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Does anyone have any positive experiences with Assisted Living Facilities. Just began looking at them as an option, since Mom (82) and Dad (87) may need a back up plan in the future. I am not in a position to add any more caregiving than I have over the past 4 years (nine years total for other family members) Exhaustion, health issues of my own, a small condo and the need to maintain my employment are the primary reasons. Mom and Dad are doing ok, but both have become less healthy and I can see the possibility of them not being able to live alone in the future due to declining health situations.

Assisted living was suggested to me, and although I thought it was too expensive at first, I found 2 facilities that they could afford and that seem very nice. Also one of the facilities has a 90 percent refund of the buy in price as an option, I imagine that is if the resident does not want to continue to live there.

Any feedback would be appreciated!

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My 85 yr old mother has Alzheimer's Disease, currently in early moderate stage. We moved her from one dementia facility (it was wretched!) into an Assisted Living & Dementia facility. She started in the dementia section but has been reassessed into A.L. Currently she's thriving! Excellent skilled employees, first class cuisine, tons of activities and socializing. However, HEADS UP! Because she's in A.L. she has virtually total freedom. Lacking the insight/common sense/discernment she once had, she took a walk outside in the snow without boots, winter coat, hat or gloves and fell. Despite being told by administration that she can no longer walk without a staff member, she has availed herself of the staff entrance/exit. As DPOA, I can REQUEST that no one other than myself be permitted to take her off premises, but cannot be guaranteed because she's in Assisted Living. There are pros & cons. By and large we're extremely pleased with Mom being in AL. I know that things will change eventually, but for right now we're all working together to make sure Mom is safe while she lives her life to the fullest.
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Assisted Living Centers that are for-profit are not to be trusted. I posted on 9-26-13 about the need to watch everything. I posted in another thread this week about how lazy night shift staff made it possible for a man, with issues, to enter my mom's room (door ajar by night staff w/o a master key) and get in bed with her and touch her inappropriately. The administrators did not think my mom remembered it because it happened in the middle of the night--and pushed that idea on me--but she was able to remember everything when I sat down with her and waited for the memory to come out. She was molested and groped in private part and could tell me about it. She may have memory issues, but I know how to work with her. I am so upset and disturbed. My state's Elder Abuse dept. Is investigating. Although they say I will not be identified, you know they'll know what is going on. I had a few safety measures done right away but I know the whole thing is going to be their trying to cover their you-know-whats. So, friends, don't believe ANYTHING! I will probably lose it or die or stress out or have a heart attach about this. My mom will probably outlive me. I cry, I can't eat, and I can't sleep. And I cannot do all my mom needs. Hope you all fare better. Here I go for another sleepless night.
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Assisted Living can be a godsend! Check out the places you're considering carefully, and if possible have your parent actively involved in this checking out process--partly because no matter how well you know your parent's tastes, she or he knows even better! Sometimes it's gut reaction--it was with my mom: we walked into a place we hadn't originally thought we'd consider seriously, she looked around in the nicely furnished lobby, and said, "Oh, this FEELS like home." A couple weeks later, having looked at several other places, we returned to the "like home" place, she moved in, and it BECAME home. She is currently at a very low level of need for assistance (medical management, and someone on call if needed), and has lots of independence. Takes her walker out into the neighborhood for an hour or more a day, and loves sitting on her balcony and watching the neighbor kids and dogs.... She didn't expect to like living with "all those old people", but it ended up great for her: They're all of the same generation, they share memories, they endured the Depression and the War, they remember the same music....they have so much more in common than people in mixed communities--even than families, an many ways!

There are lots of support systems, from the residence bus for shopping trips, to Access-A-Ride, to people who bring dogs for visiting, and there are various activities she's welcome to engage in, whether movies, or bingo, or prayer groups, or political discussion groups--the residents have ideas for activities they'd like to participate in, and pass those ideas along, and if there's enough interest they happen!

