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What You Need to Know: Basic Facts About Assisted Living

Joseph Coupal - Monday, July 30, 2018

Spring Arbor - VA, NC, TN, SCIt’s important to know that “assisted living” is an industry term. It isn’t strictly defined, and there’s great variety in terms of assisted daily living services provided. For example, some but not all assisted living centers have 24/7 nurse staffing. The following facts about assisted living can help you understand the diversity. The more you know about possible differences from place to place, the better your odds of making a great move.

1. Cost is usually a top concern whenever people hunt for housing. Here’s a good basic fact: Assisted living generally costs much less than nursing home care.

In 2016 the licensing group CareScout compared costs using data they collected from 4,400 geographic regions of the US. They report than on average, the cost of assisted living per month was about $3,600. Nursing home care was more than double at around $7,700 for a private room and $6,800 for a shared room. Of course, $3,600 /month isn’t small change for most — but if the price looks intimidating, stay strong. Prices vary by region and the services needed. Also, individuals and families find many ways to pay for assisted living without draining their resources.

2. Services with assisted living vary from place to place. The US lacks a nationwide or federal definition for assisted living, and state governments all have different industry regulations. Many states issue more than one type of license for assisted living facilities, resulting in different levels of care being allowed. Licensing also matters for payment to be covered by Medicaid, private insurance and other sources. Facilities with the most advanced licenses may provide advanced medical care when a resident becomes bedridden or has symptoms of dementia. Others might need the resident to transfer to a nursing home, hire a personal nurse, or choose in-home healthcare. Main categories of assisted daily living services (ADLs) are:

  • Bathing
  • Dressing
  • Medication Management
  • Meal Services
  • Transportation

Residents might also get help with housekeeping needs such as dishwashing, laundry and vacuuming. Examples of specialty services that might cost extra are hairdressing, physical therapy, memory therapy, and help with scheduling appointments. Besides providing personal care services, most independent living centers facilitate social groups and outings. With all kinds of activities, there’s something for everyone! Educational activities such as art classes and computer lessons are offered too. Generally the larger the assisted living community, the more activities it sponsors.

3. Memory care is an option at select assisted living centers. If you or a loved one is in an early stage of Alzheimer’s or other dementia, then choosing an assisted care facility might be your best option in terms of stretching your money and allowing a longer period of independent living. Staff at specially licensed centers can help delay the progression of dementia with various therapies. They can also help minimize or prevent common dementia-related challenges such as wandering and anxiety. When the condition becomes advanced, it might be possible to live at the same facility, but in a different area with secured doors and other special accommodations.

4. Culture or “personality” matters. The US has thousands of assisted living facilities and no two are quite alike…

  • In some the decor is formal; in others it’s relaxed.
  • Some are very small communities and others have hundreds of residents.
  • Depending on the property’s layout, and also the local climate, residents might tend to spend lots of time outdoors, or else tend to stay inside. And of course residents bring different cultures along. When you search for assisted living centers, you can find homes that tend to attract residents from specific ethnic backgrounds, language groups, religious affiliations and so forth. Lately as more baby boomers are moving to assisted living, we’re seeing more and more “special interest” communities too. Residents are brought together by shared interests in areas as diverse as art, golf, LGBT issues, vegetarianism and community service.

5. Pets are welcome in many independent living communities. Sometimes animal care services such as grooming and dog walking are available for an extra charge. Some communities have their own “mascot” dogs and cats. When animal companions are allowed, generally there are restrictions about the size or breed. Homes have different policies about aquariums, birds and other “pet issues” — so before choosing an assisted care facility, verify that the pet policy fits your preferences.

For more information on assisted living contact Spring Arbor.


Stages of Alzheimer’s Symptoms

Joseph Coupal - Friday, July 20, 2018

Spring Arbor, SC, NC, VA, TN Health care providers describe Alzheimer’s as having three stages: mild, moderate and severe. Researchers have also identified a pre-clinical period. During pre-clinical Alzheimer’s disease, brain changes might be evident on an MRI but symptoms of these changes aren’t evident.

Independent living is possible with mild Alzheimer’s symptoms. For example, symptoms might be limited to:

  • Having trouble making plans or performing a work task
  • Being unable to remember the names of new acquaintances
  • Misplacing items and being unable to retrace one’s steps

The moderate stage of Alzheimer’s can last for several years or longer. During this time, changes in mood and personality are likely to arise. Alzheimer’s patients also tend to become restless in the middle stage. This could show up as insomnia, fidgeting and/or wandering. Becoming lost when wandering is a common danger to patients, so Alzheimer’s assisted living centers and nursing homes set up for memory care have especially secure perimeters. Eventually patients require 24-hour supervision. With severe Alzheimer’s a person needs health care and personal care support, and they need to be monitored for their own safety and the safety of others.

