Tammy DeCaro, Executive Director of Barrington Terrace of Naples, sits down with Melissa to talk about what assisted living looks like at Arbor, the different types of care available at the community, and when it’s a good time to consider a move to assisted living. 

Video Transcript

- Hello everyone. And welcome into senior living live. My name is Melissa. As always, I hope you are having a fantastic day today. Well, we have been checking in with Arbor communities, staff and residents to help you get to know some of the people behind the scenes. What exactly makes their experiences the best that it can possibly be. Today we are going to introduce you to Tammy DeCaro, the executive director of Barrington Terrace of Naples. How are you today, Tammy?

- I'm fantastic on this beautiful day in Florida.

- Yes. And it's always sunny in Florida. We know that. And hey, senior living is a very popular topic out in the area in which you reside. So first and foremost, Tammy, tell us a little bit about yourself. How did you become a part of the Arbor company? What's your background?

- Sure. So I've actually been a healthcare administrator of some level for 20 plus years. I have been at the Arbor company for seven, as the executive director of Barrington Terrace, however, I was a vendor with hospice for 10 years prior to that. And so I got to know the community here in Naples very well, including the director of nursing and when my career path kind of transitioned towards assisted living, I actually waited until there was an opening at this community with this director of nursing and with Arbor company. So, you know, having been the vendor, I was very familiar with the level of care that was provided and the company and the company culture. And I very much wanted to become a part of the Arbor company and I waited little impatiently for a few years for that position, but it finally came through for me in 2014 and I've been here ever since.

- Yeah. So a woman who knows what she wants, I think we can all appreciate that very much. So obviously a part of the Arbor company, doing fantastic things there at your community. And as someone who has worked in healthcare for 20 plus years, you know that senior living has changed a lot. There are so many different types of senior living communities, and we want to sort of break down a few of those types of communities. So Tammy, can you explain to us today the difference between assisted living and dementia care?

- Absolutely. Well, you know, this is also in the context of Florida and one of the things that I think people need to be aware of is that different states license assisted living facilities in different ways. So what's true in Florida may be a little different in other states. So always check locally with what your local regulations are. But, you know, in assisted living in Florida is a general category. A memory care community, as well as an assisted living community, all fall under an assisted living license. The difference is for a memory care community and a community like ours, which has both assisted living and memory care under one umbrella roof, the process in the type of client that you serve in each of those neighborhoods is different. So there's a misconception sometimes that in assisted living, you don't have folks that have a cognitive impairment or dementia of some kind, and that's actually not accurate. There are an enormous number of folks in traditional assisted living settings who have some level of cognitive impairment and usually it's a mild or moderate stage and they do very well in assisted living with activities and engagement, meals, and socialization. When that dementia worsens then you look at memory care or a memory care community. And that's obviously specially trained community staff, a different engagement level, engagement professionals that are trained to provide engagement to different types of cognitive levels, so that residents are engaged while they're going through that journey and the care is appropriate for them. Generally, you'll find that memory care neighborhoods are secure, though that's not always the case. And that is something to ask, when folks are looking at assisted living communities. But I think that, you know, just having a family member with cognitive impairment doesn't necessarily mean a memory care community is the right level of care for them. It's really important to talk to the nursing director and find out.

- Sure. Yeah. And so in discussing assisted living, there's dementia care, we have what we call bridges. We also have independent living. I know you also have another specialized neighborhood at your community that has a waiting list. Why are all of these neighborhoods so important?

- So, you know, assisted living has so many different parameters and it's important for the community to be able to serve the client with the engagement and the nursing care and the socialization and dining services that's appropriate for that person at that time in their life. And, you know, traditionally you would find, someone moving into assisted living ideally would transition to bridges, when bridges is needed and bridges, is at it's named, the bridge between assisted living and a memory care neighborhood. And then as they go down the path of cognitive stages, then of course memory care becomes very important and that resident would move then to memory care and at Naples, which is unique and different, we have a fourth level of care, which is that palliative care reflections neighborhood. And that is for very later stages of cognitive impairment where a quieter namaste focused environment is important. More attention on nursing needs and physical care as well as dining needs. What we find when people get into the later stages of dementia is that they need a lot of queuing and one-on-one attention during meals in order to can continue to thrive. And our reflections neighborhood provides that. It's the highest level of care. In fact the staffing model there is better than ICU. And certainly, like I mentioned, you know, right now we're on a waiting list in that neighborhood. And we piloted that program in 2016, it's been incredibly successful. It has grown since then, largely due to our team's familiarity and comfort with hospice and palliative care services, our partnership with hospices locally. And that means that residents who come here truly can age in place and stay at their home.

