Each AL has their own protocols in place. My father was a 1 person assist and accepted at the 2 ALs he lived in. When he became a 2 person assist is when the issues began. But, with hospice on board, dad's AL was fine with keeping him until he passed, even being a 2 person assist.
Check the ALs in your area. Each elder must be evaluated to see if they are determined to be in able enough condition to live there.
Not for most ALF, no. At least not for my brother's. But the care level for someone w/c bound with need for transfer would be quite high. This often requires two caregivers and with some frequency.
For all of these things it is best to discuss disabilities of ANY kind with the facility itself, and to request a list of care levels and what they consist of, and cost.
It varies according to state regs as well. In Connecticut, you can be a two person assist and still be in AL while in neighboring New York, only NHs are able to admit 2 person assists. At least that was the case in 2013.
There are always exceptions and rules vary. What matters is what you need and who will provide it. People going into ALFs are in transition. The manpower is more limited in ALF than a NH. My DH aunt went into an ALF while bedfast. She’s a small woman, was on hospice, had an aide daily. So there are many factors that might make a difference in a decision to accept a patient or not.
If you checked out a couple of places and get the same response then your answer comes from your state scope of practices. If you are close to a state border then you can compare. Usually, the facilities that take a higher level of care will also have a higher cost
We had an uncle in assisted living with advanced Parkinson’s. When his caregiving needs got intense, involving having to be fed for every meal, and a two person assist for every transfer, the assisted living place kept him while fully admitting it was beyond their scope of care. This happened because the family had shown up daily, gotten to know the staff, and befriended them. They were liked there and uncle was a kind, cooperative man. Your basic answer is “depends on the place and the regulations” but having a cooperative, well like resident and family can make a big difference as well
If you are looking at a specific facility ask what their regulations are. Most if not all AL and most MC can not use equipment to transfer a person. The use of equipment is regulated in Skilled Nursing. This is a safety precaution for both the staff and the resident. It may also depend on how much help a person needs to transfer. If it is minimal help that is different than a staff member doing all the work during the transfer. Might actually depend on if the person is a 295 pounds or 105. And if this is a 1 or 2 person transfer. Not a good reason or excuse but reality ....With the staffing shortage if 1 or 2 staff persons have to help 1 person 5, 6, 7 times a day that is taking time that other residents may need help.
I have dealt with 3 different ALs here in MO with my in laws and my parents. They all accept 1 person transfers, if they needed 2 they had to go to skilled. The facility my father is still in does both AL and SN, so when mom went from a 1 to 2 person she was able to stay there, but under skilled, at an increased cost, of course.
No.. Like many young people, she thinks independent living and assisted living are the same thing. People who need permanent help with transfer are not accepted for independent living. It is a good idea to review the policies of the facility though to determine if the facility you have in mind delivers the services you need.
People who cannot independently transferred usually don't meet the criteria for assisted living either. Usually people who cannot transfer independently are placed in the board and care section of a nursing home. They don't necessarily need skilled nursing care, but they do need invalid care (transferring with assistance, diapering, feeding, bathing, etc...).
I believe she may be correct. If someone cannot stand up, pivot and then take a step to get on a toilet or into another chair, etc, then it requires 1 or 2 people to safely lift them up and get them where they need to be. Unfortunately, assisted living is not staffed to accommodate those needs. AL can give meds, wash your clothing, provide meals in a dining room setting (that you have to be able to get to) arrange group outings to the store, etc. If someone need hands on care, they probably need a nursing home and maybe skilled nursing depending on what other issues are going on.
That information is based on my experience at my moms previous assisted living facility. There may be other AL's that provide different levels of care than the one mom was in.
It depends on the facility. My mother was in a small memory care. She was a one person assist in the beginning. When she progressed to a 2 person assist, they kept her. They had quite a few 2 person assists. They were definitely more lenient than most places. She was there for 4 and a half years.
It depends. Most assisted living facilities do not take residents who cannot transfer themselves, are invalid, or whose dementia has regressed them back into a toddler who needs 24 hour supervision.
Assisted living means there are staff who will 'assist' a resident with certain ADL's like meals, housekeeping, laundry, medication supervision, and hygiene. Not provide total invalid care for a person who can't even get up on their own.
I was a supervisor at a very nice AL some time back. Our citeria for residence was that a person had to be able to walk without assist of another person and we did not allow wheelchairs. Walkers or canes were fine. A resident had to still be using a toilet without assistance. An actual toilet because we did not allow bedside commodes. No one who was diaper-dependent was allowed to move in, or stay if they became so. If you used a pull-up or pad for extra security that was fine. Residents had to be able to properly dispose of these things in their own. We had residents with dementia, but when it progressed and the resident no longer met our criteria for residency, they had to go.
This is how most assisted living facilities operate.
At the nursing home my mom and aunt is in she didn’t have to have a car to drive . They have a bus that takes them . Now they do charge for the bus rides to drs apt in assisted living . You would have to check with whatever assisted living you are looking into,
Lots of info here, but in reality is really depends on your specific State laws and regulations as both independent living and assistive living (most "memory care" (MC) units too if NOT Medicaid approved) are for the most part ONLY state regulated. Albeit there are a few State AL programs that are "Medicaid eligible" and some skilled nursing homes (SNFs) that are both Medicare and Medicaid approved have "memory care units" within them). SNFs and Post Acute Care Rehab facilities that are Medicare and Medicaid approved are regulated by the Feds and they can handle folks that require help with transfers.
