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Assisted Living: Knowing When the Time is Right

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Assisted Living offers seniors a comfortable and safe lifestyle, while giving their adult children peace of mind. But how does one know when to make the move?

Highview in the Woodlands, Rockton, Ill., offers residents a chance to relax and socialize at any time of the day.

Eight years ago, Art and Erna West started a new life together, when they married and moved into a Lake Carroll, Ill., home. The couple, both widowed, had met at church. But in the past couple of years, reccurring health problems for Erna, now 80, and a diagnosis of Alzheimer’s for Art, 87, forced the couple to take a long look at their future. When Erna was hospitalized for three weeks last spring, the decision became clear: It was time to explore other living arrangements.

Fortunately, the couple didn’t have to make the decision alone. Art’s son, Tim West, and Erna’s brother, Bill Bergner, took an active role in helping the couple determine the next course of action. “Our concern was their quality of life,” Tim says. “Erna’s health got a little worse every year, and when she was hospitalized, the doctors said she couldn’t go home and take care of herself and Dad. That’s when we started to look at assisted living facilities.”

Tim, his wife Sue, and Bergner spent nearly six months researching a range of locations, including religious-based, chain and privately-owned facilities. They reviewed a long list of questions they had prepared for each facility they visited: Is it clean? Can we afford it? Is it staffed appropriately? Do the residents appear clean and happy? Is the property well maintained? How is the quality of food? What activities are offered?

“They came to visit many times, always with a list of questions,” says Stacy Nelson, director of sales and marketing, Liberty Village, Freeport. “They were very thorough and wanted the best for Art and Erna. That’s the way it should be done. They did it the right way.”

Erna and Art West (seated) enjoy a visit with Erna’s brother, Bill Bergner, standing left; and son Tim and his wife, Sue, at Hawthorne Inn, Freeport, Ill.

After careful deliberation, Art and Erna moved to Hawthorne Inn, Liberty Village’s assisted living facility, in July of last year. While the couple wanted to stay in their own home for as long as they could, ultimately, they understood that assisted living was the necessary next step. “From a physical standpoint, it was the obvious thing to do,” Erna says. “I couldn’t keep up with housekeeping and cooking, but it was a difficult decision. We had to put our home up for sale and find a place for all of our things. We were moving away from our memories.”

Experts say that very few older adults plan for senior living care. Either they don’t think they need it, or they want to save their assets for their children. “We’re seeing a push for people to stay in their homes longer,” says Ferol Labash, development director of Pinecrest Community in Mt. Morris. “The trend is to stay home as long as possible. That’s why you see assisted living in the industry. It’s not as expensive as nursing care, and assisted living allows the resident to remain as independent as possible.”

What is Assisted Living?

Regulated at the state level, assisted living surfaced in the 1990s as an alternative for seniors who could no longer live independently, but didn’t need the 24-hour medical care provided by a nursing home.

Assisted living is often viewed as the best of both worlds. Residents have as much independence as they want, knowing that personal care and support services are available if they need them. Facilities vary greatly in size. A Continuing Care Retirement Center combines independent living, assisted living and nursing care under one umbrella, so residents can easily access more care as needed.

These communities offer a more home-like atmosphere, with apartment styles that typically include studio and one-bedroom models. Kitchenettes usually include a small refrigerator and microwave. Rooms are equipped to handle wheelchairs and walkers. “Everything is designed with the residents in mind,” says Tammy Bargman, director of Prairie View Assisted Living in Winnebago. “They’re not just residents to us. They’re more like family.”

Pinecrest Community is an independent living and skilled nursing facility in Mt. Morris, Ill.

According to the Assisted Living Federation of America, the average age of assisted living residents is 86.9 years. Female residents (73.6 percent) outnumber male residents by almost 3 to 1. The majority of assisted living residents (76.6 percent) are widowed. Their average length of stay is 28 months.

Assisted living staff may help residents with basic activities such as bathing, grooming and dressing. Many times, a shuttle van is available to take residents shopping if they can’t drive. And worrying about shoveling sidewalks or mowing the lawn is a thing of the past.

“At home, they have to rely on family members to go shopping,” Nelson says. “Family members become their caregivers and do a lot of the housework for them. Once you come into assisted living, the staff becomes your caregivers. Assistance may include the supervision of medication, or personal care services provided by a trained staff person. We will assist with anything.”

