Article by Lexi Klinkenberg 
 
There are all kinds of benefits to downsizing in your golden years — lower energy bills, a smaller space to clean and maintain, and the potential of moving closer to loved ones. It’s a wonderful way to open the door to the next stage of your life. Even so, decluttering and downsizing can be a difficult and sometimes painful experience for older adults. Saying goodbye to the home they’ve raised a family in doesn’t come easily.

This guide is designed to make the downsizing process as simple as possible for aging adults and their loved ones. It will help you prepare for the transition, as well as offer advice to loved ones on what they can do to help. Keep the lines of communication open, take it one step at a time, and don’t rush into anything before you’re ready.

Step One: Determine the area and size of the new home

It’s important to establish exactly where your loved one is headed. Not only will it affect just how much they should (or must) declutter and downsize, it adds an exciting element to the process. So whether they want to move to Dallas, TX to live with loved ones, or downsize to a condo in Miami, instead of focusing on leaving their old home behind, your downsizing parent can look forward to the new one. 

Of course, where the older adult moves to will depend on any number of factors. Mobility and ability restrictions, caregiving needs, location of loved ones, and budget will all play a role. Your loved one’s preferences are also crucial to the equation and should be taken into consideration at each step. There will likely need to be compromises, especially if budget concerns are an issue, so be prepared to have multiple conversations to work out all the details. Keep in mind that the arrangements can look just about any way you want them to — many retirement communities and assisted living facilities offer personalized options to meet any need or comfort — so it’s important to make sure everyone feels comfortable with them.
 
There are five main options for seniors looking to downsize:

• Buying a smaller house or condo
• Renting a smaller home
• Moving in with a loved one (adult child, sibling, etc.)
• Moving into a retirement community
• Entering assisted living

The sooner you discuss what decluttering and downsizing will actually look like, the more time everyone will have to evaluate all of the options. Don’t force the conversation if your loved one seems resistant to the idea; unless your aging parent or family member has had a recent medical or caregiving issue that could hinder their quality of life, there’s no need to rush into talking about it. Bring the topic up again at a later date, potentially with additional support from family or friends. It shouldn’t feel like an intervention or anyone trying to make decisions for your loved one, but a group of people who genuinely want to help figure out a positive solution to their living situation.

Step Two: Declutter and organize

It’s amazing the number of things you can acquire over the course of a lifetime. From an endless array of dishes to closets full of linens to the many mementos and knickknacks of a life well-lived, addressing where all these items will go can be overwhelming. It’s also an incredibly emotional process for everyone involved. These aren’t just objects, they’re memories; they’re what’s made the house a home for all these years. It’s important to acknowledge and respect this loss. Go into the process prepared to part with plenty, but giving yourself room to keep the items that mean most.
 
The most straightforward way to sort through items is to ask yourself four questions about the item:
 

• Do I need it or want it?
• Does it have sentimental value?
• Do I use it often?
• Do I have another item that performs the same function?

​Do I need it or want it?
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You don’t have to throw away everything you could live without, but you should be pretty strict about your definition of need. If you have a bread maker that’s been sitting in the cabinet untouched for years, don’t feel like you “should” keep it just because it was a Hanukkah gift. Think realistically about the years ahead: will you use it more than a few times? Are you genuinely excited for the few times you’ll use it? Will it make an important difference in your life to hold onto the item? It’s okay to say yes, but it is also okay to decide you don’t need it. decluttering and downsizing is about simplifying, so make a decision and feel confident in sticking to it.
 
Does it have sentimental value?
 
The hardest items to part with will be the ones directly tied to beloved memories with your family and friends. Still, if you kept absolutely everything of sentimental value, decluttering and downsizing would be impossible. Use the packing and sorting process as a way to reflect and let go. As you and a loved one go through your things, talk about them and the memories they conjure up. 
 
Do I use this item often?
 
There are going to be some items you’re simply used to having around, but ultimately don’t use very much. Think about your day-to-day routine: which items do you use the most? When looking around your house, which objects have been merely functional décor? Additionally, consider whether where you’re going will have a valuable replacement — just because you’ve always used a traditional toaster doesn’t mean you can’t adapt to your daughter’s toaster oven, for instance. Continue to be realistic about the future, keeping in mind that there might be someone else who would get much more use out of the item than you might.
 
