Power of Attorney – Common Questions

(The following article is designed to give general information to common questions about Power of Attorney and is not to be considered legal advice. If you have specific questions about your particular situation, please contact an attorney.)

As our loved ones age, their mental capacities generally decline as well. With that, they will eventually need a responsible individual to care for their financial and health affairs. Whether you feel your loved one is approaching such a time soon or not-so-soon, most attorneys will agree that now is the best time to prepare a Power of Attorney document. Why? Simply put, you will save yourself a great deal of heartache and courtroom involvement if you handle the paperwork while your loved one’s mental capacity is still in tact.

There are many misconceptions surrounding this powerful document so let’s look at some common questions to help clarify the issue.

What is a Power of Attorney and why do I need it?

A Power of Attorney is a legal document that empowers someone of your choosing to act on your behalf. It’s usually restricted to a specific matter. For instance, if you wish to close on the sale of real estate in another state but you are unable to attend personally, you could assign someone else as your POA agent to sign the paperwork and close the sale. In this typical POA example, the POA ends as the specified task is completed. If the person dies or becomes incapacitated, however, the POA ends also.

Since you are looking to care for the needs of your loved one as they become deficient in doing so, you will not need a typical POA. You will need a “durable POA”. A durable POA is similar to a typical POA except that the agency relationship established remains effective even if your loved one becomes incapacitated. In the event that incapacity should occur, you can maintain your loved one’s affairs without legal interruption. As the trusted agent, you will have the power to manage things such as their investments, pay their bills, and direct medical care.

Remember, an incompetent person cannot execute a durable POA. The person granting the power must understand what a power of attorney is, what it authorizes and be aware of the extent of his or her property. This awareness must be demonstrated to the satisfaction of the notary at the time of signing. If your loved one appears confused or incompetent, the notary is legally bound to refuse the signing.

What types of durable POA are there?

There are two types of durable POA: medical and financial. They are more commonly referred to as a “durable power of attorney for health care” and a “durable power of attorney for finances”. A frequent question about the two is, “Can I  just do one POA to cover both medical and financial?”. The simple answer to that is, “Yes, you could.”, but most attorneys suggest keeping the two separate. Keeping the two separate makes the job simpler for the agent. It also avoids unnecessarily revealing details of your loved one’s finances to their doctor or health provider and, conversely, offering health information to finance professionals such as CPA’s or brokers.

What doesn’t a Durable POA cover?

Durable power of attorneys are not without limits. They will not spell out the wishes of your loved one for future events. Such wishes would need to be addressed in a Living Will. The Living Will allows your loved one to specify parameters of their future care. It may include things such as whether or not to administer life-sustaining treatment if diagnosed with a terminal disease, or irreversible coma.

Many states combine the Living Will and Durable POA for Health Care” into a single document known as an “advanced health care directive”. Arizona is such a state that offers such forms. It is called the “Arizona Advanced Directive” and the forms can easily be found at www.azag.gov.

Do I need an attorney to accomplish this?

The short answer to this question is “No, an attorney is not a requirement”. You actually have several options for choosing forms in Arizona. There are Living Will and Health Care Power of Attorney forms published by the state of Arizona that you may use free of cost. They can be downloaded from the Arizona Attorney General’s Office website.

There are other acceptable forms that are valid as well assuming they adhere to state law requirements. Quicken WillMaker, for example, is an estate planning software program that allows you to fill in the blanks and spell out your loved one’s wishes. It is a great product that conforms to all Arizona state law requirements. Once the forms are completed, however, you’ll still need to adhere to the state’s signing, witnessing, and notarization rules.  (See Arizona Revised Statutes §§ 36-3224 and 36-3262.)

What objection will I likely face from my loved one?

An important thing to be aware of is that a durable POA is effective as soon as it is signed. In essence, your loved one will be putting much of their future in your hands immediately. Some are not comfortable with that idea – and have opted to use a “springing” Power of Attorney which can only take effect once a specific triggering event happens – such your incapacity.  However, these springing POA’s are more trouble than they’re worth and create more problems than they solve. For one, you (the agent) will need an affidavit showing the triggering event has occurred before the POA can take effect and that is quite a hassle involving doctors and lawyers. Even if you survive proving the springing event occurred and get the affidavit, you will likely have problems getting banks and investment institutions to recognize your power as the use of these forms is rare and they are sensitive to liability. The affidavit is problematic also because it can be deemed invalid in other states. The best way to overcome your loved ones inhibitions about the POA taking effect so soon is to have open conversations about the subject and build trust. Show them that they still maintain complete control of their lives until they need you to step in. And when that day comes, the transition will be seamless and less painful for everyone.

It can be a difficult topic to address with your loved one early but if a durable POA is not in place before some unfortunate debilitating event, you will likely have to go to court to get the authority to take over their affairs. Anyone who has suffered that process will undoubtedly tell you to prepare the durable POA sooner rather than later.

If you have any questions about the process or are in need of assisted living in the Phoenix metroplex, contact Transitions Assisted Living.  They are a small group of professionals dedicated to knowing the assisted living market.

Assisted Living or In-Home Care?

 If your loved one has reached a point where you no longer feel like they can adequately care for themselves, then you are likely weighing the pros and cons of assisted living vs. in-home care. It can be a difficult place to find yourself because we all want the best for our loved ones and sometimes the answer is not obvious. Balancing factors such of required care level, safety, personality, uncertain longevity and resources can make the selection process stressful. In an effort to help you make a wise choice, consider the following 3 big differences between assisted living and in-home care.

