The Last Stop: It’s the Little Things

Life goes on for me at my retirement community. Nothing too dramatic. I listen to the world news, the national news, the weather traumas, and know how fortunate I am to be living in this safe, comfortable environment in Colorado. Yet with that said, I still Margery's friends work on a puzzleam aware that every day offers a personal choice, a decision and an opportunity.

It’s the little things that I plan to share with my readers in this essay. Little things such as how I manage my meal choices, the leaving of friends and how a new friend resolved his personal complication. No matter how one simplifies one’s life, living is never without decisions.

Read more about the little things that make a difference in Margery’s life in “Part 12: It’s the Little Things.”

This post was written by Margery Fridstein, an author and retired psychotherapist who lives in a CCRC outside of Denver, CO. She is chronicling her experience in the monthly series, “The Last Stop With Margery Fridstein.”

SeniorHomes.com Honored as One of Washington’s Fastest-Growing Companies!

We are proud and honored to be listed as one of Washington State’s 100 fastest-growing private companies, as ranked by the Puget Sound Business Journal!

SeniorHomes.com, which is based in Seattle, ranks 69th on the PSBJ’s annual list. In all, the 100 companies combined to record more than $2.08 billion in revenue in 2013. In order to qualify for consideration, companies must have recorded at least $500,000 in revenue in 2011 and demonstrated revenue growth through 2013.

All companies must be privately held during the reporting period and be headquartered in Washington State. Additionally, they may not be subsidiaries of other companies. Revenue growth is calculated as a percentage between 2011 and 2013, and this figure is used to determine each company’s rank.SeniorHomes.com

This represents the third such recognition in a string of awards and honors received by us in recent months, which COO Jay Goldstein attributes to the company’s strong culture and commitment to success.

“The credit for this accomplishment goes to everyone in our company,” Goldstein says.  “None of this would be possible without the hard work, intelligent insights, and focus on customers (both consumers and providers) that each of our team members brings to SeniorHomes.com every day.”

Earlier this year, we earned a spot in the prestigious Inc. 5000 for 2014, landing at number 678 among 5,000 innovative, successful enterprises. Additionally, we were recognized in the 23rd annual National Mature Media Awards Program by the Mature Market Resource Center, earning a Silver Award for the National Media Division in the Web Site Category.

“We’ve put the customer at the forefront from day one, and it’s allowed us to envision and execute innovative programs, like our Best Senior Living Awards program, the industry’s only quantitative-based evaluation system for senior living communities,” says CEO Chris Rodde. “We’re honored to receive a distinction so well-deserved by our dedicated team.”

Through our directory of more than 80,000 senior living communities, the innovative Best Senior Living Awards program, thousands of expert-written articles and free Care Advisor service, SeniorHomes.com aids more than three million seniors and their families in their search for senior housing every year. We are proud of what we do each and every day here, proud of our growth and recognition, and invite you to find out what sets us apart!

Joan’s Journey: Famous 1873 Poem Describes Senior Living

Ron. Harriette. Jerry. Three names commonly used in today’s Western countries. Common names, yes—but unique to each individual who answered to the words. For me, “Ron,” “Harriette”  and “Jerry” are the names of folks whose memories evoke smiles on my face and joy in my heartJoan's friend Harriette (left)

These three folks, “like ships passing in the night,” touched my life ever so briefly along my journey of senior living at Holiday Villa East (HVE). Within six months of my arrival, each had passed away. But their friendship, kindness, intelligence and grace, under the most difficult of circumstances, will remain with me forever.

Welcome, Joan’s Journeyers. In our last blog, I was completely upfront about the life-cycle experience of illness, dying and death at senior living. I chose this topic for discussion because I believe it’s extremely important for a senior and his or her family to consciously explore one’s feelings of all aspects of senior community living—before one makes a choice of residence. A past blog, “Senior Communities Embrace Life, Even at the End,” posted on Oct. 1, discussed this topic.

Our current blog advances further to personally highlight three fabulous folks who experienced illness, dying and death while living in a senior community.

