Independent Living Facilities: Requirements & Regulations

In the broad spectrum of senior living facilities, independent living facilities are the ones with the most, well, independence. The name says it all. These facilities focus on providing their residents nutritious meals, social interaction, and best of all, the freedom to live their lives the way they see fit. Due to this hands-off approach, independent living facilities do not have as many requirements and regulations as many long-term care facilities do. In this article, we will explain what exactly is offered in independent living facilities, types of communities, age requirement information, how they are regulated, and some costs you can expect to see. 

What are Independent Living Facilities?

Independent living facilities are senior housing arrangements designed for older adults usually aged 55 and older. The housing facilities can be anything from apartments to site-built homes. The facilities are usually tailored for older adults, being smaller and easier to navigate, as well as no maintenance or yard work to be done. Here are some of the services you can typically expect from an independent living facility: 

  • All-inclusive rent, though phone and cable may be excluded
  • Meals, 1-3 times daily
  • Security 
  • Grounds maintenance
  • Transportation services
  • Housekeeping services
  • Laundry
  • Emergency support services

A typical resident at an independent living facility is mentally and physically capable of living alone, and have no major health conditions. These seniors need little to no skilled nursing care or help with activities of daily living (ADLs). Most facilities do not have medical care or nurse staffing. However, third-party home health care services can be hired separately if needed. In this way, independent living facilities differ from assisted living facilities. Assisted living facilities offer more long-term care with the assistance of ADLs, as well as some health care services. 

Like assisted living facilities, many independent living communities offer its residents various amenities, services, and activities in their on-site recreation centers or clubhouses. Having such a facility allows seniors to connect and socialize together in community activities. Socializing reduces depression symptoms, which also means extended life span. Of course, all facilities are different, but here are some offerings you can find in independent living facilities:

  • Arts and crafts
  • Holiday gatherings
  • Continuing education classes
  • Movie nights
  • Swimming pools
  • Fitness centers 
  • Tennis courts
  • Golf courses
  • Various clubs and interests groups 
  • Spas
  • Beauty and barber salons

So now that we have an idea of what independent living facilities have to offer, let’s explore the different types of facilities out there. There are various options at varying price points with different amenities, social interaction, and continuing care. We will explore them all and give you some idea of what each one requires, and what you can expect. 

Types of Independent Living Facilities

Senior Apartments: This type of facility goes by many names including senior housing, senior living facility, senior living community, independent living facility, or independent living community. This is the most common type of independent living facility. Not only does this type of facility offer independent living, it often accommodates other care options. These can include assisted living, nursing home services, and memory care for Alzheimer’s disease and other forms of dementia. The range of services in senior apartments can be quite broad and can be tailored to the needs of seniors. The services available will vary widely depending on price points. Some facilities can be quite inexpensive, while some higher-end facilities will include extensive amenities like computer labs, gardens, libraries, salons, and fitness centers. 

Recreational programs, transportation services, and meals are offered at these facilities. There are other features such as in-house emergency systems, like pull-cords in each room to pull in case of an emergency. Staff is available 24/7 to assist. In these communities, safety and security are made a priority. 

Personal and medical care may be outsourced because the rent does not cover extra care. This is the difference between independent living and assisted living facilities. If more assistance in ADLs is needed, an assisted living community or nursing home might be a better fit. And, even though senior apartments often have age requirements, these facilities are privately owned and operated, and therefore able to set their eligibility requirements. 

Retirement Communities: Retirement communities are also referred to as age-restricted communities, retirement homes, adult active communities, and 55+ or 62+ communities. These communities are great for social interaction and have a more basic set of services than senior apartments. Residents in retirement communities tend to be much more independent, active, and able-bodied than those in other senior living options. Retirement community residents cook their meals and do their cleaning. However, grounds maintenance is taken care of by the community, and residents set up their recreational activities. 

Homes in retirement communities are most often owned by the residents, not rented. Owning the property however may not pay for additional monthly fees for services like yard maintenance, rec centers, or clubhouses. If the property is rented, this means it is part of a co-op or is rented from the property owner. Typical retirement community residences include single-family homes, duplexes, mobile homes, townhouses, or condominiums. This type of community is great for seniors who are still quite independent and want to own their own homes. They can be more active with people in their age group. 

Subsidized Housing: The Department of Housing and Urban Development (HUD) or charities provide this type of housing for seniors with low-income. Also known as supportive, affordable, and low-income housing, these communities have strict criteria and have long waiting lists. The housing that is provided is similar to that of senior apartments but at below-market rates. 

The subsidizing of rent payments is possible through the Section 202 program called Supportive Housing for the Elderly. This is provided for “low income” to “very low income” seniors, enabling them to pay 30 percent or less of their income on rent. It is also possible for seniors to be allowed Section 8 rent subsidies in voucher form. This can be as much as $2,000 a month. However, not all communities accept these vouchers, and these funds can be refused by property managers. 

So what are the requirements to be eligible for subsidized housing? Typically the minimum age for subsidized housing is 62 years old. They must have an income at or below 80% of the median income in their county to be considered for lower-income housing. If the resident only makes 50% of the average annual income, that would qualify them for very low-income housing. Once eligible, it is also important to be aware of any caps on income and assets. 

Some low-income senior housing facilities are owned and operated by non-profit groups. These groups work with USDA’s Rural Housing Service as well as HUD. However, these types of facilities are not available everywhere and there can be wait times of up to 12 months.

Other subsidized housing options are available through the Public Housing Authority (PHA). Called public housing, this means the property is owned by the federal government and allows its residents to spend less than 30% of their income on rent. These housing units are available for people of all ages, not only seniors. Therefore they might not be designed with seniors in mind. Another type of rental assistance program for all is called the HOME Investment Partnership Program, which HUD manages. 

Though subsidized housing may be for low-income residents, these properties are usually in safe neighborhoods and well managed. They are also designed specifically for seniors. The benefits of living in this type of community are not only affordability but the fact that seniors can remain independent amongst a community of their peers. 

Co-Care: Also known as senior co-housing, this is a shared housing unit where residents live with other older adults in multiple bedroom units. This is a good option for middle-income seniors. A newer type of independent living community, co-care allows residents to maintain common areas, socialize, and dine together. Private households include shared grounds or a common house. Typically the homes are designed to suit older adults for long-term living. Residents plan their social calendar and assess the needs of their community. 

There are even co-housing organizations and companies that provide senior co-housing. These can include housing cooperatives, homeowner associations, and condo associations. Oftentimes a group of seniors who are already friends will decide to move into a co-care arrangement. 

Co-care is also referred to as adult foster care at times. Though it usually means that a caregiver is taking care of several older adults in their own home, it can also refer to a community-based cohousing organization, usually on a small scale. 

Not only is co-care a good option for those seniors who enjoy the socialization aspect of a living arrangement shared with others, but another great benefit is also the affordability. Residents share bulk food costs, save electricity, and share resources, which all cut costs. This option is great for seniors who want to be involved in their community decisions, be independent, yet still socialize and live affordably.

Continuing Care Retirement Community (CCRC): A continuing care retirement community (CCRC), also known as a life plan community, is a great residential care facility for “aging in place.” A CCRC is especially attractive to baby-boomers who are more active and living longer than previous generations. This is because these care facilities in a CCRC offer varying levels of continuing senior care, including independent senior living, assisted living, skilled nursing, and memory care units. They are similar to senior apartments in that they offer many similar services and amenities. However, personal care and health services are included in the costs. Residents can transfer to different levels of care on the CCRC campus as their needs change. Living in these kinds of long-term care facilities allows for peace of mind because your needs will be met, even after you lose your ability to be independent. Not moving will allow you or your loved one to feel calm and now worry about moving to another facility when the time comes. Because of this, you can plant your roots, make friends that will last, and still have all the services and amenities available to you for entertainment and recreation. 

Although this may be the most ideal option, the price may not be ideal. The entrance fee is often pricey, although some of the money may be returned to the adult children upon the death of their parent. Then there are also housing payments and homeowner association fees on top of that. Sometimes benevolence rates or non-profit offerings can be given to seniors in some CCRCs who are in need financially.

Age Requirements at Independent Living Facilities

As we’ve discussed, there is a minimum age requirement for some communities. This is regulated by HUD. Although HUD’s Fair Housing Act (FHA) does prohibit age-based housing discrimination, there was an exemption made called Housing for Older Persons Act (HOPA). HOPA protects senior communities from being sued for age discrimination. For a community to quality for the HOPA exemption, the community must be either of the following:

  • Designed and operated to accommodate elderly people
  • Occupied by people 62 years old or older
  • Occupied by people 55 years old or older 

For the 55+ communities, all of the following must be fulfilled to qualify for HOPA:

  • A minimum of 80% of the community units must have at least one occupant who is 55 or older
  • The community has to publish and comply with the policies and procedures demonstrating that they will operate as a 55+ community
  • The community must adhere to the HUD’s age verification requirements of its residents

As long as the community meets all of the HOPA requirements, it can create its own rules of how the age restrictions are defined. They just have to comply with state laws. For example, the community can require that all the residents are over 55. 

Regulations of Independent Living Facilities

Senior housing licensure is granted by the state. Typically these licenses are limited to the nursing center and food service. All the states vary in their regulations levels and procedures for licensures. To operate legally, each facility must have the appropriate licenses required. 

Inspections take place semiannually or annually by the state’s department of health and/or social services. Inspection teams consist of public health officials, nurses, sanitarians, and social workers. Any staff member, resident, and sometimes even a relative can be surveyed by the inspectors. The services like daily living activities, resident assessments, meals, and housekeeping are utilized to observe their quality and catch any issues. Medical appointments, money management, and records can also be scrutinized. Keep in mind, however, that independent communities that do not have many services do not need to be regulated because they don’t require state licensing. It is best to check your state regulations for more details.

Some independent living facilities are regulated more than others, depending on how much medical care is provided. Those facilities that are certified by the Centers for Medicare and Medicaid Services (CMS) will be surveyed by the states themselves to ensure facilities comply with the Nursing Home Reform Act. There are no nationwide regulations regarding skilled nursing facilities and nursing homes. Some independent living facilities that could be subject to these regulatory measures would be CCRCs since they offer medical care. You can research report cards on these facilities online, and learn about any violations or citations they may have. There is a five-star scale on which the facilities are rated, to follow the strict CMS standards. Another option is to contact a local long-term care ombudsman for advice on choosing the right facility.

If the independent living facility isn’t CMS-certified, there are other methods to evaluate these facilities. Third-party sites, which offer online reviews, will give you a good idea of the community you are interested in. You can also contact individual state or federal agencies to learn about the specific regulations in your state. 

Cost of Independent Living Facilities

Subsidized senior housing is the most affordable option, as previously mentioned. Those with low income can apply. The amount of rent assistance you receive depends on your income. 

Due to the low need for medical services of its residents, Independent living facilities are one of the cheaper senior living options. Costs widely vary due to many factors, ranging from $1,500 to $6,000 a month. On average, the cost for a one-bedroom senior independent living apartment is $2,750 a month. This can be compared with a comparable apartment in an assisted living community at $3,477 a month on average. Costs vary depending on the type of community, how big the apartment is, the location, and any services that may be offered. 

Home prices in a retirement community can fluctuate in price depending on the market. You could rent an efficiency apartment for $1,000 a month, or purchase a home for $1,000,000. It all depends on the number of bedrooms, features, and location of the property. Don’t forget there could also be buy-in costs for amenities, as well as HOA monthly dues. 

A co-housing arrangement varies depending on the property and how many other seniors are living in the property. 

CCRCs are the most expensive of all the senior living options. The entrance fees range from $20,000 to $500,000. Then of course there are monthly fees that can range from $500 to $3,000, depending on what contract and services you agree on. 

Independence Contributes to a Greater Quality of Life

Whether it’s living in a 55+ community to a large scale CCRC, your loved one will thrive when surrounded by peers their own age. The independence they gain from living in such a community allows for greater quality of life. We here at CareAsOne hope that you have learned what you can expect from independent living facilities and how your loved one can benefit from them.

What is Post-Acute Care & What Are the Benefits?

As your loved one is bounced around from one care facility to the next, the terminology, levels of care, and procedures for each place can get confusing. The care options swirl in your head as you tentatively try to make the right choices for your loved one. If he or she has been staying in a hospital due to an illness or injury, it is possible that the next step could be admission to a post-acute care provider. This happens when your loved one is still recovering, yet not well enough to return home. In this article, we will discuss what post-acute care is, common providers that practice this type of care, the growth of this industry, and some benefits of post-acute care. First, let’s dive deep into what the terminology refers to.

What Does Post-Acute Mean Exactly?

Post-acute care is a transitional type of care that involves rehabilitation, recuperation, symptom management, and continued medical treatment received after receiving acute care. While the staff may assist your loved one with activities of daily living (ADLs), the primary purpose is recovery after an injury, surgery, or illness. The ultimate goal of post-acute care is to return the patient to wellness and independence. Post-acute care can be provided in a facility, as ongoing outpatient therapy, or as home care. Care services are temporary, ranging from intensive short-term rehab to longer-term restorative care. Post-acute care can last anywhere from a few days to several months. Living at the facility indefinitely is not an option. 

As mentioned before, the post-acute care is received after the patient has undergone acute care. So what is the difference between acute and post-acute care? Acute care is a branch of health care where the patient receives active, short-term treatment for an injury, illness, surgery, or other urgent medical condition. Acute care is the opposite of long-term care. It can be applied in the ER of a hospital, surgery center, urgent care, or another short-term care facility. Following acute care, the patient may not be ready to go home, but cannot stay in the hospital. Thus, the reason they enter post-acute care. It is not as urgent as acute care, but still necessary in the recovery process. 

During the process of receiving post-acute care, many patients will either undergo a full recovery or learn to manage their chronic illness. Some common conditions that often receive post-acute care include patients in recovery from cardiac or pulmonary disease, stroke or neurological disorders, or orthopedic surgeries. This is because these conditions require rehabilitative therapies between the hospital stay and going home. Other patients have been profoundly affected by accidents, aging, or chronic illnesses. Unlike nursing homes and many other long-term care facilities, post-acute care is for patients of all ages. Although it is more common for older patients to require this type of care, young patients are also in need of intense rehabilitation and monitoring as they recover. 

