by Diane Masson | May 24, 2015
It is important that seniors make a plan while they are healthy and well OR they will find themselves in a situation where family members have to “put them someplace.” My in-laws waited for a health care crisis that you can read about HERE and the adult children were forced to “put them” in more supportive environments. The doctor told my father-in-law that he needed 24/7 assisted living care and another doctor required that my mother-in-law with Alzheimer’s move into a secured memory care simultaneously.
How do you find a good retirement community, assisted living, memory care or skilled nursing care? “Your Senior Housing Options,” gives tips and advice on exactly what questions a senior needs to ask in order to determine if a senior living provider is great or mediocre.
Almost every week I speak to 50 to 75 seniors about their future health care and housing options. Two months ago, I created a new presentation based on my book, “Your Senior Housing Options.” What an impact it has made. Seniors share how grateful they are for clear and concise information that they can apply immediately in making a decision for themselves. This is my passion and I want to help seniors make a wise choice.
The book articulates the costs and consequences of the various senior living options. I share the ramifications of waiting too long and how a senior can save money and stress by planning ahead.
Seniors can take away valuable tips they can utilize immediately as they begin to research and explore long-term health choices. Most seniors have no knowledge of how to select a reputable home care company or retirement community. It’s important to know states vary on requirements for caregiver training, drug screening and finger printing. Due diligence of care choices can prevent elder abuse!
Ultimately, a senior can continue to live by a river in Egypt called denial or they can make proactive decisions and create a plan for their future health care. It is scary for seniors to contemplate running out of resources in a higher level of care, but it can happen (my own mom ran out of money living in assisted living for seven years). Hopefully, seniors choose a plan that has a safety net, in case they run out of money.
Current presentations based on this new book are helping seniors make proactive decisions for their future health care needs. Hopefully, this is the beginning of a movement to educate seniors.
Diane Masson has worked in senior housing for 17 years and is the regional marketing director for two debt-free Continuing Care Retirement Communities in Southern CA (Freedom Village in Lake Forest and The Village in Hemet). Her first book “Senior Housing Marketing – How to Increase Your Occupancy and Stay Full,” is being utilized by senior housing professionals across the country. Both her first book and second book, “Your Senior Housing Options,” have a 5-star rating on Amazon.com.
For weekly tips and advice go to www.Tips2Seniors.com and learn more from author and senior housing expert Diane Twohy Masson.
by Diane Masson | May 17, 2015
Drug Restraints and the Haldol Shuffle
Adult children just want their parent with dementia to be okay. Most do not have a clue on psychotropic (mind altering) medications or how they work. Families rely on professionals to recommend doses and medications for their senior parents. If a professional doctor or memory care community says that our mom or dad needs these medications, we tend to accept their wisdom. We are programed to not question authority. Yet when a parent is sedated in a drugged stupor over an extended period of time, more adult children are starting to ask why. At this point it can be too late for a senior with dementia.
Psychotropic medications can have a lasting affect on a senior with dementia.
Seniors may never be able to return to their baseline, before taking psychotropic drugs. My mother-in-law was given Haldol and now does the Haldol shuffle. It is a continuous stand up, walk, sit down and then it starts all over again. It is so sad to watch and they can’t stop. A professional told me it’s like their skin is crawling and they have to keep moving to make the feeling go away.
When we recently brought my mother-in-law her favorite Greek food for lunch, she sat down in front of her favorite foods at the table and then immediately stood back up and started the Haldol shuffle again. She had no desire to eat her favorite foods.
It has taken four months for the family to get her off the Haldol. My sister-in-law had to physically take my mother-in-law to her primary care physician and demand for the Haldol to be discontinued last week. The doctor was shocked my mother-in-law had been on Haldol for such a long period of time, with no recorded outbursts requiring such a strong medication.
So what happened?
My father-in-law, Bill, and mother-in-law, Amy, refused to move from their home of 56 years. Bill had been Amy’s caregiver for the last four years because she had dementia. When Bill had a sudden heart attack and went to the hospital, Amy was in jeopardy in the family home. The local children rallied around the dad in the hospital. For all intensive purposes, Amy was left alone for three days and three nights. My husband and I live 1000 miles away and we hired a geriatric care nurse. Amy was having delusions, not recognizing her own children, making unsafe choices, refusing to take her medications and eloped (she walked away and the police brought her home).
