Assisted Living

ime was, high-cost nursing homes and cost prohibitive retirement communities were the only choices for the elderly for alternative living arrangements. Today facilities which provide "assisted living" or "independent living" are available as an alternative housing solution.

Many senior citizens used to have nursing home care as the only option when they began having difficulties maintaining their own activities of daily living (cooking, washing, housecleaning). These people are still active but just need some assistance with their daily living. They feel constrained, dependent, and "old" living in the nursing home environment. Retirement communities or centers are generally expensive, don't provide any type of assisted living and are best suited for persons who desire a more social or community living environment rather than actual help.

An in-between solution
Assisted living and independent living facilities fill the gap for people who don't need the high supervision or medical care provided by a nursing home, but really shouldn't or don't want to be living alone or who can no longer drive. These facilities provide an array of services to assist the resident with their daily living needs, provide a social outlet, interaction in the community, and encourage the person to remain as independent as possible.

With many different services available to meet the residents' needs, a person can remain in an assisted living home during times of recuperation from illness or minor lapses in their health. They do not have to move to skilled nursing facilities or nursing homes, which occurs frequently when a person is living alone. Also as a person's needs grow, the amount of assistance can grow to meet new needs and keep independent. Assisted living and independent living factitious are an exciting option for the senior citizen or disabled population in promoting and preserving their independence.

Is assisted living right for your elder?
There are many situations where assisted living may be appropriate. Some examples:

• Assisted living facilities or independent living facilities are for people who need or want a place where they can live in a community independently, but where assistance with their Activities of daily living are readily available. These people may need help cooking their meals, washing their clothes, bathing, and keeping their house clean.

• Assisted living is an excellent choice for persons who are no longer able to drive. They may not live in an area where transportation is available or may have physical limitations where mass transportation services (like buses, subways, and trains) are restrictive or hard to manage. They find it difficult to meet their physical and social needs such as grocery shopping, church, socialization, and doctor appointments.

• People who now desire to live in a more community based environment for socialization can also benefit from assisted living facilities. They want a place to interact with their peers minimizing the common problem of feelings of isolation in the elderly population. But they want a place that is their "home" not an institution and where they will be able to stay long term. They are anticipating the reality of possible future decline in health or physical functioning and want a place that can provide additional services as their needs grow.

What should I look for in an assisted living facility?
The most important consideration is to compare assisted living facilities. There can be a wide range of costs and services provided by different facilities. You should have a firm idea of what your needs and expectations of the facility are. Here are some guidelines and tips when selecting a facility:

Meet the staff and tour the facility. Always tour a facility with your elder. If the facility does not provide for a tour, then forget it! Remember, this is going to be your elder's new home. You should meet the staff and other residents. Are the staff readily available, friendly, and helpful? These are the people you will be relying on. Is the facility building attractive, pleasant, and clean? This will be home! The building must be a place your elder will want to live in. What will the living accommodations look like? Is the room furnished or can you bring familiar furniture? If there's a favorite bed, easy chair, family heirloom dresser, will they allow you to bring it even if they provide furnishings? Will they allow you to place pictures on the walls to make the quarters feel like the home that it is? Not all facilities will allow for this.

Look hard at the costs. Most facilities charge a monthly fee. There may be different costs based on the type of room and the amount of services. The facility should clearly state what you will be receiving for your money. Find out exactly what levels of assistance the facility provides and how these services effect monthly costs. You should not have to pay for services that your elder currently does not need. You should be able to easily upgrade or downgrade the amount of services you need and your costs for these services. Find out about hidden costs which you may be responsible for such as utilities, phone service, and cable TV.

Make sure the facility will listen to your elder's and your input. What process does the facility have in place to address your concerns or desires related to the facility operations and services? Although the facility may be bound by certain state and licensure guidelines, they should always be open to hearing your concerns, comments, and suggestions. The resident should have some type of means to express their desires or concerns. After all, this is his home. Is there a particular person you express your concerns to? Meet this person. This person should be friendly, attentive, open, and accessible. Some facilities may have Residents Council meetings where all the residents can meet to discuss their wishes and concerns and then forward this information to the administrators of the facility. The type of system really doesn't matter as long as a system is in place that is effective.

Check into safety. This is a very important consideration. Are there locks on the doors to protect valuables? Who has a key to your room besides the resident? Someone trusted from the facility should have access in case there's a medical emergency or your elder is locked out of the room. Are the entrance and exit doors to the facility locked at night for security and at what times? Can you still get in if you have been out late visiting? Are there fire extinguishers, smoke detectors, and possibly even sprinklers readily available throughout the facility? Does the facility have some type of check-in system to monitor who comes into the facility from the outside? Are there security personnel available at the facility?

Where is the facility located? Location, location, location. The assisted living facility should be located nearby the community resources that your elder will most commonly need. Are they located nearby doctors, hospitals, shopping, church, and entertainment venues? Is it close to family?

Look into transportation services. Of course location does not help much if transportation is not available. Assisted living facilities should provide some level of transportation into the community. You should ask if the assisted living facility charges extra for this service or if it is included in your monthly fee. Ask them where they will provide transportation to and what their transportation schedule is. Do they schedule weekly excursions for shopping and church? Anywhere else? If they provide transportation to doctors appointments then how do you schedule this and how much notice do they need? Do they offer scheduled transportation into the community for social activities and how frequently?

Is the facility truly accessible? Many senior citizens need aiding devices to get around. They may need to use canes, walkers, or wheelchairs. Is the facility truly accessible for these devices? How easy is it to get to the dining room, get your food, and sit at the table? Do the bathrooms provide safety devices such as grab bars in the tub or shower? Can your elder get from his room to the different areas of the facility without becoming too tired?

How are meals handled? How many meals do they provide? This can range from no meals to three meals per day. If meals are provided, can they accommodate special diet needs such as low fat, low salt, or diabetic diet needs? If meals are not provided, do they have cooking accommodations in the rooms? If yes, then do they screen the residents to ensure that this is not a safety hazard for all the residents? For some persons, having cooking accommodations may be a risky business if they have physical limitations or forgetfulness where they may leave a stove on.

Is Assisted Daily Living (ADL) available? What and how much assistance will the facility provide, and how does this effect monthly costs? Minimally they should provide housekeeping services in your base costs. You should not have to pay someone to come in for housekeeping services. Are laundry services available and is this an extra cost? Some facilities state "laundry available," and this means coin-operated washer and dryer machines are available. So your elder will still need to be able to physically do his own laundry and get clothes to and from the laundry facilities. This can be a problem if he uses a cane, walker, or wheelchair. Are nursing and aide assistance available if needed? If available, what services are they able to provide and how closely will they work with your doctor? If not, then what outside services, such as home health, are available locally and what are the extent of these services? Recent Medicare cutbacks in home health services generally allow for services in a limited capacity related to a recent illness and for only a short duration.

Check into the activities schedule. What social and recreational activities are provided for at the facility? There should be regularly scheduled activities such as cards, bingo, crafts, or book clubs as examples. Who schedules these activities and are the residents able to suggest activities they are interested in? Many facilities schedule special events such as dances, parties, and holiday events. Is there a common, comfortable area for residents to meet and socialize such as a lobby or patio area. Are there grounds at the facility for those who enjoy being outside or who are interested in gardening?

Assisted living and independent living facilities can be a viable and enriching living alternative for many people. Being informed when you and your elder choose a facility will guarantee both of you long term happiness.

This article on assisted living is provided by Admiral Retirement Home, one of many cost effective assisted living facilities. Kellie Stevens, P.T., has over 20 years experience in health care committed to providing health care information and products via the internet at http://www.kasenterprises.com.

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