Tips for Finding Assisted Living Communities

October 17, 2011 By 6 Comments

Recall that assisted living communities offer your loved one a place to live where they can receive basic assistance, while retaining a measure of their privacy and independence. This assistance could be housekeeping, meal preparation, 24-7 monitoring, shower assistance, toileting, medication assistance or reminders; transportation and help with eating, or dressing. The amenities of assisted living should also include interesting and engaging activities, as well as opportunities for social activity.

Assisted living communities vary in size. In a small assisted living community, you will have 16 or fewer apartments/rooms (much like a residential home). In a large community, you will have over 17 apartments/rooms and up to over 100 apartments/rooms.

You can locate local assisted living communities through a number of means. I’ve found both the Medicare tool and several public web sites will cast a wide net for you to start your search

Medicare’s Long-Term Care Planning Tool

The Internet is playing a growing role in caregiving and healthcare. One such tool worth mentioning here is Medicare’s Long-Term Care Planning Tool. The stated goals of Medicare’s Long-Term Care Planning tool are to help you understand:

  • What long-term care services are available
  • How much you can expect to pay for long-term care
  • What financing options are available to support your long-term care costs

This tool will ask between twelve and twenty questions and will then provide you with the long-term care results you need by comparing your answers to those of individuals with similar profiles.

For those that want a quick snapshot of communities, the tool only requires a few questions. However, if you have specific care needs, financial constraints or care needs, the tool enables you to indicate those requirements.

While the results of this online tool are general in nature, and certainly not intended to replace comprehensive financial and other long-term personal planning, they will give you important insights.

An initial recommendation can be provided from only a few basic questions. By answering optional questions, the user can further narrow the list of recommendations. Here’s a tip: be sure to check out the Resources tab while you’re on the site. There’s a wealth of links to various government programs and agencies

Other Ways to Search

In addition to the Medicare online tool just mentioned, I’ve got some tips to get you started on choosing the right assisted living community for your loved one. First, you’ll want to know all of the options in the area in which you are interested. To get a full list of the communities near you, you can:

  • Visit or call your local senior center
  • Use Google to find the listings for assisted living in your area or zip code
  • Get a list from a local hospital or skilled nursing community
  • Or Go “old-school” and look in the Yellow Pages

Assisted living communities aren’t always easy to find, and many are nestled in between neighborhoods. While there are many sites on the Internet that list assisted living options on a regional basis, such as the ones listed above, the three that I found most useful are noted below. They’re good places to take a broad view of what’s available. Write down the ones closest to you. As you work your way through the process,  you’ll want to narrow this down to a short-list to choose from.

My favorites:

Snap For Seniors
Snap for Senior is a great resource for senior care communities and has the largest database of senior resources in the country.  I’ve met the co-founders Derek Preston and Eve Stern and they are fantastic people with a high-degree of integrity.  I would start my search there.

Senior Housing Net
Senior Housing Net is a fee community located from Move.com. Through this site, you can find local assisted living communities as well as prepared for your loved one’s move.

ElderCarelink
ElderCarelink is an internet-based referral service–free to consumers–that specializes in eldercare case matching for elders and their families. ElderCarelink assists families in finding a multitude of services, including assisted living, nursing homes, adult day care, private duty nursing, care management and homecare.

Stay tuned for part two of this blog post next week with more tips and suggestions on finding assisted living communities.

Photo Credit: maureen lunn

Filed Under: Assisted Living Tagged With: , ,

Long-term Care And Financial Considerations

October 13, 2011 By 6 Comments

As you’ve seen, long-term care is expensive. Even a temporary stay in an assisted living facility can derail years of careful financial planning. Although costs may vary significantly depending upon where you live, a family’s assets can be quickly depleted.

According to the U.S. Department of Health and Human Services, one year of care in a nursing home (based on the 2006 national average) will cost over $62,000 for a semi-private room. One year of care at home, assuming someone needs periodic personal care help from a home health aide (the average is about three times a week), could cost almost $16,000 a year. I’ve seen folks spend close to $100,000 per year on 24-hour in-home care.

When my father died in 1989, my mom invested what he left her and did well. She thought she had planned for everything, including adjusting her expenses to be comfortable for many years. The one thing she didn’t plan for was an illness that required long-term care, where all expenses are paid privately. While she was fortunate that my father planned for her, the growing expenses continue to be a growing burden. Each year, the financial-related stress increases.

