Transition Hints

Moving can be challenging for anyone. A move that involves relocating from and/or selling a family home can be both physically and emotionally draining.  The process can even sometimes leave participants second guessing a sound decision that most often has been made with thoughtful consideration.  With a little planning and preparation, moving into a senior living community can be an exciting time in anticipation of the quality of life to come.

Because this type of move often involves emotional attachment, it can be even more challenging to downsize as needed.  When this appears to be an issue, it is sometimes advisable to engage the services of a third party who specializes in assisting seniors with this task.  Having an objective voice can be just the thing that is needed to deal with tough choices. Your senior living community may also have a list of resources such as movers, or charities that pick-up donations should you need it.  If multiple family members are assisting you in preparation for, or during the move, in order to avoid confusion, it is also advisable to designate one person, either you or your family member or other designee, to communicate with the senior living community on your behalf during the move.

Before the Move

Before your move day, make sure that you have all the information that you need. Ask for a list of names and phone numbers for the point person for your move – someone who can assist you if you have a question or require assistance the day of the move. Make sure that you are comfortable that you (or your loved one if you are coordinating their move) have visited and are familiar with the apartment or room and with key staff; and that you have met other residents who will help “show you the ropes” as you settle in to your new home.

Also, double check that all documents/forms needed by the senior community have been completed prior to move date. This will make the process go more smoothly, with no last minute panic over something that is required in order for the resident to move in.

Make sure that you have an agreed upon date and approximate time that the movers and the resident will arrive. Additionally, ask for specific instructions for the movers – should they come to a service entrance and/or elevator? Who should they see upon their arrival? Will you be on hand to direct furniture/belongings placement or if you are moving to an apartment or assisted living suite, have you furnished the movers with a floor plan of where you want things to go?

If you are moving to Independent Living:

Prior to your move, examine the apartment. Take measurements of each room, and plan for the furniture you wish to bring and where it will go. Take into consideration the space available at your new home when selecting items you wish to keep. You may wish to include your children or another family member in this process. Be realistic in your plans – that is, if you are moving from a five bedroom home with a basement, to a one or two bedroom apartment, plan thoughtfully for what you wish to bring. This is a good time, well ahead of your move date, to make sure that certain items which you wish to gift to another family member or friend is done. This doesn’t mean giving up special treasures such as artwork, books, lamps, or a chair you love – plan your apartment décor to accommodate those things. Other options for things you will not bring to your new apartment include holding a yard sale, hiring an estate sales professional, donating items to charity and giving items to others.

Examine the kitchen area and know what appliances are provided and what you will need to bring, such as a microwave, toaster, etc.  Is phone service and/or cable or satellite television provided or do you need to contact someone to arrange for your service? Knowing these things help make for easier packing decisions. It is also a good idea to pack grooming essentials in a small bag that you can carry for immediate access.

Prior to your move, double check that you have signed your residency agreement; picked up your keys; know where the dining room is located and have a meal schedule; know where the trash bins are located; know the optional services that are available and how to access things like the hair salon; and provided accurate information regarding whom you wish to be contacted in case of emergency.

If you have not already done so, you may wish to consider renter’s insurance for your personal property. Also, once the move is complete, share your new address and preferred contact information with your family, friends and others as you wish.

If you are moving to assisted living:

When moving to assisted living, preparation for the move is much the same as outlined in independent living.  The main difference is that because assisted living provides health related services and is regulated by the state, it is necessary to make sure certain requirements are met.

Many assisted living communities require personal assessment of a prospective resident prior to acceptance for admission. The purpose of the assessment is to identify level of care needs and to insure that an individual can be appropriately cared for at the assisted living level of care.  Things such as cognitive functioning (memory) and physical abilities are assessed.  Depending on the level of cognitive functioning, some individuals may need a more specialized environment such as a Specialty Care Assisted Living (specialized memory care center).  Additionally, should physical/medical needs dictate more advance monitoring and care, a skilled nursing environment may be recommended.

Residents moving into an Alabama assisted living are also required by regulation to have a care plan signed by their physician prior to their move-in, and a negative chest x-ray or tuberculin skin test within 30 days prior to move-in.  Since physicians’ offices are often very busy places dealing with a lot of paperwork, it is best to schedule your physician’s appointment well ahead of your move date and remind the office staff that the plan should be transmitted to the assisted living several days prior to the planned move date.  That way, should there be questions, errors or omissions, corrections can be requested and received prior to the move date.  Common issues include clarifying medications, ambulation assistance needs, etc.

