Understanding the Durable Power of Attorney

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Durable Power of Attorney for Healthcare and Finances

What happens if you should suddenly have a life-threatening emergency? You are unable to talk and unable to tell the medical professionals what your wishes are. The medical personnel have taken an oath to do everything possible to save you. They may give you medical attention you do not want.

As you look to the future it is important to put safeguards in place to make sure your wishes are carried out through the rest of your life. There are things you can do at any age to put your wishes in writing and designate someone to follow your decisions in case you are unable to do so.

A Durable Power of Attorney for Health Care (DPOA) enables you to designate another person, called the attorney-in-fact (agent), to act on your behalf regarding healthcare issues. It is important you pick an agent who understands what your wishes are, and promises to follow you guidelines. Some people pick family members, others pick a friend. Be sure this person is aware of and agrees to what you are asking them to do. There is a place on the form to designate a second person in case the first one cannot fulfill the responsibility. I feel the second person should be someone younger than you are. I often see DPOAs that list the husband or the wife of the person being admitted to the Sierra View Homes Nursing Care. There are times when that person is too emotionally distraught or unavailable to do the job.

The DPOA not only states who is to be your agent but also states what your wishes are regarding end-of-life issues. Do you want to be kept alive no matter what?

You can state what limitations of treatment you want. Be specific with timelines of treatment procedures and when it is time to discontinue them.

The DPOA can be prepared and is filed away for future use or you can have it be in affect right away. It is important to have this document in your doctor’s office and with the person who will be acting at your agent. Hospitals, nursing homes, assisted living facilities and doctors respect the DPOA for Healthcare.

You can find the form for the DPOA for Healthcare online, in your local nursing homes or you can have a lawyer draft one for you. After you complete the form, two witnesses must watch you sign it. These two witnesses must have no direct interest in how long you live. It should be two friends rather than two family members. Once the signatures are in place the document is legal. If you would prefer, you could have the document signed with a notary. When you use a notary you do not need witnesses. There is a different procedure that must be followed when you are a resident in a nursing home. There is a law that states the DPOA must be completed in the presence of an Ombudsman. The Ombudsman serves as a neutral third party to ensure the resident in the nursing home is making the choices of their own free will.

Durable Power of Attorney for Finances

What happens if you cannot take care of your financial obligations because you have a serious health issue or struggle to understand all the bills? There is a Durable Power of Attorney for Finances to name an attorney-in fact (agent) to act on your behalf. Your agent is given the ability to handle your financial affairs. It is important to state in your document if you want your agent to handle your affairs on an ongoing basis or for a short period of time, immediately, or in the future. You can limit what your agent can do for you. But keep in mind that if you become unable to continue handling your affairs the limitation may cause problems.

It is important you find an agent, who can and wants to handle the task. This person needs to be someone you can trust, who keeps good records and will be around for an extended period of time. Talk to the person you have chosen so that they understand what you expect of them. Be sure they understand what their responsibility will be. The DPOA for finances should be on file where you do business.

At Sierra View Homes Retirement Community, I have seen how difficult it is when the resident has no documentation explaining what his/her end of life wishes are. Often families are emotional or in disagreement with each other when it comes to making difficult but necessary decisions. Residents who have completed a DPOA for Healthcare have already expressed what their wishes are and have designated someone to follow those directions. Some of the guidelines may not be what the family members want but they can follow through knowing this is what my loved one wants.

The fact is, we are all living longer and statistics show that many of us will have some form of disability in the future. I encourage everyone to take steps to ensure your wishes are documented. Talk with someone you trust to determine what your wishes are and who you want to act as your agents. Then get the DPOA for Healthcare completed. Likewise think about your finances and who you would like to help you if you could no longer take care of your own finances. Then get that DPOA done too. Both forms are good until you decide to change them. It gives you peace of mind to have some of those hard decisions determined.

Continuing Care Retirement Communities – Retirement Living, Looking to the Future

Retirement can be an exciting time. It is a time to rediscover the things you enjoy in life. You now have time to branch out and try new things, make new friends, and explore those things you have wanted to learn about. It is time to relax, enjoy life, and become revitalized. Retirement is also the time to look ahead and plan where and how you want to live later in life.

One thing to consider is, do you want to live in a retirement community? If you do, what type of community do you want to be in? Retirement communities come in all types, shapes, and sizes. Some offer a wide variety of services, while others are quite narrow in service offerings. Reedley is fortunate to have two retirement communities and now they are more similar than different. Both have always offered independent living, assisted living, and skilled nursing.

