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Maybe 90% Of Older People Don't Want To Live At Home

Joseph Coupal - Thursday, April 19, 2018

Spring Arbor, Richmond, VAResearchers keep producing articles and reports saying that older people want to live at home. Well, duh! If you ask anyone about living at home you’re going to get the same response. What I really want to know is, of those people who are infirm, that is, cannot make it to the bathroom on their own, feed themselves, go to the store, or bathe themselves safely (all the Activities of Daily Living), how many of them want to live at home, especially if it means living by themselves? That’s the really important piece of information needed to make real decisions and policies.

I find it curious that when you ask these same older people about whether they'd want to live at home if they knew their family would have to take care of them, they respond “No.”

What’s also curious to me is, what is the real question these respondents are answering? When my mother-in-law was living in an assisted living facility she kept repeating to us, “I want to go home.” We kept wondering what she meant and asked, “Where do you mean?” Turns out, she didn’t mean the last place she had lived in before moving into the facility. Or even to the house she and her husband lived in for 40 years. She meant the past. She wanted to go back to the time when she was living in her wonderful home with her family and most of her life was ahead of her.

I’m in the demographic group that researchers survey. That is, I’m “over 65.” (According to a widely cited study by the AARP, almost 90% of those 65 and older want to stay in their current homes for as long as possible.) And of course I want to live at home. If I didn’t, I'd move. And if could afford it, I’d move myself into a hotel or, better yet, a full-time resort. Or if I didn’t like my current home, I’d move to another one. The key here is that I know I’m perfectly capable of living by myself.

I also want to know the feelings people would have about living "at home" if they knew they'd be living alone. I think we know the answer to that. After my stepmother died, my father lived in the apartment by himself and had a caregiver live there with him. The apartment was far from me and from my brother. My father wasn’t mobile, he had few friends since he had outlived most of them, and the few that were left never came to visit. Plus, he needed someone to live with him — to prepare his meals, clean, get him to and from the bathroom, etc., all the activities of daily living. Still, he said he wanted to stay in the apartment. And so he did. After a few months he told us that it was getting too hard for him and he was feeling too lonely being by himself all the time, even with the caregiver we had hired. So then he told us he wanted to move, and it was with our blessing. He moved into an assisted living facility closer to my brother, and there my father lived out the rest of his life. He was much happier there and had frequent visits from the family. He didn’t have a lot of friends at the facility. But meals were with other people and sometimes they talked with each other. He went to a few activities and again, he interacted with people, not just the one caregiver he would have had access to at home. He told me, close to the end of his life as it turned out, that he was happy there. He used the word “content.” Moving to the facility was definitely the right thing to do. And had researchers asked him about whether he wanted to live at home, he would have said, “No, I didn’t want to live at home.” For one, he had too many bad memories of what it had been like for him at home after his wife died. But really, he would have said, “I couldn’t manage by myself and, frankly, I was lonely.”

So I challenge researchers to sample the right population before making sweeping comments about how “older people” want to live in their homes. Also, researchers, be sure you define what the word “home” means to the people you’re surveying. “90% want to live at home” makes a great headline. But it’s a meaningless statistic.

For more information on assisted living, contact Spring Arbor.

#HowYouLive

Forbes


Choosing the Right Assisted Living Community

Joseph Coupal - Tuesday, April 17, 2018

Spring Arbor, Greensboro, NC Lack of oversight and caregiving shortfalls could put residents at risk. Here's how to avoid problems.

For many frail older Americans, assisted living has become an increasingly popular alternative to remaining in their homes. You can live in a comfortable residence, receive the services that you need, such as help with bathing and dressing, as well as avoid the institutionalized setting of a nursing home.

But finding the right residence can be a daunting challenge. It's also difficult to judge the quality of care you will get.

Many more people going into assisted living facilities today have high care needs. But many of the facilities aren’t set up for high levels of care.

Smart Questions to Ask

For families seeking assisted living for a loved one, there are ways to find a facility that delivers quality care in a comfortable setting. The key is to do careful research.

