Senior Living: How To Find The Best Senior Community

August 23, 2009

Finding the right Senior Living Community, also known as Assisted Living Facilities can be a challenging task if you’re unaware of what to look for. Senior Assisted Living can come in many forms, sizes and care types and it can be a good idea to try out a short term assisted Living, also know as a respite stay before making a lifestyle change. The list below are a few questions to ponder and ask before moving into any Assisted Living Community. Read more

Assisted Living Cost

June 3, 2009

Assisted living is more of a marketing term referring to a generalized care model then it is a specific form of care delivery. It is an attempt by the industry that offers these services to bring a disparate number of service providers under one umbrella.

Assisted living, also called residential care, is a type of living arrangement in which personal care services such as meals, housekeeping, transportation, and assistance with activities of daily living are available as needed. Also an important aspect of the assisted living model is to provide security, comfort and meaningful activities for residents. But unlike nursing homes, residents in assisted living remain independent, living on their own in a residential setting. Assistance with activities of daily living may include help with bathing, dressing, toileting, diapering, medicating, helping with daily living decisions and moving from one place to another.

The definition of the term assisted living and what it is called in licensing regulations vary from state to state. One of the reasons many terms exist for similar facilities is that each state has its own licensing requirements. Regulations to govern these facilities are not uniform. Allowable services also vary from state to state. Assisted living services allowed in one state may only be available in a nursing home in another state. Recently there is an effort among many state legislatures to unify assisted living licensing provisions based on a common model for all states.

Here are some examples of the titles states use for assisted living:

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Residential care
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Personal care
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Adult congregate living care
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Board and care
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Adult living facilitiesSupported care
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Enhanced care
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Adult homes
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Sheltered housing
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Retirement residences
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Adult foster care
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Community based retirement facilities

The difference in licensing is usually based on the size of the facility or the services it can offer.

For example, residential or board and care is usually a converted home or small facility with three to ten beds where the caregiver is a homeowner or single proprietor with little or no support staff. These facilities typically are not allowed to offer much care beyond bathing, dressing, providing meals or helping residents move around. Some of these homes however, may contract with home health agencies, home visiting doctors or nurses to provide care for their residents.

The cost for board and care homes is typically much less than with large, new, apartment-style assisted living facilities. People who operate board and care homes have a love for the elderly and in essence are taking these people into their homes to care for them as if they were family members. Unfortunately because of their small size these operations have little money to advertise and their residents usually come to them from referrals or word of mouth.

Assisted living fills a gap between home care and nursing homes. Years ago, before assisted living, a person needing professional care went to a nursing home even though the care didn’t always merit the intensive supervision and control of a nursing home. The fairly new alternative of assisted living provides a more homelike environment for people needing or anticipating help with activities of daily living or incidental activities of daily living but for which 24-hour nursing care is not a necessity.

Instead of the hospital environment of a nursing home, newer assisted living facilities look more like apartment buildings with private rooms or suites and locked doors. Instead of a nurses desk, there is a help desk. And instead of a hospital-like lounge area and sterile cafeteria, assisted living has gathering areas with couches, fireplaces, gardens, atriums, etc. Central dining areas look more like banquet rooms and often offer entertainment during or after mealtimes. Meaningful activities and chats with neighbors in pleasant surroundings, keep residents active and stimulated. Frequent outings are also planned. And transportation is available to residents who can’t drive.

Many assisted living facilities allow home health agencies to come in and offer services for residents. Some states may allow facilities to have a resident nurse or therapist to help with minor medical problems. And some states even allow variances for assisted living to offer limited nursing home services.

Some assisted living facilities specialize in the care of Alzheimer’s patients. An Alzheimer’s patient typically does not require a lot of medical attention but often requires supervision and confinement. Alzheimer’s facilities have locked entrance doors to prevent residents from wandering.

Prior to assisted living, many people had to reside in nursing homes but didn’t need the level of care provided. Yet there were few options for other living arrangements. With assisted living, these people now have the choice of a more homelike environment at about half the cost of a nursing home. Demonstrating the popularity of ALF’s over nursing homes is the fact that the number of nursing home beds in this country has increased only slightly over the last decade to about 1,800,000 beds, whereas assisted living beds have grown from about 600,000 to well over 2,000,000 beds over the same period.

Not all residents of ALF’s need significant care or assistance. Many are there because they want a simpler lifestyle without the worry of maintaining a home and they seek the companionship of other people their own age. They also may have chosen assisted living over an independent retirement community because they may need some minor help such as taking medications or they desire a secure environment or they may require some minor supervision. They may be able to get this help other places but they anticipate a time when they may need the more intensive care available only with an assisted living facility. Source for below: National Center for Assisted Living, 2001

A Difficult Decision

The decision to place a loved one in an assisted living facility is a difficult but frequently unavoidable one. Even though the choice may be absolutely necessary, the person forced to make the decision for their spouse or parent often feels an overwhelming sense of guilt.

When the time came for me to decide to place my mother, who suffers from Parkinson’s disease, into assisted living, I knew as a nurse that it was the best decision for both my mother and me. All the same, I felt an enormous amount of guilt, and when I came home after helping my mother move into her new community; I broke down, sobbing.

Today I work as a marketing counselor for the facility where my mother lives – so I see her every day and know firsthand that she receives excellent care – yet there are still times when I fail to hold back the tears.

Many caretakers who decide to put their loved one in an assisted living facility think they have failed them somehow, even if they have already spent years caring for them and simply cannot do so any more. I had been taking care of my mother for three years before bringing her to live in a long-term care community, helping her with daily tasks and spending every other night at her house. I even managed to make it a family effort, with my son easing much of the burden during his summers home from college. My mother did not want to leave her home, and I did all I could to see that she would not have to leave.

But eventually that time came. In a fall my mother broke her foot, but she hid the injury from me. A fall like my mother’s is especially worrisome because Parkinson’s is an incurable disease which progressively and inevitably gets worse. Patients are often able to minimize the ill effects of the disease for a time, but eventually they will require frequent or constant assistance from a caregiver.

