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Signs it May be Time for Assisted Living

Joseph Coupal - Monday, August 28, 2017

Spring Arbor, Greensboro, NCThe decision to help an aging adult move out of a current home is a complex one -- both emotionally and practically. Above all, you want the person to be safe and well. How can you all feel more confident about whether circumstances suggest that your loved one should no longer be living alone?

Although every situation is different, looking at the following signs will give you valuable information to help make the decision about of it is time to consider assisted living.

1. Big-picture signs it might be time for assisted living

Keep the big red flags in mind. Certain situations make it more obvious that it's wise to start thinking about assisted living communities.

Look for:

  • Recent accidents or close calls. Did your loved one take a fall, have a medical scare, or get in a fender bender (or worse)? Who responded and how long did it take? Accidents do happen, but as people get older, the odds rise of them happening again.
  • A slow recovery. How did the person you're caring for weather the most recent illness (for example, a flu or bad cold)? Was he or she able and willing to seek medical care when needed, or did last winter's cold develop into untreated bronchitis?
  • A chronic health condition that's worsening. Progressive problems such as COPD, dementia, and congestive heart failure can decline gradually or precipitously, but either way, their presence means your loved one will increasingly need help.
  • Increasing difficulty managing the activities of daily living (ADLs) and instrumental activities of daily living (IADLs). ADLs and IADLs are the skills needed to live independently -- dressing, shopping, cooking, doing laundry, managing medications, and so on. Doctors, social workers, and other geriatric experts evaluate them as part of a functional assessment, which is one way to get an expert's view of the situation. Difficulties with ADLs and IADLs can sometimes be remedied by bringing in more in-home help.

2. Up-close signs it might be time for assisted living

Give your loved one a big hug. Clues aren't always visible from a distance; especially when you don't see the person every day, you might learn more through touch.

Look for:

  • Noticeable weight loss. Does the person feel thinner? Are clothes loose, or has he added notches to his belt? Many conditions, from depression to cancer, can cause weight loss. A person who is having trouble getting out to shop or remembering how to cook (or to eat) can lose weight; check the fridge and watch meal-prep skills.
  • Seeming more frail. Do you feel anything "different" about the person's strength and stature when you hug? Can your loved one rise easily from a chair? Does she or he seem unsteady or unable to balance? Compare these observations to the last time you were together.
  • Noticeable weight gain. Common causes include an injury slowing the person down, diabetes, and dementia (when someone doesn't remember eating, he or she may indulge in meals and snacks all day long). Someone with money troubles may choose fewer fresh foods and more packaged goods or dried pasta and bread.
  • Strange body odor. Unfortunately, a close hug can also reveal changes in personal hygiene habits. Causes range from memory trouble to depression to other physical ailments.
  • Changes in appearance. Does the person's hair and makeup look all right? Are clothes clean? Someone known for crisply ironed shirts who's now in a stained sweatshirt may lack the dexterity for buttons or may have lost the strength for managing an ironing board and iron. A formerly clean-shaven man with an unkempt beard may be forgetting to shave (or forgetting how to shave).

3. Social signs it might be time for assisted living

Think realistically about the person's social connections. Social circles tend to shrink with age, which can have health and safety implications.

Look for:

  • Signs of active friendships. Does your loved one still get together for lunches or outings with friends or visits with neighbors, or participate in religious activities or other group events? Does he or she talk about others or keep a calendar of appointments? Lack of companionship is associated with depression and heart problems in older adults. If friends have died or moved away, moving to a place where other people are around could be lifesaving.
  • Signs that your loved one has cut back on activities and interests. Is a hobby area abandoned? Has a club membership been given up? A library card gone unused? There are many reasons people cut back, but dropping out of everything and showing interest in almost nothing is a red flag for depression.
  • Days spent without leaving the house. This sometimes happens because the person can no longer drive or is afraid to take public transportation alone and lacks a companion to come along. While many older adults fear being "locked away" in a retirement home, many such facilities offer regular outings that may keep them more mobile and active, not less.
  • Someone who checks in on a regular basis. If not you or another family member, who does this? Is your loved one willing to consider a home-safety alarm system, a personal alarm system, or a daily calling service?
  • A plan for a worst-case scenario. If there's a fire, earthquake, flood, or other disaster, is someone on standby to assist? Does your loved one understand the plan?