 

Costs

 

The major selling point of in-home care is that your loved one can stay in their existing home. It’s popularity is understandable because it is an obvious choice of least resistance. In other words, a move to assisted living is a bigger change compared to having a visitor helping with daily chores. Remember though that assisted living is a very misunderstood term because our older generations still falsely associate it with the poorly run nursing homes of the 70’s and 80’s. In fact, in-home care agencies are notorious for throwing around the “nursing home” term  – precisely because of these negative connotations. Assisted living today however is much different. In fact, many locations could more accurately be described as “resort-style living”. So the fear your loved one has of “the home” might be may actually be hindering them from enjoying a more fulfilling life – depending on their situation. In-home care is a fine option for those in need of such things as housecleaning, laundry, and cooking but it can become extremely costly as your loved one becomes more and more dependent. Let’s look at the numbers.

 

The cost of a single in-home caregiver costs between $20-$30 an hour and assisted living can cost between $1500-$4500/month. For the sake of comparison, let’s compare $20/hr of in-home care vs the average $3300/mo in assisted living costs. The typical rule of thumb in the senior living industry is that once 40 hours a week of in-home care is needed (8 hrs a day), then assisted living is the best option from a cost perspective. However, that rule is a broad sweeping and flawed generality. The math in this scenario is $20/hr at 8 hrs a day x 30 days in a month = $4800/mo. Even that number could be exacerbated by other costs as well. Costs such as their mortgage/rent, electricity and water, cable tv, etc. The cost of assisted living on the other hand includes all such costs while providing 24 hr care. The point is that even 20 hours of in-home care could be unreasonable financially depending on varying situations. So, know what your loved one is paying a month, and compare it to the cost of assisted living to see what makes sense. 

 

Imagine if you were able to find quality assisted living for $2500/mo rather than $3300/mo. That could even make 20 hours a week of in-home care look like an unwise financial choice. It’s a juggling act for sure but costs are critical to those that have set incomes. Keep a long-term perspective and stretch your loved one’s resources further. 

 

Social Interaction

 

Anyone in the medical community will tell you that social interaction is critical to living a happier and fulfilling life. As our loved ones age, it’s common for them to begin avoiding social situations outside of family get togethers. They may even say that they prefer to be alone. More times that not however, this is just a defense mechanism to hide the fact that they do not feel comfortable doing things they once did. A walk to the neighbors house, for instance, may be a terrifying thought for them because they fear the idea of a trip or fall. 

 

In-home care is great for providing companionship a few hours a day but there is only so much social connection a lone caregiver can offer. Conversely, assisted living, offers a larger community of like-minded peers and social opportunities conducive to building friendships. In fact, many assisted living locations have event coordinators who plan movie nights, BBQ’s, games, crafts and outings. When you consider your loved one’s happiness, consider their style of socialization and personality as well.

 

Specialized Care

 

The moment you begin contacting assisted living communities or in-home health companies, you can expect to be asked what type of care level your loved one is in need of. A physician will need to give you specific direction in that regard but if you feel like your loved one will be in need of specialized care in the near future, you may want to consider the 24/hr a day specialized care assisted living can offer. For instance if your loved one shows signs of slight dementia or memory loss, then in-home care would be a band-aid solution from a long-term perspective. Dementia is a degenerative disease that progressively requires a higher and higher level of care. You may have the greatest in-home caregiver but he or she cannot possibly meet your loved one’s needs during off hours which is perhaps the greatest drawback to in-home care. Many assisted living locations, however, offer multiple caregivers – 24 hours a day. In this way, they are better equipped to assist in emergencies and provide early treatment. 

 

Differing situations call for differing solutions but determining your loved one’s care level and near-future care-level are critical factors in the decision of assisted living vs in-home care. 

 

 

We hope this comparison of assisted living vs in-home care helped you gain insight into your situation. If you would like more information about quality assisted living facilities and their prices in the greater Phoenix, AZ area, contact Transitions Assisted Living. Transitions takes pride in knowing the market and helping you find that perfect assisted living location that meets your care level, location, and budget requirements. And, since their fee is paid by their partners, they provide their services to you free of charge. In the end, both assisted living and in-home care are fine options – depending on your specific situation.

 

A Map to Your Loved One’s Happiness

Ask any well-intentioned adult child what exactly they want out of their search for assisted living and they will almost always respond in some form that they just want their loved one “to be happy”.  That is the ultimate goal isn’t it? Unfortunately, many do not know exactly how to go about finding that perfect assisted living location for mom or dad. Transitions Assisted Living is happy to reveal to you their winning formula for resident placement and happiness.

Though it’s difficult to determine their origin, medical professionals overwhelmingly agree on the following “6 dimensions of wellness”:

  1. Physical
  2. Intellectual
  3. Emotional
  4. Social
  5. Spiritual
  6. Environmental

If the happiness of your loved one is paramount, you would do well to keep each of these in mind during your assisted living search. These are your roadmap to finding the perfect assisted living location. Let’s take a closer look at them.

Physical Wellness

There isn’t a medical professional worth their weight in salt that believes physical activity is not a major contributor to health and wellness. Take stock of what your loved one enjoys doing and the extent to which they can be active. What motivates them to move? Maybe they like to go for walks. There are facilities and locations that have ample room to walk around and even outdoor walking tracks. Maybe they enjoy putting. There are locations with putting greens as well. Remaining active cannot be understated for both physical and mental health so make sure the location you choose has active opportunities that your loved one shows interest in.

Intellectual Wellness

Brain stimulation is extremely important to maintaining a healthy lifestyle. Consider your loved one’s creative outlets or interests as it relates to their mind. Do they like learning new crafts or painting? There are facilities that offer related classes. Do they enjoy games or stimulating conversation? Consider a location that has like-minded residents. Simple conversation alone promotes critical thinking and creativity skills. Does the facility you are considering look as though your loved one would get the intellectual wellness they need?

