Most of our readers have not yet reached the age where they are having trouble remaining in their home alone or are beginning to look at the different living options that retirement communities provide. However, many of you may have it on your minds as your parents or grandparents are probably reaching that age and you have taken on the task of trying to help them as much as possible. This can be a very challenging process, especially if your senior loved ones are experiencing physical or mental health impairments that make everything more emotional and difficult. Fortunately, there is help available! Whether you are trying to help your loved one remain in his or her home or it’s time to think about other options, you can easily find those who are educated in these types of issues and can guide you in the right direction.
Staying in the Home
If they are able to, many people want to stay in their own homes and it’s understandable why. This is probably the home they have spent many years in and is full of their possessions and memories. They may have raised children in this home and perhaps they have lost a spouse who they bought and shared the home with. Many times, with some adjustments, it is possible for seniors to remain in their homes for much (or all) of their retirement years. You simply need to communicate with them and know how to recognize when they need help.
There is no shame in admitting that a senior needs help remaining in their home and there is no shame on your part for admitting that you cannot provide all the help they need. This does not necessarily mean that your loved one needs to move out of his or her home, it could simply mean that they need some extra help.
“Guardian Angels Homecare’s business model is based on the inherent value of each person,” states Tony Fulton of Guardian Angels. “We apply this to our clients and our staff. Keeping elders in their home contributes to the fabric of our community. Aging in place allows them to continue to interact with neighbors and friends, maintain home ownership and demonstrate that they still have value to contribute to those around them. Our caregivers share a vision and live it out as they form both professional and personal bonds with our clients. We are literally serving the generation which first served us.”
There are a number of qualified agencies in town that can provide a wide range of in-home care, from non-medical issues such as laundry, cooking meals and companionship, to medical needs. Even if your loved one is experiencing major medical conditions, they may still be able to remain in their home in partnership with a business like Health at Home Consultants. “Health at Home Consultants is the first Nurse Practitioner owned house call practice in the state of Nebraska,” says Sarah Baltensperger with Health at Home Consultants. “We specialize in bringing high quality, cost effective healthcare to the geriatric population in their home environment. Our Nurse Practitioners offer a valuable service to homebound individuals, resulting in a perfect niche to home care.
The growing number of individuals who are considered homebound due to chronic medical conditions, decreased mobility and/or memory loss often do not receive medical attention without having a house call. According to the American Society on Aging, there are now more than 40 million people in the United States who are 65 or older, and 37 percent of this group are reported to have severe disability, with 16 percent requiring some type of assistance. Also, a review of Medicare data from 1998 to 2003 showed that the total number of house calls increased by 43 percent, and this number will continue to grow dramatically.
The goal of Health at Home Consultants (HAH) is to provide home care medicine in one of the most rapidly expanding areas of healthcare. We 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. Health at Home Consultants can play a major role in the expanded healthcare delivery, by setting our sights on what is best for the future of our patients.”
Benefits of Moving to a Retirement Community
In many cases, it makes sense for a senior to make the move to a retirement community. This should in no way be seen as ‘giving up’ or failing and it’s important for you to help your loved one realize this. Even if your loved one is doing fine in their home and are not experiencing medical issues, a retirement community (depending on which one you choose) provides added benefits such as socialization, chef-prepared meals, exercise facilities and/or classes, outings and so much more.
“Socializing not only contributes to a longer, happier life, but it also improves cognitive performance,” explains Karla Frese with Savannah Pines. “Of course, we all want to live longer while remaining healthy and alert. Adding a circle of new friends and a support group will help enrich your loved one’s life in innumerable ways. The only regret our residents have is they wish they would have done it sooner. One of the most important factors in aging successfully is social connectivity. Living alone in one’s home often limits their socialization opportunities, which leads to faster decline. Those who live alone in their own homes must also cope with grocery shopping, home maintenance, cleaning, daily responsibilities, etc. At Savannah Pines, these items are all provided for or handled by the community. Socialization, security and peace of mind are important benefits of Savannah Pines.”
