Moving your parent to a Senior Living Home
March 18, 2014 12:03 PM Subscribe
My friend is faced with moving her mother to a 'Senior Living Home'. (Connecticut) A lot of factors led to this; tests and professional advice, safety concerns, Mom's reluctant consent etc. Daughter understands all this, and will be relieved by her Mom's move to full-time care, but at the same time feels devastated taking this action. Abandonment, loss of memory and communication...... While other family members have visited the location and are happy with it, we will be visiting soon for the first time. 1. What should we consider? Where can a consumer look for possible violations or complaints? 2. I never had to face this. How can I support her?
My mother-in-law was moved to a memory support unit when caring for her at home became too much for my husband and I. We looked at so many different facilities before deciding on one near us.
Some of the tests we did -
We ate a meal in their dining room during our interview. It wasn't a special day, and gave us a feel for their flexibility with our requests/what kind of food they served on an every day basis.
We sat in common areas without coats on to see if we felt it was too hot or too cold. (We found that it was WAY too cool to the point all the residents had coats on inside at some places).
We discussed care options - how much of her outside care would be continued, what are their procedures for notifying the family for changes in care, etc - how often the residents see their physician.
Something that was important to us was therapy animals (as my MIL was an avid animal lover). Do they have unit cats? Are there therapy dogs that come by for visits? This was one of the big wins for us.
Really, the basic stuff is getting to know the unit staff, the manager, the nurses that will be taking care of her mother, the tech staff etc. Do you get a good vibe off them? or do they seem to not want to talk with you?
Best of luck to you and your friend
posted by Suffocating Kitty at 12:20 PM on March 18, 2014 [3 favorites]
Some of the tests we did -
We ate a meal in their dining room during our interview. It wasn't a special day, and gave us a feel for their flexibility with our requests/what kind of food they served on an every day basis.
We sat in common areas without coats on to see if we felt it was too hot or too cold. (We found that it was WAY too cool to the point all the residents had coats on inside at some places).
We discussed care options - how much of her outside care would be continued, what are their procedures for notifying the family for changes in care, etc - how often the residents see their physician.
Something that was important to us was therapy animals (as my MIL was an avid animal lover). Do they have unit cats? Are there therapy dogs that come by for visits? This was one of the big wins for us.
Really, the basic stuff is getting to know the unit staff, the manager, the nurses that will be taking care of her mother, the tech staff etc. Do you get a good vibe off them? or do they seem to not want to talk with you?
Best of luck to you and your friend
posted by Suffocating Kitty at 12:20 PM on March 18, 2014 [3 favorites]
I have done this two times with two grandmothers and I am in the process of moving my in-laws into assisted living.
Your friend is not abandoning her mother. My Grandma T, after living alone 20 miles from me for 25 years after my grandpa died had to move to assisted living. Once there, she went to sing-a-longs, made new friends, met a man and married him at 90 (because they couldn't "y'know" without being married). She was SUPER-resistant, but she could not survive on her own anymore.
Grandma B moved into assisted living when other grandpa died. She turned 90 last week, she has a million friends, a couple of boyfriends, she plays pan and canasta and bridge and does crafts every day. Frankly, she's kind of having a blast. I see her about once a week, my cousins and sister see her about the same, but we have to make an appointment.
Boredom and inactivity can kill a person - or kill their will to live and even with Alzheimer's or dementia, there is so much more that they can do in a senior community. The place the in-laws are moving to in 3 weeks has daily trips to stores, wine and cheese, movie screenings, scenic drives, exercise classes every day. Due to my FIL's Alzheimer's disease, they've both been completely trapped in their home and they're living with us until the apartment opens up, but frankly, I think they're going to have a blast.
