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ElderCare

AGING AND THE OPTIONS
By Vinton Murray |

At the turn of the century, Americans lived an average of 45 years. In 1935, when Franklin Roosevelt signed the Social Security Act, citizens could look forward to about 62 years. Today, the normal life expectancy is 74 for men and 78 for women, increasing the number of candles on the cake by 69 percent in the last hundred years.

For many people celebrating 60, 70, or 80 years, the thought of living longer than one’s parents or grandparents is exciting. More birthdays mean a fuller life. But with increased longevity comes a downside. Living an extra 10 or 15 years can mean being “old” that much longer. Visions of being alone or sick, and possibly dependent on someone else for life’s necessities, can be depressing. Aging gracefully, and with dignity, becomes more of a challenge than a natural rite of passage.

Although the sadder realities of old age can be tough to swallow, the good news is there are more care facilities than ever before and more attention is being paid to the quality of life in these environments. The dreaded image of the drab and careless “nursing home” is diminishing. There are nearly 200 facilities for seniors in and around Dallas-most of which are listed in a magazine called New Lifestyles: An Area Guide to Senior Residences and Care Options for Dallas.

The range of facilities for senior living is as wide as the list of care givers is long. From “assisted living,” in which a person is helped to perform basic daily functions, to varying levels of nursing care, to specialized Alzheimer units, residents can receive full care within a single community. For those who want a smaller setting or need less service, there are homes, day care centers, and individual facilities that focus on one or more aspects of senior care.

Choosing the right facility is critical and making the best choice requires research and planning. “The most important thing you car do, to meet your needs or those of your loved ones, is to thoroughly investigate all the possibilities and determine what you, or your parents, want. And you should do this while you, and I hey, are healthy,” advises Dr. Kevan Namazi, chair of the Gerontology and Geriatrics Department at HT Southwestern Medical Center. “Family involvement and prior planning are key to success in elder care.” he adds.

“Baby boomers, currently in their 40s and 50s, who are helping their parents plan their later years, face special problems,” says Godwin Dixon, executive director of Signature Pointe on the Lake, the first comprehensive senior facility north of LBJ Freeway. “They want to be as successful and generous at caretaking as their parents were for them. “But.” he cautions, “the parents of the baby boom are the last generation to have been touched deeply by the Great Depression, and the thought of relinquishing both their independence and their savings isn’t easy for them to accept.” Scheduled to open in June, Signature Pointe is the most recent development of the Telesis Co.. which introduced assisted living to Texas in 1980.

Signature Pointe is considered an example of the new breed of facilities for seniors. Architecturally and philosophically sophisticated, the development’s goal is to be the most advanced facility of its kind. Dixon, who traveled 8,000 miles through six states and visited more man 22 facilities before finalizing his ideas for the design of Signature Pointe, says, “It’s a new generation of senior care. Rather than passive care, which often made seniors invalids, we focus on the residents’ participation. We have found that if we. as managers of the facility, are flexible for the individual, we all benefit. It is important that our residents don’t live in a ’facility.” We work in their home.”

“We have designed a retirement community with all the support systems,” says Pat Rainwater, director of admissions at Presbyterian Village North. A nonprofit CCRC (continuing care retirement community), Presbyterian Village North is the only facility in North Texas affiliated with multiple hospitals. The 70-acre complex houses 525 residents, the majority of whom live in houses, duplexes, or apartments. “When people need more assistance or nursing care, it is available and only minutes from their doorsteps.”

“One of the important aspects of our complex is community: if someone in independent or assisted living gets sick and has to go into one of the nursing floors, friends can come see them. It’s a short walk. Those friendships.” Rainwater adds, “are a big part of health and the healing process.”

“A feeling of home makes anybody feel more secure.” says Rainwater. “That is why we’ve designed the new Alzheimer’s building with four ’homes’ instead of traditional, institutional rooms and halls.” Scheduled to open in June, the building will house 56 residents, with 13-14 residents per home. Il will have an adult day care center so those who live with a family member with Alzheimer’s can go to work or simply recharge their batteries. “For the person with Alzheimer’s, activity that stimulates awareness of the world outside of himself is the best possible medicine. We will encourage participation so that everyone at the center will be able to function ai his or her highest potential on any given day.”

Alzheimer’s, identified by Dr. Alois Alzheimer in 1906, is the plague of the elderly. Defined as the loss of intellectual function (thinking, remembering, and reasoning), which becomes so severe that it interferes with an individual’s daily functioning and eventually results in death, it is the fourth leading cause of death in adults behind heart disease, cancer. and stroke.

Recently it was predicted that 14 million people will be affected by the middle of the next century. “We know that for those people who reach 85 years old, 30 to 35 percent of them will suffer some form of dementia,” remaries Dr. Namazi.

For Betty Williams, whose mother died of Alzheimer’s two years ago, caring for others suffering from the illness has become a career. Williams, who serves as director of Heartfield Residence in Lewisville, says, “I chose this because I saw the ravages of the illness on the patient and the family. I wanted to make life better for others.” Heartfield, a five-person home devoted to people with Alzheimer’s and related disorders, opened in December and a second home, also in Lewisville, will open in June for seven residents.