During their stay or term of post-acute care, patients typically receive physical and occupational rehabilitative therapy every day. This can even occur multiple times a day, depending on the severity of his or her condition. Patients are monitored by one or more doctors, a team of nurses, and therapists to ensure their recovery progression. Skilled nurses are on duty 24-hours a day, ensuring your loved one receives the help they need any time of day or night. 

Having a full extent of knowledge of the different healthcare systems will help in your decision for what is best for your loved one. With so many different kinds of healthcare facilities out there, it is easy to confuse what kind of facilities offer what type of care and services. Next, we will go over some of the facilities in which post-acute care may be received. This will help clear up any common misconceptions or confusion you may have. Some of the places your loved one may receive post-acute care include:

  • Long-term care hospitals (LTCHs)
  • Inpatient rehabilitation facilities (IRFs)
  • Skilled nursing facilities (SNFs)
  • Home health agencies

Health Care Providers That Offer Post-Acute Care

Long-Term Care Hospitals (LTCHs): Also known as a long-term acute care hospital, or LTACH, this care facility is similar to an ICU in that it provides care to patients receiving prolonged ventilation. These patients require extended hospitalization and provide a higher level of care than a skilled nursing facility or nursing home. Common patients suffer from tuberculosis, complex wound care or burn care, severed brain injuries, respiratory therapy, ventilator weaning, or a chronic disease. Those patients who need intravenous medications or fluids, or require a feeding tube will probably stay at a LTACH. LTACHs came into existence due to Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999. LTACHs are said to house patients for longer than 25 days. These individuals have clinically complex problems that need hospital-level care for extended periods. 

Inpatient Rehabilitation Facilities (IRF): IRFs provide intense therapeutic rehabilitative care for those regaining their function after an injury or illness. These patients receive daily therapy of at least three hours, and five days a week. Care at a rehabilitation center is managed by a team composed of doctors, nurses, and therapists. Common patients at an IRF include those who have suffered brain injuries, strokes, other neurological disorders, multiple joint replacements, and fractures to lower extremities or pelvis. Inpatient rehabilitation hospitals strive to offer tailored strategies that help the patient to become independent again and to return home. They want to prevent readmissions. Some patients, however, may need a higher level of care than can be offered at an IRF. 

Skilled Nursing Facilities (SNF): A SNF is another common pitstop after being discharged from the hospital. It is best for patients who do not need a high level of care, such as at a LTACH, although they still require medical care and support. The staff at a skilled nursing facility not only provides help with activities of daily living, or ADLs, they provide specific medical care in response to health conditions or injuries. Patients commonly admitted to SNFs are those who have suffered heart attacks or shock, hip or femur fractures or surgeries, joint replacements, sepsis, and kidney and urinary infections. Patients can remain at the facility as long as needed, however, the average length of stay is about four weeks. A patient will receive at least one hour of therapy a day. Doctors are on staff, but nurses provide most of the daily care. Skilled nursing care is paid for by Medicare Part A for up to 100 days. 

Home Health Agencies: Home health agencies are also considered part of the post-acute care landscape. Medicare offers a home health benefit that covers skilled nursing and therapy services to patients in their own homes. The patient can receive care under a care plan established by their doctor. They must be homebound and require skilled services on an intermittent basis. This type of care is received after an acute care hospital stay and may need rehabilitation therapy services from a highly-skilled nurse, physical therapist, occupational therapist, speech-language pathologist, or medical social worker. Home health aides are also provided if personal care support is needed. These days in-home health care is made even easier with the ability of mobile monitoring and wearable technologies.

Choosing the Right Post-Acute Care Provider

So how can you find the right post-acute care provider for your loved one’s needs? Think about what exactly your loved one needs to make a full recovery. Consult a doctor to help choose which option may be best. Research the facilities available, and find out what kind of experience they have, how quickly patients recover on average, and how they will help you and your loved one with your goals. Here are some other factors to consider:

The Complexity of Medical Care: You may have noticed that the LTACHs have the most complex, intensive care available, as opposed to SNFs, IRFs, and home health caregivers. Therefore patients who need this type of care should choose a LTACH. However, if only moderate care is necessary, SNFs or IRFs are good options. Home health care is probably best for lower-level care than the other 3 options, due to the lack of complex medical equipment available. 

Level of Therapy Offered: IRFs are the best option for specific therapies as well as intensive rehab programs to restore independence. LTACHs do offer therapies and rehab programs, but these are not the main focus of these facilities. SNFs also offer such services, but at a lower level. Keep in mind that IRFs require at least three hours of physical therapy or rehab a day, so if your loved one is not willing to commit that amount of time, one of these other options might be a better choice. 

Staffing: LTACHs have an array of in-house doctors. Patients in a LTACH can see a doctor at least once a day. IRFs and SNFs also have doctors, but nurses and therapists do most of the daily care. Home health care staffing can include registered nurses (RNs), Licensed Vocational or Practical Nurses (LVN, LPNs), personal care aides (PCAs), home health aides (HHAs), physical therapists (PTs), occupational therapists (OTs), speech-language pathologists (STs), and medical social workers (MSWs).

Costs: LTACHs are the most expensive. SNFs are more cost-effective if the patient does not have complex needs. It is necessary to be familiar with Medicare and Medicaid and their coverages. Medicaid tends to cover long-term nursing home care. Payers like private insurance programs, Medicare, and sometimes Medicaid can help with SNF expenses. Medicare payment for inpatient rehab will extend for 100 days of treatment in each benefit period. However, you have to have been in a hospital for at least three days before the rehab treatment. The benefit period starts when you go into the hospital, and ends when you have not received any care in the hospital or skilled nursing care for 60 days. 

The Growth of Post-Acute Care

These days, the post-acute care industry is booming in our healthcare system. Nearly 40 percent of Medicare beneficiaries receive post-acute care services after leaving the hospital. That totaled $60 billion in 2015 alone. How caused this boom in post-acute care to occur? The Affordable Care Act, Medicare, and insurance companies have something to do with it. The Affordable Care Act has increased the incentives for acute care systems to work closely with post-acute providers, while Medicare and health insurance companies have been shifting more of the risk to hospitals. Many insurance companies no longer pay for readmissions within a certain time after the patients have been discharged. So, if a patient gets discharged, and then returns to the hospital not long after for the same issue or a related one, the hospital will have to absorb the cost and take responsibility. This has affected the improvement of patient care in hospitals and ensuring that the hospital staff will focus on addressing all possible issues of the patient. The patient will then be treated to the best of their ability, drastically reducing the possibility for his or her readmission. Here are some of the financial incentives for hospitals to align with post-acute providers: 

  • DRG-based hospital payments
  • Penalties for hospital readmissions
  • Mortality penalties
  • Federal meaningful use requirements
  • Patient satisfaction
  • Cost accountability programs

For these reasons, hospitals are now taking an extra step to ensure patient recovery through a continuum of care. They have begun to develop partnerships with post-acute care facilities. Patients who no longer need acute care health services at the hospital will be discharged to a post-acute care setting. This will enable them to continue to receive proper care while they recover. 

Due to this newfound cooperation between hospitals and post-acute care providers, the post-acute care continuum is exploding in growth. The crowds in these facilities are not only due to this growing movement, but also due to the aging population, rising healthcare costs, and the uptick in chronic disease. And this growth curve is projected to continue. 

The high demand for post-acute care has caused a growth in hospice care, skilled nursing facilities, as well as services like care coordination and medical transportation. Home care is also developing due to advances in technological innovation in service delivery as well as quality control. 

Benefits of Post-Acute Care

Post-acute care has many advantages to those who have come from a hospital setting. We will now discuss some of the benefits the patient will receive in this transition period.

Less Likely to Be Readmitted to the Hospital: While in post-acute care, your loved one will be closely monitored for complications or changes in their condition. As a result, the likelihood of catching a new or recurring problem early is high. And they will be able to get the problem cared for on an outpatient basis, outside of an acute care setting.

Primary Care Professionals at Your Disposal: Unlike a busy hospital, post-acute care facilities do not have doctors running around frantically. Experienced professionals are always available to answer your questions and assist with any challenging tasks.

More Home-Like and Comfortable:  Some care centers offer a variety of activities and fun social events to participate in. There are also excursions which promote socialization and mental well being. Some activities can include crafts, sensory activities, puzzles, coloring, reading time, musical performances, church services, bingo, cards, books on tape, as well as community outings.  

Customized Treatment Plans: Doctors tailor the care plans to your specific needs, which ensures the shortest recovery time possible. Having a focused plan personalized for your loved one proves a remarkable quality of care. The patient-centered approach is applied in the most appropriate setting by using evidence-based guidelines to determine the level of care, as well as the most appropriate site of care. Their goal is to transition the patient to their home promptly. 

Improved Outcomes: Data suggests that patients who were treated in post-acute facilities do better than a traditional nursing facility. These patients tended to live longer, spend more days at home, and fewer days in healthcare facilities. They also have fewer emergency room visits. Another analysis indicated that in-home post-acute care is a good option for stronger, healthier patients, and would lead to fewer re-hospitalizations. Stroke victims especially benefit from post-acute care, showing a huge increase in functional recovery enhancement, as well as increased independence in ADLs. 

Health Care Pitstop

On this long and bumpy road to recovery, post-acute care is a pitstop on your loved one’s health journey. Post-acute care professionals listen to your loved one’s needs, are there 24 hours a day, and enact a customized care plan that will ensure the quickest recovery. The goal is focused on your loved one’s independence, allowing them to get back on the road of life. In this article, we have outlined everything you need to know about post-acute care. We here at CareAsOne hope that you have learned a bit more about the healthcare industry, and what post-acute care can do for your loved one. All the best. 

5 Gait Training Exercises That Help With Mobility

The loss of function in a lower extremity can be debilitating and impact every facet of your life. Fortunately, there are many ways to alleviate the loss of function and mobility, one of them being gaiting training. The word gait means the way an individual walks. Therefore gait training refers to training someone how to walk or to walk a certain way. Gait training is considered a kind of physical therapy that strengthens and improves your ability to stand and walk. It is often recommended by a doctor after an illness or an injury has occurred which impairs someone’s ability to get around. You can also perform these exercises in combination with other types of physical therapy and treatments. Gait training will help you or your loved one walk independently and confidently, with and without the help of an adaptive device. People who can greatly benefit from gait training include those suffering from:

  • Spinal cord injury
  • Joint injuries or replacements
  • Broken legs or pelvis
  • Strokes
  • Neurological disorders such as multiple sclerosis (MS), Parkinson’s disease, and cerebral palsy
  • Lower limb amputations or other orthopedic impairments
  • Muscular dystrophy, osteoarthritis, or other musculoskeletal disorders
  • Brain injury
  • Sports injury

It is important to note, however, that everyone can benefit from gait training exercises. It is especially beneficial for elderly people who are starting to have reduced mobility in their lower limbs. Let’s touch on some of the benefits of gait training exercises:

  • Increased strength in muscles and joints
  • Improved balance and posture
  • Cardiovascular improvement
  • Improved muscle memory
  • Decreased risk of falls
  • Allows for repetition of movement
  • Increased range of motion
  • Increased endurance
  • Lowers risk of illnesses like heart disease and osteoporosis due to increased physical activity and mobility

Choosing to keep moving rather than choosing to be immobile is always a good decision. This will improve your overall health, and thus enable you to live longer, happier, and healthier. In this article, we will analyze gaits and various types of them, weight-bearing status, assistive devices, and finally gait training exercises that help with mobility.

All About Gaits

So walking is as easy as putting one foot in front of the other right? When we break it down we see that it is not that simple. So many muscles, bones, joints, and neurological impulses all work together to create this precious movement. Gait abnormalities will occur if even one of these components fails. It is important to figure out where exactly your issue is coming from to fix the problem. 

A gait cycle is a summation of several movements that occur when moving your leg to a certain position as you walk. A normal gait ambulation cycle occurs from the point your foot leaves the ground to the next time it leaves the ground again. The gait cycle is broken down into two phases: the swing phase and the stance phase. Each of these phases is also broken down further based on the way the foot is positioned during the phase.

Stance: The stance phase starts when the foot reaches the ground and the bodyweight is shifted to that anchor. Next comes the four intervals: load response, midstance, terminal stance, and pre-swing. Load response is when all the weight is put on the single foot and the other foot starts to lift off the ground in its swing phase. Midstance occurs when all the weight is on one foot while the other is completely off the ground. The terminal stance is when the heel of the standing foot is beginning to lift off of the ground. The pre-swing occurs when the toe of the standing foot comes off the ground and the weight is transferred to the previous swing foot. 

Swing: This phase occurs when the foot is not in contact with the ground and is broken down in three intervals: initial swing, midswing, and terminal swing. Initial swing is when the foot is taken off the floor. During midswing, the foot is completely off the ground, moving in the air. Then in the terminal phase, the swing foot plants back on the floor and begins its stance phase.

Undergoing a gait analysis of your movement patterns by your clinician may identify a certain troublesome gait pattern you are experiencing. Here are some examples of gait problems you may be experiencing:

  • Spastic gait: one side is stiff and causing one foot to drag as you walk
  • Propulsive gait: your postural stance is stooped and rigid with your head and neck bend forward
  • Scissor gait: your knees are slightly bent while your knees and thighs cross in a scissor-like movement
  • Steppage gait: the toes scrape the ground as you walk due to the foot hanging and toes pointing down
  • Waddling gait: due to hips being unstable, you walk with exaggerated side-to-side movements

Weight Bearing Status

Your doctor or physical therapist will examine your gait and also determine your weight-bearing status. Then they will instruct your new gait based on this status. Weight-bearing status means how much body weight can be supported by the legs, coordination, and strength. You must be aware of your weight-bearing status so you do not further injure yourself. It is also possible that this status is likely to change during your treatment, due to improvement in your condition. Your doctor will oversee any changes to weight-bearing status and instruct you when it is ok to make this change. Here are the four possible weight-bearing statuses:

  • Non-Weight Bearing (NWB): No weight is allowed on the injured leg
  • Touch-Down Weight Bearing (TDWB) or Toe Touch Weight Bearing (TTWB): could be 20% of body weight allowed or between 10 to 15 kg of weight
  • Partial Weight Bearing (PWB): anywhere from 25 to 50% of weight is allowed
  • Weight-Bearing as Tolerated (WBAT): The person can bear the weight as long as the pain is tolerable

Starting Gait Training

When it comes to gait training, it is best to start early. Your DPT will probably recommend that you start gait training as soon as you can after an injury or illness has affected your walking ability. The first task is to build muscle strength. Make sure that you are healthy enough to begin. As long as your joints are healthy and strong enough to support these new movements, you can begin at any time. Throughout the gait training process, you will be focusing on strengthening specific muscles. Focus on movements that are repetitive to build up your muscle strength.

