Entering assisted living is a life-changing decision that can cause a lot of stress and emotion that rivals other big events. Here are some tips to make the process a little easier.
1. Plan Ahead
Gather the family together and decide who will handle what. Make a list of the necessary things that need to be done, decide who will do them, and when. If possible, include the senior in these discussions as much as possible. This will help ease the anxiety they will be feeling. Planning can also involve encouraging them to maintain a productive frame of mind and remain flexible.
2. Stay Positive
What you’re doing is difficult, but remember that it’s the right thing. It’s natural to feel some guilt, but try to let it go. Take care of yourself, ask for help if you need it, and manage your own stress. Keep in mind that this process takes a toll on caregivers too, sometimes even when it goes well. You may be surprised to find that you are the one feeling forgotten if your loved one makes new friends quickly and doesn’t want to spend a lot of time with you.
3. Communicate Clearly About Tough Decisions
Make sure everyone knows who will be doing what and who will be making decisions about financial and medical matters. Is it necessary for a family member to have Power of Attorney? Is a Living Will in place? It’s a good idea to have a conversation with your loved one’s lawyer and doctor about your options. These discussions may or may not seem necessary when entering assisted living, but having the conversation in advance can cut down on confusion during a future medical crisis.
4. Make Assisted Living Feel Like Home
Personalizing the space can go a long way towards making it feel comfortable. Hang curtains, put decorations on the walls, and use a familiar quilt or bedspread. Beyond decorating, encourage your senior to become active and make friends in their new community. It’s the people who make a home.
5. Listen to Your Loved One
Don’t forget what a difficult time this is. It can be extremely hard for seniors to give up some of the control they’ve had for all their adult lives. Honor their desires as much as you can and take their concerns seriously. Reassure them that you will be there if they need help and that they’re not being abandoned. It would be a good idea to set aside some of your time to be in their lives a little more during this period. At the same time, give them the space they need to adjust on their own – they can’t become fully comfortable with their new lives if you’re always there. Also understand that at this time, emotions over seemingly small issues can really be driven by something much larger. Sadness over a pair of socks that were lost in the wash could really be sadness about giving up a home and independence.
Expect the adjustment to take a few months, and don’t try to rush the process. New homes take time to get used to.
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When birthdays or holidays come around, people want to do something nice for the older people in their lives who are now assisted living residents. But figuring out what to give can be a challenge. Below are some gift ideas that senior will appreciate.
Personal Mementos
If the resident doesn’t have already have one, gather as many addresses as you can for them into a fancy address book. Enlarge a family photo for the wall (perhaps your loved one’s favorite photo of themselves in their younger days), or put together a photo album. You can buy items like coffee mugs or calendars that are customized with family photos. As long as your loved one can see the electronic screen, a digital picture frame will always give them something new to see. Some can even have pictures added to them remotely, which makes it easy for far-flung family to add their own contributions.
Small Decorations
A plant or flowers in a vase that you can refill every time you visit can really brighten up a room. If they have a tree outside their window, setting up a bird feeder for them that you refill periodically would be a wonderful treat. Give decorations related to an upcoming holiday for a festive change. Air fresheners or flameless candle burners make a strange room feel a little more like home.
Media
A subscription to a magazine or newspaper is a wonderful gift. Not only does the resident get reading material, but they also have the joy of getting interesting mail! You may choose a publication from a favorite town or city they once lived in. They would also love a CD or tape of their favorite music, or an inexpensive DVD player with movies or favorite TV shows.
Books always make great gifts, but keep in mind that the resident may not be able to see well. Organizations that make materials for the visually impaired can be helpful resources in these situations: some even offer materials for free. Or you can just buy books on tape. There are even services that act like Netflix for audio books, so your senior will always have something new to listen to. Don’t forget headphones! Big old-fashioned ones are easier for seniors to handle than earbuds.
Cozy Comforts
Anything to keep residents warm and comfortable will likely be appreciated, especially if it’s easy for them to put on and remove. Bed jackets, shawls, and blankets are a great choice. Even though we think of them as being kids’ toys, a doll, teddy bear, or other stuffed animal can be very welcome.
