Retirement Home Living: The Past and Present and what to expect

Times have changed. That's for sure. It was not long ago when someone said that they were considering moving into a retirement home that usually meant one of two things.

For many seniors the consideration of moving into a retirement home meant upgrading their style of life. This was a time to finally enjoy the pleasures of life. This is what they had worked hard for many years. They wanted to have the freedom of not having to worry about the ongoing issues and concerns owning and managing their own household. No more cutting grass. No more shoveling snow. No more grocery shopping in cooking meals each and every day. No more housekeeping. No more doing laundry. Every meal served “restaurant style”. The thought of a retirement home offered a resort-style lifestyle that afforded them many luxuries and freedom. It is true that it was not long ago when many retirement communities and retirement homes only accepted Independent, fully capable and mobile residents. This was lifestyle like living on a cruise ship. Waking up each morning their biggest decision would be what to have for breakfast. Served and catered to them in a dining room. Then again the same would happen at lunch time and for supper. Decisions daily about what activity or social gathering to attend to. To play a round of golf or go to the wine tasting. Dry cleaning laundry and housekeeping all provided for. Life is good. This truly was the mindset and provisions, services and amenities provided by the majority of “retirement homes” not long ago.

At the opposite end of the spectrum were the extremely frail seniors. Many had aged and developed some form of illness or mobility restriction and needed the daily assistance and support of assisted living.

This group of seniors had to accept the reality that they could no longer live on their own independently. They needed some level of assistance on a daily basis or more frequently. Most often this was a result of some level of illness or perhaps multiple falls within their own private residence that led to some form of hospitalization. Often it is the hospital medical team that would not allow for the senior to return to their home to an independent living scenario.

Fast forward to today. I write to you on warm sunny day in August of 2020. Things are a little different. For one, there exists heavily regulated Long Term Care LTC facilities (“nursing homes”) which are not retirement residences. LTC facilities now provide for the heaviest level of care for our most frail seniors.

Retirement Homes, on the other hand, can be licensed to offer a wide range of services and care.

When I say “wide range” I mean it. Some retirement homes are in fact, still a place to transition to the next phase of one’s life in style and comforts. These places usually offer no or little care services but instead are designed to cater to a resort style or cruise ship style of life. These are in fact beautiful places and would be desired by many. However, if you experience even the slightest frailty, some mobility constraints or any form of memory loss or dementia, you will asked to leave.

The largest grouping of retirement residences in Ontario are in fact, loosely stated, more like a dedicated seniors apartment with onsite staffing to provide for services, care and extra amenities. In my experience, I would easily suggest that most retirement residences have care team consisting of RPN nurses, PSWS, UCPs and other personal care support staff. This is to support a large compliment of their residents; seniors who require some form of support with one or more ADL and required the services of assisted living.

We are not suggesting that today’s retirement homes look like long-term care facilities or nursing homes, but in fact the average retirement home in Ontario is a blend of both the independent, full-service amenities with qualified nursing and PSW care support. Given a cross section of a one hundred resident seniors complex, it would be usual to see about a third of these residents quite and fully capable to live independently (some even have their own car, etc.), about a third of the residents would be those who are mostly independent in mobility and memory loss, but need someone there “just in case” an accident, fall or illness suddenly occurs. The final third of residents would require some form of daily ADL assisted living support and are often on a waiting list for Long term care.

As a natural question in this process, we always get asked about costs and pricing. I have written about this in a previous post, and used criteria based on location of residence, quality of the building, apartment unit and amenities and the care and services provided. All of these factors play a key role in the total monthly costs of a resident’s stay at a retirement residence. Here’s the general range: an upper scale home with high end finishes located in Toronto, GTA will run you about $7,000 to $9,000 per month. And this may not include any care services. On contrast, a mid-range quality building, spaces and amenities with a decent supplement of care and services included, located well outside Toronto, GTA or any other major city, will run about $2,500 for a studio. Hence the interest from Toronto area seniors in moving to a retirement home located outside the GTA such as Port Hope or Cobourg, Ontario, as one example.

