Getting to Know Nursing Homes: Some Facts & Myths

When a loved one reaches a point in his or her life in which self-care becomes challenging, the next step may be a little overwhelming; particularly when trying to make the best choice for your loved one and your family. Some families struggle with guilt because it may not be financially, emotionally, or physically feasible for some individuals to become a caregiver. Often times a hired in-home caregiver is only a temporary solution until the aging or ill loved one requires more specialized care. Unfortunately, more often than not, many people are hesitant to choose the most common option of a nursing home facility due to the horror stories or bad reputations they can have.

Although a nursing home can be an intimidating next step, if you know what to look for and monitor closely, your elderly loved one can continue to live a healthy and safe life.

Myth #1: Nursing Homes Mark the “Final Days” of an Elderly Individual

While it is true that many elderly individuals may live their final years in a nursing home, it doesn’t automatically mean that an elder is living his or her last days. A nursing home is not a hospital, as it often mistaken for, but does have medically trained staff available 24 hours a day. Nursing home candidates do not need to be in a hospital, but are no longer to be cared for in their home or cannot take care of themselves. Although a majority of nursing home residents are older seniors, some younger seniors have short stays in a nursing home after a lengthy illness or after a surgery.

Myth #2: “If I move my elderly relative into a nursing home, he’ll lose all of his independence.”

When selecting a nursing home, many are fearful to move someone into a facility out of fear that he or she will have no independence. Many facilities respect and even encourage independence as much as possible. Even if one individual may have mobility issues, the staff will encourage other independent activities such as eating, grooming, and participating in activities. When deciding on whether or not to move your loved one into the appropriate care, keep in mind that the need for assistance is not the result of a loss of independence as we all require help sometimes.

Myth #3: “If my loved one moves into a nursing home, she will be mistreated by staff and there will be nothing I can do.”

We’ve all heard the terrible stories of nursing home abuse or elder abuse. Unfortunately, these stories of physical, emotional, and financial mistreatment are true, but they don’t apply to every nursing home facility across the country. First off, the best way to prevent elder abuse from occurring is by being active in your elder’s life. Before you choose a facility, take a tour, look around, and ask questions because this is the time in which you are interviewing facilities in search of the best possible care your loved one can receive. If anything feels or looks wrong, you don’t have to settle for that particular home. Be sure to educate yourself on how to recognize and respond to any sign mistreatment of your loved one.

Once you have found a suitable home for your elder, visit often, communicate regularly with staff, keep track of any changes to physical appearance and his or her emotional or mental state. Changes could be part of aging, but it could also indicate abuse. If you suspect any abuse, contact authorities immediately. This next chapter in your loved one’s life can be a positive transition and an opportunity to feel confident that they are being provided with the best care and surrounded by friends and family.

Elder Spring Cleaning

Many people take the beginning of spring as a time to clean, organize, and reset. With longer days on the way and warm weather on the rise, people feel a general increase in productivity during the spring.  Unfortunately, there are elderly folks living in senior care facilities are not always equipped to take on this kind of a task. Whether they are limited in mobility or just have too much cleaning and organizing to tackle on their own, your assistance might be necessary to complete spring cleaning. Below are some of the best ways for you and your loved one in a care facility to tackle spring cleaning this year.

Prioritize:  Before you even start your spring cleaning, it is best to begin by making a list of everything your elderly family member or friend would like to accomplish during their spring cleaning process. Once you have made your list, number  those tasks in order of importance. Tackle the biggest, most important projects first, like organizing medications or paperwork. As you complete those large tasks,  complete smaller, simpler projects in between. This will allow you to accomplish more!

Organize:  For the elderly, it’s especially important to keep items maintained and organized. Start by clearing out drawers and cabinets of their contents. Organize items by category. Everyday items should be kept in places where they are easily accessible, so keep that in mind when organizing closets, cabinets, and refrigerators. Also be sure to organize any relevant medical paper work, insurance information, or bills, and stow them away in a safe but easily accessible place. Organizing belongings makes it easier to find what you’re looking for, and will make it that much easier to find what they need when they need it.

Sanitize:  A clean living environment is vital to anyone at any age. If your loved one’s living space is looking lackluster, used sanitizing cleansers to clean flooring, countertops, and bathroom surfaces. This will spruce up the space instantly, and give your loved one a fresh reset to start the spring season in a healthy manner. Throughout the rest of the season, explain the small chores they’ll need to do to maintain the cleanliness, but a deep spring cleaning is a good jumping off point.

