Sandra Essich grows a wealth of flowers around her home at Carroll Lutheran Village.

Written By Barbara Pash, Photos by: Phil Grout

Hazel Rectanus knew it was time to leave when things got too difficult. Going up and down the stairs was hard. Keeping up with the garden was impossible. Eight years ago, Rectanus moved from her long time Ellicott City home to Carroll Lutheran Village, an assisted-living community in Westminster. She has not looked back.

Rectanus lives in Wakefield Overlook, the independent-living section, where she has made friends, volunteers at a local hospice and does water aerobics at the swimming pool.

“We call ourselves the cruise ship that doesn’t move,” said Rectanus, 81.

Felicitas and John Seifert moved from their home in Reisterstown to Brightview Westminster Ridge, an independent and assisted-living facility, two years ago. The couple, married for over 55 years, is delighted with a facility that her husband, 80, calls “well-maintained and managed.”

Still, every weekday for two hours a day, Seifert pays for an aide from a home-care company to help his wife, 85, shower and dress, then do household chores.

“We’re lucky to be here, but we do need a fair amount of help,” he says.

As they get older, senior adults face lifestyle options: Stay at home, often with help, or move to a facility. It’s a difficult decision and the choice depends on factors like health, finances and family support. Here’s what the experts advise:

Professionals have another name for staying at home. It’s called aging-in-place and, because of rising health care costs, an industry has developed to support it. In a few places around the country, there are even aging-in-place communities, where households in a specific geographic area can opt to pay a monthly fee for services like maintenance and transportation.

In Carroll County, Design Build Remodeling Group, in Eldersburg, specializes in renovations that make kitchens wheelchair-accessible, retrofit bathrooms with safety features or turn a first-floor space into a bedroom suite. Tom Sinor says customers range from seniors staying in their homes to those moving in with an adult child.

Right At Home is a home-care company that provides lifestyle services like personal grooming, meal preparation, light housekeeping and transportation for an hourly fee of $18 to $22. The company works primarily in private homes but, like the Seifert’s, one of its clients, in independent and assisted-living facilities as well.

“We meet with the senior and the family,” said Carole Luber who, with her husband Steve, founded and runs the home-care company. “We ask what they need help with. These are the activities of daily living and it’s important that the senior makes the decision.”

As supervisor of the Carroll County Department of Social Services’ senior adult services, Heather Robb’s goal is to help seniors live in their homes for as long as possible. To that end, Robb oversees an array of resources, some from the county and others, like Meals on Wheels and a fee-based transportation service, from outside the county.

Robb typically works with people in their 70s and 80s. “They’ve been in their homes 40, 50 years and they’re comfortable there,” she says, “although in some cases, the cost [of a facility] is a factor.”

As part of her job, Robb does an in-home assessment. She looks for safety hazards like scatter rugs and piles of newspapers/magazines. She asks about major needs – transportation and personal care are frequently mentioned. She makes suggestions, from a grab-bar in the shower to a walker, and can assist in obtaining them.

But – and it’s a big but – under Maryland law, adults can choose to live wherever they want, even though Robb has encountered cases where staying at home may not be best.

“If they have trouble remembering to take their medications, if they have dementia and start wandering,” said Robb, giving two examples of questionable situations.

“I had a daughter who wanted Mom to live with her but the daughter works full-time,” said Robb. “In that case, adult day care was a good option.”

Dr. Kharia J. Holmes is a gerontologist with Carroll Health Group, part of Carroll Hospital Center. When the decision to stay or move comes up, Holmes asks her senior adult patients and their families a series of questions:

Are the seniors eating? Are they taking their medications? Are they experiencing repeated falls? Can they safely get through the night at home without assistance?

“These are signs that keeping a senior at home, even with daytime help, may not work,” said Holmes. As hard as it may be to leave one’s home, she adds, facilities may be the better – sometimes, the only – option.

PAD Relocation, headquartered in Gaithersburg, offers a menu of services for people moving into a facility, from packing up the former residence to planning for the new space.

The majority of its clients are 75 and older, and “what they tell us is, ÔWe should have done this five years ago,’” said Susie Danick, PAD co-owner with her husband Joel.

Carroll Lutheran Village, where Helen Rectanus lives, has 700 residents, divided among 398 homes and apartments for independent living, 50 assisted-living units and 150 skilled nursing beds. The non-profit continuing care-retirement community is owned by the Conference of Delaware/Maryland Lutheran Synod but has residents of all religions.

In an arrangement typical of such communities, there is a one-time entrance fee and a monthly fee based on the size of the unit and single or double occupancy. At the Village, the entrance fee ranges from $54,000 to $300,000 and the monthly fee from $1,200 to $3,000.

Residents do not own their units, but the monthly fee includes meals, utilities, maintenance inside and out, and shuttle buses to medical offices and grocery stores within a certain radius of the campus.

Lisa Albin and Chris Spicer, director of church and public relations and director of sales respectively, say the Village and facilities like it give seniors peace of mind.

In the independent-living area, “the residents are so busy traveling and volunteering – some even work – they wear us out,” said Albin and Spicer.

But with a social worker and medical personnel on staff, they said, “residents are monitored and we make sure they move along the continuing care spectrum when the time comes.”

Doing Research? Start Here

  • Carroll Area Transit System at 410-852-0884. Private, non-profit shuttle bus service.
  • Carroll County Bureau of Aging at 410-386-3800. Operates Medicaid waiver program for in-home support.
  • Carroll County Department of Social Services senior adult program at 410-386-3434. In-home assessment and follow-ups, programs from State Department of Human Resources’ office of adult services, referrals to services like Meals on Wheels.
  • Maryland Office of Health Care Quality at 877-463-3464. Licenses and regulates assisted-living and skilled nursing (aka nursing home) facilities. Check for license updates.
  • Meals on Wheels of Central Maryland, Carroll County Branch at 410-857-4447. Meal delivery program.