Wisdom Wednesday: Aging Wisdom's Podcast

Making sense of all the senior housing and long-term care options can be overwhelming. But you don’t have to make the decision alone.

There are several different avenues you can go for guidance.

Most senior centers have a social worker on site that can be a great resource.

Your local Area Agency on Aging is another resource. Here in greater Seattle, you can start by contacting Community Living Connections as the portal through which you can access objective, confidential information about community resources and services options. 

You can also use the Eldercare Locator, a public service of the Administration for Community Living to connect you to services for older adults and their families. 

And then there are Aging Life Care Professionals like our Care Managers at Aging Wisdom. These professionals can help families navigate all these complicated choices and coach them along the way. A Care Manager is also adept at helping tailor choices depending on care needs, finances, how to make aging in place safe and supportive, or determining when a move is the best option.

Aging Life Care Managers help you not be alone during a stressful time and provide expert guidance and navigation, especially at those times of uncertainty.

Additional Resources

·      When to hire an Aging Life Care Manager

·      What is Ongoing Care Management?

·      Supporting Families in Times of Crisis

·      Dementia Caregiving is a Marathon, Not a Sprint

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Adult Family Homes (AFHs) are located in neighborhoods, usually licensed for six residents. They are common in Washington State, though not an option in every state.  They provide room, board, laundry, necessary supervision, and necessary help with activities of daily living, personal care, and social services. 

The adult family home model has created a residence for individuals to get a high-level of care, but in a comfortable, home-like setting. AFH are especially wonderful for residents who would benefit from more one-on-one support and a calmer environment.

There are a lot of adult family homes in our area (greater Seattle-Bellevue). We like this model when someone needs a lot of care related to physical changes (such as prone to falls) and medical challenges and especially care for people who are in the more advanced stages of dementia. 

As Care Managers, we start talking to families about adult family homes if the person in their care has been in assisted living and makes the transition to memory care. It may be going well for a while, then something changes, and suddenly, it doesn't feel right. 

What we typically see is someone at a stage in their dementia where they're feeling overly stimulated by their environment. There's too much going on. They're having a harder time benefiting from the activities that are provided. There's a lot of coming and going and that's too much for them to process. They need a smaller, calmer environment. This is where adult family homes are so beneficial.

Sometimes people are experiencing behavioral or mood changes related to their dementia, and they need more focused one-on-one support. Staffing ratios are usually two caregivers to five or six residents. This way, residents can get more personalized attention. 

It's also a great option for people who have medically complex needs. For example, we've had clients move to adult family homes where maybe they were on a ventilator, or they had a feeding tube. Years ago, the only option for them would have been to live in a skilled nursing facility, which is a clinical, institutional atmosphere, rather than the more intimate, residential setting of an AFH.  

The number of adult family homes to choose from in our area can be overwhelming. Families often aren’t sure what to look for or how to assess which AFH will be the best fit for the person in their care. We help families navigate and narrow down the options and find the best fit for the person in their care. 

If you’re anticipating a move and not sure how to move forward, click here to schedule a free, get acquainted call with one of our Care Managers.

Additional Reading and Resources

• Adult Family Homes: Smaller, calmer residential environments (Aging Wisdom podcast episode)
• Moving to Memory Care or an Adult Family Home  (Aging Wisdom podcast episode)

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CCRCs and Life Plan Communities (LPCs) are larger, high-end communities that typically include Independent Living, Assisted Living, Memory Care, and sometimes Skilled Nursing. 

Healthy, active adults move into a CCRC as an independent resident. If you need more support over time, there are various levels of care within that building or campus available to provide care. 

Care is provided as a continuum. Needing a higher level of care (Assisted Living or Memory Care) often requires moving to another apartment or floor. Some communities offer “flexible licensing,” meaning you can stay in your Independent Living apartment and add Assisted Living services when needed. For Assisted Living and Memory Care, ask to see a “Disclosure of Services” that clearly outlines what the facility does and does not provide.

CCRCs and LPCs offer many amenities and social engagement opportunities. These may include lectures, pool and sports/fitness areas, craft rooms and workshops, movie theatre, organized outings, and trips. You will also typically find a beauty shop, barber shop, and a spa. 

CCRCs require a buy-in or entry fee ranging from $300,000 to $1 million. Different contracts dictate what happens to that money if you leave the building or pass away. Monthly rent and any needed care charges are additional. Each CCRC offers different contracts. It's important to understand the type of contract, what is covered, and how costs increase as your needs change. We advise that an attorney and/or financial advisor review the contract with you, so you understand the terms of the buy-in fee. 

