Thursday, January 11, 2018

Senior Care Referral Agents--How We Spend Our Days

One of my favorite children's storybook authors, Richard Scarry, wrote an immensely popular book in 1968 called, "What do people do all day?"  In it, darling animals build houses, fly planes, keep house and grow food.

People ask you and me, perhaps in different words, "What do you do all day?"  I am a senior care referral agent, and I help families find the right choice in in-home care, assisted living or adult family homes.

I'm not alone.  At Silver Age Housing and Care Referrals, where I work, we are a team.  Each member has an area or areas of expertise:  occupational therapy,  caregiving, ombudsman experience and finance.  We share knowledge, benefitting our clients.

There are approximately 70 senior care referral agencies in Washington State. Like the characters in Scarry's book, we keep busy helping families.

Ever day, all day, we do the following:

SUPPORT--This is the social work part of our job.  When a family member calls us, the first thing we often ask is, "What's going on with  your loved one?"  Then the story--and they are nearly all different--comes tumbling out.  Mom had a stroke, is in rehab, and needs a more permanent home.  Dad has been caring for Mom and his health is now failing.  Mom lives in Illinois, and daughter has been using all her frequent flyer and cash to fly back and forth.

Bottom line, placing a loved one is one of the hardest things a family can do.  It's hard because it's our mother, or father, or other loved one for which we're making the decision, not simply a client. And it's hard because this might be their last home on earth.  Very often professional help can make the job easier.

Another thing  that helps:  the referral agencies' services are generally free to families.  The communities pay a commission to the agency on move-in.

TEACH--A senior care referral agent is a vital source of information.  At Silver Age, we know which communities accept Medicaid, which specialize in heavy care and which are located in the family's desired locations.  We provide a list of questions to ask when touring communities, and we tour alongside the family.  We have questions that we feel are especially important to ask; the family will think of others.  They are experts on their loved one; we are very knowledgeable about assisted living communities and adult family homes.  We inspect them before touring with a family and we check to see which places have enforcement letters from the state and may not be worth touring.

INSPECT BUILDINGS AND EVALUATE PROGRAMS  People often ask me, "Are you a Realtor?"  There certainly are some similarities.  Like a Realtor, we keep abreast of what's available.  Depending on the client's desires, we will search for communities with full kitchens, two bedrooms, or patios.  Finally the community has to be a good financial fit for the client. So in many ways we are like Realtors.   But there are differences.  Care needs--both physical and cognitive-- are a huge concern for many people.  Memory care is another potential issue.  For still others, an active social program is a must-have.  For most families, the key issue, besides availability of care, is the vital interaction of residents with staff.  Many people compare searching for  an assisted living or adult family home to looking for a college, private day school or kindergarten.  The building is important, but it's not everything.  Caring, knowledgeable staff are what matter most.


Need some help with obtaining housing and/or care for a loved one?  Contact Silver Age Housing and Care Referrals.

Saturday, December 16, 2017

A Group Legacy Letter to an Aging Parent--Does it work?

Five eldercare blog posts on a single subject?  I never thought I'd do it.  But here goes.

This is the fifth post on the subject of "A Legacy Letter," a gift you can give the elder in your life. A Legacy Letter is similar to a tribute at a funeral, but the recipient is alive, reading the letter or having the letter read aloud to them. A  Legacy Letter points out the recipient's key qualities, and uses  examples and stories to "show" a well as "tell the story."

Christmas is a great time to write and present a Legacy Letter.  But other occasions work as well:  Thanksgiving, Valentine's Day, a special anniversary, or a big birthday.

The letter is usually written by one person.  But last October, the idea dawned on me to make the Legacy Letter a group effort. The upcoming big occasion was my mother-in-law's 90th birthday which fell on Thanksgiving this year.

How would the group letter idea go over with the two Boomer children and five grandchildren? I emailed them an assignment to answer "What qualities stand out in Grandma's life?"  And what contributions has she made to us and to others?" 

Stories highlighting Grandma's contribution were essential. 

Believe it or not, everyone made their deadline!  Our daughter prefaced her contribution with  , "Mom, I'm so glad you asked us to write this!  For the last two weeks in between errands and other tasks, I've been thinking about Grandma and the memories we've had."  More importantly, she and the others said wonderful things about Grandma Margie.

Imagine the look on Grandma's face when her son--my husband--began reading the letter.  Here are a couple of excerpts:

"You have been my cheerleader as long as I can remember...always standing behind me, encouraging me and cheering me on."

"I have treasured the many memories I have made with you both growing up and as an adult....I remember running around the Kirkland house and eating canned peaches and ice cream.."