Go look at the activities list. Make it a positive but ABSOLUTELY acknowledge that it's going to be a tough transition which may take weeks or months depending on how social her mom is. Ultimately, if she is at all active, she should be supported fully by the staff and residents in taking part in activities, even with memory loss and communication difficulties.
posted by Sophie1 at 12:22 PM on March 18, 2014 [3 favorites]
Your friend is not abandoning her mother. My Grandma T, after living alone 20 miles from me for 25 years after my grandpa died had to move to assisted living. Once there, she went to sing-a-longs, made new friends, met a man and married him at 90 (because they couldn't "y'know" without being married). She was SUPER-resistant, but she could not survive on her own anymore.
Grandma B moved into assisted living when other grandpa died. She turned 90 last week, she has a million friends, a couple of boyfriends, she plays pan and canasta and bridge and does crafts every day. Frankly, she's kind of having a blast. I see her about once a week, my cousins and sister see her about the same, but we have to make an appointment.
Boredom and inactivity can kill a person - or kill their will to live and even with Alzheimer's or dementia, there is so much more that they can do in a senior community. The place the in-laws are moving to in 3 weeks has daily trips to stores, wine and cheese, movie screenings, scenic drives, exercise classes every day. Due to my FIL's Alzheimer's disease, they've both been completely trapped in their home and they're living with us until the apartment opens up, but frankly, I think they're going to have a blast.
Go look at the activities list. Make it a positive but ABSOLUTELY acknowledge that it's going to be a tough transition which may take weeks or months depending on how social her mom is. Ultimately, if she is at all active, she should be supported fully by the staff and residents in taking part in activities, even with memory loss and communication difficulties.
posted by Sophie1 at 12:22 PM on March 18, 2014 [3 favorites]
Any transition is hard, but the longer a person has been somewhere, the harder it is to move.
There are so many pluses to being in assisted living though, that soon everyone will be very happy with the decision.
There are so many fewer things to worry about. If you don't feel like making dinner, you can go downstairs and enjoy a meal that's already made. There are activities, and if you want company, there are community rooms.
Therapy animals are awesome, at a facility my friend's husband worked at, they adoped a little dog that everyone loved!
Husbunny used to be a nurse on a Memory Care ward. Look for people who seem to be happy where they are. Husbunny liked the work because he saw the same folks for the most part. He knew them and what to expect from them.
Ask how long different folks have been there. Happy staff means happy residents.
posted by Ruthless Bunny at 12:31 PM on March 18, 2014 [1 favorite]
There are so many pluses to being in assisted living though, that soon everyone will be very happy with the decision.
There are so many fewer things to worry about. If you don't feel like making dinner, you can go downstairs and enjoy a meal that's already made. There are activities, and if you want company, there are community rooms.
Therapy animals are awesome, at a facility my friend's husband worked at, they adoped a little dog that everyone loved!
Husbunny used to be a nurse on a Memory Care ward. Look for people who seem to be happy where they are. Husbunny liked the work because he saw the same folks for the most part. He knew them and what to expect from them.
Ask how long different folks have been there. Happy staff means happy residents.
posted by Ruthless Bunny at 12:31 PM on March 18, 2014 [1 favorite]
For better or worse, I've been around lots of nursing homes and the like. A few things:
1. The state will have a list of citations. Take these with a grain of salt. Nursing homes are usually inspected a couple times a year. Some citations are cause for real concern, some are political maneuvering. Be skeptically cautious but concerned about complaints; again, some are founded, some are part of financial schemes or are proven to be false. Obviously, when you are dealing with memory issues combined with very emotional families and caretakers trying to do their best, things can get messy. Abuse is not common though there is much fear mongering; minor neglect because of caretaker burnout is much more common. That doesn't excuse it, but these aren't typically malicious environments. It's underpaid and overworked staff doing an impossible job everyday.
