Assisted Living: Combining Independence with Personal Care

In this episode John McQueen interviews Theresa Putnam with Patrick Manor Assisted Living Facility

Owner of Patrick Manor Assisted Living Facility in St. Petersburg, FL

Owner of Patrick Manor Assisted Living Facility in St. Petersburg, FL

John McQueen:  [0:01] Welcome to Anderson‑McQueen’s radio show “Undertakings.” I’m John McQueen, President and Owner of Anderson‑McQueen Funeral Homes. As always on this show, we undertake those subjects that you want to know about.

[0:13] Remember, if there is a specific topic you would like for us to talk about or if you have a question you would like to ask one of our upcoming guests, please email them to us at radio@andersonmcqueen.com. We always do our best to include everyone’s request if at all possible.

[0:33] Today’s topic is “Combining Independence with Personal Care.” Our special guest today is Theresa Putnam. We are broadcasting live from the beautiful Patrick Manor Assisted Living facility. Theresa is going to help us to undertake this worthy subject. Welcome, Theresa.

Theresa Putnam:  [0:51] Hi, John.

John:  [0:52] I appreciate you having us here today. The facilities, as always, is beautiful. I know you do a great job here in our community providing assisted living to individuals who need it and need a little extra care and attention. I appreciate you taking time out today to share with us some of your thoughts. Can you tell us a little bit about what drew you into the field of assisted living?

Theresa:  [1:18] That’s a funny question, because I came into assisted living in 1991. I answered an ad, when we used to use newspapers, for a secretary of an adult congregate living facility. In 1992, I went through the administrator’s course. In 1995, I was helping run a 54‑bed facility.

[1:41] In ’95, I decided it was time for me to go on my own. I started a little 16‑bed facility, and grew quite quickly in those couple of years, and had to add a 24‑bed because I had a steady waiting list.

John:  [1:54] That’s a good problem to have, though.

Theresa:  [1:56] Yeah. In 2002, I acquired this facility, which is 55 beds with 10 independent living apartments.

John:  [2:02] That’s great. That’s quite the story. The other facilities, did you sell those off or you still have them?

Theresa:  [2:08] I did sell those off. The Little Patrick Manor, I did sell it as an assisted living facility, and it’s still operating as an assisted living facility under a different name. My 24‑bed is now becoming a high‑rise apartment on the backside of Baywalk.

John:  [2:24] Really?

Theresa:  [2:25] Yeah.

John:  [2:27] That’s great. I know you do a fabulous job. I hear a lot of great things in the community about Patrick Manor. One of the things many families ask us though is, what’s the difference between an assisted living facility and a nursing home?

[2:43] I was hoping maybe you could elaborate on the different types of care. What designates some of these facilities as a different name, whether it’s assisted living or nursing home?

Theresa:  [2:52] Assisted living is exactly what it is. It’s a combination of housing, personalized supportive, care services such as bathing dressing, grooming, and activities of daily living.

[3:04] Medication is a huge thing, with medication management, supervision of medication, making sure they’re taking the right amount of medication at the right time.

[3:12] We’re doing their meals for them, their laundry, anything that they need help with that they just can’t do on their own anymore. The difference in a nursing home is you’re getting a medical skilled staff, 24 hours a day that are meeting the needs of more advanced medical care, as far as catheters, IVs, and things like that.

John:  [3:39] You had shared with me a little earlier though that, I think, in years passed, maybe assisted living facilities, people would start out, maybe in assisted living facility and then possible move to a nursing home, then ultimately, come to the funeral home.

[3:56] Nowadays, that’s not necessarily the case. That you all can, actually, take them in when they’re still independent, and then care for them all the way till the end.

Theresa:  [4:06] Exactly, we can. The laws and rules have changed so much. There’s different levels of care with assisted living. They have extended congregate care, limited nursing, and mental health.

[4:19] The limited nursing actually has an LPN on staff. Our facility is a standard assisted living facility, but we do have a house doctor, podiatrist. Doctor Salva is our medical director here.

[4:32] He’s here to help any of the residents. I also take care of mental health veterans, which I’m very tight in communication with the VA for their care.

[4:42] With the help of Sun Coast Hospice, which is a wonderful organization, we are able to have a registered nurse come in and stay with the resident, when they are declining and becoming eminent.

[4:55] They stay with them until the end of life, and our staff is able to stay right here with them.

