When is a good time to talk about moving into a senior living community? Nancy Kriseman, licensed clinical social worker and eldercare expert, walks us through a few scenarios and how to start the conversation with your loved one.
Video Transcript
- Hello everybody and welcome in to "Senior Living LIVE!" My name is Melissa. Thank you so much for being with us. Today we are discussing when it might be a good time to have the discussion about moving into a senior living community. When is it the right time for a loved one, and is it the right move for a loved one? We'll discuss a few scenarios here today. Nancy Kriseman is an excellent resource for this topic with more than 35 years helping families cope with elder care issues. Nancy, thank you so much for being with us. It is a pleasure.
- It is my pleasure to be here too. It is definitely a topic that I have a lot of passion for, and really wanna make sure that families get good information.
- Absolutely, and that is why you are here. So, if you are watching I suggest you grab a pen and some paper and take some notes because Nancy knows this topic so well. So, before we get going, Nancy, let's talk a little bit about you and your background.
- Sure, so I am what's called a licensed clinical social worker, LCSW, and I have been actually in the field of aging now for 40 years, which is hard to believe. I also am a family therapist, and I know that it's super important that we figure out ways to involve the whole family and try to get family members to understand the importance of this so that we can all be on the same page. And that is where the challenges are sometimes, and that's where my work really has been is trying to work with family members who may not think the person needs to move or the elder themselves doesn't think they need to move. And that's the sort of work I do. One last thing, I also taught Aging and the Family at Kennesaw State University, which is a four-year college here in Atlanta, for almost 14 years I think it was. So, it's my pleasure again to be here with you and try to help you today.
- Yeah, great resource. So, let's start with really the question that will open all of this up, and that is what are some of the common reasons someone would want to or need to make that move into senior living?
- Well, they're actually two different questions in a sense. And by the way, I forgot to say a very important part, which is my mother was diagnosed with Alzheimer's at the age of 71. And when she was diagnosed I was in the field at the time, and I really made it my passion to try to find ways to help her, as I knew she would, her cognition would be declining more, still feel at ease in her life, still have meaning in her life. And that really segues into why somebody might wanna look into a retirement community. And that is, or whether it's an independent retirement or if it's assisted living or memory care. In my mother's case it was really important to have her still have meaningful engagement. And if she was living by herself, and by the way, she was in Florida in a condo, a real nice, beautiful condo on the water, but she wasn't getting any engagement. She was staying in her apartment. She had a caregiver in there. And when I moved her into an Arbor community actually in Florida, at the time I didn't even realize that much about the Arbor community, it was amazing the difference. She played the piano for people, she would go to the library and get books and bring them back for folks that were interested 'cause she could still walk and do a lot of things. So, it's so important that people still have that engagement piece, and it doesn't happen at home. It really doesn't. Watching television is not engagement.
- No, and we talk about that all the time when we have these, we have dementia webinars, and we have people who have dementia and are currently in the process of dealing with that on a day-to-day basis say the exact same thing. It is absolutely critical. And I'm happy to hear that your mother was able to begin thriving by living in
- Yes, exactly.
- an Arbor community because of that engagement and those engagement opportunities. So, and I love that you have this personal experience. And I know that we're gonna hear this throughout, and that's fantastic because I think people can see themselves within you and your examples. So, how does someone have a discussion with a parent or parents about moving into a senior living community, and kind of how did you have that conversation with your own mother?
- Well, at the time my mom was still capable of being able to understand, like she really didn't want to move. I don't know any, all my clients, for the most part, none of them really rose their hand and said, "I can't wait to move into a retirement community." Whether they had dementia or didn't have dementia, people tend to want to stay in their own homes because that's what they're most familiar with. But really what I, the way I usually suggest to families to have this conversation with an elder family member, and let's say somebody that doesn't have dementia, it might be that you take it off yourself and you say something like, "You know mom, I was talking to my friend Alice and her mom just decided, she was 80 years old, that it's time for her to move into a retirement community. And so, her own mom actually made that decision, and I wondered mom, what you thought of that?" And so, that's one way of doing it is to take it off your own family member and put it on, even if you have to make up a little story, I think it's a good way. Another thing to do would be to say to the parent, "You know, have you ever thought about reasons why you might need to move into a retirement community, and what would some of the positive things?" 'Cause elders are very quick to say, "I don't wanna do, I'm used to my home. I'm familiar here, I'm comfortable here." And I think some of it is fear, fear of the unknown. So, asking them questions like do you have any idea what maybe the pros could be, the good things about a retirement community? What are the things that you're worried about or you would be unhappy around? And that way you can have a conversation and get things going.
