Making the Right Move: Senior Housing Solutions

In this enlightening episode of "Getting Your Edge," hosts Dennis Day and Judy Gratton sit down with senior housing expert, Erin Kershaw, who specializes in helping individuals and families make the right move when it comes to senior housing solutions. With a focus on downsizing and optimizing their living situations, their guest brings a wealth of experience in placing people in senior homes, assisted living facilities, memory care, and arranging in-home assistance.

Throughout the episode, listeners gain valuable insights into the often complex and emotional process of downsizing for seniors. The discussion touches on various aspects of senior housing solutions, including the range of options available, the considerations involved in choosing the right fit, and how to navigate the financial and emotional aspects of the transition.

Erin also shares personal stories and success stories from their work, shedding light on the positive outcomes that can result from making the right move at the right time. Whether you're a senior contemplating downsizing, a family member seeking guidance, or simply curious about senior housing solutions, this episode offers practical advice and compassionate wisdom to help you or your loved ones embark on this important journey with confidence and peace of mind. Tune in to Episode 23, "Making the Right Move - Senior Housing Solutions," and take your first step towards rightsizing your home and life.

Transcript

Ep. 23 Making the Right Move: Senior Housing Solutions

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@1:39 - Dennis Day 

Okay. Heidi Ho good neighbors and welcome back to the Getting Your Edge: How to Write Size of Your Home and Life podcast.

I'm Dennis Day and I've got our guest hosts. Excuse me. Our co-host, Judy Gratton.

@1:55 - Judy Gratton 

How are you today, Judy? I'm great.

@1:57 - Dennis Day 

Thank you. How are you? Good. We just had our first. First giveaway this weekend.

@2:02 - Judy Gratton 

Erin, can you explain a little bit about that? Well, we did a back to school relief basket for all of those parents that had to get kids off to school and we had a winter Amanda.

We met her in front of PCC and delivered the basket to her. She loved it.

@2:21 - Dennis Day 

It ends up that she works for the North Shore School District. So that was really fun. And we put that on video and we did ask people what would you like to see in the next giveaway basket.

So we're waiting to hear that from people. Hey, well, we're gonna give away another basket in October. So I want to introduce our guest.

This is Erin Kershaw. Hi there. she is with the home care company.

@2:51 - Erin Kershaw

Is that correct? Correct. Yes, the home care company and senior living options.

@2:59 - Dennis Day 

And Erin's here to talk about. Out. Something that's kind of tough on families, I would say, is that finding the options that work right for you or someone in your family.

And I've known Erin for quite a few years and she's helped us our family with both my father and my mother.

And Erin was our family's guardian angel. Like most people, we were not prepared for what was going to happen.

So tell us a little bit about your background, Erin, and what you do with the home care company.

@3:47 - Erin Kershaw

Sure. So I've been in healthcare for about 30 years. started as an admission director in a skilled nursing facility in Southern California.

And then I've worked for a hospice company. So I've done hospice admissions before. Her work for home health companies, of course, private duty home care and placement.

kind of run the gamut. So currently for the home care company and senior living options, my role is to let the community know that we exist as a company and how we can help them.

So the home care company is a private duty home care company. So that's where we can send care providers into one's home to keep you safe.

If for whatever reason being at home is not an option, then I can help find a safe place to go where the care is built in.

@4:38 - Judy Gratton

Mom.

@4:40 - Dennis Day 

And what are those options? So we have somebody come to your home, but what are the options when that is not going to work?

@4:50 - Erin Kershaw

Yeah, so that's so being at home with a care provider is typically, as you know, most people's first option or choice really.

Everyone likes where they live. They would like to stay home. So if For some reason, you can't be at home with a care provider then.

One option is assisted living and assisted living can be a great option. They're not one size fits all. So typically in assisted living, you have your own apartment, you pay rent and the rent covers, your meals, your room and board, the bus that takes you places activities, housekeeping once a week, and then they do an assessment and identify what your care needs are.

And you have your care costs. you add those two numbers together, rent and care, and that's your monthly obligation.

You can expect sometimes the rate of the room to go up and the care costs to go up as we get older and we're in an assisted living community longer.

You certainly can see those rates move up. So that's a conversation to have as a family when you budget for that type of move.

