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Quiz - Is My Loved One Ready For Assisted Living?

Apr 8, 2018

1.      Doesn’t go out unless it is to a medical appointment or to take care of other necessary errands?   YES   or   NO


2.      Is lonely or socially isolated?   YES   or   NO


3.      Is falling or frequently suffering an injury?   YES   or   NO


4.      Sometimes forgets to take their medication?   YES   or   NO


5.      Has difficulty keeping up with household chores and responsibilities?   YES   or   NO


6.      Is losing weight or becoming weak?   YES   or   NO


7.      No longer cooks balanced meals?   YES   or   NO


8.      Isn’t paying bills on time?   YES   or   NO


9.      Needs help with daily activities such as shopping, cooking, eating, cleaning, bathing and dressing?   YES   or   NO


10.    Thinks people are stealing their personal possessions?   YES   or   NO


11.    Has slower reaction time, and should not be driving?   YES   or   NO


12.    Buys multiples of the same product because they can’t remember what they have at home?   YES   or   NO


13.    Gets lost when driving and can’t remember how to get to familiar places?   YES   or   NO


14.    No longer takes pride in personal appearance?   YES   or   NO


15.    Has stale or expired food in the refrigerator?   YES   or   NO


16.    Wears the same clothes for days or dresses inappropriately?   YES   or   NO


17.    Is longing for a maintenance free lifestyle but is worried about making a change?  YES   or   NO


18.    Spends too much time sitting in front of the TV?   YES   or   NO


19.    Often seems bored of anxious?   YES   or   NO


20.    Has difficulty remembering recommendations from the doctor or family members?   YES   or  NO


Number of "YES”:   ______________      Number of "NO”:   ______________


Annual Costs: New Jersey - State Median (2017 vs. 2018)

Feb 28, 2018

Below is the Genworth Annual Cost: New Jersey - State Median 2017 vs. 2018 comparison. As you can see prices are going up due to shortage of caregivers. Please note when factoring additional costs, when considering home care services, you will need to factor in all of the household expenses such as groceries, lawn care, snow removal, association fee's, etc. Also, the home care cost is based off 44 hours per week. If you were to hire a live-in (24 hour caregiver) the average cost per day is $225.00 making the annual average of $82,125.00. Assisted Living Community 2017 - $69,732 2018 - $71,824 Home Health Aide (based off 44 hours per week) 2017 - $52,624 2018 - $54,203 Nursing Home (semi-private room) 2017 - $120,450 2018 - $124,064 Call Next Stage today to discuss your options and what care service suits your financies!

Assisted Living vs. Nursing Home Comparison

Feb 23, 2018

Levels of Care:

The Assisted Living Communities will help with activities of daily living (ADL’s) such as bathing, toileting, dressing, hygiene, and grooming (personal care).  The aides/nurses on staff at the assisted living will also assist with medication management and administration.  

A Nursing Home will also aid with ADL’s and personal care as well as the medication management and administration.  How nursing home differentiates themselves with Assisted Living is they are required to have nurses on staff 24/7 so they can assist with all skilled nursing care however they are limited to medical treatments.  Nursing Home are a much higher level of care is more of a hospital setting. 


Assisted Living Communities
have extensive recreational activities for their residents.  They will offer non-medical transportation to doctor appointments and outings.  All meals, laundry and housekeeping will be covered by the staff.  There will be 24/7 supervision in the community always.

Unlike Assisted Living’s, Nursing Homes will have very limited recreational activities. They will also unlikely provide non-medical transportation to appointments or outings.  Most patients who are in a Nursing Home setting are mostly bounded to that facility.  The independence is much less than Assisted Living Communities.  However, Nursing Homes will provide meals, laundry, housekeeping and 24/7 supervision just like the Assisted Living would.    

Living Areas:

Assisted Living
offers private or shared apartments and studios with private baths and kitchenettes.  They will have extensive common living space with usage of all outside grounds.