I’ve spoken to many people in similar situations. Those who don’t have the financial ability to pay for their assisted living solution, through asset allocation or long-term care insurance may find themselves forced to depend on their family to pay their bills – and that can be devastating.

It is imperative that you assess where the money can be found to implement any forthcoming decision regarding a specific assisted living location and I urge you to do so early on in the process.

What are the costs of long-term care?

And costs for long-term residential care services vary greatly depending on the type and amount of care, the provider, and in which state your loved one resides.

It is a surprise to some that ordinary health insurance policies and Medicare usually do not pay for long-term care expenses. I repeat: ordinary health insurance policies and Medicare do not pay for long-term care expenses.

Medicare pays only about 2% of all nursing facility costs, and nothing at all for residential care. Medicaid, a federal/ state health insurance program, will only pay for long-term care if the person has already spent most of their savings or other assets, and Medicaid pays nothing at all for assisted living or residential care facilities.

The average stay in a long-term care facility, according to the government findings, is about three years.

Private Long-Term Care Insurance

According to the U.S. Department of Health and Human Services (2007), at least 60 percent of people over age 65 will require some long-term care services at some point in their lives. The Department estimates that about 12 million Americans over the age of 65 will need long-term care services by the year 2020. This same study found a person may need long-term care services at any age: Forty percent of people currently receiving long-term care are adults 18 to 64 years old.

At costs ranging from $60-100,000 a year, you can easily see why Long Term Care insurance is of interest to many Americans – but as you age, it can become prohibitively expensive. According to Dianne Duva, Certified Financial Planner and Senior Financial Advisor for the JWS Group, Merrill Lynch, there’s a ‘sweet spot’ for purchasing this coverage: that optimal age where you’re not so old that such coverage is prohibitively expensive, and not so young that you’re paying needlessly for insurance you won’t use for many years.

Policy Parameters

Benefit Amounts: Policy benefits may be paid on a daily, weekly, monthly, annual or other basis. For example, a policyholder may receive $100 per day to cover their nursing home costs or $350 per week for home health care. It is important to know the average cost for nursing home care in the area before selecting a benefit amount for your loved one’s policy.

The Elimination Period: Most policies include an elimination period of 20, 30, 60, 90 or 100 days. This means that a policyholder will not receive benefits until after the elimination period has passed. Policies with longer elimination periods cost less than policies with shorter elimination periods.

The Benefit Period: This is the length of time that benefits will be received from the policy. Benefit periods can range from one year to life.

Lifetime Maximum Benefits: Most plans have a total maximum benefit paid over the length of the policy’s duration.

Inflation Protection Rider: Without inflation protection, policy benefits may be much lower than what is actually needed down the road to maintain your loved one’s standard of living.

Naturally, your loved one may not have had the opportunity to purchase such a policy. After all, we’re talking about “at-need” situations, not “pre-need.” If your loved one needs assisted living right now; paying for it has become a major issue in the present.

What’s next?

It’s time to look closely at your loved one’s assets and income. When families get together to talk about money, emotions can run rather high; it may prove useful to bring in the family attorney, accountant, or other objective third party to assist you.

You’ll quickly discover (unless your loved one has been extremely attentive to these details) that the financial and ownership records you’ll need are to be found in different places: safety deposit boxes, checking or savings accounts in different banks, stock portfolios held by different brokers; pension records, mortgage documents, deeds of trust. It’s time to get them all organized and accounted for.

Photo Credit: Images_of_Money

Filed Under: Legal & Financial Tagged With: , ,

People Rise to the Challenge

October 4, 2011 By 6 Comments

I want to share a story that serves as an important lesson that many of us already know, but we’d likely forget under the stress of caring for a loved one. The story starts with a single sentence that forever changed my mom’s life: “People rise to the challenge.”

This isn’t my quote. To be fair, I heard these words for the first time after visiting many, many skilled nursing facilities. The source of the quote was a woman by the name of Andrea Arambula, and she was the admissions director at Belmont Village (formerly Crown Cove). It is to Andrea that I owe an enormous debt of gratitude. Andrea, if you are reading this, thank you!!!

