No one likes to think about the loss of independence that often accompanies the aging process. However, it’s very much a fact of life for many seniors. While putting off senior care may seem easier in the short-term, it can have serious long-term repercussions.
As the Director of Community Relations at ECH, Joanie Lepping Gillis has seen these repercussions firsthand. Joanie oversees admissions for long-term care, long-term care with memory care long-term care, personal care, and personal care with memory care. She also leads tours at ECH and oversees the move-in process from start to finish. We sat down with Joanie to discuss how individuals can plan ahead and ease their loved one’s transition into senior care.
JOANIE: In an ideal world, everybody preplans. But the reality is that people don't. Some do, but most people wait until a crisis hits. In a crisis, no one is thinking right, and you’re making split-second decisions. You also don’t have the same options that you do when you plan ahead.
It’s so important to have everyone on the same page because there are [more factors to consider] than people think about. There’s gathering legal documents, selecting a community, picking a new physician, coordinating the move-in process, communicating with family members, and more.
For example, Kentucky state regulations require that a resident have a history and physical completed within 14 days of admission to long-term care or personal care facility. So when a crisis hits, and your loved one is being discharged from a hospital or your mom has fallen multiple times in the last week and you have to find placement in the next two days, then the question begs itself: have they had a history and physical within the last 14 days? If they haven’t, then either you have to scramble to get your loved one into their primary care physician, or I have to arrange for a provider to be here on the day of admission to do an H&P immediately—which we can do, but it asks a lot of the providers.
Another thing to keep in mind, especially for those who choose to age in place, is that family members should understand the limits to their loved one’s current living situation and keep an eye out for those limits. For example, if your limit is that your mom starts falling, don’t wait until she’s fallen for the seventh time to consider senior care. All it takes is one bad fall.
JOANIE: I absolutely think it contributes to the residents’ quality of life. Even if you have a resident whois totally prepared to move in—if you have a stressed-out family, nothing is going to feel right. Proactive planning can really take the heat off a family because they’ve had the opportunity to get all the siblings on the same page, and they’re not making split-second decisions. Everything is more cool, calm, and collected.
Families seek [ECH] to make the move as smooth as possible. That is my primary role. I tell families every day that it is my privilege to do this, and it is my job to make the transition seamless for them and make sure they don’t see any of the back-burner stress that I do. Unfortunately, some of that seeps over when we do emergency move-ins because I’m asking them for everything upfront. It’s a lot. And when you have siblings that aren’t on the same page, everything [becomes even more] complicated. If it’s crucial that siblings tour a facility together, then pre-planning is extremely important.
JOANIE: Absolutely. [Even if touring together is not essential,] touring is a big part of pre-planning. Call a community before and talk to somebody. Understand the care levels. That’s another huge part of pre-planning. It’s so critical. Kentucky does not make it easy. Personal care is not offered in most states—only in Kentucky and Pennsylvania—so most families don’t understand what personal care encompasses and what it doesn’t. So, understand the different care levels and determine which is the most appropriate for your loved one.
JOANIE: I think one of the biggest barriers to people pre-planning is denial. There are also financial concerns; they think they can’t afford [to move to a senior living community], and that it’s cheaper to stay home. But if long-term care is in your future, it actually behooves you to move sooner rather than later. People think they can live at home cheaper than they can at ECH. But if you stay in your current living situation and bring in services to assist you (or even if you don’t), you’re spending down your money. So, it’s better to come to the community sooner, so you can claim all those assets toward your acceptance into the community.
Another barrier to joining a waitlist is that people don’t want to financially commit themselves. I can only speak for the Episcopal Church Home, but if someone submits a deposit with their personal care application, it’s a refundable fee. You’re not out anything, but you still get the security of having a place, if you need it.
JOANIE: Loneliness, a spouse passing, a pet passing, giving up their car keys, or any other significant life event that could cause your loved one to lose their “purpose.” Family members have to be so aware of where their loved ones’ sense of purpose comes from.
Any sort of a health status change is another really good time to look into a senior living community. But also when someone is perfectly able and willing and cognitively alert to go on a tour, so they feel like they’re a part of the conversation. If a physician mentions it, that’s a good time to start the conversation, too.
JOANIE: A lot of times when I tell people that ECH will never ask residents to leave [if they outlive their financial resources], they say “we should have come here in the first place” or “we should have moved mom here six years ago.”
You can’t change the past, but what you can do as a consumer and as a decision-maker is just ask questions. Even if you know you have unlimited funds, ask questions about what happens when funds run out. People should not be afraid to ask that question—or any question. I think it’s a valuable way to determine the integrity of a community.
JOANIE: Have a conversation. Sometimes by having a family conversation, you learn what things are “absolutely off the table” and whether you need to involve someone else, such as a trusted relative or primary care physician. This [approach] will help you tackle the issue at hand better. And even if your loved one says that senior care is “off the table” now, you’ve planted the seed.
Then, start asking questions. Call around, and schedule tours. Also, schedule tours at communities that have the right level of care for your loved one. Find somebody you really trust and have a conversation to figure out what the appropriate care level is.
JOANIE: I am so thankful for this role. It brings me so much purpose. It is truly my privilege. One of my favorite things is that I have the opportunity to help people “connect the dots” and find a solution. It’s not about me, and it’s not about ECH: it’s about their loved one. At the end of the day, people have to make a choice that truly fits into their life. I have the opportunity to support people, genuinely be who I am, and serve people as they seek to make one of the hardest decisions of their lives.
I also see myself as a resource. Even if you don’t choose to move forward with the Episcopal Church Home, use me as a resource. I’ve been in the industry for eight years now. I am here to be a listening ear, find solutions, inform, and encourage.
You can reach Joanie Lepping Gillis at (502) 736-7800 or jgillis@erslife.org. For more information on senior care or ECH specifically, fill out an information request form here. We hope you will visit us for a tour!