Founded and privately owned by Diana Lee, an entrepreneur in health care from Wichita, Kan., Heartfield currently houses four women and is expecting its fifth resident, a man, sometime later this month. Located in a quiet residential neighborhood, the ranch-style home has no signage in the yard and resembles other houses in the area, with a beautifully manicured yard, a garden, and a gazebo in the back, “It’s important to create a normal home and to accept the Alzheimer’s patient as he or she is. Our goal is to ’habilitate’ them, in other words, make this world their home, radier than insist they adjust to a new and foreign situation,” Williams adds.

To make the new environments homelike, family photographs and shadow boxes with trinkets and mementos of residents’ lives identify each resident’s room at Signature Pointe, and pictures and artwork of all kinds are on the walls of Heartfield. All three facilities encourage the resident to bring their own furniture, quilts, and accessories, particularly ones that may jog a memory.

“We’ve learned that by turning normal life into activities and making a few architectural adjustments, we can help the Alzheimer’s patient help him or herself,’* says Dixon. Innovations like compartmentalized dressers, which can be made smaller to narrow decision-making and line-of-sight bathrooms with easy-to-identify toilets, help the Alzheimer’s patient avoid demeaning accidents.

“Communicating with Alzheimer’s patients presents special challenges,” says Dixon. “You have to get into their reality,” Well-stocked libraries, arts and crafts, day trips, educational programs, and new techniques such as aromatherapy are being introduced.

Most retirement or “independent” living options, which range from free-standing homes and duplexes to garden apartments and smaller studio apartments, begin at $1,500. At Signature Pointe, the apartments in the retirement wing of me facility run from $1,650 to $3,300 a month and include continental breakfast and one other meal a day.

Assisted living ranges from $1,700 to $3.100 a month, and nursing floors range from $3,000 to $6,000 per month, depending on the extent of care. A good rule of thumb, according to Dr. Namazi, is to count on $150 a day. or $4,500 per month.

Presbyterian Village North has a fairly unique payment program called prepaid leasing. If you lease one of the executive homes on the property, which range in size from 1,800 to 2,400 square feet, you pay a one-time fee of $125,000 to $177,000, which guarantees your rent on that home for 10 years. That translates into $ 1,000 to $ 1.500 a month. The money can also be used as a credit source should you need to be moved to another level of care in the facility. After the initial payment, your only charge is a monthly maintenance fee. which currently ranges between $ 1,300 and $ 1.600. At the end of the 10 years, there is no rent applied and you only pay the monthly fee.

To accommodate the growing senior population, area hospitals like Baylor and Medical City, have created special centers that focus on a variety of issues. “For many seniors, finding a primary care physician after they’ve gone on Medicare is difficult. A lot of doctors don’t want to be bothered with all the red tape and extra paperwork,” says Julie Finnan, director of the Senior Health Center at Medical City.

With locations in Dallas and Garland. the senior health facilities operate as outpatient clinics for the hospital and provide seniors with primary care physicians, health education, community events, and clinics on related health issues. “We also refer our patients to other doctors or levels of service they may need but cannot find on their own.” Firman says.

The recently created Baylor Center for Geriatrics will provide similar services, as well as house calls for the homebound elderly and a research program in conjunction with Johns Hopkins University. Referring to a $500.000 grant from the Hillcrest Foundation. Dr. Wilson Weatherford. director of the Baylor Senior Health Network, says. “This funding is the underpinning that lets us begin to do some innovative things for the elderly we wouldn’t be able to do otherwise.”

“The great part of all the new work is that the older person is getting better care than ever before.” says South western’s Dr. Namazi. “In the past, in an average nursing home, a patient did nothing-absolutely nothing for 17 1/2 hours a day. Now that is unacceptable. We are restoring dignity and trust.” With proper research and planning, the latter years of one’s life can be fully enjoyed with dignity and respect.

When selecting a facility for a loved one. Dr. Kevan Namazi, chair of the Gerontology and Geriatrics Services Department at UT Southwestern Medical Center recommends the following steps.

Understand the needs of the elderly person. With professional advice, determine the comprehensive physical and psychological needs of the individual.

Get referrals from doctors, social workers, and friends with parents and relatives in the same situation.

Visit several facilities, preferably ones near family members’ homes. If you can’t get there, don’t leave your loved one there.

After you’ve had an initial, formal tour of the facility, go back unexpectedly at 8 a.m. or 2 p.m. Talk to residents, their families and their guardians about the care. Then continue these “spot checks’’ after admissio

You want a safe and pleasant environment so check the rooms for paint, carpeting, and furniture. If you walk into any facility and smell urine, leave.

‧ Inquire about the staff turnover rate. Continuity in staffing reflects both a good work environment and a sense of community, which will aid in the care of your relative.

‧ Research the costs. Price ranges are wide and varied. Check for hidden and added costs.