On September 28, 2022, when Hurricane Ian one of the most destructive storms in US history made landfall in Southwest Florida with 150 mph winds and a 15-foot storm surge, The Arlington was prepared. Through that terrible afternoon and into the next day, residents and team members were able to shelter safely and comfortably in place, as did many first responders from the nearby Collier County Emergency Management facility. Not even a window was broken.We were certainly fortunate. But it wasnt a matter of luck.When we opened in 2015 on 39 acres in Naples Lely Resort, The Arlington was one of the first retirement communities designed to meet stringent hurricane-resistance standards with steel-and-mortar construction, wind-resistant roofs, backup power generation and impact-resistant windows and doors rated to withstand 150 mph winds. The robust design was soon put to the test in 2017, when Irma, a Category 4 hurricane, barreled into Naples. The Arlington suffered no damage.That made an impression on David Dosa, an associate professor at Brown University who studied the health outcomes for seniors during major weather events. Interviewed for a 2018 New Yorker magazine article on the dangers of evacuating older adults during storms, Dr. Dosa identified one community built to shelter residents safely in place: a high-end senior [community] in Naples, Florida, not far from the Gulf of Mexico, called The Arlington.
We all feel blue sometimes, and thats OK. But when sadness and other symptoms interfere with our daily living, it might be something to address.As we age, we may be at increased risk for depression, but this treatable medical condition is not necessarily a normal part of getting older. Depression is not a character flaw. It is not a weakness. It is not your fault. It is an illness. While major life events such as bereavement can trigger it, depression is different from the negative feelings from a difficult life event. Depression causes feelings that are intense, chronic and out of proportion to circumstances. Depression can last for several weeks, months or years, often becoming a chronic illness like diabetes or hypertension that requires treatment. It is the leading cause of disability worldwide, according to the World Health Organization.Undiagnosed depression can have a physical toll. The National Institutes of Health says that adults with a depressive disorder or symptoms have a 64% higher risk of developing coronary artery disease than those without depression. Some people might be prone to depression due to their genetics, but there is no single cause of depression in older adults. The National Council on Aging lists these as some additional risk factors: Chronic conditions (about 80% of older adults have at least one chronic health condition, per the CDC) Decreased functional ability Reduced mobility Chronic pain Financial issues Elder abuse Caregiver stress Lack of physical activity Loneliness Symptoms of depression may differ across cultures, as well as by sex/gender. For instance, according to the Mayo Clinic, women are twice as likely to be diagnosed with depression than men. In men, depression often shows up as anger or irritability. Furthermore, symptoms of depression are often different from those in younger people. Sadness is not always the main symptom. It can be a feeling of numbness or lack of interest in activities, which is often attributed to age. Mental health professionals and healthcare providers may sometimes mistake symptoms as reactions to illness or life changes.There are several reasons why depression may be missed. Older adults may be isolated, with few around to notice their symptoms or distress. Also, many do not realize that physical pain can sometimes indicate depression. In addition, we may feel stigma admitting to mental health problems and may be reluctant to talk about feelings and ask for help. Certain medications and medical illnesses can bring on depression or have similar symptoms.As a result, it is important to understand the signs, symptoms and consequences of depression. According to the CDC, here are some of the potential symptoms of depression: Feelings of hopelessness and/or pessimism Feelings of guilt, worthlessness and/or helplessness Anxiety and worry Irritability, restlessness Loss of interest in activities or hobbies once pleasurable Fatigue and decreased energy Difficulty concentrating, remembering details and making decisions Insomnia, earlymorning wakefulness, or excessive sleeping Overeating or appetite loss Thoughts of suicide, suicide attempts Persistent aches or pains, headaches, cramps, or digestive problems that do not get better, even with treatment. Memory problems Lack of motivation and energy Slowed movement and speech Neglecting personal care (skipping meals, forgetting meds, neglecting personal hygiene). Throughout our lives, we are told that lifestyle changes can improve health and wellness, including mental health. Meditation, breathing exercises and exercise can help people of any age.According to the National Institute on Aging, we can also lower the risk of depression by: Getting seven to nine hours of sleep every night Avoiding isolation and staying connected with friends and family Doing activities that make them happy Telling family, friends or a healthcare provider if they are developing depressive symptoms. Depression is easier to treat before it escalates. Health professionals can rule out any underlying medical conditions that could be causing symptoms of depression such as dementia, Parkinsons disease, heart disease or medication interactions. A primary care doctor can also screen for signs of depression and recommend treatment that might include medication, therapy or a combination of both.Many people with mild to moderate depression respond to psychotherapy, such as cognitive behavior therapy, which teaches new ways of thinking and behavior, and changing habits that might contribute to depression. Finding the right medication to treat depression is similar to treating some other illnesses; it might take time to find the right medicine, particularly with age-related changes to metabolism and drug interactions. The most important thing to know if you feel you or someone you know may be suffering from depression is you are not alone. Depression can be treated. ABOUT THE AUTHOR Courtney L. Whitt, Ph.D. is Director of Behavioral Health at Healthcare Network, which offers behavioral health services as a routine part of comprehensive care and traditional counseling services. Healthcare Network provides quality primary care services for children and adults in locations throughout Collier County. To learn more or make an appointment, please call 239.658.3000 or visit HealthcareSWFL.org.
