Options for senior long term care are growing quickly as the baby boomers continue get older. This can be a wonderful thing as it creates more options for seniors as they grow older. Assisted living is one area that provides senior care services and has grown in popularity. While the increased senior care options are nice, they also create a problem. How do you know which facilities provide the best care for parents?

One solution is Assisted Living Reviews. There are a few companies and individuals that perform reviews for senior long term care facilities. Geriatric care managers often do this service for their clients and often do an excellent job. The only draw back is that it can be rather expensive. CareGrade offers free assistance along with assisted living reviews for their clients to help them make an informed decision when choosing care.

If you are looking for long term care for seniors, you should consider researching the facilities and including reviews.

Is Live-in care something that could benefit your parents? Live in senior care puts a caregiver in the home of the senior to provide 24 hour in home care services. It is the most cost effective way to provide care if you require more than 9 hours of care each day. The caregiver can work a few hours here and a few hours there, basically when you need it. The great part is that they are always there.

You are required to provide room and board on top of their pay and they do need to have time to sleep as well as time for themselves. Live-in home healthcare can be a great alternative to a nursing home for seniors who need extra supervision.

There are several companies out there who advertise free referrals for senior care services. These include home health care, assisted living, Alzheimer’s care, nursing homes and more. While this can be an excellent service when done by the right person, there are a few things you need to look out for. One is whether the company does any kind of review or follow-up on the services they are referring. Many times they will refer any company who pays to have their service advertised.

You also need to be careful of the motivation of the referral source. Often times, a referral source will make a recommendation to service based on who is paying them the best for each referral. Make sure you are careful that your parents are getting the best service for them, and not what is best for the referral source.

As many seniors return from their winter migration to a warmer area of the country, they may need to reassess their needs. For some, there may have been a decline in their health since they were last in their home. Things to consider include:
• Any changes or adaptations to their house to help them with new limitations.
• Considering hiring home hare services. While they may not have been necessary in the past, some additional help around the house can make a huge difference in the quality of life for a senior.
• It may be time to consider downsizing to a smaller home or assisted living facility.

Not only should the senior themselves be aware of changes, but their children should also be aware. Ask your parent if there have been any changes since they were last in their home and make plans prior to them coming up.

If they are using home health care services in their winter home, have the agency they are currently getting service from communicate with the agency they will be using. If you do not have an agency already, they may be able to refer you to one.

A Professional Care Managers View

In our ongoing series of interviews, CareGrade.com spoke with professional care manager Michele Tyson C.M.C. to find out what a professional care manager looks for in assisted living facilities.

CG - What do you, as a care manager; look for in an assisted living facility?

MT – Quality of care is my major concern. I want to know if there is a nurse available, is the placed staffed by home health aides, what are the staffing ratios.

I also look to see what levels of service are available. Do they offer special services such as secured dementia unit or dementia programs? Do they offer a higher level of care or is this a facility for higher functioning people only.

Lastly, I look to see where the facility is located. Is it close to major hospitals, doctors and shopping? Is it on a busy road or a quieter location?

CG - What problems do you most often encounter?

MT – The most common problems I see are when people are not happy with the food, or when there are care issues.

CG - What questions should a family ask when speaking with an agency and trying to make a choice?

MT - Is there a registered nurse available 24 hours per day?

How are medications handled?

What services are included in monthly fee and what additional costs do they need to be aware of?

What activities and programs are available?

Is transportation available, especially for doctors’ appointments?

Are special diets accommodated for?

CG - How long does it usually take for a person to move into a facility?

MT - If a bed is available, they should be able to get in within 24-72 hours as long as the physicals are completed and the other issues such as preparing to move are all taken care of. While a family can definitely make all the arrangement for moving into a facility by themselves, a geriatric care manager could make it easier and speed things up.

CG - What are the most difficult people to find assisted living for?

MT - Finding a facility with a secured dementia unit can be tough. There is often a waiting list for these. The other big challenge I see is finding a bed for a person with limited resources.

CG – Is there any other advice you would give a family looking for assisted living?

MT - Look early; don’t wait until there is a crisis situation where placement is absolutely necessary.

Schedule appointments to visit with several communities.

Ask if you can stay for lunch or dinner. Most communities will accommodate that without a problem

A Professional Care Managers View

CareGrade.com did an interview with professional care manager Liz Salston, LSW to find out what a professional care manager looks for in assisted living facilities.

CG - What do you, as a care manager, look for in an assisted living facility?

LS - The first thing I look for is to see if it is truly a homey environment. This is not an institution these people are moving into, it is a new home. While being homey is important, the facility must also be well run and have a kind staff. I look for a place that all employees, from housekeeping all the way up to the director, will drop whatever they are doing to help a resident with whatever their needs are

Other things I look for include

An environment that is protective for people who are memory impaired. I like to see that the higher functioning people are able to come out and socialize with the rest of the resident, as long as there is staff supervision.

