OSRAA

Oregon Senior Referral Agency Association Raising Industry Standards since 2004

planning ahead

Having “The Conversation” About Moving to Assisted Living

By 1 Comment

Kate called me last month asking about assisted living options for her mother. Mom had been living at home by herself and was doing fine (her words when family checked in on her by phone).  It wasn’t until there was a family gathering at Mom’s house that they realized things weren’t as “fine” as they thought. The milk was expired and the bread was moldy. Piles of bills and other paperwork covered all the tables, unread newspapers were piling up by the front door and the yard which she took pride in was obviously untended.  Everybody could tell Mom had lost weight, her clothes and her house were very dirty and she seemed confused.  The family got together and decided she wasn’t safe to be at home any longer and needed to move somewhere where she would get some assistance.  We toured several assisted living buildings and found one the family thought was perfect. Next came the question I dreaded “How do we tell Mom she needs to move?”

According to recent Marist research, 80 million Americans are reportedly conversation avoiders, meaning they haven’t talked about any important end-of-life issues with their parents or children.  In addition, research by Home Instead Senior Care revealed 70% of family conversations about aging are prompted by an event such as health crisis or other emergency.

Why aren’t families talking? It’s difficult! Research by Home Instead Senior Care indicates a majority of adult children (54%) described their critical conversations with parents as uncomfortable at times, difficult but necessary, emotional with yelling and tears, or difficult and unsuccessful.  How do we get the conversations started earlier so it’s not prompted by a crisis?

Home Instead Senior Care has very comprehensive materials on getting the ‘talk’ started and focuses on areas such as driving, health care, relationships and dating, end of life.  In an effort to guide Kate, in the example above talking about the future far in advance of the crisis would have helped a lot.

Starting the conversation is the hardest part. Caring phrases can get the conversation going. “I know we want the best for one another. Let’s talk about options that will work for both of us” or “I know you want to remain home for as long as possible. But I want you to be safe. I’d be less worried if we had a plan now in case something happens in the future.” “I know you want to be independent as long as possible, let’s make short, medium and long term plans and define what may trigger implementing each of the plans when necessary.”

During the conversation ask questions such as “What if you could no longer drive, what would you want to do?” “If you’re unable to navigate the stairs in your house what would you do?” “Where would you live if you have to make a change someday?” “Who (or what) do you want to live near?” “What can you afford?” “Do you have long term care insurance that would help pay for care at assisted living?” “What activities are important to you that you want to continue doing if you move in to assisted living?” “What possessions are important to you that you must have if you move to assisted living?” You may want to tour some assisted living communities to see what’s available and choose where to go when the time comes. Document the plan and keep in a safe but accessible place so it’s readily available when needed.

Making decisions, identifying choices and conveying wishes are an important part of the road ahead. Working together to develop the plan helps Mom feel like a part of the decision rather than having the decision made for her. By having the conversation early you’ll both feel more comfortable with the aging process and you’ll avoid having to make decisions during a crisis.

There Comes a Time in Every Family

By Leave a Comment

Judy, age 80, had been her husband John’s caregiver for the past 10 years; ever since his diagnosis of dementia. Now she was starting to see her own health fail as a he began getting agitated in the evenings and would frequently be up at all hours of the night, convinced he needed to go “home”. As much as Judy would try to soothe and reassure him, John’s agitation continued to increase.

The couple have 2 very supportive adult children who were becoming increasingly concerned about how all the stress was affecting their mother’s health. They were worried she might collapse from all the pressure and lack of sleep. They realized something needed to be done so they called a family meeting.

During the course of the meeting Judy made it very clear that the most important thing to her was that she and John stay together, no matter what. They had been married for 55 years and she wasn’t about to leave his side now. Sarah, the eldest daughter, had spoken with a friend before the meeting who suggested they call a placement and referral specialist who could help sort out available options. Sarah was pleased to learn that the agency would not charge them for services, that instead, the agency contracts with communities themselves for payment. Sarah made arrangements for the Placement Specialist to meet with them.

At the consultation the family learned there were basically 3 choices available; hire care to come into the home, John and Judy could move to a community together that offered Independent Living for her and Memory Care for him, or Judy could stay at home and find placement for John. Everyone knew what Judy’s choice was.

As the situation unfolded, the family learned that it could cost upwards of $6000-$8000 per month for Judy and John to live in a community that met both their needs and a whopping $10,000 per month to have a caregiver from an agency in their home to help 24 x 7. At this point Judy agreed they would have to rethink their strategy.

The couple owned their home free and clear, they had downsized to one car and had about $150,000 in investments. As they continued to explore more affordable options, the referral agency was able to guide the family toward looking into having John move into Memory Care somewhere relatively close to Judy. That way she could visit as often as she liked without having to be the one responsible for care, and could just enjoy being with her husband without all the headaches and stress.

The Agency, looking longer term, suggested they explore Assisted Living/Memory Care communities with a Medicaid contract. That way, if Judy decided at some point she would like to join John, she could, having the security of knowing if they ever spent down their assets, they could both stay.