Start by asking these five key questions:

1. What Kind of Help Do You Need?

Think about what kind of help you or your family member needs now and in the future. Are you looking to help your loved one enjoy more social interaction, or get help with memory loss, or more medical care? Different facilities offer varying levels of care—not all have memory units, for example. The social activities vary as well, so check to see if the book clubs or trips to the symphony fit in with your loved one’s interests.

It’s also a good idea to have your family member evaluated by a physician to have a better understanding of the level of care required and how that might change. That way, you can judge whether the facility will meet your loved one’s needs over the long term.

2. What Is the Quality of Care?

Check into the residence’s licensing and inspection records to see if there are reasons for concern. Depending on your state, you may find this data online—a good starting point is your state Agency on Aging. You can also contact your state ombudsman about the facility’s complaint record. (Go to ltcombudsman.org; use the map tool to find links for your state.

You should also ask if the facility has a registered nurse on staff. If the facility doesn’t have one, your loved one may end up going to the ER more frequently.

To get a feel for the quality of life, make multiple visits to the facility. Go for meals and during the weekends, when fewer staff are on duty. And speak with residents and their families about their experiences.

3. What Are the Real Costs of Care?

As noted above, the typical cost of care is high. And add-on fees could push those costs even higher, which will stretch, or exceed, many retirees' budgets. (Read this story for tips on affording assisted living care.)

Be sure to get a written list of fees and charges from the residence, and check to see that they’re included in the contract. While some facilities have all-in costs for room, board, and a particular level of care, others have a point system or charge à la carte. Find out what circumstances might lead to more fees, such as needing help walking to meals or falling ill for a week or so.

Given the high costs involved, it can be a prudent move to hire an elder law attorney who is familiar with local facilities to review the terms of the contract.

4. Can Your Loved One Age in Place?

One of the biggest risks for assisted living residents is involuntary discharge, or eviction, which can happen through lack of payment or when the care required exceeds the facility’s ability to provide services. These circumstances might include cognitive decline, lack of mobility, or complex medical needs.

Find out what situations might trigger a discharge, and whether you could hire private aides if more care is needed. Also ask what assistance the facility would be able to provide if a move is required.

Some nonprofit facilities, for example, may help a resident running low on funds to qualify for Medicaid, which could pay for nursing home care, or funds that may help your loved one stay in place.

5. Will Your Family Member Have an Advocate?

Once you’ve found a residence for your loved one, it’s important to have family and friends drop by regularly. That way, you will be able to spot any lapses in care quickly, which is especially important if your family member is ill or confused and cannot advocate for herself.

If you or your family are not able to visit regularly, consider hiring an aging-life-care expert or asking a friend living nearby to check in on your family member. Spotting issues early may help prevent more costly problems later. And if the assisted living management knows you’re keeping a close eye on your loved one, that can help ensure the quality of care.

For more information on assisted living, contact Spring Arbor.

#HowYouLive

Consumer Reports


Traumatic Brain Injuries Linked to Dementia

Joseph Coupal - Thursday, April 12, 2018

Spring Arbor, Richmond, VAIn one of the largest studies on the association, researchers found people who suffered traumatic brain injuries were more likely to develop dementia and Alzheimer's disease. A traumatic brain injury can occur when there is a bump, blow or jolt to the head.

People who have suffered a traumatic brain injury have a significantly higher risk of dementia, including Alzheimer's disease, than people who have no history of injury.

In one of the largest studies on the subject, researchers studied 2.8 million patient records. They found people with a history of brain injury had a 24 percent higher risk of dementia than those who did not.

The Centers for Disease Control and Prevention defines traumatic brain injury as "a disruption in the normal function of the brain that can be caused by a bump, blow or jolt to the head, or penetrating head injury."

Approximately 50 million people worldwide experience such injuries per year, a press release from the University of Washington School of Medicine reported. About 47 million people worldwide suffer from dementia.

According to the study, a single traumatic brain injury defined as "severe" increased the risk of developing dementia by 35 percent. A single incident of a "mild" case or concussion increased the risk by 17 percent.

