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Senior Assisted Living Blog

Ways to Celebrate Father's Day When Dad Has Dementia

Joseph Coupal - Friday, May 31, 2019
Spring Arbor, Greensboro, NC

When your father is living with dementia, you often struggled with how to approach Father’s Day. Even though they often don't know what day it is, it's important to to celebrate and honor a father.

Here are some ideas:

Reminiscing over Favorite Foods

Arranged to eat in the care community’s private dining area and bring in a meal featuring your father's current favorites and some gems from the past. As you eat, talk about meals past. Inspired by the familiar tastes, smells and textures

Naming His Tunes

Seniors often liked to dance with their spouses. Print out song lyrics and sing some of their old standards.

Scrapbooking Life Stories

Created a story scrapbook that incorporates highlights and photos from your father's life, along with a meaningful storyline that captures the essence of his life story. Read from the book, using the stories as conversational catalysts. You will all enjoy remembering all his adventures and your many shared experiences.

Celebrating Special Qualities and Life Lessons

Sit together and talk about some of your father's many stellar qualities.

Just being together is wonderful. And taking time to really celebrate your father with a tender mixture of food, photos, stories, and affirmations will be pure magic.

For information on memory care, contact Spring Arbor.


Essential Documents to Prepare Before Alzheimer's Sets In

Joseph Coupal - Tuesday, May 28, 2019
Spring Arbor - VA, NC, TN, SC

Prepare these documents, and update older ones, while you still have the decision-making capacity to do so.

Advance-planning documents can help ensure that all your financial and medical wishes are carried out to the letter. This is especially important when Alzheimer's disease and dementia come into play. It's essential to draw up these documents -- and update older ones -- while you still have the decision-making capacity to do so. If you don't have the appropriate documents, a court may step in and appoint a guardian for you. Because of the differences in state law and the complexities involved in ensuring that your instructions are airtight, see a lawyer for help in drawing up these documents.

Power of attorney for finances.

This legal document allows another person to manage your finances on your behalf. Naming a competent, trustworthy agent is essential. Many seniors designate a family member for this task. You can build in checks and balances by requiring that the agent provide a periodic accounting to a third party, such as another relative or a lawyer. Or you can require that another individual sign off on any gifts of your property.

Powers of attorney should state the agent's authority to handle specific investment accounts, annuities and other assets -- details that aren't included in some off-the-shelf documents. Make sure the power of attorney is "durable," meaning that the agent's powers continue when the person creating the power of attorney becomes incapacitated.

Living trust.

This document can provide detailed guidelines on how your property should be managed if you become incapacitated. You transfer your investments, real estate and other assets into the trust and name yourself as trustee, so you maintain control of the property. You also name one or more successor trustees to manage the property if you become incapacitated, and you include detailed instructions on how the money should be used if you are hospitalized or need long-term care.

After you die, the trust allows the successor trustee to transfer your property to your beneficiaries without having to go through probate. If you have a living trust, you still need a financial power of attorney to manage transactions that may fall outside the scope of the trust, such as dealing with credit card accounts. To provide checks and balances, it's best to name different individuals as your living trust's successor trustee and as your agent under a power of attorney.

Health care directives.

A living will documents your wishes regarding life-sustaining treatment. Some states combine the living will with a health care power of attorney in one form.

The health care power of attorney allows you to appoint someone to make medical decisions for you if you become incapacitated. You also can include specific instructions on how your agent should make your health care decisions. Laws governing these documents can vary from state to state.

Also, seniors looking to include more details in their advance directives might consider the Five Wishes form, which meets legal requirements in more than 40 states. The form, available at, allows users to designate a health care proxy and outline the care they want under various medical scenarios.

Standard will.

The will identifies the individual's beneficiaries, who will receive the assets in the estate. It also names the executor, the person who manages the estate. The executor will have no legal authority until the person dies. Separately, individuals must designate beneficiaries of their retirement plans on the plan documents themselves; naming beneficiaries for retirement-plan assets in a will is not legally binding.

Letter of instruction.

This document will provide your family the financial and other information they need if you become incapacitated. At the very least, the letter should list all of your investment accounts, insurance policies, loans, cemetery plot records, real estate holdings, military benefits, overseas assets and even frequent-flier memberships. It should also provide the location of important documents and the names of key contacts, such as your lawyer, financial adviser and insurance agent. Make sure to include the computer passwords for all of your online accounts.

Your letter also could direct heirs to cancel club memberships and to call current and past employers regarding company benefits and stock options. Include funeral instructions and information you would like in your obituary. You can place all of the documents in a binder.

Special needs trust.