My mother’s fall was a sure sign that she could no longer live on her own. When her doctor discovered that her foot was broken, he told her this in no uncertain terms. Now it became my responsibility to help her find a new home, and though part of me wanted to take care of her just as she had taken care of me as a child, I knew that I did not have the capability to care for her as her Parkinson’s progressed.

In some respects my mother and I have been fortunate, in that she was aware of her doctor’s instruction and conscious of the reasons for entering an assisted living facility. Children and spouses of Alzheimer’s patients, on the other hand, must bear the full weight of responsibility when choosing the option of assisted living, though many spend months or even years denying this fact. Usually, when it comes time to seek out an assisted living facility for an Alzheimer’s patient, that patient has already reached an advanced stage of the disease and likely exhibits a number of disturbing symptoms.

If the caregiver has decided that it is time to consider assisted living, the patient may already be in need of help with dressing, shaving, eating, and even using the bathroom. Perhaps the patient has become delusional, convinced for instance that the caregiver wishes to harm them. These are all common symptoms of Alzheimer’s disease, and, like Parkinson’s, such symptoms will only get progressively worse.

Recognizing that a patient whose Alzheimer’s has reached such a stage and may need to enter an assisted living facility is positive. Unfortunately, I have met many people who think they can convince their parent or spouse of their need to enter an assisted living community, when in fact it is only the children or spouse of Alzheimer’s patients who can ultimately make the decision.

Compounding the grief is that patients who have reached an advanced stage of Alzheimer’s often lose awareness of recent experiences and surroundings, and may even lose recognition of their caregiver and other loved ones. Because of this, the patient will probably be confused by the move and unaware of the suffering of the child or spouse responsible for placing them in assisted living. Like I did, people begin to cry at times. Depression and anxiety, caused by guilt, sometimes become acute.

But there are a number of things that one can do to diminish feelings of guilt. In my case, besides visiting my mother every day, I always make sure that she has fresh flowers in her room. When she was able to, she spent a lot of time in her garden, and the flowers help her to experience a bit of the garden all the time.

On Sundays, I spend the day with my mother in my home, picking her up early in the morning and taking her back to her assisted living facility in the evening. I try never to miss a week.

Beyond that, it helps to remind oneself of the advantages that an assisted living facility affords. Working in the community where my mother resides provides me with some added insight into those advantages, for which I am grateful. Besides the obvious – the physical aspect of care – there is the always-important social aspect of continuing care communities. My mother, even before entering the facility, was very antisocial, and I even made a friendly bet with the staff that they would not be able to get her out of her room. For three and a half years I was winning that bet, but six months ago, after much persistence on the staff’s part, they finally got her to participate in the events.

One day recently, while I was with my mother, she took out a quarter from a drawer in her room. Though Parkinson’s makes it difficult for her to speak, she managed to say, “cards” – my mother had won the quarter playing cards. She never used to play cards.

Despite moments like these, which remind me of all that an assisted living facility offers that I alone could not, the guilt and the grief never entirely go away. But I know my decision was the right one, and I know that I am not alone in feeling involuntary pangs of guilt. My hope is that others in my position share these same realizations.

Paulette Kaufman is currently Director of Sales at Keswick Pines, a Lifecare Center in New Jersey , which offers assisted living and comprehensive health care programs to residents, providing personal assistance, nursing care, pain management, and memory impairment support. Ms. Kaufman’s mother has been a resident of Keswick Pines for four years.

LENGTH-OF-STAY:

A 1999 survey done by the National Council For Assisted Living e stimates the average length of stay in an assisted living facility ranges from approximately 2.5 to 3 years. Residents who leave typically do so because they need to move to a nursing home for more care or because of death. A 2000 study found that, among those who moved to another setting, the need for more care was the most commonly cited reason for leaving.

ASSISTED LIVING COST:

In most cases residents pay a regular monthly rent to include meals and housekeeping and the care services are added as extra cost as needed. In smaller facilities the entire cost includes room and board as well as care services. Some facilities provide levels of care based on need and charges are uniform for each level. For instance a level or grade 1 care might cost an additional $400.00 a month. A second level or grade 2 might cost $800.00 a month and so on.

A rule of thumb estimate is that assisted living costs about 60% of the cost of a nursing home. In many areas of the country this might price assisted living at about $2,400.00 a month. It should be noted that this would typically be the charge for newer apartment style complexes. So-called Board-and-Care homes which are typically individual residences converted to accommodate a small number of residents are going to be considerably less in cost. For example a board and care where two people are sharing the same room might cost about $1,000.00 a month.

There are also assisted living facilities that cater to people with money. These facilities would be more like living in a high-rise condominium but having in addition long-term care, housekeeping, meals, planned activities and transportation included in the package. Obviously facilities like this are going to cost a great deal of money.

A common and growing trend is for care providers to integrate care systems in one complex or in close proximity to each other. For example, a nursing home may have an assisted living wing along with an adult day center and an in house home health agency. These could be in the same building or in buildings on a common campus.

There are at least three advantages to this arrangement. One is, as the need for care progresses the care facility can retain a paying client by providing higher levels of care and not losing the client to a competitor. A second reason is that residents who have formed friendships or who have a spouse in one area of the care facility can maintain those relationships by moving to another area that is virtually in the same place. A third reason is that the care facility may have been chosen due to its proximity to the family. Keeping their loved one in the same place as the need for care escalates can be very valuable to the family.

WHO PAYS?

In 2002, Medicaid helped pay for services for approximately 11% of assisted living residents in 41 states. It should be noted that Medicaid typically only pays for care costs in assisted living and does not pay for room and board. Also a person receiving Medicaid can have no assets exceeding $2,000.00. As a percentage of the cost of total assisted living care the Medicaid portion would be considerably less than 11%. Based on care costs alone Medicaid might only pay about 5% of the total cost of assisted living.

Medicare does not pay for assisted living. About 75% of all costs are paid by residents out of personal funds or family assistance. SSI (supplemental security income) pays for 14% and 2% is covered by long-term care insurance. It should also be noted that the majority of SSI payments for assisted living are for specialized units for mentally retarded and developmentally disabled individuals. These units are maintained and staffed on behalf of state welfare programs. These would not be your typical apartment style assisted living complexes. This means that for the general public–excluding those on SSI welfare payments–more than 90% of the cost of assisted living is paid by individuals or families out of pocket.