“The safety and security afforded to seniors by living in a retirement community such as what Gateway Senior Living is a primary reason,” says Amy Fish with Gateway Senior Living. “In addition, the daily social interaction is another significant reason for wanting to make the move. Often, seniors find they also don’t need or want the hassle or stress of the ongoing maintenance in their own home. Not having to pay for lawn care, home repairs, or housekeeping services is a plus in a retirement community. Plus, they don’t have to worry about cooking or having meals delivered to their home. The luxury of enjoying chef-prepared meals is another significant advantage.”
“The unexpected costs associated with owning property are also sometimes more than people want to deal with at this stage of their lives,” adds Jay Bohlken with Legacy Communities. “This would include things like plumbing, electrical or concrete problems. They also may not want to invest in upgrading their existing home with a new 
roof, carpeting, or appliances. Beyond the basics of a comfortable living environment and a balanced, consistent diet, the biggest advantage of a retirement community is the social aspect. There is value in being around other people. This is especially true when living among your peers. Our residents are generally from the “Greatest Generation” and have lived through the same historic events. This common bond allows our people to relate well with one another. We also have a number of young staff members. This intergenerational mingling is beneficial for everyone.”
In some cases, a senior’s health (either emotional or physical) makes it necessary for them to either employ in-home health or make the move to a retirement community. Some of these issues, according to Karla Frese with Savannah Pines, include frailty and/or arthritis (this can be become a big issue if their home has stairs they need to navigate on a daily basis), visual impairment or macular degeneration, confusion and/or forgetfulness, hesitation or inability to drive, no desire to cook, change in weight, loneliness, withdrawal from current social activities and/or lack of exercise, instability and/or fear of falling, needing help with medications and change in cognitive abilities. While some of these can be managed by in-home help, moving to a community where there is plenty of help around at all times and where the facility is specifically built to care for those who may be experiencing the same issues can often be the better answer. Bringing this up to your loved one and helping to ease them into the idea of moving can be a challenge.
Karla says, “As you visit with your loved ones, use this special time to offer much-needed support and check in on their health. The goal of Savannah Pines is to encourage healthy lifestyles, provide social activities for residents to stay involved, simplify daily living and to raise awareness of options available to plan ahead before a crisis happens. Many communities are full with a wait list, so it is very important to start planning ahead of time. One way to begin the conversation with your aging loved one is to provide an example of someone you know who has received help and the positive impact it has made. 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 before symptoms begin to show and look at the benefits of Savannah Pines Retirement Community.”
Sara Engelhaupt with The Lexington suggests, “Have an open discussion about the possibilities of a senior community with your parent or parents. If they are open to the idea, move forward with the next steps. If they are resistant, then slowly talk to them over a period of time and let them know that a community setting can still provide them with their independence, but maybe offer that little bit of extra help or the security of always having someone around. Determine what it is that they specifically need. Would they benefit the most from an independent living, assisted living or skilled-care community? Once those needs are identified, the adult children can start shopping around to the various types of communities within their preferred locations.”
Choosing the Best Community
Looking at the big picture and deciding what is best for your parents’ overall health (both mental and physical) is the most important thing when helping them make decisions. Getting some outside help to focus your efforts is always a good idea. Robbie Nathan with Care Consultants for the Aging says, “I help families look at the whole picture—what they or their loved one both want and need for themselves, where they want to receive their services, how they would like care done and who they will have do that care. It is helpful to understand not only the person you are assisting, but also the family and the environment.”
When a representative from Care Consultants works with a family, especially if they are staying in the home, they always encourage them to LISTEN to each other. “It is very difficult for parents to have their children care for them, yet alone they admit they need extra care,” Robbie explains. “Sometimes is it less challenging if a child suggests that they are tired and have the need for someone else to come in and perform the care. This takes the focus/guilt off the person actually needing the care. Introduce a caregiver early and slowly. Sometimes just a couple of hours a week sets the stage for more detailed care in the future. Be proactive and again, listen!”
