Let’s Talk about Home

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Making the decision about SENIOR LIVING OPTIONS in Fairfield County

About a decade ago, Ann Jamison began to suspect her father, Dirk, was struggling at home. A medical condition that impaired his vision had made driving impossible. As the widower advanced into his late seventies and his world got smaller, his daughter found him increasingly anxious and depressed. “He was always a social guy who enjoyed his friends, his church and the groups he was part of,” Jamison explains. “I worried about how much time he was spending alone and what was happening when no one was there to help.”

One day, Jamison drove from her Fairfield home to her father’s place in Ridgefield unannounced. “When I popped in on him, a lot of the things I was worrying about were confirmed,” she recalls. “He wasn’t shaven. The house was unkempt. The fridge was a mess and there wasn’t much food. Things were clearly just not going well.”

So began a long, and at times, challenging conversation between Jamison and her father that led to him eventually taking an apartment in an assisted living facility close to his Ridgefield friends and connections. There, Jamison says her dad lived “nine-and-a-half incredibly happy years.”

Getting to the place where her father would even discuss assisted living wasn’t easy. “There was a lot of resistance, and when he finally did decide to consider a senior community, the process of choosing felt completely overwhelming,” Jamison says.

Her dilemma then has become an increasingly common one today for both seniors and their adult children or caregivers. Now the owner of Senior Living Options, a Stamford-based consulting firm that guides other seniors and their families through the process of navigating their living options, Jamison provides free services—inspired by her own experiences seeking the right living situation for her dad—that are increasingly in demand. She notes that research suggests some 70 percent of today’s Baby Boomers, age sixty-five and older, will need some sort of help living independently during their lifetime.

“When you see that number, you realize it’s kind of staggering,” she says. “Which is why conversations about how we want to live as we get older is something we should all be talking about.”

Yet too often, geriatrics experts say, the conversations don’t happen soon enough.

Roni Lang, a clinical social worker at Greenwich Hospital’s Center for Healthy Aging, says she counsels seniors and their families in the aftermath of emergencies, such as falls, the onset of a chronic illness or the sudden death of spouses and partners. These situations often force people into hasty decisions about their care. Case in point was a female client with dementia whose husband, her devoted caregiver, died unexpectedly.

“Too often, that question of, ‘What do we do about Mom or Dad?’ is being asked when there is a crisis,” says Lang. “While I see a great desire on the part of many seniors to age in place at home, that can have its own complications if you don’t have the ability to put good systems in place.”

THE ASSISTED LIVING BOOM
For those who can afford it, assisted living communities, where residents live in their own apartments but receive additional care and support, have become an increasingly popular option. The appeal is that these facilities tend to offer round-the-clock care in socially dynamic environments where residents can still enjoy the privacy of their own apartments. Some luxe local communities boast everything from swimming pools and day spas to French lessons and yoga classes.

By the year 2040, the U.S. Census Bureau estimates stock of this type of senior housing in the United States will have doubled. That trend is evident in Fairfield County, where it seems an assisted living facility is now populating prominent corners from Greenwich to Fairfield and there are several more in various stages of development.

“Done right, assisted living can actually begin to turn back the clock,” says Ted Doyle, vice president of marketing and communications for LCB Senior Living, a regional manager and developer of luxury assisted living facilities. Its local properties include The Residence at Summer Street in Stamford, The Residence at Selleck’s Woods in Darien and, soon, The Residence at Westport (set to open in summer 2020). “If you are in a good facility with the right supports and social opportunities,” he says, “you almost get to be yourself again because some of the isolation you’ve been experiencing ends.”

Doyle says that some of the most progressive senior living communities, including LCB’s, recognize that many seniors experiencing age-related challenges still want—and deserve—to be deeply connected to the world around them. “While bingo and a glass of wine can be fun, our focus tends to be more on stimulating engagement; things like foreign language lessons, lectures, yoga or Tai Chi classes,” he explains.

IS IT THE RIGHT FIT FOR YOU?
“I start to talk about assisted living as an option whenever I see someone really struggling with the tasks of daily living,” says Nancy Becker, supervisor at Hartford HealthCare’s Center for Healthy Aging, which provides free referral and assessment services to seniors and their families throughout the state. (The service is expanding in Fairfield County due to Hartford HealthCare’s recent affiliation with Bridgeport-based St. Vincent’s Medical Center.) “The things that start to worry you are when people can no longer tend to basic things like meal preparation, personal hygiene, managing their medications or just running errands,” she says. “If someone has lost their ability to drive, you are also dealing with greater isolation, which can also lead to a lot of depression. One challenge builds on the next, so that the person really starts to decline.”

