Your CarePatrol Senior Advisors share their knowledge and experience when considering placement in an Assisted Living home. Learn more about Assisted Living care to help you make the right decisions for you and your loved ones.

What Exactly is Assisted Living?

 

When the parents of the Baby Boomer generation were raising their families, the average lifespan for Americans was 67.  For the small minority who did not live with their children as they reached old age, communities had rest homes or retirement homes. When the Older Americans Act and Medicare/Medicaid became law in 1965, the added healthcare created buildings known as nursing homes. While a few smaller board and care homes remained, federal government funding made nursing homes the new normal.

Increased institutionalism over the next couple decades opened an opportunity for a more homelike setting that also provided healthcare. The goal of the least restrictive environment became known as assisted living and quickly was influenced by the hospitality industry. Those three attributes – housing, healthcare and hospitality – resulted in the first public companies in the rapidly expanding assisted-iving industry in 1995.  In July of 1999 the Supreme Court issued a ruling in the Olmstead case insisting on access to community-based care versus institutional care.

Today’s assisted living industry is preparing for those Baby Boomers born between 1946 and 1965. Unlike their parents, whose lifespan ended a year or two after retirement, Baby Boomers expect 13 years of retirement. The post-retirement that comes from the increased longevity means those age 75+ is who the growth is focused on.  In 1970, less than 8 million Americans were 75 or older.  50 years later, before the first Baby Boomer turns 75, we have over 23 million in that age group.  By 2030 there will be 34 million Americans over age 75.

The number of assisted living communities around the country has grown dramatically along with the aging population. The demographics are undeniable as the growth is poised to increase even faster. This type of living provides a homelike apartment, meals, housekeeping, transportation, activities and includes utilities.  It adds hands-on care, medication administration or management, and other personal services including emergency response.  A variety of nursing services are available based on licensing in each state.

The socialization aspect of assisted living that is often missed is the serious health concerns that come from chronic loneliness. Studies have shown the positive effect socialization has on the immune system, sleeping patterns, and even blood pressure. In many markets the newest assisted living communities are more like cruise ships on land and provide almost a party atmosphere.  One-third of all seniors over 65 live in the four most populous states of California, Florida, Texas and New York. Investors in senior housing, however, see opportunity in all the states.

Alarming Myths About Senior Living

 

It is human nature to believe myths about senior living, but it can also lead to needless worry and hinder positive aging and safety.  After working with thousands of families we collected some common ones that often start from a false perspective about aging. “To be old is to be sick” ignores the huge improvement in rates of chronic disease and disability. “You can’t teach an old dog new tricks” does not account for the high degree of neuroplasticity human brains have. “The horse is out of the barn” ignores payoffs from healthier lifestyles.

  • Moving into senior living will cause me to lose my independence.
  • Talking with my family about this will only alarm them.
  • The government will take care of my estate.
  • Medicare will pay for all my long-term care needs.
  • People lose their memory as they age.
  • I’m not well, so exercise is a NO-NO.
  • It’s best that I wait until I can’t care for myself.
  • Using a walker only makes me dependent.
  • The food is bound to be terrible.
  • I don’t need my vision and hearing checked annually.
  • There won’t be anything to do in these places.
  • People become less productive and creative as they age.
  • I can’t take my pets with me in senior living.
  • Falling happens to other people, not me.
  • Communities are more expensive than homecare.
  • All communities are the same.
  • Frailty can’t be reversed with exercise and nutrition.
  • Senior living is only for old people.

All these myths are not true, but may fit your perspective. If they do, give us a call for a free tour of the “right places” for your personalized needs and wants. Being productive again and safe living is often attitudinal. Life experiences and expertise can be important to others. Positive lifestyle changes –  socially, behaviorally, and physically, often make an enormous difference in daily life. Reduce the worry for you and your children by having a plan that uses real facts, not false myths.

Board and Care Homes – a Great Option for Seniors

 

For seniors who prefer to live in a smaller setting, a board and care home may be a good option. These facilities are residential houses that have been outfitted and staffed for a small group of seniors to live in a family-like setting. Board and care homes go by many different names, depending on the area they are located. In some states, they are most commonly referred to as group homes or residential care homes. In California, “board and care home” is the most commonly used terminology.

 

What’s Included?