Do I have another item that performs the same function?
 
Whether it’s two blenders or a dozen winter coats, duplicate items are the easiest way to declutter and downsize. Choose the newest or best-functioning electronics, and a reasonable amount of more practical items like towels, blankets, outerwear, and other clothing. Use the opportunity to clean out your closet and embrace the opportunity to minimize. Hiring a senior move manager, professional organizer, or declutterer can make a world of difference during this process and make the transition much more simple. 
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Step 3: Find new homes for the items you aren’t keeping

​Moving expenses can become pricey. Yard sales are a great way to make some extra money to help fund the move, and a great way to find new homes for your things quickly. Choose a day that’s likely to be nice, even if it’s somewhat far in the future. Having your yard sale on a nice day is likely to draw in more customers who are looking for bargains. 
 
Donate any remaining items that did not sell during your yard sale. Many charities and organizations can even pick up boxes directly from your home. It can feel impersonal and somewhat distressing sometimes — even with a yard sale, your items tend to go to neighbors you’re familiar with — but it’s important to focus on the end result. Someone in need will truly benefit from your donation and appreciate it each and every day.

Step 4: Prepare for the move

After you have taken the time to declutter and get rid of unwanted items you can start to think about packing and making the move to your new home. Moving can be stressful and difficult. Hiring a senior move manager to assist you with this transition can be very beneficial. They can help make your move as stress-free as possible and will be there by your side throughout the entire process. 
​

Step 5: Say goodbye to the house

Just as aging adults have to say goodbye to their possessions, the time will come to say goodbye to the house, as well. It will be a difficult process, but one with plenty of love and support from family and friends.
The truth is, there’s not necessarily a right or wrong way to say goodbye to the family home. Discuss what will work best for your family in an open and honest setting; don’t feel ashamed if you’re having trouble. It’s vital that the entire family supports one another throughout the decluttering and downsizing process, so don’t be afraid to ask for or offer help.
 
However the goodbyes are said, make it a point to bid farewell. You’re closing a major, important chapter of your life. It’s OK to feel sad, even as if you’ve suffered a loss, but don’t lose sight of the exciting next step that lies ahead.
​

Step 6: Make the transition

No matter where you are headed, your new home won’t feel like home right away. Do what you can to bring in the most important items first, those that will make you feel especially comforted. Move-in day should be a family affair, even if you already have help from a senior move manager or movers. Any family member who is able to should stop by to help out, bring food and refreshments, troubleshoot issues, and simply make the occasion a happy one. Keep the mood as light and exciting as possible: focus on the fact that it’s a new beginning rather than an end.
 
You should check in on your loved ones regularly to discuss how things are going. You don’t have to stop by every day, but a nightly call for the first week or two can certainly make aging adults feel less lonely. It’s especially important if they’ve just moved to an assisted living facility or nursing home. Find the balance between hovering and checking-in, even rotating responsibility among family members.
 
Decluttering and downsizing is often one of the best choices an aging parent can make, but it’s their decision when and if they want to. Ease into the idea and keep the conversation ongoing. It will be painful, but the inevitable sting of leaving the family home should never stop anyone from simplified and happier living.

Originally Published on Redfin
June 16, 2020

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Article by Alyssa Elting McGuire, MA, MPA
Contact Alyssa

Guest article by Michelle Walch
michellewalch.com

Adult foster care home work is a 24-hour, seven day-per-week job. Care home staff not only help with resident meals, errands, bathing and medical tasks, but these staff also give very much of themselves physically and emotionally. Many find the work rewarding, but it can be physically and emotionally challenging. That said, it is important to manage your own well-being so you can provide the best care.  

What is Burnout?

“Burnout” occurs when someone is physically, mentally, and emotionally overwhelmed, according to Healthline. The rate of burnout is 53.3% for caregivers, and the rate of severe burnout is 27.1%, according to a Japanese study.