Some IL, AL, and MC facilities will indeed handle/accept folks who need some help with transferring, but this REALLY depends on 1) your state laws/rules for what each entity "must" do, 2) what they are licensed to do or NOT do, 3) and their contracts. For example, some ALs that are more "group home" oriented (they take maybe 5-8 residents; may provide some "transfer type" help for "major things, like bathing" but nevertheless one still is expected to be able to transfer to the bed, toilet, to chairs, etc....
All to say, start first with your State (the State where you LO will be placed) so that you have a clear understanding of what each entity is licensed/required to do or NOT. Also, be aware that most AL are private pay and once one runs out of funds OR needs more help (such as more help with transferring or more medical help beyond "medication management"), then one is generally looking at long term skilled nursing home care and potentially moving to Medicaid to pick up the bill after "spending down."
Where we live (east coast urban area) the group home ALs, are about $10K month (private pay). Nice places but NOT much in the way of amenities (like no private bath) and there are "lights out policies" so NOT like one is in their own apt., you get a room. The nice AL that are more apt-like with private baths and you do your own thing in your apt (no lights out) but there are helpers if you need assistance to get to the dinning hall, there are activities, there is laundry/cleaning services, and medical management is about $18K a month for a one bed, one bath.
SNK is about $15K a month, but w/a SNF and one is on Medicaid one may not have a private room. In a SNF, you typically have a roommate if on Medicaid. And in a SNF they handle all ALDs and medical care, plus food, cleaning, activities. SNFs are really for those who need a lot of help and medical care; help with bathing, dressing, feeding, transferring, regular medical help (perhaps oxygen, wound care, IVs,) and/or who have lots of cognitive decline/dementia that it is no longer safe for them to be even in a group AL home, much less their own IL or AL/senior apt....
Good luck with this. It is so confusing as each State is totally different if one is NOT looking at entities regulated by the Feds (SNF or Rehab).
Medicare doesn't pay for assisted living, nursing homes, or memory care. Medicare pays for a person to have some rehab days in a facility. They do not pay when that person becomes long term.
Most AL's have a "lights out policy" and the doors got locked at 8pm. If a resident was going to be staying out past that time they had to let us know.
Even though they had all these rules, the residents didn't follow them. Quite a few of the AL residents I knew liked to party at night. There'd be drinking and cards going on in someone's room. The old-timers used to order pay-per-view sporting events and have a party in their room for that. Everyone just brought a chair. People had dates their rooms private dinnesr delivered from the outside. Those old people kept it lively. There would always be some old biddie who would snitch to the administration during the day, but it didn't do any good.
Ask administrator. Facilities offer different amenities and services. Likely different in each city / county.
If I were you, I would create a 'worksheet' so you can more easily compare after doing your research:
Get a file and/or binder
Date Facility (address) Spoke to (name, title) - Phone (they may have direct line Specific re transfer(s) Other services (i.e., transportation) or 'see brochures' - keep in a file or binder. Taking new residents ? ( ) yes ( ) no waiting list ( ) yes / ( ) no Cost: ( ) studio ( ) shared room ( ) ______________
The key is to be organized so tracking your research will help. I design / develop forms / offer organizational management ... so this works for me.
In TN we have a "13 min rule" that came about as a result of getting aged residents out of the facility in a timely manner. Some assisted living facilities are able to house a small percentage of residents who are on hospice, but don't usually admit the same. these hospice patients are the few that are aging in place at the ALF. Each state is regulated differently; see your specific state's regs. The ability for one to be able to transfer from bed to chair, etc is twofoild: 1. Resident needs to escape in timely fashion 2. Appropriate level of care placement
Ifm, this question needs to be addressed to the facility. I am in Arizona and our AL facilities have so many different criteria for each one, it's not regulated so they tend to fill a need at the time they open.
My personal experience, I have known a woman that was paralyzed from the neck down, due to a fall and she was in AL with the highest level of care they offered. I have also known a man that had to move from his AL when he needed incontinence care. Crazy making.
This is why I say speak to the facility because they can offer any care they choose and it seems to be all over the place.
If you have a loved one needing facility care, I highly recommend, calling the local counsel on aging and get a needs assessment done. This will help you find the correct care.
Best of luck, this is never easy and having no standards in care for AL makes it even more challenging.
Check the ALs in your area. Each elder must be evaluated to see if they are determined to be in able enough condition to live there.
For all of these things it is best to discuss disabilities of ANY kind with the facility itself, and to request a list of care levels and what they consist of, and cost.
Best of luck.
The manpower is more limited in ALF than a NH.
My DH aunt went into an ALF while bedfast. She’s a small woman, was on hospice, had an aide daily. So there are many factors that might make a difference in a decision to accept a patient or not.
That's unusual about where your uncle was because it would pose an issue with their liability insurance coverage.
