I Have Fallen and Need Some Help

What you need to know about Senior Living Pt. 1

March 30, 2023 Erin Thompson
I Have Fallen and Need Some Help
What you need to know about Senior Living Pt. 1
Show Notes Transcript

This episode is a very basic introduction into what senior living is and the types of communities in the senior living industry. I will be diving into many more topics inside the senior living industry in later episodes, but I wanted to get the basic understanding a definitions discussed first.

My wish is that you contact me and let me know what questions you would love answered on the following podcasts where I dive into how to talk to your loved ones about senior living, how to identify a good and great community, ways to pay for senior living and the pros and cons. 


You can connect with me at www.aspireformorewitherin.com

You can join my email list here.

You can schedule a call for us to connect about your caregiving journey here.

Hi, and welcome to the newest episode of the, I have fallen and need some help podcast. I'm Erin Thompson, your host. Thank you for being here today. I am going to talk about the basic. Understanding and philosophies, I guess you could say. Of the senior living industry. And my goal is over the next. Few episodes that I dive into each. Type of community. Independently. So we're going to discuss independent living assisted living memory care, and then skilled nursing. Now my background is primarily inside assisted living in memory care. Independent living is not something that I've actually worked in, but I have been around it and surrounded by it many, my, basically my entire career. So we can certainly go into that topic, but where the meat of my experience is in the assisted living and memory care, we're going to dive into. Lots of different things. Like. How to talk to your loved ones about the senior living industry. And how to actually make the move happen and use my own personal experiences with my grandmother, who I moved into my community. So stay tuned with me, but today we are going to talk primarily just about an introduction into each type of community that the senior living industry offers. So we'll start with independent living. There are many types of independent living that you can choose from. They have. You know, homes and neighborhoods that would be considered. Part of an independent living community complex. They may have a, um, a, um, Guest house or a clubhouse, or they may have a dining room where you can come and get a meal. Then you would move into. Another type of independent living would be, uh, one that has cottages. And then also some that have apartments complex altogether. And there may be meal plans with that. But you would have the opportunity to have a kitchen and the stove and all the things that you need to prepare your meals inside of those communities. Then you would have strictly apartment living where there may be two to three meals available per day. Uh, and then you would have ones independent livings that are connected to an assisted living. Um, and different levels of care. So independent living can be, again, like I said, homes, it can be homes and apartments. It could be apartment only. There are indeed. Um, There are financial based. Independent livings. And then there are private pay, independent livings. My grandmother lived inside of a, um, financially based. Um, income-based independent living apartment called the HIPAA apartments. And I'm not exactly sure how widespread they are, but in the know, in my area there and in both in the surrounding counties. And they go based on the income of the senior. Then there are the bigger corporation, independent living communities. Um, that are. Private pay that are not income-based at all. And then you have. The. Continuum care, retirement communities that start off. With the independent living the cottages, and then you have a buy-in and then you would. That big upfront costs that you pay would then cover you or. Promise you that they're able to care for your needs. As your needs change. And so each. Opportunity, right. Each community offers a set of experiences that either are good for you or not good for you. It just depends people that do not have children or that do not have that set plan of people to take care of them. Tend to really, if they have the money. Tend to really like those CCRC. The continuum care retirement communities. Where your needs will be met at each level. Inside that particular community. And that is certainly something that is worth noting and considering, but there are other types of communities that do not offer that guarantee, but have the product types that may be able to help you. So if you were an independent living, but then you needed assisted living, you would still have that in the same campus. And then there's some of them, some of the communities that also have memory care. So then you would have the same. Promise. That, that next level of care is there in the same. Uh, community in the same complex, which. Is almost like a promise, right? Because it's there. In the same. Parking lot, so to speak. So making your choice. Uh, wisely is very important. Independent living doesn't necessarily promise three meals a day. There are meal plans. Are there no meal options? And I believe that the, the number one premise of. What independent living is about is to build the socialization aspect. Because isolation inside of a home. Is not good for anyone. No one. So what independent living offers. Is that idea of socialization with other people like minded people. And. Maintenance free living. Which let's face. It is very nice. Very nice. Especially if you're in your seventies and you can't do all the things that you used to do, maintenance free living. Would be worth it. You know, if we had the money, it would be worth it. Um, There's activities. There's people dedicated to activities. There's constant, intentional effort to get