The onset of dementia and diseases, such as Alzheimer’s, is another reason many families consider assisted living communities, as they provide a level security and attention many families want for their loved ones, Ann Jamison adds.

“A great deal of what many decisions come down to is proximity and a sense that you believe the person moving in will be well cared for,” says LCB’s Ted Doyle. “For many families, the idea that you can stop by to visit Mom on the way home from work becomes a major consideration.”

One downside to assisted living can be its significant costs. Unlike skilled nursing facilities, the price of moving in is not covered by federal programs such as Medicare or Medicaid. Fairfield County rents for these units can range from around $5,000 to $7,000 a month, often more for memory-care units.

“On paper, the costs can elicit some sticker shock,” says Doyle, “but one thing we encourage people to do is really crunch those numbers. Many people in Fairfield County have homes that hold a great deal of value that can actually cover the costs. When you compare costs for things such as property taxes, utilities, food, transportation, entertainment and housekeeping, “in many cases, assisted living is actually less expensive than staying at home, especially if there’s substantial care involved.”

Yet Becker notes for many seniors, the costs of assisted living can be prohibitive, particularly if they lack quality long-term care insurance or significant savings and other assets. She points out the same can be true of home-based care if someone requires round-the-clock live-in help.

Becker works closely with families to evaluate all their financial options before ruling anything out. “If a house needs to be sold to afford it—and often that’s the case—a bridge loan can sometimes help. Sometimes, children will step in to help cover the rent until the house is sold or other assets are liquidated.” She also notes that there are some limited benefits available for veterans and, on rarer occasions, help available through community-based housing programs.

WHEN IT’S TIME TO MAKE A CHOICE
Tour an assisted living facility and, inevitably, you’ll be warmly greeted by the marketing team and gifted upon your departure with a freshly baked pound cake or some other decadent treat to serve as an enticing reminder that you or your loved one will feel right at home.

To get beyond the allure of the goodies, Doyle urges “trusting your gut” when making these important decisions. “Pay attention to everything,” he stresses. “If you are on a tour with the executive director, are they greeting the residents by name? Are the maintenance people doing the same? If you see something that touches you when you walk through, going with that feeling can be really important.”

Two years ago, Jane, an eighty-three-year-old widow from Westport, put her Colonial on the market and moved into an assisted living facility in a nearby town. Her decision came months after she suffered a serious fall and learned she was in the early stages of a progressive neurological disorder. After weeks in a rehab facility, she reluctantly accepted the fact that she could not safely return to her sprawling two-story home without major renovations and daily help.

“The idea of leaving my home was a tough pill to swallow, but the reality is that my health will continue to decline, and I will eventually need a lot more help than I do right now,” explains Jane, who asked that her full name not be used because she has not shared details of her medical condition beyond immediate family.

While Jane’s two adult daughters asked her to move in with them (and she briefly took turns doing so with both), she opted for a one-bedroom assisted living apartment in an effort to maintain some cherished independence.
“I adore my daughters and their families, but I’ve lived alone for fifteen years and I’m just used to it.”

The residential community she chose now has her living two miles from one daughter and fifteen from the other.

Jane speaks warmly of a staff caregiver who helps her daily with light chores and dressing. She also enjoys a Tai Chi class on the premises. While she says it took time to get used to taking meals in a communal dining room, “I have lots of help with things I need help with, but still come and go as I please.” To that end, she was about to take a ride service to her grandson’s soccer game and then planned to spend the evening with his family.

Ann Jamison, whose dad, Dirk, died unexpectedly a few years ago, says after initially resisting the mere suggestion of assisted living, he became a happier more engaged guy within weeks of moving in. “The residents and staff became like an extended family. The day before he died, Dad was dancing and went out to dinner with friends,” she says. “As his daughter, I could not have imagined a more meaningful way for him to live his last decade.”


Resources

The Center for Healthy Aging at Greenwich Hospital: Recognized as a National Center of Excellence from the American Geriatrics Society, the center provides comprehensive services with elderly patients, including support groups. Fees are charged for most services, but many are covered by insurance. 203-863-4363

Hartford HealthCare Center for Healthy Aging: Provides free referral and assessment services to seniors and their families throughout Connecticut. 860-456-6785

LCB Senior Living: Luxury assisted living facilities, with locations in Stamford, Darien and, soon, Westport. lcbseniorliving.com

Senior Living Options: Founder Ann Jamison offers consulting services to seniors and their families guiding them on a variety of care options and even joins her clients for facility tours and related interviews. She receives referral fees from some of these care facilities if a client ultimately uses their services, but there is no charge for her services. 203-359-5777


TALKING IT OUT

For the adult children worried that older parents or relatives are struggling to live independently, discussing their needs can be intensely complicated. “Even in families with the best of intentions, these things can get tense, especially when you are talking about someone leaving a home where they have been for decades,” notes Roni Lang of Greenwich Hospital’s Center for Healthy Aging. “The conversations can open up old wounds and dredge up emotional baggage that’s existed in families for years.” Here are some tips for broaching this sensitive subject.