Rewind back to December 2005. My mom had been in skilled nursing for more than five months. As dicussed in the previous blog post, skilled nursing is a mix between a hospital and an apartment. Patients usually share a room, and nearly all require treatments from a registered nurse. While my mom was there, one of her roommates passed away and several others were taken to the hospital. They did not return. While some are in skilled nursing for a short stay, many have declined to the point where it is required.

After driving 120 miles round trip, 4-5 times a week, usually after a full day at work, I decided to move my mom closer to me. I asked the head nurse for a care recommendation. She recommended skilled nursing.

She went so far as to tell me that my mom would likely be permanently bedridden, and that I should explore hospice. At the time, I was 34 years old and knew no better than to take her advice at face value. I started looking for skilled nursing facilities closer to my home in Orange County.

By chance, I called one assisted living facility and a woman answered the phone. It was Andrea.
She convinced me that my mom had no medical necessity for skilled nursing. Sure, she had problems walking, but that was a physical therapy issue. She told me something repeatedly, and I’ll always remember the words. People rise to the challenge. You just have to let them.

So I reviewed my mom’s medical records with her doctor, the assisted living community, the physical therapist and Andrea. It was a go! My mom was going to need a lot of help, but I was convinced that she would rise to the challenge.

I’ll always remember the ride there. Since my mom needed to be lifted (yes, lifted) into a wheelchair, driving my car was not an option. So I rented a shuttle, and my mom and I rode a little over an hour in the back of a wheelchair- accessible Super Shuttle (yes, the ones you take to the airport).

She was scared. I was scared. But in my heart I knew she could do it. When she first entered assisted living, she couldn’t walk. In fact, she couldn’t roll herself out of bed. She needed two people to literally pick her up and put her in a chair.

Within a year, she could walk the hallways with a walker, walk to dinner, come over to my house for BBQs, get in and out of a car, and resume some normalcy in her life. In fact, she even got featured in her physical therapist’s brochure. I guess she’s a testimonial for hard work and good physical therapy.

Each time my mother passed a new milestone, I thought of the skilled nursing recommendation and urging to explore hospice. And each time I smiled about the progress my mom made.

Why the long story? The details of the story are important. It’s human nature to fight, struggle and be determined. And regardless of your age, most people respond to the challenges they face. In the case of my mom, it was walking. In the case of your loved one, it may be something else.

So while I learned from Andrea that people rise to the occasion. I learned from mom that you have to let them.

So trust in your loved one. Trust in yourself. And I know you’ll find that you can both rise to the occasion. Perhaps – and most likely — there will be tears along the way, but there will be many wonderful moments of warmth and laughter, too.

Photo Credit: Vick the Viking

Filed Under: Caregiving Tagged With: , , ,

A Guide to Different Levels of Elder Care

September 26, 2011 By 5 Comments

Before you can even begin the process of evaluating assisted living, it’s im- portant to familiarize yourself with all the terms. There are many types of care ranging from skilled nursing to senior living. They all vary based on the level of assistance required by the resident. What is the difference? Let’s find out.

Senior Communities

Senior housing is designed for high-functioning elders, defined as those not requiring assistance with ADLs. Senior communities are usually neighborhoods or towns (consider Sun City, the nation’s “first and finest” senior community) that are limited to people of a minimum age. They are designed for active seniors and have a variety of social clubs such as golf, arts and crafts and cards.

While some senior communities offer additional levels of care, many are not equipped for individuals who require assistance with ADLs. Some senior communities require the resident move on, should they require this level of care.

Continuing Care

Continuing care communities are sometimes called “step care” or “progressive” care facilities. They offer a wide range of options, all the way from independent living to special care. Residents are usually admitted when they live independently. As their needs increase, they are guaranteed vacancies in the lower level of care. An entry fee is often required, making this option quite expensive.

Assisted Living

Assisted living offers the elderly a place to live outside of their own home, where they can receive basic assistance in one or more of the following areas: housekeeping, meal preparation, 24-7 monitoring, shower assistance, toileting, medication assistance or reminders, transportation, eating, dressing, activities or socialization.

In assisted living, your loved one will likely have their own apartment, unless you or your loved one consents to sharing a room with someone. A private bathroom is most often in the apartment to allow for privacy and dignity. Most facilities will have a kitchenette in the apartment with a sink, microwave, refrigerator, and cupboard space. Each apartment will likely be climate controlled individually. There will be access to common areas such as a TV room, an activity room, dining room, library, and communal sitting areas.

