Wisdom Wednesday: Aging Wisdom's Podcast

Cost of Assisted Living

Some assisted living communities require a one-time community fee and that could be quite the range.

A community fee for month-to-month assisted living is different than a buy-in fee or an entrance fee with a CCRC. This is a one-time fee. We typically see these as low as $3,000 and in some of the newer, higher-end buildings as high as $40,000 to $50,000. 

In terms of the monthly fixed costs, it depends on the community you choose and the type of apartment you select. Make sure you ask what, specifically, is included. In most communities, food and beverage, housekeeping, Wi-Fi, laundry, some transportation, and activities are included. 

In the Seattle area, we see apartment as low as $2 - $3,000 a month, and as high as $9,000  for a newer, high-end community for a two-bedroom apartment with a view.

In terms of care costs, someone needing a basic level of support such as medication management, costs are around $500 monthly. If the resident is prescribed a lot of medicine, it can be $1,000.

An important question our care managers coach families to ask is: “Tell me about the resident that's getting the highest level of care that you can provide and what does that person pay for their care?” The answer can help family plan for the highest levels of care if and when needed.

We like families to understand the high as well as the low range of fixed costs and care cost in planning. As we age, care needs often change, and it's helpful to anticipate the factors that impact assisted living costs because the price structure is dependent on the level of care that a resident requires.

The community care assessment helps with determining initial care needs. It's important for families to sit down with a representative at that community to understand what supports are needed and the associated cost for care. Now is also a good time to plan ahead. Plan for how mom is going to age and how the community can or cannot support her. 

Be prepared to ask questions, if relevant to your situation now or in the future, such as:

·       Can you provide a two-person assist or transfer? 

·       Can you do a Hoyer lift, or the Sara lift for a non-weight bearing resident? 

·       Can you provide sliding scale insulin? 

·       Talk to me about open wounds and wound care. What does that look like? 

·       What does their license permit them to provide?

Resources:

• To get a baseline on the costs of long-term care, including assisted living, check the Genworth Cost of Care Survey: https://www.genworth.com/aging-and-you/finances/cost-of-care.html
• How Much Does Assisted Living Cost? Prices by state and ways to pay (from Caring.com) https://www.caring.com/senior-living/assisted-living/how-to-pay/  

Interested in exploring and planning for long-term care housing 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. 

This podcast is part of a longer conversation between Nicole Amico Kane, Director of Care Management at Aging Wisdom, and Brenda Dodd, Director of Training and Special Projects at Áegis Living. 

Thanks for listening! Follow us on Facebook and LinkedIn. 

Assisted Living is housing designed for individuals who need support with various levels of personal and medical care. Assisted living can benefit those needing assistance with  transferring or functional mobility (transferring from bed to wheelchair, for example), showering or bathing, toileting, dressing, personal hygiene, and meal preparation, as well as medication management, housekeeping, laundry, transportation, and socialization.

MONTH-TO-MONTH. Assisted living is typically a month-to-month model, so you're not paying a sizable buy-in or entrance fee like you would with a CCRC or Life Plan Community (as we discussed last week).

FIXED COSTS. You choose your apartment: it could be a studio, one bedroom, or two bedroom, and you pay base rent for your apartment. So that's a fixed cost.  Also included are utilities, activities (life enrichment programs and outings), many if not all meals, in addition to basic housekeeping, laundry, and certain transportation, depending on the community. Some communities also provided wireless internet access as part of the daily rate.

CARE COSTS. On top of those charges, you will have a care assessment that determines what your actual care needs are and what the nursing and caregiving team is going to be doing for you on a daily basis. This assessment determines your care costs.

ASK QUESTIONS SPECIFIC TO YOUR SITUATION. As Nicole points out, there's lots of variability from one assisted living to the next in terms of the care they can and cannot provide. It's really important to ask very specific questions that apply to your family's situation.

In Washington state it is a requirement that every facility provide a Disclosure of Services  that clearly outlines what that facility does and does not provide. Sometimes it's a starting point and actually helps you know where to ask more questions.

SOME EXAMPLES OF CARE NEEDS NOT COVERED. Some of the limiting factors at communities that provide lighter Assisted Living support that Nicole has seen specific to care needs includes:

• Transfers, also called functional mobility: how much help someone needs getting from bed to chair or standing.
• Incontinence care.
• Physical help with feeding or accommodating a modified diet.
• Challenging behaviors related to dementia. 

As you review potential communities, those are the key areas that we focus on. And ask yourself, Is this a community that can support those needs now? And what does that look like down the road if and when needs change?

