Most of us want to view our parents as healthy, strong and everlasting. As they age, it is inevitable that they will eventually require some form of senior living care to meet their changing needs. The best decisions are rarely made in an emergency situation, so we encourage you to have conversations with your parents while they are still healthy, active and can provide some input.
More recently, the pandemic has brought to light many other unexpected considerations for the senior community; i.e., isolation, access to care, wellness checks, and the challenges to their children (the sandwich generation). One senior client who has decided to make a move to an over sixty community recently said, “I am making this decision while it’s still mine to make.” Some see a move like this as a gift to their adult children, who will never be burdened with having to make this decision for their loved ones.
We all want to respect our parents’ wishes and support them in living a happy engaged life, in whatever way this is defined. When we start to see signs of decline, whether physical or cognitive, this is when we encourage adult children to start educating themselves.
In Home Care
Many of our clients have expressed a desire to receive care in their home as long as feasible. This can be extremely expensive depending on the degree of support needed. Some only need 3-4 hours daily for showering, making meals and light cleaning. These are often referred to as companion services. As their needs increase, memory issues become more concerning and then safety becomes the priority. At this juncture, you may want to explore other options.
The question many of us are asking is how do we know when the time has come, and what should we be looking for?
Senior Living Communities
Senior communities fall into many categories, for purposes of this article we’re going to simplify it into three: 1) Independent living 2) Assisted living and 3) Long-Term (or Memory) Care.
Communities that provide tiered care, allowing your parent to increase levels of care as needed, are an ideal choice. Understanding the financial commitments of the full spectrum of services are very important for a family to understand at the outset.
Individuals often move to an independent living while they’re active and healthy because they want to truly make the community their home. They can fully enjoy all the benefits that come with a maintenance and worry free lifestyle while having the peace of mind that they'll be able to comfortably age in place without having to move again.
Independent living is an appealing choice as residents explain they actually enjoy more independence, free from homeownership, yard maintenance, cooking, cleaning etc.
There are many models and options, and we typically see two financial models.
- Equity or Ownership: Unit is purchased by resident, followed by monthly community fee. Typically, the resident or estate would be returned 90% of the deposit upon termination of residency.
- Rental Agreement: includes a rental fee and a community fee, but no ownership.
An Assisted Living Community will provide the much-needed support and care that many of us are not equipped to provide for our loved one, while giving them a safe and independent environment to enjoy. Contrary to what some may believe, a Long-Term Care Facility is a medical model; an Assisted Living space is a social model, which is equipped to provide clinical assistance 24x7. This includes (but is not limited to) medication administration, as well as help with all Activities of Daily Living (ADLs), which are performed by Certified Nurses Assistants who support the daily care of residents.
Many assisted Living Communities offer restaurant style dining rooms, pubs or bistros, fitness centers, media room, hair salon and most importantly social engagement. The planned activities offer diverse opportunities for social engagement, which allows the resident to be as active and entertained as they desire! Most essential is the peace of mind knowing your parent’s Assisted Living Community will have a supportive staff on location, available 24x7, to keep your loved one safe and well cared for.
It may be time for a long-term care facility when your loved one begins to exhibit struggles with Activities of Daily Living (ADLs). When you hear long-term care facility, you might automatically think nursing home, it's not surprising. However, long-term care encompasses a spectrum of options and a progression of choices.
The typical models you will find in Long Term Care include:
- Nursing Homes provide medical and personal care services beyond what's available in assisted living. Nursing care, 24-hour supervision, assistance with activities of daily living and three daily meals are standard. Most nursing home residents have chronic physical or mental health conditions, or both.
- Memory Care. For people with Alzheimer's disease, other types of dementia or serious memory problems, memory care involves an extra level of care and supervision. Secured memory care units are located within many nursing homes and assisted living facilities. Staff members receive special training to provide 24-hour care and daily assistance to this group. Memory care typically costs more than non-memory care.
- Skilled Nursing Facilities. The terms nursing home and skilled nursing facility are often used interchangeably, because the types of care involved often overlap, but they aren't identical. Skilled nursing facilities are more likely to have a consistent presence of nurses or physicians and offer rehabilitation services such as occupational, physical and speech therapy. SNFs and nursing homes fall under different sets of regulations.
The cost of care is often a major factor in long-term care choices. The issue of how to pay for long-term care, and what is and isn't covered by Long-term Care insurance policies, Medicare or Medicaid, is a huge decision element.
It's never too soon to plan ahead for long-term care, whether for yourself or a family member. People underestimate the cost; they underestimate the amount of time they may need services and the sheer number of options available to them. There are great resources available such as geriatricians, social workers, community senior centers, visiting nurses, elder-law attorneys, administrators of assisted-living facilities.
Please feel welcome to reach out with any questions, as we have amassed quite a list of resources and would be happy to help guide you through this transition.