Retirement living centers

Chris Schutz, Staff Writer

Published: October 3, 2008

People choosing a retirement living center — whether for themselves or for a relative — have a lot of research, and some field trips to do, several experts in the field said.

The first thing to consider is the types of services the person will require, said Don Hudman, executive director for the state Areawide Aging Agency.

“Mobility is oftentimes a big factor in this,” Hudman said. “There are wonderful options if the individuals are mobile and active.” Such people would be suited for so-called independent living, which is like living in a regular apartment, but help is available with things like housekeeping and transportation.

Hudman said some people opt for a “continuum of care” community where people might start out at the independent living level. If needed, there is the option of moving to an assisted living level, where they can get help with activities such as bathing, dressing and taking medication. Continuum of care communities also offer nursing home areas and areas devoted to care of people with memory problems.

An advantage of choosing a community with more advanced levels of care is that they must be licensed, Hudman said. “You have a quality indicator. Someone has been in making sure that things are OK.”

A visit to the kitchen of a senior community can reveal a lot about the quality of the place, he said.

Cost is a significant factor in choosing a community, said Karen Elliott, longterm care ombudsman for the Areawide Aging Agency. Independent or assisted living costs $1,500 to more than $2,000 a month. An additional “buy-in” of $100,000 or more can be required at “continuum of care” facilities. Some of that money can be returned to the person or their estate if they leave or die.

Esther Houser, a longterm care ombudsman for the state Department of Human Services, noted that no licensing requirements exist for communities offering independent care. In addition, there are no special licensing standards for “special units” dedicated to Alzheimer’s patients or those with dementia, Houser said.

Assisted living facilities are not required to have a nurse; all that is required is a person who is awake and on duty, Houser said. She cautions families of Alzheimer’s patients to look for more than a locked door. She said she likes to say, “a locked door does not a special care unit make.”

Attention to detail is especially important before moving an elderly person because the stress of moving can cause “transfer trauma,” which can be deadly, Houser said.

“That’s all the more reason to be careful on the front end,” she said.

Clifton Grider, editor of Seasoned Reader, an Oklahoma City publication dedicated to topics of interest to senior citizens, said people can be too trusting when they’re choosing a retirement community.

“Just because they’re in the business of helping seniors doesn’t mean they’re a reputable company,” said Grider, the former executive director of two retirement communities in Oklahoma City.

He suggests looking at “the entire spectrum” of communities available in the area where the person wants to live.

Margaret Whittemore, a retired professor of gerontology for the University of Central Oklahoma, said she advises making an appointment for a first visit, to give the marketing representative a chance to describe what the community offers. Then she suggests making an unannounced visit to see it in its normal state.

During a visit to a community, Grider suggests asking how long the executive director and administrators have been there. “High turnover typically means a problem,” he said.

With independent living communities, it’s important to ask whether the resident will be required to leave if certain physical problems, such as incontinence, develop, Grider said. Some communities restrict the use of walkers or wheelchairs in some areas, such as the dining room.

While considering a community, the person should take a tour, eat lunch and “make that tour as long as they’re comfortable staying there. Stay for the afternoon activity and meet some of the neighbors,” Grider said. Even better, request a 24-hour “test drive” — come for supper, spend the night, eat breakfast, go to morning exercise and have lunch.

Trying the food is important, Grider said. “The food is the biggest challenge of retirement communities today.”

An extended visit, with a chance to chat with people who live there, will be the best source of “accurate and true information,” Grider said. “You only want to make this move one time.”

The “test drive” will give an idea of problems with the community, such as excessive noise, Grider said.

The best chance of success is if the resident is involved with the choice and understands positive reasons for moving, Grider said.

Once there, it can take a resident several months to adjust to the change, he said.

Whittemore said a resident has the best chance of adapting if he or she goes in with the attitude, “I’m going to participate and I’m going to join in and I’m going to enjoy whatever’s available.”

She advises families to visit often and make friends with the staff. She said, “The more frequently a family member goes, the more attention (the resident) gets.”

Some questions to ask when considering a retirement center

Are pets allowed?
What activities are offered?
What’s included in the housekeeping services?
Is help with laundry available?
Is there a church service?
How often are monthly costs adjusted?
How long has the retirement community’s director been there? Is there frequent turnover?
Are there any restrictions on the use of walkers or wheelchairs?
In an assisted living situation, what type of nursing services or medication assistance are available?
Under what conditions (such as need for an additional level of care) can a resident be discharged from the facility?


Pros/cons of retirement living centers:

Advantages:
Built-in social circle, with 30 to 150 neighbors
All or most meals available in the dining room
Transportation usually available
Activities
Staff help available
No yard or house to maintain

Disadvantages:
Cost can be high and rates have been going up.
A move may be necessary if the center doesn’t suit the resident
Resident may not like the food
No back yard

Chris Schutz: 292-6105, cschutz@oklahoman.com

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