Helping Seniors Make the Transition
By LORI PRICEFor The Herald
Decisions concerning the long-term care of aging adults can be difficult for adult children to make.
Often the wishes of an elderly parent in need of care may be unknown to their children as the topic can be an unpleasant one for families, and has therefore been avoided.
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Photo by Amy Paterson/New Jersey Herald
Carolyn Seifried, of Home Changes with Heart, at right, and Beverly Vance, of Johnsonburg talk about their methods for preserving family heirlooms and the stories that go with them. Seifried’s Layton business helps seniors and their families with the emotional and physical aspects of moving, downsizing or modifying their homes. |
The Foundation Programs and Services of AARP encourage families to talk with each other in order to create a care giving plan early so that all family members know the wishes of a loved one and what to expect in the future. AARP offers a comprehensive five-step planning guide for families, which includes important and helpful forms to download and print.
Sometimes a family might need more advice than can be found online. Mark Hontz, an elder law attorney in Newton, provides legal services for individuals in need of care, their adult children, spouses or other family members concerned about a loved one’s future.
In order to ensure ones wishes are legally carried out, clients will seek Hontz’s legal expertise.
"My clients usually have two areas of concern. One concern is the preservation and distribution of their assets. This concern can involve Medicaid planning, estate taxation planning, trusts, disclaimers and, of course, one’s last will and testament," Hontz said.
"A second area of concern is management of decision-making. This area includes durable powers of attorney, health care directives (often called living wills) and guardianship proceedings."
Once a decision has been made regarding the care of an elderly loved one, there may still be the transition of moving to deal with, which can be a painful ordeal.
The National Association of Senior Move Managers is a nonprofit, professional association of organizations dedicated to assisting older adults and their families with the physical and emotional demands of middle- and later-life transitions. The association is nationally recognized for its innovative programs, leadership and expertise on issues related to assisting seniors who have to move from their longtime homes to a smaller residence or care facility. Association members can address all aspects of an elder move, from emotional support to sorting through belongings, preparing written schedules and supervision of the move.
Carolyn Seifried knows first-hand the struggles families endure when confronted with elder-care decisions. She recalls the emotional decisions over personal items, such as what to bring and what to give up, when her own parents made a move.
"When we moved my parents from the 55-and-older community to the continuous-care community, my brother had to give my mother lots of tender loving care when the final piece of furniture was removed from the home and onto the moving van. She was upset," Seifried said. According to Seifried, a great deal of a person’s identity, especially for a woman in the older generation, is tied up in their things and the house where they raised their family. They represent lifetime accomplishments.
"After my father died in 2005, and we moved mom from an independent living arrangement to an assisted-living room, her initial feeling was she no longer had a home," Seifried said.
At each move, the family was faced with the difficult task of downsizing space and belongings. To make the moves more comfortable for her mother, Seifried tried to create familiarity and continuity in her new surroundings.
"I took the items that we moved and set them up as close to how they had been in the past as possible. Although there was less and less room, I did what I could for her to feel at home," Seifried said.
She was so touched by her parents’ experience and the need for assistance for senior relocations that Seifried left her corporate job and began a business, Home Changes with Heart.
Her business, located in Layton, provides move management, assistance and support to individuals and their families. Seifried completed the Certified Relocation Transition Specialist program and is a member of the National Association of Senior Move Managers.
"My job is to listen to the emotions, help them work through them during such moves and be supportive while getting the work done," she said.
Not all elder transition moves are depressing to seniors. Some are ready to make the move to less demanding environments. Possessions and homes they were emotionally attached to may be replaced with positive new surroundings and, for many, a new beginning.
"While helping a woman hang pictures in her new place, (I found) she was happy to get rid of some of the things she’d had for years. She was ready for a new look," Seifried said.
Mary Kay Buysse, executive director of the National Association of Senior Move Managers, believes its members, who are independent contractors like Seifried, make relocations more positive for their clients.
"There is loss and grieving involved when going through lifelong possessions and space planning in a new home. To have a senior move manager assist you through it makes such a difference," Buysse said.
According to Buysse, senior move managers started up about 15 years ago in the Northeast, when many seniors were moving to Florida and needed more than a moving van company.
"It soon became obvious that with the aging baby boomers, this was an area of explosive growth. We are now seeing assisted care facilities offer this service," Buysse said.
