In the past year, I’ve seen first-hand how devastating a fall can be to an elderly person. My 84-year-old father has fallen twice in his independent living apartment. The first time, he was on the floor for about 36 hours before he was found; the second time, he was down for about five hours. He has been very lucky – he has recovered fully from both incidents, with no long-term effects. In fact, I think his two artificial hips have actually been a blessing in these  falls – his right hip did dislocate both times, but doctors were able to pop it back into place; had this been his natural hip, it likely would have broken, leading to a much more difficult recovery.

The sad reality is that falls are one of the most common causes of accidental death in the elderly. A series this week in the Minneapolis Star-Tribune aims to raise awareness of the prevalence of falls in Minnesota nursing homes; I have to believe this is a similar problem nationwide, and not just in nursing homes but in assisted living facilities, independent living communities and private homes. In her commentary on the series, Star-Tribune editor and senior vice-president Nancy Barnes writes, “I urge our readers not to look away, despite the distressing nature of these stories. Nothing is more certain in life than death; we can only hope that we will be allowed the gift of dignity. In many of these stories, that is simply not the case.”

The investigative article is long and, at times, difficult to read. But it is important. Worth sharing. As one doctor quoted in the  article states, “”I think if you asked a person on the street, not one of them would know that if you take the frequency of falling and the consequences of falling, it’s as big a problem as heart attacks and strokes.” My father was one of the lucky ones. For many elderly people, a single fall can trigger a rapid decline in health. I hope you will take a few minutes to read this article. And I hope you’ll share your thoughts by leaving a comment.

I remember when my father was trying to select a Florida senior living facility. The process was frustrating (which is in part why I created Florida Senior Living Advisor) and tiring – driving around from one senior facility to the next, trying to keep track of the different features, costs, options, etc. By the time he had made his decision, we were both a bit worn down and just ready to be done with it. In actuality, that was the time we probably should have been at our sharpest – focused on reading every bit of fine print before he signed on the dotted lines. Yes, we did read over the pages and pages of paperwork very closely; but I’m not confident that we truly scrutinized every point, and we certainly didn’t have it independently reviewed by an attorney.

Thus far, my father has not had any issues, and (knock on wood) I don’t foresee any in his future. But when I came across this article from The Washington Post about contracts at continuing care retirement communities, I figured it was worth sharing. It makes reference to a specific CCRC in Northern Virginia, but the concepts are universal.

Scrutinize any contract to avoid nasty surprises at continuing care community

By David S. Hilzenrath

If you are considering moving to a continuing care retirement community, you would do well to consult a lawyer and read the fine print of any contract to determine whether the potential benefits outweigh the risks. A “Residence and Care Agreement” for Ashby Ponds, an Erickson community in Ashburn, illustrates some of the trade-offs the decision could entail.

You might be drawn to Ashby Ponds by the potential to avoid another disruptive move when you are least able to cope with it, but there is no guarantee you would be able to move to an assisted-living or nursing facility on the same campus — even when those facilities are completed. If the assisted-living and nursing home beds at Ashby Ponds are full, management could arrange for you to go elsewhere.

Some delay in building those facilities is routine at Erickson developments, said Ronald E. Walker, chairman of a nonprofit group associated with Erickson campuses. Though Ashby Ponds opened in September 2008, the assisted-living and skilled-nursing portions were not expected to open until the end of 2011 or the beginning of 2012, according to a May report from the community’s management.)

The deposit you post to move in does not limit the amount you could be required to pay on a monthly basis; management can raise the monthly fees. In addition, the fees can go up as you move from one level of care to the next. At Erickson communities, the average monthly fees range from $1,750 for singles in independent living to $5,178 in assisted living and $307 per day — as much as $9,517 per month — in the nursing homes, Erickson spokesman Mel Tansill said.

Management can decide to transfer you to a higher level of care. If you refuse to go, management can kick you out and hold on to your deposit until 60 days after it finds a new tenant. To gain admission to the community, you have to pass financial and medical reviews. If you marry a nonresident, your new spouse would have to pass such a review before being allowed to move in.