Practical Items
Stationery and stamps are popular, especially for residents with far away friends and family. An electric toothbrush may be useful. A resident who uses a walker will get a lot of use out of a basket or pouch that they can attach to carry things. Anything related to a hobby that your loved one can still enjoy will help them feel good about themselves and keep their mind active. A flashlight might make them feel a little safer, and a fan is helpful if your resident tends to be hot. A clock with large numbers is also a great idea.
Yourself
What will make your loved on happiest is quality time spent with you. You don’t need to make awkward conversation for an hour if you’re not very talkative – instead you can choose an activity on the schedule to participate in with your resident. You can also volunteer to lead or help with an event, and allow your loved one to brag about how well you did later. Simply reading aloud to them counts as quality time. You can also videotape family events, such as a school band concert or a birthday party, and show it while recounting all the behind-the-scenes stories. Don’t forget to bring the kids! Time with children is especially welcome. Family members who live far away can record messages or stories that the senior can listen to again and again, or can send cards or letters.
Your loved one may also enjoy a visit from a pet. You likely won’t be able to bring an animal into the facility, but you can bring the resident outside and have them meet the animal there.
Residents will appreciate little trips outside the facility. Some ideas include a tour of the Christmas or Halloween decorations in nearby neighborhoods, getting an ice cream cone, watching a child’s sports game, or even just cruising around on a nice day. Short walks in nice weather will be appreciated too.
Meals that are home cooked or from a favorite restaurant are a special treat. Even something like pizza or Chinese can be wonderful since it’s not something residents have often anymore (make sure this is OK for the resident’s diet).
When buying gifts for your loved one, the key thing to remember is that this is a situation where less is more. Bulky or heavy gifts take up a lot of space, and even trinkets and magazines can easily become clutter in a small room. It’s usually best to avoid expensive gifts as it’s a real possibility that another confused resident can mistakenly wander off with something. For many seniors, at this point in their lives it’s the simple pleasures that matter most, and what will make them the happiest is knowing that you care and are thinking about them.
/by Moti GamburdOne of the hardest things for seniors living on their own is having meals that are both nutritious and enjoyable. Cooking for one person is tough enough when you’re young and energetic, but when everyday tasks are more difficult and you move more slowly, it’s that much more difficult. Some seniors can’t get out to the grocery store to even get food to begin with. Especially when it comes to men and others who may not have done much cooking earlier in their lives, making your own meals can seem like an impossible task. In these situations, seniors tend to go for what’s quick and easy, not what would be the most ideal choice from a health standpoint.
In addition, seniors living by themselves eat alone much of the time. Having dinner with only the TV for company can be pretty lonely. Even if the senior lives with family, how often in busy homes with kids does everyone come together to share a meal? Despite the living situation the end result may be the same: a microwave dinner in front of the evening news while children stay late to deal with work responsibilities and grandchildren attend basketball practice or reherse for the school play. This scenario may make the senior feel even more cast aside.
To be fair, some seniors are still excellent cooks and can fend for themselves. But the chances are good that sooner or later, food will become an issue. When it does, it can contribute to making a senior’s delicate health even worse. Poor nuturition makes people more likely to get sick, can exacerbate conditions like Alzheimer’s and dementia, and can lead to depression.
Those who are concerned about their older loved ones should not wait for the senior to ask for help, as sometimes they will fear the loss of their independence and hide problems. Watch for clues like excessive weight loss or a refrigerator with barren shelves or expired food. Consider whether getting to the grocery store is a challenge: does the senior have trouble getting outside his or her home? You also may want to ask if he or she is having problems with swallowing or chewing or if they’re experiencing a loss of appetite.
This is one area in which assisted living can make a big difference in a senior’s life. Assisted living residents do not have to worry about cooking for themselves. They get to have regular mealtimes within a community and experience the comfort of gathering together with people they know. A good assisted living facility will make sure the senior gets the proper diet for his or her specific health issues.
We all feel happier when eating well and enjoying good company. Attention to this area can be a huge boost in a senior’s quality of life.
/by Moti GamburdWhen they first see the cost of assisted living, many people are taken aback. Their first reaction is that it’s “too expensive,” especially compared to having the senior just live at home. While this initial response is understandable, it’s not quite accurate. You need to take into account all the benefits that assisted living provides, and compare it to total monthly expenses incurred outside of assisted living, before you make a judgment.
