Sometimes, an unforeseen event can force you to rapidly move your loved one into an assisted living community. When a situation like this arises, it can cause financial strain if funding sources are not immediately available – for example, if most of your loved one’s assets are tied up in their home and life insurance policies. A good solution for many seniors and their families is the senior line of credit. This option allows you and other family members some breathing room and time so you can liquidate assets at the best possible return to pay for your loved one’s housing and care and so you can evaluate longer-term financial plans to fund your loved one’s needs.
There are six key steps to establishing how big your senior line of credit needs to be:
1. Determine the monthly cost of care at your chosen assisted living community.
2. Clarify any additional monthly costs related to eldercare.
3. Ascertain any personal monthly costs not related to eldercare.
4. Find out how much financing your family has been approved for.
5. Establish how much your loved one can afford to pay out-of-pocket each month.
6. Discuss and decide how much you and other family members can contribute to your loved one’s care needs each month.
The above six-step process is critical and many families considering a senior line of credit turn to financial counseling with firms that have expertise in eldercare issues to help them navigate these unfamiliar waters.
Take note, though, that not every senior is a good candidate. This financial vehicle is only for seniors who are moving into an assisted living, senior living or retirement community. Payments are sent directly to the housing community; these payments come from the lender, not come from family members, thereby ensuring the integrity of the whole process. Families turn to a senior line of credit when they need time and flexibility while they wait for access to other financial resources, such as the proceeds from a home sale or veteran’s benefits. Many families find they don’t need a month-to-month solution, but rather some money to cover large upfront costs like first months’ rent or move-in-fees.
However, if the senior does not have a support system such as family, trusted financial planners or an eldercare attorney, the senior line of credit is not a good solution. Additionally, a single senior without a reliable support system will likely have trouble getting approved because it’s likely that his or her income will be insufficient to make the required payments. Seniors without family should enlist the help of a professional advisor to go over the process and the paperwork.
If you’re considering this option, be sure to look at all the implications and make sure all family members involved in the decision understand what’s required too. Tell us about your experiences obtaining a senior line of credit for your loved one.
Do you think a senior line of credit is for you?
If you think a senior line of credit might be an option for you or your families, make sure you learn the details yourself. A Senior Solutions executive director can refer you to a qualified provider.
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Finding an assisted living community with a good activity program is a must when you’re seeking a community for your loved one. Many studies conclude that activities are a major social and emotional outlet for the assisted living resident and contribute significantly to their physical and mental well-being. At the heart of any good assisted living community activity program is the Activity Director. This person is charged with organizing and overseeing all the community’s activities. A first-rate Activity Director is essential to a good life for your loved one.
Always interview assisted living activity directors when you visit assisted living communities. Here are six important questions to ask:
1. How do you view the role of activities in an assisted living environment?
Look for assisted living activity directors who understand that activities are key to keeping the mind and body challenged and stimulated during the day. Make sure they understand that activities promote socialization, which helps your loved one feel connected to the new residence.
2. How do you customize activities for every assisted living resident?
One of the biggest mistakes assisted living centers make is a focus on activities that work for most of the residents; this can leave those with special needs like physical, visual or hearing limitations out in the cold. Furthermore, it can cause dissatisfaction and isolation for residents who don’t particularly enjoy those mainstream activities. The director needs to know what your dad or mom used to enjoy, can still enjoy, and find a way to work that into the calendar.
3. What kind of physical activities do you offer?
Take a very close look at the available physical activities. This is vital for seniors so they avoid or minimize many of the health problems that can come with age. An active senior has a lower risk of developing type 2 diabetes, heart disease, bone mass loss, muscle deterioration…the list goes on and on. And very importantly, physically fit seniors have better balance and are less likely to suffer falls. According to the National Safety Council, falls are the leading cause of injury-related deaths among adults age 73 and older and the second leading cause among those aged 60 to 73 years.
4. What about mental activities for my folks?
Good assisted living activities directors understand the link between cognitive function and mental stimulation. One study of more than 5,500 participants aged 65 years or older concluded that stimulating leisure activities were significantly associated with a reduced risk of dementia. Look for programs that include, for example, word games, digital learning tools, scavenger hunts, cooking classes (which combine both physical and mental activity), puzzles, and crafts.
