Additional Resources Mentioned
Takeaways
Tip 1: Know your goals.
Tip 2: Decide on your preferred geographic location.
Tip 3: Decide on your all in budget.
Tip 4: Understand the care component.
Tip 5: Go on a tour.
Tip 6: Consider using an expert
Full Episode Transcript
Nancy Treaster
You were hoping this day would never come, and yet here you are, trying to choose the right memory care community for your loved one. If you don’t know what to do, you are not alone. In this episode, Sue and I are talking with Kelly Graffius, certified senior advisor and president of OASIS Senior Advisors in Roswell, Georgia, about how families can cut through the noise and choose the right care community with confidence.
We’re sharing six tips.
Sue Ryan
If you’re early in the dementia journey, we realize that for you and your loved one living with dementia, you may start out by evaluating independent or assisted living communities. No matter where you start, it’s likely that you’re going to end up evaluating memory care. And this is our focus today. Our podcast episode number 28 is titled Tips for Considering Home versus Community Living, and it’s a helpful companion to this episode.
Kelly, thank you so much for joining us today. Please share with our listeners more about you, more about your background and what drew you to helping families navigate this decision.
Kelly Graffius
Well, hi, Sue and Nancy. Thank you so much for having me. Yeah, so I spent 25 years in the hospitality industry. And during the last tenure of my time, my dad was diagnosed with Alzheimer’s. He passed away at the age of 72. I had a young family working a full-time job and really trying to be the adult try child, trying to navigate all of the things to support him and my mom. I knew I wanted to do something to help families navigate all the complexities of caring for their aging loved ones.
Sue Ryan
Kelly, thank you so much. We’re so appreciative of you sharing your expertise to help our listeners approach this decision. So let’s get started.
Kelly Graffius
Choosing a memory care community is one of the most emotional and difficult decisions a caregiver will ever make. There’s no perfect option out there and there’s no community that’s going to check every single box. It’s important to understand what we’re trying to accomplish.
Tip number one is know your goals. We start by identifying what are we really trying to accomplish? Are we planning to keep our loved one at home for as long as possible? Do we want to consider a memory care community? Oftentimes it’s important to consider the memory care community, even if our goal is to keep them at home as long as possible. That way we’re not making decisions in a crisis mode.
Where is your loved one on that on their dementia journey? There’s an eligibility component to senior living options, assisted living and memory care. So it’s really important to have these conversations well before they’re needed because we can determine whether or not we’re still within that window of opportunity.
Nancy Treaster
So Kelly, what are some examples of eligibility?
Kelly Graffius
Absolutely. So eligibility for state requirements include ambulation, being able to stand and bear weight, being able to not being bedbound, if you will. So as a person living with dementia, their disease progresses, their physical abilities change. Once we’ve made a decision to move into a community, then they’re kind of grandfathered in and they are often allowed to age in place there. But initially when upon that first move in, they need to physically be able to participate in their own care needs, if you will. And that’s the best way to describe it.
Nancy Treaster
So we gotta be careful we don’t wait too late. Or memory care is not even an option. .
Sue Ryan
Kelly, once you’re clear on your goals, what’s the next most important thing for people to be considering and focusing on?
Kelly Graffius)
Yep. tip number two is to decide on your preferred geographic location. Think about what makes sense for you and your life. If you live in one part of town and work in another, you want to make sure the communities are within that bubble, I often refer to it. If you plan on visiting every day, what is traffic like during that time? Or if you’re planning to visit on a Saturday morning.
Are you willing to go a little bit further? So really think about what makes sense for your life, for your family’s life. Where do you run errands? Where do your children go to school? You know, think about that radius and that and again that bubble.
Sue Ryan
Kelly, that’s a really good point. When we were moving my dad into a continuing care community, as well as my husband Jack, we looked at that radius. How long do we want it to be at the peak of traffic for us to be able to get there? And how far is that?
Nancy Treaster
Location does narrow things down a lot, which is great, but of course there’s a lot more to consider. So what’s next, Kelly?
Kelly Graffius
Tip number three, decide on your all-in budget. When I talk with families, it’s very important to discuss what the all-in budget is, not just for today, but for the future as well.
