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2011-04-26 19:47:07

When Experts Are Put To The Test


This should be an easy article to write. After all, I am an expert at understanding seniors.

I am one of the real estate professionals who discovered “seniors” in the last decade of the twentieth century. John Tucillo and Buddy West wrote a book called “Working With the Over-55 Client.” Tim Corliss founded the Senior Advantage Council and asked me to write the education module used by students to earn the SRES® Designation.


But today I am not working with “seniors”, I am working with my mom and dad, ages 93 and 95 respectively. They both exhibit all the personality traits of their G.I. generation peers. They are fiercely independent and want to believe they can remain self-sufficient. They want to make all the decisions. They own their home and have investments, but they want to preserve their estate, so they maintain a frugality so ingrained in their generation. And most of all they do not want to burden the family so they try to stay in their home despite the obvious (to me) safety issues.


I look back on some of what I wrote for the SRES® and GHS™ designations and find much more meaning to the statistics I presented. 80% of seniors cannot afford nursing care and Medicare is not available for even essential custodial care. The result is that there are 65 million caregivers in the United States now and the typical caregiver is a daughter (or daughter-in-law) with grown children of her own. Since this is my article, I hasten to add that in my case my brother is very involved in working through the challenges.


There are some choices that can be considered, as long as the senior is willing to give up some independence.


Independent Living means staying at home. There are at-home services but when the need is 24/7 it becomes very expensive. Shift workers cost more than live-in. But there are challenges with a live-in. As my dad would say “she is always hovering.” Insurance issues should be addressed as well as withholding tax and social security if you are not using a professional referral service. If you hire on your own what about references, theft, elder abuse, immigration status etc? A list of services should be investigated. Who does the shopping? Who does the cooking? Who is in charge when the caretaker takes her legally mandated 5 or 8 hour sleep break?


Continuing care facilities have onsite “sections” where the senior can start in independent care, move to assisted, and then to skilled care. Some may have a section for memory care, which means a lock-down Alzheimer center. Of the 65-million caregivers I referred to above, 15 million care for Alzheimer’s patients. Many of these facilities have a “buy-in” and may not have resale options.


Assisted living allows for singles or couples to be in a safe, secure environment with dining facilities, social interaction, and a menu of added-on services. These might be as simple as laundry or as intimate as incontinence care and bathing. They have a staff nurse and some trained medical assistants. But, it is not “home.” 


Board and Care is a residential house with fewer than 17 persons, although most are about 6 persons based upon the usual configuration of a house in a residential neighborhood. Some have private bedrooms while some are shared bedrooms. Bathrooms are normally shared. There is staff available 24 hours but may not be medical professionals.


Skilled care facilities usually require a doctor referral and may be eligible for Medicare. When mom broke her pelvis she was there for 6 weeks. By week 4 we started to get notes “threatening” to release her within 48 hours if she could put weight on her legs. Mind you she could not get up by herself; but, with assistance she could finally stand with a walker and move 200 feet so they sent her packing. And the medical chart included a diagnosis that was new to us of Alzheimer’s Dementia, which completely eliminated any option for care choices other than a live-in at home or an Alzheimer’s facility.


So, what are the challenges my brother and I are facing? Mom and Dad want to be together. They have been married 70 years. They are fearful of what will happen. Even though Mom says she has had a good life and is “ready to go” she is still clinging to some need for power over her destiny. She doesn’t understand why we have taken over dispensing her medications. She bristles at the fact that we are having conversations with her doctor or her caregiver. She gets agitated and belligerent and sometimes delusional. She insists that we should fire the caregiver and that she and dad can handle it alone. She does not understand that dad is not physically capable of helping her and that he is now having dizzy spells of his own. Dad is neither supportive nor realistic about her condition or his abilities. He will be devastated if his driver’s license does not get renewed.


We have tried to present ideas to them as whole concepts that will provide for a quality of life while keeping them safe. While we try to acknowledge their need for independence we fear their lack of judgment. The challenge is to know when we step in and take control. And the even greater challenge is knowing how to do that.


Carmen and Lloyd Multhauf are the founding developers of the Generational Housing Specialist™Council, a national real estate designation that focuses on the unique impacts made by different generations in establishing housing trends, financial products, negotiating skills and reaching a successful closing. You can read more at

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