​When you live where you work, you never really have a place to take a break. You are always on duty. Many caregivers don't reach out for help and don't take a break from their work. As a result, exhaustion takes its toll.

What are the Signs/Symptoms?

Be aware of the burnout warning signs:

• anxiety 
• isolation
• depression
• lack of energy
• fatigue
• insomnia

It is important to know the difference between burnout and depression. Depression is a disorder of your state of mind. Burnout is a reaction to severe stress in your environment. The World Health Organization (WHO) calls it occupational burnout to describe work-related stress. This is different from the medical condition of depression.

An article in Psychology Today has a compassion fatigue questionnaire (similar to burnout) and suggestions on self- care if you scored high on the questionnaire.

When you live and work in the home, how do you build a break into your schedule?

Planning and Prevention

Alyssa Elting McGuire, of Oregon Care Home Consulting, recommends planning to prevent burnout. "Self-care is like being in an airplane when the oxygen mask comes down. You give yourself oxygen before you give it to someone you are caring for. When you take care of yourself, you can then take care of others."

A care provider in Washington County, Oregon, offered suggestions to prevent burnout:

• Allocate time for self-care
• Schedule breaks for both staff and yourself
• Don't over commit. Be okay with saying "no," and setting boundaries.
• Honor your personal needs
• For providers, trust your caregivers. You have well-trained caregivers. Trust them to take care of the residents while you're away.
• Pre-plan a time weekly (on say, Sunday evening) to review records and take care of what needs to be done
• Recognize the difference between what needs to be done now, and what can wait

Article by Alyssa Elting McGuire, MA, MPA
Contact Alyssa

November is National Caregiver Appreciation Month. In honor of the work adult care home providers and staff do day-in and day-out, I would like to take time to recognize and appreciate the work they do by telling their stories. Recently, I interviewed provider Vicky Barbu and her business partner and daughter Adriana Gavozdea about their experiences moving to America and starting their adult foster home in Tigard.  They shared their stories of how they came to work in the adult care home field and provided their ideas on what makes adult care home providers, and other staff, successful.

Interviews have been edited for clarity and brevity.

Interview with Adriana Gavozdea

How long have you worked in the adult foster/care home business?
 
I’ve worked in this business for eight years, since I moved here from Romania. My mom owned the adult foster home for eight years prior. I came here to start a new life, and I actually started this job two days after I landed. My mom trained me at her level because someday when she wants to retire, I can take over the home. We work together, and we’re a team.
 
What do you love most about the work you do?
 
I love that I make a difference, honestly. For example, when a resident can’t brush their teeth and you help them, it makes their day better. Recently, a client who wasn’t doing well was having trouble putting on her sandals. She asked me to do if for her, but instead I coached her and watched her closely, and she did it by herself. She was so happy at the end and thanked me so much. That’s my joy.
 
What do you believe makes someone’s work successful?
 
Compassion, and you have to be built for this. What I mean by that, is I’ve met people in this industry who didn’t have passion and they were miserable. You have to love what you do and help other people. If you do it for the money, you may succeed financially, but at the end of the day you’ll be so burned out, it won’t matter. You have to like to help people.

​Anything else you’d like us to know about you?
 
I think we’re amazing!  My mom and I were doing other things back in Romania. I never worked in healthcare before. She was an accountant and I was CEO, and we ended up in America, starting a new life from scratch. You land here and have to start all over. My mom arrived at age 45 and I arrived here when I was 30.
Since we have other skills, there is always another option, but we want to do this.

​We’re not stuck in this job, but we like this work. We got used to being at home, being home with you kids, be at home for meals. We are so family oriented. In Romania, you take care of the seniors, so we are used to being in the home with the older generations. In Romania, after I gave birth to my daughter, I went back to work. My grandmother took care of my daughter until she was four, and my grandmother was at my house all the time. It’s a cultural thing.

 Interview with Vicky Barbu
 
How long have you worked in the adult foster/care home business?
 