After you have built up some strength in your muscles, then you can focus on task-specific training. This will all depend on your goal. If you have an illness or injury, your training will be centered around what needs improvement. Consult with your doctor or physical therapist about what kind of training is best for your needs. 

Gait training is a commitment. You will not see improvement if you do not put in consistent work into strengthening and training your muscles. Be aware that the process can be challenging, both physically and mentally. However, with the right mindset and showing up every day to do the work, you will see results guaranteed. 

Gait Training 

Gait training exercises usually include walking on a treadmill and muscle-strengthening activities. However, the type, intensity, and duration of your gait training all depend on your diagnoses and what you are physically able to do. It is often necessary for some people to utilize assistive devices to better help them strengthen and train their muscles. 

Assistive Devices: You may be given an assistive device to help maintain a regular gait cycle or to keep balance. This is especially prevalent when you have had surgery, a leg injury, or balance and strength impairment. Assistive devices may also be deemed necessary for those that have a loss of perception in their legs, weakness in the legs, walking pain, susceptible to falls, and more. Having an assistive device will provide support and can protect and prevent your legs from getting more injured. However, the goal is to strengthen your legs enough to where you have less dependence or no longer need these devices. Here are some common assistive devices that may be helpful: 

  • Straight cane
  • Axillary crutches
  • Walkers
  • Lofstrand crutches
  • Parallel bars

Gait Training Exercises

These exercises target the muscles that enable you to walk. Knowing your target muscles can help you build a strength training program that will most efficiently suit your gait training needs. The hip extensors, hamstrings, and glutes are the muscles responsible for straightening the hip joint while you walk. The quads should also be targeted due to their knee activation when straightening the legs. Calf muscles enable the plantar flexion for each footstep. And lastly, the dorsiflexor muscles of your shins enable your ankle to flex.

Your gait training program should be specifically suited to your needs. But before starting your exercise program, you should be confident that your joints are strong enough. You can start priming your muscles by doing simple stretches every day. You can also try a stationary bike. This will keep your muscles active. It is best to avoid sitting for too long due to pain and stiffness that may occur. So now that we have a basic knowledge of gait training and what it entails, let’s go through some of the common gait training exercises that will help with mobility:

1. Walking with a Harness on a Treadmill

Utilizing a harness while treadmill training can give body weight support to help you mimic a normal walking gait. This locomotor training exercise has been an especially helpful tool for those with neurological disorders. Decreasing the load on the limbs reduces energy expenditure. With the external support of the harness, the person can control their posture and then concentrate their physical energy on step-taking. 

If you do not have access to a treadmill or harness, simply focus on taking a walk every day to the best of your ability. Then, gradually over time, begin to make the walks more challenging. You can start to increase your walking speed over short distances. You can change your walking direction, such as backward, or side-stepping. You can increase your step length. You can try turning your head right to left, side to side, and up and down. You can hold items for added weight as you walk. You can increase your coordination by walking to the beat of some music. You can become more agile by walking in a circle pattern. 

The more you walk, the more your muscles will be trained to work for you. Do not be discouraged by slow progress. Just making the effort will make a difference over time. Combined with the following strength training exercises, you will no doubt be happy with your improvement. 

2. Sit-and-Stands

This exercise not only improves the leg strength you need for walking, it enables you to get up easier from low chairs or soft couches. Similar to squats, this exercise improves leg strength, functional balance, and control. Not only that, you aren’t at risk of getting hurt while doing this exercise. Your quads, hamstrings, and glutes, and the targets in this exercise.

  1. Seat yourself in a sturdy chair, your feet planted a hip-distance apart.
  2. Tip forward at the hips, engaging your core. Try to avoid using your hands or arms to assist you. 
  3. Push from all 4 corners of your feet to enable yourself to stand. Extend your knees and hips fully. 
  4. Reverse the movement by pressing your hips back and bending your knees as you slowly lower yourself to a seated position. 
  5. Repeat 10 times or as many as are comfortable for you.

3. Stepping Over Objects

Not all walking surfaces are smooth. For this reason, it is important to be able to lift your legs to step over objects. Therefore the best practice for this is to step over objects. This will also keep you from shuffling your feet, which can sometimes cause trips and falls. Therapists will often use foam objects spaced a foot or so apart to help you practice your agility while improving balance. If you do this at home, be sure to have a railing or something you can hold onto to keep your balance. This technique has been proven to be especially helpful for those who have suffered damage to the nervous system, as with stroke patients. 

4. Leg Lifts

This exercise helps strengthen the quads, abs, and hip flexors. The ab muscles are used isometrically to stabilize the body during the motion, therefore the rectus abdominal muscle and the internal and external oblique muscles are strengthened. Consistently repeating this exercise over time will help you gain strength and to walk with greater ease. Many variations can be done once you have mastered this one. 

  1. Lay flat on your back with one knee bent and one straight.
  2. With your toes pointed upward toward the ceiling, raise the straightened leg to be level with the bent knee. 
  3. Return to the starting position and repeat 10 times.
  4. Switch to the other leg. 

5. Single Leg Stance

Single leg stances are an effective method to incorporate into your balance training. This is an incredibly simple and basic exercise. However, you must master it to improve your balance and decrease the risk of falls. Make sure your breathing is normal, calm, and controlled.  

  1. Stand behind a steady desk or chair, holding onto the back of it.
  2. Lift your right foot as you balance on your left foot.
  3. Hold the position as long as you can, then return your right foot to standing position.
  4. Switch to the other foot.
  5. Repeat 10 times, or as many as you are able.

As your strength increases, you will be introduced to more and more exercises that will improve your strength, balance, and mobility. You can also incorporate the use of free weights, resistance bands, or ankle weights for some added challenge. Always listen to your body and make sure you are not taking on more than you can handle. If something is too much, stop, take a break. Little by little you will get to where you want to go.

Talk to Your Doctor

We hope these gait training exercises are the beginning of your journey to increased motor control and mobility. Gait training exercises can be difficult, especially if you are coming out of a very traumatic illness or injury and are relearning how to walk. The process of recovery can take a while, sometimes even longer than we expect. Keep in mind that this is a mental health care challenges as well as a physical one. The stronger your belief in your improvement, the more likely it will occur. Make sure that every step of the way is guided by a physical therapist or doctor. This will eliminate any potential hazards and roadblocks to your recovery. Health care staff will go over your condition, your gait training plan, and long-term outlook. We here at CareAsOne believe that being surrounded by a strong support network and keeping a strong positive outlook will get you through your gait training process and recovery. 

The Truth About Senior Living Advisors

Supporting your loved one during their changes in health is the best thing you can do for them. Oftentimes their life circumstances change rapidly, leaving you scrambling. You are taking them to doctor’s appointments, and also dealing with new tasks of caregiving. Perhaps you have decided it is time to look for more quality care for your loved one in a senior housing facility. But you are too busy to find the right place to suit your loved one’s needs. Evaluating different options including independent living, skilled nursing, or an assisted living facility takes a lot of time and effort. A senior living advisor’s placement services can help you and your family with this process. 

Senior living advisors, also called eldercare advisors, are agents who guide seniors and their families through the quest for the best housing option for their needs and budget. These advisors work for an advising company that has built a connection network with the senior housing communities in the area. They should be quite familiar with each facility’s care options, housing, as well as insider knowledge of the senior care market. Senior living advisors work at no cost to the family. They are paid by the senior communities whenever their referrals move in. 

The benefits of enlisting the help of a senior care advisor are that it can save you time and money. This is especially helpful when you are in a hurry. The advisor will narrow the focus to the right level of care and the communities or home care agencies that will best meet your loved one’s needs. A care advisor with experience in your local community should know the senior care options available like the back of their hand. They will know which options are quality, and which aren’t and will steer you in the right direction accordingly. In comparison, if you were to try to gather this information on your own, it would take days of phone calls and meetings. You would also be subjected to numerous sales pitches just to get the information you need, and even then you aren’t sure if you can trust the information 100%. And finally, senior living advisors can advise you and your loved one how to negotiate with your new facility and make sure to sign up for the correct level of care, which could save you a lot of time and money in the long run.

Although senior living advisors can be so helpful, there are also a lot of things to be aware of when choosing the best one to advise you. In this article, we will discuss what senior living advisors do, how exactly they are paid, possible red flags or scams to look out for, and questions you can ask them to get them to better work for you.

What They Do

Listen to Your Specific Needs: A good senior living advisor will make the experience personal and customized for your loved one. First, they will gather all relevant information. They will find out your situation, including your loved one’s background, emotional, and health care needs, and what they want. 

Research: Then they will research their resources and come up with personalized senior living options with your loved one’s care and housing needs considered. Many factors come into play into this process. The advisor thinks about location, cost, current and future care requirements, community-specific information, as well as amenities needed or desired. This search can all be done in a matter of minutes. Not only will an advisor have answers to all the obvious questions, but they will also have access to information that a family often doesn’t think about. This can include information on pricing variables, occupancy rates, number of residents, resident to staff ratios, distance from nearest hospitals, reviews, as well as complaints the facility may have encountered. They will also have information about processes each facility will need for admission, and the next steps you can take. Once all the options have been presented to you and your loved one, you can start to discuss and narrow down your favorite options. 

Tours & Exploring Options: Senior living advisors will help guide you through the next step of exploring your top choices. They will make phone calls to learn more about certain options and schedule tours. They will often come along with you on tours or meetings to better facilitate the process. Tours are necessary, though can be time-consuming, emotionally challenging, and difficult. Having someone to help narrow down the choices will more than likely decrease the number of tours you end up taking. On your own, you may go on 5 tours. With a senior living advisor, they can help narrow it down to 1 or 2. This saves you a massive amount of time.

Follow-Through: Ideally a senior living advisor will guide you through to the end of your senior housing quest. Their job isn’t done until their client has received all the information needed to make a decision, and knowing what steps to take to move forward. A senior living advisor should be there for you until the move has actually been made and are settled in comfortably into their new living arrangement.

How Do Senior Living Advisors Get Paid?

You may be thinking, this all sounds great. And they do all this work without being paid by the client? So how exactly do senior living advisors get paid? The short answer is, they get paid by the senior community after they have guided someone to move in. Families need to understand exactly how these advising companies make money because some may not appreciate their personal information being shared. 

Most senior living referral services make money when someone they have referred successfully moves into the residence. The senior living community compensates the senior living advisor. This is usually equal to the client’s first month of rent. Keep in mind this is how senior living advising companies make money, but there are also some other things to pay attention to behind the scenes.

When you first contact a senior living advising service through a website or by calling them, they gather some information about you. This information will include your name and contact information, your relationship to the person in need, and the city in which you are looking for a residence. After you have provided this information, the service will pass it on to a few care facilities in the area that you specified. Then you will start getting calls from these communities. You may be surprised just how quickly this will happen. This is because the referring company wants to get credit for introducing you to the community. They will in turn get paid when your loved one moves in.  

The senior care services choose to participate in a network represented by senior advisor companies. This also means that the network the advisors have access to is not necessarily comprehensive. Not all community options are part of the network. This means the advisor may be less familiar with them, or even not at all. As a result, these communities probably will not be recommended to you and your loved one. It is helpful to do a bit of research on your own before meeting with your advisor, and bring up any communities that still interest you but have not been presented to you. 

Your senior living advisor should be giving you an unbiased view of the communities because they will be getting paid regardless of which one you choose. You must make them work for you. There is no doubt you may have heard of many of the scams and debacles in the senior care industry. It is easy to find yourself in the middle of a scam if you aren’t careful. For this reason, we want to touch on some red flags to look out for. 

Red Flags to Look Out For 

Rushing the Process: If your senior living advisor is rushing the process, they may not have your best interests at heart. They should be providing personalized service that will go at your pace. If you are just starting the process of gathering information, and the advisor is already trying to get you to go on tours, this may be a bad sign. Make sure the advisor knows your timeline and is comfortable with it. If you are in a dire situation and your loved one needs to be placed quickly, this is a different matter. Always make sure the advisor is going at the pace you are comfortable with. 

Trying to Sell You on a Specific Company: If your senior living advisor seems honed in on one senior care provider that you aren’t interested in, this could be a bad sign. He or she should remain unbiased and neutral, only advocating for what is best for your loved one. The advisor should not be acting like a salesperson. If it seems this way, it could be that they would be receiving some added benefit they are not telling you about. 

Does Not Have Senior Care Experience: A senior care referral agency is not required to have employees who have senior care experience. But a good agency will run background checks, drug tests, and everyone working is CCA and HIPAA certified. 

Has a Low Number of Communities on Their Referral List: This could mean the advisor has some personal problems with the care providers or has some financial gain from the few on the list. 

Aren’t Familiar with the Communities: Although it is not possible to know every detail about every community, your advisor should have a pretty good grasp on what each facility has to offer. It is a plus if they inspect the properties on a semi-regular basis to keep familiar with the goings-on in each community. If your advisor hasn’t been to the community in over 2 months, this could be a bad sign. Keep in mind that new senior housing does pop up quickly and may fly under their radar, but if your advisor is unfamiliar with an established community, they may be quite green.

Try to Profit on the Elderly: If your advisor is trying to move your loved one into housing they cannot afford in the long term, this is a bad sign. Your senior living advisor should be concerned that you and your family can handle the payments long-term. They should be assessing everything, including their income, chronic health issues, and any potential future problems to help choose the right place for your loved one. 

