So many of us worry about our loved ones being safe, comfortable and treated with kindness when they are living a senior community (i.e. assisted living).

The sad fact is most elder abuse is by a family member. Abuse can come in many forms such as intimidation (emotional), physical or financial, neglect, etc.

But what about in care settings? Most reported abuse doesn’t happen in care settings. But what can you do to make sure your loved one is getting the best care?

1. Come from a place of support to staff. We recommend you are an active, visible advocate in the senior community. Get to know the caregivers, nurse’s and managers and even other family members.
2. Visit often and at different times of the day.
3. Know warning signs of the various types of abuse.

It’s always wise to ask questions of the staff when you are unsure about community procedures and situations.  And it never hurts to bring a treat or something else to the staff. Let them know you respect and care about what they do for your family member.

Questions You Can Ask Your Loved One

Older adults are often grateful for the care they receive and they may not want to complain.  It is true caregiving may never be perfect, but to some extent, we may need to pick the battles.  The other thing you can do is ask the older adult the following questions:

• Who is responsible for caring for you (during the day, in the evening, etc.)?
• Do you feel safe where you are living?
• Does anyone scold you or shout at you?
• Has anyone ever hit or slapped you?
• Has anyone left you alone waiting for food, drink or care?
• Has anyone ever made you do things you don’t want to do?
• Have you ever signed something you do not understand?

When Your Loved-one Has Memory Loss

The important thing to consider in this evaluation is memory loss.  If the resident suffers from Mild Cognitive Impairment (MCI), then you can usually have faith in their answers to these questions.  However, if your loved one has more moderate or severe memory loss or his/her memory is getting worse, be aware that suspicion and confusion is common.  Older adults with memory loss can’t always understand or process what is going on around them, so they will express feelings differently.  In these cases, changes in behavior might be the best indicator of something isn’t quite right.

What To Do If You Suspect Abuse

Get your facts and information together.  Keep an open mind and seek to understand.  Local senior living communities have a grievance process which should be posted in their community in an obvious place.  If you don’t see it, ask for it.  Try to resolve a concern internally with owners and managers.

You may also wish to the local Ombudsman’s Program via the county Area Agency on Aging.  To find your local Area Agency on Aging visit https://www.usaging.org/

A last resort would be to contact the county Adult Protective Services office via the local Area Agency on Aging. https://www.usaging.org/ http://vaaaa.org/

If your family has decided that an older adult needs constant care and that living together is probably the best solution, then you may be wondering why any further discussion is necessary. Even if you think it isn’t, consider taking a few minutes to sit down with your loved-one to answer the following questions. Doing this may help prevent misunderstandings in the future.

1.Will home care still be used to care for a loved one? If not, who will take time from their career (family) to care for an aging parent? What will be the trigger to get professional help?

2. How will this affect lost income? Will that person be compensated by the family? Who will relieve the primary care provider when they need a break?

3. Is the home accessible: ramps, railings, stair lifts, spacious bathrooms, etc.? Will there need to be modifications/renovation? How much will the modifications/renovation cost? Who will pay for them?

4. What is the budget for caregiving, room and board, etc.? Will you need to learn about Medicaid Community Based Services? What other services are needed?

5.What training will the primary caregiver need? Who will pay for the training?

6. If there is dementia, wandering, or severe behavior issues that become unmanageable, how will they be handled?

7. How and who will be educated about dementia? Everyone in the family or only the primary care provider?

8. Will there always be joint (family) meals? How much time will be spent together daily, weekly, etc.?

9. What household space is available (or can be designated) for private, more secluded time for everyone in the family?

10. How will grandparents interact with grandchildren or participate in discipline?

11. Do family members living together agree on the division of duties? Are there conflicts over tasks, duties & expectations?

12. Will the family be willing to or need to hire a professional counselor or mediator to resolve issues?

13. What will the older adult (e.g. grandparent) be able to contribute to the household activities?

14. Do the grandparents have local opportunities to engage with peers (e.g. senior center)?

15. What if an adult child needs to move? Is there a back-up plan?

We all have expectations and boundaries when living together. Communication early on may help set the stage for future conversations and negotiations.

If you find it difficult to come to a consensus, or you need help in exploring living and care options, contact us at 571-488-9396 [email protected]

You may recall the days when parents lived with their grown children (think The Walton’s).  Many cultures adopted this arrangement for financial or traditional reasons. Then an era of independence became more common.  I recall my grandmother wanting her own household in the sixties. Over time, changes in society have caused us to re-examine independent households in favor of extended family households.  The 2008 recession, living longer, and managing chronic conditions have been catalysts for change.  The fact is, living with family is becoming more popular.

Is it right for you?*

We spoke with a few families who have made the change.

Kathy and her husband, Richard lived very close to Kathy’s father, Bill.  The grandchildren enjoyed frequent visits to Grandpa’s house.

One day, they found Grandpa Bill unresponsive on the kitchen floor.  Fortunately, he was okay, but Kathy and Richard agreed it was enough of a scare to start the conversation. There was no reason why Dad couldn’t live with them.

It took Bill, a widower, a little while to get used to the idea. But when he thought about the future and his daughter’s responsibilities, he felt it would be a wise move.

