The Advantaged Investor: Helping Mom and Dad Transition to Assisted Living or Retirement Facilities - (Episode 103)
Senior Portfolio Manager Neela White joins the podcast and host Chris Cooksey to discuss how we can ease the transition of moving mom and dad into retirement or assisted living facilities, including:
- What sort of preplanning should be done?
- How do you transition into assisted living?
- What do you do with their new space? How do you make it feel like home?
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Transcript
Chris Cooksey: Hello and welcome to the Advantaged Investor, a Raymond James Limited podcast that provides perspective for Canadian investors who want to remain knowledgeable, informed, and focused on long term success. Today is September 12h, 2024. I am Chris Cooksey from the Raymond James Corporate Communications and Marketing Department, and today, Senior Portfolio Manager, Neela White, returns to the podcast for back-to-back episodes -- Neela, I think you might be the first one. Last time we discussed financial tips that can affect women, but also apply generally as well. Today we are discussing how we can ease the transition of moving mom and dad into retirement or assisted living. I invite you to check out the archives for a lot of great episodes, many featuring Neela. So welcome back to the Advantaged Investor, Neela. I hope you are well today.
Neela White: Thanks for having me back again. Chris and I am. What could go wrong on a day with the humidex being in the thirties in Toronto?
Chris Cooksey: Hey man, for September, I will take it, Neela. We are discussing as I mentioned off the top how we can help mom and dad, but I guess really whomever in our lives, to become comfortable with a pretty large life event for many moving into a retirement home or assisted living space. On a personal level, my two grandmothers went through this. I wasn't involved in the decision at the time, but I remember visiting, and my parents aren't there yet, so I am looking forward to learning more from you on this subject today, Neela, as it is something that affects more and more of us, it seems as we move forward. And of course, we have spoken about this during COVID and sort of some of the issues that COVID brought to light. I'm sure for many, this is sort of, if not the last, one of the last big life changes that can occur. Is that an accurate statement?
Neela White: You know what? I think it's one of definitely one of those life events that impacts everyone, not just mom and dad, but the adult children as well. It affects their social connections. And I think it's one of those things that we have to realize that life events do not occur in a straight line, right? There's all sorts of dips and doodles and really, it's just being aware of them and planning for them and talking about them. And I think that's the biggest thing -- we tend to shy away from these conversations which does not help decision making, right? Because what do we shy away from? Things we fear. So how can decision making be made when you already have fearful thoughts, right?
Chris Cooksey: Right. And this is one of those decisions I, I would guess that it doesn't make sense to me that you would wait to the last minute to try to figure things out. You want to plan this out.
Neela White: Yeah.
Chris Cooksey: Talking about it, is important. You may have something in your mind that the person is not going to want to do this. They love their garden, or they love their dog and they don't want to do any of this stuff. But then you talk to them and they are like, man, I don't want to cut the lawn anymore. I guess that's why it can be both a very positive, easier conversation though probably never easy, but easier conversation or as we talked about, quite difficult.
Neela White: Yeah, I think it depends on who feels in control, right? So I, unfortunately, you know, when I was a caregiver, I was a caregiver for a decade of my life, and unfortunately, as a caregiver, sometimes you're just looking to solve everything as quickly as possible, and that sometimes does not include the care recipient's ability to be part of the decision making and feel as if they're part of what's happening to them. So I think the first thing is, we always have to involve them in the decision making. And it helps just because it lets your parents feel in control. It lets them feel respected. And it reduces those feelings of being forced and abandoned, right? Because they are going to be separated from everything they know. They are going to be in a new environment. And the easiest way to do it is sitting down, and they're not easy conversations, as you mentioned, but having open, honest conversations, about why assisted living might be beneficial and the next step, It's so important to tour these places. Unfortunately, assisted living, especially if it comes to long term care, which is different than retirement home or some forms of supportive assisted living, it has a negative stigma.
