Preparing for the Move: Finding the Best Apartment

Step 1: Assessment of resident with regard to frailty, cognition, and other medical issues

• Has ADL (Activities of Daily Living) assessment been conducted?
• What limitations or requirements does the result of the assessment place on possible locations?
• Does resident use mobility devices: walker, cane, wheelchair, scooter, etc.?
• Is resident able to handle any new additions or changes to regular routines?
  • New bills to pay?
  • Trash disposal?
  • Recycling?
  • Options for smoking, if applicable.
• Is the apartment on bus route if resident can use regular Transit services?
• Establish how resident will get to grocery store, pharmacy, medical appointments, Senior Center, Food Bank, Rescue Missions, church, or other services used.

Step 2: Looking at prospective apartment

• Exterior
  • Can resident manage any steps outside apartment?
  • Is proposed apartment exterior accessible with devices used?
  • Note location(s) of mailboxes, ease of access.
  • Route to transportation (car/Paratransit, cab, buses, and vans):
    • Can individual navigate curbs and walkways with mobility devices?
    • Is the pathway well lit?
  • Trash storage/disposal and recycling – how is it done, and can it be managed? Is it handicap accessible?
  • Access to designated handicap parking spaces for either/both resident/guests

• Exterior: Safety
  • Are walkways and sidewalks level, or does location require walking up and down elevations?
  • Is front door of apartment visible and well lit?
  • Can individual easily navigate unlocking of door and entering apartment with bags (ex: groceries) and any devices used?
  • Is there an outside threshold that requires stepping up with mobility device?
  • Do exterior lights come on automatically in darkness?
  • Are walkways well lit?
  • Is there a security system (interior or exterior) that must be understood and used?
    • Degree of difficulty in using the security system?
    • If there is a security system, does the system require a landline to access it or can a mobile phone be used? Does resident have a mobile phone?
  • Has check been completed with local police or sheriff’s office on recent crime in complex and/or area?
  • In case of 911 calls, is there 24-hour availability of master key to allow emergency services/law enforcement entrance to apartment without immediate forcing of door if resident doesn’t answer at knock?

• Interior: General and Safety
  • Are the heat/AC controls different from previous experience? Ease of use?
  • Is there a security system? Intercom?
  • Does the building have a controlled outside entry?
    • If not, how does resident identify callers before opening door?
  • Emergency egress?
  • Are smoke and carbon monoxide alarms installed?

• Interior: General Mobility
  • Note any raised thresholds; ease of moving from room to room
  • Are doorways wide enough, particularly with use of walker, so that individual is not risking injury on doorways, doors?
  • Ability of individual to move into, around and out of bathroom with walker/cane
  • What type of flooring is used vs that in last residence?
    • Will flooring affect use of mobility devices; will it require change of habit in shoes/slippers/socks to avoid falls?
  • Is resident used to using rugs in previous residence?
    • If so, will rugs be safe in new apartment?
    • If used, how to secure to wood/tile/vinyl flooring?

• Interior: Kitchens
  • Black countertops and appliances in new apartment complexes: can the individual see well enough to use the range top safely?
  • Where are controls?
    • Does individual have to reach over burners to use controls?
    • Is this different from previous range?
  • Will the individual need help in learning to use a different type of range (electric vs gas)?
  • Is the microwave (if provided) on the counter or above the stove? (Not a good choice for senior with mobility, balance, sight issues)
  • Is the kitchen well lit?
  • In older units, are light switches easy to reach?
  • Are ceiling fan switches easy to reach and control?
  • Are upper cabinets accessible without climbing or stepping up?
    • Can resident use grabbers adequately for some items?
  • If there is an island unit, is there space to use a walker in between wall and island?
  • Are water faucets labeled correctly and visibly?
  • How does eating area differ from previous residence?
    • Will resident need or have to replace current table and chairs?

• Interior: Bathrooms
  • Bathrooms need hand bars for use of toilet and bathtub/shower:
    • Are they in place and are they placed correctly?
  • Ease of moving from bedroom to bathroom?
  • Does resident use a bench in tub for bathing? If yes, will the one in current use work in new residence?
  • Does resident use a handheld showerhead? If so, is there one in the new residence or can one be added?
  • Does apartment have a medicine cabinet?
    • How does this compare to cabinet in previous residence?
    • Where does the resident normally keep prescriptions, over-the-counter medications, other personal use items? If this will be different in new residence, where will these items be kept?
    • Are water faucets labeled correctly?
    • Is toilet high or low? Will resident need rails or elevated toilet seat?

