Seniors considering a choice between entering an assisted living facility or staying in their homes should honestly assess their needs before making a decision.
That’s the advice of area experts who work in assisted living facilities and home-care services.
Janice Harris, admissions director at Pickersgill Retirement Community in Towson, said finances may be one of the first areas to consider – examining the cost of additional services in the home such as housekeeping, meal preparation, transportation and safety and security adaptation.
“Compare these cost factors to the monthly fee in the assisted living facility,” Harris said.
Those considering assisted living facilities should factor in affordability, she said, looking at whether they can pay the monthly costs over their life expectancy and asking what would happen if they ran out of money.
“Examine the level of assistance each home can provide as you age in place,” she said. “Will you eventually need to make another move? Is there a nurse on call 24 hours a day for emergency situations?”
Lynn Berberich, owner of BrightStar Healthcare of Baltimore City/County, said housekeeping, assistance in bathrooms, social interaction and safety features should all be considered.
“Look at the reputation of the provider and their licensing,” she said. “If you are looking at in-home care and need the support of an agency, recognize not all agencies are the same. Cheaper is not better.”
Berberich noted that agencies should have a Residential Services Agency license from the state. The caregivers should be employees of the agency and not contractors, she said.
“If you use a contractor, the family is responsible if the caregiver is injured and needs to get a rider on their homeowner’s or renter’s insurance,” she explained. “If you use an agency that has employees, you know that taxes are being paid.”
An agency with employees will have a different level of supervision than a company that uses independent contractors, Berberich said.
There are groups that provide a range of resources to help people age in place. Berberich noted that the Baltimore National Aging in Place Council has members that provide everything from in-home nursing care to in-home veterinary service, in-home podiatry, home renovation, handyman services, home pharmacy service and financial planning or legal resources.
If a person wants to stay at home, he or she should examine the house’s physical components, she said.
“The Baltimore National Aging in Place Council has architects that can plan home renovations to make your house handicapped accessible – wider doorways, ramps, bathrooms and bedrooms on the main floor,” she said. “Look at the bathroom. Is it easy and safe to get in and out of the shower and bath? Are there grips to prevent falling in the bathroom? Is the toilet the right height? Are there lights that make it easy to see to get to the bathroom at night?”
Berberich noted that people often look at the quality of the furniture, interior design and the size of rooms when exploring assisted living facilities.
“More important,” she said, “are things like, is it easy to get in the shower without having to step over a lip? Is the bathroom convenient to the bed and easily accessible? What is the atmosphere and sense of community?”
If a loved one has dementia, family members should consider whether the entire facility is designed with their needs in mind or if they will be restricted to a specific floor or hall, she said.
Phil Golden, director and principal of Springwell Senior Living in Mount Washington, said socialization is another key factor.
“To me, this is one of the most powerful benefits of assisted living – the interaction of the new resident with other residents who they potentially share a lot in common and with staff who go out of their way to help a newcomer integrate and feel part of a community,” he said.
Though there can be a good one-on-one relationship with a home care provider, Golden believes it can be more difficult to establish a sense of community.
“Where there is neither, the senior can decline both physically and mentally if their only source of socialization is with TV characters,” Golden said.