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Also known as
"Board and Care Homes", "Personal Care
Homes", "Adult Foster Care Homes",
"Residential Care Homes", "Group Homes",
"Domiciliary Care Homes", "Family Care
Homes", these residences are designed to help seniors
who do not need to live in a nursing home, but who do need a
certain amount of help with daily tasks such as bathing,
dressing, preparing meals, housekeeping and laundry, or taking
medications.
Assisted living
residences come in all shapes and sizes. There may be a house
down the street that is home to one or more elderly people. The
big new place just down the road may house more than 100, with
retirement apartments and a nursing home on the grounds.
What all assisted living
residences have in common is that they are non-medical
facilities, although many have a nurse on staff or on call. If
your elder has reached the point where she is no longer able to
live alone safely, but she could get along fine if someone were
there to give her a little help, then assisted living might be
the answer.
Often loneliness is a big part
of an elder's life. Loss of a spouse and old friends, even pets,
can be devastating. The opportunity to socialize at meals or
during activities adds a new dimension to living for someone who
has been isolated and lonely.
Licensing For Assisted
Living
There is no
national oversight of assisted living, like there is for nursing
homes. As the number of residences increases there has been
considerable notice taken, and the states are now beginning to
license these facilities under a variety of names (see above).
Some states are now publishing lists of licensed facilities on
the internet.
Assisted Living Costs
Fees for
assisted living are usually lower than for nursing homes, but
higher than for simple board and care homes with fewer resources
and amenities. Fees will depend upon the cost of the care
provided (meals, housekeeping, personal assistance), the size of
the room and whether it is private or shared with another
resident, and, of course, the costs associated with building and
maintaining the facility.
Some assisted
living facilities charge an all-inclusive fee which is usually
based on the size of the room or apartment. This arrangement
makes it easy to calculate your budget, because there will be no
increases as the need for help grows. On the other hand, you may
be paying more in the beginning, when the need for help is less.
Other assisted
living facilities offer a basic package (sometimes called the
"base" level) and add charges to cover additional
services. You will pay less in the beginning, but your costs
will increase as needs increase. Ask which system they use, and
how fees are calculated. How much notice will you have if an
increase is necessary? Will you be charged an additional fee if
your elder is ill and needs to have a meal delivered to the
room?
There is no
national standard for how assisted living fees are calculated.
In addition to the daily or monthly rate, there may also be a
one-time deposit, or "entry" or "assessment"
fees, and deposits for pets, smokers, electric wheelchairs or
scooters.
Assisted living is usually privately paid, although many
long-term care insurance policies cover assisted living.
Medicare does not cover assisted living. Some states have a
Medicaid nursing home waiver program that may cover assisted
living services in selected facilities. These programs have
strict income and asset requirements. They often have long
waiting lists, so the Medicaid waiver programs are not generally
an option if you must make a move quickly.
Finding an
Assisted Living Residence
There is
absolutely no substitute for a personal visit. Several personal
visits. Your own eyes and ears, and the answers you get to your
questions, are the best way to select an assisted living
residence.
Ask the people
you know for recommendations. You might be surprised how many
have had experience with the various facilities in your
area.
There are
several directories on the internet. Some will sell you
"evaluations" of facilities that in reality are little
more than summaries of health department or state inspection
reports that are available to you at little or no cost. Beware
of purchasing an evaluation unless you can be assured that a
representative has actually visited the facility more
than once.
Some web
directories or referral agencies have contracts with facilities.
They will refer you to the facilities that pay them a referral
fee. If a website is offering "free placement
assistance," this is how they are being paid.
There's nothing
wrong with that as long as you know up-front how the deal works.
If you decide to use a free referral service your best bet is to
read up a bit about assisted living so you can ask the right
questions about the facilities they are recommending.
The
Insider's Guide to Assisted Living gives you all the
questions you'll need answers to before you make a decision.
Of course,
your best bet would be to consult with a local
specialist who has direct
professional knowledge about the places you might be
considering. An experienced professional will be able to tell
you whether a specific residence is right for your particular
elder's personality and needs. If you're looking in the Dallas,
Texas area give me a call at (972) 395-7823. I can help you
locate the best choice for your individual needs. The cost of a
private consultation is significantly less than the cost in
time, expense, and anxiety for both you and your elder loved one
if you make the wrong choice.
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