Are you Safe in your Home?
The Savvy Senior
By Robert Goodman, MSW
Every so often we hear about a resident who was found deceased in his or her home or apartment after several days. One has to wonder if that could have been prevented. One way to prevent such a tragedy is for neighbors to look out for each other. If you see something suspicious about a neighbor call 911.
Home care is an option for some who need a little help getting around and preforming activities of daily living. A reminder that privately hired home health aides must now be fingerprinted and checked with the County Department of Consumer Affairs. Once a person starts needing more than a little support to stay independent they should seriously consider other options.
There are a variety of options when looking for senior housing. One of course is an active adult community like Century Village. Another option is a Life Care Community where you come in as an Independent senior and buy your apartment. Life Care Communities offer service and housing packages that allow access to independent living, assisted living, and skilled nursing facilities in one community. If residents begin to need help with activities of daily living, for example, they can transfer to an assisted living or skilled nursing facility on the same site. You receive meals, transportation, and social activities as well as other amenities. You pay a monthly maintenance fee for all these services. Non Life Care Retirement communities can provide the same services and amenities but there is no buy in, simply a monthly rental fee for the apartment style or care needs.
When is it time to move into a more supervised setting, such as an Independent or Assisted Living Residence? Assisted living residences are NOT nursing homes. They are facilities that provide supervision for people who may need assistance with daily living skills or with medication management.
Ask yourself (or a neighbor) these questions:
Are you having difficulty getting around your home or community? Are you falling frequently?
Are you having difficulty in caring for yourself or your apartment?
(including cleaning the apartment, dressing, cooking, eating, personal hygiene, bathing, toileting, taking medications, housekeeping, etc)
Do you have a health condition that needs monitoring? Are you going to the hospital frequently?
Are you homebound and isolated from family and friends and need socialization? Are you feeling depressed?
Are you having trouble managing your finances?
Are you forgetting major things like paying bills, turning off the stove, etc?
If you answered yes to even a few of these questions, you may be ready for an assisted living residence.
We all want to remain independent and age in place as long as possible. There are many services in the community that can enable someone to live on his/her own. There are home health services, Palm Tran Connection, telephone reassurance and medical alerts. But at some point these services may not be enough. You may need more help than these services can provide. Do you feel safe in your home? Can a home health aide meet all your needs? Why endanger yourself or have your family worry about your safety and well being? It is important that you recognize when you need help, and when it’s time for assisted living.
Assisted living residences come in all sizes, from six beds to over a hundred beds. They provide a full range of services. Some have special dementia or Alzheimer’s units. Many ALFs offer several levels of care – everything from just offering the meals (special diets including kosher, kosher style, etc), housekeeping, activities, transportation, and limited support, to offering medical management, help with dressing, bathing and toileting. Often, residents or their families also hire aides on their own. They fluctuate in pricing and entrance fees. I should note that if someone needs 24 hour nursing care and supervision that a nursing home may be best suited to meet his/her needs.
Arnie Cowan of Sunshine Senior Placement suggests looking at the following when considering a move to an ALF:
People: Who is the administrator, director of nursing (RN or LPN) caregivers (CNA’s or HHA’s), and their qualifications and how long have they been there. Who is the physician, dietitian, home health, therapy, pharmacy, beautician that service the community? What type of Residents live here – alert and oriented or needing memory care. The two don’t mix. Ask for family testimonials.
Price: Have a budget in mind first. Don’t look at places you can’t afford. Find out if there are extra costs such as an entrance fee, security deposit, level of care, annual rent increase, incontinent charges, transportation, phone and utility charges. Find out if they accept Medicaid Diversion or Waiver and can guide you to obtaining these financial assistance programs including Veteran’s Aide and Attendance. Ask if they are having any special move-in incentives. Always review the lease contract before signing and know the termination policy.
Product: ALF’s come in all sizes from the numerous privately owned residential 6 beds to the larger corporately owned with 100’s of Residents. Know what license they have: Standard, Limited Nursing, or Extended Congregate Care. Do they have a memory care or secured wing for Residents who wander? Inquire about staffing ratios on day, evening and nights. Do they accept Residents who are in wheelchairs and scooters? Do they care for Residents with catheters, GI tubes, oxygen, special diets and more complicated medical needs? Look at the menu and activity calendar to see the quality of meals and programs offered and by whom.
The type of license dictates the type of service permitted:
Standard: Provide assistance with the activities of daily living (bathing/dressing/grooming/feeding/walking/transferring) and assistance with medications. Resident must be able to self-maintain oxygen.
Limited Nursing: includes all of the Standard plus passive range of motion exercise; applying ice or heat; cutting toe nails of diabetics, conducting ear and eye irrigation; catheter and colostomy care; changing routine dressings; wound care continuous – stage 2; caring for casts, braces and splints; caring for anti-embolism stockings or hosiery. An RN must conduct nursing assessments.
Extended Congregate Care: includes all of Limited Nursing as well as total catheter care; total oxygen care; and GI tube feeding.
Property: Is the location in a good, safe neighborhood. Is the community well maintained externally and internally with appropriate design for seniors and handicapped accessible? Are the furniture and décor pleasing and the building clean and odor free? Is there an emergency generator, hurricane shutters, emergency supplies and water, an elevator that works and tied to the generator? Is there a security system and emergency call system? Is the community located in a flood and evacuation zone and does the community have an emergency preparedness plan in place.
Are you concerned about costs? Compare the cost of paying a mortgage, electric, telephone, two maintenances, insurance, taxes, and other household expenses to the monthly cost of an ALF. Often they are about the same.
The most important thing is that you are safe in your home and community. Make a choice that is best for you. A good website to learn more is www.alfa.org
