In life one thing is unavoidable: aging. For some of us, aging will be no big deal. But, for the rest of us, aging will be a process that never seems to get easier. Most of our readers have not reached their senior years yet and are still active in their careers and blossoming families. Even if you are not in your senior years, your parents most likely are. As their kids, you want them to be as healthy as possible as they reach those older ages. It is important to know different resources available to help care for senior loved ones, especially if you don’t have the time to be a part-time caregiver on your own.

“Elder care needs to continue to grow, as 10,000 baby boomers turn 65-years-old every day. This does not even count in those “younger” people who have need of 24/7 care who have suffered strokes, Parkinson’s, car accidents, etc. Many communities have age requirements, so care is not available to everyone who may need it,” Larry Van Hunnik at Milder Manor said.

In the New Year, one thing to prepare for while pre-planning for senior living is the newly appointed Affordable Health Care Act. “There are so many changes that are yet to come as the Affordable Health Care Act takes shape; a good attorney may be needed, but our own local resources such as the Area Agency on Aging are there to help as well.  Those people who seek Medicaid benefits will most likely keep on rising as costs of healthcare continue to climb; requirements to qualify for those benefits need to be understood and planned for in advance.  Private insurance companies may also be making some changes to benefits, so everyone needs to pay attention to the policies that they already have and that are in place,” Barb suggested.

Seniors, and children of seniors, need to be educated on all of the changes being made to health care. “As health care reform changes the face of health care, seniors need to be educated on the changes that will affect their care in the hospital and in skilled nursing facilities,” pointed out Stephanie Farmer with The Ambassador. “As costs continue to rise, health care facilities will be challenged to find ways to get the patient better quicker and back to an independent lifestyle as soon as possible.  What this means for patients is that they can expect shorter stays in the hospital and ultimately, shorter rehabilitation stays in a skilled nursing facility. Also, many Medicare beneficiaries are under the assumption that Medicare will pay for their entire stay in a skilled nursing facility.  This is not the case, and beneficiaries (and their families) need to be aware of their available benefits and the requirements to receive those benefits.  In order to qualify for a Medicare Part A stay in a skilled nursing facility, a patient must be admitted to a hospital for three consecutive days (not counting day of discharge).  A physician must also certify that the patient requires the level of care that is provided in a skilled nursing facility.  Medicare Part A will pay 100% of Days 1-20 in the skilled nursing facility.  On Day 21-100, the patient will become responsible for a daily co-insurance rate that is set by Medicare.  Medicare will no longer pay for a portion of the patient’s care after Day 100.”

Staying in the home

Many seniors prefer to stay in their homes as they age so they can remain near neighbors they’ve probably known for years, close to stores and restaurants they are familiar with and surrounded by the memories they’ve created over the years with their families. While some seniors can continue to live on their own with minimal to no assistance, others require a little more care.

“As a caregiver for an aging parent, the demands of daily life can make caring for your loved one difficult at times,” explained Jamie Peters, APRN, with Health at Home Consultants. “Trips to the doctor’s office, for example, may be challenging due to busy work schedules, and transporting your loved one to and from their doctor’s office is not always easy. There is a solution! Health at Home Consultants is a Nurse Practitioner-owned business, specializing in high quality, cost effective, in-home medical care. They give compassionate and coordinated care with the entire healthcare team, considerate attention to prevent unnecessary hospitalizations by providing regularly scheduled visits, and availability for last minute needs in the home setting.”

Lisa Osborne, Director of Continuum Navigation at Tabitha Elder Care Services, encourages the children of seniors to be aware of all the options available when helping their parents make decisions. “Be informed,” she advised. “Take the time to educate yourselves about elder care options before you need them.  Often times people wait until they are in a crisis to look at services and costs.  Unfortunately when you are in a crisis situation, your choices become more limited by the time that you have to make decisions.  Tabitha welcomes seniors and their families to visit with a Continuum Navigator at any time to find out what Tabitha’s Continuum of Services can do for them now and in the future.  Often times if someone starts with a small amount of help in their home, it can prevent falls and hospitalizations.  Being proactive and starting with the simple things can make a big difference in reducing risk, illness and frailty in the future.

Tabitha’s Continuum of Elder care services, for example, provides a wide range of services to help a senior remain in their home.  Tabitha provides Skilled Home Health Care, non-medical home care for assistance with homemaking, laundry, personal care and companionship.  We also provide Voice Care/Emergency Response and Meals on Wheels.  If a family member has a senior living with them and they need a safe place for the senior to go during the day, Tabitha also has an Adult Day program.  This allows a senior to remain in their home but provide a break to a caregiver during the day for work, school or respite.”

