July 29, 2015

Where Should I Live in My Final Years? Option One: Move to a Senior Residence

When I was first diagnosed with Parkinson's six years ago, I experienced an unusual side effect -- temporary insanity. I became convinced I needed to sell the house I love and move out of the neighborhood I love and into a senior residence. I shudder every time I think about how close I came to doing just that.

Late last year, I had a recurrence of my Parkinsonian insanity… at least I hope it proves to be insanity. I became convinced that 2015 was likely to be my last year on earth. That notion was likely a side effect of the struggle I was having with blood pressure (BP) spikes that drove my systolic (top) numbers above 180… occasionally above 200 -- definitely stroke and heart attack territory.

The BP struggle that continued through the first half of this year is now resolved. Click here for the first in a series of posts about this positive turn around.

The idea that I might be around in 2016 and beyond was further bolstered when my neurologist remarked during a recent consultation that the rate at which one's Parkinson's progresses at the outset is unlikely to change. My disease has been progressing relatively slowly.

So, I'm looking at my future through new rose-colored glasses. As a result, I’m taking a fresh look at what is probably the number one question for seniors like me who are still hanging on: Should I move into a senior residence or should I age in place?

I know what my answer is for today: age in place. But I know my situation could change. A sudden fall could send me quickly into a senior residence – the option we’ll consider today.

Choosing an Assisted Living Residence
The Washington metropolitan area has dozens of senior residences. Most of them are designed so residents can choose independent living and later move into assisted living. Some places also add a nursing care option or a facility for people with dementia.

Here are some examples of the choices available in the Washington area that appeal to me.

Suburban Virginia: The Goodwin House, Alexandria
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This was one of the places I checked out during the insanity of 2009. I knew several people who had moved into the Goodwin House in Alexandria or into its sister facility in Baileys Crossroads, Va.

I toured the Alexandria facility with a resident couple who were old friends. The place offers a high-quality lifestyle that's a bit much for me. I prefer less elegance and more relaxed casualness.

As a drove to the sister residence in Baileys Crossroads, I said to myself, "I can't live in a place surrounded by highways and strip malls." I turned around and headed back into the District.

Even so, I have urged other retired friends to consider the Goodwin Houses.

All the senior residences I've checked out have many options for residence type and financing. For the purpose of comparison in this post, I'll consider the least costly of the regular independent living one-bedroom residences at each facility..

Goodwin House Alexandria requires an entrance fee of $192,150 and a $2,680 monthly fee. That entrance fee is refundable based on a declining formula of 1% per month if the resident moves out, or 4% per month if the resident dies.

Choosing a senior residence can get complicated. One also has to consider the possibility that part of the entrance fee might be tax deductible as a health care expense.

Goodwin House is rare among area senior residences because it guarantees access to all levels of care without an increase in monthly fees. A resident in independent living could move into assisted living or nursing care without additional cost.
Washington, DC: the Residences at Thomas Circle  

I would've ended up here if my 2009 Parkinsonian madness had prevailed.
“The Thomas House” is in the heart of the city, an easy walk of several blocks to Studio Theatre, where I've held season tickets for years.

A block from Studio Theatre is a Whole Foods market whose 2000 opening is credited with starting the rapid gentrification of the neighborhood along 14th Street. It seems like every time I walk down that street toward Studio Theatre, I see a new restaurant or condo.

In a nine-month period between 2012 and 2013, 24 new restaurants opened on 14th Street. In a similar two-year span, almost every block along that corridor saw a major residential redevelopment project.

Another short walk from the Thomas House is Logan Circle, which now rivals DuPont Circle as the center for gay life.

So the Thomas House is right next to DC's new cool 'hood. While enjoying a Sunday lunch in the dining room there in a 2009 visit, I looked around and saw a good mix of white and black residents. My "gaydar" told me that I wasn't the only homosexual in the room. Diversity like this is rare in senior residences.

My treasured friend Lili Crane was my role model for happy aging. She spent almost all her senior years living in her own apartment on upper Connecticut Avenue in DC. But in the last of her 93 years, her daughters convinced her that she needed to move into a senior residence. She picked the Thomas House. On the day she died, I was invited to join the family for dinner at the Pearl Dive Oyster Palace on 14th Street... one of Lili's finds during her short stay at the Thomas House.

The financial arrangements at the Thomas House include an entrance fee between $2,500 and $3,500… the lowest of all facilities I examined. The monthly charges for an independent living apartment range from $3,489 to $4,000.
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So the Thomas House would be near the top of my list of candidates. Look at the photo above, taken from the rooftop terrace. Can you guess my major reservation about this residence? Yep. The lack of trees and greenery. I want to live in both a city and a forest. Not easy to do but, as I noted in a post last week, it's easier to do in Washington than it is most cities.

So where to find an urban senior residence with trees? Here's what immediately comes to mind.

DC: Ingleside at Rock Creek

Click here to see why this looks like a great choice for someone like me who wants to live in the city with a surrounding forest. There's only one problem: Many others have come to the same conclusion.

