Shopping for Assisted Living
Assisted Living Primer
Assisted Living vs. Nursing continued...
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.
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.