Because the government participates little in the cost of assisted living for the non – SSI public, individuals anticipating a future need for assisted living would do well to consider the purchase of long-term care insurance. All modern comprehensive policies cover assisted living. You must, however, qualify for benefits under the policy. Some in assisted living may not need long-term care and until the need for care comes about the policy would not pay.

Insurance is certainly more cost-effective than paying out-of-pocket and may make assisted living a possible living arrangement where otherwise it would not have worked. Depending on your age, 20 years worth of premiums, as an example, might only cost 3% to 8% of the actual amount the insurance policy would pay for a 3 year stay. That’s a lot cheaper than paying 100% out-of-pocket.

Buying and paying for a policy before retirement might mean that assisted living would be an alternative with a retirement income that otherwise could not afford assisted living. For example, one could leverage a $3,000.00 per month assisted living cost with a $100.00 a month long term care insurance premium.

Choosing an Assisted Living Facility

An ALF staff worker can tell you whether or not you or a loved one will qualify for assisted living. But you may be forced to choose a nursing home instead because the level of care that an ALF can offer is dictated by the licensing provisions of that particular facility. In the event that you are turned down for care by one ALF, it is very important to get evaluations from other facilities. Many ALFs have found ways to stretch eligibility and you shouldn’t give up after one try.

Below is a copy of a reprinted article from the Assisted Living Federation of America’s Assisted Living Today Magazine, copyright 1999, ALFA. This article is found on-line at http://www.alfa.org/public/articles/details.cfm?id=77.

How to Choose a Residence

Making the right choice is easier when you thoroughly evaluate residences using these criteria – By Elizabeth Parker Welton MSW, LCSW

Assisted living residences, in both rural and urban areas, allow today’s consumers to be highly discriminating in their choice of a residence. A wide range of choices, however, may produce confusion and anxiety. With choice often comes the implied responsibility for making the ‘right choice.’ Family members engaged in this search sometimes feel like they’re looking for a needle in a haystack without the benefit of a map.

ALFA has developed a complete checklist to be used in the evaluation and selection process. Consider the following elements when searching for that needle in a haystack.

Atmosphere: Family members involved in the selection process must look at the residences they visit through the eyes of the person who will be living there. When touring facilities, family members often comment, ‘I could imagine myself living here.’ Although that is a positive reaction, what is truly relevant is whether they can imagine their loved one living in that setting.

How does the prospective resident react when he or she meets the staff and other residents? Is the decor welcoming and homelike? Do the current residents appear to be compatible with your loved one? Will the particular personality and culture of that setting support the physical, emotional, mental, and spiritual needs of the prospective resident? The answer to that question is critical in determining the success of your and your loved one’s choice.

Make several return visits to the residence on the top of your list to experience staff and residents in a variety of situations. Although crisis sometimes necessitates a more immediate choice, it is always ideal to take the time to make a slower and more informed decision guided by as much information as you can gather.

Physical Features: A residence that is modern and tastefully decorated almost always creates an initial favorable impression. However, an aesthetically pleasing setting that is not designed to maximize comfort and ease in functioning may not be a particularly wise choice. For example, a beautifully decorated unit that does not have doorways wide enough to easily accommodate a wheelchair does not allow for ease and comfort in movement. A bathroom that is too small to permit a wheelchair or walker to enter without precise maneuvering also reflects poor design. Hallways that are long and/or poorly lit without handrails may confuse and overwhelm elderly residents.

It can be extremely helpful to choose a potential unit and have the future resident move about in that space as if he or she is already in residence there. It gives you an excellent opportunity to evaluate how well the space is designed to promote both comfort and ease in movement as well as how it supports independent functioning.

Needs Assessment, Contracts, Costs, and Finances: Assessing the fairness and comprehensiveness of the contractual agreement is important. Most people are accustomed to evaluating and signing contracts fairly routinely. But it will be important to understand any future costs for increased levels of care and service should the resident’s physical and/or cognitive functioning decline. It is reasonable to expect costs will increase over time as independent or minimally assisted functioning declines. Being prepared for that eventuality will help you decide whether that particular residence is financially feasible. Visit ALFA’s Web site (www.alfa.org) to view a standard ‘Consumer Information Statement’ or disclosure form, which identifies questions you should ask specific to fees and services.

Another way to determine the viability of a particular residence is to learn whether each resident has a written care plan. Without such a tool, it’s possible the care needs of residents will be unrecognized and therefore unmet. A comprehensive care plan should be created with the help and input of the resident, all available family members, the family physician, and any staff members who will have direct contact with the resident. This care plan must be reviewed and updated as the resident’s needs change. The process of developing a care plan allows the resident to feel that all of his needs are both recognized and important to those around him. This frequently allays much of the anxiety associated with such a major life change.

Education and Health Care: The majority of people entering an assisted living residence are on at least two daily medications. Many choose this type of setting because medication self administration, among other things, has become difficult. Understand what specific policies are in place for giving medication as well as for any medical emergency that may arise.

Is a licensed nurse available to residents and staff in a full-time capacity? If the prospective resident has chronic hypertension, can you be confident his blood pressure will be taken and recorded on a frequent basis? Does a staff person arrange for visits from a physical therapist, occupational therapist, hospice nurse, etc.? The coordination of services with agencies in the community allows for a full continuum of care to be provided. It not only significantly benefits the health and well being of residents but also establishes the residence as a true member of the outside community. The relationship between the residence and the local community will support the resident in not feeling isolated or sequestered.

Services: Determining as specifically as possible the prospective resident’s daily care needs is a critical step in choosing a residence. Make a detailed list of the type of assistance that will be required with each activity of daily living. For example, will this resident require assistance in dressing and undressing? If so, what specific type of assistance will be required? If her clothes are laid out for her, can she dress herself or will she require assistance in the actual dressing process? Does the staffing pattern allow residents who are wheelchair bound to receive help quickly if they need toileting? Inquire about the staff/resident ratio on all shifts. This information will give some indication of how quickly staff can be available to assist residents.

The ease and availability of transportation to shopping, the hairdresser, and other community activities also is important information. The ability to move relatively effortlessly between the residence and the community is another significant way the resident’s autonomy and independence are valued and encouraged. Transportation provided by the residence may or may not represent an additional monthly charge.