4. Money signs it might be time for assisted living

Riffle through the mail. Your loved one's mail can offer an often-overlooked clue to how he or she is managing money, a common early warning sign of cognitive trouble.

Look for:

  • Snowdrifts of mail in various places. Finding lots of mail scattered around raises concern about how bills, insurance, and other matters are being managed. (Piles of mail are also a potential tripping hazard.)
  • Unopened personal mail. Everybody skips junk mail, but few of us can ignore a good old-fashioned, hand-addressed letter.
  • Unopened bills. This can indicate that your loved one is having difficulty managing finances -- one of the most common first signs of dementia.
  • Letters from banks, creditors, or insurers. Routine business letters aren't worrisome. But it's alarming if they're referring to overdue payments, overdrawn balances, recent accidents, or other concerning events.
  • Thank-you messages from charities. Older adults are often vulnerable to scammers. Even those who have always been fiscally prudent are vulnerable if they're having trouble with thinking skills (a common sign of Alzheimer's disease). Some charities hit up givers over and over, and your loved one may not remember having donating the first time.
  • Lots of crisp, unread magazines. The person may unknowingly have repeat-renewal subscriptions that he or she doesn't need.

5. Driving signs it might be time for assisted living

Take a drive -- with your loved one behind the wheel, if he or she is still driving. Often, the ability to drive is practically a requirement for living independently in our culture (or the arrangement of alternate transportation options).

Look for:

  • Nicks or dents on the car. Notice the car body as you get in and out. Damage marks can be signs of careless driving.
  • Whether the person promptly fastens his or her seatbelt. Even people with mild dementia usually follow the rote basics of driving. It's worrisome if he or she is forgetting this step.
  • "Tension, preoccupation, or being easily distracted. The person may turn off the radio, for example, or be unwilling to engage in conversation while driving. He or she may avoid certain routes, highway driving, or driving at night and in rain -- a safe kind of self-policing but also signals of changing ability.
  • Signs of dangerous driving. People whose driving ability is impaired are more likely to tailgate, drift from their lane, go below the speed limit, react slowly to lights or other cars, and mix up gas and brake pedals. See 8 ways to assess someone's driving.
  • Warning lights. Check out the dashboard as you ride along. Does the car have sufficient oil, gas, antifreeze, windshield-wiper fluid?

6. Kitchen signs it might be signs for assisted living

Go through the kitchen, from fridge to cupboards to oven. Because people spend so much time in this room, you can learn a lot.

Look for:

  • Stale or expired foods. We all buy more than we need. Look for signs that food is not only old but that this is unnoticed -- mold, sour milk that's still used, or expiration dates well past due, for example.
  • Multiples of the same item. Ten bottles of ketchup? More cereal than can be eaten in a year? Multiples often reveal that the shopper can't remember from one store trip to the next what's in stock at home.
  • A freezer full of TV dinners. Your loved one may buy them for convenience sake, but frozen dinners tend not to make healthy diet. If there's not much fresh food in the house (because it's too hard to for the person to procure or cook), your loved one might be ready to have help with meal prep or delivery services.
  • Broken appliances. Check them all: microwave, coffeemaker, toaster, washer, and dryer -- any device you know your loved one uses (or used to use) routinely.
  • Signs of fire. Are stove knobs charred? Pot bottoms singed badly (or thrown out)? Do any potholders have burned edges? Also look for a discharged fire extinguisher, smoke detectors that have been disassembled, or boxes of baking soda near the stove. Accidents happen; ask for the story behind what you see. Accidental fires are a common home danger for older adults.
  • Increased use of takeout or simpler cooking. A change in physical or mental abilities might explain a downshift to simpler recipes or food choices.

7. Around-the-house signs it might be time for assisted living

Look around the living areas. Sometimes the most obvious sign is hard to see because we become so used to it.

