Monday, January 27, 2014

Elder Care Options - Assisted Living

Knowing the Elder Care options makes the decision easier for the entire family.

It usually happens unexpectedly.  A fall or an illness leads to hospitalization and rehabilitation. In the midst of all the worry, concern and fear over your loved one’s health and well being, you are told that going home is not a safe option.  Pressed into finding a solution before your loved one is discharged and not even knowing where to start is a very stressful situation for the entire family. Knowing your care options can be a help.  Here is some basic information about one such option – Assisted Living facilities.

What is an Assisted Living facility?
Assisted Living Facilities are designed for individuals that need assistance with basic activities of daily living (ADL's). These activities are self-care tasks that we all learned in childhood, but become more and more difficult to perform as people go through the aging process. ADL’s include feeding, bathing, toileting, dressing and grooming, walking and transferring plus self administration of medications. 

Assisted Living, also known as Assisted Living Facilities (ALF) or Community Based Residential Facilities (CBRF's) are usually used by people who need assistance with their daily living. These people find it difficult to live on their own without relying heavily on family, friends or a home care agency.  People who use Assisted Living Facilities may require medical care in addition to receiving assistance with ADL’s, but they can still maintain some level of independence and do not yet need the level of continuous skilled nursing care as found in institutions like nursing homes.

Assisted Living Facilities are licensed and regulated by state guidelines. They are grouped into three classes depending upon the level of care provided. Typically “A” class signifies very little external help with ADL’s whereas “B” and “C” class progress in the amount of care that can be provided. A “C” class assisted living facility is licensed to provide all levels of care including most skilled medical care tasks, which traditionally used to be only managed through nursing homes.

It is important to understand the classification of the facility you are considering, as some facilities will accept a Resident at one level of care only to require them to move later as their care needs increase beyond their ability to provide care.

People generally choose between home care, assisted living or nursing home care depending upon the amount of independence the individual can maintain, the amount of care needed, and the cost of that care.

Who can benefit from Assisted Living and how?
There are many types of people who can benefit from residing at an Assisted Living Facility.  Assisted Living is ideal for elderly individuals, or couples, who are capable of some level of independence but require assistance with the basic activities of daily living.  They may also have some medical concerns that require supervision or continuous attention.  An ALF is also a safe place for those suffering from Alzheimer’s or Dementia related problems.  Assisted Living is an ideal living arrangement for disabled individuals as well as those recovering from hospitalization or illness and in need of medical supervision.

There are many benefits for those who choose to live in an Assisted Living facility. The most important benefit is derived from the basic concept of “assisted” living.  The philosophy of assisted living is that it promotes independence, autonomy, privacy and dignity for the residents who live there.  The concept of Assisted Living is more concerned with the approach towards care rather than the actual care received.  This concept is important to families struggling with the less appealing option of placing their loved one in a traditional nursing home or juggling their own lives with the many care needs of their loved ones.  Assisted Living facilities strive to support and maintain the current level of independence enjoyed by residents, but with additional supervision and assistance when necessary.

One important benefit gained for residents and families alike is family roles are often restored when caregiver responsibilities are taken over by trained staff.  The professional care provided by assisted living facilities relieves the stress and burnout experienced by families when dealing with loved ones who need daily care.

Peace of mind is gained from living in an Assisted Living facility.  The residents benefit from continual monitoring of their health by the trained caregivers, Facility Directors and RN.   Safety against accidents or falls is another plus. The availability of nutritious meals and housekeeping, in addition to opportunities for social interaction, all add to the quality of life experienced by residents at assisted living facilities.

Who lives in Assisted Living facilities?
Currently, more than a million Americans live in an estimated 20,000 assisted living residences.  Assisted living residents can be young or old, affluent or low income, frail or disabled. A typical resident is mid-eighty and is either widowed or single. Residents may suffer from Alzheimer's disease or other memory disorders.  Residents may also need help with incontinence or mobility.

How much does Assisted Living cost?
Each resident has unique needs and preferences.  That is why most Assisted Living facilities will schedule an initial assessment meeting with each potential resident and his or her family.  The goal of the assessment is to learn more about the resident and determine what type of care is needed.

After an initial assessment, the facility will work together with your loved one’s health care provider to put together a Care Plan.  The Care plan is an individualized list and schedule of the services your loved one will receive.  The goal is to provide a level of care that addresses health concerns and provides necessary assistance while helping seniors to maintain their lifestyles.

Only after the Care plan is developed should there be a determination of the monthly cost of care.  That way there never should be any hidden costs or surprises.   On average Assisted Living costs are usually half the costs of nursing home care or full-time, 24 hour a day, home care.  While some assisted living facilities charge per item of care or service, there are some that includes a wide range of services within a standard monthly fee.  There are also some assisted living facilities which base their prices on a sliding scale and often raise rates for each additional service required. Those can start out at a rather reasonable price but soon escalate to be quite costly as care needs increase.

How does Assisted Living compare to institutionalized care?
A: The main difference between an assisted living facilities and institutionalized facilities, such as nursing homes, is the level of care a resident receives and the level freedom the residents are allowed to enjoy. 

In nursing homes, a majority of the residents have health issues that require continual medical supervision as well as need of assistance with daily living tasks.  They are no longer capable of living independently.  Residents in such a facility usually live in shared rooms with little to no private space.  Nursing staff provide medical and general assistance, but are limited in their time and attention by a high resident to staff ratio.  Nursing home residents typically are unable to leave the facility on their own, mainly because they are physically or mentally unable to.

Assisted living residents are far more independent.  They typically do not need as much hands-on medical attention.  Beyond requiring assistance with medicine management, bathing and other tasks of daily living, residents remain very independent. In many assisted living facilities they have individual room furnished and decorated to their own tastes.  Assisted living residents might still cook, entertain, participate in activities, and go on outings, while still enjoying the security of medical supervision and social interaction with other residents.

In the past the main distinction between Assisted Living facilities and institutionalized facilities, like nursing homes, was the ability to provide skilled nursing care.  These days Class C Assisted Living facilities are able to provide many medical services.  Under the supervision of a RN, medical care usually includes medication monitoring, pharmaceutical services, Alzheimer's and Dementia Care, physical and occupational therapy, pain management and hospice care.

Getting an overview of Assisted Living faculties does not make choosing the best one for your loved one’s needs any easier.  But knowing some of the basics about Assisted Living can help with asking the right questions so you make the right choice. 

Kate McCarthy is Director of Operations for HomeAid Health Care which provides services for the elderly who wish to remain safe and independent at home.  HomeAid is sister company to Prairie Home Assisted Living which has served the physical, spiritual, mental and health needs of their residents since 1999.  Together the two family owned companies provide comprehensive care for the elderly and disabled in the Fox Valley of Wisconsin.