Guide to Retirement Living and Continuing Care

The concept of retirement and senior living is not what it once was.



Vibrant communities providing a fulfilling lifestyle have created a welcoming, attentive atmosphere tailored for individuals’ needs. And yet, preparing for a phase of life that involves so much of the unknown can feel overwhelming. As parents, loved ones and partners begin to age, it becomes increasingly important to have a plan in place to provide for their medical, social and cultural needs.

The time to investigate senior living options is now.

We spoke with a number of senior living executives from around the state to learn more about how to approach the topic, what to look for, what to expect and how best to prepare.

Our panel of experts:


STARTING THE PROCESS

How can people know if moving to a senior community is right for them or a family member?

Paul Charlton, Taylor Community: “Knowing that a community is right for you has more to do with how you feel about it as opposed to what you think. Clearly, in doing your homework and visiting and learning about different communities, you need to gather the facts — how much does it cost, what do the floor plans look like, what services and amenities are offered, etc. But at the end of the day you need to get a good sense of what it will feel like living there. Narrow your search down to two or three communities and then spend as much time as possible there speaking to as many staff and residents as you can.”

John Parolin: “If you have started to wonder and had a conversation with family about what your next steps would be when you no longer wish to mow the lawn, remove the snow or paint the house, then you also have more than likely begun to consider the benefits of moving to a retirement community. If you have been a planner all your life, continuing to plan for your future doesn’t stop at retirement. A life plan community is a perfect solution for a worry-free and long retirement.”

Karen Johnson: “You’ll know when you begin to see changes in an individual’s ability to live independently, or decision-making in general is becoming overwhelming.”

Brittany Talbot: “This is such a difficult time for anyone going through this process. Often there are signs: The house may not be as clean as it may normally be, your loved one may be wearing the same clothes over and over again, forgetting to take medication, food in refrigerator may be spoiled or not eaten, not reading the newspaper, possible skin tears from falls, forgetting doctor’s appointments, birthdays and I think the biggest one is isolating themselves. Senior living communities offer solutions to all of these concerns.”

Heidi Morrison: “At The Arbors of Bedford, we understand the search for senior living can be confusing. You probably know some things you should watch for and a few important things to ask questions about when you visit: How clean is the community? Is the physical plant well-cared for? Do residents seem happy? What types of services are offered and at what price? Each of these helps you form a basic opinion about the senior living communities you visit. However, since you likely haven’t been through this process before, you might not know what else to ask.”

How can you start the conversation with a loved one who may benefit from transitioning to a senior community?

Cathleen Toomey: “If you’re asking that question, congratulations — you are already halfway there. The most important factor is to start the conversation as early as possible. If you wait until a crisis, then your options are much more limited. It is also easier to contemplate a move when you can outline all the reasons why life is easier and you have more time to enjoy and meet people, as compared to making a need-based decision.”

Karen Johnson: “Most importantly, listen when your loved one makes a statement about themselves (even if you disagree with what they’ve said) or a situation. Ask them to tell you more.”

How does someone decide what type of senior living arrangement is best for them or a family member?

Paul Charlton, Taylor Community: “I think only through exploring the different options and by visiting and talking with the people who live and work there can you confidently decide which community is right for you. And I don’t think you can overdo this. After you’ve narrowed your search down to a select few, visit multiple times and speak with residents and staff members beyond those in sales and marketing. Nobody can paint a more accurate and complete picture of what it is like living there than those who are already residents.”

Cathleen Toomey: “Ideally, the person making the move is the one who should make the decision. My best advice to family members is to put the decision in their hands early by starting the conversation now. If you are a parent, take the first step and bring it up with your family before your kids have to make the decision down the road. Take a look at a number of different communities — compare pricing and contracts. Not all communities are the same.”

Karen Johnson: “Visit various facilities and communities. Meet the residents. Talk with the marketing director to find out what population(s) are served in that particular community.”

Brittany Talbot: “There are so many options out there that the best way to know what is best is to visit a few different places. Ask each place what sets them apart from other communities. The community needs to feel homey and a place where you feel comfortable. Make sure you get to meet some of associates and residents during a visit. This will tell you a lot about the community. It seems overwhelming at first but what truly makes you decide is how you feel when you walk into a community.”

Ellen Quinn: “All senior communities are different. You will want to call the communities in your area, and ask for a tour so you can see what the apartments and the community spaces look like. Our communities offer an open house tour every Wednesday at 12:30 p.m. The brochure packets are helpful, but experiencing the community gives you so much more.”


