Family Advisors
Take Your Next Step
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Living Option Types
These locations can take on a variety of space plans and amenities. They are available in almost every market. It may include larger buildings, cottages, townhomes and co-housing options. Most are available to people 55 plus who require no assistance with activities for daily living. Locations often offer swimming, pickleball, fitness centers, a lounge/Happy Hour Bar, and often an onsite restaurant as well. A person requiring any level of care or assistance outside of an acute occurrence will most likely not be able to select this option for their next step.
Life Plan Communities, formerly called CCRC’s, are locations that provide a comprehensive approach in that they offer a full spectrum of care continuum, from independent lifestyle living to Skilled Nursing Care. Many individuals and couples like these communities because all their needs can be met on one campus. If a spouse or significant other were to fall for example, after a hospital stay if needed, he or she could rehabilitate in the on-site Skilled Rehabilitation while enjoying convenient visits from their spouse who also lives on campus. All Life Planning Communities offer both Assisted Living and Memory Supportive locations as well. However, as your care needs progress you typically are required to move internally within the campus to the segment of the community that is best suited to manage needs as they arise. A true life planning community typically has a, “Buy In” , but also delivers on the guarantee that should you or your loved one outlive their assets, they will not be required to move, but will instead receive care onsite regardless of ability to pay. The buy in for these communities is different by each location and your Family Advisor can help you understand the various options.
These two types of living options are often co-mingled in a larger building with apartment types available. In many cases a person may select this type of option while completely independent of any needs for care, but as care needs arise, they are able to stay in the original apartment they selected. Typically, these communities have a Health & Wellness Director who is an LPN or RN and has licensed nurse staffing anywhere from 8-24 hours a day. This does not mean that one may never need to move, as when many of us age, we may require a supportive setting for either Cognitive support/ Memory Support or Enhanced Assisted Living. An Enhanced AL is a location when very heavy levels of care can be accommodated and the staff to resident ratio is higher. Most location will require a person to select an Enhanced product and make a move internally if offered, or if not offered this may be a time where you or your loved one will need to look at Adult Family Home options.
An enhanced Assisted Living is for people that require what is called a MESOCIAL, or Medical Social model for care. Residents in an Enhanced Assisted living are often fine cognitively but their physicality has moved them beyond what a typically staffed Assisted Living can offer. Most Enhanced Assisted Living or EAL locations, are housed within existing Assisted Living Communities, and Residents in an EAL supportive location can still participate in all the activities and amenities offered to the Residents in Assisted Living if they desire to.
A Memory Supportive location is licensed as an Assisted Living community and is secure to protect its residents from elopement. The staff in a memory supportive community is highly trained around cognitive support, redirection and life enrichment. Each staff member knows how to appropriately and respectfully care for these residents while attending to their individual needs. Memory Supportive locations often encourage communal dining and specific programming to help residents within live their lives to the fullest possible potential with the highest-level dignity. The goal of a Memory Supportive location is met when a service plan is developed and provided that truly meets the resident where their skill set, and abilities are each day.
An Adult Family Home (AFH) is the perfect alternative to a Skilled Nursing Facility for someone who needs a heavy amount of physical care. They are residential homes licensed to care for up to eight people with someone awake and on duty 24 hours/day. They provide meals, laundry, assistance with medications, activities of daily living and often social and holiday activities. They will cost less than a Skilled Nursing facility and often have an RN or LPN as the owner and/or on staff. Medically complex needs would still require hospitalization or skilled services.
These locations offer a very high level of complex and skilled care and must be licensed to administer medication in any route determined from oral to IV. There is a federal level of standards and policies that are required for a skilled nursing license that must be met. If a Skilled Nursing location also accepts Medicare Part A, they are subject to imposed daily rates and outcomes that are established upon admission for future forward planning. Typically, Medicare pays for 20-days of skilled rehab care per spell of illness. This can be different depending on whether an individual has straight Medicare A&B which could allow for up to 90-days or an Advantage Plan which utilizes and intermediary to determine coverage period based on ability to continue to make progress. Once an individual has been considered to have plateaued on progress, they are no longer eligible for Medicare coverage and will be billed privately or with secondary insurance. They offer rehabilitative and various complex nursing and medical procedures. Skilled nursing, unless covered by Medicaid can be very expensive and can often be avoided as the only long -term care option for insurance policies. Alternatives to long term skilled nursing private pay could be an Adult Family Home or an Assisted Living community with an Enhanced service area. If there are no assets available most skilled nursing communities will provide care and bill Medicaid directly.
