by Diane Masson | Aug 16, 2015
I asked the same question to four memory care communities that were licensed as assisted living. The responses might surprise you and help you determine where to place your own mom or dad.
What happens if my mother-in-law wakes up disoriented at 2:00 AM and gets up to find the bathroom? Then she falls…
Memory Care Community A – “When we find her, a med tech would evaluate her. If she hit her head or something major happened, then 911 is called. My husband asked about the med tech training. Is it like an emergency medical technician (EMT) with a minimum of 140 hours of medical training? She said, “No, it is like a CNA (Certified Nursing Assistant). There are specific criteria that they are trained on.”
Does someone go with the dementia resident if they go out 911? No!
Diane’s opinion: In my experience, no CNA has the medical expertise to make a judgment call on a fall. My mother’s assisted living community always sent my mom out 911 from a fall in the middle of the night. It happened five times. It was highly traumatic for her. When someone arrives at the emergency room with dementia, it is scary and confusing. It would disorient her for days after each traumatic adventure.
Memory Care Community B – “We have certain guidelines to know when to call 911. In the past month we have had two seniors go out 911. Eighty percent of the time falls do not require 911. We would call the family to meet the senior at the hospital.”
Does someone go with the dementia resident if they go out 911? No!
Diane’s opinion: Some assisted living communities ship senior residents out by 911 because they don’t want liability of a mistake. The pattern I am noticing is that if a community is licensed as an assisted living (board and care) and they do not have a 24-hour nurse, they get shipped out by 911 after a fall during the night.
Memory Care Community C – “If she got up at 2:00 AM, the motion sensors go off and a care manager goes into her room immediately. There are two care managers and a nurse. She will be assessed. If she is okay they will try to help her complete what she was trying to do initially, like going to the bathroom. If the fall is major, then the care manager will go to the hospital with them. If it is not major, she will be continually monitored every 15 minutes.”
Does someone go with the dementia resident if they go out 911? Yes!
Diane’s Opinion: This was the most impressive answer I received to my question. This community had a nurse on staff 24-7 and was priced at the high end of memory care communities. Bad news: My mother-in-law lived at this memory care community and fell. The answer they gave above does not match the reality of what happened. My mother-in-law was found on the floor beside her bed for an undetermined amount of time. Fortunately, she did not have to go out 911.
Memory Care Community D – “A motion sensor goes off, we assess her, and the nurse can be called. We are hesitant to send them out 911 unless absolutely necessary. We do send them out if they have had a head injury. Some places just call 911 but it is too hard on the families. A staff member will go with them to the emergency room.”
Does someone go with the dementia resident if they go out 911? Yes!
Diane’s Opinion: This memory care community had a nurse 14 hours a day. The longer they have a nurse on staff in a 24-hour period of time the more likely they have enough staffing to accompany a resident to the emergency room. Good news: My mother-in-law lived at this memory care community too. She fell and they did accompany her out 911 on several occasions. Thank you!
What Happens When a Senior Falls at 2:00 AM in Assisted Living?
This is a vital question that you need to ask in order to evaluate and choose an assisted living or memory care community for your loved one. Be proactive. Be an advocate. When someone has dementia it is very difficult for them if you pull them out of their normal routine, it can mess them up for days or weeks depending upon the severity of his or her dementia. Assisted living and memory care communities should not send out a dementia resident without accompaniment. My poor mother was always terrified and disoriented at the emergency room.
What has been your experience?
Your Senior Housing Options,” has a simplistic title, but what’s inside this new book can save a you months of research time. Hear Diane Masson’s interview of how her mother and in-law’s faced the pivotal decision to plan ahead or wait until a crisis. Learn the pitfalls from transitioning from your home to senior housing. Understand what questions to ask, insider tips and dirty secrets revealed. The decision to stay home requires caregivers. Prevent elder abuse by determining if a home care agency is reputable, before they move into your home. You are just not looking for today’s needs, but for your future care. Discover key differences between rental facilities vs Continuing Care Retirement Communities. Do you have enough financial resources if you need to be in a higher level of care for an extended period of time? For weekly tips join at: Www.Tips2Seniors.com
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.
by Diane Masson | Aug 9, 2015
My seatmate flying up to Seattle shared that his mom can no longer prepare her own meals. She was diagnosed with Parkinson’s about one year ago. She is currently living in Washington State and can no longer drive. The local family needs to bring her meals to sustain her.
Is it fair to rely on your family to keep you at home?
The mom refused to move to California to live with one of her sons. He specifically bought a home with a “mother-in-law apartment” for her. But she did not want to leave her home or local friends.
Another adult child comes monthly to take her to doctor appointments. My seatmate, her son, visits her about every six months because he lives 1000 miles away.