If you are to the point that you just need a smaller environment, more eyes on you. You need and want to control your costs.

Then the adult family home setting can be a great setting. Memory care can also be an option and those can be free standing buildings or a section of an assisted living where it's a secure unit for those that are experiencing any type of memory impairment and need to be in a safe place.

@6:23 - Judy Gratton 

That's a lot. I have, bottle has quite a few senior living facilities over by the North Shore Senior Center and I've been in a few of them.

They're absolutely beautiful. In fact, I remember going into one of, I can't remember, it might have been Riverside and I was so impressed.

I was like, I'd like to move in here today. I have someone take care of the cooking and do that sort of thing.

you know, what should families and individuals look for when they're choosing the right home option for the unique needs?

needs and preferences of their family or maybe how do they determine what they even need? Do you help them make that decision?

@7:09 - Erin Kershaw

I do. So I often say if you aren't safe alone behind closed doors, you may not be a good candidate for assisted living.

So that doesn't mean I don't like assisted living because I do. And assisted living is often like a cruise ship that never leaves port, right?

They have activities and a bus that takes you places and people that come in and give lectures and a lot.

And that can be a wonderful setting for people that are in the stage of life where they can take advantage of that.

can get around well and they are late in life learners. So what I really like to drill down is what are the care needs.

So if you are really the opposite of what I just described, if you are following a lot, if you have advanced memory loss, if you need to be in a situation where they monitor you a lot.

Because you If have a lot of different. For health concerns, then you're probably better off in one of those smaller adult family homes.

In all honesty, another thing that really dictates where people can go and should go is quite honestly their financial situation.

So many assisted living communities do not accept Medicaid, which is state and federal resources. It's a welfare program. So if you run out of money, then you can live in most adult family homes and have Medicaid pay if you have paid privately for a period of time.

But the bigger assisted living, they really can't function on that reimbursement. many of them don't take Medicaid. So I always tell a family, if you feel like you're going to run out of money relatively soon, then sure, I'll help you move into assisted living, but just know that we'll probably have to make a move to an adult family home that accepts Medicaid.

So it really is something to pay attention to. Jen Chu, so the two things that are like I said really important are the care needs.

What really is best for that particular person in reference to their needs and financially. How long can you sustain paying privately for any of the settings I mentioned?

@9:16 - Judy Gratton 

Can you explain what the difference between the retirement communities and the adult care family homes, just so people can kind of get a picture of what you've kind of talked a little bit about the communities.

@9:29 - Erin Kershaw

What does the adult care family home look like? Yeah, so everyone is pretty familiar with assisted living. It's generally anywhere from small to very large size.

Anything in between building and it will have a sign on the lawn. It'll say assisted living. They often have multiple floors, different size apartment, studio, one bedroom, two bedroom.

They have a lot of common area spaces. Like I said, a bus that can take people places. So that's assisted living.

The adult family home is a home that looks like any home we would live in. And it's a single family home.

And it's either built from the ground up, which I call purpose built, or it is a home that has been remodeled to be an adult family home.

So the state of Washington says that you can have no more than six people. Some of them can accommodate eight if they have a sprinkler system.

They're in good standing with the state and they need to meet some other criteria. So typically, depending on your budget, you have your own bedroom and you can decorate it any way you want anything that's safe for So fits in the room can go there.

And the model is typically to have two caregivers during the day and one at night so it's a really good caregiver to they call them resident ratio.

So once again those that just need more individualized attention will do well in these homes. They offer home cooked meals, snacks, coffee water, all sorts of things in between.

Like you said, they're lovely. of them are custom built homes and have been remodeled, they're stunning. They, many of them also will have activities.

Coordinators come in a couple times a week to do activities with the resident. The lab musicians come in and play music.

Certainly, if the resident is safe to go out with their friends and family, they can do that and that's also encouraged.

So it's something that there's nothing going on in adult family home. mean, it is definitely a quiet, more quiet environment, low STEM, because memory loss is so prevalent as a diagnosis, whether it's vascular dementia, Alzheimer's, anything in between.

A lot of these homes can be good for that diagnosis because, again, you're one of six residents, so it does tend to be a little more quiet.

And for some people, that is really the better setting.

@11:48 - Judy Gratton 

Okay.