The number of brain injuries greatly increases the chances of developing dementia or Alzheimer's disease. People who suffered two or more traumatic brain injuries had a 33 percent increased chance. People who had suffered four or more had a 61 percent increased chance, and people who suffered five or more had a 183 percent increased chance.

"What surprised us was that even a single mild TBI was associated with a significantly higher risk of dementia," lead author Jesse Fann said in the press release. Fann is a professor of psychiatry and behavioral sciences at the university.

"And the relationship between the number of traumatic brain injuries and risk of dementia was very clear. ... Similarly, a single severe brain injury seems to have twice the risk associated with dementia as a single mild traumatic brain injury." 

When a person suffers a traumatic brain injury also affects the likelihood of developing dementia. If someone suffers a brain injury in their 20s, they are 60 percent more likely to develop dementia or Alzheimer's disease in their 50s.

This is concerning because traumatic brain injuries are more common in younger people.

While not every person who suffers a single traumatic brain injury or concussion will eventually develop dementia, the findings may prompt those with histories of such injuries to alter their lifestyles and take control of other risk factors for dementia, including limiting alcohol and tobacco use, increasing exercise, preventing obesity and treating diabetes.

For more information on dementia care, contact Spring Arbor.

#HowYouLive

US News


Questions to Ask Before Choosing a Memory Care Community

Joseph Coupal - Monday, April 09, 2018

Spring Arbor - VA, NC, TN, SCAs you search for memory care communities, you will eventually come up with a list of your top choices. It is important to take time to tour each one, if possible. Ask questions of staff and other families whose loved ones reside at the community, to determine if the community is the right fit for your loved one.

Here are some questions that you may want to ask memory care communities you’re considering:

  1. What level of care does the community provide?
  2. What type of training has the staff received?
  3. What is the monthly rate for housing and care? What services does that rate include?
  4. Are rooms private or semi-private? How do prices vary for each?
  5. What level of personal assistance can residents expect?
  6. What is the policy for handling medical emergencies?
  7. How is the community secured?
  8. What meals are provided? Are special dietary requests, such as kosher meals, accommodated?
  9. How often are housekeeping and laundry service provided?
  10. What programs (exercise, physical therapy, social and other activities) does the facility offer?
  11. Does the facility accommodate special care needs, such as diabetic care, mobility issues, physical aggressiveness or wandering?
  12. Are residents grouped by cognitive level?
  13. What is the ratio of staff to residents during the day/night?
  14. How does the facility communicate with families about a resident’s well-being?
  15. What is the discharge policy?

Families making care decisions about loved ones far away may want to make sure they know where a community is located and perhaps consider travel costs. For more information on memory care, contact Spring Arbor.

#HowYouLive

alzheimers.net


Retire in Virginia

Joseph Coupal - Friday, March 30, 2018
  • When deciding the best place to retire, it's important to consider affordability, quality of life, and health care.
  • Minnesota is the best for quality of life and healthcare, but has low affordability for retirees.
  • Florida is the best state for retirees, not surprising considering it has the most senior citizens.
Spring Arbor - VA, NC, TN, SCThe US is very large and experiences can vary drastically within the country.

If you decide to stay in America when you are done working, you might want to know which state is best for retirement. WalletHub recently released their 2018 retirement rankings. Using 41 metrics in three broad categories, they were able to rank every state to find the best and worst places to retire.

The three main categories used were affordability, quality of life, and health care. WalletHub weighted the affordability section 40% and the other two areas were given equal weight of 30%.

Where you decide to live during retirement depends on what you value. Residents of Hawaii have the highest life expectancy, while the lowest is found in Mississippi. On the other hand, the cost of living is totally flipped with Mississippi coming in first and Hawaii ranked last.

If you are looking to be entertained in retirement, New York might be a good option. Despite the state's lackluster overall rating for retirement, WalletHub's analysis found that the Empire State has the most museums and theaters per capita.

The same state — Minnesota — can claim to have the best quality of life and health care. However, a low score on the affordability measure kept Minnesota from being one of the best overall states for retirement.

As for each of the three categories: affordability, quality of life, and health care, where did Virginia rank?

