As we get older we start thinking about where we are going to live out our retirement. Will we move to the beach or the mountain? Possibly move in, or near, our children? Some of the Senior Living Communities are pretty nice!
When it comes to caring for our older adults there can be many people involved as there are items to discuss.
This is where family and caregiver meetings are imperative. We want everyone to be on the same page and everyone will have different thoughts, feelings, opinions, and beliefs.
The Family Caregiver Alliance (FCA) promotes 5 Keys to holding a successful Caregiver Meeting. By following these steps we can ensure that not only does the older adult get the appropriate level of care and that all parties are doing their share.
Family-Every family is different and has a different perspective as to who is “family”. Generally you want to include the people that are a part of the team which could mean friends, extended family, paid and unpaid caregivers.
The Group Can Change-The topic (family finances vs meal-planning and housework) may determine who is in attendance at any given meeting
Mediator-Do you need one? These may be challenging discussions and often a “non-interested” 3rd Party can help.
Including the Older Adult….Or Not-This will depend on the situation and the individual. Make sure you and your team include the older adult as necessary.
How Do We Begin?
Technology provides an opportunity for everyone to attend regardless of their location. Make sure you utilize Skype and Google Hangouts as options
Have an agenda. This is very important so everyone know what is to be discussed at this particular meeting. Then you can take suggestions for topics at an upcoming meeting. The FCA has some topic examples to use as a guide.
Choose a location that people feel comfortable. At a family member’s house or some place neutral such as a coffee shop, library, etc.
Create a “safe place” for an open discussion. Everyone will want to be able to express their thoughts and feelings without fear of being judged or attacked.
Don’t jump into problem solving at the first meeting. Use this first meeting to hear everyone’s thoughts and concerns. Make a list of the topics.
Be respectful and use words that keep everyone calm and the meeting productive. “I feel…” rather than “you always…” If there is a disagreement find some sort of common ground.
Make sure agreements & responsibilities are clear. Before you end the meeting make sure all parties know what they are to do and what the timelines look like. Get solid commitment from each person.
Meet regularly…caring for an older adult is an continuous responsibility. You want to meet on a regular basis to keep everyone up-to-date on medical issues, etc. Setting up a regular time and place can be helpful; so it is a standing date on everyone’s calendar.
Family meetings are not always smooth. There is always some history that may or may not be helpful and conducive to a productive meeting. Also, people deal differently with sensitive subjects….especially where their mother or father are concerned.
This article includes helpful examples of potential conflict and how to work best in understanding and keeping the meeting moving forward in a productive way.
Work toward general agreement. Not everything is going to be completely solved in one meeting or in ten. Even if a meeting gets stressful and uncomfortalble remember it is the care of the older adult that is important.
Accept compromises and appreciate help. There is no perfect solution for everyone. Each person involved with have to compromise in some way at some time.
Keep everything in writing. There are many topics that are discussed and the landscape can change. Make sure everything is in writing including who is responsible for what, deadlines, timelines, etc.
Helping a parent move can be very stressful for everyone. Next to the death of a spouse, moving ranks as one of the highest sources of anxiety among Seniors. People cling to their posessions rather than acknowledging the fear of the change. While adult children see stuff to be sorted through and tossed out; a parent sees memories and treasures.
Whether they are staying on their own and simply moving to a smaller home where they can age in place or if an assisted living community with more hands on care is required helping seniors move requires research and conversations that must take place first.
For many years when an elder person could no longer take care of themselves they were sent to the dreaded “nursing home.” In the 1980s and 1990s we started seeing new models….Assisted Living and Memory Care. Also, more people are choosing to stay in their home and age in place.
When searching for an assisted living and memory care community for your loved ones or yourself the first criteria you want to check is are they licensed. There are two forms of licensing, A license and B license.
Types of Licensing
Type A assisted living facilities have residents who do not require routine attendance during sleeping hours and are capable of following instructions during an emergency evacuation.
Type B assisted living facilities have residents who require routine attendance during sleeping hours and are incapable of following directions during an emergency evacuation. Therefore, they can live in the community until end of life…including hospice care… if desired.
