Assisted Living Explained with Miriam Bogard

Join Kelly and her guest, Miriam Bogard, Owner of Assisted Living Locators of East Columbus, as they discuss assisted living.

In this episode:
✔  When to look at assisted living

✔  Important questions to ask assisted living communities

✔  How much assisted living costs

✔  How to pay for assisted living

🔹 Watch this episode on YouTube: https://youtu.be/E7mCnM2DJfY

Learn more about Assisted Living Locators of East Columbus: https://assistedlivinglocators.com/care-advisor/eastcolumbus 

For additional information about Kelly, check her out on Linkedin or www.SteadfastAgents.com.

To explore your options for long-term care insurance, click here.

Steadfast Care Planning podcast is made possible by AMADA Senior Care and Steadfast Insurance LLC.

Come back next time for more helpful guidance!

Transcript

Kelly Augspurger: [00:00:02] Hey everyone, welcome to Steadfast Care Planning podcast, where we plan for care to live well. I'm your guide, Kelly Augspurger. Today with me is Miriam Bogard. Miriam is the owner of Assisted Living Locators of East Columbus in Ohio. Miriam, welcome. Thanks for being here today!

Miriam Bogard: [00:00:17] Thank you so much, Kelly, for having me.

Kelly Augspurger: [00:00:18] Today we are going to be talking about assisted living communities. So Miriam, let's jump right in. How do people know when it's time to look at assisted living and then actually placed a loved one in assisted living?

Miriam Bogard: [00:00:32] When your loved one is truly experiencing challenges where they can't independently care for themselves, it's time to take a look at care in general. It's never too early to learn about your options throughout the whole aging process and identify what might be some options to consider, whether it be now or down the line. But basically medicine management tends to be the key mitigating factor when you're looking at alternatives because oftentimes you have a loved one that is not taking their medicine on a regular basis, not taking food with their medicine, and there are lapses in that, and those chemicals in our bodies are to be regulated for a reason to get the most optimal benefit out of it. So usually when someone transitions from an independent living situation or possibly a home situation, medicine management is is part of that consideration.

Kelly Augspurger: [00:01:31] That's such a good point. A lot of people that I know of that are receiving care, or at least they're making plans for care plan on, you know what, "I'm going to stay at home as long as possible. I want to receive care at home." But we got to think it may not be realistic for you to stay at home forever. There might be at some point it might make more sense to transition from home care into an assisted living community, and that medicine management is a really important piece of that puzzle. What are some other things to consider? I would imagine if someone is receiving 24/7 care at home, Miriam, that's probably going to get pretty darn expensive, and even at that point, people might consider, even if it's not 24/7 care, maybe it's 12 hours a day. Does it make sense to move to a community or even the socialization? Can you talk about that? I know that's really important too.

Miriam Bogard: [00:02:25] Sure, I mean, for every family, it's different. You know, we're not born into this world to be caregivers. We are daughters, sons, and loved ones of family members, and it varies from family to family as to what might be the triggering point for them to consider assisted living. However, you have brought up some really good points. You know, when it comes to the economics of things. Your home care, private duty home care service is going to be somewhere in the ballpark of $30 to $35 an hour. If you are doing four hours, just four hours a day for seven days a week, you're up into the $3,000, $4,000 mark per month for that care, and the family starts to question themselves as to $3,000-$4,000 for an additional $1,000 I can get my loved one into a community possibly and have 24/7 care available at the touch of a fingertip or the door knocking regularly every two hours for someone checking on their loved ones. So there comes that point where it just is more economically feasible. And then you also have the mitigating factor of managing that home care service. You have Bonnie from Home Care Agency X coming to your home, but when Bonnie has to call off because she has a situation at her own home, you know, you're calling the home agency and it takes time for them to either possibly get someone out to replace Bonnie or they are just going to say, you know, we can't provide that care today. Well, when you're in an assisted living community situation, if Bonnie were to call off, yes that is compromising to the staff overall care levels, but Susie down the hall can cover for Bonnie until that replacement can be made. So there's a lot more flexibility and hands on deck in a community situation that can provide that additional support and care for your loved one when those challenges do come up. So there's also overnight care which can be more expensive, weekend care can be more expensive, and then just the overall challenges of what hours of the day is mom or dad or your loved one going to need the most care? Is it in the morning or in the evening? A lot of times we talk with families that they were like, "Well, we'd like to have 45 minutes in the morning and then another hour or two in the evening." And that finds it very difficult for personal care service to come to the home for those times of day throughout the day, leaving and coming back without paying for the time in between.

