Wednesday, 28 October 2015 03:20

Continuum of Care

Written by  Mary Irene Dolan

As we age, things change. We’d like to prepare for those changes and feel cared for, active and not a burden to family and friends. Moving into a Continuing Care Retirement Community, or CCRC, is one way to secure our future and address some of aging’s difficult issues.

We talked with local senior communities to find out how CCRCs can help us and our loved ones with some of these challenges.

What Is a CCRC?

Reading Room - Senior CommunityEvery CCRC is different, especially in different states. Yet all share a common feature: they provide a multi-tiered approach to aging with a series of care levels—typically Independent Living, Assisted Living and Skilled Nursing Care, but may include services like Rehabilitation and Respite Care.

One thing that makes CCRCs special is all levels of care are provided on the same campus—not always so for other senior communities.

Most CCRCs offer one or more of three types of contracts: 1) “Lifetime” models, where an entrance fee and fixed monthly charges guarantee long-term care and lifetime occupancy; 2) fee-for-service or rental models, or 3) a combination of both. The best choice depends on income and current health of a prospective resident.


Like Home But Better

Moving into a CCRC to age in place may seem counterintuitive, especially if a person is still in good health. But in the long run, it’s often the least stressful option.

“It’s hard enough for seniors to move from a home they’ve lived in for so long,” says Matthew Pavlick at Forwood Manor. “Knowing they can get the help they need now, as well as what they may need down the road gives them comfort knowing they won’t have to make another move.”

And some residents find community life is even better than living at home! “Married couples especially can benefit from a CCRC, as everyone ages at different rates,” notes Pavlick. If one spouse needs more assistance, separation isn’t necessary with all services on one campus. The couple can still easily visit each other and can rest assured their loved one is being cared for.

Plus the wide range of amenities at many CCRCs keep residents occupied and active, often more so than at home. Tel Hai Retirement’s Jolene Weaver says, “Here residents enjoy a worry-free lifestyle in a vibrant community.” With many options for residences, activities, clubs, travel and wellness opportunities, seniors make the most of their retirement—and are excited about their move.

That variety of choice is key in helping seniors feel independent. Tel Hai residents can customize their living space, adding privacy and accessibility features to suit their needs. “By choosing a home environment that’s conducive to ‘aging in place,’ residents are free from the burdens of a care-based move,” says Weaver.

One common stress about leaving home is parting with an animal companion. Luckily, communities like Dunwoody Village have pet-friendly policies allowing furry friends of any size anywhere on campus—even in personal care rooms. Owners and pets love Dunwoody’s outdoor walkways, and the policy helps pet owners feel more at home with a familiar face keeping them company.


When Needs Change

Most seniors arrive at a CCRC able to live independently in apartment or cottage homes. But as needs change, they may have to move to a higher level of care. How do they know which level?

“Well, no one ever knows what level of care they need. Most residents and their families aren't realistic about their level of functioning,” says Anda Durso, at Wellington at Hershey’s Mill. “That’s why we have an interdisciplinary team working closely with residents to watch for signs of when it’s time for them to receive more care.”

And that transition doesn’t have to be sudden. Wellington residents might first receive in-apartment outsourced help with things like taking medications and making grocery lists before moving to personal care or skilled nursing homes on site. “It’s great because they’re already familiar with the residents and staff,” notes Durso. “And we try to make the transition as smooth as possible, meeting with families for support and keeping them involved in the process.”

Some residents may need more specialized care, like memory care or rehabilitation. That’s why CCRCs like White Horse Village have these services on campus. Their newly renovated Four Seasons wing is designed specifically for advanced memory care. Dottie Mallon notes, “Our staff provides not only excellent medical care but also the personal warmth, emotional support and respect necessary to maintain the dignity and individuality of each resident.”

White Horse Village residents needn’t go far for rehabilitation services either. However long their stay, “They’re still very much a part of the whole community,” Mallon says. “They continue to enjoy all the enrichment programs and events offered.” CCRCs make this type of integration possible, resulting in less disruption in residents’ lives.


Sense of Community

Pool table and game in session - two men.Although many seniors think they’d feel more comfortable aging at home, they may not realize the friendship and support available in CCRCs from people their own age, in the same stage of life. “Moving is such an emotional decision, and it’s not for everyone,” agrees Mitchell Hanna, at Quarryville Presbyterian Retirement Community. “But many residents, after moving in, are amazed at how much more social and involved their lives become.”

Residents interact every day at meals and in common areas, and everything is just a short walk away. Also, Quarryville’s faith-based outlook brings together many likeminded people, making residents feel welcomed and understood. “As some communities grow more secular, we’ve kept our roots in the church,” says Hanna. “Our residents really appreciate it.”

And there are different types of communities for different types of folks. While many focus on amenities, others like Friends Home in Kennett pride themselves on Quaker simplicity and a down-to-earth atmosphere. “We attract all kinds of seniors,” says Dot Folz. “Both older seniors who are not enticed by upscale features and are more interested in homey, comfortable living, as well as more active seniors who want easy access to a vibrant, inviting town literally steps away.” And that’s exactly what Kennett Square offers.


Quality and Quantity

As the concept of senior living changes, the population of seniors is changing too. Bob Bertolette, of Riddle Village is excited about the change. “Aging used to be about the quality of life,” he says. “Now it’s also about the quantity of years lived.” He notices many reasons seniors are living longer in CCRCs.

One reason may be that residents are more active than ever—90-year-olds on treadmills is a common sight! Also there’s greater medical intervention, with skilled help on site when something goes wrong.

But the biggest reason CCRC residents thrive into their 90s and even 100s is the psychosocial benefits. There’s less depression, more social and mental stimulation, and a whole community of staff and residents providing emotional support. “It’s difficult when a resident’s health starts to decline or someone loses a spouse,” says Bertolette, “but no one here has to go through those challenging times alone.”

“There’s one thing we hear all the time,” he says, “and that’s, ‘I wish I moved sooner.’”


In-Home Care: Another Option

According to AARP, about 90% of seniors want to age in place in their homes. For them, in-home care is an ideal option and a stepping stone for those who aren’t ready to move to a CCRC or Assisted Living Community but still need help with daily tasks.

Angel Companions’ Ed Rofi says, “We’re certainly not in competition with assisted living communities; we simply provide another option.” After all, the wishes of the person being cared for should be the priority.

Many seniors aren’t ready to leave the communities they’re still active in and prefer to stay close to family and friends. “When a person begins to need assistance with dressing, cleaning, meals and other daily tasks, we step in to provide that,” says Rofi. As the name suggests, Angel Companions also provide essential company for those who’ve grown isolated.

For many seniors, maintaining independence and dignity is as important as maintaining their home, regardless of how much care they may need. Christi Seidel at Surrey Services notes, “Some people just need a bit of assistance with meal prep, errands and light housekeeping, while others may need more assistance or medical care.” Either way, in home care allows them to retain some self-sufficiency.

“It’s also beneficial for people coming out of a hospital or rehab stay, or for family caregivers who need respite care,” says Seidel. Clients are able to recover in their own homes without needing their family to help.

Luckily, in-home care is gaining popularity according to Mitzie Greene at Bayada Home Health Care. “Quite simply, it promotes healing,” she says. Clients not only stay in a familiar environment but also become active participants in directing their care. “They continue to engage in the activities they love,” says Greene, “and family members are saved from the stress of caring for them. That stress is replaced with a better quality of life for all involved.”

If they choose, with the help of qualified caregivers and the comprehensive services available, many seniors can safely and comfortably age in place.