“What really helped my father accept a new living arrangement was having a lot of control.  He helped hire an architect and Dad directed most of the in-law addition designing.  Dad was still sharp. He listened to our ideas, and he enjoyed the process.”

When I asked Kathy how they prepared to combine lifestyles, she said it was pretty easy.  Richard, the son-in-law, worked during the week and Kathy was able to spend some time with Dad.  When the weekend came, Grandpa Bill respected their family time.  Richard had no problems with his father-in-law being around. There were some shared meals, by invitation only. Grandpa Bill always knocked on their door in the morning just to say Hi and I’m okay.

What really worked out well is the in-law suite. It was very private and self-contained.  Hiring a good architect made all the difference, according to Kathy.

To finance the home addition, Grandpa Bill paid for most of it. Kathy and Richard were able to create an upper level master suite and bath, so they agreed to pay a portion of the renovation taking into consideration future home equity.

What didn’t work so well, according to Kathy, was her brother’s  response.

“During this time, my brother had to learn that I was the Executor of my Dad’s estate and that I was named as having Power of Attorney. I let my Father have that conversation with my brother.  But I knew my brother didn’t want the responsibility of caring for Dad full-time and everything that comes with it.  Eventually everyone came to terms with the financial implications.”

Parents Living with Dementia

Kathy’s family was blessed with a relatively smooth arrangement.

Other families have a more complicated situation. For instance, when memory loss affects one or both parents.

The person living with dementia may experience confusion, suspicions, and even more severe behavior issues. Some families assume resistance is stubbornness. Most of the time, it is fear of the change and a new environment.

The trigger to change living arrangements? When one-on-one caregiving becomes necessary, many older adults move in with their families.  Without some forethought, the primary caregiver, usually a daughter and her family, can find the arrangement burdensome to a point of compassion fatigue.

Did the Walton’s have the right idea? In our next blog, we will discuss questions, expectations and boundaries.

If you or someone you know is exploring living and care arrangements for a loved one, we can help make the transition a little easier. 571-488-9396 [email protected]

*Names are fictitious.

For some of us, what we hear on the news about the pandemic occurring in nursing homes, and other congregate living communities can be frightening.  Is now the best time to move? For independent living retirement communities (aka CCRC’s) much is the same.  Here are two communities in Northern VA sharing what has changed, if anything.

Goodwin House (Bailey’s Crossroads and Alexandria 703.820.1488) has seen very few changes.  Due to their geographic location, move-ins remain strong during the pandemic.  By proactively sharing how infection control is managed, older adults are feeling comfortable to continue their transition plans to enter a robust retirement community.  However, according to Sue Dolton in Sales and Marketing, Goodwin House has seen about a 47% drop in new inquiries.  Tours are not being done and some older adults are postponing decision to become a priority club member (aka waitlist). Potential residents indicate they feel the world is uncertain.  Others find the prospect of putting their home on the market and having buyers walk through their homes feels unsafe at this time.  What older adults do not appear concerned about is the current real estate market and the strength of their finances according to Sue.

Resident life in Goodwin house has changed to some degree.  There is no congregate dining currently. Three meals a day are being delivered to residents in their apartments.  Activities and events are occurring, but differently.  Many opportunities to be active are happening outside in the warmer weather.  Masks, 6 ft. social distancing, etc. is the standard practice during gatherings.

Non-essential, non-emergency visitors are discouraged. Visitors are screened. Testing of residents and staff is ongoing at Goodwin House to ensure a safe and healthy community.

In Loudoun County, Ashby Ponds, (703.723.1999) a continuing care retirement community developed and managed by Erickson Living, has seen a modest decline in new inquiries.  According to Holly Henderson, Director of Sales, the community and its marketing partners quickly recognized reductions in advertising (direct mail, digital) would be wise for the time being.  What has remained strong are the number of inquiries and engagement levels for Priority List members.  These members are still learning about the campus by speaking with residents and employees about how Ashby Ponds is responding to the COVID-19 crisis.  Like other senior living communities, Ashby Ponds is taking all necessary precautions to protect everyone’s health.  Families of current residents share grateful messages to the staff for keeping their loved ones safe during the pandemic.

Move-ins at Ashby Ponds are occurring due to a continued hot real estate market, according to Holly. “…Some new residents literally had no place to go” because their homes sold quickly. Other potential residents are waiting to move until a vaccine can provide a higher level of comfort or, at the very least, lightening of government restrictions.  However, Holly noted an uptick of cross country moves so residents can be nearer to family in Northern Virginia, providing a better support system during the pandemic.

There’s no doubt that making the decision to move without being able to visit does present a challenge in really getting the feel of the community lifestyle in person. Currently, Ashby Ponds is using technology like never before, such as for virtual tours of apartment homes.  The anticipation is for Virginia to be lifting restrictions soon and the summer and fall will be an even busier move-in season than normal.

As many of us are on ‘hold’ to make changes in our lives, it’s good to know older adults are moving along to make their dreams and plans of living in a retirement community a reality no matter what the circumstances may be.

For further information or help with selecting the best senior living community for you, call 571.437.9396 Caring Considerations Email: [email protected]