Board and care homes are meant for seniors who need some assistance with daily activities but do not require skilled nursing assistance. The level of care provided is similar to what’s offered at assisted living communities. Typically, all three meals and snacks are included in the cost of rent. Most homes include cleaning and laundry services as well. Caregivers are on standby to assist with activities like eating, medication management, toileting, and personal grooming.

Licensing requirements vary by state. In California, licensing is handled by the Community Care Licensing Division of the California Department of Social Services. Your CarePatrol representative will be able to help you find a reputable board and care home that meets your loved one’s needs.

 

How is it Different?

Assisted Living facilities tend to be more well-known than board and care homes because they house more residents – often 50 to 200 or more. They also have a robust activity program.    Also, food is served in a main dining room.  These are the main 3 differences between the two types of facilities. There is no standard definition for board and care homes throughout the United States. In California, a board and care home is a senior living facility licensed to care for 6 to 20 residents who need some assistance, but do not require ongoing skilled nursing care.

Outside of California, the requirements and terminology do change a little. So keep that in mind if you live out of state, or you are helping a senior loved one who lives in another state. Residential care home, group home, and personal care home are all terms that refer to essentially the same thing.

 

What Should We Look Out For?

Board and care homes are a great option for seniors who are transitioning from independent living to long-term care. While researching options available in your area, make sure any board and care homes you look at meet the following criteria:

  • It has a cozy environment that feels more like a home than an institution.
  • It has adequate staffing so that all residents get plenty of attention.
  • Residents are able to relax and spend the day how they choose.

Now, board and care homes are not the best option for all seniors. It’s important that you consider assisted living facilities as an option as well. Typically, assisted living facilities differ from board and care homes in the following ways:

  • Assisted Living options have more amenities and planned recreational activities.
  • Board and care homes typically have shared kitchen and living spaces whereas some assisted living residents have their own full apartment or attached kitchenette.
  • The smaller population at board and care homes can make it more difficult for seniors to find friends.

No matter what type of assistance your loved one needs, your local CarePatrol representative can help you find the perfect fit. Set up a time to talk with us if you have questions about board and care homes, assisted living, or any other concern.

Can Guilt Be Dealt With?

 

Guilt is a common emotion that Wikipedia calls “a cognitive experience that a person has when they compromise their own standards or have violated a moral code they were taught”. Psychologists say we start feeling it before age 5, and it is nearly always concerning other people. Understanding its origin will help you deal with situations where it raises its head inappropriately.

As older family members age the time for assisted living is rarely planned for. The assumption is it won’t be needed and if it is, other family members will step in as caregivers. In some families there are even promises made that placement will not happen, often made during times of great health. Physical frailty or cognitive decline eventually brings up the potential for discussion.

Early turmoil comes while making the decision that it is time for placement. Despite family desire to care for a loved one at home and simultaneously remain in the workplace and maintain all other commitments, it becomes overwhelming. Physician or clerical advice that it is time may ring true mentally but emotionally the guilt can get mixed with anxiety and even fear.

Acknowledging and expressing those emotions head-on is the best way to deal with guilt. If you don’t have trusted confidants to bounce things off, a business exists that allows just that. You can contact a Life Guide at https://www.lifeguides.com/carepatrol Lifeguides partnership with CarePatrol will match you up with a guide who has been through the process you are facing. CarePatrol provides for two free sessions and you’ll feel better. It will also be easier to take action after talking through it.

Even after working with a CarePatrol placement professional to find the safe and appropriate senior living community for your family, the guilt may not fade away nearly as fast as you would prefer. Your LifeGuide will still be at the other end of the phone to share your feelings with in a confidential and stress reducing way. Guilt, like all negative emotions, can be dealt with. Having a professional team on your side helps.

The Payback Decade

 

For most people, the decade between age 75 and 85 is when the body communicates that it is payback time for all the things done to it earlier in life. When those body parts complain they often use the communication method of pain. Medical care continues to improve, so average life span has moved from 75 in 1989 to 81 today. A normal human response to pain is to move around less, attend fewer social outings and request pain medications. That results in an impaired immune system and possible falls as movement and socialization are key parts of the immune system and muscular support.

