Families struggle with how to help aging parents and other loved ones as they begin to lose independence. Especially when the elder lives at a distance from family, assisted living seems to be a solution. Kids don’t want to move closer to the aging parent and parents don’t want to move from the familiar town or city where they have lived for a long time. The elder needs help and to be watched over and the seniors’ community of assisted living looks attractive in that way.
The Hidden Truths
For families with loved ones who can’t manage safely alone anymore, assisted living can be a good choice, but it is certainly not for everyone. Essentially, assisted living is an enriched social environment with helpers to aid with activities like bathing, walking, and dressing. It is most definitely not a nursing home. No residence with an assisted living license is considered a “health care facility” in the sense that licensed nurses are on staff and available to deliver skilled care.
A hidden truth is that as aging loved ones decline, there is no clear requirement in assisted living homes that at any specific point, the elder must be moved out to a more suitable place with nursing and medical staff present. It’s all sort of vague to the consumer, often an adult child urging Mom or Dad to move in. The place may look nice. There may be very friendly sales staff touting all the activities available. And some facilities we’ve seen at AgingParents.com, where we consult with families, are excellent. They go above and beyond what large chain facilities normally do. However, the average assisted living places we have interfaced with over the last 15 years for clients are far less trustworthy than the best ones. The best ones are well run and safer. Many of these less than ideal places pose safety risks.
Risks for Families
The risks are that families trust the assisted living folks to watch out for their loved ones’ safety. But there is no specific way to measure whether that trust is deserved. Numerous lawsuits are filed against these kinds of homes due to neglect of elders, failure to contact physicians when the need is present, falls and other misfortunes for the elder residents. These assisted living facilities are not providing “nursing” care. Rather, as Medicare defines it, the help with activities of daily living, is “custodial care.” Medicare does not cover it at all. When the aging person slips downward into a level when skilled care is needed, the family might not realize it. The only way to determine whether the aging parent is getting what they need in assisted living is to monitor what is going on with frequency.
How To Monitor Your Elder In Assisted Living
Here are some ways:
- If you have a family member planning to move to assisted living, the first step is to check them out personally before you and they make any decision about which place to choose. We advise that you not rely on any placement service that tells you which are the “best” facilities. Typically, the placement service is getting a commission for getting someone to move into an assisted living location. The incentive for the commission motivates them to tell you which places are “best”. It may or may not be true at all. It’s a bit like buying something on Amazon
Amazon
- Next, establish a relationship with an experienced person at the assisted living home and agree to contact on a regular basis. Why not just ask your elder who is living there? They may not be aware of the whole picture. For example, in all my years of nursing experience, I never heard a patient say that no one was attending to a bedsore, or that they weren’t getting the correct medications. In other words, the elder resident may not be aware of any danger. At least you have a known person on staff there to communicate with you. You can ask them to check out any suspicions you have about your aging loved one, or just ask about specifics known to you about their medical problems. For example, “Has Mom had any falls?” And, “How is Dad eating this week?” They are not going to call you unless they must, so small problems can go unreported and unnoticed unless you focus on certain things and ask about them.
- If you live at a distance, I advocate for hiring a geriatric care manager, a nurse friend or trusted other to keep an eye on your loved one. It is wise to have someone you know or hire to regularly, personally check on your aging loved one, even if they sound fine on the phone or video.
The Takeaways
If assisted living is what you want, choose wisely and without a placement service. Do the research on your own, even if it takes time. Visit in person and see for yourself.
Monitor regularly. Focus on your aging parents’ known health conditions and keep an eye on whether there are changes. Many chronic conditions do decline over time.
Know that untoward events happen in assisted living facilities. They do not provide licensed nurses to deliver skilled care. If your love one’s conditions worsen, you may need to make the decision to go to the next level of care, which is skilled nursing homes. It may be totally up to family to make that decision, with the input of the primary care physician.