5. Do you include activities that tie into the local community?
Many seniors were active volunteers before they moved into assisted living. Volunteerism gives seniors a chance to serve a valuable community role and feel they have an important purpose in their day-to-day life. A good assisted living activity program should include some outside community service projects. For example, some groups knit caps or blankets for local children’s hospitals; help create community gardens with Boy or Girl Scout troops; or assemble care packages for soldiers.
6. Do you have a resident council that can suggest new activities?
Residents should have choices in their schedule and activities and that’s where a good resident council can be important. This is the resident’s home and they deserve a say in what goes on.
What other questions would you ask assisted living Activities Directors? Leave your comments below.
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Though your loved one has been diagnosed with dementia, you understand that your mom or dad is still able to experience joy, fun, pain, affection and meaning in the activities of daily life. This is why it’s vital that you find an assisted living community with a high-quality dementia care program based on the “person-centered care” model. This is care tailored to the unique abilities and needs of each resident.
Consider these key care areas during your community tours:
1. Mealtimes
Staff should make sure each resident gets the proper amount of food and fluid; inadequate or inappropriate consumption can negatively impact resident’s health, warns the Alzheimer’s Association. Visit during mealtimes and see if staff makes mealtime a pleasant and enjoyable time; coercive or demanding staff behavior is a red flag. Ask to see the week’s meal plan and find out how the community defines a nutritious meal. Observe the help residents get with proper fluid intake; do staff help them drink if needed? Does the residence customize meals based on the medical needs of each resident? Does the community do a family interview to find out what foods the loved one likes and dislikes? Oftentimes, a resident who repeatedly refuses food may simply be a picky eater who doesn’t like specific foods.
2. Resident engagement
Engagement in meaningful activities is one of the critical elements of a good dementia care program. Residents are better able to maintain functional abilities, gain a sense of community and enjoy their day. On your tour, look at what activities are going on and how staff engage with residents. A room full of residents sitting alone with no staff interaction may be a red flag to investigate.
3. Physical environment
A good dementia care program pays attention to the residence’s physical layout. A positive environment offers easy-to-find dining, activity and restroom areas as well as other cues and physical assistance tools to help residents safely navigate the residence. Does it offer good lighting, handrails along hallways, pleasant music, comfortable chairs and couches, and a happy, clean and homelike décor?
4. Wandering safety
It’s important for your loved ones to be able to go outdoors by themselves, if they are capable, and to enjoy sunshine and flower gardens. However, dementia patients often begin wandering and can put themselves at great risk if the community isn’t properly secured. Make sure it provides a safe and secure setting so residents can wander without endangering themselves. Ask about around-the-clock staffing, and check out the physical security provided; fully-fenced communities, password gate entries, locks, and cameras are common security features.
5. Communication with residents
Caregivers should provide a failure-free communication environment. How staff communicates with residents and how residents communicate with staff are important overall care cues you should look for. Staff should speak in simple, direct language, be patient and compassionate and provide positive physical contact. Dementia sufferers are often confused about time and place and may think they are living at their old home, or their parent’s home. Staff should not correct these impressions, but rather offer a reassuring smile, a friendly comment or a hand to be held.
6. Cleanliness
Look at how clean the resident’s clothes are. See if hair looks freshly shampooed and brushed. Do a smell-check to see if you detect unpleasant odors that might point to an unsanitary residence.
During a tour, collect information that helps you decide which residence is right for your loved one. What do you think is most important?
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It’s estimated that more than one million seniors live in assisted living communities. Furthermore, as the U.S. population continues to age – according to the U.S. Census Bureau, there are now more than 40 million individuals over the age of 65, up from 31 million in 1990 – the need for good assisted living centers will only increase.
When considering whether assisted living is the right choice for you or your loved one, look carefully at the range of activities available to community residents. That’s because one of the benefits of assisted living that you’ll hear many a resident boast about is the easy access to a whole range of activities, events, social functions and outings. Activity choice is a key part of the philosophy of person-centered care now followed at more enlightened assisted living communities.
Here are six reasons why activities help the assisted living resident feel content and proud of the community:
1. Activities provide a sense of purpose.
Residents want activities that are meaningful, such as those that produce or teach, says a study by the Centers for Medicare and Medicaid; such activities contribute to a resident’s positive self-image, which enhances their overall wellness.
