Thursday, August 13, 2009

I Found the Perfect Place for Mom and Dad- Now What?

You have most likely just navigated some very important decisions regarding the care of your loved one. You now have several additional decisions to make about their new home and lifestyle changes. This following suggestions are designed to help you “organize” your thoughts and help you plan for the next steps.

Is there a home to sell? If your loved one owns a home, planning and preparation for selling the home must begin soon, especially if the funds from the sale of the home will be used to finance new living accommodations. The first professional you need to talk with is a Seniors Real Estate Specialist. These Realtor's have received specific training and education to address the needs of home buyers and sellers 50+. You can locate an agent by browsing The Senior List category of "Real Estate Services" in your city and state or visit the SRES website.

Is the home filled with years of personal and meaningful possessions? Does the task of packing, deciding what to keep and what to give away seem overwhelming? Most of us have a lot of stuff: furniture, kitchen accessories, clothes, hobbies, linens, and everything else that we accumulate throughout our life-time. There are a variety of services available to assist with organizing belongings and helping with the tedious task of deciding what to keep, what to pass on, what to donate, and what to simply throw away. Again, check the listings on The Senior List for local Senior Move Managers in your area, or visit the official National Association of Senior Move Managers site.

Is there a car or two? Most care communities have transportation available for the residents. If your loved still drives, they only need one car, if that. If you are concerned about driving abilities or safety, now is the perfect time to encourage your loved one to let go of the wheels. You may be able to find a non-profit in your area that will accept donated cars and your loved one will benefit from the tax credit.

Prior to move-in to any care community, they will be requesting copies of your loved one's advanced directives, power of attorney documents, and any other health directives. If these documents are already in place, now is a great time to review them with your loved one to ensure they are up to date and accurately reflect their wishes. If these documents are not in place, you must have them before move-in takes place. In fact, everyone, regardless of age, should have these documents. If you need assistance with these legal forms, I recommend you contact an elder law attorney. You can find these specialists on The Senior List or visit the National Academy of Elder Law Attorney's.

These are tough decisions and tasks for any individual to complete on their own. These resources will alleviate stress and anxiety for families and seniors alike during this difficult transition time.

Amie Clark, Co-Founder, The Senior

Tuesday, June 9, 2009

Communication is Key to Better Care, Happy Families

You are traveling. Your mom is in an assisted living community. She isn't sleeping well or taking her medications. You have three sisters, who also lead busy lives. You are constantly playing phone tag between flights and meetings to find out the most recent update about her health and in turn, call each of your sisters to keep them up to date. Sound familiar?

Communication with care providers continues to be a full time job for many family members who are the primary contact for their loved one. As a family liaison myself, I am all too familiar with the time-sucker of phone tag, waiting on hold, and talking to several caregivers before I can get to the bottom of the issue for my clients. "Medications need refills, didn't eat lunch, won't take a shower, wants to go out for lunch, yelled at table mate, didn't sleep well, having a good day, needs new undershirts" were all separate phone calls I fielded during the course of a week for one client. Once I received the information from the care providers, I was then in charge of notifying the family and care team. I estimate that in one week, I spent at least an hour per issue between talking with the care providers, dealing with the issue, and reporting back to family members. So, you can imagine how thrilled I am to write about a company that will solve my communication woes.

Connect for Healthcare, in very simple terms, improves communication between care providers and families. How? Connect for Healthcare allows families to choose their preferred method of contact, email, text, or through a very well designed, easy to use, web portal. The founder, Neil Moore created the service after dealing with his own communication issues while his father resided in an assisted living facility.

"Connect for Healthcare is an inexpensive, easy-to-use, subscription-based web service that uses modern technologies - the Internet, e-mail and text messaging - to create and maintain a new and vital link between families and their loved ones in long-term care. It enables care providers to easily give regular, proactive, specific wellness updates to family members and loved ones no matter where they might be in the world. The family benefits by staying better informed and feeling more connected, their loved ones in long-term care benefit because the better informed and more engaged the family is, the better care they can receive, and the provider benefits by having a simple, one-step method of giving families what they really want."

What I like most about Connect for Healthcare is that each family member can be notified through their preferred method of communication, without any work from the primary family communicator. The family web portal allows families to not only establish their preferred contact method, but to designate what they would like to be notified about. Each client profile is tailored specifically to the client, family, and care provider.

For care providers, using Connect for Healthcare as a tool to communicate with families will save staff time, decrease communication errors, and in many cases, will simplify documentation and charting. Many long term care providers are offering Connect for Healthcare to the families they serve as an additional feature of their community. Families may also request Connect for Healthcare to be set up for their loved one, costs range anywhere from $15-$37 per month. To find out more about pricing or to view a tutorial of the program, visit

Amie Clark, Co-Founder, The Senior List

Monday, November 17, 2008

The Future of Elder Care: Part 1: Elder Cohousing

In my work with families who are placing a loved one in a care community, I am often asked about the future of long term care. Many people I talk with are uncomfortable with the concept of long term care for themselves but think it’s adequate for their parents. I have good news and bad news: There is an alternative to long term care options known as Elder cohousing, but don’t expect it to show up in your neighborhood anytime soon.

The cohousing model was adopted from Denmark and migrated to the US in 1988. Initially conceived as multi-generational cohousing, neighbors adopted rules and built structures that allowed them to live supportively with one another, sharing common facilities and incorporating non-hierarchical decision-making, two of the six main characteristics that all cohousing communities share. Now, a similar concept, Elder cohousing, is becoming more popular with the 50 and older crowd in the US. Elder cohousing is an environmentally sustainable alternative to the existing models of housing for boomers and elders alike who yearn for their independence within a supportive community environment.

