As one ages, many needs change. By the time an adult reaches retirement age, their needs and desires are usually quite different than in the earlier stages of life. Most people look forward to their retirement years. For some, it is a time to pursue opportunities in the community. For others it is a time to travel and do all the things that had been put off earlier in life. For most, retirement is a time to simplify the daily routine and enjoy life to its fullest.
Although many retirees are still quite active and independent, they desire a simpler lifestyle with less responsibilities and more social activities. 55+ Communities can be the perfect solution. People move to 55+ Communities for many reasons. Some of the most common reasons people move include:
- The desire to relocate to a smaller home with less maintenance and upkeep.
- Less yardwork.
- Social contact with others at the same stage in life.
- Easy access to activities and recreation.
- Need money from the sale of the home for other uses.
- The current neighborhood has declined over the years.
- Fortified, secure community.
- The desire for a “lock and leave” home.
Some 55+ Communities are single-family or multi-family residential. Others incorporate assisted and skilled levels of care allowing the resident to remain in the community throughout the remainder of their life. There are many Retirement Communities available and it is important to research a community before you sign on the dotted line. Some of the things to consider when looking at a 55+ Community include:
- Is there an admission or buy-in fee? If so, what does it cover and is there a refund schedule if you decide to move out?
- What are the monthly fees and what do they cover?
- What is the financial stability of the company who owns the property?
- Do they have a nurse on the property?
- Do they provide transportation?
- What types of activities are available?
- Are there any restrictions on age or number of visitors staying with you?
- Do they provide higher levels of care (assisted living, skilled care) on the same property?
For many seniors, 55+ Communities offer the independence and comfort of living in your own home with the social and recreational opportunities so many of us desire.
Unfortunately for some, the retirement years are not what were expected. Poor physical health or a decline in cognitive abilities is not always planned for. For some, the retirement years are difficult, a struggle to care for one’s self or their significant other. When a senior is experiencing difficulty with their daily routine, it is often a friend or family member who becomes involved.
What happens when a family member notices that mom isn’t eating well and she is loosing weight, or dad is coming home with dents in the car, but he doesn’t know how they got there? Every day families and friends are faced with the issues of an older adult who is living at home and struggling with daily activities.
Sometimes it is the death of a spouse or the diagnosis of a progressive disease that rallies family to the aid of their older family member. Other times it is a call from a neighbor or trusted friend. No matter how it happens, the call to action can be overwhelming. Today there are many options available for older adults, everything from assistance in the home to multiple types of care facilities. Sometimes the tasks and choices can be overwhelming as family ask themselves “Where do we begin?”
Typically as older adults decline, they want to remain in their current home. It is a place of security and comfort with memories of years gone by. When weighing the options for assistance, the safety and well-being of the older person must be weighed against the intrusion on their independence. In addition, the options should always allow the older adult to remain in the least restrictive setting. When looking at the appropriate living situation for an older adult, the following issues need to be addressed:
- What are the older adult’s wishes?
- What are the safety risks associated with these wishes?
- Are the older adult’s needs currently being met?
- Is the older adult performing their activities of daily living?
- What method of transportation is currently being used? Is it appropriate?
- Is the older adult getting their nutritional needs met? Has there been any significant weight loss or gain in the past year?
- Is the older adult receiving appropriate medical care?
- Are they compliant with their medication and the instructions of their healthcare providers?
- Is the home being properly maintained?
- What financial resources are available to provide care and services for the older adult?
- Is the older adult competent to make decisions about their person and their finances? If not, who will make these decisions?
- Is there any long-term care insurance?
- Is there family or friends who can assist with care needs?
- What government assistance will they be eligible for? What needs to be done to plan for this assistance?
Honoring a person’s wishes is paramount. Most older adults want to remain independent as long as possible. Independence is an important part of an older person’s identity and they will fight to keep their independence as long as possible. For the person with cognitive or physical impairments, it is difficult to maintain a delicate balance of the individual’s independence while maintaining a safe living environment. A person with cognitive or physical impairments may be unable to safely perform the tasks which were previously associated with independence. In addition, the impaired person may not have the insight into their deficits and, therefore, may not be aware of their declining abilities. This situation puts the person at risk. In these situations, the most common types of risk are harm to self, harm to others, financial exploitation, and self-neglect.
