Ease your parents' move to a home

By Melinda Fulmer

Helping your parents keep as much of their old lifestyle and mementos as possible helps to ease the transition to assisted living, geriatric-care experts say.

"One of the most common mistakes that people make is they make their (facility) choice based on their values, rather than the values of their parent," said Linda Fodrini-Johnson, founder of Walnut Creek, Calif.-based Eldercare Services.

If you can keep whatever it is in their life that gives it value, then you can minimize a lot of the depression that accompanies a move to assisted living, Johnson said.

Since most places only allow the furniture, appliances and belongings that can fit into their room or apartment, you have to sit down with a parent and choose these items carefully.

Johnson recommends talking about what items have the most memories associated with them. It may surprise you, she said. Rather than a beautiful dresser, your mother may be more sentimental about an antique treadle sewing machine that she used with her own mother.

An experienced eye helps

Likewise, children need to consider a parent's hobbies and lifestyle.

Can Mom take her pet? Many facilities now accept animals under certain conditions, and that can help ease the transition to a new place. Does she have a space to garden or window onto a garden? Is it near her church, trusted doctor or community center she attends? Can she do her own laundry?

"Some adult children come in kind of bossy and parental," Johnson said. "It's better to come in as more of a peer and a friend." Talk to parents about what's important and give them a couple of options, she said.

Moreover, consumer advocates say, it's often better to get a second, professional opinion on your choice.

Geriatric care managers, which can be found through the government elder-care locator number, 1-800-677-1116, or at CareManager.org, can assess a parent to determine their needs and recommend facilities in your area that might be a good fit.

"They can also help when a family member feels a placement is necessary, but the older person may not," Johnson said.

For a few hours of paid time, these specialists -- typically social workers or registered nurses -- can save you headaches down the road, experts say.

"They can say this facility gives good care, this one has had problems," said Washington, D.C.-based estate-planning and elder-law attorney William Fralin. "A lot of the facilities have figured out how to decorate nicely . . . but the care manager knows which ones are well run."

There is no federal oversight of assisted-living facilities and only limited state oversight, so this information can be especially helpful, as can advice from an ombudsman affiliated with your area's council on aging.

How much care is enough?

To check out an elder-care community, drop in unannounced, experts say, to see how residents are being treated. Taste the food and see how the place looks and smells. How friendly are people? Do activities happen as planned?

Another thing that Fralin and other care managers recommend is looking at the different levels of care offered by a community. Does it offer several options from independent living to skilled nursing? Does it have a special Alzheimer's unit? While your parent may operate just fine with an apartment and prepared meals today, he or she might not be as capable a year from now.

Being in a community with a continuum of care also is a good insurance policy should your parent's money run out. Most assisted-living facilities give priority for their Medicaid-funded beds to current residents.

Finding another attractive facility that accepts Medicaid, rather than private pay, can be difficult.

"If it does have Medicaid beds, it's probably not as desirable," Fralin said.

Plan for the extra costs

Most facilities are private pay, which means that a house must be sold or pensions used to pay the $3,000 to $6,000 a month that most places charge.

And these facilities often also charge an extra up-front "community fee," says Kathleen Cameron, chair of the Consumer Consortium on Assisted Living, which typically amounts to one month's board.

Cameron said it's important for consumers to know that these fees are negotiable.

Assisted-living centers charge many additional fees, and it's best for people to be familiar with them and plan for them up front, so they don't come as a surprise with that first bill.

Will your parent need extra nursing, equipment or rehabilitation services? These are often billed separately. There may also be charges for housekeeping or hairdressing. If residents need a meal delivered to their room or apartment, that can cost extra, too.

Likewise, transportation can impose an additional cost. Since most assisted-living residents don't drive, a van is usually provided at least one day a week to take them to a doctor appointment or bank in the surrounding area.

Continued: Arranging for transportation, medication

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