Recently, Sierra View Homes obtained a Continuing Care Retirement Community (CCRC) License. Licensure means the community has proven its financial and organizational viability to the State Department of Social Services. The services that Sierra View Homes will offer are the same, but now the community will receive credit for what it has been doing all along. A continuing care retirement community assures the residents who sign up that there will be a caring place for them for the rest of their life. A CCRC offers a range of services and amenities; all geared to helping the residents stay healthy and independent for as long as possible. The biggest advantage is that the independent residents have access to assisted living and skilled nursing care.

I found that there are different ways retirement communities can be licensed as a CCRC. Most have all care levels; Independent Living, Assisted living, and Skilled Nursing Care all covered by the CCRC license. Sierra View Homes went through a vigorous review because of the independent apartment section of the campus. All of the independent apartments had to be placed in a wholly-owned subsidiary called Sierra View Residences, LLC. Sierra View and Monte Vista Grove in Pasadena are the two communities that have this variance in their CCRC license.

Each continuing care retirement community has a contractual obligation to move residents from the different service levels. Most, but not all, CCRCs have entrance fees. These fees are not uniform. As you look at the different retirement communities, it is very important to ask how much their upfront fee is. Also, ask if the community also offers a reduction in the market rate of their monthly care fees. Sierra View Homes has chosen to have no entry fee at this time.

The number of people living in CCRCs nationwide keeps increasing. Each community offers general services for their residents and also has unique services that create the atmosphere of the community. The availability of programs and activities designed to support each resident’s health and well-being are a big draw. The idea of aging in place, since each CCRC member will be able to use the community’s different levels of care when they need those services, offers peace of mind.

Macular Degeneration

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There is something mystical about sight. Vision is so mechanically complex that we all take our eyesight for granted until something goes wrong. As we age there are numerous ways that our eyesight can be compromised. Many of us are familiar with cataracts and understand what they do to blur vision. Cataracts are one of many possible vision problems as we age. Lately, my attention has been drawn to a number of my friends at Sierra View Homes and family members who have been diagnosed with macular degeneration. I realized I did not know much about the disease and became interested in understanding macular degeneration better. 

In a healthy eye, the eye receives and processes light. The retina takes the light and turns it into signals that the brain interprets as visual images. The macula is part of the retina where the detailed central vision happens. Peripheral vision is the side vision and is the less acute vision and is not affected by macular degeneration. 

People 50 years and older can be affected by Adult Related Macular Degeneration (AMD). AMD happens when the macula part of the retina is slowly destroyed, and represents the leading cause of vision loss in older adults. People who have macular degeneration talk about how blurred the central part of their vision is. AMD affects the central vision of one or both eyes by causing blurred vision and shadows that create blind spots. This causes problems with activities such as driving, sewing and reading. b            

There are two forms of AMD: wet and dry. Either version can cause severe vision loss. The dry form is the most common. It has three stages, early, intermediate and advanced. The dry AMD increases slowly as the light-sensitive cells in the macula gradually break down causing the central vision to blur. There are few symptoms in the early stages so you may not be aware things are changing.  AMD is not painful and if you are not getting regular eye exams you may miss the early symptoms. In the later stages, the blurred vision is the most common symptom. AMD usually does not affect both eyes equally. You can have it in one eye, or it can be in both eyes but in different stages. 

The wet AMD is the advanced form of AMD. People who have the dry AMD are at risk of the disease progressing to the wet AMD. Wet AMD happens when new blood vessels under the macula leak blood and fluid causing the macula to break down quickly. Blood and fluid can cause the macula to swell damaging the retina and create scarring of the retina. Wet AMD causes the central vision to become distorted. Straight lines look wavy and blurred. It can also cause a blind spot that is in the center of your vision. The good news for people with wet AMD is that eye care professionals can delay or even stop the progression of the disease. There are several therapies that could be done. None of them are a cure for AMD. It is important that you work closely with an eye care professional to determine what  is the best therapy for you. 

AMD affects older adults. People who are 50 and older should get regular testing done.  As we age our chances of AMD increases. Caucasians are more likely to get AMD than people of other nationalities. If you smoke you double your chances of AMD and if your grandparents or your parents had AMD you are at higher risk. 