Fortunately, the senior living industry continues to progress in a more positive direction every year. “I see better communication when several ‘services’ are in place with one client,” says Robbie. “Hospitals and rehabs are working to decrease the ‘under 30 day’ readmits. When a person goes home with home health care, the caregivers know much more about what is expected of them. I also see the families suggesting and seeking outside help somewhat earlier, whether in the home or at a senior living campus. The stigma of needing ‘help’ is fading.
Lincoln is so fortunate to have quality services. There is always a fit for everyone. It is so vital that there is a comfort level between the caregiver and the family. This is possible if research and decisions are made before a crisis or during a crisis. Care Consultants for the Aging has an excellent ElderCare Resource Handbook for just that purpose and it can be obtained by contacting their office or website: http://www.careconsultants.com.”
Adult children often play a large part in helping their loved one choose the right community for their needs. Often times, they are the ones making all the decisions, especially if their loved one is resisting the move or if their health has declined to the point where they aren’t making many decisions for themselves any longer.
“Each resident’s relationship with their children is unique,” explains Jay Bohlken with Legacy. “Many times, adult children who live locally are very involved in the moving process. They may even visit a number of communities and make a recommendation as to their preference. However, there are a number of residents who want to make the choice independently. They may feel that the decision is theirs alone to make and they don’t want to burden their family by asking for help. “
When they are involved, children can take the advice of the many experts in eldercare in the area to help guide them in the right direction. Amy Fish with Gateway Senior Living states, “Adult children don’t want to wait until a crisis develops to begin the search for the perfect retirement community for their parent(s). Their children should try to keep their parent(s) actively involved in the discussions, tours and selection if possible. They should also know and understand their financial status so they may assist with helping facilitate any necessary financial assistance programs. Children will generally help weight the positives and negatives of different housing options, assist with the actual move, help with the transfer of any important information and most importantly, help with the overall adjustment to a new living environment.”
Karla Frese with Savannah Pines adds, “Take the time to prioritize what choices and options you are looking for in a retirement community. Is having a continuum of care important so that, as your needs change, your address doesn’t? Are wellness and rehabilitation services a must? Then, as you tour various communities, ask to have a meal, visit with some of the current residents and get an overall ‘feel’ of the campus. Don’t be afraid to ask plenty of questions in order to make your needs known. Use the available resources within the community. The team at Gateway Senior Living believes we must be a resource for seniors on the various options of senior living. As experts in the field, we are able to assist seniors with understanding the various requirements of admission, helping to understand insurance policy information, and guide them towards the services that best fit their expectations or need.”
Visiting different communities is very important as you just can’t get a feel for a community by looking at a brochure, talking to representatives on the phone or looking at their website. When touring a community, Karla Frese suggests asking about the following: “Socialization and transportation is important. Ask for an activity calendar and if they charge for rides. Then research their dining program. Do they offer three meals a day? Be sure to try a meal there to learn for yourself what they have to offer. Finally, ask about choice, options and flexibility. Is there a long-term commitment or a buy-in? 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? For example, Savannah Pines welcomes all home health care agencies to help residents with additional care services such as medicine, physical therapy and bathing aids to keep them thriving in an independent environment with a little extra help as needed.”
Jay Bohlken with Legacy reiterates, “The best way to choose a community is to personally visit. Take the time to leisurely stroll the community. Observe the interaction between residents and staff members. Talk to current residents about their experience at the community. It is important to get to know the personality of the community to ensure it would be a good fit for you or your loved one.”
There are a number of options to choose from in Lincoln and the surrounding area and there’s no reason to drag your senior loved one to all of them as this might be overwhelming. It would be easier for you to do the legwork yourself and then narrow down the options to two or three that you think would be the best choices. “At this point, take them to those communities to let them see for themselves and get a feel for each community they visit,” says Amy Fish. “This will allow for a discussion between the children and parents on the pros and cons for each community they visited.”