• Interior: Other Living Spaces
  • Lighting:
    • Are ceiling fixtures in all rooms? If not, does individual own lamps?
    • How will bedroom be arranged to ensure easy navigation to bathroom at night?
    • Are blinds or shades provided for all windows? Will resident need instruction on using them?
    • Is resident used to hanging curtains at windows? If so, are rods available/able to be installed?
  • Can bedroom be arranged so resident can get into and out of bed on same side as they have done? (Lessens chance of falls)
  • Is there a need for medical equipment (ex: bedside commode) in bedroom? If so, is there room for appropriate placement?

PREPARING FOR THE MOVE: PRE-MOVE PLANNING

• Depending on resident wishes/needs, create a move team
• Will the individual’s current furniture fit in the apartment and still allow for safe movement?
• Determine what happens to any items the resident isn’t taking to new residence, including pantry items.
• Establish and write down a plan for actual moving day so resident understands and can refer to it:
  • When does the resident leave current residence and arrive at new residence?
  • Who will take the resident to new residence, stay for the day, and help with immediate unpacking needs, make up bed, etc.?
  • Create a basic “move-in day” grocery list to be filled and delivered to new residence.
• Change of Address Actions required:
  • USPS: One month before moving
  • Meals on Wheels, if applicable
  • Prescription delivery services, medical providers, and medical equipment providers:
    • Resident may need forms signed for release of medical information
    • Changes should be made with adequate notice to ensure proper transfer of information.
  • Insurance companies and agents
  • Credit card companies
  • Social Security Administration
  • Banks (ensure that all departments make appropriate changes)
  • Voter registration
  • State Vehicle Registration – State ID cards for non-drivers
  • IRS
  • Any subscriptions, memberships
  • Family and friends
• Utilities
  • Changing phone service(s)?
    • Landlines? Mobile phones?
    • What has to happen to change service?
  • Any utilities to discontinue or add? Deposits to be made or be returned?
  • Cable and internet services?
    • It is important to ensure resident has phone/cable/internet services on arrival at new residence as part of lessening isolation and gaining sense of normalcy in new home.
  • Set up calendar with stickers for trash/recycling, if needed.
• Transportation
  • If not currently enrolled, discuss signing up for and using Transit, Transit Plus and Taxi Voucher Program (TAP) as appropriate.

PREPARING FOR THE MOVE: PACKING

• Set aside legal, financial, medical and insurance papers and records – DO NOT PACK
  • Include Advance Directives and Living Will; any forms posted on refrigerator for EMS.
  • If resident has a bank safe deposit box, know where the key is and add to records.
  • Set aside jewelry/any valuables to be transported by resident on moving day.
  • DO NOT PACK any medical testing devices or equipment.

• Consider using bright-color-coded tape on boxes in addition to labels, with easily accessible chart noting colors and room names.
• If resident will be unpacking alone, consider size of boxes and do not pack heavily.
• Ensure that resident has all prescriptions filled, if possible, so they won’t need to do so the first week in a new residence.

• Early Packing:
  • List inventory on side of each box.
  • Pack items not being used, such as holiday decorations, seasonal clothing, items already in storage and not in use and label – large, easy to read letters.
  • Pack kitchen items not in daily use and label and color code for kitchen.
  • Pack extra linens not in daily use. Label and code for appropriate closet.
  • Pack books, music, etc., not in regular use. Label and code for appropriate room or storage. 
  • Pack decorative items.

• Second Stage Packing: Right Before Move
  • Pack a box of “Immediate Use – First Week” items for bathroom and kitchen and label clearly.
    • Linens
    • Enough cutlery, dishes, pans, kitchen linens for use
    • Clothing for 1 week
  • Pack majority of clothing not needed for first week of living in new home. Label for appropriate storage.
  • Pack remainder of kitchen/bathroom items. Label appropriately, including pantry items.
  • Pack a box of special personal items (ex: a few photos, afghan, etc.) to be moved with resident on moving day and set up that day to establish recognition and normalcy.
  • Pack box of legal, medical, insurance, financial records, and valuables to be hand carried with resident on moving day. (See above).

MOVING DAY

• Helpers should have a box of food items for immediate use (see above) and basic cleaning supplies.
• Helpers should take a portable chair so resident can sit prior to/during delivery of possessions.
• Ensure resident has had breakfast and taken all medications as needed in a.m.
• Gather items being transported with the resident (see above) and move with resident to new residence, including medications, dentures, hearing aids, glucose monitor, bathroom/bedroom items used overnight and that morning.
• Move resident to new residence.
• Groceries to refrigerator
• Are shelves at appropriate levels for resident?

