Home For the Holidays: Can a Resident of Assisted Living Visit Home?

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Photo credit: stock.xchng, MeiTeng

“There’s no place like home for the holidays,” say the lyrics to a popular Christmas song. And as friends and families gather to celebrate their beliefs or enjoy traditional meal around a table, the absence of a family member can be very difficult. Is grandma, grandpa, mom or dad allowed to leave his or her assisted care facility or nursing home to join in the holiday festivities?

Many residents of assisted living facilities and care homes are able to leave the facility for special occasions, as long as family members give notice ahead of time, are able to care for their loved one while he or she is home and the resident is healthy enough to endure travel. Make sure you have wheelchair access if necessary, that you stick to medication schedules and adhere to special diets.

Concern over Medicare Coverage

If your loved one’s stay in a nursing home or care facility is funded in any way by Medicare, you may be concerned that you’ll forfeit Medicare coverage if he or she leaves the facility. According to the Center for Medicare Advocacy, Inc., that is not a necessary concern. The Medicare Benefit Policy manual recognizes that leaving for a short time to attend a religious service, holiday gathering, family occasion or even a trial visit home, does not indicate a resident no longer needs skilled nursing care. Nursing home residents are permitted to leave for a short time without giving up Medicare funding.

Ways to Celebrate In the Assisted Living Facility

Although you may feel like the holidays aren’t the same without grandma or dad at home with the rest of the family, consider whether or not the visit is the right thing for them. Returning home–for just a short time–may trigger feelings of homesickness and loneliness upon their return. Are you having them home to satisfy your need for a family holiday, or theirs?

If it’s not feasible for your loved ones to come home, there are many ways to bring the holidays to them. Share photo albums from holidays past and talk about old memories. If your loved one has special ornaments or decorations, get them out and decorate his or her space. The taste of a favorite food may bring back memories of a happy time or satisfy the need for tradition. And most facilities go to great lengths to help their residents celebrate, inviting church choir groups, children’s groups, other seniors and families to participate in activities.

You may wonder, if your family member has dementia or is suffering from Alzheimer’s, why bother making an effort? Carol Bradley Bursak, editor-in-chief of ElderCareLink, says that even if your loved one is suffering from memory problems or dementia, their short-term memory is often foggy while they are able to remember things from the long-ago past. Ornaments and photos may provide a sense of familiarity and comfort. In fact, new items or recent pictures may add to his or her confusion. At the very heart, including an elderly loved one in your traditions reaffirms their humanity. Make each moment count.

Common Myths and Assumptions About Assisted Living

Assisted living is often the most attractive option for the elderly. Yet many elderly people, or the younger relatives on whom they depend, are afraid to try it because of the many myths that surround it, which often focus on negative aspects of this form of elderly care. In this article we will dispel many of those myths and talk about what assisted living is really like.

What exactly is assisted living?

One of the common myths relates to the very term “assisted living” itself. Many people think that it is just a newly coined term which refers to something that has already existed for a long time—namely, living in a nursing home. The fact is that assisted living is as modern as the term; it arose only in the 1990s and is a way of helping the elderly live as independently as possible during the final years of their lives. Assisted living facilities are thus replete with programs to enable their residents to enjoy the activities of daily life—playing games, watching TV, listening to music, and outdoor activities such as swimming or going on walks or hikes. Thus, they typically do not have the special equipment for medical monitoring that one would expect to find in a nursing home, although they do have trained personnel who work around the clock to provide required services.

The residence of an assisted living facility usually have their own private apartments, complete with their own bedrooms and bathrooms; or they may be built in the form of semi- private dormitories, with a common room for social activities, as well as a dining room and kitchen.

Who is admitted to an ALF?

Many people also have the misunderstanding that if an elder person needs to be in a wheelchair, or is suffering from urinary incontinence, then he or she will not be admitted into an assisted living facility. The fact is, wheelchairs are allowed on such facilities; however, if a person needs the help of more than one other person in getting in and out of the chair, then an assisted living facility is definitely not the appropriate solution. As for the problem of urinary incontinence, most ALFs will accept such patients as long as the problem can be easily managed, though if it cannot be, the resident will need to be put into a nursing home because it might pose a health risk.