2. Activities foster connectedness.
Many studies show that socializing benefits seniors in multiple ways. Spending time with other residents helps keep minds sharp, and lowers depression that can result from a sense of isolation. The assisted living resident who makes meaningful connections with other residents feels like the community is home, and that adds immeasurably to well-being.
3. Activities enhance physical welfare.
We all know how important physical activity is for maintaining health. This is vital for seniors and a key reason to investigate what sorts of activities are available at any assisted living community you consider. Many include walking clubs with beautiful onsite walking paths, exercise classes and even yoga classes. Most communities include fitness rooms and staff on hand to help each assisted living resident develop a customized exercise plan.
4. Activities sustain lifetime interests.
Most residents bring a lifetime of interests, hobbies and abilities with them to their new community. The avid gardener still wants to garden; the gourmet cook wants to share recipes and try new ones; the scrapbooker wants to continue arts and crafts. Enabling residents to keep doing those things that they’ve always enjoyed is another key reason for a strong activity program.
5. Activities promote mental growth.
Even old(er) dogs can learn new tricks. The senior living community that offers a variety of activities to residents helps engage them and stretch their mind. Residents take pride in learning something new and get to brag about it to their kids and grandkids.
6. Activities foster a sense of exploration and fun.
People who are having fun feel better and smile more often; and we know from numerous studies that happiness is a huge component of overall well-being. Fun activities like bringing in a magician or having a sing-along can greatly enrich the life of the assisted living resident.
Activities designed to meet the physical, mental and psychosocial well-being of each resident should be high on the priority list at any assisted living community. Tell us about your favorite activities and why they’re important to you.
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The emerging epidemic of dementia cases – which may reach 100 million by 2050 – has led to a burgeoning industry of so-called ‘brain fitness’ tools. Even healthy older adults with no sign of cognitive decline are getting onboard the brain fitness train, in hopes of sustaining their brain function over a long period of time.
Assisted living communities, too, are recognizing this trend and many have begun introducing brain fitness programs as part of their resident activities.
Primarily digitally-based products, they include video games, computer software programs, online learning tutorials, and other products claiming to maintain or enhance memory, concentration, visual and spatial skills, verbal recall and executive functions. While many products are backed by good studies and respected professionals, keep in mind these three important caveats:
- Relatively few have undergone traditional scientific long-term tests.
- It’s not clear if the benefits of these tools generalize to overall thinking skills and whether they actually improve activities of daily living, a significant life-quality factor for older adults
- The brain doesn’t exist independently from the rest of our body. Other forces can affect brain health, including diet, physical exercise, genetics, toxin exposure and interpersonal relations; don’t view brain exercises as a magic bullet solution to age-related cognitive challenges.
So with those cautions in mind, let’s explore the world of brain fitness and take a look at five of the more popular products:
Nintendo
Maker of many top-selling video games, Nintendo offers the popular Brain Age game for $20.00. It’s designed to work with the Nintendo DS handheld game system, which ranges in price from $99 to $170.00. Handheld size and graphics could pose a challenge for older eyes so keep that in mind. Brain Age can be played alone or with others; activities include quickly solving math problems and counting people going in and out of a house simultaneously. Users can draw pictures on the touch screen or read classic literature aloud; the popular Sudoko number puzzle game is included too. A Wall Street Journal review noted that your “brain age” can drop by decades in just a few days, making the science behind the metrics a bit suspect.
MyBrainTrainer.com
Calling itself the “world’s first and best virtual mental gymnasium,” this online site offers 48 online exercises for a fee of $9.95 for three months or $29.95 for one year. That Wall Street Journal review found this “the worst of the group for clarity and directions, but with some worthwhile exercises.”
Posit Science
Posit Science claims that its software programs “speed up and s
harpen the brain, so people think faster, focus better and remember more.” Priced at $345.00 for the total software package, the company offers products that test auditory, visual and driving skills. Reviewers called it “basic” and “boring” but “backed by real science.”
Dakim Brain Fitness
Dakim offers two brain training concepts for seniors:
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BrainFitness™ System: Designed for non-computer users, this self-contained plug and play console system costs $2349 and offers a varie
ty of brain exercises.