We also have a three to five percent cost of living increase year over year. So we need to make sure we have that factored in as well. There’s lots of different financial models that we need to consider when we’re considering an all-in budget.
Sue Ryan
Kelly, several things you said I lived through and they’re so incredibly important. One of the first things that you talked about is the different levels of care. One of the things that I was disappointed that I wasn’t f told in a really forthright manner is that I was looking at my husband and my dad at being ambulatory in the care community. So they were bringing the pricing models for that. They were not even asking me to consider what it would be and telling me that it would be a different financial model if they were not ambulatory. So you want to know what the different costs are going to be. And part of the reason is, and this was shocking, when I went through and I’m looking at the agreements, they do not cap increases. So you can’t say, okay, it’s going to be three percent year over year. They don’t cap those. So those are things that you want to make sure you’re really clear with. And the third thing that was incredible for all of the evaluations is that there are no two communities that have the same financial models. They are not there’s not an apples to apples comparison. It was really challenging. This is why one of the things when we talk about bringing in an expert, this is a place where they really, really, really make a difference.
Nancy Treaster
And you know, Sue, I also remember, there was a point in Jack’s journey where you felt like he would be better off with a shared room than a single room. And I’m sure that’s different as well in terms of how much it cost.
Sue Ryan
Absolutely. Nancy, that’s a really good point because I didn’t know about the difference with that. And it wasn’t something in the beginning that I was thinking about. I was thinking about having Jack be in a room by himself. Same thing with my dad is that they would go into a room by themselves. What transitions when they’ve been in there longer is they’re better off in a shared room, not because it’s the financial model completely, but it’s also there’s more social stimulation. There’s more going on.
So it’s really good for multiple reasons, but that’s not necessarily introduced. So having people be able to give you that information is really going to make a difference.
Kelly Graffius
Absolutely. So, you know, some communities offer all inclusive rates versus a room rate plus level of care. You know, we’re looking in our geographic area, we have communities that are priced at $10,000 a month and also that are some that are priced at $5,000 a month. They’re not all, as you said, Sue, you can’t compare apples to apples. So it’s really important to, you know your budget, understand what the long-term plan, financial plan is for this, and then also really temper your expectation. You know, a ten thousand dollar community is not going to have the same look and feel as a five thousand dollar community.
Sue Ryan
And yet a $5,000 community may be a better community for your care receiver than the $10,000 one. So you’ve got to really evaluate it.
Kelly, these are great tips. And while budget and location get us in the door, they really don’t tell us anything about the care once we’re in there.
Kelly Graffius
This leads me to tip four. Understand current and future care competencies. It is not about how pretty a community is. Those marble countertops and that chandelier is not going to come down and help mom go to the bathroom in the middle of the night.
The prettiest and the most expensive community is not necessarily always the best fit. I know you mentioned that earlier, Sue, and that’s really important to reiterate because it’s really about the staff and the executive leadership team and understanding how to be a good care partner for your loved one, working with those staff side by side with them daily. It’s important to understand, the tenure of the community staff, you know, has the executive leadership team been around for 15 years? I truly believe that this is a calling, not a job. So you can see that when you walk into a building, you can feel that. Some really important tips in regards to competencies is what ongoing training does that care staff have? Not only, you know, first on onboarding training, but ongoing training is really important. How do they learn to cope and manage behaviors and keep residents, all of the residents, safe?
The other thing is do we lead and does the community lead a resident-centered program, especially when it comes to medication? You know, managing medication is a big question for families. You know, it’s one thing to be slightly medicated versus being overly medicated. So how does the community manage that medication and what those needs are, particularly around people living with dementia that have some adverse behaviors?
Nancy Treaster
I looked at communities for my in-laws. My father-in-law had Alzheimer’s and my mother-in-law just had mobility challenges. And of course I knew he would land eventually in memory care. And just like you guys are talking about, the community that I found was best for them was a very small community within a reasonable geographic location.
It was not the prettiest. But when I looked at the memory care group of the day staffers that I talked to, I think they had six, four of them had worked in that community for over 15 years. And that just spoke to me. Everybody looked, they just felt like they were there for the residents. So there’s so much more to it. And it was not the most expensive community by far. So as all the things we’re saying, it was smaller, it was less expensive, and yet it felt like the right community for them.