John:  [5:00] That must bring a lot of peace and comfort to your patients to be able, and your residents to know, that they don’t have to, now pack up, and move someplace else. They get to stay there.

Theresa:  [5:11] Right. Where they don’t know familiarized faces, and they actually trust the staff. The staff is there to give them the love all the way until the end, through their journey.

John:  [5:20] That’s great. I’ve had the pleasure of being here before, even seeing the facilities, and being here with my daughter, and some of her high school friends got to sing songs for the residents, and things like that, which was great.

[5:35] But, having been around your facilities, I’ve seen movie theaters to the dining facilities, to the piano when you come in, things like that. It seems like you offer a lot of options for families and your residents to be able lot have plenty of activities, to keep them up and moving, is that right?

Theresa:  [5:57] Yes. They do. The state requires us to have 12 hours of activities a week. At our facility, we probably average around 48 hours of activities that go on in different levels. We have entertainment to Yahtzee, Bingo, singers that come in.

[6:16] We have one wonderful little group of elderly people called “The Love Notes.” They are hilarious. They get in the big blow up outfits, and they bounce off of each other. They sing, and they dance. They really interact with our residents.

[6:31] We also have people that come in and do exercise classes. They have the ladies do nail care day. We have the hairdresser that comes in. We have hair day. We can meet the needs of just about everyone.

[6:46] I don’t think I mentioned that we also have a memory care unit. We meet the needs of people with limited memory that need a little more coaching and cueing. We’re also meeting their small…I don’t know what I wanted to say. They can’t do as much as everybody else can. Their memory inhibits that action to be as active as some.

John:  [7:17] Having had a mother who, she’s left this world now, had had Alzheimer’s for many years, I know how tough that can be for some families, when a loved one doesn’t have that memory capability they did before.

[7:31] It’s great that you even have options available for them to still keep them somewhat active in ways. Hearing all the great things that you had going, I want to know how I can go by getting a room?

[7:44] [laughter]

Theresa:  [7:45] You would want to, because we have three fantastic chefs.

John:  [7:48] That sounds good, too.

Theresa:  [7:50] We spare no expense at meals.

John:  [7:51] My wife and I may have to take you up on that. Maybe you could give some advice to some of our families. Many times, we get asked questions as a resource, as I’m sure you do in the community.

[8:03] But, when a family is looking at ALFs for somebody, another family member, what questions do you recommend that they ask as they’re touring different facilities and trying to choose the right one for them?

Theresa:  [8:16] I think a lot of people say, “Is there facilities you’d recommend?” No, there’s none. Myself. [laughs] I don’t want to be held responsible. But I will say that I would go in unannounced. I wouldn’t make an appointment with anyone, because then you’re going to see the real facility.

[8:35] You’re going to see the real staff, how the staff interact with the residents, how the management interacts with the residents, do they know then by name, or they’re just a statistic of the facility. Go at meal times. Go on weekends. I wouldn’t allow a facility to arrange an appointment so they can always put their best foot forward, because that may not be what you’re getting in the end.

[8:59] You want to walk in. We’re very homey. We’re not big corporate America. I’m a solely owned and operated facility. I encourage people. When they call here and they say, “Can I make an appointment?” I’m like, “Absolutely not.” [laughs]

[9:16] “I’m encouraging you to come whenever it’s convenient for you. If you want to let me know, that’s fine, because I will make sure I’m here. If I just happen not to be on the premises, which I work about 12 to 16 hours a day here, my staff will call me, and I can be here within minutes. Or any of my staff is capable of giving a tour of the facility.”

[9:37] I would encourage them to look at the food, look at how the other residents are kept, see if the residents are happy, maybe even speak to some of them and say, “Hi. Do you like living here?” because the state does that now in their inspections and licensing.

[9:52] They actually come in, and they want to know the opinion of the resident, of the staff, and the care that they’re getting, because they feel like getting from the horse is the best place to get it.

John:  [10:04] We do something similar with our Cremation Tribute Center. We always encourage families to tour the facility ‑‑ not just ours, but other crematories too ‑‑ and do the same thing, show up unannounced. That’s when you’re actually going to see really how they maintain the facility. I can say every time I’ve shown up hear unannounced it’s been great opportunity for me to see things.

[10:26] Also, another thing families will ask us often times and I’m sure it’s much like funerals people will ask us, “Well, how much does a funeral cost?” That’s kind of a loaded question I guess in a way because we have a wide array of options really depending upon what the person wants.