Assisted living facilities are designed for people who need help with complex ADLs on a daily basis. If you remember from the previous chapters, basic ADLs include eating, bathing, dressing and hygiene. More complex ADLs include cooking, shopping and money management. Assisted living aims to be the mid- point between independent living and long-term care.

Most assisted living facilities have a dining room decorated like a restaurant as well as a variety of activities. Most assisted living facilities are not licensed to administer IVs, requiring patients who need IVs to temporarily relocate to a skilled nursing facility.

Board and Care

Board and care is similar to assisted living in terms of care, although some group homes work with lower functionality seniors than those found in assisted living. A woman I spoke with recently had placed her mother, suffering from Alzheimer’s disease, in a board and care facility, sometimes known as a ‘group home.’ This is usually a single-family dwelling which has been converted into a residence for elderly and disabled residents. The monthly rent paid commonly includes room, three meals a day, laundry services, and some transportation – in addition to a 24-hour staff person. While basic medical care can be attended to, residents who have serious medical conditions will be expected to move into a more suitable facility.

Skilled Nursing

Skilled nursing (also called SNF or “sniff”) is the first level of care that is licensed to administer medical treatment with nurses. In fact, there are strict regulations that require nurses to be on duty and to regulation the nurse-patient ration.

As the name denotes, such a facility offers extensive nursing services for the residents. Admission must be initiated by a person’s physician, who recommends that a patient enter either ‘rehab care’ or a ‘special care’ facility.

  • Rehab care. Located in hospitals or nursing homes, rehab care programs are sometimes called “Level 1” or transitional care. They provide intensive medical care for patients who are expected to regain functional capacity and return home in a relatively short time.
  • Special care. There are two types of special care facilities: those involved with unique medical issues (sometimes called “Level 2” care), and those which manage behavioral problems that may arise from dementia.

Many patients are admitted to skilled nursing to address an acute condition such as rehabilitating a broken hip, or treating an infection with IV antibiotics.

Many skilled nursing facilities have a portion of their residents who are long- term care patients. These are patients who require the treatment capabilities of a SNF, yet their condition requires that level of care permanently. Long-term care includes nursing supervision, but it is custodial in nature – focused on maintenance as opposed to curative care. Here the condition is not expected to improve, and the nursing activities are focused on keeping the person healthy and safe. The table below summarizes the differences between the levels of care and residential options.

This table is an updated, compiled version of those found in both offline and online sources, many of them listed in the resources section, the Book Club listings or 2008 Long-Term Care Cost Study, The Prudential Insurance Company of America, 751 Broad Street, Newark, NJ 07102-3777.

Photo Credit: gilbert928.

Filed Under: Assisted Living, Skilled Nursing Tagged With: , , ,

3 More Signs of Functional Decline

September 5, 2011 By 3 Comments

elder careIn the last blog, I discussed some of the warning signs that your loved one could be experiencing functional decline, including difficulty communicating and the disturbance of everyday functions and tasks. These kinds of hardships may be symptoms of a more serious functional decline, in which your loved one is losing the skills needed to maintain basic independence.

In the previous blog, I gave a detailed account of physical, perceptual and cognitive changes that can indicate a functional decline. Now here are three more areas to monitor if you believe your loved one may be experiencing functional decline.

1. Hearing and Vision Loss

Hearing loss is hard to hide; it’s often one of the first indications your loved one is in need of assistance. Here’s a list of things to note:

  • Saying “What?” over and over again during conversations, or repeating what you just said, as if to confirm what they heard.
  • Turning the volume up on the television repeatedly, until the neighbors may be able to hear it – while your loved one still complains it’s ‘too low.’
  • An inability to distinguish certain sounds, such as f, t, and z, resulting in misunderstandings and miscommunication.
  • Nodding frequently during conversations, as if to confirm that they are participating fully in the dialogue.

And then there is eyesight – often the first of the senses to be noticeably affected by age. Focusing on small details becomes difficult; self-grooming becomes challenging – and who can write out the checks to pay bills when you can’t see the numbers?
As with hearing loss, compromised vision is also a safety issue. What are some of the signs of decreased visual acumen? Just ask yourself these questions:

  • Has your loved one lost interest in reading, playing cards, or other hobbies where clear vision is required (embroidery or television viewing, for example)?
  • Are their clothes, shoes or socks frequently mismatched?
  • If they still drive a car, are they getting lost more often (because they can’t see the street signs)?
  • Has your loved one started to fall, trip or bump into things more frequently?