Miriam Bogard: [00:05:16] So it can be very challenging and daunting to try to navigate that. And there's a lot of really great benefits to community living. You brought up the isolation aspect of things. In a home environment while you are surrounded by the love and care of your family and the familiarity of your home that you've lived in for many years, there is that sense of isolation and just being left alone during those off time hours of not receiving care or people coming in and out. When you're in a community environment, you are socializing with other residents your age, with residents that are maybe experiencing the same types of challenges that you are in a dining room setting just engaging in meals with other people, maybe participating in an activity or even just coming down to the lobby area when entertainment is being presented, which typically is once a week just coming out of your room and, you know, having that opportunity for engagement with others is just tremendous. That's all part of healthy living. A lot of people think that those things don't matter, but the really nuts and bolts of things: medicine management, socialization, eating healthy meals in a timely fashion, those all contribute to our overall health and well being.

Kelly Augspurger: [00:06:40] I totally agree. I think the social health is often not considered very much as we age and people think about the physical, the mental, the emotional health, spiritual health, but the social health is really important. If you've got an older adult that is isolated, that can lead to depression really quickly, and so what do we see? If someone is depressed, then often their physical health goes down and so then they're not able maybe to take care of themselves. So if you are in a community where you have that opportunity for socialization, maybe you're not a social butterfly, but at least if you have the opportunity and it's there, you might be more willing to go down the hall, and talk to Betty or talk to so-and-so, sit with other people at a table, have a meal, have a conversation that's really going to contribute to a better overall health for the long haul.

Miriam Bogard: [00:07:38] I agree and even just having your door open. There's a lot of times we walk down the halls in our communities and it's kind of like when you have your door open, it's like an open invitation, right, for someone to peek in and say hello or just how are you doing today, that kind of thing. And just knowing that there are other people on the other side of the door that care about you is really important and does energize a lot of people.

Kelly Augspurger: [00:08:05] Right. I had another podcast guest on in the beginning of my podcast, and one of the things he talked about, like with an assisted living community, he's like, it's like going back to college. You got your buddies down the hall, you've got activities and there's all these things to do, and it is a really good point because again, that socialization, it's an important factor in aging well, and I think aging gracefully. And it's not to be swept under the rug, like that definitely needs to be something considered when we're talking about getting a plan for extended care in the future for yourself and for your loved ones is how are you going to really take care of yourself in that social aspect, too. So I think that's really important.

Miriam Bogard: [00:08:48] Especially when a spouse passes away and you're left alone. That's a critical time for families to reassess and figure out what is this going to do in the overall well being of the loved one that is still living? That is often difficult, and then we always encourage our families to, like you say, plan ahead, but also prepare and make this transition sooner rather than later. You don't want to make the transition when your loved one is already experiencing a large amount of their time spent in bed, they're unable to be able to get up and be mobile. You know, that is difficult in and of itself, let alone coming into a foreign environment at that point. Embrace it, coming in and and enjoying what the community has to offer is all part of it.

Kelly Augspurger: [00:09:44] That's a really good point because I think a lot of families look at this further down in the process where it's okay something happened, maybe you were receiving care at home, it's not safe for mom or dad to be at home anymore or they are really depressed, there's signs of depression. Maybe they're on medication and so it's like "we got to do something quick," and making this fast decision. Whereas you're saying, you know, maybe we need to consider this sooner, sooner than what some families actually consider. It doesn't need to be a crisis event. There should be some preplanning here.

Kelly Augspurger: [00:10:17] And now for a brief message from our show sponsor, the Steadfast Care Planning podcast is sponsored by the CLTC, Certified in Long Term Care Training Program, which gives financial advisors tools to discuss extended care planning with their clients. Look for the CLTC designation when choosing an advisor.

Kelly Augspurger: [00:10:36] What are some questions, Miriam, that are important to ask when you are looking at assisted living communities for your loved one? What's a good checklist?

