Wednesday, May 6, 2009

Consider these things about an Assisted Living facility

After hearing that I recently moved my own mother to an assisted living facility (ALF), a friend called to ask about my selection criteria. Given the choices in Mom's home town, the shear low number of options helped narrow the list. I was also lucky enough to have a classmate who works for the state and had some suggestions. I added our concerns in italics:

From Rena D, consider these things and your parents needs:
Transportation & Outings for business and pleasure We wanted to make sure that Mom could go and get some assistance without extra fees
Special diet and food preferences Mom has no allergies but should she have special needs these are met with no extra fees
Extra fees for services Some ALF's nickle and dime residents making financial planning impossible. We chose to move Mom to a one-price ALF because she needs so much help; if she were able to do more for herself then a fee-for-service ALF could be less expensive.
Activities, are these scheduled regularly?
Laundry for Mom, laundry is picked up weekly. I had to put her name or initials on EVERYTHING - socks, sheets, pillows, underwear. It's a pain but will ensure I don't have to replace anything. Some ALFs have daily or twice daily pick up for special needs but you must ask for that.
Staffing Ratio; is there a nurse in the building or on call? Mom's has at least one LPN on 8-5 and one on-call evenings and weekends.
What's included in the monthly rent? cable, phone?
Can you keep your own doctor or must you change? I would be very WARRY of any ALF that required a resident to change doctors. Unless there is some special need, the ALF should be able to work with ANY doctor.

One very strong recommendation: ALWAYS seek the opinion of your parents regular doctor before making a decision on a specific facility. Physicians know the conditions of patients and the type of care they get; they also need to have clear and easy communication with the facility. The physician might not be comfortable telling you past experiences but ask if they would move their own parent to a particular facility.


I had some concerns of my own:
Is there a private dining room where the family can gather with Mom?
Can she keep her own pharmacy? What must the pharmacy do to meet the criteria of the assisted living facility? Mom's ALF requires that all her meds are bubble packed and that the pharmacy deliver them. The family is also required to pick up and deliver any one-off medications. At first they told me we'd have to switch but Mom feels some loyalty to her old pharmacist so I asked if they could meet the ALF's requirements and they said yes. The ALF at first told me we MUST use THEIR pharmacy located in a city two hours away. Such a requirement reeks of conflict of interest to me so I pushed back and went with the local store instead. I promised that if it didn't work out after 3 months we could use their pharmacy but if I saw increases in the costs, we'd have to talk.
How easy is it to take Mom on an outing? In Mom's case, it's very easy, I simply sign her out. But she requires no special equipment or wheel chair. If she will be away more than 5 hours, I check with the nurses desk and they'll give me her regular medications so she stays on schedule. They trust that I'll give the meds to her. I don't know what they'd do if she were taking some highly controlled narcotic - that might be something to ask your local ALF since regulations might change from state to state.
Can I spend the night in Mom's room? Given Mom's epilepsy, I know there will be times when she needs me or someone to stay with her, plus, I just want to be able to hang out with her. Her ALF has a roll away bed that visitors can use any time. I can also join her for meals for a small fee.
Can Mom have food or a coffee maker in her room? Mom loves to play hostess and have coffee and treates at 3pm daily so she keeps these in her room. If she can keep up that routine and include some friends, it will feel more like home to her.
Can we join Mom for activities like bingo or concerts: This ALF welcomes family members for most activities. There are a few events where liability and safety are of concern (and thus the insurance company) like fishing where Mom might have to ride in their bus but we can meet them at their destination and join in.