To get an accurate sense of the relative cost, you need to start with an accurate budget. Look at your financial records closely and see what you really spent over the last few months. It’s easy to underestimate what you spent on food, for example, and forget about small impulse purchases.
Once you do that, you are more prepared to evaluate the price tag of a given assisted living facility. The monthly fee will cover all basic needs: food, housing, and utilities. In addition, that fee also provides housekeeping, health monitoring, repairs and maintenance of your living space and yard, security, entertainment, and trash removal.
You should especially consider the value of the social activities that assisted living facilities provide. Many seniors are isolated living on their own, or skimping on entertainment in order to save money. But in assisted living these things are part of the whole package. Many seniors value these living arrangements precisely because of the chance to have a good time with people their own age. Activities and socialization also help seniors maintain their physical and mental well-being.
Senior couples may receive additional value from assisted living that aren’t immediately revealed by the numbers. Many wives see their workloads increase when their husbands retire, as they now have to care for someone full-time. Assisted living can finally allow both partners to take a break because someone else is worrying about the chores. Husband and wife can simply enjoy each other’s company instead.
Don’t let the price of assisted living deter you from taking a closer look. People forget to take into account all the things that assisted living provides which inflate the cost of the senior living on their own. And it’s impossible to put a price on enjoying those last years without worry about the lawn or the leaky roof, and also knowing that you or your loved one has someone immediately available to help them, at any time of the day or night. You’ll likely find, as many have, that assisted living is actually a better value than your other options.
/by Moti GamburdSome assisted living facilities are specially equipped to work with dementia and Alzheimer’s patients. This means that the environment is designed to be friendlier to residents with these conditions and that staff has been trained to meet their specific needs. How do you know if a facility that claims to specialize in these conditions is really right for your loved one? The only way is to visit. You’ll want to start by looking at our checklist of things to consider when visiting an assisted living facility, but you should also be alert for how the facility performs in each of the following categories.
Environment
Alzheimer’s and dementia patients are aided by routine and can easily become over-stimulated. The environment should be calm and peaceful, and the daily schedule should be consistent. Another sign that the facility is friendly to Alzheimer’s and dementia patients is cues that enable them to get around and complete tasks on their own, such as personal mementos that make it easy to identify a resident’s room and color-coded guides to common areas.
Safety
Facilities that cater to Alzheimer’s and dementia patients should have motion detectors or other monitoring systems to alert staff when there might be a problem, such as a resident wandering off. There should be systems in place to insure residents get the right medicine at the right time. Also pay attention to how disruptive behavior and outbursts are handled. The staff should not be using physical restraints or sedation.
Staffing
First and foremost, the staff should have the compassion to make your loved one feel comfortable. Ask about their training and experience, and consider how many staff members work each shift. Make sure there is adequate staff on weekends and holidays. The facility should also seem to be a pleasant place to both live and work. What does management do to prevent staff burnout? If staff turnover is high, this can be disorienting to residents.
Quality of Care
How much information does the staff request about your loved one, and is that information then used to design a detailed care plan? Are they taking comfort and psychological well-being into account in addition to health and safety? How many of the residents have dementia or Alzheimer’s? Ask what the staff does differently for these patients.
Policies
One of the most important things to note is how the facility handles the progression of the disease. How is it decided when additional care is necessary, and to what extent is family involved? Find out what happens when a resident needs to go to the hospital. Will his or her place in the community be reserved, and what are the fees in this situation? In general, what additional costs does the facility charge for care of dementia or Alzheimer’s patients?
Watching for how a facility performs on the above categories can help you find a place that is truly suited to your loved one’s needs, and not just marketing a specialization that they don’t really have. Your loved one deserves quality care.
/by Moti GamburdMore and more, you’ve been worrying about an elderly parent or loved one who lives alone. Do they need more help? Are things really just fine, or are they in denial and trying to hang on to living on their own longer than they should? These signs can help you determine whether it’s time to have a talk with them about moving into assisted living.
/by Moti Gamburd- Has your loved one become forgetful about important things, such as medical appointments, paying bills and when to eat?
- Has your loved one experienced any weight change? This could indicate that he or she is having trouble shopping for and preparing proper meals.