Nursing Homes
will also offer private and shared rooms.  They do not offer studios, private baths and kitchenettes.  There will be usage to some common areas and limited or NO outside areas. 

Number of Residents:

Assisted Living
tends to be on a smaller scale when it comes to number of residents.  The range will vary from as few as 5 to as many as 300 residents. The average is approximately 50 individuals. 

As for as Nursing Homes go, the majority are large and will accommodate on average 100 patients. 

Who Qualifies:

The typical resident for Assisted Living will require some personal care (ADL’s).  The resident will need to be able to walk or are ambulatory.  They need to be receptive to assistance.  Most important is that the resident is able sit to stand and can transfer in and out of bed safely. 

The Nursing Home patient will require much more extensive personal care and will also require daily medical care.  They are not mobile unless they have assistance.  There will be severe cognitive impairments and may be late stage Alzheimer’s.  A patient who is in nursing home care will be for the most part bed bound/wheelchair bound.


Assisted Living
costs will depend based off geographic location and level of care.  The average costs for Assisted Living varies from $5,500/month to $7,500/month. 

Nursing Home
costs will depend based off geographic location as well.  The average Nursing Home costs in New Jersey is $9,000/month to $11,000/month. 

Payment Options:

Predominately Assisted Living is paid for out-of-pocket however financial assistance is available.  A couple options for assistance with payment are, VA Pensions, Medicaid, Alzheimer grants, Long Term Care Insurance and other options exist.

Nursing Homes
are predominately paid by Medicaid but beneficiaries must spend down their own assets on care before coverage kicks in or alternatively working with a Medicaid planner can preserve assets (i.e. Elder Law Attorney and Medicaid Specialists). 

For more information regarding Assisted Living and Nursing Home Care Information please call Next Stage Senior Guidance at 732.310.3647.  

15 Signs Why Your Loved One May Benefit From Next Stage's Services

Feb 3, 2018

Next Stage has compiled a list of 15 signs why your loved one may benefit from our services.  If your loved one is experiencing one more multiple of these signs and you are looking for advice, guidance or support please contact our office today and speak with a Senior Advisor. 

1. Diagnosed with Dementia or Early Onset Alzheimers

2. Unable to manage daily intake of medications

3. Loss of interest in activities & hobbies

4. Weight loss & lack of appetite

5. Falling behind on bills & bouncing checks

6. Not keeping up with personal care (bathing, toileting, dressing, etc.)

7. No longer doing housekeeping, clutter & laundry piling up

8. Incontenience issues & smell of urine in the home

9. Forgetfulness & confusion when performing familiar tasks

10. Desire to be social and active

11. Difficulty with walking, balance & mobility

12. Missing scheduled appointments

13. Spoiled food that does not get thrown away

14. Bruising on the body that is unexplained

15. Unexplained dents & scratches on the car

Key Questions To Ask When Hiring A Caregiver For You or Your Loved One

Jan 26, 2018

Hiring a caregiver for you or your loved one is a daunting task.  Since you are opening your home up to this individual and trusting them with one of your most prized possession you want to make sure the individual that you hire is trustworthy and qualified for the job.  


To help with this process, Next Stage Senior Guidance came up with 5 key questions to ask when interviewing your potential candidate.  


1)    Why did you choose to be a caregiver?


A good caregiver is a kind hearted, warm and caring individual.  You are looking for someone who takes pride in their job and enjoys helping the elderly.  If there are in this industry for only a paycheck than the individual is not fit for you or your loved one.  


2)    What kind of training and certificate do you have in caregiving?


The answer you are looking for when asking this question is that the individual is a Certified Home Health Aide (CHHA) licensed through the state of NJ.  Ask to see proof of license.  You can also verify online through the board of nursing.  You want to make sure that their license is in good standing and has no disciplinary action against it.  You will also want to make sure that they are keeping up to date with their CEU’s (continuing education unit).  A bonus would be if the caregiver is CPR and first aid training as well.    


3)    Tell me about your work experience.  