- Yeah, I like that you sort of took the burden off that person and maybe put it elsewhere, and just to start that conversation. But then you can run into a mom or dad who is going to show resistance, right? So, how can you get mom or dad to look at a senior living or a retirement community when they don't want to move, and they've made that very clear?
- So, again, it really depends on the age of the person. 'Cause what I find is that individuals who were born before 1945, so they're now in their late 70s, 80s, 90s, they're a generation of people who are very independent, really wanna stay in their homes, lived in their homes a long time. And so yeah, it's gonna be, they're going to be resistant. And so, to say to them, "Mom or dad, I'd like for you to think about moving." That's not gonna work at all. I think a better approach might be to say something like, "You know mom and dad, I can't imagine, if it was me and I was your age I think it would be really hard to think about moving somewhere else. But I also know that if I was in my 80s my guess would be that I'm gonna need some help. And I also know that it's possible that my husband or my wife," whoever you're talking with, "I might be alone and I don't think that would be great for myself. And I wondered how you would feel about that?" So, again, you sort of have the adult child or family member sort of put it on themselves, I'm thinking about this, and I can't imagine when I get to be 80 what it might be like 'cause I'm not in your shoes. 'Cause see, I think what happens, what elders tell me is that they get mad that their children want to make decisions for them and don't give them enough, and that they, some of them say, "My adult children think I'm stupid."
- Yeah.
- So, as much as we can put it back on ourselves first and start that conversation, take it off of them and begin to think about, "Gosh, if I was, I've gone to some of these retirement communities dad, and I'm amazed they have pools and they have all kinds of, it's not just bingo. Really, there's yoga, there's all kinds of different things that you can't possibly have, get in your home." And that sometimes gets, kind of breaks through that resistance. But I think the most important thing is to recognize the resistance and to respect it.
- Yeah, and if you know your parent is extremely independent it's all about tact, and it's all about how you approach that conversation.
- Yep.
- Especially the first time, right? Because it's almost like you gotta do it right the first time and sort of have that conversation so that it almost comes across as if it's their idea when it does happen.
- Exactly.
- Yeah, I love that.
- And the more we push, it's like anything, even with our children, the more you tell them not to do something
- Yeah.
- they're gonna do, they're gonna do it. We don't wanna, that resistance, that's what resistance is is putting your foot down and saying, "I'm not gonna do it." So, giving them permission is what helps to break through that resistance.
- Yeah, and it's human nature, you know?
- Yep, it sure is.
- We get this particular question quite a bit, my mother believes that she and the rest of the family should take care of dad yet we know we really can't. At this stage in her life she can't do it, and I'm working, or I've got things that I've got going on and it's challenging. So, how do we, or somebody in this particular situation, address this so that she might be open to considering a retirement community?
- Yeah, again, I think it depends on that how old the folks are because that older generation of people, the first thing they're gonna say to you is, "Well, I took care of my mother."
- Right.
- "Why can't you take care of me?" Well, guess what? In most cases the mother might have only been 65, not 85.
- Yeah.
- And there's a huge difference
- Oh yeah.
- in the kind of care and support an 85-year-old person now needs than back then at 65. So, that's one thing that I always try. And another thing that I hear elders say to me all the time when I was working with them, "I don't wanna be a burden."
- Yeah.
- Okay mom, you don't wanna be a burden, but you're also saying to me in the same breath that you want us to take care of you.
- Yeah.
- So, how do we navigate through this? What are some of your ideas so that you don't feel like you're a burden? And then the third thing that I think is super important is for the adults to actually say to their parents, "Look it, I have children that I'm taking care of, I have a full-time job. I have a lot of responsibilities, and let me share with you what some of those are and what my schedule looks like. And it would really help me, we would work more as a team and I would feel less worried." That's another thing that adult children tell me all the time, "I'm really worried about my elder family member living by themselves." So, those might be ways to at least start to work with that conversation.
- Yeah. There's the worry and then potentially the guilt because they can't give the time to that parent because they have so much going on in their own personal life with their own families, their core families with their children and their husband, or could be a wife in that situation. So, yeah, this is why we're having this discussion today is so that if you're in that position right now you could start making strides to get that conversation started, and hopefully everybody's happy at the end of the day. That's what we're looking for here.