Involve:  While your elderly family member will surely appreciate your help, they don’t want to be completely left out of the process. Depending on their physical ability, you can have your loved one help out with certain spring cleaning tasks. Have them organize paper work while you organize a hard-to-reach cabinet, or assign another task that allows them to remain stationary. Helping out even in the slightest will allow them to feel involved and accomplished when the day of cleaning is done.

Facilitate:  Proper health care is a top priority for the elderly. Checking expiration dates of food and pills should also be part of your spring cleaning process. Make sure the senior care facility your loved one is in is a safe home for them to inhabit, clearing the floor of any trip-and-fall hazards. If your family member uses any type of medical devices, ensure they are functioning properly and ready for use. A list of phone numbers should be programmed into their phone or placed next to a phone in case of emergencies.

If you feel like this is a lot to take on yourself, make a day of it with the family. Helping out your loved one living in a senior care facility with their spring cleaning is a great way to spend time with them. Plus, doing so will allow them more time to participate in activities and socialize.

About The Author

Ruth Folger Weiss loves writing for The Waterford On The Bay, a senior living community in Brooklyn, New York.

 

The Best Apps for Older People

Apps for Older People Infographic

Source: http://www.homecaretechnologies.ie/

Do Your Due Diligence When Selecting an Assisted Living Facility

Choosing an assisted-living or long-term care facility for your family member can seem like a daunting task. The decision to move into a nursing home is seldom an easy one, and relatives have every right to be concerned and anxious about the level of care their loved one will receive. This can be especially true for those with special needs, or those who haven’t spent an extensive part of their life away from a home with a nuclear family.

News reports and first-hand accounts of nursing home abuse may only heighten your concerns. However, there are many well-run residential care facilities, and selecting one of these nursing homes will significantly decrease the likelihood that your family member becomes an abuse victim.

But how do you know which long-term care facilities are well run and which are prone to problems? There are a number of resources that can help you vet facilities before making a selection. When researching long-term care facilities for your family member, there are a few sources of information you should consider:

  • A state agency (often the Department of Health and Human Services, or its equivalent) is responsible for licensing each nursing homes operating in the state, conducting periodic inspections, and investigating complaints of elder abuse and other problems at assisted living facilities. You should be able to visit the agency’s website to confirm that a facility’s license is in good standing, view inspection reports, and learn more about the nature of complaints and how they were resolved.
  • It’s important to consider the context when reviewing this information. For example, spot check the complaints that have been filed for several facilities in the area, including those with the best reputations, to gauge how many complaints is a typical, above-average and below-average number. In addition, reviews can also be a valuable resource.
  • The state, county or city Agency on Aging can normally provide you with a list of residential care facilities in the area. In talking to an agency representative, you may be able to get informal feedback about a particular facility’s reputation in the community.
  • Each state also has a Long-Term Care Ombudsman, whose job is to advocate on behalf of assisted-living facility residents, and educate residents and their families. Your state’s ombudsman can help you learn more about long-term care facilities and regulations in your area.
  • It’s critical to talk to people with first-hand knowledge of local nursing home facilities, including people who have relatives in assisted living facilities, as well as residents of the nursing home you’re considering. Ask a lot of questions. What did families learn during the facility selection process and what would they do differently? What do residents like and dislike about a particular assisted-living facility? Would the resident recommend the facility to others?
  • If you know any nursing home abuse attorneys in your area, consider asking them for feedback on the resident care facilities you’re considering. Because nursing home abuse attorneys represent the abuse victims, they’ll be well aware of which facilities have a chronic history of problems and which are well-run. And if you are friends with people who work in the assisted living industry, ask them for their impressions and feedback about specific facilities.
  • The Assisted Living Federation of American, which is the trade group for assisted living facilities, maintains a list of links to regulations and assisted living regulatory agencies on a state-by-state basis.
  • The National Center for Assisted Living, which is run by another industry trade group, publishes an annual review that summarizes assisted-living regulations on a state-by-state basis. If you are considering residential care facilities in more than one state, this document can help you learn more about each state’s regulatory standards and requirements.
About the Author

Alan Brady is a single father, a part-time care provider for his grandmother, and an advocate for reducing caregiver abuse and neglect. He recommends seeking the services of a nursing home abuse attorney if you or a loved one experiences either while in the care of a nursing home.