Additional Resources

• You may find this free online course of help. Should I Move Mom? 
• Types of Long-Term Care (article from the Aging Wisdom blog)
• Choosing the Right Long-Term Care Facility (an article from AARP)

Interested in exploring and planning for long-term care housing and not sure where to start? We can help! Schedule a free get-acquainted call today. 

This podcast is part of a longer conversation between Nicole Amico Kane, Director of Care Management at Aging Wisdom, and Brenda Dodd, Director of Training and Special Projects at Áegis Living. 

Thanks for listening! Follow us on Facebook and LinkedIn. 

In today's podcast and over the coming weeks, Nicole will provide a general overview of different housing options for long-term care: Continuing Care Retirement Communities, Assisted Living, Memory Care, and Adult Family Homes  

Today she looks at Continuing Care Retirement Communities (CCRCs), also known as Life Plan Communities. 

As Nicole shares, "This is really an option for people who are at a stage in their life where they're proactively planning ahead. Maybe they're ready to downsize. They're attracted to that retirement lifestyle, relatively healthy and independent." 

You move in to a CCRC as an independent resident and if you need more support over time, there are different levels of care within that building or campus that can support you over a continuum. 

CCRCs typically include Independent living, Assisted living, Memory care, and Skilled Nursing. Some include Short-term rehab.

CCRCs are usually high end communities with lots of amenities. They require a buy-in or  entry fee. In our area, that could mean a range from $300,000 to $1 million. This is in addition to your monthly  maintenance or service fee. Each CCRC offers different contracts. It's important to understand the type of contract, what is covered, and if cost will increase as your needs change.

Additional Reading and Resources:

• How Continuing Care Retirement Communities Work (AARP webpage)
• Washington state DSHS CCRC Registry

Interested in exploring and planning for long-term care housing 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. 

This podcast is part of a longer conversation between Nicole Amico Kane, Director of Care Management at Aging Wisdom, and Brenda Dodd, Director of Training and Special Projects at Áegis Living. 

Thanks for listening! Follow us on Facebook and LinkedIn. 

Focus on the true care needs of your parent, or your spouse, or yourself.  Look at what is needed in the short term, and also consider  how the situation may look and change over time.

You need to factor in the finances too. 

Starting with next week's podcast, we'll talk specifically about the different levels and types of care and what that means in terms of the services and supports that are offered. Where we see  the greatest variability is in assisted living communities in terms of care.

It can be so helpful  for family members to have an objective care assessment of what their parent or spouse really needs -- again, looking at both the short term and what care might look like down the road. 

One of the tips we give families, especially if someone has heavier care needs, or some complexity, is to ask: "Tell me about a resident that had to leave your community because you were no longer able to meet their needs." 

Ask for some real life scenarios. Maybe it's that the physical care needs became too much, for example, someone that's in a wheelchair that needs two caregivers to help transfer them. There's a lot of communities that cannot provide that level of support. And then for people who have more needs around dementia, are there challenges with their care related to their dementia? How can that community support it?

It's important to ask questions. Bring a notebook.

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!

If you live outside the area, you can find an Aging Life Care Expert near you by visiting the Aging Life Care Association.

Additional Resources

• You may find this free online course of help. Should I Move Mom? Understand the options and build confidence in helping an older loved one to move to a retirement community.
• Types of Long-Term Care (article from the Aging Wisdom blog)
• Choosing the Right Long-Term Care Facility (an article from AARP)

This podcast is part of a longer conversation between Nicole Amico Kane, Director of Care Management at Aging Wisdom, and Brenda Dodd, Director of Training and Special Projects at Áegis Living. 

Thanks for listening! Follow us on Facebook and LinkedIn. 

When we meet with families and start to talk about care and housing options, it's not unusual for them to ask if Medicare covers what we are recommending. Typically, the answer is no.

Medicare covers very limited supports around long-term care and typically that's a short-term care stay, such as an inpatient rehabilitation usually following a hospitalization -- for example, when someone has had a cardiac event, or they're recovering from a hip fracture and surgery. They go to rehabilitation to recover and get stronger, with the goal that they'll eventually transition back to their home.  Medicare will cover that to some extent.

When it comes to paying for your long-term care, however, it's typically covered through  personal funds as an out-of-pocket expense.

Some people have long-term care insurance policies that can also supplement those expenses.

Medicaid funding is available to individuals with limited income and meet other eligibility requirements. Eligibility and services covered vary from state to state.

There's a whole other universe of planning that comes along if someone's thinking that they will need Medicaid at some point in their life. That's also something that we can coach families about.

Additionally, depending on military service, the individual needing long-term care may also qualify for Department of Veterans Affairs benefits.