- And you know, another thing that I wanted to have people understand is that you can say to somebody, "Look mom, we're just gonna, we want to look at places and we'd like for you to go because, to look with us, because you're the one that's gonna be potentially, ultimately might have to live there, and we don't want to have to make a choice about a place in a crisis. Because the worst decisions get made in a crisis because everybody's so emotional, you're exhausted, and we may choose a place that isn't so great for you." And I think if you put it to them that way, I mean, I know for myself I would much prefer to go see some places myself if I was moving, if I had to. And it's not like that, you can say to them, "It doesn't have to be tomorrow that you're gonna move, but we really want to begin to sort this out and make some good choices for you."
- Yeah, and the other cool thing about that is, if someone's looking at an Arbor community, they can call up, they can go visit, they can see, they can touch, they can interact with the people that are there. And what I think is cool is if you find yourself in a situation where say you're caring for a spouse, somebody at that community is doing the same thing that you did and they already made that decision, and they can tell you what their day-to-day now looks like now that they have help to care for that spouse and how that has freed up other avenues in their life. And I hear it all the time, "I feel less guilty. I feel like I get to live my life, and I get to do it with my spouse who's being well cared for beyond what I could have ever have done." So, that's great that you mentioned that and prompted me to think of that as well because they're out there, and they're just like you and they already made that decision. So, what about this scenario? So, my mother has dementia, doesn't understand why she has to move. I've selected an Arbor community, but I don't know how to transition her with, to make it as easy as possible for her. So, what are some options on that end to make that transition as simple and easy for everybody involved?
- Yeah, and the word that I like to use for families is the word ease.
- Yeah.
- Because when you think about it, we often will say that somebody with Alzheimer's has a disease, it's an Alzheimer's disease. And I think about break that word up, dis-ease, and what we wanna do is help people feel more at ease. And somebody with dementia oftentimes they're at a place where they really don't have the executive functioning to be able to make a good choice for themselves or to understand that they're not safe where they are, 'cause safety's such a big issue. Engagement, safety, those are two really major reasons why somebody with dementia needs to move somewhere. And so, there's going to be resistance, just like there always is with everything, whether somebody has cognitive impairment or not. In this case though, what I often suggest is that the families set up the apartment so that when the person moves in they're moving into a space that feels very familiar. And even if there's a way they can think about where the bed faced, just like a picture that they can look at that they're used to looking at say from their bed, and have familiar things, pictures and other, if there's a favorite chair, just things that are gonna make them feel more at ease that way I think is very important. With my mom, for example, she was a big piano player. Now we couldn't put a piano in her room, in her apartment, however, we had some of her music scores 'cause she wrote music and we had some of that. We actually framed some of them, and then we put 'em in her room. And on her door to her apartment it had music notes, and it said Doris on it. And so, it was a way finding, so she knew where her room was 'cause sometimes she didn't even remember her name. Another thing that I often suggest is that it's so important that the families be proactive and tell the Arbor staff what helps people feel more at ease. They used to, my mother didn't like taking, she was always a bath person, so taking showers was hard for her. But they would say, "Doris, we're gonna take a shower, but we're gonna give you a Milky Way bar that you could eat." And I know that sounds kind of silly and crazy, but it worked. There were things that my mom, and other clients that I've worked with, that if you know that it's gonna help them, play music in the apartment or when they're, even let's say you're taking them on the tour and the apartment that you're looking at, what if you even had music that they loved playing while they went into that apartment? Smells, familiar smells, and then most important when they're actually moving in, to make sure that you try your best to have things done in the same way. Like my mom was a morning bath person, so it was really important that the staff work out a schedule so that she got her bath in the morning. 'Cause if she had it at night, one, she had sundowning, two, she was much more agitated. She refused to take a bath. Foods, all that sort of stuff can really hugely make a difference for people.
- Yeah.
- And ease them more in.
- And as you know, when you move into an Arbor community that there's a whole list of questions that sort of prompt these
- Yes.
- answers that you just said so that the staff knows exactly what could put that person at ease day one. And so, I'm so glad that you mentioned that. We're here, this is obviously for the Arbor Company, but if you decide you wanna choose another community or they're currently in another community and you say, "You know what, we didn't do that," do it today.
- Yes.
