Unveiling the Assessment Process

At Caring Considerations/ Aging Life Care Managers®, we understand the intricate challenges families face while caring for seniors. Our assessments will create a roadmap for balanced, enriched, healthy living. We confront obstacles, align goals, and ensure documentation of your healthcare.  Assessment can mean different things to you and to us.  Here’s our most common approach.

Through targeted questions and the gathering of information, we uncover your unique situation:

Health Snapshot: Medical history and recent physician visits.
Medication Check: Medication list and reviewing management systems.
Safe Spaces: Home assessment for secure aging.
Wellness: Nutrition and overall health.
Legal Review: Your documentation for incapacity planning.
Emotional Insights: Psychosocial understanding.
Future Readiness: Funeral plans and crisis prevention.
Create a Plan of Care and Informed Steps Ahead…

Our assessment also covers these crucial aspects:

Defining Goals: Your aspirations and their aspirations.
Addressing Concerns: Primary worries and fears.
Visualizing Success: Ideal outcomes for your family.
Effective Strategies: Past successes and failures.
Family Dynamics: Understanding inter-family conversations.
Comprehensive, Electronic Health Documentation…

We finish an assessment by providing a verbal and email report packed with insights and actionable recommendations.

What’s your definition of an assessment? We want to know how we can elevate your family’s quality of life. Contact us at 571-488-9396  [email protected]

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/

“Do you want to be resuscitated if your heart stops—meaning if it happened at this moment, would you?”

Depending on the stage of a person’s life, many reply, “No, I don’t want to be resuscitated and those wishes are documented in my Living Will (aka Advance Directives).”

The difference between a Living Will and a Do Not Resuscitate (DNR) order and how they are used is a common misunderstanding among older adults and their adult children.

The Problem

If your heart stops and you are unconscious (aka cardiac arrest), someone will call 911.

Paramedics will arrive and attempt to resuscitate you by default. They will not ask to see a copy of your Living Will or Advance Directives while fighting to save your life.

How will you communicate your wishes outside of your legal advance directives?

Unlike most Americans, you have been conscientious about legally preparing for the future. You have been thoughtful and diligent about getting your ducks in a row.

Our Observation

We estimate at least 90% of older adults and families we serve do not recognize the difference between the legal documents designed to carry out your end-of-life wishes and a Physician-signed Do Not Resuscitate (DNR) order.

The reason may be that when we are younger, our Advance Directive may indicate the desire to prohibit life-sustaining interventions in the event of a lengthy coma with no reasonable expectation to survive. (Do you recall the case of Terri Schiavo?) When medical professionals have determined your body cannot function without artificial means (i.e. a ventilator) our Living Will reveals our wishes to family.  However, outside of traumatic permanent injuries, most of us want to be resuscitated when we are young.

Older adults often feel differently. By their advanced years, many adults have dealt with cancers, several chronic conditions such as COPD, diabetes, heart disease, arthritis, dementia, etc. By the time they reach a certain age, they may feel fulfilled and are comfortable with letting nature take its course.

The Solution

If you do not want to be resuscitated, then it is time to talk to your doctor. Debbie Aggen RN, CMC, CDP tells her clients, “A DNR is not a document written up by an attorney. It is a medical order from the doctor. Medical professionals have to follow a doctor’s order, that includes Paramedics, EMT, hospitals, nurses and home care aides or others who may be in your home.“

Ask your doctor if it is time to consider a DNR.

Questions to Ask

Discuss medical interventions and how they may affect you with your doctor. Medicare will cover the doctor conversation.

Here are questions to start the dialogue:

• What are the chances that CPR will save your life?
• What happens to my body when CPR is administered?
• When would artificial nutrition be appropriate?
• What if I just want to be kept comfortable? When would respiratory therapy be considered?
• DNR: Where should the DNR go and who should have it?

The two most important places a DNR should be kept:

• The Refrigerator
• In Your Wallet.

Make several copies and make sure your family and doctor also have a copy.

Consider how a Living Will and a DNR affects your life.

Your life is your choice.

Still Have Questions?

Do you need additional information about a DNR? Contact Us. We look forward to answering your questions.

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]