Most CCRCs and LPCs have wait lists. A nursing assessment is required and those with pre-existing care and/or cognitive needs may not be accepted. Couples should understand how costs will increase if they require different levels of care and occupy separate apartments.

Would you like a partner in planning?
Click Here to Schedule a Get-Acquainted Call with one of our Aging Life Care Experts.

Additional Reading

• What is a "life plan community" (aka "CCRC")? (Aging Wisdom blog article)
• Continuing Care Retirement Communities (CCRCs) (Aging Wisdom podcast episode)
• Navigating Long-Term Care Options (Aging Wisdom blog article)

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Skilled nursing facilities, nursing homes, and rehab centers provide short-term, residential rehabilitation services to individuals recovering after a hospital stay following an illness, injury, or surgery, or long-term care for individuals who require more specialized medical support. 

They differ from the other options we’ve discussed in that they are geared for two types of care: one is short-term rehab following a hospitalization.  This is where someone may receive physical therapy, occupational therapy, speech therapy, nursing care, and medical oversight. 

The other type of care is more specialized and geared towards residents who need 24/7 medical oversight. For example, significant care such as a two-person transfer, insulin-dependent diabetes, or skin issues requiring wound care, or more complex medical issues such as a feeding tube.

Additional Resources

• Skilled Nursing Facility Care Coverage – Medicare
• Washington DSHS Long-Term Care Residential Options
• Washington State Nursing Home Locator and Inspection Reports

Planning for long-term care and not sure where to start? We can help! Schedule a free get-acquainted call today to learn more about your situation and to determine together whether our services are a good fit for your needs. 

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In the early stages of Alzheimer’s and other dementias, most people can live and be safely cared for at home by family or professional caregivers, or in an assisted living residence. 

A move to memory care may be prompted by a change in health or cognition that is unsafe or unhealthy for the person living with dementia or their primary care partner.  

Memory Care is specifically designed to provide a safe, secure, supportive living environment, be it a stand-alone community or a separate unit within assisted living or a CCRC or Life Plan community. Memory care communities provide 24/7 care for individuals living with memory or  other cognitive changes such as Alzheimer’s disease and other dementias.

Staff also assist with activities of daily living, medication management, and meals, just like in assisted living, but are specially trained to support individuals living with Alzheimer’s or another dementia. Staff provide regular routines, added structure, and extra assistance for those with middle stage to advanced dementia. Staff also offer social engagement and life enrichment activities.

While units or communities are often secure to protect residents, many offer enclosed exterior spaces for walking, access to greenspaces, gardening activities, fresh air, and sunshine. Others have circular interior walkways with supportive handrails, and windows offering comforting views of nature.

How do you choose the right community? 

Picking the best environment is important. It can also be daunting. And just like searching for home care and professional caregivers, an online search will provide hundreds of choices. How do you narrow down the options?

Aging Wisdom Care Management and Creative Engagement staff regularly visit clients who are residents in many different long-term care communities throughout King and Snohomish Counties. We have extensive knowledge of these communities, including assisted living, rehab and nursing home facilities, adult family homes, and specialized memory care services. We can also advise on costs and quality of care when evaluating options.

Our Care Managers also understand the more nuanced needs of a client’s well-being and enhance quality of life, and which communities would be the most supportive for your parent’s unique circumstances, goals, and personality.

This is about more than care. It’s about having an experienced partner beside you, navigating the journey with wisdom, compassion, and heart. Click here to Schedule a Get Acquainted Call today to explore how we can help.

Additional Reading

• When is It Time to Move? (Aging Wisdom blog article)
• Steps for a Successful Move to Memory Care (Aging Wisdom blog article)
• What is Memory Care? When is It Appropriate? (Aging Wisdom podcast episode)

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It’s important to be realistic about what Assisted Living provides – these are some aspects to consider:

• A move to Assisted Living for someone who has been struggling with navigating living in their single-family home or condo can be transformative. 
• Assisted Living support is intermittent, not one-on-one. Assisted Living provides specific support for Activities of Daily Living (ADLs) such as bathing, dressing, toileting, personal hygiene, transferring/moving, and eating., and Instrumental Activities of Daily Living (IADLs) such as medication management, meals, and housekeeping. 
• If health or condition changes, and a resident needs more assistance, consideration of a move to a higher level of care will likely be necessary to ensure safety.
• Comforting to know that trained, skilled staff provide support and oversight.

If you’re not sure where to start, and you live in the greater Seattle-Bellevue area, CLICK HERE to schedule a FREE get-acquainted call today!

Live outside the area? You can find an Aging Life Care Expert near you by visiting the Aging Life Care Association.