Cognitively impaired adults may need a different type of assistance in their daily functioning. Are safety measures in place to contain possible wandering? Is the staff trained in techniques important to the care and comfort of mentally confused residents? Are specific areas and/or units designed to provide specialized care and programming for those who are cognitively impaired?

Individual Unit Features: Nurturing the spirit and individuality of residents as they move from their home into a residence is both challenging and achievable. The opportunity to have a choice in one’s living space is an important way to achieve this goal. Some people value their privacy and don’t thrive in double-occupancy units. Others may feel too isolated in a unit by themselves and will welcome a roommate.

Bringing some treasured pieces of furniture and pictures from home will greatly facilitate the transition and should be encouraged. The presence of a kitchen area in each unit allows for maximum choice and autonomy. Although most prospective residents will acknowledge that they are excited at the prospect of not cooking, the ability to prepare snacks or even a light meal is an important option. One of the fundamental goals of an assisted living residence is to provide comprehensive care to older adults while preserving their ability to be independent and have as many choices in their environment as is feasible. A future resident’s participation in the choice of a residence, and the various options available within that residence, will have a direct and vital effect on the quality of that resident’s adjustment to his new home.

Social and Recreational Activities: A diverse program of planned activities both within the residence and the community is vital to the happiness and contentment of residents. Does a staff member have sole responsibility to plan and direct social events? Do residents have a voice in planning activities both within and outside the residence? Does the selection of activities reflect the interests and lifestyle of the residents in an appropriate and satisfying way? Are residents who are less social encouraged to participate in activities? Are activities designed to not only nurture the spirit but challenge the intellect? Are activities in the residence consistently well attended by residents?

A well-balanced coordination of activities both within the residence and in the community allows the resident to feel a sense of belonging in both places. Activities are an important way in which social and emotional connections are made in a new setting.

In addition, research shows that the presence of animals in the lives of older adults is another important way of nurturing the spirit. However important and necessary the move to an assisted living residence might be, it involves significant losses. A residence that has a dog or cat viewed as the house pet can provide opportunity for constancy and daily love for someone who may be feeling a sense of loss. Many residences allow a small animal to accompany its owner in the move. When discussing this option with the staff, gain a full understanding of how the animal will be cared for.

Food Service: Food is a significant part of life. We look forward to meals and savor not only the food that we eat but the ambiance in which the food is served. If you polled assisted living residents about what contributes most to their customer satisfaction, food would rank high on their list. One of the universally significant ways in which people feel nurtured is through the food they eat. Keeping that in mind, food preparation should include fresh, diverse, and interesting ingredients.

At each meal, residents should have a choice of entree and dessert. Because individuals’ tastes in food differ, no one offering can possibly please everyone. Resident input in the menu selection is another important way of promoting choice and respecting individual tastes.

The kitchen’s capacity to provide for special diets that are medically mandated is another critical piece of information to gather. If a resident is feeling too ill to come to the dining room for a meal, can food be delivered to his room?

Is the dining room visually appealing to encourage residents to linger over their meals there? One of the most important avenues for socialization is dining with other people. It represents a natural opportunity to gather and share the events of the day and sometimes a lifetime.

In addition to using the guidelines ALFA has developed for choosing a residence, use your own knowledge of the prospective resident as a guide in making your choice. In what setting will he or she feel most supported and at the same time be able to function most independently? What are the particular and unique physical, mental, emotional, and spiritual needs of this person and in what setting are those needs most likely to be recognized and met?

The goal you set in choosing a residence should not be considered met until a setting has been selected in which the prospective resident can feel physically cared for and can thrive emotionally. Many older adults who are living independently, but struggling each day with physical and/or cognitive disabilities, are isolated and afraid. Moving into the appropriate assisted living residence can relieve the daily struggle to function and release the energy to fully and joyfully engage in life again.

Elizabeth Parker Welton MSW, LCSW is a psychotherapist in private practice in Arlington, VA. She can be reached at 703/524-3169.Be Informed, Be Prepared, Be Thoughtful

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Be Informed:

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Learn about assisted living. Find out what services are provided by the residences in your area. Keep in mind that residences can vary greatly.
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Shop around. Finding a new home takes time. Plan ahead to visit as many residences as you can. Know what services you need and what to shop for. Make an appointment to meet with staff.
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Visit and revisit. Once you’ve decided on your top choices, revisit each facility at least one more time and at different times during the day. Talk to staff, residents, other family members, and the local long-term care ombudsman.
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Ask for written material. Information is essential. Review marketing material, consumer information brochures, the resident contract agreement, and state survey information about the residence. Consider having an elder law attorney review the resident contract agreement. Read the fine print.
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You’re doing business so ask the right questions. Find out about prices and what initiates a price increase. How much do the extras cost? Find out how each resident’s needs are assessed and monitored. Inquire about policies on refunds, transfers, and discharges. What will happen if the facility closes? Is there an appeals plan for dissatisfied residents?

Be Prepared:

Know the costs. Assisted living can be expensive. Be familiar with what each facility charges for each level of care, plus the charges for extra services beyond the monthly rate.

Examine your finances. Monthly rates vary. Determine the affordable price range and shop accordingly. Will family members contribute and how much?

Be Thoughtful:

In most cases, adult children play a major role in helping a parent secure an assisted living residence. Respect the interests, needs, and wishes of your loved one. Although many assisted living facilities offer a lifestyle that preserves autonomy and dignity, moving from home to a new place can be a difficult transition. Work together to make plans and decisions. Don’t exclude your parent from the process.

Elderly Forgo Move to Assisted Living Because They Can’t Sell Homes

May 29, 2009

Should You Consider Renting Your Home? Help Pay For Assisted Living Cost…

The housing crisis has kept thousands of older Americans who need support and care from moving into retirement communities or assisted-living centers, effectively stranding them in their own homes.

Without selling their houses or condominiums, many cannot buy into retirement homes that require a payment of $100,000 to $500,000 just to move in. So they are scratching themselves off waiting lists, canceling plans with packing services and staying put, in houses that fit well 30 years ago, but over the years have become lonely, too large or too treacherous to navigate.

