Nursing Home Planning

What You Need to Know About Assisted Living Facilities

It’s as important to understand what services are not offered at an assisted living facility, as it is to know what services are available.

It’s as important to understand what services are not offered at an assisted living facility, as it is to know what services are available. Residents with medical issues may not be suited for this lifestyle setting.

NursingFor seniors who no longer wish to live on their own, assisted living facilities seem like a great idea.  However, for those with complex or chronic medical issues, assisted living facilities may not be a good fit. These residential facilities are not required to have nurses or medical personal present. The only medical solution is an emergency ambulance ride to the local hospital.

As The San Diego Union-Tribunereports in its recent article, “The key thing to know about assisted living,”there are about 7,500 assisted living (AL) facilities in California. They range from small, six-bed residential homes to larger facilities with 100-plus beds. The larger facilities typically have the decor and ambience of an upscale hotel, rather than an institutional medical facility. Regardless of size, they all have a few things in common:

  • They’re less expensive than skilled nursing facilities;
  • They’re predominantly private pay;
  • They’re regulated by the Dept. of Social Services and Community Care Licensing Division;
  • There’s no current rating system to help consumers make informed decisions, when selecting an assisted living facility for their loved one; and
  • They don’t have the strict regulation and record keeping that the Departments of Public Health and Health Care Services require of skilled nursing facilities.

According to the National Institutes of Health, assisted living facilities provide care to a large number of older adults, including many with complex health problems. The most common reasons for entering AL are dementia and functional impairment, but most residents (94%) have at least one chronic medical condition, with 76% having two or more chronic conditions.

Families often don't have realistic expectations. The marketing person makes promises about what's available. However, families don't know to ask questions about the staffing levels, the supervision, and how medications are administered. Loved ones don't realize it’s not a nursing home, and that it doesn’t have skilled nursing care.

The reality of this lower level of care may result in loved ones receiving a midnight call that Mom got confused, wandered away from the facility and is now lost. Or that Mom’s fallen and broken a hip.

Seniors and family caregivers who live in San Diego have access to a county funded program, Choose Well. It is a rating system for assisted living and board-and-care facilities. It is said to be the first rating system for these kinds of facilities in California and is a starting point for getting information.

If the facility is licensed by the state, visit the state’s website to learn about citations, violations complaints and any other information about the facility. Do your homework, so that your loved one is in a suitable and safe living environment.

Reference: San Diego Union-Tribune (May 9, 2018)“The key thing to know about assisted living”

How to Tackle Nursing Home Challenges

Unless you have experienced the feelings of powerlessness and confusion that often accompanies being admitted to a nursing home, it’s hard to imagine how difficult an adjustment this can be.

Unless you have experienced the feelings of powerlessness and confusion that often accompanies being admitted to a nursing home, it’s hard to imagine how difficult an adjustment this can be.

NursingPatients are not the only ones who have a tough time getting used to life in a nursing home or assisted living facility. Families are often at a loss with how to deal with a chaotic situation and often find themselves fighting with each other, as they struggle to cope.

Forbes’recent article, “How Nursing Homes Can Destroy Families,”says that we depend on the people with the most experience to help us through this. However, it does not always work out for the best. In that case, as the situation for a loved one continues to deteriorate and as family members try to address mounting issues, it can take a toll on relationships. Let’s look at some of the factors:

Poor Organization. See if there’s a clear chain of command at the nursing home and find out who you should contact with your questions. Get one person to work with in order to avoid confusion. There may be a high turnover rate among employees, so try to maintain contact with the highest-level staff member and secure a secondary contact.

Misinformation. In workplaces with high turnover, some may be unsure of their own roles. Whether the staff members are new, poorly trained, or even disinterested in their positions, this is problematic because you’re relying on these employees for critical information. To avoid this, try to discuss things with one person and document every interaction. You may consider making email your primary mode of contact, so you have a written record of everything that’s been said. That record may be valuable, if there’s an issue.

Staffing Problems.Nursing homes struggle to keep employees, especially the good ones. You may quickly see how much this impacts the quality of care at many different levels, for your loved one. This could present itself in poorly maintained rooms or poorly maintained records. An understaffed senior residence can be a dangerous place. However, there may be little that you can do. This isn’t an uncommon issue and seniors could be left being neglected. Make the effort to be friendly with the staff and show them you’re invested.It will send the message that you’re kind but persistent.

Family Fighting. Families can battle over the care plan or squabble over assets, and tempers may flare. The nursing home setting may worsen this dynamic. In addition to the frustration with any gaps in care, family members may find themselves arguing about all sorts of issues.

Medical Malpractice. In some instances, a nursing home resident can be physically or mentally harmed by negligent medical care.

An elder law attorney will be able to help you navigate through certain challenges of dealing with the nursing home. She or he will also be able to refer you to a social worker outside of the nursing home, who will be able to help your family address the emotional stress that often accompanies this type of situation.

Reference: Forbes(April 28, 2018) “How Nursing Homes Can Destroy Families”