Getting older can be a beautiful thing, when approached with good humor and wise planning. While both are of equal importance, the second requires a bit more research. Fortunately, a great many resources are available to individuals looking at senior living options.
Effectively vetting a community or provider is of vital importance, and organizations such as the Bureau of Human Services Licensing (Pennsylvania) or the state Department of Health (New Jersey) can help verify whether a particular facility is in good standing. Marcy Schachinger, director of community relations with Brandywine Senior Living, suggests other resources include elder care attorneys, who can be invaluable in terms of financial planning, and geriatric or senior care managers, who can assist with everything from helping a person downsize or sell their home to determining the answers to questions such “What’s the right community for me?” and “What can I afford?”
According to Schachinger, individuals can seek out a reputable geriatric care manager via the nonprofit organization Aging Life Care, formerly known as The National Association of Professional Geriatric Care Managers. Also, in Pennsylvania, trusted elder law attorneys can be found via the Pennsylvania Association of Elder Law Attorneys. Additionally, she suggests seeing what others have to say about a community by touring the campus, speaking with residents or checking online resources such as aplaceformom.com, retirement-living.com or leadingage.com.
Among the “most comprehensive” resources is the Guide to Retirement Living SourceBook, according to Dottie Mallon, vice president of marketing and public relations for White Horse Village. The resource can be obtained for free via an online request.
Touring a facility is invaluable in ensuring a senior finds a community that is not only up to standard but also a good fit for an individual. As Lisa Kelly of CareOne Assisted Living suggests, stay for a meal when on a visit to sample the quality of cuisine the senior will be receiving three times a day.
Ask how a facility or company is governed. This question speaks directly to the future of a facility, which is quite important for obvious reasons. One doesn’t want to move into a facility, or begin to procure services, if a particular facility or location has instability on the horizon.
In an effort to help ease the decision for seniors and their loved ones alike, Suburban Life has worked with local “life plan communities” and other service providers to compile a list of four must-ask questions for seniors when mulling their options.
1. Which is the right option—homecare or independent and assisted living?
For those who don’t know quite where to begin, it is helpful to first determine the level of necessary care a senior requires as, for many, retirement homes and in-home care are only considered once a necessity arises. Ask: Can I or my loved one remain at home? Or: Would it be more appropriate to consider a nursing home—a specially licensed medical facility? Or: Is a personal care facility—one that offers residents personal care services, assistance and supervision—the best option?
Answering these questions is a vital first step in determining the best route for caring for an aging person. If the individual wishes to, and is able to, stay at home, home care may be the best option. If the person wishes to, or must, move into a community of peers with 24-7 care, a nursing or personal care facility may be more appropriate.
That having been said, although many seniors retain their independence by living at home, living alone can lead to isolation, depression and malnutrition, all of which can lead to a decline in health. This dichotomy leads many to a crossroads—namely, stay or go?
The largest part of this discussion must take into account the senior’s wishes. Homecare can provide many seniors with the freedom they wish to maintain while providing the daily care they require; yet, a move to an assisted living facility can remove any stress associated with not just maintaining a home—utilities payments, land maintenance, taxes, etc.—but also offer opportunities to be among peers in an environment with around-the-clock care.
“According to LeadingAge, the national organization of not-for-profit homes and services for the aging, living in a community … adds five years to a person’s average life,” says Mallon. “People are engaged in lifelong learning—brain stimulation—fitness and wellness programs—physical stimulation—good nutrition and a healthy diet, and they are surrounded by other people with similar interests so they are not isolated and alone somewhere.”
Homecare, too, has its advantages.
“One of the biggest advantages, I feel, for in-home care for seniors is it allows older adults to age in place,” says Colleen Moran, R.N., president and CEO of Dunwoody at Home homecare and home health care service, a subsidiary of Dunwoody Village. “I feel like seniors feel more comfortable in their home environment and they thrive more being at home, around their loved ones. ... They feel like they might be more in control and they still have their independence, and one of the biggest concerns for seniors is losing their independence.
“In-home care,” she continues, “also gives family members confidence and peace knowing that their loved ones are comfortable at home and receiving professional compassionate care at home.”
Moran stresses, however, that homecare and in-home health care are not the same. Homecare refers to nonmedical in-home care services, while home health care is usually short term—a period of time up to 60 days—for an acute illness or ailment such as recuperating from a surgery. Home health care is usually paid for by Medicare, she explains. “The main difference, too, between home care and home health care is homecare is usually private pay,” Moran notes.
Ultimately, the decision must be based on what is best for the senior.
2. What is the cost associated with the services?
This question is likely one of the first to arise, as most senior living facilities and services can be quite costly. Costs vary greatly depending on the level of care given, as well as the size of a person’s residence in a locale such as an assisted living facility.
Dunwoody homecare services run in the neighborhood of $19 to $24 per hour, according to Moran, and the number of hours per week varies by client. “We do services from three hours a day to 24 hours a day, seven days a week, so it is all customized to what that individual client needs in their home,” she says.
Mallon estimates monthly fees at White Horse Village range from $2,500 to $5,700. While such fees may initially seem high, it is important to remember the services included in that price—“utilities, meals, parking, storage, 24-hour security, housekeeping, maintenance, landscaping, trash removal, full use of all common areas, wellness, fitness, entertainment, etc., as well as long-term nursing care,” Mallon explains.
