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Senior Assisted Living Blog

Nursing Home, Assisted Living, or Independent Living?

Joseph Coupal - Monday, November 06, 2017

Spring Arbor, Richmond, VAThe first step to finding the best senior housing for your loved one is to understand what type of care facility is the best fit. There are six main types of residential elder care options:

Independent living facilities are ofen the best senior housing options for active adults who want built-in community without giving up their privacy. Most feature studio or multi-bedroom apartments with kitchens so residents can stay independent as long as possible.

Continuing care retirement communities, or CCRCs, are best for those seeking a continuum of care from independent living to skilled nursing, all in one location. CCRCs generally have studio or multi-bedroom apartments for their most independent residents and private or shared rooms for residents who need more care.

Assisted living facilities are best for for those who need some care and supervision but who don't need skilled nursing care. Most assisted living residents live in private or semi-private rooms within a complex.

Memory care communities are facilities designed specifically for seniors with Alzheimer’s disease or other forms of dementia or serious cognitive impairments. Also known as dementia care, memory care communities are often housed in one part of an existing assisted living community or skilled nursing facility. These communities are best for those with severe dementia or cognitive impairment who are no longer able to live independently.

Board and care facilities, also known as care homes, are best for those who can't live independently due to physical or mental disabilities but who don't require fulltime skilled nursing care. They feature private or semi-private rooms in a complex (often a large home) that usually provides communal dining.

Skilled nursing facilities, also called nursing homes, are residential care facilities that are best for those with illnesses or mental conditions requiring fulltime monitoring and medical care. Most skilled nursing residents live in semi-private rooms, and meals are generally provided.

Want more information? Contact Spring Arbor.


Alzheimer’s and The Holidays

Joseph Coupal - Monday, October 30, 2017

Spring Arbor, Greensboro, NCAccording to the Alzheimer's Association, Alzheimer's disease is the sixth leading cause of death in the United States today, with more than 5 million Americans currently living with the disease. Since 2000, deaths by heart disease have decreased by 14 percent while deaths from Alzheimer's have increased by 89 percent. The disease, which causes memory loss and dementia, kills more people than breast and prostate cancer combined.

Holiday gatherings are just around the corner, and although many love spending time with Grandparents and parents, Thanksgiving and Christmas can be overwhelming and confusing with the large crowds and new places outside of their typical routine.

The author of "I Care — A Handbook for Care Partners of People with Dementia," offers some tips for helping an elderly family member get through these holiday events with minimal stress.

Try not to get frustrated. Older adults may not remember everything, but they are aware if you are frustrated with the conversation. Be patient. Dedicate someone to help seniors during the gathering. A son or daughter may be able to fill in the gaps, assist with details such as where the bathroom is or where to sit at the dinner table or answer other questions as they arise.

Try to keep grandma or grandpa busy with a task in the kitchen or a walk around the yard or home while dinner is getting ready. Give them a purpose, so they feel useful and stay engaged.

Use pictures to stimulate memories, but don't force them to recollect something they simply don't remember.

And don't forget safety first. Make sure someone drives your elderly relative to the event and keep a watchful eye out for potential dangers to someone who can't remember things clearly.

Most of all, continue to love, spend time with and have conversations with those suffering from Alzheimer's. You may repeat yourself often. You may feel hurt if they forget your name. But you'll never regret the precious moments spent with your loved one.

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


Time to Downsize Your Home: How to Prepare

Joseph Coupal - Monday, October 23, 2017

Spring Arbor, Richmond, VAConsider this: Your kids have all moved away from home. Their rooms are now empty and filling with dust. You’ve thought about making one bedroom a “home office,” but the issue remains: You have more space than you really need.

What do you do now? One option is to downsize your home.

There are plenty of things to look at before making that move, so we’ve put together a list to get you thinking about what might be best for you.

Less Space, More Money, More Time

Those empty rooms we mentioned are still being heated, air conditioned and cleaned. By moving into a smaller space, you’re likely to save on utility bills and maintenance costs. Depending on where you move, your utilities may even be covered at your next home.

You can also use the time you spent cleaning all that extra square footage for more enjoyable activities, like visiting your children in their new homes or playing with the grandkids.

