When the St. Paul’s Towers Resident Council met at the beginning of 2020, Council President Laura Galvin presented the idea of developing resident liaisons to promote connection across different levels of care within the community. This idea kicked off the creation of the Three Levels of Care (TLC) program, which seeks to create well-meaning relationships, increase socialization, and decrease isolation by connecting residents in Independent and Assisted Living.
SPT resident Irene Olson realized that as an Independent Living (IL) resident she didn’t know a great deal about Assisted Living (AL). She found herself asking, “What happens when we move to Assisted Living one day?” Olson was inspired to get involved, developing initiatives such as shared lunches and apartment visits so that IL residents could create lasting relationships with residents in AL.
“TLC is a way to break down silos between the continuum and live together as equals,” notes Connie Yuen, St. Paul’s Towers Assistant Health Care Administrator. “I am so proud of Ms. Olson and the residents who set up such a fantastic program that focuses on inclusion and community building.”
The TLC program is currently paused while sheltering in place but Olson is excited to continue growing the program once shelter in place is done. There are discussions about making the TLC program a permanent committee at St. Paul’s and after working on connecting IL and AL residents, the plan is to “expand to SNF (skilled nursing),” says Olson.
The TLC program shows great promise. Resident volunteers partnered with the Assisted Living Activities Coordinator to get more AL residents involved in community events and to develop relationships one on one. These volunteers, including Olson, help bring AL residents to dinner, happy hour, concerts, classes, and activities. They even developed a wheelchair brigade, which Olson says was created “to increase participation and socialization.”
Resident volunteers work hard to make sure that the experience is not only fun but also meaningful. Volunteers check in with AL residents, asking what would make the experience meaningful for them and tailoring the program to their needs.
For Joe, one of the AL residents that Olson worked with at the TLC program’s inception, the focus was on maintaining old friendships and getting to know new residents. Olson set out to make this happen for Joe by bringing him to the main dining room for meals and art classes to see his friends. All of this work helped them “develop such a strong bond over a short time,” notes Olson.
Though the TLC program is currently only at St. Paul’s Towers, Olson hopes that it will inspire “all Covia communities to get more involved at the AL level.” She notes, “It’s so easy to spend time with the resident in their room, play a game together, and find out what they need and how we can achieve something meaningful together. TLC is so easy at SPT. Everything is an elevator ride away so go see someone who is looking forward to spending time with you.”
Lytton Gardens in Palo Alto offers something almost unheard of in senior affordable housing: an Assisted Living option. Openings are currently available for seniors age 62 and older who meet certain financial eligibility requirements.
Housing Administrator Doris Lee says, “Affordable Housing usually only has independent living, so to have the assisted living and the nursing home on the same campus is truly unique.”
“Many people know about Lytton Gardens independent living and Webster House Healthcare Center. The assisted living is not as widely recognized. Our assisted living is more affordable than others in the area, and we want to spread the word out that we have affordable assisted living,” adds Lee.
Assisted Living allows residents to remain independent in many areas while provide support for activities of daily living, such as dressing or bathing, that may require additional support. A typical Assisted Living community can cost anywhere from $5,000 to $8,000 per month or more, far out of reach for many seniors.
At Lytton Gardens, however, the cost is far less. In fact, the maximum allowable income to qualify as determined by the Department of Housing and Urban Development (HUD) is currently set at $66,150 for a single person or $75,600 for a couple. Once income-qualified, residents at Lytton Gardens Assisted Living pay 30% or less of their monthly income for rent, a meal fee of $642.60, and a personal care fee of $1350. For this, residents receive three meals a day, housekeeping and laundry services, and 24-hour staff assistance. The rest of the resident’s rent is subsidized by HUD.
Located only blocks away from downtown Palo Alto, Lytton Gardens offers not just a place to live, but a community, with many activities and special events as well as a weekly Market Day. “Having the different levels of care on one campus allows the resident to still live amongst the friends they have cultivated and in the place they have called home for so long,” says Lee. “Although the resident needs to move to a different apartment, they are still part of the Lytton Gardens community. Also having the nursing home on site has given some residents the extra motivation to be able to look out their window and see their apartment and work extra hard to be able to return to their apartment safely.”
One resident who has been living in Lytton’s Assisted Living for three years says, “I love the central location of the community, so close to all the shops and restaurants on University Ave. I love my apartment. Having maintenance crew on site is a plus. All the caregivers are great and they personalize the care.”