The good news is that frailty is reversible. The beauty of assisted living is that the movement and socialization are disguised as FUN. Before you or your loved ones hits the age of the payback decade, establishing a plan designed for maximum health and satisfaction is wise. Pain relief can be addressed with non-prescription ways that help overall health. Many people find themselves in the “sandwich” generation. Elderly parents to care for, growing children that still need attention, career considerations, and dealing with all the unknowns of the rapidly changing systems. Doctors and documents become keywords. Estate planning, tax and risk avoidance, and trusts or wills can’t be put off any longer.

 

When is Aging in Place Wrong?

 

Studies indicate over 80% of seniors want to spend the rest of their life in their home, a concept called aging in place. Most companies, agencies, and senior care professionals work toward that goal. There are however some exceptions to aging in place as the desired lifestyle.  The first is safety, and the second is social.  A reminder of Safety Or Social is SOS, the universal call for help. Let’s examine twenty areas of concern that need to be addressed for safety:

  1. Forgetting to take medications – or taking more than the prescribed dosage (or sharing)
  2. Diagnosis of an identified dementia or Alzheimer’s – forgetfulness
  3. Spoiled food that doesn’t get thrown away – poor diet or forgetting to eat
  4. Dirty house, extreme clutter and dirty laundry piling up – decline in grooming
  5. Missing important appointments, especially doctor’s appointments
  6. Unexplained bruising, or continual skin tears that invite infection
  7. Trouble getting up from a seated position or trouble getting out of bed
  8. Difficulty with walking, balance and mobility – unexplained dents on a car
  9. Uncertainty and confusion when performing once-familiar tasks
  10. Expenditures for un-needed repairs or purchases – changes in activities
  11. Infrequent showering or bathing – use of perfumes to mask
  12. Stacks of unopened mail – late payment notices – bill collectors

While each of those 12 are of great concern there are situations that make out-of-home placement an urgent priority for the safety of the senior:

  1. Wandering from home (or driving and not remembering how to get home)
  2. Frequent medication mistakes, especially if medications are for a disease
  3. Unsafe behavior like leaving the stove on or front door unlocked.
  4. Cannot afford an in-home caregiver for an adequate number of hours
  5. Physical abuse of spouse, caregiver or self-neglect
  6. Lack of adequate fluids or nutrition
  7. Increased falls
  8. Signs of depression

While safety is key, the last item (depression) is often a link to a need for social interaction. The National Institute on Aging reported studies that show social relationships are consistently associated with bio-markers of health and social isolation constitutes a major risk factor for morbidity and mortality. Those without adequate social interaction were twice as likely to die prematurely. Social isolation impairs the immune system and boosts inflammation. Even worse, in our society people are reluctant to admit to loneliness. Seniors want to participate in social activities and need to be with other people, but the opportunities are often reduced and a resulting focus on self then moves thoughts to negativity. In these cases, they can become trapped in their home by a lack of mobility and loss of family and friends.  The social interaction in communal living like independent and assisted living communities often helps. If your family has an SOS, call us at CarePatrol.  Our free community service finds an immediate solution.

 

Tips for Moving Loved Ones into Assisted Living

 

After all the researching, tours and talking with loved ones you are now ready to help them move into the community you all felt was the best fit.

Now the real challenge and worry can come into place for the new resident.  They have had many first-time nerves like the first day of kindergarten, wedding day, or bringing their first child home from the hospital.  All these first will be no different than the feeling they get when moving into their new home. It can be really tough on your loved one getting to know everyone, not doing or saying something wrong to those new friends, and of course the realization of knowing you are never going back to your old house.

With this in mind we wanted to share a few suggestions to you that will help your loved one handle this new step into a great community, and what all can be done to help with what they may be feeling.

Help your loved one be fashionable.  Showing up in a new outfit or with updated accessories can really help them feel confident and comfortable.  Take them out to a local store and work with them to find the new popular color and combination that really fits them and is currently in style.  These new items or outfit might just spark a great conversation which breaks the ice and gets them talking about all different things.

Another great tip is to help them find a friend that has common interests as they do.  Talking to the community about this can really help and they should be able to guide you in the right direction to match those common interests.  Ask that your loved one be able to sit next to that person or persons who they share interest, hobbies or whatever it may be to get them talking and enjoying their time together.  The more friends they make in a short time will help get them into more activities, which help them meet even more people which adds to them enjoying their new home.