5. Virginia

  • Affordability rank: 18
  • Quality of life rank: 9
  • Health care rank: 21

For more information on apartments in Roanoke, VA contact Honeywood.

#HowYouLive

businessinsider.com


Choosing the Right Type of Senior Living

Joseph Coupal - Friday, March 23, 2018

Spring Arbor - VA, NC, TN, SCWhen you decide you’d rather live in a community than age in place at home, the next step is choosing the right place. The choices are many and include independent living, assisted living, memory care and a continuing care retirement community or a life plan community. Asking yourself these questions will help you make up your mind about which community is the right choice for your needs.

  • Independent Living
  • Assisted Living
  • Memory Care
  • CCRC (Continuing Care Retirement Community) or Life Plan Community

Asking the Right Questions about Senior Living

How you answer community-specific questions can be a good indicator of what type of senior living community will be a good fit.

Independent Living

Older adults who choose an independent living community often do so for reasons of convenience and socialization. Is it right for you? Ask yourself:

  • Are you an active, independent senior?
  • Can you safely manage your personal care needs?
  • Are you able to independently manage your medications?
  • Do you intend – and are you able – to maintain your active lifestyle?

When you prefer not to worry about household maintenance and repairs, so you have more time for life enrichment activities, travel and family, an independent living community could be a very good choice.

Assisted Living

Adult children and their aging parents often find an assisted living community to be an agreeable compromise. The senior maintains their privacy and independence in a private apartment or suite. And their adult child will feel confident their parent is safe and has the extra care and support they need.

Is assisted living the right choice?

  • Are there signs more help is needed with the activities of daily living, such as bathing and dressing?
  • Are there increasing concerns about personal care and safety?
  • Have there been falls – or a series of falls?
  • Is meal preparation becoming more difficult? Are there signs of hunger – or evidence that dietary and nutrition needs aren’t being met?
  • Has the family caregiver become worn-out, or are they experiencing health problems of their own?
  • Do home care expenses exceed the cost of moving to an assisted living community?
  • Do mobility issues make it difficult (or impossible) to safely maneuver inside and outside the home?
  • Are you worried about isolation?

If you answered yes to one or more of these questions, you should find out more about the assisted living communities near you.

Memory Care

Specialized care for adults with Alzheimer’s disease or other form of age-related dementia is often referred to as memory care. While no cure has yet been found for Alzheimer’s, memory care programs continue to benefit from research. Today, these programs are quite effective in maintaining the quality of life for those who have memory loss. Consult with your physician if you answer yes to any of the following about your loved one:

  • Is around-the-clock supervision required for safety?
  • Are there difficult-to-manage behaviors, such as Sundowner’s Syndrome, wandering or aggression?
  • Is it a struggle to remain engaged in meaningful activities?

Finally, is caring for your loved one taking a toll on your family or your career? Are you or others involved in care developing ailments attributable to stress and emotional/physical overload? If you answer yes to any of these questions, it’s time to consult professionals and get to know more about memory care programs near you.

Continuing Care Retirement Community (CCRC) or Life Plan Community

These campus-like environments offer a full continuum of senior care from independent living to assisted living and skilled nursing. Many also offer home care, memory care and hospice services. Typically, however, CCRCs or life plan communities are the choice of seniors eager to remain independent and active while lining up a plan for their future, too. Is this right for you?

  • Are you looking for a community that meets your current active, independent agenda, but can also accommodate future changes to your health?
  • Would you prefer not to ask your adult children for help someday with caregiving for yourself or your spouse?
  • Do you need one type of senior living, but your spouse requires another?

A CCRC or life plan community can be a good long-term solution for seniors who want a comprehensive senior care community with a variety of options for now and the future.

For more information on senior living, contact Spring Arbor.

#HowYouLive

Where You Live Matters


After an Alzheimer's Diagnosis, What Comes Next?

Joseph Coupal - Monday, March 19, 2018

Spring Arbor, SC, NC, VA, TNMake sure the information you are getting is accurate as there are many misconceptions about the disease. The caregiver and the person who has been diagnosed with Alzheimer's Disease should keep informed so they know what to expect as the disease progresses.

