Explain the difference between assisted living and a skilled nursing facility, or “nursing home”:
An assisted living community is really an extension of someone’s home. The idea is to maintain as much independence as possible while still providing help with one or more activities of daily living, such as feeding, bathing, dressing, laundry, transportation, etc.. There is also assistance with medication management. At some communities, new residents need to be able to stand and pivot. Those with more serious conditions, for example requiring full body lifts from staff, or a continual need for medical care such as diabetic wound treatments, would likely need to be in a skilled setting, or may be accommodated by additional fees. However, once someone has established residency, some of these services can be provided by the community for an additional cost, or through an outside contractor. Every community is different, so these are important questions to be asked.
What should families look for when considering an assisted living community for their loved one:
First, is the staff friendly and engaged? The receptionist at the front desk should be friendly and welcoming, and as you tour the community see the interactions between the staff, you as a guest, and the residents. Look also at the overall reaction from residents. There will always be a few who would have difficulty in any setting, but if the overall feeling from the residents is a positive one that’s a good sign.
Second, call it the smell test. While there is likely to be some trace smell from incontinence in any community, the overall cleanliness of the community and the residents is extremely important. If smells are strong, residents look dirty or unkempt, or the community looks like it is not well-maintained, that usually translates into other issues that may not be as visible to an outsider.
Third, the quality of the food being served. Families should definitely have a meal there, and if possible have their loved one do so also. Food is an important part of daily life, not only because of its nutritional content but also because mealtimes should be enjoyable and are an important part of socialization. While the dietary needs of elders often lead to more bland tasting fare, eye appeal and variety are important factors.
Fourth, what activities are available to residents. There should be a well-well rounded schedule of daily events that have broad appeal, such as music, movies, games, physical exercise and social outings. If your loved one has special interests, are those available either in the building or nearby in the larger community. Transportation is also an important factor here; no one lives in their home 24/7 so shopping, cultural events, and outings are all important to quality of life.
Finally, how are health problems handled? If skilled care is necessary, are there accommodations in the building? If not, what options are nearby? What about relationships with outside contractors who can provide these services?
What additional considerations are involved if a loved one suffers from Alzheimer’s or dementia:
First, assisted living can be an excellent option for most dementia patients. They do not need to worry about preparing meals, there is help available for their daily needs, and they are in a home-like environment that will provide the social stimulation they need. The main reason to consider a memory-care facility is safety. If your loved one is wandering, leaving the building, then it is necessary to place them in a secure, locked environment. The other big difference is that where activities in an assisted living community are schedule based, those in memory care need to be much more individualized. Most good memory care communities now have activity stations: a make-up area, a workbench, a desk, so that residents go through their day they can be directed and kept occupied. Music therapy is also very important. The goal is to strive for small accomplishments, for example folding towels or tying shoes, some that gives a sense of purpose to the day.
What about cost?
That is always the first question asked, when it really needs to be the last. The first question is, what does my loved one need to meet their physical needs, and the second is what do they need to meet their intellectual and emotional needs. Once those questions are answered, then the cost for those services can be evaluated and a decision can be made. Assisted living is generally a more affordable option than a skilled nursing facility, but resources such as Medicaid and Veterans benefits also play an important part in the final decision if means are limited.
The Alzheimer’s Care Resource Center can help families in determining if assisted living is right for their loved one, identify resources, and help families deal with the emotional issues involved with their decision. Our number is 561-588-4545