Don’t let them be in a rush to make a snap judgement on their new home or new friends.  It’s not going to be easy for them at first and not everything will be perfect or go the way they want.  As with any new situation you need to get comfortable with how things are done, adapt and let the community get to know them and how they like things done.  Encourage your loved one to try the new things, explain how they like things done and find the happy middle when possible.  Once they have been in the community for a while and gotten to understand how things work, then you can talk more in depth about the situation and if it will work out for them in the long run.

Another great suggestion is to make your loved one’s new home feel like home, and as close to what they are use to as possible.  Don’t just move boxes in and leave, help them unpack and take as many boxes away as possible.  You want their apartment to feel as comfortable as it possibly can be and be comfortable that first night when they go to bed.  Make sure you have the bed pillows and some of the little things in place to help them sleep better and wake up relaxed.  You can also take pictures of their old house and how everything is set up before moving the items, and then set them up the same way as before.  They are use to things in certain places, so don’t shake it up for your liking, but set it up as they have always liked it.

Lastly, the most important thing might just be having the first meal with them in their new home.  By doing this you will add a little bit of comfortability to their stressful situation, and you can get to know a few of the other residents as well.  Definitely ask the community to sit with a few residents and not just go over on your own.  By doing this your loved one will be able to get to know a couple other residents without being thrown in deep to the new community setting.  A lot of communities will provide you with some free meal passes, so take advantage of that and in the first month or two make sure you stop in to visit, have a meal with your loved one and meet their new friends while hearing about the exciting things they have been doing.

Hopefully by doing these tips your loved one will have a successful first few days and months in their new home, and want to stay and make the most of their new house and life!

Pets and Seniors

 

Pets are a longstanding tradition among Americans – dogs, cats, birds, even fish.  Having a pet can make a person feel loved, and like there’s always a friend nearby.  Pets are loyal and not ever judgmental – they bring joy to their owners.  There is nothing like the unconditional love and devotion that can be seen in the eyes of a dog as they look at their owner.

A pet can be very beneficial to a senior, especially one who lives apart from family.  It is a comfort to know there is another being with you, even dependent on you.  The bond that is developed between a solitary person and their pet is deep and long lasting.

Seniors who need to move into Assisted Living can feel much anxiety over potentially losing their pet who is their friend, and sometimes even feels like family.  Even when it has become a burden to care for the pet, there is still the worry of giving up a companion who depends on you.  It can also be an issue for the family of the senior who is moving, since many times they cannot be with their senior family member and may feel guilt over leaving them alone.

Many times, when the health of a senior declines, so does their ability to care for a pet.  If they are unable to move as easily or walk without aid, the pet does not get exercise.  The loss of the ability to drive or lift can greatly hamper buying pet food and supplies, as well as regular veterinary appointments.  Especially if the pet is a large dog, it can even be dangerous for the senior to continue to try to care for the animal, or control it.  Obviously, a smaller pet, such as a small dog or a cat or bird, will not pose as many difficulties, but decline in the health of a senior is many times associated with decline on the care and health of their pet.

However, the health benefits of having a pet only increase as a person ages.  Pets are associated with more exercise, leading to better cardiovascular heath.  They also have been shown to decrease depression and lower blood pressure.  It can give a senior something outside of themselves to focus on, and a schedule for an otherwise empty day, and something to be concerned about outside of themselves.  In addition, caring for a pet can bring a person into a community of other pet owners and lovers, and social interaction is very helpful to anyone.  It may take some strategizing to get the right pet for the person, but if managed well, a pet can be invaluable to an aging person.

Assisted Living: I’m Moving In, Now What Should I Bring?

 

Now that the big decision is made, what should you take?   Most people say to take the items that will be used every day. But the important part to remember is that usually space is limited.  So it would be a good Idea to scale back on the number of things you bring. For example, instead of bringing that 12-piece dining set for 10, maybe just bring 2-4 pieces. You will want to set their new place up with the same comforts that they have at home, just in a smaller scale.

Oftentimes family think it’s best to start off with all new or something different than what they have at home.  But as long as it isn’t worn out or in poor condition it is often better to keep the same furniture and belongings that they are comfortable with.  It’s best to visit with your loved one and find out what their needs and wants are.