No community would accept her without medications
No assisted living would take her, because she had eloped. A memory care community came to assess whether they would accept Amy and said they would not take her unless she was medicated. The family understood drugs were a requirement at this point. My sister-in-law called Amy’s doctor’s office and explained Amy symptoms of delusions and etc., they did not want her in the clinic. Are you kidding me?!!? Amy’s doctor’s nurse said to take her to urgent care. But according to urgent care she was not bad enough to be admitted to the hospital. They sent her home with five pills of Adavan. Now what? Medications were required live in the memory care community. What could we do? She was not safe at home by herself and she didn’t want her adult children (she no longer recognized) to be with her. Finally a geriatric nurse provoked Amy to hit her. Then the police came and Amy was taken to the hospital by ambulance. There was no room in the psych ward so she was drug restrained in the emergency room for three days and two nights.
So the psychotropic nightmare began
The hospital said strong medication was necessary and started the Haldol. She was in the hospital for three weeks. Both memory care communities said the medications were necessary for Amy too. The family stupidly believed the professionals. Amy’s HMO had poor communication between the doctor, the hospital, the memory care communities and the home health professionals that saw Amy in person.
The first memory care community recommended making no drug changes for one or two months. When my husband and I flew to Seattle and saw Amy’s level of sedation, I said, “No way,” and fought to have the Haldol reduced by half. After the family figured out that the memory care community had no intention of supporting the reduction of medications, we moved Amy.
The second memory care community promised to reduce the psychotropic drugs and get her off the Haldol. Within two weeks they reduced the Haldol by half. Yet Amy was still in a drugged stupor. She was on a mix of AM and PM psychotropic drugs. This secure memory care community had a staffing ratio of one staff to ten residents.
We have since learned that drug restraints in memory care are common, particularly if they are short staffed.
I wrote this article to warn others adult children to demand reductions in psychotropic medications immediately. I am so sick of professionals saying to wait a month or more to see what happens with the medications. Then it’s too late. Amy went from fully toileting herself to incontinent. She went from eloping (walking away and the police brought her back) to barely walking. She went from smiling and talking to having a blank look on her face and staring into space.
We want to find Amy’s baseline again. She will never be at the same level of cognition from four months ago. There are moments and sentences were her personality returns. It is so sad to see her in this reduced state.
I am not saying that I am anti-drugs, but a Power of Attorney (POA) needs to be informed of the consequences of psychotropic medications. My own mother with dementia benefited from psychotropic drugs when she became very anxious and delusional in the later stages of her dementia. The price she paid for taking those psychotropic medications was permanently losing the ability to walk. I wish I had known then what I know now. Now my mother-in-law can barely walk…
Any hope? Have you had a similar experience with your parent? What happened? Have you witnessed drug restraints in memory care communities or hospitals? How can we stop it? How can a family find a good memory care that does not require drug restraints? What are the proper questions to ask?
Don’t wait until you’re in a health care crisis like author Diane Masson’s in-laws. It has been a nightmare for her in-laws and all the adult children. Research your future choices NOW to avoid being “put” somewhere, or having decisions made for you by others. “Your Senior Housing Options” is a new resource book available on Amazon.com with a 5-star rating. It offers a step-by-step guide to the options, including staying home.
Seniors, Boomer children, spouses, family members and caregivers are desperate to learn how to truly differentiate good senior housing from mediocre at best. Diane Masson’s new book will answer these heart-wrenching issues in an easy, simple, story telling format with humorous illustrations.
Diane has worked in senior housing for 17 years and is the regional marketing director for two debt-free Continuing Care Retirement Communities in Southern CA (Freedom Village in Lake Forest and The Village in Hemet). Her first book “Senior Housing Marketing – How to Increase Your Occupancy and Stay Full,” is being utilized by senior housing professionals across the country.
