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How do you get families to understand that independent living is just what it says it is? There are no services in these types of facilities and the staff is not in the capacity to monitor whereabouts, medications or anything else. Families are responsible for their loved ones and their needs unless they are in assisted living etc. A big frustration of mine is families depositing their aging loved ones and not wanting to listen when I tell them more services or a different facility is needed. I would love some insight on why this happens and how to get through to them.

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churchmouse, if you have a communicable disease, you simply are not allowed to move in. That's NY state health law, it's not up to the facility. Gosh, I can remember when you needed a blood test for syphilis before you could get a marriage license in NY. That test is gone, but now they test for sickle cell anemia in high risk groups. You watch, pretty soon they will test for Zika.
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I think some did not understand that these are not private pay that are full or market priced. Some are subsidized by the Federal Government in one way or another. Ex: tax credit
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Just curious about that last point - prurient curiosity, I admit - what if he has? You can get barred from an ALF for having genital warts???
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staceyb-- Most assisted living places do their own assessment. Go for a tour and ask some questions. Allow them time to speak with him, try not to answer for him. They will also have a form for the MD to fill out. Just a heads up--his doctor has to certify that Dad has no "communicable diseases" which is a polite way of saying gonorrhea and syphilis or genital warts or HIV/AIDS.
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All of this is great information, however I am now doing my pre research into this exact scenario for my LO, and it clearly shows, that I absolutely must have him evaluated by a Geriatric Dr, or who? Who would be the best person/professional, to have my FIL evaluated, before I place him into a Senior Living facility? I really need your feedback on this, as I'm concerned about his safety and ability to manage in Independent or Assisted living on his own. Thanks you all!
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Delaware claims they do a "brief period of assessment" prior to independent living approval. WEA2016 should be able to insist on seeing that document or ask her employer to establish a policy requiring the applicant to have the "brief period of assessment" as outlined by the Office of Independent Living.
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Genuine question: how is it not up to you to decide the criteria for admission? Who sets the standard, then?
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Churchmouse-That's just it if they qualify by income, age or disability we can't reject them even if it is obvious that they are barely able to care for themselves at the point of move in. We can't and don't evaluate to make that determination. Another function that is up to the family. I have made many a call to the Health and social services agency in our state to have someone evaluated because my pleas are disregarded and a resident's well being is not be attended to. That is the only thing I find that forces them to react/respond to the situation.
CWillie-We do exactly that we tell prospective residents there are NO services. It seems to go in one ear and out the other. If a resident needs to move to Long term care or assisted living I gladly let them out of their lease regardless. What sense does it make to keep them when they can't fend for themselves just to collect rent and not have a vacancy???
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My apologies to you, Churchmouse- for taking the heat that should have come to me. I was the one who mentioned a little TLC. However, Churchmouse made my point for me in her reply - and that is - if there is no extra attention, why on earth are the residents paying two to three times the rent for a comparable apartment elsewhere and what's the point it calling it anything different. The difference in title and hefty rent implies if nothing else - more. I'd hate to think it's all just a scam to get into the pocketbooks of already frighten seniors and their equally frighten families.
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We chose independent living for my inlaws because we needed an environment that was designed and built for aging in place. Our IL is fully ADA compliant and has important safety features inside the apartment. The staff have gotten to know their habits and preferences, and go out of their way to make residents feel special. Our IL includes meals in the rent, which is a huge relief, because each of my inlaws needs 1,000+ balanced and nutritious meals each year. Had we not found this IL, my inlaws still would have needed to move because their home was not working for them and it was only going to get worse.
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Absolutely right Veronica! If all an apartment complex offers is age restricted housing then there is little justification for the increased rents they charge. Even if the complex management does not provide extra care they should have a relationship with outside service providers that can be recommended as needed.
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What is the reason for independent living if there is no supervision? i understand it is a means of downsizing the elders living arrangements but at what cost?
Why not just move the loved on into a senior apartment until they do actually need help. It is probably cheaper and may even have the rent subsidized. A phone call once or twice a day and visits to take the person shopping or bring supplies may be all that is needed in the beginning. Adding a lifeline pendant if the facility does not have an emergency call button is helpful and getting such services as meals on wheels or county health services where available. All of these things exist where I live and one of the local pharmacies will deliver drugs and basic food supplies. A local bus service is also available which is handicapped access able to go to places like Walmart. This is all in a small city in upstate NYS. Our hospice had several patients who were able to remain in this accommodation till the end of life.
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I have often said that more important than giving prospective residents a list of the amenities of their new home, be it IL or AL, would be a list of things NOT covered. And someone should take the time to go over this point by point at the time contracts are signed so there can be no excuse for lack of understanding.
Another thing that I see as a problem is that long term residents are not reassessed as often as they should be. It has also been my experience that sometimes management will keep a resident who should have a higher level of care because they don't want a vacant room, a problem in some of the older buildings because people opt for the newer options.
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? I don't think I said anything about TLC, did I...? Not that it matters.

I completely understand that it must be frustrating when people visit your facility, see what it comprises, and then stubbornly close their eyes and move their frail, dependent elders in there anyway.

But you were asking why. And one reason is that the elder won't consider anything that involves a higher level of care = interference in their freedom of action; another is wishful thinking; another is desperation, as in "placement comes first"; yet another is cost. What it all amounts to is false economies and short-term thinking; and yes, it must leave you all too often with your heart in your mouth about how you're going to cope with these people, and your heart in your boots about the kind of conversations you'll be facing with the relatives when it all goes belly-up.

Having said that, what can you do at your end to reject applications from obviously unsuitable candidates? Do you use some kind of formal assessment?

