When the time comes to move to an assisted living facility there are some questions you must ask. It is a difficult, traumatic and long term decision. You have to make sure that the move is pleasant and right. Below are a set of guidelines/questions that can help in making your decision.
- Is the residence licensed? Is it a good location to family/doctors? Is the entire facility wheel chair accessible? Is the décor attractive and home-like? Is there good natural and artificial lighting?
- do the residents socialize with each other? Do they appear happy and comfortable? Is the facility clean and odor-free?
- does the facility assist with self-administration of medications? What is their policy on medication storage? Do physicians visit patients on the premises?
- Is there 24-hour help available? Is the staff friendly & properly dressed? Does the staff know the residents by name?
- Are units private or shared? What safety features do they have in each apartment? Can residents bring their own furnishings? Is there a kitchen area in the unit?
- Is there an activities program? Is there a wheelchair-accessible van for transportation? Do residents have access to computers and the internet?
- Do they provide three meals daily? Do they provide snacks too? Are there set meal times? Are there special diets available?
- Are the rates all-inclusive or do you have to pay more for higher levels of care? Do they accept the Medicaid Waiver/Diversion programs? If so, is the family/resident expected to contribute financially to help cover the cost of care?
Asking the right questions will help ensure that the decision made is the right one.
I’m not alone when I say that I would like to live long enough to see my grandchildren become young adults, but only if I am in good health. There are many in my generation that feel the same way. Much has been written about the potential longevity of the baby boomer generation and the effects it will have on entitlement programs like social security and Medicare. However, recent studies present a different picture. According to a University of Illinois study baby boomers will not live longer than their parents have despite the healthcare improvements, new drugs and the long 20th century experience of ever-rising life expectations; the culprit – factors like elevated rates of obesity, cancer and suicide.
Another study by Rice University claims that it would be a mistake to project longevity gains of the last century throughout this one. Health status of the baby boom versus the preceding generation reveals that they are in worse shape. There is a higher propensity to suicide particularly for those in their 40’s, a time when those rates typically head down. And then there is the ‘Big C’. The post war generation has a higher rate of cancer at younger ages than the previous generation. Women of this generation are the heaviest smoking cohort in U.S. history and they are now suffering its effects.
Obesity among boomers is linked to rising disability and serious health problems like diabetes and heart disease. However, the true impact on longevity that obesity has cannot be seen until we get older. Socioeconomic factors will also significantly impact longevity. It is a well-known fact that rich people live longer than poor people do. We know that the gap between rich and poor keeps widening in this country and that the impoverishment of individuals keeps creeping up. The most at risk, of course, are Latinos and Blacks who swell the ranks of those living under the poverty level. They will see drastic declines in health status over the years.
The moral of the story is that in order to live longer we must have been blessed with good genes and the absence of major health problems, a socioeconomic position that allowed us to have access to preventive healthcare and live healthier lives, otherwise it makes no sense to live forever.
America is a relatively young country as far as the percentage of individuals 65 years and older in the U.S. today. About 12% of the population in the U.S. is 65 years and older. However, that percentage is projected to increase to 20% within the next decade. Compare those numbers with that of other countries like Japan with the highest percentage of seniors currently at 21.5% of the population. Global aging affects all aspects of our society: work, health care, retirement, services and housing, among others. One of the major challenges is what we call the dependency ratio which means that for every person age 65 years and older there will be fewer than two persons in the workforce and available to care for the older generation. Exceptions are those countries with high birth rates (Mexico, Iceland and Turkey) or in countries like Australia, Canada and New Zealand with high immigration. However, in most countries the dependency ratio will sharply increase from 2020 to 2050. It is becoming more important that we create new ways to care for this aging population that is cost effective and dignified. The U.S. has the highest per capita health care expenditure in the world with a per capita cost per individual of $6,714. Japan, on the other hand, has the lowest health expenditure with a per capita expenditure of $2,581, half of that of the U.S. Most of the expenditure in Japan is paid by the government.
During the Ashoka Summit held this month we were able to discuss with other Fellows challenges facing their countries. Masue Katayama, a Fellow from Japan, has worked for the past twenty years in providing services to the older population in Japan. She came to learn how our firm has been able to change how we care for this older population. We believe that the global financial crisis is pushing us to make due with less and to learn how to use government funding more efficiently. Our firm has a proven track record of being able to service three times as many seniors with the funding the government spends on one. Japan, along with many European countries, has older people and lower health care spending than the U.S. They do this by fixing prices and manipulating prices to keep costs down. Every two years the price of each treatment, test and medication is examined to see if excess profits are leading to overuse and if so the price is cut. This is not done in the U.S. because those who profit from high prices are so powerful. This rationing and price cutting impacts the ability to control chronic illnesses at an early stage. Instead of rationing, Japan should look at ways to improve people’s lives by systematically changing lifestyles through better diets, exercise, medication management and supervision. This is something that Japan and other European countries can learn from the U.S.
Masue and I sat down to establish a collaborative effort that will enable us to learn from each other. She visited one of our affordable assisted living facilities and was impressed with the home atmosphere and the improvement in the physical and cognitive health of our residents. We agreed to formalize this collaboration by her sending a group of her operators to the U.S. for a month to live and learn at one of our facilities. Mia will do the same as we know that there are lessons to be learned from Japan as they tackle the common challenges of global aging.