Moving a Loved One to Assisted Living: A Checklist
Many callers ask our advice regarding appropriate placement for a loved one who is experiencing increasing difficulty living independently. Assisted Living Facilities (ALF) may be a viable option in the early to middle stages of dementia. For those in more advanced stages of the disease, some ALFs has dementia units that provide a more advanced level of care and allow the individual to remain in the facility for a longer period of time.
Families should investigate a number of facilities before placing their loved one, in terms of quality, programming, staff and cost. You should look at several facilities and compare one to another before reaching a decision. Preparing a checklist can be very helpful.
1. Rate facilities on how they smell and look, the level of cleanliness and the level of noise.
2. Take note of the relationship between staff and residents.
3. Look at the bedrooms/apartments to see if they look and feel comfortable for your loved one and ask what the different rooms cost per month.
4. Can your loved one bring his or her furniture? You may also want to inquire if living with a companion is an option.
5. Are there grab bars, safety rails and well-marked signs?
6. Find out about arrangements for meals including how many, type of cuisine and where these are offered.
7. Are housekeeping and personal laundry services included?
8. How available is the staff and how secure is the facility?
9. Inquire about transportation to medical appointments and ask to see an activity schedule to determine if the social, recreational and exercise activities are ones that your loved one will enjoy.
10. You may also want to inquire about smoking rules.
The cost for a room does not include the cost of the various levels of care. These costs reflect the amount of assistance your loved one will require with their activities of daily living (i.e., showering, dressing, and undressing). This figure is added on to the monthly cost of living.
Another cost that is added on is medication management. For those who can continue to order and maintain their own medications, the fee per month may be nominal. The fee rises when more intervention is required. For example, if the facility orders, stores and administers up to perhaps seven medications a day, the fee rises; up to eight, higher still; and even higher for any respiratory ailments.
In terms of cost, there are facilities that have some beds that are covered by Medicaid. It certainly is worth a phone call or a visit to get that information. Most private pay arrangements are covered by personal assets and/or long-term care policies if your loved one has that coverage.
Most ALFs require that a resident be able to ambulate on their own, which means being able to walk 100 feet unassisted. Walkers and canes are permitted, and some facilities allow wheelchairs, but generally require that the resident live on the first level of the facility.
If a resident is admitted to a hospital, discharge plans back to the facility must be made by a family member or other concerned party. Finally, it is important to know that most ALFs do allow hospice services.