The transition can be difficult for seniors, but there is a trade-off, says Carol M. Cox, CEO of Highview Retirement Home Association for Highview in the Woodlands, Rockton.

“One of the things that we offer, which is very important to our residents, is an on-site nurse, 24 hours a day, seven days a week,” she says. “Not all assisted living facilities offer this, but we do, because we know it can be very frightening for a senior to wake up in the night with a pain or some health issue that’s unusual for them. Our nurse assesses the situation, reaches the senior’s doctor if necessary, and so on. This kind of health security is very reassuring to our residents and an important reason that they value what we offer.”

Of course, they also love having delicious meals prepared for them three times a day and having their housekeeping needs met “But the best trade-off is that they have daily socialization,” Cox adds. “It’s not forced, but it’s there. There’s always something for them to do. There are coffee and ice cream socials, people to talk to, new friendships and entertainment. Most of all, there’s help available if something happens.”

Brian and Stacy Weavel stop by for a visit with Stacy’s father, Dennis Zell, at Prarie View in Winnebago.

Three years ago, Dennis Zell was one of the first residents to move into Prairie View’s 30-unit facility, coming from his home in Mt. Morris to be closer to his daughter, Stacy Weavel, and her husband, Brian.

Zell suffers from progressive supranuclear palsy, a rare disorder that damages nuclei in the brain, causing problems with balance and eyesight, as well as memory loss and forgetfulness. Zell’s family grew concerned, as he occasionally fell and injured himself; they worried that he might forget where he lived.

These days, Zell is getting the help he needs while maintaining his independence. The best part? His family is close and stops in daily to visit. “It quickly became his home,” Brian says. “This is a perfect situation for him. Here, he can live alone and be very independent, but he feels safe. He can still exercise, and he can have a social life. It’s become a big family to him.”

No Easy Decision

When is the right time to consider an assisted living arrangement for you or a loved one?

“When you start to see a decline, that’s when you start to have the conversation about how long they can live on their own,” says Dr. Kyle Cushing, a licensed clinical psychologist practicing in Rockford. “Some people can live on their own and not have any problems. They can take care of themselves, have a very strong social network of family and friends, and can maintain that lifestyle well into their 80s. Others get isolated as they get older. They’re retired and don’t have the camaraderie that they once had in the workplace. Depression can set in.”

And it’s not just seniors who struggle with making the transition. “Sometimes you’ll see adult children in denial,” Cushing says. “They want to see their parents or grandparents as the people they remember growing up. They’ll say, ‘Mom is just fine’ or ‘She’s doing okay at home,’ when that might not be the case. It’s a tough decision, especially when the loved one doesn’t want to move and has dug their heels in. If it gets to the point where they can’t take care of themselves anymore, without putting themselves in danger, that’s when you have to step in and make the decision for them. That’s not easy. There’s a lot of second guessing that goes on.”

Crimson Pointe, Rockford, offers restaurant-style fine dining and private dining rooms for residents and guests to enjoy special occasions.

Oftentimes, a watershed moment occurs – a fall in the home, or an oven left on. “Assisted living is for people who are faced with the struggles of everyday life, such as the cooking, the cleaning,” says Peggy Werner, marketing director of Crimson Pointe in Rockford. “Let’s face it. Living at home is an everyday job. There’s always maintenance to be done. There’s always yard work to be done. It’s a big responsibility. Assisted living is a way for people to enjoy life more, and it’s a chance to hand the drudgery over to someone else.”

Werner speaks from personal experience. Before becoming marketing director at the 73-unit facility on Rockford’s east side, she was the daughter of a resident there. She first discovered the facility when her mother, Mary Sagona, could no longer live on her own. Werner did her homework, researching several different facilities and visiting many of them with her mother, who chose Crimson Pointe. “I was never going to make her move,” Werner says. “I wanted her to be a part of the decision-making. Everyone wants that.”

Assisted living is typically paid for from private funds, but there are a few exceptions. Some long-term care insurance policies cover licensed assisted living. In a limited number of states, including Illinois, Medicaid funds and waivers are available to help with assisted living costs. War veterans may also qualify for assistance through the Department of Veteran Affairs.

