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Each assisted living center is different. They don't have the Federal regulation of nursing homes. Read the contract carefully so you know exactly what care is covered in the basic contract, and what they charge extra for.
Carol
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My favorite thing to say is, "there isn't much assistance in assisted living."
When my mom moved here, I looked into several ALFs. They were lovely. They always want to show you the pool, conference center, library, dining hall, etc. However, when I asked them the tough questions, ie: what personal services do you offer, there were few. (or they were provided at extra expense.)
In my area a decent ALF costs 3,500-5000 per month. For that amount she would receive two meals, laundry, and activities. When I asked what do you do if a person can not get to the dining room, they said it was extra for "room service." Also, they did not provide personal care (bathing, hair, etc.) and no housekeeping. Errands, doc visits, and medications had to be provided by someone else - or, as you guessed it - you pay extra for them.
I think most of these places are just picking the pockets of seniors. The brochures promise a way of life that you have to overpay for or that really does not exist. None of these places wants to do the "hard work" that famlies provide. So they end up being very expensive apartments.

that's more than my 2 cents
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You are correct. We checked out 3 different places. The cheaper they are - the LESS they do and the MORE they charge for extras.

We have settled on one that 'goes above and beyond' the others and the cost isn't that much greater and thankfully, they take Veteran's Aid and Attendance and Medicaid. My MIL hasn't moved in yet - but that will happen soon. We are hoping for the best and holding our breath.
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Make sure you shop around and compare prices and services. Don't feel pressured into signing any kind of lease or putting up a deposit. One place may offer linen service, which is not needed and not offer another service that IS needed such as med reminders.
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I investigated/visited 9 different ALs. Before I went, I found a checklist on-line with areas to ask about. And I cam up with a list of things that were important for my Mom, then my aunt, then my MIL.

Now with 15 months experience, here are some 'flaws'. What is the cost structure? I have my Mom in a memory care center that has a flat fee on the assumption that each resident needs help with everything. Aunt and MIL didn't need memory care and are in a different place. As their needs increased, so did the charges as everything is an extra cost.

Medical care. Both places we are involved with have a problem with this. The MDs come and go as they please, it's difficult to be with your loved one for appointments as they are unpredictable. Alternative is to take them to a doctor of your choice outside of the AL.

Communications within both ALs are a problem. Despite both being in existence for 10 years, they seem to lack processes and procedures that make it simple for the resident and the family.

Visit several times before making any decisions. Speak with visiting family members about their likes/dislikes. No place is perfect but things that are not acceptable for you are better known ahead of time. Good luck
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Ask your local Council on Aging or Home Health/Visiting Nurse association about what is available locally as far as assisted living. If you have friends in the area who have placed their parents in an ALF, ask them about the pros and cons.

My mom has dementia and can no longer live alone. We brought her up to our home, 400 miles from her own town, and tried caring for her on our own, but she was up all night, getting lost, falling down, taking her clothes off and having incontinence problems during the night. She was with me all day, and then I'd have to care for her all night. I was a wreck. We had to find some kind of solution.

We compared the cost of assisted living to the cost of hiring someone to stay in our home overnight with my mom because of her wandering, and so we could get some sleep. The overnight help would require a minimum of 12 hours at $23 per hour. OK, so that would be $276 per night, just to be on duty and make sure Mom didn't hurt herself.

So we asked around. There is a facility right down the road from us, but we checked it out and they have no one on duty during the night, so that was out. There was another beautiful one nearby that looked perfect, but they also had no supervision after 6:30 PM, and there were no activities except one jigsaw puzzle in the living room. The owner said, "We tried activities, but no one wanted to do them."

Then, our social worker from Home Health mentioned a non-profit 44-bed facility. It's about 25 minutes away, but it is perfect for my mom's needs.
Wandering? No problem, they have staff on duty at night that will bring folks back to their rooms. Disrobing? Same thing.
Activities? Yep - exercise, reading circles, live music sing-alongs, table-top bowling, bingo, and art class, plus field trips to performances.
Help with getting dressed? Sure, just press the red button and someone will come!
Meds? Yep! They come around with the med cart and make sure she gets her vitamins and other meds on time.

I just want to reassure you that there ARE some nice places out there. Word of mouth is the best way to find a good fit for your loved one. Don't give up!