For weekly tips and advice go to www.Tips2Seniors.com and learn more from author and senior housing expert Diane Twohy Masson.
by Diane Masson | May 10, 2015
Comatose in Memory Care
My mother-in-law who got over drugged in the hospital several months ago is now in her second memory care community in Seattle. The first high-end memory care community in downtown Seattle wanted to follow the doctor’s recommendations of sedation. It took me three days to get the drugs reduced by half after I saw my overmedicated mother-in-law. Then the second memory care community promised our family that they would get her off the reduced Haldol dose. We believed them and paid a hefty community fee (a one time move-in fee) Sigh…
It’s been almost two months in the second Memory care.
We had an unproductive care conference about two weeks ago. When the family talked about changing the psych drugs the conversation led to considering Amy as a candidate for hospice because she was not eating. What? It turns out one of the drugs she began in the hospital was also an appetite suppressant.
She was overmedicated in the hospital because there were no rooms in the psych ward, so my mother-in-law stayed in the emergency room for three days and two nights. Getting the picture of sedation now?
My sister-in-law is on the warpath. She is demanding changes for her mom and talking about moving her to a third place. Will it help?
The second memory care called my husband to see if they could save the move out. He simple said, “You have known that the family wanted my mom off the Haldol. How many phone calls and faxes have you made to the doctor to make that happen?” The administrator started to back pedal.
My sister-in-law took my mother-in-law to her doctor yesterday. A 15-minute appointment turned into nearly hours. The doctor is going to take her off the Haldol but does not have a clue what medications will help or are necessary. My mother-in-law has significant dementia, and seemed to have had a psychotic break when she lost her home of 50 years and her husband within a week.
Why is it so hard to unsedate a senior who cannot speak on his or her own behalf? Is it easier for the memory care staff if the residents are half sedated? Can anyone help us on how to turn this around? Any tips on psychotropic drugs? Which ones are best?
Don’t wait until you’re in a health care crisis like author Diane Masson’s in-laws. It has been a nightmare for her in-laws and all the adult children. Learn how to plan ahead like Masson’s mom. Research your future choices NOW to avoid being “put” somewhere, or having decisions made for you by others. “Your Senior Housing Options” is a new resource book available on Amazon.com with a 5-star rating. It offers a step-by-step guide to the options, including staying home.
Seniors, Boomer children, spouses, family members and caregivers are desperate to learn how to truly differentiate good senior housing from mediocre at best. Diane Masson’s new book will answer these heart-wrenching issues in an easy, simple, story telling format with humorous illustrations.
Diane has worked in senior housing for 17 years and is the regional marketing director for two debt-free Continuing Care Retirement Communities in Southern CA (Freedom Village in Lake Forest and The Village in Hemet). Her first book “Senior Housing Marketing – How to Increase Your Occupancy and Stay Full,” is being utilized by senior housing professionals across the country.
For weekly tips and advice go to www.Tips2Seniors.com and learn more from author and senior housing expert Diane Twohy Masson.
by Diane Masson | May 3, 2015
Mean Mom, Nice Mom and Dementia
Here is a painful subject that I am going to bring up. Hundreds of people have reached out to me in the last week since my mother passed. So many of them shared a story about their own mom passing. Some were wonderful experiences that they will treasure and others were not. Sudden deaths are very hard. Every personal death I have experienced in my life was sudden, except for my mom’s death. You can read about my mom’s passing experience HERE.
You either had a loving caring parent or you did not. This article is for those who did not.
Many vulnerable sons and daughters were abused by either their mom or dad, sometimes both. We live in world that accepts dysfunctional families now. Family abuse that was hidden in the 1950’s and 1960’s can now be accepted in the mainstream. There are resources and counseling available so abused children (who have become adults) can acknowledge the abuse and move on.
My mother was abusive to all her young children. You can read my article MEAN MOM, NICE MOM and DEMENTIA HERE.
A wonderful counselor changed my life for the better and his recommendation is explained in my article MEAN MOM, NICE MOM and DEMENTIA HERE. My mom and I enjoyed over 20 years of a good adult relationship. I forgave her. Many of you know I have advocated for my mom’s care needs for the past 10 years.
So what happens if an abused adult son or daughter still has unresolved issues at death with mom? Do they go to the funeral? Do they have a free pass not to attend?