The placement specialist also recommended the family see an Elder Law Attorney to make sure they have everything in order and are knowledgeable about their rights. The State of Oregon has laws that protect “the community based spouse,” that is, the partner who stays in the home, making sure they do not become impoverished by spending all the couple’s assets for their spouse’s care. Medicaid planning is one of the many services in which Elder Law Attorney’s specialize in.

If you are in need of guidance or just have questions regarding a friend or family member who is having trouble managing independently, call a member of OSRAA for professional guidance.

 

[author] [author_image timthumb=’on’]http://osraa.com/wp-content/uploads/2014/04/highres_11658246.jpeg[/author_image] [author_info]Michele, a native Oregonian, was inspired to begin Lets Share Housing out of a passion for making a difference in the lives of our boomers and seniors. She was introduced to the senior housing industry by having owned and operated an Adult Care Home of her own from 1997-2000. In 1997 she also founded Adult Placement Network, an agency that assists families find the most appropriate care setting for their aging loved ones. Having spoken with thousands of people, each with their own unique situation, Michele began seeing a huge population that was not being served by the system; those that had a limited income but no care needs. Lets Share Housing was then born to offer a vibrant, sustainable and affordable alternative to what is presently available.[/author_info] [/author]

 

 

Stroke? Too Close to Home!

By Leave a Comment

A very close friend and her family have recently experienced a tragedy that so many other families experience every day.  I asked to her to write about it to share the many valuable lessons she and her family learned…. here is what she wrote.

The medical stories about people experiencing a heart attack or stroke are in the news every day, I heard them but I really didn’t pay much attention. For me those stories took place far away and to other people.  Then in an instant my 72 year old thriving father collapsed from a stroke. It hit without warning in a restaurant during a busy lunch rush. From the moment I heard the news I was on crash course of learning about the intense world of stroke recovery. I hope the dreaded moment never touches someone you love. However, I wanted to share a few initial experiences I had with my dad.

I could come up with well over a 100 lessons to share, but I’ll keep my list to ten…

  1. If you are the first family member to arrive at the hospital and the doctor reviews the facts with you, you’re now the family messenger. It’s up to you to get the word out and with details.

  1. Do not leave your loved one alone. I thought, “Dad’s fine, he’s in a hospital with 24 hour care.” I couldn’t have been more wrong. With the damage from the stroke and heavy medications there was NO way he could find the “call button” for help. My mom, brother, sister and I broke up the 24 hour day into shifts. I took the 9:00pm to 7:00am shift to be at my dad’s bedside. There were countless moments when he reached out for a hand to hold, needed more pain medication, a pillow to be adjusted, a warm blanket for his partially paralyzed body, his eyes covered at 4:30am when hospital staff would blast into the room and turn on the overhead lights to take a blood sample and so many more tasks in the role of patient advocate.

  1. Hold off assuming a nurse’s denial of a request is just plain mean. When dad arrived at the hospital he was so thirsty. I didn’t understand why they wouldn’t let him have an ice chip or a sip of water. Later I found out they hadn’t tested his ability to swallow yet, they were looking out for his safety.

  1. Don’t take children to visit too soon. Let some healing occur. I waited for nearly a month before I took the kids to see him. It was a heartwarming reunion. Dad was in a wheelchair with a smile, and not hooked up to IV’s, writhing in pain or fading in and out of a sedated sleep.

  1. Communicate the good and the not so good with family and friends. Honesty can be difficult when you feel you must be stoic for everyone. Accept help. One of the greatest gifts of support was from a dear friend who gave three hours of housekeeping.  Use your support system.

  1. Celebrate the most simple of achievements. We wanted to bring out the pompoms and marching band when dad brought an ice chip to his mouth with a spoon for the first time.

  1. Record voices and moments. Four days after his stroke I asked my dad to record a message to his grandchildren. His words were slurred, his thoughts were slow, but he told them how much he loved them. A few days later I recorded him again. He found such motivation from hearing how far his speech had improved in less than a week. His grandchildren also heard his improvement.

  1. Caring for a stroke patient is exhausting. Dad was with 24/7 hospital care for five weeks. The very hard work started when he came home. I had no idea!!

  1. There will be many tears. There will be many heart wrenching moments. There will be many heartwarming moments. There will be smiles and laughter along the way.

  1. Family life won’t be the same, but be realistic, learn and grow from the personal challenges of being exposed to the cruel and anguishing experience of stroke.

Our family is now in the early process of selling my parent’s two level home on the Oregon coast and building a one level ADA home near the family in Portland, Oregon. We feel such peace knowing if their house sells before the new one is ready, the placement and referral service I have selected to work with is right there to find mom and dad a temporary senior living environment with all the amenities they could possibly need.

[author] [author_image timthumb=’on’]http://osraa.com/wp-content/uploads/2014/03/Cherie-Henry-Pic.jpg[/author_image] [author_info]A member of the “golden girls” team at Golden Placement Services, Cherie is a senior housing and transition specialist. She has extensive experience as a licensed administrator in assisted living communities. Cherie has a passion for making sure seniors are secure, comfortable, and happy, so she works diligently to ensure they find that right place. Cherie has been happily married to her best friend for over 30 years and loves travel and golf, preferably together.[/author_info] [/author]