Caring for Aging Parents – HOUSING OPTIONS
Many of us will face the day when our parents can no longer live on their own, when the physical toll of caring for them becomes overwhelming for family members, and additional care is required to meet their needs. The best time to evaluate senior housing options is before your parent falls and breaks a hip.
Do you have the information you will need to make the right choice for your parents? “My mother wanted to be cared for at home but understood there was no way for our family to care for her any longer,” says Rochester resident Kathy Johnson. “It was a very tough decision to have her live in a nursing home and not what we wanted to do.” Transitioning from independent living to a senior housing option can be gradual or immediate; the reasons for doing so vary, and the process can be difficult for all. “[My mother] has been in the nursing home for about three and one-half years,” says Johnson, whose mother was prone to falls and suffered a serious injury that led to her housing change. When it became clear Johnson’s mother needed to move to a nursing home, a social worker identified available rehabilitation and housing options. A nursing home was available that the family was familiar with, where Johnson’s grandmother had lived. The family’s immediate needs eliminated many opportunities for personal choices—where Johnson’s mother could live, cost, and timeline. Availability of appropriate care became the key criteria. Before crisis hits and a loved one requires extra care, it’s helpful for family members to explore senior living options and seek answers to the many questions, such as: What services are included in home healthcare? What types of clinical assistance are available to be administered in my parents’ home? Who provides memory care, long-term skilled nursing care, short-term rehabilitation and assisted living? What independent living option is the best for my parent?
PLAN BEFORE CRISIS OCCURS “We advise families to plan ahead, before a crisis occurs,” says Marcia Carrigan, marketing consultant for Cottagewood Senior Communities, an exclusive memory care community. She recommends validating parents’ fears by reassuring them that you want to comply with their wishes. “We encourage families to educate themselves by attending Cottagewood’s monthly support group,” she says. The organization welcomes families to tour the facility and experience the community. “I would encourage anyone who has a loved one who could benefit from a change of lifestyle, whether it is for health reasons, safety or a desire for additional activities and friendship, to take them to visit several senior retirement campuses and see firsthand what they look like inside, learn what they have to offer and ask lots of questions,” says Pam Mensink, director of marketing for Madonna Living Community, which comprises Madonna Towers of Rochester, Madonna Meadows of Rochester and Madonna Living Community Foundation.Sheila Nieland-Snyder, executive director of River Bend Assisted Living and Memory Care, suggests also contacting local county human service representatives, Aging Services of Minnesota or the Alzheimer’s Association. “The best way to approach the topic with a loved one is with honesty and heartfelt love for the individual,” she says. “Chances are your aging parents have already been thinking about it but are unsure themselves about how to take the next steps because it is a big change for everyone involved.”
ASSISTED LIVING AT HOME For those who can stay in their home with some assistance, Visiting Angels provides services that help maintain independence and familiar surroundings. Families have the opportunity to interview caregivers and make the final decision about the individual who may provide assistance with a variety of activities, such as bathing and dressing, mobility, medication assistance and reminders, light housekeeping, meal preparations, shopping, errands, appointments and companionship. “We also provide this help for adults who reside in apartments, independent and assisted living arrangements and hotels,” says Director Joe Sedelmeyer. A unique service, Rochester Home Infusion (RHI), enables patients to receive intravenous medications in their home, rather than being hospitalized for weeks, having to go to an infusion center or making other living arrangements. “Our services are for all ages, from pediatrics to seniors needing long-term intravenous medication lasting for weeks, months or even years,” says Joselyn Raymundo, founder of RHI. “We also support patients who are not able to take oral food because their gut is unable to absorb nutrients.” RHI can provide total parenteral nutrition to sustain these patients for life and can assist patients who have transplants or are in hospice care and need pain control, as well as cancer patients needing supportive or palliative therapy.
WHEN HOME IS NO LONGER SAFE Madonna Living Community organizations provide a continuum of care ranging from independent living, assisted living, home healthcare and memory care to long-term, skilled nursing care and short-term rehabilitation. The process for an individual to become part of the community includes application approval and a waitlist for a unit of choice. Considerations for housing may include amenities that can eliminate the worries of getting loved ones to their appointments. “Our services include dentistry, podiatry, optometry, ophthalmology and audiology, as well as on-call clinicians,” says Carrigan. Cottagewood Senior Communities’ home-like environment is staged for early, middle and late stages of memory loss. Other care services provided for loved ones with memory loss include behavioral management and hospice of choice to assist an individual through end of life. When determining housing options, Nieland-Snyder says another important consideration should be location. “Should they stay in their current hometown? Do they have enough support locally to help with day-to-day things, such as grocery shopping, or should they move closer to family?” She adds, “Finances are always tricky.’”
HOW TO PAY The costs associated with senior living options vary based on services provided. “Again, a very helpful resource here is your county human services division,” says Mensink. “Speak with your financial advisor and your insurance agent for information about long-term care insurance and additional financial guidance.” The majority of commercial insurance companies cover home infusion services, such as medications, supplies, clinical monitoring and nursing visits. “Medicare also provides some level of coverage with some limitations,” says Raymundo, noting that for some patients, home infusion is more affordable because it typically costs less than receiving the same therapy in a hospital or clinic setting. It can also be more effective because “home is where a person heals best and is most comfortable,” she says. Do you know if your parents have long-term care insurance? When gathering information and considering options about services available, Sedelmeyer suggests confirming if a loved one has this coverage, which could help pay for services. Mensink emphasizes that because services and facilities are very different, so are the costs. It’s helpful to carefully consider costs and coverage of services now, in addition to costs that might be incurred if healthcare needs increase. “It is important to research costs and financial options for long-term continuing care,” concurs Carrigan. “It is very expensive, so to avoid ‘sticker shock,’ do your homework. We encourage families to seek financial advice.” Some options, like Cottagewood, accept Medicare.
THE RIGHT CHOICE “You will be hesitant about whether you made the right choice for your parent for about the first three months or so,” says Nieland- Snyder. “However, once you see your loved one begin to adjust and blossom, you will feel confident that you have made the right choice.” Initially, Kathy Johnson’s family didn’t want her mother to live anywhere but at home. She recalls how difficult the process was. But today, her mother is comfortable and adjusted to full nursing home care. “It’s been good for her,” says Johnson. “All things have lined up.” Clearly, the right choice was made for all the right reasons.
Trish Amundson is a Rochester-area freelance writer.