Reading the promotional materials for retirement communities can leave you feeling as if they offer residents a little slice of heaven on Earth. However, the slick advertisements and sales pitches could be hiding some uncomfortable truths about senior living. A retirement home may not share this information, but here are eight things you should know before moving into a senior living community.
Cliques don't end in high school. Senior communities are just like any other social setting, and some personalities will click while others don't. Some communities have welcome or ambassador programs to ease the transition. Seniors should be prepared for a period of adjustment while they find their place in the community, says Scott Greenberg, CEO of ComForCare Senior Services in Palm Beach Gardens, Florida."It may take some time, and you have to be patient and realistic," he says.
It's up to you to share end-of-life preferences. Many communities simply don't broach the subject of end-of-life arrangements. If you have a do-not-resuscitate order or a living will, it is often your responsibility to make sure the community staff has a copy on file and understands your wishes. "What are you willing to go through and not willing to go through the for sake of more time," says Atul Gawande, a medical doctor, co-chair of the Massachusetts Coalition for Serious Illness Care and author of "Being Mortal: Medicine and What Matters in the End." "Once you make it clear, most places are open to you not going to the hospital [in certain circumstances]."
You may not control when you move next. It is typically the community's call when it comes time to discharge someone. "You are often signing away control," Gawande says. "The decision is not yours. The administrator is making that decision." Changes in medication needs or behavioral patterns could also spur a discharge or transfer to a facility offering greater care. "Consumers should definitely inquire about these criteria, as they can be a very unsettling discovery when learned about after the fact," says Sharon Roth Maguire, chief clinical quality officer for BrightStar Care Senior Living in Madison, Wisconsin. "For example, if you require more physical assistance than what the community is willing or able to provide, you may be required to move out."
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The community may dictate your routines. Many senior communities offer some flexibility, but new residents may still be surprised by how much of their day is dictated by the facility's schedule. "Things like meal times have to be based on when and how meals are prepared [by the community]," says Jeff Salter, CEO and founder of Caring Senior Service. Residents may be awoken at certain times, receive medications on a set schedule and participate in other activities at times over which they have no control. "At home, [seniors] may have settled into a routine around their own schedule, but this often changes," Salter says.
The government has a say, too. It's not just the community that dictates how residents live. State regulations could impact routines as well. "While this can vary widely by state, common requirements include things related to life safety like regular fire drills, evacuation ability assessments and the like," Roth Maguire says.
Activities don't always occur as advertised. Retirement communities like to boast of a long list of activities, but Greenberg says potential residents shouldn't rely on the bulletin board in the community room to tell them what's available. "Go show up unannounced and see if the activities on that board are actually happening," he says. Either from lack of resident interest, insufficient staffing or other reasons, scheduled activities may not always occur as promised.
Staffing ratios can be misleading. Another point of pride for many retirement communities is their staff-to-resident ratios. Again, Greenberg advises against taking these numbers at face value."Drill down far enough to how many are direct care, how many are dining and how many are maintenance," he says. Roth Maguire recommends taking a closer look at the number of direct care workers who interact with residents and asking about their training. "I'd like to know if a nurse has been involved in their training, especially if your loved one has more complex needs," she says. What's more, in memory care units, consistency is critical, and family members should ask if these facilities have their own dedicated staff
You may be able to use a private caregiver. Although this does vary by community, residents may be able to hire a private caregiver to come into a retirement home. For seniors who already have a home care aide they like, using that person for errands or companionship visits can make the transition to a new environment less stressful. Before hiring a private caregiver, check with the community's rules.
The above items shouldn't be enough to keep you out of a retirement community, but they should serve as a warning to look beyond the glossy fliers when selecting a new home. Understanding all the details is crucial to finding the ideal living arrangement for your golden years.
Copyright 2016 U.S. News & World Report