Assisted Living Information
Smaller SpaceClick thumbnail to view full-size
The Current Facility
You may not be aware that there are many homes in local middle-class neighborhoods that have been converted to assisted living homes for the elderly. They vary in size, housing between four to thirteen persons. Not all patients are elderly. Some have special needs and require special care. All services necessary for daily living are provided for a monthly fee. Medical personnel are often contracted to visit with the patient or take care of special medical needs. State requirements are monitored and must be met. These requirements include the condition of the facility and the daily care provided to the patient. If the requirements are not met, the license for business can be revoked.
This facility is located in the middle of a quiet residential neighborhood. The owner bought it and modified it for an assisted living facility. This site has a large dining area, a living room and kitchen/ breakfast/nurse station as well as eight bedrooms with two and a half baths. Both full baths have showers. Three of the bedrooms are single occupancy. Two of the rooms currently house residents in hospital beds. An additional resident rents a double occupancy room as a single room, paying $6,000 a month!
The lawn is green and well kept with flowers and ivy surrounding a large front porch. The backyard has a covered patio which is used for outside events In nice weather.
All meals are served in the dining room. The meals vary from week to week. Six or seven residents are able to come to the dining room. A few residents are bedridden and don't join the group for meals.
Medications are monitored appropriately. This is the first facility that has faithfully monitored Mom's blood pressure. When it ran high, they contacted the director and the doctor as needed. I also received a call and text message. After expressing my desire several times to be notified when there are problems, this director has followed through.
Care of the Facility
In this facility, the staff regularly clean the bathrooms and sweep the floors. They dust the bedrooms occasionally. All laundry has been marked with Mom's name and is normally returned to her without a problem. The routine for laundry is that all dirty clothes are washed that same day. Wet clothes are removed to be washed immediately. This process eliminates many of the odors often encountered In an eldercare facility. Once in awhile we find clothes that don't belong to Mom that are left in a drawer or hung in her closet. If I take it to the laundry area, staff will relocate that item to the correct owner.
One Saturday, I walked into Mom's room to find her recently cleaned clothes thrown across her chair, her night clothes were "wadded up" in her dresser drawer and inside out, and her closet looked like a tornado had blown through it. I complained to the staff person while putting things back into order. Thank goodness I have not seen that situation again!
State requirements regulate the number of residents per staff. There are basic requirements for bathing, meals, bath rooming, etc. If I were going to change eldercare standards in this country, I would advocate for state regulations to be modified. The basic issue in daily care is that there are too many residents for one staff person. Staff cannot possibly meet the overall personal needs of residents, dispense medications, cook a decent meal, sweep the floors and maintain clean bathrooms well under current ratios.
The residents are dressed for the day. Their job of "waiting" begins. Many of the elderly in assisted living facilities no longer walk, but instead are confined to wheelchairs or to their bed. They wait to be moved to the dining room and they wait for the meal or snack to be served. After the meal or snack, they wait for a bathroom trip and a trip back to their comfortable recliner and the television. In the evenings, an additional staff person is sometimes scheduled for a few hours to bathe the residents and feed those who are bedridden. With this assistance, the process of moving individuals from the dinner table becomes more efficient. Additional staff is also present in the mornings to get the residents up for the day and dressed, fed and meds dispensed.
Weekends become less organized because only one staff person is on duty. The wait times increase for the residents. Interaction with the elderly individuals is less frequent. Residents may sit in the dining room for an hour after dinner so that the staff on duty can feed a bedridden patient or wash dishes after dinner.
You Are Important
All facilities are similar when it comes to patient care. State regulations set the standard for daily care. The facility is making money for the owner. Never forget that profit is their bottom line!
Visit your loved one regularly. Provide the individual interaction that is needed. Take a special treat. Be a voice when adequate care is not provided. It is the least you can do for your family member!
Without belaboring the subject, let me summarize the various facilities I have experienced over the last five years.
The first level of care facility provided meals and apartment cleaning for all with medical and personal care services available as needed. Activities of all types were offered to those who were interested, from card games to trips to a movie. There was a freedom to come and go.
The second facility was locked with nurse care around the clock. It was an Alzheimer unit. There were levels of service available dependent on the patient functioning abilities. Daily activities such as music and crafts were provided.
The third eldercare facility was a residential home that was not state licensed. It had inadequate services and lacked the quality of care needed for its residents.
The last facility is also a converted residential home. It is state licensed and provides basic care.
Each of these facilities offered services congruent to Mom's needs during her years of decline. As her world has gotten smaller, she has shown less of a desire for activities and entertainment and more need for basic care. As her advocate, I have been called to voice her needs in various circumstances so that she would not be lost in the shuffle, forgotten, missed, or skipped over.
My husband and I were discussing this journey with Mom last night at dinner. He shared a very truthful insight. Each facility viewed her as more capable than she was. They did not adjust or compensate well with the changes she was experiencing. Her world became smaller in each facility and we had to move on to have those needs met. Well said.