Here in Washington State we also have a number of PACE programs (Program of All-Inclusive Care for the Elderly) , a "Medicare program that provides care and services to people who otherwise would need care in a nursing home. PACE covers medical, social service, and long-term care costs for frail people."

Overwhelmed by the options and now sure where to start?  We can help! If you live in the greater Seattle-Bellevue area, CLICK HERE to schedule a FREE get-acquainted call today!

If you live outside the area, you can find an Aging Life Care Expert near you by visiting the Aging Life Care Association.

Resources

• Paying for Care (National Institute on Aging webpage) 
• Parents Reluctant to Spend Money on Their Own Care (Aging Wisdom blog)
• Should I Move Mom? free online course from Aging Wisdom
• The Cost of Senior Housing and Long-term Care: Will it break the bank? online course from Aging Wisdom

This podcast is part of a longer conversation between Nicole Amico Kane, Director of Care Management at Aging Wisdom, and Brenda Dodd, Director of Training and Special Projects at Áegis Living on "Navigating Care and Housing Options." 

Thanks for listening! Follow us on Facebook and LinkedIn. 

Do you have a plan for the time when home is no longer safe and supportive for your parent/s, your spouse, or you?

Families are usually pragmatic and understand that an older adult who is living with a dementia or Parkinson's diagnosis, for example, will eventually need to move to a safer, more supportive environment in the future.

What are the signs that it's time for a move?

In this Wisdom Wednesday excerpt of a longer conversation, our colleague Nicole Amico Kane, talks with Brenda Dodd at Aegis Living, about the common concerns and signs that it's time to consider a move to a long-term care community:

• Health and medical related changes, oftentimes memory and cognitive changes. 
• Supports and services such as a professional caregiver, a companion, or household help, have been brought into the home, but the efforts have failed. 
• The supports that have been brought into the home are no longer enough. 
• A family member or friend has been the primary caregiving support at home, and they feel their caregiving responsibilities are no longer sustainable. Caregiving is taking a toll on their health and well-being. 
• A consideration we've paid more attention to during the pandemic is that home can be isolating for someone who's aging in place because the world is just a little too small.
• The cost of  care is no longer financially sustainable. When you start to need a lot of care at home, things can get expensive real fast, and costs can become prohibitive especially when you're thinking about longer range planning and how resources will support someone over their lifetime. That's an important consideration. 

Every family and every situation is different. Understanding the landscape and planning for what's to come can save a lot of stress and heartache in the long-run.

Our Aging Life Care Professionals (aka geriatric Care Managers) have the experience and knowledge to guide families on planning for today as well as the future.  

• Why is Change So Hard? (an Aging Wisdom blog article)
• Seven Signs an Older Loved One May Need Help (an Aging Wisdom blog article)
• What is Aging Life Care? (an Aging Wisdom fact sheet) 

Not quite sure what steps to take next? You can schedule a free call with us to determine together whether our services are a good fit for your needs.

Thanks for listening! Follow us on Facebook and LinkedIn. 

Don't we all need a ray of sunshine or a beacon of hope when life gets challenging? 

As a family caregiver, you can become comfortable with the daily routines and rhythms of caregiving and not realize how stressed, or physically and emotionally exhausted you've become.

You are doing an amazing job!  Caregiving is difficult, complicated work. 

But have you ever spilled coffee in the car or missed an important appointment and found yourself so overwhelmed in those moments that you couldn't take another step forward?  This is when you've reached the point of burnout.

The good news is, you don't have to do it alone.

An Aging Life Care Professional (aka geriatric Care Manager) can bring  that ray of sunshine and offer the beacon of hope you so richly deserve and need.

Outsourcing some of those tasks to a Care Manager  frees up time for you to focus on yourself (and let us stress that self-care is not selfish, you are a priority!)

And as Lisa said, "My parting thought that's really been on my mind lately is hope, that it can feel so hopeless at times being an adult child supporting a parent, especially in the sandwich generation.

No matter how messy the situation, how frustrating, how complicated, it can get better. And your life can feel easier. And that there is hope, and that there are people out there to make it easier and to help you get some of your life back, and help you put some boundaries in place, and help you feel better."

Looking for guidance on how best to move forward? Our Care Managers are experts in helping family caregivers live well.

if you live in the greater Seattle area, CLICK HERE to schedule a FREE get-acquainted call today.

If you live outside the greater Seattle area, click here to find an Aging Life Care Professional near you.

This is an excerpt of a longer conversation between Lisa Mayfield, Aging Wisdom's founder and principal, and Laura Vaillancourt, MA, LMHC, GMHS on her 'Life on Repeat podcast'. 

Thanks for listening! Follow us on Facebook and LinkedIn. 

