One exciting new option for elder care that I’m seeing more of, at least in my neck of the woods of North Dakota, is licensed homes. These homes care for only a handful (three to five) of otherwise healthy Alzheimer’s patients and are a very good solution for some elders who get anxious in larger settings, such as tradional nursing homes or large assisted living facilities.
Some of these settings are in a couple’s home in a town or city. Some are snug country settings, on farms close to town, where people can garden, care for animals, watch farm equipment in action, cook and do other things they have, in the past, enjoyed. Only, in this case, they would have care and supervision - and they wouldn’t be obligated to complete tasks if they weren’t up to it.
What to Look for in a Licensed Home
1. Make sure they are licensed and inspected. You can find this out through your county adult social services.
2. As with any facility, visit with the staff. In this case, meet the owners. How are the “vibes.” Would you leave your child with them?
3. What is the staffing ratio? How many residents are there; how many staff?
4. Is at least one person medically certified to take care of emergencies?
5. Is the entire staff trained to at least a CNA level?
6. Stop in at different times of day. Stop in on a weekend. What is the atmosphere?
7. Do residents go out to shop? For lunch or another fun trip?
8. Do they escort residents to medical appointments?
9. The idea of a home facility is that it is more like family life. Are there children and maybe safe, small pets around?
10. Can residents help cook or do meaningful tasks if they choose to and are able?
Red Flags for Licensed Homes
1. Residents smelling of urine or feces (for a period of time)
2. Short tempers (staff)
3. Dementia patients left alone to sleep (unless there is a medical reason - and then, are they checked on regularly?)
4. Unexplained weight loss.
5. Owners asking visitors to aways call before stopping in.
Not everyone can stay at home with their dementia-stricken elder, nor can they afford to hire someone to stay around-the-clock. However, some elders are extremely resistant to the institutional feel of even the nicest nursing facility. I’m thinking of Frank, a retired farmer, who thinks three people are a crowd. He doesn’t like restaurants. He hates parties. Frank does well in a home setting.
I live in a mid-size city in the Midwest, but we are surrounded by small towns and farms. For elders who were never even comfortable taking a shopping trip to the mega-mall in Fargo, moving to a facility in the heart of the city can be hard. Others don’t notice the difference, and we have fine larger facilities with very homelike atmospheres. There is no one size fits all when it comes to caregiving settings.
Still, there are some elders - and I’m thinking of my inbox with letters from column readers, now - who would do better by staying in a home atmosphere in a small, familiar town. For those people, group home care facilities (some may use other terms) can be the solution. People get to stay close to their roots, their friends can visit more easily, and they aren’t surrounded by zillions of people in the dining room.
Some of the homes in our area advertise, but most stay pretty full because of referrals from county social services or from satisfied family members related to those who have used the business. This is certainly something to look into, if you have an elder who would thrive in a small atmosphere. It’s getting to be a popular option. Just be sure the home is properly licensed and regulated. And, of course, family and/or friends should visit regularly.
For another perspective on the benefits of intimate care settings, read Lynn Taetzsch’s blog, The Benefits of Excellent Assisted Living. For more information about Carol go to www.mindingourelders.com or www.mindingoureldersblogs.com.
Carol Bradley Bursack is a veteran family caregiver who spent more than two decades caring for a total of seven elders. She is a newspaper columnist and the author of Minding Our Elders: Caregivers Share Their Personal Stories. Bradley Bursack is also a contributor to several books on caregiving and dementia, and is passionate about preserving the dignity of elders. Her website is www.mindingourelders.com. Follow Carol on Twitter @mindingourelder and on Facebook at Minding Our Elders.