Kelly Graffius
Yeah, I will often say a smaller community may be a better fit than a larger one. It really depends on your loved one’s personality. Even before the diagnosis, are they the life of the party kind of person? Loved engagement, love to be in the center of all the things. If not, then maybe a smaller, more intimate community where there’s some more one-on-one engagement opportunities may be a better fit.
Sometimes people can feel very overwhelmed by a large community and those large group settings. So really knowing what your loved one’s preference and personality plays into it is gonna help you make that decision too.
Sue Ryan
And then you talk about the staffing, Kelly. One of the things that I learned is that in the state of Georgia versus the state of Florida, you’ve got different staffing requirements.
Tell us a little bit about that.
Kelly Graffius
How I view staffing for communities when I explain this to families is think about it as on-demand care versus one-to-one care. Oftentimes families will consider home care where that is that one-to-one care. You have that one care recipient to that one caregiver. In a community setting, it really is on demand care.
So for the state of Georgia, our requirements are one resident to one caregiver to every 10 residents. And so what that means is your loved one is kind of in a queue and they have and they take priority. The care staff takes priority of what the care needs are.
Nancy Treaster
But one thing I’ve told people, and I know Sue this was a big factor for you, particularly with Jack, is because I have people call me all the time. I don’t know what to do with my mother-in-law. You know, should we look at a memory care community? Should we keep her at home? One of the big things is yes, on-demand care, because I think that’s something really important. You have to recognize it’s not going to be the same one-on-one care you have at home. But on the other side, lots of times one on one at home is sitting around watching TV doing nothing with no social stimulation whatsoever. And so there’s the whole advantage on the plus side of getting in the middle of a bunch of other people and activities and just much more engagement. So, you know, something to know when you’re looking at that community.
Kelly Graffius
Absolutely. And then something to consider too is that the ratios often are fluid within our communities, depending on the care needs of the residents. And also something to note is that a lot of times the really good communities have higher care ratios than what the state’s requirements are. So those are really great questions that we will ask the communities when we’re considering them.
Nancy Treaster
So once we understand the care model, I bet it’s time to see it in person. So that feels like maybe we should go on a tour? Tip five, perhaps?
Kelly Graffius
Absolutely. Tip number five, go on a tour and let’s check out all the things. You know, I prep my families often when we’re talking about touring communities. And I often will say, the salespeople are lovely people. They are friendly, they are warm, they are inviting. That’s their job to invite you in and to feel at home. It’s important to, yes, number one, feel at home in those communities on that tour. But it’s when we’re looking beyond the salesperson, we want to get to know who are the players in the building. So once you make that decision, you probably aren’t gonna have a very ongoing relationship with that salesperson anymore. So you really want to meet that executive director, meet that wellness director, meet that memory care director.
Possibly even, you know, meet some staff along the way as we’re touring. It’s really important to be alert during our tour and to look out for some really important key points. You know, is the staff engaging to us? Do they smile and say hello while we’re walking down the hall? Do the residents look clean and well kept and are they engaging with us?
Is the community clean? Does it smell? It seems very simple to say, but it’s really important. Is the building well kept? Something I tell my families is how did it feel? Did you connect with the building? Did you connect with the people in the building? Because that’s going to feel like home for your loved one.
Sue Ryan
Kelly, these are such great tips. And I think this is a good place for us to introduce something, which is a checklist.
One of the things that we’re bringing to all of the listeners is we have now created a checklist for you. And so we’ll have a link to it in the show notes. It’s going to be on our guides page. But we put together a checklist to help you with the questions. Now we are not saying this is every question you want to have, but this will get you started.
It’s also, the checklist is great, but having somebody who already knows what’s going on and they know how to evaluate the different financial models and the different kinds of things to consider is incredibly valuable. In working with this person, which you’ve identified is called a senior care advisor, and I’ve worked with them and highly recommend them as well. Part of what was so valuable is this isn’t a resource for us that we don’t pay for. There’s no financial investment on our part for this very valuable expertise. Would you please share with us, Kelly, what to expect when we’re working with a senior care advisor or some other expert in this process?