Ask about their previous jobs.  Did they work privately for a family or did they work with a licensed agency.  How many years of experience do they have in the industry.  How long have they been a certified home health aide?  It is also good to find out what other conditions or diagnosis their past clients have had.  You want to look for someone who is familiar with your loved one’s condition so they can teach you a thing or two vs. you having to teach them.  Ask for 2-3 professional references and make sure to call and verify employment.  Lastly, make sure a criminal background check is run.  You can order this through an online site.  It will cost between $30-50.00 but will be worth every dollar. 


4)    How long do you intend to stay at this job?


Caregiver turnover will have a negative impact on you or your loved one’s quality of life.  Continuity and consistency is very important as you are searching for a caregiver.  When asking this question, you are looking for someone who does not plan on leaving after a short period of time.  You want someone who is in it for the long haul.  


5)    Are you able to lift heavy weights?

Making sure your potential caregiver does not have lifting restrictions is also very important.  You need to prepare for the future.  You or your loved one may not need assistance with lifting now however in the future this may be an important task to the care plan.  Also, you want to avoid the caregiver getting injured while on shift.  This can cause additional expenses as well as jeopardizing you or your loved one’s health.

For more information regarding how to hire a caregiver and the appropriate questions to ask, please call Next Stage Senior Guidance at 732-310-3647!  We are here to help and put ease to this difficult process.  

In The Know - Assisted Living Referral Services

Dec 29, 2017

What Is An Assisted Living Referral Service

Assisted Living Referral Services or Assisted Living Placement Agencies (as they were called prior to the Internet age) are organizations that help families identify which assisted living residence is best for their loved one. Choosing a residence is a surprisingly difficult process, especially for persons unfamiliar with assisted living and who are currently caring for an elderly person. They are also helpful for persons who live far from their loved ones that require care. Referral services provide significant assistance in narrowing down the choices and they provide their services to families free of charge.

Services Assisted Living Referral Services Provide

When matching an individual to an assisted living community, there are many factors to be considered, such as location, cost, current and future care requirements, and amenities. Referral services can provide all of this, as well as more community-specific information in minutes. Were an individual to attempt to gather this information from each of the many assisted living communities in their preferred geographic area, it would take them days of phone calls and meetings. It would also subject them to countless sales pitches in which it would still be difficult to obtain the information they require.

In addition to the obvious information a family would want, referral services also have access to information about which a family might not necessarily think to inquire. Information, such as pricing variables, occupancy rates, number of residents, resident to staff ratios, proximity to hospitals, family reviews, and resident complaints. Furthermore, referral services can save families money by helping them to understand how to negotiate with the assisted living residence and making sure they sign-up for the correct level of care.

Prior to deciding on a community, most families will take a tour of the residence. Tours are necessary, but vastly time-consuming, difficult, and emotionally challenging. Working with a referral service might decrease the number of tours that are needed from 5 to 6 to just 1 or 2. In addition, they provide scheduling assistance in arranging tours.

Pro's of An Assisted Living Referral Services

-Free service
-Have comprehensive list of residences
-Can save families money
-Access to information that families do not have
-Reduces the number of tours a family takes
-Provide free tools to help you with your search

How Assisted Living Referral Services Are Compensated

Assisted Living Referral Services is a FREE service to the client who they are placing.  The agency is directly compensated by the community that you or your loved one moves into.  Payment occurs 30 days after client has moved in.

How To Best Use An Assisted Living Referral Service

While assisted living referral services help you figure out which is the best assisted living community for your loved one, it is helpful to give some thought about assisted living residences prior to contacting them. At a minimum, you should know the location in which you are seeking a residence. Be that a specific city or town, or (for example) something less than a 30-minute drive from your home. You should also know the approximate type of care your loved one requires, specifically do they require assistance because of Alzheimer’s / dementia or simply assistance with the activities of daily livingFinally, you should also know if you are seeking the most affordable assisted living in the area, a mid-range or high-end residence.