What have you encountered?
It seems ironic now, that my new book is dedicated to my mom. Writing this blog has been therapy for me over the last three years. After sharing numerous stories about my mom, several senior living people said you should write a book to help other seniors and their families. So I did and “Your Senior Housing Options” was published recently.
I love you mother and hope your stories peppered through the book can help others learn their options and plan ahead. So many seniors fight to stay home and then a sudden crisis causes them to lose their ability to choose like my in-laws did. What person in their right mind wants to be put someplace? My in-laws have no choices now. Seniors and their families should study the options and costs now. The greatest gift my mom ever gave me was to plan ahead at age 75, so her transition to assisted living was a good one. She recently passed at age 92 in skilled nursing care.
Diane has worked in senior housing for 17 years and is the regional marketing director for two debt-free Continuing Care Retirement Communities in Southern CA (Freedom Village in Lake Forest and The Village in Hemet). Her first book “Senior Housing Marketing – How to Increase Your Occupancy and Stay Full,” is being utilized by senior housing professionals across the country.
by Diane Masson | Apr 26, 2015
My Mom and I
My mother’s blood sugar spiked to 400 on Monday and 520 on Tuesday. She was fighting a UTI and ecoli. At 92, her body tried to fight it off. The doctor said the antibiotics would either work in two days or she would go down hill fast. It was the later.
The care ambassadors and nurses at Freedom Village were amazing. I lost count after twenty-three staff came in to say good-bye and provide loving care. One care ambassador said, “I’ve known your mom for two years and she was my family.” Another said, “Everyday she would greet me in the hall and compliment what I was wearing that day.” My favorite was someone reminding me of her love of cats and how she usually had one with her or would respond to the mechanical one that meowed, purred and moved. Her face would light up with joy.
My mom lived in a higher level of care for nine years. Seven years in assisted living and almost two years in skilled nursing in Lake Forest, CA. Six years ago, a doctor made a comment that her life was not worth living because she had dementia and couldn’t remember anything. I replied, “How many of your patients said thank you and complimented you today?” The doctor sheepishly said, “Only your mom.” I said, “Then she still is fulfilling her purpose isn’t she?” The doctor backed off and gave the best care until my mom left that Seattle hospital.
Through nine years of advocacy for my mom, I have done the best I was able, making decisions with the knowledge that I have. I am not a nurse and based my advocacy on her wishes and trying to keep her comfortable.
Extraordinary Versus Comfort Care
Hospice began on Tuesday and they were a Godsend. My husband was in Seattle saying goodbye to his dad on hospice when everything happened. A nurse, a social worker and a chaplain came from hospice to support my mom and me. I learned the differences between extraordinary care and comfort care at the end. The IV’s, antibiotics and unnecessary medicine disappeared. The morphine and adavan began.
Final Burst of Energy
After the chaplain said some beautiful words, my mom had what they call a “burst of energy.” I was holding her hand when she opened her eyes half way and said, “I love you,” seven times and “thank you” twice. Then she closed her eyes and the energy was gone. I will treasure that memory.
After she choked while attempting to eat, I said no more food. A caregiver patiently helped her drink some juice even though it took 15 minutes. That was the last time I saw her drink because she could not swallow again.
The turns every two hours caused her to cry out. The repositioning was to prevent bedsores. I called hospice when the gentle turns seemed to hurt her more and they said to reduce the turns to every three hours and give the morphine 20 minutes before. The nurses and care ambassadors were outstanding. This little tip made the gentle turns easier for her.
The last day, she started to moan with every exhale. I called hospice again. The gurgling in the throat had started and it was time to start the medication that helped with that. The director of nursing arrived before hospice and we started the PRN of morphine and adavan that had been preapproved by her wonderful doctor. Hospice increased the frequency of the medications to once an hour and said she was not to be turned again. Alleluia.
The director of nursing was there every hour to administer the comfort medications. I cannot say enough about the staff of Freedom Village Health Care Center and how they supported and loved my mom and I, to the end.