- Is there a lot of expired food in the refrigerator or is it empty?
- Is your parent following the proper medication regimen? Can your parent tell you about the different medicines and what they’re for?
- Are you worried about your parent’s ability to be behind the wheel? Have they had a recent traffic incident or are there scratches and dents on the car that weren’t there before?
- Has your loved one had a fall recently?
- Is your loved one hiding bruises, cuts or burns from you, or does he or she not know how they happened?
- Has your parent had a problem with small fires?
- Does your loved one wear the same clothes all the time?
- Does your loved one seem to be keeping up with his or her hygiene? Do they have strong body odor, or do you smell urine in the house?
- Are they continuing to maintain their home and the yard or have they neglected tasks that they usually take care of?
- Is your parent able to stand from a seated position with relative ease? Can they maneuver as they need to?
- Does your loved one tell you that he or she hears noises at night?
- Does your parent seem to be isolating him or herself and spending more time alone?
- Has your parent become unusually suspicious or fearful?
- How does your parent react in an emergency?
- Is your parent behaving strangely or uncharacteristically in any way? Has he or she been expressing any disorientation?
There are many misconceptions about assisted living floating around out there due to the complexity of senior care. How senior care is offered has also changed, so someone who hasn’t had any contact with this area in recent years may have ideas that are out of date. Finally, negative perceptions tend to get repeated more often both among acquaintances and in the media. Let’s examine some of these misconceptions.
An assisted living facility is the same thing as a nursing home.
Assisted living facilities actually have come about relatively recently, and they are distinct from nursing homes. Assisted living is designed to address the needs of the senior who may need help with some things, but is otherwise independent and healthy. In contrast, nursing homes are for those who need to have skilled medical care available around the clock. Assisted living facilities encourage seniors to be as active and as independent as possible. They focus on allowing seniors to feel that they’re living on their own and not burdening their families, but that help is still close by.
Medicare pays for assisted living.
Unfortunately, as many seniors learn when they investigate assisted living, this is false. While nursing homes are able to accept Medicare, assisted living facilities cannot. Medicare only pays for medical expenses, and assisted living facilities do not provide medical care. Usually, people pay for assisted living with long-term care insurance or private funds. There are some assisted living facilities who will accept Medicaid, but these residents may not best be served by assisted living communities.
The food in assisted living facilities is lousy.
At least at Raya’s Paradise, that’s not true! Our residents savor delicious home-cooked meals and snacks.
Seniors with Alzheimer’s won’t be accepted into an assisted living facility.
Some facilities, such as Raya’s Paradise, offer specialized care for residents with memory problems, including Alzheimer’s.
Assisted living facilities have poor resident to caregiver ratios.
Out of all the types of senior care, assisted living actually has the best resident to caregiver ratios. Raya’s Paradise has one caregiver for every three residents. In comparison, nursing homes sometimes have one caregiver tending to 20 or even 30 residents.
Assisted living is expensive.
Different types of senior care use different pricing models, so you’ll have to carefully compare what level of care you’re getting at a particular rate, and consider whether a certain level of care is necessary. Generally, assisted living facilities are cheaper than nursing homes, which offer constant medical care to seniors with serious problems.
Assisted living offers a solution for seniors who are independent in some ways but need help in others. It often can be a way for seniors to make the most of the time they have left and feel secure. It allows them to maintain their quality of life, which everyone can agree is the goal.
/by Moti GamburdJust because an assisted living facility doesn’t have fifty beds or more doesn’t mean it’s inferior in any way. Small homes need to meet requirements in order to be licensed, just like larger facilities do, and this insures a certain standard of care across the board. In fact, smaller homes are quite likely to be better!
Customized and Responsive Care
In smaller facilities, the staff can get to know the residents well and better understand their unique needs. The staff is also much more likely to notice and address any problems immediately. There is probably a smaller staff-to-resident ratio, insuring thorough care and quicker help. Smaller facilities tend to do a lot more for their residents. The rate of staff turnover is also likely to be low.