Make sure you take advantage of any unique aspects that a community has to offer, either on your own or with your loved one if that becomes one of your top choices. “Savannah Pines invites you to enjoy entertainment in the theatre,” says Karla Frese. “Call and ask if there are any activities or events that you could participate in or observe. This is a relaxing way to have a fun da out and get a tour.” Many communities offer dances, outings, movies, casino nights, car shows and other fun events that are open to the public, so even if you don’t choose that community, it can still be an opportunity to get out with your loved one and help them get a little more socialization. Almost all communities also invite the public to try out a meal with them and this can be a nice way to take your loved out for a meal and help them make new friends.
“Navigating the senior housing choices can be overwhelming,” sums up Roxann Rogers Meyer with The Landing at Williamsburg Village. “There is a lack of education and understanding on the part of the consumer and most consumers do not know the difference between Independent Living, Assisted Living, Alzheimer’s and Skilled Nursing.
At The Landing at Williamsburg Village, we often visit with the adult child initially before the prospective resident has the opportunity for a personal visit to the community.
Many adult children become involved in the research and decision when they are dealing with their aging parents. Oftentimes these decisions come with complications including health, finances, insurance, family dynamics, lack of future planning or understanding when it comes to the various levels of care available to seniors.
Our goal is to help guide adult children and their parents on this journey and help them come up with the option that best meets their needs.
Planning for the future is the most important factor to aging successfully. You can enjoy your loved ones when they are living in a senior living community. Rather than caring for them, you can use your time and energy to focus on spending time with them, enjoying events, activities and conversation.”
If your loved one needs more care than what an independent or assisted living community can provide, there are a few more considerations that will be factored into your decision. Barb Tyler with Milder Manor explains, “It is likely that all of us at some time in our lives will require health care services beyond independent or assisted living. It is at that point that many life-long Lincolnites and Nebraskans look to Milder Manor; with its rich history and exceptional reputation, Milder Manor is a natural choice for people who look to ensure that each new resident’s contributions are not forgotten nor their special needs are ignored. Milder Manor makes it their mission to give these members of our community a place to feel respected, safe, comfortable, and happy.
When selecting a long term care community which may be combined with rehabilitation services like Milder Manor provides, families should look for a facility that treats everyone with respect and allows independence and dignity. We understand that leaving a life you know to receive more assistance is a difficult decision, even if the arrangement is only temporary. Services are centered around each person’s lifestyle, with the choice of when to wake up or when it’s time to go to bed, to the time a meal is served, to the different functions and programs held within the community. Family and friends are welcome to visit and participate in activities any time.”
Remember, the ultimate choice of where they should live should be up to your loved one. Even if you have a number of reasons why you would choose one community over another, you are not the one who will be making it your home. Unless they honestly are not mentally able to make the decision, your loved one should have the final decision when it comes to where they would like to move.
Benefits of Exercise
Whether they are staying in their home or moving to a retirement community, exercise is vital to the health of your loved one. Here are some ideas on helping them stay active:
–Go for walks with them. If you live close by, this is a great way to not only help them get exercise, but also spend time with them and get a little exercise yourself. If the weather is too bad for this, visit the mall or another indoor facility and walk around there.
–Enroll them in classes. There are a number of exercise classes that are geared toward seniors. Refinery Fitness, for example, has a number of classes specifically designed for seniors as well as personal trainers who can help customize the perfect program for your loved one. Classes carry the added extra benefit of socialization as they will be taking them with other seniors they can form relationships with.