This trust is set up to provide for an incapacitated spouse if the well caregiver dies first. The amount put in the trust will be based on the expected cost of care over the individual's lifetime. Such trusts are drafted so that the assets are not considered to belong to the disabled person. That protects eligibility for certain government benefits, such as Medicaid benefits for nursing-home care, without requiring the ill patient to first spend down all assets. Assets could be spent on extras, such as special therapies, a geriatric care manager or a private nursing-home room. A trustee would make spending decisions.



How to Choose Memory Care

Joseph Coupal - Friday, May 17, 2019

When a loved one with dementia can no longer live at home, you may want to seek out a residential facility that specializes in memory care. But how do you know if a facility offers more than just a fancy label and a premium price tag?

Spring Arbor, SC, NC, VA, TN

Memory care units, sometimes called special care units, are often housed within an assisted-living or skilled-nursing facility. At their best, they can offer staff extensively trained in caring for people with dementia, individualized care that minimizes the use of dangerous psychotropic drugs, a home-like environment and activities that improve residents’ quality of life. But at their worst, they may offer little more than a locked door. There are no consistent standards for memory care.

If you’re considering memory care for a loved one, you need to go beyond the label to find out exactly what services are being offered at the facility. That means making multiple visits to each facility on your short list, studying staff interactions with residents, talking to residents’ families, and asking a host of questions about staff training, daily routines, methods of dealing with challenging behavior and other issues.

To start your search for a facility, first focus on the one factor that patient advocates say can all but guarantee better outcomes: proximity to family and friends. The task is not just to choose a good facility, “but also being there on a regular basis and being very involved,” says Ruth Drew, director of family and information services at the Alzheimer’s Association.

Do In-Person Research

When you have narrowed down your choices, make multiple visits to each facility—including unscheduled visits at night or on weekends, when the staff is more likely to be stretched thin. Is the facility clean? Does the food look appetizing and taste good? Is there adequate staff to assist those who need help eating? Are there residents calling out who are being ignored?

Ask about the staff-to-resident ratio and the level of staff turnover. Memory care facilities should have at least one staff member for every five residents. If you don’t have that, you end up with people placed in front of the television. If there’s a high level of staff turnover, that’s a very bad sign, because people with dementia tend to respond better to familiar routines and consistent caregivers. Ask about the type and amount of training the staff receives, both initially and on an annual basis.

Look for signs that the facility is responding to individual residents’ needs—not forcing them into a fixed routine.

Make sure the facility offers activities that can keep your loved one engaged—even at night, when many dementia sufferers are awake.

Ask how the facility responds to residents who may wander or become aggressive. If the answer is locked doors and antipsychotic drugs, that’s a red flag. Facilities should have a circular corridor, an enclosed outdoor area or other spaces that let residents roam freely. And they should provide enough individual attention to detect hunger, pain and other common triggers for aggression, rather than resorting to drugs.

Because transitions can be unsettling for dementia sufferers, make sure that your loved one will be able to remain at the facility for the foreseeable future. In some states, assisted-living facilities can’t provide complex medical care, so residents who need skilled nursing may have to leave—or the facility may contract with a home health nurse to provide care, at additional cost. Ask what health conditions might require your loved one to leave the facility or move to a higher—and more expensive—level of care within the facility. And find out if the facility accepts Medicaid. If not, a resident who runs out of money may be forced to move.

To be sure a facility has been treating residents well, talk with family members of residents at different stages of dementia about their experience with the facility. For memory care units housed within skilled-nursing facilities, go to and click “find nursing homes” to see star ratings for a nursing home’s health inspections, staffing and other measures. If the unit is within an assisted-living facility, contact the state licensing agency (which is often the state health department) for information on inspection reports and any sanctions against the facility.

For more information, contact Spring Arbor.


Tips for Finding the Best Senior Living Care Near You

Joseph Coupal - Monday, May 13, 2019
Spring Arbor - VA, NC, TN, SC

As we get older, there are those of us who can’t safely handle all our daily tasks without senior care. When this time comes, the best move is to start considering different senior living facilities to find a new place to call home.This is not an easy decision, as there aren’t many people who want to leave their homes and it’s quite a commitment to make the move.

The happiness of you or your loved one is very important. Most seniors are at least a little resistant to leaving home to move to a senior-assisted living facility, skilled nursing facility or nursing home at first. But if you spend some time finding the best fit, this transition will be less stressful, and your long-term happiness is much more likely.

Figure Out What Level Of Service You Need

When considering senior living facilities, you’ll first need to determine exactly what services and support you require. Write down anything you need help with right now. No matter how small and insignificant it may be, everything is important. Then, think about what you may need help with in the future. Although you may not need help with some daily tasks today, you may really need that help in the next few years.