“It is part of the hidden problem of the recession,” said Larry Minnix, president of the American Association of Homes and Services for the Aging. “Every neighborhood, every family’s got them.”

Facilities that have watched their waiting lists wither and their occupancy rates fall in the last year are now scrambling to bring people through their doors. Some assisted-living centers have called in real estate agents to teach prospective residents about online advertising and how to clean and preen their homes for showings. Others have set up programs with banks to provide bridge loans to homeowners, or are discounting apartments and offering low-interest loans.

The Cedar Community, which provides a range of housing for the elderly in West Bend, Wis., has seen independent-living occupancy rates drop by 4 percent this year. There were so many people waiting for their homes to sell that the facility decided, in some cases, to let new residents pay month-to-month until they could unload their houses and use the proceeds on the facility’s entry deposit.

“We’ve never done that before,” said Tracey MacGregor, a spokeswoman at Cedar Community.

But for people like Ruth Scher, 85, selling their home is a critical first step before moving on, or moving anywhere. Ms. Scher put her two-bedroom condominium in Delray Beach, Fla., on the market last year, but no one has made an offer.

In the 34 years since she moved to South Florida, Ms. Scher’s husband has died, the siblings who moved south from New York to join her have died, and her friends have moved away. She is recovering from a fall that broke her clavicle and suffers from arthritis in one shoulder, and she says it is time to move back.

“It’s lonesome,” Ms. Scher said. “So many other people have passed away or moved away. It’s very lonely. The children would love me to come up and I would love to, but I just can’t sell.”

Ms. Scher hoped to move to a retirement community in Cornwall, N.Y., where she has friends. But in the year her home sat on the market, she could not even find a broker willing to sell the property, she said. She finally de-listed her condominium.

“They tell you, ‘We’re sorry, we can’t get any people to come and look,’ ” Ms. Scher said. “If I can’t sell here, I can’t go nowhere.”

There is no way to say how many older Americans are in similar straits, as no statistics track how many of America’s 4.27 million unsold homes are owned by people 65 or older. But industry groups and administrators at retirement homes call the problem a growing one, which worsened as the financial crisis spread from real estate to lending markets. It has been felt worst in regions hit hardest by the housing bust.

“It remains to be seen whether we have a short-term stress, or whether we’re facing a crisis,” said Mr. Minnix, of the Association of Homes and Services for the Aging. “We’re into brand new territory here. It is deeper and potentially broader.”

Across the country, occupancy rates for independent and assisted-living facilities have fallen slightly in the last year, by about 2 percent through the middle of 2008, according to the National Investment Center for the Seniors Housing and Care Industry.

But the problem is playing out acutely in hard-hit areas like Florida, where the vacancy rate at some facilities is up 20 percent to 30 percent over last year, said Paul Williams, director of government relations for the Assisted Living Federation of America. At Luther Manor, a retiree community in Milwaukee, the number of residents moving into independent living has dropped 20 percent this year. In southern Ohio, 65 percent of the people who visited the Bristol Village retirement community this year said they could not buy a unit because their homes were still hanging around their necks.

For these businesses, each occupied room generates thousands of dollars each year. Retirement condos charge monthly fees ranging from a few hundred dollars to $5,000, while the average price for private-pay care in assisted living is $3,013 per month, or $36,156 per year, according to a MetLife study.

At the Crosby Commons assisted-living center in Shelton, Conn., where waiting lists that once ran two years or more have shrunk to six months, some residents who moved before selling their homes are spending through their savings as they wait, said Lois Poultney, the center’s director. One resident had to move from Crosby’s free-market homes to its subsidized rent-controlled apartments, Ms. Poultney said.

“I’m hearing it over and over again: ‘Mom needs to sell her house before she can afford to move in,’ ” she said.

There are signs some families and retirees are turning to adult day care services as a stopgap. Providers say their business has spiked as people look for an alternative to continuing care or home aides to provide food, companionship and therapeutic services. But Mr. Williams of the Assisted Living Federation said that people who need more day-to-day care, those who have trouble getting up stairs or who need someone to check on them, were taking a risk by staying at home.

“When they’re coming in at 85, they’re coming in very frail and needing services,” he said. “They can’t wait this out. They need the care when they need the care. That’s the scary part. You have people putting it off when they need care right now.”

For Katherine Styberg, 84, that moment of realization came when she slipped on a patch of ice in February and fractured a vertebra. She has to use a cane when she walks now, and she says she has been thinking about how she lives alone, and if she fell in her two-bedroom condominium in Milwaukee, no one could catch her or help her up.

The real estate broker calls Ms. Styberg a day before bringing potential buyers to see her apartment, and a few have come to look around, but no one has made an offer yet.

As parents linger in their homes, they say their children start to worry. Some adult children are even facing financial hardships if they cannot sell their parents’ homes.

In April, Ruth Swessel, 84, of Milwaukee, had a stroke that aggravated the effects of her aging, leaving her unable to follow “Meet the Press” or read the political magazines she once loved. Her daughter, Laura Westling, had to put her into skilled care, and the family began the process of selling Ms. Swessel’s house to pay for the facility’s $60,000 annual cost.

The house has been sitting on the market since the summer, and Ms. Swessel’s family has lowered the price twice, to $174,500 from $189,900, but they have not been able to close a deal. Her children are spending her investments to pay for her care, but Ms. Westling said they did not know what they would do once that money ran out.

“It’s not easy,” she said.

As stock markets have slid in the last year, homes have become a more critical source of wealth for retirees who have watched their mutual funds and 401(k) accounts hollow out. Next to accrued Social Security benefits, housing is the single greatest asset for people 60 to 70 years old, making up 22 percent of their total wealth and outweighing investments and pensions, according to the Center for Retirement Research. For retirees like Herman McHan, who watched the value of his mutual funds fall to $35,000, from $70,000, or Sylvia Merlin, whose portfolio has lost nearly $200,000 of value, owning an interminably on-the-market home compounds the worries of their dwindling investments.

