As many of us who are deeply involved with care transitions know, everyone has there own opinions about what type of care is best. Usually those giving the strongest opinions coincidentally own or be work for the very type of business they are touting. In the end it's really up to the family members and person needing care to fully understand the different options and decide for themselves which is best. In the case of housing and more specifically the decision between Assisted Living and Nursing Homes, the question really comes down to the level of care required.
At the most simplistic level, many residents and family members sometimes fail to understand the fundamental differences between assisted living homes and nursing care facilities.
Choosing the right facility for you or for a loved one who can no longer live on his or her own can be a difficult experience. Many seniors who are reluctant to go into a nursing home environment may be more amenable to assisted living, but need to understand the limitations on the care that will be provided in these facilities. A failure to understand the differences and a failure to move on from assisted living into a nursing home setting when necessary can have devastating consequences.
A recent documentary told stories of several patients who receive improper supervision and care in an assisted living environment. In one example an assisted living resident died from consuming industrial strength dishwashing liquid that the facility did not have properly secured. Another patient with dementia left the facility and froze to death.
The stories of these patients raise questions about why the proper care was not offered to prevent these awful tragedies in the first place. Unfortunately, the fact is that assisted living facilities are not the right setting for patients whose medical conditions have developed to the point where they require advanced medical help and supervision.
Assisted living facilities offer a home-like independent environment where residents may have their own apartments or their own units or may live in a hotel-like setting. The services and amenities offered at each facility will vary, but usually there is housekeeping service provided, grocery service provided and some type of food service and/or transportation assistance. Individual units may have their own bedrooms, bathrooms, living areas and kitchens and residents may largely care for themselves with minimal aid provided by staff members. While there may be trained medical staff on site to assist with certain medical needs, such as administering medications, there is typically no regular nursing care offered.
The regulation of assisted living facilities is set on an individual state level and typically there is less oversight and less control over these facilities than for nursing homes. Medicare and Medicaid typically do not cover assisted living facilities either, so unlike nursing homes that must meet baseline standards to continue to be a qualified Medicare/Medicaid facility
Those who choose to live in an assisted living environment, therefore, should be aware that they will receive some assistance but not generally advanced medical care or supervision. It is important to do research on the specific services provided by the facility to ensure that it will meet the needs of the senior. It is also essential to ensure that once a senior’s health condition deteriorates to the point that more medical help or supervision is necessary, that the senior moves to the right type of facility.
Once a senior has decided on the appropriate setting, it's important that family members continue to check-in and monitor the health condition of relatives in all care settings, including assisted living facilities to ensure that seniors are transitioned when it becomes necessary for their health and safety.
More education, awareness and transparency must be provided to all those looking at Assisted Living versus Nursing Care options (and for that matter all levels of post-acute care). As someone who spends 100% of my time in this space and industry, I cannot tell you how often I meet people who just don’t understand these fundamental differences. But who can blame them?
Frankly, nobody wants to think about care transitions until they have to. One day an event happens, whether it is mom falling, dad having a massive stroke or a friend or close acquaintance who goes through “the event” and then needs care eminently. Though, often at that moment, it is too late and a mad dash ensues to figure out any options. When this happens it can be easy for people to make rash decisions without understanding all the key issues and differences. It's our duty to continue to educate and provide more information to consumers so that we can avoid some of the tragedies that may then occur.
Please share any of your personal experiences and/or feedback in the comments section. Let’s keep this discussion going!