thinking about senior living options? find the right home!

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Thinking About Senior Living?

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Old Paradigm – Step 1

IndependentLiving

AssistedLiving

SkilledNursingHome

Independent LivingEnjoying “carefree” life in the company of older adults


Independent Living

•  Private homes, condos, townhouses or apartments

•  Maintenance free: meals, basic housekeeping & laundry services

•  Impressive amenities & social calendar


What Does Independent Living Offer?

Active life with peers•  100 to 200 residents per community •  May enjoy meals in restaurant-like setting •  Wide range of organized gatherings, classes, clubs,

activities & outings



Luxury amenities•  Well-appointed lobbies & common areas •  Fitness centers, swimming pools, tennis courts, golf courses •  Club houses, game rooms, activity rooms, libraries, chapels •  Private meeting or dining rooms •  Beauty parlors & barbershops •  Onsite medical clinics •  Covered parking



A more convenient life•  Freedom from worry & isolation of home ownership •  Easier to order basic necessities & engage with others •  Shuttles to stores, medical offices & other local sites •  Built-in safety & security measures


How Much Does Independent Living Cost?

–  Initial “Community Fee”

– Monthly rent & fees total $3,000 to $5,000 (Johnson County, KS)

•  12-month lease

•  Monthly rent may increase at annual renewal

•  A la carte fees for meals, maintenance, amenities & special programs vary


How Do You Pay for Independent Living?

Covered by resident’s private funds•  Pension

•  Social Security

•  Proceeds from the sale of family home

•  Personal savings


When Do People Leave Independent Living?


When they need more than minor help–  Bathing, dressing, toileting & other personal care –  Taking medications or –  Meeting other medical needs

Communities require that residents-  Perform all activities of daily living on their own OR

-  Arrange & pay for any personal care services they need OR

-  Contract with private caregivers provided by the community


IndependentLiving

AssistedLiving

SkilledNursingHome

Assisted LivingEnjoying privacy & independence with a little help


Assisted Living

•  Simple apartments or private/semiprivate rooms

•  Maintenance free •  Assisted social & recreational activities •  Limited help with personal care: getting out

of bed, bathing, toileting, dressing, walking, medications


What Does Assisted Living Offer?

Help maintaining an independent life•  Onsite caregivers available round the clock •  Scheduled care & emergency response •  Nurse to monitor medical condition, oversee medications &

coordinate healthcare services •  A la carte billing for medical or personal services delivered by

onsite or visiting professionals


What Does Assisted Living Offer?

Peers with similar interests & abilities•  40 to 80 residents per facility •  Most meals served in group dining area •  Assisted activities & outings, designed to keep residents

engaged.


How Much Does Assisted Living Cost?

–  Initial “Community Fee”– Monthly rent & fees total $3,000 to $6,000 (Johnson County, KS)

•  12-month lease or month to month

•  Cost higher for private versus shared room

•  Monthly rent may increase upon renewal

•  A la carte fees for special programs & services vary


How Do You Pay for Assisted Living?

May be covered by•  Resident’s private funds

•  Long-term care insurance

•  VA Aid & Attendance benefit

•  In some cases, in participating facilities, Medicaid provides limited benefit to qualifying residents


When Do People Leave Assisted Living?

When they need more than a little help–  Bathing, dressing, toileting, walking & other personal care –  Transfers, especially those requiring 2 people or lifts –  Feeding –  Incontinence management –  Medication (insulin-dependent diabetes, IV therapies) –  Significant medical & behavioral concerns (e.g., infectious disease,

open wounds, intensive rehab or therapy, feeding tubes, aggression) –  Alzheimer’s or another dementia presents wandering, exit-seeking & other safety concerns



IndependentLiving

AssistedLiving

SkilledNursingHome

Skilled Nursing (Nursing Homes)

Complex medical care & extra physical assistance, 24/7


Skilled Nursing

•  Private & shared rooms in healthcare

setting •  Long-term medical & physical care •  Short-term rehab


What Does Skilled Nursing Offer?

Highest level of medical care outside a hospital

•  Skilled, complex medical or psychological care •  Physical assistance routinely includes feeding & 2-person

transfers •  Care directed by facility’s physician •  Nurse onsite round the clock •  Once the only solution for long-term care


What Does Skilled Nursing Offer?

Encouragement to remain engaged•  30 to 80 residents per facility •  Opportunity to share meals in group setting •  Group entertainment, assisted activities


How Much Does Skilled Nursing Cost?

$6,000 to $9,000 per month (Johnson County, KS)



•  Additional fees for special programs & services vary


How Do You Pay for Skilled Nursing?


– The only long-term care for which Medicaid pays 100% of costs of qualifying residents

– Also may be covered by•  Resident’s private funds



•  Medicare (only for specified short-term medical services)

•  Private health insurance

Old Paradigm – Continuing Care

IndependentLiving

AssistedLiving

SkilledNursingHome

Continuing Care Retirement Communities Attempting to provide for all long-term needs


Continuing CareRetirement Communities


•  Single campus may include independent living, assisted living & skilled nursing

•  Buy-in guarantees lifelong care within community

•  With either buy-in or monthly rental, residents move across campus as needs change, but remain members of umbrella community

What Does Continuing Care Offer?

Old friends & familiar places•  150 to 300 residents per community •  Atmosphere of “elder village” •  Remain in vicinity of friends & favorite amenities, even after

moving to different level of care •  Ideal for couples who need different levels of care but wish

to remain close together


What Does Continuing Care Offer?

With buy-in, long-term security•  Similar to buying home with long-term care insurance •  Popular choice if you have no one to oversee future care or

wish to make your own arrangements •  Nonprofit facilities may offer attractive safety net •  Critical to know – What entry fee covers – What portion is refundable (70 - 90%) & whether

community can afford to repay – Likelihood that advanced care will be available


How Much Does Continuing Care Cost?