For Ms. Merlin, it is a disconcerting place to be at age 93. She said she and her late husband, Al, had lived modestly to raise their four children, taking one vacation a year, to the Jersey Shore. She is on oxygen now, and finds it harder to get around her fifth-floor apartment outside of Philadelphia. The doorman’s wife takes her to the hairdresser on Fridays, but Ms. Merlin said she wanted more consistent care.

“I’m going to be 94, and I need help,” she said. “Making the bed is difficult. I need a little help taking a shower. Those things are difficult. I was a great cook, but I really don’t cook anymore. I bought the TV dinners, and they’re pretty lousy.”

No one has made an offer on her condominium, and Ms. Merlin said the retirement home had refunded the $1,000 deposit on the $130,000 unit she hoped to buy. Now, instead of moving, she said she had decided to stay.

“I just couldn’t go anywhere until I sold my apartment,” she said. “I and a lot of other oldsters are stuck.”

Assisted Living for seniors: a Perfect Place for Care and Independence

May 15, 2009

Assisted Living for seniors: a Perfect Place for Care and Independence

As a person enters his or her retirement years it is expected that he or she requires some assistance with daily activities. Family members accustomed to business and office work may find it difficult to take proper care of seniors at home. They often forget to provide seniors medicine in time, help them in getting a bath or dress. For such families ‘Assisted Living Facility’ (ALF) is a perfect choice for seniors.

Assisted living for seniors maintains their independence and at the same time helps them on their day to day activities. Thus, assisted living offers best of the both worlds for all seniors. An ALF can provide complete care and help seniors who need assistance in daily activities like bathing, medication and dressing. Such care never takes away their freedom of independence. They are not bound to remain confined in the premises of the facility.

Assisted Living Facility therefore is a middle ground between nursing home and independent living. Every assisted living tries to promote as much self-sufficiency as the resident is capable of to all seniors. Most assisted living facilities offer round the clock supervision and plethora of services to maintain space, privacy and dignity that nursing homes fail. All these facilities are available at an affordable cost.

Nearly 30,000 plus assisted living facilities are operating in the US at present. Such a facility is also called – personal care homes, domiciliary care, community residences, sheltered housings, and residential care facilities. Personal care of an assisted living facility includes eating, getting around, medicine care, dressing, bathing, toileting, and grooming. Assisted living facilities don’t offer extensive medical care. The staff and caretakers only remind and help in taking medicines prescribed on time, but don’t offer medical health facilities like nursing homes.

Costs of an Assisted Living Facility
Assisted living for seniors are operated and owned by both non-profit and for-profit organizations. Therefore, assisted living facilities would cost you $900 to $4,500 a month. The cost actually depends on the place where you live. It varies from state to state in the US. However the costs of assisted living for seniors are less than nursing home cares and home health services.

Choosing the Right Assisted Living Facility
Before you choose an assisted living facility for seniors in your family consider some factors that would determine how reliable an ALF is. Evaluating of a facility will determine whether it is suitable to the lifestyle of your family’s seniors or not. Assessing the following points will help you select a good ALF:
Friendliness and warm nature of employees.
Level of independence and freedom.
If the facility is licensed?
Hygiene and cleanliness of the ALF.
Security provisions in the ALF.
Level of privacy.
Availability of 24 hour emergency facility.
Safety equipments and facilities for physically handicapped.

Assisted Living Solutions – Wayne Dyer “What Are You Creating Right Now?”

March 28, 2009

WHAT ARE YOU CREATING RIGHT NOW?

“You create your thoughts, your thoughts create your intentions, and your intentions create your reality.”
Dr. Wayne Dyer

For years I’ve been fascination by the human brain and its vast potential. First from a psychological v.p. & now from a spiritual view point, not in the religious sense, but in the more mystical/creative realm. I’m convinced that our ability to create begins in our brain; God created us to create. Creation begins with one tiny thought. It may come from within you, or someone else, and once you accept it as yours and begin to think about it, you’ve started the process of creation. The more emotion you have with that thought the more powerful is your ability to attract what you want. Once your brain gets the go-ahead from you, it springs into action and clicks in to perform your command perfectly. That is why it’s extremely important to be aware of your own thoughts and the words you say. Your brain doesn’t sort out positive from the negative; it waits for your command. It simply acts on your thought.
I’ve spent half of my life learning about and teaching how powerful the brain is and how important our thoughts are. When I was a kid I used to hear my father speak of the dreaded “evil eye” in his native Sicily. I snickered and thought it was a bunch of nonsense even though the stories made the hair on the back of my neck stand at attention. I’ve since learned about the power of the mind and believe that if I told you that something terrible was going to happen to you, and you believed me, YOU could make it happen simply by the power/energy/focus you give it;  your own mind would work to carry out whatever you feared. 
        I believe that the power of the mind can also make us ill, or worse. One of my favorite examples of the power of suggestion is this one: During the winter months we are ambushed with news that the flu is epidemic. We’re sure we can’t escape it so we begin to worry. If we get the sniffles we’re certain we’ve got something that’s going around. We reinforce our fear by thinking that we have a cold, and we tell everyone who will listen. (It may have only been hay fever.) Next, we think we will be really sick, probably run a fever and by the end of the week we are certain we will be in bed vomiting or worse. Well, guess what? I believe that since we’ve programmed ourselves for a week full of illness— that is exactly what we will get. We’ve created it with our powerful minds. The brain has taken instructions and followed them exactly as we’ve prescribed it.
Arthritis is one of my pet peeves. If we break or sprain something doctors are quick to say arthritis will set in. My doc knows “I don’t do arthritis.” She snickers. I refer to it as the nasty “A” word. People take possession of arthritis as soon as they think they have it. I.E.: A younger friend’s fingers began aching; her mother had arthritis so she was certain she’d inherited it. (How many of us do that?) She took possession of it and referred to it as “my arthritis.”  We had a little discussion and it “amazingly” disappeared! I believe strongly that it isn’t necessary to talk about any symptom or medical sentence your doctor has decreed for you. To acknowledge it is to reinforce it. Taking possession of it and making it yours only gives it permission to proceed. Once we start talking about it to others, it grabs that energy/power to accelerate. That energy can better be used to create positive thoughts of healing for yourself. Get the needed treatment. Then if you must tell someone, say, “I’m catching healing,” and let it go. You can tell those symptoms that they are not welcome in your body and to flee. You must believe it, however, and you must be persistent, for the habit of illness is like a child who pushes the envelope to see if you mean business.. It’s up to you to stick in there and show the old habit who is boss. It takes a while to break old habits and patterns, so don’t expect the symptoms to disappear quickly. Like a spoiled child who is suddenly being disciplined, there will be rebellion within. Remember to put lots of emotion behind your thoughts of healing and be persistent.
We are never too old or too sick or too busy, to have creative minds. We “create” every second of every day and it is either negative or positive —depleting energy or increasing energy.
We deplete our energy if we focus on a negative situation, be it our own or someone else’s. Our energy level plummets and a cloud of doom and gloom cloaks us. When we change our thought pattern to those that are sunny, energy levels are elevated to a healthier state; we are less vulnerable to illness & to attracting negative thinking people into our lives.. Thoughts are contagious. Choose wisely.
 