Using Home Equity as Secondary Income

After years of owning a home and paying off the mortgage, or at least a part of it, you earn equity in your home. When you move to sell your property, that money can help supplement your lifestyle. Because most properties that are smaller in size tend to be lower in cost, you may see some profit off your home sale.

Consider the Emotional Costs

They say home is where the heart is, and that can be true for many. Leaving behind the place you raised a family can be difficult, so thinking about the emotional side of the move is big part of this decision.

It can also be a difficult thing for your adult children to deal with. Remember, this was their childhood home, too. Perhaps having a final get-together with your family in the home could help alleviate some of that anxiety. It can help create closure for everyone about the move, and it gives them a chance to come pick up any memory boxes or mementos they want to keep from the house.

Keep in mind the best thing for you and your partner may not be the most comfortable one for everyone in your family, but by taking time to acknowledge those emotions, you can get moving in the right direction.

What to do With All That Stuff

One option is selling any unwanted items before your move. This can be done at estate sales, auction or consignment stores. If you have items you’re planning to gift to your children or grandchildren or leave as a legacy item, consider doing it before you move. Then you know it’s gone to the intended person and you’ll have less to pack up if you decide to downsize.

Moving into any new place can be a cause of stress, so consider hiring a moving company and packing up each room one-by-one to avoid the anxiety of trying to get everything out at once. Don’t be afraid to eliminate unnecessary items. It’s not likely you’ll be able to fit everything you own into a smaller space, so try to only bring your most used and needed items with you.

Deciding to move into a smaller home is not an easy decision to make, and it’s not one you should make alone. Be sure to talk over these factors with your spouse, and consider speaking with a financial adviser about how a move could affect your wallet. By using these tools, you’ll be able to make the best choice on whether downsizing your home is the right move for you.

For more information on senior living communities and assisted living, contact Spring Arbor.


Caring for Yourself While Caring for Someone With Alzheimer’s

Joseph Coupal - Monday, October 16, 2017

Spring Arbor, Greensboro, NCWhy is it important for caregivers to care for themselves and participate in activities that bring them joy? Because caregiver burnout is real and can inadvertently lead to losing the very person providing care due to their own neglected health, financial strains and other accompanying problems. In a recent study, caregiver "strain" was associated with a 63 percent increased mortality risk, even after controlling for presence of cardiovascular disease and sociodemographic factors. Caregivers might even be at higher risk of cognitive impairment or dementia than non-caregivers.

According to 2015 figures, 5.4 million Americans are living with Alzheimer’s disease. It is the 5th leading cause of death for Americans over age 65. With an increase in the number of diagnoses comes an increase in the need for care provided by caregivers. In 2015 alone, 15 million Americans dedicated over 18 billion hours and provided $221.3 billion worth of caregiving services. Yet, when asked to spend just a few dollars or hours on their own care, caregivers often initially react with resistance.

Here is advice on how to avoid burnout and minimize caregiver-related stress.

Our caregivers have found these tips helpful:

  • Seek help, whether it's professional or informal from family, friends or religious institutions. You don’t have to do this alone.
  • Connect with your local chapter of the Alzheimer’s Association or similar organizations to inquire about caregiver resources, like grants to pay for respite programs.
  • If employed, speak with your HR department and ask about family or other leave policies. For example, the Family Medical Leave Act of 1993 can be used to secure time to care for a loved one diagnosed with Alzheimer’s.
  • Let go of little details (e.g. your mom wants to wear rain boots on a sunny day) and celebrate small victories (e.g. she is dressed and arrives for an appointment). This is a point I emphasize often; in the daily life of an Alzheimer’s caregiver, letting go of what one thinks should be happening will reduce stress.
  • Choose an enjoyable activity as effortless as ordering a cup of coffee. Say, “Will I have a small, medium or large?”

Commit to one small thing daily, a medium monthly and a large annually.

  • Small: Take a 15-minute walk, listen to music or practice meditation.
  • Medium: Go out for a meal/movie, secure reliable help, say yes to family/friends offering to help or attend support group meetings.
  • Large: Book a day at the spa, secure a stay at a respite program for your loved one or go on a cruise.

Caring for a family member with Alzheimer’s has been described by caregivers as "‘my honor; my job." In addition to helping the patient diagnosed with dementia, make sure caregivers don’t forget their care.

For more information on Alzheimer's Care, contact Spring Arbor.


