Choosing Senior Care, Part One: A Look inside Assisted Living Facilities
Choosing Senior Care, Part One: A Look inside Assisted Living Facilities
By Carolyn Campbell
This article is Part One in a Two-Part Series.
I have cherished memories of watching my mom care for my grandmother in her own home. As my grandmother’s health declined, she was surrounded by the rooms she knew so well and the possessions that she loved. I was there the night before my grandmother died. I will always remember my mom’s tender voice speaking to my grandmother on the last night of her life, just hours before she passed away in her own bed.
I admired Mom’s calm voice and gentle spirit and set a goal to follow in her footsteps, to care for her at her own house until the end. For years, I was her regular caregiver. But then, at a time when I faced surgery, Mom fell at her house. Both paramedics and hospice workers told me that my mom could no longer live alone. She now needed constant care.
Exploring the Options
I began researching and found I had more options that I had expected. Because of my own impending operation, I thought I had only two choices—to either place Mom in a care facility or to hire caregivers that could be there around the clock. Hoping to make the best choice, I decided to investigate both possibilities.
Bettyanne Bruin, director of marketing at The Coventry, explains that families typically consider outside care when they feel a loved one is no longer safe at home, is depressed, is struggling with incontinence issues, or needs help in taking medicines regularly. Care options include living with an adult child, moving to assisted or retirement living facilities, or home care with the help of professional caregivers.
This article will focus on my research about assisted living facilities.
What Is an Assisted Living Center?
Bruin explains that assisted living facilities have changed in recent years. When I visited several assisted living facilities, I discovered they were different from those I remembered from my grandparents’ time. The décor was homier and more cheery than I expected, and the residents seemed to enjoy socializing together. Senior living designers and care professionals asked themselves why nursing homes sometimes felt dreary and institutional and set out to achieve something different. The concept of assisted living was born from their inquiry.
Today, there are many variations of assisted living communities, from tall apartment buildings to broad suburban complexes to single homes catering to a small resident population. Most assisted living communities are licensed to care for at least 20 people, but a large community could house hundreds of residents. Smaller communities usually feature a home-like atmosphere, while the larger facilities offer an abundance of activities and recreational opportunities.
“Looking for an assisted living center is like looking for a pair of shoes,” says Bruin. “You shop around until you find the right one. The first consideration is usually financial, the second is location, and the third is feel. Visit several until you find the one that fits.”
Day-to-Day Life
Assisted living facilities are licensed medical facilities run by state regulations, and often include a staff of 50-60 people. Bruin explains that running an assisted living facility is an orchestrated event. If someone faints or falls, the staff fills out an incident report. Each resident has a chart that includes information about bathing and dressing, toileting, and the amount of food eaten each day. An adult child, concerned his mother is not eating enough, could be reassured by a chart showing that she ate 80% of her food. “Everything is regulated now and nothing can fall through the cracks. The goal is to produce quality of life,” says Bruin.
She explains that people who come to the facility get a clean slate as far as their past lives. “All we know is that you are here and need care.” She adds that there should be meetings with family members throughout the year to give updates on how care is going and whether needs are being met. There are also meetings if there is a change of condition.
Finding the Right Fit
Every assisted living community has a different personality. It’s possible to visit two communities down the street from one another that look similar and offer the same care and services but still feel very different. If you and/or your loved one don’t like one community, that doesn’t mean the next one won’t feel right. Different from the nursing home stereotype—a place where sick and dying people went—assisted living communities “are more like cruise ships—people go there to live. In the past, people went there to decline—now they go there to improve,” explains Bruin.
The medical focus of such facilities is now more camouflaged, while the visible focus today is more on socialization and food. Socialization is vital for seniors—one study conducted at BYU stated that loneliness is as harmful to seniors as alcoholism.
Bruin suggests, “The dining room is a good place to see how a property is working and how the staff interacts with residents. Feel free to ask a resident, ‘How do you like it here?’ Make sure to observe the staff, how they interact with each other and with the executive director.”
As you visit assisted living facilities, ask what level of care each facility expects to assign your loved one upon their entrance to the facility. Joel Hoffman, Director of The Bureau of Health Facility Licensing and Certification for the Utah Department of Health, explains that in a Level 1 assisted living facility, residents are able to walk without any extra help (except maybe a walker). Residents who need some stabilizing help in activities such as walking, being able to get out of bed, or transferring from a bed to a wheelchair would be appropriate for a Level 2 assisted living facility. Those who are unable to walk would be assigned to a nursing facility. If your loved one requires more care than their designation offers, some facilities may not be willing to admit your loved one.
Keeping Your Loved One Safe and Happy
When your loved one enters a facility, realize that you and the staff are all working together rather than against each other. Bruin says, “It takes about six weeks for the staff to work out all the kinks and understand the little nuances of a resident, such as she doesn’t like her shades shut at night, or that she’d always rather have ice cream rather than a quesadilla for a snack.” Bruin suggests envisioning the assisted living facility as a village where everyone is working hard to care for the residents. Realize that assisted living facilities never close and they are a round-the-clock endeavor. Go in with an appreciative attitude and always ask questions rather than demand. For example, say, “Help me understand this,” or “Does she need any supplies?” or “How is Mom doing?”
“Do what you can to make it the best experience possible. Maybe you surprise the staff with donuts. Spread as much love around as you can,” says Bruin. She adds that almost everybody who works in the assisted living industry does so because they want to be there. “They love what they do. At some point, your mom becomes my mom.” After six weeks, a bond should have developed between the resident and the assisted living facility. If a bond doesn’t seem to be developing, it might not be the right match. If you feel that the placement truly isn’t right for your loved one, consider asking the administrator, “Can you help me find another place?”
Of course, if you do feel there is an important problem, you could consider contacting the Utah Department of Health Licensing and Certification by visiting www.health.utah.gov/hflcra or calling 1-800-662-4157. Make a GRAMA request for additional information regarding a particular facility. Each state has a State Survey Agency that is tasked with conducting inspections to certify nursing homes and home health care agencies for Medicare and Medicaid compliance. They also investigate and validate complaints made by individuals. Bruin comments that reported deficiencies could be something as simple as forgetting the cover on the sprinkles for ice cream. “They are very sensitive in their regulations. Every light bulb has to be in.”
When encountering problems, it’s also possible to contact the state Long-Term Care Ombudsman. Ombudsmen get extensive training before being certified. They help frail seniors who are 60 or older with advocacy and assistance in nursing homes and assisted living. They can help locate and identify resources and services. Their services are free and confidential. The county you live in determines who your ombudsman is. Visit http://daas.utah.gov/long-term-care-ombudsman/ for more information.
A New Beginning
While my original goal was to pursue home care for Mom, my siblings outvoted me. Feeling sad that I was not able to follow in my mother’s footsteps and provide home care until the end, I nevertheless listened to their advice and thoughts. My son said, “Mom, I know this wasn’t the choice you wanted. But now you need to accept this reality and move ahead to make this new situation the best that it can be for Grandma.” His words rang true. As I began to visit Mom at the assisted living facility regularly, I saw there were many benefits there—such as companionship and socialization, activities and good food—that enriched both Mother’s life and my own.
I’ve been grateful to learn of the many options available to seniors and their families today and especially to find out how much assisted living facilities offer today. You may find it beneficial to check into these facilities for yourself or for a loved one. It can be the beginning of a whole new life!
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