According to the U.S. Department of Health and Human Services, about 70 percent of individuals over 65 years of age need some form of long-term care.Once you have this list written down, you should start looking at the different forms of senior living facilities to find which one best matches your needs. Here’s a short summary of the most common types of senior living facilities:

Independent Senior Living Facilities

These homes remove the burden of owning your own home so that you can focus on your interests and your health, both emotionally and physically. They also offer plenty of opportunities to make new friends.

If, after looking over your list, you determine that your overall health is just fine and there’s no need for help with the normal daily tasks, one of these places could be a great fit.

Assisted Senior Living Facilities

By assisting you with daily tasks, home maintenance, and transportation, these communities allow you continue living independently, but with a little more help. If you’re having trouble managing your medications, dealing with mobility issues, struggling to get dressed or worry about getting in and out of the bath, you should consider an assisted living facility.

Skilled Nursing Care (Nursing Home Facilities)

These places can provide continuous skilled nursing care for those with complex health issues or those recovering from an injury or surgery. If your health issues are becoming more complex or your needs require full-time care, these facilities may offer the best choice for you.

Continuing Care Retirement Communities Or “CCRCs” (Life Plan Communities)

CCRCs are a fairly new idea, but they offer a great option for many seniors. Residents at these senior living facilities benefit from a full continuum of care including memory care, skilled nursing, independent living services and assisted living services.

By providing all of these options in the same community, they allow seniors to enjoy their independence now, but still have access to levels of care they may need in the future.

Make Safety A Priority

Whether you’re looking at care options for yourself or a loved one, safety should always be a priority. This means security from the world outside the facility and from internal concerns. There is really no price tag on the preservation of well-being, especially when it comes to old age.Here are a few ways to help you find a safe senior living facility:

Take A Look at State Records

While they may make a place look great, clean common areas and green gardens do not reflect the safety of the facility. Mistreatment and wrongdoing typically happens when no one is looking for the best way to check for these issues are by looking at state records.

Records of reprimands, offenses, and crimes among senior living facilities can be found at state offices that focus on senior care. These records can give you a “background check” as you search for the right place for you.

Talk to The Staff and Current Residents

During a visit to one of these senior living facilities, you should take the opportunity to talk with staff members and current residents about what it is like there. They may be more willing to open up about their experiences than you would think. Even if you’re nervous to ask the residents, it is important to know if they feel completely safe and comfortable. You need to take all actions possible to uncover issues before you commit to a place and learn the hard way.

Get A Breakdown of Security Policies and Features

You can find out about a facility’s security features by asking the administrator or director. While you speak with this leader of the facility, you can also ask them about resident complaints and hiring policies. If you or your loved one has special medical needs, you should also make sure they will receive regular, highly-skilled care to address these needs as a safety precaution.

Costs And Income

Although senior living homes can be expensive, most people are surprised at how affordable it can be when compared to the costs of owning a home. Either way, it is important to crunch some numbers before you get too far along in the process of finding a new home.Take a look at how much it costs you (or your loved one) to live in your own home.

Even if the mortgage has already been paid-off, the list of expenses can be quite long. From utilities, taxes, groceries, and entertainment to continuous home maintenance and age-related renovations, the costs can add up quickly. If you have any current medical costs or expenses associated with home health care, those should also be included in your calculations.

After that, consider your financial resources. Include your assets and income sources like surviving spouse benefits, veteran’s benefits, retirement investments, pensions and long-term care insurance. You can then combine all of this information by adding up financial resources and expenses that will no longer occur to create a budget.

Then you’ll know what you can afford when it comes to senior living facilities.If the numbers still aren’t adding up, you can look into federal aid programs like Supportive Housing for the Elderly, Low-Income Housing credits and other government-provided options.

Tour The Facility

After all of this research, you’ve already got a big head start on finding the best senior living facilities near you. However, you should never make a big decision like this one based solely on Internet research. The only way to truly understand which facility will be best for you is to take a tour.

Start by calling each facility on your shortened list. They should be accustomed to helping people set up tours of the facilities. Once you arrive, make sure that you walk the whole facility including the resident’s rooms. And as we mentioned earlier, don’t be afraid to talk to some of the current residents and staff members to hear their opinion.

You would never want to buy a house without doing a walk-through first, so you shouldn’t commit to a senior living facility before a tour either. You need to be completely confident that the facility will be a comfortable place that will support the overall happiness of you or your loved one.