Does Medicare pay?

A third myth is that the services provided at an ALF will be paid for by Medicare. But only highly skilled care services are financed through that system; the less skilled ones have to be paid for either by private individuals or be covered by a long term health insurance policy. Recipients of Medicaid may sometimes be able to live in apartments licensed by ALFs, which may also have programs for those below a certain median income level.

Why are people so reluctant?

Elderly people often think that they cannot move into an ALF because they need to have their families around in case they need help. But many assisted living communities have emergency features that their residence can use when they need them. Others are afraid of the prospect of having to give up the independence that they have grown accustomed to over many decades of living in the houses that they own and have worked so hard to attain—and similarly, being able to come and go any time they want to. In fact, not only do the residents of an ALF enjoy the same privacy and independence as they did in years gone by, but they can also choose among the types of apartments they get to live in—sizes, floor plans, even whether they have separate entrances.

Yet another reason why so many senior citizens are reluctant to move into an ALF is that they do not know the people there, and that they will not be able to do the things they love to do. An ALF can be a great place to make new friends, and residents can choose among the activities they participate in; they can even discover new hobbies!

What To Look For In An Assisted Living Facility

Deciding that your loved one may need to be placed in an assisted living facility can be a difficult decision. However, an assisted living facility can provide your loved one with a safe place where she can receive assistance from certified staff members for basic activities, such as bathing, household chores and attending medical appointments while also allowing her to keep her independence. Finding the right assisted living facility can be accomplished by looking for particular components.

Population of Residents

Some assisted living facilities are quite large and have hundreds of residents. While this type of residential facility can be helpful for new residents who are social and want to meet several new people, other residents can benefit from a more intimate setting. Families should also investigate the type of residents who currently live in the assisted living facility and inquire about the age and general health condition of the existing residents to validate whether the facility is a good match for your loved one. Be sure that you take a tour of the facility and see how residents interact with each other to assess the general culture of the facility.

Quality of Staff

The staff is one of the most important components to an assisted living facility. Ask the facility’s director about the level of education and experience that staff members have. Also, inquire about the type of license or certification that the staff members possess. You should also ask detailed questions about what type of services that the staff members provide so that you can ensure that your loved one will receive the type of care that he or she requires. Look at the way that staff members treat the residents on your tour. Look for aspects such as:

- Staff members take time to speak with you during the tour
- Staff members display an interest in the residents
- Staff members interact well with the residents
- Staff members are able to respond to emergencies if necessary
- Residents appear that they can freely communicate with staff members
- Residents seem to enjoy the facility

Safety

Safety should be a top priority for all families that are considering placing a loved one in an assisted living facility. Check to make sure that the assisted living facility’s quarters are appropriately equipped, such as having bathtub bars and wheelchair accessible entryways and ramps. You should also check if emergency measures are put in place, such as having emergency buttons that residents can push when they are in dire need of assistance and periodic check-ups on the residents. A doctor should also be available to make house calls for residents in need. You should also inquire about when your loved one’s condition would escalate to a level that would require alternate care and residency.

Activities

You want your loved one to easily transition into his or her new home. Choosing a facility with a complete list of activities and hobbies can help you accomplish this goal. Look for activities that are regularly scheduled, such as weekly card games or entertainment nights. Also look for activities that are more structured around individual hobbies, such as bird-watching or book clubs. These smaller settings can help your loved one forge new relationships with other residents.

Amenities

If your loved one’s mobility is limited, it is important to choose an assisted living facility that has additional amenities that your loved one can use. Some amenities that you may want to look for include:

- gym
- swimming pool
- spa
- library
- religious room
- rec center
- game room
- computer room

Dining Options

Also check on the quality and diversity of the food. Ask the staff how dietary restrictions and preferences are handled. You may want your loved one to eat in a cafeteria to socialize with other residents, but some residents will want to ensure that they can eat in their own room or have a kitchenette to prepare their own food.