Kelly Graffius
So that brings me to tip number six, consider using an expert. So one of the things that you get with an expert, as you mentioned, Sue, our service is at no cost to our families. We walk the journey from beginning to end and truly everything in between with the family. So as you mentioned, you know, oftentimes I will ask questions on a tour that the family may not think of in that moment, just to help prompt that conversation around what’s important to them in conversations we’ve had previously.
But beyond that, an expert is going to have checked state regulations, state filings, their inspection reports. They’re going to know kind of the good, the bad, and the ugly of all of what’s going on in the building. One of the things that we do here with OASIS is we stay very well connected with our families beyond a move.
And that’s for a couple of different reasons. Number one, I genuinely want to know how my our families are doing in the community. you know, we’ve built this very intimate relationship over, you know, either a course of several weeks, several months, or even maybe a year or more. And so I genuinely want to know how they’re doing. I want to make sure that, you know, their experience is everything they had hoped for, and that, you know, all of the things during that sales pitch has been honored for that family.
The other thing is that’s also kind of my ear to the ground on what’s going on in these communities day to day. So it’s really important for me to stay connected with what the real time, real experience is.
I often use the phrase, this is a business of imperfect people caring for imperfect people. And it’s really, really important to kind of keep that in mind and have that as your expectation going into this decision. So, you know, understanding what that means and how communication plays into the ongoing experience of your loved one. things are gonna happen. So how does that community communicate with you? And how do they talk about how they can make it right or what they are going to do in the future to make sure that something doesn’t happen again.
The other thing that I really love to do is oftentimes I will connect families who I have moved into communities with families who are considering that community. I think it’s really important to let them have a voice. And you know, share the good, the bad and the ugly, because they will share all of the things they’re experiencing.
Sue Ryan
We talked about, you know, our role being that of primary caregiver. When we move our loved one into the care community, we shift from being the primary caregiver for all of the responsibilities of their care to becoming the care partner.
We created a podcast episode, it’s podcast episode number 35, and it says how to be a and it’s titled How to Be a Good Care Partner with a Care Community. And these are the things that come after you’ve made your choice. So in addition to this podcast episode, please listen to that podcast episode. Because even though you’re not as responsible for the day-to-day responsibilities, you’re now a supporter, a care partner with those professional caregivers who are providing that day-to-day care.
Kelly Graffius
My perspective is the more involved you are, the better the care your loved one will receive. Setting those expectations early really makes a difference. You know, as Sue mentioned, you’re going from being the primary caregiver to being a care partner. Your job doesn’t end with moving a loved one into a community setting. It just changes.
Sue Ryan
Kelly, you’ve shared so much great wisdom for us today and it’s all so practical. Thank you very, very much. Before we wrap up, please tell our listeners how they can find you and learn more about the work that you do.
Kelly Graffius
Well, thank you so much for the opportunity. It has been a real pleasure chatting with you both. So I can be found through our website, Oasis Senior Advisors Roswell, or I can be reached by phone, text or call at 678-753-8155.
Sue Ryan
And Kelly, we’ll put that information in the show notes for everyone so they’ll have access to it.
Nancy Treaster
Absolutely. Well, let’s summarize.
Thank you, Kelly, so much for helping us navigate this really difficult decision process and giving us great tips on how to find the right memory care community for our loved one.
We shared six tips.
Sue Ryan
Tip number one, know your goals.
Nancy Treaster
Tip number two, decide on your preferred geographic location.
Sue Ryan
Tip number three, decide on your all in budget.
Nancy Treaster
Tip number four, understand the care component.
Sue Ryan
Tip number five, go on a tour.
Nancy Treaster
And tip number six, there was a lot going on in this episode. So hopefully you’ll consider using an expert so that you actually don’t have to figure this all out on your own.
Now, if you have tips on how to select the best memory care community, please leave them on our Facebook page or our Instagram page. The links are in the podcast description, or some people call it the show notes.
For every podcast, there’s a matching blog. So find the number of this podcast. You can go to the blog page on our website, thecaregiversjourney.org, and you can find the blog with the exact same number. That’s effectively a written version of this podcast, or what we say, we’ve taken the show the notes for you.
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Sue Ryan
We’re all on this journey together.
Nancy Treaster
Yes, we are.
