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| The stereotypical image of grandma and grandpa…Is there such a thing anymore? I know the memories of my grandparents range from the traditional to the modern. My father’s parents were the sweet older couple: He sat in his chair and always had gum for the grandkids; she baked cookies and told us stories as we sat in the backyard. My mother’s parents, on the other hand, were quite a bit younger and were always out and about. They traveled and entertained their large circle of friends. Each couple differed from the other, but both sets of grandparents taught and influenced their grandchildren in so many ways. The idea of “older” people in general is not what it used to be. In fact, the term “older population” is used specifically for people ages 65 and older. When I think of my parents and their friends, I know they are approaching this demographic, but they are far from the idea of what the title “older population” denotes. According to the Administration on Aging, as of the 2006 census, there were 37.3 million Americans ages 65 and up. By the year 2030, that number is expected to reach 71.5 million, or approximately 20% of the projected population. People are living longer and are living very full and exciting lives. The classic image of the older couple on the porch swing may be a thing of the past. Today, that older couple is more likely to be seen riding a golf cart or zipping through town in a convertible. With the older population growing and thriving, the need and desire for specialized living arrangements is in high demand. As with the traditional image of the elderly vanishing, the common perceptions of retirement communities are changing just as quickly. There are a variety of housing options for those 65 and up, and just as many reasons to choose to live in one. Some people may need assistance with some of their daily activities, while others simply may not want the upkeep a home of their own requires. Either way, there are many options to explore and many things to consider when looking into an independent or assisted living arrangement. Independent living communities are typically for those seniors who want to live independently and are able to do so, but they choose to live near their peers. They are living a carefree lifestyle and don’t want to be bogged down by home maintenance and other similar issues. Think “condos” over “convalescence.” Independent living communities often have swimming pools and tennis courts, and they often provide shopping trips and cultural excursions. Extra security and around-the-clock visitor screening are added bonuses. These communities may also be associated with health care facilities. Names of these facilities can vary from state to state, and include senior apartments, senior housing, and active 55+ communities. Assisted living communities are for those individuals who may not be able to live independently, but do not require full medical care either. Assisted living programs provide residents with their daily meals, health care, personal services, and access to 24-hour care. Most residents of assisted living need help with one or more Activities of Daily Living (ADL’s). These ADL’s may consist of bathing, taking medications, housekeeping, and preparation of meals. The staff will assist the resident based on his or her individual needs. Surveys show that while 26% of residents need no assistance with ADL’s, the average resident will need help with one to two daily activities. The male/female ratio is 25% male to 75% female. The average assisted living resident is an 85-year-old woman who is mobile but does require help with two ADL’s. Other names for assisted living communities are residential care facilities for the elderly, community-based retirement facilities, adult living communities, and enhanced care. Continuing Care Retirement Communities, or CCRC’s, are a combination of independent and assisted living communities. CCRC’s allow healthy, active seniors to live in an independent community with the comfort of knowing they will be cared for as their needs change. Upon moving to a CCRC, residents sign a contract guaranteeing lifelong shelter and health care services. Most CCRC’s have three main types of facilities available to residents. These include independent housing for those relinquishing the burdens of homeownership and/or who may have acute medical needs; assisted living for those requiring aid with some of their daily activities and/or some skilled nursing care; and skilled nursing care for those individuals who need short-term or long-term around-the-clock nursing care. There may be restrictions, and prospective residents are expected to meet some minimum requirements. Candidates will most likely need to undergo both physical and mental assessments. If there are preexisting conditions, this could prohibit acceptance into the CCRC. Applicants are expected to be mobile and independent. They will need to meet age requirements, and some communities may be affiliated with a particular religious, ethnic, or fraternal group of which membership may be required. And of course, the financial requirements will need to be met. Upon acceptance, the resident will pay an entrance fee plus the monthly payments. As for the contracts to be signed, there are generally three types: Extensive contracts provide shelter, residential services, and amenities in addition to unlimited long-term medical care at a constant monthly rate. Entrance fees and monthly payments for extensive contracts are usually at the higher end of the spectrum. Modified contracts