Emotional Wellness

The move to assisted living can be an emotional time of change. As a result, your loved one’s emotional wellness has much to do with you as a family and the caregivers/administrators of your assisted living facility of choice. That being said, be discerning in your facility consideration. Ask yourself, “Are these caregivers smiling?” And “Do these residents appear happy?”. Ultimately you want caregivers who consider the feelings of their residents and treat them with respect and dignity. The family’s role cannot be understated here either. Your frequent visits can accomplish more for your loved one’s emotional health than any other single thing. So, provide your loved one an emotional outlet and commit to visiting as often as possible.

Social Wellness

The resounding sentiment in the medical and psychological community is that people who have more meaningful social relationships are healthier, happier, and even live longer. This reality makes a strong case for the popularity of modern assisted living. If your loved one’s mobility is declining, it is safe to say their opportunities for social interaction are as well. Many of our elderly wish to stay in their homes alone but isolation from social opportunities is detrimental to their health. Their resistance could most likely be characterized as a smoke screen to avoid change. Consider your loved one’s social health. What type of people do they gravitate towards or connect with? Are the residents in this assisted living facility mostly lower-functioning or can my loved one connect here socially? These are great questions to ponder in your search.

Spiritual Wellness

Spiritual Wellness can mean many things to many people but everyone has the need to feel as though their life has meaning and purpose. As it relates to your loved one, be sensitive to what fulfills this need in life. Certainly religious faith can be categorized here and there are many assisted living facilities that are predominately Catholic, Jewish, etc. Even locations of no religious affiliation may offer on-site church services or pastoral ministry. If faith-based activities are important to your loved one, see what the assisted living property offers. Perhaps personal meditation is important to your loved one. Then try to make an effort to get them a more private room. Opportunities for your loved one to experience nature can provide spiritual healing as well. The bottom line is to be aware of what your loved one needs to be spiritually well.

Environmental Wellness

Environmental Wellness refers to our understanding that our surroundings have a direct impact on personal well-being. A cramped living space, for instance, with an obstructed window view can cramp one’s environmental wellness. More modern assisted living properties incorporate large great rooms, shaded patios, or community centers for this very reason – so that their residents have that sense of comfort in their environment. A feeling of connection to nature can go a long way in improving your loved one’s environmental wellness too. Things such as meditation gardens, elevated vegetable gardens, or even bird watching opportunities from a shaded patio can be found at select assisted living locations.

 

There you have it – the Transitions formula for senior placement success. These 6 points of wellness are not easy to achieve for your loved one but, they are determining factors for a successful assisted living placement. Their complex interaction can ultimately make or break one’s quality of life. And a great quality of life is what your loved one deserves!

(Learn more here about what Transitions can do to place your loved one free of charge!)

My Search For Assisted Living: An Interview

The search to find the perfect assisted living location for a loved one is a daunting task. If you are facing such a search, you undoubtedly feel the weight upon your shoulders to make wise decisions that best fit your loved ones care needs, personality, location, and budget. Below is an interview with Tracy J (abbreviated per her privacy request) who recently faced such a search.  

 

Interviewer: “Thanks for agreeing to do this interview Tracy. Our hope is that others who are facing the task of finding the right assisted living location for their loved one will find comfort in relating to your real-life search.”

 

Tracy: “Of course. I’m happy to do it.”

 

Q: “So, tell me, when did you come to the realization that your mother was in need of assisted living?”

 

A: “Well, I remember it well because it was just before Christmas, 2015. My father had passed two years before in 2013 and I felt the need to check in on mom at her home more often…. which I did about 3 times a week. But it wasn’t until Christmas time, when I was able to spend larger periods of time with her, that I really became alarmed about her living alone.”

Q: “What specifically do you mean? What was it that alarmed you?”

 

A: “Well, it started with small things that, now looking back, I wish I had paid more attention to. For instance, I remember mom telling the same story at the dinner table that she had already told us earlier that day. My husband and I made eye contact as she told it again but I just discounted it to old age. Then, later, she forgot to take her medications which I reminded her about. But again, I reasoned in my mind that it was an honest mistake. Really, I wasn’t truly alarmed until we began cooking Christmas dinner. That’s when I noticed her clumsiness around the oven and stove. In fact, I had to insist that she sit down after mishandling a pot of boiling water.”

 

Q: “Wow. So when did you decide to begin your assisted living search?”

 

A: “Well, when the holidays were over, mom went home and our busy lives picked up where they left off…..my husband and I went back to work, kids went back to school, homework, soccer practice, gymnastics, planning dinners….you know…..life. But at night I just couldn’t sleep. I was worried. I mean, we had a home health company doing groceries and laundry for her but those couple of hours a day were a far cry from the 24 hour care I knew she needed. I had a string of anxious nights when my husband and I finally made the decision to approach her about assisted living.”

 

Q: “How did it go? What was the conversation like?”

 

A: “Well, my husband and I knew enough not to come on too strong with the idea. My mother is very strong-willed and I suspected she would be resistant. First I contacted my sister because I knew she would want to be involved. With her on board, we decided to continue with the frequent visits but now with a plan to intentionally steer the conversations towards her plans for the future. We really wanted it to be her decision and not ours….you know….but change for her is difficult to digest. That’s why we made an effort to bring up the subject as naturally as possible – over time.”

 

Q: “How long did it take for your mom to warm up to the idea of assisted living?”

 

A: (laughing) “Not as fast as I would have liked! Like I said, I was such a wreck with her home alone so much, so I wanted to move forward right away…..But I knew that would not be respectful of her feelings so I tried to put myself in her shoes, you know? I think that served me well. Had my sister and I sat my mom down and voiced all of our concerns and told her what was best for her, I think she would have felt disrespected and miserable no matter where we placed her….No, I think we spoke to her increasingly about options and what she wanted for the future over the course of 5-6 weeks or so.”

 

Q: “So, at what point did you see that she was open to assisted living?”