Another thing to look out for is if the advisor is trying to cater more towards your interests than your loved ones’. In the past, some advisors have tried to reserve funds so the family member can receive a bigger inheritance. The senior living advisor should be working for your loved one, not for you. They should be making sure your loved one is getting all the funds they are entitled, including Veteran’s Benefits. 

And if you are finding that living in a community may not be the best option for your loved one, the senior living advisor should be advocating a way that they can stay at home. They will help to assess a way that they can stay at home, and for how long. They will be able to refer in-home caregivers to suit your loved one’s needs. 

Making Your Senior Living Advisor Work For You

Now that we know some things to look for, let’s talk about how to make your senior living advisor work for you. As previously mentioned, you might want to first do a little research on your own first. Having this information together will help them more efficiently narrow down your choices. At the least, you should know the location where your loved one would like to live, whether it is a specific city or town. It should ideally be less than a 30-minute drive from where you live. 

It is also helpful to know what sort of care your loved one may need. There are many types of senior living communities: nursing homes, life plan communities, assisted living, skilled nursing, the list goes on. Narrow it down by learning about the different types of facilities, then determining what level of care your loved one needs. Is your loved one in the middle stages of Alzheimer’s or dementia? A memory care facility might be what you are looking for. Or are they mostly healthy, but need some help with their activities of daily living (ADLs)? Then an assisted living facility might be the best. Or are they still quite active and want to be around other active adults their age? Then perhaps a retirement community will meet their needs. Also start thinking about price ranges you and your loved one can afford. 

Once you get in contact with a senior living advisor, give them this basic information. They will ask you more questions that will help you narrow down your choices. Make sure to ask them for all the specific communities that meet your criteria. Keep in mind at this point, communities will start calling you. If this is a bother to you, just tell the caller that you would prefer to work with the senior living advisor first before talking with any senior community representative directly. Politely tell them to not call you again, and that you will possibly call them if you decide they are a viable option for you and your loved one. 

While you, your loved one, and your advisor narrow down your list of options, ask your advisor how to best negotiate with the senior living communities. Your advisor can discuss occupancy rates and can tell you which fees are negotiable or not. You can even use the advisor to gain leverage over one residence or another by creating a discount war between them. 

If your senior living advisor doesn’t know an answer to a question that you ask, they should attempt to find it out for you. Do not allow them to expect you to find out for yourself. They should be able to answer your question within a day or two, ideally. If they do not have the answer at that time, they should at least tell you when they will be able to answer it for you.

If you aren’t happy with the service you are getting from your senior living advisor, do not be afraid to switch to another service. There are plenty of good ones out there who will respect your time and accommodate your needs. You are actually under no obligation to continue working with the service even though you initially started the process with them. 

To get the most out of your senior living advisor, we’ve included a list of questions you can ask them:

  • How do you help a senior find a community that is right for their needs?
  • How do you help determine what type of care my loved one needs?
  • How much experience and training do you have as an advisor in the senior care industry?
  • How many other families are you working with right now?
  • How many families have you helped in the past?
  • How long does the process of finding a community usually take?
  • Will you be setting up appointments and tours for us?
  • Do you have pricing information?
  • How many communities do you recommend we visit?
  • Will you give us some tips on what to look for and questions to ask on our tours?
  • Do you know of any financial resources that might help us pay for care?
  • Are we required to sign a contract with you?
  • Do you charge for advice and guidance?
  • Do you have contact information for realtors and moving companies that are senior-friendly?

Find a Local, Established Agency to Best Suit Your Needs

Finding a long-term care facility for your loved one can be a tough process. And while utilizing a senior living advisor can help guide you and make the process a bit quicker and smoother, you have to keep in mind they might have their interests. Take for example the reputation the website A Place for Mom has gotten. Research the agency before you start handing out your name and phone number. We here at CareAsOne recommend you find an established local senior living advising agency with a strong reputation. In this way, you will be most satisfied with your final decision. We wish you and your loved one all the best in this process. 

What is a Life Plan Community?

The aging process can be a rough and bumpy one. Your loved one may transfer from facility to facility over the years, each big life change becoming increasingly more difficult for them. On average, seniors will live in an independent living facility for 10 to 12 years, an assisted living facility for 1 to 2 years, and then a skilled nursing facility for 1 to 2 years. Why not have all these facilities in one place? That is where life plan communities come in. In a life plan community, residents are said to “age in place.” This is because life plan facilities include a variety of services that cater to all possible health and aging needs, allowing for a continuum of care. And all of this is available on one big residential campus. This alleviates the pressure for your loved one to constantly move as his or her needs change. 

Typically, seniors move to a life plan community while still living independently, with only a few health concerns. The needs of residents are consistently monitored and cared for. As their medical needs change, the level of care is increased proportionally. The residents will “age in place” until they have reached the end of life, surrounded by all the best medical care for their needs. 

Not only is such an environment beneficial for the consistent and accurate care of your loved one’s health needs, but it is also advantageous for their social needs. Seniors often find themselves socially isolated as they age. However, being around similarly aged peers will help them fight depression and loneliness. Being part of a social environment will help them to live longer. A life plan community with its vast social network is perfect for the active adult. Baby boomers, which account for 28% of our population, fit perfectly into this retirement living option. There is often quite a range of social activities and amenities available in life plan communities, which will keep your loved one busy and happy. 

What is Life Plan Community?

So what exactly is a life plan community? We will break it down for you. Since the term “life plan community” is relatively new, you may have never heard it before. It was in fact, at one time called “continuing care retirement communities,” or CCRCs. The two terms are often used synonymously. In 2014, a national task force was established to discuss the name and evaluate the effectiveness of the CCRC title. The task force agreed upon the term “life plan” instead. They wanted the new name to make these new communities more welcoming to adults who do not need nursing care. The new name encourages residents to feel welcomed and comfortable, no matter what stage of the aging process they are in, and what services they need. With the name change, life plan communities have been able to emphasize the active lifestyle residents can have, rather than the previous care-focused mentality. 

In this article, we will touch on all the important aspects of what you should know to expect from a life plan community. Here are the three things that you will experience from a life plan community:

  • An active lifestyle that promotes personal growth, new skill development, and access to entertainment
  • Various levels of care on campus to suit residents’ changing needs
  • A lifestyle plan and contract options for the stages of older adults lives

Active Lifestyle and Structure

With about 2,000 life plan communities in the US today, many communities have included extensive libraries, fitness centers, and dining venues with elegant dining rooms. There are beauty and barbershops, as well as entertainment. Activities may include music events, dancing, games, art, dance, history, lectures, and movies. Life plan communities often have an upscale nature to them, usually with picturesque surroundings, and boasting beautiful living spaces that have an elegance that most senior communities do not. 

The various levels of care provided can be housed in a single high-rise building or a group of buildings like garden apartments, cottages, duplexes, mid- and low-rise buildings, or on a campus setting. The size of senior housing buildings varies from one to another, but the average is over 330 units. Broken down, this would be about 231 independent living units, 34 assisted living beds, and 70 skilled nursing home beds. 

Levels of Care

So by now, you’ve probably ascertained some of the varying types of care available at a life plan senior living community. They include independent living, assisted living, skilled nursing, and memory care. We will go over each of them: 

Independent Residential Living: This is the lowest level of care provided at a life plan community. Residents live in apartments and cottages in a community of like-aged individuals with a similar level of health. Maintenance and grounds care are taken care of by the staff, and seniors can enjoy social and wellness activities. There are a variety of on-campus amenities available, such as fitness centers, salons, dining, physical services, therapy service, and transportation services. 

Assisted Living & Personal Care: The community may offer either assisted living or personal care. Personal care is care in which residents are assisted in performing activities of daily living (ADLs). This could include medication management, incontinence care, grooming, housekeeping, or memory support. The amount of support, and thus the cost depends on how much assistance is needed. Personal care units can be anything from a small studio apartment to a single-room unity with a full bathroom. Assisted living services are slightly different in that they offer additional medical support.

Skilled Nursing Care & Healthcare Centers

Skilled nursing services means 24-hour nursing home care, and can be used for long-term care, end-of-life care, or short-term rehabilitation. Licensed nurses provide skilled nursing care, thus making this a higher-level of care due to the residents’ one-time or ongoing medical conditions. 

Short-term rehabilitation means a temporary stay in this type of care. The resident may have just come out of surgery, had a stroke, or had other serious health issues. They will get the treatment they are needed, recuperate, and then return home. 

Long-term care is meant for those with chronic or progressive conditions. These can include strokes, dementia, or disabilities that are permanent. Due to the seriousness of their health issues, they have access to qualified professionals 24-7. 

End-of-life care can be provided in a skilled nursing facility. This includes hospice care and the care for the patient during the final stages of life. 

Memory Care: End-of-life care can sometimes be provided at a memory care unit, but in general, these units are meant for those with memory loss complications. Memory care units provide a calm, safe environment for those with dementia, Alzheimer’s disease, or any memory-related issues. The staff is specifically trained and provide personal assistance to support these residents. Carefully planned activities are set up with each individuals’ needs in mind. Sometimes these memory care units can be a part of the assisted living or skilled nursing units. 

Types of Contracts in a Life Plan Community

With the name life plan community, it is easily inferred that with this community, the emphasis will be on having a plan for the upcoming stages of life. Unlike many other senior living categories, life plan communities require a legal process and life-care contract upon admittance to the community. But first, seniors must qualify through an application process. With this application, the potential resident will have to provide extensive financial and medical history information. Since life plan communities can be quite expensive, the administrators must be detailed in evaluating potential candidates. They often require health and financial assurances for validation purposes to qualify a resident. They also must be sure there is enough room available at the facilities based on their current care needs.

Once the potential resident has been qualified, they enter into a formal business arrangement for the commitment of time as well as rental or purchase of their living space. The stipulations of these contracts can vary, and specify in print important matters like housing arrangements, residential services, personal health care services, and nursing care. This comes with a guarantee that they will receive the agreed-upon services during their stay in the community. An entry fee is required most of the time, but oftentimes a large part of it is returned to the family later on. 

The present costs of these services will be specified, as well as under what conditions the costs could increase. It also details under what conditions the resident will transfer to varying levels of care. Having a contract in place will protect your loved one’s rights. It is not uncommon to have a lawyer involved in this process. 

There are three main contract types, all distinguished by the American Seniors Housing Association (ASHA). These contracts have majorly different fee scales for personal assistance and nursing care, as well as to what extent care is available without the added expense. We will discuss the three main types, plus any other types of contracts you may be presented with. In practice, however, residents can have contracts that are a blend of these first three types: 

Type A or Life Care Contracts: Communities offering Type A contracts are sometimes called life care communities. Also known as extensive all-inclusive contracts, Type A contracts guarantee the resident shelter, residential services, personal assistance, nursing care, and amenities for the rest of their lives. There will be an initial entrance fee and a monthly payment schedule. The required entry fee may be partially refundable, or non-refundable depending on the length of stay. This type of contract is most often chosen by those living in the independent living units. When they move to assisted living or nursing care accommodations in the community, the residents will continue to pay a monthly fee, only slightly higher. Fees only increase when compensating for increasing operating costs. Under this care plan, the community absorbs the risk of health cost increases for the resident. 

Type B or Modified Contracts: Type B contracts usually have lower monthly fees than Type A contracts. They do still include the same shelter and residential amenities. Not all health care services are included in the initial monthly fee, however. When a resident moves to a higher level of care, they will still be charged the independent living rate, but only for some time, after which they must pay the full or discounted per diem rate. For example, a resident could move to assisted living care for 30 days without a change in monthly cost, but then afterward would pay the market daily rate or discounted daily rate. In this way, they are facing the risk of having to pay more for necessary care.

Type C or Fee-for-Service Contracts: The Type C contracts usually have a lower entrance fee than both Types A and B. Sometimes there is no entrance fee at all. Under this contract, residents will be prioritized or guaranteed admission in the higher levels of care, but are not eligible for discounted health care or assisted living services. Upon admission into the assisted living or nursing home care, these residents will pay a regular price or higher. This type of contract is typically signed by older residents being admitted into an assisted living or nursing home type of care. The Type C contract puts all the risk of high long-term care expenses on the resident.

Type D or rental Agreements: Sometimes communities will offer Type D as a fourth option. Usually, there is no entrance fee required. Instead, there is a monthly fee that includes some of the independent living amenities, and the ability to utilize care services. With this type of contract, you will pay as you go and incur all the risk of all their expenses.

Equity Model: Some communities uncommonly use this type of system where the resident owns the unit they are in, which they will sell once their needs change.

If you are having trouble choosing which is best for your loved one, simply compare the total expected entrance and monthly fees over the expected lifetime for each contract option. Type A and C contracts are becoming increasingly popular, and it is possible that entrance fees have and will increase. Here are some figures to give you a ball-park estimate:

Costs of a Life Plan Community

Life plan communities are by far the most convenient care option for seniors. However, they are also very pricey, though these prices vary widely in the entrance and recurring fees. Before we lay the prices on you, we want to mention that life plan communities can be some of the most expensive senior living options out there. And, life plan communities are paid for out-of-pocket by the resident and/or family. Typically residents pay for their entry fees through the proceeds from selling their residence. The entry fees for studio apartments can range from $40,000 to $90,000. Two-bedroom homes can range from $200,000 to $300,000. Keep in mind that families generally receive back 50 to 90% of the entry fee upon the passing of their loved one. The monthly fee usually ranges from $1,500 to $5,000. And higher-end communities can cost even more. Though the up-front costs are quite high, residents in a life plan community may end up paying less in their last year than in other comparable senior communities. 

Accreditation for Life Plan Communities 

The majority of life plan communities are not reimbursed by Medicaid or Medicare. As a result, there is no mandated requirement to be accredited. Even so, communities strive for independent accreditation. When looking for a life plan community, consider finding one that is CARF-accredited. “CARF” is an acronym for Commission on Accreditation of Rehabilitation Facilities, which is a nationwide accreditor for life plan communities. 

To become accredited, a life plan community should have an internal examination of its programs, and then afterward be exposed to a rigorous on-site survey by CARF. To maintain this accreditation, the community must continually make improvements. This accreditation review is voluntary and paid for by the community.  

