How Do You Know When it is Time to Leave Sun City Carolina Lakes?

Carole Miller, RN,BSN

One in a series by HealthShare

Hopefully you moved here Sun City Carolina Lakes because you wanted to enjoy our independent, active life style, be closer to family, pay lower taxes, or for the warmer weather. All of those are reasons most often heard for residing here. Occasionally someone moves here because they or their family think that we are a retirement community that caters to all of the needs of the elderly. That is a misconception. SCCL is not a community with all levels of care. Maybe you or a neighbor has come to realize that their needs are greater than can be met here, or perhaps you have seen the signs but the resident and/or his or her family are in denial. How do you know, and what can you do?

Some of the signs that alternate living arrangements should be considered include the following:

• Recent accidents—falls, “fender benders”
• Chronic health conditions that are worsening (COPD, Arthritis, Heart disease, Dementia)
• Frequent 911 calls
• Difficulty recovering from even common illnesses such as colds or the flu
• Transportation problems that limit access to health care, grocery shopping, prescriptions
• Isolation—not wanting to leave the house and decreased interest in any outside activities
• Changes in appearance—unkempt, staying in night clothes all day
• Noticeable weight loss or gain—signs of poor nutrition
• Dying plants that normally were well maintained
• Pets that don’t seem well cared for
• Mail piled up in the mailbox
• Newspapers not picked up
• Household clutter
• Stale or expired foods and multiples of the same items (sign of forgetfulness)
• Nicks or dents on the car and any signs of dangerous driving

If you identify some of these signs in yourself please talk with your family or with a health care professional as it may be time to move to a location that can provide the assistance you may need, or seek outside assistance that is available in our area and able to help in your home here.

But what if you are a neighbor or friend who notices many of the above signs in a SCCL resident? What do you do? If you know the family and can talk with a family member about your observations that would be the first thing to do, even though it may not make you popular with your neighbor and assuming you have already tried to talk with the resident without success. This is of particular importance if there is a safety issue such as an accident or fire safety. If there is no one to contact, it may become necessary to report the condition to the Lancaster Council on Aging and they can direct you as to how to proceed.

There are some modes of assistance available to residents that can prolong your ability to continue to live here and those include online grocery shopping (available at Harris Teeter), housekeeping services for a fee, Lancaster Area Ride Service (LARS), and home health services, both Medicare and private agencies. Medicare covered home health care requires the order of a physician but does not require hospitalization first, and is for homebound patients, meaning inability to leave the home on a regular basis for the needed service. Medicare covered home health is temporary and intermittent and may include a nurse, physical therapist, occupational therapist, and a home health aide. Private home health services are fee based and the cost varies. Home health can often facilitate the recovery and rehabilitation of an acute illness or surgery. It is important to know that you can request this service from your physician or a case manager in the hospital. Physicians are often not aware of the home circumstances and the need for additional services.

When it becomes time to search for alternate living arrangements, it is important that the resident be involved in the planning and thus the importance of early detection of need. A phrase we do not want to hear is “We are going to have to put Mama (or Papa) somewhere.” None of us want to be “put” anywhere but would rather “choose” to move to a location that we have had input into selecting with the assistance of family or a loved one. If the decision is made in an acute situation there is often not much choice as the best assisted living facilities and nursing homes usually have a waiting list. You want to visit facilities based on services provided, location, affordability, and other individual preferences. There are retirement communities that do provide all three levels of care from independent with minimal assistance such as meals, assisted living which can provide assistance with medications, some personal care, and transportation, and nursing home care which is usually total care. Other facilities are more defined such as just assisted living or nursing home care. It is important to be located close to family so that they can visit often. Ask about activities and if there is a recreational director. Talk with some of the residents. If a desirable facility is found, you may, in some cases, be placed on a waiting list without any obligation so that if you are not ready to move when your name comes up, you can be moved back to the bottom of the list.

There are online sites that can help with finding facilities in our area in both North and South Carolina. One is www.allaboutseniors.org and another is www.aplaceformom.com. Talking with friends and neighbors is also a good resource for information. This is not a subject that most of us t want to talk about, but is so important in our long term care planning. If you are someone with long term care insurance be familiar with your coverage. If you have no insurance be sure you have enough savings to cover your long term care if needed. There are a variety of payment plans which may include renting, buying into your place and paying a maintenance fee, and buying but having the option to sell or use funds for additional costs of assisted living or nursing home care. Do your research early to avoid being “put” someplace!