If you are a fully independent and capable senior looking to escape your daily routines living in your home and considering a move into a retirement home is today's version of a retirement community a suitable setting for you? Will you will receive all the luxuries, services, activities and social and amenities from the good old days or are you comfortable living in a community of seniors that have these comforts but also include a mix of seniors that both resemble yourself and others that are requiring daily assistance? Perhaps that will take a little bit of a mindset adjustment.

Family Involvement in the Decision-Making Process of Moving into a Retirement Home - Part 1

Over the years, we've conducted tours for possible new resident admissions at our Retirement Home ope. And we've learned a few key things, a few key trends that might be useful and helpful to those families considering a parent's possible move into a retirement residence.

The biggest observation we have made is the plain and simple truth that in most cases, it is the son or daughter that begins the "search" for a retirement home on behalf of their parent. This is a great idea, especially if the parent is not as well versed in using the internet, google search, etc. The "child" then calls or emails the potential retirement homes for some information as a starting point. And in the world of COVID-19, much of this information will be gathered either virtually or by way of a telephone call.

Here is the first tip:

prepare a list of questions to ask the retirement home.

Some questions you should ask are:

• what is included in the "basic monthly rate?"

This question is important, because in our experience many callers will quickly ask "what is the monthly rate" early in the call, and they might be misled in thinking that the lowest rate, if affordability is an issue, is the Home that should be first considered. The reason I point this out is due to the fact that Retirement Homes offer different things - services and care - and some include this in their basic monthly rate, and others do not and add these on as an Extra Service with fees attached. So what you might think is a less-expensive option to get your mom or dad into a retirement home may be the highest rate when you add fees for all sorts of services like laundry, bathing, medication assistance and any Personal Care.

From this, the next natural question is:

• what "Extra Care and Services" does your Retirement Home offer and what are the costs?

Take good notes of these things, or better still have them emailed to you.

Example:

Retirement Residence #1 has a basic monthly rate of $2,500 for a Studio suite (this is about the average in Ontario, by the way). They charge for Extra Services and Care of $100 monthly for assisting with Bathing, $250 for assisting or managing medications and $150 for weekly laundry services. Now the "true" total monthly rate is $3,000.

Retirement Home #2 has a basic monthly rate of $2,800 for a Studio suite, and it includes quite a bit of Care and Services, such as assisting with Bathing, assisting or managing medications and weekly laundry services.

Additional questions that you should ask could be:

In the event that my mom or dad has a Fall or need for immediate Personal care Support, what measures does your retirement home offer to this level of support?

At the very least, you are seeking a response that includes:

• we are staffed by a team of trained and educated PSW Personal Support Workers and the Care Team is managed by a Registered Nurse;

• we are staffed around the clock, 24 hours a day by at least one member of the Care Team;

• we have an emergency call system (nurse call system) for immediate alert and response to an emergency.

In addition, ideally, the Home should have a disciplined program to check in on residents on regular intervals and chart this.

The next key point we will offer to you involves getting your parent involved in the decision-making process early on. Oh boy, this is a biggeee. How often the child spends so much time doing great research, spends quite a bit of time gathering information, telephone calls and possibly even touring the retirement home, and in the end...the parent wasn't psychological or emotionally prepared for the move.

The number one piece of advice on this aspect is to simply have the parent involved in this process early on. Well before you begin the research stage, these discussions should be ongoing. In most cases, this is a process that will take several weeks or months to "mentally prepare" the parent for the change. Plant the seed as they say. In many ways. Ongoing. Often. Every time there is an opportunity, bring up the idea. We suggest you do it in a way that best meets your parents ways - you know them best, so you'll have to decide on this.

At the Tower of Port Hope Retirement Residence and Assisted living, we have a full-time Life Enrichment Aide. The main role and responsibility of this employee is the social, psychological and emotional well-being and health of the resident. We have interviewed her for some greater insight into the Psyche of the resident to be able to offer to you some further guidance on how to encourage your parent to take the next steps in considering a move to a retirement home.

Unfortunately, most often we receive the calls from family months after the initial calls and discussions and now, we are being called upon to act quickly to help because my mom or dad is in hospital after a fall and they need a retirement home to help them recover.

Stay tuned for Part 2 of this discussion where we promise to continue to provide informative insight with the attempt on helping you assist your parent in the decision-making process of a move into a retirement home.

Take care and stay safe.

The Team at The Tower of Port Hope Retirement Residence