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Different seniors have different needs, so many senior living communities offer multiple levels of care. This not only allows them to accommodate a broad spectrum of necessities, but also helps provide a smooth transition in cases where a senior needs to move from one level of care to another.

Kathy Kemper Busch, nurse and family liaison at Kemper House in Highland Heights and Strongsville; and Ginger Atwood, corporate director of marketing and communications at Harbor Retirement Associates in Vero Beach, Fla., which oversees HarborChase of Shaker Heights, discussed the levels of care offered to seniors and how they work to serve residents.

“A skilled nursing facility is a short-term rehabilitation stay to help the person regain the skills they may have lost after a fall, an infection or whatever the reason for their need,” Kemper Busch explained.

Long-term care facilities differ from skilled nursing facilities in that they are nursing homes where residents live, she said, adding that the time spent in skilled nursing is often driven by insurance and the person’s ability to advance and participate in their rehab, whereas long-term care is usually paid for by private funds, Medicaid or a combination of the two.

“Memory care is a home that is very specifically designed to care for people with all levels of dementia,” she said. “Most people that need memory care are folks that need some degree or complete help with all parts of their activities of daily living, such as personal care, dressing, dining, etcetera.”

Kemper Busch advised that families searching for a memory care community make sure the programming and levels of care offered are specifically designed to support all levels of memory care and the specific needs that come with each level.

“Ask about their dementia program,” she suggested. “A locked door is not a program. The needs of people with any form of dementia is very different from those with no or very minimal cognitive decline.”

Assisted living communities are ones where residents can take care of themselves, for the most part, but may need help with care or medication administration, she said.

“Most assisted living (communities) are private pay and most charge by level of care or needs,” she noted.

Signs that a family may want to consider moving their loved one to a senior living community include declines in a person’s abilities to perform personal care, dining and medication administration. In addition, a lessening in the abilities to use stairs, cooking, take telephone calls, answer the door and recognize when they may be in an unsafe situation are indicators that families may need to reconsider their loved one’s living situation, Kemper Busch explained.

She warned that, for some, meetings with families can be a “sales game,” so it is important for families to be cautious if they do not like the answers to their questions at an initial meeting with a care facility, or if they feel pressured. She recommended reaching out to one’s circle of acquaintances for recommendations on good places to consider moving their loved one.

“Everyone knows someone that has been touched by dementia,” she said. “Use their experiences to help guide you. Most often, word of mouth will help you find the very best person to turn to.”

She pointed out that most seniors will not willingly leave their homes or recognize that they can’t take care of themselves.

“This is the time when the family has to be very realistic with the situation in front of them,” Kemper Busch said. “This is, in my experience, the most difficult for families to go through. No husband, wife, son, daughter wants to see their loved one as weak or sick, so most are not honest with themselves. This creates frustration and anxiety all around.”

She noted that she is often asked when a family will know the time is right to place their senior loved one in a care facility.

“Well, the time always finds you, so be prepared,” she said.

She recommended getting one’s affairs in order now, such as powers of attorney, living wills and financial matters.

Kemper Busch suggested visiting an elder care attorney, adding that it is worth the expense to have someone help a family be prepared.

“In assisted living communities, residents receive assistance with activities of daily living, while still managing most activities on their own,” Atwood explained. “In a skilled nursing community, residents receive constant nursing care and need assistance with most, if not all, activities of daily living.”

Memory care communities provide continued care and appropriate activities in secure environments for people who suffer from mid- to late-stage dementia, including Alzheimer’s disease, she continued.

Families should be mindful of signs such as declines in health, recent or frequent falls, mobility issues, forgetting to take medication, loneliness due to a lack of connection with peers, difficulty managing medical and financial affairs, issues managing a household and personal hygiene, or changes in mood or behavior, as these may indicate that a new living situation is needed, Atwood said.

“When considering moving your loved one into a senior living community, do your research,” she said. “Not all communities are created equal. Tour the community and participate in an event, enjoy a meal in one of their restaurants, and talk to other residents and associates.”

She also suggested that families have conversations with their loved one’s primary care physician, as they can be instrumental in guiding them in the right direction.

“It is natural to think it is a difficult move and complicated decision,” she pointed out. “The reality (is) it’s often the best decision you can make and one that affords your loved one the opportunity to thrive.”

For assisted living situations, Atwood suggested that families speak to their loved ones ahead of time, before there is an imminent need to move.

“The key word is ‘conversation,’” she said. “Approach the topic with empathy and really listen to them to learn what matters most so you can help them find the best next step for their unique needs and wants.”

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