Making Smarter Choices about Senior Housing

If you’re thinking of buying a new dishwasher, where do you turn? If you’re like many people, you probably turn to the Internet at some point during your search to read reviews from other consumers who have direct experience with the brands you are evaluating. And you’ll find an abundance of such reviews across dozens of websites. The decision to place a loved one in a senior living community — and deciding which senior community is right for your loved one —  is a far more important choice. Yet, you won’t find the same abundance of reviews online from real consumers.

But that’s starting to change. The population is aging rapidly, and the need for different types of senior housing options is growing. Today’s consumers are savvier and more educated, and fully aware that the decision is far more complex than simply choosing a community based on its location and the amenities listed in a brochure. Word-of-mouth marketing and personal recommendations aren’t new, but the availability of this information from dozens to hundreds of consumers at your fingertips is a growing concept in the senior living industry.

What Makes a Good Senior Community Review?

When you consider online reviews as a whole, there’s a clear differentiation between those that are genuine and valuable and those that are untrustworthy. It’s not uncommon for a brand to pay consumers or offer an incentive in exchange for a positive review. In the senior living space, you need real reviews, from real consumers who have had direct experiences with the communities they’re reviewing.

There’s also an important role for expert opinions. Geriatric care managers, home care workers and other industry professionals have a different perspective on the communities they interact with on a regular basis—a perspective that’s important for consumers to learn before making a decision as big as selecting a senior living community.

Senior community reviews should address the most important considerations families face when choosing a senior community for a loved one, including:

  • Staff friendliness, as well as issues with turnover and staffing ratios.
  • The facility itself, such as cleanliness and updated furnishings, as well as the available amenities on the property.
  • Quality of care, such as prompt attention to concerns, adequate care for resident needs and whether the care provided inspires confidence and trust.
  • Dining services, including the ability for residents to choose dining times, accommodation of special dietary needs and the quality of the food provided.

Inspection Data Becomes Increasingly Important

Finally, data from state inspections has become increasingly important to consumers. Nursing homes and other providers are required to make the results of these inspections available to any resident, family member or visitor in most states—and much of this data has been made available online in recent years.

Even the government has taken notice of the demand for critical decision-making data, launching a number of initiatives that provide information to consumers on the Internet, including the Five-Star Nursing Home Quality Rating System and Nursing Home Compare. In fact, the Centers for Medicare and Medicaid Services plans to make even more nursing home deficiency information available online in the near future, thanks to the steady consumer demand for easily accessible data at their fingertips.

Un-Biased Reviews a Critical Aid for Complex Decision-Making

Choosing a senior community for a loved-one is a complex and often nerve-wracking process for families. Locating senior communities on the web, reviewing the available information on services and amenities, touring facilities and meeting with staff and administrators can be a daunting process. Despite all this, many families still enter a senior community experience not knowing what to expect.

Legitimate, unbiased online reviews of senior communities can alleviate some of the unknown associated with such a new experience, easing the minds of both seniors and their loved ones who are each undergoing their own journey through this process. Online reviews can provide consumers with dozens or hundreds of detailed opinions, describing the atmosphere at a community, the quality of care, staffing, amenities, services provided and even personal experiences.

There’s no real way to make the decision of choosing a senior community an easy one. But online reviews will allow seniors and their loved ones to be more confident in their choices, reducing the stress for everyone involved in this life-changing process. The availability of online senior community reviews is one way that technology is reducing some of the challenges associated with aging.

About the Author

Chris Rodde is the CEO and co-founder of SeniorHomes.com, a free resource for people looking for senior housing or senior care for a loved one or themselves. SeniorHomes recently launched a national ratings system to help seniors and their families make more informed decisions. To learn more about the ratings program and the Best of Senior Living Awards visit: http://www.seniorhomes.com/p/2013-best-senior-living-awards/

Photo credit: moodboardphotography

Elder Care Abuse: How to Know and When to Act

Elder abuse is something that occurs in the United States more frequently than many of us know.  According to Elder Abuse Daily in 2010, there are almost 6 million elder abuse cases every year.  This estimate demonstrates a growth since the American Psychological Association reported in 1999 that an average of over 2.1 million elder abuse cases occur every year.