In smaller facilities owners and the management feel a sense of pride about providing a well-run home for the seniors living there. Think for example of the better service you receive at a mom and pop store or a small boutique, compared to a large impersonal corporation like your cable company or a huge bank. As with any large institution, it takes a lot to run the bigger assisted living facilities. They require a large staff to keep on top of things, and a large staff requires another layer of management on top of that. To keep order there are likely to be rigid schedules and routines. It takes so much effort just to keep everything running smoothly that the individual residents living there can easily get lost and not experience the flexibility they need. Smaller facilities can instead adapt to the residents and their wants and habits.
Ease of Communication
Smaller facilities are able to communicate with residents and their families on a more personal level. When you call, you will likely be able to speak to someone in a high-level position of responsibility quickly. If you have a concern, you can be confident that you can easily reach someone who can help.
Intimate and Less Stressful Environment
A smaller facility is much more likely to feel like a home rather than an institution. It may, in fact, even be located in a house. Close bonds are formed both among the residents and between the residents and the staff. And we all prefer home-style cooking to that served by a big cafeteria!
The small environment can be easier for seniors to adapt to and navigate, especially seniors with Alzheimer’s or dementia. With larger hotel-style facilities, it can be a challenge for residents just to find their rooms! The less stress residents experience due to their environment, the more they can enjoy their stay.
If you value having a responsive, caring, and comfortable facility, make it a priority to seek out smaller assisted living homes.
/by Moti GamburdMaking the mistake of choosing a bad assisted living facility is a nightmare scenario for seniors and their families. Imagine living in a place where there are all sorts of hidden dangers to your safety that make it more likely you will have an accident, where the people around you are indifferent or even hostile, where you have no control or say in how to live. Your calls for help go unanswered, and when your family tries to advocate for you they get mired in arguments with the management. No one wants to make such a large commitment and then realize that they are stuck, even temporarily, in horrible living conditions.
Some bad facilities can be spotted right away due to their deteriorating physical conditions and clearly depressed residents. But in facilities that on the surface seem just fine, there are other smaller signs you should look for that could be clues to larger problems. Many of them are listed below. Any facility that takes pride in providing excellent senior care should have these items covered.
/by Moti Gamburd- Is the facility’s state license and a Resident Bill of Rights displayed in the lobby?
- Where are smoke detectors located? They should be in rooms, hallways, and community areas.
- Do the windows have safety locks?
- Is there an emergency generator or some other way to provide electricity if the power goes out?
- Does the facility have fire drills and are emergency plans easy to find?
- What is the crime rate in the neighborhood where the facility is located?
- Will the carpeting in the rooms prevent residents from moving easily with walkers or canes?
- Handrails should also be plentiful throughout the facility.
- Does the bottom step on stairs have recessed lighting or colored tape to make it more easily seen?
- Have area rugs wandered so that they’re sticking out over the top step of the stairs?
- Is the light in the facility adequately bright?
- Is there a way to call for help in the bathrooms? Are there non-slip mats and handrails near the toilet and inside and outside of the shower? There should be a shower and not a tub, and the shower should have a seat where residents can sit if they need to.
- Are there strong smells? A heavy cleaning chemical smell could indicate that the facility is trying to cover something up.
- Ask to see an occupied room. Is it clean?
- Is there a big difference between the atmosphere of the lobby and common areas and the rooms?
- Try to listen to how the staff addresses and talks about the residents. Are they using the residents’ names?
- How does the staff treat you? Are you acknowledged or ignored?
- How does the staff speak to residents or to one another? If they are polite to you and to residents when in your presence, but rude to each other, that may be a sign of how they treat the residents on a daily basis. People can only be on their best behavior for so long, and if you don’t like how they act with people they are comfortable with you probably won’t like how they act once you’ve signed a contract and paid the entrance fee.
- Do calls for help seem to be answered quickly?
- Are there residents sitting alone in wheelchairs with no one to help them?
- Are residents eating all their food at mealtimes?
- Do residents seem happy, active, and social?
- Is their appearance clean and well-groomed?
- Are common areas being used?
- Does the facility seem chaotic or crowded?
- Does the facility seem open to visitors during your tour? Are you able to speak with residents?
- If a parent and adult child are visiting the home together, does the tour guide make an effort to include the senior in conversations as well?
- If you stop by unannounced, will the staff let you in?
- What do you find when you research the facility through the Better Business Bureau, local agencies, or online? How does the agency respond when you ask them about negative feedback? Have they responded to negative feedback left online?