Reasons to Consider Moving to Senior Living Communities

Joseph Coupal - Tuesday, October 10, 2017

Spring Arbor, Richmond, VAFor many, the American Dream is all about owning your own home. But when kids leave the nest and retirement looms, that sprawling home can start to feel more like a burden than a dream. There are gutters to clean, lawns to be mowed, garages to organize – not to mention the daily household duties of cooking, cleaning and endless laundry.

Eventually, the idea of downsizing can be a welcome relief — one that more and more seniors are starting to explore. If you haven't yet thought about your next move, there are a few reasons you should probably start.

It's not exactly downsizing

Think of it as supersizing rather than downsizing. Senior living residents have so much less to deal with, from cleaning to cooking. All of those things go away, but in the meantime, they gain access to fitness centers, dining, activities, excursions, and more. So the personal space might decrease, but in the meantime, they have many more activities and amenities available to them.

When you think of your golden years, chances are they don't include the daily grind and upkeep of maintaining a home and household. When you downsize to a senior living community, you can focus on making your retirement an enriching and rewarding time. Make new, like-minded friends — all in the comfort of your own comfortable, private apartment.

Moving is the scariest part

For many, giving up “home” is a big decision – one that can seem intimidating, but many wish that they moved sooner.

You're investing in your future

For many seniors, downsizing to a senior living community isn't just about convenience, though it certainly provides that. If you decide to move to a Continuing Care Retirement Community, this can be a wise move for your financial future. According to Kiplinger, a CCRC can be a wise investment, as they allow seniors to age in place, with skilled nursing and long-term medical care available on-site. And with several financial plans from which to choose, you can select the program that works with your health, your budget and your needs.

It's peace of mind

Even if you're not yet ready to downsize, it's important to understand your options.

There are people who talk to communities before turning 62 and the minute they turned 62 they move in. And there are those people who move in at 85. It's never too late, and talking to someone about it doesn't mean you have to make the decision now. But, it's better to plan earlier so you know what your options are.

For more information, contact Spring Arbor.


Early Signs and Symptoms of Dementia

Joseph Coupal - Monday, October 02, 2017

Spring Arbor, Greensboro, NCThis article outlines some of the early signs and symptoms of dementia and Alzheimer’s. Keep in mind that some symptoms can also be attributed to the normal effects of aging. If your loved one experiences any of these symptoms, detecting Alzheimer’s or dementia early on is important and it’s best to consult a physician for a proper diagnosis. Because Alzheimer’s and other dementias affect the brain and its functioning, both behavioral and cognitive changes are apparent early in the course of the disease. Some of the most common behavioral and cognitive changes are listed below.

Cognitive Changes

Difficulty or issues in any of the following cognitive areas should be brought to a physician’s attention immediately. The doctor can then perform the necessary tests required for detecting Alzheimer’s disease and forms of dementia.


Memory loss is one of the most common signs of dementia or Alzheimer’s. While occasionally forgetting names or appointments is normal, a person in the early stages of Alzheimer’s or dementia will often be unable to recall recently learned information. That person’s forgetfulness also will occur with increasing frequency.

Familiar Tasks

Everyday tasks such as acts of basic hygiene (e.g., showering or brushing one’s teeth), meal preparation or placing a telephone call can seem unfamiliar to someone in the beginning stages of Alzheimer’s or dementia. Sometimes all or most of the steps required to perform the action are recalled, but the order is jumbled.


Although occasionally forgetting the correct word for an object is normal, a person in the early stages of Alzheimer’s or dementia will forget simple words or use unusual terms. Both speech and writing can be affected and might be slightly puzzling or difficult to understand. Be aware that the onset of jumbled speech could also be a symptom of a stroke.


Occasional bouts of forgetfulness are normal, but early symptoms of dementia or Alzheimer’s make people unaware of their surroundings even in familiar places, such as his or her neighborhood or inside the home.

Abstract Thinking

Complex mental tasks or ones that require several steps may become difficult (if not impossible) to perform. The difficulty usually becomes apparent in tasks that require a person to input information from various sources and then combine, assess or analyze that information. Depending on the individual and the stage of the disease, this could include an activity such as balancing a checkbook or following a group discussion.


An inability to make a sound decision based on a given set of factors, when a person normally shows sound judgment, is one of the other possible signs of dementia or Alzheimer’s. A common example is dressing inappropriately for the weather.