It may also depend on how much help a person needs to transfer. If it is minimal help that is different than a staff member doing all the work during the transfer. Might actually depend on if the person is a 295 pounds or 105. And if this is a 1 or 2 person transfer.
Not a good reason or excuse but reality ....With the staffing shortage if 1 or 2 staff persons have to help 1 person 5, 6, 7 times a day that is taking time that other residents may need help.
I also agree it depends on factors mentioned by others.
They don't necessarily need skilled nursing care, but they do need invalid care (transferring with assistance, diapering, feeding, bathing, etc...).
That information is based on my experience at my moms previous assisted living facility. There may be other AL's that provide different levels of care than the one mom was in.
person assist in the beginning. When she progressed to a 2 person assist, they
kept her. They had quite a few 2 person assists. They were definitely more
lenient than most places. She was there for 4 and a half years.
Assisted living means there are staff who will 'assist' a resident with certain ADL's like meals, housekeeping, laundry, medication supervision, and hygiene. Not provide total invalid care for a person who can't even get up on their own.
I was a supervisor at a very nice AL some time back. Our citeria for residence was that a person had to be able to walk without assist of another person and we did not allow wheelchairs. Walkers or canes were fine. A resident had to still be using a toilet without assistance. An actual toilet because we did not allow bedside commodes. No one who was diaper-dependent was allowed to move in, or stay if they became so. If you used a pull-up or pad for extra security that was fine. Residents had to be able to properly dispose of these things in their own. We had residents with dementia, but when it progressed and the resident no longer met our criteria for residency, they had to go.
This is how most assisted living facilities operate.
Some IL, AL, and MC facilities will indeed handle/accept folks who need some help with transferring, but this REALLY depends on 1) your state laws/rules for what each entity "must" do, 2) what they are licensed to do or NOT do, 3) and their contracts. For example, some ALs that are more "group home" oriented (they take maybe 5-8 residents; may provide some "transfer type" help for "major things, like bathing" but nevertheless one still is expected to be able to transfer to the bed, toilet, to chairs, etc....
All to say, start first with your State (the State where you LO will be placed) so that you have a clear understanding of what each entity is licensed/required to do or NOT. Also, be aware that most AL are private pay and once one runs out of funds OR needs more help (such as more help with transferring or more medical help beyond "medication management"), then one is generally looking at long term skilled nursing home care and potentially moving to Medicaid to pick up the bill after "spending down."
Where we live (east coast urban area) the group home ALs, are about $10K month (private pay). Nice places but NOT much in the way of amenities (like no private bath) and there are "lights out policies" so NOT like one is in their own apt., you get a room. The nice AL that are more apt-like with private baths and you do your own thing in your apt (no lights out) but there are helpers if you need assistance to get to the dinning hall, there are activities, there is laundry/cleaning services, and medical management is about $18K a month for a one bed, one bath.
SNK is about $15K a month, but w/a SNF and one is on Medicaid one may not have a private room. In a SNF, you typically have a roommate if on Medicaid. And in a SNF they handle all ALDs and medical care, plus food, cleaning, activities. SNFs are really for those who need a lot of help and medical care; help with bathing, dressing, feeding, transferring, regular medical help (perhaps oxygen, wound care, IVs,) and/or who have lots of cognitive decline/dementia that it is no longer safe for them to be even in a group AL home, much less their own IL or AL/senior apt....
Good luck with this. It is so confusing as each State is totally different if one is NOT looking at entities regulated by the Feds (SNF or Rehab).
Most AL's have a "lights out policy" and the doors got locked at 8pm. If a resident was going to be staying out past that time they had to let us know.
Even though they had all these rules, the residents didn't follow them. Quite a few of the AL residents I knew liked to party at night. There'd be drinking and cards going on in someone's room. The old-timers used to order pay-per-view sporting events and have a party in their room for that. Everyone just brought a chair. People had dates their rooms private dinnesr delivered from the outside. Those old people kept it lively. There would always be some old biddie who would snitch to the administration during the day, but it didn't do any good.
Likely different in each city / county.
If I were you, I would create a 'worksheet' so you can more easily compare after doing your research:
Get a file and/or binder
Date
Facility (address)
Spoke to (name, title)
- Phone (they may have direct line
Specific re transfer(s)
Other services (i.e., transportation) or 'see brochures' - keep in a file or binder.
Taking new residents ? ( ) yes ( ) no
waiting list ( ) yes / ( ) no
Cost: ( ) studio ( ) shared room ( ) ______________
The key is to be organized so tracking your research will help.
I design / develop forms / offer organizational management ... so this works for me.
Gena / Touch Matters
1. Resident needs to escape in timely fashion
2. Appropriate level of care placement
My personal experience, I have known a woman that was paralyzed from the neck down, due to a fall and she was in AL with the highest level of care they offered. I have also known a man that had to move from his AL when he needed incontinence care. Crazy making.
This is why I say speak to the facility because they can offer any care they choose and it seems to be all over the place.
If you have a loved one needing facility care, I highly recommend, calling the local counsel on aging and get a needs assessment done. This will help you find the correct care.
Best of luck, this is never easy and having no standards in care for AL makes it even more challenging.