–Choose the right retirement community. Many communities offer exercise programs for their residents because they know how important it is. “Those considering the move to an independent living community will be interested to learn that the American College of Sports Medicine (ACSM) has focused on the theme “Exercise as Medicine” since 2008. In short, exercise and the socializing that often accompanies heart, health and wellness activities, is the most potent and side-effect free medicine available. Exercise positively affects every aspect of the body, mind and yes, spirit,” says Janette Drohman, Lifestyle Director at Savannah Pines. “Our residents enjoy participating in exercises through our numerous fitness programs including water aerobics, dance aerobics, weight lifting, walking club, sittercises, stretching and Wii Sports.”
Helping with Medical Needs
Of course, as your senior loved one ages, he or she will experience more issues than just decisions on where to live. It’s important to help your loved one navigate the health care system and get the care they need for any medical problems before they have serious adverse effects on their lives. Osteoporosis and other bone density issues are one common problem that many seniors face.
“We lose bone density as we age, about 0.5-1.0 % per year, beginning in our twenties,” states Mary Curtis, M.D. with Advanced Medical Imaging. “Women age 65 and older and men age 70 years and older should be screened for osteoporosis (abnormally decreased bone density and bone quality) which makes one more susceptible to fractures. However, men under 70 years old and women who are postmenopausal or during the menopausal transition or even younger with risk factors for fracture should be evaluated as well. Risk factors for fracture include low body weight, loss of height and personal history of a prior fracture especially fracture of hip, spine or wrist following minimal trauma such as a fall from standing height. Other risk factors include taking high-risk medications (for example, steroids, Depo-provera, anti-seizure medications, heparin, etc.) or chronic diseases such as COPD, Crohn’s disease, celiac disease, lupus, rheumatoid arthritis, thyroid problems (especially overfunctioning) and thyroid cancer. Bone loss in women accelerates with menopause and this phase lasts 5-10 years. For men and women, advancing age leads to increased risk for osteoporosis and fracture, with each decade of aging past age 50 approximately doubling the fracture risk. So senior citizens are at even higher risk for osteoporosis and fractures.
Bone density scans are critical to diagnosing osteoporosis and assessing fracture risk and whether therapy is working. For example, hip fractures are not only painful, they increase the risk of mortality by 24-30% within one year and 50% of hip fracture survivors are permanently incapacitated. 20% of hip fracture survivors require long-term nursing home care. So preventing or decreasing the chance of a fracture is important for quality of life and survival.”
Breast cancer is another risk that increases with age. “The American Cancer Society and American College of Radiology recommend that women have a mammogram every year beginning at age 40,” says Dr. Curtis. “A woman’s risk of developing breast cancer increases with age. About one out of eight invasive breast cancers are found in women under 45 years of age. About two of three invasive breast cancers are found in women age 55 or older.
About 1 in 8 American women will develop breast cancer in their lifetime. Breast cancer is the most common cancer among women and the second leading cause of cancer death among women. Mammograms are an important tool in diagnosing breast cancer and the earlier breast cancer is diagnosed, the more likely it is to be treatable or curable. An annual mammogram is recommended in screening for breast cancer.”
If your loved one needs one of these tests, you can help them by choosing a place for them to get the tests done. “Consider quality and convenience,” advises Dr. Curtis. “Are the facilities credentialed and are the interpreting physicians board-certified? Also, bone density scans are much more accurate to assess change and improvement if performed on the exact same machine each time. Similarly, prior comparison mammograms are critical in the interpretation of the current mammogram. Some facilities offer both bone density testing and mammography. Advanced Medical Imaging can perform both examinations in one convenient visit, with results sent to your doctor usually within 24 hours.”
Preplanning
No one wants to think about the funerals of their loved ones. We all know it’s inevitable, but thinking about it, let alone planning for it, can seem morbid. However, by not pre-planning, you’re causing your family extra stress in a time when they don’t need it and the burden of planning and paying for the funeral now falls on their shoulders. If your loved one has not yet planned for their funeral, share this information with them supplied by Bryan Block of Butherus Maser & Love Funeral Home:
Many years ago someone in this industry told me that more people pre-arrange their funerals when the economy is doing poorly than when we have a robust economy. I don’t know if I can say that is accurate all the time, but we have certainly seen a surge of people wishing to pre-plan their funeral arrangements in the last year. As much as we like to have fun and purchase frivolous things, everyone is still a little pragmatic and starts to prioritize their purchases at some point. Funeral Plans are something that will have to be done at some point and many people see the wisdom in making these arrangements at today’s costs.
