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We're looking at an ALF for my 91 year old mother and have been told that the ratio of caregiver to resident is 1 to 25 (1 to 18 if you count the medical director on duty). The manager explained quickly that 33 of the residents need almost no help (beyond a reminder to take meds, etc.), another 11 need moderate levels of care, and only 10 need significant assistance (i.e., dressing, grooming, meds, reminder to eat, etc.). My Mother would be in that group, but I'm scared that she will get lost among the 50+ residents with so few caregivers. What do you think?

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In view of the 'broad state policy' my suggestion would be to choose a place that is geographically close to family and visit often and at different times of day. There is still a certain amount of care that you will be giving, no facility can do it all. Make it easy to visit and do the extras. Good luck.
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Thank you, Geewiz. Apparently, Tennessee doesn't have a specific required ratio. The phrase is just something like, "sufficient staff to care for residents," or wording similar to that. That gives ALFs a lot of leeway. My mother has some aphasia, and while she's very good at answering questions, she doesn't initiate much conversation. I'm concerned that she will get overlooked because she isn't going to be requesting attention.
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WOW that doesn't sound like enough help by any stretch . You can check with your state or local department of aging. The state I live in has a standard aide/resident ratio. It's is 8 residents:1 aide. There are times I don't think that is enough! But do consider other employees and what each is responsible for. The place I am using for my Mom has LPNs that distribute meds, activity staff that keep the residents busy, etc. Revisit this point with the facility and ask what each person does. If an aide truly has 18 or 25 residents to assist, it's not enough in my experience.
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