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The regs differ from state to state. This was explained to us by someone from A Place for Mom which is a service ((paid for by the care homes) who will visit your parent and give you advice about what might be appropriate and cost effective. In new york, if your parent needs two people to assist them with a transfer, they can only be cared for in an NH. In the neighboring state of Connecticut, that's allowed in Assisted Living.
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I also think the terminology differs by what part of the country you live in. "Assisted living" vs "nursing home" vs "memory care" are sometimes used interchangeably. Someone may say "assisted living" when technically it's a nursing home.
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Also, assisted living facilities are less costly than a nursing home. All are very expensive anyway. Sometimes you can find an adult family home that will provide adequate care for less $. In assisted living "exit seeking" (running away from home) is a big no-no, as is physically assaulting other residents. Usually folk in assisted living either have mobility or mental issues that prevent them from living independently. Nursing homes are for more debilitated residents and are sometimes reimbursed by Medicare (if hospitalized for a set # of days prior to admission) for a brief period of time. Either one can wipe out a fortune in no time.
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I might also add that in NC there are Assisted Living Memory Care units who do provide more hands on assistance to the resident than a regular assisted living facility. They are also secure facilities. They monitor the resident and help them with all care to varying degrees, as long as the resident doesn't need feeding tubes, IV meds, etc.
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In Assisted Living, the resident must be able to get to the dining hall and back to their room without getting lost. They must be willing and able to follow directions from staff without being verbally or physically assaultive. They cannot be bowel incontinent. Ok if they wear Depends as long as they can change their own. They must not wander off the premises, this is not a locked door facility. Care is provided by LPN's and CNA's.
Nursing Homes accept patients who are bedridden, who have IV meds or feeding tubes, who cannot clean or dress themselves or cannot feed themselves. NH provides 24/7 care with RN's and a supervising MD.
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