She summed up by saying, “Any time you see a decline or change in your parent’s ability to take care of themselves, or their home, this may indicate that something might be going on.  Your parent’s physician should be consulted to rule out any medical issues that require treatment.  Once you have assured that medical issues are addressed, then a Continuum Navigator can come to your parent’s home to discuss what Tabitha services can best meet your parent’s needs.”

Retirement communities

Many times, it makes more sense for a senior to downsize their belongings and home responsibilities and transition to a retirement community. It’s important that your loved one knows that this is in no way ‘giving up’ and that many times, they will live even more active and engaged lifestyles in a retirement community.

Immanuel communities is striving to educate consumers on all the choices available for senior housing and senior services.  According to LeadingAge, the American Association of Housing and Services for the Aging, there is an ocean of aging-services out there but finding the best fit is a real challenge.  Understanding what help is available, the level of care needed, and that seniors’ circumstances are constantly changing can be confusing.

“Our goal is to help guide seniors and their families as they make important decisions regarding retirement living choices,” explained Roxann Rogers Meyer with Immanuel Communities.  “We can navigate the resources and choices to help families make the right decision that fits their specific situation.

We encourage seniors and their families to plan ahead.  The earlier you explore your senior housing options, the more choices and control you will have over your future.  Researchers have found that seniors who move into a retirement community when they are healthy and independent will live five to seven years longer than if they wait until they have a health crisis.

We find that residents are pleasantly surprised at how much they enjoy independent living as they take advantage of our lifestyle programs, our exceptional dining program and the stimulating activities and events.  An added bonus is the fellowship and new friendships that are forged.”

“The senior living industry is growing and that means options and opportunities for those looking to make a change,” said Kayla Schaf with Legacy Retirement Communities. “At Legacy, we want our community to be the best fit for the individual and their family. We feel that it is very important for families to take the time to look around at the different communities to really understand what options are available.”

Legacy believes in independent living at their community. “At Legacy Retirement Communities we want our residents to enjoy their own private residence. Live as they always have, but without home ownership responsibilities like mowing the lawn, working in the kitchen or even vacuuming. Independent Living can help lighten the load of home ownership while continuing to allow an active and independent lifestyle. For those who need help and need more personal assistance with the day-to-day tasks, Assisted Living provides a higher level of care. We often see that some may need a little help in between; having both Independent and Assisted Living under one roof can accommodate that need. We feel that it is important for our residents to make personal choices based on their living needs,” Kayla said.

At Legacy, connections between staff and residents make connections that feel like true friendships. They believe that this sort of connection should be seen in any retirement community. “Making the best choice can seem daunting, but I feel once people actually get out and look around the right choice becomes clear. At Legacy Retirement Communities you have to experience our communities to truly understand our culture. It’s the feel of our communities that people talk most about. We feel there is a true family connection with our residents and staff that is organic and natural.

Observations while visiting a community can be a key indicator of the community culture. How are you greeted and approached by current residents and staff? How do the current residents respond or react? Are the people in the community full of life and smiles or do they look disconnected,” Kayla said.

One thing that Legacy has noticed is that being active in their retirement community makes the seniors blossom. “The benefits of making a move to a retirement community are widespread, from safety and security to friendships and social engagement to physical and emotional support. I decided to get some feedback from some of our staff. Katie Johnson, our wellness director shared that at Legacy Retirement Communities, being physically active is a way of life. Once our residents move in and become active in the Fitness and Wellness programs they start to blossom. We’ve had many residents move in and strongly depend on a cane or other walking device. After a few months, they are standing taller, their balance is better and they feel great. The great thing is that once their body starts to feel better, then their emotional outlook also gets better. It’s a whole body change,” Kayla said.

They have also noticed new interests surfacing because of different activities provided. “Often times we see residents exploring interests that they might have never tried before. Our residents are really living! We see that once our residents settle in, they take advantage of the opportunities to learn something or do something out of their comfort zone. These new opportunities are offered at our residents’ doorstep. If they want to try something new, the opportunity is there, if they choose to relax in the comfort of their own home, they are welcome to do so. There is a wealth of opportunities on a daily basis that can bring life enrichment to everyone,” Kimberly Kaufman, an Enrichment coordinator said.