Additional Reading

• Signs an Older Person You Care About May Need Help (Aging Wisdom article)
• Supportive and insightful podcasts for family caregivers (Aging Wisdom article)
• When is It Time to Move? (Aging Wisdom article) 

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Last week we provided an overview of Assisted Living (AL). 

While “aging in place” has its benefits, such individualized care can be expensive. Additionally, it can be isolating. Senior housing and long-term care options require a move but are more social and can be cost effective.

• Assisted living. People move to assisted living when they are ready to stop cooking, cleaning, and maybe even driving. They enjoy social activities but need more help than an independent retirement community might offer. 

In this episode we explore a few of the advantages to moving to an assisted living community:

• Socialization and engagement opportunities; community.
• Flexibility of care: You can move in as an independent resident, with access to support when needed.
• Most AL communities are a month-to-month arrangement, which can provide flexibility too -- if it's not a good fit, moving to a different community can be done relatively risk-free.

Need a partner in planning? Click here to Schedule A Call to get the conversation started.

Additional Reading:

* A Move to a Retirement Community Could Mean More Independence (Aging Wisdom article) 

* Choosing a long-term care facility (Aging Wisdom article)

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Assisted Living provides personalized, supported care in a residential setting. Residents have their own apartments The monthly cost is reflective of the size of the apartment and supports needed. 

People often move to assisted living when they are ready to stop cooking, cleaning, and maybe even driving. They enjoy social activities but need more help than an independent retirement community might offer. Though not a setting for people with advanced dementia, some assisted living residents may be experiencing cognitive change.

Assistance can range from no assistance to providing full care. Personal care is provided as needed for Activities of Daily Living (ADLs). Nurses are often available to assist. Costs will increase as care needs increase. 

Meals are usually included, as is transportation. Activities are often a highlight. Additional amenities may include a hair salon, barber, massage, swimming pool, and a fitness room. Some communities also have workshops, craft rooms, and libraries.

Additional Reading

• 3 Questions You Should Ask about Long-Term Care Planning (Aging Wisdom article)
• Choosing a Long-Term Care Facility (Aging Wisdom article)
• Navigating Long-Term Care Options (in greater Seattle) Part II (Aging Wisdom article)

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Understanding the differences between senior housing and long-term care options is essential to making the best choice to meet needs, goals, and well-being, while providing peace of mind. The choices can be overwhelming when it comes to retirement communities, especially if you live in a metropolitan area. 

In this next series of episodes, we provide a comprehensive overview of the six most common options: Assisted Living, Memory Care, Skilled Nursing/Rehab, Continuing Care Retirement Communities, and Adult Family Homes, starting with Independent Living.

Why choose independent living?
Many people move to independent living to downsize from a now-too-large home, or to relocate to a quieter neighborhood and do less driving. Some people seek relief from decades of cooking and cleaning. Another big draw is having a built-in community and activities, from book clubs to seminars to fitness centers. 

Additional Resources

• Considering an independent living community (Aging Wisdom blog article)
• When is it Time to Move? (Aging Wisdom blog article)
• A Move to a Retirement Community Could Mean More Independence (Aging Wisdom blog article)

Let us help you understand the options and help you plan your move. Click here to Schedule a Get-Acquainted Call to get the conversation started.

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Now what? 4 steps to understanding options, risks and benefits of each.

• First step: Get educate about care options.
• Second step: Understanding the cost of various options and your parents’ financial situation.
• Third step: What level of care do your parents need?
• Fourth step: Create a plan based on your parents’ preferences, their specific care needs, and their financial situation.

Who can help families navigate these sticky and complicated situations and create a plan?

• Most local senior centers have a social worker on-site who can be a resource
• Your parents’ doctor might also be able to assist you in making decisions about your parents’ care
• An Area Agency on Aging: https://www.n4a.org
• The Alzheimer’s Association is a great resource if dementia is a concern: www.alz.org 
• Or professionals like us at Aging Wisdom: https://agingwisdom.com
• You can find an Aging Life Care Expert in your area through the Aging Life Care Association: https://www.aginglifecare.org

How can an Aging Life Care Professional Help? 

• Provide education and resources
• Help you understand the care options and what they entail – Stay home? Moving? Cost?
• Provide a care assessment 
• Create a plan to move forward
• Help you make progress with your parents to help them buy in with the idea of accepting assistance
• Navigate family dynamics
• Scenario planning 
• Partner with you on the journey so you don’t feel alone. Help you make difficult decisions. 

You're not alone. To explore how Aging Wisdom can help you navigate the journey and plan for the future, click here to schedule a get-acquainted call. 

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