- This is what these resources are for. We create these videos so that everybody, no matter where you're at, no matter where you're staying, no matter what you're doing, you have the same information that we do here at the Arbor Company. And if you choose to come to the Arbor Company, fantastic, but we want you to be armed with as much knowledge as possible to help your elder loved one. And that is what we are talking about today. I thank you so much for being here. Before we leave though, do you have any additional resources or somewhere that we can guide viewers to to get more information about this topic? And also, if somebody has additional questions for you and they wanna chat with you one-on-one, how can they do that, how can they reach you Nancy?
- Well, a couple things. I'm just gonna share two books that I wrote that I think could be extremely helpful to families. And I'm not saying it just because I wrote it. I wrote it mainly because of my own personal experience with my mother 'cause she had Alzheimer's for 14 years. But also all the clients I've worked with over the years and the things, so it's called "The Mindful Caregiver:
- Okay.
- Finding Ease in the Caregiving Journey." And then the other one is, because I know that families, they've told me this over and over, "Nancy, when I go visit my family member, particularly when they have dementia, I don't know how to be with them. I dread visiting them." So, I wrote a book called "Meaningful Connections: Positive Ways to Be with a Loved One Who Has Dementia." And it's chock-full of all kinds of ideas, which you can take some of those ideas out of that book because it is hard sometimes to visit with people, period.
- Sure.
- And we wanna try to find, and of course, visiting with people when there's an activity. And the one thing I will say about the Arbor Company that I love so much is that you guys have always been wonderful. I mean, you put a lot of money and training and time into making sure there's good engagement.
- Yeah.
- And that is so important. So, many places I've been to where elders are just sitting there in these assisted livings, whereas the Arbor Company has very specific, Bridges program, all your different engagement programs can make such a, make people thrive, you know? And that's what we're looking for.
- Yeah, thank you for saying that.
- Yeah.
- This is data driven, right? You can see it, you can see the difference between somebody who is suffering from dementia when they have engagement and when they don't. And you started the conversation off here today talking about that specifically, and I'm glad that you did because it just makes a world of difference.
- I mean that's, in my opinion, that's what you're paying for.
- Sure.
- You're paying, not how beautiful the place is. I mean, you want it to be nice and safe and clean and smell good and all that, but it's really the engagement and making sure there's enough staff that know how to engage somebody that has dementia, and meaningful engagement. Not just having them fold towels, you know? I mean there's lots of things people with dementia can do. 'Cause I worry the most about, there's lots, with the other engagement programs it's a little bit easier. And that's what I think Arbor's done a nice job with. I mean, really, really good in terms of thinking about that for folks with dementia. One last thing I was gonna say, in terms of resources, there is a wonderful organization called the Dementia Action Alliance.
- We love them.
- Yeah, and I just, they just sent out something. They've put together sort of a booklet that I haven't had a chance to look through it yet, but they are a very, they're a wonderful resource because they really want there to be positive thriving things for people, particularly people with dementia.
- Yeah, Dementia Action Alliance, you can find it if you Google it. Also, it's DAA for short.
- Yes.
- We've had those involved with DAA on our program, and you are absolutely right. They're a fantastic resource. And Nancy, this is the first time you've been a part of our conversations with the Arbor Company and come back anytime.
- Yes.
- We can continue to have this conversation for hours because there's, it's literally just touching the tip of the iceberg here, and there's so much more that we can delve into here. And your books, before we leave, where can somebody purchase them?
- I mean, basically if you get on Amazon you can get both. If you put in my name on Amazon under books it'll come up.
- Okay.
- Nancy Kriseman.
- How do you spell your last name Nancy, for everybody watching?
- Yeah, K-R-I-S as in Sam, E-M-A-N. One more thing I did wanna say, perhaps I will come back on for another program, which would be just for spouses and partners.
- Oh, yeah.
- Because dealing, their issues, and anybody listening to this will understand. It's very different to be a spouse caring for somebody who's elder or has dementia versus an adult child.
- Yeah.
- And so, that's another whole topic.
- Yes, it is .
- And conversation.
- It is absolutely its own topic, and so there we go.
- Okay.
- Look for that video with Nancy in the future because you're going to have it. Nancy, it has been a pleasure. You are a wealth of knowledge.
- Thank you.
- Thank you for sharing it with us today.
- Thank you for inviting me, have a wonderful day. Bye-bye.
- Absolutely. Now, if you enjoyed this video with Nancy please head on over to our website, it's www.seniorlivinglive.com. All of our videos there are all about senior living. They are available 24 hours a day, seven days a week. As always, thank you so much for being a part of "Senior Living LIVE!" Have a great day everybody.