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


Finding The Best Memory Care Facility

Joseph Coupal - Wednesday, July 18, 2018

Spring Arbor - VA, NC, TN, SCYour mom who is 78-years-old and lives alone forgets to pay her bills. She can’t remember how to use the kitchen stove. She forgets appointments. These are signs of memory loss, and she may need assisted living with memory care.

Memory care is a type of skilled nursing for people diagnosed with memory problems. Among seniors the typical memory care patient shows symptoms of Alzheimer’s disease or another form of dementia. Some memory care patients have cognitive challenges resulting from traumatic brain injury (TBI) and other causes. Memory care is care for people who have diagnosed with memory loss and who need help with areas of daily living (ADLs).

If you or your loved suspects there is a memory problem, contact a medical professional for evaluation.

About Memory Loss

As we age, we lose brain cells. This loss of cells sometimes affects our ability to remember a name or remember where we left our car keys. These are often referred to as “senior moments.” It is a normal process of aging. But significant changes in our memory refer to something else.

When the term memory loss is used, it’s usually associated with Alzheimer’s disease (AD) because AD is the most common type of loss, occurring in about 5 million Americans. The broader term for memory loss is dementia (not a specific disease itself), which is the loss of memory from brain trauma, stroke, or a degenerative disease, as well as a loss of at least one other brain function like language.

Dementia affects your mental abilities, which affect your ability to carry out ADLs.

People with dementia usually have trouble solving problems, doing daily tasks, and may even have trouble controlling their emotions.

Here are some signs that are not part of normal memory loss.

  • Forgetting things much more often than you used to
  • Forgetting how to do things you’ve done many times before
  • Trouble learning new things
  • Repeating phrases or stories in the same conversation
  • Trouble making choices or handling money
  • Not being able to keep track of what happens each day

Alzheimer’s disease is according to the National Institute on Aging, an “irreversible, progressive brain disease that slowly destroys memory and thinking skills, and eventually even the ability to carry out the simplest tasks.” It accounts for 50% to 80% of dementia cases.

Unfortunately, there is no cure for Alzheimer’s disease, but there are care options.

For their own safety — and the safety of others — a person with progressive dementia will eventually need 24-hour supervision. He or she will also need help with:

  • Personal Care,
  • Medication Management, and
  • other Activities of Daily Living (ADLs).

At first the individual might be able to live at home with help from loved ones. Family can get support from in-home care providers and adult day care. But as dementia progresses and the patient’s needs grow, the spouse or other unpaid caregiver can become exhausted; we can only be superhuman for so long. Choosing a memory care facility becomes the best option. Most memory care centers are specialized nursing homes or specialized areas of nursing homes. Assisted living communities increasingly have memory care divisions too. Memory care centers ensure that residents won’t wander away; exits are carefully monitored. Employees and visiting specialists facilitate daily social events and potentially therapeutic activities. They provide meals, health care and personal care. All states regulate and license senior care centers, but many states lack special criteria for memory care nursing homes. It’s important to compare facilities carefully.

Choosing a memory care facility can be emotionally exhausting, but spending time on research can make a difference to your loved one’s quality of life and your family’s financial security. This article can streamline your task with an overview of what you need to know about when memory care is needed, what services are available, typical costs and payment solutions.

For more information on memory care, contact Spring Arbor.


Downsize Your Home and Right-Size Your Retirement

Joseph Coupal - Monday, July 09, 2018

Spring Arbor, SC, NC, VA, TN Most likely your home is your biggest asset. It’s also your biggest expense. Unfortunately when it comes to retirement planning, the family home is often last on the list of later-in-life changes.

There are many reasons for this delay. Emotionally it’s difficult to let go of a home filled with memories; moving can be a big process; and downsizing to a smaller home or assisted living community may not produce a substantial cash windfall. For these reasons, many retirees delay for years moving.

However, in many cases the benefits of downsizing sooner rather than later can be significant.