Contact area organizations, like Alzheimer's Services, for programs and support services. Attend educational sessions offered by agencies and health care providers on particular topics about the disease.

Another good idea is to seek out other families and caregivers who have been through the journey or who are presently experiencing the effects of the disease so you can get support and also learn more about the disease. Consider enrolling in clinical trials, such as the various ones being conducted at area hospitals.

Making decisions on long-term care can be a sensitive subject, but it is important to have these conversations with the person who has been diagnosed. Additionally, that person should complete advance directives and legal documents, such as wills and trusts, early in the disease so they have the cognition to offer input.

Keep everyday routines in place as this gives someone with the disease a sense of normalcy in a chaotic internal world he or she is living through the disease. It is helpful to keep clocks and calendars around the house in the beginning of the disease to orient the person with Alzheimer's.

Another thing to consider is home safety. Keep sharp objects, toxic cleaners and solutions as well as medications in locked cabinets or out of reach. If wandering becomes an issue, make sure doors are secured.

Don't ignore good nutrition. A low-fat diet rich in fruits, vegetables and omega-3 fatty acids helps protect brain cells. And, along with a good diet, a daily exercise regimen is recommended for both the caregiver and the affected person.

Finally, socialization is a key component in sustaining a quality of life and a sense of well-being. Find ways of mingling with others. Attend social events as much as possible. Invite friends and family members to visit. Socialization, especially for the person with Alzheimer's, is crucial in avoiding total isolation, which can speed the progression of the disease.

For more information on Alzheimer’s care, contact Spring Arbor.

#HowYouLive

theadvocate.com


Determining if Downsizing is for You

Joseph Coupal - Thursday, March 15, 2018

Spring Arbor - VA, NC, TN, SC Many retirees downsize their homes, but this decision requires careful consideration of a variety of factors.

As men and women retire or approach retirement age, many opt to downsize their homes. Such a decision can save older adults substantial amounts of money while also liberating them from the hassle of maintaining large homes they no longer need.

Downsizing to assisted living communities is a significant step, one that should be given ample consideration before making the final decisions. The following are a handful of tips to help homeowners determine if downsizing to smaller homes is the right move.

  • Get a grip on the real estate market. Downsizing is not solely about money, but it’s important that homeowners consider the real estate market before putting their homes up for sale.

Speak with a local realtor or your financial advisor about the current state of your real estate market.

Downsizing can help homeowners save money on utilities, taxes and mortgage payments, but those savings may be negated if you sell your house in a buyer’s market instead of a seller’s market. Luckily, right now is a seller's market.

  • Take inventory of what’s in your house. Empty nesters often find that their homes are still filled with their children’s possessions, even long after those children have entered adulthood and left home. If the storage in your home is dominated by items that belong to your children and not you, then downsizing might be right for you.

Tell your children you are thinking of downsizing and invite them over to pick through any items still in your home.

Once they have done so and taken what they want, you can host a yard sale, ultimately donating or discarding what you cannot sell. Once all of the items are gone, you may realize that moving into a smaller place is the financially prudent decision.

  • Examine your own items as well. Your children’s items are likely not the only items taking up space in your home.

Take inventory of your own possessions as well, making note of items you can live without and those you want to keep.

If the list of items you can live without doesn't really bother you, then you probably won’t have a problem moving into an apartment.

If you aren’t quite ready to say goodbye to many of your possessions, then you might benefit from staying put for a little while longer.

  • Consider your retirement lifestyle. If you have already retired or on the verge of retirement and plan to spend lots of time traveling, then downsizing to an apartment may free up money you can spend on trips.

And if you really do see yourself as a silver-haired jet-setter, then you likely won’t miss your current home because you won’t be home frequently enough to enjoy it.

For more information on senior living contact Spring Arbor.

#HowYouLive

thechronicleherald.ca


Signs That It's Time for Assisted Living

Joseph Coupal - Monday, March 12, 2018

Spring Arbor - VA, NC, TN, SCNo one wants to move from their home into assisted living. However, in some cases, it is the best option to keep elderly or aging parents safe and healthy.