Keep in mind, however, that if the life plan community you are looking at is not CARF-accredited, this most certainly does not mean that it is subpar. There are only a few communities that apply for and meet the demanding requirements of CARF. Just know that when you come across a CARF-accredited community, you have found one with a sterling reputation.

Peace of Mind is Priceless

Despite the high price tag, a life plan community gives you something priceless: peace of mind. In this kind of place, today’s seniors can continue to experience life as if they weren’t at a nursing home. They will be surrounded by friends for years, and not have to be uprooted constantly. If you are looking for an option for your loved one in which you do not have to worry, this is it. We here at CareAsOne hope that this article has given you a little bit more of an idea of what you can expect from a life plan community. 

The 10 Best Apps for Seniors & Elderly People

Who would have thought that in this day and age that our life can be enhanced so much by a chunk of metal we hold in our hands? Apps tell us what restaurants are good, how to get there, enable us to invite friends last minute, call a ride, and advise us to bring an umbrella because it is going to rain. For most of us, these apps have become so ingrained in us that they are now our second nature. However, the transition is a bit harder for our elderly loved ones. Not having grown up with technology can leave them at a disadvantage these days. 

The gradual takeover of smartphone technology can be a bit scary, overwhelming, or frustrating for the elderly, but there are so many benefits that enhance seniors’ daily lives that are hard to ignore. Helping them download and learn some of these beneficial apps is one of the most helpful things we can do for them. Whether it is with an Android or an iPhone, the addition of several key apps on their mobile phones can increase seniors’ health and well-being tenfold. We will discuss in this article our top 10 picks of apps for the elderly, and exactly why they can be of great benefit to them. 

1. Skype (available for iOS and Android)

Staying connected with family and friends is as essential to seniors’ lives as diet, medication, and exercise. Depression and isolation can often cause a downward health spiral which can sometimes cause early death. For this reason, it is so important for seniors to not be socially isolated. Being able to call a friend or family member has become increasingly easier with the development of modern-day technologies. And to be able to see your loved one through a video call almost makes it seem like they are in the room. 

The best way to keep in touch with family and friends is through Skype. This app offers HD video and audio calling on your smartphone or exchanging messages by way of the Internet. It can also be used to call cell phones and landlines, not just other people who have the app. The computer versions of the Skype app enable you access to your phone’s text messages, allowing you to read and reply to them. 

Using Skype is typically free, but some features cost a small fee. For instance, calling cell phones or landlines in the US is available through monthly packages starting at $2.99. International calls are also available but at different price points. However as long as you are calling, messaging, and video chatting with fellow Skype users, it is free! No more outrageous fees for international and long-distance calls adding up. You no longer have to wait for your granddaughter to come back to tell you about her backpacking adventures to Europe. You can join along as you Skype with her through video chat. Hike up the Eiffel Tower with your loved one, all in the comfort of your own home.

2. Blood Pressure Monitor (available for iOS only)

Anywhere from 30 to 50% of people over the age of 50 have issues with hypertension (chronic high blood pressure). Those that suffer from this condition are at a higher risk of further health problems like heart disease, stroke, vision loss, and dementia to name a few. For this reason, blood pressure monitoring can be so important to notice an issue before it causes great harm. Not only is blood pressure monitoring helpful for those with hypertension, but it can also be used by all older adults to assess and optimize their well-being. Checking your blood pressure daily allows you to check for a serious illness, help reduce the risk of falls, and to monitor recent medication changes. 

The Blood Pressure Monitor app helps you keep track of all your blood pressure and weight readings over time. It also provides statistics, health reminders, and allows you to export your data to your doctor. Keep in mind that this app does not read your blood pressure. You must input the data manually. The Blood Pressure Monitor is available for your iPhone and iPad through the App Store, but there are similar apps available for Android smartphone users. 

3. Amazon Kindle (available for Android, iOS, Mac, and PC)

Getting lost in a good book can keep senior’s minds active, entertained, and engaged. The act of reading enhances memory, sharpens decision-making skills, reduces stress, and improves sleep. Not to mention reading can also delay the onset of Alzheimer’s disease and other forms of dementia

Kindle allows you to read unlimited books right from your phone, computer, or iPad. You do not need the Kindle device. And not only can seniors read a variety of books that help them gain insight into their health problems, but they can also get lost in a Clive Cussler western or John Steinbeck novel. The ability to escape into a new world can help seniors break up the monotony of their day. And reading can also be social. Encourage your loved one to join a book club with friends. Kindle will help them easily find the exact book to read along with their reader’s circle. 

Though Kindle is available for Android and iOS users, Apple has an alternative app. AppleBooks offers digital books as well as audiobooks for your iPhone, iPad, iPod touch, or Apple Watch. Happy reading!

4. LibriVox (available for iOS and Android)

If your loved one is a voracious reader but struggles with a visual impairment, Librivox can be a good alternative. The LibriVox app has more than 27,000 audiobooks he or she can listen to. They can be streamed online or be downloaded for later. There are new releases every day, as the volunteer team at LibriVox records new releases every day. And best of all, it is free!

The LibriVox catalog offers world literature of both fiction and non-fiction, including novels, biographies, history books, short stories, classic bestsellers, old radio dramas, poetry, and so much more. US users also have access to an additional 75,000 audiobooks, such as new releases and bestsellers, at a price. Another honorable mention for those who like to listen to interesting programs would be the NPR app, which broadcasts tons of interesting news, podcasts, stories, humor, and music.

5. Lumosity (available for Android, iOS, and PC)

You may have noticed your loved one becoming more forgetful over time. The reason for this is that brains shrink in volume over time. Some neurons are lost, and the remaining neurons slow down when the brain sends messages. But the good news is, that seniors can combat this with an active routine, a healthy diet, daily socialization, and of course, mental exercise. Your brain is a muscle that can be trained just like other physical body parts. 

Lumosity is a great app that encourages brain training through hundreds of challenging puzzles and brain teasers. Not only does it improve your memory, attention, speed, mental flexibility, and problem-solving skills, it is fun! Available in both free and paid versions, this helpful app is based on the science of neuroplasticity, meaning the brain can change and reorganize itself. And this means, at any age! You can easily tell the app what areas you would like improvement in, and it will recommend a series of games every day to work on those areas. You will see a big difference over time if you stick with it!

6. Pillboxie (available for iOS)

Medications keep your loved one well. They are a big part of senior citizens’ daily routines and ensure their functionality in living with many conditions. The average elderly person takes more than 5 prescription medications at any given time. The average nursing home resident takes 7. Often they are meant to be taken at various times of day, with or without food. Keeping track of the medication schedule can be difficult for most seniors. Therefore, we would like to recommend Pillboxie. 

The Pillboxie app sends you notification reminders for scheduled medication times that you set. You can customize your medications by color. This makes it easy to organize your schedule by visuals because you can drag your specifically-colored medication into a pillbox marked with the corresponding time to take them. The device will make a noise at the desired reminder time, and the user can check off the dose as they take it. The medication will be grayed out once it has been checked off. Your loved one can customize the settings to register all of his or her medications and dose times, all for only $1.99. Android also has medication management apps like Medisafe in the GooglePlay store. 

7. AARP (available on iOS and Android)

Being part of a community gives seniors meaning and purpose in their lives, especially after retirement. Sometimes the elderly feel a bit excluded in today’s fast-paced society. However, with the American Association of Retired Persons (AARP), it is all about the senior community. AARP not only advocates for the elderly in terms of things like social security and Medicare, but they also supply age-related news, nearby event listings, and incredible members-only benefits and senior discounts. To be a member of AARP is only $16 a year, and we believe it is well worth it if you take advantage of the many discounts available. Having the AARP app, however, is free to members and non-members alike. Stay up-to-date on senior-related news to know what is going on in your senior community. You can also easily share interesting AARP news through your social media channel. But with the yearly membership, you or your loved one can have easy access to additional benefits on your phone. Get discounts on anything from health insurance and pharmacy costs to gas, tech, and travel. The list goes on and on. And having the app makes it even easier.

8. Magnifying Glass + Flashlight (available for iOS and Android)

Vision loss is a common problem amongst the elderly. Have you ever brought your loved one out to a restaurant and they stare at the menu for a while only to realize he or she forgot the “readers.” They often can’t go anywhere without needing their reading glasses. You or your loved one can now have “readers” on your phone with the free Magnifying Glass + Flashlight app. This handy app will not only zoom in on small print and images up to 5 times, but it will illuminate it, making it even easier to read. It also can capture screenshots of what you magnify, which can be handy for saving useful information. With this magnifier, your loved one will no longer have trouble with the fine print on restaurant menus, maps, mailers, contracts, or keypads. Simply position the mobile device’s camera over the desired text and move the screen slider. The text will be automatically lit up and enlarged, making reading a breeze for the visually-impaired. 

9. Uber (available for iOS and Android)

The inability to get in their car and go where they want to can be frustrating for seniors. Many have been used to having their freedom of mobility in their younger years, but as time goes on, they lose the ability to drive for many different reasons. This can be due to stiff joints and muscles, hearing or vision loss, dementia, or slower reaction time. Certain medications they take can also affect their driving ability. Despite these issues, they would still like to be as mobile as possible. And you might not always be around to take them where they need to go.

That is where Uber comes in. This mobile app can easily enable your loved one to catch a ride to the store whenever they want. They can go to a concert in the park with friends, a Saturday bridge game, or a quick trip to the pharmacy all without your assistance. Having this type of freedom can help a senior to feel more independent, which leads to greater well-being. They feel more in charge of their schedule and daily activities and can arrange them how they see fit.

Your loved one can order a car from home, and then again when they have finished at their destination. Average wait times for an Uber can be anywhere from 5 to 15 minutes, depending on what area you are in. Incredible, isn’t it? The Uber app itself is free, but the rides will charge your credit card in the app, depending on the length of the trip.

10. WebMD

Health concerns are the most prevalent issues seniors have to deal with in their daily lives. New symptoms pop up all the time, which can leave your loved one stressed and frightened about what it could signify. He or she may not be able to schedule an immediate doctor visit to discuss the symptom. Well, you no longer have to Google your symptoms and browse through pages of results anymore. With the free WebMD app, you can easily check your symptoms, learn about potential health conditions, medication side effects, and find doctors in your area. This app also sets medication reminders. Having the physician-reviewed information at your fingertips can ease a lot of stress that seniors face. 

Another useful aspect of the WebMD app is the “Healthy Target” section. This feature allows you to establish eating and exercise goals, and then gives you actionable insights at the end of the week, based on your input information. Keeping on top of your health and fitness goals is essential for a senior who values a healthy lifestyle. And you don’t need a personal trainer to do it! This is one of the best health apps out there.

Always remember that any information given on this app should not replace any advice or diagnosis your doctor can give you. The WebMD app is simply giving supplemental material that you can use as a tool to learn about, and better your health. 

Stepping into the Modern Age

Introducing one or more of these smartphone apps for seniors to your loved one can be challenging, and even frustrating at first. But as he or she gets to know the benefits of these useful apps, you will see a delight that spreads across his or her face that will in turn bring you so much joy. Adding a new app to a senior’s life can be like them gaining a new superpower. Your loved one can now read and listen to books limitlessly, train their brain with fun games, order a car to see friends, manage medications and learn about symptoms, stay connected with the senior community, and best of all, stay connected with friends and family all over the world. With these apps, we have no doubt your loved one will live with more ease and freedom, which in turn brings you more peace of mind. We here at CareAsOne send our best wishes to you and your loved ones in this modern age. 

The 3 Different Levels of Care for Assisted Living

Assisted living facilities are versatile senior living communities that offer different levels of care to residents. Living in their own apartments can ensure older adults their independence while still providing that their ever-changing needs are met. Care plans are drawn up upon enrollment and are often assessed and revised as your loved one’s needs change. The ability to do so is done through a needs assessment that evaluates the level of care necessary to best maintain the health of a resident. Some residents require more assistance, while some can perform their activities of daily living (ADLs) completely independently. Support and management of resident’s health care needs also contribute to the amount of care needed. 

The more help a senior needs, the higher the level of care provided will be. This level of care directly affects the amount of staff and supervision needed to assist your loved one, not to mention the level of training for them to properly care for these needs. Thus the level of care also directly affects the price of residency. In this article, we will go over the common 3 levels of care in an assisted living facility, and how they are often defined, assessed, and priced.

State-to-State Variations

Unlike nursing home communities, there is no nationwide definition for assisted living. It is the states who license and regulate assisted living facilities. Therefore the rules, regulations, and procedures vary from one community to another, even if they are in the same state. For this reason, it is difficult to clearly define what constitutes the level of care, and how many there are in each facility. Some communities offer many of the same services as a skilled nursing facility. This is done by utilizing home health agencies or staff members with the proper training. Other communities may focus strictly on ADLs, like helping to feed, dress, and bathe patients. And some may have focused memory care units, which are made strictly for the supervision and assistance of Alzheimer, dementia, and memory loss residents. The restrictions of what can and can’t be done at a facility are all determined by the licensing. All that being said, we will now define the varying levels of care on a broad scope to help you get an idea of what you can generally expect. 

Assisted Living Levels of Care

As we just mentioned, the type of assisted living facilities varies wildly. However, there are typically 3 levels of care at any given facility, regardless of the license. Keep in mind that the levels of care can sometimes range up to 5 levels.

Level 1 Assisted Living Definition-Low Level of Care: This individual is mostly independent. A low level of care refers to a resident needing occasional assistance or support in one or more personal care or health care areas. He or she may need to be reminded to perform ADLs. A low level of supervision or assistance may be required for some to make sure that the ADLs are done correctly and safely. Some other examples include needing help getting to doctor visits, simple medical treatments, managing occasional behavior changes, or help to participate in social or recreational activities. 

Level 2 Assisted Living Definition-Moderate Level of Care: This level of care refers to a resident who requires substantial assistance or support in one or more health care or personal care areas. This individual may be able to independently perform some ADLs, but need help with others. For example, he or she may be able to feed themselves but are unable to get on or off the toilet. Other examples of common areas of support at a moderate level are helping to get to doctor’s visits, performing needed medical treatments,  or managing behavior changes.

