In my 30+ years’ experience in senior housing, I have met clients who struggle with having conversations with their loved ones about making the decision to move to a senior living community. There are many emotions involved in these conversations including guilt, fear, sadness and rejection. Unfortunately, these conversations never get any easier and the longer it takes, the harder they become. Hopefully these insights will be helpful to you.
Change is not easy
The common phrase I hear is “We have spoken with dad and he refuses to move.” People who have dementia have a difficult time with change. They become accustomed to their daily routine and surroundings. If you bring up the subject about moving or bring in help, the immediate response will be “No, I don’t need any help.” This is very common with people with dementia. They resist any type of help and they don’t realize the impact that their decision is having on you or your family. Until you realize that your roles have changed in your household, this cycle will continue.
Dementia effects judgement too
Many people think dementia is only about someone’s memory loss. It is important to realize is that dementia can also effect judgement. This is especially difficult if the former decision- maker of the family is not able to make sound decisions anymore. Many spouses who are caregivers find themselves in the situation, where they expect their spouse to make logical decisions and have a hard time recognizing their loved one is not capable of doing so anymore.
Like a hike in the woods
A good analogy to consider is a hiker lost in the woods. The hiker walks endlessly in the circles trying to find the right path out of the woods, however he is unable to find the right way out. It is frustrating, scary and a embarrassing to be lost. Imagine now, you find this hiker and you take him by the hand and lead him down the correct path. Yes, there could be some resistance along the way, however you know you are the doing the right thing. You stay the course and eventually, you and the hiker arrive at a safe place that is familiar. You have saved the day! Discussing the senior housing option is very similar. You need to take the lead and make the decision. Yes, your role as the follower has changed. You now need to take charge and be the leader.
The danger of doing nothing
Yes, you can do nothing and not ‘rock the apple cart,’ however doing nothing is actually doing something. The end result may not be what you expected! Too many times, the caregiver is the one that becomes ill and requires care. By being the caregiver, your immune system is weakening and you are most susceptible to illness or experiencing a severe medical condition or even a fall. If something happens to you, who is going to take care of your spouse? Unfortunately, the person with dementia and the denial to do anything is creating a potentially dangerous situation for you. In addition, senior housing options become more limited and more expensive if you wait until care is needed to force a decision. It is always better to “select rather than settle.” Making a decision in a crisis mode is never a good idea. Being proactive and recognizing that it is important to have a plan for your future health care needs is a much wiser (and less expensive) route to take.
Conversation tactics
Prepare to be open, honest, and non-argumentative when discussing these topics with your loved ones. These conversations need to take place in a quiet and comfortable setting such as your living room or around the kitchen table. Keep in mind that you already know the resistance you will be get. Be prepared. You also need to recognize that you know best in this situation and that even though you would like your loved one’s approval, a decision needs to be make. Maintaining the status quo is no longer an option. One tactic that I’ve found to be useful to tell your loved that a temporary move needs to occur. It can because of a home repair or a pending vacation to go up North. A temporary change is much easier to handle rather than a permanent move. You can also tell your loved one that he needs to do this for you since you are not feeling well and you need some extra help. Keep in mind that even though you would want your spouse’s agreement, you are in charge now and the decision is yours to make. “Honey, we are going to do this and we are going to make the best of it together.”
Seek counsel
Trying to resolve this by yourself is difficult. If what you have been trying isn’t working, it’s time to call in the cavalry. Seeking the help of an independent third party to step in is not a bad idea. Do you have a family member or close friend that can be ‘the heavy?’ You may also want to reach out to your doctor, clergy. attorney and financial advisor. There are support networks such as the Alzheimer’s support network and other caregiver support groups to help you. As senior housing advisors, we can also help. We have year’s of experience helping people through these difficult situations. We do the research for you and have resources available to make this much easier on you.
The new normal
Amazingly, once the decision has been made and you move to your new home at a senior living community, a huge weight is lifted off your shoulders. There are many advantages of living at a senior living community and it won’t take long for your new home to be your new normal. Your loved one, who put up so much resistance will develop his routine in very little time and be thankful you made the decision. Just like the hiker in the woods, you have save the day!