The only trouble is, this place is in California, and my mom is running out of money, and California doesn't allow, for example, Medicaid (Medical) to help her unless she's truly NURSING HOME bound--which she isn't. So now we're looking to move her to Colorado (where another of her kids lives), and there she is on the waiting list for a HUD subsidized apartment that will be quite as nice as where she is (actually, nicer), and cost her about 10% as much! This is an Independent Living senior residence, which none-the-less has lots of support for seniors--transportation, hair salon and nails in the building, 24-hour emergency on-call people, meals, and so forth. But as her needs increase, she will be able to move into their Assisted Living section, which DOES get Medicaid support, though it is NOT like what we all think of as a nursing home. She'll still have a buffet apartment, and can use as much or as little of the assistance as she needs. Lots of individual planning and support and counseling. And the nice thing is, she'll still have the same group of friends she started out with in Independent Living, as both sections mix as much as people want to.

What I looked for, in helping my mom find these places, was of course cleanliness and a comfortably safe-feeling environment, cheerful people, and lots of friendly interaction among staff and residents (do they call each other by name? Do they laugh together?). How is the food? Is there as much freedom as my mom likes, and yet are people available in times of need? What's there for the spiritual side that she values?

One tip: as my generation (I'm 68) is aging, and we're looking to live in such places, they are filling up. Especially the affordable ones! So when you first begin to consider this kind of living, get on a list! Good places used to have some openings....now, fewer and fewer! In fact, many good places have waiting lists of from 6 months to two years! So better to get on a list even if you're not sure, so that once you're sure, you have less of a wait! (NONE of the places we considered, by the way, required any payment simply for applying and for being on a wait list; this makes it pretty risk-free!)

Hope your mom finds a lovely a new home as mine did!
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I understand some times it is necessary to find an ALF for an elder. However, since the majority are for profit/corporate outfits I wouldn't trust them to care for my parent. It was tons of work to care for my parents alone but I never regret it.
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my mom is at a assisted living and they treat her like she is a queen. If she hasnt came for breakfast, they come to see why. If she doesnt like what they are having for any of the meals, she can order what ever she wants. They keep her involved in all kinds of activities and she has a blast. She has dementia and refused to move in with me or my sister and picked this place out herself. She has been there over a yr now and loves it. Just like nursing homes, not all of them are horrible. I suggest looking for another home.
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I totally agree with you ! I have taken pictures also. .People Ive showed them to can't believe what they are looking at. Its all about the money that's all they really care about. When you find thing that are bad or unsafe or no healthy for your loved one Turn them in too social services and adult protective services file a complaint form. and everytime you see something else wrong take a picture and file another complaint on them. hopefully something will change with these places.
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Knownunknowns has a really good point, as do several other of this lovely group of caregiver/commentators. Do look carefully at the turnover rate, at all levels, at the facility where your loved one lives. When I got burned out with caring physically for my mom, who is a sweetheart but needs a good bit of assistance and cannot be left alone, I researched and visited and decided on an ALF that was reasonable in price and had a longstanding good reputation in our town. They do respite, and we had some trials with that before making the big decision. For over a year, everything was great. Then, about a year ago, the long-time facility director left or was let go by the company that runs the place. No one really knows, till this day, what happened. He was a good manager, hands-on, and had an open door policy. The new director, who came from another ALF in town that was not so highly rated, changed everything. Long-time staff who were really good left. She hired people who were her buddies for administrative positions and hired awful, untrained people for the lower-paid staff positions. She is not particularly approachable. Since she hired some replacements recently that interact with my mother, things have been happening like stealing clothes and bed linens, less checking on supplies like disposable briefs, toilet paper, and tissues, untimely notification to me about meds running out, calling in refills to the wrong pharmacy--I could go on. I am stressed and unhappy that the care has declined. When I politely bring up incidents, nothing happens to change the situation. And, the rates have gone up for "Level of Care"--coincidence or expectation of good management and care? Several recent problems have had me running out to replace dirty linens at 10 p.m. because the spare set were missing. And, when my dear mother was out of toilet paper for a couple of days, no one noticed until I found a wash cloth and towel that she had been using to wipe herself. Nice, right? I documented everything with my cell phone camera. I suggest that all of you do the same thing. The administrators may not worry about resident care, but they do worry about lawsuits. This post is long, but I cannot emphasize enough how important good directors and managers are. Turnover is a sign that something is going on and it might not be good. And yes, I am starting to look for another ALF. Good luck to you all.
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NO I Haven't FOUND ANYTHING GOOD ABOUT THESE PLACES. THEY DON'T TAKE CARE OF MY MOTHER AT ALL. SHE HAS LOST WEIGHT SHES DOWN TO 86lbs THEY LET HER LOCK HERSELF IN HER ROOM FOR HRS SOMETIMES DAYS. I HAVE TO TAKE HER FOOD ALL THE TIME BECAUSE SHE IS ALWAYS STARVING.SHE STAYS IN THE SAME DIRTY CLOTHES FOR WEEKS EVERY TIME I GO THERE SHE BEGGS ME TO TAKE HER HOME. IT BREAKS MY HEART. SOME OF THE REAL $$$$ PLACES R PROBLEY BETTER BUT MOST OF THEM ITS ALL ABOUT THE MONEY NOT THE CARE. I DON'T KNOW WHAT TO DO YET? SHE HAS HATED IT THERE SINCE DAY 1.
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Thank you everyone for the wonderful insights
I agree with the idea that in one way or another
we will be spending money on care, and I always assumed that assisted living
would be a safe environment if my parents ever got to the point that they could not maintain their home. Also Mom has mentioned that she would not want to live alone in their home if something happened to Dad first. Dad is just the opposite, does not want to leave the house ever....so we are really looking at all options as back up plans for the future.
Trying to be as prepared as possible for any scenario.