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Online brain fitness software usable with a standard computer system costs $249.00 and includes one year of content and software updates.
CogniFit
This web-based program, voted “most fun and seemingly most effective” by those WSJ reviewers, is accessed online and priced depending on subscription terms. CogniFit Personal Coach and Senior Driver are the two most popular brain fitness programs.
Assisted living communities that focus on creating a person-centered, failure-free environment for their residents are adding brain-building tools to their care options. Tell us what you think about these tools
.
Medication management is one of the main reasons for moving into assisted living. One recent study found that 80% of assisted living residents need help with their medications, and that on average, residents take 7.6 prescription medications and 2.3 over-the-counter medications per day. In an assisted living setting, residents will rely on well-trained staff to assist with their medication needs. And, given that over 10 percent of hospital admissions in older adults are associated with adverse drug reactions, it is critically important for family members to educate themselves on the medication management policies at their loved one’s assisted living community. This helps ensure that medication is being correctly organized, administered and stored.
Many assisted living communities centrally store resident medication in what is informally called the “med room.” This is a restricted-entry office that holds all resident medication, dosage records and prescription histories. When you are touring assisted living communities, be sure to include a visit to the med room so you can do your own quality-check on how the center handles medication management. Look for the following items in your visit:
1. Stored medications should be:
- Kept in a locked room at all times.
- Kept in a room that is well-lit, well-ventilated, clean and uncluttered.
- Located in an area free of dampness and at normal temperature levels, unless the medication must be refrigerated.
- If refrigerated, the medication must be kept in a locked container in the refrigerator, or the area where it is located must be locked.
- Kept in their legally dispensed, labeled package, and kept separately from the medication of other residents. Weekly pill organizers should not be centrally stored without proper labeling.
- Accessible with keys to staff trained to assist with or licensed to administer medications.
2. The storage area should be well-organized to reduce the risk of errors and to save time when medication is accessed. Files should be well-organized too. Look for a systematic order for medication storage, for example, in alpha order by resident’s name.
3. Assisted living staff should be able to quickly share with you information about your loved one’s medication management and prescription history. Ask them to notify you when medications are added or discontinued, or dosages are changed, so that you are always aware of precisely what medication regimen your loved one is following.
4. Contact information for your loved one’s doctors is readily available.
5. Verify that discontinued medication is stored separately from medications currently used, so that staff doesn’t accidently give your loved one a medicine that is no longer prescribed by his or her physician.
Medication management is a very important part of a good assisted living community. Make sure you understand this issue and stay involved so that your loved one enjoys a comfortable and high quality-of-life experience. Check out our medication management room when you visit one of our communities.
What medication-related issues have you concerned? Leave your opinions in the comments below.
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Medicare and Medicaid are sometimes confused; it’s important to understand that these programs are not the same. While Medicare serves all retirees over the age of 65 who paid into the Social Security system for a specified time period, Medicaid is the health program for individuals and families with low incomes and negligible resources. It is means-tested and jointly funded and administered by the states and federal government. Medicaid is the largest U.S. funding source for medical and health-related services for those with limited income.
If you qualify for Medicaid coverage, your benefits include some types of long-term care, home health care services for qualified individuals, and both inpatient and outpatient hospital services. That “if you qualify for Medicaid coverage” phrase is critically important. Medicaid planning is a strategy used to satisfy financial eligibility requirements. It is basically a legal way to restructure assets and income so that an individual or family can qualify for Medicaid long-term care assistance.
How It Works
Every individual or family’s circumstances are assessed on a case-by-case basis. Though each state varies somewhat in case treatment, there are several common factors taken into consideration:
- Marital status
- Home ownership
- Pension benefits or social security income
- Assets such as real estate, stocks and bonds, mineral interests, annuities and IRAs
- Appropriately drafted legal documents such as a will, power of attorney, living wills, trusts or other similar estate and disability planning
- Mental competency, i.e. the ability to change documents and handle asset
- Family support
- Urgency of required care
Based on the above factors, here are some of the legal methods to restructure your existing assets so you qualify for Medicaid assistance. However, do not attempt to do anything without the input and guidance of an experienced attorney who understands Medicaid rules and regulations:
- Convert assets that Medicaid considers countable to those it considers exempt or
- Convert an asset into an income
- Transfer assets to other persons in or outside of the
- Exercise provisions which allow a client to expand the amount of protected assets beyond statutory limits. This is called resource expansion.