- Yeah. Oh, wow. So one of the other questions I was going to ask was about what it means to age in place. And I think you've really hit the nail on the head there in terms of kind of giving somebody a... when they hear this, to be able to visualize what that looks like. So, being able to age in place is almost exactly what you just explained and you can do it all in one place.

- Yes, yes. And the nursing team, you know, we have great cohesion between the assisted living nursing and the memory care nursing, so that when a resident transfers to another apartment in another neighborhood, the team has already very familiar with them. The collaboration among the team leaders is important. We have great transition for our residents when they go to a new neighborhood. And you know, one of the things that we're really proud of here at Naples, particularly after going through this past year is the tenure of our staff. We have historically, prior to 2020, a 9% turnover. After COVID, we kind of went into the 12 and 13% turnover range. But compared to the industry, which is 60 to 70% turnover of frontline care team, we have still a very low turnover. Some of our longest residents care assistants are in our memory care neighborhood, 16, 17 years with us. And you know, that team is very loyal. When one of their residents moves to reflections and palliative care, they continue to visit, they continue to see them, they continue to make that connection with that resident that they've cared for for so many years. And I'm incredibly proud that this nursing team and their dedication to the residents, it's what makes Barrington special.

- Yeah. Well, a national average, 60 to 70% and your community 12 or less, 12% or less, that is huge. And these people are truly, this is not just a career for them, this is like calling for these individuals. So great numbers to share there. So who should or when should someone begin looking into assisted living? And if they're on the fence about moving now because of the pandemic, as we're starting to get out of the pandemic, why is now a good time?

- Now's a good time for many reasons. You know, I find that with families, they've been thinking about, talking about moving for their parent or their spouse for quite a while. And often, you know, they may even begin their search, but not really commit or make a decision until a medical event happens. And then, you know, that decision feels rushed, it feels urgent, it doesn't set that resident up for success to come into a new community, a new environment, a new team of people with a higher need because of a medical emergency. I think that the best time to look at coming into assisted living for someone is when they start to notice that they're not able to do a lot of the things around the house that they've been able to do in the past. And particularly after the past year, when you find that mom or dad is not as social as they used to be, they're not going to church, they're not going to the club, they're not going to their bridge games, you know, social isolation is one of the most overlooked issues for seniors, but yet it has the, I feel the highest impact on that person's wellness and overall health. And I think social isolation leads to so many things that you can link to physical changes in the body and overall decline. So ideally, someone would come into assisted living when they're starting to think that they might need a little extra help with household tasks, like cooking and cleaning and laundry, so that can meet new friends, they can make friends, they can enjoy and engage and go on activities and not have to worry about laundry, or who's going to fix the gutter, or right now what's so important for us is what if there's a hurricane? So, you know, the great thing for families is the peace of mind of knowing mom and dad moved into a community, they don't really need a lot right now, but they're in that community and the team is there ready to help if something changes. And that's really where we've seen our residents the happiest.

- Peace of mind for everybody and really ease of living. If you're the senior that's moving into the community. So wow, just a wealth of information here. And your community is awesome. And we cannot stress enough how important it is to have that cohesive, long time staff that you have, and that you are so proud of and that we're proud of too, at the Arbor company. So Tammy, we do appreciate your time today. Tammy DeCaro of Barrington Terrace of Naples. Thank you so much.

- Thank you.

- Well, if you enjoyed this interview with Tammy head on over to www.seniorlivinglive.com for more of our video content, all about senior living, it's available 24 hours a day, seven days a week. As always, we thank you for watching senior living live. Have a great day everybody.

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