Fortunately communities in Texas can be both. When selecting an assisted living community it is always important to understand the type of licensing they have. If a family member begins to deteriorate you might have to transfer your loved one to another facility. Type B communities will allow you to stay in the same location all the way to your end-of-life while a Type A facility might not be able to do so.
Assisted Living is typically defined as apartments where the resident brings their own furniture and accessories. There are individualized support services and usually some sort of Medication Management. Each new resident is assessed by a nurse upon move-in to determine each individual’s needs.
“Not all assisted living communities are equal. Some provide lighter care, and some can even provide care for those who bedridden or who need help eating while still remaining in assisted living as opposed to a nursing home.” It often depends on the community’s licensing. Many states have a tiered system of licensing whereby communities with a higher degree of licensing are able to provide more care.
The spaces in Memory Care communities will be smaller; cozier. Common services include 24-hour supervised care, medical monitoring and assistance with daily living tasks, in addition to a pleasing environment that is easy for residents to navigate.
Memory Care is for those people who have been diagnosed with Alzheimer’s or other Dementia Disease. For these people life needs to be simple with few decisions for them to make. This keeps the anxiety level down.
The staff should be trained specifically in the care of people with Dementia Diseases. The staff should know what makes a person uncomfortable (triggers) and what brings them comfort.
One example is a gentleman was becoming agitated and anxious. The caregiver, recognizing this, walked over to him, took his hand, and began to dance with him. His anxiety reduced immediately. She knew that dancing would make him comfortable again.
Alzheimers.net recommends you consider these questions when considering a memory care community.
What level of care does the community provide?
What type of training has the staff received?
What is the monthly rate for housing and care? What services does that rate include?
Are rooms private or semi-private? How do prices vary for each?
What level of personal assistance can residents expect?
What is the policy for handling medical emergencies?
How is the community secured?
What meals are provided? Are special dietary requests, such as kosher meals, accommodated?
How often are housekeeping and laundry service provided?
What programs (exercise, physical therapy, social and other activities) does the facility offer?
Does the facility accommodate special care needs, such as diabetic care, mobility issues, physical aggressiveness or wandering?
Are residents grouped by cognitive level?
What is the ratio of staff to residents during the day/night?
How does the facility communicate with families about a resident’s well-being?
What is the discharge policy?
Paying for Assisted Living and Memory Care
Additionally, more seniors are purchasing long-term care insurance to help finance their long-term care needs. Wartime veterans and their spouses may eligible for VA benefits that can offset the cost of care.
A Place for Mom’s Guide to Financing Senior Care has details about creative financing plans that can make care affordable as well. Those with low income may to need use Medicaid to pay for senior care. To explore this option, contact your local Area Agency on Aging Office, which can be located at: www.eldercare.gov.
In Texas, long-term care is expensive, whether in a nursing home, assisted living facility, or home health care. Medicare coverage for long-term care is very limited, private health insurance policies generally do not cover long-term care, and few people have purchased private long-term care insurance policies. For Texans needing long-term care, Medicaid is the most common source of funding.
Medicaid for Texans in Assisted Living Facilities
Assisted living facilities provide food, personal care services like help with bathing or dressing, and medication administration. Historically, Medicaid did not pay for assisted living facilities. However, Texas has two programs that offer Medicaid payment for assisted living facilities, if you meet specific criteria.
If you are otherwise eligible for Medicaid and if you can show that a nursing home is medically necessary for you (also called “meeting the nursing home level of care”), then you may qualify for Community Based Alternative (CBA) Medicaid or for STAR PLUS Medicaid Waiver services.
Both programs pay for home and community based services, including assisted living facilities, for people who would otherwise have to be institutionalized in a nursing home. CBA and STAR PLUS have limited enrollment and are not available in all parts of the state. For more information, contact your local Texas Department of Aging and Disability Services office.
Texas has a particular kind of assisted living facility called a continuing care facility (CCF). CCFs provide custodial care through round-the-clock supervision, but not round-the-clock nursing care. CCFs are not covered by Medicaid.
When you are visiting different communities talk to everyone! Talk to the residents, the kitchen staff, the nursing staff, and the cleaning staff. Ask the residents how they like the food and the staff. Inquire how the chef prepares the meals and the staff how long they have worked there; what motivates them to work in the assisted living environment.