It is always a good recommendation to follow-up with the community to see what their limitations and preferred items would be. Some buildings already provide items for you, (small fridge, microwave, paper towels).  Also many buildings have things that they do not allow: hot plates, coffeemakers, and toasters.  The other thing to think about is if you would like to limit the amount of jewelry and expensive items you bring.  It may be a good time to pass along those family heirlooms.  Also make sure that all items are marked including clothes.

Furniture

  • Bed (bring a bed with a familiar mattress, usually a full or smaller size)
  • Nightstand (ideally with drawers and shelves)
  • Seating (chairs with arms, rocker; avoid chairs on casters)
  • Small table(s) with storage, such as shelves or drawers
  • Small kitchen table or drop-leaf table (a standard dining table is usually too big)
  • Dresser (it may fit in closet for extra storage; drawers are often easier than hanging everything)

Housewares

  • Microwave, small fridge (if not provided)
  • Dishes and glasses to use every day (but probably not settings for 10 or 12)
  • Pots and pans (large and small pots and frying pans may be sufficient)
  • Coffeemaker( if allowed)
  • Mixer (if doing any cooking)
  • Nice serving dish (if your loved one likes to cook, there will be entertaining and social opportunities)
  • Bedding (two sets of sheets, blankets, pillows, and a comforter — easier than a separate decorative bedspread)
  • Bath towels, hangers, trash cans

Personal items

  • Clothes (winnowed to fit closet space; include pajamas, robe, bathing suit if applicable, sweaters for air conditioning, nice outfits for socializing; two weeks’ worth of underwear and socks so there’s a clean set available while the other is in the laundry)
  • Shoes, nonskid slippers (minimal pairs needed)
  • Basic toiletries
  • Medications (unless they need to be ordered by building)
  • Small file or other storage for medical, legal, and financial paperwork
  • Photographs to display or look at in books (digitize everything else to store)
  • Special heirloom or memento to give a sense of home (if not passed on)
  • Small safe (but don’t bring jewelry, etc., that’s not regularly used)

Cleaning supplies

  • Dish soap
  • Dish towels
  • Surface wipes
  • Window cleaner
  • Bathroom cleaner
  • Laundry basket
  • Laundry detergent
  • Dusting cloths

Decorations

  • Wall decor (photographs, paintings)
  • Curtains (check ahead – blinds are usually already in place)
  • Lamps, light bulbs
  • Clock
  • Vase
  • Throw (for toss-on warmth)
  • Holiday decoration

Entertainment

  • Television (if used, make sure your loved one knows how to operate it)
  • Music system (if used, make sure your loved one knows how to operate it)
  • Desktop, laptop, or tablet computer (if your loved one will use it)
  • Tool kit (some communities have workshop areas)
  • Hobby supplies (needlework, paints, craft materials within reason, cards, books)

What NOT to Pack for a Move to Assisted Living

As with most moves it is a good time to go through and decide what is really needed.  But most moves to assisted living are a downsizing time.  So remember to bring what is going to be used regularly.  Also there are a few things that are discouraged and not recommended and need to be carefully considered before bringing:

  • Lots of knick-knacks or collectibles (surface space will be limited)
  • Throw rugs or area rugs (they’re a tripping hazard)
  • Chairs on wheels
  • Seldom-worn jewelry
  • Multiples of most things (e.g., mugs, appliances, bathrobes, coats, handbags)
  • Large-scale furniture
  • Boxes of stored items (bring only what’s used regularly)

Finding Confidence with an Aging Mind and Body

 

The message from society is pervasive. Fight aging and stay young. But that’s not a goal any of us can truly achieve. What we can do is recognize and embrace the normal changes from the aging process. Find new ways to do the things we love to do and accept changes that come with the passage of time. When we face the unavoidable changes with acceptance we give ourselves more control of the things that we actually can change…our choices. Feeling more in control is a huge confidence booster, and can actually help you live independently longer and enjoy life more.

