Shopping for Assisted Living
Assisted Living Primer
Assisted Living vs. Nursing continued...
Of course, nursing home regulations are in place to protect
residents' rights and ensure that they aren't neglected. Some are not able to
make decisions for themselves -- people with advanced Alzheimer's disease, for
example. Nevertheless, "sometimes less care is better than more care,"
"Nursing home regulations were just a disaster,"
Schurman says, referring to the Nursing Home Reform Act, passed by Congress in
1987. The goal of the ALW, he says, is to come up with regulations for assisted
living that ensure high quality, but are more flexible.
In terms of cost, the difference between nursing-home care and
assisted living is "really not all that significant," Willging
Jones says that although Medicare and Medicaid often pay for
nursing-home care -- whereas assisted living is generally paid for
out-of-pocket -- those who would be best served by assisted living may not
qualify for government support. They would have to pay for either option.
Another key difference between assisted living and nursing
homes is that assisted-living facilities offer a more home-like atmosphere.
Willging says that "sounds like a hackneyed phrase, but it's really
Jones agrees that assisted-living facilities have done a good
job of making things feel homier.
"You -- the family, the child -- know better than anybody
what makes mom happy," Willging says.
Have a talk with her about what she would want in an
assisted-living arrangement, and then visit several facilities. Don't just let
your fingers do the walking: Some real legwork is in order. "Essentially,
you want to look at the facility," Willging says.
To begin with, let first impressions guide you. "You want
to be comfortable with both the interior and exterior physical
environment," Willging says. Also pay attention to the staff's demeanor.
Watch how they relate to the residents. Talk to some of the residents, too.
You'll be sure to get an honest appraisal of the facility from them.
"Know what you're expecting, and then ask tons of
questions," Willging says.
Once you think you're ready to settle on a place, "read the
contract carefully," Jones says. All the services, amenities, and rules
should be detailed in the contract. You should pay particular attention to the
discharge terms. A resident may be forced to leave within a certain period of
time if his or her health deteriorates. A facility's brochure may suggest that
residents can stay until they die, no matter what, but the contract may state
that they must move out if the staff can't meet their needs. If you're not
comfortable with the terms, don't accept them.
Compare the terms of the contract with your state regulations,
too. It can be hard to find these regulations because various departments of
state government regulate assisted living. In Vermont, it's the Department of
Aging and Disabilities; in Florida, it's the Agency for Health Care
Administration, and so on. You can find contact information for the agencies
that handle assisted living regulations in all 50 states and the U.S.
territories at http://www.seniorresource.com/states.htm