 

A: “Well, it wasn’t like a light came on so to speak and suddenly she wanted to make the move. She was open only….and I mean only…to taking a look at assisted living properties after about 5-6 weeks of heart-to-heart conversations. We did our best to help her see the true nature of the situation and when we felt it was appropriate, we voiced our own concerns in a loving way as well.”

 

Q: “Okay. Well, how did you decide what locations to show her?”

 

A: “Well, during that 5 or 6 week time that we were trying to get an idea of mom’s level of resistance and having conversations about her future, I was trying to research online to be prepared for that moment …..when she might agree.”

 

Q: “How did the research go?”

 

A: “Like I said, my husband and I were very busy with our jobs and kid activities and visiting mom so most of my research was done late at night. It was exhausting but after about a week or so I had found a few locations online that looked good to me. I called a couple and made plans to visit both.”

 

Q: “And what happened?”

 

A: “Well, the first assisted living facility I took a look at was about a mile from my home. I met the manager but I could tell right away that it was not going to work for mom.”

 

Q: “Why?”

 

A: “It was a small group home with very low-functioning residents. The manager was very nice but the residents did not look especially happy and the caregivers didn’t seem especially happy – one caregiver had such a thick accent that it was difficult to understand what she was saying.”

 

Q: “What about the second facility?”

 

A: “Well, the next location I visited was a similar situation. In fact, I remember a terrible odor as soon as I entered. I knew that this location would not work either but I felt obligated to sit through the whole sales spiel again. I remember the manager there mentioning that there were over 2000 assisted living locations in the Phoenix area and that’s when my heart sank into my stomach……because I knew I was in trouble. I felt like I needed a friend that knew the market or something……someone to help point me in the right direction.”

 

Q: “So what did you do?”

 

A: “Well, I remembered in my research that there was a local company in Phoenix called Transitions Assisted Living that helped people find quality assisted living in the Phoenix area at no charge to their clients. I looked them up and submitted my information online the next-“

 

Q: “No charge to their clients? How does that work?”

 

A: (laughing) “Yes, I was skeptical too at first but their fee is paid by their participating partners – a ‘bird-dog’ fee you might say.”

 

Q: “So, I imagine the facility pads your monthly fee to cover the finders fee expense then?”

 

A: (laughing) “You and I think alike……I thought the same thing…..But actually, no. I asked (senior living associate) about that myself. As it turns out, they (Transitions) have gone out of their way to make sure the prices quoted are the same whether I used their services or not.”

 

Q: “Ok. So then what? Were they helpful to you?”

 

A: “Absolutely. They were amazing. They called me the next morning and we had a short discussion about my mom’s care needs and personality. They asked me about my target area of town and price range and how I wanted to proceed. Within a matter of about 48 hours, I had detailed information on a handful of assisted living properties that were highly recommended for my mom.”

 

Q: “What do you mean by ‘highly recommended’? What did they do that you couldn’t?”

 

A: “Well, for one, they had already physically toured the facilities in my area, interviewed the administrators, and knew what each facility had to offer. That was huge to me because the one thing I knew was that I didn’t want to continue stretching my schedule to make time to visit locations that were a waste of my time…..you know? Another eye-opening thing for me was when I mentioned my poor assisted living experiences to (senior living associate). I told him the names of the facilities and it turned out that they both had been recently cited for health and safety violations. That’s really when I knew I was finally on the right track.”

 

Q: “Ok. So was there a difference in the facilities they recommended and the one’s you toured on your own?”

 

A: “There was a difference. I had 5 locations to see at first. They were all highly ranked by the Transitions touring team and I could see why right away……because the administrators were gracious and the residents appeared happy and very well cared for…..playing board games, laughing……I remember one older gentleman liked to paint and there he was painting away. It was different for sure.”

 

Q: “What about the price?”

 

A: “That’s a great point. I’m a price hound myself. I like to get the most for my money but at the same time I didn’t want to sacrifice mom’s happiness. I mean, I knew we needed to stretch moms money as far as possible but she wasn’t going to be okay with any old property. After speaking to (Transitions) about the budget, he was able to really focus in on a “sweet spot” you know? I guess what I mean by that is that the locations he recommended were amazing balances of my “must haves” such as budget and care quality while being flexible on other things that were not so important.”

 

Q: “I’m not sure I know what you mean.”

 

A: “Well, for instance, the location where my mom ended up would have never been on my radar….. had I gone at it alone I mean. I realized that my initial location requirements were selfish and I needed to be more flexible for my mom to be happy and comfortable.”

 

Q: “Interesting. So how does this story end?”

 

A: “Well, we toured about 6 or 7 places and mom decided on an amazing assisted living group home that my sister and I could not be happier with. The care givers are great. The facility is beautiful with a covered patio in the back. There’s no work for her to do around the house or reason for me to worry at night. You know…there’s a small elevated garden in the back she likes to tinker with….She plays board games and watches her shows. And it’s close enough for my sister and I to visit often.”

 

Q: “I’d say that’s a great outcome….wasn’t it?”

 

A: “Yes, it definitely was.”

 

Q: “Tell me, would you recommend Transitions Assisted Living to others in a similar situation as yours?”

 

A: “Absolutely. I know in my heart that I could have never found such a perfect fit for mom without the help of Transitions. My greatest fear was to have to move her more than once and lose her spirit in the process. Transitions was the advocate I needed. I’d recommend them to anyone.”

 

Interviewer: “That’s great Tracy. Thanks again for your time and I wish you and your mom the best.”

 

Tracy: Of course. It’s my pleasure.

Balancing the Costs of Assisted Living

If you’ve just recently began your search for assisted living then you’ve likely found yourself trying to make sense of the wide range of prices in the market. The truth is that there are many factors that can affect the price of assisted living. Here are a few of the major contributors to pricing.