Some advice Kayla has for children with aging parents is to get educated about options early. “Start early and get educated. Moving to a retirement community is one of the biggest decisions in an individual’s lifetime and the decision needs to be made with a lot of consideration and planning. Understand the finances of moving a loved one. When the time comes to move a loved one into a community, the emotions and logistics of moving can be stressful for a number of reasons. Planning ahead can help reduce the stress of the transition.

Start downsizing prior to planning a move. Many seniors are very overwhelmed by just the idea of moving and getting rid of things. Peter Walsh, an organization expert has a great book called It’s All Too Much: An Easy Plan for Living a Richer Life with Less Stuff. This book offers some great tips on how to get started with the downsizing,” Kayla said.

Preparing for changes in aging seniors is as important as actually making the changes. “Exploring the many senior living options before the actual need for services exists is the single biggest step adult children can take to advocate for their parents,” Karla Frese, Savannah Pines Retirement said.

At Savannah Pines Retirement, they help with preparations by providing a one-stop resource network. “We provide a one stop resource with the extensive network and awareness of the market to be of assistance to all adult children in the research mode,” Karla said.
Some retirement centers, like Savannah Pines, could have a wait list. This is why early preparation is so important. “We want to find ways to provide freedom and independence so your loved one can enjoy life and their families can receive peace of mind. Prepare in advance and look at the benefits of a retirement community. “Walk in unscheduled to tour any day of the week or weekend and see what the community is really like.  Ask for a copy of the rental or lease agreement and read it over beforehand,” Karla said. “The only regret our residents have is they wish they would have done it sooner. It is important that you or your loved one chooses where to start their retirement; when the time comes that you are ready or crisis arises, you’ve already made the decision.”

Savannah Pines also offers trial stays so someone could “try out” their place. “At Savannah Pines we offer free trial stay vacations for someone to experience the freedom to enjoy life,” Karla said. “At Savannah Pines we go above and beyond to meet every resident’s emotional, physical, and personal needs. We continue to exceed expectations by “wowing” the socks off our residents and their family members by serving our residents with love, that makes each day special. Our residents deserve the best and it’s exciting to see how happy they are here at Savannah Pines.”

When calling a retirement center, you should also ask for these three things, according to Karla.

Socialization & Transportation (Ask for Activity Calendar, do they charge for rides?) Great Dining Program, with 3 meals a day  (Be sure to try lunch!) Choice, Options, & Flexibility (Is there a long-term commitment, or buy-in? or is it Month-to-Month) Can you try it for 30 days with a Satisfaction Guarantee? Can you use home health care to provide additional Assistance down the road so you don’t have to move? Example: Savannah Pines welcomes all Home Health Care Agencies to help residents with additional care services such as medicines, Physical Therapy, and bathing aids to keep them thriving in an independent environment with a little extra help as needed.

“There are a variety of options for seniors when evaluating retirement communities,” Amy Fish with Gateway Senior Living pointed out. “Amenities that support an individual’s interests or hobbies should be considered, as well as services that meet their current and future clinical needs. Gateway Senior Living is Lincoln’s most experienced senior living community, celebrating our 50th anniversary this year! Gateway offers the unique ability to provide the full continuum of care from independent living to skilled nursing and rehabilitation all on one campus. Seniors have the option of independent living in a duplex or apartment setting, as well as options to receive assisted living or skilled nursing care when needed. These options are particularly important to spouses with differing care needs.

The adult children should consider what is most important to their parent(s) now, while recognizing how their needs might change in the future. None of us enjoy the process of moving, so adult children should assist in the process of finding options that will accommodate changes in their parents needs including their overall health needs, social needs, and financial support.”

Amy also sees the positive effects retirement communities have on their residents on a daily basis. “Every day we see positive examples of how the social and clinical interaction between our team members and the seniors who call Gateway their home helps to improve their mental, emotional, and physical health. Having the availability of a full continuum of care on our campus, we are able to offer just the right amount of assistance in order for seniors to stay as independent as possible, for as long as possible. This flexibility also allows for spouses to reside under the same roof, even if their care needs differ. Our campus is designed with emphasis on embracing a social model of interaction and fun. The social and activity programming is designed to engage seniors in their life long interests, as well as to introduce new and exciting learning opportunities. At Gateway Senior Living you may find the local Bookmobile parked out front, while other seniors are busy taking a class on Graphoanalysis or Geneology. Programs and services are designed to promote individual choice in everything we do.”