Miriam Bogard: [00:10:44] Well, there's a number of different questions to think about. First of all, there are different levels of care within senior living. There's independent living, assisted living, there's memory care, there's special care, there's skilled nursing care, there's all these different levels, and just because they have the words assisted living or senior living community on the outside of their building, you really need to identify what specifically do they offer within that community and know what the thresholds are within that community and their abilities to care for your loved one. I'm working with a family right now and they're adamant "Mom, dad, they're independent, they don't need any care." But we really try to look holistically at the situation and trying to identify, "Well, that's good today, but what does five years down the line, maybe even next year, bring to that family?" And making sure that they're not having to transition again and identifying what their particular needs are, their particular challenges, the diseases that they might be experiencing, and allowing you to know just the ins and outs of those communities and what their thresholds are in their abilities to care for someone. Someone with Parkinson's disease, someone with memory care challenges, those are of a different concern and question that you might want to ask when you're touring the communities to make sure that they can encompass the care needs, not just for today, but down the line. I would also say, what does the staff look like? How does the leadership participate in the day to day operations of the community? Are they just behind their desk, in their offices, or are they out mingling with the staff? Do they know the residents? As you're walking through the building, are they saying hi and acknowledging them? That's a sure telling sign that they are engaged and actively caring about the residents once they move into them and then the staff in and of itself. What is the longevity of the staff? Do they have consistency in their staff and is the staff their own or are they using agency staff coming into the building because they can't seem to keep the health care workers necessary within their own organization from time to time. You know, they all experience, I'm just going to throw this out there. They all experience times of challenges with staffing. I mean, it's going on in the industry as a whole.

Kelly Augspurger: [00:13:16] Oh, yeah.

Miriam Bogard: [00:13:17] And and we need to be we need to give them grace during those times. But the question is, are they consistently using that agency or are they trying to maintain their own staff and the type of employee retention that they need to within their community? And what type of training do they have? If you're looking for memory care, are the caregivers back in memory care experienced with dementia? What type of training do they use? Educating their staff on how to handle different types of residents and their situation and needs. Another question to think about is do they have a nurse on staff 24/7? You know, the state of Ohio doesn't require a nurse to be on the property 24/7. That is part of the law. However, most communities do offer 24/7 nursing care, but there are some that have those lapses in that care, and what does that look like? You know, and it's fine for some people. It just depends on the environment and what your overall plan and of course, budget is for for the care needs of your loved one. Other things to consider are therapies. What type of other supportive services do they welcome into the community hospice? What does that look like? How do they play a role within caring for your loved one within a community? And what overall therapies do they offer? Do they have an in-house therapy team? A lot of times communities are partnering with third party agencies, but they have a presence within the building and they're there consistently each and every day. That's really important to think about because you want someone that if mom is not feeling well today and her appointment really is at 10:00 on Wednesday and she's not feeling well. Well, if there's presence in the building with that company, they might be able to come back in the afternoon and just double check because they might have a window of opportunity open in their schedule to say, "Hey, I know you weren't feeling well this morning, but would you like to try it this afternoon?"

Kelly Augspurger: [00:15:22] Good point.

Miriam Bogard: [00:15:22] Whereas if it's an agency that is coming to your home or at the community that is not a regular presence within that community, that opportunity window has gone and they're on to another community property. So that's something to think about too. And then of course, there's the cost of care and what does that look like and what is covered within those costs?

Kelly Augspurger: [00:15:47] Okay. Yeah, that's a great checklist, Miriam. So when we're looking at different assisted living communities, whether it's Central Ohio or other areas of the country, can you give us some pros and cons, which I know we've probably already talked about, but let's just kind of clearly go over what some of those pros and cons would be when looking at communities.

Miriam Bogard: [00:16:06] It just depends on kind of what the amenities are that resonate with the individual. So do you like outdoor space? Do you enjoy sitting outdoors and having your own private balcony type space, or is there a certain particular craft that you enjoy that you want to make sure other residents are there and connect? I know a couple communities here locally in central Ohio have lifelong learning programs, so a lot of the residents within the communities are retired professors or pastors or world travelers, and they end up connecting. So my job and part of what we do is really try to hone in and identify with what are the overall experiences that the individual that we're working with enjoys and has resonated with over the past and making sure that they get into a community environment that offers those same similar things that they may want and thrive on. There's also the opportunity once you get into a community where the family can then focus on being the family for that loved one and not necessarily their caregiving needs. So you're able to sit down and enjoy those conversations again as brothers or sisters and daughters and sons of the loved one and not necessarily worrying about their care needs because you know that that can be handled.

Kelly Augspurger: [00:17:38] Yeah.