1) Quality of Care. As your loved one’s advocate, this is the fundamental essential cost you’ll never want to skimp on. Quality care givers demand to be compensated fairly. The last thing you want is to place your loved one in a facility with poorly compensated caregivers who are there only for the paycheck and do the minimum they can get away with. But how do you really know the difference between a great caregiver and a marginal one? There are a handful of ways that are cumbersome but let us offer a great but simple litmus test. The difference is in the heart. At Transitions Assisted Living we have toured hundreds of facilities and we’ve discovered that one of the most important questions to ask yourself is: Do the caregivers smile? – not just smile – But do they smile with their eyes so to speak? This will give you excellent insight into knowing their hearts and the contentment level of the staff. More importantly, it’s indicative of the quality of care you can expect when nobody is looking. A great price cannot be at the expense of quality care.

2) Care Level. The greatest single factor that will affect your price for assisted living is your loved one’s care requirements. Unfortunately, it is also the cost you will have the least control over as well. The care level needs to be determined accurately by way of a doctor’s assessment. When considering any assisted living location, you can expect one of the first questions you’ll be asked is, “Has an assessment been completed?”. Simply put, the assessment is meant to indicate how much daily attention your loved one will require. An independently mobile resident in need of meals, laundry services and the like will cost less than those who require help out of bed, assistance eating, etc. The highest jumps in assisted living costs are associated with those in need of memory care, heavy residents, night wanderers,  and combative residents. Residents in need of memory care relate to those suffering from Alzheimer’s or dementia. These residents require significant safety precautions and attention. Heavy residents are difficult to care for as well because they require multiple caregivers and/or a hoist in order to transfer them. Residents who sleep during the day and wanderer during the night are also problematic and require a greater deal of attention. And lastly, combative residents pose a threat to their surroundings and require the highest of attention levels.

3) Accommodations. There are 2,000+ assisted living facilities in the greater Phoenix, AZ area. Their competition has produced seemingly endless accommodation options to choose from. If your loved one has a special interest, there’s likely a facility that can accommodate.  Was your loved one a golfer? There are locations with putting greens. Do they enjoy activities? There are locations with activity directors who plan them daily. The thing to remember when balancing costs is that the facilities who offer the most accommodations under one roof will charge accordingly. An excellent way to curb costs is to determine your loved one’s top couple of interests and locate a facility that offers those things but does not offer an exhaustive list of accommodations. For instance, your loved one may like movie nights and board games but has no interest in sight-seeing on a bus. In that case, you will likely save costs by locating a facility that does not incur the costs of owning and operating a bus.

4) Amenities. Amenities relates to the quality of the facility. For instance, a particular facility may be able to get away with charging more because they have vaulted ceilings, large shaded patios, or remodeled rooms. At Transitions, our experience has been that this is an amazing opportunity in terms of cost savings and really offers a “sweet spot” in the endeavor to balance costs. An older facility, for instance, that may be in need of some updates but has well-compensated/happy caregivers, smiling residents and offers a moderate list of accommodations is where you will get the best bang for your buck.

5) Private vs Semi-Private Rooms. Another way to curb costs dramatically is to be open to a shared or “semi-private” room. The thing to remember here though is that everyone prefers a private room. If you ask your loved one at the beginning of your search if they want a private or semi-private room, they will always choose private and now your costs just became less manageable. In reality, semi-private rooms can be great deals. In group homes for example, the master bedroom is often designated for semi-private use. The two residents actually have more space in the master than the smaller private rooms have – and they pay less as well. By not closing your mind to the idea of a shared room, you may find a gem and balance costs as well.

6) Private vs Shared Bathroom. A great way to save costs is to be open to a shared bathroom. Obviously a private room with a private bath is the most luxurious option and thus costs the most. But, if your projected costs are higher than you would like because your loved one is insistent on a private room, then consider a private room with a common bathroom area. In this way, your loved one will be comfortable with privacy while still curbing costs.

7) Location. “Location, location, location” is a common theme in the real estate market and the same applies to the costs of assisted living. As with any location, there are higher and lower rent districts. As a result, owners who operate facilities in higher rent districts have higher overhead and require more from their residents in monthly fees. In order to balance costs, you’ll want to consider the importance of location. Most people would like their loved one to be close to their home. However, if you are making an effort to curb costs, you may want to consider keeping them close to an area you frequent instead.   For instance, if you live in Scottsdale, AZ which happens to be a higher rent district, but you work in Tempe, AZ, perhaps you could consider a location for your loved one in Tempe in order to reduce costs. Resist closing the door early on locations. You may be glad you did!

8) “Not Included”. When balancing assisted living costs, don’t forget to consider the needs that are NOT included in the monthly price. For example, pharmaceutical products and toiletries such as adult diapers and colostomy bags are often required to be supplied by the family above and beyond the agreed monthly price. Also, does your loved one currently enjoy getting manicures or having their hair done? If so, there are facilities who set hairdressing and manicure appointments but the prices are not included in the monthly payment for care. So before agreeing to move your loved one in, make sure you are aware of what additional costs will be necessary.

Balancing the costs of assisted living is not easy. Adding the additional difficulties of finding an excellent overall fit for your loved one has proven to make the search even harder. It’s a tough spot adult children find themselves in trying to balance costs, location, interests, etc. Transitions Assisted Living offers their industry expertise to anyone who may like some help in their search. Since Transitions is compensated by their participating partners, they are able to offer their services to you free of charge. We hope these major contributors to cost will help you balance costs effectively. Happy hunting!

 

Solving The Senior Living Puzzle

The term “senior living” is a commonly used phrase that encompasses a wide range of living options and care types. It’s easy for seniors or adult children to become frustrated in trying to make sense of it’s many segments. Let’s take a closer look at the pieces that make up the senior living “puzzle”.