The other day, I received a call from a daughter of a client. She was in tears and shared with me the issues she is dealing with overseeing her dad’s care. As she explained, she is now responsible to oversee her dad’s day to day care while her two brothers are helping financially. Tearfully, she said, “all I want to do is be my dad’s daughter again.” This situation resonated with me because I see so many people afraid of change who are in a state of denial about their future long-term care needs and are unaware of the impact their decisions have on their family. There are many advantages of living at a senior living community. These include:
Access to on-site services and amenities
Senior living communities are designed to help promote one’s independence and provide a care-free lifestyle for their residents. On-site services and amenities typically include dining, housekeeping, transportation, maintenance, security and social activities. Residents enjoy chef-prepared meals without the hassle of shopping, prepping, cooking and cleaning. Say goodbye to TV dinners and dining alone. Many senior communities have a wide spectrum of activities including fitness programs, card playing and lectures and seminars. Well stocked libraries and even happy hours are common. Your days will be as full as you want them. Yes, you can bring your own car, however transportation services to shopping, doctors’ appointments, area excursions and cultural events are available to make your life easier. Remember, you might be able to drive today, but in the future, it may be safer to let someone do it for you. If something stops working in your apartment like your air conditioner or your disposal, all you do is make one phone call and the issue is handled. You don’t even need to stick around for the obnoxious “window of time” waiting for someone to show up. You can go to your aqua aerobics class and when you return, the issue has been resolved. Life is good!
Access to on-site health care
As we age, we might require more assistance. This could be on short term rehab basis or longer term. Yes, you can bring in care in your home, however there is a limit to what can be provided and is expensive and difficult to manage. Imagine living at a senior community and being able to use the on-site physical therapy services or being able to see your doctor right on campus. Yes, the convenience factor is huge, however the ability to have access to these services will help you stay active and independent longer. On-site services may also include assistance with bathing, dressing and ambulation and even medication management. These services are available for you when you need them. Most senior living communities have 24 emergency response systems in case someone fell or not feeling well. Having on-site emergency response can literally save your life! Many senior living communities have visiting doctors including specialists who will see patients right at the community. No more boring waiting rooms for you! Knowing that you have access to these on-site services will help you stay active longer and provide you with the peace of mind that you know if something ever happens, that you have planned ahead.
Peace of mind
Knowing that you are not a burden to your spouse or your family can not be understated. The peace of mind of knowing you have planned ahead and that you are able to live carefree is priceless. Recognizing that something will probably change in your health and that is better to have a plan in place before it does is an important step. There are too many people who live in a state of denial and wait for a crisis to occur before making any plans. This is not a wise move. Researching the right place that fits your needs and lifestyle will take some time and the last thing you want to do is let someone else make this decision for you.
Financial security
It is amazing when you compare what you are paying in your own home versus what is included in a senior living community, you will see what a value the senior living community provides. Your food and household expenses will dramatically be lowered. Knowing you have a predictable monthly fee will help you develop a better financial plan. There are different financial arrangements for senior living communities including rental, buy-in (CCRC) or equity ownership. If you elect to stay at home and bring in care, your financial situation could change drastically because of the expense of home health care. There are other financial assistance programs available if you move to an assisted living facility include Aid and Attendance through the Veteran’s Administration. Unfortunately, Medicare does not pay for assisted living and there are only a few assisted living facilities that will accept Medicaid. Usually, someone needs to be living in assisted living before being able to tap into Medicaid. Again, planning ahead is the key.
Friendships and Fun
Senior living communities provide the opportunity for life-long friendships and never being lonely again. There have been numerous studies done that prove people live longer and healthier when they are around other people. Socialization at senior communities is what makes people always say, “I wish I would have done it sooner.” Knowing that you can participate in as much of or as little of activities provides you with opportunities to meet people and have fun. And, there is a lot of fun being had at these senior living communities. Mostly because, the worry burden is off of your shoulders. Many people also continue their interests outside the community include participating in church activities, volunteering and entertaining with friends. Most importantly, your family now can be your family again and not be 24/7 caregivers.
Selecting a senior living community is a complicated process. Here are the top 10 senior housing researching tips.
1). Consult with a senior housing advisor. Make your life easier by consulting with an expert who is familiar with all the options in the area and someone who takes the time to understand your wants, needs and desires. Ideally, this advisor should be looking after your best interest and have a fiduciary relationship with you. Understand how the advisor is compensated since some advisors will collect commissions from the senior housing community they recommend to you which may not be in your best interest. This is could be a huge conflict of interest.