The scene reminded me of "Queen for a Day."

For more information on Legacy Letters, contact Melanie Vetter, Health Advocate, at Well Fleet Circle.

Thursday, November 30, 2017

Faith and Dementia: One Man's Story

I often have the privilege of attending assessments for seniors moving into adult family homes.  Last spring I got to meet Bill, 83, his daughter-in-law Jennifer and Sylvia, RN, the nurse.

"Does faith play a vital role in your life?" Sylvia asked.

It's a question worth asking for all of us, whether we work with seniors, are an adult child of a senior, or are seniors ourselves. 

Bill's answer to the faith question?  What? I don't understand."  His blank look told me it wasn't just hearing loss that kept him from comprehending.  The nurse was speaking clearly, and he had heard the other questions.  But that word--faith--tripped him up.  It had slipped away from his word bank. 

"Faith" is abstract and that category of noun often is the first to be lost to dementia.  Concrete nouns are remembered longer and better.  So how do we translate faith into a concrete noun that makes sense to Bill and others with dementia?

Sylvia tried another tactic.  "Is religion important to you?"  Bill's response was the same.  No dice.  Blank stare.

Bill's daughter-in-law Jennifer tried a crack at the question.  "Do you believe in God, Bill?" Bill relaxed,  a glimmer of recognition crossing his face.  I could tell they were making progress.

Jennifer continued her query into Bill's soul.  "You know Jesus, don't you?"  Suddenly Bill lit up.  "Jesus, oh Jesus!" 

"I don't think He is very happy with me now.  I haven't done much for him lately." 

Jennifer responded, "None of us has done much for Jesus.  But He loves us anyway,  He loves you, Bill.  He loves you!"

Note:  My role as a senior care housing and care specialist with Silver Age Referrals in this assessment was to provide support to the nurse and family.  Jennifer, the family member, led into the discussion of God and ultimately Jesus.  As professionals, we ask about faith as we see an openness on the part of the family or the senior.  And sometimes exciting things happen!






Wednesday, November 22, 2017

A Group Effort: Writing a Legacy Letter to an Aging Loved One

What do these occasions have in common for an elderly person?
  • A big birthday, such as 80, 90 or even 100.
  • A big anniversary.
  • Thanksgiving.
  • Christmas.
  • A move from one home to one with more care.
Answer:  They all call for a big celebration. 

In our family, we're not only celebrating Thanksgiving tomorrow. It's also the day my mother-in-law turns 90.  A birthday luncheon and a Thanksgiving dinner:  what a day!

My husband, his sister, and the grandchildren have all been working on a Group Legacy Letter.  See Your Aging Parent's Legacy, Pt. 3 A Sample Legacy Letter.)  It will be read at Mom's birthday luncheon.  They each wrote expressions of love and appreciation, including examples and stories.  They were asked to answer:  What has she taught me by her life and her example?  I combined their letters into a whole, editing and trying to keep their individual voices.

My husband, Don, will read the letter aloud to his mother at the luncheon. 

I'm pretty sure Mom will be pleasantly surprised.  After all, most of these kinds of tributes are presented at a funeral.  Though 90, Mom is very much alive, and we wanted her to know how much she means to us and to others.

How have you and your family celebrated the "Big Occasions" in your elderly loved one's life?

Tuesday, October 31, 2017

Senior Care Pros: Ways to Build Trust with Boomers, Parents

You work with seniors and their families.  What's the most important key to success?

It's not intelligence.  Nor experience. Nor charm.  It's trust.  Seniors, and all of us, for that matter, need to trust a professional before we will part with our dollars or our good will.

Earning trust isn't instant and it isn't  magical. But it happens little by little.  In my case, I've worked with seniors and their children for 20-plus years.  I've learned from them what works and what doesn't.  Some of the following tools came to me from mentors, others from reading, and still others from making my own mistakes.

1.  Be on time, or a little early.  If you say you will email or call by a certain date, do it.  And if you can't, explain why.  Tardiness has always been a fault with which I've struggled.  With seniors, especially, I've learned promptness the hard way.  One day on my way to an appointment I lost cell coverage, and my battery's juice dipped as it tried to find a signal.  When I finally arrived, I was very late. At the end of the presentation, the husband said, "My time is very precious.  And you wasted it."  Ouch!  Seniors are used to waiting for doctors, and grousing about the wait.  But we are not doctors, not even close.  We need to value our clients' time.