cover all of the above, but a specified amount is given for medical care. After this limit is reached, the resident pays for future nursing care at regular industry rates. The final contract option is called “fee-for-service.” This type of agreement covers only the basics of shelter, residential services, and amenities. Any medical care (other than emergency or short-term nursing care, which is usually included) is the responsibility of the resident. Entrance fees and monthly payments are usually lower for the fee-for-service plan since the individuals are responsible for their own health care costs. The prices for some plans may seem overwhelming, but it is important to look at the whole picture and consider both present and future needs. Also, it is highly recommended that your attorney review any contracts before you sign them. CCRC’s may also be known as life care facilities or life care communities. Planning ahead for the future not only involves being prepared for when seniors need extra help with ADL’s, but should also include planning for the possibility of Alzheimer’s care. Some assisted living and CCRC’s may be equipped to care for Alzheimer’s patients. In fact, most of these facilities will be able to help care for seniors while they’re in the early to mid-stages of the disease. However, if your retirement community does not have a separate Alzheimer’s unit for when the patient is in the later stages of the disease, it would be best to transfer to a facility that cares specifically for dementia patients. The staff at an Alzheimer’s care facility is specifically trained to work with residents experiencing disorientation and memory loss. Organized activities involve residents in reality orientation behavior and work on everyday activities. The surroundings are safe and secure and are especially designed to help residents who become easily disoriented, including color-coded hallways. Choosing which retirement community to move into is a huge decision, whether it is for yourself or your parents. This is quite possibly a once-in-a-lifetime decision that will strongly affect their happiness and well-being. When researching the various communities, make sure you ask questions and get the answers you need. The facility will have a resident’s handbook listing their rules and regulations, what they expect from residents, what is allowed, and what is not allowed. In turn, each facility will have a list of the residents’ rights and responsibilities. Make sure you get a copy of both. These rights should also be posted in plain sight of the residents at all times. Among residents’ rights should be: privacy; to be treated with dignity and respect at all times; control of personal finances; to interact freely with others in the community; and to be able to organize resident councils. Regulations and licensing criteria for assisted and independent living facilities vary from state to state. Ask the administrator if the state requires licensure, and request a copy of the latest inspection report. You can also check with the appropriate state agency for their guidelines concerning the state regulations. The residence’s administrator should be open to discussing the rules and be willing to answer your questions openly and honestly. When visiting these communities and making your decision, it is important to see the facility in its “natural state.” Don’t just speak to the residence’s administrator, but also with the staff that will be in direct contact with the residents on a daily basis. Are these workers friendly? Are they happy to be there? Do they look you in the eye when speaking to you? Also chat with the people who already live there. What do they think about the facility? Are they happy? Do they appear healthy and well taken care of? What is the appearance of the facility itself? Does it look clean? Does it smell clean? What about safety precautions? Take it all in and trust your first impression. Both you and the potential resident should feel comfortable with the surroundings and the staff. When you are ready to sign the contract, make sure you understand what you are signing. The agreement should specify what services will be provided under your contract; the rates for these services; the accommodations the facility provides for health care, personal care, and the like; and the monthly payments. What is the pay schedule, and will the rates be increased? If so, under what circumstances? What about renter’s insurance…is it required? Can the agreement be terminated? If the resident is not satisfied, is there an appeal process or a refund policy? There are many issues to contend with on a personal level, a contractual level, and a financial level. But the good news is there is so much information out there to assist you in making this important decision. One place to start is the Web site www.carepathways.com. This site provides helpful information, such as detailed checklists for various types of senior living arrangements; a needs assessment; and links to other sites for legal, medical, and financial advice. The National Center for Assisted Living (www.ncal.org) and The Commission on Accreditation of Rehabilitation Facilities (www.carf.org) both have Web sites that can also help guide you toward the right decision for you and your family. Sources for this story included: www.carepathways.com, www.ncal.org, www.retirement101.info/communities/different-types-of-retirement-communities, www.seniorresource.com/hasc.htm, and www.seniorhousingnet.com/care-types/alzheimers.aspx. |
Retirement Communities |
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