After a hospital stay, the time may come when elderly patients cannot return home to care for themselves. Options are many, depending on health, insurance and pricing. It is great to turn to family, but often a family member is unable to provide care or is caught in the middle, responsible for caring for children. The growing number of people who find themselves in this situation have earned the title “sandwich generation.” The responsibilities they face include helping aging parents, who as a group are living longer than their parents, funding their retirement and family’s health care and saving for their children’s college education.

“The sandwich generation is very real, and growing,” says Debbie Pate-Newberry, director of communications and outreach for the California Association of Homes and Services for the Aging. “Though you hear a lot about baby boomers entering retirement, we need to realize that retirement for them will be quite different than for their parents. Many boomers have had choices their entire lives that their parents never dreamt of. This means they see retirement as a time to have fun and experience life. This desire to be in control and make their own decisions is spilling into their quest for control of where their parents live as their parents become the ‘old elderly.’ “

For some, this adds up to an overwhelming situation, but one that a number of San Diego agencies are moving to address.

“Responsiveness to demand has resulted in a variety of options now available to consumers — options relating to services, special programs, activities, community size and amenities,” says Sally Michael, president of California Assisted Living Association. “Because consumers’ preferences and needs vary widely, there is no single blueprint. Assisted living communities can range from a converted Victorian home to a high-rise complex to a multi-acre campus.”

Assisted living communities in California are licensed as Residential Care Facilities for the Elderly, regulated by the Department of Social Services. Inspections by state officials, staff training and certification requirements, family and community involvement, and quality assurance efforts bolster care standards.

Jewish Family Services in San Diego provides everything from information and referral to geriatric care management specialists to Grandpa Cohen’s Fix-It Service (home repairs to low-income seniors and disabled persons at cost of supplies only).

JFS has a full-time placement/referral coordinator who works with seniors and family members to find appropriate care. “Our referral coordinator assists clients and their families with identifying and moving into retirement, assisted-living, and skilled nursing facilities,” says Craig Lambert, director of senior services, Jewish Family Service. “Our geriatric care management program provides geriatric social workers and counselors to help seniors who are ambivalent regarding the move.”

The decision on senior housing is not one to be taken lightly. “Research, research, research,” is what Pate-Newberry says must go into selecting a place. “Visit these communities. Talk to the residents; talk to the staff. CAHSA members provide caring, home-like atmospheres. Because many are religious or fraternal based, they try to provide a service where they see a need in their community. And they do it to serve the seniors, not to make money.”

The California Department of Social Services lists 201 licensed residential care facilities for the elderly in San Diego. The majority are small, serving six or fewer residents. Many communities provide amenities typical of a hotel or resort. Considerations during a visit should include atmosphere, services, costs, health care needs, activities and any other areas of importance to the individual.

“Every community is unique,” Michaels says. “We recommend making several visits, at various times of day, to each community being considered. As a person starts a search, it is important to assess their needs as they are now and ask each provider how they might accommodate any changes over time. It also is important to examine finances and ask about costs as monthly rates and fee structures vary.”

— Maria L. Kirkpatrick