Level 3 Assisted Living Definition-High level of Care: A high level of care refers to a resident who needs extensive and frequent assistance in the areas of several personal care or health care needs. This resident has mental or physical impairments that affect their ability to perform multiple ADLs. They may require total assistance from multiple caregivers. Some examples include ensuring doctors’ visits, administering medications, performing ADLs, performing necessary medical treatments, managing frequent behavior changes, and ensuring the resident engages in social or recreational activities. 

Memory Care: It should be noted that memory care programs are run a little differently than the typical residential care plan. Memory care units in assisted living facilities house residents with forms of dementia like Alzheimer’s disease, or have memory-loss issues. These programs are focused on resident engagement and safety. The trained staff guide residents in activities that allow the resident to feel more independent. Often gourmet meals are provided, which helps promote independence and dignity in a calm fine dining environment. Since a memory care unit is a more specialized approach, it often falls outside the realm of the ordinary assisted living level of care plans. Therefore they are assessed and priced differently. 

Level of Care Assessment for Assisted Living

To determine the level of care needed for a new resident, a needs assessment will be conducted. The needs assessment is typically done by an assisted living facility nurse or staff member as a pre-screening for admission. The outcome of the assessment will help develop your loved one’s personal care services plan. It is also possible that the facility may determine your loved one will be better served in a different kind of senior care facility, like a nursing home.

The assessment will inventory and rank the mental and physical condition of your loved one, as well as his or her ability to perform ADLs. In some facilities, a points system is used to rank the prospective resident’s ability to do each task, and to what degree. Then, depending on the number of points accumulated, the level of care will be determined. Different facilities categorize the levels of care differently. Therefore it is best to research how your facility’s assessment system works to be sure what level of care will be received. 

The following are some of the areas the needs assessment test will cover to determine your loved one’s level of care:

Behavioral Condition: An analysis of a senior’s behavior is necessary to determine whether or not he or she can comply with policies of the facility, can respond to staff direction, and can respect other residents, staff members, and property. Behavior is assessed to make sure your loved one won’t jeopardize the health and safety of themselves and others. On a level of care assessment test, the behavior could range from a low-level of care when described as “consistently appropriate” and a higher level of care when he or she is a “safety risk to self and others.”

Mental Condition: A prospective resident’s cognitive and mental condition will be assessed to see if they are experiencing confusion or dementia. This is a huge determination of how much staffing they might need to assist your loved one. Dementia sufferers and other confused persons could experience wandering which means constant supervision. On an assessment test, they could be ranked anywhere from “consistently normal cognitive function”, a low level of care, to a higher level of care described as “accelerated dementia requiring frequent staff intervention.”

Medical Needs: You and your loved one will need to supply past medical history as well as an evaluation from their current primary care physician. The facility may conduct an in-house medical exam. Some health and issues and conditions they will pay particular attention to include: vision or hearing problems, incontinence, arthritis, cancer, heart issues, diabetes, and digestive disorders. Knowing exactly what sort of medical issues exist enables the facility to accurately anticipate your loved one’s medical care needs. The level of care will vary depending on how much support is needed for management, treatments, and medication services. 

Special Support Needs: If your loved one requires any kind of special support, this will be documented in the needs assessment. Special support could include anything from a special diet, oxygen assistance, or mobility assistance. 

Personal Care and Hygiene Needs: Your loved one’s ability to take care of themselves will be assessed. This includes personal care, bathing, hygiene, grooming, and whether or not they can use the bathroom unassisted. On the bathing portion of a needs assessment test, the level of care range could be anywhere from a low-level for “independent with bathing and showering,” to a high level for “assistance 4 times a week.”

Once your loved one has been admitted to the facility, the care plan can be adjusted. The needs will inevitably change as time goes on. A needs assessment should ideally be done by the staff every few months or when the staff thinks a change is needed. Also, remember that any changes will affect the cost. Check with your assisted living facility to find out their policy on the frequency of assessment tests, and notifications on pricing changes. Next, we will touch on the various ADLs and what level of care services your loved one may expect, based on their current ability to perform each. 

Activities of Daily Living (ADLs) and their Level of Care

Bathing:  Bathing is one of the most dangerous situations seniors may face daily. This is because of the chance of shower-related falls that cause injury. Bathing, of course, is also imperative for residents’ hygiene. Seniors who can shower on their own without help are at a lower level of care than a senior who needs someone present or needs to be reminded to bathe. Someone at a middle level of care might need assistance with shower or bath preparation and possibly some verbal cueing but can mostly complete the task on their own. For these residents, it might be helpful for someone to be nearby if they are at risk of falling. If the resident is has a shower or bath more than two times a week, the level of care may go up simply due to the addition of manpower to accommodate that need. A higher level of care would be used for someone who needs one or more caregivers to help with bathing.

Dressing: Seniors who are otherwise quite independent may have trouble dressing and undressing. They may have trouble with small buttons and hooks due to reduced manual dexterity. Or they may just have trouble picking out clothes to wear depending on the occasion or the weather. Someone who can complete the task on their own would qualify for a low level of care. The level of care would increase as does the amount of physical assistance necessary and times a day someone needs assistance.

Grooming: Grooming would include tasks such as teeth brushing, hair styling, and brushing, as well as shaving. This sort of assistance may be necessary for someone who has a decreased range of motion in his or her shoulders. Someone who cannot perform any of these tasks will be needing a high level of care.  

Feeding: Residents need help with feeding for various reasons. Some are able to feed themselves but cannot cut up their food. This may require a low level of care assistance. Higher levels of care would be necessary for those who have a choking risk and need someone present simply for safety. A higher level of care would also be necessary for a resident with limited upper body function and needs help feeding themselves.

Mobility: Mobility, or ambulation, refers to the ability to get from one place to another. Getting help with this necessary function comes with varying levels of care. Residents who are able to get around on their own, or with a cane, walker, wheelchair, or scooter without help can qualify as a low level of care. What causes the level of care to go up is how much assistance is needed from staff members to get around. When someone requires assistance walking or standing, this could be perceived as a higher level care because they cannot get around independently.

Toileting/Incontinence: Toileting refers to getting on or off the toilet, and also includes any hygiene or incontinence needs a resident has. Someone who is able to complete this task independently, including changing their own protective underwear, is considered to be at a low level of care. Anyone needing hands-on or verbal assistance, or has the community order incontinence products instead of providing their own, will require a higher level of care. 

Medication: A resident who is able to fill and take medications without help is regarded to need a low level of care. Residents who are physically unable to open pill bottles or administer their own injections would probably be regarded as a moderate to high level of care. Those who rely on daily reminders of medication management but are able to complete the task themselves probably would be considered to need a moderate level of care. 

Pricing Based on Level of Care

Depending on the level of care your loved one needs, assisted living communities can be much more affordable than home care or a nursing home facility. The monthly rates at an assisted living facility change and can vary widely. This all depends on the location, amenities, and level of care. The typical range is $3,000 to $6,000 on average, and plans are on a month-to-month basis. So you can expect to pay about $3,000 a month for a low level of care, ranging to $6,000 for a high level of care. You can compare this to the average cost of a nursing home which ranges $5,000 to $10,000 a month. And home care is $4,000 per month, based on 40 hours of care per week. You can easily infer from this that assisted living is quite affordable, and is a valid option, especially for those with a low level of care who desire independent living. 

Keep in mind that Medicaid can help pay for assisted living if your loved one has low income and few assets. But Medicare, however, does not help pay for assisted living. 

Assess Your Loved One’s Level of Care and Plan Accordingly

Assisted living is a long-term facility where the quality of life flourishes. You and your family members can rest assured that your loved one will be provided the right amount of assistance for his or her level of care needs. But if however, upon reading this article you have decided that assisted living option is not right for you, be aware that there are so many senior living options to choose from. Perhaps more short-term care is needed, such as at a skilled nursing facility. Or, a bigger senior living community might be what your loved one needs. Continuing care retirement communities meet a variety of different needs, offering independent living, skilled nursing, and assisted living all in one place. Or, perhaps, your loved one is in more advanced stages, whereas a nursing home might be more appropriate. Consider the highest well-being of your loved one, what level of care is needed, and plan accordingly. We here at CareAsOne wish you and your loved all the best.

Requirements for Assisted Living Facilities

Choosing the right long-term care facility for you or your loved one can be exhausting. There are many options of care providers to choose from, as well as much preparation to be done before moving in. In this article, we will go over how to choose the right facility for your needs, and exactly what are the requirements for an assisted living facility. 

What is Assisted Living?

If you clicked on this article, you probably have a good inclination that an assisted living facility is what you are after. Assisted living is a long-term care facility that ensures more senior independence by providing limited day-to-day care. There is less medical treatment than a nursing home or skilled nursing facility, and more focus on assisting seniors in activities of daily living (ADLs). ADLs include things like bathing, toileting, dressing, eating, and mobility.

For many, an assisted living facility (ALF), also known as a residential care home, feels like a more safe living environment than a nursing home. This is because they can maintain their privacy, independence, and keep a routine lifestyle of their design. Assisted living services are extremely flexible and can be tailored to your loved one’s wants and needs.  Having a loved one in an assisted living facility provides their family with peace of mind, knowing that they have 24-hour access to help if there is an emergency. This is much less stressful than knowing a senior is living alone at home.

Making Sure Assisted Living is the Right Choice For You

So we have established that assisted living is a great choice for those that want to maintain independence. And who doesn’t want to be independent? But the truth is, these kinds of facilities are not meant for everyone. Assisted living simply does not provide an advanced level of care for everyone. We do not recommend an assisted living facility for the following cases:

  • Those who use a wheelchair for mobility
  • Those who have a severe of late-state cognitive disability, like Alzheimer’s disease
  • Those with complex or involved medical needs
  • Those with dangerous behaviors, including wandering
  • Those with extensive medical needs

Analyze other health care options and determine whether a nursing home, skilled nursing facility, or a hospital might be a better fit for any of the above cases. A nursing home is a long-term care facility that provides medical treatment as well as ADLs. Skilled nursing facilities are more often short-term and focus on the recovery of an illness or injury after leaving a hospital and before returning home. And of course, hospitals provide the most advanced medical support but are short-term. Alternative care options to an assisted living facility could also include home care, adult day care, family care homes, supportive services,  independent living facilities, and medical alert systems. For an early-stage Alzheimer prospective resident, an assisted living facility could be a good option. Keep in mind, however, as the disease progresses, the resident will need to be transferred to a facility with a higher level of care, such as a memory care facility or nursing home. So now that we have an idea of what needs assisted living facilities do not provide for, let’s take a look at some of the reasons people choose these facilities over other options:

  • Personal needs and preferences are the priority. Personal care and medical attention are only provided on an as-needed basis, ensuring that seniors stay independent.
  • Residents can alter care plans as their needs shift.
  • Residents feel more self-sufficient, dignified, and in control as compared to other options.
  • Assisted living services facilitate interaction with residents’ friends, family, and community so they will maintain social support networks, good mental health, and thus better quality of life.
  • Residents do not need frequent medical assistance, but still need some help to a degree.
  • Residents may need help with specific, minimal tasks on a day-to-day basis.
  • Residents don’t yet need nursing home type of services but aren’t completely able to live on their own. 
  • Residents want to maintain their independence and privacy as long as possible.
  • Residents are still able to be active members of the community.

Assisted Living Accommodations and Services 

Accommodations in residential care facilities often consist of the resident’s semi-private or private apartment. These apartments include either a furnished or unfurnished bedroom, kitchen, and bathroom. It is also possible to obtain a private studio apartment, one-bedroom private apartment, one-bedroom shared apartments or a dorm-style bedroom. Services offered at assisted living facilities vary from state to state, but here is a list of the most common services:

  • Personal care services, including ADLs
  • Educational activities
  • Meal preparation
  • Emergency call systems in private and common areas
  • Exercise activities
  • 24-hour security
  • 24-hour supervision and support
  • Transportation arrangements
  • Laundry services
  • Housekeeping and maintenance
  • Health care services and medication administration
  • Dementia and disability care
  • Recreational activities
  • Social services and religious activities
  • Wellness programs

Many residential care facilities also work with home health agencies to provide skilled nursing care or hospice services.

When visiting potential assisted living facilities for your loved one, be sure to be aware of what services are and aren’t provided. The service coordinator should also make an initial evaluation of your loved one to determine what he or she needs. Upon moving into the facility, your loved one should also undergo evaluations regularly to modify the services received as needed. Your loved one should have copies of these evaluations for his or her records. Residents generally can choose which services they are provided. Having this control over their lifestyle allows seniors to relax and enjoy their day-to-day routine that suits their needs.  So now that we have covered what assisted living facilities are all about, and you’re still reading, let’s cover the next step of finding the right facility for you.

What to Look for in an Assisted Living Facility:

Types of Assisted Living Facilities: When looking for the right facility for you or your loved one, it is important to distinguish between the varying facilities. Once you can identify the type of facility that is best for your situation, your search will narrow down immensely. Keep in mind the following types of assisted living facilities are not clear-cut and followed by all states. Here are some examples of types of facilities you may be looking for: 

Type A Facility: In this facility, a resident is physically and mentally capable of evacuating unassisted. This may include mobile, non-ambulatory persons such as people in wheelchairs or electric carts. These are people who don’t require routine care during nighttime hours and can follow directions during an emergency.

Type B Facility: In this facility, a resident may require a staff assistant to evacuate. However, they are capable of following directions during an emergency. They may require attendance during nighttime hours or not permanently bedridden but require assistance in transferring to and from a wheelchair.

Type C Facility: These facilities are four-bed facilities that contract with the state and provide adult foster care. They have to meet specific contracting requirements.

Type E Facility: This type of facility limits the number of residents, all of whom are physically and mentally capable to evacuate in an emergency unassisted. This could include people who are mobile, and non-ambulatory, like people in wheelchairs or electric carts with the ability to transfer and evacuate themselves during an emergency. They do not require routine attendance during nighttime hours and are capable of following directions during an emergency. 