I opened my home in 2007, and before that, I was working as a caregiver in another adult foster home. We came to the U.S. in April of 2002, and I started as a caregiver in June. I was a bookkeeper in Romania for manufacturing, and I was also a foster mother.
 
I came to America when I was 45. It’s hard to go back to school with new culture and language. When I arrived, I could understand English, but it was hard for me to talk. I learned to speak English well with residents while working.
 
What do you love most about the work you do?
 
When you are helping residents. When residents really need help and you can give them the help they need, you get to see how happy they are and how well they are feeling. This makes you proud and think, “I did something good today.”
 
What do you believe makes someone successful?
 
I am trying to do my job the best I can do. It is very hard work, and especially working with people with disease processes. Sure, it sometimes makes you crazy, but you have to have patience and try to understand the residents’ needs, that it’s not their personality, but it’s the disease. They don’t necessarily want to do what they’re doing.
 
In this work, you need to have a lot of patience. It’s important to show residents you care about them. Much of the time, we know them very well, so we should try to be their voice (e.g. to medical staff and others).
 
With every resident, you’re learning something new. Use that new information to learn and help the next residents. I learn a lot with every resident. You have to be open to learn new things. You don’t have to know everything. Open your mind and pay attention, and then you will learn.
 
Anything else you’d like us to know about you?
 
I am trying to make everything very smooth for my business behind the scenes. I know what I have to follow, so I’m trying to follow rules and make it run smoothly. My advice is make residents happy and follow the rules, and things will work well. ​

About the Author

Alyssa is founder, principal consultant and training specialist with Oregon Care Home Consulting. She has spent the majority of her career providing program service delivery, regulatory leadership, training development, and program coordination and management in government and not-for-profit organizations. She is passionate about helping current and  future adult care home providers in Oregon successfully navigate the licensing process and provide quality care to seniors. ​

Article by Alyssa Elting McGuire, MA, MPA
​Contact Alyssa

Most hospitals and skilled nursing facilities adopted electronic medical records years ago. Now, larger community-based facilities, such as assisted living and residential care, are slowly adopting electronic health records; however, the adult care home industry has yet to jump on the electronic records bandwagon.

This lag in adoption is likely due to several factors. Adopting electronic records can be more challenging for adult care home providers without electronic record experience who may initially believe they lack the money, staffing, and infrastructure to implement this change. Fortunately, these potential barriers are not insurmountable.

As larger facilities migrate to electronic record-keeping, it is simply a matter of time before more and more providers in Oregon start implementing electronic record-keeping systems in their adult care homes.
One trailblazer in the area of electronic record use in adult care homes is Shannon Carskadon. Shannon owns and operates Silver Cloud Adult Family Homes in Forest Grove and has been in the business for 25 years. I recently had the opportunity to sit down with Shannon to talk about her experience transitioning to an electronic records system earlier this year.

The system Shannon uses is supported through Beaverton-based company Care Facility Management Systems, LLC, which works with individual adult care home providers to “cost-effectively transition their business operations from paper to electronic records.” Owners Gueipin Xi and Elaine Hartman bring over twenty years of experience providing technical support and security to health care clients.

Interview with provider Shannon Carskadon(Interview has been edited for brevity and clarity)

Have you used electronic records for your homes before?
I used Excel files, which I printed out for licensing, but I had no system set up.

What made you decide to transition to electronic records?
There were current issues [with the hard copy records]. At licensing inspections, the books would be torn apart and nothing got put back correctly. There was too much repetition and similar mistakes. There was a huge potential for medication errors.
​
Elaine [with Care Facility Management Systems, LLC] called me and asked if I’d be interested in helping build this program for use in other adult foster homes. The company takes care of online security with a private network, and provides training and support to use the system. I was all for it.

Tell me about the process of transitioning your paper records to the electronic records? How long did it take?
​Gueipin and Elaine provided me with the hardware and software, set up, and training. They also provide the system security, and ongoing technical support for the electronic records system. The support is amazing. Often, providers are isolated. For me, it feels like a professional system with support and cohesion.