2.  Value the relationship over the products or services you're providing.  When I first started in the business of serving seniors, I heard a short sentence that sets the mark for my work.  "People over paper."  That means we value people even over the paper (money) we receive from our work.  And if we can help provide a good experience for our clients in a difficult situation, all of us benefit.  Sometimes putting people first means we will help them find a solution that doesn't involve our company.  And that's okay.

3.  Ask questions and don't be pushy.  Seniors and everyone, for that matter, want to be heard.  That means when we ask questions, we listen to their body language, and their questions behind the questions.  As far as pushiness goes, don't even try.  Seniors have experienced professionals of all kinds over their lifetime, and they know how to practice selective hearing, if needed. And they talk to their friends about "that pushy sales person."  It's a reputation I don't want to have.

4.  Don't ignore the senior.  Have you ever had a conversation in which the adult child dominates and his or her parent is lost in the dark?  I have. I've also seen marketing professionals lead a community tour, speaking only to the adult child, and walking ahead of the elder. In any situation, I need to remember who we're serving, whether they're quiet or not, in good health or not. 

Can you think of other ways we can build trust with our senior clients and their children?


Monday, September 25, 2017

Great Eldercare Help: For Free, Pt. 3

Free sources of eldercare help are generally found on websites.  Not always, though.  The following offer in-person assistance. Check them out.

Senior centersNorthshore Senior Center in Bothell, Washington, is an example of a senior center offering lots of good educational social opportunities, mostly for free.  There's a caregiver support group, a social worker who does one on one counseling, plus an array of classes on everything from financial planning to nutrition to exercise.  There's even a hiking club!

Senior Referral Agencies:  I'm proud to work for a senior referral agency, Silver Age Referrals.   Our company and similar organizations help families find quality care for their loved ones, usually in retirement communities, assisted living communities and adult family homes.  Agents are similar to teachers, social workers and realtors rolled into one, helping families choose the right care setting, based on budget, care needs, location, etc.  Families don't generally pay for these services.  Instead, the care providers (assisted living communities or adult family homes) pay a commission on move-in.  Senior referral agencies are commonly used on both the East Coast and the West Coast and in other areas of the country with a high population of seniors.  In Washington State, the Association of Senior Referral Professionals of Washington is a good resource for finding referral agencies who are ethical and professional.

Sunday, September 10, 2017

Great Eldercare Help, for Free, Pt. 2

OK, there may not be a free lunch.  However, there are some great websites that can give you
eldercare help, for FREE.  I promise.

Nursing Home Compare--this website is terrific if you or a loved one is looking for a skilled nursing facility, either for rehab or for long term care.  The site ranks nursing homes in several different areas, giving a 1 to 5 rating for each category.  Each nursing home also receives an overall  rating of 1 to 5.  In addition, you can input the names of up to three facilities, and the site will give you a comparison table instantly.  Another feature:  if you don't know what facilities are available in a certain area, the you can input a city, and the site will give you a list of nearby facilities, along with quality scores for each.  This website is helpful in choosing a nursing home if used with other sources including professional referrals, friends' references, etc.

State Health Insurance Assistance Programs (SHIPS)--When questions about Medicare arise, and they inevitably will, you can contact a nationwide program that uses trained volunteers to offer free help, either by email or by phone.  They could come in handy soon, when the Medicare open enrollment period begins on October 15.  It runs through December 7.   During that period you can make some changes to your parents' or your Medicare plans. You can switch from original Medicare to a Medicare Advantage Program and vice versa.  You can switch from one Medicare Advantage Plan to another.  For help in understanding the plans and their costs, a trained volunteer can give you information without trying to sell a product.

My next post will discuss two more sources of free eldercare help. 

Monday, August 28, 2017

Great Eldercare Help: For Free, Pt. 1

A few days ago I spoke on the phone to a nursing home social worker who had a problem. Perhaps you can relate.

The social worker needed online information on a local adult family home.  She typed the home's name without much success. The listings she found included the name and the address, but no phone number or detailed information.  Instead, she was redirected to an 800-number of a senior referral agency with a sales person on the other end.

The social worker didn't want to be sold; she just wanted help. And she wanted it for free.

 I suggested she and I try the DSHS website. DSHS website The site gives basic information on all the nursing homes, assisted living and adult family homes in Washington State.   There are similar databases in other areas of the country as well.

On the site, we found the owner's name and phone number, number of rooms, and Medicaid policy.  The site allows people to search for eldercare options by city, county or zip code.  They can also look up enforcement letters which spell out fines levied on the communities or adult family homes.  Some communities also have their services listed in detail in a document called "Disclosure of Services."