I think it's really important to go with mom and dad and an uncle or whoever, to go on a tour so they can become familiar with their new environment as opposed to drop them off and leave. Imagine your child, the first day of kindergarten, imagine that feeling of the child when after being with mom and dad so long, they're dropped off and they see the backs of mom and dad. It's the same sort of abandonment feeling and the way we all know to ease children into that is gradual, right? So take them to the facility a couple times, have dinner there, have lunch there, participate in a couple of the activities. Go to places where you can recount, “Hey, mom and dad, you enjoy reading by a window.” Go look at the facility or the floor and say, hey, look, here's a window. Here's a nice chair. You can still read by the window. That sort of stuff.
Chris Cooksey: I think the first step would be planning or pre planning and obviously visiting would be part of that discussion, but is there an order that you would suggest you go through when you're thinking about preplanning? So maybe we can go over that.
Neela White: I, I think logically the first thing is to have that conversation, to recognize why there is a need for support. It could be they're not eating properly. They're unable to safely bathe themselves, safely go up and down stairs, inability to cook, that sort of stuff. I think once you can point out that, not in a condescending way, but to be able to promote how much longer they can maintain their independence through supportive living. So it's not as if in supportive living or assisted living, they're going to do everything for you. It just provides an environment where you have the support, where you can continue to be as independent as possible, and the little gaps are filled in.
I think the first thing is involve them in the decision making, have a conversation about what is it you want, what can we afford. Remember, this is, some of this is budget dependent, and come to a plan A, plan B, plan C. Plan A, let's say that involves retirement homes or assisted living. Go take a look in the neighbourhood, whether it's around your parents or around who is going to be the potential caregiver or person visiting often. Make sure it's accessible. Make sure the place is nice. Make sure that family can come and visit. Make sure that your social connections are aware and you're thinking about making this transition. Because the biggest thing also that helps with the settling in at any location is to have your friends, your community, the social groups know where you are, so you're not like they disappeared off the face of the earth and to be able to continue with those social connections.
Chris Cooksey: Right. That totally makes sense. I know with one of my grandmothers, she actually moved from Kingston where my mom grew up, but my mom and her sisters had all moved from Kingston. Fortunately, they were all in Ottawa, so that transition was easier, but you know, they were very concerned about plucking my grandmother out of her comfort zone and moving her to a new town, because you know, friends and the social side of it for sure. So lots of considerations, I guess is really what I'm getting at here.
Neela White: I was just going to say, one of the biggest things for anyone, whether there's no place like home and you want to age in place or you're going to retirement living or anything, you want to do as much as you can to prevent the feelings of loneliness and isolation. If I'm not mistaken, the World Health Organization declared loneliness as a epidemic. Think of that, just the lack of social connection. This is definitely a point in your life where you want to maintain as many of those as possible. We do have technology, maybe it's a little hard for an elderly friend to visit an elderly friend, but there's still video chats, there's still the phone, the phone still works, right? Letters still work, postcards still work. All of these things are still validation of you exist and you're cared for and you're remembered, and there's relationships that you can count on.
Chris Cooksey: Yeah, totally makes sense. I would imagine the transition into assisted living is a little different. Sure there are rules, and I'm sure if you come from a condo, the rules are similar. You can't put this on your door and all that fun stuff, but you have your dinner times, and you might have a little kitchenette or whatnot, but it would be different. I mean, I don't think anyone can argue that. So how do you transition into assisted living? What were some of those tips?
Neela White: I'd say there's two steps, gradual, if the facility permits it, gradual transitioning usually tends to be the best. So that it's not this cut and dry environment where I woke up this morning in my own house, in my own bed, and tonight I'm going to sleep in a strange place, in a strange bed. A lot of facilities offer respite stays, vacation stays, where you can go and stay for the weekend, you can stay for a week, I think that's a good way to make the environment less intimidating and get used to the new routine of meals and the social activities and stuff like that. I think a transition helps with the emotional impact of changing an environment. If possible, start with short stays, start with visits, start with respite. so you get used to it. And then I think the second part is once you actually make that move. Once you decide you're making that move, a room is going to fit much less than an apartment, a condo or a house. I think you'd want to write down a list of 10 items that are very personal to you that would help you create a sense of continuity and comfort.