The financial benefits may seem small initially, but in the long term they can extend the life of your retirement savings. You may hesitate to sell a mortgage-free house and move to senior living community with a monthly rent payment, but with a home many of the expenses are hidden. It’s the ongoing maintenance such as: roof, furnace, windows, grass cutting and landscaping or snow removal — not to mention the annual costs of heat, electricity and taxes on a large older home. These costs add up to a substantial amount.

Selling your home will eliminate any mortgage or other debt and reduce your monthly expenses. Add in the income you will earn from investing the equity of your home and the savings from no home maintenance. Compare that to the monthly rental with built in levels of care for assistance while you age.

In many cases retirees are financially better off by renting. If downsizing makes sense, don’t wait. Sometimes people have a hesitation to downsize because they like to keep the family home so when children and grandchildren visit they can stay there. You should carefully consider the cost of this decision. It’s cheaper to pay for a hotel for the relatives than cling to the family home and all its associated costs (taxes, maintenance, heat, etcetera).

Trading the variable and hidden costs of home ownership for the visible cost of a set monthly fee can help with planning and budgeting. You know what your fixed costs will be.

Even without a mortgage, housing will often account for 30 per cent of retirement expenses.

Besides the financial benefits, is simply the practicality. Many people fail to consider how the aging process makes it harder to move. The process is exhausting at a young age. It’s much more daunting for retirees.

For more information on senior living contact Spring Arbor.


Summer Travel with Parents with Dementia

Joseph Coupal - Monday, July 02, 2018

Spring Arbor - VA, NC, TN, SCWith the summer vacation travel season upon us, families cringe with anxiety at the thought of traveling with a loved one who struggles with a dementia. We are often be asked if a loved one with Alzheimer’s can travel, and how to prepare for the journey. If your loved one is still in the beginning, mild stage he or she may be able to enjoy the trip, but precautions and preparation are paramount to a successful trip.

New faces, new environments, a change in daily routine, not to mention a time zone change, can prove to be a challenge for the dementia patient. That being said, if your loved one is still in the early stages of the disease, you should consider planning trips to visit family and friends now, before the disease progress. Once the individual is in need of assistance with bathing, dressing and toileting, travel will present significant problems, even just a short drive will be problematic for the more advanced dementia patient. Individuals exhibiting any of the following most likely will have a very difficult time traveling:

  • Being disoriented, confused or agitated
  • Asking to go home
  • Difficulty managing bladder and bowel
  • Anxiety or isolating behavior
  • Agitation or signs of wandering
  • Paranoia, hallucinations
  • Being verbally or physically aggressive
  • Spontaneous crying
  • History of falls

You won’t know how your loved one will tolerate travel until you take that first trip. So test the waters by planning a short trip away from home. Perhaps a weekend at a favorite destination within an hour or so of home. Suffice it to say, if your loved one doesn’t do well on a short trip away, he or she most likely will not be able to tolerate an extended trip.

If your destination is more than a two hour drive you might want to consider traveling by plane or train. Try to travel on off peak days, and consider if it would be better for your loved one to spend a day traveling by car instead of a crowded plane or train.

If your trip is longer than 5 or 6 hours, make arrangements for someone else to go along so that you can take turns driving. Preferably, someone who has experience with dementia or someone familiar with your loved one. You don’t want to drive alone with a dementia patient who becomes easily agitated or aggressive. Dementia patients are likely to swing open the car door in an attempt to get out, grab at the steering wheel or hit the driver. Have your loved one sit in the back seat with your driving companion. If your car is equipped with child safety locks, make sure they are engaged prior to your departure; this will prohibit your loved one from opening the door during travel. If your loved one does become agitated or aggressive, pull over as soon as possible to help redirect and calm him or her.

Be sure to pack a few things to keep your loved one occupied and comfortable. Perhaps a book or magazines, playing cards, favorite music, a favorite object or blanket from home, photos of the people or places you are headed to visit. Snacks are a good way to keep your loved one occupied, and water is a must to help prevent dehydration.

Be prepared to make frequent rest stops along the route. Remember, your loved one can no longer tell you if they are hungry, thirsty, tired, need to be toileted, etc., so it’s up to you to keep track of these matters. When you do stop, don’t ever leave your loved one unattended – too many things can go wrong. The unfamiliar surroundings of a rest stop, restaurant or service station will cause confusion and may trigger your loved one to wander off or exhibit aggressive behaviors. Try to visit places that your loved one once enjoyed, places that might seem somewhat familiar.