To determine if it's time for assisted living, or if your elderly parent can safely remain at home, take a good look at the present housing situation, health status and medical needs. Ask yourself these questions.

Signs that may indicate it's time for assisted living:

  • Is your parent telling you that he is eating, but you're seeing food go bad in the refrigerator?
  • Is your parent falling? To determine the answer, is your parent covering up bruises he or she doesn't want you to see?
  • Is your parent wearing the same clothes when you go to visit? Can they bathe themselves, groom adequately and launder clothes?
  • When you look around the house or yard, is it as neat and clean as it used to be?
  • Is your aging parent remembering to take medications correctly, with the right dosages and at the right time? Are medications expired?
  • Are they able to operate appliances safely? Do they remember to turn appliances off when they are finished cooking?
  • Is the home equipped with safety features such as grab bars and emergency response systems?
  • Do they have a plan in place to contact help in case of an emergency?
  • Are they driving? Should they be driving? Do they have alternate means of transportation?
  • Are there stacks of papers and unpaid bills lying around?
  • Do they have friends, or are they isolated from others most of the time?
  • When you really look at your parent, do you see the bright and vibrant person from years ago, or do you see a more limited person who needs some help one hour a day, or even around the clock?

Making the decision to move a parent into assisted living is one of the hardest and most heart-wrenching decisions of your life. But if it keeps your parent healthy and safe and perhaps even happy, then it is probably for the best for the parent, the caregiver and the family. To learn more about Assisted Living, contact Spring Arbor.

#HowYouLive

agingcare.com


Downsizing or Rightsizing May Be the Best Fit For Your Life

Joseph Coupal - Friday, March 09, 2018

Spring Arbor, Greensboro, NCIf you are starting to feel like you have too much stuff and too much space, ask yourself what is holding you back from making a change. Is it some outdated notion that cutting back on the quantity of your possessions or the size of your home will change how others perceive you? Could you be living with an outdated notion of what success or happiness looks like? Maybe you are ready to enjoy time visiting family and friends, traveling to new places with different experiences or spending time on a freshly discovered hobby — anything other than spending your time and money on home upkeep and maintenance.

In today’s world, what used to be called “downsizing” is rapidly being replaced with the word “rightsizing,” and for good reason. Rightsizing implies that this is a healthy and highly personalized process — one that each couple or individual may decide to undertake and then accomplish at their own pace and in their own way. That being said, no one can tell you exactly how to decide you are ready to downsize or give you a concise plan on how to make this process fit you and your needs.

As you begin to consider this idea of rightsizing, pay attention to the daily things that are most meaningful and useful to you, and ask yourself, “Does my current lifestyle and home support the things that are most meaningful to me? What fits the current ‘me’ and what no longer works for me?” If more of your daily lifestyle and environment comes out not fitting, then maybe it is truly time to rightsize your life.

Here are some lifestyle and environment questions to ask yourself:

  • Are you living in a home with more rooms that aren’t being used than ones that are?
  • Do you find yourself avoiding the thought and expense of making your old home fit your new lifestyle?
  • Do you have a two-story home and find yourself spending most of your time on one of the two floors?
  • Are you wishing the kitchen you remodeled 20 years ago had all the newest conveniences and amenities?
  • How many times in the last year have you avoided completing routine house maintenance or chose to call an outside handyman, or maybe even just let it go, when you used to always be on top of it all?
  • Has your neighborhood grown so that you can no longer easily jump in the car to grab groceries or go out to dinner?
  • Are their new hobbies or activities you would like to try but can’t find someone to go with or a place to get started?
  • Do you have children and grandchildren growing up further away than is easy for you to reach by car or easy for them to visit you?
  • Do you think about wanting more control over how your next move unfolds?

As you into the season of Spring which is a season of new beginnings, be mindful of how your current situation fits your evolving needs.

For more information on senior living in Greensboro, NC contact Spring Arbor.

#HowYouLive

brentwoodhomepage.com