Understand what the financial picture looks like.With so many senior living options at so many different price points, it can be hard to know which option is best for you and your loved one. Before making a decision, its important to understand the different types of residences available to youand their associated costs.Evaluating Your Housing NeedsWhen determining senior housing costs, your first step is to decide which type of housing your loved one needs. There are a wide range of options and care services available for senior living, including:Independent livingAssisted living communitiesAssisted living homesAlzheimers and dementia careIn-home companion careSkilled nursing careAssisted living is often less expensive than in-home care. Costs will also vary depending on unit sizefor example, a studio, versus a one or two-bedroom apartment. The average nationwide cost for a private, one-bedroom apartment in an assisted living residence is about $3,000 per month. And just like general housing, there is a wide difference in senior housing and care costs depending on which part of the country in which you live. Your local Assisted Living Locators Care Advisor can tell you about the costs in your area.Additional Senior Housing CostsWhen evaluating senior housing options, be sure to ask about:Pricing models. Most assisted living communities have a base rate for the room and a tiered pricing add-on that varies based on the level of care required. The more care that is required, the higher the care add-on price. Other residences may be all-inclusive, a la carte, or charge on a fee-for-service basis.Additional fees. The base rate for senior housing typically covers room and board, meals, housekeeping, activities and 24-hour onsite support. Additional charges may include entrance fees, deposits, and fees for other services such as transportation, laundry, pets and cable.Lease length. Most assisted living residences charge on a month-to-month basis, but some may require a more long-term arrangement.Determining Your BudgetMany senior living residents and their families pay for senior housing costs through private financial resources. Long Term Care Insurance (LTCI) is also a way families defray costs. Many communities also operate on a spend down model, where the senior pays privately for their housing and care for an agreed upon period of time, and once their financial resources are depleted, they are transitioned into state provided Medicaid assistance. These policies and procedures can vary by state; contact your local Assisted Living Locators Care Advisor in your area for the rules in your community.How Much Can You Afford?When trying to calculate what you can afford for independent retirement, assisted living or dementia/Alzheimers care, the place to start is figuring out your current expenses. When a person moves into one of these communities, almost all day to day expenses are covered. Usually, the only additional out-of-pocket costs are a phone, cable, out of pocket medical, and petty cash for entertainment, clothes or sundries.Monthly CostRent or Mortgage$Utilities$Repairs/Maintenance$House Cleaning$Property Taxes$Enhanced Cable Service/Internet$Home Insurance$Security$Food$Local Transportation$Leisure Activities$Personal Assistance$Other$Total ExpensesFinancial Assistance OptionsWe know you want the very best for your loved one. If your budget is limited, that doesnt mean that you cant afford suitable care. There are several government programs to help subsidize senior housing costs.Medicare. While neither Medicare A nor B offer coverage for assisted living, Medicare A (hospital insurance) may cover costs incurred in a skilled nursing facility for the first 100 days after being released from hospitalization for an acute illness or injury. Ask Medicare can provide more information on these benefits, plus other helpful tools to help you make informed health decisions for your loved one.Medicaid. Medicaid, which provides federal health-care assistance to lower-income Americans, is the biggest payer for room, board, nursing care, and social activities in nursing homes. Many states cover some assisted living services under their Medicaid programs. With the Assisted Living Housing Waiver, eligible low-income adults can choose to receive senior living care services in a community-based setting rather than in a nursing facility.Housing Subsidies. Seniors with annual incomes under $12,000 may qualify for U.S. Department of Housing and Urban Development 202 and Section 8 senior housing. This can provide rent subsidies to help you pay for room-and-board at either an independent or assisted living residence.Veterans Subsidies. Aid and Attendance is a benefit paid by Veterans Affairs (VA) to veterans, veterans spouses or surviving spouses. Long-term care insurance is an insurance product that helps pay for the costs associated with long-term care. Long-term care insurance covers care generally not covered by health insurance, Medicare, or Medicaid. Additionally, in certain instances an in-force life insurance policy contains an assisted living rider or can be converted into a long term care insurance product.For more information and advice on financing senior living or memory care services, you can visit the Center for Long-Term Care Financing, AARP, the National Association of Insurance Commissioners, and Americas Health Insurance Plans.