Look for:

  • Lots of clutter. An inability to throw anything away may be a sign of a neurological or physical issue. Obviously it's more worrisome in a neatnik than in a chronic slob. Papers or pet toys all over the floor represent a tripping hazard.
  • Signs of lax housekeeping. Spills that haven't been cleaned up are a common sign of dementia -- the person lacks the follow-through to tidy. Keep an eye out for cobwebs, bathroom mold, thick dust, or other signs of slackness. Physical limitations can mean your loved one needs housekeeping help or a living situation where this is taken care of for him or her.
  • Bathroom grime and clutter. A common scenario: Your loved one makes an effort to tidy up living areas but overlooks the bathroom. Or the guest bath is clean, but not the one the person uses all the time (the one off a bedroom, for example). Here you may see a truer picture of how your loved one is keeping up.

8. Pet-care and plant-care signs it might be time for assisted living

Be sure to check out how the other living things are faring. An ability to take care of pets and plants goes along with self-care.

Look for:

  • Plants that are dying, dead, or just gone. Most of us have seen plants go brown sometimes. Keep an eye out for chronic neglect, especially in a former plant-lover's home.
  • Animals that don't seem well tended. Common problems: dogs with long nails, cat litter boxes that haven't been changed lately, or dead fish in the fish tank. Poor grooming, overfeeding, and underfeeding are other red flags.

9. Home-maintenance signs it might be time for assisted living

Walk around the yard. Yard maintenance -- or lack of it -- can yield clues that your loved one isn't faring as well at home alone anymore.

Look for:

  • Signs of neglect. Look for discolored siding or ceilings that might indicate a leak, gutters choked with leaves, broken windows or fences, dirty windows.
  • Newspapers in the bushes. Are papers being delivered but ignored? Sometimes people pick up those they can see on a driveway but not those that go off into the yard.
  • Mail piled up in the mailbox. Go out and check -- it's an indication that your loved one doesn't even retrieve it regularly.

10. Get help looking for signs it might be time for assisted living

Get the input of others who know your loved one in order to collect a fuller picture of reality. Gently probing about what others think isn't nosy; you're being loving, concerned, and proactive.

Look for:

  • Input from those in your loved one's circle. Talk to old friends and close relatives to get their sense of how the person is faring. Listen for stories that hint that the person doesn't get out much ("She doesn't come over anymore." "She quit book club."). Pay attention to comments that indicate ongoing concerns ("Has he had that heart test yet?" "We were worried the day the ambulance came.").
  • Medical insight. With appropriate permission, your loved one's primary doctor may share your concerns about his or her patient's safety at home -- or may be able to alleviate those concerns or suggest where to get a home assessment.
  • A second opinion. A social worker or professional geriatric care manager visits older adults' homes and does informal evaluations. While your loved one may initially resist the notion of a "total stranger" checking on them, try pitching it as a professional (and neutral) second opinion, or ask the doctor to "prescribe" it. Some people wind up sharing doubts or vulnerabilities with a sympathetic, experienced stranger that they're loathe to admit to their own children or family.

11. Caregivers' signs it might be time for assisted living

Finally, realize that some of the information you collect is intangible -- it has to do with feelings and emotions, and the stress levels of everyone involved.

Look for:

  • How you're doing. While this decision to remain in one's home is not primarily about you -- the son, daughter, grandchild, caregiver -- your own exhaustion can be a good gauge of a decline in older adults' ability to care for themselves. Keeping someone at home can require lots of hands-on support or care coordination, and this is time-consuming. If your loved one's need for care is just plain wearing you out, or if a spouse or children are feeling the collective strain of your caregiving activities, these are major signs that it's time to start looking at other options.
  • Your loved one's emotional state. Safety is crucial, of course, but so is emotional well-being. If someone living alone is riddled with anxieties or increasingly lonely, then that may tip the scales toward a move not solely based on health and safety reasons.
  • If your loved one has a full life, a close neighborhood and community connections, and seems to be thriving, it's worth exploring as many in-home care options as possible before raising stress levels by pressing a move from a beloved home.
  • If, on the other hand, your loved one is showing signs that living alone is a strain, it may be time for a talk. Broach the subject of where to live in a neutral way and you may find that your loved one harbors the same fears for current and future safety and security that you do. Find out what your loved one fears most about moving and about staying before launching into your own worries and what you think ought to be done.

For more information on assisted living, contact Spring Arbor.

