Home Care, Adult Day Health and Supportive Living

sanborn placeby Janet Simpson Benvenuti

Each month I visit assisted living and continuous care retirement communities to learn more about housing options for seniors. While most are well-managed, beautifully-appointed communities replete with book clubs and outings, dining rooms and transportation services, I remain uncomfortable that these communities are financially out-of-reach for the majority of moderate-income families. Last week I visited Reading, Massachusetts, population 24,747, to meet Jacqueline Carson, executive director of Sanborn Place, an integrated care solution for lower income seniors and adults with disabilities that includes home care, adult day services, and a continuous care housing option. Recently, Sanborn Place has received national attention and will be featured in Dr. Atul Gawande’s next book on elder care and end of life.

Here are the three programs Jacqui supervises:

Sanborn Home Care provides home care services in short increments, if necessary, working in partnership with the local Visiting Nurses Association, the VNA of Middlesex East.

Sanborn Day is an adult day health center with capacity for 75 seniors or younger people with disabilities. Visually resembling the lobby of an upscale hotel, the center provides breakfast and lunch, exercise classes in partnership with the local YMCA, physical therapy, medication supervision, counseling for caregivers, and activities including a pool table, crafts, and computer games such as the Dakim Brain Fitness Program. My visit interrupted a game of charades with a roomful of joyful elders and it included an unanticipated discussion about the Massachusetts governor’s race with a well-informed senior.

Sanborn Place is a non-profit, federally funded facility for seniors whose incomes do not exceed $33,050 (single) or $37,800 (couple). Upon arrival, I was greeted by four older women sitting in the lobby who proudly revealed their ages: 93, 95, 87 and 83 as they awaited their friend, age 102, who was taking a nap. The community has 73 units, half assigned to seniors who require daily support, others for those needing weekly support or none at all. Each apartment includes a living room and kitchen with a private bath and bedroom not unlike those in high-end communities. Seniors remain in their apartment until the end of their lives.

Payment for these services comes from many sources including Medicare (for skilled nursing care and PT or OT services), HUD, the Veterans Benefits, and Mass Health.

While many communities offer similar programs, what’s unique is the integrated way that care is provided and the number of private citizens involved. Jacqui oversees the delivery of these three programs supported by a stellar team of professionals and individuals like brothers Gregg and Bruce Johnson, who created DKJ Foundation in honor of their father to raise funds for Sanborn Place. You may learn more about their foundation here.

As the tsunami of boomers age, many without enough family members to fill the role of caregiver, I remain encouraged and inspired by people like Jacqui, Bruce and Gregg who take responsibility for the well-being of all of the older citizens in their town and do so with a passionate commitment to help them remain a vibrant part of the community they’ve always called home.

© 2013 Circle of Life Partners, LLC. All rights reserved.

Nursing Homes, Assisted Living, & Retirement Communities: When an Elder Must Move

by Jan Simpson

Recently I got a call from a friend in California.  He told me that he and his sisters were worried about their 88- and 86-year-old parents who live on the East Coast.  Concerned about their ability to remain safely in their own home, this circumstance is a familiar one: his parents are approaching a tipping point where a housing change  is necessary.  How each family makes this decision is unique, but it’s useful to evaluate alternatives before a crisis forces a hasty change.

What are those housing alternatives? Some adult children have their ill or widowed parents move in with them. Today, more than 3.6 million parents live with their adult children, according to David Horgan and Shira Block, authors of When Your Parent Moves In: Every Adult Child’s Guide to Living with an Aging Parent. While the book gives strategies for creating a harmonious living arrangement, it also cautions the reader about jumping into this arrangement without first considering the long-term implications.  They offer the reader a “Moving In Quiz,” a sample of which is below.

Guilt: Using a scale of 1-Never, 2-Almost Never, 3-Sometimes, 4-Almost Always, and 5-Always, how often do the following apply?

___  Why am I the only one who steps up to the plate? If I don’t take care of Mom, no one will.

___   Dad refuses to go into an assisted-living facility or even let us send a home health aide to see him. What choice do I have?

___   My spouse doesn’t say it, but I know he/she expects me to take care of his/her mother. I don’t want to upset anyone, so I’ll just go along and try to make the best of it.

___   I can’t abandon my parent. I couldn’t live with myself if I did.

___   I know my mother thinks I don’t care about her. That’s not true, but she is always trying to make me feel bad.

According to the authors, if you score an average of three or higher, you may be walking into “a minefield of guilt leading to resentment, frustration, and the potential breakdown of your own well-being.”

While housing elderly parents may be the right choice for some, assisted living facilities, elderly apartments, and continuous care communities are other housing choices to seriously consider. Who can you contact to get a quick list of available options and guidance?  Physicians, friends, social workers, and nurses are all helpful resources, as is www.eldercare.gov.  Here are three other sources of free information:

  • Area Council on Aging—In addition to offering activities for seniors, local Councils on Aging have a trove of information about local home care services, elder law attorneys, local assisted living, and skilled nursing homes (see www.ncoa.org). Arrange to speak or meet with the director and explain your parents’ situation. They will help you develop a short list of options and provide insight into how best to evaluate choices.
  • Social Worker affiliated with a local hospital or the Visiting Nurse Association—If your parent has had a recent hospital stay, schedule a telephone or face-to-face appointment with the hospital’s social worker. Ask about local facilities and other services that may be of help. A quick call to a social worker affiliated with the local Visiting Nurse Association (www.vnaa.org) may also be useful.
  • A Place for Mom—A social worker who advises families that are dispersed geographically recommended this organization, a free service for families who need to evaluate a range of housing choices. They do not charge the callers, but rather are compensated by the facility where your parent may move (see www.aplaceformom.com).  Skeptical at first, I contacted them recently about a complex family situation that included a loved one with dementia, and I was surprised to find how helpful and how quickly they were able to identify potential facilities that the family could evaluate. (A reminder, I do not have any financial arrangement with this service; they are simply another resource easily accessible.)

In the end, my friend and his sisters evaluated their options and decided, collaboratively with their parents, to move them into an assisted living facility.

Have your parents or older loved ones had to make a housing change? If so, share your thoughts about how best to make that transition.

©Circle of Life Partners™