Once you contact the referral service, ask them specifically what other factors should be taken into consideration when choosing an assisted living residence. Keep a list of the factors and request that the referral service research those factors for all the potential communities in your area.

When you’ve narrowed the decision down to several options, ask your Referral Service Advisor about negotiating with the communities. They should be able to discuss "occupancy rates” and know which fees are negotiable and which are not. Use the Service to pit one residence against another to determine if a discount is available.

A good assisted living referral service will be informative and unbiased about the residences. If they do not know an answer to a question you have, they should volunteer to find that information out. They should not put that responsibility on you. They should also be responsive. Expect answers to your questions (which they cannot answer immediately) within a day or two. If they don’t respond within that time frame, expect them to follow up and say when they will be able to respond. Finally, if you do not like the service you are receiving, do not hesitate to find another service. You are under no obligation to continue working with anyone just because you initially started working with that agency.

Assisted Living 101

Dec 6, 2017

Interested in learning more about Assisted Living? Click here to read our comprehensive guidebook. Inside you'll find information on the benefits and cost of Assisted Living, as well as whether or not Assisted Living is the best choice for you or your loved one. To read the black and white version, please click here.

Conversations Adult Children Must Have With Their Aging Loved One's

Dec 2, 2017

As today's senior population continues to age, it has become increasingly important for their adult children to step and make sure that they are prepared to take care of their aging parents. Whether parents suddenly pass, need to go to the hospital or must be moved to an assisted living facility, many times these big life changes come unexpectedly.

While these conversations can be uncomfortable for both seniors and their adult children, it is very important that all loved ones are prepared with some specific information on their senior loved one and their wishes. Having legal documents in order and knowing how to handle a senior's state of affairs can ensure that this individual has all of their wishes met, and it can make life much easier for the family of that senior should something happen.

Power of Attorney

If there is one conversation that all adult children need to have with their senior parent, it should be about a power of attorney. All seniors should have someone in mind to act as power of attorney so they have someone to take care of their affairs if they are unable to make decisions on their own. This can be a physical or mental incapacitation set on by an accident or even an illness such as Alzheimer's disease. This power of attorney can either handle all decisions, or they can have a health proxy and a financial proxy, meaning one person to handle health decisions and one to handle financial ones.

Wills and Living Trusts

All seniors need to have some type of will or living trust. These important legal documents detail what a person wants to happen to their money and possessions once they pass away. A living trust is slightly different than a will and it indicates who they want to be in charge of their assets in case they are incapacitated or pass away. Both of these documents are very important, knowing where they are can help all parties involved make decisions in the interest of the senior, should something happen to them.

End-of-Life Wishes

This is perhaps one of the most uncomfortable conversations that adult children tend to have with their senior parents, but it is a very important one to have. Many seniors will have what is known as a living will which proclaims their choices about end-of-life care, such as a "do not resuscitate" statement or information on whether or not they would want to stay alive in a permanent coma. Living wills are the best way to make sure this information is clear, but children should at minimum know what their parent's wishes are, especially if they are the health care proxy.

Access to Documents

There are a number of legal documents, including their will and bank information that they may need at one point or another. If they are unable to located these documents themselves, it is important that their children know how to get their hands on this information. This may be a safety deposit box or a safe. In these situations, someone should have a key or combination that lets the individual into these secured areas.

General Health Information

It is always a good idea to check in with seniors about their general state of health, especially when the topic isn't brought up very often. Many adult children are surprised to find that they really do not know much about the parent's health condition, even if they feel very involved in their day-to-day life. Many senior adults are understandably private about their health information.

With this in mind, it is important for adult children to check in on their loved one's health, make sure that they are visiting the doctor regularly and to double check on all medication that their parent or loved one is taking. A great question to ask in order to get a feel for a senior's understanding of their medication is to ask them if they understand why they are taking all of the medications they have been prescribed, this can give any person a clear picture of whether or not they are able to manage their own medications and insight on that senior's overall health, should a medical emergency take place.