@11:50 - Dennis Day 

So what should families be looking for? You've mentioned cost and the care. Anything else that you can add to that?

@12:00 - Erin Kershaw

Well, I mean, location, so I often drill down just location and depending on how many siblings that can sort of be hard, right?

will live, you know, far north and south and someone's in the middle. So that's something else we talk about is what is going to be the best location.

But the other thing is, just when you go to these homes and meet the owners and tour them, it often comes down to just who you click with because you are going to be having a lot of conversations about how your loved one is doing, what the physician says, any recommendation made.

So often it really comes down to who you connect with. So of course, you can see two or three in the area that you're looking for.

It often just comes down to visually what you find most appealing and or how you connect with the owner.

Sometimes someone really wants to nurse owned and run home. You don't necessarily have to have that to thrive in a

The adult family home, the state of Washington says that all adult family homes are overseen by a nurse. So that's comfort for the family to know that there is nurse oversight.

So it really just comes down to what resonates with you and how you connect with the owner.

@13:18 - Judy Gratton 

So downsizing in and of itself can be very emotional, but when you start talking about taking you, either your personal self or your parents or even your children if they're disabled and putting them into an adult family care home, that's really emotional.

How do you deal with that? Do you help these people with those sorts of things?

@13:44 - Erin Kershaw

A little bit. Generally, sometimes the phone call will come from someone who is already in their own home and they are trying to decide, are they going to stay home with home care?

Do they need to make a move? Are they just getting information? And often it happens that there's an event and the person is hospitalized, so they really

She goes from the hospital to either assisted living, adult family home memory care. And that can be tough because that means there maybe wasn't a lot of conversation that was had prior to this.

And this does happen all the time that someone says that they need help because their loved one is in the hospital and they were fine.

They were driving last week. They just went on vacation. They go to water aerobics, whatever it is. So truthfully, a lot of times these situations come out of nowhere and the family hasn't had much time to really prepare.

What I do say is really when someone is in their 60s, it's time to start having this conversation of where are the important papers?

What is the expectation? Do they have the finances to stay home with a care provider? Would it work to sell the home and maybe move to a ramblur where there's no stairs?

And they also could stay home with care providers. Is it better financially based on what the person has? I think it's good just to at least start the conversation and tell your loved one.

You know, maybe don't make any promises as to where they're going to go because again, it's not when size fits all.

You don't know when someone's in their 60s when they're perfectly healthy. Really what's going to be the perfect fit when they're 80 something.

But I always say promise you will make the best decision at the time based on the level of care they need.

So I do encourage families to really start getting rid of a lot of personal possessions that maybe they're not using anymore because it happens again all the time that these situations come out of nowhere.

And then I know you hear it too. You have this large home that was purchased years ago that has a ton of stuff in it.

It's sentimental. No one's wanted to get rid of it. Or no one wants it anymore. you know, it used to be an honor to get your mother-in-law's child.

I think really being proactive and the preemptive strike when we're younger, just knowing this is down the road for most of us.

So start organizing and donating. And you know, you plan to give it, leave it to someone in your will for heaven's sakes.

you're not using it now, just let them have it. It really makes less stress for the adult children and everyone else when they're emotionally, Saddled with picking a place or hiring care and trying to figure out what to do with the home and getting stuff out of the home.

I mean, it's just so overwhelming to do all of that at once. advice is to start this process in your 60s or at least the conversation.

@16:48 - Judy Gratton 3

Very good.

@16:50 - Dennis Day 

Great advice. I wish we had followed that ourselves. My family, Erin, you were a great help. I wish we had And really.

So this ahead of time because it really came down to a lot of last minute by the CD ER fans decisions that you hoped would turn out.

Aaron, how do you, you mentioned not every home healthcare situation. it is alike. How do you separate the quality places from those that you don't want your clients to go to?

@17:27 - Erin Kershaw

That's a great question. So in visiting them, you definitely get to see what they look like inside. So, you know, for whatever reason the setting has changed or fallen into disrepair, that's something to keep in mind.

All of these places have random inspections by the state. it used to be on an annual basis, but COVID kind of put everything behind schedule.

assisted living, memory care adult family homes, they're all subject to random inspection by the state. And certainly the families are welcome to to read them.

