One thing I have noticed: if people enter independent living and then assisted living, they seem to be allowed to stay when their health and disabilities would have made entry impossible. I am watching the older generation, so to speak, at my mother’s facility, remain in assisted living when they probably would otherwise be required to enter memory care or skilled nursing. Then the new admissions are better off, and so it goes.
This may be another reason to enter early- the facilities let you stay past the point I would have expected. But if you applied further on, they would say no.
This can be an issue. Sometimes people stay in assisted living too long, when they really should go to a skilled facility. I have experienced this with my father. After each hospital stay over the past two years (and there have been many), the assisted living would assess him and say they can care for him. In reality they were not equipped to care for him (couldn’t do things like change his catheter or accommodate his increased oxygen need). He would then end up needing something they couldn’t deal with and they would send him to the ER (meaning another hospital trip).
We would rather avoid skilled nursing but felt that many residents could have benefited from memory care. Assisted living should be able to handle oxygen but maybe not catheter. I changed my mother’s colostomy wafer every other day to avoid skilled nursing.
Assisted living facilities don’t keep people. I mean we have the choice. I was going to move my mother to memory care but then COVID hit. I agree services for dementia are not really sufficient but would still prefer assisted living over a nursing home. Until absolutely needed or required by regs.
I agree on this one, but it may be that the patient/client is pretty easy to care for generally, and they (the facility) are comfortable with the situation and ‘status quo’.
I also agree that one wants to move into IL or AL before they don’t qualify - especially if it is a multi-level facility where they move into AL, memory care, or skilled care once they need it.
Parents caring for parents is a tricky situation for many families.
Even the head nurse at the assisted living whom I spoke with said it is hard to explain to families and residents that sometimes they need more care than the assisted living can provide. My father truly considered his assisted living apartment his home. After every trip to the hospital, he was excited to return home to his apartment there. However, as his health declined, so many things he needed required skilled care that they just couldn’t provide him with. All they could do was use visiting nurses to fill some gaps and when they couldn’t they called 911 and sent him to the ER. I hope that this change will put an end to him ending up in the hospital on an almost monthly basis.
I read all these stories with sadness, and a bit of fear as well. How can we do better for our own children – and ourselves? What have you seen that works well? What can we promote for our own futures?
I’ve told my own children, that if I need more assistance, and am unable to choose myself, to consider:
Not-For-Profit Facilities (I TEND to think these run under a different value system, but realize it can vary considerably).
Consider smaller “adult family homes” rather than larger facilities. I’m starting to see more of these, that feel far less institutional. They do not provide full nursing care however, and are likely not to increase substantially due to difficulty finding employees.
Choose an environment they would choose for themselves (I ASSUME they would want quality care, and look beyond the fancy lobbies and often empty but impressive community/craft/multi-purpose areas).
Yes, I think I’d prefer a smaller family care home over the place my mom is living at, with its fancy lobby and the activities she’s never participated in. They said at the AL, she’d have to take the rails off the hospital bed she has, because they claim it’s a limb entrapment risk. We and she feels removing the rails increases the risk she will fall out of the bed! The independent living is OK but overpriced if one doesn’t use most of the facilities and I have read/heard bad things about “higher levels of care.”. The worst part is they can move patients to increasing levels of care over objection of patient and family.
In my in laws’ first independent /assisted /memory care facility, the staff provided fabulous programming. They worked hard to bring every resident “into the fold,” and over time they added programming that residents requested. I can’t say enough good things about the facility. They constantly win awards. MIL moved to be closer to SIL, and this facility has far less in terms of programming. If I had a loved one who would benefit from being engaged with a community, this is not the place I would want them to live. There is a BIG difference in cost, with the new one being less expensive. MIL started to withdraw from the community just before she asked to move, so the new facility meets her needs … but I would not have wanted her there when she was more active and involved.
My mom is moving into independent living, so I’ll have to report how she likes it in the future.
Mom has good cognitive abilities so that’s less we have to worry about.
It will be nice to have PT in-house because she will be referred as soon as she’s assessed once she leaves rehab.
She’s looking forward to not have the burden of house maintenance. I think it will be easier for her to have her food taken care of.
Mom will participate in the many card games there as she’s a very active bridge player.
One of our neighbors operated a home care facility. She was a very nice person (she retired due to health issues) and I know how much she cared about her “ladies”. But she converted her basement to rooms. There are several reasons I wouldn’t put my parent there. Limited opportunities for socialization. Space was small, residents stayed in the basement, I rarely even saw them outside. They did not go upstairs. And when my neighbor had a health issue, her residents had to find another spot in a hurry. My neighbor also had a problem finding help, so it was her doing the care all the time.
For my mom, I guess a bigger more active community would be her/our preference.
A lot of stuff went away during COVID. All the group activities, eating together in the dinning hall, etc. They basically kept all the residents in their rooms by themselves for over a year. I believe this was very detrimental to mental and emotional health (as well as physical health). It seems like things are back to normal now in these places. Pre-pandemic when my father toured the assisted living he was at, I was so excited for him for all the activities (they had tons of physical and social events.) He participated in very few of them (even then when he was in better health pre-pandemic).
Same at my FIL’s AL, supposedly a state regulations in MN. He fell out of his regular bed at his home last year and fractured his vertebrae. After months of trying to recover at rehab, a different AL, at home, he had to become a permanent resident at his current AL (at the highest level care).
He doesn’t sleep in the hospital bed in the AL now bc he’s afraid to fall out again. So he sleeps in a recliner, which I don’t think is healthy or helpful. If he had rails on his bed, he wouldn’t resort to the recliner.
I hope she’ll adjust to her new environment. Her willingness to participate is so important. My FIL is an introvert (90 years old) and does not like to socialize so he rarely leaves his room. Residents are encouraged to eat in the dining room, but he doesn’t want to so meals are brought up to him. Transporting meals mean the food is rarely hot, rather ice cold according to him. He can ask them to reheat for him in his room, but he doesn’t like to be a bother. He’s paying a premium to be in this AL and he doesn’t take advantage of any of the services. Sign.
Wow. Never heard that about bed rails. But just browsing google came up with varying laws and regulations. There are different regulations covering full length bed rails and half rails. Half rails may require a doctor’s prescription which lasts six months. I’m sure it depends on your state. I’m just putting this out there because while a facility says they can’t be used that may not be the case depending on the circumstances.
We took care of my dad at home and we considered putting a rail up to make sure he didn’t roll over at night and fall out of bed. Instead we put TV tray tables right up to bed edge each night. That way he had easy access to whatever he needed plus a barrier from falling out.
Maybe this isn’t possible but I immediately thought of crib bumpers. Isn’t there a solution that can be safe and effective for both falls and limb entrapment? Even if it required removing and replacing a system daily?
At my aunts skilled care facility they had the beds low to the ground, so unlikely to be injured with a fall. They also had a silent alarm that went off in the nurses station so that if a resident who was a fall risk was trying to get out of bed they could go in and help.