• Walk through residence with resident.
• Allow for resting.
• Helper works with movers to place furniture and boxes in correct areas of residence.
• Depending on residence, cleaning as needed.
• Bedroom is set up (see above):
  • Alarm clock
  • Where does resident normally place glasses, hearing aids, etc., at night?
  • Bedside lamp
  • Beside phone
  • Charger for cell phone/portable phone plugged in and easily accessible.
  • Install nightlights to help with navigation to bathroom and kitchen.
  • Locate flashlights in usual/easy to locate positions.
  • Place nightclothes in familiar location.
  • Clothes for next week placed in normal locations in drawers, closets.
  • Special personal items placed in recognizable locations.
  • Valuables and papers placed in safe location.
  • Bathroom items placed in recognizable locations.
  • Medical items used daily are placed in recognizable locations.
  • TV, phone, radio set up and connected.
  • Lamps should be plugged in the outlet connected to light switch that is typically near the door.
  • Calendar is posted and easy to see.
  • Any EMS forms/materials posted on refrigerator. (1 Red magnetic EMS folder per household available from the Mobile Community Healthcare Program, 301-600-HELP (4357) or by completing an online form at Frederickcountymd.gov/Red Folder Program.
  • Easy to read list of contact numbers for questions/problems/general contacts near phone and/or kitchen and bedroom. 

• Ensure resident has lunch.
• Walk/talk resident through their plan for first night/next morning in new residence if no one is staying with them.
  • Establish time to call in the morning and/or visiting time.
  • Resident can lock and unlock doors and windows.
  • If resident now has a second door, such as a patio door, verify understanding of any security devices and locks to ensure it stays locked.
  • Discuss how resident will keep keys to ensure not being locked out of apartment when going outside. 
  • Discuss routine for feeling safe in new residence.
  • How to operate range, microwave for dinner, breakfast.
  • Ensure resident can operate faucets in kitchen and bathroom if they are different type/style from previous residence.
    • Check hot water temperature – too hot can result in scalding
    • How will resident get in and out of bathtub? Practice stepping in and out if not using shower chair/bench.
  • Walk to mailbox; practice using key if needed; walk back to residence.

FOLLOWING THE MOVE

Next day follow-up:

• Morning call
• Scheduled visit
• How did the night go?

Unpacking

• Who will help with the unpacking?
• Allow resident to decide what goes where: ease of use, etc.
• What can resident do at his/her speed and timing vs. needing help?
• Disposing of boxes
• Hanging pictures, personal items (or create time plan for next few weeks)

First Week in New Apartment

• Depending on individual, review (if/as needed):
• The use of new appliances
• Help resident complete a load of laundry if washer/dryer are new.

• How and when to dispose of trash and recycling: pick-up calendar, where bins are located, etc.
• Ensure resident is aware of/understands signal of installed smoke detectors should one or more activate:
  • Who to call if unit activates for non-emergency reason?
  • Battery operated (older units): who checks/replaces batteries?
• Move furniture if needed to ensure safest navigation of rooms.
• Grocery shopping, especially for heavier items such as laundry detergent.
• Discuss transportation:
  • When will resident make first trip to store or upcoming appointment?
• Who is making regular calls/visits to ensure transition and watch for signs of problems?
• Plan for socialization in first month.

First 6 Months in New Residence

• Regular calls and visits to assess transition.
  • Medication being taken correctly? Prescriptions filled?
  • Getting to regular medical appointments, including any wound care, regular screenings, or therapies?
  • Any falls or difficulty in navigating new home, outside areas?
  • Does resident have appropriate groceries? Is he/she eating properly? Is the refrigerator clean/ no rotten food?
  • Has resident been out? Used transportation comfortably?
  • Followed normal schedule for bathing, dressing, safety, and good health?
  • Any 911 calls? If so, reason and follow-up?
  • Bills are paid?
  • Connected to Senior Center for activities?
  • Possibility of connection to Daybreak Adult Day Program?

• Assessment for changes?
  • Recognition of family and friends?
  • Ability to hold a coherent conversation?
  • Any atypical signs of memory loss?
  • Any episodes of confusion or being lost?
  • Ease of communicating needs and wants?
  • Any changes in balance or mobility?
  • Changes in emotional state?
  • Monitor weight loss/gain: both up and down can be signs of depression.