Putting Things in the Wrong Place

Another of the more common early warning signs of dementia or Alzheimer’s is placing objects in inappropriate or nonsensical places, such as putting keys in the refrigerator.

Behavioral Changes

Major shifts in personality, behavior and mood or energy levels can also be indicative of early-stage symptoms of dementia or Alzheimer’s.


A noticeable shift in personality can be one of the early signs of dementia or Alzheimer’s. Sometimes personality changes are hard to pinpoint, but take note if the person isn’t acting in accordance with his or her normal patterns of behavior. In the early stages of Alzheimer’s and dementia, an individual often understands that he or she has forgotten an important piece of information, and the inability to recall it causes frustration.

Behavior or Mood

Alzheimer’s and other dementias can cause severe and rapidly changing moods, resulting in an individual experiencing various emotions ranging from rage to sadness and complete calm within the course of a few minutes.


Passivity, sleeping for prolonged periods of time, and sitting for hours watching TV or otherwise not speaking with anyone are other early warning signs of dementia or Alzheimer’s. A lack of energy or passion for life can manifest in a lack of desire to participate in normal activities, especially ones that the person previously enjoyed. A physician should be consulted to rule out the possibility that these symptoms are not signs of depression.

Detecting Alzheimer’s Disease and Dementia

Detecting Alzheimer’s and dementia early is important for treatment and the progression of the disease course. If your loved one is experiencing any of the signs of dementia and/or Alzheimer’s outlined above, contact a physician right away. There are basic tests that doctors use when detecting Alzheimer’s, dementia, or mild cognitive impairment. These include Mini Mental Status Exam (MMSE) and/or Saint Louis University Mental Status Exam (SLUMS).

For information on memory care, contact Spring Arbor.

Virginia: On the List for "Best State to Retire"

Joseph Coupal - Friday, September 29, 2017

Spring Arbor, Richmond, VAIt's time to retire, to downsize, maybe to move, to enjoy life. You’re really going to do it. You worked your last day, you ate the cake and you decided to move to the best retirement spot in America. Next question: Where is that?

Bankrate looked at costs, weather, health care, crime, taxes, cultural amenities and a few other things important to seniors and have determined the best 10 places to retire.

Before you start packing, find out if you’ll need snowsuits or swimming suits.

Virginia is for lovers of affordable prices, communities where you can feel safe and relatively pleasant weather year-round. The fall foliage in the Shenandoah Valley is an annual treat, spring brings cherry blossoms, and in summer you can hit the state’s Atlantic beaches.

#6 Virginia Scores highest for:

  • Cost of living
  • Relatively low crime rates
  • Weather

For more information on senior living in Richmond, VA, contact Spring Arbor.


Aging in Place

Joseph Coupal - Monday, September 25, 2017

Spring Arbor, Greensboro, NCThe great majority of older adults say they'd prefer to live out their days in their own home. For many, this desire is so strong that they’ll insist on staying in the face of what seems to be an impossible situation.

But even as a friend or relative begins to decline and need more support, "aging in place" can usually continue to work.

The good news is that there’s a wide and growing array of supports available to help older adults age in place safely and in comfort.

Practical needs

Practical needs to consider include:

Transportation. Driving -- which many older adults perceive as the key to their independence -- is a touchy subject, but talking about it is crucial, as is assessing an older adult's ability to continue to drive safely. Assisted living offers a number of available alternatives.

In-home safety. In assisted living they have installed things like bright lighting throughout the home, light switches, and grab bars in the bathroom, for starters. A certified aging-in-place specialist can make suggestions and help figure out how to implement needed changes.

Finances. Like driving, money is a touchy subject, but it's important for aging-in-place older adults to have a clear sense of their financial resources and how long they will last.

More ways to help an older adult age in place

Financial needs

Sit down with your relative and go over whether they have the income to cover their needs over time. A financial planner who specializes in eldercare can help. If it looks like there's going to be a lack of funds, become familiar with financial options.

Healthcare. Again, planning is key. If they’re willing, review healthcare coverage and make a list of doctors and nearby hospitals. Make sure everyone caring for your loved one knows what the plan is if a medical problem arises. The more information you have at hand before something happens, the better prepared you'll be to help when it does.

Household maintenance. One of the main reasons older adults wind up moving to senior living communities is because they have trouble "keeping up with the house."