Financial Advisor

Many seniors have financial advisors that are managing their money and their assets, children or caregivers that may need to oversee this senior's estate in the future should have information on who that financial advisor is and how to get in contact with them.

Long-Term Care Coverage

There are many seniors who have some type of long-term care coverage such as long-term care insurance or even a special savings account meant for long-term care. Either way, their children and loved ones should know what finances are in place should that senior need to suddenly transition to assisted living. Some seniors have a plan, while others do not. 

Assisted Living

There are many seniors who have ideas or thoughts on where they would like to go if they can no longer care for themselves. Conversations about long-term care can be uncomfortable, but getting a senior parent involved in the discussion early on can help adult children and their loved ones plan for the future. Some seniors will be open to the idea of assisted living while others may prefer in-home care. While not every senior ultimately gets to be in the place they want, knowing what they would prefer can help families make more informed care decisions in the future.

No one ever wants something bad to happen to their loved one, but it is still important to have these conversations with aging seniors sooner rather than later. Sometime as seemingly minor as a slip and fall can put any senior in the hospital or in rehabilitation, and many families will have wished that they had this information handy. Family members should it slow and approach these topics in a calm manner and they can get the information that you need to keep their senior's best interest in mind and make sure their family is prepared for the unexpected should it ever arise

Assisted Living Communities - What Can You Afford

Jul 11, 2017

What Can You Afford

 Paying for assisted living comes from private funding and your own financial resources. Other sources for paying for the long-term care include an insurance policy, Medicaid, reverse mortgage, home equity loans and other financial assistance programs.

 When meeting with senior living providers, ask for written material, including copies of the community's resident agreement that outlines, at a minimum, services, prices, extra charges, move-in and move-out criteria, staffing, and house rules.

  • Options potential residents and their families use to pay for assisted living:
  • Income from social security and other pensions
  • The sale of the family home and other investments
  • Personal retirement savings
  • Assistance from family
  • Long-term care insurance
  • VA Aid and Attendance Program
  • Settlement of a life insurance policy that is no longer needed
  • Medicaid is available on a limited basis to income-eligible seniors
  • Choosing to share your apartment with a roommate
  • Determine how much you can afford

Things To Consider When Choosing Assisted Living Facilities

Jul 4, 2017

Things to Consider When Choosing Assisted Living  

Locating a Community

When you have decided that assisted living is the right option the question becomes, "How do we find the one that best suits his or her needs?” Planning ahead, when you are not in crisis, will give you the opportunity to explore the different populations served, settings offered, and available service options. Your family member’s physical and mental needs will serve as guideposts for your decision making and discussions with admissions personnel. Seek recommendations and referrals from doctors, friends, and other community agencies. 

 Choosing a Community

When choosing an assisted living residence, you want to consider one that embraces the philosophy of consumer choice as described below by the National Center for Assisted Living and the American Health Care Association.6 

You should expect to:

Be treated with dignity and respect 

Be informed of services available and the limitations of those services

 Services and Costs

Assisted living communities usually charge a base rate which covers a certain set of the services. Other services are offered at an additional cost. The fees for services vary considerably by community size, and the number of services included in the base rate vary, impacting the overall cost of care. As residents age, they may experience a reduction in their capacities and require additional services over time that were not required when they entered the community. Check with the community to find out which of these are included in the base rate and which ones may be offered à la carte:

• Care management and monitoring

• Help with activities of daily living

• Housekeeping and laundry

• Medication management

• Recreational activities

• Security

• Transportation 

• Two meals per day or more

• Increase in frequency and time for personal care

• Incontinence care

• Laundry service beyond basic service

• Meals delivered to living quarters

• Specialized care for dementia

Find out if there are different levels of care. If someone needs more services or care, how would that be determined? Would they be able to move to a higher level of care within the same community? Would the family be notified? When and how is it determined that a resident is no longer appropriate for the community?

