Assisted Living is an Option for Seniors Who Need Minimal Assistance

As you get older, maintaining your own home and independence gets more difficult. Many seniors do not have children or family members close at hand to help them on a daily basis. Should you consider assisted living as the next step?

What is Assisted Living?

Assisted Living is a long term living option where you move to a residential living facility. There are large facilities and small ones. All of them include 2 to 3 meals, housekeeping services, activities, minimal assistance, and medical services such as transportation to doctors for routine or emergency care. After this point, everything is dependent on the individual facility.

Each facility offers different services, expanded services and upgrades. Some facilities may only accept private care, not Medicaid so ask first. Medicaid in many cases does not cover assistant living facilities or does not cover expenses fully.

Even if you have insurance, you may be required to pay for the first three months out of pocket before the insurance will kick in. Read your Medicare and long term insurance papers carefully. Ask the finance director for their financial requirements as well.

Facility Options:

Small Residential Homes: Home that houses 10 residents or less; Some of them are converted houses. You may have your own room or share one; community living room with TV; a porch or back yard for all the group; meals, medication assistance, assistance with dressing and showering if necessary; limited in the activities they can offer; more personalized care than bigger facilities. The main advantage to a smaller group home is aide to client ratio. The main disadvantage is social interchange and inability to provide the quality of in-house activities that larger ones can. If they have a problem with the other residents in the smaller home, they are more confined to be around them.

Some small homes do compensate by taking residents on weekly outings. Keep in mind, that many seniors do not participate in the activities provided in larger facilities. I have seen some great small residential homes who really worked at creating interesting activities for their seniors.

Large Residential Facilities: Usually two people in each large room; rooms may be larger; private rooms are very expensive; large dining room; large recreation room with lots of activities including exercise class, computer room, card games, bingo, arts and crafts, music and singing; transportation to doctors and shopping;
The rate for a 1^st floor private one-bedroom apt may go for $2,575 and up. Third floor (skilled nursing) services cost the resident from $3000 to $5000 a month. Cost varies from state to state based on the state, city, and quality of the facility and its care.

Levels Of Care Provided:

Some residential facilities do not offer assistance. You must pay for that privately. You must be able to attend to your own needs completely. The atmosphere is more upbeat and residents are at a higher level of health here. They enjoy the level of activities and independence provided. Some of these require the client to buy-in to their small apartment instead of renting it. If they become ill and have to move, they must get sub-lease it or continue to pay for two places.

Special Needs Facilities: they cater only to residents who require minimal help and others are mainly for Alzheimer's patients.

Large Assisted Living Facilities: Most provide three levels of care. Over 100 residents often.

1^st Floor: clients are still sharp mentally, can dress themselves, and find the dining room on their own. They have their own private room, coming and going as they wish. They often still own a car or golf cart and can easily take a bus by themselves. Minimal assistance is required.

2^nd Floor: clients are beginning to decline either physically or mentally; some memory problems; need help showering or dressing; may need help finding the dining room; and may begin to have some behavior or memory problems off and on. They require more enhanced assistance. At this level, the care cost goes up. Often couples will both move down to that level to stay together.

3^rd Floor: The resident many have had a stroke, heart attack, or deteriorated in health. Often, there are two sections on this floor. There is one side for the patients who are seriously physically sick, bedridden or gurney bound. Often they are unable even to feed themselves without help. There is a separate locked part of this floor for residents who are mentally impaired and need to be confined for either behavior problems or severe dementia or both. This is entered into by locked doors. The outside patio is enclosed so they cannot wander off. The skilled nursing floor can cost the resident from $3000 to $6000 dollars depending on the services and city.

Larger Residential Facility Advantages: you can stay in the same facility as your health deteriorates; you just move down to the next floor as your assistance needs increase; If you move in as a couple with one partner requiring skilled nursing care, you can live in same facility, even if it is on different floors; The healthier, independent spouse continues to live on the upper floor while the sick one is moved to the skilled nursing care floor. This makes it easier for the healthier spouse to visit their ill partner. Many seniors cannot drive by this point and cannot easily visit their loved one who is in skilled nursing. It also allows the healthier spouse to continue to live independently, enjoy the activities and events he or she is still able to do.

Larger Residential Facility Disadvantages: couples who have been married for 20-50 years are very distressed to be separated and living on different floors. They often become depressed, and in some cases refuse to eat, when separated. I have spent a lot of time in residential facilities as a volunteer. This separation often causes great stress and grief. I have seen it numerous times. Often even in the expensive facilities, there is under-staffing at night and on some days. The aide to patient ratio is often low. Often girls don't show up or call in sick. They often do not have enough staff to help the ones that cannot eat or give them proper care; I have seen this personally in several expensive facilities. Just because the facility is expensive or is in an expensive area does not mean that it is not understaffed at times. Often this under-staffing occurs on the grave yard shift or during times when there are few family members to observe the violations. Weekends when there are lots of family visiting is usually well staffed.

How do you know if a facility is a good one?

#1 Rule To Remember;

The tour they give you is marketing. Brochure-stated services may or may not be true. The tour director is not going to tell you about staff problems or state cited violations. This I can assure you. Beautiful brochures just mean they have a great marketing program. It is important that you understand this point. They often leave out the locked areas in the tour. You want to know how they take care of those residents, because you may end up on that floor. Insist on a tour of all floor levels.

Investigation and Due Diligence Is The Key:

No matter what size the facility, you must be extremely watchful and observant. Violations occur in most of them. Notice cleanliness of the facility, rooms, and the clients themselves; notice the smell in the patients rooms; visit it in the late evening or on the weekdays to observe the aide to client ratio; visit the dining room and notice the food; check the menu; pay to eat there a couple of times; ask several residents who live there how the food and care is; ask several visitors to rate the facility; read your contract well to make sure what services are covered and at what cost; ask specific questions on what is included in the main fee; know that often such items as adult diapers, OTC medications, and other supplies are added on to the main bill. Ask before you sign. Do not assume anything. Analyze every aspect of both the facility and the contract. Call the better business bureau; and Visit this site, Assisted Living Federation of America, for federal regulations regarding for these facilities: Assisted Living Regulations and Licensing

References:

http://www.alfa.org/alfa/What_is_Assisted_Living1.asp

http://www.alfa.org/alfa/Choosing_a_Community.asp?SnID=202896805

http://www.alfa.org/alfa/Checklist_for_Evaluating_Communities.asp?SnID=202896805

http://www.alfa.org/alfa/State_Affiliates_Contact_Info.asp?SnID=202896805