Another retirement option in the community is Milder Manor. Milder Manor is a long-term facility that offers 24/7 nursing care. “Long term care facilities may have basically the same “features”, such as 24/7 nursing care, but some additional advantages that children may want to focus on include a rehabilitation area with top-notch therapists such as what Milder Manor has on board,” stated Larry Van Hunnik. “Also, an area devoted to dementia and/or Alzheimer residents is a plus, as those residents who don’t have memory problems when they come in but develop issues over time will have a quick transition for further support, without having the families making new arrangements for them.  A good life enrichment team is also something to consider as that team keeps the residents stimulated and interested in everyday life activities.”

Milder Manor, along with Legacy and Savannah Pines believes the retirement community atmosphere helps improve mental, emotional or physical health of senior living there. “Socialization along with constant healthcare being provided to residents is the largest benefit to the residents,” stated Larry.  “However, this is not to dismiss the relief and assurance that the residents FAMILIES feel with a move to a community; their stress is relieved as much or more than the residents!  Safety for the individual(s), good nutrition, and help with everyday chores such as dressing and bathing give comfort and peace of mind to residents and families alike.”

Transitional Rehab

Some seniors may be in need of services that result from an injury or illness. It’s important to get them the professional assistance they need so they do not begin a decline they cannot recover form.

“Individuals in need of short-term transitional rehabilitation have experienced some form of illness, injury, or surgery that has caused them to require assistance with getting through their day successfully,” Stephanie Farmer with The Ambassador explained. “These individuals are generally not feeling well, are in great amounts of pain, or have just experienced a traumatic incident that has left them feeling mentally and physically fatigued.  Although they may not be in the best spirits when they first arrive, it doesn’t take long for them to realize that our goal is their independence and once they see our staff working aggressively to assist with their recovery, they begin to cheer up and see the light at the end of the tunnel.  Short-term rehabilitation not only improves a person’s physical health, but it helps them to regain the confidence needs to go back to living independently once again.”

As you get older, your mobility starts to weaken. At The Ambassador Health System, they can help aging senior’s get back on their feet again. They believe in transitional rehabilitation. “Transitional rehabilitation is designed around the concept of bridging the gap between the hospital and the home.  The goal of transitional rehabilitation is to assist the patient with reaching his/her goals for recovery, which in most situations, involves a transition to a lower level of care,” Stephanie Farmer said. “Patients who are recovering from an acute hospital stay may require skilled nursing care.  Skilled care provides 24-hour nursing care for individuals with extensive medical and/or rehabilitative needs.  These services might include: aggressive therapy, IV therapy, or wound care.  The goal is to return the patient to their prior level of functioning and independence.”

The Ambassador encourages short-term transitional rehabilitation care following a hospital stay because of the level of care needed after hospital visits. “When an individual has been hospitalized for an illness, injury, or surgery, he/she requires a level of care that is focused on recovery and stabilization.  At the time of discharge from an acute hospital setting, many individuals still require some form of rehabilitation to return to their pre-hospital level of independence and functioning.  This care will be provided by a transitional rehabilitation program.” Stephanie stated. “If a patient returns home too quickly following a hospital stay, they run the risk of re-injury or illness which could result in a re-hospitalization.  Transitional rehabilitation cuts down on the possibility of re-hospitalization by providing therapy and skilled nursing that allows the patient to regain their strength and improve their overall condition.”

Convincing someone to go to a rehabilitation facility can be a hard task, especially if that person is stubborn and self-reliant. “For the majority of individuals, independence is something highly valued.  Children of seniors need to recognize how difficult the loss of independence can be, and must remain mindful of the difficulty that goes with making the decision to receive transitional rehabilitation.  Children play a vital role in encouraging their parent to consider short-term rehabilitation and need to emphasize that such programs are designed to assist the patient with regaining his/her independence and ultimately returning home.  By utilizing transitional rehabilitation, the senior is reducing the likelihood that he/she will be re-hospitalized for the same condition once again,” Stephanie said.

At The Ambassador they specialize in creating an environment that encourages healing and making the right steps to becoming you again. “Since The Ambassador Lincoln specializes in short-term transitional rehabilitation, our physical building has been designed around this concept and fosters an environment of healing and recovery.  Our patient rooms are all private, which allows short-term patients to recovery in the privacy of their own room.  Private rooms also allow families to spend time with their loved one during the recovery process,” Stephanie said.