2. Be skeptical of a facility that seems 'too good to be true.' There are lots of seemingly wonderful facilities but, upon further inspection, you realize everyone there is simply too healthy. That's because there are many assisted living programs that will take reasonably financially well off and reasonably healthy older people until those people begin to require too much care, at which time they will be released or transferred to a facility better equipped to handle long-term illness and memory issues. The reality is that any facility with a memory unit or a long-term care unit is going to have some depressing aspects to it. These are not country clubs - they are medical facilities designed to provide 24 hour care to a very care-intensive population. It's important to manage your expectations.
3. Some people do really, really well in nursing homes. Studies have shown that women who go to nursing facilities in their home communities tend to do especially well. So that may be a reason for optimism. They have access to social activities and the like. Often, the stigma of going into long-term care is worse than the reality.
4. Meet the staff. This will tell you a lot. Do they seem caring and helpful? Then they probably really are. Have they been there a long time or has there been tons of turnover? There are nursing home staff who's life work is to care for the elderly - and these folks are amazing. But don't expect every staff member to be this. Just make sure they are kind, caring and attentive to resident's needs.
5. Food is probably the biggest variable. So, try the food. Obviously nursing homes cannot be short order cafes, but they should have reasonable accommodations. The best nutrition services are usually medically based - i.e. carefully weighed in terms of nutrients, calories and so forth and should be much more health oriented than something like a school lunch program. It's typical, for example, for lunch, not dinner, to be the biggest meal of the day. A lot of the food may not look great because it's been prepared with Thick-It or some other swallow-assisting agent. Don't let this turn you off. It's necessary.
6. Ask about programmed activities, outings, service animals, access to the outdoors, etc. These are key aspects to living well for a lot of elderly people. It's not great if the main activity is always watching television.
7. If there are memory issues involved, make sure to understand all of the potential legal and financial complications that may arise.
It is a tough decision, but I have no doubt your friend is making the right one. They should not feel guilt.
posted by Lutoslawski at 1:38 PM on March 18, 2014 [5 favorites]
1. The state will have a list of citations. Take these with a grain of salt. Nursing homes are usually inspected a couple times a year. Some citations are cause for real concern, some are political maneuvering. Be skeptically cautious but concerned about complaints; again, some are founded, some are part of financial schemes or are proven to be false. Obviously, when you are dealing with memory issues combined with very emotional families and caretakers trying to do their best, things can get messy. Abuse is not common though there is much fear mongering; minor neglect because of caretaker burnout is much more common. That doesn't excuse it, but these aren't typically malicious environments. It's underpaid and overworked staff doing an impossible job everyday.
2. Be skeptical of a facility that seems 'too good to be true.' There are lots of seemingly wonderful facilities but, upon further inspection, you realize everyone there is simply too healthy. That's because there are many assisted living programs that will take reasonably financially well off and reasonably healthy older people until those people begin to require too much care, at which time they will be released or transferred to a facility better equipped to handle long-term illness and memory issues. The reality is that any facility with a memory unit or a long-term care unit is going to have some depressing aspects to it. These are not country clubs - they are medical facilities designed to provide 24 hour care to a very care-intensive population. It's important to manage your expectations.
3. Some people do really, really well in nursing homes. Studies have shown that women who go to nursing facilities in their home communities tend to do especially well. So that may be a reason for optimism. They have access to social activities and the like. Often, the stigma of going into long-term care is worse than the reality.
4. Meet the staff. This will tell you a lot. Do they seem caring and helpful? Then they probably really are. Have they been there a long time or has there been tons of turnover? There are nursing home staff who's life work is to care for the elderly - and these folks are amazing. But don't expect every staff member to be this. Just make sure they are kind, caring and attentive to resident's needs.
5. Food is probably the biggest variable. So, try the food. Obviously nursing homes cannot be short order cafes, but they should have reasonable accommodations. The best nutrition services are usually medically based - i.e. carefully weighed in terms of nutrients, calories and so forth and should be much more health oriented than something like a school lunch program. It's typical, for example, for lunch, not dinner, to be the biggest meal of the day. A lot of the food may not look great because it's been prepared with Thick-It or some other swallow-assisting agent. Don't let this turn you off. It's necessary.