Some 100 people are on the waiting list for one-bedroom apartments, and the estimated waiting time is about two years... perhaps about the time I have left to live. Two women friends my age who still live in their own homes were smart enough to put their names on the waiting list Some time ago.

For a one-bedroom apartment, the current entrance fee is $444,510 with a 50% refund or $632,310 with a 90% refund. The monthly fee is $2,167.

DC: Grand Oaks at Sibley

Image result for Grand Oaks at Sibley

Grand Oaks opened in September 2000, right next to Sibley Hospital. Both are on the western border of my Palisades neighborhood in DC, just before Maryland line. I watched it being built, and I've driven past it a thousand times.

It has 139 apartments, all of them assisted living units. It has no independent living residences.

It reminds me of the Goodwin House in Alexandria, Virginia that I already mentioned. They both have an elegant style that makes me a bit uncomfortable.

While it overlooks the tree-lined streets of the Palisades, it has only a small garden walk within the facility. The nearest restaurants and shops are not within walking distance.

For those still able to get around by car, it could be a good choice. But for me, it falls short of my "urban forest" ideal.

Grand Oaks has a relatively low entrance fee of $9,000. But the monthly fees range from $7,000 to $9,000. This tariff looks steep by comparison, but the residences I mentioned earlier were for independent living units, and the Grand Oaks residences are all assisted living.

Grand Oaks' location and proximity to Sibley Hospital are a decided plus.

Washington, DC.: Sunrise on Connecticut Avenue

Welcome to Sunrise on Connecticut Avenue

I'd place Sunrise near the top of my list. For urban amenities, it offers as much to me as the Thomas House, mainly because The Politics & Prose Bookstore and Café is just a block away.

When I restricted my driving to neighborhood destinations only, I couldn't make the regular trips to P&P... outings that had become an especially enjoyable part of my life in Washington.

Here's how Wikipedia describes the store:
Politics and Prose is known for its knowledgeable staff and is seen as a part of DC culture. Its author events attract a number of famous speakers, such as Bill Clinton and J.K. Rowling, and have a reputation for their astute audiences.
I averaged about a trip a week to the bookstore to hear one of the 7pm author talks. Every other week when my housecleaning lady came, you could find me having lunch at the store's café. Living a block away sounds idyllic! Several pretty good restaurants are in the same block.

I don't know much about the amenities at Sunrise. A few years ago, I went there several times to play bridge with a resident who could no longer leave the facility. My experience at the place was limited, but the amenities at Sunrise looked fine.

Like Grand Oaks, Sunrise is an assisted living facility exclusively. It has no independent living units. The entrance fee is $7,500. Sunrise uses a daily fee, rather than the usual monthly. It is $250 a day, $275 with meals. But then on top of that Sunrise adds a daily fee for the medical care provided. Depending on the care level, it is $31, $59 or $84 a day. The daily basic charge of $275 plus the lowest level of medical care at $31 adds up to $306 which would be $9180 for a 30-day month 

Suburban MD: Asbury Methodist Village

This is a last-minute entry in my senior residence round-up. I made the addition after conversations I had this week with Allen Weinstein's widow Adrienne Dominique and his son Andrew.

They told me that the family (and Allen) was very pleased that Allen was able to spend his final days at this facility. I hadn't realized that Allen also ended up with dementia, in addition to his Parkinson's,  

What registered with me was Adrienne.s description of the pleasure she and Allen got when she took him for walks around Asbury's 130 acre campus with its trees, rolling lawns, ponds and many paths.

The entrance fee for a one-bedroom at Asbury ranges from $126,900 to $270,000. The daily fee goes  from $250 to $400.

I've looked at their website and their brochure, and I've spoken with the retirement counselor. This fall, I may well take up the counselor's offer to bring me out there by car for a tour of the facility. It's not the urban setting I prefer, but if I end up with dementia and am unable to make my planned flight to Switzerland for a final exit, I might suggest this option to my family for consideration.

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Preparing this post has been an interesting exercise for me. But the more I learned, the more I realized how happy I am with the choice I've made so far -- aging in place. I'll discuss that option tomorrow.

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Virginia suburbs
Washington, DC
Maryland Suburbs


Anonymous said...

I envy the many choices that are available to you but the way you are thinking about it is helpful to everyone no matter where they live. It's something those with PD will need to think about.

Anonymous said...

Have you ever been to Maplewood in Bethesda? I have several friends there who are very happy. You own your apartment, which will be sold when you are no longer there. Don't know about other aspects of financing, but assume it's fairly expensive. It also has nursing as well as independent and assisted living options.

Then there is Ingleside in Rockville. Too far out for me, but also popular with some of my friends.

Anonymous said...

John- I looked at Asbury for my grandmother. It was actually very nice. We also looked at Ginger Cove in Annapolis. Ironically enough, it had a 2.5 year wait list. She dismissed it as too long. As it turns out, she didn't move until 3 years after she saw Ginger Cove. She wound up in Springfield at Greensprings. As it turns out, Annapolis would have been WAY too far away given some of her medical emergencies.