Navigating Senior Living: Your Guide to Making Informed Choices

Whether downsizing to a home with more manageable upkeep or needing a home where additional care is available, deciding where to live as a senior is a big decision. In this video, Molly Cole, Chief Marketing Officer & Chief Resident Experience Officer for Chateau Retirement Communities, discusses:

• various options for senior living
• financial and health care considerations
• questions you should ask when researching senior living communities
• and more!

A transcript of the video is below and includes bonus content about meal plans, amenities, and how loved ones can support.

Below is a transcript adapted from our conversation with Molly.

0:29 | What are the various options for senior living and how are they different?

Stay at home: this is a possible option for those that plan ahead and prepare for the unexpected, like the loss of a spouse or a physical concern that needs more help. If someone stays home, it’s important to consider things like whether their home will need any remodeling to install things like grab bars, and whether there are stairs to climb each day. Also, is there family nearby that can move in or easily stop by to help? Will they need home health? Staying home is an option, but it does require careful planning.

Move to a community:

• Independent: These communities are typically for adults who don’t need much assistance or medical care. Most communities have this option, and may also have options for both assisted living and memory care.
  
• Assisted: In these communities, staff help residents with their daily activities.
  
• Memory Care: These communities are designed to help care for those living with Alzheimer’s disease and other forms of dementia.
  
• Adult Family Homes: These tend to be for individuals that need a higher level of care and a smaller setting.
  
• Continuing Care Retirement Community (CCRC): A community that offers multiple levels of care.

2:08 | What are some of the important financial considerations to make?
Financial considerations are very important! When I’m working with families, the two primary things I ask are:

• what levels of care are needed now or in the future?
• and what are the financial restraints?

At this time, Medicare does not cover assisted living, which means the financial burden is on that resident and/or the families through private pay. That said, there are a few options for financial support:

• Medicaid will cover for those with a lower income who qualify for assisted living.
  
• Long-term care insurance is an option for residents that have been paying into it over time. All plans are a little different, but they typically include assisted living, but not independent living.
  
• Veteran (VA) Aid and Attendance for those residents and/or spouses that qualify. I would encourage anyone who served or had a spouse who served for even one day during a time of war to check and see if they qualify for VA Aid and Attendance.

3:53 | How might someone’s health care plan affect their decision?
The only important consideration around health care plans is knowing whether the doctor your health care plan covers you under is near your community. Within a community, there aren’t many considerations because most communities are not subject to health care programs as there is no financial coverage within a community itself.

4:29 | What happens if one spouse’s health needs change and they require a different level of care? Or if one of them passes away? How easy is it to transition those accommodations?
That’s a very difficult question because there are many things to consider and though most couples would love to be able to have their wants and needs progress at the same time, that is rarely the case. When you move into a community, you want to know what it looks like when a couple moves in together, as well as what it looks like when one is no longer there.

Nine times out of ten, when couples move in, it’s because one of them is the caregiver for the other and the caregiver needs to make the move because they’re exhausted. The one that’s being taken care of tends to be the one that’s most hesitant. It’s really important that couples start this conversation before there is a need and have an agreement between them that when one is ready to make the move, whether it’s because of their physical and mental needs, or because it’s the caregivers physical limits and needs, that they will agree to make that move together. It gives the caregiver the rest, it gives the one who needs the care even better care, and it allows the spouse to become the spouse again, and not the caregiver.

Also, when and if one of those members of that couple passes away, the surviving partner already has a built-in support group. They’ve already made friends; they already have activities to engage in, and people who are there to go with them along this journey and catch them when they need support.

My recommendation would be to find the top three communities that you love and let your loved ones, power of attorneys, and best friends know that if something were to happen to you and you end up in a hospital and can’t go home, what those top three options are. This is important because something might happen unexpectedly and you might not be able to make that decision yourself, so be proactive before the need happens.

6:57 | What are the most important questions that people should ask when they’re making these decisions?
The most important questions to me will always involve financial questions and healthcare questions. At the end of the day, those are the things that truly matter.

Healthcare Questions

• Can the community handle my current and future healthcare needs?
  
• If you’re a couple, can you live together?
  
• If one of the partners needs progress differently than the other, can we stay in an apartment together? If not, what does that look like?
  In many communities, there are a certain number of apartments available in independent living, which is often the highest number of options, but then that number drops in assisted living, and drops again in skilled nursing, and drops again in memory care.
  
• Do I have to bring in my own care?
  
• Do I have to pay extra?

Financial Questions

• What is the financial commitment?
• What is the community fee? (Also known as a move-in fee.)
• Is there an entry fee?
• Is there a monthly fee?
• What is the cost of care?
• Is there on-site nursing care?