For more information on assisted living and aging in place, contact Spring Arbor.


Find The Best Place to Grow Old

Joseph Coupal - Monday, September 18, 2017

Spring Arbor, Richmond, VAIt's time to sell the family home and relocate to somewhere a bit more -- peaceful? Affordable? Friendly? Cultured? We all have different needs when it comes to choosing the ideal location to live out our later years. Here, ten things to consider when it comes to planning out your "second life."

1. Access to medical care

One of the biggest mistakes people make when choosing where to live out their later years is neglecting to ensure they have access to complete, modern medical services. People have this idealized view of what their retirement will be like. They picture somewhere picturesque and serene, and before you know it they're out at the end of a country road with the nearest hospital 25 miles away. Then when illness strikes, which it's likely to do during the later years, there's no system in place to manage treatment.

What to look for? Make sure the area you choose has a full-service hospital or medical facility that can provide care for any kind of chronic or acute illness, including chemotherapy or radiation for cancer, cardiac care and rehabilitation, diabetes management, and other types of geriatric services, such as Alzheimer's expertise. If you don't have access to these services, chances are high that you're going to regret your move at some point. Just as with disaster planning, you want to plan for the worst -- then you can hope for the best.

2. Low-cost housing options

Affordable housing is an essential factor in choosing where to live when you're on a fixed income or need to make your retirement savings last. Sell a $300,000 home and move into one costing $150,000, and you've not only cut your costs in half but put an equal amount into savings. Of course, this does tend to mean moving away from popular urban areas on the East and West coasts. But as recent real estate data attests, baby boomers are also finding ways to stay in their beloved urban centers by learning to live in much smaller spaces. In the past few years, many cities have built or are building condo and loft developments aimed at active seniors, and they're proving extremely popular.

When calculating your cost of housing look at a number of factors beyond simply the real estate itself. Property taxes, heating costs, and homeowners insurance all contribute to how much you're paying to put a roof over your head.

Culture and affordability

3. At least one great bookstore

Sure, it sounds odd, at first, to focus on such a small detail, but many experts in senior relocation have learned to use this factor as a bellwether. Why? Because great independent bookstores are cultural hubs, offering classes, sponsoring author talks, and functioning as gathering places for like-minded people. The presence of a good bookstore also says a lot about the more subtle qualities of a town's population, especially if you're looking to settle where you're likely to find interesting people. After all, a town has to have at least a reasonable number of cultured, intellectually curious people to sustain the bookstore over time.

4. Overall affordability

The people who study retirement affordability have many different calculations and indexes that they use to evaluate the cost of living in various communities and geographic areas. The cost of housing is a primary factor, of course, but the cost of transportation and other services can be equally or more important. Then there's the fact that some states don't have any sales tax, while other areas tack on as much as 10 percent per purchase.

And the cost of medical and dental services varies much more than most people realize. Surgery in a big-city teaching hospital, for example, could set you back 40 percent more than the same surgery in a community hospital.

Jobs and weather

5. A strong job market for second-career job seekers

This is an increasingly important factor for baby boomers looking to settle down for the second half of life but not ready to pull out the recliner just yet. The criteria for this one are pretty straightforward: You want a town with below-average unemployment.

It also helps if an area specializes in particular industries that tend to fit with your job skills and work history. Capital cities are strong in government jobs, which tend to offer good options for older workers. And cities in which there are new or growing industries and service sectors, are more welcoming to older job seekers as well.

6. Good weather

What constitutes good weather is largely a matter of personal taste; some people want to ski all winter while others can't stand the thought of not seeing fall color. But by and large, when you look at the criteria that experts use to pick the best places for retirement or aging, they tend to be in the sun belt and other areas with mild winters. And that makes sense; tasks like driving do become more difficult as we get older, so throw in driving in the snow and you have a potentially dangerous mix. And many residents of the Northeast and Midwest are all too ready to flee south and stop paying astronomical heating bills.

Still, start by thinking what good weather means to you, personally. Are you willing to put up with high temperatures in the summer in order to enjoy a mild winter? Are there outdoor activities that are important to you that depend on the weather? Hint: Mosquitoes can scotch a fishing trip, and gardening can be frustrating in the desert.