Lots of work to do! Thank you everyone for taking the time out of your busy day
to respond.
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As a very wise hospice worker said to me - you will be spending your parents money one way or the other...it is how you choose to spend the money. We were very fortunate to find wonderful caregivers who came to my parents condo. If you do choose an assisted living facility the only way to insure good care is by being present frequently and engaged - ask questions frequently - introduce yourself to as many staff as you can - become conversant with them and familiar to them. If you cannot be present then seek out those who can on your behalf.
Courage in this most important job of your lifetime! Anita
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I'm a big fan of assisted living. My mom moved from a Florida Condo to an assisted living facility in New York and it worked out very well. She didn't want to move at first. But a "big event" made it impossible for her to continue to live on her own. I researched places I thought that she might like and took her to visit. I also helped an elderly cousin move into another assisted living facility. She too didn't want to go initially, but it has worked out well for her.
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Over seeing the care of my 86 y/o mother with dementia in a ALF has it's own stress and frustration. She has limited $$ so we can't afford the ones that have topnotch administration. (When we first came to this one we did have a good admin, she left 4 months later and took half the staff!) Visit several times at various times and at least one meal time, a location that is convenient helps, noise level is important, (TV, aides, cleanup other residents.) I am a squeaky wheel when I need to be. If I had to do it again I would take the list and ask about the longevity of the staff and question what admin's goal are. We did have a list and asked many of the questions. I've found where ever she's been ALF, rehab, hospital, dental hygiene is not big priority. Even BM's seem to be low on the list, to me the more regular a person the less discomfort...ha of course I know IBS is another issue. Get on a waiting list and start now, don't wait until burnout, or the fire has started to take action. Be well ~M
not sure why my first post was deleted...i noticed the link for the check list went away the first day /-: what up admin????
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I've visited some lovely facilities and some not so hot. You already have some good suggestions, so by all means make your list and check things out. Get their care policies, add ons, etc. in writing and take home and compare to others.