Moving can be overwhelming and sorting through years of belongings can be emotional, as well as time consuming. Many adult children simply don’t have the time to help parents because they have jobs, they live far away, or they, too, find the task daunting.
Many clients and their families know this is the last move for an elderly parent, and it can ease some of the emotional pain to enlist the services of a neutral party to assist in the transition.
There are 36,000 assisted living options to choose from in the United States, and a wide variety in the level of care that is provided. Senior housing facilities in the Sussex County area offer independent care and/or assisted living.
It is important to assess the needs of a loved one in order to choose the appropriate facility which best meets an individual’s physical, emotional and/or medical needs. Some are designed to meet the needs of the frail elderly who require a high level of assistance while others cater to the independent seniors who may require minor assistance with daily living or medication management.
The social workers and admissions personnel at the Home-stead Nursing home in Frankford are first-hand witnesses to the range of emotions expressed by caregivers and residents as the often-difficult decision is made to transition into a nursing care facility.
Typically an adult child or a spouse is making the decision. Since many elderly require constant supervision due to mental or physical disabilities, the choice to place them in a facility where their needs will be met becomes a necessity. Often, a caregiver will feel a tremendous amount of guilt when the decision is made to place a loved one into a continuing care facility.
Lori Baker, a social worker for the Social Service Department for the Homestead, has seen residents express both relief and heartache when moving permanently to a long-term care facility.
"Some are relieved not to have to deal with the pressure of living and functioning in the community," said Baker. "Others experience loss and grief from not being independent anymore."
The Homestead offers sub-acute care following a hospital stay when a person is in need of temporary, follow-up care such as rehabilitation, or wound care before returning home.
"Some get accustomed to the surroundings and the routine of the nursing home and decide to stay permanently," said Mary Ellen Quinlan, admissions and volunteer coordinator. "Some may feel they were a burden on a loved one and that is a factor which contributes to their decision."
Quinlan believes that much of the negativity about nursing homes is in the minds of the generation in need of them. Many of the elderly in today’s society remember the stereotypical nursing homes that they may have known a relative to reside at.
"They were more institutional. Those thoughts and memories can be frightening and the reason for reluctance to move into assisted living. As a result, the adult children or the spouse feel a tremendous amount of guilt," said Quinlan. "Assisted living and nursing homes have changed for the better over the decades and many prospective residents are pleasantly surprised."
For information:
According to the State Department of the Public Advocate, an assisted living facility is licensed by the Department of Health and Senior Services to provide housing and meals to residents who need some supportive personal and health services, available 24 hours a day. An assisted living facility provides an apartment with a private bathroom, a kitchenette and a lockable door, and is intended to promote "aging in place," allowing residents to receive increasing services as their needs change for as long as possible. Assisted living facilities fill a gap for people who are no longer able to live entirely on their own, but who do not need or want nursing home care.
Nursing homes, on the other hand, provide long-term skilled nursing care. Nursing homes are highly regulated, with requirements covering everything from staffing, dental care and pharmacy services to activities and laundry.
The Centers for Medicare & Medicaid Services offers a free guide to choosing a nursing home at www.medicare.gov. The center also offers an online tool called Home Compare that can be used to compare nursing homes.
If you do not have computer access and would like to compare nursing homes, you can call 1-800-MEDICARE (1-800-633-4227) and a customer service representative will read the information over the telephone.
You can also get a printed copy of the comparison information in the mail, which typically takes about three weeks.
The New Jersey Department of Health and Senior Services prepares nursing home report cards, which consumers can search online at www.state.nj.us//health/senior and at http://web.doh.state.nj.us/apps2/healthfacilities/fsReportAll.aspx.
Sussex County Division of Senior Services One Spring Street, Newton, N.J. 07860 (973) 579-0555 seniorservices@sussex.nj.us www.sussex.nj.us
National Association of Senior Move Managers www. NASMM.org 1 (877) 606-2766.
Home Changes with Heart, LLC. PO Box 11 Layton, NJ 07851 (973) 948-2088 (office) (973) 534-0992 (cell) carolyn@homechangeswithheart.com www.homechangeswithheart.com
National Association of Retired Persons (AARP) has advice on its Web site on choosing a care facility www.aarp.org click on "Long-Term Care."
The original article appeared in the NJ Herald and is ©2008