According to the U.S. Administration on Aging, elder abuse is the, “knowing, intentional, or negligent act by a caregiver or any other person that causes harm or a serious risk of harm to a vulnerable adult.”  The administration states that these are the common abuse types:

  1. Physical Abuse is the infliction of “physical pain or injury on a senior, e.g. slapping, bruising, or restraining by physical or chemical means.”
  2. Sexual Abuse is the “non-consensual sexual contact of any kind.”
  3. Neglect is “the failure by those responsible to provide food, shelter, health care, or protection for a vulnerable elder.”
  4. Exploitation is “the illegal taking, misuse, or concealment of funds, property, or assets of a senior for someone else’s benefit.”
  5. Emotional Abuse is the infliction of “mental pain, anguish, or distress on an elder person through verbal or nonverbal acts, e.g. humiliating, intimidating, or threatening.”
  6. Abandonment is the “desertion of a vulnerable elder by anyone who has assumed the responsibility for care or custody of that person.”

According to the National Institute of Justice (NIJ), emotional abuse, financial abuse, and neglect are the most prevalent of all elder abuses.

Unfortunately, elder abuse is not a crime commonly reported.  The National Center on Elder Abuse estimates that 83 percent of elder abuse cases never get reported.  According to a 2009 NIJ research report, the majority of the elderly’s abusers are people they know.  Through surveys, the NIJ found that the elderly are most likely to underrepresent abuses:

  • That happened more than a year ago.
  • That they did not report them to the police.
  • If the abuser was not a stranger.

Sadly, the unwillingness of the elderly to properly represent or report these abuses is detrimental; the majority of elders surveyed by the NIJ had been abused over a year ago, had not reported the abuse to police, and knew their abuser/s.

How to Protect the Elderly from Abuse

In order to protect your elderly loved one from abuse, you must:

  1. Ensure he/she is in a quality elder care program.
  2. Do research.
  3. Ask the elder care facilities that you visit for their state survey reports.
  4. Visit, inspect, and ask questions.
  5. Ensure that your chosen facility has a proper staff-resident ratio. According to the Health and Human Services (HHS), 90 percent of nursing homes are understaffed. Nursing home staffs spend less than 3 hours total with residents each day (HHS) despite about 4 hours being what the government and expert recommendation for patient care each day.
  6. Check on your loved one frequently.Visit your loved one as much as possible to ensure he/she is receiving sufficient senior care.
  7. Physically check your loved one for signs of abuse. A list of abuse symptoms can be found on the NIJ website.
  8. Know your loved one’s rights as a resident. You can view these rights on the website below or by asking your loved one’s care facility for a copy of your state’s “Resident’s Bill of Rights.”

About the Author: Amber Paley is a guest blogger and article writer specializing in elder abuse prevention. Amber spends much of her professional life writing about abuse in nursing homes.

Photo credit: pedrosimoes7

Understanding Assisted Living Residency Agreements: Part Two

In the previous post, we defined what an assisted living residency agreement is and the key tenets of such an agreement. We also worked our way through several basic sections of a sample agreement and highlighted questions to ask and language to look for in each section.

Let’s continue walking through the sections of a sample residency agreement. For each section, we’ll provide some tips and advice on what to look for.

IX. Use of Unit
The purpose of this section is to clearly define how and for what the unit can be used. This section normally addresses issues like pets, parking, guests and storage of materials. The language in this section is usually specific, so make sure and ask questions about items you don’t see in the text.

Some common questions to ask:

  • Is parking included? If not, is there an additional fee?
  • Can your loved one have overnight guests? Are there restrictions to how many nights they can stay? Are there additional costs associated with it?
  • Are pets allowed? How many? Are there optional services available such as dog walking, grooming, etc? What are the additional fees associated with pets?
  • Can there be joint occupancy? This is particularly relevant if spouses want to live together in an assisted living community. How does this affect the cost? Is there a cost benefit to joint occupancy? How do the costs change if one resident leaves? For example, at my mother’s community, a resident’s wife spends the night several times a week, but maintains her own home down the street. How would a scenario such as this be treated under the agreement?
  • Are caregivers considered to be joint occupants? Are the fees or meal charges associated with live-in caregivers? At one local community, a monthly surcharge is assessed for caregivers, which is nearly $1,000.

XI. Termination
The termination section of the contract defines in what situations the contract may be terminated, what money is refunded after termination and what sections of the agreement continue after the end of the contract. Our sample agreement defines termination rules in a variety of scenarios, including: termination by the resident, termination by the community and termination in the event of closure.