1) Retirement Communities. Retirement communities or “55+ communities” are designed specifically for seniors who are active and widely self-sufficient. The most distinguishing factor for these communities are that they consists of a conglomerate of single-family homes that are able to be bought and sold like any other home. The community leaders provide a wide variety of services, activities, and social programs and the property is usually surrounded by golf courses and dotted with social centers.

2) Independent Living. Retirement communities and independent living facilities are closely related but easily confused simply because they both consist of seniors that are largely independent. However, as a general rule, independent living is most commonly meant to describe a living arrangement involving rentable apartments or detached condos on a common property. Again, there may be surrounding golf courses and social centers complete with prearranged activities but this style of senior living is much more service oriented – much like a hotel. House cleaning and laundry services, for instance, are provided. The resident is not responsible for yard maintenance and meals are provided if the resident prefers. Also, there are administrators on the property at all times in the event of an emergency.

3) Assisted Living Home Care. Assisted living homes are residential facilities that provide care for up to ten residents at a time. They are licensed and regulated by the Department of Health who audits them periodically. Within assisted living home care, there are 3 levels of care a facility may be licensed for: Supervisory, Personal or Directed. Perhaps the best analogy to convey the 3 differences is with the act of brushing teeth. That is, supervisory care is being present and mindful that a resident is brushing their teeth. Personal care would be where a caregiver prepares the toothbrush and water for the resident, and directed care would be where the caregiver is hands-on actually brushing a resident’s teeth. With that in mind, take a look at a more defined explanation of the 3 care levels.

  • Supervisory Care can best be characterized as general supervision. Caregivers have daily awareness of the resident’s functioning and continuing needs, while having the ability to intervene in an emergency. Medication management and  assistance in the self-administration of medications are included as well.
  • Personal Care goes a bit further than supervisory. It relates to what the state defines as “assistance with activities of daily living that can be performed by persons without professional skills or professional training”. Personal care would include things like coordinating intermittent nursing services or the administration of medications and treatments by a licensed nurse.
  • Directed Care is the highest level of care a residential care home can be licensed for and may include memory care as well (see memory care below). It includes personal care services and is designed to provide protection to those who are incapable of summoning assistance, recognizing danger or able to understand their own pressing needs.

There are close to 2,000 of these locations in the greater Phoenix, AZ metroplex and that number is continually on the rise. Like any industry, there are excellent care homes and not-so-good ones. You’ll need to do your homework. Luckily, Transitions Assisted Living, LLC has done the work for you and offer their services free to you as their fee is covered by their participating partners.

4) Assisted Living Centers. Assisted living centers are commercial care facilities that care for 11 or more residents. Generally speaking, they are larger facilities caring for over 100 residents and offer private rooms that feed into large common areas. They too must be licensed for the 3 levels of care outlined above (supervisory, personal, and directed). Though assisted living centers offer a great deal including more social opportunities, they have differing amenities, price ranges, and price adjustments.

5) Nursing Homes. The term “nursing home” has become a generic term that people use whenever it has been determined that nursing services are needed. However, it can mean one of two different things: skilled nursing facilities or nursing home care. Nursing homes are defined by the government as “Skilled nursing facilities”. Skilled nursing facilities provide 24 hour skilled nursing services, and have a doctor on call at all times. Many confuse skilled nursing facilities with “Nursing home care” which is used to indicate the need for skilled nursing services but not necessarily the need for continual nurse oversight. Some people immediately assume that because their loved one is in need of skilled nursing services that they must look strictly for a skilled nursing facility that provides 24 hour skilled medical services. Depending on the situation, that may not be necessary. Intermittent nursing services are an option for those not in need of 24 hour nursing services and can be provided at many assisted living facilities. Caregivers may not be skilled nurses but they are open to scheduling skilled nursing or physician visits that can satisfy the needs of their residents.

6) Memory Care. Memory care is among the highest level of care available today. It is designed specifically for those suffering from such things as dementia or Alzheimers. Today there are many facilities who cater specifically to those suffering from memory impairment of some kind and have features such as private apartments and secured common areas for safety. Planned activities are often provided as well in order to support their resident’s quality of life.

Sometimes it can be difficult to know where you or your loved one fits into the differing segments of senior living. Transitions Assisted Living understands how important it is to find that right location for your loved one. They have been serving seniors for years and offer their expertise free to you. Hopefully this has helped you better understand where your loved one fits into the puzzle of senior living.

The Greatest Assisted Living Myth – Exposed

Are you an adult child beginning your assisted living search for a loved one? If so, beware of the greatest assisted living myth that has born regret in so many before you – the myth that all assisted living facilities are essentially the same. This false assumption  is a prevalent notion that has many detrimental effects. In fact, the majority of complaints and discontent of assisted living residents can be traced back to this very belief. Adult children who had never given much thought to assisted living often find themselves having to make a decision about their parent shortly after an unfortunate fall or medication mishap. This stress combined with the existing demands of their own family and careers makes it easy for this myth to take root. Let’s take a closer look at some statements that lend themselves to this myth.

1) “All assisted living facilities are regulated by government agencies, so they’ll all take good care of my loved one”.

FACT: Yes, it’s true that all assisted living facilities are regulated by government agencies, however, any given facility could have any number of violations. Such violations can range from nominal paperwork mismanagement to serious health and safety violations.

2)” I’ve researched many facilities online and they all seem to offer the same quality services.”

FACT: Just because a facility has a dominant internet presence doesn’t legitimize them as a top-notch facility. In fact, a case could be made for just the opposite. Excellent facilities with great caregivers are typically at full capacity. If they have an opening, it will likely be short-lived. As a result, these locations do not feel any pressure or need to market themselves online. In fact, some do not even own a website. On occasion successful facilities will open additional locations which are great opportunities to jump on – or even wait for.

3)”The facility owners/managers are caring individuals and run assisted living facilities because they care about the elderly.”