people together, to hang out, to build that. Socialization aspect. That is very important. Uh, for somebody who is looking for that kind of entertainment and again, each community is different and what they offer. And it's important for you to know what your you, or your loved one wants. What type of socialization do you want? How important is socialization for you? And. Is that a deciding factor for you? We'll take the income based apartments, for example. My grandmother lived there for about 10 years and there is not an activity director. Nor is there. Um, intentional activities scheduled each day. That's led by an employee. But there are resident led activities. And that is something that is still fun and it's still engaging and it's still socializing. And the residents who were leading it have a great time and they have support from the administrator. Um, or the complex manager who's running that particular community. But when you go into other communities that have that designated activities director, then the level of opportunities to engage. Are there. And. They should be fun. And worth going to. That is the high points of what independent living is. And we'll go more into that in a later episode. The next category of senior living is assisted living. And that is my happy place. Assisted living. Um, And just going over the high points of what assisted living is and what they offer. They offer just from a big picture standpoint, help with activities of daily living. So what are activities of daily living? Bathing dressing, grooming. Eating. And toileting going to the bathroom. So it's assistance with those activities of daily living. It's not necessarily full care of those activities of daily living, but it is assistance. So we can assist you with getting dressed. We can assist you in and out of the shower. We can assist you in the shower. We can assist you. Um, going to the restroom and in all the forms that you may need help in that. Activity of daily living. There are also full-time activities involved in every single community, which is to me worth its weight in gold. Um, the activity program inside of any assisted living industry should really be what you look at one of the top. Three things that you look at when you're looking for assisted living, because that is the personality of the community. And if that activities department is being supported properly, it is the mainstay of the entire community. How is each department helping that as that activities director? Because that's where the residents are happy. And so are they able to show you the room can they talk to you about the activities? Are they involved? Do they get that activities director involved? In your tour of the community. Another aspect of assisted living. That's very important for you to understand, and we will get into this later, but just a tidbit. If you're going to move a loved one from a state. From a certain state into another state. You need to check what the rules are for assisted living residents in that state, because each state has different rules that they are governed by that the assisted living communities are governed by. So I'm an Alabama. And so I'm surrounded by a Florida and Mississippi. And Florida has less stringent. Rules of operating for the assisted living communities than Alabama does. And Mississippi runs completely different. And so I don't even know how to compare the two. So, if you were coming from a different state and your loved one requires a certain level of care, it's important to ask the community that you're looking at, what the rules are for governing their particular community and how your loved one will kind of fall into. Um, Where they would fall into for those. Particular rules. So I know that in Alabama, Let's just say cognition is a little bit of a sticky situation that Florida is a little less sticky about, right. So some people choose to move to Florida because there's a potential. That a resident could stay there longer. And an assisted living versus a memory care. And my thoughts on that. R. There are pros and cons to every scenario. Alabama memory cares. Have a tendency to be a little bit more. Active and involved. Whereas Florida memory cares seem to be a little bit more. A little bit less active and involved, and it's just the type of resident that lives there. So we'll go more into that in depth. But the main thing is, is that if you're going to move from state to state, it's important that you are aware of the regs. And the good assisted living community. Would talk to you about that upon assessment, or maybe even upon your first tour there. And when you talk about. Um, moving from state to state. I assisted livings. Are not for. A resident to stay potentially for their entire life. It can happen. And it does happen a lot, but it's not necessarily something that anyone can guarantee. And I think it's important that you know, that going into the tour. And then if somebody does guarantee that, that your loved one can stay there for the rest of their life. Um, I wouldn't believe them. Now again, each state is different. But they do have rules and assisted living is not a skilled nursing community. And if your loved one needs skilled nursing, Assistance then. Assisted living may not be the best place for them. Assisted living is great. And it changes people's lives and I love it. Um, and I think it's important for you to know that it is not a failure to move into assisted living. It is not. My grandmother moved into assisted living at 95 into the community that I worked at. And it changed. Her. Life and in changing her life, it changed my life and my mother's life who were her primary caregivers. The activities program, the care, all of it, the security that assisted living offers, it just changed our lives. And we waited too long. But on the flip side, assisted living is costly and not everybody can afford it. Although there are a lot of states that do offer Medicaid