Research is telling us to avoid smoking, exercise, maintain normal blood pressure and cholesterol levels, and eat a healthy diet with an abundance of green leafy vegetables and fish to reduce the impact of AMD. Have regular eye exams and follow your eye care professional’s advice to slow down or stop the progression of the disease. 

In my discussions with people with macular degeneration, I sense the frustration of not being able to do the things that once were so easy. It becomes difficult to sing out of the hymnal in church because the eyes can’t focus to read the print of the song. Using the computer becomes more frustrating because there is not enough contrast to see clear enough to work the different functions. Driving becomes difficult when you need to look all directions and have a spot you can’t see through. The central part of our vision is necessary for so many tasks. It would be easy to become depressed. If someone you know has AMD, it is important to stay supportive and to help the person as they work on rearranging their life style to accommodate the vision changes. There is no cure for AMD but with support those affected by AMD can lead a happy healthy lifestyle.

Train Your Brain

Train Your Brain

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Your brain is like a muscle – don’t use it, you lose it!
The following are online resources for training your brain, and some argue that they can increase your intelligence and functional ability in daily tasks:

  • Luminosity – The recognized leader in online brain training, with 40 million registered users.
  • Cognifit – An online brain training program that also offers a downloadable app for iPhone and iPod.
  • Jungle Memory – Brain training designed specifically for children.
  • Cogmed – This offline brain training program claims to help those with traumatic brain injury or ADHD, and has been implemented in hospitals and over 100 U.S. schools.
The health of your brain has also been linked to diet, exercise, and heart health. Marden’s Place, Sierra View Homes’ Alzheimer’s assisted living wing dedicate to residents with dementia and memory difficulties, makes use of games, diet, and exercise to keep our residents active and using their brains. We also encourage the residents in our independent senior apartments and assisted living to remain active, both physically and mentally.

For more resources and ideas about keeping your brain healthy and avoiding Alzheimer’s, check out the resources at the Alzheimer’s Research Center sponsored by the Alzheimer’s Association.

Do You Own a Pet?

Looks like this kitty enjoyed her visit to Sierra View's nursing care center!

Pets can be good medicine.

Do you own a pet?  Pet lovers are quick to tell you about the immediate joys of pet ownership. At Sierra View, we pride ourselves in our lenient pet policy, which has allowed many independent and assisted living residents to bring their furry loved ones with them. As a result, our campus boasts many non-human residents – from small dogs, cats, birds, and fish to a friendly bunny who hops down the Sierra View hallways on a leash!

A common sight in the halls of The Terraces, Sierra View's independent senior apartment building.

One resident of Sierra View Terraces senior apartments told me she has always had a pet. “When you live on the ranch you must have dogs,” she said. Her small dog lives with her in her Sierra View Terraces apartment, and makes friends with passers-by on daily strolls around the neighborhood. “The companionship is special, and I am so thankful for my dog. He lets me know when someone is walking up to my door, and is a great conversation starter when we meet people on our walks.”

Researchers have been looking at the possibility of health benefits for pet owners.  Studies on the effects of owning and caring for a pet have revealed that pet ownership can bring remarkable results for your health. 

Studies show that pet owners are less likely to suffer from depression. Pet – especially dogs and cats – fulfill the basic human need for touch. They offer unconditional love, attention, and companionship. Caring for a pet can boost your morale and bring pleasure to your days. Pets require regular feeding and exercise so, no matter how depressed, anxious or stressed you are, your pet needs you to care for it. Being needed, and the job of taking care of an animal, can give your life purpose and provide a sense of self-worth. Veteran groups have seen amazing changes in depression with disabled soldiers. Some animals can even sense a person’s mood and purposely try to change it. 

Stroking, holding, cuddling, or otherwise touching a loving animal can have a powerful effect in lowering blood pressure. Touch and movement are two healthy ways to deal with stress. Pets encourage playfulness, laughter, and exercise. Studies show that playing with a pet can elevate levels of serotonin and dopamine, which calm and relax us. Laughing at the antics of a playful pet helps you enjoy life, and adds to your sense of well-being.   

Having a pet can also be heart-healthy. Research shows that heart attack patients who have pets recover more quickly and have longer life spans than non-pet owners. Going for walks with your dog, riding a horse, or chasing a kitten keeps you moving in heart healthy ways. “My dog has to say hello to everyone, and that makes my walks with him take a long time,” mentioned a Sierra View resident. “So I end up getting more exercise!” 