Your next step--calling a live person--will be easier, now that you have the FREE information.

Good luck!

Tuesday, August 8, 2017

Powers of Attorney: Frequently Asked Questions

Attorney in Fact.  Do you have that title for a loved one?  Bradley J. Frigon, Member of the National Academy of Elder Law Attorneys, gave a recent presentation on this subject to the Certified Senior Advisors.

Powers of Attorney are specific documents that give authority to an agent to act in the best interests of a principal.  Often the agent is a child, a spouse or other relative.  Perhaps you fill that role.

1.  Why is the word "durable" so important in a Power of Attorney document?  That word gives
the Power of Attorney continued effectiveness after the principal loses capacity. The document endures.

2.  What are the two categories of Powers of Attorney?  Financial Power of Attorney and Medical (Health Care) Power of Attorney.  Their spheres of responsibility are different, but the main role is the same:  to act in the best interests of the principal, whether managing finances or making decisions about health care.

3.  Are Power of Attorney documents standard throughout the country?   Not entirely.  However,  since 2010, well over 30 states have signed the Uniform Power of Attorney Act. in an effort toward standardization.  Most states have variations on their individual documents, and notarizing requirements so Frigon advises that when someone moves to a different state, they take the current documents to a lawyer to make any needed changes.

4.  What are Springing and Standing Powers of Attorney?  These refer to when the documents take effect.  A Springing Power of Attorney takes effect after a certain event, often when a licensed physician or physicians determine that the principal is incapacitated.  A Standing Power of Attorney takes effect as soon as it is signed by the principal.  It gives the agent immediate authority.

5.  Who can be the agent?  This is the most important role.  He or she must be 21 years old and someone whom the principal trusts.  The principal must ask permission of the person he or she wants to fill the agent role.  It's important to name a successor.  Frigon advises to limit the number of agents to avoid confusion and conflict.

6.  Anything new in this field?  We are used to agents managing financial portfolios, real estate, etc.  But what about Facebook and LinkedIn accounts, emails and photographs electronically generated?  Some states have provisions in their Power of Attorney documents which include this information.


Saturday, July 29, 2017

Your Aging Parent's Legacy, Pt. 3: A Sample Legacy Letter

 My mother-in-law will soon celebrate her 90th birthday.  Our family has discussed possible ways to remember this special day.  We know what she DOESN'T want.  No big parties or lavish gifts.  She'd prefer a family-only get together at her favorite restaurant or at one of our homes.

Perhaps you're thinking through how you will help your aging loved one celebrate his or her big day.  You might consider a Legacy Letter, a type of tribute to the wonderful contributions he or she has made to you, your family and to the broader community. A Legacy Letter can stand alone or be part of a celebration, big or small. 

The previous two posts discuss the four parts of a Legacy Letter in more detail. 

1.  The Why:  Think about what you want to say and how you want the receiver to feel after reading the letter.  Focus on the values he or she has imparted to others.

2.  The Story:  Include things that highlight your main idea.  These are the concrete things that make your letter ring true.  Things like taking hikes together, doing crossword puzzles, attending football games,  proofreading college term papers.

3.  The Reflection:  Phrases such as "You have taught me..." and "You helped me understand..." show your gratitude to them for the impact on your life.

4.  The Love:  Tell the person how much you love them.  Show how grateful you are that they are an important part of your life and the lives of others.

A Legacy Letter will be part of my mother-in-law's celebration.  We're working on a draft
right now.


Dear Mom,

If I had to choose a word to describe you, both on your 90th birthday and throughout your life, that word would be "Giver."  You have showed generosity to every member of our family and to countless others whom we don't know.

For example, you hosted family dinners well into your 80s, and were generous in baking pies, cookies and other desserts.  We certainly knew that when we left your home, we would be "stuffed to the gills," with yummy food and good memories.  At Christmas, you gave the children special personalized treats which they didn't receive at home.   And when your great-grandchildren began arriving, their parents could count on a baby afghan, hand-made by you--blue, pink or white.

Your church family and retirement community also received your gifts of time and talent.  People could count on you to attend services and other functions and to do what you were able to do to help others.  You worked at the senior community annual bazaar for years, making sure the pies were cut just right and the coffee replenished.

You have helped me understand the meaning of hospitality and the importance of doing my part to help others.  Our whole family would echo this sentiment:  you are a giver, and we thank you for it.

Our children are blessed to have a generous Grandma and Great-Grandma for their children.

Love,

Alice

We have some time to revise the letter, and I'm sure we will think of more to say about this woman's legacy.

Good luck on your own legacy letter!
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