- Look over the contract carefully. When can residents be evicted? What happens when they run out of money?
The biggest fear many have when making senior living decisions is what it will cost. The fees for assisted living facilities at first glance may seem quite high. Keep in mind though all that assisted living covers: housing, at least some meals, and help with your daily needs. Beyond assisted living and your medical expenses, you will likely need to spend very little, if anything. Assisted living is usually paid for using long-term care insurance, personal funding, or veterans benefits. These funds may be supplemented by social security.
Long-Term Care Insurance
Long-term care insurance covers services that help people who need medical or non-medical care over a long period of time. It will cover assisted living if you cannot perform two or more “activities of daily living” (ADL), such as walking, using the bathroom, or getting dressed. You may have to have an examination by a doctor chosen by the insurance company to be sure that you qualify.
The benefit is often structured so that the policy has a daily limit, usually $100-$150, and a lifetime maximum, for example $250,000. Some policies have an elimination period, an amount of time during which you must pay for your own care (similar to a deductible).
As you grow older, your premium is likely to rise since the older you get the more likely you are to require long-term care. If the premium rises beyond your ability to pay, the insurance company will likely offer a lower premium in exchange for reduced benefits. In some but not all plans, you no longer have to pay your premium once you begin using the benefit.
Personal Funding
Money to pay for assisted living may come from retirement funds like Individual Retirement Accounts (IRAs), pensions, or 401k plans.
People also use the funds from the sale of their home. A home purchased 40 or 50 years ago will yield quite a bit of equity that can go towards senior care. If you are unable to find a buyer by the time you need to move, you may be able to get a bridge loan to help pay for your care. This loan provides immediate funding, which you then pay back when your house does sell. You can usually gain at least a few extra months to sell your home before you need to start making payments on the loan.
If you don’t want to sell your home, there are other options available. You may be able to rent it out, thus giving you a monthly income. You may also be able to take out a reverse mortgage, where you receive money drawn against the equity you have in your home. You can receive this money as a lump sum, monthly payment, or revolving line of credit. Keep in mind that your spouse (or someone who owns the home with you) must still be living in your home for you to qualify. Also, the starting costs associated with these loans can make them quite expensive.
With any of these financing options, if you have relatives who are in a position to lend you money in exchange for equity in your home, you may be able to come up with a similar arrangement privately, rather than borrow from a bank or other company. Consult with a lawyer to learn more about this option.
Veterans Benefits
Veterans benefits may be able to help you finance care in an assisted living facility, if you or your spouse served in the military. This is the Aid and Attendance tier of the Improved Pension offered by the Veteran’s Administration. You do not need to have any sort of injury related to your service, though you must have been on active duty at least 90 days and one day during wartime. You also must have less than $80,000 in assets. You’ll need to file the Veteran’s Application for Compensation and/or Pension (VA Form 21-526, Parts A, B, C, and D).
A Note on Medicare and Medicaid
First, you should know that some assisted living facilities, including Raya’s Paradise, only accept long-term care insurance or private funding. Also be aware that Medicare does not pay for assisted living as assisted living is not medical care but rather assistance with your daily needs (Medicare will pay for medical expenses incurred during the time you are in the assisted living facility, such as your prescriptions or visits to the doctor). Medicaid might pay for a limited stay (often 90 days or fewer), but even then, coverage is limited. In some states Medicaid pays for the personal care services you receive, and in others it pays for room and board as well. Medicaid does not currently pay for assisted living in the following states: Pennsylvania, South Carolina, Alabama, Kentucky, and Louisiana, though it is likely that there will be national coverage in the coming years.
Finally, you may be eligible for tax deductions that can also help pay for senior living expenses by reducing your tax liability. You can learn more by doing research at www.irs.gov on the Elderly and Disabled Tax Credit and Medical Expense Tax Deductions, and on your state’s elderly care tax credits. You may also find it helpful to talk to an accountant.
/by Moti GamburdCorporate Office / General Information
Raya’s Paradise, Inc.
1156 N Gardner St.
West Hollywood, CA 90046
Tel: (310) 289-8834
Fax: (323) 851-0375
E-mail:Info@RayasParadise.com
Featured by Assisted Living Magazine as one of the best communities in Orange County