by Diane Masson | Oct 4, 2015
First, plan ahead and know that every senior has a 66% chance of needing assisted living or skilled nursing in the future.
Second, do not rely on the verbal promises of senior housing sales people. Read the agreement for services or contract. If a senior does not understand it, they should ask a savvy friend or hire an attorney to help them. The majority of retirement counselors are honest and passionate about serving seniors. A few will say “anything” to get a senior to move in immediately.
How do you know if a retirement community will really take care of you or not in your future? Here are some important questions to ask EVERY senior housing community BEFORE you move from your home:
What happens when a senior needs a higher level of care like assisted living or skilled nursing?
- Will the senior be asked to leave the retirement community?
- Do they offer a higher level of care on the same campus? How much does that cost per month?
- Does an outside company bring caregivers into the senior’s apartment home to provide care? What is the hourly cost? What is that company’s reputation?
What happens if a senior falls in the middle of the night?
- Is there an emergency call system? Who responds to it? Are they medically trained?
- What happens if a senior falls and he or she can’t hit the emergency button? Will they will be found in a timely fashion?
- Is there a daily check in system?
What happens if a senior outlives their resources?
- Will they kick you out? A senior provider kicked out a senior in Houston a week ago.
- Is there a Good Samaritan Fund or Foundation to help a senior so that he or she won’t get kicked out? Is there a limit of how many seniors can be utilizing the fund at any one time?
- Or is there just a flat guarantee of care in writing that a senior will never be kicked out unless they divest their own funds on purpose by giving gifts to their children?
What else should a senior ask in order to make a good move?
These are just some of the intelligent questions that seniors should ask a senior housing provider. Other tips and advice can be found in Diane Masson’s new book, “Your Senior Housing Options.” She has recently been interviewed for TV, radio and newspaper features. Diane Masson has worked in all types of senior housing in her 17-year career. Her first book, “Senior Housing Marketing – How to Increase Your Occupancy and Stay Full,” is being utilized by senior housing professionals around the world.
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 | 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.
by Diane Masson | Mar 2, 2015
Diane and Chris Flying 1000 Miles to Look for Affordable Memory Care for my Mother-in-law
My mother-in-law is currently in a secured memory care community. The price is very high – $6750 for 30 days of respite care. If we don’t move her within two weeks, the community fee for a permanent stay will be $10,000 and her monthly fee will be $9,000 a month. Are you kidding me? Who can afford this?
She was living in her own home six weeks ago, but a crisis you can read about HERE has left her adult children scrambling to find a permanent solution for my mother-in-law.
My husband, Chris, and I work in the senior housing profession, so who is better than us to evaluate the choices. We flew 1000 miles yesterday to be the experts on the ground in Seattle. We are going to visit three memory care communities today and one or two tomorrow. The best way to evaluate and compare retirement communities is in a short span of time. The crème always rises to the top.
We can’t base our decision on what the community looks like, the size of the rooms or the wonderful sales person. We are going to dig deeper and ask the following questions of each memory care community:
- What is the staff turnover? We want to see longevity of staff – particularly in the administrator, nurse, caregivers and possibly the chef.
- Do the staff and residents look happy? We will talk to some of each.
- What will be my mother-in-laws quality of life? What programming is offered? How often does live entertainment come in the building? How will they minimize her anxiety?
- How many hours does the nurse work per day? Twenty-four hours will always be the best answer, but you get what you pay for.
- What is the procedure if my mother-in-law falls? When my mom was in an assisted living community with dementia, every fall led to a terrifying emergency room (ER) visit that was stressful for her. If a nurse is on shift around the clock, it may save my mother-in-law from this stress. If the fall happens at 2:00 am and only a caregiver is on staff, the call to 911 will almost always lead to the terrifying ER visit.
- Do doctors come and visit my mother-in-law here or does she have to be driven to her doctor? Who will do that? Will someone accompany her? What are the costs?
- We will discuss my mother-in-law’s dietary needs and meet the chef. When my mother-in-law was in the hospital, she became incontinent. We hope it is not permanent and assume the diarrhea was from feeding her too many raw vegetables and fruit. She has not eaten those in years because of too much radiation after colon cancer. So it is important that we advocate for her in this regard. Just incontinence can cost an additional $1,000 a month.
- What is the initial community fee? What is the current monthly cost for room, board and care? What is the maximum cost it could potentially be? What are the additional costs? What have we not asked that could cost extra? What happens when someone is broke and can’t pay these hefty fees? We need to find out if the memory care community charges for my mother-in-law’s care by points, levels of care, or is all-inclusive. Pricing can be very grey and it is easy to be confused. Even us experts will have to see beyond the sales “smoke and mirror” answers.
- What is the history of their year over year monthly increases? We can’t just look at affordable costs today, but what if my mother-in-law lives for years?
- Is the room furnished? Do we just bring personal affects? Do we need to go buy a twin bed, TV or special chair?
- How do they handle hearing aids and glasses? My mother-in-law has two hearing aids that she has not used in six weeks.
- What is their procedure in contacting the family to give updates or let us know of a change in our loved one’s health?
- Is there anything that we should have asked but did not?
We will look at the entire memory care community space, her possible room and the outside walking area. I will keep you posted on our family evaluation and pricing for these communities. Hopefully, sharing my experiences and tips can help you too.
Diane Masson’s new guide book for seniors, “Your Senior Housing Options,” will be available next week on Amazon.com. If you sign up for my weekly newsletter on the right side of this blog, you will be notified when this valuable resource can be purchased. Check out my new website: Tips2Seniors.com or please follow me on Facebook.
Diane Twohy Masson is the author of “Senior Housing Marketing – How to Increase Your Occupancy and Stay Full,” available at Amazon.com with a 5-star rating. The book is required reading at George Mason University as a part of its marketing curriculum. Within this book, the author developed a sales & marketing method with 12 keys to help senior living providers increase their occupancy. Masson developed this expertise as a marketing consultant, sought-after blogger for senior housing and a regional marketing director of continuing care retirement communities in several markets. She has also been a corporate director of sales and a mystery shopper for independent living, assisted living, memory care and skilled care nursing communities in multiple states. Currently, Masson is setting move-in records as the regional marketing director of two debt-free Continuing Care Retirement Communities in Southern California – Freedom Village in Lake Forest and The Village in Hemet, California. Interestingly, this career started when she was looking for a place for her own mom and helped her loved one transition through three levels of care.
© Marketing 2 Seniors| Diane Twohy Masson 2015 All Rights Reserved. No part of this blog post may be reproduced, copied, modified or adapted, without the prior written consent of the author, unless otherwise indicated for stand-alone materials. You may share this website and or it’s content by any of the following means: 1. Using any of the share icons at the bottom of each page. 2. Providing a back-link or the URL of the content you wish to disseminate. 3. You may quote extracts from the website with attribution to Diane Masson CASP and link https://www.marketing2seniors.net For any other mode of sharing, please contact the author Diane Masson.
First, plan ahead and know that every senior has a 66% chance of needing assisted living or skilled nursing in the future. 