New Eligibility Rules
Determining eligibility can be complicated and again, points to the importance of using an experienced Medicaid attorney. The federal government’s
Affordable Care Act of 2010 filled in gaps in coverage for the poorest Americans by creating a minimum Medicaid income eligibility level across the country. Beginning in January 2014, individuals under 65 years of age with income below 133 percent of the federal poverty level (currently determined at $14,500 for an individual and $29,700 for a family of four) will be Medicaid-eligible.
Getting Qualified = Getting Advice
Most people initially think that giving away their assets will quickly qualify them, but this in fact can delay benefits. Also, you must keep impeccable records documenting any transfers made and why they were made. If you think you’re eligible, here’s the first step to take: talk to a qualified expert in the field. Help is available so you do not have to spend everything to become Medicaid-eligible.
Tell us about your Medicaid planning experiences: what advice would you offer?
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It’s important for you to meet with a wide variety of staff as you evaluate which assisted living community is the best choice for you or your loved one. When making appointments to visit the communities you’re interested in (and be sure to visit them more than once), advise the person doing the scheduling that you want to meet the admissions director, medical caregiving staff, activities director, physical therapist (if relevant to you or your loved one’s needs), chef, and, very importantly, the executive director (ED).
Why do we think that interviewing the executive director is so important? Because this individual is in essence the CEO of the assisted living community. The executive director has ultimate authority over all aspects of the community, reports the book By Families For Families Guide to Assisted Living. You need to get to know this person, for these reasons:
1. The buck stops at the ED’s office
There are certain situations that can’t be resolved by other staff members. If you have a sincere and open relationship with the ED, you more quickly resolve issues that can’t be resolved by general staff.
2. The ED establishes the care philosophy of the community
The executive director is the key to effectively implementing and maintaining the care standards and guiding philosophies of the community. For example, if the assisted living center includes memory care, it should follow a person-centered care model that is increasingly recognized as the best approach for dementia sufferers. These communities provide loved ones with state-of-the-art dementia care in a safe and professional environment. The executive director should have a deep and profound connection to helping the residents. You’ll run across executive directors that are all business. While it’s obviously important to take a business approach to the community, make sure this demeanor doesn’t come at the expense of the patience and compassion required to make the residents happy.
3. Staff performance is tied to the executive director’s management
The executive director is the individual who is ultimately responsible for modeling the practices that motivate and inspire staff. Study after study concludes that empowered staff leads to higher rates of retention and lower turnover, both of which are very important to maintaining a happy and healthy living environment for assisted living residents.
4. The ED is responsible for providing you with state health survey data
It is absolutely critical for you to ask to see recent state inspection survey results. The center is required to provide this information if asked. When you ask the ED for the most recent survey report, evaluate if it is provided without hesitation. If not, this is a huge red flag. According to the Alzheimer's Association, when you do see the report, make sure it is dated within the last 9-15 months. If the assisted living community has received a citation in a particular service area, be sure to ask the ED about this area during your visit. Be cautious about selecting a community with a very high number of deficiencies compared to other centers in your area and in your state as a whole.
After repeated visits and conversations with the executive directors at the assisted living centers that make your “finalist” list, you will likely find one who you trust most and who you believe will provide the best care for you or your loved one. Tell us about your experiences in meeting with the executive director – what do you think is important to ask?
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The aging of our population drives many local, state and federal elder policies and has led to increased attention to the needs of seniors. The state of Tennessee is no exception to this aging trend; the median age in Tennessee is 37.2 years, slightly higher than the overall median U.S. age, which is 36.2 years. Over 24 percent of Tennessee citizens are older than 55 years and many need accurate information on Tennessee senior living options.
Fortunately, there are a variety of public resources that can help in finding living choices ranging from home care to assisted living to specializedAlzheimer’s care communities. State agencies, non-profits and watchdog organizations all provide valuable assistance. Here is a checklist of five key resource sites providing information on Tennessee senior living, as well as other important eldercare issues.
