Cantissimo Senior Living Blog

For anyone living at an assisted living or skilled nursing facility, a care plan (for skilled nursing) or service plan (for assisted living) is required to promote resident health and wellbeing.

This comprehensive plan details all aspects of how a resident's care will be delivered. It guides the staff in rendering care tailored to the resident.

Step 1 – The Assessment

The creation of a care/service plan starts before a resident's official admittance to the facility. Though in some cases, it takes place on move-in day. The new resident, their family, and the facility staff participate in a meeting known as a Care Conference to assess the required level of care. Among the areas covered in the assessment are:

As lifespans have increased, the idea of "aging in place" has gained popularity. Defined as "…remaining living in the community, with some level of independence, rather than in residential care.", this typically means living in one's private residence for as long as possible. These days, a combination of family help, home health aides, and adaptions to living quarters have allowed older adults to stay in their homes longer.

For many, however, health or other problems crop up and lead to a senior living arrangement outside the home. Very often, this is assisted living.

Assisted living emerged as a concept in the early 1980s in response to the hospital-like, institutional nature of nursing homes. At the outset, assisted living focused on providing mostly non-medical support for older adults in a more home-like setting structured to preserve their independence, dignity, privacy, and choice.

Within a few years, it became apparent there was an issue for residents whose health declined beyond the facility's ability to support them. While it was clear that their increased needs weren't being met, residents were reluctant to move for two reasons. First, the move from their original home was a difficult, significant life change. Second, the move from assisted living often was to a nursing home; the very place most hoped to avoid by moving to assisted living. Residents desired an opportunity to age in place in an assisted living setting.

If you are age 50 or older, Joseph Coughlin, founder and director of the Massachusetts Institute of Technology AgeLab, thinks you are misunderstood.

In his 2017 book, "The Longevity Economy: Inside the World's Fastest-Growing, Most Misunderstood Market," Coughlin contends consumer marketing companies and society, in general, underestimate the potential of the older generation.

He says this underestimation is exemplified in the false narrative that older adults are a less important demographic than groups under 50. This attitude particularly pervades marketers who spend 500% more on millennials than all other age categories combined.

Coughlin's message to companies overlooking older adults is: Do so at your own peril.

Age 55 seems to be a life milestone when many think more seriously about future eventualities like retirement or moving out of the family home. The latter can be driven by many motivations:

• The existing home feels too big once the kids have moved out
• Home maintenance has become overwhelming
• The neighborhood has turned over, and old friends have moved away
• The current multi-level home has stairs that will become a concern with age
• A change in health status that makes the current residence impractical
• The local climate forces consideration about a place with better weather
• A desire to be closer to family

Questions to Ask

No matter the reasons, the decision to move can only be made after certain questions have been answered.

"My son, be steadfast in honoring your father; do not grieve him as long as he lives. Even if his mind fails, be considerate of him; do not revile him because you are in your prime." (Sirach 12-13).

Dementia stands out as a signature affliction of old age throughout human history. Defined as symptoms linked to loss of memory and thinking skills, dementia takes several forms, with 60-80% caused by Alzheimer's disease. Yet, it is not considered to be a part of normal aging.

Some moderate cognition changes are expected with age, but these do not lead to loss of independence. However, more serious cognitive decline can produce symptoms like rapid forgetting, navigation impairment, inability to solve everyday problems, or difficulty holding ordinary conversations.

Nevertheless, age is strongly correlated with dementia. One estimate shows only a 1.7% prevalence of dementia among those 65-69 years old. But with a doubling of new cases every five years, dementia incidence grows to over 50% by age 90.

Gathered around the patio table on a beautiful early autumn evening, talk with friends turned to caring for aging parents. Jan, whose mother lives independently several states away, related an all too familiar story.

"In our daily phone call, I asked Mom how she was doing. She told me she'd fallen the night before. She wasn't hurt but spent the entire night on the living room floor because she could not get up by herself. It wasn't until her friend came by for the usual morning coffee visit that she was able to get up."

"Thank goodness she wasn't hurt," I said. "But I thought she had a medical alert bracelet." Jan gave me an exasperated look. "She does! But she forgets she has it even though we talk about using it in that exact type of situation. When I reminded her that she should have used it, she said that she probably wouldn't have used it even if she had remembered. I asked her why, and she said then the EMTs would have to come, and that would be too much fuss."

Countless other adult children have had similar calls about issues with elderly parents. Excepting a catastrophic event, it's tempting to avoid the question of whether an older loved one should still be living on their own. Many older adults resist losing their independence, so their children are reluctant to suggest an assisted living option to avoid conflict or feelings of guilt.

Are you a cable TV subscriber? If so, does your blood pressure rise when you pay the monthly bill? In a recent Consumer Reports survey, one in five respondents who subscribed to cable TV said they were extremely or very likely to cancel. Most said to was due to the high cost.

Many disgruntled cable subscribers consider "cutting the cord" and subscribing instead to internet-based video streaming services. Netflix pioneered streaming video, and now there is a multitude of options. However, making the jump from cable needs to be done thoughtfully to avoid technology headaches and unexpected costs.

In Part 1 of this two-part blog series (Audiobooks - click here), I commented on my love of books both as physical objects and fountains of reading pleasure. The advent of e-books challenged and delighted me in both areas.

What is an E-Book? 

An e-book is a book in digital form that can be read on a smartphone, tablet, computer, or a dedicated e-book reading device ("e-reader"). The digital file containing the book's contents must be downloaded from the internet onto the device. Once downloaded, the content of the book can be read. 

You've been thinking a lot about it for a long time. Maybe years. Is it time for the big leap of faith? Is it time to move out of your house into a senior living arrangement?

This can be one of the most challenging decisions of your life. There are so many options. It's difficult to know where to start. Here are nine questions that may provide some perspective in the face of this difficult choice.

The quest for an appropriate assisted living residence for an aged loved one seems like a daunting task for families. The choices within a community range from large buildings with a hundred or more residents to smaller, home-like residences. Information about senior living choices abounds on the web. Families can easily scan among the options to make a list of residences to check out further.

After some research, initial telephone calls to the locations help to trim the list. These calls answer basic questions about the facility and allow the person in charge of admissions to learn more about the prospective resident. These calls narrow the list down to buildings worthy of onsite tours.