After all, there must be distinctions to be made between Independent Living and bog-standard rental accommodation. Otherwise what's the difference between you and any other landlord, and what's the point of calling it anything?
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Hi Everyone,

Here's my question to Churchmouse-How can you expect a little extra TLC for your loved one when you know going in that it is IL and there are no services? It's not that they don't deserve it but if you want them to have someone to do those "extra things" for them then why not make sure they are somewhere that provides those services?

The answer to the question about it being the norm, it's solely depends on what the owners of the property have it structured as. So there is no norm per se. We have the emergency pendants as well. Some residents don't wear them and we wind up getting a call to check on them and find them on the floor where they've been for hours or days or worse. Some (my IL )apartments are not staffed to be nursing homes, or assisted living facilities. There are no nurses, no doctors, no social workers- nothing. It's frustrating and unreasonable to me that the expectation is there with a staff of three...me, my part time assistant and 1 maintenance person that we provide services. It's not going to happen. Mind you I do help by checking on residents if I get a call of concern, help them find services for utility assistance etc when I can, but bottom line with what my regular responsibilites are I can't do it for everyone let alone on a daily basis. I even find myself acting as a referee when tiffs occur between residents!!

I had a daughter of a resident get angry with me for telling her that he mother is her responsibility and that she needs to check on her more often. Once every few days is not enough. Especially when they are over 80 and ailing. I was seeing signs of problems probably caused by medications she was on. Despite the fact I am not a nurse there are many things that are just common sense. It doesn't take a rocket scientist to recognize when someone is in pain or declining. If I come to you, a family member and tell you what I have observed it's because I care. She ultimately had to come back and apologize for what she said to me. She found out I was right and she almost lost her mom behind being stubborn/hard headed. This is a regular occurrence.

I am only there 8 hours a day, I don't track anyone's whereabouts, medications or anything else. I even have some people showing signs of dementia/alzheimers and talking to their family members is like talking to a brick wall. The fear I have of them wandering away and God knows what happening overwhelms me, but what can I do my words fall on deaf or selectively deaf ears.

The only way to guarantee that they will have someone to do those things they need is to have them move to assisted living because it is just what it says it is assisted living.
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I have to say the same attitude applies to assisted living, families assume everything is taken care of so they can just go on their merry way. Meanwhile mom can't get to the store to buy her toothpaste and incontinence supplies, dad isn't taking his medication because the contract says he manages on his own, Mr Smith hasn't any pants left because he threw them all away when he had "accidents", and the hospital has discharged someone back to the AL because they think there is care available... yeah, one or two warm bodies on the night shift, and one of those is working in the laundry.
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Before my inlaws moved to their independent living building they went there for a respite stay. They were evaluated by a nurse before being accepted as permanent residents.

Although my MIL has a neurodegenerative illness, my FIL is capable enough for them to be living there. We hired my MIL a helper, which she would have needed regardless of where they were living.

We have a big family and I think that reassured the IL's Director because he knew my inlaws have a big support system. We're all hoping they will get to live out their days there. We are realistic, willing to assess their situation, and hire more help as it's needed.

We chose IL because my inlaws needed a safe environment that was ADA accessible and had services like meals. If someone goes into IL thinking it's AL-lite, that's a bad match.

Do you work at an IL?
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One IL I looked at, if they didn't see the Resident at meal time, they would come looking for you. Most IL's there isn't anyone to take care of you if you get the flu etc or give meds. Where my mom finally went, there is IL, AL, MC LTC in one facility. My mom just made the transition from AL to LTC.
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Still thinking about this question but in the mean time I'd like to turn it around just a bit and ask you one, WEA2016. My parents had a two bedroom/two bathroom apartment in a large continuing care retirement community. As I noted above it came with a once a week housekeeper and alarm pendants - there was also a $230 monthly dining room credit that reset each month, no carry-over. Five years ago my parents paid $3,500 a month rent. Anywhere else in our city except for the waterfront this apartment would have gone for $1,000 a month - tops. So why shouldn't it be expected that a little extra TLC from staff be the norm?
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My parents IL place came with "I've fallen and I can't get up" pendants and a weekly housekeeper - things they could have had in their house. But there also was a procedure in place for someone to check in on them if their toilets hadn't been flushed by a certain hour in the morning- no kidding.
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I hope this won't sound cynical, but I think one reason is that families use IL as the thin end of the wedge when their loved ones are resistant to any kind of change. "Your own front door, come and go as you please, help is there if you need it but not if you don't..." [Loved One thinks "good 'cos I don't. Not Me."] You can big it up as a kind of full-service apartment.

So it can be a first step in getting consent to leave their family homes and move into a place where at least somebody will notice if they're lying outside their front door. Whereas if you try whisking them, whammo, into a full-on care environment they will fight it tooth and nail until the day comes of the broken hip and no choice at all about where they get carted off to.

But are you running or working in an IL facility where there is no option to scale up the level of assistance? I'd have thought that continuing care is becoming the norm, isn't it?
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In my area, before someone is allowed to even move into Independent Living, that person is assessed to be sure he/she can manage on their own.

My Dad is lucky to be in an independent living facility where there is optional care available at an added cost when the time comes. For example, my Dad has the "med option" where the facility comes twice a day to dispense his prescription medicine. And more recently I also opted for the higher care option where an Aide helps Dad get ready for bed at night, and checks on him every couple of hours.

As for families not realizing what level of care the love one needs I think is quite common. It's the family first rodeo so they aren't sure what to do or why. Many of us are in denial, I know I was when recently the IL side of the facility said it is time to think about moving Dad to the AL side of the facility.
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