The family is getting together from all over the country to celebrate her milestone birthday. They are going to discuss future care options, because she is not safe living alone.
I suggested he read my new book to help him with his dilemma. He learned that the assisted living community under consideration is about $5,000 a month. He didn’t know that transitioning to skilled nursing care at some point could cost the family around $90,000 a year on a national basis. The family figured all the children could chip in to support mom to live in a higher level of care. So they want to check out her possible VA Benefits as the spouse of a deceased Veteran. So I shared with him that for VA Benefits to begin, three keys need to happen:
- The mom needs to spend down her assets.
- She will require a certain amount of care dictated by the VA. (These are called ADLS or activities of daily living. Such care includes: bathing, dressing, three meals a day, transportation assistance, medication management and etc.)
- She or her spouse will have needed to serve during one day of active war.
A Veteran gets about $2,000 a month and a spouse gets approximately half of that. The paperwork is complicated, so it is best to have someone who specializes in VA Benefits fill out the paperwork.
His mom still has a house to sell. Some assisted living communities who offer Medicaid require a senior to private pay for a year or two before needing Medicaid. So I suggested the family plan ahead now while she still has a house to sell. Then when she runs out of money, she could be at a community that will transition her onto Medicaid.
Some states like California do not offer Medicaid assistance to those needing assisted living. It is important to plan ahead now.
Any other suggestions for this family? What have you experienced? For more information on VA Benefits go to: http://www.benefits.va.gov/benefits/ Photo credit: http://www.benefits.va.gov/benefits/
Your Senior Housing Options,” has a simplistic title, but what’s inside this new book can save a you months of research time. Hear Diane Masson’s interview of how her mother and in-law’s faced the pivotal decision to plan ahead or wait until a crisis. Learn the pitfalls from transitioning from your home to senior housing. Understand what questions to ask, insider tips and dirty secrets revealed. The decision to stay home requires caregivers. Prevent elder abuse by determining if a home care agency is reputable, before they move into your home. You are just not looking for today’s needs, but for your future care. Discover key differences between rental facilities vs Continuing Care Retirement Communities. Do you have enough financial resources if you need to be in a higher level of care for an extended period of time? For weekly tips join at: Www.Tips2Seniors.com
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.
by Diane Masson | Jul 26, 2015
Diane and her mom about a month before she died.
Let’s hear from professionals around the world to see if this assumption is correct! Do seniors need fewer days of hospice in assisted living and skilled nursing than at home? It makes sense to me.
An article by the Philly Voice stated, “At hospice enrollment, between 2008 and 2012, 78,130 of the patients in the study lived at home and 7,451 were in assisted living.”
My own mom with vascular dementia, living in skilled nursing care, only needed 4 days of hospice care. While my mom was actively dying with hospice care, I read about all the signs people show approaching death.
In a great little book called, “Gone from my Sight, The Dying Experience,” by Barbara Karnes, RN, I learned how seniors start to withdraw one to three months prior to death. The desire for food decreases while sleep dramatically increases. A senior can become more disoriented, agitated and talk with the unseen one or two weeks before death.
As I held my mom’s nonresponsive hand a few days before her death, I realized that most of what the book predicted had happened to my mom in the previous few months. Yet she was completely supported in her skilled nursing environment. What a gift that community gave her.
When she could not feed herself (she forgot how because of her dementia), the caregivers or I would feed her. At every meal she was given an opportunity to feed herself. The staff never gave up on her improving. If my mom had been home, I would have fretted and taken her to the doctor to learn why she was eating less.
My mom never had to be disrupted from her familiar environment and go the hospital like many hospice patients. All types of care could happen right at her skilled nursing community. My mom needed full care (bathing, dressing, medication management, two-person transfers, toileting and feeding).
I can see in my mind’s eye that many higher-level assisted livings could accomplish what my mom’s skilled nursing environment did for her. Calm caring 24/7 staff that understands declining seniors can bring a sense of peace to the patient and his or her family members.
I want to personally thank all the assisted living and skilled nursing care workers that help seniors transition to death. Bless you! Shout out to all the nurses and caregivers at Freedom Village Skilled Nursing for what you did for my mom. Your compassionate staff rocks!
Your Senior Housing Options,” has a simplistic title, but what’s inside this new book can save a you months of research time. Hear Diane Masson’s interview of how her mother and in-law’s faced the pivotal decision to plan ahead or wait until a crisis. Learn the pitfalls from transitioning from your home to senior housing. Understand what questions to ask, insider tips and dirty secrets revealed. The decision to stay home requires caregivers. Prevent elder abuse by determining if a home care agency is reputable, before they move into your home. You are just not looking for today’s needs, but for your future care. Discover key differences between rental facilities vs Continuing Care Retirement Communities. Do you have enough financial resources if you need to be in a higher level of care for an extended period of time? For weekly tips join at: Www.Tips2Seniors.com
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.
by Diane Masson | Jul 19, 2015
End of life decisions are so difficult for an advocate to make for his or her’s senior parent. A few months ago, I had to make tough choices for my mom before she passed. A month ago, my husband and his family faced difficult choices for his dad.