Compliance

Check that the facility is in compliance with all licensing requirements set forth by state and federal agencies. You can find this information by talking to the organization that provides licensing to facilities in your area and by checking the BBBB.

How To Prepare Grandchildren For a Visit To An Assisted Living Facility

It’s important to have granchildren and great-grandchildren visit their loved ones in an assisted living facility. Although it can be challenging at times, having children around can brighten the days of not only their own relatives, but of everyone at the facility. A visit from grandkids can completely alter the mood of their struggling grandparents or great-grandparents.

How To Prepare

Explain to children what they will be encountering before getting to the facility. Describe to them what the visit will be like to avoid surprises. Let them know that their loved ones are excited to see them, but if their grandparents or great-grandparents may be feeling unwell, make sure they know that too. As long as they arrive with appropriate expectations, the visit will go very smoothly. Let them know how much their loved ones value and adore them, and the children will feel good about their commitment to visiting an assisted living facility.

What to Do During Your Visit

Make sure you engage in some activities that will include both the grandchildren and grandparents or great-grandparents. Creating artworks for display in the facility is a great way to both engage the kids but will also make a lasting memory of the visit. Playing a simple card game or board game and singing songs and nursery rhymes are all wonderful pastimes because everyone can participate and feel included. Bring photographs to share with your elderly relatives, or even a home video of a birthday celebration, school play, or recital that the grandparent or great-grandparent may not have been able to attend. Sharing the grandchildren’s lives with their loved ones will make for a stronger bond between them, and they will both appreciate the love they share.

The Benefits of Visiting

It is beneficial for both grandchild and grandparent to have these regular visits. Such visits are not only a terrific way for an elderly grandparent to boost their mood, feel connected to the world outside the assisted living facility, and maintain a relationship with their family. Grandchildren will have wonderful lifelong memories of their relatives, and will feel loved and appreciated. Seeing a grandparent’s excitement in anticipation of a visit always helps the children know how special they are.

How to Strengthen the Relationship

Perhaps you can also help maintain the relationship between grandparents or great-grandparents and grandchildren by periodically having a visit over video chat systems like Skype. Though the grandparent may not have their own computer at their assisted living facility, see if the residence has a shared computer that they may use. Staff members can often help facilitate such webcam visits. Especially useful for out-of-town relatives, this can brighten the day of an elderly family member without needing to travel long distances for visits.

The Issue of Memory

Send letters and photographs in between visits to maintain correspondence and help the relationship remain constant even if visiting is hard. Talk about elderly relatives often so that very young children hear their names mentioned and can remember details about them. Both the elderly and young children can have a hard time with memory in between visits. Seeing pictures is a helpful way for both grandparents and grandchildren to have warm and lasting memories, and to make sure the relationship is maintained between visits, particularly if visits cannot happen regularly.

Conclusion

Family relationships are a wonderful thing. Even though visiting an assisted living facility may be a challenge, it’s important to value the visits and the underlying relationship between children and their elderly family members. Memories of such visits will stay with all involved relatives for a lifetime.

Announcing the “Gaming with Granny” Infographic

We’ve just released our latest infographic, titled “Gaming with Granny,” which takes a look at the growing trend of senior gaming. Did you know that senior citizens and Baby Boomers make up 38% of all social game players? And that number is only going to continue to rise in coming years.

The infographic also looks at the very real threat of gaming addiction, and give tips on how to tell if a senior you know may be addicted to online video games.

Here’s a sneak peak at the infographic:

senior gaming is a growing trend

To see the entire infographic, go to: Gaming with Granny Infographic

We encourage you to share the infographic with others and you can also add it to your own website with the handy code embed at the end of the graphic.

Finding the Best Lutheran Assisted Living Facility in Your Area

The first National Lutheran Home for the Aged was founded in 1890 to offer comfortable housing to elderly adults regardless of their economic or religious background. This commitment to caring for seniors from all walks of life continues today. Lutheran assisted living facilities have established a reputation for offering not-for-profit care in a secure, homelike environment. If you are looking for an assisted living facility for an elderly relative or client, compare the services and costs of Lutheran senior communities in your area.

