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What to Look For In Assisted Living

Author: Helen Dennis, Specialist on Aging

Here’s the story on assisted living.  Such facilities generally serve people 60 and older by providing room, board, housekeeping, supervision and assistance with personal hygiene.  They are designed for those who can no longer living independently, but do not require around-the-clock nursing care.

According to California Advocates for Nursing Home Reform, the average monthly cost for assisted living in California is more than $3,000, with costs ranging from a low of around $900 a month for a resident on Supplemental Security Income (SSI) to upward of $5,000 a month for those paying privately.

One of the key questions is, “How do I know what services I need?”    According to the article “Parkinson’s and Assisted Living:  What You Need to Know” published by WebMD (a website reviewed by doctors at the Cleveland Clinic Neuroscience Center), you should speak with family members and the care provider to determine what they think is needed.

Consider at least two questions:  Why does the living arrangement need to change?  What activities of daily living does the individual need help with, i.e. bathing, dressing, remembering medications?

The article also suggests questions to evaluate the appropriateness of the facility:

  • Is the residence licensed?  (Note assisted living facilities also are called Residential Care Facilities for the Elderly and must meet care and safety standards set. The California Department of Social Services is the licensing agency in this state.)
  • What type of insurance does the facility carry on personal property?
  • How does staff respond to medical emergencies?
  • What is the visitation policy?
  • Does the contract agreement include accommodations, personal care, health care and support services?  When can the contract be terminated and what is the refund policy?  If the resident’s needs change, are services available?
  • Do costs differ depending on the level of care?

Some facilities have special care units for people suffering from dementia related to Alzheimer’s, Parkinson’s or other diseases and conditions.  These residents typically live in the same type of apartments found in the more traditional living space.  What is different is the secure area, a 24-hour-a-day licensed nursing staff and a director of dementia care who typically develops a personal plan for each resident.  The highest priority is to provide a safe and secure environment for the resident.

There are other areas to assess, as well.  For example, find out about the features of individual units: Is there single and double occupancy? Are bathrooms private? May residents keep food in their units?

Social and recreational activities also are important.  Determine if there is an activity program, whether there are volunteers, if pets are allowed, and if residents undertake chores that benefit fellow residents.  Find out if residents participate in community activities.

Discuss the food service.  Does the residence provide three nutritionally balanced meals a day, seven days a week?   Are snacks available?  Are meals provided when the resident prefers or at set times?

Then there’s the staff.  Are they appropriately trained?  Do you receive a warm greeting from them?  Is staff available to assist residents who experience loss of memory, orientation or judgment?

The “feel” of the environment is important.  Do residents socialize with each other and appear to be happy and comfortable?  Do residents, visitors and family speak well of the facility?

Determine if there is a written plan for the care of each resident.  What is the procedure to assess the resident’s needs for service?  Are those needs periodically reassessed?

Consider consulting with a geriatric care manager to assist you in evaluating the options and moving to a family consensus about what is in the best interest of the older adult.

And finally, consult with the older person as an important partner in the decision.

© Helen Dennis 2010, all rights reserved.

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