Now, I do feel sometimes, I do try to help the family kind of interpret those. So if a place is repeatedly cited for poor care, that's something to be concerned about.

If they forget to update a care plan, accidentally leave body lotion on the counter, forget to pay a state licensing fee, those I think we can look beyond that.

No one's perfect. But if a place is repeatedly cited for poor care, that is something to consider. And the family can certainly, whether again, as assisted living, memory care, adult family home, they can ask for a copy of the most recent inspection.

I typically do provide those when I'm working with the family so they can see. And again, also just, I often say don't judge a book by its cover.

So people will often Google and look at a picture of the house. Well, we love Google. But sometimes the picture that comes up of whatever plays.

It's old and it's not a representation of what it really looks like.

@19:04 - Judy Gratton 32052

We're definitely as an representation of the care being provided inside. If a family knows that they have a loved one, I know someone right now who's going through this and her mother has early dementia and now her father has been diagnosed with cancer and she's trying to deal that the father was taking care of the mother and the mother, she's doing things like driving, which are probably not a really good idea and it appears may not really want the help.

What do you do in this situation like that? do you suggest?

@19:43 - Erin Kershaw

Yeah, that is such a great question and in all honesty, it really is a challenge because we're never really told that we might have to parent our parent and that's what it comes down to is having that tough conversation about are you really safe to

I know you're used to running your own home, but now it seems like you're kind of losing steam and you should have some help.

I think starting the conversation early, depending, mean, sometimes with people with dementia, adult children have sold it, I'm getting an assistant for you.

So they don't say it's a caregiver. They say it's an assistant who's going to come and help you with your calendar.

know you're so busy mom and you like to go to all these things or help you with certain things.

So sometimes just changing the language can help. But in all honesty, sometimes I tell people we're unfortunately just going to have to wait for an event because you can't if people are of sound mind, they can choose to make a bad decision or no decision.

So I do encourage the adult children to really pay attention to is the house not being kept up anymore.

The food not being taken out of the refrigerator and thrown away if it's old bills. Being paid several times or not paid, just really watching the store, so to speak.

So they can have these conversations and at least be aware that their parents might need some help. Because again, sometimes they just refuse to have it.

They think they're fine. They're used to managing their own life. And then it literally comes down to an illness or an injury and we're in the hospital and I get a call and something needs to be done quickly.

But again, I think having that conversation very early on and including all the siblings and that's hard, right? Everyone has a very different view of their parents, what their needs are and finances are a huge part of that.

You know what they feel they might inherit and do they want to spend any of that on their parents care?

How they feel about big assisted living as opposed to small adult family homes. It's really good to kind of work through these issues before you have a social worker staring at his or her watch in the hospital.

@22:00 - Judy Gratton 

Mom or dad needs to leave and y'all are fighting in the hall.

@22:04 - Erin Kershaw

Not to say that that happened with the day family because it did not.

@22:10 - Dennis Day 

There was a lot fighting in the. And I would say my advice is listen to the caregivers. That's one thing we did not do.

Because my parents insisted they had to be together. And after 10 days, it all fell apart and they were in separate places.

Listen to your caregivers. They they have that. Birds eye view and it's not so emotional and they usually know better.

@22:46 - Erin Kershaw

So that's the great point. So when we do have care providers in people's homes, we have two care coordinators that really oversee how the client is doing and talk frequently with the caregivers and they often.

We'll say, you know, whether it's a couple, whether they're in assisted living or at home, what the needs are.

And I think that is just the challenge sometimes is just because you're the same age or in the same age group, it doesn't mean you're going to age the same.

I notice couples tend to age very separately. often have very different health concerns. And it is really hard when you want to keep them married coupled together because really the burden ends up falling on the shoulders of the person that needs more.

So often a choice will be made to go to a place that will cater to the person that doesn't need a lot of care, which is great because they're enjoying it and they can take advantage of those bells and whistles.

But it does mean that that other person that maybe needs that adult family home might be alone behind closed doors and not have as much interaction when they really need a smaller environment.

So that's sometimes just a challenge that can be hard to fix because I understand I'm married. Anyone that's married wants to

Peter these full-time jobs and then having either kids or grandkids that were very involved in raising and being with and sandwiched in there is our parents that are starting to need more attention.

