San Francisco Chronicle - (Sunday)
Elder care: Discover the next best step for your loved one
Some call it the “Silver Tsunami.” Others use the nickname, “Grey Wave.”
Whatever you call it, there’s no question that as Baby Boomers age — 10,000 people in the United States turn 65 every day — most will need to work with their partners and adult children to reevaluate living situations and plan for the future.
This, in a nutshell, is the basis of elder care — the process of caring for the elder members of society as they grow old.
According to the Centers for Disease Control and Prevention, in 2016 there were approximately 15,600 elder care facilities in the United States with 1.7 million licensed beds, occupied by roughly 1.4 million patients. Those numbers undoubtedly have changed due to the coronavirus pandemic, but they’re still likely pretty close.
Here in the Bay Area, there are numerous options for families who feel elder care is the next step.
All these choices can be overwhelming, especially if you’re the partner or adult child of someone who is in the throes of health problems and needs help fast. And according to Dr. Shoshana Ungerleider, founder of End Well, a San Francisco nonprofit focused on transforming the end of life into a humancentered experience, making the right choice can help the seniors in your life enjoy the last years of theirs.
“Not all elder care facilities are created equal,” she said. “It’s important to understand the differences between the options available and see what kind of facility matches up with the needs of your loved one and your family as a whole.”
INDEPENDENT LIVING COMMUNITIES
The most common elder care options in the Bay Area also are the most basic; think of these communities like college dorms, only for people over 55.
In most independent living communities, residents are flourishing into old age and are perfectly capable of caring for themselves. The communities are set up so residents can enjoy a lifestyle free from everyday worries and chores such as cooking, cleaning, driving or home maintenance.
Most of these facilities have chefprepared meals made daily, wellness coordinators that plan numerous events, weekly housekeeping and linen service, local transportation services, 24hour security, onsite barber shops and beauty salons and more. In most cases, residents receive access to these amenities as part of allinclusive monthly rent payments. Some facilities also have an entrance or “buyin” fee.
“Independent living communities usually have a really social aspect,” said Lynn Goehner, founder of Eldercare Specialists, a geriatric care management firm based in Corte Madera. “That socialization leads to emotional support since many of the residents form friendships and stay together for a long time.”
» “Independent living communities usually have a really social aspect.”
Lynn Goehner, founder of Eldercare Specialists
CONTINUING CARE RETIREMENT COMMUNITIES
These facilities, known colloquially as CCRCs, combine residential accommodations ( like those found at independent living communities) with basic health services. As Goehner explained it, the purpose of this approach is to allow residents to receive appropriate care across a continuum as their needs change without ever having to leave the community.
Services typically can include basic assistance with activities such as personal hygiene, dressing, eating and walking, as well as more aggressive assistance such as nurse service and highend medical care.
“At CCRCs, the idea is to ensure that residents are cared for through endoflife,” Goehner said. She added that CCRCs are good options for seniors whose health is starting to decline or for seniors whose adult children live farther away and can’t visit regularly.
Monthly fees for most CCRCs are decided by the level of attention and services a resident requires.
ASSISTED LIVING FACILITIES
This next level of elder care facilities provide care for individuals who cannot live independently but do not require 24hour skilled nursing care.
According to Jim Cassin, coowner of Premier Resident Placement Service, an elder care consulting firm based in Novato, three types of assisted living options are common in the counties that surround San Francisco: Largescale entities that have both shared and private rooms, as well as private apartments. Smallerscale facilities that are much more intimate called BoardandCare Homes, which usually exist in private residential settings and house between four and 10 residents at a time. Special operations dubbed Memory Care Facilities for patients suffering from dementia.
Cassin said assisted living facilities often offer the “best value” when one considers room, board and the services they include. Many provide some housekeeping, social activities, supervision and assistance with basic personal hygiene. Cassin added that many facilities offer three meals per day, as well as snacks.
“These facilities are great for peace of mind,” said Cassin, who operates his business with his father, Tony. “That reassurance exists not only for the resident but for the family as well.”
SKILLED NURSING FACILITIES
Formerly known as nursing homes, skilled nursing facilities comprise most of the elder care facilities in California — and around the world. These entities are licensed health care facilities that are regularly inspected and regulated by a state’s Department of Health Services.
They also provide skilled nursing care ( and other medical expertise) 24/ 7 should patients need it.
As Cassin explained it, skilled nursing care involves trained professionals performing services such as medicine management; physical, speech and occupational therapy; social and educational activities and more. Because these skilled facilities are licensed, the state keeps a searchable public record of infractions at www.cdss.ca.gov/inforesources/communitycarelicensing.
“It’s nice to be able to do some homework on these facilities and get a sense of which ones have infractions and what those infractions are,” he said. “To me, that’s all part of research process.”
As Ungerleider noted, elder care facilities aren’t like ball caps — one size rarely fits all. Understanding the differences between options and asking yourselves the right questions in the beginning ( see below) both are keys to making sure the facility you choose will be write for the senior you love.