The cost for an assisted living community can vary dramatically by location. Most medical insurance, including Medicare, does not provide any reimbursement for assisted living. Assisted living is a covered service in many long-term care insurance policies, as it is becoming an increasingly popular long-term care service option. Many comprehensive long-term care insurance policies cover costs associated with room and board in assisted living, but there can be other charges based on the needs of the individual. Individuals who have a policy should check with their insurance company and review their plan to determine how benefits are paid for assisted living services.

Although the majority of residents pay out-of-pocket, a number of states provide subsidies or Medicaid waivers that cover assisted living for those who meet Medicaid income and asset guidelines.  Medicaid waivers enable residents of the state to receive community-based long-term care services, such as assisted living.

Be sure to ask about billing, bed reservations, refunds, and payments. Take the time to carefully review the contract. Do you understand everything in it? Does the contract specify all the services that your family member needs and how frequently they are provided? Are health services included? Which ones? Does the contract address levels of care? Take into account your loved one’s resources and the amount of time he or she is expected to be in an assisted living community. It is always good to speak to a financial professional and an elder law attorney when planning for long-term care. 


Location may be of key importance, in order to be near friends, family, and familiar, quality medical providers. If possible, consider a community within a 20- to 30-minute drive, in order to maintain contact and encourage visitors. 


Assisted living residences may have as few as three rooms or as many as 200. Most have between 25 and 120 units.9 A smaller residence may be in a traditional home in a residential neighborhood, offering residents a room. A larger residence may be a community, offering apartments with a central dining area and recreation areas. If the community is spread out, is the staff available to help accommodate individuals who may need assistance with walking or using their wheelchairs? What type of setting would your family member prefer? Bigger does not always mean better and small does not confirm that your family member will receive more care. 


As you are looking at different communities, you will want to compare the staff. The attitudes of the staff will tell you a lot about the residence. You may also want to look into the turnover rate of staff, and note how they interact with residents. If you visit at different times during the day you will be able to observe how the staff members balance the residents’ needs with the competing demands, and how they carry out house rules and routines. Also, you will want to know whether there is a nurse on staff for medications and assessments. If not, determine who is responsible for the process and evaluating the care needs of the residents.

Medical and Specialized Care

For individuals who have a cognitive impairment like Alzheimer’s or a similar disorder, and who require supervision for personal safety, you will need to find a setting that is dedicated to providing specialized care. You will need to consider your family member’s mental and physical health needs, and consider whether the environment will provide the needed stimulation to help him or her thrive emotionally, and with dignity. 

You will want to know what services and systems are in place to provide your loved one with adequate health care oversight, monitoring, and access to emergency medical care. What transportation is available to assist residents with getting to their doctors? Is there a therapeutic exercise or fitness program? What are the procedures for getting emergency medical attention? How often do residents get health care monitoring? If, for example, your loved one takes a blood thinner, it will be important to make sure that the staff of the assisted living community will be able to arrange for a lab to come to the residence to draw blood, and then coordinate the necessary follow-up with the doctor, and if necessary, the pharmacy. As a family member, you are the link, the one who can assure that your loved one’s health care needs are recognized and appropriately addressed.

How to Evaluate the Quality of Care

Ask whether the community is licensed in your state.  You will want to use your senses when you visit the communities. You and your loved one will be able to observe how different staff interact with the residents, whether the meals are appetizing and prepared to accommodate dietary needs, and whether there are scheduled activities that will meet your loved one’s social needs. You may also want to make one unannounced visit. Notice whether there are any disagreeable odors or high noise levels, as well as the overall condition of the community. 

Making a Successful Transition

With any move, there is always a period of adjustment. Give your family member time and stay involved and visible in his or her life. Learn the names of people to contact for giving and getting information about your family member. Be sure to praise good work and show appreciation to the staff. Find out procedures for sharing your concerns, and don’t be afraid to speak up when you see a change that concerns you. Individuals whose families are involved in a positive way generally have higher morale and receive better care.

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