The average cost for a private one-bedroom apartment in an assisted living residence is $2,575 per month, according to the Assisted Living Federation of America. Costs vary with the residence, apartment size and types of services needed. The basic rate may cover all services, or there may be additional charges for special services such as housekeeping and laundry, though many providers include those services.

Most assisted living residences charge on a month-to-month lease basis, but a few require long-term arrangements. Assisted living is typically less expensive than home health or nursing home care.

“It’s important for families to plan, in the event a parent has to move to a retirement facility,” says Pinecrest’s Labash. “For the most part, Medicare doesn’t pay for assisted living or nursing care. That has to be paid for with personal resources. That’s why it is important to consider long-term care insurance. People need to start looking into it in their 40s or 50s and know what their policy will pay for. The longer you wait, the more expensive it gets.”

Home Sweet Home

After selling her home, Edna Hassel moved in with her son and daughter-in-law, but they both worked full-time and were concerned about Hassel staying home alone. That’s when the family looked into Prairie View.

It’s taken Hassel time to adjust, but she’s come around in the past year. She’s met new friends and takes part in a variety of activities, whether it’s weekly bingo or 30-minute daily exercise classes. Occasionally, Hassel’s family stops by and has dinner with her in the dining room. “I know I’m taken care of,” she says. “If I need help, the staff is here. It’s a good feeling to know they’re looking out for me.”

Experts say it’s not uncommon for seniors to take some time getting used to their new surroundings. “It depends on the resident,” says Bargman. “There’s an adjustment period, but you get some residents who hit it off right away.”

Edna Hassel (left) enjoys a card game with friend Carol Schmoock at Prairie View in Winnebago.

When they do get settled, family, friends and staff often notice a dramatic increase in their overall disposition. “We see residents blossom when they come to live with us,” Labash says. “Many of their worries are gone. They eat with others, meet new friends and try new activities. They’re not home alone, shut in and isolated. They really enjoy themselves. Often, residents say, ‘I should have done this a long time ago.’”

Likewise, staff members grow attached to the residents. “It’s almost overwhelming to think of how many families we’ve come to know over the years,” says Cox. “Taking care of people in this environment can be very humbling. We see firsthand what can be done to make their lives better. That’s a good feeling.”

Tim West feels good now that his father and stepmother have become comfortable in their new surroundings. “It can be an emotional and stressful time,” he says. “You do have doubt. On the way home, I’m thinking, ‘Am I doing the right thing?’

“At home, other than a friend and a neighbor, they had no one. Daily life was a chore. Not now. Every time we go there, we know we’re going to have a great visit. It’s like being a family again.”

That’s a common scenario at Crimson Pointe.

“I’ve seen people change before my eyes,” Werner says. “They come here and start getting three delicious meals. They start talking to people and getting involved in activities. I saw it with my own mom, and I’ve seen it in other residents. It’s a whole new world.” ❚

Choosing an Assisted Living Facility: Tips for Seniors and Adult Children


Don’t wait for a crisis. This forces adult children to do most of the decision-making, often in panic mode. It’s best when seniors and their children take the time they need to make a good decision together. Knowledge is power, and the more information you gather, the easier it will be to make your decision and feel good about it.

Ask questions – a lot of questions. Talk to residents and staff members to see what they have to say about where they live and work. If you need help on what to ask, the Northwestern Illinois Area Agency on Aging or, in Wisconsin, the Rock County Council on Aging, can provide you with a checklist.

Children, remember that your parents may envision old-fashioned nursing homes when you say “assisted living.” Times have changed, and today’s facilities are much more about amenities than restrictions. Visiting assisted living facilities is the best way to dispel misperceptions.

After doing research, narrow your choices to two or three places, and then take a deeper look at what each offers. Visit a community more than once, to see if you like what you sense and observe when you walk through the doors.

Know that by accepting the help they need, seniors actually stay independent and active longer, as they focus on enjoyable activities rather than household chores that have become difficult. Getting help with daily tasks is a step up, not down.

Try not to become overwhelmed, and therefore emotionally paralyzed, as you think about all that’s involved with making such a major change. Take one step at a time, day by day, and before you know it, the transition is made.

**Editor’s Note: This version has been corrected from our print edition.

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