Long Term Care Planning: Community-Based Care Settings

We were invited to write a series of brief articles for the monthly newsletter of our friends at MDK Insurance Services, describing the continuum of long term care, and how to navigate oneself through it. You can sign up for the newsletter on their website, and each month we provide a copy of the article here as well. Please share the information with someone you know who is thinking ahead about how to plan for (and pay for) their own or a loved one's long term care.

Volume VI: Community-based care settings

Previous installments of this series have described the resources available to those planning for care at home, and the goal of this issue is to describe the basic options for community-based long term care. Those who choose to move out of a private home and into a "senior living" setting do so for a variety of reasons. For some, it is a financial decision, while for others it is a lifestyle choice - freedom from the day-to-day responsibilities of managing a household, or the opportunity to interact socially with more people on a daily basis.

Independent Living communities are also sometimes referred to as "retirement communities." Some amenities such as communal dining, light housekeeping, transportation services, and planned activities may be available, but no personal care is provided. In these communities, residents must usually be able to ambulate independently.

Residential Care refers to a range of different housing providers that are licensed (in California by the Department of Social Services' Community Care Licensing division) to provide assistance with activities of daily living such as bathing, dressing, and medication management. A Board and Care home is a small residence (usually a single family home) with between six and twelve residents and a small staff of attendants. An Assisted Living facility is a larger community that usually offers several different levels of care and more supportive services.

Skilled Nursing Facilities are sometimes referred to as "nursing homes." They are licensed (in California by the Department of Public Health) to provide skilled nursing and supportive services for those who require assistance with most - or all - of the activities of daily living.

Next month we'll explore some additional specialty community-based residential services that are available, and then we will move on to a discussion of fees and funding sources for each level of care.

Are Your Employees Orange?

We have spoken earlier about the great research done by Chester Elton and Adrian Gostick in The Carrot Principle, a book about employee engagement and the effects of recognition in the workplace. The authors have done it again, this time in The Orange Revolution, which discusses teamwork. The book encompasses what makes a great team, and how an "orange" team, or one with a high sense of unity in a common goal, achieves breakthrough, positive results.

Teams exist in almost every organization, in every arena. The elder care industry is no exception, especially when you consider geriatric care management, and the team it takes to care for an elder in their home. Elton and Gostick found that once an initial level of basic competence is met, there are 5 key factors every team needs in order to achieve "orange" status and be effective:

• Goal Setting (knowing where the team is going)
• Communication (wise use of your voice and ears)
• Trust (believing in others and being trustworthy)
• Accountability (doing what you say you will do)
• Recognition (appreciating others' strengths and contributions)

A geriatric care manager and an organization that employs caregivers to the elderly has a key responsibility to ensure their employees are humming the same tune when it comes to those five factors. Supervisors who set clear goals, encourage and provide detailed communication, build trust, hold team members accountable, and recognize great work will undoubtedly have an engaged team environment built around the client.

Since October brings us lots of orange in pumpkins, Halloween, and harvest colors, I encourage you to survey your employees and client care teams to see if they are engaged and orange, too.