My Mother Emily: Tim, Part Seven, Home at Last

grandma and tim caregiver

My Mother Emily: Tim, Part Seven, Home at Last

It’s been awhile since I last blogged about my Mom’s journey as she settled in at LiveWell Residential Assisted Living in Cary on November 7th.  It was quite an experience and and ultimately not the best environment for her. After researching larger assisted living facilities, we were fortunate to move Mom to the assisted living community of Waltonwood Cary.  What was our experience at LiveWell?  What did we learn?  What advice would we pass on to families evaluating residential assisted living?  Let’s start with what we learned and our advice to families evaluating residential assisted living.


What did we learn? Our advice:

1. We learned that it’s very important to understand the goals of the residential assisted living home in terms of the cognitive abilities of the residents to come.  Mom was the very first resident.  Mom has mild dementia but for the most part Mom is with it and likes to engage in conversation and do things (i.e. activities).  She enjoys meeting people and making friends.  When Mom was coming to the house I emphasized with LiveWell it would be very good for have at least two residents, preferably female, on or above Mom’s cognitive level.  Why? For Mom to make friends and do things with her friends.

What happened was while efforts we’re made to find new residents that were on or above Mom’s cognitive level, short terms residents came to live in the home temporarily.  These residents had cognitive challenges and required a lot of attention from the new staff.  This had several negative impacts on Mom.  (1) She was lonely.  The two residents did not have the capabilities to socialize let alone have a conversation, (2) The attention required by these residents was significant and often times Mom was on her own, (3) one of the residents occasionally would get angry and yell.  This scared Mom.  Also, this resident sometimes wondered into Mom’s room unannounced and scared Mom.  A solution proposed by LiveWell was to put a sign on the door saying do not enter and a lock.  I don’t think I need to say anything about this.  Needless to say when Gina and I came to the home and saw this we took it down.
This was the major factor in moving Mom out of LiveWell.  Mom felt isolated and alone and at times threatened.

Key point: If it’s a new residential home like this one, get a commitment from the management team about the goals of the house. Will the 5-7 residents have the cognitive and mobile capabilities that foster socialization and activities? Or will the goal of the house be to help residents with severe cognitive issues? I don’t think it’s a realistic scenario of mix and match.

2. Make sure the house is of Universal Design.  

I moved Mom in knowing the house still needed modifications to support residents with disabilities. One of the bedrooms with bathroom was totally inadequate to support a resident in a wheelchair. Mom was offered the largest bedroom with its own bathroom due to an issue with one of the residents (the wanderer), which was great. The problem was, she couldn’t use the bathroom (no walk-in shower and the door was too narrow for a wheelchair) and had to go out and use the hallway bathroom.  Again, this would mostly be an issue for new homes.

Key point:
Make sure the house meets the code for residential assisted living and is of universal design. If you have issues, get it in writing when they will be addressed and when.

3. We learned that setting up and managing activities for the home is not so easy.  Don’t just assume there will be wonderful activities.  

First, it’s very difficult to have a cohesive activities schedule for a small home when you have a mix of residents that are at different cognitive levels.  A couple of weeks into Mom’s stay, we were introduced to an activities coordinator.  A person that was contracted by LiveWell to put together an activities program for the house.  I thought this was pretty innovative and was encouraged when we met her.  She even made time to visit my Mom at SarahCare Adult Day care in Raleigh to meet her before she started to put together activities.  A couple of weeks later this person mysteriously vanished with no explanation.  Again, it’s difficult to put together a cohesive activity schedule with residents at different cognitive levels so I was not surprised.  I was surprised that LiveWell never explained the situation.

Key point:
Take time and invest in how the house engages the residents in activities.  It’s so important the residents have things to look forward to and engage. This includes activities outside the home like going to the senior center, shopping, etc.

Note: Even before Mom moved in I reached out to Marcia Jarrell, the Executive Director of SarahCare Adult Day Care at Lake Boone Trail in Raleigh. The strategy was to have Mom go to SarahCare three times a week and continue until additional residents came and activities picked up at the LiveWell home. I whole heartedly recommend SarahCare as a wonderful way to provide a gathering place for people to meet, engage, and form relationships both with the staff and people coming to SarahCare.  Mom initially was a bit reluctant.  She even laughed that we had a complete role reversal.  She remembered when I went to Green Hill Day Camp in Syosset New York as a 3 year old when school was out for the summer.  I was proud of her for rolling with it and after a short time she looked forward to going to SarahCare.  Marsha would pick Mom up in the morning and Mom looked forward to chatting with her and felt she had a good friend and confidant in Marsha.  I think that says volumes of Marsha and SarahCare and it speaks to the quality of people in the care industry here in Raleigh and Cary.  We all have a lot of heart and compassion about caregiving.  A big shout out to Marsha and the staff at SarahCare of Lake Boone Trail.

4. Look for a North Carolina Department of Health and Human Resources Division of Health Service Regulation License to operate an adult care home prominently displayed in the home.  