DETAILS TO CONSIDER

What questions should families ask/what should someone look for when visiting a senior living community?

Cathleen Toomey: “Ask about everything. This is one of the biggest decisions of your life and you have the right to ask about every detail. Marketing materials for communities can look similar, but the offerings can differ greatly. Meet with the community’s CFO and ask questions about contracts and copies of past financial statements to see the community’s financial track record. Meet the residents, separately from the marketing team, and see if you can envision yourself there. Have a meal, stay overnight, and get a feel for what the community is like before you make your decision. We’ve created a workbook titled “The Insider’s Guide to Choosing a Continuing Care Retirement Community” as a way to help seniors assess the risks and rewards of different communities. It can be found at RiverWoodsRC.org/RESOURCES.”

Timothy Martin: “What is the ownership of the community (is it a nonprofit) how long has the organization been in business, can the applicant look at financial information and what are the occupancy rates?”

Karen Johnson: “Ask about the longevity of facility and staff, activities, living arrangements, cost, size of facility and available health care services as an individual’s needs change or decline.”

Brittany Talbot: “When a family tours assisted living communities, the first impressions is often the most lasting impression. When entering into a community it should feel like home — welcoming and friendly. Watching how associates interact with each other as well as residents is crucial — do they appear happy? Do they stop and say hello when you are touring? Look at the residents — are they engaged? Are the activities something that your loved one may enjoy? Are they well groomed? Do the meals and/or menu look appealing? Ask about outings, levels of care, special diets, and about when would one have to move to a nursing home, do they provide end of life care, diabetic care or offer medication assistance.”

Ellen Quinn: “Does it offer the amenities that support your living independently? Does it have beautiful and comfortable communal areas, lounges, library, dining room, etc.? Ask yourself, does it encourage gatherings and fun times by the residents?  Are you going to be driving? Does the community offer access to buses for grocery shopping and getting out into the larger community? Ask yourself, ‘what if I don’t want to cook all the time?’ What options for meals does the community offer?”

Heidi Morrison: “Questions about the programs that make a real difference in the resident experience are not as obvious. But these are important factors that can help you determine how well a senior living community cares for its residents, and for the team members who care for those residents. Or questions about how an organization sets its goals and holds itself accountable for quality. And the role industry experience plays in continuously monitoring, measuring and improving the quality of care.

Our residents and their families choose us because they have confidence in our experience. After all, we’ve been caring for seniors for 20 years now.

What are most people concerned about when they first move to a senior living community, and how do you address that concern?

Paul Charlton: “I hear prospective residents sometimes questioning whether they will fit in, or they’re concerned they may have difficulty meeting people and forming new friendships. Ask staff members whether there is anything in place to help new residents become oriented, get involved and feel welcomed. And don’t limit your questions to those in sales and marketing. Talk to staff in activities or resident life, care management, health services and other departments. Combined they should be able to provide a good picture of what to expect when you move in.”

Cathleen Toomey: “Initially, people are concerned about downsizing, and how they can manage to bring their most treasured possessions with them, and many communities offer professional downsizing help to make packing easier. Once they move in, the next concern is how to meet others. At RiverWoods, we have an extensive welcoming process, where RiverWoods residents and staff connect with the new resident and ensure they get to meet other people.”

Timothy Martin: “People are often concerned with how long can they stay, what happens when their needs increase and can they afford it.”

Brittany Talbot: “Most residents are concerned about not knowing where to go and not knowing anyone. We champion the move-in process. The department head team meets with the new resident to explain what he/she is responsible for in the community and one department head will have a meal with the resident for the first three days. This helps with introducing our new resident to other residents as well as escorting and inviting them to meals and social gatherings. We also have a welcoming committee that will help orient the new resident into the community.”

John Parolin: “When contemplating a move to a life plan community or any senior living opportunity, there is a natural anxiety about the process that can seem overwhelming. Our communities can connect future residents with professionals who can assist with ways to downsize. There are guides with step-by-step tips on how to accomplish this. Remember, it’s easier to think about a journey of 1,000 miles if you simply begin with a single step. Pick a closet, start there and then move on to the next. The sale of the family home is an emotional transaction. There are real estate and moving professionals who will work closely with you to help with the sale of your home and the move that follows. Keep in mind that your memories, photos and the other items that made your house a home will accompany you. It’s amazing how quickly your new residence will become your new home.”