So we're getting more phone calls from them or neighbors seeing something just isn't right. So what I love to see is once someone either has a care provider in place at home or they move somewhere just the adult children really feeling like they have their life back.

And they just get to go back to being a son, a daughter, a niece, nephew, whatever the case may be, because it is really crazy making and stressful to manage your full-time job, your family, your social life, and to always be on the phone managing your parents' health concern.

And I don't think that we realize how stressed out and tired we are in doing so until, again, a care provider comes in or they move to a place where the care is built in.

And then, yeah, they get some phone calls here and there, but it's not the constant unwinding and managing someone else's life.

So I think that tends to be the most rewarding is when I know that the adult kids can go to dinner, they can take a vacation, they can be at work uninterrupted.

They just finally get their life back. And it doesn't mean they don't love mom and dad, but it just means that you just can't continue to manage how it's been going.

I would say those are the big success stories.

@26:04 - Judy Gratton 32052

Those are the big success When it finally happens. Good. So in your experience, what advice or tips can you offer to listeners who might be considering downsizing for themselves or the loved ones in the near future?

@26:19 - Erin Kershaw

You know, so I think it's really important going back to that early conversation and actually speaking, whether it's like a elder law attorney, wealth manager, it's important to know where all where everything is.

Important paperwork. It's lost. And if you have dementia, you might put it somewhere where no one's going to find it.

And then again, you're trying to get in touch with someone to sell your home, sell your parents home and you don't know where important papers are.

So I think it's really important and really important to be organized early on about what will people have What Who is the power of attorney?

Where is the paperwork? What does everyone have? Is mom and dad's monthly income, the investments, et cetera. And again, just have the conversation with your mom and dad almost like a what if.

Like what if this happens? What is your preference? To the extent I can honor your wishes, what's your preference?

you want to stay home with care providers? certainly we can provide those resources. So where's all the paperwork to help us do that?

Do you want to move out of this lovely home with 7 million stairs into a rambler? Because Dennis or Judy could help you do that.

And then again, you could stay home with caregivers. But let's do this now, you know, before it's a crisis.

So I think the advice I would give is let's just have this conversation because it's just none of this is talked about in high school or college or trade schools.

And it's a reality for all of us. If you don't suddenly pass away, you will get older and you will need help.

And the best thing you can do is have these conversations before there's a crisis or an illness at all.

And make sure you're organized. And again, the other thing I would say if you're not using it, if you haven't used it in a year, give it away, let the miracle start with you.

Because again, it's so overwhelming for, and I know you've seen it, you walk in and you think, oh my gosh, we will never clear this house out.

So I think it's important to just bless those that don't have as much donated, give it away, if you want to give it to a family member, do it ahead of time.

Just be proactive and have these conversations before it's a crisis.

@28:34 - Judy Gratton

I know a lot of people, I mean, this is like the thing that nobody wants to talk about. Oh gosh, no.

Especially the mom and dad. They don't want to talk about this. They don't want to consider that. And we run into that a lot.

And then you have the emergency situations like you're referring to.

@28:54 - Erin Kershaw

I do say that stubbornitis is the most deadly disease. So people will. Say, gosh, when someone calls you, what's the most common thing?

And aside from falls, which are incredibly common, it is stubbornitis. It is that 96-year-old that is digging his or her heels in, and they will not allow a care provider in.

They are not moving. They are not doing anything yet. are falling. Adult protective services has been involved. They are frequent fliers at the hospital.

And sometimes you just can't solve that. That might just be a personality trait. But again, I think if the conversation starts when it isn't a crisis, it just kind of will take a light moment at a family dinner and kind of talk about this and get this settled.

It goes over better because I don't think anyone really wants to talk about being diminished or not being able to conduct their life as they have.

The generation that we're really caring for is a very frugal generation. of them were the depression era where 50 people had to tell you that your washing machine did

And work before you got a new one. Now Apple comes out with a new iPhone and we have it ordered really not long after we got the last one.

And they're used to often having multi generations in the house. So we are excited about assisted living, right? you said, you want to move in there.

There's a ton of stuff going on in lectures and they go places, they see the tulips, they go to plays like sign us up.

The generation that we're working with now often is incredibly financially frugal and very money. So division of roles. was the man that was the provider and fix things around the house and the woman kept the social calendar and watched the kids.