Learn more about Ron, Harriette and Jerry, and the impact they had on Joan’s life, visit the latest installment of Joan’s Journey, “Part 23: Famous 1873 Poem Describes Senior Living.

Joan London, a former Houston Chronicle correspondent and noted magazine writer/editor, specializes in freelance writing/editing of issues relating to seniors. London moved to a senior community in Southern California, where she has enhanced her quality of life and is close to her children and grandchildren. Follow her series, Joan’s Journey, on SeniorHomes.com.

CMS to Overhaul Nursing Home Compare

It seems the Centers for Medicare and Medicaid Services (CMS) has been paying attention. While the agency’s five-star rating system for nursing homes has always been the subject of a fair share of criticism, new concerns started gaining speed in the media within the past few months. At the beginning of September, we reported on criticisms surrounding the self-reporting measures and other practices leading some experts to say that they doubt the integrity of the rating system as a true barometer of quality of care.

IMPACT Act aims to improve quality ratings for skilled nursing facilities

On Oct. 6, President Obama signed the Improving Medicare Post-Acute Care Transformation (IMPACT) Act, which aims to improve quality through increased transparency and standardized assessments in several areas surrounding critical care issues across skilled nursing facilities, home health agencies, long-term care hospitals, inpatient rehabilitation facilities, and other post-acute care (PAC) providers. Nursing Home Compare overhauls rating system

IMPACT will allow both payments and patient outcomes to be compared across these providers, fueling the development and public reporting of quality measures and facilitating the provision of new PAC payment models, to be presented to Congress by the Medicare Payment Advisory Commission (MedPAC), according to Long-Term Living Magazine.

New changes directly address recent criticisms

But in direct relation to the current five-star rating system used by CMS to grade skilled nursing facilities, there are some big changes coming, many targeted specifically at areas of concern recently addressed in the media. IMPACT, it’s worth noting, however, was first introduced back on June 26 and enrolled as a bill on Sept. 18.

Long-Term Living Magazine summarizes some of the changes that will occur as a result of the passing of the IMPACT Act of 2014:

  • More quality measures will be added to the rating system, beginning in January 2015, including re-hospitalization rates and anti-psychotic drug use.
  • Staffing data will be gathered directly from payroll records rather than through self-report.
  • Scoring methods will be re-evaluated to ensure they accurately represent the quality of providers earning these ratings.
  • A national auditing system will be rolled out to verify information reported through on-site visits.

New measures taken to verify formerly self-reported data, such as staffing ratios and staff turnover rates, are particularly welcomed by critics. Cheryl Phillips, MD, LeadingAge’s senior vice president of public policy and advocacy, tells Long-Term Living Magazine that staffing is one of the most accurate indicators of quality in long-term care settings.

Self-reported quality measures overshadow accuracy

In fact, it’s the self-reporting measures which the debate has primarily centered on in recent months. The controversy surrounding the hotly debated Medicare star-rating system heated up again after the U.S. Department of Health and Human Services Office of Inspector General released an August 2014 report finding that in a random sampling of 209 nursing homes, only 53 percent of allegations of elderly abuse, neglect, or exploitation are reported to federal agencies.

As self-reporting is currently the relied-upon method the CMS utilizes to gather data which determines a skilled nursing facility’s star rating, this naturally casts a shadow over the perceived accuracy of the ratings.

Sweeping changes to data collection and verification to begin in January 2015

While the improvements are expected to take at least one year to implement, consumers will begin to have access to more legitimate, verified data beginning in January. Nursing homes will begin reporting staffing ratios quarterly, and this information will be verified through payroll documents.

Also beginning in January, nursing homes will be rated on the percentage of residents:

  • Receiving anti-psychotic drugs
  • Re-admitted to a hospital
  • Discharged (released) from nursing home care

Most importantly, the system will eventually provide consumers access to this deeper data, such as staff turnover rates and other quality measures. While the additional measures will begin to be incorporated in 2015, this new data won’t actually be reflected in nursing home ratings until 2016.