Most communities will negotiate little on this section of the agreement, as it defines much of how their business is operated. You should still be aware the rules in each scenario so that you can plan accordingly. It never hurts to ask what can be changed negotiation, so give it a shot!

Some things to be aware of:

  • What are the resident’s termination rights? What notice is required? Thirty days is fair, but don’t let it be more than that, as you will lose your flexibility. Is there a shorter notice period in the case of death or health reasons, such as admission to a hospital or the requirement for extended skilled nursing care?
  • Ensure that you can terminate, with notice, without reason.

So what are the community’s termination rights?

  • Ensure the community can only terminate for cause rather than for any reason. Cause typically includes things like failure to pay rent, failure to meet residency requirements, intentional damage of the community, being a danger to other residents, etc.
  • In the event you are under threat of termination, attempt to negotiate a period of time to remedy the situation. Most contracts allow for thirty days to remedy contractual issues.
  • What is the appeal procedure if you feel you are being terminated or evicted unjustly?
  • The community may also terminate contracts in the event they lose their license or close. What happens in this case?

What happens when the contract is terminated?

  • How long does your loved one have to remove his or her belongings?
  • What should you expect in terms of refunds, e.g. security deposits, community fees or unused monthly fees? Depending on the amount of the community fee that was prepaid, you may be entitled to some type of refund.
  • Within how many days is the community required to issue these refunds?

Other Legal Stuff
Most contacts have several pages of standard legal language. Most of the time, these sections have no impact on the substance of your agreement. While much of this section is standard legal language, it does make sense to alert you to a few “gotchas” below:

  • Costs and attorney’s fees. If there is a provision that resident shall bear all costs and fees (including attorney’s fees) to enforce the agreement, try to remove that language. Attorney’s fees can become quite costly and these fees should be part of the community’s cost of doing business.
  • Insurance and liability. First, most communities will require the resident to maintain their own insurance to cover personal property. You’ll likely be unable to change this, but you should get insurance if it is not provided. Second, the community will likely try and disclaim all liability. You want to try and negotiate this such that the community is at least responsible where the community or its staff has acted intentionally, recklessly or with gross negligence.
  • Assigning or subletting. Most agreements will not allow you to sublet the unit to someone else. However, in the event the community does this, you may still be responsible financial. In other words, make sure you protect yourself in the event of subletting so you are not on the hook for damages, rent and other expenses. Read this section carefully.
  • Arbitration. Arbitration is a clause put into contracts so that disagreements are resolved by a third party and not in court. Arbitration can be conducted anywhere, and many companies would like to have arbitration close to their corporate offices. In the case of a residency agreement, you want to make sure the arbitration location is near your home. You don’t need to incur additional expenses should the need for arbitration arise.
  • Entire agreement. Make sure the residency agreement presented to you represents the entire agreement. You have a right to review all auxiliary materials referenced in the contract, including documents, handbooks or verbal representations.

Residency agreements are not very complex. In fact, they usually very clearly articulate what happens in what scenario and what fee will be assessed. Some key things to remember:

  • Ask questions
  • Negotiate
  • Walk away if you are not comfortable

Photo credit: Waponi

Understanding Assisted Living Residency Agreements: Part One

One of the most daunting tasks of a transition to assisted living is the signing of the residency agreement. Similar to a rental agreement or lease on an apartment, the residency agreement governs cost, services and termination options for your loved one’s stay in assisted living.

It always struck me as odd how little families pay attention to these agreements. We spend hours test driving cars or strolling through the mall, but oddly, very few people read these agreements in detail. And even fewer take them to an attorney for review.

What is a Residency Agreement?

If you Google search “assisted living residency agreement,” you will find many agreements from state or local agencies or assisted living communities. For the purposes of this blog, I’ll be walking through a standard residency agreement from a typical assisted living community. While many agreements may be smaller, this particular agreement is relatively thorough, easy to read and provides a great example for discussion. And with the consolidation occurring in the industry, it makes sense to start there.