The facility has nursing supervision 24 hours per day

Transportation to doctors and outside recreation is provided.

There is an affordable tier system of care level.

The survey.

Lastly, I like a facility that either has a separate skilled section of its own or a relationship with a skilled facility. I want to know that if a person requires the skilled care for a short term stay, that they will be transitioned back to their home in the assisted living facility once they are better.

CG - What problems do you most often encounter?

LS - I really don’t see many problems with the facilities I use.

CG - What questions should a family ask when speaking with an agency and trying to make a choice?

LS - Will staff engage their parents?

Will they push the residents to go to activities or encourage them to participate?

Do the residents each get lifeline pendants in case of emergency?

How does staff help settle a person into their new surrounding?

Is their any type of support group separate from resident council?

CG - How long does it usually take for a person to move into a facility?

LS - If there is no waiting list, a person should be able to move in within a week. It definitely saves time and speeds everything up when a family works with a good care manager. We have already done all the homework and know what facilities would be best for each individual.

CG - What are the most difficult people to find assisted living for?

LS - Individuals with behavior problems and psychiatric conditions or people who are agitated tend to be the most difficult to find the appropriate accommodations. Another group are those that have problems making the adjustment to a new place to live.

Liz Salston is a social worker with 22 years of experience in the field of services for older adults. She has served as Director of Recreation and Social Services at the Martin and Edith Stein Assisted Living Residence and as a social worker at the Central New Jersey Jewish Home for the Aged in Somerset. She has run several socialization and respite groups at the Jewish Family Service of Southern Middlesex County and has worked as a social worker in HUD senior housing.

Liz holds dual Bachelor of Arts degrees in Sociology and Judaic Studies, a Master of Social Work, as well as a Master of Arts in Contemporary Jewish History.

She is a licensed social worker in the state of New Jersey, a member of the National Association of Professional Geriatric Care Managers, Inc., and the National Association of Social Workers.

You may reach Liz at www.salstoneldercare.com (732) 238-1775

CareGrade.com did an interview with professional care manager Mark Zilberman, LCSW to find out what a professional care manager looks for in assisted living facilities.

CG What do you, as a care manager, look for in an assisted living facility?

MK I like to see what my immediate reaction to the place is. How are the aesthetics? Is the place comfortable? Do I feel good there?

Then I look to see what services are offered, in particular, what is included in the base fee. One of the biggest problems I encounter when trying to compare one place against the other is figuring out what is included and what is extra. Some places seem like they cost more, but when you really compare apples to apples, you see that they are offering a lot more services in the base price. Other places are more ala carte.

I also check to see what happens when a person runs out of money. Is the facility set up to work with them when that happens? Some facilities are accepting Medicaid, but sadly most places do not.

When possible, I check to see what other people say about the facility. I look for input from people who have had actual experience. A service like CareGrade can be helpful with something like that.

I also look to see what staff they have available. Do they have a social worker and nurse? What days and hours are they available? Does a doctor come in to see patients and how often do they come? Do they have transportation available?

As a care manager, I also look for facilities that work with me and include me in the patient care process. I like to form an alliance and work with them to help bring about the best results.

CG What problems do you most often encounter?

MK The biggest complaint I hear about from people is assisted living facilities is the food.

CG How long does it usually take for a person to move into a facility?

MK That depends on a lot of factors. If a person needs to pack up their belongings, sell their home, fill out the paperwork, get financing settled and a host of other circumstances it can take a several weeks or longer. People who work with care managers such as myself tend to move in much faster, as I am experienced in helping them with all of the things they need to do. It goes much faster and easier when a professional is there to help.

CG What are the most difficult people to find assisted living for?

MK I think that one of the more challenging things is when a person is borderline between a nursing home and assisted living. I try and work with the facility to see what the best place for the person would be.

Mark Zilberman, LCSW, has been working in geriatric care management for almost seven years. He brings diverse experience to the field, having worked and studied in the specializations of substance abuse, mental health, developmental disabilities, and homelessness. As Founder of NorthStar Care and Guidance, he and his organization are called upon to manage a spectrum of issues for families. Zilberman was previously affiliated with SeniorBridge, Inc., Beth Israel Medical Center, and The Floating Hospital.

He received his MSW from SUNY at Stony Brook. A licensed clinical social worker in NY and NJ, Zilberman holds credentials in substance abuse counseling from both states. Mark is a member of the National Association of Geriatric Care Management.

You may reach Zilberman at www.NorthStarCare.net, 888-288-6152