Warning signs that a senior may need assistance include:
- Sudden change in functioning
- Failure to pay bills
- Inability to obtain help in case of emergency
- Leaving appliances on or unattended
- Lack of attention to household cleaning, maintenance and upkeep
- Frequent falls
- Poor personal hygiene
- Lack of attention to appearance
- Dressing inappropriately for the weather
- Getting lost in familiar surroundings
- Poor eating habits
- Recent weight loss
- Anxiety or depression
- Sudden deterioration in physical condition
- Non-compliance with doctor’s recommendations
- Non-compliance with medications
- Accumulation of mail, laundry or trash
- Lost cash, jewelry or assets without recollection
- Multiple traffic violations or accidents
- Dents in the car or broken tail lights
If one or more of the above warning signs or symptoms is noticed, it is important to determine the cause of the problem, not just treat the symptom. It can be difficult for family or friends to address these issues with an older adult because it acknowledges a loss of ability and potentially a loss of independence. There is also an emotional tie between family or friends and the older adult that can make it more difficult to address these issues. When these concerns are addressed with the older adult, often it is met by resistance or denial.
Frequently family members are faced with the responsibility of obtaining assistance for the older adult but are unaware of the resources or options to provide the support needed. Due to the increasing size of the aging population, there are ever-increasing resources to assist families and older adults to remain at their highest functional level and assist them to remain as independent as possible. The problem is that many people are not aware of the various resources and support systems available.
As a person’s needs increase, it is important to balance the safety and well being of the client with their need for independence. Today there are many resources and support services available to assist the older adult to remain at the highest functional level possible for as long as possible. Some of the resources to consider for people wishing to remain in their home include:
- Emergency response system in the home
- Adult day care
- Various durable medical equipment
- Public transportation
- Companions or caregivers in the home
If remaining in the home is not an option, there are several alternatives available:
- Assisted Living Homes and Centers
- Memory Care Centers
- Skilled Nursing Care Centers
Determining what resources are appropriate and where to begin can be overwhelming. When dealing with the issues of a loved one, often the emotions and prior roles (i.e. dominant parent over submissive child) interfere with making good choices. At times, the assistance of a professional versed in the needs of the older adult and resources available can be of great assistance. There are many professionals who focus their services on the elderly client. Some of these professionals include:
- Area Agency on Aging
- Certified Care Manager
- Elder Law attorney
- Financial planner
- Arizona Long Term Care System (ALTCS) planner
- Durable medical equipment providers
- Non-medical and non-emergent transportation companies
- Parish nurses
Although there are many options and numerous professionals, the difficulty is in deciding what services are appropriate and who to choose to provide those services. Many families are turning to a certified care manager to assist with this process. A certified care manager is an individual who has advanced degrees in nursing, social work, or gerontology. Certified care managers are trained to assess, plan, coordinate, monitor, and provide services for the elderly and their families. Certified care managers have extensive knowledge about the costs, quality, and availability of services in their community. The certified care manager works with the client and the family to provide services and referrals that are tailored to the needs of the client and family. The certified care manager objectively views the decisions to be made, always keeping the best interests and needs of the client first. The services provided by the certified care manager can include the following:
- Extensive evaluation and on-going monitoring of physical, emotional, psychological, spiritual, financial, legal, and environmental needs
- Individual and family counseling and crisis intervention
- Implementation and on-going revision of the older adult’s Plan of Care (a plan outlining the care needs and services/resources to meet those needs)
- Coordinate medical care and offer referrals to appropriate specialists
- Identify the most viable options, resources, and support services to optimize care and provide for the health, safety, well-being, and autonomy of the client
A list of certified care managers for your area can be found through the Aging Life Care Association (aginglifecare.org). Engaging a certified care manager to assist with the care of an older adult will connect you with all the services an older adult may need.
The good news is that there are more options for care assistance than ever before, but don’t wait until the hour of crisis, plan ahead. Proactive planning by family and the older adult can help prevent emergencies and accidents and allow the older adult to remain safe and independent for as long as possible.
If you or someone in your family are facing these or other concerns about aging, please give us a call at 480-804-7200 or email us at Heather@DesertCareManagement.com. We’ll be happy to assist!