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My husband and I visited a few Assisted Living facilities (that will accept Medicaid) in hopes of finding a safe place for his mom. She is 65 y/o type 2 insulin dependent diabetic with stage 4 vascular dementia. I was very surprised by the horrible condition of the residents. First of all I saw absolutely no one under age 80. Secondly, all the residents were sitting in the lobby, hall, dining room etc... in wheelchairs with their heads hanging down just staring at the floor. They all looked drugged. None of the people I saw looked like they could even feed themselves. Third, the whole place had a nursing home feel. They didn't have apartments of their own, they were piled two people to a tiny room with no kitchen. The staff were completely ignoring the residents. The memory care "wing" was freakin terrifying. It was like a gated prison. When I asked how the memory care residents got out to go to activities or the dining room. She said "oh, they don't go out, they eat here" (pointing to the 15x15 beige room full of tables with a 12" tv up in the corner. And of course all the people were asleep, or staring at the wall. Is this what Assisted Living is supposed to be like? I always had this picture in my head of elderly people playing bingo, shuffle board, reading, knitting and doing water aerobics in the pool. I realize there are different stages of dementia and that my MIL will be In that condition one day but right now she's not. Where are all the people like her? Where do all the 40,50 & 60 somethings with physical or cognitive problems go? She can still take care of herself she just needs "assistance" with her meds twice a day, blood glucose testing and insulin injections 4 times a day, healthy meals on a set schedule and other people close to her age to interact with and repeat her stories to. Isn't that what assisted living should be?

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November of 2014, mom broke her hip. She needed placement in a rehab (slash "long-term assisted living") location.
I visited 4 local ones.
Every single one had those sleeping or drugged residents looking hopeless in wheelchairs lining the hallways.
Some were strapped in as to not fall out.
I finally went to visit one that looked beautiful! Lovely decor, carpeting, just like in a nice home, chandeliers... it was gorgeous. I said to myself, 'this is it' and placed mom there.
Guess what? They drugged her when she became angry or agitated - they totally overmedicated her, they were short-staffed (aren't all of these places?) and to top it off, I randomly popped in one day to find my mom NOT strapped into a wheelchair, totally over medicated and literally hanging out of it with one hand touching the floor!!!
SO NO... I am going to spend 1/3 of the cost it would take to put her in a memory care lockdown unit and I am going to keep her in her own house, which is paid for, with her pet, and a caregiver that will give her one-on-one attention.
In my experience, home is always better than assisted living until they are completely unaware.
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This is not the case at my moms Assisted Living. Plenty of activities all day. Residents are happy, I can see the friendships between the residents. At meal time don't get in their way to the dining room. My mom is on the same medications that she's been taking for high blood pressure, cholesterol, thyroid. My mom is happy there, We had looked at quite a few places. She didn't like the "fancy" places. Where she is living is very casual. Even if my mom declines, they will keep her in her apartment, she will just have more help. I was looking online for facilities that I haven't already looked at, and this place popped up and my mom was excited to see it. Great move for her.
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My father was moved around from dementia unit to lock downs to assisted livings. He hated them all and they all drugged the hell out of him. I have him now at home with me and took him off all the crap and looked up all the natural vitamins and he is fine and better because of me. At 89 years old he is doing great and happy living with family.
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A few times I have seen my mother sitting in a common area or at a table with nothing to do. I've immediately gotten her a little basket of towels to fold or some magazines. I brought this up at the first care conference. Mother is still with it enough to get bored and it is not acceptable for her to be left anywhere without something to do. Now she almost always has something to read or do when I arrive. If she doesn't, I bring it to staff attention. She is in a nursing home and many residents can't even concentrate on a picture magazine, but my mother can and the staff knows that we expect something to be provided. They are awesome about taking her to organized activities, and now they are pretty good about seeing that she isn't sitting staring at nothing. Sometimes it takes family input, so everyone can work together.

I read a scholarly article about important factors in successful placements. The two things that rated highest were 1) ratio of RNs to patients. (Not general staff to patients) and 2) the activities program and ratio of activities staff to patient. I can believe this. If I had to place someone else, those are things I'd inquire about.
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If you are up for a move, you can check NC. A lot of people from the northern states come to NC for their Assisted Living and nursing homes. They are considerably less expensive than many other states.