waivers. For the most part assisted living is private pay. There are options like VA aid and attendance. Long-term care insurance and then families. Getting together and. Paying the difference that maybe your loved one. I cannot afford, which is what my family did for my grandmother. But again, we'll get into that in later details. Just no. That assisted living is not failure. If you move a loved one in it will change their lives. Um, primarily private pay, but some states have Medicaid options and each state has different rules and assisted living is primarily offering activities of daily living. For your elderly loved one with socialization that will help your loved one. Thrive. That is almost a guarantee. If your loved one. We'll come down and engage. They will eventually, sometimes it takes a little, little prompting little patients, but for the most part. Most residents will engage at some point. Memory care is basically assisted living, but in a secured environment and typically. Um, Offers. More care. In a concentrated cognitive effort than assisted living. Does. So. The activities of daily living are still the same. They're just more cognitive centered. Then physically centered, like in assisted living, so to speak again, some states are different, so you would have more dementia maybe at a little advanced. Rate in some other states than what I'm necessarily used to. So assisted living could also offer. A lot of cognitive queuing and activities of daily living. But I have seen memory care offer in the state of Alabama. Cognitive queuing would be. You know, let's put our socks on here's your first sock. Let's put it on your first foot. Here's your second sock. Let's put it on the other one. I'm going to grab your shirt now, lift your hands up and then we're going to pull it over. Do you have it? Can you do it the rest of the way? Those are examples of cognitive queuing. Most memory cares are primarily made for people with dementia who are not safe. Um, and are constantly exit seeking. So exit seeking, wandering pacing, um, eloping, which is basically walking away is who. The memory care is made for. We have had had residents who walked out of assisted living say, and they were going to the store to get some sugar. We have had residents say they were going to their daughter's house. Or they were going to work or they were trying to catch the bus to the city that they lived in. Those are all examples of why memory care was made. And it's great because memory it's still a customer service based element just like assisted living is, and it's not necessarily skilled first. Like skilled nursing is long-term care. And that's the thing about assisted living is that it is primarily private pay. And so it is customer service based. First, whereas nursing homes long-term care, skilled nursing communities are skilled in medical needs. First. Customer service. Back a few notches from. Being the top priority. But memory care is still customer service based. And a lot of activity programming. For people who suffer from cognitive impairment. I love memory care. I love it. Um, I have a unique son. Um, so I can tell you that autism and Alzheimer's or dementia. Um, mirror each other very, very much. And so it's literally, you know, two people going down or up the developmental hill. Um, Uh, in opposite directions, but a lot of the same caregiving type. Of needs. Are there. What I have noticed in regards to being in a memory care. Is that there's a level of freedom. And a level of. Expectation. That just. Allow success to happen. Expectations can really stress people out. You know, so if you have a loved one who has dementia and you're taking them to an environment that is loud and noisy and they're expected to do things that they would normally do, that maybe they're not capable of anymore. You could potentially see behaviors for that. Whereas in memory care, there are no expectations. We just allow you to be who you are and there's freedom in that. I had so much fun singing and dancing with my memory care residents, just because I could do it. And no one would judge me. And that's the beauty. Of loving someone with dementia is. Just allowing them to be who they are. And serve them where they are. And being thankful that you still have them. Even though it's a different version of who they were. There's just an innocence to it. That. Is inspiring, honestly. And being a mother of a special needs child and the mother of a typical child and seeing the special needs community and how embracing of imperfection and just acceptance that we all have for each other. Memory care mirrors that. And yes, our residents in memory care need an advocate. They need the family member to ensure that we're doing the memory care is doing the right things the right way that benefits them, that their Dignity's in tact. And that they get all the services that. They promised. It's just, they need love and acceptance more than anything. And if you find a good memory care and there's good people inside that memory care, you're going to find that you're gonna find that. Dementia is hard. It's hard to navigate. And so finding the beauty and a team effort and supporting your loved one. Is very, very important. Because take it from me. Uh, mother of a special needs child, it can get very, very difficult. Because I still want my son to be something that he's not from time to time. And when I struggle with that. The dynamic between. My son and I can struggle. Unintentionally because I just. Want for him, something that is not possible. And that brings sadness. But then when I remember everything that he's overcome and how much joy he brings to my life and how he keeps our lives. Set on what is really important, that brings so much joy. And it refocuses us to what's really important in life. So, yes, having to move a loved one into a memory care is sad. And it's traumatic and it's nothing anybody wants to do. But there is good in it. There