If you are moving to skilled nursing:

Skilled nursing must comply with state and federal regulatory requirements when admitting residents.  A move to skilled nursing generally falls into 2 categories: for short term rehabilitation; or for long term care.

Generally, skilled nursing rooms are either private or semi-private and generally are furnished with items necessary and appropriate for the care of residents.  While most skilled nursing rooms may be personalized with a resident’s belongings such as family photos or artwork. Remember to discuss this with your admissions representative for advice regarding appropriate items.  Sometimes a personal chair or small piece of furniture may be added to the room, depending on space and the ability of the healthcare team to easily maneuver in the room to provide care for the resident.  Bear in mind that issues such as the size of the item and fabric (vinyl, fire retardant, etc.) may come into play.  It is always advisable to leave items of high value with a trusted family member or friend.

Admissions to short term rehabilitation often follow a hospital admission after a surgery, injury or illness.  Due to the temporary nature of a short term stay, rooms generally have everything needed for the duration of the stay and are not detailed with personal decorative items or furnishings. Most include telephone and television service as well. Admissions from the hospital require communication with the hospital care plan team and are usually coordinated by a case manager, discharge planner and/or social worker. When preparing for a short term stay, it is advisable to communicate your personal skilled nursing choice to your care plan team and authorize them to provide required information to your preferred choice.  Prior to the admission, the skilled nursing center must receive physician orders for your care; a clear list of your medications and administration orders; a discharge summary; a negative chest x-ray or tuberculin skin test and mental status documentation.  Additionally, a signed admission agreement and verification of insurance or another source of payment is required prior to acceptance of the resident.  Most insurance companies require prior authorization for skilled nursing benefits so make sure that your insurance information has been provided to the skilled nursing admissions representative.  Additionally, check your benefit information carefully so that you are aware of any deductibles or co-pays that may apply.

It also important for the skilled nursing staff to be aware of a resident’s wishes regarding their care, therefore, you will be asked for copies of any living wills and/or advance directives. If you are a family member agent (typically referred to as sponsor) for the patient/resident, make an appointment with the admissions representative to review and take care of these items prior to your loved ones discharge.  Additionally, establish with the hospital the recommended mode of transportation.  Does the resident require ambulance transport or will a family member or friend be transporting them by car?  For private transportation, ask your skilled nursing admission representative for clear instruction on the location of the building entrance to be used and who to contact for assistance with transporting the resident from the vehicle to their room.

Long term admissions require the same documents and care plans as short term admissions, with care plans and chest x-rays or skin tests having been completed within 30 days of admission.  A major difference is that long term admissions are not covered by health insurance.  Typical payment methods for long term care are private pay from a resident’s own funds, long term care insurance, and Medicaid for qualifying individuals.  Additionally, it is not uncommon for long term residents to be admitted from home.  If admitting from home, ask your skilled nursing admission representative for clear instructions as to what is required from the resident’s physician and any other documentation needed.   It is best to schedule a physician’s appointment well ahead of a resident’s anticipated admission date and remind the office staff that it should be transmitted to the skilled nursing representative several days prior to the planned date.  That way, should there be questions, errors or omissions to the care plan, corrections can be requested and received prior to admission.  Common issues include clarifying medications, etc.

Planning for a skilled nursing admission also involves having a clear financial plan as to how the prospective resident’s care will be financed.  Documentation of the payment source will likely be required, i.e., a statement of personal funds, verification of a long term care insurance benefits and/or plan to establish Medicaid eligibility.  If a potential resident requires Medicaid assistance, begin these discussions with the admissions representative right away so that she/he can familiarize you with general eligibility requirements and the documentation that the state Medicaid agency will require from you in order to process your loved ones application.  Planning early will also give you time to contact an outside source, such as an elder-law attorney or financial planner for advice if needed.

Once a final decision to admit is made and necessary documentation is in order, schedule an appointment with your skilled nursing admission representative to complete and sign the residency agreement and review all applicable documents. This is your opportunity to ask any remaining questions you may have.