Pets also help us take better care of ourselves. When you have a pet, you have to be there to take care of it. In fact, pet owners over age 65 are less likely to need to visit the doctor with ailments. Pets encourage laughter, playfulness, and exercise. All three boost your immune system and increase your energy. 

A pet does not have to be a cat or a dog. There are many animals to consider. When you decide to get a pet, look at your home environment, your time commitments, how active you are now, and who else lives in your home. Some pets require more time than others, so think about what the pet requires and if that commitment works for you. 

Pets are not for everyone. It is important to weigh the pros and cons when considering a pet. Food, shots and equipment can represent a significant financial investment. Some animals, especially dogs, may need training and ongoing time for walks and outdoor play. The time commitment cannot be shortchanged, so it is necessary to look at the time you can devote to a pet. Additionally, a particular pet’s lifespan and adult size should be considered – for example, some tortoises sold in pet stores can live up to 100 years and grow to weigh hundreds of pounds. 

Throughout our retirement campus, Sierra View Homes Retirement Community has several birds and aquariums for residents to enjoy. Sierra, one of our most popular birds, can often be found on a resident’s shoulder happily taking a break from sitting in her cage.  Recently, three-week-old kittens brought smiles and cuddles to many people in both our Nursing Care Center and Assisted Living. We also have visiting animals, such as a therapy dog that stops by frequently to cheer up anyone who wants a bit of love. 

Owning a pet has many positive attributes. If you (or your parents) are feeling down, stressed out, lonely, or have health issues, consider purchasing a pet. Researchers have found the pet owner feels remarkably better in just a few short months. As we age and our families and friendships change, caring for a pet can give you the lift you need to stay healthy and happy well into the future.

Announcement: Sierra View Homes Applying for CCRC Designation

Vito Genna, Executive Director/CEO

I am happy to announce that Sierra View Homes Retirement Community has begun the process of applying to convert our multi-level retirement community to a Continuing Care Retirement Community (CCRC). A steering committee, as directed by the Strategic Planning Committee and the Sierra View Homes Board of Directors, met with the Continuing Care Contracts Branch of Department of Social Services in Sacramento to discuss this conversion. Lillian Dueck of the Garden Apartments, Joe Halpen of the Terraces, and Bob Mason, Chairman of the Board, were part of this historic meeting. We have contracted with an attorney that specializes in this process and consultants to facilitate the effort that will likely take between three and six months. As progress is being made we will keep you informed.

The reasons to make the conversion are many for both the individual residents and the future of the Sierra View Homes corporation. As you are aware, for the past 50 years Sierra View Homes has grown from its origin of a small one-wing nursing home to a 13-acre campus that provides independent living, assisted living, memory care, skilled nursing, and outpatient services. Certainly the change will make Sierra View a stronger retirement community with additional marketing value and some tax savings. The benefits for the independent residents will include more choice, better access to other service lines as needed, and possible ways to keep monthly fees lower.

It is important to understand that although resident agreements will change and terminology will be slightly different, our basic services and the way we do business will appear to have little change. All residents that are currently living on campus will be given a choice to join the CCRC without any up front costs or they can remain on a month-to-month basis. Future residents will have more choices for discounting their monthly rate if they pay an entry fee. Since specifics will be more clear as we go through the application and approval process, additional explanation will come over time.

The license for our skilled nursing center will remain under the Department of Public Health, and our Assisted Living and Marden’s Place will remain licensed by the Department of Social Services. As we become closer to CCRC approval, each resident will receive an individual letter of explanation. The Board expects that residents will be pleased with the new developments while reinforcing the long-term plans of providing expanded services to our residents. Again, we will keep you abreast of our progress.

Have a great May!

Vito Genna
Executive Director/CEO, Sierra View Homes Retirement Community

Quilters Unite!

“Quilting is the only place where I feel like I’m artistic,” said Joann Kalafut, “I just love fabric!”  Joann, along with two other residents of Sierra View’s independent senior apartments, Agnes Jantz and Edith Allensworth, have joined forces on their second quilting project while living at Sierra View.  These three ladies enjoy the friendship and conversation hand-quilting promotes and agree that quilters are people who are pleasant to be around. Edith said, “A quilt is a cherished possession,” and each of these ladies have made and given quilts to family members and close friends.  “A quilt is something that needs to be shared” said Agnes as she recalled a quilt she made for her grandson when he was 6 years old. “He took it with him to college.”  Joann remarked, “Unlike cooking which is consumed, and cleaning which gets messed up again, a quilt gives me something to show for the work I’ve done.”