Schachinger estimates costs at Brandywine Senior Living on average, across all communities and taking into account all care levels, to be at approximately $200 per day. This could be less, or more, depending on the level of care a person requires.
Respite stays—a short-term stay at a senior living community—can cost $150 per day, up to $300 per day at a facility such as Care One Assisted Living. Kelly explains that costs vary depending on a number of factors. For example, if a person is in the later stages of Alzheimer’s, care will be more costly. Geography can also impact cost.
Mallon notes it is important to understand before signing a contract, whether a community is fee for service or full service. “There is a big difference between the two, and understanding the fee plans is critical in the decision-making process,” she says.
Long-term-care insurance can help with costs for services such as homecare or retirement living. As Schachinger explains, “Long-term-care insurance can cover a myriad of services, from home care services provided by private agencies to care and rent in a personal care community or memory care neighborhood … to care in a more acute setting like a skilled nursing facility.
“Policies … can be customized with daily maximum allowable covered dollar amounts and different lifetime maximums,” she continues. “These customization factors are known as ‘riders’ to a policy. Whatever each policy covers and how comprehensive it can become, by adding additional riders, will directly impact the premium that the person buying the coverage will pay.”
Insurance companies, financial advisors or planners and elder care attorneys are good resources to consult for more information on long term care insurance.
3. What type of health care is provided?
As Kelly observes, “The most important thing is to make sure [a facility] has a proper nursing staff.”
Another point to address regards transitional services, should a person decline in health. Can this facility or service provide transitional care so a senior may age in place? Is there a secure memory care community on site? Additionally, does the facility offer subacute care, or care for individuals recovering from a health incident such as a fall or pneumonia?
Of a homecare service, Moran suggests asking many questions, including: How does the company hire and train their caregivers? Are the caregivers bonded and insured? Are they direct employees of the homecare agency, or are they contracted employees? How closely does the agency supervise and evaluate the quality of homecare? Do they make unannounced visits? Are they licensed by the state?
Do I have the opportunity to interview some of the caregivers that might be coming to the home? What type of employee screening is done?
With both homecare and personal care, questions such as “How frequently will the professional be visiting the patient?” and “What are the provider’s qualifications?” are important to note.
Another important question is, “What is the nurse-to-patient ratio?” Too high of a ratio could mean spotty care and less adequate attention per patient.
4. What exactly do you provide in the realm of services for seniors?
This applies more to a personal care facility than a homecare, where a person’s daily routine is less likely to change. Even so, senior living encompasses far more than health care alone; it also speaks to quality of life. Typical homecare duties can include helping a client with activities of daily living such as dressing, personal hygiene, medication reminders, bathing, meal preparations, light housekeeping, social activities and taking the client to doctors’ appointments.
Personal care homes often offer an array of regular activities for seniors. Ask: What types of amenities are provided “above and beyond”? Is there a special spa or salon, just for residents? Are activities varied, to include physical activities such as water aerobics or yoga, or are activities bland and repetitive?
With the assisted living at Care One Assisted Living, seniors can enjoy trips to the spa and salon as well as regularly planned excursions. At White Horse Village, Mallon says fitness programs are designed to the unique needs of each resident—balance programs for those who are at risk for falls, equipment to improve posture, aquatics classes for those with arthritis, etc. At Brandywine Senior Living, personal care residents benefit from “Escapades for Life,” a program offering arts and engaging activities because, as Schachinger says, “We want people to write their own story and continue to live their own life.”
Taking all of these questions into account, choosing a care option for oneself or an aging family member can provide new opportunities for independence and adventure. Whether a senior chooses to remain at home with assistance or move into a community, only one question truly matters: How can this senior live his or her best life?
Resource Guide
The future can sneak up quickly, so making decisions regarding a senior’s living options should be mapped out carefully and well in advance. The following organizations can help seniors and their families find the right option to suit their individual preferences and circumstances.
Attleboro Retirement Village
Langhorne
215-750-7575
attleborovillage.com
Barclay Friends
West Chester
610-696-5211
bf.kendal.org
Bayada
Newtown Square
610-353-5000
bayada.com
Beaumont at Bryn Mawr
Bryn Mawr
610-526-7000
beaumontretirement.com
The Birches at Newtown
Newtown
215-497-7400
thebirchesatnewtown.com
Brandywine Senior Living
Visit brandycare.com for details on locations throughout the Greater Philadelphia Area.
The Bridges at Warwick
Warwick
215-269-7745
thebridgesatwarwick.com
CareOne Assisted Living
Visit care-one.com for details on locations throughout the Greater Philadelphia Area.
Dunwoody Homecare
Newtown Square
610-359-4503
dunwoodyathome.org
Dunwoody Village
Newtown Square
610-359-4400
dunwoody.org
Friends Home & Village
Newtown
215-968-3346
fhvpa.org
The Hill at Whitemarsh
Lafayette Hill
215-402-8500
thehillatwhitemarsh.org
Pine Run Retirement Community
Doylestown
800-992-8992
pinerun.org
Visiting Angels Senior Care
Doylestown
215-345-9600
visitingangels.com/doylestown
Waverly Heights
Gladwyne
610-645-8600
waverlyheightsltd.org
White Horse Village
Newtown Square
610-558-5000
whitehorsevillage.org
Wood River Village
Bensalem
215-741-3030
woodrivervillage.com