Once again, a primary concern here is one of safety. How safe can your loved one be, if they can’t clearly hear or see the world around them? And if they’re driving, it can be catastrophic.

3. Frequent Falling

Certainly, frequent falling may not be related simply to poor eyesight; it could be the result of medical conditions related to poor physical health. Or repeated falling in the home environment could be the result of poor safety habits: loose throw rugs, a cluttered living space, exposed wiring, no handrails or poor lighting. There are also those elderly who refuse to use their assistive devices such as canes, walkers and wheelchairs – even refusing to wear their eyeglasses!

Whatever the causes, the consequences are serious – and should be addressed by your family or geriatric physician. Here are some things to watch out for:

  • Unexplained cuts and bruises, or explanations for these injuries that seem far-fetched or implausible.
  • Hesitancy when walking or climbing stairs.
  • Reticence to leave the familiarity and relative safety of their home.

4.  Psychological Changes

May Lamberton Becker – the journalist and literary critic once said, “We grow neither better nor worse as we get old, but more like ourselves.” What she’s describing is the process called disinhibition, where those personality traits that may have once been charming or quirky slowly become exaggerated as we age. Aunt Rosemary used to be rather bossy, but now she’s dictatorial; your father, who used to simply be self-reliant, is now completely resistive and argumentative.

It seems that the natural process of disinhibition is magnified when aging is coupled with fear and unhappiness. If it is complicated even further by depression or anxiety, your loved one will completely cling to those coping strategies that served them so well in their younger days – to the point they completely interfere with an independent life.

So, whatever you do, don’t delay in taking action. Start actively assessing all six areas of your loved one’s strengths and abilities as soon as possible. If there are signs of a serious functional decline, then you may want to consider a transition to assisted living.

Photo Credit: Flickr user One From RM.

Filed Under: Assisted Living Tagged With: , , ,

3 Common Signs of Functional Decline

August 29, 2011 By 4 Comments

Everyone changes physically and mentally with age, but there are some changes that can really put a loved one’s safety at risk.  If you think that a loved one may require a transition to assisted living or elderly care, then you must first assess whether they are undergoing a true functional decline.

Functional decline is sometimes difficult to diagnose as individual symptoms often go unnoticed. Below is a list of symptoms of functional decline to be familiar with.

  • Misusing medication (over or under use and deviating from a schedule)
  • Reports of inexplicable behavior from friends, neighbors or family members
  • Poor personal hygiene
  • Unpaid bills
  • Changes in spending patterns
  • inappropriate clothing
  • Stains on clothing or upholstery from urine or feces
  • Forgetting how to use simple tools
  • Poorly cared-for pets
  • Repetitive questioning
  • Difficulty in communicating
  • Confusion
  • Unfinished tasks and chores
  • Spoiled or poorly-prepared food

Studies have documented that functional decline, i.e., the loss of either complex or basic ADL functions is due to changes in one or more of six areas: physical, perceptual, cognitive, visual and hearing, falling and psychological.  Below I will describe the first three areas in more detail and I will discuss the latter three areas in the next blog post.

1. Physical Changes

It’s obvious to anyone: as the human body ages it loses physical strength, stamina, muscle coordination, and balance. Those of us who had aging grandparents or aunts and uncles saw firsthand how the natural aging process affected their abilities to perform commonplace tasks.

2. Perceptual Changes

Here we’re considering all the senses: vision, hearing, sensitivity to touch, taste – even smell. After all, each is important to overall well-being. If you can’t smell smoke, you may lose your life to a house fire; if your sense of touch is diminished by poor circulation, you may be burned by scalding water.

Many medications are responsible for changes in taste perception. When this happens, it’s easier to eat spoiled food, or even choose not to eat at all, as food no longer tastes like it used to. I have noticed that after older people are less able to use the telephone with ease. Warning alarms and buzzers may go unnoticed.

3.  Cognitive Changes

While our thinking may remain clear, the speed at which a human can process information slows considerably as we age. It’s not just the speed at which we perform tasks. It’s also our ability to multitask. Our ability to divide our attention fades as we age.