Abiding by State Laws

While nursing homes and skilled nursing services are regulated and rated by the federal agency Centers for Medicare & Medicaid Services (CMS), assisted living facilities are regulated by the states, not the federal government. Each state’s health department or social services office regulates assisted living communities, depending on the state. The CMS does, however, offer some guidance to the state Medicaid services for those assisted living facilities that are Medicaid-certified, which is about half of them. When researching your assisted living community, verify that the facility has obtained licensure, as well as make sure they have undergone the appropriate inspections required in your particular state. Here are some areas the state enforces regarding facilities’ assisted living requirements:

  • Resident agreements which inform potential residents of associated costs of care before move-in
  • Resident admission and retention policies which are clearly defined, and based on needs and/or behavior
  • Support services and service plans that which describe the type of care residents receive in detail
  • Required medication provisions, stating who can administer certain medications, and to what degree unlicensed staff can administer those medications
  • Foodservice and dietary provisions, as in how many meals residents receive daily, and any dietary recommendations the facility must follow
  • Staffing requirements, as in rules on background checks, training, and requirements of continuing education
  • Size of apartments, roommate rules, and the number of people allowed to share a bathroom
  • Inspection and monitoring requirements
  • Consequences to facilities for noncompliance

Even though all these aspects are all covered by state assisted living regulations, the specifics of these assisted living requirements vary for each state. One example is that 40 states enforce “direct care worker” training, but the required training hours can range from one to 80. This is a gaping difference that can determine the likelihood of competent and incompetent staff. Get to know the assisted living requirements in your state to see what are the mandatory requirements. 

Be aware that some facilities choose to remain unlicensed. Sometimes the facility offers quality care, not harming the residents. But keep in mind that without proper licensing and inspections, there is no way of knowing whether the facility is following standards for resident care, disaster planning, medication management, and so forth. It is also important that the facility complies with the Department of Health regulations. Not following these procedures and regulations may result in fines and eventual closure of the facility. Although a properly licensed facility doesn’t mean they will provide the highest quality of care, it does mean they are following the state guidelines. Be sure to verify the facility you are interested in is licensed to your satisfaction.

Touring the Facility 

Once you and your family have narrowed down the search a bit, select a few residential care facilities at the top of your list. Touring these facilities to learn about the different senior care services, programs, and amenities will help make you make your final decision. We have composed a list of questions you can ask as you tour the facility, particularly regarding their compliance with the required laws: 

  • How do you identify which care services my loved one needs, and how often will he or she be reevaluated?
  • Who conducts these evaluations?
  • What is the entire range of services offered at this facility?
  • How is the payment plan set-up?
  • Which services are included in the base monthly plan?
  • What is your policy regarding the use of outside services?
  • Is there a deposit, and is it refundable if my loved one needs to move?
  • If my loved one’s needs change, will the fees reflect these changes?
  • How much notice will my loved one be given if the fees change?
  • Can the fees increase if his or her needs do not?

When touring the facility, you and your family members will be met with assisted living staff. Ask the questions above, as well as any questions regarding senior living programs, activities, and other services you may be interested in. Most of these facilities offer free lunch so that you and your loved one can sample the food. If this is something you are interested in doing, make sure to inform the staff ahead of time so they can arrange that for you. 

Once you have toured the facilities that interest you, and your loved one and family have settled on their favorite, next comes the process of applying to the facility. Luckily the process to apply to an assisted living facility is much simpler than a lot of long-term care facilities. We have broken it down in the next steps to make it even easier for you. 

Requirements for Assisted Living Facilities

Room Deposit

As you’re touring the facility, it is a good idea to ask about reservations/deposit details with the staff. Oftentimes assisted living facilities are filled, so a deposit might be required as you attend to your paperwork in the next steps. You and your loved one will select a private or semi-private room depending on the availability and then pay the deposit, which varies between facilities.

Assessment of Care Needs 

A staff member or nurse at the facility will need to assess the condition of your loved one to determine what level of care he or she requires. If necessary, the assessment can even be done in the comfort of your loved one’s home. If the assisted living staff decides your loved one does not meet the required criteria, the room deposit will be refunded. 

Paperwork Submission

Once the representative has determined your loved one is an eligible candidate for their facility, you and your loved one will need to complete and submit the necessary admission paperwork, along with other documents required. Here is a list of all the required paperwork: 

  • Facility admissions forms, including a resident agreement outlining the services to be provided and the required fees
  • Medical history and physical assessment, which should be completed by the future resident’s primary care physician. Typically, the physical assessment should be done a month before the start date for services.
  • Negative Tuberculosis (TB) Test or Chest X-Ray
  • Care needs assessment is completed by a staff member. This assessment is completed to document the senior’s abilities to complete ADLs. This assessment will also record the senior’s individual needs and capacity for social interactions. It functions as a guide when determining how much assistance the senior will need.
  • The care plan, which will provide the resident with details on the services they’ll be receiving. The plan will explain when and how the services will be provided, and who will administer them. The care plan provides residents the opportunity to make adjustments as needed to fit their preferences and comfort level. Care plans are usually updated at least every six months to account for the resident’s changing needs.

After all the paperwork has been submitted, the administrator or staff at the facility will contact you to schedule the move-in date and time that will work best. Then, it will be time to review and sign the assisted living contract before move-in.

Resident Agreement Contract Signing and Payment Details

The contract is signed by the senior or their Power of Attorney. There is usually no annual contract at an assisted living community as it is usually a month-to-month basis. Carefully read all the details of the contract and be sure to ask any questions that may occur to you. The format should be clear, easy to understand, and uses words that have common and everyday meaning. Make sure any services listed in any brochures or advertising you have read are also highlighted in the contract. Be sure to specifically review the admissions and discharge agreement. The discharge policy will define the steps taken during the discharge process. Here is a list of the details your contract should cover:

  • Costs such as community fee and monthly rent payment
  • Services
  • Discharge policies
  • Grievance procedure
  • The rights and obligations as a resident

Higher Quality of Life at Assisted Living

We here at CareAsOne hope that you have learned a little bit more about what you can expect from your assisted living facility. You are also more knowledgeable about the application process and the requirements of residential care facilities. Understand that the step into assisted living is one that will ensure you and your loved one less stress. Your loved one will be able to live a functional, independent lifestyle, which is sure to promise a higher quality of life.

How to File for Guardianship of an Adult

An unfortunate truth is that we do not keep all our faculties towards the end of life. Some adults are unable to make sound decisions for themselves, which is where adult guardianship or conservatorship becomes necessary. Adult guardianship is when a guardian ad litem is declared by a judge to be fit to make decisions regarding the person’s finances, medical care, and personal care, or both. Not having an appointed guardian could be a huge mistake which may lead to bad decisions that are not in line with the person’s well-being. If no one has already been appointed, a court will have to assign guardianship.

A person declared to make decisions based on the person’s medical and personal life is called a “conservator (or guardian) of the person.” A person declared to make decisions based on the person’s financial aspect is called “conservator (or guardian) of the estate.” If the person in question needs both, the judge would declare the same person as both. The decisions made by the conservator are backed by the court legally. The word conservatorship is used interchangeably with adult guardianship, and different states use one or the other. 

The Circumstances that Necessitate an Adult Guardianship

Knowing when the guardianship of an adult might be necessary will help you make a confident step in the right decision for you and your loved one. To help give you an idea of when an adult guardianship is necessary, we will provide some examples. Consider filing for legal guardianship of your loved one has mental or physical impairment afflicted by:

  • Alzheimer’s or other forms of dementia
  • A stroke
  • An accident that has impaired his or her faculties
  • Mental illness
  • Mental incapacity
  • Developmental disabilities
  • Disease
  • Mental deficiency

And not only must the person be physically or mentally incapable of making important decisions for herself as with the examples above, but other outside factors would necessitate a legal guardianship. These outside factors would be that he or she has not already prepared the legal documents that cover decisions about personal and financial matters. Here is a list of outside circumstances, along with his or her incapabilities, that would prompt a legal guardianship:

  • A guardian of the estate would be needed if he or she hasn’t prepared a power of attorney for finances.
  • A guardian of the person would be needed for healthcare decisions if he or she didn’t have a medical directive, caregiver contract, or living will.
  • A guardian of the person to decide healthcare decisions might still be needed if there was a medical directive but his or her health matters were not covered in it, and there was no one named to make those decisions.
  • A guardian of the person would be needed to make decisions about his or her personal life even if there is a power of attorney for both health care and finances. This would include decisions like where he or she will live, or who is allowed to spend time with them.

The Process For Filing for Guardianship of an Adult 

To obtain guardianship of your loved one, you will need to file formal legal papers, after which you will have a court hearing in front of a judge. These formal documents must clearly emphasize his or her physical or mental impairments that cause the inability to make decisions. Family members and of course your loved one must be notified and given to opportunity to contest and file their paperwork in opposition. 

To do all this, legal help is necessary. Choose a local lawyer that has elder law or conservatorship experience. To find the right one for you, contact the state bar association in your county, and ask for the lawyer referral service. This must be the county in which you or your loved one live. Another way to find a lawyer would be to contact the National Academy of Elder Law Attorneys and ask for a referral of an attorney in your area. 

Here is the abridged version for the process of filing for adult guardianship, after which we will break down in detail: 

  1. Determine which type of adult guardianship is necessary.
  2. Complete the guardianship forms for adults.
  3. File the paperwork.
  4. Serve the relatives and required agencies.
  5. Attend court hearing in front of a judge.

1. Determine Which Type of Adult Guardianship is Necessary

Before starting the paperwork, be sure to know the types of guardianships to know which you are going for. It is also helpful at this stage to discuss with other family members in the decision-making process who would be the best person to be guardian, as well as which type of guardianship will be necessary. Figuring this out ahead of time will make the process smoother and reduce stress, not to mention a less expensive legal process. Get to know the different types of adult guardianships, decide which type may be necessary, and then agree on who is the best person for the job. Here are a few of the different adult guardianship titles you and your family members may be considering: 

Emergency Guardianship: It usually takes several months to complete the process of obtaining guardianship for a disabled adult, which sometimes is too long in some cases. Emergency guardianship can be sought in limited circumstances in which the individual’s mental or physical health is at risk or an immediate decision must be made regarding their health or estate. This form of adult guardianship is temporary, sometimes lasting only 72 hours. The laws on emergency guardianship vary from state to state.  

Guardianship of the Person: This form of adult guardianship requires the guardian to make decisions about the care and support of an elderly or incapacitated adult The best person for the job would probably be an adult child or sibling who lives close to the person. The guardianship duties would include making medical decisions, monitoring medical treatments, arranging professional interventions, ensuring healthy living conditions, and making the difficult end-of-life decisions. The appointed person may also be required to submit an annual report of any decisions made. All these duties should be done all while considering the person’s wishes and physical and financial needs. This guardianship lasts until the person passes away, or when the court decides guardianship is not needed anymore.

Guardianship of the Estate: For this form of guardianship, the person chosen should be someone who is competent in financial affairs and can handle substantial or complicated finances. If no family members are capable of making sound financial decisions, the judge can appoint a public officer or private conservator. The guardianship of the state would assume the responsibility of the incapacitated person’s personal property. The duties of this form of guardianship include preserving and protecting assets including bank accounts, distributing income, estate planning, and getting appraisals of the personal property. It is also in their duty to keep the court informed of the estate and any changes made. For instance, in some states the guardian must immediately provide a Proof of Blocked Account form, then after 60 days must submit an inventory and appraisal of the estate and asset valuation. A monthly budget and an annual accounting packet are sometimes required. Check the laws in your state to determine what will be required of you. Guardianship of the estate continues until the person passes away or the court decides a guardianship is no longer necessary. 

Guardianship of the Person and Estate: This form of guardianship is the combination of the previous two forms. This guardian would have total control of the person’s financial, medical, and personal decisions. The appointed person will decide about his or her everyday care, handle administrative matters, and decide how to best spend the assets on long-term care or where to live. Some examples of administrative matters would include dealing with doctors, Medicare, insurance, or the long-term care facility he or she resides in. The guardian would apply for benefits, medical coverage, or pensions that an incapacitated person might be eligible for. 

The guardian must keep clear records of any decisions that have been made on the person’s behalf. The court will require that these records are regularly reported to them, though different states have different requirements. A judge may even require the guardian to check in with the court before making any particularly important decisions, like when selling the person’s home, or transferring the person to any new place of living, especially if it is out of state. 

2. Complete the Guardianship Forms for Adults

Now that you’ve decided with your family members which type of guardianship will be necessary, you can obtain the applicable forms you will need to complete. In some states, you will need to complete a form acknowledging your duties. The forms used to gain guardianship all vary from state to state. However, all of them require the same basic information. Your lawyer will guide you through this process. You will pay for the correct forms to be drafted, or you can ask for legal advice to guide you through the process. It is possible to draw up your guardianship template as a low-cost solution to obtain guardianship. If you choose to do so, you must make sure the forms comply with state law and your state-specific court rules. To make sure that you get the right adult guardianship forms, visit your state’s legal aid office or the self-help section of the website for your county court. They sometimes have free adult guardianship documents you can use. Here are the major components of the adult guardianship forms:

Everyone Involved is Identified: This will include the full legal names of the disabled person, the person who is preparing the form, and the guardian or guardians who are being appointed. Any assets of the person should be listed, as well as the person’s date of birth and gender. Information about the appointed guardian or guardians should be included, such as their addresses, contact information, and the relationship to the incapacitated person.

The Time Period of Duties: You will need to specify what period of time the guardianship duties will be assumed. This will be especially necessary if the guardianship is temporary. Before adding in the dates, be sure to check what amount of time is allowed in your specific states. This is because maximum guardianship times can vary depending on what state you are in. 

Guardian Responsibilities and Limitations: Explicitly state in detail what duties the guardian will and won’t be in charge of. It is especially important to know what he or she is not legally able to do so that they do not cross any lines that could hold them legally responsible. For instance, they could be held liable when making decisions regarding medications when they aren’t allowed to, which may cause damage to the affected person.