FACT: Unfortunately some facility owners are more interested in being profitable than caring for their residents. Although the owner is ultimately liable for health and safety violations and the performance of their places, many of them hire a manager to oversee the caregivers and day-to-day operations. As with anything, there are good managers and bad ones. The bad ones rack up a list of violations at one facility, where they are fired, and then pop up as a manager at a different facility. You would be wise to know the managers past. As a general rule, an involved, hands-on owner is a big bonus.

4) “Facility residents are all in need of assistance with activities of daily life so my loved one will fit in just great with them.”

FACT: Not all assisted living residents are the same. If your loved one enjoys playing games, having conversations and socializing, then why place them in a facility with lower-functioning residents? Consider your loved one’s personality and spirit. If they prefer to keep to themselves and watch tv, then they will probably not appreciate a location that plans frequent activities, celebrations and bbq’s. You’ll want to be aware of the existing resident personalities in the facility you are considering.

5) “I want my loved one to be close to my home so one of the facilities closest to me will work out perfectly.”

FACT: The locations closest to your home is more than likely not the best fit for your loved one. Be open to pushing your comfort zone as it relates to location and make an effort to balance desired amenities in the mix too.  For example, if your elderly mom really enjoys gardening, wouldn’t it be worth a small drive to know she is happy at a facility that has an outdoor garden to tend? Not all facilities offer the same amenities.

The myth that all assisted living facilities are generally the same is a typical assumption of those who simply haven’t had much experience with the topic. The unfortunate reality is that adult children feel the pressure to make pivotal decisions for their loved one quickly and with only a surface knowledge of facilities and their administrators. Fortunately, Transitions Assisted Living has done the necessary groundwork and research to help you locate the perfect assisted living facility in your area. They make it their business to know assisted living within the greater Phoenix metroplex. And, because they are paid by their participating partners, they are able to offer their services free of charge. Dispel the myth and locate the perfect place for your loved one!

 

Why is Mom Resistant To Assisted Living?

If you’ve ever presented the option of assisted living to your parent without careful thought about your approach, then it’s somewhat safe to say you’ve run head-on with avid resistance to the thought. The reality is that older generations generally oppose the idea because they associate assisted living with being “put away in an old folks home”. Nothing could be further from the truth but this is nonetheless a pervasive notion among those 70 years old and older. In order to understand why the resistence is so strong, you’ll need to step back for a moment and try to understand a little about the history and evolution of assisted living.

Older generations who are currently in their 70’s and 80’s were 20 and 30 years old in the 1960’s and 1970’s. At that time senior housing (as we know it today) was non-existent. Rather, seniors requiring daily assistance were unfortunately classified into a single category and moved into nursing homes. These homes were dismal and depressing places at best – and this is likely the mental picture your loved one paints in their minds when you mention assisted living.

Needless to say, the nursing home care industry earned itself a well-deserved poor reputation over the years and your parent likely witnessed their own grandparents bite, scratch, and claw through activities of daily life in order to avoid “the home”.

When 1979 rolled around, however, everything began to change. A new consumer-focused business approach began to evolve. The approach was wildly successful in the 80’s and continued to gain steam. By 1993, the government officially distinguished between four types of assisted living and by the year 2000, “quality of care” was the catch phrase of a new industry standard.

Yes, it is true that “assisted living” can be best defined as a type of housing intended for seniors that require some amount of personal or medical assistance. And, yes, your parent will likely associate this definition to mean the old nursing homes of the 60’s. However, that definition is but only a postscript to the amazing care homes available to seniors today. In fact, many facilities could be better characterized as resort-style living. Obviously not all facilities have comparable amenities or staff. You’ll need to do your homework but, as a whole, the industry is miles apart from the 1960’s “nursing home” stereotype. So, if you’re aware that this stereotype may be a driving force behind your loved one’s smokescreen of objections, it will help you address the true issue more directly.

Take a quick look at a shortlist of benefits and activities assisted living offers your loved one today:

– Daily Housekeeping Provided

– Laundry Completed

– Live Music – On-site Concerts

– Planned Outing Activities

– Monitored Nutrition

– Individual Apartments/Rooms Available

– Educational Classes

– Movie Nights

– Barbecues

– Medication Management

– Spa and/or Pool Access

– Social Opportunities

– Birthday and Holiday Celebrations

– Fitness Rooms

– Gardening

– Safe Environment

– Family and Friend Open-Door Policy

– Physical Assistance Available 24/7

– Transportation Buses: Prepared and Safe

– Board Game Tournaments

– Physical Activity Classes

– Spiritual Services

Assisted living can sometimes be a difficult topic to introduce but there has never been a better time than now to make the transition. As with all industries, assisted living still has room for improvement. Some facilities are definitely better than others as it relates to ownership, caregivers, locations, amenities, and prices. Fortunately, Transitions Assisted Living, LLC has already done the work to help you locate that very special assisted living Phoenix area facility. They are truely the assisted living Phoenix AZ specialists supporting you and your loved one’s smooth transition.

Objections are a natural part of the assisted living conversation. Hopefully this insight into the past will help you understand your loved one’s apprehension and allow you to have more productive conversations in the future.

Top 7 Signs It’s Time For Assisted Living

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When is it the right time to move a parent or loved one into assisted living? This is a question adult children are faced with more and more as the baby boomer generation ages. Unfortunately the majority of these decisions are made immediately following a senior’s fall or similar unfortunate event.  Adult children are flung into a situation where they must make multiple big decisions – and quickly. These questions may include:

  • How will my loved one respond to the idea of assisted living?
  • What assisted living location best fits my loved one’s personality?
  • What assisted living location will best fit my loved one’s budget?
  • How will my loved one respond to the idea of moving out of their home?
  • What assisted living location is convenient for me and my family to visit?
  • Will my siblings and I agree about the move to assisted living?
  • Should I sell my parent’s home?