Those changes are within the range of normal and expected changes; but what of the complications of dementia and Alzheimer’s disease? With dementia and Alzheimer’s loss of memory, language processing skills and inability to solve problems greatly affects your loved one’s level of independence.

Look for these warning signs:

  • Disorientation, fright or confusion when faced with a change of location, such as a doctor’s visit, visiting friends or family, or eating out at a local restaurant.
  • Giving incorrect or evasive answers when asked simple questions. For example, “What day is it?” gets the response, “What, don’t you know?”
  • Aggressive behavior or noticeable personality changes.
  • An inability to concentrate on television programs, tasks or conversations.
  • A gradual (or sudden) loss of memory.
  • Disinterest in routine tasks, such as cooking or housekeeping.
  • A decline in social skills, such as successfully engaging in conversation, or eating a meal with the correct utensil.
  • A decline in judgment skills, or inability to recognize consequences. This could manifest itself in leaving the water running, not shutting off the stove, or leaving the front door unlocked.

There are three more areas to monitor in order to determine whether a loved one is experiencing a real functional decline: hearing and vision loss, frequent falling and negative psychological changes. In the next blog post we’ll discuss symptoms within these three areas and how these problems can lead to a functional decline and loss of independence in aging individuals.

Photo Credit: Flickr user e-MagineArt.com.

Filed Under: Alzheimer's, Assisted Living Tagged With: , , , ,

Is it Time for Assisted Living?

August 22, 2011 By 4 Comments

elder careYou’ve come to this blog for a reason. More than likely, you’ve seen changes in your loved one that have you concerned. They are likely changes that worry you, but have not fully convinced you that your loved one may need additional care. Whether a spouse, or a parent – even an aging sibling, this person has come to an impasse in life’s journey. And it’s at that impasse that you wish to help them overcome.

The first step is getting clarity about what’s going on today, and to temper that clarity with loving compassion and an understanding of what the future may hold. This assessment process can be emotionally challenging. It’s something I’ve learned firsthand.

Take a deep breath, and let’s move on to step one: the assessment of your loved one’s current capabilities and needs.

How is Your Loved One Feeling Today?

Regardless of our age, our bodies are in a continuous state of decline. Whether it is reading glasses, arthritis or a doctor’s warning about your lifestyle, our bodies emit warnings about its decline.

It’s no different with our loved ones, except that while it can be an inconvenience for us, it is a matter of independence for them. Since you are concerned about your loved one, you’ll want to do an assessment.

An assessment looks at four areas where change may have taken a toll on your loved one’s independence: the physical, perceptual, cognitive and psychological manifestations of aging. We’re going to explore those areas with one overriding premise: ensuring their safety, and the safety of those around them.

Physical changes and loss of abilities (to some degree) are natural in the aging process. Your loved one is not the same as they were 10 years ago, or even 5 years ago – any more than you are the same as you were then. With that said, the essential key in the assessment process is to recognize symptoms and actions which fall outside the range of expected and acceptable changes. What defines “acceptable changes”? I would say they are those changes that don’t significantly interfere with the way they’ve lived their daily life.

Many changes are subtle and inconsistent; and many don’t put their lives, or the lives of others, at risk. Truly then, the focus should be on risk management. Continually ask yourself this question: Is my loved one a risk to themselves or others?

The criterion most often used by doctors, social workers, and geriatric care managers is a list of activities of daily living, or ADLs. These are those most common activities, divided into two categories: basic and complex.

The early warning signs are often losses in the realm of complex skills. Usually (but not always) loss of basic ADLs comes later on in the decline in the quality of your loved one’s life. As every person is an individual, so is his or her aging; assessment can only be done on a case-by-case basis.

Basic Skills

  • Ability to feed oneself
  • Ability to use the bathroom appropriately
  • Ability to maintain good personal hygiene
  • Ability to dress appropriately for the season

Complex Skills

  • Cooking
  • Shopping
  • Effective communication
  • Following directions
  • Taking medications appropriately
  • Money management

This list of activities appears rather brief; however you can see that each element listed, whether ‘basic’ or ‘complex’ is essential. Everyone should be able to use the bathroom appropriately, or follow directions.

If your loved one is having difficulties with one or more of these tasks, then they are in a state of functional decline and you should more thoroughly asses the state of their decline and possible solutions. In my next post I will discuss common signs of functional decline in greater detail.