Houses and services

7. Comfortable houses for aging in place

That dream house you're lusting after? Yes, it has a gorgeous deck with a view and the cutest window seat, but does it also have wide doorways and a one-story floor plan? These are the criteria people all too often overlook. And housing stock tends to vary greatly by community. In one town, all the houses might be more than a hundred years old with multiple floors and narrow hallways, while in another area all the housing stock is post-'50s ranches much more suitable to aging in place.

When you buy a house at 65, chances are good you're still going to be living in it at 85, so that's what you need to plan for. A one-story floor plan with few stairs? Check. Doors wide enough to accommodate a walker or wheelchair? Check. Tubs big enough to put a bath stool in? Check. What about the laundry -- do you have to go down to the basement to do it? These are the kinds of things people don't think about at first but that become hugely important in determining whether they're happy with their choice down the line.

8. Availability of services

Make sure any area you're considering has access to the services you want. Need a decent bakery? Check that your new town has one. Similarly, if you regularly visit a chiropractor, massage therapist, or acupuncturist, you won't be happy if you have to give those services up -- or drive 30 miles to access them. If it's important to you to have a beautiful garden, you may want to see if gardeners are plentiful -- and affordable -- in the community you're considering. And if you hope to live out the rest of your life in your own home and don't have a lot of family close by, chances are you'll need some in-home care at some point.

Leisure and family

9. Golf and the arts

We all like to spend our free time in different ways, but by and large most people are in search of a community with rich offerings when it comes to the arts and leisure activities. After all, what's retirement (or semi-retirement) for, if not to enjoy all the interests we were too busy for when we were putting in 50-hour weeks?

10. Proximity to family

If you have adult children, and especially if you're lucky enough to have grandchildren or are hoping for some, proximity to family's going to be one of your major considerations, and rightly so. But it still pays to be creative when thinking about this situation, rather than rushing off to buy a house down the street.

Younger families may need to be in an expensive urban area because of job and school requirements, and you don't have those considerations driving you. One solution: proximity to a major airport. Choose to live within an hour of a major airport, and family can visit you easily and conveniently even if they're a state or two away, opening up many more options.

Take future caregiving needs into consideration as well. The statistics show that 70 percent of long-term care is provided by family, typically a daughter. So talk openly with your adult children and grandchildren about who might be willing to take on that role. Be sensitive to potential family conflicts, too.

I tell people: Live close enough to get there easily, but far enough away that if you're mad at each other, you don't have to run into each other at the drugstore.

For more information on assisted living, contact Spring Arbor.


Life Thrives in Assisted Living

Joseph Coupal - Friday, September 15, 2017

Spring Arbor, Greensboro, NCFor many families, the biggest questions are about the type of skilled nursing facility that is best for their loved ones and how assisted living and personal care differs from other forms of around the clock care.

Assisted living is a fairly new category of care, but one that is sure to grow in the coming years. One of the things families need to know is that life doesn’t stop at an assisted living or personal care home; it thrives. By incorporating larger living and activity space and embodying the concept of allowing residents to age in place, this type of care provides residents with quality around the clock assistance without having to move to a licensed long-term facility when their care needs increase.

The term ‘assisted living’ has been used for more than 20 years and applies to assisted living residences. They can design programs to meet individual needs – for short-term stays when support services are required, and for permanent residency when chronic conditions exist. Both offer a holistic approach to health care that provides residents with quality around the clock care from trained caregivers and in many cases nurses too, but also supports an environment in which residents have a wide variety of options and choice when it comes to their daily activities.

However, assisted living differs from personal care in three ways: construction, concept and level of care. This model has been adapted over the years and still is focused on social benefits, but very much incorporates many of the medical services that older residents need to lead full, satisfying lives, while also granting them a greater degree of independence.

Assisted living residents come from all around and they provide a homelike atmosphere and focus on the needs of residents and what makes them happy.

People come for various reasons; some for short term stays, but most are looking for a community that will allow them to age in place and live their lives to the fullest, and that’s where the focus is.

The decision to move a loved one into an assisted living or personal care community is a family decision and with the holidays coming up, many families will be spending a greater deal of time together. Most people would rather age in place at home, but that’s not always an option. While talking about short-term and long-term plans for loved ones isn’t necessarily anyone’s favorite subject, this upcoming season provides a good opportunity to have those difficult discussions and look at options.

For more information on assisted living, contact Spring Arbor.