These changes represent an increasing demand among today’s savvier consumers for high-quality, independent data that provides a true standard metric for navigating the challenges in decision-making when it comes to placing an aging loved one in senior housing. This is the need SeniorHomes.com aims to address with the Best Senior Living Awards, an independent rating system for assisted living, independent living, and other senior housing options to provide families with a standard metric and valid, third-party ratings from experts to aid the decision-making process.

Big Changes to Assisted Living Laws in California

California Gov. Jerry Brown just signed into law 10 of 14 bills aimed at protecting assisted living residents in the state. According to the Sacramento Business Journal, the laws are “designed to address what some say is a crisis of care in assisted living facilities across the state.” The new laws span a variety of components of assisted living, such as additional training requirements for owners of assisted living communities, to statutory rights for residents, and perhaps the most critical change: State regulators now have the ability to suspend admissions to an assisted living community which has received a number of violations deemed to pose a risk to the health and/or safety of residents.

Increased fines and stricter training requirements New California Assisted Living Laws

U-T San Diego notes that the largest fine is now $15,000—for violations resulting in the death of a resident—a marked increase from just $150. This particular bill, focusing on increased fines, was co-authored by Assemblyman Brian Maienschein, R-San Diego, and it applies to all community care facilities in the state, not just assisted living communities. U-T San Diego brought attention to the markedly low fines for serious injury and death in a series of articles which highlighted 27 deaths and hundreds of injuries caused to residents in senior living communities in San Diego county alone, allegedly caused by abuse and neglect. U-T San Diego calls this series of bills “the state’s most sweeping overhaul of the industry in nearly three decades.”

The entire reform package was initiated earlier this year, sponsored by California Advocates for Nursing Home Reform, which released its own report last year with some concerning details about residential care in California. Legislators were motivated by this and other reports concerning a lack of adequate oversight in the senior living industry.

Here’s a look at the 10 bills signed into law by Gov. Brown and the focus of each:

  • SB 1153 by Senator Mark Leno (D-San Francisco) – This bill permits state regulators to suspend admissions to a residential care community with violations that place resident health and safety at risk.
  • AB 1570 by Assemblymember Wesley Chesbro (D-Arcata) – This bill outlines increased training requirements for owners of residential care communities in the state, as well as direct care staff.
  • SB 911 by Senator Marty Block (D-San Diego) – Similar to AB 1570, this bill increases training requirements for administrators of residential care communities (rather than licensees) and direct care staff who perform specific duties.
  • SB 1382 by Senator Marty Block (D-San Diego) – Another bill relating to increased training requirements, this bill addresses increased requirements for licensees (owners), administrators, and direct care staff.
  • AB 1751 by Assemblymember Richard H. Bloom (D-Santa Monica) – The signing of this law means that residents in California assisted living communities must now have representation on governing boards of residential care facilities as well as quarterly reporting of financial statements.
  • AB 1899 by Assemblymember Cheryl Brown (D-San Bernardino) – This law, in response to an incident occurring in response to the abandonment of 19 residents at a senior living community at Valley Springs Manor in Castro Valley, now prohibits the reinstating of a license to any licensee who abandons a facility and therefore places residents’ health and safety at risk.
  • B 2044 by Assemblymember Freddie Rodriguez (D-Pomona) – This bill addresses specific staffing requirements for residential care communities, along with health and safety requirements.
  • AB 2171 by Assemblymember Bob Wieckowski (D-Fremont) – Establishes statutory rights for residents, and requires the display of resident rights within the senior living community.
  • AB 2231 by Assemblymember Richard S. Gordon (D-Menlo Park) – Re-instates a previous program which provides property tax deferment for seniors and the disabled.
  • SB 895 by Senator Ellen Corbett (D-Hayward) – The signing of this bill means that residential care communities must now rectify licensing deficiencies within 10 days after notification.

Changes are beneficial for residents

These new requirements will now mandate that a CPR-certified staff member be on site at all times. Additionally, senior living community operators are now prohibited from punishing a staff member for calling 911 to obtain help for a resident facing a serious or emergent health concern. Previously, this was discouraged by some operators who believed it to reflect poorly on the community’s ability to provide adequate care, and, in some cases, was discouraged due to the impact transport would create for the community’s occupancy levels. In any case, staff members may now feel confident in seeking the necessary help for residents in emergent situations without fear of repercussion.

When Harry Met Grandma Sally’s Keepsakes: How To Repurpose Items After A Move

When you’ve lived a full, comfortable life surrounded by decades of accumulated belongings, deciding what to take to a smaller assisted living space is anything but simple. After the big move, what becomes of what’s been left behind? The receipts, the clothing, the stacks upon stacks of letters … aren’t you glad we just e-mail everything now?!

Instead of throwing all of Grandma’s old records out, there are plenty of ways you can not only repurpose them, but preserve these keepsakes for years of admiration to come. To get ourselves in the sentimental mood, let’s just think of this upcycling mission in terms of quotes from popular romantic comedies, shall we?

“To me, you are (a) perfect (postcard.)” — Love Actually

Back in the day, people sent each other greeting cards. All. The. Time. While snail mail has arguably lost its everyday appeal, special occasions still call for a postcard once in a while.Grandma's Keepsakes

Luckily for you, the vintage artwork of old greeting cards will never go out of style.

Simply cut off the decorative front of an old greeting card, and voila! A brand new (to you) postcard. Sign, seal and deliver it to your oldest and farthest friend.

“I came here tonight because when you realize you want to spend the rest of your life with somebody(‘s sweater), you want the rest of your life to start as soon as possible.” — When Harry Met Sally

With sweater weather fast approaching, you’ve got to look good. A simple tailoring of the sleeves, taking in the sides and scooping out the neck can make any “grandpa sweater” fit like a glove.

“Nobody puts baby (blankets) in a corner.” — Dirty Dancing

So what about other clothing items that are not suitable for public wearing, yet you can’t quite bring yourself to donate or throw them out? Well, the sky is the limit when it comes to creating something out of pieces of fabric.

A great way to connect an older relative to a very young one is through material belongings. Making a teddy bear out of an old curtain, or a baby blanket out of several old pieces of clothing, can bond a child to their older relative in a really touching way—either now or years down the road, depending on their level of cognition.

“I’ll never let go, (love letter from) Jack.” — Titanic

Honestly, is there anything more romantic than old-fashioned love letters? Short of framing and displaying them all on the living room wall, perhaps try something a little more discreet with just as much pizzazz, such as jewelry. Cut an especially touching section out of a letter, laminate it, and put it into a locket. You can go above and beyond by decoupaging the letters onto just about anything—jewelry, picture frames, wine bottles, etc. Just like your grandparents’ love, their words will never fade. (Awww.)

“You gotta hear this one (melted) song. It’ll change your life. I swear.” — Garden State

First, be sure the old records aren’t worth something—there’s a big hipster market out there for vinyl. If not, here’s how to make some cool pinched bowls:

  1. Heat oven to 300-400°.
  2. Set the record on the mouth of a glass bowl—this will be its mold.
  3. Heat in the oven for a few minutes, just until the record is hot enough to bend.
  4. Press down into the bowl, allowing the sides to crinkle.
  5. Let cool and solidify.
  6. It’s a decorative bowl! Be careful while doing this and don’t forget to turn the oven off.

“I am just a girl standing in front of a boy asking him to love (scrapbooking with) her.” — Notting Hill

Scrapbooking … the old standby! There’s really no better way to condense a lot of photos, letters and postcards than into one (or several) handy scrapbooks. Here are some tips to help get your creative juices flowing:

  • Only use materials that are acid-free. This is critical to preserving the papers and photos.
  • Create a focal point on each page, then build around it with snippets and photos.
  • Tear some edges instead of cutting all of them. It gives a cool, textured look.
  • Use paper clips to adhere letters. It looks more authentic.
  • Use fabric instead of paper. Bonus points if you can put a piece of your grandmother’s old scarf underneath a photo of her wearing it!
  • A fine-tipped pen looks classic and elegant; a bolder pen looks more casual.

Conclusion

When sifting through the sea of mementos and personal items often left behind when an elderly loved one moves into a smaller living space, it can be difficult to make sense of the boxes of keepsakes left behind. Whatever you do, don’t let these precious family heirlooms spend another 50 years in an attic! By repurposing with tender loving care, these family memories can be passed on for generations to come.

Shayne Fitz-Coy is the Co-CEO and President of Alert-1, an aging-in-place technology company headquartered in Williamsport, Pennsylvania with offices nationwide. Shayne has a Bachelor’s degree in Psychology from Harvard College and a Masters in Business Administration from the Stanford Graduate School of Business. Shayne hails from Maryland, and now calls the Bay Area home.

Harvard Says U.S. Senior Living Industry Unprepared for Coming Aging Wave

America is aging, and an AARP blog post by Melissa Stanton explains that Harvard reports the country is totally unprepared for what that really means. A report, “Housing America’s Older Adults: Meeting the Needs of an Aging Population,” released September 2 by the Harvard Joint Center for Housing Studies with the support of the AARP Foundation, clearly shows that “both individually and as a nation we’re not ready for all that comes with age.”

The authors of the Harvard report explain that existing housing is “unprepared to meet the escalating need for affordability, accessibility, social connectivity, and supportive services.” Moreover, the country’s transportation and pedestrian infrastructure “is generally ill-suited to those who cannot or choose not to drive, isolating older adults from friends and family.” Plus, “disconnects between housing programs and the health care system put many older adults with disabilities or long-term care needs at risk of premature institutionalization.”

Aging will be expensive in the coming years

Stanton points out four eye-opening statistics and facts that show just how challenging it will be for seniors to afford aging:

  • Typical homeowners over age 65 can afford in-home assistance for about 6 to 9 years of assisted living
  • Typical renters over 65 only can afford two months of support
  • In 2012, 1/3 of adults 50+ paid more than 30% of their income for housing, including nearly 9.6 million who paid more than 50% of their income for housing
  • Low-income seniors significantly cut back on food, health care, and retirement savings because of high housing costs

Housing, necessities, transportation, and more create obstacles

Maicie Jones, program manager for AARP Foundation’s Housing Impact Team, breaks down the 5 essential facts from the Harvard study, highlighting the housing challenges that face older U.S. adults. Her key findings:

  • In order to remain housed, older people are “skimping” on necessities
  • The needs of older adults are not going to be met by a large portion of America’s available housing
  • Driving is essential to living in America, and older adults who don’t have the ability will feel isolated
  • Older people’s independence is at risk because of the increased costs associated with the lack of integration between housing and healthcare
  • It is not too late to help a majority of aging Americans

Some Boomers skeptical about the potential for positive outcomes

At age 50, Richard Mize is not so sure about the positive note the report ends on, and with which Jones ends her list of 5 facts. He knows “older folks who are really struggling. My own house needs repairs and modifications I can’t afford.” He also says that because of these challenges facing older adults, “aging-in-place might as well be aging-in-space.” Because of his experience as one of the older adults the study refers to, Mize has a few bullet points of his own that he wants to highlight for the aging population:

  • “The existing housing stock is unprepared to meet the escalating need for affordability, accessibility, social connectivity, and supportive services.”
  • “High housing costs force millions of low-income older adults to sacrifice spending on other necessities including food, undermining their health and well-being.”
  • “Much of the nation’s housing inventory lacks basic accessibility features, preventing older adults with disabilities from living safely and comfortable in their homes.”
  • “The nation’s transportation and pedestrian infrastructure is generally ill-suited to those who cannot or choose not to drive, isolating older adults from friends and family.”
  • “Disconnects between housing programs and the health care system put many older adults with disabilities or long-term care needs at risk of premature institutionalization.”

You see, Mize admits that he is thankful for the hopeful note at the end of the study, but he is doubtful. He points out that Baby Boomers have “the most cause to be concerned” because they “have not seen that much ‘effective action’ ‘at all levels of government’ working with the private and nonprofit sectors on a national level.” He cites the report’s point that the older population numbers are swelling because younger boomers are in their 50s, “‘with lower incomes, wealth, homeownership rates, and more debt than generations before them, members of this large age group may be unable to cover the costs of appropriate housing or long-term care in their retirement years.’”

Mize concludes by lamenting the fact that the study’s hope is awfully high and he’s not convinced that America understands the ramifications of such a swell in the older population: “Besides, ‘high quality,’ ‘independent,’ and ‘financially secure’ are not the usual attributes of the aged, not in history. It can’t happen without all, or at least most, members of a community pulling together across generations.”

Are you concerned about being able to afford aging? What is your plan for a financially secure and housed future? Share in the comments to get the discussion going.

Images via Flickr by Maria Popova and Dan Moyle

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LGBT Seniors Face Additional Caregiving Challenges

Caregiving is both physically and emotionally demanding for any family caregiver, but those caring for LGBT loved ones may face additional challenges. There are a variety of contributing factors, ranging from fear of being judged or discriminated against, a lack of social support from family and friends, and lack of access to healthcare. This often happens when LGBT seniors resist moving to senior living communities out of fear that they won’t be accepted by homosexual residents or will face ridicule. Essentially, aging sends some LGBT older adults back into the closet, despite the struggles and challenges they’ve overcome earlier in their lives in the process of coming out to family and friends.

The result is that many LGBT caregivers report feelings of isolation or feeling as though it’s just them against the world. Many are afraid to reach out and ask for help, and grief is magnified as LGBT spouses or partners are sometimes afraid of talking about their feelings with other loved ones out of fear that they won’t be understood or accepted.

Legal challenges only further complicate matters. Presently, only 19 states have legalized gay marriage. That means LGBT partners may be faced with losing their homes, losing financial and other assets, and even personal belongings if other family members are handling their partner’s estate — particularly if those family members disapproved of the relationship. When these same partners feel a lack of social support elsewhere, as well, it’s not uncommon for them to shut off from the world, disengage in the activities they once enjoyed, and basically seclude themselves from the outside world for six months or more.

That’s why it’s so important for healthcare providers and staff at senior living communities to undergo sensitivity training. The less judgement LGBT aging adults feel as they enter their elderly years and may need to seek support or housing for help with activities of daily living, the more likely they will be to make use of these resources. But even more important is for anyone with a LGBT friend or loved one to reach out and offer a helping hand, to provide support and compassion, to help spouses and partners successfully manage their grief after the loss of a loved one.

Caregiving is challenging for anyone. No one should have to go through it alone. For more information on the challenges facing LGBT caregivers, read this article.

 

Image via Flickr by r. nial bradshaw

Joan’s Journey: Senior Communities Embrace Life, Even at the End

Just before 8 p.m. on a beautiful fall night in Santa Monica, the enchanting quiet of my “senior hotel” room was blasted with high-pitched sirens, annoying loud beeps and screeching tires. I was seated at my desk in the exact spot where, and time when, the recent 5.0 earthquake occurred. This evening, however, the unwanted sounds were manmade—those of an ambulance and a fire truck arriving at the front door of Holiday Villa East (HVE).

Unfortunately, living at HVE, these sounds are all too familiar. In fact, I hear them routinely—some weeks Ambulancemore frequently than others. The location of my room allows these unnerving sounds to penetrate into my room day and night. That’s a compromise I’ve made to occupy a lovely space with a balcony overlooking a busy urban street with three major hospitals, two fire stations and a police station within less than a mile.

Rapidly, the noises stop. Ambulance double-doors slam and footsteps scurry up the ramp. A resident needs immediate medical care.

Welcome, Joan’s Journeyers. Our story, but not our blog, ends here.

To read the rest of Joan’s post, and see how communities—and their residents—handle the loss of a friend, visit the latest installment of Joan’s Journey, “Part 22: Senior Communities Embrace Life, Even at the End.

Joan London, a freelance writer who specializes in topics on aging, enjoys living in senior housing in Southern California, where she is close to her children and grandchildren. London has a new roommate, Heather, 6 months, a beautiful Ragdoll Kitten. Follow her series, Joan’s Journey, on SeniorHomes.com.