Photo Credit: Flickr user Titoy.

Filed Under: Assisted Living Tagged With: , , ,

My Experience with Elder Care and Assisted Living

August 15, 2011 By 12 Comments
elder careEighty-four percent of Americans over the age of 50 expect an immediate family member to move into a senior living community within the next 10 years, while 24 percent over the age of 65 expect the same for themselves, according to a new national survey of American attitudes on assisted living released today by the Coalition to Protect Choice in Senior Living (CPCSL). The poll found just more than half (51 percent) expect their parents to live in a senior living community within 10 years, with 15 percent expecting the same for their spouse and 10 percent for a sibling.

My Story

I’d like to briefly share the story of the event that started me on this path. I imagine it’s similar to your own in that it begins with an unexpected phone call.

My wife and I had just returned from celebrating our engagement in Greece, and we were sharing stories over bowling with some good friends.

I was the product of a second marriage, and my mom and I had become quite close since my father’s passing while I was in high school. We spoke often, so I wasn’t surprised when my cell phone rang and the caller ID showed it was her.
I was surprised when I answered and it was the paramedics.

Apparently, my mother called 411 asking for my name and phone number as she could not remember it. The operator called 911, and in a matter of minutes, they had arrived, kicked down the door and called me.

My mother had a stroke. I was only 33, and totally unprepared for the depth of emotions, or the complexity of the decisions I was about to face.

That a 73-year old woman had a stroke is not unusual. My mom’s case was unique because of the series of complications that nearly killed her. In the eighteen months following her stroke, she endured major back surgery to remove a staph infection from her spine, a perforated intestine that required stomach surgery, several MRSA infections1 requiring IV antibiotics and a broken hip. She spent several weeks in the surgical intensive care unit recovering from her back surgery. Many of these nights, I feared the worst. But my mom is a fighter.

The medical system these days isn’t designed for long-term recovery. Hospital personnel are highly trained at treating acute problems and dealing with specific injuries and conditions. In fact, we have some of the most skilled doctors in the world.

But when you’re older and recovering from a serious illness, your options are usually to go home, or go to a skilled nursing facility – where staff can provide physical or occupational therapy, administer IVs and perform other functions requiring a registered nurse.

During this time, she spent nearly six months moving back and forth between the hospital and skilled nursing. In January of 2006, I moved Mom from San Diego to Orange County. She graduated from skilled nursing and was on her way to assisted living.

Trust, Hope and Hard Work

When Mom arrived in assisted living, she could not stand or walk and required a 24-hour caregiver. She could not eat or drink on her own and was in a deep state of depression.

While I found much advice on medical conditions and treatment, I found virtually nothing on understanding assisted living. Sure, there were some Websites that taught you the basics, like “make sure a nurse is on duty” or “make sure the kitchen is clean.” But this is my mom and I wanted far better for her. I wasn’t putting her away; I was playing a key role in her recovery.

Because of the lessons I learned – and a lot of hard work on the part of my mother – she is doing very well. In fact, we’ve become very close friends. She walks with a walker; her memories are clear and vibrant. She has a circle of friends and a packed calendar.

She even made it to my wedding. And she looked beautiful. I cried. They say your wedding toast is one of the most important speaking opportunities you’ll ever have. And I consider myself to be a good public speaker, routinely speaking at tradeshows and other events. But when I looked into the crowd and saw my mother smiling, I fell apart.

The joy I felt at seeing her on that special day was overwhelming. So was my commitment to her continued well being. It was my clear intention that she be given every opportunity in her assisted living situation to thrive, to grow, and to be fulfilled.

Recall the statistics at the beginning of the chapter. While I was shocked these numbers were so high, I completely agree. I did some homework. In an informal study of about 40 people, I sensed an almost inevitability about needing assisted living. I also found that financial issues and quality of care topped the list of concerns for both Baby Boomers and their children.

I followed up my informal study with a formal study of nearly 200 families. The Assisted Living Family Attitude and Preparedness Report showed that 75% of respondents believed a friend or family member would soon require assisted living. The report is free to anyone who wants to read it and can be accessed at the link above.