So you’ve done all the research, taken tours, and asked for professional help. Are you still struggling to find the best senior living facility for you? The truth is you could spend the rest of your days stressing over this decision, but, at the end of the day, your gut feeling should help you make the final commitment.

Don’t be swayed by shiny marketing strategies and sales pitches. Trust all of the work you’ve done and don’t ignore your instincts.

For more information contact Spring Arbor.



Choosing A Senior Living Community

Joseph Coupal - Monday, May 06, 2019
Spring Arbor, NC, VA

Choosing a senior living community for yourself or a loved one can feel overwhelming. There are many options for long-term care available, and it may be difficult to know what will best suit your needs. Doing some research is a good first step. And you'll need to arm yourself with a list of questions to ask senior living communities.

Getting started

Among the questions to ask , one of the first should be about the level of care you or a loved one needs. The options boil down to three levels:

Skilled nursing is typically for people who can no longer care for themselves, and need the help of a nurse or nursing assistant 24 hours a day. Residents live in separate rooms, and may have a roommate. Assisted living is meant for people who need help with a few activities of daily living, such as bathing, dressing, cooking, or remembering to take medication. Residents live in private rooms or apartments, meals are provided, and nursing staff or nursing assistants check on residents each day.

Independent living is for people who can take care of themselves, but want the convenience of someone else to do the cooking and cleaning. Those services are provided. Residents live in private apartments or condos, usually without someone to check on them or provide nursing care.

Asking about safety

Safety and quality of care are also important to list among questions to ask . There are many rules and regulations that retirement facilities must follow.

Other questions

Knowing about a facility's services and safety will help you narrow your choices when you're choosing a senior living communities. Once you have a shortlist, you'll need to visit each facility and talk to the managers, health care providers, and residents. Make sure you get the answers to the following questions to ask senior living communities:

  1. Is the facility licensed and operating legally?
  2. Has its license ever been revoked—and if so, why?
  3. Are recent inspection reports available?
  4. How long has it been in business?
  5. Are financial records available?
  6. Can it supply satisfactory references?
  7. What is the staff-to-resident ratio?
  8. What training does the staff receive? Do staff and residents treat one another with dignity and respect?
  9. Can you speak to residents about their experiences at the facility? Are they happy?
  10. Are there educational and exercise programs, and clubs and opportunities to develop new hobbies and interests?
  11. Is there an active residents' council, and what role does the council play in advising practices?
  12. Does the facility have what you're looking for in terms of a private room, private bath, or stand-alone house?
  13. Is the facility clean, attractive, and in good shape?
  14. Does it have space for gardens, entertaining, or hobbies?
  15. What meals are provided? Does the food suit your taste, nutritional requirements, and cultural preferences?
  16. Are doors and locks secure?
  17. Is someone on duty 24 hours a day, or is there an emergency call service?
  18. Are medical services available around the clock? What does this actually entail? For instance, can the medical staff place intravenous lines, or do you need to go to a hospital for that?
  19. Are there nurses on staff and a doctor on call?
  20. Can those with physical disabilities get around the facility?

Get answers sooner, not later

Choosing a senior living community can take time, so it's a good idea to start your research sooner, not later. It may even help to begin looking well before you need to make the transition. After all, you may not be able to predict when a serious illness or accident will require that you make the move. Compiling a shortlist of potential retirement facilities that interest you, and creating a list of questions to ask senior living communities will ease some of the stress you may experience in this new chapter of life.

For more information, contact Spring Arbor.


Questions to Ask When Exploring Memory Care

Joseph Coupal - Friday, May 03, 2019
Spring Arbor, Greensboro, NC

Memory care is a distinct form of long-term care designed to meet the specific needs of a person with Alzheimer’s disease, dementia or other types of memory problems. Before you choose a memory care option, you may want to compile a list of questions that cover your concerns about your loved one’s care, comfort and safety.

Typical Memory Care Services

When it comes to finding the right memory care community for your loved one, questions about the costs and services provided may come to mind. But, memory care communities offer a range of services, some of which might be more important to your loved one than others.

If you are considering memory care for your loved one, understand that many assisted living communities offer a special memory care unit (SCU) on a separate wing or floor. Or, you can choose an independent memory care community – just remember that memory care is specialized skilled nursing distinct from assisted living. Care costs are generally higher at these communities, even if the memory care unit is part of an assisted living residence.

Regardless of whether you choose a memory care facility or SCU, know that staff members have received special training to assist people with dementia or impaired cognition. Common services include 24-hour supervised care, medical monitoring and assistance with daily living tasks, in addition to a pleasing environment that is easy for residents to navigate.

Questions to Ask Before Choosing a Memory Care Community

As 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:

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