Joann, Agnes and Edith got to know each other while working on a quilt earlier in the year for the former Sierra View chaplain, Laura Neufeld along with other residents, LaVada Brandt and Florence Siebert. When that quilt was done they were eager for another project. Some fellow residents suggested that they work on a quilt that could be used as a fundraiser, and they agreed. Most of the quilt top is made from scraps they already had, but they’ve special ordered fabric for the backing and border. The ladies will set up a quilt frame in the lobby of the Sierra View Terraces apartments and anyone who is interested can bring their needle and thimble and join in the fun.  They hope it will be done by early June, but said, “We’re doing this for fun, so when it’s done, it’s done.  If we get more volunteers to help, we’ll finish sooner.”

Music and Memory

Music is a powerful thing. It is part of our lives from the time we are young to the time we die, and triggers memories and emotions in us. Listening to certain songs tend to bring back feelings and emotions from a particular time in our lives. Music and emotions activate in the same part of the brain, which is why music has the power to sooth or to energize. Music can bring calm to a difficult day, energize and add a spark to an exercise program, help you focus to complete a task, or raise your spirits.

Dementia care researchers are studying whether music can help caregivers be less stressed and more successful as they take care of the people they love. Recent studies have found that patterned behavior can be more effective when accompanied by a song. In one such project, the caregiver found that if he sang the cues to his mother, who had dementia, she was much more willing to participate. For example, before the addition of the musical cue, she called prune juice poison and would not touch it. However when he sang a song about drinking it, she was more willing to drink it. He also sang bathroom cues, and other cues for activities of daily living, with similar results.

Researchers are also testing whether music may help people with dementia retain new information. They have found that when information is sung to the person, he or she retains it longer than if the information was spoken. Memories are made in the hippocampus, a part of the brain that Alzheimer’s disease attacks first. They theorize that since music uses different parts of the brain to create memories which aren’t as damaged by the disease, music can access an alternative memory center. This theory is supported by anecdotal evidence that people who do not recognize their own family and typically sit and stare into space, sometimes “wake up” and have a short logical conversation after listening to their favorite music. Check out this touching youtube video illustrating this effect!

I have been in Marden’s Place Memory Care at Sierra View Homes Retirement Community when the residents were attending a hymn sing along. I was amazed how many of the residents not only knew the first verse but could sing with gusto all the verses of favorite hymns.

If you are a caregiver of someone who is slowly losing short-term memory, try to find some music from the time they were young. The music should come from some time when they were between 10 and 30 years of age. Find those favorite songs they recognize. You may be able to enjoy the positive energy that happens as your loved one listens and remembers long forgotten memories.  Also, consider singing the cues you give for use of the restroom, eating, getting dressed and more. Have an “eat your lunch song,” “brush your teeth song,” “toilet use” song, and the list goes on. Using tunes like Twinkle Twinkle Little Star but changing the words to give the cue is a good place to start. A tune you make up yourself is good too. You are hopefully triggering a part of the brain that still functions quite well.

Marden’s Place staff has found that music can redirect residents and stop sad emotions. At the meal time, soft soothing music is played to encourage the residents to relax and enjoy the meal. Sierra View Homes also uses drum circles where each resident gets to play a rhythm instrument to a familiar song. The circles are well attended and the residents are attentive and happy – even family members participate!

Music plays a part in our overall demeanor throughout our lives. We listen to music in all sorts of ways and for many reasons. A song can transport us back in time to a special memory, encourage us, stimulate us, or give us peace of mind during a stressful time. Now we are seeing it might help people with dementia have more quality of life. I encourage you to incorporate music into your day if you are a caregiver of someone with dementia. Hopefully you will see positive results for a less stressful day.

Have you laughed today?

Do you know some of laughter’s amazing benefits?

Studies show that laughing is very beneficial to one’s overall health. It helps reduce pain, brings greater happiness, reduces stress and even boosts the immune system.

Humor is infectious. The sound of someone laughing is very contagious. Laughing is a natural event that we do from a very early age.  Infants start to smile after just a few weeks. After several months babies laugh easily, often with gusto. As we age and go through life’s bumps and bruises, our laughter tends to decrease.

When people laugh together they feel a bond of happiness and intimacy. It creates a common bond that brings friends together and keeps the relationship fresh and exciting. Laughter and playing together adds joy, vitality and resilience.  Humor helps to heal resentments, disagreements, and hurts.