Some amenities The Ambassador has include daily therapy sessions, independent activities and an in-house dietician. “Rehab patients spend their time working with physical, occupational, speech, and/or respiratory therapists to return to their prior level of independence and functioning.  Daily therapy sessions not only work on strengthening parts of the patient’s body, but also help the patient engage in activities of daily living so that they can transition back to their “normal” lifestyle at home (i.e. cleaning, baking, driving, etc.). The Ambassador Lincoln has a chef and a dietician that customize each patient’s nutritional plan to also assist in their recovery and rehabilitation.  Nutrition is a key element in the recovery process, plus food is extremely important in our culture and it is crucial that our patients enjoy their meals during their stay,” Stephanie stated.

Funeral options

The thought is hard to think about, but it is something everyone must deal with: planning the funeral. While the idea seems like something not to consider early, pre-planning a funeral is very important.

“There are many reasons I recommend pre-planning your funeral, explained Vicki Newman at Lincoln Family Funeral. “I will start with a few of the most common reasons:

It relieves the emotional burden from your family and loved ones and allows them to concentrate on supporting each other and grieving.  There are over 120 different decisions that need to be made in a very short amount of time.  If you can make some of them yourself before death, it is a wonderful gift to give your family.

Another reason is you can express your own wishes.  Often families are confused about what you would have wanted and they agonize over making the right decisions.  By selecting your options in advance, you remove that doubt and second-guessing by your family.  Plans can always be revised if your choices change

Finally, it relieves the financial burden.  If you choose to take care of the funding of your funeral in advance, there are plans that will ensure that your survivors will never have to pay additional funds for the services and merchandise you selected.  So, you protect yourself from inflationary costs.”

Another of the benefits of pre-planning is crossing that task off of your to-do list. “One of the most interesting comments I have had a family share when we were done with her pre-arrangement was, ‘there, now I can concentrate on living’,” Vicki said. “Many people when they are getting older and facing their own mortality end up fixating on it and as a result, they worry and fret but until they do something about it, peace of mind seems to be elusive.”

As a child of aging parents, it’s especially important that you listen and support when your parents talk of pre-planning their funeral. “Mainly by being open to the subject and willing to really listen when their parents talk.  Frequently, the parent is ready to talk but their children are the ones that aren’t.  By talking, it makes the concept of losing one of their parents more of a reality.  If the children knew how much stress they would be relieving from their parents by even having a simple conversation, I think it would be easier,” Vicki said.

Pre-planning early can also help with the financial burden of a funeral. “My first reaction to this question really shows my practical side.  The sooner someone pre-plans, the greater the eventual financial savings.  I worked with a family that had made their financial pre-arrangements in their twenties.  The casket the wife chose was only $325 at that time.  When she died 60 years later, if she had not pre-planned, that same casket would have cost her family $5,600 at the time of her death.  The family didn’t have to pay anything additional.  Statistics tell us though, that most people pre-plan in their late ‘60s to early ‘70s or only if they were diagnosed with a fatal disease.  A recent survey also showed that 89% of people think they should pre-plan in some way but the truth is that only about 4% actually do,” Vicki said.

Pre-planning is a hard task to take on and Vicki suggests taking it on in chunks. “Many times, pre-planning is done in steps.  The first step is to simply contact a funeral home representative to discuss what kind of a service you need and to educate yourself about what options you really want. I do recommend visiting a couple to check prices and find the one you feel the most comfortable with. The main goal is to get yourself thinking, if you were a “fly on the wall” at your own service, what do you envision?  What kind of food would be served?  What are your favorite songs?  Do you want your service at the funeral home, the church or in your own back yard?  A good representative will help you think through all of these details.

The next step is to sit down with your family and loved ones and have an open discussion about your wishes.  By doing this, you will get feedback that will also let you know how they envision the service.  This is important because the service is really for the living and their input along with your decisions will give everyone peace of mind.  The final step is to financially fund the service and lock in your pricing.”

We all want our parents and other senior loved ones to age gracefully. We want them to be able to keep as much of their independence as possible and thrive in an environment that stimulates their social, emotional and physical health. As their child, you are their main advocate and should be helping them navigate through the maze of eldercare to make the right decisions. However, you are also a busy individual with a career, family and other obligations and it is usually not feasible for you to be their full-time caregiver. By working with experts in the aging industry, you can ensure that you are helping your senior loved one make the best decisions without sacrificing your precious parent-child relationship in the process.