[10:45] Many times we will get families that will ask us, well mom might need to go into an assistant living facility or a nursing home. Do you have any idea what monthly cost are or something like that. There must be some sort of maybe a ballpark idea that you can share with us.

Theresa:  [11:01] There’s a huge ballpark. I can say just seeing other facilities and knowing, and of course, like anything you’re going to get what you pay for. ALFs can run from anywhere 1,500 to probably $4,500. And $4,500 you’re talking about memory care, private room. You’re looking at different options. Assistant living, straight assistant living or independent living is going to be of course much lower cost.

[11:31] The one thing I would watch for is to make sure everything is cost inclusive. That you’re not having an `a la carte option and there are a lot of facilities that do that. They will charge you to come in and do your medication. They will charge you to give you a bath. They’ll charge you to do your laundry once a week. They’ll charge you to clean your room.

[11:50] Here we try to keep everything cost inclusive. You have daily housekeeping. Your laundry is done. Your linens are done and all those services. If you want one bath a week or if you want 10 baths a week it’s all one price. We keep a standard rate. We want everybody to get the same amount of care for the same amount of money and not say, you want one more hug it’s going to cost you. No, no those are free.

John:  [12:18] That’s great. Again, like I said it sounds like we’re very similar in the way we run our businesses with our funeral home. It’s one price depending on what it is you’re looking for. A lot of other out there everything is an `a la carte add‑on and we’re not that way. If it takes five hours to make your loved ones funeral arrangement or 30 minutes to make your loved one we’re going to give you the same amount of attention regardless and not an additional cost.

[12:48] I know even myself with my mom when she had to go into an additional care beyond the home. Many times that can be tough for a parent probably tough and emotional for the child too. I’ve had several of my friends whose parents had to go into assistant living or things. And leaving that family home and making that big move could be difficult.

[13:15] Any suggestions for maybe how the children can help mom or dad make that move a little easier? Is there certain things they should look to do or ways to make it easier?

Theresa:  [13:26] I got a couple of suggestions. If the parent or loved one is capable of helping make that decision let them come make that decision. Let them tour different facilities to see where they’re going to be comfortable. Because leaving home is huge. It’s very traumatic. Going in and out of hospitals is very traumatic for the resident. We try to keep our hospitalizations low. That is tough on them to go to and fro.

[13:53] As far as picking out an ALF, they’re the ones who have to live there and be comfortable. If they are able and capable of helping with that decision let them be a huge part of that decision, because that is going to be their home. The children, the caregiver they don’t have to stay there. They walk away and they go home and they sleep in their bed.

[14:14] The parent or their loved one I would say let them come to a meal and get to know some of the other residents before they move in. Let them see the room that they’re going to be staying in. So when they get home they can help with ideas of, I’ll like to bring this chair, this lamp.

[14:32] We have basic furniture, but I always encourage everyone if you want to bring your own I can make this disappear. Please bring favorite pillows, even if it’s a throw pillow, pictures, any trinkets, any little dust collectors. Make sure that they have everything that makes them feel at home. When you look around their house you see what their home is made of, memories and you want those memories to come with them and stay with them because those are very comforting.

[15:02] I would suggest that if they are capable let them help with every step of the process except for the moving. What I suggest for that is I’ve dealt with a lot of different families and if their capable or financially able to have a mover come in set the things aside. Let the mover move everything in.

[15:25] Maybe you take them out for dinner or lunch or an outing. Let them have an enjoyable fun time with you. When the movers or the other family members can bring the items to the facility my staff and, of course, myself I’m a huge part of a move‑in because I want the room to look great when they walk in. That’s their new home.

[15:47] I want to take all their little items and make it like their home as much as possible. My grandmother lived on her own hurt herself, ended up in the hospital with a couple of broken ribs falling. While she was in the hospital she actually decided she wanted to move in here. So she lives here.

[16:07] I took everything from her independent apartment and made her room look just like her apartment. So when she came home that was very emotional for her because she just couldn’t believe what I had done overnight. All her things were there and they made her feel like she never missed a step. She went from home to home.

John:  [16:30] That’s great. I’m sure it’s a big comfort to them when they make that move and they can feel like I’m back in my house.

Theresa:  [16:40] Just a little bit different room shape and lots of new friends.

John:  [16:45] It sounds like your staff is very involved in making that transition as easy as possible for families which is a wonderful thing. As I think more and more about this I hear about when you mention moving the memories over with them. I’ll bring my memories and my wife and you can take care of the cooking and the cleaning and the housekeeping. That’s sounding better and better.