6. Ask about programmed activities, outings, service animals, access to the outdoors, etc. These are key aspects to living well for a lot of elderly people. It's not great if the main activity is always watching television.
7. If there are memory issues involved, make sure to understand all of the potential legal and financial complications that may arise.
It is a tough decision, but I have no doubt your friend is making the right one. They should not feel guilt.
posted by Lutoslawski at 1:38 PM on March 18, 2014 [5 favorites]
Medicare.gov has information on nursing homes here.
Pro Publica did an excellent (though horrifying) series of articles about assisted living; the most immediately useful article to your friend will be this article on what to ask when looking at assisted living facility, though you might want to just copy the article itself into an email to your friend if you don't want to scare her more with the other articles in the series.
Also, it is useful to find and familiarize yourself with the nursing home bill of rights for your area, if there is one.
posted by carrienation at 9:18 PM on March 18, 2014
Pro Publica did an excellent (though horrifying) series of articles about assisted living; the most immediately useful article to your friend will be this article on what to ask when looking at assisted living facility, though you might want to just copy the article itself into an email to your friend if you don't want to scare her more with the other articles in the series.
Also, it is useful to find and familiarize yourself with the nursing home bill of rights for your area, if there is one.
posted by carrienation at 9:18 PM on March 18, 2014
Ask what the staffing is on the weekends. The place my father-in-law is in cuts their staffing on the weekends at night to where there are only two nurses on-duty to cover the needs of the entire facility. This results in long delays for things like scheduled bathings, medication, etc. It also results in undue delays in the case of a resident needing emergency help. Unfortunately, this seems to be the norm for facilities in our area that provides the level of care he needs.
posted by Thorzdad at 7:02 AM on March 19, 2014 [1 favorite]
posted by Thorzdad at 7:02 AM on March 19, 2014 [1 favorite]
Like Lutoslawski, I've seen the good and the bad. Seconding in capital letters to make sure that the facility is well staffed, and that the staff they do have seem happy and productive. I can't stress this enough. An overworked, under-appreciated staff will not be able to give the best care possible. Happy, dedicated, appreciated staff give the best care.
posted by Grlnxtdr at 1:31 PM on March 19, 2014
posted by Grlnxtdr at 1:31 PM on March 19, 2014
I don't know the financial situation of the parent, so please forgive me if none of this applies...
Does the facility the parent is moving to accept Medicaid? That's a big question to ask.
These places charge astronomical fees, which can quickly deplete the savings and income of even the best-prepared senior. Costs can easily run $4000-6000 a month, or more, depending on the services required. Once a senior's savings have dwindled below their ability to pay the costs, they usually end up applying for Medicaid. Unfortunately, it's a very rare facility that accepts Medicaid, and the ones that do often limit it to just a handful of beds in semi-private rooms.
If the place doesn't accept Medicaid, ask what their procedure is for a resident who can no longer afford to stay. Do they help them find a Medicaid facility? Or do they just cut them loose and let the family fend for themselves?
posted by Thorzdad at 1:51 PM on March 19, 2014
Does the facility the parent is moving to accept Medicaid? That's a big question to ask.
These places charge astronomical fees, which can quickly deplete the savings and income of even the best-prepared senior. Costs can easily run $4000-6000 a month, or more, depending on the services required. Once a senior's savings have dwindled below their ability to pay the costs, they usually end up applying for Medicaid. Unfortunately, it's a very rare facility that accepts Medicaid, and the ones that do often limit it to just a handful of beds in semi-private rooms.
If the place doesn't accept Medicaid, ask what their procedure is for a resident who can no longer afford to stay. Do they help them find a Medicaid facility? Or do they just cut them loose and let the family fend for themselves?
posted by Thorzdad at 1:51 PM on March 19, 2014
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posted by Riverine at 12:20 PM on March 18, 2014