Ask some good questions and a lot of what ifs...
What happens when person is hospitalized, needs assistance following hospitalization, rehab, etc.
How will they handle lonliness, isolation, person's refusal to participate in activities
What do they consider nuicances and cause for dismissal or moving from facility - violent outbursts, crying, hitting, stealing, etc. - who on staff handles these matters? do they redirect the behavior or drug the person? how are they resolved; will they consult with family?
Add on charges
Can you hire outside help to check on the person or care for the person if extra care is warranted for limited time?
Just some things to consider and be sure it is in writing.
Visit weekdays, weekends and spend some time talking and observing the residents, do they like it? how do staff acknowledge the resident, is it clean, cheery? what calendar activities do they have - are these activities well attended? will you parent or loved one enjoy these activities?
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I had mother with me in my home for two years. alot of ups and downs. she couldn't go to the bathroom her self. Or fix her own food. I couldn't go anywhere with out someone there to watch her. She would fall, have a diabetic reaction, call my name. etc. So I didn't get out much. But she could stand on her own enough to get on the toilet if I got her next to it. I still would have to wipe her etc. Then she
got so she couldn't stand, even just a transfer to the toilet ,we got a port-a poty. My
disabled son and I would try our best, My husband traveled alot. But we just couldn;t do it. l transfered mom to a "behive House" she almost died. They assured me they could handle her. They knew she couldn't walk at all. It was an
experience I don't want to remember. Then we put Mother in a full care facility and
that has been the best thing in the world for her. It is expensive. We are barely making it. The only problem we've had is Laundry. I have to go get her laundry,
or it disapears,. I have actually seen other patience wearing her things, They blame me saying I didn't put her name one it. Witch if course is stupidl Of course I
did! We are very afraid to bring anything to her room that is in the last bit valuable.
But she gets taken care of very well.
If your loved one can stand on her own. then an assisted living may work for
you. For us it was a disaster. She was drugged the whole time. She doesn't
even remember ever being there. It took weeks at the full care facility to get the
drugs out of her system. After being in intensive care unit and almost dying.
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I saw good and bad with the AL community experience for my parent. It started out affordable. However, the "add-ons" escalated after a few years. Rates of $3.50 to do a 20-second dropoff of a meal at the door. They had a cart and did them all on a "route" at mealtimes, not when the parent wanted the meal. They charged what they deemed "1/2- hour service" to do a 5 minute job like adjust a tv, change a lightbulb, etc, I was amazed when I asked for a detailed printout of charges. Also, the rate increases! The residents got a letter informing them of the increases, and the wording indicated "like it or move." I do not think when one section's A/C units go out that the entire complex should ante up. Doesn't the company have a capital fund or insurance to pay for those things? Also, the staff decreased and the costs increased. I found a lot of BS reasons for increases. Once the rent-increases are in place they are never decreased, even if the "repair" gets paid for or the staffing costs adjust. Increases of at least $100/mo per resident? When increases got to $150/mo on top of almost $3.000 in rent already, I had to move my parent to a regular apartment and direct-hire companion aides from an agency who devote their paid time to the person. We've also added Life Alert for emergencies.

The Asst Living community is pretty place and would be fine for those who have no income worries. If families know that there is a limit on the amount they can spend per month, then they need to read the fine print and shop around.
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Thank you everyone for all of these well thought suggestions and insights.

So many things I never would have even thought of if you all hadn't mentioned them! I'm going to re read all these posts and write a nice long list of things to look for for when I start visiting
these places so I can weed out the list. I was not aware of many of the
negative situations that can occur so thank you all for the heads up on those things..very helpful to look out for them before moving someone in.

I will definately start now before a crises (great idea). Great idea of hiring someone as an on call driver to take
the resident wherever they want to go whenever they want to.
I can see that greatly helping to maintain the emotional/mental state of the parent as well as the physical.

Thank you all so much for taking the time to respond.