is. You can find joy in it. And acceptance will be your best friend.'cause a lot of people feel guilty about that. And my favorite quote to them is if you didn't inject them with the disease, then you don't have to feel guilty. Because all that's required of parenting and caregiving is your best. And if your best is not good enough, then the next best thing is to find someone or somebody who is. Give yourself a little bit of grace. You're doing a great job. And you will do a great job. If. It has to come to that for you and for your family. Skilled nursing is the same thing as long-term care and a nursing home. So, what I want to say is that there may be nuance differences that I'm not aware of because I've never worked inside of a skilled nursing. I have. Dealt with several residents who have lived in skilled nursing, who has been in rehab inside of the skilled nursing. But there are maybe small nuance differences, but a long-term care can be interchanged with a skilled nursing or a nursing home. It is. Skilled medical needs. First. It's not necessarily customer service based. First. Okay. It is. Bye all. Intensive purposes, potentially a last resort. Um, it can be paid by Medicaid, but there are stipulations for that. Um, it is also private pay. Long-term care. Insurance will also pay and the VA lieutenants will also help support. Uh, family member. If they qualify or have those types of insurance policies. Typically. You have shared room options and also you have in some communities, um, a private room option, but neither one of them are guaranteed in any single immunity. You can go to a skilled nursing facility for rehab for 21 days that Medicare will pay for. Sometimes we get confused on Medicare and Medicaid. Medicare is an insurance that will pay for rehab. Medicaid is also an insurance that will pay for a skilled nursing facility. If the financial and medical stipulations are met. Medicaid is a federally. It's a federal program that the states run. So each state has different rules in regards to who gets Medicaid. And for what? So asking those questions are important. Um, I am not a Medicaid expert by any stretch of the imagination. But I do know that each state is different and it is not a guarantee that Medicaid will pay for a long-term care stay full time. There are things that you have to qualify for and how your loved one spins their money. Is very, very important. And so one of the things that I always suggest is a trust for people and also to have conversations about money and decisions about money far in advance before a decision has to be made in regards to healthcare needs. But long-term care. Skilled nursing or nursing home. They're all the same. They typically have 24 hour a day nursing. Um, If you need wound care or any other type of skilled care catheter, colostomy. Um, diabetic care, all those options are there. 24 hours a day, seven days a week, which is unlike assisted living because in most states assisted living does not even require a nurse. Assisted living is a social model that helps with the activities of daily living. Whereas a skilled nursing nursing home long-term care community. Requirements or to literally perform the care. Perform the care that the resident needs, not necessarily based on customer service, they just do it all. With customer service, potentially not being their number one goal, your skilled needs, your medical needs are their number one goal. Customer service is still very important. But assisted living. Would be the place to have a more customer service oriented. Community based on my experience. Inside of the assistant inside the senior living industry. That is my short synopsis of the three types of communities inside the senior living industry. And what I want to ask you to do as I dive in deeper to each model, each product type inside the assisted living industry. I want you to think about what questions that you could ask. Let's say air quotes, an expert. Of the senior living industry. So, if you could talk to an assisted living administrator, a memory care administrator or somebody who's helped thousands of family members navigate their journey through the senior living industry. What would it be? Because I'm going to dive into the details of how to talk to your loved one about senior living, how to overcome their objections after they've already agreed how to handle the moving into an a community. Um, how to talk to the people who are working inside of the community. And I feel like ways to help you make sure that your loved one gets taken care of the best way possible. And that's by engaging staff members inside the community and building relationships and connection. I'm going to dive into all of those details, but what would it be that you would like me to talk about? I would be happy. Um, to read your emails, to, um, get your. Posts and comments on social media and to just create a podcast for my listeners so I can educate them the most. On what they want the most, where they want to know the most. Again, my grandmother lived inside two of the communities that I worked at. My grandmother-in-law lived inside of the community that I worked at. I have experience from. Every facet. Of caring for my grandmother for 15 years before she moved into assisted living, being inside the assisted living that she worked at and all of the guilt feelings that she. So. Uh, professionally was able to deliver to me every day for two years, and then also dealing with my in-laws and moving my grandmother-in-law inside. So. I can answer a lot of questions. I can talk to you about the way I felt and how I overcame those feelings. And then watching her thrive inside of a community was really one of the biggest joys of my life. So. I am ready, willing, able to answer those questions for you. And I look forward to them. Thank you for giving me your time today. And I look forward to. The next few episodes in this series of senior living. Have a great day.