 6  Choices That Can Raise Self-Confidence

  1. Feeling Valued through Connection. We all need to know we are loved, needed, connected to someone. Keeping your connections strong boosts self worth and self-confidence. Actively make that happen. Don’t wait for others to reach out. Be the one to do the reaching. If you are lonely make some calls. If you need help ask. If someone is on your mind let that someone know. Adult children can help this process by being receptive when an older relative tries to make contact.
  2. Minimize the Risk of Falls. A fall can happen to anyone, but the consequence of a fall gets much greater as we age. The likelihood of a fall goes up too, but there are things we can do to mitigate that risk. Improve balance and strength through class like chair yoga. Take a daily walk to maintain basic fitness. Keep floors and stairs free of clutter. Knowing you have taken steps to reduce fall risks well allow you to feel confident about performing activities of daily living.
  3. Shift Perception of Aging. As part of the natural process of aging we face a decrease in our physical capabilities. We have hearing and vision loss, we lose muscle mass, we lose height, and we lose stamina and flexibility. Do not view these losses a personal failure. These losses are a natural part of human aging and should not bring shame. Sometimes our children are our biggest critics, as they want us to be as we were when they were young. If they are lucky, they will age too. Be a role model on accepting an aging body. Be the best you that you can be today, and face the world with grace and confidence.
  4. Home Alterations. Many home modifications are available to allow people to perform activities of daily living independently at home. Some examples are improved lighting, handrails, and lowered cabinets. If your house was not design with older resident in mind, a few minor modifications can make a world of difference.
  5. Share your Wisdom. Your teenage grandson may not show gratitude for your advice, but he needs it nonetheless. There is great satisfaction in knowing that we will live on through our impact on our loved ones. Through the years your advice will be played back in your loved ones’ minds again and again and become a part of the wisdom that they pass down as well.
  6. Keep up with Current Affairs. Stay engaged with what’s happening in your community, in your state, in your country and your world. These events are common to us all and can help you make conversation with friends and loved ones old and new. This will also give you confidence in demonstrating your mental sharpness.
  7. Communicate Your Needs. Loved ones may not know that you cannot hear them, you cannot walk as fast as you used to, you cannot read that tiny print. Help them to be patient by letting them know that you have a limitation and what they can do to accommodate it. Say “I cannot hear as well as I used to. It really helps me if you slow down you speech and enunciate clearly”. Everyone will be less frustrated once you let them know what they need to do.

All of these steps can boost self-confidence and improve your experience as an aging adult. The changes are normal. Accept your limitations and problem- solve to live your best life today. Do not push your loved ones away. Instead engage them in continuing to be a part of your life.

Frailty is Reversible

 

Frailty develops over time so it allows people to accept the incremental changes, but the good news is that frailty is reversible. As frailty develops there are often many opportunities for prevention, so fighting the tendency to accept it as a part of aging is important. Addressing issues quickly and talking with your primary physician and other professionals to establish a personalized course of action is key. The process from vigor to frailty takes many years, so the reversibility takes time and effort.

Frailty is defined as meeting three of these descriptions: self-reported exhaustion, slow-walking speed, low physical activity, weakness in grip strength and unintentional weight loss of more than 10 pounds in a year. It also often includes frequent falls, a decrease in libido, mood disturbances, incontinence, and muscle wasting (sarcopenia). The failure to thrive can make the late stages of frailty extremely difficult to reverse course, so the earlier an intervention the better. The time to start is always now.

Due to the American health system relying so heavily on prescription drugs for responding to systems, we looked at other countries for studies on how frailty is reversible. In a 2011 study at the University of Sydney in Australia, as an example, key treatments and interventions made the reversal a reality in the vast majority of people. Exercise was the primary treatment that had the most positive effect. The strength, balance, and endurance exercises can be found at www.webb.org.au. There are similar programs here in the States.

The second largest treatment in reversing frailty is nutrition. Personalized nutritional advice and supplementation matches the nutritional gaps with the diet for the senior. Seniors need more nutrition and fewer calories so involving a nutritionist or dietitian can be helpful. The third area that also affects depression is a combination called social factors. Options to increase social engagements along with encouragement to participate add mental aspects to the physical activities taking place. Chronic disease management is required as well as advocacy for prevention of diseases.

Senior care varies from the extreme of acute hospital care where there are interventions for symptoms and sometimes complications from the intervention, to the friendly neighbor stopping by every few weeks to check on someone. In between there are senior centers, home care companies, assisted living communities, skilled nursing facilities and many government programs to encourage healthy seniors. Care Patrol provides Certified Senior Advisors at no cost to help figure out which will work.

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