Assisted living is about $3700 per month. So, it's about $124 a day, including 3 meals and all of the activities, laundry service and help. You certainly get more bang for your buck if you can find a comfortable, welcoming and professional place.
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sympavt - where did you find this treasure of an ALF? The same services you list are costing my mother $6000/month!
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@Undecided, we live in Vermont. The facility is in a small town in the middle of the state. It has a very homey, family atmosphere. There is something to be said for living in rural areas of the country. We may not have all the bells and whistles,(no pool at the facility!) but people are friendly, get to know each other, and there is a strong Yankee work ethic among the staff. Turnover is low, so there is continuity for the residents. I am so pleased with the progress my mother has made in the 8 weeks she has been there.
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My mom is in a wonderful assisted living facility. They are staffed 24 hours/day and I can call at any time and speak to a staff member about my mom. A Nurse Practitioner visits each week and will also speak with me anytime I call. They have lots of activities, 3 meals per day plus snacks and maintain a very clean and friendly environment. My mom has her own room/apartment and the cost is $2575 per month. I couldn't even get part-time care for her at home for that amount. I have no complaints about the care she receives.
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Here in Louisiana at AL, it is an apartment with a bedroom, fairly large bathroom, living room/kitchen. Enough room for one person to stay comfortably. In the beginning, there weren't many extra fees. However, once I moved Mom into the AL, there was a service to package her meds (plus the copays are extra) & deliver, another service to come twice a day to open locked cabinet to administer her meds, another company with nurse practitoner that will make house calls so to speak & she can also write scripts & give injections if needed, & another company for physical therapy. The NH where she had been went from an almost 5 to just under a 3 rating. My Mom was slowly being killed with all the meds. Dr. was in & out. I would have to get very upset to find out anything. She fell or slipped out the wheel chair & broke her femor a 2nd time in the NH & PT wasted her last 60 days of Medicare. She was wheelchair bound but PT kept telling her she was doing so good. Now, in 2 1/2 months with one on one PT 2-3 times/week, she is now using the rollator pretty well. The progress has been worth the move & the cost. I am hoping that she may really have a chance to move back to her home. We would take her 24/7 helpers (CNA's) privately hired if they will consider to stay with her. I am so happy for her. I am also going to get the NPractitioner to order a full physical to see where her body & mind are before I make this decision. She has exhibited short term memory loss because of the drugs they had her on. But the AL facility leaves a lot to be desired as far as I'm considered. It is sufficient but so many things that older folks need are lacking. The food is also not always great. They are working on that right now at this one. Hey take it easy. None of these decisions are easy. It is very stressful.
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Sounds like a homework question...

Angel
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I guess it depends on the facility and definitely on the area/state. In upstate NY they are all about the same. Mom's was really nice (and expensive $4250 for level 2) It was not perfect, but a lot nicer than the nursing home she is in now!
The downside to AL is the adjustment of moving from a home or apartment to one fairly small room with an attached bathroom. They change beds and launder clothes, but they don't hang them up or iron them. The food was ok, not gourmet by any means but they would bring it to Mom's room if she didn't feel well and she could go to the dining room any time of day for a snack, etc. They don't "hover" but keep an eye on them so if they are causing no problem, little things can happen that will fall through the cracks if you are not vigilant. That means the family needs to visit often and keep tabs on things - we know our parents behaviors better than they do, we know they are there because they cannot care for themselves or make decisions like they used to. We have to detect little problems they won't recognize.
AL's are limited in what they can "make" a resident do. For instance, they were supposed to assist Mom to shower and she refused to bathe, and they legally couldn't force her - it took 3 months before one aide got her trust occasionally. Mom refused to let them take her hearing aids at night, and they couldn't make her. As a result she lost them both and it cost us $1500 to replace. We had to come up with a way to "fool her" into giving them up. They didn't always notice Mom needed to replace the batteries, and Mom's dementia was bad enough that she no longer had the common sense to recognize she needed them and ask for help.
The key word is "assisted" which means it is assumed that the resident doesn't need 24/7 care or monitoring. It probably works better for residents who need physical help and have all their mental faculties because they can communicate needs and cooperate. With mild/moderate dementia patients like Mom, its harder due to their poor communication and inability to recognize their own needs.
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