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Indicators for Assisted Care

With the availability of community based services, seniors and their families will often strive to stay in their own home as long as possible. Staying in a familiar environment, finances, and retaining independence are some reasons that seniors and their families choose to remain in their home. But what about when staying at home is no longer safe? How do you know when mom or dad need more monitoring? There are indicators that additional assisted care may be required to keep your loved one safe.

Is there a lack of adequate food in cupboards or refrigerator? Have there been any falls? Are medications being taken as scheduled? Is there a lack of social interaction outside the home? Are there incidents of bed or clothing being soiled? Have mom or dad wandered and gotten lost outside the home? Is the family having difficulty meeting the needs of the aging parent? It may be time to consider assisted care options

A Variety of Assisted Living Options

You have decided that care outside the home setting may be in order. What is next? Depending upon where you live, there may be anywhere from a handful to a plethora of options! Assisted living options come in many sizes, styles, and offer a variety of care choices.

Available options may include small homes, large resort-like communities, assisted neighborhoods with groupings of small homes, and apartments attached to skilled nursing centers. The options available, and the policies that regulate them, differ from state to state. Additionally, each residence may offer a different level of care.

For example, some assisted living communities may offer only minimal hands on care while others may allow for a resident who is bed bound and at the end of life. Some assisted living homes offer security to protect those with wandering dementia, while others may not. Know what is important to you and your loved one. Do your homework. Ask a medical provider for suggestions.

The Value of Assisted Living

Assisted Living is never an inexpensive choice, but it may be a valuable choice. Family members oftentimes do not have the physical ability, emotional stamina, or time to spend the day with a loved one. As the needed hours for outside help increase, it may be worth a peek at the overall cost.

When families begin the process of investigating assisted living options, they are sometimes surprised by the fees involved. What do these fees cover?

Let's look at the math. Assisted living homes and communities usually include 2-3 meals a day, medication management, monitoring and security during the day and at night, certified caregiving and administrative staff, and housekeeping, just for starters.

What types of things won’t a parent need to pay for any more if they move out of their own home? Groceries, transportation, utilities, home repair, and in-home care are possible examples. Don’t be a victim of sticker shock. It may be that the value received by an assisted living option outweighs the cost of staying in the home.

The Benefits of Community

If a smaller care home is not your cup of tea, consider an assisted living community. A community may range from eleven residents to over one hundred. The elderly person may benefit greatly from opportunities for socialization.

Feeling engaged in a planned event, pursuing an interest, or simply having one-on-one conversations with others can boost the spirit and foster an interest in life.

Assisted living communities typically offer a range of activities from simple board games and puzzles to art programs, religious or spiritual studies, and live music programs.

Often, assisted living communities provide assessment and guidance so that activities are targeted to the desires and interests of each resident.

An Opportunity to Observe

What if mom or dad tends to stick to themselves? What if dad has always preferred to just watch television and isn’t interested in activities? A common misconception is that an elderly person may not benefit from a community that offers activities.

Interestingly, what we sometimes find is that a resident may start out choosing to observe from a distance, but later decides to participate.

Stimulation can be provided not only by doing, but by seeing and hearing an activity as well. Providing an opportunity for residents to choose what and when to join in an activity is important. It provides the right to independence.

Not One Size Fits All

Communities come in a variety of sizes and designs. Some communities are large groups of buildings in a resort style setting with lush and landscaped grounds, some appear more institutional in design, some are attached to skilled nursing facilities, while others are resemble a neighborhood.

When you open the door, what is inside? Fancy lobbies do not equate to better care. Layout and design can have significant impact on the flow of care and the comfort of the residents. Larger communities may offer room to roam and things to do. This might be a perfect fit for mom. But what if it feels too overwhelming?

Perhaps a smaller community would offer the best of both worlds. A community that offers activities, access to outdoor areas, quiet or private spaces but in smaller more intimate setting may fit the bill. What feels good? Listen to your gut. Does a place have a “good feel”? Often your gut knows better than you think!

Making the Move

Moving into an assisted living community is a significant life transition. Ideally the move is planned over a period of time. Unfortunately sometimes this transition occurs suddenly due to a change in condition of a parent or significant other. Prompted by a recent inpatient stay at a hospital or skilled nursing facility, families often scramble to choose a new home with little time to prepare.

There may be a sense of losing independence. An elderly person may feel that they are now at the mercy of others to care for them. However, it is important to understand that accepting care when needed can actually prolong and improve independence and health outcomes.

The Value of Recollection

Every person has a history full of colors and experiences. Every person has experienced both negative and positive situations. The average person has some painful memories and regrets. Each person also has positive memories and emotions. Some elderly dwell on the difficulties of the past. Family and loved ones can assist in reflecting upon the positive aspects of the past by encouraging recollection.

Some ideas for recollection might be to develop a scrapbook together, go through photo albums, tell stories, view home movies, or perhaps listen to music of that elder’s youth.

Anticipating the Future

Uncertainty about the future is common among the elderly, especially during times of transition. The transition into an assisted living community can feel overwhelming. Worry, anxiety, fear, and helplessness are some emotions that the elderly person might feel.

While it is natural to have these feelings, there are some actions that can be taken by caregivers and family to ease their loved one's mind.

Give hope by focusing on the abilities that a loved one still has instead of the loss of certain functions. Set some goals to accomplish. Plan an outing or a special activity together at the community. Anticipating a future event or activity gives the elderly person something to look forward to.

Access to Nature

Contact with nature is known to have significant positive effects on older adult health. When choosing a new assisted living home, it is important to look at the environment of the home. Whether in a smaller or larger assisted living community, identify the residents’ connection to nature.

Does the community have easy access to the outdoors? Are the outdoor areas maintained in such a way that they are inviting and safe? Does the landscaping reflect visually interesting aspects of nature and with varied colors and textures?

Bird feeders, flowers, plants, and different seating options offer residents a way to connect with their outdoor world.

Covering Care in Assisted Living

You may be surprised to find out that Medicare does not cover assisted living services for your loved one. The premise of assisted care is that a person can receive help with non-medical needs such as medication reminders, assistance with dressing or bathing, eating, mobility, and even housekeeping.

One would assume that since these basic needs are essential for the care and safety of their loved one, that they would be covered. This is not the case. Care and safety related services, sometimes referred to as “custodial” services, are considered non-medical/non-skilled care in the eyes of Medicare.

In the assisted living setting, room, board, and custodial services are paid privately by the resident. This means out-of-pocket expense for the resident or family members. Since the price tag on these services may be cost-prohibitive for some, there are a few different programs a person can use to help fund this care.

Veteran related assistance, long-term care insurance, and state-funded assistance may provide supplemental funds. These types of assistance all come with their own requirements and should be planned for in advance of actually needing them.

Medicare and Assisted Living

The room, board, and personal/custodial care services provided in the assisted living setting are not covered by Medicare. Physician services, medication, lab work, health nursing and therapies continue to be covered by your Medicare or other health insurance policy.

Residents and their family are still in control of their medical care in that they may continue with primary and specialty physician appointments in the office setting. However, some assisted living facilities may offer their own in-house physician services.

This may be a very prudent choice for residents. In-house physician care can alleviate difficulties with outside scheduling and transportation. It is also a great option for those residents with dementia, as it eliminates waiting in a crowded physician office which may prove to be over-stimulating and stressful.