“As you cannot have a sweet and wholesome abode unless you admit the air and sunshine freely into your rooms, so a strong body and a bright, happy, or serene countenance can only result from the free admittance into the mind of thoughts of joy and goodwill and serenity.”  — James Allen 1864-1912  (note the dates—this is not “new age” enlightenment, but time-proven.)

Assisted Living San Francisco Bay Area, Ca

March 7, 2009

The Chateau of Pleasant Hill, California is a senior living community that offers assisted living, Alzheimer’s care, dementia care, home care and a whole host of senior care services.

Ruby MacDonald writes a monthly column in the Senior Insights Newsletter and it has become a favorite amongst the elderly residents who say that Ruby’s positive words and inspirations make them feel wonderful.

Ruby’s word for the day:

EMPOWERED LIVING   by  Ruby MacDonald                                                     

HOW WELL ARE YOU . . .   HEARING ?                                                                                          

Empowered living includes the use of our very important five senses. “Hearing” is one of those senses. It’s one fifth. For those who cannot hear, one-fifth of their senses are impaired.
I do not take hearing for granted because my hearing became impaired around midlife. I speak from experience when I say that not being able to hear easily causes many problems and changes in lifestyle. For instance, do you hesitate answering the phone? Or do you only use the phone when it’s an absolute necessity? Has your social life receded and slowly turned you into an introvert? Do you stay away from social gatherings because you can’t hear in a crowd?

Rush Limbaugh, the nationally syndicated radio talk show host, experienced a rapid loss of hearing and within three months he was deaf in one ear and had an 80% loss in the other. He could no longer understand radio, TV, or the voices of call-in listeners. He has a severe bi-laterial sensorineural hearing loss due to an autoimmune inner ear disease. AIED causes less than 1% of all cases of sensorineural hearing loss; most cases are due to aging, noise exposure, or inherited hearing loss and develop very gradually. Most patients respond to early treatment of steroids and benefit from the use of hearing aids; some need cochlear implants.

Today there is little or no excuse for anyone to be hearing impaired even though statistics show that most people with  hearing loss do nothing about it! A healthy, positive approach is to take charge of your hearing healthcare and find a way to hear as well as possible again. Nothing can be done until you admit you have a hearing loss.

Which type are you?  Do you consider your hearing “good enough” to get by on?”  It doesn’t matter that you force everyone to repeat nearly everything they say? Or, do you want to hear as well as possible?  I hope you cherish the latter and want to enjoy hearing to the fullest.

Here are a few empowering secrets to hearing: Wear hearing aids in one or both ears. Lipreading is helpful as a third hearing aid. There are telephone and TV amplifiers. Ask people to look at you and speak more slowly. In a group, always sit by a wall to block sounds.

Find a good audiologist, one recommended by a friend rather than selected at random from the phone book. They will evaluate your hearing and hearing needs

SENIOR LIVING SOLUTIONS

February 25, 2009

Senior Living Solutions Overview:Once submitted, you can sit back, relax, and leave the work to us! Within hours, we will email you valuable information that will help you not only understand the different senior housing and care options available but also supply you with vital information that will educate you on what to look for and what questions to ask before making any commitment. And once your request has been assessed, a qualified retirement counselor will contact you directly by your preferred method of communication, via phone or email to further discuss how to best address your senior housing and eldercare needs.

Our mission is to offer you the very best in Senior Living and Senior Care service. To help ensure this, all providers are screened and vetted prior to participating in our program, so you can feel confident knowing that you are being referred only to quality and safe organizations.  And unlike most online referral programs, with Senior Living Solutions you are under NO OBLIGATION to buy anything, ever.Senior Living and Senior Care Services Available to You:
When it comes to caring for an elderly loved one, a variety of different services may be required.  Senior Living Solutions is ready to help with each and every one of them. Here are just a few of the services available through Senior Living Solutions:

*Assisted Living Facilities
*Alzheimer’s and Dementia Care Facilities
*Independent Senior Apartments
*Home Care

 

*Short Term Respite and/or vacation staysFrequently Asked Questions About Senior Living Solutions:

*Am I obligated to buy anything?
No. Never. By completing a Needs Assessment survey, you are under NO obligation to purchase anything.  We simply provide you with options and leave the decision entirely up to you as to whether you would like to follow up with any of the network service or product providers who respond to your request.

How are Senior Living Solutions providers screened?
Depending on the particular industry, each eldercare provider specialty has its own set of standards and certifications.  In order to participate in the Senior Living Solutions network, providers must provide evidence that they are legally authorized to provide the services and/or products they sell to consumers. Furthermore, each and every provider is required at all times to meet Senior Living Solutions Provider Participation Standards and abide by Senior Living Solutions Terms of Use. If, for any reason, Senior Living Solutions learns that a provider has failed to meet or abide by before mentioned Standards and/or Terms of Use, the provider will be disqualified from continued participation in the Senior Living Solutions program.

What if there are no participating providers who meet my needs in my geographic area?
If there are no providers in the Senior Living Solutions network that meet your specific requirements, we will promptly notify you and give you the option to either save or permanently remove your information from the Senior Living Solutions secure database.  By opting to save your information in our database, we can notify you at a later date if a provider enters our network and is right for your personal needs.