Theresa:  [17:10] That’s exactly what we do. When they move in my staff is very attentive to them. We call it our honeymoon period. I really encourage a lot of close families to give us a week or two to let that resident become dependent upon us and let us bond. Because they’re use to being dependent on that care giver or loved one. I want them to ‑‑ I want that care giver to now relax and be able to enjoy their visit. I want the resident to be able to know that if you need something we’re here.

John:  [17:46] Can you tell us a little bit about the typical day in the life of being in an assistant living residence? I get up in the morning and…

Theresa:  [18:01] Get up in the morning. Breakfast is from 7:00 to 8:00, so you’ve got breakfast ready for you. Then the medications are always a part of that day. We have medications going around in the morning. Lunch is at noon time. They have lunch, medications, if applicable. Then we have our dinner at 5:00.

[18:23] In here, we have more of a traditional dinner. There’s a lot of older facilities that still have their big dinner at noon, but since I also take care of mental health veterans, our big meal is at 5:00. The boys like it that way.

[18:36] [laughter]

Theresa:  [18:37] Meat, potatoes. We have some really great menus. In between those times, we have a lot of scheduled activities. They may have Bingo, they may have Yahtzee, they may have a game they called LCR, or they may go on an outing. Some of them go to outpatient programs.

[18:55] Some of them just love to watch Turner Classic Movies. They are hooked on it, almost like and addiction. Or they just may want to lay around. Each individual has their little routine that they build. But they all come together as a community. We also have a Bible study on Wednesdays. We have a Holy Family Church that comes on Sunday and does communion. We have something for everyone, every single day.

John:  [19:26] It sounds like, in many ways, at least the breakfast, lunch, and dinner provides some structure throughout the day.

Theresa:  [19:36] Very much.

John:  [19:37] I would assume, for some of the older residents, that that structure is probably important.

Theresa:  [19:44] As you get older, you get very regimented. “It’s 6:30, 7 o’clock. My grandma is in there getting ready for bed, and watching a little TV, and has her little thing that she does every night.” We have our other residents in our memory care unit. Every night at seven o’clock, they’re having a snack.

[20:07] They’re doing different activities. They’re playing ball, they’re playing bowling, they play with balloons, they have aromatherapy. Lavender is very soothing for them. They have a lot of different things. Every day at two o’clock, in the memory care unit, they lay down for a nap. They’ve had their lunch, they’ve got full tummies, and they lay down for a nap for about an hour and a half. That’s nap time in there.

John:  [20:30] There you go. My wife would like that part too.

[20:33] [laughter]

John:  [20:33] She enjoys her afternoon nap, when she can get one. Anything else that you think that our listeners would like to hear or know about as far as anything else with assisted living, or anything along those lines that they should know?

Theresa:  [20:49] There is something, that I’ve mentioned to you before, that I think is huge for us. It’s pre‑need. Any of our families, one of the questions we ask them when they come in here is do they have funeral arrangements? I love it when I hear Anderson‑McQueen.

[21:06] [laughter]

[21:06] [crosstalk]

John:  [21:06] Thank you. I do too.

Theresa:  [21:07] Because I know that they’re going to get the best care from the beginning to the end. That was one of the things, not because I know you socially or personally. I have seen your staff. When they come here to receive a body, it’s so dignified and so caring that it touches your heart. You know it’s a very sensitive situation, at that time.

[21:36] The families, if they don’t have any funeral arrangements, I’m the first one to say, “Check out Anderson‑McQueen. They’re going to treat you good. They’re very good with pre‑need.” I myself have learned this, probably. I learn everything the hard way.

[21:57] But four, five years ago, we went and did pre‑need arrangements for my uncle and my grandfather. Little did I even believe, a couple of years later, I would need those arrangements for my grandfather, and just recently had to use those arrangements for my great‑uncle.

[22:14] When you go in, your staff is awesome. They’re right there. You’re at a time where you are not mourning. You are able to make very educated decisions. You can say, “I want to do this, this, this.” Your staff is right on top of it.

[22:33] When it comes time, I saw this with my cousin just recently, we came to the facility, and I thought five of us were going to have drag her in. We had already done the pre‑need. She got in there. The hardest thing was the obituary, for her. But your staff made her feel absolutely comfortable. We were able to laugh. We had some coffee. She had a cookie.