Finding a Lutheran Assisted Living Community

Lutheran assisted living facilities are widely available throughout the United States. It’s not always obvious that a facility is affiliated with the Lutheran Church until you speak to a representative or visit the community. A Lutheran pastor or a member of the congregation may be able to direct you to senior resources that are sponsored by the ministry. A family doctor can provide valuable advice on which facility offers the most appropriate services for your elderly client or loved one. A senior care coordinator or geriatric case manager can recommend Lutheran communities that provide superior care.

Touring a Lutheran Assisted Living Residence

As you look for a Lutheran assisted living facility, consider the location of the residence as well as its religious affiliation. The residence should be located close to family and friends if possible, and near hospitals or clinics and cultural activities. Lutheran senior communities are known for creating a welcoming, close-knit atmosphere for residents and their families, regardless of the resident’s faith. When you tour a community, consider the condition of the grounds and building, the cleanliness of the environment and the attitudes of the staff. The facility should be safe, tidy and private with adequate lighting, fire extinguishers, clear walkways and secured entries.

As you walk around the building, consider whether the public areas and private rooms make you feel at home. In addition to talking with the residence director, chat with aides, housekeepers and other staff members about the community. Staff members should be friendly, courteous and willing to answer questions. Ask residents about their feelings about the community and whether they would recommend the residence to other seniors.

Levels of Lutheran Assisted Living Care

The best Lutheran assisted living facilities promote independence while supporting senior health and safety. Most assisted living communities offer help with housekeeping, laundry and light personal care. A resident who requires assistance with mobility, eating, bathing, toileting or medication management may be placed at a more advanced level of care and may be charged a higher rate for these services.

Skilled nursing and rehabilitation are generally not available at the assisted living level. Some Lutheran assisted living facilities combine assisted living, skilled nursing and rehabilitative services in the same community, so that residents can easily transfer to a higher level of care if necessary. Ask a facility representative how an elder’s medical needs would be handled if he or she becomes ill or is injured. Access to emergency services should be readily available if a resident needs immediate attention.

The Lutheran Church prides itself on offering comprehensive senior care that nurtures the body and spirit. Lutheran assisted living facilities provide a range of services and activities that promote independence, encourage social activity and fulfill spiritual needs. To find a community that offers the care you’re looking for, tour several of the recommended Lutheran assisted living ommunities in your area before making a decision.

 

Episcopal Assisted Living – Tips for Finding an Episcopal Assisted Living Community

Whether you are looking for an Episcopal Assisted Living Community for yourself or for a loved one, choosing an Assisted Living Community can be an emotionally charged experience that is frustrating and confusing to make with all the different choices out there, but it doesn’t need to be. There are a number of important considerations to make in order to find the right place for you or for your loved one.

Why an Episcopal Assisted Living Community?

An Episcopal Assisted Living Community is ideal for a person who has taken their faith seriously all their life and continues to do so. It places him or her right in the heart of others who are similar minded, and makes for a smoother transition into life style and new friendships. In addition, the knowledge that the staff and members of the community share the individuals most foundational and valuable beliefs makes a significant difference and provides the individual and their family with much needed peace of mind.

Determine What you Need From Your Episcopal Assisted Living Community

Choosing an Episcopal Assisted Living Community based primarily on the fact that it is Episcopal is only the first consideration out of many others. In order to find the right place for you or your loved ones, it is important to determine beforehand what is needed medically, socially, and spiritually and to match the needs to the services provided. For example, do you or your loved one need skilled nursing, specialized memory care or rehabilitation services? Would you prefer enriched living apartments or independent housing or a patio home? Keeping these considerations in mind when choosing the right place can make a big difference in the overall comfort and adjustment long term into an assisted living community.

Other important considerations include meals, social activities, visiting schedules, and so on. If for example you or your loved one is a social person, choosing an assisted living community that encourages social interactions and is set up with opportunities for residents to get together and enjoy each other’s company at meal times or during organized events, then the resident is more likely to enjoy their time at the community and have an enriched quality of life.