What if we’re not satisfied with the service we receive from the provider?
Because all providers who participate in the Senior Living Solutions network are independently owned and operated, all customer satisfaction issues and/or complaints must be handled through the individual provider or company. To help make sure you receive the appropriate level of attention, Senior Living Solutions requires all participating providers to have a published policy regarding customer dispute resolution. If your complaint has gone unaddressed or you are dissatisfied with the response from one of our participating providers, please let us know. Providers who demonstrate a pattern of unresolved customer satisfaction complaints and/or problems can be terminated from participating in our program.

If I don’t pay for this service, who does?
Senior care providers pay a fee to be able to participate in the Senior Living Solutions program, allowing us to offer you the highest quality matching service at absolutely no cost to you.

Find local Senior Living Solutions providers and senior services

Words Are The Most Powerful Thing In The Universe! – Senior Living Insights

February 21, 2009

Words are the most powerful thing in the universe.

Senior Living Insights By Ruby MacDonald
WORDS ARE POWERFUL. How we use them is most important. Positive words are powerful enough to bring healing. Negative words have the power to kill our spirit as illustrated in a newspaper article which clearly demonstrates how powerful and healing just a few simple words can be. After you’ve read this column perhaps, you’ll be moved to say some healing words to someone who waits, hoping to hear them.

Maybe you read the article in the Contra Costa Times on July 3, 2002; the headlines read: WOMAN RELIEVED TO HEAR SON’S KILLER APOLOGIZE. There was also a photo of Liz Kiepert—smiling!

You may remember back to 1998 when  an 11-year-old boy shot and killed Larry Kiepert, a 13 year old neighbor boy who was playing basketball in his own yard.  The eleven year old served four years for voluntary manslaughter.. This week when he attended his parole hearing, so did Liz Kiepert, the mother of the boy who was killed.

According to the news article written by Contra Costa Times Staff Writer, Celeste Ward,  Liz Kiepert  had suffered depression, anxiety, panic attacks and post-traumatic stress disorder after she watched her son be shot to death. She had said she wished the boy would have to serve the entire 14-year sentence and she did not understand how he could be rehabilitated when her family was still torn apart.

As the hearing date approached, Liz Kiepert wasn’t sure she wanted to be there. Two doctors had advised her against it but she needed to be there to vindicate her son. She went alone.  What occurred at the hearing is the best thing that could have happened, short of bringing her son back to life.

Moments before his release, the now 15 year-old boy had something to say. Liz says, “He turned around to face me and at first was mumbling. He said, ‘Mrs. Kiepert, if there was anything I could do differently, I would. I wish I could bring Larry back.’ Then he started to cry, and I asked the judge if I could hug him. That came out of my heart. When I saw him crying, I thought, ‘He’s a child.’ I hugged him 10 to 20 seconds and he kept whispering in my ear, ‘I’m so sorry.’  I told him Larry would forgive him, and to go make a good life for himself. I had the whole courtroom in tears.”

Liz Kiepert felt the years of bitterness and anger melt away as the judge released the boy. She said, “It was a relief. He said what I wanted to hear all these years. I felt like a weight was taken off my shoulders. Now I can go forward.” Liz Kiepert has returned to work after a long absence. A photo accompanying the newspaper article showed Liz smiling. Her family and friends said they noticed a difference in her in that the anguished look she had carried was gone. Finally, the weight had been lifted.

The weight of holding resentment and not being able to forgive is perhaps one of the most destructive emotions we can cling to. Even when we feel it is justified, the end result is the damage it does to our bodies and minds. We always have a choice, just as Liz Kiepert had. She chose to forgive and free both herself and the young man who still has a life to live.

WORDS. Just a few simple but meaningful words have put a smile back on Liz’s face and life back into her spirit.  As you’ve seen, words are powerful.

Reverse a stroke

February 15, 2009

STROKE: Remember the 1st Three Letters….S.T.R.

STROKE IDENTIFICATION
It only takes a minute to read this…

A neurologist says that if he can get to a stroke victim within 3 hours he can totally reverse the effects of a stroke…totally. He said the trick was getting a stroke recognized, diagnosed, and then getting the patient medically cared for within 3 hours, which is tough.

RECOGNIZING A STROKE

Remember the ’3′ steps, STR . Read and Learn!

Sometimes symptoms of a stroke are difficult to identify. Unfortunately, the lack of awareness spells disaster. The stroke victim may suffer severe brain damage when people nearby fail to recognize the symptoms of a stroke.

Now doctors say a bystander can recognize a stroke by asking three simple questions:

S *Ask the individual to SMILE.
T *Ask the person to TALK and SPEAK A SIMPLE SENTENCE (Coherently) (i.e. It is sunny out today.)
R *Ask him or her to RAISE BOTH ARMS.

If he or she has trouble with ANY ONE of these tasks, call emergency number immediately and describe the symptoms to the dispatcher.

New Sign of a Stroke ——– Stick out Your Tongue

NOTE: Another ‘sign’ of a stroke is this: Ask the person to ‘stick’ out his tongue.. If the tongue is ‘crooked’, if it goes to one side or the other, that is also an indication of a stroke.

A cardiologist says if everyone who gets this e-mail sends it on to others; lives will be saved.

What Makes a Great Senior Community?

February 3, 2009

The Executive Director. The Administrator. The person who puts a team together that has one common goal; to give their residents a truly outstanding lifestyle. A lifestyle rich in love and compassion, understanding and dedication.

But to often seniors move into an Assisted Living community because they appreciate the decor, or the size of the apartments or that it’s in the town they’re most familiar. But little do they know, choosing a senior living residence is as important as choosing a spouse. The community will take on the overall personality of the one who is directing it. If you have a stale, bitter director, you’ll have a stale, bitter community. If you have a happy, peaceful director, guess what? You’ll have a happy and peaceful community.

Have you ever heard the term, Like attracts like? When the director hires the team that will be running the facility, they will hire people that generally have similiar attitudes and beliefs as their own. Believe it or not, this will even trickle down to the types of residents who decide to move into the community. Like atracts like. Happy director, happy residents. Un-happy director, un-happy residents. So if you want to save time and money investigating which Senior Living Community is right for you, start at the top and get to know the Executive Director first. And remember, like attracts like. Practice happiness:)

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