My father-in-law, Bill, had been on home hospice with 24/7 care for about three months. He was frail (worn out from being a caregiver for his wife who had Alzheimer’s), had inoperable blockages in his heart, had four small strokes that my sister-in-law witnessed and was frustrated with early dementia.
He was reaching for the cat when he fell.
The hospital determined that his pelvis was fractured in multiple locations and his femur (thigh bone) was broken. So Bill would be bed ridden the rest of his life. Sigh…he was in so much pain.
They were turning Bill every two hours to prevent bedsores. He could only be on his back and the side without the broken femur. He was a two-person transfer.
The fall that sent him to the hospital was a non-hospice related incident so it was covered by insurance. With no hope of improvement the hospital determined that he was once again comfort care. So according to the hospital, he was a hospice patent who needed to move out of the hospital or pay privately.
The only skilled nursing care facility in the area was not an option (bad reputation). There were no hospice facilities in the local area.
So the only two choices were:
- Stay in the hospital for a cost of $48,000 a month.
- Go home with two around-the-clock caregivers for a cost of $32,000 a month (because he was a two person transfer). The going home option would require my sister-in-law to stay home (she works full time) and manage the caregivers. The family would have to reimburse her normal salary.
My wonderful but exhausted sister-in-law found a temporary solution, which she badly needed. It is called hospice respite care, which includes a 5-day stay. Medicare Part A will pay for up to five days of respite care for a hospice patent who is otherwise cared for in the home. It gives a break to the caregiver. It can be provided in a hospice facility, nursing home or hospital. So we started the 5-day clock and didn’t have to move Bill. He was so frail and moving him would have been horrible painful. He died about three days later, pain free, with family at his side.
He worked hard his whole life and the family agreed upfront to pay the $48,000 a month after the respite 5-day stay.
What if a senior does not have this kind of money or a home to sell?
My own 92 year old mother died in skilled nursing care on Medi-cal. It was in a caring compassionate 5-star rated skilled nursing community called Freedom Village in Lake Forest, CA. My mom was lucky. Many skilled nursing facilities that offer Medicaid assistance are not wonderful experiences.
Families need to research choices, advocate and make the best end of life decisions possible at the time.
Hospice Note: Our family’s goal was for Bill to die at home. My sister-in-law was fully prepared through hospice to make this happen. Bill’s devastating fall that required a two person transfer changed the situation. Just shifting him in his hospital bed was horribly painful. We could not imagine moving him in a ambulance at this point to any another location.
This situation is still very raw for me and it has taken me over a month to be able to write about this topic in my blog.
Your Senior Housing Options,” has a simplistic title, but what’s inside this new book can save a you months of research time. Hear Diane Masson’s interview of how her mother and in-law’s faced the pivotal decision to plan ahead or wait until a crisis. Learn the pitfalls from transitioning from your home to senior housing. Understand what questions to ask, insider tips and dirty secrets revealed. The decision to stay home requires caregivers. Prevent elder abuse by determining if a home care agency is reputable, before they move into your home. You are just not looking for today’s needs, but for your future care. Discover key differences between rental facilities vs Continuing Care Retirement Communities. Do you have enough financial resources if you need to be in a higher level of care for an extended period of time? For weekly tips join at: Www.Tips2Seniors.com
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.
by Diane Masson | Jul 5, 2015
Professionals have told me that a trauma could have caused Amy’s dementia (my favorite mother-in-law) to escalate rapidly. Is this true? Can all the dementia professionals and family members weigh in with their experiences?
My mother-in-law’s dementia was progressing slowly like my mom’s vascular dementia. There are four stages of memory loss and Amy was in stage 2, before the trauma. She repeated herself a lot, needed cueing for personal hygiene, medication management and had little desire to leave the home. Amy talked about not being able to remember stuff, but she could still read the paper, dress, bathe, toilet and feed herself.
Then Bill, my favorite father-in-law and Amy’s 24-7 caretaker, had a heart attack and went to the hospital. Amy could not understand where her rock and husband of 65 years had gone. She ended up having a psychotic break and eloping (The police had to find her and bring her back home.). A whole series of dramas happened and she hit a nurse. Then she too was hospitalized and put on psychotropic medications. Amy was in the hospital for three weeks in the psych ward.