There are three elder cohousing projects that have been completed in the US. The three lucky states are Virginia, California, and Colorado. To date, there are eight elder cohousing projects actively underway according to Some communities are spearheaded by a group of friends or neighbors; others are formed by a few members who then recruit other future “neighbors” for investment and participation.

Studies suggest that people remain healthier and may live more independently if they have strong community ties. Cohousing fits this prescription perfectly as each member of a cohousing project has duties and contributions they are expected to provide. In one cohousing community, members’ professions included the following:
* Architect and Project Manager
* Technical illustrator/painter/sculptor
* Librarian
* Builder/Developer
* Teacher
* Retired English professor
* Financial planner
* Ombudsman
* Psychotherapist
* Retired businessman
* Social services for youth in prison.

If a member of an elder cohousing project needs care at some point in their journey, they continue to live at the site for as long as possible. Members are expected to help provide for one another; some will hire in-home care or employ caregivers for those who are in need. In the event that a member needs to live in a long term care community, members of the elder cooperative will continue to remain a part of the member’s life. This allows members to age in place for as long as possible, decreasing the financial, psychosocial, and health burden of the individual.

If you would like to learn more about elder cohousing, or how to form your own cohousing project, visit

Amie Clark, Founder, The Senior List

Wednesday, June 4, 2008

Assisted Living- The Good, Bad and the Ugly

There are almost 35,000 Assisted Living Facilities licensed and operating in the US today. These communities range widely in size, price and amenities and are all fiercely competing for your businesses. The real trick is finding the one the suites your needs, life-style, and pocketbook.
What is Assisted Living?

The typical Assisted Living model is based on apartment style living with care services built in. This model encourages independence and autonomy while providing supervision and daily assistance with care needs. Meals are typically served in a main dining area with the intent of a social gathering while enjoying meals selected by the residents. Activities will be offered, including outings, scenic bus rides, and trips to the grocery store, bank, and doctors visits on designated days of the week.

What type of care is provided in Assisted Living?

Assisted Living provides custodial care, not medical care.

  • Bathing, Dressing, Toileting, Grooming, Mobility, Medication Management
  • Cooking, Housekeeping, Transportation, Laundry

What can I expect to pay for Assisted Living?

Most Assisted Living facilities structure their costs on an "ala carte" system. You will be quoted a "base cost" or "room and board cost" ranging from $1500-$3000 per month, depending on geography, size of apartment, and amenities offered. Expect to see additional costs added on right away. Based on an assessment of your care needs, the price will increase accordingly. This price can vary from month-to-month, especially if care needs drastically improve or decline over time.

What are the advantages to Assisted Living?
  • Less expensive than nursing home care
  • Private apartments to optimize privacy, autonomy, and independence
  • Three meals a day served in a social dining atmosphere
  • Security and call bell systems
  • Designed with accessibility in mind (roll-in showers, etc)
  • Exercise programs
  • Care Services available- to be used as little or as much as you require
  • Activity programs designed to keep residents active, social, and healthy
  • Most have a beauty parlor on site
What are the limitations of Assisted Living?
  • Despite staff presence and encouragement, some residents can become isolated
  • Most do not allow residents to cook, for safety reasons
  • Assisted Living can not accommodate residents who are wandering or exit seeking
  • Minimal staffing requirements in most states. On average, expect to see 1 caregiver for every 30 residents during peak hours, and much less at night
  • While facilities tout their abilities to care for residents through the end of life, many will ask families to hire private caregivers or transfer to a higher level of care if the residents needs are beyond the scope of their staffing levels
What do I look for in an Assisted Living community?
  • Ask to see the latest survey
  • Invite yourself to lunch (most will happily invite you first). Do you have menu options? Can family or friends join you for a meal? What is the cost for guest meals?
  • Do the other residents interact well with each other? Are the staff friendly and kind? Do they know the residents by name?
  • What is the caregiver-to-resident staffing ratio for each shift?
  • Is a nurse available? What hours is the nurse in the building?
  • Does the facility have a comfortable atmosphere? Is it clean? Are there any noticeable odors? What safety features are available?
  • Is transportation available? Is there an additional cost?
  • How often is the care plan reviewed? Is the resident or responsible party involved in the review? (they should be)
  • What is the turn-over rate for staff? *Note* Most facilities have a high turn-over rate. It's a huge problem. What is the facility doing to keep current staff and attract new quality caregivers?
  • If you have a pet, ask about any fees you will be expected to pay for your pet. Typically, an additional move-in fee and cleaning deposit will be incurred.
  • What cost of living increases can be expected? (we have noticed 3-6% yearly for most communities)
  • If the community can no longer meet your needs, how much notice will you receive and what assistance will be available to relocate to another level of care?
  • Trust your instincts!!!
Who pays for Assisted Living?
  • Private Pay (you)
  • Long Term Care Insurance- Check your policy for coverage, waiting periods, etc...
  • Medicaid- If you already qualify for Medicaid, or will qualify in the near future, make sure the facility you are considering has a Medicaid contract- many do not. You can check with the facility or your local Agency on Aging office for a list of contracted facilities in your area. If a facility does have a contract, chances are they are trying to balance Medicaid v.s. private pay in the building. Some will have a waiting list for Medicaid, so plan ahead. Do not wait until a crisis to start your search!!!

If you are just starting your search for an Assisted Living Community, you may consider working with a geriatric care manager or placement and referral agency to guide you. These professionals will know the communities in your area and save you valuable time and energy.

Amie Clark, Founder of The Senior List