To reassure management that you have the ability to pay expenses, you must agree not to give away any assets that would bring your net worth below a minimum requirement. Evan H. Farr, a Fairfax lawyer who specializes in issues facing the elderly, recommends putting any extra assets in an asset protection trust before you move in.

Unlike a real estate investment, the deposit you post to enter the community does not grow as property values rise. But it can shrink as property values fall. If it takes management a long time to replace you, you may be offered the option of accepting a smaller payout so that management can in effect cut the price of admission for the next tenant to occupy your apartment.

If an elderly family member suffers from hearing loss, here is something you need to know: Florida Telecommunications Relay, Inc., (FTRI) will provide specialized phone equipment for them at no cost. FTRI is a statewide non-profit organization that provides this equipment as mandated by the Florida Legislature. The program is funded by an 11 cent surchage on all landlines in Florida. And these phones can be used in private residences, or in Florida nursing homes, Florida assisted living facilities, and Florida continuing care retirement communities.

And now FTRI has added a cordless amplified phone to its mix of available equipment. The Clarity W425 Pro amplifies incoming sounds up to 45 db.

Clarity W425 Pro cordless amplified phone

Permanent Florida residents who are certified as having a hearing loss can easily obtain the W425 Pro by completing an application and visiting one of FTRI’s 22 conveniently located distribution centers throughout the state.  For more information, call FTRI at 1-800-222-3448 or visit www.ftri.org. 

“FTRI aims to provide individuals with hearing loss a telephone solution like the Clarity W425 Pro,” said James Forstall, FTRI’s executive director.  “The majority of the people we serve are senior citizens and the Clarity W425 Pro is a device that may assist them with communicating with others on the telephone.”

 FTRI estimates that nearly three million Floridians experience some degree of hearing loss. Along with amplification technology, the W425 Pro contains large backlit numbers, a bright visual ringer, and is hearing aid compatible. 

 “FTRI is an outstanding program which helps so many people throughout Florida,” said Carsten Trads, president of Clarity.  “Hearing loss is a serious, yet often overlooked issue.  Many people are not aware that solutions like amplified telephones even exist.  Thanks to FTRI, hopefully more people in Florida will take the necessary steps to address their hearing loss and consider using amplified telephones.” 

FTRI also offers equipment for Florida residents who are deaf,  blind or speech impaired. Many other states have similar free programs.  Visit the Telecommunications Equipment Distribution Program  Association to learn more.

Funny how life gets in the way. It’s been several days since I posted on this Florida Senior Living Advisor blog. There are two reasons: first, I was busy helping my elderly father address some issues he is having with his eyes. Looks like cataract surgery is in his future. First he has to see a retina specialist, to make sure there are no underlying issues with his retina. I don’t mind taking him back and forth to doctors, but the fact is it is very time-consuming.

In addition to those obligations, I was busy on Friday and Saturday attending an amazing conferenced about social media and blogging. It was called “Izeafest” – a reference to the company that organized it, Orlando’s Izea, Inc. I learned so much and met so many wonderful people. I’m still going through all of my notes, mapping out next steps for this blog and for the Florida Senior Living Advisor website. But I know one my priorities needs to be to find other websites and blogs to link to me. So this is my first shout-out: if you know of a useful blog that focuses on issues such as senior care, senior living facilities, nursing homes, assisted living facilities, Alzheimer’s disease, Medicare, really ANYTHING of interest to seniors, please tell me about the site in a comment below. I also want to know about these sites so I can add them to my “Helpful Links” section of Florida Senior Living Advisor.

The Florida Department of Children and Families is investigating an alleged case of sexual abuse of an elderly resident at a Jacksonville nursing home. The Jacksonville Sheriff’s Office arrested 35-year-old Anthony Mgugua Njorge early Sunday morning at Regents Park nursing home. He is charged with sexual battery on a mentally impaired and physically helpless victim.