Lytton Gardens Assisted Living is currently accepting applications. Please contact Lytton Gardens to schedule a tour or call (650) 617-7338 to speak with the Assisted Living Manager, Anahi McKane.
To observe National Assisted Living Week, Laura Darling, Senior Director of Communications, talked to some of our staff to explain more about this misunderstood part of community life.
LD: What do you wish people knew about Assisted Living?
Barb Fischer, Director of Resident Health Services, St. Paul’s Towers: Many people think that Assisted Living refers to a nursing home. I want people to realize that Assisted Living communities are just like Independent Living communities, except assistance of different levels can be provided in their apartment and staff are available 24/7.
Lucy L. Ascalon, RN, Assistant Director of Resident Health Services & Assisted Living Manager, San Francisco Towers: I wish people knew more about Assisted Living, how we take care of people and what other services we provide as a whole.
Charmaine Verador, Director of Resident Health Services, Los Gatos Meadows: One question that always comes up is “Do I have to share a room?” Our assisted living residents, just like independent living residents have their own apartments that they enjoy privately.
Our assisted living residents mingle and socialize with independent living residents because really, there is not much difference. They have the same apartment settings, go to the same dining room and activities as they can tolerate. Residents in assisted living are only getting assistance so that they can continue with their daily lives.
In Assisted Living we do not take over everything. We personalize our care according to what they need. For example if the resident is still able to shower but will need medication management, then we encourage their independence on the shower task and assist with their medications.
LD: My sense is a lot of people are afraid of moving from Independent Living to Assisted Living. What would you like people who feel that way to know about Assisted Living?
Barb Fischer: This is totally true! I always joke about our independent living residents hiding when they see me coming down the hall as they are fearful I want to move them. I really don’t have that desire at all! I want the residents to stay in their apartments as long as possible and have help there if they need it. That is the great thing about the whole community being licensed, which allows residents to receive care or assistance in their Independent Living apartment just like Assisted Living. It gives us the ability to provide assistance in their apartment for longer periods of time.
Lucy L. Ascalon: I think the reason basically that they are afraid of moving to Assisted Living is that they believe they will give up being independent. But I would like the residents to know that we also can extend their being independent by assisting them and keeping them safe and sound, by having somebody 24/7 that checks with them all shift.
Charmaine Verador: Residents feel like they are losing their independence when they move to Assisted Living. But when a resident needs assistance, it is because they have a hard time safely completing some but not all of their activities of daily living. Most of the time, it takes all their energy and effort to accomplish one task that in the end they are no longer able to do anything else for the day because they are too tired. For example, I have a resident that took 2 hour showers because he had a hard time reaching over, getting in and out of the shower, and picking his clothes from the closet. When he moved to Assisted Living, it seems that he had more energy walking to the dining room for meals, and he gets his shower done faster and more efficiently. He is able to go to activities and has thrived well in Assisted Living – better than when he was in Independent Living. He now also appears worry free and is enjoying more activities.
LD: How do you support people who make the move from Independent Living to Assisted Living?
Barb Fischer: In the event the move to Assisted Living is necessary, we always look at the pros and what the benefits are to living on a floor with staffing 24 hours a day. Sometimes it makes more sense for the resident to reside in an Assisted Living apartment based on their needs.
Lucy L. Ascalon: We give them our 100% support in any way we can.
Charmaine Verador: Although it is not required by licensing, we have a nurse 24 hours that checks on the residents when needed. Once they move to Assisted Living, the nurse would visit them more frequently in the beginning just to make sure that their needs are met and that they are settling well. I also visit them during the first day or first few days to see how they settled in.
We have continuity of care meeting every week and we talk about the care of the resident that has just moved to Assisted Living (i.e. are they adjusting well, etc.). During monthly meetings, the staff contribute their feedback and observation about new resident in Assisted Living and we come up with an action plan if there is a need. If needed, we follow up with a care conference. We also check in with the family and see if there is anything else we can do.
LD: What else would you like to share about your work or about Assisted Living in your community?
Barb Fischer: I believe the key to creating a happy assisted living community is letting the residents be involved in their care, keep them as independent as we can for as long as possible, and consistent communication with families. For the families, it’s all about the details. As long as we get the details right and our resident feels safe and secure, we are good!
Lucy L. Ascalon: For me I love what I do, I love serving people and I feel productive every day knowing that I am able to help the staff and the residents.