Saturday, November 27, 2010


After Dad returned from California to see Jennifer and announced that he was going to file for divorce, I took him to see some Continuing Care Retirement Communities. I couldn't stand the thought of him being alone and cooking for himself. I'm sure he would benefit from a community, having food and social opportunities all around him.
Dad arrived home on a Tuesday and was disappointed that I didn't have an appointment at a CCRC until Thursday. He was anxious to see what might be available to him. That certainly was good news. It would break my heart to force something on my dad that he had no interest in! We had a great visit at this first community. In fact, the community was ideal and we really didn't even think of going to see another. That is, we didn't think about it until my dad was well into the application process and the organization indicated that because of his diagnosis of 'early stages of Alzheimer's Disease' they wouldn't take him.So, onward in our quest.
I was surprised at the number of very nice communities in our area. I also found it surprising to see the differences in prices. We visited communities that had buy-ins and those without. We visited some that had beautiful common areas, but terrible apartments. We saw some great apartments at communities that also had lousy amenities. We visited very large communities and those that were much smaller. We saw some that were in high rise apartment buildings and some that had fairly large campuses with walking trails and outdoor activities.
Fortunately we found a second community that Dad really liked. As he is the sort to make snap-decisions, within a week of our first visit he was finishing the paperwork and a move would shortly follow.

So, what did I learn in this process that may be of help to others?
  •  I discovered that it is really helpful to preview the community myself. I have a good idea of what my dad would and wouldn't like, and he found visiting the communities very tiring. This way I could eliminate some trips and we could focus on the most likely candidates. 
  • I also found that dad was easily confused about what he had seen at one community or another. Heck, I had trouble keeping them sorted out myself! So we set up folders with all of the information and I took copious notes at our visits. Since I was the official note taker he could relax a bit and concentrate on what the community representative had to say. I took pictures of the apartments we visited so he could compare the pictures to floor plans that he was given. I didn't take pictures in the common areas, but in hindsight this would have been very helpful for him in sorting out the communities and their amenities. 
  • I began to start my inquiries by asking if the community accepts individuals with Alzheimer's Disease. I didn't want to run into another situation where my father would be turned down. 
  • Each community is very different and the fees are often structured in a different way. 
    • Type A communities charge an entrance fee and a set monthly fee regardless of the level of service required. Thus, if a person needed full-time nursing care, the fee would be the same as if he was living independently in an apartment. This is a 'Life Care' or 'Extensive' contract.
    • Tybe B communities charge an entrance fee and a set monthly fee. If the resident requires nursing care they may offer it at a discounted rate, but their monthly fee would be higher than the monthly fee for independent living.
    • Type C communities charge an entrance fee and a monthly fee with additional fees for services used. Thus, the resident may pay extra for transportation, classes, access to the gym, parking, etc. 
    • Rental Communities: a few communities charge no entrance fee and the residents pay a monthly rental. Additional services may often be billed to the resident. 
  • Spend one or more nights at the community. Every community we visited offered to have us stay for lunch or dinner in the dining room. Several communities have guest suites and a few offered to let my dad spend an evening. I think this was helpful for him. He had the opportunity to experience several meals and to talk to many residents. It helped him get a feel for the community.
  • It may have been helpful in choosing one community over another if my Dad had listed or ranked services and amenities that he felt would be important to him before we visited communities. For example, he isn't a swimmer, but we did meet a couple who's first priority was a salt-water filtered pool. Certainly there were things we thought would be important, such as a transportation system, but it may have made the decision making process easier if the items were listed and ranked before we visited our first community. We built our list as we went along: nice view, two bedroom apartment, transportation, meals available....Dad is pretty easy to please!

Thursday, November 18, 2010

Can You Hear Me Now?

When it comes to gadgets my dad has always wanted to have the latest and greatest. One of his more recent big-boy-tech-toys is his iPhone. Dad's financial adviser was showing him the iPhone a while back and he enthusiastically showed Dad everything it could do. Within a week Dad had his own iPhone and within a month he had given each of his kids a gift certificate to get  iPhones for ourselves.
I will have to admit that at the time I was not overly enthused because the gift of the iPhone meant that I would have to change to a different service provider, begin a new contract period and incur greater expenses. Gee, thanks, Dad! However, in hindsight it was a smart move. At least when Dad calls with a question about the workings of his phone I have some clue (unlike when he calls me about his Apple computer) and I have an iPhone in hand and can talk him through things step by step. For example, he often calls people in error, by trying to delete their listing on the 'Recents' screen. Since this screen is different than the Voicemail screen, he gets confused and needs me to point him to the 'Clear' button.
There are many times that I can't get Dad on his iPhone. Sometimes he turns the ringer off (as do I) in error when he pockets the phone. Other times, the volume of the speaker is turned down inadvertently as he handles the phone. I do the same thing and know, when we finally connect, how to help him to 'fix' his phone.

Sunday, November 14, 2010

Does He? Or...Doesn't He?

I often wonder if my dad really has Alzheimer's disease. His doctor performed the MMSE (Mini-Mental State Exam) in 2009 and repeated it recently. A score of 23 or below is indicative of cognitive impairment. My dad scored a 26 both times.When I asked the doctor about her diagnosis, she stated that the 'patterns of behavior' she is seeing lead her to believe that he does indeed have Alzheimer's Disease. Once I asked her to what degree information provided by Jennifer might have influenced her diagnosis. She paused and told me that was a good question, and she wasn't sure. Jennifer, soon to be  my dad's ex-wife, tends to obsess about some things and probably has whined about pointed out all of the behaviors she has seen that highlight my dad's memory issues.
There is no doubt that Dad has very poor short term recall. Some days he will ask me almost the same question three or four times within a few minutes. Often I will be chatting about something I have done, and when I allude to it again, he asks me what I'm talking about. He occasionally misplaces his keys, wallet or a document and can't remember where he put them. He'll put something on his shopping list that he already has in the kitchen, either forgetting he has it or forgetting that he already purchased the item. Is it Alzheimer's or is it age?
Dad decided to divorce my step-mother because she was often away, visiting her family, leaving him by himself. I took Dad to see a number of continuing care retirement communities that have independent living facilities as well as long-term care programs and 'memory care' units that he may need in the future. We found a fabulous facility. The people were great. The location was ideal. The apartments were modern, roomy and appealing. Sadly, because the Doctor reported that my dad had the early stages of Alzheimer's, this particular community denied my father's entrance. How frustrating! How demoralizing for Dad. How does she know for sure?