MAKING ARRANGEMENTS

What is the timeline for planning senior living? When should I start?

Karen Johnson: “Sooner than you’d think! Senior living involves both financial planning and medical care. Try to be objective and consider future care needs. Don’t wait for a crisis before planning a move.”

Paul Charlton, Taylor Community: “In my experience, no one ever starts too soon but many who move into a community will say things like, ‘We should have done this years ago.’ Unfortunately, many have this perception that you move to a retirement community because you have to. The reality is that you move because you get to. Just because you’re capable of shoveling snow or taking care of your home maintenance, doesn’t mean that’s what you want to spend your time doing. And those who move in at a younger age are really able to take full advantage of all that the community has to offer.”

Cathleen Toomey: “Start now. Do a cost comparison of what your expenses are now and what they would be in a community. Many communities will provide these worksheets for you. With a growing number of baby boomers moving into communities, waiting lists can as long as 5-10 years. Don’t be afraid to get on a waiting list. If a community has a refundable wait-list deposit, you can always say ‘no, thank you’ when your name comes up, and you may even be able to get back your deposit.”

Timothy Martin: “The average age on entry, nationally, is 81. Planning should start as early as possible so they are able to make the move when they are healthy and not in a crisis or an emergency situation when they hear they cannot go home.”

Brittany Talbot: “Starting the search early is the best advice I can give. I find that many times seniors find themselves searching for a community when they are in a midst of a crisis. Touring communities and educating yourself will allow you choices and to ensure you have found the community that suits your needs.”

John Parolin: “Planning for a move to a life plan community needs to begin long before you have decided it’s time to take that step. There are two components that play into a move to any life plan community. Financially, planning begins well before retirement. Study after study warns that current saving trends among boomers may not result in the accumulation of assets that will allow a lifestyle comparable to that which many are accustomed to. Enrollment in a 401k, 403b, IRA and other systematic investments will all play a part in the planning for an eventual move to a community. For many, reliance on Social Security and home equity alone will not suffice. One must also be in good health and able to live independently. There is a focus on life enrichment and wellness programs in our communities that serves as a continuation of the pre-retirement independent lifestyles enjoyed by our residents.”

What’s your No. 1 tip about the moving process?

Lynda Brislin: “Seniors are sometimes under the impression that all communities are the same and that they offer the same levels of care, the same standards or the same accommodations. This is most definitely untrue. They’re sometimes afraid that they will lose their freedom or independence, and that remaining in their home is the best place to live as you age. In actuality, it is the environment which provides safety, more freedom and convenience along with more care and certainly less stress or worry than perhaps staying alone in your home can provide. Another misconception is that you will lose connections with family or friends. The reality is that families and friends visit more frequently, and those visits are more enjoyable as they’re not providing care that was needed before moving into a community.”

Karen Johnson: “Be ready to simplify. Bring a few favorite items, but be willing to see the possibilities in having a brand new home.”

Paul Charlton: “Take advantage of help that is available. Moving is a lot of work and can be physically and emotionally draining. Most will work through it on their own, and yet services are available that can make the whole process from start to finish so much easier. Look into so-called senior move managers in your area. We connect many people moving to Taylor with a local outfit and the rave reviews would have you thinking these ladies are saints and their fees are very reasonable.”

Cathleen Toomey: “The most important key to success is to downsize. Downsize now, downsize often. We all accumulate more than we need, and this is a challenging and emotional process. Involve your children — ask what things of yours they might like. Start gifting your things at the holidays instead of buying new items. Your children will be honest with you and you may be surprised at what they don’t want.”

Timothy Martin: “Being realistic about how much space they will need, and being able to let go of things that they no longer need when they are downsizing.”

When should someone consider a life plan community/CCRC (continuing care retirement community)?

Paul Charlton: “Before you need to.”

John Parolin: “When you begin your search for a life plan community you should consider the history and culture of a community. Is it an active community? Are there wellness programs in place to keep you at the top of your game? Visit and experience what may become your new home. You should enjoy the dining experience, speak with residents and ask for the community program calendar. In addition, the financial stability of any community should be an important part of your research. Ask to review the audited financial statements of each one you visit. You will know by appearance the level of pride a community takes in its physical plant. View apartment homes and cottages and most of all, ask questions.”