My husband came back from Seattle and the room filled with music. When the chaplain arrived they sang together and it felt like a send off party. Her doctor entered about this time, gave me a hug and said, “She is going out in style. I am so happy that she is comfortable.” A priest came to give her last rites. I said and prayed everything I wanted to with my mom and have zero regrets.
After nine hours, my husband and I decided to take a dinner break. The director of nursing said she would not leave my mother until we returned. Another change happened right before we got back.
The chaplain and hospice were called. The moan on each exhale came back and I requested more morphine for her. Her doctor gave permission. Chris and I sang a couple of songs to her. The chaplain arrived. I requested scripture and the chaplain was reading from the Gospel of John when she passed. God’s presence was in the room. She was comfortable and at peace.
Today is Sunday and I would normally go and visit with my mom. I wrote this blog to help me with my own grief today.
It seems ironic now, that my new book is dedicated to my mom. Writing this blog has been therapy for me over the last three years. After sharing numerous stories about my mom, several senior living people said you should write a book to help other seniors and their families. So I did and “Your Senior Housing Options” was published recently.
I love you mother and hope your stories in the book can help others learn their options and plan ahead. So many seniors wait until a crisis and lose their ability to choose like my in-laws did. The greatest gift my mom ever gave me was to plan ahead and move into a Continuing Care Retirement Community. Over 16 years, my mom had good transitions through three levels of care.
by Diane Masson | Apr 19, 2015
If a senior living sales person or ANYONE said to you, “We are half sold out,” what would be your first thought? I bet, it would not create urgency for you to act now.
When I was considering buying comedy tickets at the Improv last night, I inquired if the event was already sold out. The salesperson divulged, “We are half sold out. Getting tickets should be no problem. We are really surprised that only half the tickets have sold two days before the event.” I thought, oh, this comedian is not as popular as I thought. I will wait to buy my tickets. I was actually disappointed that the salesperson did not create urgency for a famous comic.
It was shocking to me that she would be so forth coming and I walked away disheartened. I told her that I would come back later and did. But I decided to not buy the tickets, because apparently I could just show up in a couple of days and buy the tickets on the day of the event. Her over sharing will continue to affect sales until a manager catches it.
The comedy club sales person over shared. What could she have said instead? “Gosh, let me check, I might be able to get you some tickets. It’s very unusual to have this comic coming to our location. How many tickets would you like?” I would have bought the tickets instantly.
Remember that famous Beanie Baby craze of the 1980’s? It was all about urgency for stuffed toys. Yes, I am the proud owner of 100 Ty bears and still like them.
What are your senior living sales people saying? Is your independent living, assisted living, or skilled nursing sales people saying, “I have quite a few rooms to choose from…”? Cough, cough… You will never fill up with this language. Everyone wants something that they can’t have. There is such a thing as divulging too much information. If a family is given the opportunity to put off the decision to move, they will. Ninety-six percent of seniors end up staying in their own home and not moving. Why encourage them to stay home? How about creating a solution for their needs and offering them the perfect apartment in your senior living community?
Every apartment is unique in some respect, such as the floor plan, the view or where it is situated in the building. Create value for every single senior living apartment. Teach urgency and watch your occupancy rise. I go into a lot more detail in my book, “Senior Housing Marketing – How to Increase Your Occupancy and Stay Full.”
Senior living communities have heavy attrition these days, so it can take two or three more move-ins than move-outs to move up one percent in occupancy. It’s always nice to see the arrow sliding up to 100% full.
So have you encountered too much honesty like me? Do you think it is stupid?
Everyone of us knows at least one senior that needs to move now. Here is a resource to help you or them make an informed decision. Diane Twohy Masson’s new guide book for seniors, “Your Senior Housing Options,” is available on Amazon.com with a 5-star rating. It reveals a proactive approach to navigating the complex maze of senior housing options. It will help you understand the costs and consequences of planning ahead or waiting too long. Learn firsthand tips from someone who is currently advocating for three aging parents.
Among the thousands of seniors she and her teams have assisted in finding the right senior living community, the most difficult case has been helping her own parent. Masson spent two years exploring senior housing options with her mother before finding the ideal Continuing Care Retirement Community for her. After eight years in this independent living setting, she helped her mother transition into an assisted living community. Seven years later, even as a senior housing expert, Masson struggled with the decision to move her mother into a skilled nursing community.
