Mom is getting on in years, and she's not getting around as
well as she used to. She dreads the thought of being stuck in a nursing home,
and so do you; but where else can she go?
What's called "assisted living" may be the best option
for an older person who doesn't need round-the-clock nursing care, but who
needs some help with daily activities and occasional medical attention.
Each month WebMD the Magazine puts your questions about weight loss
and fitness to top exercise and motivational experts. This month, John Harvey,
an 86-year-old retired physician, asked for help beginning a fitness routine.
Harvey moved with his wife to a retirement community in Bethesda, Md., about a
year ago. He's never been obese, but at 225 pounds he's leaning more on his
cane and is unsteady on his feet. For advice, we turned to Anthony Absalon, a
fitness trainer at Fox Hill Senior Living...
At the moment, however, the definition of assisted living is
vague -- and in many people's minds, it's just a euphemism for a nursing home.
There are some generally agreed-upon differences, but "there's no standard
model" for assisted living, says Lauren Jones of AARP.
That means shopping around for a place for your older loved one
to live can be a confusing experience.
"I think the biggest question right now is figuring out
what assisted living is," says Bradley Schurman of the Assisted Living Work
Group (ALW), a group of doctors, nurses, consumer advocates, and industry
representatives appointed by the US Senate Special Committee on Aging to
develop national standards for assisted living.
An assisted living facility could be "a trailer in the back
of somebody's yard," Schurman says, or "500 apartments in a gleaming
tower in downtown New York." That's how widely definitions and regulations
differ from state to state.
What's more, "costs vary greatly," Jones says --
typically ranging from $1,000 to $3,000 a month.
The ALW recommendations are due to be presented to the Senate
in April 2003. Until national standards are put in place, shopping for an
assisted living arrangement will be a headache, unless you know what you're
Assisted Living vs. Nursing
Jones says the main difference between assisted living and a
nursing home is "the level of care someone needs." She says a nursing
home would be the right choice for someone who doesn't need to be in a
hospital, but who needs fairly constant nursing care. An assisted living
facility typically offers more independence and less intensive medical
Paul Willging, the newly appointed president of the Assisted
Living Federation of America (ALFA), has another take on the difference between
assisted living and nursing homes. He was, until taking his current job, the
president of the American Health Care Association, which represents nursing
homes in the U.S.
He says it all comes down to "customer focus."
"Nursing facilities have had a tendency to look at the
government as their customer," he says. That's because Medicare and
Medicaid usually pick up a resident's tab.
In his opinion, nursing homes are not able to cater to a
resident's individual preferences because they are overregulated by the federal
government. These regulations decide when residents take their meals and even
how often they bathe. Assisted living, he says, allows residents to make these
decisions for themselves: It's a matter of being asked vs. being told.