Home Care in Assisted Living Facilities
Home care, of course, happens at home. But where is home? For many senior home care clients, home is in a retirement or assisted living facility.
The majority of home care does occur in private homes. Seniors generally want to age in place and remain at home as long as possible. But remaining at home isn’t the best choice for everyone. For an older adult living alone, aging in place can sometimes be isolating and lonely. It can also be a health risk factor if, for example, the person is at risk for falls, isn’t taking medications correctly or has trouble with meal preparation.
Many older adults choose to move to retirement homes and an increasing number are moving to retirement with assisted living. There are also stand alone assisted living facilities. In addition to meals and light housekeeping, assisted living facilities generally provide their residents help with activities of daily living such as bathing, dressing, and ambulation.
Another popular choice is the CCRC or continuing care retirement community which combines retirement, assisted living, and skilled nursing. The idea is that someone can move in, receive care for the rest of their life and not have to move again.
If only things were that easy. Here’s a surprising statistic. About 15% of Family Resource Home Care’s clients live in assisted living facilities. I suspect most home care agencies have similar numbers.
Why should anyone living in a assisted living facility need to hire an outside home care agency? Isn’t that what the facility is supposed to provide? Here are some reasons:
- Many facilities do provided needed assistance, but a resident has to move from their independent apartment in order to receive services. In addition to giving up a probably much nicer place to live, moving to the “assisted living wing” often has a stigma attached to it. A couple may have to make the difficult decision to stay in their independent apartment and hire help from the outside, or separate, with one spouse going to assisted living and the other staying in the apartment. Some choice!
- A resident may need a higher level of services than the facility provides in assisted living. Or the resident may need longer or more frequent hours than the facility can staff.
- Compared to a home care agency, a facility will have most likely have less flexibility in both assigning staff and the times they can provide services. A home care agency may send several caregivers out to a home over a period of time in an effort to make a good match and will work with the client to provide the help at the times requested. An assisted living facility will probably not have that luxury.
There are many wonderful assisted living facilities and CCRCs that provide a high quality of life for their residents. Many caring and dedicated people work there who bend over backwards helping senior adults maintain independence within their lifestyle and budget needs.
New residents who are thinking about moving into a retirement/assisted living facility are understandably motivated by the lovely dining room, the helpful front desk, the social aspects, and the list of fun activities. Families are swayed by the idea of having a safe, comfortable place for their aging relatives. But prospective residents of assisted living and retirement/assisted living facilities should also consider the day they actually will need assistance and make themselves aware of what assistance will be provided when, at what additional cost, at what availability, and by whom.
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Very good points. And watch out for house rules that may change. My cousin, after buying-in, was told that she was not permitted to go to the dining room in her wheelchair. And what about the dress code? And alcohol? And who knows what else? The older I get, the more I like to do things my way. I shudder at management’s social director nagging me to remaing “vital and active” when my body and mind are both slowing down, and doing things the easy way (or not at all) become important. Already I I wear a sweatshirt instead of a shirt that buttons, and seldom wear a jacket. Having to meet other peoples standards would grate. Aging in place is very attractive indeed.
The problem then is how to anticipate what services and activities will be needed, having them available, and being able to pay for them. My friend, returning home from the hospital, has had an agency thrust upon her that has a minimum of twelve hours a week. (Her case manager likes the agency.) My friend may indeed need twelve hours at first, but later may need only half that. Then what? The devil is in the details and the “village” concept would seem to be a good approach. ===gm===
I’ve recently started a blog, the information you provide on this site has helped me tremendously. Thank you for all of your time & work.
Thanks. I had an interesting conversation this weekend with a resident at Horizon House, a very nice CCRC in downtown Seattle. He’s an independent resident who understood the question marks surrounding assisted living. He was very happy with the arrangement at Horizon House where when it becomes time a resident needs assistance, one can contract with their people or hire from the outside. It’s all explained up front.
What a great resource!