By the time she got out of the hospital, the Amy I had seen months earlier was gone. The first time my husband and I saw her after the hospitalization (we live three states away) was so sad. The vivacious and sarcastic Amy was gone. It was like seeing a shell of her former self. Her lip trembled, her arm shook and she was so sleepy from the Haldol drugs. We immediately got the psychotropic medication reduced by half. It took us another three months to get her completely off the Haldol because we are not Amy’s Power of Attorney.
Amy was suddenly in stage 4 dementia. She needs help with absolutely everything and is not able to communicate her thoughts or needs. Hospice has been discussed in care plan meetings.
Has anyone else seen such a rapid decline with a family member or resident with dementia? Was it losing her husband, the psychotropic medications or both that caused Amy’s rapid deterioration? I believe that if my in-laws had planned ahead and moved into a Continuing Care Retirement Community (CCRC) that staff and residents would have supported Amy when her husband was first hospitalized. The CCRC would have rallied around her, helped her transition to the care level she needed and her world wouldn’t have changed so dramatically (she would have been dining daily with resident friends instead of being isolated in her own home).
What do you think?
“Your Senior Housing Options,” has a simplistic title, but what’s inside this new book can save a you months of research time. Hear Diane Masson’s interview of how her mother and in-law’s faced the pivotal decision to plan ahead or wait until a crisis. Learn the pitfalls from transitioning from your home to senior housing. Understand what questions to ask, insider tips and dirty secrets revealed. The decision to stay home requires caregivers. Prevent elder abuse by determining if a home care agency is reputable, before they move into your home. You are just not looking for today’s needs, but for your future care. Discover key differences between rental facilities vs Continuing Care Retirement Communities. Do you have enough financial resources if you need to be in a higher level of care for an extended period of time? For weekly tips join at: Www.Tips2Seniors.com
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.
by Diane Masson | Jun 28, 2015
We all go through storms!
We all have storms in our lives. Maybe the storm is a death, sickness, or major life crisis. It could even be one of Mother Nature’s storms such as hurricane, tornado or earthquake. You or a senior you know may be going through a storm at this moment.
At some point the storm always ends. There is peace and calmness again. No one is the same after one of life’s storms. The length of the storm will most likely determine the amount of wisdom gained. One of my best friends is a breast cancer survivor. Now she uses the knowledge of her successful treatments and faith to help others. She can make someone elses cancer journey less scary. What a gift!
As retirement counselors in senior living and housing, we can provide that gift of knowledge to a senior considering a move. A senior may feel like they are in a storm processing a major life move to your community. Being pulled toward the benefits of living in a retirement community and simultaneously being drawn back to the security of their home can create conflict for a senior.
Here are a few tips:
First, a retirement counselor needs to acknowledge that a senior is facing an emotional decision (the storm). The decision is to plan ahead or wait until a health care crisis.
Second, if a senior chooses to wait until a health crisis they will be forcing their adult children to eventually “put them someplace” (bigger storm). Many seniors don’t realize this truth. Seniors are typically shocked to learn they will have a 66% chance of needing a higher level of care at some point like assisted living or skilled nursing care.
Third, if a senior moves into a senior living community that transitions them into higher levels of care like assisted living and skilled nursing care, it is a proactive choice to plan ahead (smaller storm for the senior and the family in the future).
Retirement counselors in senior housing should focus on educating seniors about their future health care choices and how your retirement community can be a solution.
If you have ever felt slightly sick standing on the deck of a boat in the ocean, the captain always tells you to look toward the horizon. Don’t focus on the waves that are swirling close around you. Look beyond to the distant skyline. Seniors need to visualize what they are gaining by making a move and planning ahead for their future care. Others can’t get past the overwhelming thought of the turmoil that moving will create for them.
The calm after a storm is usually filled with a sense of peace and wisdom.
Planning ahead could be the greatest gift a senior can give their children. When my mom moved into a Continuing Care Retirement Community in Seattle, WA, it was the smartest decision she ever made. Thank you mom!
How do you help educate seniors? What tips can you share?
“Your Senior Housing Options,” has a simplistic title, but what’s inside this new book can save a you months of research time. Hear Diane Masson’s interview of how her mother and in-law’s faced the pivotal decision to plan ahead or wait until a crisis. Learn the pitfalls from transitioning from your home to senior housing. Understand what questions to ask, insider tips and dirty secrets revealed. The decision to stay home requires caregivers. Prevent elder abuse by determining if a home care agency is reputable, before they move into your home. You are just not looking for today’s needs, but for your future care. Discover key differences between rental facilities vs Continuing Care Retirement Communities. Do you have enough financial resources if you need to be in a higher level of care for an extended period of time? For weekly tips join at: Www.Tips2Seniors.com
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.
I asked the same question to four memory care communities that were licensed as assisted living. The responses might surprise you and help you determine where to place your own mom or dad.