At first, it was about 10-15 hours of work at the first of the month. I first started with medications only [eMAR], and it took as long as it takes to enter medication orders. The eMAR is a no fail system. For example, with a PRN, caregivers have to write the result in the record, or they cannot close the entry. Also, I can easily track narcotics using the system.

There was a learning curve, but my caregivers picked it up quickly. We worked on it piece-by-piece until they were comfortable with each section.

Elaine then came to my home with a large scanner. I scanned all resident records into the system and they’re saved in a secure folder. All the [paper] records I have left are in two binders.

What are some other benefits of the system?
​I can send and receive [electronic] faxes to the doctor, and I can have legal representatives electronically sign documents.
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We also use the system to document resident activities and facility records, such as smoke detector testing. I can add reminders and tasks for staff. Caregivers log in with an individual login and see the reminders and tasks. I can run reports and look at tasks that were done. I can also see when caregivers read an email I sent.
My data is secure and consistently updated, and I can access the information securely and remotely. If we have a fire or earthquake, I can get into the system remotely and I don’t have to worry about losing records.

Tell me about your renewal inspection after you started using an electronic records system.
​It saved a lot of time. The inspection at my first home was in January (2019), and the renewal inspection of my second home was in March. I learned from the first inspection, and had everything ready to go for my second inspection. The licensor was in-and-out in two hours and got everything [the licensor] needed. I had no medication violations.

What advice do you have for other providers who are considering the transition to electronic records, but are concerned about either cost, the challenge of transitioning, licensing, or other issues?
​Take the time to learn the program. It’s especially beneficial for multiple homes. I can run compliance reports, and I can check on caregivers remotely and run audits to see who logged in, when, and what actions they took. The program is customized so it meets licensing requirements. If you do your due diligence, the system helps you be compliant.
​
Finally, the cost is worth it. It’s less than ink and paper, and that doesn’t include the time saved. We’ve been thrilled with this. I can’t say enough positive about it.

About the Author

Alyssa is founder, principal consultant and training specialist with Oregon Care Home Consulting. She has spent the majority of her career providing program service delivery, regulatory leadership, training development, and program coordination and management in government and not-for-profit organizations. She is passionate about helping current and  future adult care home providers in Oregon successfully navigate the licensing process and provide quality care to seniors. ​

Article by Alyssa Elting McGuire, MA, MPA
​Contact Alyssa

Today, March 8th, is International Women’s Day. March is Women’s History Month. Every day should be a day to celebrate the lives, strengths, and accomplishments of women.

It’s no secret that women make up the majority of caregivers for both seniors and children. It has been researched and written about for years. In families, of course, the care burden is primarily placed on the shoulders of female spouses and daughters. According to the Alzheimer’s Association, “Approximately two-thirds of caregivers are women…and one-third of dementia caregivers are daughters.”

If we look at the numbers for adult care homes, we can see there isn’t a significant difference between family and professional caregivers, in this regard. There are almost 1,600 adult care homes in Oregon, and based on a quick sampling of the State’s provider list, it is plain to see the majority are owned by women.
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I think we’re starting to see a slow paradigm shift where there is less expectation that caregiving is “women’s work,” and where more men are proudly taking on caregiving roles. Anecdotally, I’ve seen a significant increase in the number of men opening adult care homes over the past few years and being the primary caregivers, or working along side their female partners. This is a good thing.

​Even with this slow shift taking place, the majority of caregivers are still women. According to a 2018 Portland State University report on adult foster homes in Oregon, 88% of providers live in the adult care home, and a third had children under 17 living at home. From this, we can conclude that many women are both providing care for residents and their children. This is both a benefit and a challenge. It really is more of a benefit, though, if we consider these women would be caring for children, or having to find care for children, regardless of where they worked.

In this regard, one significant benefit of owning an adult care home is that parents can stay home with their children while working. The adult care home business provides women with the opportunity to be their own bosses yet also care for children or aging parents while working at home and making a solid income. What other business truly provides this opportunity for women?

So, on this International Women’s Day, let’s take the opportunity to recognize and appreciate the work of women around the world, and also here at home. Let’s continue to recognize the important work of adult care home providers and support those providers who are making an important contribution to both the older generations, and the next.