An article, “A Room With A Grim View: The ‘Ambient Despair’ That Marks Life In Assisted Living,” authored by Martin Bayne and published by Health Affairs was republished in the Health & Science section of The Washington Post, July 10, under the headline, “They call it assisted living, but it can take the life out of you.”
Mr. Bayne, now 62, entered an assisted living facility at age 53 because of young-onset Parkinson’s. In his article, Mr. Bayne makes several compelling points:
Aging in place harkens back to a time when caring for our elders at home was not only common place, but expected. Over the years, our ideas about aging have metamorphosized in America; taking care of elders at home, old folks homes, nursing homes, NORCs (naturally occurring retirement communities), assisted living, CCRCs (continuing care retirement communities), retirement villages, and neighborhood-based senior villages have all grown out of necessity. They are all relevant in the health care continuum. Retirement Communities often help fill a gap for those who do not need nursing care or assisted living, but no longer want to deal with the hassles of home ownership. Unlike gated apartment complexes, retirement communities offer a village-like setting for seniors to bond and socialize on a daily basis.
Home care for seniors continues to become more popular than it was 10 years ago, let alone a generation ago. As assisted living costs increase, so does the desire of the elderly and disabled to reside in an independent living environment; to age in place in their own homes, not some retirement community. Non-medical home care costs have been in line with institutional care for some time now, so why don’t more families choose independent living over nursing homes and retirement communities? The answer in many cases is that their homes were not designed to be accessible to seniors, the frail, or persons with disabilities. Although Adaptive technologies to help senior citizens age in place are increasing every day, understanding universal design, or accessible design, means understanding our entire environment. Adaptive and assistive technologies inside the home are only the first part of the equation. The second part is our community, both physical and social.
Resident Rights in Long Term Care Nursing Facilities
We take our personal rights for granted. However, when a family member or a friend moves into a long term care nursing facility the question is often asked whether the family member or friend has any rights as a resident of such facility. Federal law, Section 483.10 of the Code of Federal Regulations http://cfr.vlex.com/vid/10-resident-rights-19811580 requires that long term care nursing facilities must protect and promote the rights of each resident by providing specific, enumerated rights.
Assisted living for Seniors: Will you or your loved one be happy in assisted living? Will you get your money’s worth?
A primer by Joan Van De Moortel, Executive Director of Care for You.
Care for You Companions meet the needs of residents in assisted living facilities as well as in clients’ homes.
Most people want to remain in their homes. It terrifies and depresses them to leave. They end up taking more medications, which can lead to more side effects and accelerate mental and physical decline.
At Care for You, therefore, we believe it is usually best for people to remain in their homes as long as possible. Yet the time may come to search for an assisted living facility for a loved one. If so, here are questions you should consider—they most likely will not be considered by others.
- Does my loved one want to go into this facility?
- What will be the total cost? Compute the basic rate plus each additional service, such as extra meals, help with medications, assistance with bathing and dressing, personal laundry, transportation, etc.
- What services EXACTLY does the facility offer? Commonly, assistance consists only of three meals a day and laundering of bed linens (for which you pay).
- What is the resident-to-staff ratio? A ratio of 6 to 1 is considered outstanding, but very few facilities have this ratio. Twelve to 1 is more common. For a person with dementia or Alzheimer’s, even a 6 to 1 ratio does not provide enough care. That resident really should receive one-on-one attention.
- What is the schedule for providing services? In most facilities care is provided by CNAs (Certified Nursing Assistants), who operate on a medical model and address physical needs on a time clock: get up at this time, bathe at this time, eat at this time, etc. Mental and emotional needs aren’t addressed. This usually doesn’t work with dementia, as time and space are very relative. The fact that it’s time for a certain activity not only doesn’t register for a person with dementia, it can cause anxiety, resistance, acting out. This often leads to increased medication to control the acting out. It doesn’t matter when a person with dementia bathes—7:00, 8:00, 9:00, or 10:00 a.m.—nor does it matter on which days he or she bathes. What’s important is that the person bathes two to three times per week, without being traumatized.
Make visits to any facility you consider, both announced and—even better—unannounced, and scrutinize the following:
- How many workers there are.
- What the residents are doing. Are they in activities? Sitting in front of a TV in a day room? Sitting alone in their rooms? If they have hearing, vision, or stability issues, is someone helping them?
- The physical condition of the residents. Is there any bruising, particularly on the left hand or arm? This is often a result of being pulled up too quickly and too hard.
- The food served. Is it nutritious? Tasty? Attractive? Often, two things happen: First, on the day you’re invited to the facility, the food is great. On other days, not so swell. Second, nutrition can be seriously lacking. Breakfasts of doughnuts and sweet rolls are common. Lunches and dinners can be tasteless and unappealing, with little nutrition.
- The building itself. Is it clean? Well-lit? How does it smell? What do you hear?