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Live Life On Your Own Terms

choose the right al optWhat happens if our three-part needs assessment – of physical, psychosocial and mental status – shows that it’s time to move to an assisted living facility?

Then, the question is, which one? And it’s a tough one. As a former executive director of assisted living communities, I know just how confusing, how complex, how segmented, and how seemingly endless the array of senior care assisted living options can be.

Based on this experience in both holistic senior care and the assisted living industry, and knowing your specific needs, we can give you and your family a neutral analysis of your options, complete with each one’s advantages and drawbacks.

But the decision itself is yours, and it needs to be based on your own first-hand observations. Here are some tips for evaluating each option.

What to look for

It’s a good idea to visit an assisted care facility you’re considering twice – once for a scheduled tour and later for a surprise visit.

On the day your tour is scheduled, get there 10 minutes early. Look around and get an overall feel for the place. On the tour itself, try to chat with residents and families. Ask how they feel about the home and if they’d recommend it. At the end of the tour, ask to see the community’s most recent staff survey.

After the tour, if you’re still seriously interested in the home, come back for a surprise visit, preferably during a meal or scheduled activity. Do things look the same as on the tour? Talk to residents and family members, without a staff member there, to find out how they like the home.

What to ask

Once you have an overall idea of the place, ask questions to drill down to the specifics:

  • Level of service – Do your services include social work? Therapy? Pharmacy?
  • Costs ­– Do you have a buy-in fee? If so, how much? Do you charge extra for services such as medication management?
  • How do you welcome newcomers? Is there a welcoming committee? Does it include residents as well as staff? Is there a “buddy system” to help newcomers meet new people, adjust well, etc.?
  • How do you get to know newcomers? Do you have a formal questionnaire? Do you talk with newcomers and their families about their preferences and interests? How do you help the rest of the staff get to know them?
  • How do you develop a resident’s service plan? What input do residents have?
  • How consistent are caregiver assignments?
  • Do residents choose their own sleep and wakeup times? And is breakfast available throughout the morning?
  • If residents need bathing assistance, how and when do they get it? Do you accommodate their personal bathing schedule?
  • What kind of meal service do you have? Is it restaurant, buffet, family style, or a choice of all three? How many menu choices are there for each meal? What input do residents have into meal planning? Do you have proper utensils for people with eating difficulty? Can individual residents get a snack 24 hours a day?
  • What kind of activities do you have? What’s on the monthly schedule? Do your activities include intellectual stimulation? Physical engagement? New learning? Conversation? Spirituality? Are they off-site as well as on-site? What if residents want activities that aren’t on the schedule?
  • How do you maintain social activity? What opportunities are there for residents to get together with each other? With staff? To maintain ties with the outside community? Are family members and friends welcome at meals, celebrations and events?
  • What input do residents have on how things are done? And how often?
  • How much access do family members have? Can they visit anytime? Take part in activities? Talk to staff members?
  • How do you measure resident and family satisfaction? With group meetings? With annual surveys? If the latter, ask to see the most recent survey form and, if possible, the results.

To learn more about assisted living, or anything else about holistic senior care, please click here for a free 30-minute consultation.

It’s a great way to make the difference between an assisted living facility and an assisted living home.

who needs assisted livingAccording to the Family Caregiver Alliance there’s a 68 percent probability that a disability will keep people 65 or older from performing at least two Activities of Daily Living (ADLs) during the rest of their lives. These ADLs include bathing, dressing, eating, toileting, oral hygiene, grooming, and walking from place to place.

And according to the National Center for Assisted Living, more than 735,000 Americans live in assisted living settings, which combine homelike living, a social setting, and ADL assistance. In a 2010 CDC national survey, some 70 percent of residents reported needing help with bathing, just under 60 percent with going outside, and about 45 percent with dressing. Yet, almost one-third of respondents to the same survey reported receiving no ADL assistance at all.

So the first question for yourself, a parent or an older family member is, how much assistance, of what kind, is needed. That’s why our holistic senior care management starts with a detailed three-part assessment – with seniors and their families – of physical, psychosocial and mental status. Then you’ll know what kind of care you need and where it’s needed.

It may be that assistance is needed not for ADLs, but for Instrumental (i.e., non-basic) Activities of Daily Living (IDLs), such as managing money, basic housework, shopping, preparing and cleaning up after meals, and using phones, televisions and computers. For those, we can help you to either provide the needed help yourself or hire someone for significantly less than the cost of an assisted living facility. We can also suggest devices that help seniors perform ADLs at home, such as:

  • Long-handled sponges for bathing
  • Splints to help stabilize wrists and ankles
  • Dinnerware like nonskid bowls, soft-grip utensils and plate guards for meals
  • Dressing sticks and long-handled shoehorns for dressing without having to bend over

And if our assessment shows that an assisted living facility is, in fact, what’s needed, we can give you honest, objective input about locally available choices.

So please email us or phone 804-270-3619 for a free 30-minute consultation. It’s a great option for learning more about all your senior care options.

healthcare advocate optDoctors and hospitals, even the very best, are neither infallible nor omniscient. Moreover, since they see you only from time to time, none has as intimate and up-to-date knowledge of your own body as you do.

That’s why, to ensure proper care, everybody needs a healthcare advocate. And why the older you are – with more health issues, more different doctors and doctor visits, and more prescriptions– the more you need one.

Your healthcare advocate can be a family member, a friend, a volunteer from your religious congregation, or a social worker. It can be a patient advocate from a hospital or Medicare Advantage Plan (though most are there for you at the time of discharge from a hospital, residential rehab center or skilled nursing facility, rather than continuously). It can be a nonprofit advocacy organization or a professional healthcare advocacy consultant.

clockMedicare Part A covers hospice care for terminally ill patients “with a life expectancy of six months or less” as determined by the patient’s physician. But with a 2011-2016 average of just 2½ months of hospice care, some 1.4 million hospice care beneficiaries in 2016 could have benefitted much more had they signed up sooner.

Why the delay? One reason may be the patients’ and families’ all-too-human tendency to keep hoping against hope that the inevitable won’t happen. They tend to associate hospice care with resignation, with lacking the courage to keep on fighting whatever condition they suffer from. Perhaps some physicians are also uncomfortable talking with patients and their families about end-of-life issues.

medicare checkupThis month marks the start of Medicare's annual open enrollment period. Instead of automatically renewing your current plan, it makes good sense to give it a thorough examination, to make sure it's still fulfilling your needs and that you're not paying for coverage you don't need.

More than your health could be at stake here. 

The average Medicare beneficiary runs up $16,000 in medical costs each year and pays about half of them – $8,000 or  more – out of pocket. And according to consulting firm Goodcare.com, at least 90 percent of Medicare beneficiaries are shelling out for more out-of-pocket medical costs than they need to.

While Medicare Parts A and B cover 80 percent of doctor visit and hospital charges, what they don't cover can be expensive.