The latest inspection report of Regents Park, conducted by the Florida Agency on Health Care Administration in August, gives the facility just one star out of five in most categories. According to the AHCA website, “The fewer stars a facility receives, the more the facility was found to be in noncompliance with the regulations governing nursing homes.” The Federal Centers for Medicare and Medicaid Services also publishes a Nursing Home Compare web site that provides additional information to compare nursing homes in Florida and the nation.

In this particular incident, a witness told police she heard something from one of the rooms, and when she went in she saw Njorge engaged in a sexual activity with a woman in the room. The woman is disabled.The witness told police she reached for her cell phone, but Njorge tried to stop her.She was able to make a call and someone else came into the room. That witness told police she saw Njorge cleaning up and then throw something in the disposal room.

DCF Spokesperson John Harrell says his agency has investigated eight allegations of abuse at Regents Park in the past year, though none have been verified.

“Of those eight reports, four showed no findings, but four had some findings, including inadequate supervision [of patients]. That happened a couple of times,” Harrell said.

Njorge also worked at Life Care Center, another Southside nursing home. DCF is now looking into whether the attack is an isolated incident.Police are withholding any further information due to the nature of the crime and the investigation. Njorge remains in jail on a $500,000 bond.

Florida Senior Living Advisor offers a complete searchable database of all senior living facilities in Florida, including nursing homes, assisted living facilities, adult day care centers, skilled nursing units, independent living, continuing care retirement communities and hospice. As part of your research on particular facilities, you can check their rating in the AHCA guide; of course, you should always visit and inspect a facility in person before making such an important decision.

I’ve heard from many people lately who are just beginning their efforts to help a loved one select a Florida senior living facility. They tell me they feel overwhelmed and are so afraid of making a wrong decision. While every situation is unique, there are some standard ideas and steps that I suggest, including:

• Determine what type of facility the person needs. You can read my definitions to learn the differences between nursing homes, skilled nursing units, assisted living facilities, continuing care retirement communities and adult day care centers. In general, most people hope to retain as much independence as possible. (An increasingly popular option is in-home care. I’ll write more about a great home care company located in Central Florida in one of my next blogs.)
• Decide what part of the state of Florida your loved one is interested or willing to live. I’ve divided my database into the following regions: Panhandle, North Florida, Central Florida, Central Gulf Coast, Southeast Coast, Southwest Gulf Coast, South Central Florida. You can also look at my map to understand where those regions are.
• Conduct a search of the Florida Senior Living Advisor database, based on your answers to the above two questions. If a facility has a website, I provide a direct link to it from the database. So look at the facility’s website to get more information. Of course, keep in mind that some of these Florida senior living facilities provide very detailed information on their websites, others do not. If a facility you are interested in does not have a website, you will need to call to get more information.
• Look at Florida Senior Living Advisor’s “Evaluating Facilities” page for a list of the questions that I asked – and some I wish I had asked – as I was researching facilities for my elderly father. The answers you receive can help you start to narrow down your list of options.
• Of course a big deciding factor is cost. This will vary greatly from facility to facility.

And don’t forget good, old-fashioned word-of-mouth. Talk to friends and neighbors. This is what lead me to help my father find the perfect facility – a casual conversation at a social event with an acquaintance I had not seen in several months. When she asked, “What’s new?” I proceeded to explain how I was immersed  in helping my father select a Florida senior living facility. She responded by telling me about a facility she had just visited with her elderly mother. And the rest, as they say, is history.

One more idea: if you feel like you need more help, someone to walk you through the process, consider hiring a senior care management company. I  recently met a wonderful woman named Patrice Antony who owns and operates Elder Advocates, Inc. in the Orlando area. Patrice is a Physical Therapist and Geriatric Clinical Specialist with more than 27 years of experience in working with the handicapped and the elderly. Patrice and her staff will do as much or as little as you need – from helping you research and select a senior facility, to consulting with medical staff on a client’s behalf, and negotiating with insurance companies. For more information, visit the Elder Advocates website.