Core Components of a Residency Agreement
A residency agreement has many specific sections, but they can be grouped for the sake of discussion into several topics. They are:

  • Accommodations and Term. This topic deals with the actual unit being rented and the duration of the residency agreement.
  • Fees, Core Services and Meals. This topic sets the fee schedule and identifies both included and extra costs. This topic also discusses the “what, when, where, how” of meal service.
  • Residency Qualifications. This topic discusses the qualifications required to be admitted to the community and maintain residency.
  • Maintenance and Use. This topic communicates the service levels regarding building and unit maintenance, and identifies how the rented unit is to be (and not be) used.
  • Termination, Legal Stuff and Arbitration. This topic sets how the agreement can be terminated and includes a lot of standard legal language. One important item discussed in this section it arbitration.

Always remember with contracts that many things are negotiable, so don’t hesitate to ask. This is especially true if the community has many vacancies.

Now we will look at each section of the sample agreement and provide tips, concerns, items to be aware and suggestions to negotiate. I recommend you have an attorney review any contract that is presented to you.

I. Living Accommodations
This section of the contract describes the unit and common areas to be leased by the resident. The language in this section is fairly self-explanatory. Some things to be aware of include:

  • Confirm the exact unit identified in the contract is the unit you’ve agreed to rent
  • Confirm that your loved one, his/her friends and your family have the right to use common areas. These are areas of the community that are freely available to residents, although some communities put restrictions on who other than residents can use them.

II. Term of Residency Agreement
This section of the contract defines the term of the agreement and what happens at termination. Several things are defined: the resident’s rights to ownership (there are none), the length of the agreement, and the “what do to” at termination and with personal property. Things to be aware of in this section include:

  • The length of the agreement should preferably be monthly. Be cautious of longer agreements, especially if you have no termination rights in the event your loved one is no longer able to live there.
  • No auto-renewal. In the event you agree to a term longer than monthly, ensure there is no auto-renewal clause. As you may imagine from its name, auto-renewal automatically renews the contract for a specified period of time, unless you notify in writing your desire not to renew. If the term is monthly, then auto-renewal doesn’t matter as much as you’ll only have 30 days exposure financially.
  • Limit obligations at vacancy. Whether it is due to health or death, inquire about your obligations in the event your loved one is no longer able to reside in the community. Some examples include: How long are you obligated to pay after your loved one has left? How long do you have to remove his or her belongings?
  • Reasonable notice. Ensure your loved one is provided reasonable notice before the community shows your unit to a potential resident. 24-48 hours is reasonable in most situations. Try to avoid anything that doesn’t require notice, as this can be stressful to your loved one.

These sections are fairly standard, but the above tips will help you ask the right questions and negotiate where you feel necessary.

VII. Residency Qualifications
This section is designed to protect both your loved one and the assisted living community. Why? Assisted living communities are only licensed and staffed to provide certain types of care. By defining the qualifications of residency, the community ensures they have the staff and resources to take care of your loved one. There are also requirements to protect other residents such as those requirements around contagions like tuberculosis.
Some things you should be aware of:

  • Review the minimum requirements carefully and make sure your loved one meets these requirements. It’s important to be honest with yourself, as you don’t want to be in a situation where you’ve violated the agreement within the first week.
  • Does the contract state what happens in the event your loved one ceases to meet these requirements? For example, will they be forced to move out and with what notice? Is there an appeal process to dispute whether your loved one meets the requirements? How does that process work?
  • Some communities may require the presentation of medical records or results from a recent medical exam. Make sure the contract ensures the results of the exam are kept confidential except as released by you or your loved one.
  • Some communities may require a pre-admission assessment in which a nurse and community executive conduct an interview and/or medical exam. Make sure to understand in advance the purpose of the exam and what will be covered.

Skilled Nursing Transfers
My mother came to assisted living from a skilled nursing community. In her case, the assisted living community did not conduct a pre-admission assessment. However, they did require medical records from the skilled nursing community and had a lengthy conversation with the head nurse.

In this case, you should follow up with both parties to ensure consistency of the results. The goal here is to avoid any inconsistencies during the admission process. While this part of the contract may in some cases appear intimidating, it is important to realize that it benefits both parties.

VIII. Maintenance, Repairs and Alterations
This section defines the rules to be followed regarding redecoration, alterations and basic housekeeping. It also defines to what extent the assisted living community will be responsible for maintenance and repairs, as well as the resident’s responsibility for damages.