I am often asked by families, “How can we save some money on our funeral arrangements?” There are really three ways to save on funeral costs: 1) In the products you select. We would be happy to visit with you and show you a wide range of items to assure you select the products you are comfortable with. 2) By avoiding the ‘emotional purchase’. Studies show families will spend more when making these decisions after a death has occurred than if they would have pre-planned, and 3) By pre-planning at today’s costs and minimizing the inflationary impact on the type of service you would like to have.
Whether you and your family wish to have the most basic of arrangements or a funeral with all the extras, this is a major purchase either way. To leave that financial obligation to your children or other friends and relatives can be burdensome and can lay the groundwork for strife among family members. The memory I want my children to have is that I cared enough to take care of the decisions and payment ahead of time so they didn’t have to worry about it.
Wills and Power of Attorney
If your loved one does not have a will or power of attorney, it is crucial that you help them make arrangements for them NOW. In addition, if you personally do not have a will or power of attorney, it would make sense to get one of your own.
A will is a legal document in which a person provides instruction on how their assets are to be distributed and who will become caregivers for any minors. A will is your final wishes. If you die without a will you die “intestate” and your assets are distributed according to your provincial or state laws, which may not always be what you wanted. Therefore it is vital to have an updated will. Two of the most important people in your will are your executor and the beneficiary. The executor is the person you have chosen to execute your wishes and is responsible for making sure your taxes and bills are paid and your will is executed as you wanted it. Generally, you state what percentage of your estate should be paid to the executor.
The beneficiary is the party who will receive some of your assets and you can have several beneficiaries in your will. The executor and beneficiary could be the same person, but due to potential conflict of interest, it is better to avoid that.
Even if you do not have a lot of assets, it is important to have a will and update it annually or as your situation changes. Dying intestate can cause family disputes and lawsuits, all this can be prevented if an updated Will is in place. Having a will does not mean there won’t be any disputes and potential lawsuits, however it will reduce the chances significantly.
Power of Attorney basically gives someone else to right to act on your behalf; there are two types of powers of attorney:
Power of Attorney for Personal Care is the type of power of attorney that gives someone the right to make decisions regarding your health on your behalf if you are unable to do so, for example, if you are in a coma. There can be many cases where someone else may need to make an important medical decision on your behalf and the only way one can do it is through the power of attorney.
Power of Attorney for Financial Matters gives someone else the power to make financial decisions for you if you are unable to. This will give your power of attorney access to your finances and this person can be the same or different from your power of attorney for personal care.
Many are often concerned with the cost associate with these documents, but they forget the potential cost of not having them. Depending on our situation a will can cost between $100-$2000 and more, the more complex your situation the more expensive it will be. There may also be charges for annual updates, but not having a will can cost your family a lot more. Powers of attorney are usually cheaper, but again it depends on your situation. Regardless of the cost Wills and Powers of Attorney are an absolute must for everyone, especially those with families. Your financial plan is incomplete without them.
As you are helping your senior loved one navigate the issues that come with aging, you should also put some thought into your future plans. These do not only include wills and power of attorney, but also pre-planning of your own funeral services as well as looking into issues such as long-term care insurance. We never know what life will throw at us and it’s inevitable that we will all age. Why not make arrangements now so that your children are not faced with the burden of caring for you when you are older or having to pay for someone else to do so.?
Helping your senior loved one be their happiest and healthiest is top priority for anyone with aging parents. With the help of the wonderful aging experts in our community, you can make sure you guide them on their way in the correct fashion and with the most support possible.