All,

After talking with folks at the assisted living facilities in the spreadsheet I previously sent you, visiting all but one in the local area myself and having the facilities back home send a representative to see Nanny, I think we have the information we need for the final decision.

I talked with Nanny for almost 15 minutes last night, going over with her one more time what she truly desires.

She has seen that she’s not getting many visits from her hometown friends and will continue to get less, possibly leading back to the loneliness she felt at her house.  Her church, which used to be her strongest tie to the community, doesn’t have the appeal it once did.  Thus, with her closest living relatives all begging her to come here, she has decided that the move (with a clear promise to transport her whole deceased body to her hometown for a Christian memorial at the funeral home (and at the church only if we strongly desire so) and burial in the family plot (“all you have to do is add the last date to the stone”)) will satisfy both her and her grand/children’s wishes.

In addition, she expressed her desire not to be in a place that was too busy/confusing with lots of activities.  She wants a quiet, comfortable, but socially-engaging life.

 Thus, here, it appears that two places are best for her, at both an appropriate price point and comfort level – the Multilevel Building and the Single Floor Facility.

The Single Floor Facility, designed on the smaller-is-better concept, has a dining/community area that’s more like a great room in a house (seating all 16 residents) than a restaurant.  Note that it’s locally owned and operated.

The Multilevel Building, on the other hand, like several larger facilities in town, offers many conveniences, including a big dining area that is more of a restaurant than a dining room.  Note that it’s operated by an out-of-town corporation.

If you read this far down in the email, I’ll share with you an observation from a friend of my parents, Linda Bena, who has specialized in geriatric social services for 17 years in Florida.  She highly recommends, especially for a person in her 70s or early 80s, a facility that offers multiple healthcare services (a CCRC or “continuing care retirement community,” as they call it), including independent living, assisted living, skilled nursing, physical therapy and a memory care (Alzheimer’s/dementia) unit.  That way, the person, after making new friends in the facility, can still get convenient visits from these friends in the same facility and enjoy a continuity of “home” life from entry to end-of-life (through hospice care, if desired).

Neither the Multilevel Building nor the Single Floor Facility offers the full suite of CCRC healthcare services that a larger facility like others in town offer.  At the same time, as Linda noted, Nanny, at 93, is much older than the typical person who enters an independent/assisted/skilled nursing facility so a CCRC may not be necessary for her quality of life.

That summarizes the information up to this point.

I still need to figure out the ramifications of moving Nanny from the health insurance plan in her hometown to whatever’s available here because her current health insurance is NOT available locally, which means we’d have to put her on a new Medicare insurance plan by 1 July.

Of course, we’ll get a moving van to transfer personal furniture to the new facility, as well.

My wife will work with her mother to make the final decision.

By the way, the social worker at the physical rehab unit is meeting with the staff for Medicare patient planning later today and will inform me this afternoon if there’s any change in Nanny’s scheduled discharge date – the social worker also has to place orders with the staff doctor on Thursday for Nanny’s transfer to her new home so we need to inform her ASAP tomorrow what the decision is.

Regards,

Rick