I think most people will find this section to be reasonable and consistent with renting a house or apartment. However, you should read it closely to be sure there are no unreasonable requirements in the contract.
Some things to be aware of:

  • You and your loved one will likely want their unit to feel like home, and therefore may want to redecorate. While our sample agreement provides for things like paint and wallpaper, you should ask specifically if you intend to do something not mentioned. If the community agrees with your request, get it in writing during the contract negotiation. Similar, if you are already a resident, all redecorations should be pre-approved in writing before the project begins.
  • Similar to redecorating, should you wish to make structural or non- structural alterations to the unit, make sure you get written permission during the contract negotiation. Usually, the cost for non-structural alterations like fixtures, toilet items and shelving are the responsibility of the resident. If your loved one is handicap or disabled, the community should make reasonable efforts to accommodate their needs. In our sample agreement, this language is very vague. Make sure you articulate your loved one’s needs and get in writing the community’s intent to provide those alterations. You should also insist that these alterations are completed prior to your agreed up move-in date.
  • Most communities provide some housekeeping services and things like routine carpet cleaning. Some communities charge extra for additional housekeeping. If you intend to have an outside housekeeper visit your loved one’s unit, make sure this is allowed for in the agreement.
  • Damages are often ambiguous in many lease agreements and residency agreements are no different. Ask the community to define damages versus normal wear and tear and to give examples. Some questions to ask: Who conducts the repairs? Are costs based on actual material cost or does the resident pay for asso-ciated labor as well? How do residents resolve situations in which repair costs appear to be abnormally high? If the resident can repair the damage on their own, how much time do they have to complete the project?

Stay tuned for part two of this post next week, where we’ll continue to work our way through the sections of a sample residencey agreement.

Photo credit: Orin Zebest

A System for Selecting an Assisted Living Community

As you have likely learned through reading our blog posts and your own life experiences, the transition to assisted living is a stressful and emotionally charged period of your life. It’s also likely an incredibly scary and uneasy part of your loved one’s life.

In previous posts, we’ve shared information to help prepare you for this moment – the time when you and your loved one will select an assisted living community.

Visit our previous posts for resources on what to look for when researching and touring assisted living facilities. This information can help to convert a chaotic and often panic-filled situation into a calm, thoughtful and logical decision making process.

Now let’s discuss how to select the right assisted living community for your loved one:

Comparing the Finalists
By now you should have collected detailed information on several assisted living communities. You’ve had good and bad first impressions of communities, people, insurance companies and all the things that run hand-in-hand with this transition. For reasons both known and unknown to you, you’ve probably also excluded several communities.

When trying to find a community for my mom, my sister and I looked at many communities before ultimately making a decision. We struggled to find a technique that enabled us to make a decision that satisfied three criteria:

1. Compare all communities across the same attributes

2. Give some attributes more weight than others

3. Deliver an objective, measurable final selection

Why were we so formal? Because we knew that we had put every ounce of our souls into finding the best community we could. We didn’t want to ruin a decision by injecting too much bias into it..

Choosing Attributes

We decided on six attributes on which to make our community selection. They are:

  • Location: the geographic location of the community; proximity to family, friends and shopping; amenities of the community and size/ layout of the apartment.
  • Staff: experience of the executive team; friendliness of the dining room staff; staff treatment of residents and their observed interactions.
  • Activities: activities calendar; personality and demeanor of the activities director; amenities related to activities including transportation, game rooms and other entertainment.
  • Quality of care: the experience of the nursing staff; proximity to fire, hospital and emergency services; rehabilitation rooms and quality of the therapists.
  • Cost: total monthly cost of community at the level of care required for my mother.
  • Gut feeling: you have instincts for a reason. Use them.

Over the last several years, I’ve shared this list with many people and validated that it addressed the vast majority of families. Now that you have a group of attributes against which you can measure your finalists, let’s add a measure of importance to each one.

Weighing Attributes
Different things are important to different people, and you’ll likely have strong feelings about the relative important of one attribute over another. This is called weighting.

Weights are applied by giving each attribute a percentage from 0-100%. Those attributes you deem most important receive the highest percentage weight. The total of all attributes must equal 100%.
It’s important that you apply weights to the attributes before you begin ranking your community finalists. This will enable you to minimize unnecessary bias before the score process.

Ranking Final Communities
Now that you have removed the unnecessary bias from your decision, you can score each community against the others. The score will occur for each attribute above. You will likely find communities will be a leader in some attributes and a follower in others. This is normal.

Armed with this system, you will be able to sift through all of the information you’ve gathered and decide on a community that will meet your loved one’s and your family’s needs.

Photo credit: winnifredxoxo