#HowYouLive

caring.com


What You Didn't Know About Assisted Living

Joseph Coupal - Friday, August 25, 2017

Spring Arbor, Richmond, VAIf you’re just beginning your search for a senior community to care for a loved one, you may not be entirely clear about what an assisted living community means. It might be easy to assume that “assisted living community” is the new “nursing home” or “retirement home.” But, assisted living is not just a form of the institutional nursing homes where we visited elderly relatives prior to the 1980s. A few decades ago, senior living designers and senior care professionals asked, “What is it about nursing homes that make can make them sometimes feel dreary and institutional? How can we achieve the something different?” Out of their inquiry, assisted living was born.

Little Known Facts About Assisted Living

According to the National Investment Center’s 2010 Investment Guide, there were 6,315 professionally managed assisted living communities in the U.S. with approximately 475,500 apartments.

1. What Assisted Living Provides

Because there is no nationwide definition for assisted living (although it is regulated in all 50 states), senior communities that call themselves assisted living facilities can offer differing levels of care. They offer a less-expensive, residential approach to delivering many of the same services available in skilled nursing, either by employing personal care staff or contracting with home health agencies and other outside professionals.

Not all assisted living communities are equal. Some provide lighter care, and some can even provide care for those who bedridden or who need help eating while still remaining in assisted living as opposed to a nursing home. It often depends on the community’s licensing. Many states have a tiered system of licensing whereby communities with a higher degree of licensing are able to provide more care.

2. Each Community Has a Unique Personality

Care aside, the look and feel of communities varies as well. Some communities have a more formal, traditional design sensibility, while others may have a more home-like, down to earth ambiance. Some communities may have art deco decor while others are firmly grounded in mid-century modern design. Assisted living communities come in all shapes and sizes. They can be towering apartment buildings in urban centers, sprawling complexes in the suburbs, cottages or more intimate communities catering to a relatively small number of residents. There’s no nationwide standard size, but according to our own definition, assisted living communities are licensed to care for at least 20 people, but many communities have hundreds of residents. Smaller communities usually offer a homelike atmosphere while the larger communities offer an abundance of interest clubs, recreational opportunities, and acreage for recreation.

Every assisted living community has a different personality. You can visit two communities down the street from one another that offer the same care and services, they may even look identical to one another, but that feel very different. Just because your loved one didn’t like one community, doesn’t mean the next one won’t feel right.

3. Yes, You Can Bring Your Pet

Senior living communities have different pet policies with specific weight limits and breed restrictions, so it’s important to do your research. For example, some communities have “pet interviews” to determine whether the pet is right for their community, while others allow dogs and cats under 20 lbs. Birds and fish are also welcome in many communities, and some communities even have Pet Coordinators to care for the furry and feathered friends. Some communities only allow pets on a case-by-case basis. So make sure to contact your communities of choice and ask about their particular pet policy.

4. Assisted Living Costs are Lower Than You Think

Assisted living is often less expensive than home health or nursing home care in the same geographic area. According to a 2012 Senior Care Survey, the national average rate for a one-bedroom apartment was approximately $3,300 per month. While 86.2% of assisted living residents pay from their personal financial resources, 41 states offer “home and community-based waivers” that allow low-income residents to live in assisted living.

Additionally, more seniors are purchasing long-term care insurance to help plan for and finance their long-term care needs. Wartime veterans and their spouses may eligible for VA benefits known as Aid and Attendance that can offset the cost of care.

5. Assisted Living is Not Synonymous with Nursing Homes

Our research suggests that many families believe they need they need nursing homes for their ailing older loved one when in fact assisted living is the most appropriate option. An assessment by an Advisor or medical professional is the best way to determine the care type needed, but some general distinctions can be drawn between assisted living and nursing homes. For instance:

  • Assisted living residents are mainly independent but may need help with daily living personal care tasks such as bathing and dressing, while nursing home residents tend to need 24-hour assistance with every activity of daily living
  • Assisted living residents are mobile, while those who are bed ridden require nursing homes
  • Nursing home residents generally have a single or semi-private room, while assisted living residents typically live in a studio or one-bedroom apartment
  • Nursing home residents require fully staffed, skilled nursing medical attention on a daily basis, while assisted living residents are more stable and do not need ongoing medical attention

6. Culturally Diverse Options

An increasing number of assisted living communities are designed to meet the unique cultural, religious, dietary and language-based needs of local populations. 