Miriam Bogard: [00:17:39] We talked about the social interaction and what that plays on and things of that level. And then, you know, some of the challenges are new environments, right? You're having to get re-acclimated with different light switches and down the hall and around the corner. What does that look like? And finding the dining room and getting around in the community, but the advantage is that there's always ambassador programs within the community. So there's always residents that are on these teams that welcome new residents. The leadership staff should be very involved. The first week of acclimating your loved one to the new environment. And then, of course, Medicare does pick up and cover initial therapy sessions and part of occupational and physical therapy is getting adjusted to their new environment. So that is typically free through your Medicare program that will provide those free initial therapy sessions whenever you transition into a different environment to help with the coverage of that. So that's always a good thing to make sure that you ask as well.

Kelly Augspurger: [00:18:51] When we're looking at Central Ohio what are estimated costs? And I'm sure there's a range, right, minimums, maximums, averages in- between, but what's the range there? What can people expect to pay for an assisted living community in Central Ohio?

Miriam Bogard: [00:19:07] It has gone up just over the last 12 months significantly, as everything has in our economy, but I would venture to say that your assisted living is going to be anywhere between $4,000 and $6,000 a month, maybe even $7,000, depending on what care costs are and your individual needs. There is a base rate that someone pays when they come into a community and that typically covers the apartment rental and all of your utilities, housekeeping, linen services, laundry services, if it's assisted living, all of your meals, maintenance, transportation, all of those are incorporated into your base rate. And then typically, if you're going into assisted living, you would get an assessment done by their clinical team and a nurse practitioner identifying what is the individual care plan for your loved one. And that can range from anywhere from just getting them up in the morning, getting their medicines or giving them concierge services, taking them to and from activities and monitoring them on a closer level throughout the day. So there are level of care costs that are on top of your base rate and that can range as well. Some communities do what I call a la carte services or charge by each individual act, I guess, if you will, and the time frame that it costs for that. Others do level of care and then some are incorporated into what we call an all inclusive program, typically memory care and there are a few communities out there that do an all inclusive, which includes that base rate and any level of care needs that are incorporated into that, but you can expect to pay $4,000 to $7,000 for assisted living. Your memory care is going to be anywhere from high fives to $7,000 or $8,000 per month.

Kelly Augspurger: [00:21:06] Okay.

Miriam Bogard: [00:21:07] And then, of course, everyone says that's expensive, but if you ever end up in long term care or a skilled nursing facility, there you're looking at $10,000 to $12,000, if not more, per month for that care.

Kelly Augspurger: [00:21:21] How are you seeing residents pay for this care in assisted living communities? Are you seeing self-pay, family pay, long term care insurance, combination? What do you see?

Miriam Bogard: [00:21:31] It's a combination of of a lot of different things. You know, the generation that is actually moving into assisted living now, these are the lifers that have been guaranteed pensions from companies that they've worked with for, 30 years or whatever. So they have Social Security, they have pension or some type of program. Some might have already tapped into an annuity that they're receiving on a monthly basis. So that's all considered into that and you have to take that off of what your budget needs are. And then if it costs $5,000 and you're making $2,000, then now you have a differential of $3,000, so it's, well, where do I get that $3,000? And you can tap into VA Aid and Attendance if you served during military time of combat, which affects a lot of seniors nowadays that are retiring and moving into communities. The spouses can even receive some support as long as they are married to the military veteran. Then there's also long term care insurance. I'm a daughter who is blessed with a 93 year old father that has a policy and that's a saving grace as well because those are definite opportunities to help pay for the cost of care because it is expensive. I'm definitely a proponent of long term care insurance. There's also selling of the property. A lot of times people stay in their homes because they don't know how to do it and that's where connecting with a Senior Care Advisor like myself can walk them through all the different options that are available and don't make it so overwhelming and unmanageable to be able to get to that community that you know that you're going to thrive in and enjoy. I had a 90 year old woman a couple of summers ago that I connected with, and she had lived through the pandemic. It almost made you cry about how sad she felt in her home every time I met with her and initially I just got to know her and we talked about different options and you could just see on her face she just didn't know how she was going to do it. She has one son and he was disabled himself, so she knew she couldn't rely on him to help make these decisions for her be able to navigate the system. We identified a community that she thinks she was going to like and the apartment we explained the budget to her and how that might look and I was able to connect her with a realtor. I sat right there at her kitchen table and she interviewed with the realtor to be able to determine if what the realtor was telling her, if she wanted to list with her, the things that she needed to change about her house. And then I was able to connect her with a resource that totally comes in and helps her go through her entire house, downsizing it, identifying what she's going to keep, what she's going to throw away, what she's going to donate, and really hone in on all those aspects to help make that decision so that she's not doing it alone. I was the project manager for that whole thing and I have to tell you, once she got into her assisted living community, I see her quite regularly, and she beams from side to side with smiles. She loves it there. She has friends there and she is enjoying all the aspects that she wasn't able to experience and enjoy through COVID and being isolated in her home.