1. Tennessee Commission on Aging and Disability
This commission’s stated mission is to “bring together and leverage programs, resources and organizations to protect and ensure the quality of life and independence of older Tennesseans and adults with disabilities.” It provides a wide range of elder information, including caregiving, Alzheimer’s, elder abuse, and long-term ombudsman programs.
2. Tennessee Area Agencies on Aging and Disability
Nine area agencies on aging (AAADs) organized into regional county groupings across Tennessee provide “accurate and unbiased information on all aspects of life related to aging or living with a disability,” according to the website:
3. Tennessee Assisted Living Facilities
This comprehensive site offers data on costs of assisted living communities, admission requirements and scope of care. Visitors can also search currentTennessee senior living license status and find out who owns a particular assisted living community center, last licensing survey date, how many beds, and other important pieces of information that help individuals make informed decisions about their or their loved ones’ senior care.
4. National Clearinghouse on Long Term Care Information
Developed by the U.S. Department of Health and Human Services, this website provides information to help you and your family plan for long-term care needs. Included is information on Medicare/Medicaid coverage, long-term care insurance and senior living housing choices. Click on your state for more information on Tennessee senior living options.
5. ConsumerHealthRatings.com
This is a comprehensive listing of organizations that rate/report on the performance of health care providers; search for the state of Tennessee.
Choosing the right senior living situation for you or your loved ones is a critically important job and these resources should help you sort through all the information. Tell us about your experience searching for senior living options – what sites were the most helpful?
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First you get the devastating news that your loved one has Alzheimer’s disease. Then you struggle to cope as your parent gradually loses the ability to perform daily living functions. Years of caretaking can cause declining health for the primary caregiver and conflict among family members. Finally you decide to place your parent in a dementia care community; now you face a whole new set of stressors as you seek the right community.
The only good news in this heartbreaking situation is that today’s dementia care communities are much better than what existed just thirty years ago. The old model of the cold clinical institution has given way to person-centered” dementia care. This model utilizes highly-trained staff who deliver a more holistic style of care to create a supportive and failure-free resident environment. Such communities often have success in reducing the use of behavior-related medications. Here are eight things to look for in a dementia care community.
1. Staffing skill level
Staff in a person-centered community regularly attend intensive training programs on dementia care and frequently meet to discuss each resident’s care needs. Ask about specialized dementia training programs, turnover rates, average employment length at that community and what background checks are performed. Spend time watching staff interact with residents and talk with them yourself. The Alzheimer’s Association recommends that you ask for recent state inspection results and compare any deficiencies/citations to your state’s average.
2. Security
A person-centered dementia care community provides a safe and secure setting. Make sure around- the-clock staffing is a care standard; check that the community is secured with locks, cameras, password gate entries and other modern security solutions.
3. Clean home-like setting
Modern dementia care communities are clean, warm and homey and are purpose-built for dementia sufferers. The person-centered care community enables residents to personalize their room with family photos, pillows, favorite quilts or stuffed animals – it will not look and feel like an institution.
4. Family accessibility
Family members should have unlimited access to the dementia care community. To verify this, drop in at unexpected and unannounced times to evaluate what is happening with your loved one. Make sure that families are encouraged and welcomed in care planning and are notified of changes in the resident’s condition, medication or care needs. Seek a community that creates a customized plan for your loved one and involves you in that planning process.
5. Respect and dignity are priorities
The guiding principle behind person-centered care is that your loved one is an individual with unique perspectives and life experiences who is supported, valued and respected. Some communities call it a “failure-free” resident model. This approach is superior to old models that focused on control techniques such as medicating, corrected “wrong” behaviors and placed little value on the dignity and privacy of each resident.
6. Stimulating activities
Find a community that understands the background of each resident and incorporates important events or abilities into your loved one’s activities. This might include acknowledging military veterans or making certain holidays a priority. Look for a community offering stimulating activities such as sing-alongs, drawing/painting or therapy pet visits.
7. Holistic care approach
Research shows that a person-centered holistic community reduces the need for medical dementia care and control. Look for a community that focuses instead on friendship, personal care and customized activities.
8. Customized nutrition
Make sure the nutritional plan is appropriate for your loved one’s needs for appropriate calories, nutrients and food choices. One size does not fit all in a good person-centered dementia care community.
What things are important to you as you manage the care of an aging parent? Leave your thoughts in the comments below.
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