An Aging Life Care Professional (aka geriatric Care Manager) is a health and human services specialist who acts as a guide and advocate for families who are caring for older relatives or disabled adults. Aging Life Care Professionals are educated and experienced in any of several fields related to Aging Life Care management, including, but not limited to counseling, gerontology, mental health, nursing, occupational therapy, physical therapy, psychology, or social work; with a specialized focus on issues related to aging and elder care.

To qualify for certification as a Care Manager, candidates must meet rigorous education standards, attain a certain number of years of experience and supervision, and pass a comprehensive test to demonstrate foundational knowledge.

To maintain certification, CMCs are required to participate in continuing education and professional development. Certification is renewed every three years to ensure that Care Managers are practicing at the highest professional level.

Many Aging Life Care Professionals also have graduate degrees.

We are all guided in our professional and business practices by a Code of Ethics and Standards of Practice.

You can find an Aging Life Care Professional in your area through the Aging Life Care Association website and  search by zip code or city.

Aging Life Care Professionals typically bill for our time by the hour, very much like an attorney.  The work we do with clients and the cost is really a reflection of how much time and support you need.

Sometimes, families will come for Consultation and just need one or two sessions to get the lay of the land, to understand the options, pros/cons, to have a plan created, to be connected with the right resources. They then implement that plan. They can certainly come back, and check in, and have further problem solving along the way. Whether it be three weeks down the road, whether it be three months down the road.

And then other families will have an Aging Life Care Professional involved in a much deeper, ongoing way.  Whether that be checking in on their parents, where they're living in assisted living, or an adult family home, or coordinating doctor's appointments, going with the parent to a doctor's appointment to be able to make sure the doctor understands what's happening. Being able to follow through and be an ongoing emotional support as well as problem solver and advocate along the way.

This is an excerpt of a longer conversation between Lisa Mayfield, Aging Wisdom's founder and principal, and Laura Vaillancourt, MA, LMHC, GMHS on her 'Life on Repeat podcast'. 

Thanks for listening! Follow us on Facebook and LinkedIn. 

Families often seek our geriatric care management services when they know a parent needs help.  And it's not uncommon for the parent to resist assistance or support.

Adult children come to us at their wit's end, frustrated because "My Mom is in denial that she needs help!"

Or is she?

Sometimes, this unwillingness to accept or recognize the need for support is the result of a "lack of insight," which can be a symptom of dementia. The parent isn't denying that there are changes in their behavior or emotions, they are, in truth, unable to recognize the changes.

Lack of insight is the result of physical changes to the frontal lobes of the brain, the part of the brain that controls and manages insight. Insight is defined as "1: the ability to understand a person or a situation very clearly; also, 2 : the understanding of the truth of a situation." Merriam-Webster

Giving your parent the facts, confronting them, or trying to reason with them probably isn't having any affect. Lack of insight works that way: they are unable to understand that there are changes and reasons for concern.

Don't bang your head against the wall in frustration. As Care Managers, we can help you navigate these changes and provide education, as well as techniques, language, and approaches that will help you talk with your parent and guide them toward accepting choices that will support their safety while respecting them as a person, and bring you peace of mind.

If you live in the greater Seattle area, you can schedule a FREE get-acquainted call with us to determine together whether our services are a good fit for your needs.

There are Aging Life Care Professionals like us all over the country. To find a Care Manager near you, visit our professional association, the Aging Life Care Association.

This is an excerpt of a longer conversation between Laura Vaillancourt on her Life on Repeat podcast and Lisa Mayfield, Aging Wisdom's founder and principal. 

Thanks for listening! Follow us on Facebook and LinkedIn. 

Worried about your parents and fighting with your siblings over their care?  When it comes to mom and dad, even families who get along well will experience disagreements from time to time.

Finding common ground and reaching a mutual understanding about how best to support your parent/s isn't always easy. With the help of an unbiased professional such as an Aging Life Care Professional (aka Geriatric Care Manager), you can find balance, as well as solutions.

Resources and Supports

• Surviving and Soothing Sibling Strife When Caring for Aging Parents (Aging Wisdom blog)
• Bringing families together when there's conflict (Aging Wisdom podcast)
• The Empowered Caregiver by Linda Fordini-Johnson (book we highly recommend)
• When Your Aging Parent Needs Help by Leslie Kernisan, MD, and Paula Spencer Scott (another book we highly recommend)

This is an excerpt of a longer conversation between Laura Vaillancourt on her Life on Repeat podcast and Lisa Mayfield, Aging Wisdom's founder and principal. 

Thanks for listening! Follow us on Facebook and LinkedIn.