So she's not used to making big decisions without consulting her husband will now what if he has dementia and she's used to consulting him and we're not going to get anywhere with that.

So some problems I think we just really can't solve, but at least if we can be proactive and know that we could do some research or speak to someone like you guys or myself just to get the conversation.

@31:18 - Dennis Day (

So, seniors, if you have children and you love those children, you'll have these conversations, and you'll at least try to prepare for this because it is a huge, huge task burden and being prepared is so much easier than doing it after the panic.

@31:42 - Erin Kershaw

Exactly.

@31:46 - Dennis Day (John L Scott Real Estate)

Erin, anything else you'd like to add?

@31:49 - Erin Kershaw

No, you've been really thorough and like I said, I think it's just a matter of having a conversation and knowing that these resources are out there and it's okay to call in.

And I'll just not know what you need or just want to establish a relationship. Same with you guys. have kind of a coming soon.

Maybe the house will list soon or just what steps will I need to take if I want to downsize and have my parents move into a rambler so they can stay together and have a care provider come in or okay maybe that financially isn't sustainable.

So then what other options are there. So no, you've been really thorough. It just is one of those hard things in life.

No one likes to talk about but everyone will have to talk about.

@32:35 - Dennis Day 

Erin, one last question was compared to say a senior care facility with a small group and someone coming to your home.

Is there a great difference in cost in those?

@32:50 - Erin Kershaw

Yeah, so rates for and it can change but rates for home care started around $40 an hour so that's having a caregiver come in and

I always recommend working with an agency. It is. I know it's nice to have maybe a sweet lady from Church or Book Club or the neighborhood or a young person come in and help.

sometimes that works. Sometimes all they need to do is go grocery shopping for you and put stuff away so that can work.

But if you really do need care in the home rates, do start at around $40 an hour. And you certainly want to work with an agency that has professional liability and workers' comp insurance.

And if the care provider can't come for whatever reason, they can sub someone else. And then for assisted living, slash adult family home, generally rates start around $8,000 a month and can go up based on level of care.

So again, the financial piece plays a big part in it because just like when you folks work with someone purchasing a home, you don't want to take someone down a financial road that is not sustainable.

You want to know exactly what their down payment can be, what their monthly payment can be. You never want to see someone have to leave.

The home because they couldn't afford it. And I'm the same way. So that's why I really like to know what's the big number?

What is the amount that your parent or parent has? And can they go the distance? Will they ever need Medicaid?

And if so, then maybe the conversation is at some point to go to an adult family home that accepts Medicaid.

If finances are an issue, well, then really all options are on the table. You can stay home with a caregiver, to assisted living if they can meet your care needs, or certainly choose an adult family.

@34:32 - Dennis Day 

Thank you so much, Erin. Do you have any last words?

@34:37 - Judy Gratton 

No, I think you've covered it. I encourage people to really pay attention to what she said.

@34:43 - Dennis Day 

Yeah.

@34:44 - Erin Kershaw

Yeah. feel free to give my number up. Like I said, it's, you know, no obligation to call in. Just kind of tell me what's going on.

And I can always point people in the right direction.

@34:53 - Judy Gratton 

I'm happy to do that.

@34:55 - Dennis Day 

Well, that comes up to good.

@34:56 - Erin Kershaw

How much do you charge? So my service is free. Just to talk to you or if I need to help find an assisted living memory care adult family home, that's free.

You will only end up, of course, paying the adult family home for their care or a care provider to come in the house and provide care.

But it doesn't cost anything to call me and just let me know what's going on and I'm happy to point you in the direction that's going to work for you.

@35:22 - Dennis Day 

Okay. Thanks so much.

@35:25 - Erin Kershaw

Well, thank you for having me.

@35:26 - Judy Gratton 

Thank you so much for being here.

@35:31 - Dennis Day 

And that's it for episode 23. Can you believe that, Judy? mean, almost a year. So thanks for joining us.

I hope you have valuable information. We'll put Erin's information in the transcript and make that available so that if you want to give Erin a call, she is a guardian angel and she will help your family.

Thanks so much.

@36:01 - Erin Kershaw

Well, thank you. I've enjoyed being here.

@36:03 - Dennis Day 

Thank you. All right. Bye bye.