Exploring Housing Options
Exploring Housing Options
David: We have people come to us all the time who are either looking to age in place at home, which we'll talk about. But how can you help somebody if they do want to make a decision to move out of their home?
Michael: Well, first of all, I can listen to them. That's probably the first way I help people is I listen to them and try to resolve their problems. I have well over 40 years in the senior housing business, so I've got a depth of knowledge as to what works, how it works, and how it adapts to people's particular needs.
If somebody's looking to move out of their home, I can give them options that would be appropriate for them, from my knowledge of about 170 different facilities that I'm contracted with. There are 1,500 in the Southeast Florida area. I can't keep them all in my head, so I don't contract to work with all of them. It doesn't mean that the ones that I'm not with are not good. There's just a limit to what I can work with. And I'll try to find the right one for that person.
It's not just a question of if you're rich, can you afford the most expensive one, and is that the one you should go to? Quite often, that's not the case for various reasons.
People's social lives are not necessarily with the country club crowd. There are people who may think the most important thing in their life might be bingo, Or it might be bridge. And those are going to push to two different places in independent living and in assisted living as well.
So first of all, listening to the people and getting an understanding of who they are, what's important to them, what are the things they'd like to do, what's their comfort level, and what's their comfort level in terms of luxury of amenities.
David: Is there an interview or an intake form? How do you get the information you need?
Michael: I have an intake form. I use it sometimes, but it's really in\ my head at this point in time. I've been doing senior placement for more than 10 years. It's extensive, but it does ask what kind of help do you need.
What are your illnesses? What are your medications?
Where are you experiencing difficulties? What have you given up lately?
What is the reason that you want to change?
What are the things that you like to do? What kind of TV do you like to watch? What kind of music do you like? Any particular hobbies?
Do you like to read books? Do you like performances, eating out, and things like that? Do you have a dog? Are you familiar with computers?
Are you a quiet person who'd rather put your feet up and read a book in bed? Or are you the belle of the ball and you want to be out socializing in the lobby, talking to people, finding out about people?
Are you a volunteer and a helper?
All of those things come into play.
Although independent living facilities are very homogeneous, they're different only by the size of the room that you want, the location, and the level of luxury in the amenities. Aside from that, they all provide the same services. They do have some different characteristics.
There are some that are simply more active. There are some that are busier, and more frenetic with a higher pace. And there are some that are quieter and even a little bit older and quieter and will sustain people better who don't like the crowds.
David: Can you describe the different kinds of older adult housing options?
Michael: Let me start with independent living. Independent living is very homogeneous. They are complexes with typically around 200 apartments. Some are much bigger than that, but that's the critical size. They have five basic services:
- Meals 2x day
- Weekly housekeeping
- Activities
- Transportation
- 24/7 Security
Typically, the security will also have a call button, and maybe even a passive security system so that if somebody doesn't get up in the morning, it does register that kind of activity.
I'm going to jump over and talk about nursing homes, which is also a very homogeneous industry. Nursing homes are homogeneous for a completely different reason.
They are heavily legislated and they are essentially poor.
They have to meet the standards of legislation. None of the nursing homes go beyond that in terms of staffing, amenities, or anything else because if they did they would go bankrupt. They're not provided with the money to do that.
Nursing homes do rehabilitation as well as long-term care, but their long-term care side is very, very modest.
David: Would you say that nursing homes are more for the end of life?
Michael: Nursing homes are for people who are medically complex, and it's for people who cannot afford assisted living under any circumstances.
Assisted living is the option in the middle of the previous two. All the way between independent living, which just provides five environment-based services, where no one's touching your body.
Nursing homes are medical institutions. They're very much like hospitals. They take care of people where everything that you do is written down just like a hospital.
How much did you eat? How much did you output? Did you walk? How many steps did you walk? And so on and so forth. There are therapeutic activities. You have social workers, you have a massive amount of medical staff there.
In between those two is the entire area of assisted living that ranges from almost nursing home to almost independent living. All the assisted livings are different. They range in size from 6 beds to 180 beds. They range in focus and concentration from places that really focus on the activities and the luxury amenities and the food. We're talking about 3 meals a day, and we're talking about assistance with bathing and dressing and ambulating and incontinence and redirection, all the way to places which really focus much less on activities, much less on amenities, but much more on the amount of care that they bring to people and the amount of personal care.
Assisted livings also include a large area that serves mental health because there are mental health licensed assisted livings and a large subsegment that serves specific in memory care.
It covers a very wide range, and it's much more individualistic.
David: Do some facilities have more than one service—independent living, assisted living, maybe even skilled nursing?
Michael: Yes. There are campuses. Very few campuses have skilled nursing and assisted living and independent living, but quite a few campuses have independent living and assisted living, and quite a few campuses have assisted living and memory care. Some of them have all three.