The caregivers journey is not an easy one, but thank goodness there
are options that exist today. Great to know that there are places where the
care reciever is content, safe and happy especially for those of us who really
cant manage the 24/7 move in care.
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My husband resides in an Assistant Living facility for dementia residents. I tried to take care of him myself but since we are only two years apart, the drs. thought that was not a good idea and that I should look into placing in a nursing facility. We are blessed because he has long term care insurance. I found out that due to the licensing here in Texas, AL is classified differently and his long term care will pay a nursing home $7,000.00 per month but will only pay about $3750.00 for AL. That's okay since his retirement will make up the shortfall. We live in Dallas and he is in a very lovely AL with caring staff, daily activities, barber shop, manicures, pedicures, staff nurse, visiting doctors, etc. Though I still take him to his personal dentist, take him for a drive on good days, stop for an ice cream cone, etc. He enjoys being there. It is small and broken into four houses as we call them---different colors, etc. I chat with the other residents and they all enjoy visiting with different caregivers. He has his own room but shares a bath with another resident which is okay. They do laundry though I bought his furniture for his room and all his bedding. That way I know what he is sleeping on. And yes, I paid the community fee of $1500.00 but that was okay too. After checking many nursing homes, I found that the AL was a better fit for him. My husband was an engineer so he is among other engineers and get along splendidly. Oh yes, the food is good, after many of the caregivers including myself complained when the AL went through a bad patch with their head nutritionist. I eat lunch with my husband sometime so I know the food is good. I hope this will help you and please take care of yourself. BTW, my husband has vascular dementia and as with Alzheimer's, it will not get better.
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I agree with everyone in that you need to do your homework. Laws vary from state to state. I live in Texas, work in this industry and care for my mother-in -law who is in an Independent Living Community with Home Health and Home Care added. Medicaid does not pay for Assisted Living Communities where I live. Unfortunately if you are on medicaid your only option is a nursing home.
Your state should have a licensing bureau for all assisted living communities. Check with them to see if there is a list of reports of any complaints on any facility.
Visit at all times of day and night and talk to residents and other family members. If you drop by after work you can probably catch a few families coming and going.
Most of the people I have met in AL communities have a big heart and really care about the seniors they care for. What you need to ask however is how they like their job and how long have they worked there. I help families find places for their parents and one of the questions I tell them to ask is about staff turnover. If there is constant staff turnover stay away. The management has problems and this will affect the care your parent gives. I too am a big fan of the smaller group homes (we call them personal care homes) especially for those with dementia.
Remember you are or should be most focused on the care received not the outward visual appearance. Of course you want the place to be clean but the newest and fanciest place may not have the best care and care is what you are really paying for.
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Even though I am aged [82] I still sing in a barbershop quartet. Much of our entertaining is done at Assistd Living Homes. I knew some of the people who I see in our audiences and they are quite comfortable. I know several who have chosen assisted living and have been there for 6 or 7 years. By the way they warm my hearts by being glad to see the quartet is back again.
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My 87 year old father has been living in an Assistant Living Facility for 8 months now, and he likes it. He is able to take care of himself, so we are at the lowest rate, but as he starts to worsen, they have steps of care that we will be able to move him. His favorite thing is the meals, they have a chef that does the cooking and we like coming and having meals with him, the food is that good. He likes being with people his own age, and they have a barber/beauty shop on facility, they even have a small store that is ran by the people that live at the facility. They have functions, Friday night they have happy hour. Field trips, a bus that takes residents to shopping malls, doctor's visits, and more. My father has a home care nurse coming every other Friday to change his catheter, there is a large pond were he can watch the turtles, birds, and in the summer, they have a fishing tournament. My dad does pay for this, they do not except Medicaid, or other. They do have apartments for couples, they allow pets, it is like he lives on a cruise ship and his studio apt is just his space. Check Emeritus, they may be in your state, my father is in Southern California, and we were surprised that the facility was very reasonable for California, were everything is so expensive.
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My experience has been very good. Both in AZ and IL. My MIL is on a yearly lease. She in doing rehab due to a stroke on one side. My own mother is in a smaller one in IL. and they have been wonderful.
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I have had some older friends and relatives who have moved into nice assisted living places , some as singles or widows/widowers for the company and others as married couples who wanted a little help with some things but were mostly independent.

These places can vary wildly in facilities, rules and regulations, staff (most are underpaid and often underqualified and some just don't care about residents because they don't get paid a lot and have resentment towards employers. I know one who is a suicidal alcoholic who wrapped her car around a tree because a man turned her down for a dance at a bar) and in what payments/insurance they take. Some may offer skilled care for later on and even hospice care while others do not and you might have to move if you need those things.

Check them out to see if there have been complaints. Pop in when least expected and peek around to see what is REALLY going on. Chat with staff. Are they grumbling about residents, work, or their dating lives? Find out the qualifications to work there. Is the place clean? Talk to residents and to ex-residents. Why did people leave? If they have a Facebook page, go see what people are saying there.
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My experience since July of 2012 has not been good with assisted lving. Mother in stage 5 Alzheimer's, wet macular degeneration and fell 2/27/13 and compressed lumbar 2, not a candidate for surgery.

