What should families and aging parents consider when choosing a retirement community?

“Choose a community for the present as well as the future,” observes Sheena Parton, executive director of Llanfair Retirement Community in College Hill. “Ask yourself what is going to meet your needs tomorrow, six months, a year, two years down the line.

“Will the community care for you if you become ill?” continues Parton. “Avoid facilities in which you would need to leave and go somewhere else to get care, should you become ill.”

First things first, of course. Before any of this happens, the initial conversation has to happen. James Burton, owner of Home Instead Senior Care in Mason, invokes the “40-70 Rule” to help you decide when it’s time to for the two generations to sit down and talk about long-term health care planning.

“If you are 40 and your parents are 70, you need to begin to talk to each other about what the long-term plan is going to be,” says Burton, who points out this kind of discussion should not occur because of, and in the midst of, a crisis such as a broken hip from a fall down the stairs. Such a situtation “forces you to make life-altering decisions on a moment’s notice, because mom’s in the hospital and when she’s released, she can’t go home.

“It’s not just money, it’s not just health care that should be discussed,” adds Burton. “It’s ‘Mom, where do you want to live? And how do you want to live?’”

As the process of choosing a retirement community moves along, Parton suggests that both aging parents and their adult children keep their eyes wide open. “Observe how residents and staff interact with each other,” she says. “To a large extent, the way the staff treats the residents will more than anything else determine the quality of life that a resident experiences in a retirement community. Competent, caring staff that respect the personal dignity of each resident is essential.

“Talk to residents. Take the tour that is offered, but also look around on your own and talk to as many people as you can.”

Kathy Liguzinski — a long-term care specialist at the Retirement Resource Center in Western Hiills — notes that different communities offer different levels of care such as luxury apartment independent living, assisted living, special care for Alzheimer’s, rehabilitation, and complete nursing home care.

“Several years may be spent in this community, so it is important to plan and make the best decision as possible,” Liguzinski suggests. “Put together a network of knowledgeable people who can help make an appropriate choice. The team should consist of family and friends along with physicians and other health care professionals who understand the person’s needs. Hospital social workers, geriatric care managers, clergy and volunteer groups that work with the elderly are also valuable network members.  

“It is also important to choose a retirement center that is close and convenient to the persons who will be visiting the resident most often. Most studies of retirement center residents needing care have shown that residents who are visited often may recover more quickly, may be happier and healthier for the love and attention received, and may receive a higher quality of care if staff knows that visitors come often and unannounced.”

Information about nursing homes and retirement facilities can come from a variety of sources, Liguzinski says: Word of mouth from friends and neighbors, and state and local offices on aging. You can also request a nursing home’s Ohio Department of Health survey for the past five years. To request a survey, call (614) 466-7217.

“Once you have identified one or two nursing homes/retirement centers that seem — on paper at least — to be affordable, have the services necessary and have a vacancy, visit the facility. Ask to see the entire facility, not just the nicely decorated lobby and one wing or floor. Visit morning, afternoon, evening and a weekend to see different activities and the different staff,” Liguzinski advises. “Try to get a feel for the quality of care provided and how the residents are treated. Resident appearance, residents’ rooms, quality of food and activities are all important factors in the evaluation.  Residents who have meaningful activities and are as independent as possible are generally better able to maintain their health.”

Rose Denman, vice president of marketing and development for Maple Knoll Communities Inc., offers some final words of advice: “A classic definition of old age is 10 years older than you are today. Most people tell themselves ‘I am perfectly fine and content where I am; if things are going so well, why should I make a change?’

“I know that everyone would like to stay in their own home for as long as possible. I always recommend starting to look before there is an actual need for you to live in a community. Do it while you are still able to deal with this major life change, physically, emotionally and mentally.” 

Glossary of Terms
Accreditation: A stamp of approval or recognition given by a private organization to indicate the accredited facility meets certain standards set forth by that organization.
Activities of Daily Living (ADLs): Activities including eating, bathing, dressing, grooming, using the bathroom and transferring to and from a chair or bed. Whether a person can perform these functions alone or whether he or she needs assistance determines the appropriate level of care needed.
Ambulatory: The term means “able to walk.” Some residential facilities have an entrance requirement that residents be ambulatory, which usually means being able to walk without the use of a walker.
Assisted Living: Refers to a level of care that provides seniors with assistance with activities of daily living, including eating, bathing, grooming, using the bathroom, walking and moving to and from chair and bed. Assisted living is for those who are not able to live independently, but who do not need to live in a nursing home.
Campus setting: The term refers to a community where a number of buildings are spread out on an expanse of grounds owned by the community. For example, a senior residential facility in a campus setting might include individual patio homes for independent living in one area, several apartment buildings for assisted living in another, and a separate nursing facility elsewhere on the grounds. Senior residential facilities in a non-campus setting might include all levels of care housed in a single building or in several clustered together.
Coinsurance: A co-payment made by the insured for his or her share of the cost of a covered service. The insurer, such as Medicare or a private insurance company, pays a portion of a covered service, and the insured pays the remainder.
Continuing Care Retirement Community (CCRC): A type of senior residential facility that provides a continuum of care, including housing, a variety of services and health care to residents on a contractual basis.
Durable Power of Attorney for Health Care: A legal document in which an individual names another person as attorney-in-fact and authorizes that person to make healthcare decisions on his or her behalf in any situation in which the individual is unable to make decisions. That attorney-in-fact can make decisions not just in the event of a terminal illness or irreversible coma, but also in the case of a reversible coma or other temporary situation, as well as in the case of mental incompetence. The individual may also express in this document wishes regarding medical treatment, including the use of life-sustaining measures.
Intermediate Care Facility (ICF): A type of nursing facility that provides 24-hour basic medical care for patients who need recuperative and rehabilitative care. More intensive medical procedures, such as intravenous therapy or feeding tubes, are not provided.
Living Will: A legal document in which an individual expresses his or her desire not to be kept alive by artificial means or “heroic measures” in the event of a terminal illness or an irreversible coma. The document can prohibit specific medical treatments or all life-sustaining measures.
Skilled Nursing Facility (SNF): Licensed by the state to provide 24-hour comprehensive nursing services on a short-term or long-term basis. Skilled-nursing facilities have at least one registered nurse on duty during the day. Care is provided under the supervision of a licensed physician, who may be on call. A skilled-nursing facility is staffed and equipped to provide subacute care, which is the highest degree of care outside of a hospital. Skilled-nursing care is more intense medical care than intermediate care.