What to Consider when Choosing an Assisted Living Community Seven Things you NEED TO KNOW
By Bill Bambrick, Lexington Manor
In a perfect world there wouldn’t be a need for doctors, hospitals or nursing homes. Unfortunately, that is not the case and there may come a time when you, or a loved one, is in need of some help from others. When it becomes questionable if you can safely live in your current living situation, or if it is becoming too much of a struggle to take care of things, the option of an Assisted Living Community should be considered.
There are a lot of Assisted Living Community possibilities available. On a national level, if you add together the number of communities operated by just the two largest companies, the count exceeds 1000. When you consider all of the others, you can add many more thousands to that list. This is just one of the reasons why the search for the best personal fit can be both stressful and very overwhelming.
This article is designed to provide you with some guidance as to what to look for when considering an Assisted Living Community. In next month’s issue, you will also learn FIVE of the most common mistakes made when choosing an Assisted Living Community.
7 Things You Need To Know
1. Assisted Living Communities are not Nursing Homes. For anyone born before 1940, the concept of Assisted Living is a relatively new idea. Before there were Assisted Living Communities (commonly referred to as A.L.F.’s) there were nursing homes, or as some people called them “the home.” When some-one said their mother was in “a home,” it usually was not thought of to be a positive experience. Just like there are very nice hotels and economy hotels…there are very nice assisted living communities and some that are not so desirable. It is wise to visit multiple communities, so that you can experience the difference for yourself.
2.The Monthly Costs. There are typically two components to the monthly cost of assisted living. The Basic Rate is the price of the apartment and everything that goes with it. While there may be some minor exceptions, this basic rate will include: the private apartment with private bathroom, all the meals (3 times a day / 7 days a week), all utilities minus telephone, cable TV, housekeeping, personal laundry and transportation to community events. The second component of the monthly costs, are the charges for the personal services. The most common personal service is the management of medications. Other services can include assistance with the “Activities of Daily Living,” also known as ADL’s. Each community may use a different system to calculate the charges for these personal services (points, level of care, a-la-cart, etc.) but the charges should be relevant to the time involved to perform the service. Occasionally you may find a community that will offer an “all inclusive price.” While this may sound like a “good idea,” you must be careful with this approach. (More on this topic in next month’s article, Top FIVE Common Mistakes Made When Choosing an Assisted Living Community)
3. Admission Process. With few exceptions, the admissions process is consistent amongst the ALF’s and consists of three components. (1) The Assessment: Each ALF is going to do an assessment of the prospective resident. This will be done by either the Director of Nursing or the Executive Director. It is best if the prospective resident can be assessed during a visit to the Assisted Living Community. For individuals that are separated by a distance, a “nurse-to-nurse” phone assessment can be done. The assessment serves two purposes. The first is to determine if the individual is “appropriate” for that community. The acceptance criteria can be different even amongst ALF’s that have the same state license. Just because one ALF says a person is not appropriate, does not mean that another won’t say yes. The second purpose of the assessment is to determine exactly what personal services (if any) are going to be required to take care of the individual. (2) The 1823: This is a state mandated form that is to be completed by the individual’s doctor. Usually it is the primary care physician that does this, but it could be another if that physician is more familiar with the case. Some offices can have this done in a few hours, other offices may take days. This is the part of the admissions process that has the greatest potential to delay the process. (3) The Resident Agreement: Each ALF is going to have their own rental/lease contract. While there may be some uniqueness between communities, the basic contracts will be similar.
4. The Quality of Life. The person who lives in the country, without any neighbors nearby for miles, has a lot more freedom to do what he wants compared to an individual who lives in the city with neighbors close by. The person who lives in their own house has more freedom, and independence, than the individual that lives in a condo complex. The level of independence enjoyed in most assisted living communities is similar to that found when living in a condo. The resident can come and go as they please, have visitors at any time they wish, etc. There are some ALF’s that are known as “lock-down-facilities.” These facilities do limit access, usually with some kind of keypad security system. Generally, these communities have a higher percentage of residents whose safety might be jeopardized if they were to leave the building on their own.
5. Monthly Rental vs. Buy-In Community. There are numerous differences between a Rental Community and a Buy-In Community. A major difference is a rental community does not have a large entrance fee and the agreement can be canceled with a simple 30 day written notice. A Buy-In community requires a significant entrance fee. Among other things, is the “promise” to take care of the resident for the rest of their days. A full refund of this fee is typically not possible in the event the “promise” is not as represented. There are a lot of questions that one should ask before committing the significant funds to a buy-in community. For example: “Who will decide which part of the community I will live in and what happens if I don’t feel that I need to move to the nursing home?”
6. Make The Apartment Your Own. Most Assisted Living Communities are going to encourage the individual to move-in with their own furniture and household decorations. If it’s not possible to have the apartment equipped with the personal furniture prior to moving in, some ALF’s have furnishings they can provide. Sometimes they will do this at no cost while some communities will allow you to rent furniture at a minimal cost.
7. State Survey. Each Assisted Living Community is regularly inspected by a state agency. This inspection is called a survey. All ALF’s are required to make the results of their latest survey available to you for your review. The inspections cover the entire operations of the community to ensure that all state laws and procedures are being followed. It is a rare occurrence that an ALF has a completely perfect survey so you should expect to see some corrective actions being taken. You might be concerned if there are an excessive number of issues known as tags.
Making life changes can be a daunting task, I hope this article has provided some insight to help your family ensure your golden years remain golden. Bill Bambrick has over14 years in health care with a focus on seniors needs.
Bill can be reached by email: wm.bambrick@gmail.com.
Copyright ©2012 Bill Bambrick Port Charlotte, Florida