My goal is to share with you some of what I learned through my journey. My hope is that these lessons can make it easier for you and your mom, dad, relative or loved one. I assume you’re reading this blog because you or a loved is considering assisted living. Since you likely haven’t gone through it before, the decisions can be overwhelming. I’ve written this blog to help you make more informed decisions, and to be calm in what is likely to be an emotional storm. I sincerely hope I can help you avoid some of the pitfalls of learning the assisted living ropes.

While a move to assisted living may initially be seen as negative, I know first- hand that with some careful and thoughtful planning, you can make it a huge positive for all concerned. Over the last several years, my relationship with my mother has strengthened. She has become one of my best friends and an integral part of my life.

I hope you enjoy reading this blog and that I’m able to somehow make your journey a bit easier.

Photo Credit: andrewmalone.

Filed Under: Assisted Living, Caregiving, Family Life Tagged With: , , , , ,

Elias Papasavvas Describes the Unique Benefits of a Senior Line of Credit (Podcast)

June 12, 2011 By Leave a Comment

Podcast: Play in new window | Download

How Elias Papasavvas Describes Elder Life Financial

I believe that deep down just about every one of us is willing to give back to our parents. They were there holding our hands when we were young and vulnerable and now, when asked to hold theirs, I believe we do so, and gladly. It may not be simple, it may not be easy, but it is so.  I remember the happiness which would envelop me as a young boy whenever I kicked the ball with my dad, or enjoyed my mom’s cooking after playing all day, and having her rub my head saying I was a good kid that day. It’s the simple memories that over time, transcribe a fascinating family story.

I founded Elderlife Financial Services in the year 2000 with the spirit of helping families give back to their parents.  The banking industry at large neither understands the depth of complex family dynamics involved in caring for a loved one, nor does it know how to expediently and wholly service the family members involved in what is frequently a family decision – what to do for mom or dad.  And frequently associated with that family decision, is the issue of how to pay for things.  While there are numerous professional advisors serving useful and much needed roles, there were few consumer financing options available to help a family pay for senior living and designed to respond to the family as a unit throughout the entire care-giving journey.

Thus was born Elderlife Financial Services, and the Elderlife Line of Credit for Senior Living. Elderlife’s mission is to help families honor their parents.  We do so by helping seniors and their families access the senior living of their choice through simple, convenient financial options we create with thought and care. Frequently the Elderlife Line of Credit is used as an immediate funding bridge to help a loved one move into a private pay assisted living community until a home is sold, veterans benefits arrive, or if a family simply wants breathing room and time to make the move now. Elderlife enables families the breathing room to take their time before making financial decisions that could have long-term implications.

Often, the product is not what makes Elderlife unique (i.e., a line of credit is a line of credit and thousands of banks offer one).  Rather, it is the way with which Elderlife serves multiple family members, the speed with which it responds to the family’s need, the counseling and empathy it understands to lend in the process, the collaboration with senior care advisors and financial planners during a loved one’s move to senior living, and the “little things” that are helpful as a family is in the midst of a thousand other worries on behalf of a loved one.  This is but an inkling of what we do for families.

Today, the Elderlife Line of Credit is accepted in 2,500 senior living communities across the nation and Elderlife is the national leader in helping families finance their loved ones assisted living costs. And yet, I wake up every day rushing to work, knowing there is still so much more for us to do in our quest to help families honor their parents.

About Elias Papasavvas

Elias is the founder and chief executive officer of Elderlife Financial Services LLC.  Elias has focused his career on enhancing access to senior living.  He spent over a decade studying the impact and proper administration of consumer financing in higher education and numerous other service- and product-oriented industries prior to creating a consumer financing program for senior living. Today, Elderlife is accepted in over 2,500 senior living communities nationwide.  Elderlife’s uniqueness lies in its understanding of the various, and at times competing, needs of the senior housing provider and the family.

Before entering the senior living industry, Elias was a CPA in the Banking and Real Estate Mid-Atlantic Division of Arthur Andersen. He holds a B.S. degree from George Mason University and a Master’s of Science in Accounting from the McIntire School of Commerce at the University of Virginia. Elias also serves on the Board of Directors of the Virginia Assisted Living Association and on the Advisory Board of the George Mason University Assisted Living program.  Elias is a frequent speaker at aging and senior living conferences on the need for affordable access to senior living and is viewed as a respected authority on the field of consumer financing for senior living.

Filed Under: Podcasts Tagged With: , , ,
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