Kelly Augspurger: [00:24:54] Right. She has a new lease on life.

Miriam Bogard: [00:24:55] Yes, she does.

Kelly Augspurger: [00:24:56] And you were able to help her in that process from beginning to end. And I think that's a great point, especially for older adults who maybe they don't have family nearby or family at all that can help in that process. So you really want to find someone that's reliable and trustworthy, that can guide them through the process to help them navigate this because it can be really overwhelming if you're doing this all on your own. And then if you compound that with if there are any health issues involved, man, that can just be, "You know what, I'm just not going to do anything because it's just too much for me to consider." So teaming up with someone like Miriam to help you navigate this and figure out you know what this is manageable. We can do this. We have an advocate. We have someone here to help us that's on our side and then to really help us find the right community for me, because it is customized. So yeah, great, great stuff. Miriam, any other final advice on how people can plan now to live well?

Miriam Bogard: [00:25:51] I would just say it's never too early to get started. Even as you're working with Kelly, you know, through this long term care insurance discussion of what does that look like? Just educating yourself on the options that are available and knowing your history within your family's health will help you not make it so insurmountable when the time comes that you do need more care, and just being able to embrace, change and embrace what I always say what independent living is for the individual. You can still be in assisted living and live an independent life as best as you know how for yourself. And it may look different. You know, you may have to have some help getting dressed at night or in the morning, but at least you have the independence to be able to walk out your door and go enjoy the day, whatever that looks like for you. And that's a beautiful thing, and it's not necessarily about giving up rights. It's about enhancing and increasing the quality of life that you deserve, and as caregivers, as adult children, just know your role. You want to be the son and the daughter that is encouraging for your loved one and parent and not necessarily the one that is stressed out and trying to burn it at both ends to care for their loved one. There are professionals in this industry and you hear some, I guess, nightmare stories, but there are knowledgeable people that can help you throughout the process and can get you to a point of getting the help that you deserve.

Kelly Augspurger: [00:27:37] Beautifully said, Miriam. Well, where can people find out more information about you and how you help people?

Miriam Bogard: [00:27:42] Yeah, well, you're welcome to take a look at my website. It's www.assistedliving.com/eastcolumbus. I have a questionnaire on there that you can take to identify where you think your loved one might be sitting as far as needs are concerned and that's always good for the loved one to take the quiz and for the adult child to take the quiz because the loved one will say, "Well, I can do all that on my own." And the adult child is there to say, "Well, no, mom, you really can't because I'm doing this." So it just opens up that conversation. So I'd encourage you to go to our website and take that free questionnaire. You can also call me at (614) 636-4905. That's (614) 636-4905. You can reach out to me. Our Facebook page is Assisted Living Locators of East Columbus and I'm on LinkedIn, so feel free to connect with me. I'm out there. Just get a hold of me. Even if you want to just throw a few questions by me. I am an educated resource for the community. That's what my job is to educate seniors and their families and the communities. Don't hesitate to use me as a resource. I'm free. We don't charge anything for our services to work with the families. We are compensated by the communities throughout Central Ohio and the surrounding areas.

Kelly Augspurger: [00:29:05] Fantastic and I will just reiterate what Miriam said. She is a resource, she leads with education. If you have any questions, you have concerns, you're looking for a community for your loved one, reach out to Miriam. Thanks so much for being here, Miriam. Have a great day.

Miriam Bogard: [00:29:20] Thank you for having me, Kelly, and I just totally appreciate what you do, too and you know, you are much needed in this industry to educating us as younger people, my age of, you know, as we go down that path to finding that resource and reliability that we can count on to pay for our care needs as we age.

Kelly Augspurger: [00:29:39] Well, thanks for your time, Miriam. Have a great day.

Miriam Bogard: [00:29:40] Alright. Take care. Bye bye.

Kelly Augspurger: [00:29:42] Bye.