The staff has turned over almost 100% since she moved in. The administrator is new, there about 2 years, the last one retired from there and was wonderful. I have doubts about this administrators abilities.

They seem to look for reasons not to provide care to the residents. For instance, mother needsd a back brace since her fall and it was a battle to get that lined up and the staff has complained they shouldn't put the brace on because it is restraining her.

I suggest you read your states regulations for the assisted living facilities and ask many questions. They will lie to you. But this is one area you need to know your rights for sure since you are caring for a loved one.

I haven't met anyone that has had a pleasant experience with nursing homes or assisted living...........
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My husband is in an ALF. He prefers a family home with just a few residents as opposed to a large facility. The first 2 homes he was in did not work out. In the first one they totally ignored him except to take care of his physical needs. In the second the owner/caregiver was verbally abusive. You never know what you are getting until your loved one has been there awhile. The owners/caregivers are always nice when you interview them. He is now in a home where he is treated with respect. He has been there almost 3 years.

So, don 't give up if the first facility doesn't work out. When you find a place, make a few unannouncerd visits so you can see what is going on.

Also, check on your state's Medicaid program to see if your parent qualifies before spending all of their money on care. You may need to hire an elder law attorney to help you wade through all the legal paperwork.

Be sure to take care of yourself or you won't be of any help to your loved one.
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Over seeing the care of my 86 y/o mother with dementia in a ALF has it's own stress and frustration. She has limited $$ so we can't afford the ones that have topnotch administration. (When we first came to this one we did have a good admin, she left 4 months later and took half the staff!) Visit several times at various times and at least one meal time, a location that is convenient helps, noise level is important, (TV, aides, cleanup other residents.) I am a squeaky wheel when I need to be. If I had to do it again I would take the list and ask about the longevity of the staff and question what admin's goal are. We did have a list and asked many of the questions. I've found where ever she's been ALF, rehab, hospital, dental hygiene is not big priority. Even BM's seem to be low on the list, to me the more regular a person the less discomfort...ha of course I know IBS is another issue. Get on a waiting list and start now, don't wait until burnout, or the fire has started to take action. Be well ~M
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I have not had a family member in AL but there is one near here where 3 different ladies from our church have moved at different times and they all loved it. As I mentioned they were not there at the same time so their satisfaction was not because they were all there together as friends. Two of the ladies had dementia and have passed away. One is still there and seems to be OK mentally and is still very happy.

I have heard of more positive AL experiences than I have of those caregiving at home, or the caregiver's home. My mother is living with us and won't consider AL, but I think everyone here would be happier if she would.
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I would ask if you have any long term care policies on either of them. Nomally they need to be under 80 yr old to purchase them. If that wasn't gotten then the ability to keep them in their home with home health aides will probably fail in the long run. Neither of them are really that old yet so perhaps some paid help and keeping them in place should be considered. A they will be happier in their home and B it will not draw down as much of their financial assets. They may be young and fit enough for medical or social day care programs which gives them supervision for the day but they are back home for each evening and night.
I have one friend who had a positive relationship with an ALF for her 2 parents. However the move was made for the mother's health concerns and of course she passed about 8 mo after placement and the healthier father is stuck in the facility (he only went into the facility to be with his wife who passed away). He could really still be living independently or with a little bit of home care but it isn't an option now because all their assets have been spent at the ALF.

I would check out veteran homes too. Often an elderly person who was in the service can qualify for an opening and they are far less expensive (will not impoverish your parents). They pay a fee based on their income etc.

The trouble with all placements, you lose control over exactly who they hire to care for the residents. Yes you can complain but I haven't seen that to be very effective. Many of my friends have had problems with the aides taking care of their parents and since the facility hires them--they were stuck.

It is a big decision, if a placement is required do lots and lots of research. Get an ALF which is required to keep them when they get weaker and need nursing home level care. You don't want them to be discharged needing that level of care, without any savings left and you are looking for a quality nursing home and have no reason for them to take your parents. Most nursing homes want
patients with $$ before they lose it and go on Medicaid. These are the sad realities of elder care in our country.