Cathleen Toomey: “Don’t wait too long. We’ve seen that happen far too many times. You want to move into a CCRC when you are active and able to live a happy, healthy and independent life. If you wait until you need assisted living or skilled nursing, you won’t qualify for a CCRC, as you need to be independent in order to move in. You may never need to move into assisted living or skilled nursing, but you will have the peace of mind that health care is available if and when you need it.”


LIFESTYLE

What activities can residents expect to take part in?

Karen Johnson: “Music entertainment, art classes, outings (scenic rides, lunches, cook-outs, shopping), book clubs, discussion groups, games, special holiday events and the opportunity to meet new people.”

Paul Charlton: “Many CCRCs offer an extensive and diverse selection of activities, and while many residents will participate in a variety of things, others may choose to forgo most or all and choose to lead a more solitary life. It’s important to choose a community that doesn’t take a ‘one size fits all’ approach. What matters most is not what is available to all residents, but what is offered that fits your wants and interests. Perhaps you’re not inclined to join in fitness or aquatics classes but music and aquatics are important and appealing to you.”

Cathleen Toomey: “You name it. As far as activities go, expect the unexpected. It’s not often that one is able to say that phrase in a positive way, but when it comes to pursuing your passions, the sky is the limit at a CCRC. You can expect educational programs, fitness classes, access to cultural programs — at RiverWoods we have more than 60 different committees, all organized by residents passionate about a full range of issues from the environment to education to politics to the arts.”


MEMORY CARE

How do you begin to address senior care with someone who may have been diagnosed with Alzheimer’s Disease or dementia?

Karen Johnson: “Be objective about their changing needs, including the need for socialization. Talk with family about what can realistically be provided by yourself and others, and what changes will take place as your loved one requires more and more care.

“We strive to offer the highest level of independence, combined with safety and comfort, for each of our residents. All our memory care and assisted living apartments are private, unlike many other facilities that offer only shared living apartments.”

Lynda Brislin: “Millstone Inn is a smaller, personal wing — within the same overall community — separated by a keypad code that prevents wandering of those who may have this symptom as part of their dementia. It is a specially designed, lovely and secure unit with an outdoor enclosed courtyard as well as a large, bright three-season sunroom. The goal of our Millstone Inn is twofold — to provide a sense of security and belonging through specially trained staff, within surroundings which look and feel like home, and to add quality of life through a daily routine that incorporates music, laughter, smiles and exercise along with conversation, creativity and reflection.”

Cathleen Toomey: “RiverWoods has a person-centered care approach, so we work with each person individually to design a plan that works with them. All our caregivers are ALZessential certified, and have extensive experience working with people who have Alzheimer’s disease or dementia.”

Timothy Martin: “Research, research and more investigation as to how the community defines the disease. For example: Does the person wander and what are their individual needs? Clinical information is critical for the provider in terms of knowing whether or not they can actually meet the needs of the prospective resident.”

Heidi Morrison: “The Arbors of Bedford is dedicated exclusively to serve the needs of individuals with memory loss. We are a leading provider in memory care here in New Hampshire. Every sight, sound, taste, feeling, experience and service at The Arbors is designed to help those with memory impairments. These include comfortable lighting and cues and a dignified dining experience, among other elements. We offer Treasure Chests, Journey Stations and Parallel Programming and around-the-clock care with packages based on the very individual needs of each resident. Management is on site seven days a week to assist with immediate needs, and our innovative programming provides choice and promotes independence.”

What can family members do to help someone more easily transition into a memory care unit?

Karen Johnson: “Rely on the power of human connection and relationship through hugs, smiles and encouragement.”

Paul Charlton: “Once someone makes the move, it is helpful for family to stay away for a week or more to allow their loved one to settle in to their new environment, and to learn to trust their new caregivers. If staff asks you to wait awhile before visiting, trust that they are not asking to keep you away or for their own convenience — they are trying to do what is best to ease the transition for your loved one.”

Cathleen Toomey: “The most support that family members can provide is to visit their parents or loved one, understand the care plan and support their progress as it is designed by their care team.”

Timothy Martin: “It is hard given the resident’s ability to understand the disease they may be struggling with. When there is a need identified too late, the result is that the person in need of the memory unit often, sadly, doesn’t fully understand what’s happening. The issue often is the family’s recognition and acceptance of the condition.”

FEATURED RETIREMENT COMMUNITIES IN NEW HAMPSHIRE

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