I’d love to hear back from anyone currently going through this search process for an elderly family member. Comment on this blog or send  me an email at mitra@flseniorlivingadvisor.com.

I’m starting a new segment on the Florida Senior Living Advisor blog today called “Friday’s Featured Facility.” Every Friday I’ll tell you about one of the more than 3700 senior living facilities in Florida, everything from assisted living facilities, to nursing homes, continuing care retirement communities, hospice, skilled nursing units and adult day care centers. If you’d like to recommend a facility for me to feature, send it to me at mitra@flseniorlivingadvisor.com.

The inaugural “Friday’s Featured Facility” is Guardian Home Health in Spring Hill, Florida, about 60 miles north of Tampa. This is actually an assisted living facility, but the name “home health” refers to the fact that it is located in a single-family home. The facility is licensed to care for six residents. Of the nearly 3,000 assisted living facilities in Florida, about half have a capacity of less than 10.

Owner Elaine DeCiutiis runs Guardian Home Health, along with her husband Frank and daughter, Paulamarie Aurigemma. DeCiutiis and Aurigemma are both certified nursing assistants and have backgrounds in health care administration. They opened the home last October, with the goal of providing very personalized care to each elderly resident.

“When I’ve gone to big nursing homes, I see people just sitting there and doing nothing,” says DeCiutiis. “We try to keep them active. We play cards.  We discuss current events. We go to the movies or out to lunch.”

DeCiutiis also tailors each meal to the residents’ taste as much as possible.

“You could say we spoil them,” she says with a laugh. “But at their age, they deserve to be spoiled.” Residents are also offered a shower every day, a service that is often not possible in larger facilities where there may not be enough staff to accommodate residents in this way.

For more information on Guardian Home Health, you can visit their website at www.guardianhomehealth.org. You can also call 352-688-8832 or send an email to edecuitiis@tampabay.rr.com.    

This made me smile. I just heard about a wonderful exhibit at the Museum of Florida History in Tallahassee. “Art from the Heart” is a display of artwork from 35 nursing home and assisted living residents from throughout Florida. The elderly residents created the artwork as entries for the Florida Health Care Association’s “Art from the Heart” 2009 calendar competition. According to a news release from the FHCA, some of the artists have been creating art their entire lives, while others have recently discovered their talent. Some of the individuals who submitted pieces for this year’s calendar include:

• 82-year old Helene Kereluk’s passion is painting, as demonstrated by her “St. John’s River” artwork featured on the 2009 calendar cover. She studied art in Chicago and continued her studies after moving to DeLand, Florida, where today she resides at The Cloisters independent and assisted living facility (ALF) and teaches a monthly class for her fellow residents.
• 84-year old Sally Darcangelo never realized her natural talent for painting, ceramics and crafts until entering Palm Garden of Pinellas in Largo, where she has lived for over a year. Her “Starry Night” painting is the featured artwork for May.
• 56-year old Bruce Landers is a C5, 6, 7 quadriplegic who is paralyzed from the chest down and has no hand or finger function. He used a hand adaptation to create his “Lighthouse Keepers Home” painted jigsaw puzzle that is the featured artwork for September. Bruce resides at Park Meadows Health and Rehabilitation Center in Gainesville.

The artwork will be on display in the Museum’s Heritage Gallery through September 7. The 2009 Art from the Heart calendars sold for $7 each, with proceeds used toward FHCA’s Quality Credentialing Foundation. The Foundation focuses on improving services and quality care for those living in Florida’s nursing homes by offering long term care providers mentoring, information and resource sharing and advocacy. The Foundation also promotes increased customer satisfaction and employee retention in long term care facilities and offers continuing education and scholarships for long term care nurses, nursing assistants (CNAs) and other professional staff.

For a comprehensive searchable database of senior living facilities in Florida, visit Florida Senior Living Advisor.