It could be your favourite chair, your favourite ornaments, blankets, pictures are so important. It allows reminiscing, especially if your condition tends to be one where there's a bit of decline or memory decline and stuff like that. Pictures are a great way for caregivers and support staff to engage with that person through reminiscing.
Chris Cooksey: That makes sense. Now, you started talking about the list of 10 things, as you said, but most people are probably transitioning to a smaller space. I know that if you looked at my garage, you would see a bunch of stuff that a junk removal company would need to come in. How do you help them with this new space? And, beyond the pictures, how do you make it feel like home?
Neela White: You know what? I would say if you're able to orient stuff in the room similar to what their bedroom was. So that's one thing. Whatever is closest to where they are in the bed, you'd want to recreate a space very similar like that. Pictures, as I said, it's a huge one. Comfort items also tend to be things like, comforters, blankets. They tend to carry the feeling of home and security. I'd say that one. Favourite slippers, favourite shoes, favourite nightgown or nightdress, or favourite mug -- all of those things. Think about it this way, when we move to a smaller space, don't we usually realize, oh my gosh, how did we accumulate all this stuff? Because we only use 10 percent of it. It's sort of a bit of a similar experience. What are the 10 things that you think about when you eat breakfast? That you use when you shower, that you use when you dress, that you use when you watch TV or read. What do you use, and I would go through with what is the most important thing within each habit that you have.
Chris Cooksey: Just to finish off, this is a big topic or conversation and decision to make. What are your suggestions on timing to have this conversation? Is it plant the seed early so you can have more of a, I don't know if you can call it casual conversation about this sort of thing, but is that best - the longer, the better in terms of lead the lead up time?
Neela White: You know what? I can't stress this enough, how important it is to start these conversations early, while the conversations are still positive. I think part of the problem, and I understand this, that we tend to be very reactive in a moment of crisis, so a diagnosis comes, a fall comes, a hospitalization comes, then all of a sudden it's, oh my gosh, we don't know where to turn and you tend to make decisions that satisfy the moment or alleviate the pressure point at that time. Whereas if you start this conversation early, you can actually look at the positives because they're part of the decision making. It’s not you as caregiver or power of attorney forcing the decision upon them. They are medically more complex, the support they need is more complex. I think early is better. Focus on the positives of that move, set up a communication plan and discuss it with stories you've heard of other people going through similar things. I mean, the biggest thing is when we can share stories about the good and the bad and the ugly, that way we can address the bad and the ugly early on and then focus on the good.
Chris Cooksey: Right. Totally makes sense. Now, is there anything else you'd like to leave us with today?
Neela White: I'll be the first to say that change is difficult, transitioning is difficult. I think we need to focus on the pauses, we need to stay involved, especially if we're part of the plan, we need to stay involved, because this will affect us. I think, when the move decision is made, we need to celebrate that, celebrate it as this autonomous, independent decision that mom and dad made for themselves and it alleviates that whole feeling of guilt of, maybe I could have tried harder. Maybe if we had done this, maybe if we had done that. I think those are all positives. And yes, start early. It doesn't matter that the conversation isn't one that's necessary at the time, but conversations do stay in people's minds, and at some point it might be, I can't manage the stairs very well in the morning, or I noticed I left the stove on. What could be happening? Do I possibly need a bit of support? Who can support me? Provide that support by saying, let's go back to that conversation that we had. Help understand if there budget supports a retirement home.
Chris Cooksey: That makes sense. Well, Neela, as I've said before, I always learn something, you always give me something to take away and to think about. So really appreciate your time and I hope we do it again soon.
Neela White: Great. Thank you for having me and have a great day.
Chris Cooksey: Reach out to us at advantagedinvestorpod@raymondjames.ca. Subscribe through Apple, Spotify, or wherever you get your podcasts. Please contact your advisor with any questions you have. Thank you for taking the time to listen today. Until next time, stay well.
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