Remember, dementia doesn’t take a vacation. Just because you’re on holiday it certainly doesn’t mean your loved one requires any less care. Consider bringing someone along who can help with the care giving needs. Plan your itinerary to include short sightseeing tours or visits to family and friends, time for your loved one to rest each day, and most importantly, try to maintain the same daily routine that your loved one has become accustomed to at home. This will help ease anxiety and agitation.

Prepare the essentials and keep them with you, this includes identification, emergency contacts, a photo of your loved one for identification purposes, medications, water, snacks, a change of clothes. Keep with you a message, business card size, that you can discreetly hand to restaurant servers, hotel staff, etc. that communicates your situation “Please be patient, my loved one has Alzheimer’s” or something similar. You should also be prepared to offer a simple statement should your loved one’s behaviors start to surface (“Please forgive my wife/husband/mom/dad, she/he is cognitively impaired”).

Be flexible. Have your Plan B laid out should you need to leave a visit early or return home early from your trip. If you’re making travel plans through a travel agent, consider purchasing travel insurance. Do not tell your loved one about the trip too far in advance, this will only bring on anxiety and constant questioning.

Traveling by air with an Alzheimer’s patient can present a whole slew of challenges. It is wise to get a letter from the doctor identifying that your loved one is an Alzheimer’s patient, under medical care, cannot process instructions, gets confused and agitated easily…etc. Speak with the doctor about medications that can help keep your loved one calm. Keep a list of medications handy. Be sure to contact airline personnel as well as airport security to alert them to your situation, ask about special accommodations (i.e. pre-boarding, attendant assistance, wheelchair, etc.). You should contact the airline at least 48 hours in advance of your travel date.

Plan to travel early in the day when your loved one is at his or her best. It’s better to fly nonstop whenever possible, especially if it’s a long trip - it’s well worth it to spend a little extra to fly nonstop. But, if you have to have a layover, make sure there is plenty of time between flights so you don’t have to rush your loved one. Have a plan in place should your plane be late, if you miss your connection or if a connecting flight is cancelled. The earlier you book your fight, the better chance you have of selecting your seats. Sit side-by-side and seat your loved one by the window, this way your loved one can’t just get up and wander. An MP3 player programmed with favorite music and headphones can help make the trip more enjoyable for your loved one – music is very calming and therapeutic for a dementia patient.

It will be difficult to juggle luggage, packages, flight bags, etc., all while managing your loved one. Pack lightly, and whenever possible ship your luggage or packages. This will free you up to focus on your loved one and you won’t have the hassle of waiting at baggage claim to locate your belongings.

Prior to departure for the airport, check all pockets, place anything that would set off the metal detector in a zip lock bag, including wallets, jewelry, watches, glasses, etc. Place the bag in your flight bag, carry on or purse. Make sure you have enough medications for several days and that your loved one has on him or her identification, list of medications, emergency contact information and information on their medical conditions.

Use the restroom just prior to the flight this will help avoid the need to use the airplane lavatory. If he or she must use the on in-flight lavatory, be prepared with a plan should your loved one need assistance, will he or she be able to maneuver in the confined space? Is there a chance they’ll lock themselves in and not be able to open the door?

Take along plenty of things to keep your loved one busy, as well as snacks, and drinks. There is always the risk of dehydration, which could make symptoms worse. A favorite food or treat is also a good way to redirect behaviors.

If at all possible, have a family member or friend waiting at your destination, or hire a car service so that you don’t have to wait in long lines.

It is very possible that the new environment will cause behaviors to surface and perhaps create a wander worry. Bring along a travel door alarm. They’re typically used to alert you to someone entering your room, but in the case of someone with dementia, the alarm can alert you to your loved one trying to leave the room. Enroll your loved one in the Alzheimer’s Association’s Safe Return program ( and be sure to have a current photo of your loved on hand or on your cell phone.

Remember, excessive stimulation, loud noise, hustle and bustle, too many faces and conversations are overwhelming to a dementia patient. Try to schedule as much alone time together as possible. Try to avoid crowded events and make restaurant reservations before the dinner crowd. Allow for extra time when planning activities, this will lessen the threat of agitation. Be sure that both you and your loved one get plenty of rest – it’s very draining, even for a healthy person, to travel, even more so for a dementia patient. With proper rest during the day and adequate sleep at night, you can help avoid creating more confusions and irritability.

Above all, have fun! Gear activities toward what your loved one is capable of, a quiet dinner, a visit to a museum or a walk on the beach. Your loved one’s memory is deteriorating, but they can still find joy in the moment.

For more information on dementia care, contact Spring Arbor.