If possible, it’s always best to plan ahead for such a situation and start leading conversations early. Hurried decisions during a time when one’s thinking is muddled with high emotions and stress is not the best position to find yourself. Here are the top 7 signs that the time for transitioning to assisted living may be drawing near.

1). Mismanaged Finances. Take a look where your loved one keeps their mail. A quick run through of their mail can tell you a great deal. Are payments up to date? Are there any “final notices”? Are there any nasty letters from creditors? Are there piles of unopened mail? Are there any overdrawn bank balances? Is there any evidence of a recent accident? Look closely. Difficulty in managing money is the most common sign of dementia.

2) Poor Diet and Hygiene. Give your loved one a good hug. Do they feel noticeably thinner? Heavier? Look in your loved one’s pantry and refrigerator. Are there any expired or spoiled foods? Try to get a sense of what their diet consists of. Does it look as though they are cooking for themselves or are they heating up microwave dinners? Early red flags of dementia include incessant snacking as mealtime begins slipping their mind. Do you notice any strange odors? Are their clothes clean? Are they wearing the same clothes as the last time you saw them? Poor hygiene may point to a lack of ability to accomplish daily acts of living.

3) Housework In Decline. Take a walk around the house and look closely. Are the plants dying? Is the laundry piling up in the laundry room? Is the trash being taken out and picked up? Are spills being cleaned up? If they have a pet, are they caring for them appropriately? Are the dog droppings being picked up regularly? Does the dog or cat appear healthy? Offer to check their mail and check the mailbox. Is it overflowing? Keep an eye out for obvious signs of forgetfulness.

4) Cognitive Awareness. Offer to play a board game with your loved one. You might try both a familiar game and a not-so-familiar one too. Do they have difficulty following directions? Do they need repeated prompts and reminders throughout the game? Do you notice a lack in judgement given the strategy of the game? This can give you a great deal of insight into any cognitive decline that could become a real threat to your loved one’s future well-being.

5) Driving Issues. Take a close look at their vehicle. Are there any dents or gashes you hadn’t noticed before? Are the tags current? Do the brake lights and turn signals operate correctly? Is the insurance card current? Are there any traffic tickets in the glove compartment? Ask your loved one when the last time they drove somewhere. They may be avoiding it because they no longer feel comfortable behind the wheel but don’t want to admit it openly. Is the mileage the same as last time you visited? Does the oil change sticker show the vehicle is current? If everything looks ok, find an excuse for them to drive you somewhere close. Do they need the radio off to concentrate? Are they verbally combative while driving? Driving well under the speed limit also is a common early sign that they are losing confidence in their physical abilities as a whole.

6) Deteriorating Personality. Take stock of your loved one’s activities and friendships. You can do this by taking a look at their calendar. Are they still involved in social activities? If you notice they are socializing less frequently, that may only be evidence of slowing down which is not uncommon. On the other hand, if your loved one is withdrawing from social activities, friends, or giving up hobbies, it could be a sign that their confidence is eroding. Try to get an idea of how often they leave the house. Flip the calendar back a few months to see if any hobbies have been dropped. A lack of companionship is closely linked to depression, so if you sense your loved one is feeling alone or isolated, it may be time to begin looking into assisted living.

7) Mental Irregularities. Since you know your loved one well, make an effort to take stock of their mental health. Do you notice that they have an increased amount of anxiety about events that are routine? Do they seem easily agitated about recent events on the news or typical events in their lives? If they are increasingly irritable or temperamental, it may point to deeper problem. All of these are early signs of dementia.

These are the 7 most common indications that the time for assisted living is drawing near.  Early detection of these can not only avoid stressful situations but also help adult children ease their loved one into the idea of assisted living.  Whether you are fortunate enough to have detected the signs early or if you find yourself in the emergency room with your loved one, Transitions Assisted Living is your advocate throughout your search for assisted living Phoenix AZ and assisted living Phoenix area.

10 Surprising Facts About Senior Falls

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In a recent study published by the CDC (Center for Disease Control and Prevention) one out of three seniors 65 and older experience a fall each year. Of these falls, one out of five are reported to result in serious injury such as a broken bone or head trauma. Adult children often ignore doctors and social workers that suggest seeking immediate help for their elderly parents after a single fall but the statistics certainly justify their sentiments. In fact, the study goes on to relate that falling once nearly doubles one’s chances of falling again and the probability of future falls increase exponentially from there. Consider some surprising statistics related to senior falls.

1) Two-thirds of those who fall will do so again within six months.

2) The risk of falling is greater for women than for men and increases with age.

3) An average of 9,500 deaths in older Americans are associated with falls each year.

4) Falls are the leading cause of death from injury among people 65 and older.

5) Of those aged 65 to 69, one out of every 200 falls results in a hip fracture.

6) Of those aged 85 and older, one out of every 10 falls result in a hip fracture

7) Over 250,000 seniors 65 or older are hospitalized with hip fractures annually

8) Of those seniors who fracture a hip from a fall, one-fourth of them will die within six months of the injury.

9) More than half of all fatal falls involve people 75 or over.

10) Doctors report that the most profound effect of a fall is diminished functioning associated with independent living.

It’s been said that sometimes the best way to win a battle is to avoid fighting the battle at all. Such can be said for senior falls as well. Avoiding falls can be achieved by close and regular assessment of how your parent is getting along independently and maintaining open and honest communication. If your loved one has experienced a fall recently and you have been considering a discussion about assisted living, plan early and consider your approach. Transitions Assisted Living who specializes in assisted living Phoenix, AZ, has published this comprehesive article to help you approach the subject with your loved one: How To Talk To Your Parent About Assisted Living. Make the decision today to help your loved one avoid the pain and suffering of an accidental fall.