The Conversation & Planning
When you are first noticing even small changes to normal daily activity, a cognitive decline, or beginning of mobility impairment it can be hard to accept for oneself and for those you love. At first, you may not think that it’s serious enough to worry about, but understand that this is a part of the process that all encounter. When you start to help make accommodation for a loved one you eventually will begin to realize that you need to have a conversation about finding the next step for yourself or your loved one.
There is no easy way to start this conversation, but it is important to get ahead of the dialogue and control the dialogue before it controls you! Often when people wait too long to make a plan and hold the conversations because of fear of loss of independence or ability to make decisions for oneself, they end up in a space where they did just that and the dialogue now controls them. Do not let that happen to you or to your loved ones. Instead, embrace the opportunity of next steps and see the joy in making the decisions yourself.
With the Next Step Family Advisory Team you have expertise and resources available to you. Over the years, the entire Next Step team has helped thousands of Families like yours take control of the dialogue and help find the best option across the Modern Aging care Continuum.
We recommend starting with a list of concerns and observations. Have you noticed that you or your loved one is having trouble with activities of daily living like getting dressed? Has your relative recently been in the hospital and sent home with extensive care instructions? Take thorough notes and consider talking with other family members to get their perspectives.
Oftentimes, the hardest part of the senior care transition conversation is simply starting it. With each loved one there are individual ways to open the door to discussion, and the most productive ones share a few characteristics. Start with open-ended questions that encourage more than a yes-or-no answer and focus on your loved one. Make it about their needs, maintaining independence and personal comfort.
A few examples of conversation Kick Starts are:
- How are you feeling about living at home by yourself?
- What have your social activities been like as of late? Would it be nice to be closer to people with like interests?
- How have you been managing with your medications? (Or any other aspect of their daily life & wellness that you are concerned about.)
- Do you have a plan or preference in communities or locations you would like to go to if you need it?
- Would things be less stressful if you didn’t have to worry about taking care of the household tasks/ Driving alone for errands/ If you knew someone was just a few steps away if you needed any help?
Rome was not built in a day, and this is a series of conversations at various timing depending on the situation, which will help you and your loved ones establish a comprehensive plan. Have a goal for the first conversation, and do not try to tackle everything at once, as it will be overwhelming to all involved and not deliver the expected result. Don’t feel like you need to rush the conversation, but don’t not start it either.
Often Families have waited too long and the time for conversations evaporates. Sometimes the decisions on next steps must be made quickly, and in these scenarios a qualified Family Advisory can really help to carry the burden of decisions and option across the finish line. In truth the sooner you can come to an understanding of you or your loved one’s needs, preferences, and desires, the easier it will be to make a plan that everyone can get on board with.
The art of listening to listen will be most helpful, as like you, your loved one is grappling with some deeply felt emotions. It’s important to hear out any frustrations, objections, and fears about this next step in living space and change. When we listen to listen, we are practicing hearing all sides of an individual’s fears and concerns verbally without need or seeking of space to interject opinion or resolutions. We instead hear the individual out entirely and make thoughtful and impactful discussion based on what we have just been told. Though the decision is ultimately your or your loved ones to make, it does not mean that you do not need to make it.
The fear of a loss of independence is frightening for all of us, but as we enter the 3rd act of our lives it can be compounded and overwhelming. Patient and calm conversations can make the greatest impact on supportive decision making to best identify next steps or at least next steps in the plan.
When change is needed to ensure safety and security often emotions are running on overdrive. When this is the case as we are human, it’s easy to lose patience. We are usually blind to our own situations so in this process it is not uncommon to see the clear benefits of deciding, but to your loved one this can feel like the ultimate loss of independence and the reaction if more of a fight or flight. During these time periods kindness, patience and more patience with your loved one will help you keep the temperature of the conversation cool and assist in coming to a mutual agreement. If you aren’t in a time-sensitive or unsafe situation start the conversations with the small details first before tackling larger discussions.
It’s important that your loved one is included in the process as well as any key decision makers. Working together with an Advisor who can help with scheduling tours and provide answers to questions along the way can support making the visits smoother and enjoyable for both you and your loved ones. Seeing a community in person is paramount in making a decision that fits all your individual needs and likes, as it gives your loved one a chance to know whether they can see themselves living there. Often a loved one will have a misconception of what a Modern Aging location can be like as old institutional images may still be the most recent interaction your loved one has experienced. Your loved one may even begin to get excited about a positive change, especially when they can see themselves living in the location you viewed together.
Do You Need Help Now?
Pick up the phone and make your next step by reaching out to a Next Step Family Advisor today.