More related articles by Diane can be found at Tips2Seniors.com or like Tips 2 Seniors on Facebook.
Diane Twohy Masson has worked in senior housing since 1999. She is an award-winning certified aging services professional and the author of Senior Housing Marketing: How to Increase Your Occupancy and Stay Full for senior living professionals.
by Diane Masson | Apr 12, 2015
Diane’s Mom Driving -Illustration from the new resource guide “Your Senior Housing Options.”
What about you? Does one of your loved ones have dementia and still drive? Dementia drivers are jeopardizing other citizens walking in crosswalks and driving.
My father-in-law was driving with a diagnosis of macular degeneration. He justified his actions by only driving in the daytime and limiting himself to a 5-mile radius to run errands and go the doctor. As his dementia progressed he got lost driving home within this radius. He chose to give up driving on his own.
A friend told me about my mother driving several years ago. They said, “I saw your mom driving today, she can’t even see over the steering wheel. She is looking through the steering wheel in order to see the road.” I was horrified. This was completely unsafe. I still vividly remember the last time I drove with my mom. She was straddling two lanes (on the same side of the road). She said, “Diane, I know this looks bad, but I know exactly what I am doing.” I was terrified. It was the beginning of her dementia.
A resident of a senior living community drove into another resident’s balcony. As he was parking the car, the senior hit the gas instead of the brake. After backing up, he made the same mistake again and rammed the balcony a second time. Afterwards, he was disoriented and could not remember how the accident happened or why he hit the gas twice. He did not give up his car keys after this incident. The resident whose balcony was destroyed requested to have the parking place right outside his apartment home, because he did not want a repeat performance.
All these senior driving circumstances have made me a better defensive driver. Many people are concerned about teenage drivers, but what about seniors with dementia? No senior wants to give up the keys to the car and lose their independence. Senior housing choices that provide transportation can be a good choice for a senior who should not be driving.
Do you feel that a son or daughter should make a mom or dad give up the car keys if they are putting others at risk? What will be the trigger event to make the decision of no more driving – hitting a curb, a fender bender, or a fatal car accident?
What should the doctor’s role be in this process? Have you had the “car talk conversation” with yourself, your spouse, or your parent? How did it go? What about senior living providers who have residents that are driving unsafely in their parking lots? What did you do?
Seniors, Boomer children, spouses, family members and caregivers are desperate to learn how to truly differentiate good senior housing from mediocre at best. Diane Masson’s new book will answer these heart-wrenching issues in an easy, simple, story telling format with humorous illustrations. She has represented multiple styles of senior housing for 16 years and has sought all levels of senior housing care for her mother and stubborn German in-laws.
“Your Senior Housing Options” is a new resource book available on Amazon.com with a 5-star rating. It offers a step-by-step guide to the options, including staying home. Don’t wait until you’re in a health care crisis like author Diane Masson’s in-laws. Learn how to plan ahead like Masson’s mom. Research your future choices NOW to avoid being “put” somewhere, or having decisions made for you by others.
For weekly tips and advice go to www.Tips2Seniors.com and learn more from author and senior housing expert Diane Twohy Masson.
by Diane Masson | Apr 5, 2015
Many seniors believe Medicare will take care of everything. It is an unfortunate perception that is inaccurate. Two days ago, I was presenting senior living options to a group of seniors. One senior raised their hand and asked how Medicare fit in the picture of paying for senior housing.
Here was my answer, “You have worked hard your whole life to have Medicare insurance. Most seniors have Medicare, a HMO and supplemental insurance. These will help you pay for doctors, hospital stays and up to 100 days of skilled nursing care (if you have a qualifying hospital stay). Medicare will not pay for any long-term care such as support in an assisted living community, long-term skilled nursing care or memory care. (I know this was a short version of a long answer.)