A CCRC will almost always have an entry fee. This is a large lump sum that you pay for a particular apartment, and the cost normally ranges based on location in the building and size. It could range from a studio, a one bedroom, a two bedroom, etc., and whether it has a view, all those things will affect the price range, even if it’s the same type of apartment. Even if a community has an entry fee, they will almost always still have a monthly rental fee attached to that.   

Also, care is almost always an added cost. You want to know the cost of care and if you can receive care in the privacy of your apartment. If so, what do your levels of care look like? How is that level of care determined? Most of the time, it’s determined by a nursing assessment, which leads to another great question to ask – are there onsite nurses, on-call nurses, or just one nurse that goes to different communities? That will often make a difference financially because communities with nurses onsite will have to charge more for care because nurses are more expensive than caregivers, but if you have nurses there seven days a week, your level of care is most likely going to be better because you have nursing oversight, and nurses are worth every dime.

11:09 | Is there anything we didn’t cover that you think people should know about?
You can go visit communities whenever you want. For your first tour, I would suggest making an appointment so the community sales director can have some one-on-one time with you, and answer all of your questions personally. After that, I suggest dropping by. Drop by and see how it operates when they’re not expecting you. Ask to join for meals, whether it’s breakfast, lunch, or dinner. Ask if you can join in some of their activities. Can you come to happy hour? Can you see some of the events and sit with the residents. Ask those questions; really engage. Don’t base your decision off one meeting because this is going to be your home one day. Bring your loved ones by; try the food; talk to residents; talk to staff; walk through the buildings. Engage like you might as a resident because your whole goal is to become one. The goal for all of us in senior living is not to sell a particular community, it’s to help those make the right decision for them; it’s all about the resident and that’s how it should be.

Bonus Q&A!
Molly had so much great information to share with us that we couldn’t fit it all into one video!
See below for her answers on guests, meal plans, amenities, and how loved ones can support.

What are some of the possible amenities people might see and how are they typically reflected in the cost?
Amenities are not normally reflected in cost, but they are an important question to ask depending on what is important to you. For instance, some communities might have swimming pools, which are important to some who like water aerobics or use it as a form of physical therapy. If that is something that is really important to you, ask if they have a pool, and if they do, put it at the top of your list. If it’s not something you’re interested in, dismiss it, and don’t put it on your list. If social activities are important to you, put that at the top of the list. If being near Valley Medical Center is important to you, put that at the top of the list. Finding the right place is asking the right questions, both financially, medically, and via amenities; that would be the top advice I would give.

How should family and loved ones get involved in this decision?
Do the research with them. Go to seminars; learn; go on tours; have meals at communities; engage with your loved one in this. These conversations can be difficult for those who need care and for the loved ones providing support. The family member providing support often feels guilty bringing it up and the person that needs to make the move fears the loss of independence. Not only that, but the fear of losing the home they’ve likely had for many years. Many have raised their family there, so there are a lot of memories and comfort. There are also often worries around whether family and friends will still come and visit them. It’s change and nobody likes change, but until they are in that situation, they don’t realize they’re actually gaining independence. Moving into a community means they don’t have to ask their neighbors for help; they don’t have to ask their loved ones for help; they don’t need rides places; they don’t have to be worried about driving in the dark; they can make new friends. All these things mean their children and their friends can become their children and their friends again, and not their caregivers.

Is it common for residents to be able to have guests in their room overnight?
In most communities, family members can absolutely stay, but it’s important to let the staff know that you’re there. This is a safety issue in case of fire, or an emergency, that requires the building to be evacuated. It’s important to know how many people are within that building. Many communities, if there is space available, will have a guest room for family members to stay in.

What are the options for meal plans, especially around people with dietary restrictions or personal requests?
This really varies depending on the community. Some communities, especially those that provider higher acuity care, can often do a wider variety of meal plans and types of menus. For instance, most can accommodate those who are pescatarian or vegetarian, but not all can accommodate needs like mechanical soft or pureed. Some may or may not be able to accommodate someone with Celiac disease; they may have gluten-free options but may not be able to accommodate a full gluten free kitchen. These are very important questions to ask if there is a medical need.

Most communities will have a no-salt-added or lower sodium kitchen because it is very common for residents in a senior living community to have high blood pressure and be on blood pressure medicine. That said, no community can promise no sodium and most communities will have salt on table that you can add to a meal. Low sodium typically means they season with things like herbs, rather than salt.

Another thing to consider are meal plans. Some plans automatically include three meals a day, otherwise allow you to choose between having 1, 2 or 3 meals a day included. It’s good to know whether the community you choose has this option, and if so, what the cost difference is between the options. That said, we never want cost to be the reason a resident doesn’t have three meals a day. Appetites often decrease as we get older, so it’s not uncommon for some residents to only eat two meals a day, but we don’t want them choosing a lower meal plan option to try and save money.