Explanation of Why the Person Needs a Guardian: The person must be proven incompetent, and thus unable to make their own decisions. This will be done in front of a judge, but the documents must explain why the appointment of a guardian is necessary (list any related health issues), why the person appointed should be named guardian, and who should be notified of the appointed guardian. 

Witnesses, Signatures, and Notarization: Almost every state requires at least one neutral witness to the document’s signature and notarization. This witness or witnesses should have no personal gain regarding the appointment of guardianship. The form will be signed and dated by the proposed guardian. The rules for the signing and notarization of the document varies from state to state. 

3. File the Paperwork

Be sure to make copies for yourself and all the parties involved. Then it is time to file. You can typically file your paperwork in one of two ways. You can mail the documents in, or you can file them online. In either case, you will need to send any payments necessary for the filing fee. Sometimes a fee is not needed. The fee for the guardianship of the estate could also depend on the estimated value of the assets of the estate. Check with your local laws to see what fee you will need to pay. It is possible to even waive the fee in some cases if you cannot afford it. 

4. Serve the Relatives and Required Agencies

After successfully filing your adult guardianship forms, a copy of your petition must be served to anyone who must be notified. This would include relatives and any agencies that are affected by this change and have associated legal rights. This could be your responsibility to notify these affected parties. The guardianship process will be delayed if everyone is not properly notified. The people you serve could include the proposed protected person, their spouse, parents, children, siblings, grandparents, and older grandchildren. Any affected agencies could include the hospital or care facility the person is staying in, Medicaid, or office for Veteran’s benefits. Check the laws for your state on who specifically should be notified.

5. Attend Court Hearing in Front of Judge

You will be notified by the court of your hearing date. Next will be your guardianship proceeding on your appointed court day. The probate court judge will review your guardianship case and determine the court order, stating whether or not the person in question is capable of decision-making. Sometimes it will be obvious to them, for example in the case of someone who is unconscious or semiconscious or has an advanced form of dementia. However, some people have physical or mental limitations that are not as obvious. In these cases, the judge will have to weigh opinions and options. Here are some examples of what might happen:

  • If the person can communicate, the judge or a special court officer will speak with him or her directly, asking whether he or she understands the court proceedings and what his or her wishes are. The judge will also read doctors’ reports and testimony of family members.
  • If it still isn’t clear whether a guardian is needed, the judge can appoint a separate lawyer that will represent the person in the court proceedings.
  • The judge might appoint a limited guardian by limiting their authority. Another further court hearing will decide who will be in charge of the remainder of the issues.  

Changes to Guardianship 

The guardianship will last as long as he or she lives unless specifically stated otherwise. However, if he or she regains her ability to make decisions, the guardianship can be ended. Additionally, a guardianship of the estate can be ended if there are no longer assets to deal with.

It is also possible for the guardian to change. This is possible if the guardian dies, moves away, or can no longer manage the duties. A judge could replace the guardian if he or she repeatedly makes bad decisions or neglects his duties. The change of guardianship would have to be requested by a family member or an interested person through a filing of paperwork.

Ensuring Your Loved One’s Well-Being

The process of filing for adult guardianship can be costly, time-consuming, and painful for you, family members, and your loved one. However, if the incapacitated person has not completed a detailed durable power of attorney, living will, or medical directive, the process is necessary to ensure your loved one’s well-being. We hope that you now have a clearer idea of how to file for guardianship of your loved one. We here at CareAsOne wish you all the best in this difficult time. 

How To Get Your Loved One In a Nursing Home

The transition of your elderly loved one into a nursing home can be a delicate thing. It is hard to know exactly when is the right time to make this change. You may experience feelings of guilt and fear due to the uncertainty of such a decision. However, sometimes making this difficult decision is the best thing you can do for your loved one. To make this process a little less rocky for you, we will thoroughly discuss what you can do to navigate this difficult time. We will explain in detail what you can expect as you help your loved one transition into a nursing facility. But first, let’s make sure that this is the right decision for you and your loved one. After all, what qualifies a person for a nursing home? The following list includes some signs you can look for to determine if long term care might be the right thing for your loved one:

  • Needs 24-hour care or supervision
  • Frequently experiences trips and falls
  • Significant changes in wellness or behavior
  • Isolates him or herself
  • Has little to no nutritional food in their fridge or pantry
  • Eats foods that do not work well with his or her medications
  • Has no interest in caring for their home–it is messy or you notice that things are not getting fixed, such as the electrical or HVAC systems
  • His or her pets are malnourished
  • He or she exhibits signs of memory loss; including the inability to recognize family or friends, inability to converse, or repeating previously-held conversations
  • Requires help when buying groceries
  • Poorly manages his or her own medications
  • Needs help with dressing, bathing, showering, toileting, continence, eating, and getting around
  • Needs frequent specialist care
  • Requires rehabilitation

Perhaps your loved one displays some of the symptoms on the list. Enrolling him or her into a nursing home facility could dramatically improve these problems, and therefore his or her life quality. We will now discuss the process of how to get your loved one into a nursing home with as much ease as possible. To give you an idea of what you can expect, the following is a simplified list of the steps to getting someone in a nursing home. We will then explain each step in detail.

  1. Identify the best facility.
  2. Gather the necessary paperwork.
  3. Complete the application.
  4. Complete the Medicaid application.
  5. Complete the admission agreement.
  6. Moving day.

Finding the right facility for your loved one is key.

1. Identify Which Facility Best Suits the Needs of Your Loved One

Once you know what your loved one needs and why they need to be put into a nursing home will help determine what kind of care facility is necessary. There are many levels of care options, and which facility you should choose all depends on the person’s ability to take care of themselves. For instance, your loved one may still be quite functional and active, but still need some help with things like cleaning or yard work. In this case, an independent senior living community would probably best suit his or her needs. If your loved one has some medical issues and cannot properly take care of his or her daily needs, you will probably want to look at skilled nursing facilities. Skilled nursing care is meant to help someone recuperate from a temporary illness or injury, and will usually return to their own home after they have convalesced. If you are noticing Alzheimer symptoms, you may want to start considering a continuing care retirement community (CCRC). If your loved one needs help with their daily personal care, and not so much their medical needs, consider a nursing home which will provide long-term care services. 

Have a talk with your loved one about how they feel. Then talk to other family members in the decision-making process to make sure everyone is on the same page. It may be helpful to meet with your loved one’s doctor to assess their particular needs. Once you have decided what kind of care your loved one is in need of, review pamphlets of different options to consider. Do not just keep just one facility in mind. You may find yourself surprised as you research what some facilities offer. Then take the time to tour multiple facilities at the top of your list and figure out how each would benefit your loved one. Choose the facility that will best suit his or her medical, social, and daily needs. Here are some of the greatest advantages of nursing home care:

  • Socialization: Living in a nursing home allows seniors the ability to be around others their own age. Socializing is so important for our health and well-being, especially the older we get. Interacting in a social environment with other nursing home residents reduces the stress, anxiety, and depression that comes along with a life of loneliness and isolation. This also encourages more fitness, greater self-esteem, and even a longer life span. 
  • Consistent care: As your loved one ages, they may require more and more attention to their needs. This may not be possible for you to constantly keep watch of him or her and anticipate the needs of your loved one. Enrolling in a nursing home will allow consistent care through regular check-ins. The medical staff will have a better idea of what your loved one needs and can better anticipate any surprises in their health that may arise. 
  • Medication management: Your loved one may easily be mixing up their medications or keep forgetting to take them. This often leads to them taking it at the wrong time or wrong amount, which is detrimental to their health. And you may not have the time to remind them, or you may even mix them up yourself. Trained professionals in the nursing facility will easily ensure your loved one takes the recommended medication at the correct time, leaving the burden off of you.
  • Meal preparation: This allows your loved one with less stress about how and what they will eat next. In nursing homes, the meals are prepared and administered at consistent times. They are also prepared with your loved one’s specific diet in mind, ensuring the best quality sustenance for their individual needs. 

2. Gather the Necessary Paperwork

Now that you have decided which senior housing facility is the best fit for your loved one, it is time to gather the necessary paperwork the facility will need. Here is a list of the paperwork for nursing home admission requirements:

  • Patient Review Instrument (PRI): The PRI is a tool used to assess the physical, medical, and cognitive state of the patient to see if a nursing home is the right place for them. It also documents any services they may need. The test is administered by a registered nurse and can possibly be covered by insurance. If your insurance provider does not cover it, you may have to pay out-of-pocket. 
  • Medical Screen: A medical screen will check for any diseases or health conditions the patient may have. This has to be completed to assess what kind of care your loved one will need. 
  • Medical History: Your loved one will need to visit his or her primary care physician (PCP) to gather any medical history, prescription use, diagnoses, and any other documents that the nursing home would need. 
  • Financial History: Most facilities need to see proof of your loved one’s asset limits and resources. They will probably review the financial history of the last 5 years as well as make sure you have started a Medicaid application. 

Your loved one’s PCP should look over all the information above and help ascertain which kind of facility is best. He or she may have a different opinion than what you had in mind and could recommend either a higher or lower level of care. An example of higher level of care could be a dementia unit, while a lower level would be an assisted living facility. 

The nursing home may also recommend end-of-life planning documents, including a MOLST form (Medical Order for Life-Sustaining Treatment), a DNR Order (Do Not Resuscitate), power of attorney documents, a health care proxy, and a living will. It is wise to consult your elder law attorney if you haven’t already.

While you are gathering all the necessary paperwork, you will also need to be thinking about preparing your loved one’s home or property for the eventual move. If your loved one cannot afford the nursing home, sometimes a lien is placed on the home to be used to pay for costs in the facility. You may also think about transferring or selling the home to prevent it from being used to pay for costs. However, this could affect Medicaid eligibility. With the rest of your loved one’s assets, consider holding a yard sale to get rid of any unnecessary furniture or household items. Space in a nursing home is limited, so help your loved one prioritize what is most important to him or her.

3. Complete the Application

Next, you and your loved one should complete an application to turn into the nursing home’s admission staff. They will also need the documentation mentioned above to assess if the facility is a good fit for your loved one, whether it be medically or financially. Having a copy of the financial records will help them determine if your loved one can adequately afford nursing home costs. The application will also ask more questions about what kind of medical care your loved one may need. Try to get the nursing home application process started as soon as possible, due to the fact that some facilities may have a waitings list. This applies especially to those nursing homes that work with Medicaid.

It’s always a good idea to visit the nursing home first to see if it’s a good fit for your loved one.

4. Complete Medicaid Application if Applicable

The cost of nursing home care can be staggering. If you do not have long-term care insurance, you will need to consider other forms of payment assistance. Unfortunately, Medicare is not meant for long-term care facilities. Typically Medicare is only useful for those entering a skilled nursing facility for short-term recuperation. The Medicaid program, however, is the largest single payer for nursing home care. Keep in mind that Medicaid is a means-tested program, which indicates that the applicant must verify eligibility based on his or her means. Another factor to consider is that receiving Medicaid assistance can limit your social security income to as low as $30 a month. This is a big factor for those that rely on SSI.

As you complete the nursing home’s application process, it will become clear to you whether or not your loved one could be eligible for the federal government’s Medicaid funding. If he or she is eligible, it is important to start the Medicaid application process sooner rather than later, because the process can be lengthy. The nursing home may have a Medicaid coordinator that can help guide you through the process. If not, you can check at your local county Medicaid office for some assistance. 

Your loved one’s Medicaid application process will include an in-depth analysis of the past 5 years’’ finances. They will ask questions about any large sums your loved one has received, and require explanations of them. In order to complete the application process, the following documents will be needed:

  • Birth certificate (of both the resident and their spouse)
  • Marriage certificate
  • Military paperwork (if applicable)
  • Property documents (could include closing papers, deed, etc.)
  • Bank statements (from all accounts, and extending back 5 years)
  • Life insurance policies

Nursing homes have different procedures for admitting residents while their Medicaid eligibility is being determined. Some facilities will intake new residents while the application is in progress, while others will not admit them until Medicaid has already been approved. That is why we stress that you start this application process early to ensure your loved one enters the facility when the time is right. 

5. Meet with Nursing Home Staff Members: Complete Admission Agreement

If your loved one’s nursing home application is accepted, this means that they sufficiently believe that his or her medical needs can be met by the facility and that the financial aspect is in order. To complete the admission agreement, you and your loved one will meet with the admissions representative, a social worker, or another worker. The admission agreement will cover the following topics:

  • The Facility: The legal certifications of the facility will be discussed. It will be made clear what level of care they are able to administer.
  • The Resident: It will be discussed what is expected of the resident, including what his or her rights and responsibilities include. The rules will be made clear, such as the establishment of a non-smoking policy.
  • Finances: The agreement will make clear all the costs of the facility. You will know exactly how much room and board, care, food, and other expenses will cost. As an example, one room including food and care can be about $200 a day.
  • Personal Needs Account: This is for the residents that are receiving Medicaid assistance. A portion of the money they receive is allowed for personal use, and is put into an account meant for the patient and managed by the facility. 

After the paperwork has been thoroughly discussed and understood, the admission agreement will need to be signed by your loved one, or their representative. Be sure to ask for a copy for your personal records.

6. Moving Day

Moving into a nursing care facility is a big change for older adults. Your loved one will need your support in this sensitive time. They will be going from a familiar environment, surrounded by their own things and furnishings, to a single room nursing home placement. It may be helpful to tour and measure the size of the room beforehand to know what to expect on moving day. Take pictures to remember the room and the amenities so you can help pack all the things that will fit. 

Your loved one will have some new things to get used to, including possibly sharing a room, a bathroom, and be surrounded by louder residents. He or she may not be used to this type of environment and it is best to ease them into it, if possible. Try to fill the new room with things that will make your loved one feel at home and comfortable. However, keep in mind not to bring items that are valuable as dementia patients may misplace things, plus the possibility of theft.

Support Network

Taking care of aging parents can also take its toll on you. Family caregivers, usually adult children, can experience a lot of stress when making these types of difficult decisions. We hope that with this clearly laid-out process for your next steps will help alleviate some of that burden. Finding the right senior care facility for your loved one will help make their and your life easier. We here at CareAsOne wish you and your loved one ease in this transition process, surrounded by a caring support network of helpful nursing home staff.