Laughing helps with mood. Nothing works faster or more effectively to bring your mind and body back into balance than a good laugh. A hearty laugh with friends or coworkers can relieve tension, increase alertness and increase the feeling of connectedness. One can laugh alone, but shared laughter is more powerful. Even in the Sierra View Homes Skilled Nursing Center, where activities can be pretty intense, one resident starts an audible laugh and soon the whole group is going!

Laughter has a strong effect on health. Laughter relaxes the body by decreasing stress hormones, and thus relieving physical tension. It gives you an inner-body work out. A good belly laugh exercises the diaphragm, contracts the abs and even works out the shoulders and has been shown to have a good effect on the heart. A hearty laugh can have the effect of pleasant feelings for quite a while afterwards. Laughing increases immune cells and infection-fighting antibodies giving your body a stronger immune system and fewer physical effects of stress.

The challenge is how to bring more laughter into your life.  My first suggestion is to smile. Smiling is the beginning of laughter.  Smiling is just as contagious as laughing. Practice smiling on your family, friends and the people you meet on the street! You will be surprised at the smiles people will give back in response.

Take some time to count your blessings. By counting your blessings you start to look at the brighter, nicer things in life and the sad or stressful parts seem less daunting.   Surround yourself with pictures of happy times with family and friends.

When you hear laughter, move toward it to get in on the fun. Sometimes a joke might be private, but most of the time you will find the group will want to share the joke because it allows them to laugh again.

Spend time with people who laugh easily both at themselves and at life’s absurdities. These are people who find humor in everyday events. Look for humor in your daily activities. It is surprising how many things can be humorous once you reassess the situation.

Look for humor in your own life. If you have grandchildren or pets, watch them play. Pets and children can be fun to watch as they often will do or say something cute. If you find yourself in a stressful situation, think of how it will sound as a story. Planning how to share the story can give you the chance to see the situation as a challenge instead of a threat. Challenges are much less frightening and your mind will find solutions much easier.

Read a funny book or watch a funny TV show or movie.  Allow yourself to chuckle at the funny parts!

Laughter is a way to stay healthy and happy. It is good for your mood, your heart, and your immune system. You can’t feel anxious, angry or sad while you are laughing. So, smile more often, laugh when you think something is funny, share a humorous story with a friend, look for the humor in your life and see if your quality of life improves!

What is Assisted Living?

Question:  I see advertisements in the newspaper for assisted living facilities, and it is difficult to understand what is offered there in comparison to other care services, such as skilled nursing. Can you explain the differences? –  K.A. Reedley CA.

 Answer: Great question! The term “assisted living” became popular in the 1980’s. At that time, it was a new level of care that allowed retirement communities to provide personal care programs. Before retirement communities provided assisted living, personal care was mostly handled by small board and care facilities or nursing homes.

Assisted living facilities provide help for seniors who struggle with daily chores but do not need 24-hour medical care. One room apartments with a bathroom, meals and snacks, activities of various interests, medication observation, and some assistance with personal care are provided. The goal of assisted living is to help seniors remain as independent as they can be for as long as possible — delaying the need to live in a skilled nursing facility.

Skilled nursing care is generally utilized for people with severe disability and/or a resident who needs rehabilitation therapy. Skilled nursing is ‘total care,’ offering 24-hour staffing with licensed nursing and registered therapists to allow patients to recover or at least maintain the functions they have.

The decision to move into an assisted living facility can be a difficult one. It often means moving out of a house full of memories and downsizing, leaving precious belongings. It means allowing someone to assist you with your medications and possibly having some hands-on personal care.

When is it time to consider Assisted Living? Some simple questions will help you decide.

Fortunately, there are two very reputable retirement communities right here in Reedley that offer assisted living, as well as several small board and care facilities in the greater Reedley area. Not all facilities are alike. Just as there are different levels of care, the costs can also vary widely. Some facilities charge a basic fee and then charge separately for additional services while others have an all-inclusive rate. Assisted living can run between $2,000 to $5,000 per month, while the cost of a skilled nursing facility can be $6000 to $7000 per month.  

The best way to make a decision is to visit the facility, talk to staff and residents, and ask questions regarding care and services. As with all planning decisions, it is best done well in advance, with time to make comparisons and have all your questions answered before making such an important decision.

Not all Assisted Living communities are alike. Here are some factors to consider as you help your loved one choose.