We specialize in helping people understand the options that are available to them for their next steps. From care coordination questions to placement negotiations.
The Next Step team are experts in in helping you to navigate the often-overlapping options that are available. We strive to ensure that when your top 3 locations are identified, one of them will stand out as the perfect next step.
Our phone#: 206.501.4490
Do you need help now?
You may not have had a chance to make a plan, but you now need options and help, so do not hesitate to reach out to one of the Group of Professional Family Advisors on our Team, as each can help you with your Next Steps.
Think of us as your personal Sherpa in helping make decisions for your best possible location options in Retirement, Independent Living, Assisted living, Memory Supportive communities as well as Adult Family Homes, and Home Health Care. The Next Stepper Service Planning Team can help provide a pathway that works best. There are options that are the perfect fit for all.
Contact Next Step Family Advisory Services Today
All of us at Next Step Family Advisory, understand how important it is to find the next steps for yourself or for a loved one. Though it can seem daunting, as your sherpa through the care continuum the Next Step Team can help you and your loved ones find joy along the way and in the process.
We are based in Seattle, but our Family Advisors concentrate on their specific geographical areas from Bellingham to Vancouver Washington. Please reach out to contact us today and let us be your personal sherpa. We would love to speak with you and be of help. We work to coordinate schedules, identify best options and conduct in depth understanding of all care needs that your or your loved one may have. Contact us today and let us help you with next steps.
About Us
David Haack, Founder, All Locations
Born and raised in Minneapolis, Minnesota, David’s journey in Long-Term Care started over 37 years ago in the dietary department of a skilled nursing community, then becoming a Nursing Assistant and Licensed Nurse. Attended MCC and university of Minnesota. David has worked with many of the leading providers in the Skilled Nursing Community – from Medicare cost reporting and consumption management, to LTC technology services.
David began his career in Long-Term-Care Institutional Pharmacy Services, and since then has spearheaded both regional and national programs for controlling cost in delivery of medication services. In addition, David has acted as an independent consultant dedicated to helping Assisted Living developers identify potential locations for new construction across the country, as well as pharmacy consultation services to closed door retail operators.
In his Assisted Living Careeer David was the Executive Vice President and Chief Marketing Officer for Seatle based Living care Lifestyles, and left that team after 9 years to join Arizona based Cadence Senior Living in June of 2020 as Chief Marketing Officer. Cadence Living operates 32 Senior Living Communities across the country including Oregon. In 2023 David became the owner of Next Step Transitions Senior Move Management, to help modern agers get from point a to point b while rightsizing. In December 2024 he also started Next Step Family Advisory Services LLC, with the vision of ensuring that all modern agers and their Families truly find the best options for their next steps. A huge believer in disruption of the status quo in Modern Aging solutions, he recognizes the opportunity for optimal differentiation in the Senior Living Marketplace.
David has been an active part of the Western Washington Aging Community in many ways – from serving as President of the South End Senior Care Coalition for three years, to founding The Northwest LGBT Senior Care Providers Network. – both organizations have worked on developing a better communication bridge between LTC Providers and the local community. David has worked with many organizations, from AARP to the Washington Healthcare Association. He has also been involved in the Washington D.C. based Senior’s Coalition on challenges regarding prescription drug coverage and expense. David has had extensive involvement in the Department of Social and Health Services, and currently sits on the GALF Work Group for Washington State. He has also worked closely with the Washington Diversity Affairs Office, as chair of several DSHS Advisory Committees. David was also involved in the Governors Blue Ribbon Commission, as an Advisor for the LTC New Funding Advisory Committee specifically with the goal of ensuring that all wording and practices placed forth from the Commission are sensitive to equal access of services for all LGBTQ residents of Washington State. David continues to do this work as a leader in LGBTQ competency in LTC settings.
David has been involved in the following Boards: Department of Social and Health Services Advisory Chair, Hawaii LTC Association- Board Member, Equal Rights Washington Past Board Member and Vice Chair, Verbena- Board Member, Senior Services? Sound Generations of Seattle – Board Member, South End Senior Care Coalition Founding Member and Past President, The Puget Sound Health Care Professionals – and Founder, The NW LGBT Senior Care Providers Network and Gen Pride.
Throughout his career it has been his life mission to ensure improved services for all Modern Agers and special attention to the needs of LGBTQ +Seniors and their loved ones.
Sue Rowell – Family Advisory Team
(Bellingham, Burlington, Mount Vernon, – North Snohomish County and Everett)
Sue brings over 30 years of experience helping older adults find the right senior living communities and services. With advanced degrees in Gerontology and Counseling Psychology, along with certification as a Senior Advisor, Sue has a deep understanding of the needs and challenges faced by seniors and their families. Her extensive background in both the emotional and practical aspects of aging allows her to guide individuals toward the best options for their care, well-being, and lifestyle.