Determine your Price Range

As with all assisted living facilities, Episcopal assisted living communities offer services and have facilities at different price ranges depending on what you are looking for. It is important to set an achievable price range and search within your budget from the start in order to prevent future need for relocation and financial frustrations.

Choosing the Right Episcopal Assisted Living Community

Once you’ve established your needs, both in terms of the future resident(s) and the budget available, it’s time to begin visiting potential communities and narrowing down your choices. Making the right choice for the right Episcopal Assisted Living Community takes time and lots of research, but when it comes to the happiness and health of the resident, it’s important to really be thorough before making a final decision. Read as much literature as possible about different Episcopal Assisted Living Communities in the area, visit the actual communities, and ask as many questions as you can. Although Episcopal Assisted Living Communities strive to provide the highest level of quality services with compassion and excellence, each community will feel different and offer different types of amenities. In order for the patient(s) to feel comfortable long term, it is important to spend the right amount of time needed to make the right match from the start.

How Much Does Assisted Living Cost?

At first glance the costs associated with entering an assisted living facility seem astronomical. Depending upon the level of care required the cost can be between $35,000 and $40,000 annually. How much does this assisted living cost work out to per month? Roughly $3,000 or more. If the resident suffers from Alzheimer’s Disease, then the assisted living cost can go up to $50,000 per year or higher.

Many people look at those numbers and conclude that an assisted living facility is beyond their financial capabilities. But consider the expenses that go away while living in an assisted living facility: the resident of such a home is no longer responsible for paying to maintain their residence. They also do not need to pay the resultant property taxes and insurance. If they have been making use of a private care service, then this will no longer be necessary. Additionally, some residents, whether by choice or necessity, will give up their vehicle when moving out of their home. No longer having a car payment or being required to maintain a car can erase a significant financial burden.

Assisted living cost will vary depending on location and the level of care that is provided. Costs tend to be lower in rural settings than they are in more central or metropolitan areas. Some people open up their private homes as assisted living facilities and these services generally cost less than do those in larger facilities.

In many cases the monthly payment to the assisted living facility pays the rent on a private room or apartment. Most of these apartments have doors that individually lock, granting the residents true privacy when they desire it. The cost of living at the facility often also includes meals and snacks, entertainment and assistance with daily living activities. This assistance may include help with dressing, moving around the facility, bathing or toileting. Each resident receives individual care that meets their specific needs. Some retain quite a bit of independence, but nonetheless appreciate the opportunity to live in a communal atmosphere with people their own age.

It is this communal atmosphere that is perhaps the one aspect of the cost of living in an assisted living facility that is not at all out of line. People living in a group setting as they age engage more often in group activities. Perhaps they take a class together or simply sit in an atrium and chat. They may go on various outings in the community or enjoy performances by local artists. Such enrichment activities keep the residents involved and active. In fact, residents in assisted living facilities tend to lead longer, more fulfilling lives than their counterparts who live on their own.

The cost of moving into an assisted living facility may seem impossibly high, but after carefully considering all that is included and the benefit to the resident the expense begins to seem quite reasonable. These facilities provide a homelike atmosphere that is pleasant, congenial and active.

 

Medicaid Assisted Living Beneifts – Does Medicaid Pay for Assisted Living?

need attention and care outside the scope of our capabilities. It is important, should we have to make that ultimate decision to seek a remedy through assisted living toward the comfort and aid of those in our care—that we know what resources are available and what are the prerequisites for their use.

Medicare pays for short-term rehabilitation, and not long-term care. Medicaid, the nation’s low and no income public medical insurance program, on the other hand, does pay for long-term care. However, Medicaid does maintain a means test for the allocating of funds for nursing home care. This means test, which measures the recipient’s income level against a set percentage of the national poverty level, determines the recipient’s financial requirement for his own care. Income, for the purpose of this test, is considered to be any actual income, any real property, vehicles, and non-essential possessions; Medicaid has the right to request the sale of any property that belongs to the recipient to meet the recipient’s contribution to his long-term care. Furthermore, in part due to the Debt Reduction Act, the program utilizes a five years “look-back” to investigate any transfer of property to family members; these properties are also considered recipient income and can be seized for the payment of care.