Many seniors were surprised…here is some info from Medicare:
“At least 70 percent of people over 65 will need long-term care services and support at some point. ‘Medicare and most health insurance plans, including Medicare Supplement Insurance (Medigap) policies, don’t pay for this type of care, sometimes called ‘custodial care.’ Long-term care can be provided at home, in the community, in an assisted living facility, or in a nursing home. It’s important to start planning for long-term care now to maintain your independence and to make sure you get the care you may need, in the setting you want, in the future.” This is a quote from the official Medicare and You 2014 Handbook, page 63.
Have you encountered this misperception that Medicare will pay for long-term care?
Diane Twohy Masson’s new guide book for seniors, “Your Senior Housing Options,” is available on Amazon.com with a 5-star rating. It reveals a proactive approach to navigating the complex maze of senior housing options. It will help you understand the costs and consequences of planning ahead or waiting too long. Learn firsthand tips from someone who is currently advocating for three aging parents.
Among the thousands of seniors she and her teams have assisted in finding the right senior living community, the most difficult case has been helping her own parent. Masson spent two years exploring senior housing options with her mother before finding the ideal Continuing Care Retirement Community for her. After eight years in this independent living setting, she helped her mother transition into an assisted living community. Seven years later, even as a senior housing expert, Masson struggled with the decision to move her mother into a skilled nursing community.
More related articles by Diane can be found at Tips2Seniors.com or like Tips 2 Seniors on Facebook.
Diane Twohy Masson has worked in senior housing since 1999. She is an award-winning certified aging services professional and the author of Senior Housing Marketing: How to Increase Your Occupancy and Stay Full for senior living professionals.
by Diane Masson | Mar 29, 2015
Act FAST
My sister-in-law witnessed my father-in-law, Bill, having a mini-stroke (TIA) this week. What a heartbreaking story. She was sitting with him in the living room and noticed his face droop on one side. Then his speech became garbled. It was over in two minutes and he could talk fine again. He had no idea it happened.
She was understandable traumatized and wanted to talk about it. My husband and I are 1000 miles away and applaud her efforts to care for my father-in-law in her own home till he passes. We both think she is a saint.
Through my Internet research it says a TIA is a mini-stroke. TIA’s can be warnings that a bigger stroke can be coming. In my mom’s case, she has had so many TIA’s that she has been diagnosed with vascular dementia. I have never personally witnessed a TIA with my mom.
I guess you could say we were lucky it was only a TIA with Bill. Unfortunately, my father-in-law is now on hospice. Hospice is comfort care, so the goal is no hospitals or ambulances if at all possible.
Every caregiver, family member and senior living professional should know the signs of a stroke and what to do. Stokes can cause permanent damage. If you get someone to a hospital in time, it can reverse the affects of the stroke. Go to www.strokeassociation.org to learn more. They say you should act FAST! FAST stands for: face drooping, arm weakness, speech difficulty and time to call 911.
Have any of you encountered or witnessed a TIA or stroke?
Diane Twohy Masson’s new guide book for seniors, “Your Senior Housing Options,” is available on Amazon.com with a 5-star rating. It reveals a proactive approach to navigating the complex maze of senior housing options. It will help you understand the costs and consequences of planning ahead or waiting too long. Learn firsthand tips from someone who is currently advocating for three aging parents.
Among the thousands of seniors she and her teams have assisted in finding the right senior living community, the most difficult case has been helping her own parent. Masson spent two years exploring senior housing options with her mother before finding the ideal Continuing Care Retirement Community for her. After eight years in this independent living setting, she helped her mother transition into an assisted living community. Seven years later, even as a senior housing expert, Masson struggled with the decision to move her mother into a skilled nursing community.
More related articles by Diane can be found at Tips2Seniors.com or like Tips 2 Seniors on Facebook.
Diane Twohy Masson has worked in senior housing since 1999. She is an award-winning certified aging services professional and the author of Senior Housing Marketing: How to Increase Your Occupancy and Stay Full for senior living professionals.
by Diane Masson | Mar 22, 2015
Memory Care and Assisted Living Costs
Finding an affordable memory care or assisted living community can be a daunting task. Even this senior housing guru had to plan strategic questions before touring four memory care communities for my mother-in-law. See the questions HERE.
My husband and I flew 1000 miles to Seattle. We only had two days to tour memory care communities in the Seattle area. This required researching the Internet, calling former senior housing colleagues for recommendations and scheduling tours before we left. The timing was tricky because our limited time included visiting with my husband’s mom.