– For purchase, initial buy-in fee (from tens to hundreds of thousands of $s)

– For rental, initial community fee + monthly rental

– A la carte monthly fees for meals, maintenance, amenities & special programs•  Buy-in fee may fund advanced care when needed •  More likely, funds limited number of days in advanced care

before additional fees are charged

•  Some contracts are fee-for-service. Fees increase with higher levels of care

How Do You Pay for Continuing Care?

– Use funding sources appropriate for resident’s current level of care

– Resident’s private funds must be used for buy-in & independent living

– Some have limited number of Medicaid beds reserved for buy-in residents


Why Would Someone Leave Continuing Care?•  Dissatisfied with new level of care

•  Higher level of care unavailable within community

•  Require memory care, which currently isn’t offered in many CCRCs


New Paradigm - +Memory Care

IndependentLiving

AssistedLiving

SkilledNursingHome

MemoryCare


Memory Care:A Growing Demand

According to the Alzheimer’s Association *

•  1 in 9 people age 65 & over has Alzheimer’s disease

•  Chance of receiving a diagnosis increases with age

•  About 1/3 of people age 85 & older have Alzheimer’s

* https://www.alz.org/documents_custom/2016-facts-and-figures.pdf


https://www.alz.org/documents_custom/2016-facts-and-figures.pdf

Why Memory Care?

Dementia’sphysical, psychological,

emotional & behavioral challengesrequire special care


Why Memory Care?

Special Staffing•  Caregivers & nurses trained to

-  Provide comforting care -  Avoid problem behaviors -  Encourage social interactions that residents no longer can

initiate or continue on their own •  Higher staffing levels for closer supervision


Why Memory Care?

Special Schedules•  Comforting daily routines •  Stimulating activities to

-  Encourage socialization -  Jog long-term memory -  Preserve physical abilities & cognitive skills


Why Memory Care?

Special Places•  25 to 50 residents per unit, in private or shared rooms •  Self-contained, with secure entry & enclosed outdoor courtyard

to prevent wandering •  Amenities typical of assisted living, but separate from other

portions of retirement community •  The best feature small pods with plenty of “landmarks,” not long

corridors with over-stimulating common areas •  Alarms & other safety features effective for people with memory loss disorders


How Much Does Memory Care Cost?

–  Initial “Community Fee”– Monthly rent & fees total $5,000 to $8,000 (Johnson County, KS)

•  Month to month



•  A la carte fees for special programs & services vary


How Do You Pay for Memory Care?

Much the same as Assisted Living•  Resident’s private funds



•  In some cases, in participating facilities, Medicaid


When Do People Leave Typical Memory Care for Skilled Care?

Personal, medical and/or behavioral needs require frequent, significant attention–  Bathing, dressing, toileting, walking & other personal care –  Transfers, especially those requiring 2 people or lifts –  Feeding –  Incontinence management –  Medication (insulin-dependent diabetes, IV therapies) –  Significant medical & behavioral concerns (e.g., infectious disease, open wounds, intensive rehab or therapy, feeding tubes, aggression)


Memory Care:A Better Model

IndependentLivingHome

ResidentialCare Home

AssistedLiving


Residential Care Home

Professional memory carein the warmth of a home


Residential Care Home

•  House in residential neighborhood, modified for optimum care of older adults with dementia

•  Up to 12 residents, usually with private rooms •  Higher staffing levels than traditional facilities •  In Kansas, licensed & regulated as “Home Plus”


What Do Residential Care Homes Offer?

More Care!



Comfort care•  Family-style setting – most calming & appropriate for people

with memory loss •  Familiar, non-threatening environment that avoids over-

stimulation. May reduce need for medication •  Flexible routines, adapted to personal preferences •  Caregivers & activities assistants given time to calm, reassure

& engage each resident



Individualized care•  Consistent caregiving & nursing staff - Close, personal relationships - Understand resident preferences & abilities

•  More caregivers per resident - Anticipate needs - Quickly respond to requests & emergencies - Closely monitor changes - Better able to prevent frustration & challenging behaviors



Safety & security•  Caregivers easily spot when & where they're needed •  Nurses know each resident. Fully informed when responding

to emergencies •  Able to use personal alarm/paging systems •  Houses equipped with safety features found in larger

facilities: grab bars, handrails, ramps, zero entry showers, fenced yards, keypad door access controls, emergency generators & fire safety systems

(including fire doors, sprinklers & alarm)


How Much Do Residential Care Homes Cost?–  Initial “Community Fee”– Monthly rent & fees total $6,000 to $7,500 (Johnson County, KS)

•  Month to month

•  Monthly rent may increase upon renewal or in the event of change in level of care

•  Generally a flat pricing structure. Limited additional fees


– Much the same as other Memory Care– May be covered by

•  Resident’s private funds •  Long-term care insurance •  VA Aid & Attendance benefit •  In a few cases, in participating homes,

Medicaid

How Do You Pay for a Residential Care Home?


Residential Care Homes: A Chance to Age in Place


•  Many support the changing needs of people at all dementia’s stages

•  Most coordinate to provide any healthcare services & medical equipment required

•  Many partner with local hospices to provide dignified end-of-life care, avoiding the move to skilled nursing in all but the most extreme circumstances

Families Feel at Home, Too


•  A real home, where Mom can enjoy the rest of her days

•  Best round-the-clock, personal dementia support available

•  Helps avoid painful & upsetting medical or behavioral crises – for quality time together

•  Simpler pricing structure – to better plan Mom’s future

Find Better Memory CareVisit Us Online


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thinking about senior living options? find the right home!

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