One of the most difficult decisions a family faces is when to move an elderly family member into specialized housing.
How to start can be overwhelming, but if you follow certain steps, it can make the search more manageable.
One of the first questions you must answer is what kind of care your family member needs.
Virginia Traweek, of SeniorHousingMove.com in Dallas, said there are essentially four different levels of care offered by senior living communities, and it’s important to understand what each offers:
• Independent living. For seniors who don’t require assistance. Independent living is usually offered in either apartment or cottage settings and generally includes meals, housekeeping and social events. Costs can range from $1,000 to $3,000 a month, she said.
• Assisted living. For seniors needing assistance with activities of daily living such as bathing, dressing and eating. Costs range from $3,000 to $5,500 a month.
• Memory support/dementia care. For seniors with cognitive decline because of Alzheimer’s or other diseases. Costs range from $3,000 to $5,500 a month.
• Skilled nursing care. For seniors in the end stage of life who require care 24 hours a day. Costs range from $4,166 to $6,666 a month.
In addition, there are senior living communities that offer multiple levels of care on the same campus in what is called a continuing care retirement community, or CCRC.
For a CCRC, the entrance fee ranges from $150,000 to $400,000, with 90 percent refundable when you move out, Traweek said. Monthly fees range from $1,500 to $3,000, depending on whether the resident is single or in a couple and on the services provided.
A senior living community will want to assess your loved one’s needs before they move in.
“One of the most difficult things for family members is to be objective about the condition that their parents are in,” said John Falldine, managing director of the Edgemere senior living community in Dallas.
Here are other steps you should follow in choosing the correct senior housing:
• Start early. “Even if you think you won’t need senior care for a long time, learning about local communities, their pricing and amenities can make it easier when you decide to move,” said Traweek, a former senior housing development consultant.
Also, she notes that there are advantages to moving into senior housing before there’s a crisis.
• Visit the communities. This is critical. There’s no better way to get to know a community than spending time there.
When you visit, use your senses: sight, smell and hearing.
“Is it clean? Does it smell good?” Falldine said.
Also, notice whether residents are clean and how the staff interacts with them. Do they treat them with respect and kindness?
Vary your visits.
“Visit the place at least twice,” said Lue Taff, geriatric care manager at the Senior Source, a Dallas nonprofit. “If you visit on a weekend, you will get an idea of how the place operates without a lot of management staff there. If you visit during a meal, you will see more of the people who actually live there. You will notice if the staff is very helpful.”
When you visit, talk with the families of residents to get their insights.
“Talk with family members in the parking lot, because they will give you the real story,” Taff said.
Ask whether the facility has active family and resident councils, and speak to members about their impressions of the facility.
“How much authority does your resident council have to make decisions about the future of the community?” Traweek said.
• Understand the costs. Taff said some assisted living communities charge a monthly fee that includes things such as bathing, dressing and dispensing medication, while others charge a base fee and charge extra for “however much care you need.” That may include having meals brought to your home or getting assistance to get to the dining room.
Determine which fee structure best fits your needs and budget.
You should also ask: How does the community decide on increases in monthly fees? Does it cap yearly increases?
“In independent living, is it possible to purchase additional services from an agency or program that offers help with things like getting to the dining room, helping with medications or doing extra laundry and housekeeping?” Taff said. “What are those fees?”
It’s also important to know if there is an entrance fee to a community. This may also be known as a “buy-in” and can be substantial. Is the fee refunded after you move out or die? How long will your estate have to wait before getting the money back?
“Regardless of how much money you have, entrance fees aren’t cheap,” Traweek said. “It’s in your best interest to understand how a community will process your refund when the time comes.”
• Ask about health care. Be sure to inquire about how the senior living community will handle your loved one’s medical needs.
“What hospital will you go to if they call 911?” Taff said. “It will probably be the hospital that is closest to the facility.”
Are your loved one’s doctors and hospitals within the range of the senior community’s transportation services?
The bottom line is to trust your instincts when deciding on a place for your family member. And never move your loved one into a place that makes you uneasy or doesn’t feel safe.