Written by Cindy Kuster, Director of Institutional Relations, Lamson & Cutner, P.C.
Our needs and wants change as we move through life. The living situations that worked best when you or a loved one were younger may no longer be appropriate now or in the future. How can you figure out what situation will allow you or a loved one to live the best life right now?
Let’s say you’re an empty nester or single, and your home is starting to feel bigger than you need. Or your spouse or loved one is starting to get confused – or maybe you are – and you need to figure out what to do. Each person’s situation is unique, and the medical and social issues associated with getting older can understandably make people anxious and depressed. Fortunately, there are many options that can make your life comfortable and enjoyable, even for people with limited income. The idea is to think about it now.
This article touches on the key concerns to consider but does not cover every detail. Professionals who work with seniors, particularly Elder Law attorneys and Geriatric Care Managers (Aging Life Care Professionals) can offer valuable advice tailored to your needs as you are considering next steps so please feel free to contact one of these professionals to assist with your planning needs.
These five questions will help indicate which the best path forward may be for you or your loved one.
- Stay at Home
Often people who are getting older want to remain where they are, in their own home. This is a good option under a specific set of circumstances, namely that you have access to socialization opportunities, that you can function there safely and that you have a support system that is stable and effective. If you have mobility problems or other types of disabilities, you don’t necessarily need to leave your home. Houses and apartments can be modified to be handicapped-accessible. There are architects and contractors who are experienced in these areas, and who can help you figure out which modifications will be cost-effective.
The support system can be tricky. Paid help should be a part of the picture if you can afford it, even if you “don’t want strangers in your home.” Keep your eye on the prize – you want to stay in your home! Your goal is to find a balance that is sustainable. Calling your son or daughter every day and having them ‘pop over’ or ‘run to the grocery store for a few items’ is rarely ideal. If your children feel overwhelmed – after all, they have their own lives – they may push you to downsize, when you don’t want to go. Being considerate of their needs is likely to make them more willing to accommodate yours, when it’s necessary.
And what about socialization? Do you now or in the future will you easily have opportunities to meet with your peers, talk or engage in fun and intellectual stimulating events? How will you plan for this?
- Downsize & Options
There are numerous reasons you might decide at some point that downsizing or moving will make you or your loved one happier. This might be the case if managing the home becomes too much, if the costs of living in a large home are no longer affordable, managing the stairs is no longer safe, hiring people to help manage the house is not financially feasible or if you or your loved one is feeling lonely or isolated.
If money is a concern, if you are unsafe in your home, or if you want more social activities, moving may be the right decision. If you own your home, selling it might free up equity that you can use to pay your living expenses elsewhere. Living independently gives you maximum freedom. If you move from your home but want to continue to live independently, you have many options. For example, you can move to an apartment or condo, but on one level, to make your life simpler or downsize to a smaller house that is preferably handicapped-accessible, move in with a child or relative, move to a senior living residence or if your health requires it, move to a nursing home.
- Independent Living Versus Assisted Living
There are independent living residences that provide among other things meals, linen service, housekeeping and social activities. In this type of situation, independent living does not provide for care and so there is no one “watching over you” which can be a positive and a negative, depending on your situation.
In Assisted Living, there are staff whose job it is to look after the resident’s needs, engage them in social activities, and help them with whatever “Activities of Daily Living” they may have trouble performing. For example, assisted living provides assistance to those who need some help with bathing, dressing, and medication reminders. This type of residence usually requires that the residents be predominantly ‘self-directed’, in other words, they decide what they want to do and act to make it happen. This type of arrangement works for seniors in many different types of situations.
The socialization aspect is a large part of the appeal of assisted living. Very often, seniors who start having trouble getting around, or who have trouble with their short-term memory, for example, end up staying inside their homes most or all of the time. This isolation is not healthy. Assisted living allows easy access to socialization with others who share their interests and who are in a similar situation to their own. It can give lonely seniors a new and enjoyable lease on life. This is actually the case with my own father. His short-term memory is poor, but so is that of most of the other residents on his memory care assisted living floor – so nobody thinks anything of it. Because he lives in an assisted living community, he has access to many different types of activities and this increased access has helped to enrich his life
In many assisted livings, there are separate areas or floors that cater to people with dementia, which is a large and growing population. Although these residents are not particularly self-directing, often their needs do not rise to the level of requiring a nursing home. Assisted Living residences are preferable when possible, because they are often ‘homier’ and less institutional than a nursing home plus provides assistance to those with cognitive decline.
- Which Assisted Living to Choose
Assisted Living residences come in many different flavors and sizes. If you need or want to go to an assisted living, find the one that has the features you most prefer and require.
Ask yourself – Do you/your loved one want to be:
- Close to the area you lived in before, or will you move closer to your children?
- In an urban environment, with more cultural opportunities, or in a more suburban or rural area?
- In a larger or more intimate setting?
- In a ‘social model’ assisted living, which normally provides less medical assistance?
- In a ‘medical model’ assisted living or enhanced assisted living residence, which is designed to provide far more health care than ‘social model’ residences do. This kind of residence is ideal for example, for seniors who have chronic conditions, co-morbidities, movement disorders, etc., but who have the means to live in a residence with many more amenities and a more homelike and less “sterile” environment than a nursing home.
If your needs are more than your children, a home aide, or an assisted living can provide such as if you or a love one requires a ventilator to assist with breathing, a nursing home may be your only choice; there are some chronic conditions that require skilled nursing home oversight. As with assisted living, nursing homes work hard to provide appropriate social activities for residents.
- How to Afford the Life you Want
All these decisions have one enormous issue in common – you need to figure out how you will pay for them. Long-term health care is expensive. Fortunately for New Yorkers, our state has excellent government assistance to help people avoid financial disaster. Planning, especially in advance, can be crucial to protecting yourself or your loved one. Taking the right steps can give you better choices and help ensure that you or your loved one gets the best care possible. However, taking the right steps is rarely simple. A good Elder Law attorney can give you extremely cost-effective assistance, and often can help protect your life savings. Elder Law attorneys are authorized to give advice on legal matters regarding health care planning, many others are not. In navigating the health-care system, a Geriatric Care Manager can also provide invaluable advice. Finding the appropriate professional will give you real peace of mind.
Getting older isn’t always easy, or pleasant, but no matter what your situation, there is an environment which will be best suited to your needs and your means. New York has a very good Medicaid program, so even if you run out of money, you can find a situation which works for you. Knowing what your options are now and finding the one that best accommodates any aging-related issues you or your loved one may have in the future, is empowering. Choosing well can make the senior years enjoyable and fulfilling.