Talk Before It’s Necessary
“As difficult as it is to ask your parents how they imagine they would like to live if they needed help and care,” says Senior Living Option’s Ann Jamison, “having the conversations now, allows you to plan and consider your options before you’re forced into something.”

Choose Your Words Carefully
“Never attack anyone or put them on the defensive,” says Hartford HealthCare’s Nancy Becker, who suggests delineating concerns in the most nonjudgmental way possible. “State things you have witnessed in a very factual way without making it personal, critical or angry.”

Make It About You, Too
“Parents don’t want their kids to worry about them,” notes Jamison. She suggests saying things like, “I feel guilty that you seem to be having a hard time.” Otherwise, consider, “I am so busy, and I worry constantly that we are not doing enough to take care of you.”

Do More Listening Than Talking
Promote as much participation as possible from the seniors at the focus of the discussion. “Respect them for the mature adults that they are,” says Becker. “Try to really listen to what they want and from that you may be able to establish goals and next steps.”

Strive for Consensus
Siblings may approach their aging parents’ challenges with varying degrees of acceptance and denial, so try to have a family meeting (even scheduling folks in remotely) to get everyone on the same page. “Your sister out-of-state may think Mom is fine, but you may see her every day and be more acutely aware of her deterioration and need for support,” says Becker.

Expect Pushback
“Unless it’s a crisis, you may have to do a lot of back and forth with someone before things get settled,” says Jamison. “Don’t be surprised to take a step forward one week and go backwards the next, but the point is to have the conversations.”


TOUR CHECKLIST

While every expert we spoke with advised “gut feelings” matter when evaluating the merits of a senior living situation, each offered these insider tips for tours.

Look at the Location
“You want a place that’s convenient for the people who care about you to visit, so they can still take Mom to the grocery store or out to dinner,” notes Doyle. More remote facilities tend to offer lovely settings, but “if you want convenience, you may be better off on a main road close to town.”

Seek Sincerity
“Look for genuine and warm interaction between everyone on the staff and the residents,” advises Doyle. “Constantly ask yourself, ‘Will I feel good having the person I care about living here?’”

Try the Food
Are meals made-to-order? Is there a chef on the premises? Is there a set schedule or a come-as-you-please approach to dining? “A lot of places take a restaurant-style approach, where there’s a set menu and set meal times,” says Doyle. “But if Dad wants a steak or likes a late breakfast, it might be nice to live somewhere where he can get that when he wants it.”

Check the Social Scene
If you consider yourself or your loved one social, look for places where the community rooms and social calendars are lively, suggests Becker.

Take a Census
Low occupancy rates may be cause for concern, warns Becker.

Read the Fine Print
Ask lots of questions about what’s included in the monthly fee, advises Jamison. Is help with dressing, bathing and meals and other daily living services included? “Every company has a very different approach to how they bundle and price additional care services. Depending on your circumstances, some approaches work better than others.”

Set Priorities
Decide what matters most, says Jamison. “Proximity to family? Independence? Help with daily activities? Social opportunities?” Ranking these things “can often give you a clear sense of best fit.”

Do Due Diligence
Ask how long the management team has been in place and the ratio of CNAs (certified nursing assistants) to patients. Also: “Do research on the financial health of the company,” says Becker.

Try a See-and-Sniff Test
“If the place smells clean, it probably is,” says Becker. See if the grounds, sidewalks and common areas are well-maintained.

Count Square Feet
In some places a studio unit or something described as a one-bedroom is really tiny,” says Becker. “Make sure there’s enough room to live comfortably.”

Ask Who’s On
“It’s important to know that there are people working all the time who can help should your loved one need it,” says Jamison.

Visit Again (and Again)
Guided tours are great for first impressions, but follow-up visits can give you a better sense of the overall vibe. “Pop in at odd hours,” advises Lang. “Don’t ask questions of just the salespeople. Ask everyone—wait staff, maintenance folks, caregivers—you see.”

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