2). Determine where you want to live. This might seem basic, but it is amazing how many people research senior housing communities in areas that they know they don’t want to live. Speak with your family and determine geographically where you want to live. Once you have narrowed this down, try to narrow it down even further by zeroing in on specific areas within that geographic zone. This will help you pin-point your research.
3). Determine your time frame. There is a saying we have in this business. “It is better to be 5 years to early than 5 minutes too late.” Many quality senior housing communities have medical acceptance criteria to move in; therefore if you wait too long, you may not get accepted. Think about your time frame and what needs to occur between now and then. Keep in mind that researching various senior housing communities will take some time, so you probably want to start earlier than what you imagine. Some senior housing communities have wait lists, so it might be necessary to get your name on a list before you are able to move in.
4). Review policies and procedures. Understanding the rules of the senior housing community is something that many people fail to do before they move in. Some examples include: Is there a dress code? What is the pet policy? Can you use your extra meals for guests? What are the qualifications of the person who is responding to your apartment in case of an emergency? As a senior housing advisor, this is an area were true expertise helps to ask questions that you may not know to ask. It is always a good idea to get a copy of any agreements you will be expected to sign and have your attorney review these documents.
5). Tour one senior housing community per day. Visiting a senior housing community take a lot of energy. Call ahead and schedule a personal tour of the senior housing community. Where comfortable shoes since you should be prepared to walk some distances during your visit. Take notes and ask questions that you want to ask. Keep in mind that not only do you want to look at apartment floor plans, but more importantly, you want to get a feel of the lifestyle of the community. Can you see yourself living at this senior housing community?
6). Tour the health care facility. One of the main reasons you are considering a move to senior living community is for the peace of mind of on-site health care services, therefore touring the health care facility is a must in your research. When touring the health care center, pay attention to how the residents are being treated by the staff. Take a look at the activity calendar and the menu. Observe if the facility appears clean and fresh. If possible, speak with family members to see if their loved one is receiving quality care. Most states conduct annual inspections. Ask to see the inspections reports for the last couple of years.
7). Sample activities and dining. As part of your research, it is important to sample the lifestyle of the senior housing community you are considering. Take a look at their activity calendar to see if there program that interest you. Maybe there is an exercise class you can join in on. Maybe you are join a bridge group to see if the other residents are similar to you. It is also a good idea to have dinner at the community. You might be offered lunch, however dinner is where you will meet the majority of residents. The more can get a feel of the lifestyle of the community, the better you will be able to determine if this is the right community for you. Your transition will also be much easier since you will already know some people when you move in.
8). Understand the pricing structure. It is important that you fully understand the pricing structure of the senior housing community you are considering. What are the refund provisions? What is extra? Is future care included or do you pay extra for it? What has been the history of rate increases? It is also important to understand how financial stable this senior living community is? The last thing you want to do is move to a place and later find out that this community is having some financial challenges.
9). Look beyond the glossy brochure. You receive a beautiful brochure in the mail and you think you’ve found nirvana. Everyone looks so youthful and happy in the photos. The community is clean and immaculate. Unfortunately, these are paid models in the photos and the community photos are staged. Yes, its a good starting point, however there is much more to your research than the brochure.
10). Make an educated decision. Utilize the resources you have to help you make an educated decision. Consult with a senior housing advisor to gain valuable insight into the senior communities you are considering. Ask questions and find a community that fits your lifestyle. Take your time, but don’t wait too long.
Leading Age Florida, was established in 1963 as a Florida not-for-profit corporation. We are the only statewide association representing the full continuum of care for seniors. We serve nearly 400 mission-driven communities trusted with providing quality care and services. We promote practices that support, enable and empower people to live fully as they age.
Leading Age Florida member communities share a common bond of providing high quality care and services to the elderly. Our members include:
Continuing Care Retirement Communities (CCRCs) and Full Service Rental Retirement Communities
Retirement Housing and HUD Financed Housing for the Elderly
We’re a respected national leader and trusted partner to help people aged 60+ meet the challenges of aging. We partner with nonprofit organizations, government, and business to provide innovative community programs and services, online help, and advocacy.
Our Vision: A just and caring society in which each of us, as we age, lives with dignity, purpose, and security
Our Mission: Improve the lives of millions of older adults, especially those who are struggling
Our Social Impact Goal: Improve the health and economic security of 10 million older adults by 2020
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