[23:02] It didn’t end up being that traumatic for her. She even said that. She goes, “I thought that was going to be worse.” Because at that time you’re so emotional, and you’re driven by your emotions, you can’t make decisions; because no decision that you make at that time is going to be good enough for your loved one.

[23:21] With pre‑need, you can make those decisions using a solid mind and, “This is what I want. This is how I want it.” I think it’s huge. It’s very important. I’m going to do my own.

[23:35] [laughter]

Theresa:  [23:36] My kids don’t want to hear that, but I think I need to do my own.

John:  [23:40] Two things. Funny, the kids never want to hear that, because we never want to think about our parents passing away. But, as we always tell, and as I tell my staff, as does my wife, we say, “It’s every family, every option, every time.”

[23:55] It’s our job to educate families on what their options are, what they’re looking to do, and give them all those options and that educational background so that then they can make the appropriate decision that’s right for them because, much like choosing the appropriate assisted living facility, it’s your loved one, ultimately.

[24:20] The last thing we want to do is have you overspend on something that’s beyond your means, and then now you’re struggling to make ends meet because you did all this beyond what was necessary maybe, or going back later on going, “Gosh, I wished I had known about this,” or “I wished I had known about that.”

Theresa:  [24:41] You do allow that. You allow for altercations in advance, different arrangements at the time if you decide, “Oh, the urn I picked out wasn’t quite what I wanted. Look, you got these new styles.” You allow for that. Sometimes, it’s just like assisted living. It may cost a little more at that time. But at the time you made those arrangements, everything was very determined and unemotional.

[25:09] You’re right, because when you become emotional, you just cannot think straight. You will overspend because you tell me what urn or casket is good enough for your mom or your dad. It’s never good enough. Nothing is good enough.

[25:24] You could have it gold plated. It’s not good enough. It’s always good to make those kind of decisions when you’re not emotionally attached, at that time, to grief.

John:  [25:34] Much like with the assisted living world, in the funeral world, it’s best for families to preplan on both. The time to probably start looking for an assisted living facility or the right assisted living facility for them is not when you have an immediate need, “I’ve got to find some place by the end of the week because I’ve got to get mom there.”

[26:00] It’s probably, “As I see that mom may be starting to get to that age where maybe I need a little more care for mom, then maybe now is the time I started looking so that when I do have to get to that point, I’ve already mapped out what…”

[26:13] [crosstalk]

Theresa:  [26:13] You need to be eyes wide open for that, not in denial. You need to be able to look at your parents and say, “You know what? They’re not the same as last week when I saw them. They are starting to decline.” Don’t wait until they fall.

[26:26] I truly believe that, if some of my residents came in here earlier, I could actually extend their life expectancy with all the love and care that we have. I know it as a fact, because I’ve seen residents who have lived with me for a long time. Some of my residents have lived with me 12‑18 years, and they’re still here.

John:  [26:52] It’s home.

Theresa:  [26:53] This is home. This is it. They’ll only be going out of here feet first to you.

[26:57] [laughter]

Theresa:  [26:58] With the love and the care that we have here, and everything that we do for them, we can make their lives fuller and longer.

John:  [27:11] I know I’ve said it, but you have a great facility. We’re privileged to get to help those residents of yours when we have that opportunity to do so. We’d love for it to always be Anderson‑McQueen. But even when it’s another funeral home, the advice you’ve given about getting things taken care of ahead of time and having that mapped out is a great thing, regardless of what funeral home they choose.

[27:37] Obviously, if it’s Anderson‑McQueen, it’s even better. Theresa, thank you very much for taking the time out of your busy schedule to share with us some insights on assisted living facilities, and what we should look for, and how to really give our loved ones a better, longer, more independent living option. We appreciate that very much.

Theresa:  [28:00] Thank you. I appreciate you all.

John:  [28:02] Thank you. For all those listening out there, we appreciate you listening to Anderson‑McQueen Funeral Homes radio show, Undertakings. Never miss an episode by subscribing to Undertakings at iTunes Store. It’s easy. It’s free. In addition to our podcasts, you can also download our free funeral app at the App Store.

[28:21] If you don’t have an iTunes account, you can listen to the show on our blog at blog.andersonmcqueen.com or read a transcription of today’s show. Remember to email us those questions and show ideas to radio@andersonmcqueen.com. I’m John McQueen with Anderson‑McQueen Funeral Homes, and I thank you for listening to Undertakings.

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