about LifeBridge Solutions' household transition services, check out www.LifeBridgeSolutions.com/Household-Transitions.
Posted by Sheri Samotin on Tue, Jun 09, 2009
So, the day you've been dreading has come. You, and perhaps your siblings, have decided that Mom or Dad simply can't live in their home a moment longer. For whatever reason, moving in with one of the kids isn't an option. It's time to find the right place for the next chapter. If you are like many adult children of aging parents, your parent doesn't agree with your decision, and thinks he can stay at home just fine. She doesn't want to hear about moving into a "facility." And you feel, well, guilty. Sound familiar? Here are my top ten strategies for choosing (or helping to choose) a retirement living option for or with your aging parent.
1. Scout ahead of time - In most areas, there are many options for independent or assisted living. It can be overwhelming to figure out the best situation for a particular person. Spare everyone, by doing the leg work without your parent.
2. Understand the math - Money does matter. Your parent's resources (and maybe yours) will determine the range of available options. Don't confuse the issue by bringing your parent to see a place that is outside of your family's means.
3. Narrow the choices to no more than three or four using the Five S method - Once you have a list of possibilities that are within your budget and in the geographic area you desire, it's time to narrow the choices to a few where you think Mom or Dad will be happiest. I suggest you use the Five S method, considering size, sights, sounds, smells, and services. What you are really doing is looking for a good match based on a sixth "S" - similarities.
4. Ask for and check references - Before you decide that a particular community is on the short list, be sure to ask for and check a few references.
5. Visit with your parent - Finally, it's time to bring your parent around on a tour of the three or four best options. Only have them visit communities that fit their needs and budget and that you feel good about. If at all possible, it's best to let your parent make the final decision about which community and which living unit will be their new home.
Once you have arrived at a decision, it is important that you move ahead with it quickly. As the saying goes, "time kills all deals", and this one is no exception. You, or your parent, will always be able to come up with a reason why the right time for this move isn't now. But the truth is, if you have reached the point where you have even started visiting communities, you probably know in your heart that this move really is in your parent's best interest.
Do you have suggestions for choosing a retirement community? Please share them with us!