Jewish communities are popular too, particularly in the Northeast and East Florida. Many assisted living communities serve kosher foods (some even have certified kosher kitchens), celebrate Jewish holidays and have weekly Shabbat services.

Some communities offer multiple cultural, religious and dietary options.

7. Assisted Living Dementia Care

In 2012 there were more than 5.4 million Americans with Alzheimer’s disease and dementia who required specialized dementia care treatment. Many assisted living facilities offer Alzheimer’s memory care programs for residents which are designed to decrease wandering, agitation and improve their quality of life. Generally residents with early stage Alzheimer’s or dementia can live among the regular population of assisted living residents, but when the condition becomes advanced, residents are then transitioned from the regular assisted living section to the memory care area. Memory care is specialized assisted living that’s secure to protect residents, that has staff specially trained to care for those with Alzheimer’s and dementia, and that have other design and caregiving adaptations for the comfort and safety of memory-impaired residents.

For more information on assisted living, contact Spring Arbor.

#HowYouLive

aplaceformom.com


So Many Reasons to Retire in Greensboro, NC

Joseph Coupal - Friday, August 18, 2017

Spring Arbor, Greensboro, NCBack in 1895, the breathtaking Blue Ridge Mountains, a comfortable climate and low land prices inspired the Vanderbilts to buy up 125,000 acres of North Carolina wilderness and build the Biltmore House, the largest estate in the U.S. The same factors that attracted this wealthy family continue to make North Carolina popular among retirees and second-home buyers today.

But the Tar Heel State offers a little bit of everything, geographically and culturally. Retirees who prefer to live by the sea can find 300 miles of barrier island beaches, two national seashores and idyllic villages in the state’s eastern region.

North Carolina also has some great college towns, including Chapel Hill, Davidson, and Durham. And dynamic city living can be found in fast-growing Charlotte, which has been undergoing a restaurant renaissance, and the Raleigh-Durham-Chapel Hill-Cary vicinity, dubbed the “Research Triangle” due to its high density of high tech companies.

For anyone on a fixed budget, living costs in North Carolina can be fairly friendly. Overall, the state is 3.7% cheaper than the national average. State income taxes are also to 5.8% flat tax.

For more information on senior living in Greensboro, NC with levels of care, contact Spring Arbor.

#HowYouLive

marketwatch.com


Richmond, VA is a Great Area for Retirement

Joseph Coupal - Monday, August 14, 2017

Spring Arbor, Richmond, VAWhen the time comes to pick a place to retire, you want to make it a good one. After all, retirement is the prize at the end of a lot of long years of hard work. So what are the factors that go into picking that magical place?

The perfect place will be a little different for everyone depending on finances, family and, of course, preferences. But for the most common factors – cost of living, safety, healthcare, activities and climate – Virginia comes out on top time and again.

BankRate.com, a financial analysis website, recently published their list of the 10 Best States for Retire, ranking Virginia as #5 in the nation. We did a little more digging to find out what particular cities and towns have been recognized as top spots…and here’s what we found. Keep in mind, these aren’t in any particular order as they have all been recognized by various organizations and publications, but not analyzed side-by-side.

Richmond

Bloomberg Business ranked Richmond as one of the most affordable cities in which to retire. With beautiful neighborhoods and an abundance of cultural attractions like art museums, opera, theater and ballet, Richmond has no shortage of activities, Add to that a rich history, beautiful parks and good healthcare, and Richmond is a prime place to spend your golden years.

Whether you’re looking to be closer to the grandkids or just want a certain lifestyle, Virginia has more than enough options. If you’re retired, or thinking about retiring soon, and would like more information on senior living with levels of care, contact Spring Arbor.

#HowYouLive

onlyinyourstate.com


The Upshot to Downsizing

Joseph Coupal - Tuesday, August 08, 2017

Spring Arbor, Greensboro, NCIf you're an empty nester who's getting older, you may like the idea of downsizing. But if you don’t fancy moving into the sub-400-square-foot residences espoused by the tiny house movement, fear not; there are other options, including senior living communities with levels of care.