Good luck.

Elizabeth
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I agree elevators are a huge issue. My mom who was 85 at that time could not manage the elevators well. Although she already had a degree of dementia at that point, had lived her life in a very small community and had limited exposure to them in her life. Being on the main floor is preferable as mobility issues progress. Consider where activities are held. They are more likely to attend if they can hear the music or see that something is going on. Large facilities may have all social activities on one floor, usually the main floor. Size of the facility is also important. A maze of rooms and too many people is very overwhelming. Take them with you when you find 2 or 3 that have potential. Look at options for location and room layouts. Lwentanon has very good points. The way they eat is important. Ethnic food is rarely on the menu. We would bring food in or take mom out often.
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Yes I have had some good experiences. And please do take care of yourself before you "keel" over as I nearly did. I can think of some things to check on though. Very important is how flexible they are about food and such. They are ALL sales people, nice or not and they will show you the moon and stars but what you really get can be different.

Drop in without an appointment and talk to the residents. Match what your parents want with what the ALF offers. My mother is not social so social events would not matter to her. See if and how long they can offer increasing levels of care. If not you may have to add (at the very end, sorry) hospice to the ALF care and if that is not enough, go into a nursing home. I had the best luck with the small private houses that had slightly trained staff for my budget. Speaking of staff, make sure there is enough help. Some of the swanky ALFs that look like Club Med do not have enough staff. If your parents can still take their own meds, they can go to a place where the staff are not highly trained.
A lot of doctors are making house calls to ALFs again but I have found them to be "bottom of the barrel." Last thing I can think of is to consult someone who is an expert that is not trying to sell you. Do NOT reveal all your assets, they have wiggle room in their prices. Best of luck and prayers, Virginia
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My grandmother was in assisted living until the last 5 days of her life. So when my father was told this fall that he was unable to go home and my mom wanted to stay with him, we started looking at elderly apartments and assisted living facilities. In reviewing all their brochures and materials and visiting them. We found one that will keep my parents until life's end. When I read that I thought what does this mean? In talking with the owners what I found is that if one of my parents falls, after leaving the hospital, they come back to them, not a nursing home. If they get sick and are bedridden, they don't send them off to the nursing home, they will bring in hospice. They want them to stay in their own room and own bed until they die. So we started asking each of the facilities how they handle decreasing health issues and falls. In one of the facilities, my parents could start out in a one bedroom apartment, then if one of them passed away they would be moved to a small unit, the one remaining gets sick, they would move into a higher care room and lastly nursing home. That would be 4 moves and each time they are moved, it impacts my parents physically and mentally. Additionally we would have to do the work each time. So these words meant a lot to us, as my parents want to be together to life's end. Three weeks after moving in my mom fell and broke her hip. After 3 days in the hospital, she came back to the facilities. They arranged for physical therapy to come to her. When she was more mobile then she went out for her therapy. We are fortunate to live in Minnesota, my parents had just enough money to go ahead of the medicare list and paid for their care fir about 4 months. Now that they are there and they have spent down their money. They then were approved by the state to covering their costs and the State doesn't move them because there is cheaper care somewhere else. This is family owned assisted living facilities has about ten in our area. Extremely well run, they RN handles all the medical issues with me directly to be sure my parents are getting the best care. Look around, as there are many types of assisted living facilities. Bring your parents there to see how the staff interact with them while you are looking around. This gave us a good insight to places and how they would be with them after they moved in. Also be aware that assisted living is expensive but so is nursing home care. The staff ratio is much higher in nursing homes also.

I go to bed at night knowing that my parents are happy, safe, clean, feed and being watched, taken to the bathroom at night and getting their medicine routinely. When their health issues have changed such as falling and breaking hips, falling out of bed, confusion. I get a call and they have guided me through the process, made suggestions of equipment that would work and then the plans are followed.

In my grandmother's case, I know she loved a longer more productive life because of the people that loved and cared for her. I have seen the same thing with my parents even after one year. I know that as I get older that I would be happy to find a place like my parents have.
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