My husband created a spreadsheet to compare costs between these four memory care communities. The pricing is so complex that even someone working in the senior living field (like me) had trouble figuring out the monthly cost for my mother-in-law.
Care points, care levels or all inclusive costs?
Most assisted living and memory care communities seem to have a charge for room and board, then additional costs for care. Pricing can be very gray and feels like an illusion of smoke and mirrors. Care costs can be priced on a point system or a level system.
My mother-in-law, Amy, was assessed at 223 points at her current memory care community. Care costs varied dramaticly. Some of our tour guides were actually guessing what level of care or point total she might be, before a nurse could assess her. This is what makes pricing difficult to compare. The community recommends that you to move her in and then they will figure out the monthly price. Sigh…
Here were the room and board costs of four memory care communities in the Seattle area (these prices do not reflect care costs):
Community A Private Room: $2,330
Community B Private Room: $5,095
Community C Private Room: $4,050
Community D Private Room: $4,137
Room and board costs for a shared room in memory care are less:
Community A Shared Room: $1,050
Community B Shared Room: $4,895
Community C Shared Room: $2,850
Community D Shared Room: $3,837
So let’s try to figure out care costs:
Community A has four care levels: Amy’s current care level two (estimate) – $3,860
Community B has five care levels: Amy’s current care level three (estimate) – $2,595
Community C uses care points: Daily charge .54 a point x 223 = $3,613
Community D uses care points: Daily charge .73 a point x 223 = $4,884
So the price is so high, we decide to consider a shared room. So let’s add the shared room with the care costs to see what Amy would be charged each month:
Community A – Amy’s monthly total: $4,910
Community B – Amy’s monthly total: $7,490
Community C – Amy’s monthly total: $6,463
Community D – Amy’s monthly total: $8,721
Each place said it would reassess Amy in two weeks. They implied the price would bump down, but it might bump up in price. Right?!!? So that led us to ask what could be the maximum cost for Amy’s care in a shared room?
Community A – Amy’s maximum cost: $6,820
Community B – Amy’s maximum cost: $9,045
Community C – Amy’s maximum cost: $9,006
Community D – Amy’s maximum cost: $12,159
Community D was priced the highest, but it also had the highest staff ratio and was a drop-dead gorgeous new building. We had to eliminate it due to Amy’s finances. Community A was priced the lowest and had a wait list. It was cheaper, but gross and we saw a low staff ratio. So that left us Community B or C. Community B had a care level pricing and was brand new. Community C was based on care points and was a dated older community. This is where our spreadsheet came in handy.
The bottom line for the family: Amy’s care was more important than a new community that looked great walking in the lobby. We felt Community C had outstanding personnel! Every single person greeted us on our tour. They painted the picture of Amy’s reality, but explained how they would provide the best care in a homey environment. We felt they were experienced enough to correct Amy’s medications that had been over prescribed at the hospital (You can read about drugging and diapering seniors HERE.).
So Community C will initially cost the family around $6,000 a month, plus the one time community fee. They assessed Amy the same day we toured (another example of excellent service) and determined that 223 points was too high. Her new assessment is less than 200 points.
One-Time Community Fee
Assisted living and memory care communities typically have a community fee (one time) when someone moves in. Here were the memory care community fees for the four places we toured:
Community A: $2,500
Community B: $4,895
Community C: $6,500
Community D: $10,433
It’s complicated to compare senor-housing options; I hope this information can help you. Some other assisted living and memory care communities are all inclusive and only charge extra for incontinence care. Do your own research. Cheaper does not always mean better. Look beyond the superficial newness to the quality of the nursing and caregiver staff. Don’t forget to ask about turnover of staff. Community C has two key staff that have worked over 10 years for the company.
What have you encountered?
I haven’t even discussed who can afford these expensive prices? What about poverty level seniors? What happens when a senior runs out of money? Why is Medicaid almost impossible to find at licensed assisted living communities? These questions are addressed in my new book, “Your Senior Housing Options.” It is available on Amazon.com with a 5-star rating.