These retirement enclaves are for folks in and approaching their sunset years who might be looking for some supportive services such as meals, transportation, and housekeeping, but who don’t need the level of care associated with assisted living facilities or nursing homes.

If this sounds like your ticket to enjoying the good life in retirement, there can be a lot to think about when it comes to choosing a community.

It can be overwhelming. 

More Friends, Less Housework

The main drivers for those considering retirement communities are socialization and simplifying their lifestyle.

Even if their house is paid off, people often want to downsize from a traditional home with more bedrooms and bathrooms than they need. And they don’t want to have to deal with all the maintenance those dwellings often entail, not to mention going up and down stairs.

But it’s important not to make decisions about such major life changes too quickly.

Conversation Starter?

The retirement housing conversation can be a good time to start considering options for later when retirees aren’t as mobile and may need additional care. In the case of a surviving spouse, take three to six months to let your emotions settle and figure out what you want to prioritize for the rest of your life. Really identify what those key priorities are.

Some communities are organized around specific interests such as golf or art, or they may cater to a specific ethnic group. Some retirees have children in multiple cities, so deciding on location is also an important factor.

Location and Lifestyle

With all the services senior living communities can offer, some can get pricey. However, some may offer surprisingly good value and might actually be better economic alternatives when compared to regular apartments in certain high-rent markets in major metropolitan areas. That’s a good thing, as these are mostly private pay facilities.

Take a Test Drive

In addition to touring lots of communities, visit during mealtimes to not only sample the food, but also see the population together and explore whether the vibe feels right.

And for those who have found their social circle shrinking as they age, retirement communities can make it easier to start making friends again.

Senior living brings people back together. It really does foster those relationships.

For more information on senior living, contact Spring Arbor.

#HowYouLive

tickertape.tdameritrade.com


Assisted Living Costs

Joseph Coupal - Friday, August 04, 2017

Spring Arbor, Richmond, VARumor has it that assisted living communities are not affordable. Read on, and you may be surprised.

When people begin looking into assisted living options, they assume that they won't be able to afford a quality assisted living community. However, after researching and learning about the costs, they learn that assisted living can be affordable. If you are reading this article, you may be considering an assisted living facility for yourself or for your loved one. Here are some areas to consider as you research your options.

Working with Marketing, Sales Directors

First, schedule an in-person meeting with the director of marketing/sales. Websites are sometimes limited and may not paint a clear picture of actual costs. Many assisted living communities are managed by a company that oversees other communities across the United States. Ask which amenities and services are offered at the location you are considering. A good marketing director will take the time to help you analyze your current spending and financial situation, and how it compares to their community. You might be surprised what you really spend when living on your own. Don’t be afraid to be upfront about properties you owned, savings and any insurances policies that may help meet your care needs. The marketing director wants you to be successful, as their goal is for your loved one to live in the community long-term. If you can’t afford it, a good marketing director will be upfront and honest with you.

What to Consider?

Many assisted living communities will present you with a base rate, comprised of different care levels. Watch for à la carte fees, as these could increase the cost. Clarify what the base rate really means and ask the facility what would cause an increase in your rent. Some facilities have a mandatory rate increase every year. Make sure you understand what this entails. Base rates typically do not cover additional care needs, such as medication management or bathing. Make sure you ask about their process in identifying when you or your loved one may need to advance to the next care level. Ask that they put everything in writing so you can go home and discuss what you learned with your family. In addition, be sure to inquire about any discounts that may apply. Many assisted living communities have move in specials or are aware of outside discounts, like for veterans.

One of the most essential questions to ask, as well as one of the most difficult, is what happens when your loved one runs out of private pay funds. If your loved one can only afford assisted living for a year or two, be transparent with the facility.

Moving into an assisted living facility can be feel overwhelming at first. While you are considering your options, ask if you can participate in their activities or enjoy a meal in their dining room. The quality and level of care should be the number one priority during your search. At the same time, you want to make sure the community feels like home, so you feel welcome to take advantage of all assisted living has to offer!

For more information, contact Spring Arbor.

#HowYouLive

flagstaffbusinessnews.com