A lifelong resident of Western Washington, Sue was born in Seattle and has intimate knowledge of the region and its senior living communities. This local expertise enables her to offer valuable insights and personalized recommendations for families seeking senior living solutions in the area.
In her spare time, Sue is a passionate writer, author, and musician. In the summer of 2024, she had the opportunity to tour Spain with the Mill Creek Chorale. Her musical talents have also taken her to prestigious venues such as Benaroya Hall, Carnegie Hall, and Notre Dame, where she has performed in some of the world’s most renowned concert halls. Sue is committed to enriching her community through both her professional work and artistic endeavors.
Lisa Tierney – Family Advisory Team
(Bellevue, Kirkland, Issaquah, Mill Creek Bothell, New Castle)
Lisa Tierney comes to the Next Step Family Advisory Team with over 12 years of experience in the senior healthcare industry, She has worked closely and compassionately with hundreds of individuals and families, providing support through some of life’s most important transitions.
Lisa is a Certified Dementia Practitioner and Caregiving Professional with Hospice experience, in her extensive work she has developed a deep understanding of the unique challenges families face in the Modern Aging Space, particularly in personalized care planning and navigating complex homecare needs, while working alongside Senior and Allied Healthcare Professionals. Her goal has always been to offer compassionate, informed guidance that empowers clients and their families to make the best decisions for their loved one's next steps while ensuring comfort, safety, and quality of life.
Lisa is excited to bring her expertise and dedication to her role as a Family Advisor, after 27 years in customer service and relations, she loves the focus on guiding families through these decisions, so they receive the best possible support and living options. She looks forward to collaborating with colleagues for families, providing them with compassionate, safe care solutions in Assisted Living, Memory Care, and with Adult family Care Homes, while making a meaningful impact on the lives of those she serves.
Tracey Harvey – Family Advisory Team
(Bothell, Seattle, Redmond)
For over three decades, Tracey Harvey has been devoted to helping Americans live life to its fullest. Tracey has spent over 20 years in senior living connecting people to meaningful products, services and, programs that enhance lives while creating magic moments for all ages, especially active agers. Her roles have ranged from overseeing marketing, sales solutions, corporate communications and, wellness/activities programming. Harvey is a national presenter at aspirational conferences that specialize in improving the quality of life for older adults around the country and has over 30+ published articles.
Kristina Walker – Family Advisory Team
(Seattle, NE Seattle, Mountlake Terrace, Lynnwood, Edmonds)
"For almost 25 years, I have been passionately working in the long-term care industry. I started out in high school as a CNA in a Memory Care unit. There I fell in love with caring for seniors. I have since worked in skilled, home health, pharmacy and a variety of other settings. I am a Community Instructor and teach caregivers how to better meet the needs of seniors living in various care settings. Presently, I am excited that I get to utilize my knowledge and experience to help find a safe environment for you or your loved one to live out the rest of a fulfilling life.
I am a native Washingtonian. When I am not out on an adventure with my three daughters, you can usually find me at the gym or playing my bass guitar."
Maria Andrews – Family Advisory Team
(South Tacoma, Olympia, Centralia – Vancouver Washington)
Maria Andrews brings a wealth of professional experience and a deep passion for guiding families through the complexities of senior living and changing housing needs. As a seasoned REALTOR®, Maria has been long dedicated to helping seniors and their families. Her past experiences include assisting clients and being appointed to state-level committees.
Over the past five years, Maria has worked in memory care, independent living, and assisted living, assisting hundreds of families in finding the right senior living solutions. Her expertise spans all financial levels, from communities with a Medicaid spend-down to high-end luxury senior living communities. Maria is committed to providing personal guidance, while ensuring that both seniors and their families receive care, compassion, and the support of an accomplished professional throughout the process. At NextStep Family Advisory Services, Maria’s mission is simple: to empower families with the knowledge, resources, and peace of mind they need to make confident decisions for their loved ones.
How Can We Help?
Move Management
I need help and someone to contact me regarding move management.
Family Advisory
I would like to be contacted by a Family Advisor from Next Step Family Advisory as I am seeking options in Senior Living and would like guidance.
Both
I would like Next Step to contact me for help with both Family Advisory Services and Move Management Experience Service.
Next Step Transitions, LLC | 825 NW 97th Street, Unit A Seattle, WA 98117 | phone: 206.501.4490