These services should include a skilled license to provide for administration and giving medications.  I think you know what’s coming.  Turns out LiveWell did not have a license to operate an adult home.  I didn’t find this fact out until I moved Mom out of the house.

Key point: Obtain verification the home has a current license. Contact the DHSS Division of Health Service Regulations to check on any violations. In fact, if you can find a wonderful Geriatric Care Manager or advocate. Part of what they can do is dig into this for you. They know their stuff.

5. Know your agreement inside and out.  

I know I’ve been guilty on occasion for rocketing through these long care agreements for assisted living.  In fact, I’ve thought about forming a POA support group for all the sons and daughters like myself filling out what feels like an unending stream of paperwork.  At times it bought me to my knees.  I found a good pint of Guinness or glass of wine helped get me back on track.

Key point: If at some point we reconsider residential assisted living, I’d discuss some out clauses in the agreement if the residential assisted living doesn’t meet or fails to meet commitments agreed too, you get your community fee back. In our case with this new house, I would have asked for a commitment or statement to the intended cognitive levels of the residents. If the house needs modifications to be more Universal Design and is not, obtain commitments on certain modifications and when they will be completed.

After reading what I just wrote I ask myself ‘How did you miss all this?”   Sometimes you have difficulty seeing the forest through the trees.  Or it’s easier when it’s a client then your own mother.  Hindsight is always 20-20.  I hope what I wrote is helpful and I encourage you all not to go this alone.  There are great professionals in our community that can help you evaluate the best places for Mom and Dad to live.  It will save you a lot of time.  More importantly reduce the stress involved.  Find and work with a reputable GCM or Geriatric Advocate.

Why the short stay?

The main factor was loneliness and the lack of a social environment.  When I saw no near term end to this in late December I acted.  I visited several of the reputable assisted living communities in Cary – Waltonwood Cary, Brookdale in Cary and Woodland Terrace.  Gina and I are fortunate to know all these wonderful communities and the great people leading them.  I took Mom to each to meet key staff, tour the facility and even eat a meal and meet other residents.  This was a great process and in the end it was Mom who made the call on Waltonwood.  I was impressed and thankful to all for taking the time to meet with Mom and me.

Why Waltonwood Cary?
Really it was Mom.  She formed an opinion of all of the communities.  I think all of them are unique.  Mom liked the elegance of Waltonwood and enjoyed meeting some of the residents.  We were so fortunate that Waltonwood understood the urgency I was feeling and went the extra mile to find Mom a great apartment.

I moved Mom into Waltonwood in March.  We we’re lucky to get a nice corner apartment.  The challenge was that we were short of furniture and the room needed to be decorated.  Preferably, I would have like to have the room decorated before Mom moved in.  One of the best things we did for Mom in Glens Falls New York when we sold her home last fall was engage a professional senior move manager.  Yes, there is a certification nationally for move managers.  I worked with Neil Bindleglass who is the owner of Saratoga Senior Move Managers.  I’ll never forget his name because he was a savior.  He expertly helped us hold an Estate Sales which included staging Mom’s NY home for sale, and at the same time eyed personal things of Mom’s which included furniture to completely decorate a small studio apartment in an assisted living facility in Glens Falls.  When Mom moved in there were pictures hung, a few pieces of furniture and flowers.  She commented how nice that was.  Neil is a rock star.
With Waltonwood I called Jennie Alwood of Here2Home.  Jennie was my Neil here in NC.  I took Jenne to meet Mom in her Spartan apartment.  The apartment was great, it just wan not Mom’s.  It needed to be personalized.  By the way, additional Kudo’s to the Waltonwood staff for lending Mom pieces of furniture to bridge the gap until we had Mom’s personal pieces.  Well done Waltonwood thank You!

Jennie expertly built a schematic model of the room and designed the furnishing and decorations of the room.  She showed Mom and using pieces of paper hung them around the room until we could replace them with the real thing.   The before and after picture are impressive.  In the end, Mom had a place she felt was hers.  It reminded me of one of my favorite movies with John Wayne and Maureen O’Hara called the “Quiet Man”.  Set in Ireland in the early 50s.  Maureen O’Hara wouldn’t call the home John Wayne purchased until she had her own personal things about her which included her dowry.

Once she did, it was her home.  That’s how I felt about Moms room after Jennie finished the job.



Key point: Find a great relocation expert senior move manager to help if you are moving Mom and Dad from a big spacious house to a small apartment. Just do it.

How are things going?

It’s such a blessing to know a lot of people professionally and personally that know my Mom’s story.  They ask how’s she doing?  Well she’s doing.   I admire her spirit and she’s battling.  She’s honest.  She tells me she’s lonely at times and I understand. I advise Mom to give it some time and she nods.


I hope this Blog is helpful to professionals in our field but more importantly to the families that are on similar paths to my Mom.  Know there is help in our community.  Amazing help.  My advice, seek help.  It’s a sign of strength.

Best, Tim