As far as Medicaid assisted living benefits, neither Medicaid nor the United States’ Department of Health and Human Services has an official policy toward the payment of assisted living services or a particular predisposition toward the issue. According to AARP—formerly the American Association of Retired Persons (http://www.aarp.org/health/medicare-insurance/info-09-2010/ask_ms_medicare_question_89.html) –the individual states may, at their discretion, implement a waiver program to allow funding for assisted living facilities. Medicaid has admitted that these waiver programs are more economical than full nursing home care, and the cost saving justifies the states’ free hand in this matter.

Information on Medicaid state enrollment and the states’ waiver programs can be found at http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-State/By-State.html. Arkansas, California, Delaware, Florida, Iowa, Indiana, Maryland, Mississippi, Missouri, Nebraska, New Jersey, Ohio, Rhode Island, Vermont, Virginia, Washington, and West Virginia are the only states that currently accept all Medicaid waivers. Other states may have other long-term care programs, such as New York’s Long Term Home Health Care Program; but, funds are not specifically apportioned for assisted living care.

Choosing the right care for yourself or an elderly loved one can be overwhelming. However, it is a relief to know that the care we need can be readily available depending on our income, location and other factors. If you are looking for assisted living communities and using Medicaid, be sure to explore what options are available to you in your state, whether through a waiver program or otherwise. Checking with your local council on Aging or other elder health organization should be able to provide you with further details for your unique situation.

Hospice & Assisted Living – Hospice Care Combined with Assisted Living

It has long been thought that when a resident at an assisted living facility is declining in health, the only option is to give up their “home” and enter a nursing home.  But, this isn’t necessarily the case.  For many terminal patients their final wish is to die at home, and for many home is in an assisted living facility. This is where they may have spent the last several years developing close relationships with other residents and staff.  This is where they are most comfortable.

Although most assisted living facilities (ALF) are not equipped with in-house hospice units, many contract out with community-based hospice companies to provide end-of-life services to their residents.

Can Assisted Living Facilities and Hospice Care Work Together?

But is an assisted living facility, which by nature is designed for patients who do not necessitate the skilled medical care of a nursing home, able to accommodate patients in such decline?

According to the Center for Excellence in Assisted Living, in most cases, the answer is yes.  After all, hospice was originally designed as an In-home service with the only clinicians being those from the agency.  For many ALFs, the collaboration between their clinical staff and the hospice agencies allows for appropriate levels of care for dying patients.  For the patient, the family and sometimes even the ALF staff, the hospice agency is able to provide the much needed physical and emotional support.

In case of Emergency

There has been some discussion as to how an ALF can ensure the safety of a hospice patient in the event of an emergency. The non-ambulatory status of many hospice patients poses a distinct problem for assisted living facilities who are accustomed transferring patients with moderate assistance.  Although this may be a new dilemma for assisted livings, transporting non-ambulatory patients in the event of emergencies is easily care planned in skilled nursing facilities and hospitals.  The most common method is to simply wheel the patients’ bed to safety.

When is hospice the right choice?

According to Homeside Hospice, a privately owned hospice agency inClark,New Jersey, there are several factors which may make hospice an appropriate level of care for an assisted living resident.  They include:

  • A significant decline in resident’s physical or mental health status
  • The resident requires frequent visits to the MD’s office or the Emergency Room
  • The resident’s level of mobility has declined requiring frequent intervention by facility staff
  • The resident is losing weight which is not intentional
  • The resident is becoming weaker and requires more assistance with activities of daily living
  • The underlying disease is progressing at a rapid rate or a new diagnosis has been identified
  • The resident has recently chosen to stop aggressive treatment options

For residents in a steady decline or for those given a 6-month or less prognosis, hospice may be a comforting option and may even be recommended by the facilities social worker.  Most agencies develop collaborations with the assisted livings in order to provide the patients with the best care possible.

The dying process is never easy.  For most, it is an unwelcome inevitability; but, being able to die with dignity and honor is paramount for all.

For Information on Nursing Homes and Memory Care: