Serving Greater Northwest Indiana and Northern Indiana Counties
FALL–WINTER 2013
Retiring With Purpose Planning for retirement involves much more than financial questions.
Linda and John O’Brien
Options for Retirement Living From aging in place to comprehensive care, the right choice depends on the senior. Shari H eld here’s no place like home… there’s no place like home… Dorothy’s not alone. Northwest Indiana seniors will brave frigid winters, resisting the allure of sunny climates and proximity to family members rather than move. “The No. 1 reason older adults move is to be near family, but three-quarters of them stay,” says Robert Peek, manager, Home and Community Based Services at Northwest Indiana Community Action Corp., a not-for-profit organization in Crown Point dedicated to helping people stay independent. That’s even more surprising considering the results of the Northwest Indiana Community Action Assessment Survey for Older Adults (CASOA) released this June. Only 27 percent of responding seniors said they would recommend their community to others and only 41 percent rated the overall services provided for older adults as “excellent” or “good.” Not only are seniors staying in their communities; they are opting to stay in their own homes rather than seeking out retirement communities. For most seniors, aging in place, surrounded by their familiar support group and cherished belongings, is the ideal. “We’ve been seeing this trend a lot lately,” says Debra Soucie,
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HOW MUCH HELP? Seniors enjoy more residential choices than ever for spending their retirement years. co-owner of Visiting Angels in Schererville, which provides different levels of non-medical assistance for people who want to stay in their homes, including those with Alzheimer’s and dementia. “People feel comfortable in their surroundings and we don’t want to take away from the things they can do. We just want to be there with them so they can continue to stay in their environment.” It’s not just people in their early retirement years who opt to stay at home. “The trend we are seeing is that the population we serve is getting older,” says Karen Brock, director, Community Health Services in Munster. “A lot of the people we see are in their late 70s through
their 90s and they are requiring more assistance to stay in their homes.” Community Health Services has a skilled services side, which provides nursing, physical therapy, occupational therapy, speech therapy and medical social worker services to people in their homes, as well as a non-skilled services side, which provides companions, personal home attendants or home health aides. In the past, adult children might opt to move in with elderly parents to care for them, but that doesn’t happen as often these days. “Jobs are harder to come by, and kids are just not willing to relocate,” says Shelly Wilson, president and owner, Anchor Health Systems. “We RETIREMENT LIVING 37
find the kids are more likely to pitch in and help pay for home health care for their parents.” Anchor Health Systems, which specializes in high-tech skilled nursing and therapy, has locations in Valparaiso, South Bend and Lafayette.
Another option is for the parent to move in with adult children. Given that the norm these days is for both spouses to work, and many of those who don’t work are caring for young children, this is not always a viable option for everyone.
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RLivingmagazine.com 38 RETIREMENT LIVING
“It just depends on the family dynamics,” says Kathleen Murphy, director of marketing for Ohio-based Sprenger Health Systems. “Your parents are on one side and your children are on the other and you become the baloney in the middle of the sandwich. It can be overwhelming.”
HAVING THE “DREADED” TALK
The talk between parents and adult children that focuses on how and where the parents will spend their senior years can be emotionally charged, cathartic or anywhere in-between. But it has to happen. And sooner, rather than later. Ideally, the parents will bring it up as they approach retirement, but for many seniors, it’s a taboo topic, avoided as long as possible. No one likes to admit they are no longer capable of caring for themselves, and denial is a common reaction. Often the adult child must take the lead. Peek suggests posing “what if” questions and asking parents for guidance in certain situations. “Start with the generalities and then move on to the specifics,” he says. “Once you’ve opened that door it becomes much 11:04 AM easier to talk about.” Having the discussion over several years keeps it going and gives everyone time to consider all the options such as: Aging in place—living at home, perhaps with home care assistance, whether personal or medical. Independent retirement living—maintenance-free living in a community setting, often with amenities such as swimFALL–WINTER 2013
ming pools, exercise areas and group activities. Residents can come and go as they please and maintain their own transportation. They can also opt for personal or medical home care assistance. Assisted living—provides multiple levels of continuing care depending on the residents’ needs, such as bathing, toileting, medication assistance, dressing and grooming, special treatments, diabetes assistance, and mobility, transfer and escort services. Meals, transportation and group activities are typically provided. Alzheimer’s or memory care— secure units that offer a more structured environment and specialize in care for residents with Alzheimer’s or dementia. The
FALL–WINTER 2013
programming, layout and even the décor is designed to meet patients’ needs. Long-term or skilled nursing care—provides 24-hour ’roundthe-clock nursing care as well as help with the activities of daily life. Comprehensive care—offers the full spectrum of care so residents can progress from one level of care to another as needed, yet remain in the same familiar community setting. “The adult child generally is able to take the 5,000-foot view and look for long-term solutions,” Murphy says. She advises seniors and their families to spend as much time researching senior options as they do to preparing for pregnancy and welcoming a new baby into the
home. “You have to put that much energy into understanding what’s available for your parents as they age, how to evaluate it, and how to make good decisions for your parents or help them make good decisions,” Murphy says. Having the overall picture of the health care options is key. Wilson says seniors have a lot of confusion regarding Medicare benefits. For example, purchasing a Medicare supplement does not provide any additional services. It just picks up some of the 20-percent, out-of-pocket costs. “Folks who are now in their 50s or 60s need to know what their plan is and look for alternatives,” she says. “They should investigate a secondary plan that covers things outside
RETIREMENT LIVING 39
of the scope of Medicare.” Sometimes a spouse or a child who has taken on the role of caregiver can no longer provide the type of assistance needed, and living at home or with the adult child or caregiver is no longer an option. “People are living so much longer now, that some of the people who are calling us about their parents are in their 70s themselves,” says Jill Higgins, department assistant for Community Health Services. “They don’t have the energy to assist them.” When it comes to making the move to a skilled nursing facility, Peek says a study by South Bend-based REAL Services, which serves older adults and low-income people in North Central Indiana, indicated the
determining factor often isn’t the condition of the patient, but rather the condition of the caregiver. So the “talk” needs to encompass finances, insurance benefits, housing, health care and quality of life to ensure the best option is selected for everyone involved. One thing to note: Personal home assistance and independent living and assisted-living facilities are typically “private pay,” meaning the resident or the resident’s family must have the financial ability, whether through savings or long-term insurance, to pay for these services. Home health services and skilled nursing facilities may be paid for by insurance, at least up to a certain amount. “We’ve seen a trend where
seniors are buying more and more long-term health care insurance,” Murphy says. “Many of those policies will pay for assisted living if it is in a licensed facility.” Sprenger Health Care of Mishawaka, a licensed assisted-living facility, features 30 assisted-living apartments and 70 rooms for orthopedic rehab and skilled nursing.
AGING IN PLACE
Home is the No. 1 place most seniors want to be, but they’ll likely need assistance of some sort, whether it’s someone to run errands, help with meals, perform household chores, provide companionship or medical assistance. That does not necessarily mean they will seek it out. “When it comes to
Quality Service, Compassionate Support,
Peace of Mind.
Everyday we strive to free those we serve to experience the fullness of their lives. We are able to provide this support through our unique continuum of care, that includes: • ST. ANTHONY HOME PERSONAL CARE SERVICES (non-medical in-home care)
• FRANCISCAN ADULT DAY SERVICES • ST. ANTHONY HOME (Assisted Living, Skilled and Intermediate Care) • ST. ANTHONY HOSPICE (In-home and In-patient Care) • HOLY FAMILY CHILD CARE 40 RETIREMENT LIVING
S T. ANTHONY H O M E
FRANCISCAN COMMUNITIES 203 Franciscan Dr. • Crown Point, IN 46307
(219) 661-5100
www.stanthonyhome.com/np Sponsored by the Franciscan Sisters of Chicago
FALL–WINTER 2013
a caregiver coming into their home, people are sometimes reluctant because they feel their whole life is being taken over by another individual,” Brock says. “We are here to add to their independence. This is an important need and a growing need.” Adult children may need to initiate a “trial” in-home assistance for parents, but it’s worth it in terms of peace of mind for them and ultimately appreciated by their parents. “Eight times out of 10, within a few weeks, the parent will ask if we can come more often or if we can extend the number of hours per visit,” says Higgins, who oversees Community Health Services’ private duty area. Aging in place is not just for relatively active seniors. Even
seniors who are seriously ill can benefit from being cared for at home in lieu of a hospital stay. Sometimes insurance will cover the cost, and depending on the level of care and the frequency of care required, Wilson says the cost for home medical care can be comparable to that of a longterm-care facility. “The level of home medical care—one-on-one patient to nurse—far supersedes what you get in a facility,” says Wilson. In addition, studies show patients cared for at home make more progress toward their health goals, require less medications and are at a much lower risk for infection.
ASSESSING THE SITUATION
An assessment is standard proce-
We could offer you a one-time move in special, but we prefer a
dure when determining the level of assistance needed, whether the senior plans to receive assistance to age in place or to move to an assisted living, skilled nursing care or memory care facility. Being too close to the situation or too far away can affect the senior’s and the family’s ability to assess when and what level of care is needed. There’s no cutand-dried formula. Every case is unique and assessment encompasses the emotional well-being of clients as well as practical concerns. Several factors are key, however, when it comes to making the decision to move to an assisted-living facility or longterm-care facility. A lack of transportation or a change in health are two of the main ones.
LIFETIME OF
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Minutes East of 41 on U.S. 30 in Schererville 219.864.0700 | www.ResidencesAtDeerCreek.com FALL–WINTER 2013
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“Also, when there is no caregiver or family support present,” Wilson says. “The home health care company is not the primary caregiver. There must be support in the home.” The entire family should be present during the initial assessment, typically given in the home environment.
TAKING IT TO THE NEXT LEVEL
Seniors receiving home assistance and those living in assisted-living facilities or longterm-care facilities are generally given assessments when there is a change in health or circumstances. “We talk to our caregivers quire regularly,” says Sandra Aloia, co-owner of Visiting Angels. “When they let us know there’s a decline or something is going on with a client, Debra and I will go visit and make an assessment and notify a family member. If necessary, we may refer them to assisted living, a memory care unit or for medical treatment.” The busiest time of year is around the holidays and on the weekends. “Families visit their parents or their grandparents whom they haven’t seen in a while and notice there’s something going on,” Soucie says. “That’s when they call us. Christmas Eve is our busiest day of the year.” While seniors often would rather stay at home, all kinds of retirement housing exist for seniors in Northwest Indiana, and more options are becoming available all the time, such as the newly opened Sprenger Health Care of Mishawaka. There’s no time like the present to investigate the options! FALL–WINTER 2013