The Assisted Living where I initially placed my cousin was quite nice and upscale. They had lots of activities, social director, a t.v. room, a living room, an activity room, 2 patios, a gazebo, two dining rooms, physical therapy, RN on duty in addition to med tech, great food, weekly trips and other things. It was pleasant and the residents had a great time socializing. I sat and visited with them enjoying the conversation often. (I was there daily due to my cousin.) If your MIL is able to function at a certain level, she may fit in with that kind of an environment, but if she isn't, it will become apparent that she needs more attention. Though this place was great, they could not provide my cousin what she needed. They expected more independence and not having to deal with her resistance to care. She resisted baths, meals and activities.

Secure Memory Care can also be a nice place. I toured two places. One was super upscale and looked like a luxury resort. Very spa like. I'm serious. It was super nice. It was pricey, but they told me they would soon be accepting Medicaid. They were just waiting on the paperwork to clear.( Most residents there were paying down in order to qualify for Medicaid.) I couldn't wait and chose the other place that had an immediate opening.

It's not fancy, but is super clean with trained staff who really take care of the residents. It's small and the staff knows the residents well. My cousin immediately did much better in the Memory Care facility. She doesn't notice if it's fancy. She gets nothing from frills anymore. She feels that she is cared for and I think that's why she always says she likes it there and that they treat her well.

I don't think the people you are seeing are drugged up, because it's illegal to restrain residents in long term care facilities with drugs, belts, or anything else. With dementia, eventually, the patient loses awareness, ability to walk, sit, talk or respond. They still need to be out of the bed if possible though. So, that's why those residents are sitting in a common room in wheelchairs and geri chairs.
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Lesanne, our first experience with rehab came very quickly, w/o much time to make decisions or do our research. So we really were naïve, but learned quickly. The rehab facility appeared nice, and generally it was, but there were some issues. We got together, addressed them (it helped that my sister had been a nurse for decades) and got them resolved. It was definitely a learning experience. But there was that depressing and so sad line of elders sitting in wheelchairs lined up waiting for PT. So many of them were so pitiful, so sad, just staring catatonically.

From then on we did much more background checking, researched on the Medicare site, toured facilities, and made better choices.

One I found for my father was, as his friends put it, like a 4 star hotel. And it really was, totally, absolutely the best. I even enjoyed going there, especially after they had all 4 pianos tuned so I could play for my father. The service was superb.

But it was in a community with a large teaching university and medical complex. The hospital and specialty hospital were much better as well.

Another AL facility was surprisingly enough in a more remote area, but it was affiliated with a large medical complex if I remember correctly, and it was more like a hotel as well.

If you have any Medilodge facilities near you, tour some of them. If they're like the one in Milford, Michigan, they're outstanding. I believe though that they're just for short term rehab.

The Milford one is decorated like a lodge - massive stone fireplace with comfy chairs scattered around for visitors and residents to enjoy a nice relaxing visit, multiple other areas, some like very small intimate theaters.

The chef had been with a 4 star upscale restaurant in a tony suburb and provided a menu almost comparable to a restaurant. The private dining rooms were beautiful. There was always a big coffee pot with free coffee for visitors, accompanied of course by the little containers of flavors so a guest had a choice of hazelnut, vanilla, etc.

The only things missing were pet and music therapy.

Another facility you might try if they're in your area are the Sunrise AL complexes. I was impressed with the architecture and amenities, but the food and menus were too upscale, and there was a group of sad faced people which turned me off in considering the place. But it did have a resident pet.
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GardenArtist, you're right, I should have sample more places before jumping to conclusions. I think it's just fear of the unknown. I'm worried that since we are in South Florida and the elderly population is very high here, Medicaid's budget may me stretched in this area and services may not be as good as in other parts of the country. We are going to tour a few more places this week so I'll keep my fingers crossed. I realize that I shouldn't expect five star resort accommodations with her being on Medicaid I just needed to know if this first experience was what I should be expecting from facilities labeled Assisted Living. Apparently the first place we toured was just a really bad place and we need to keep looking until we find a place that suits her situation. I hate that she did not plan or save for her future. She has no assets or saving to assist with the cost so Medicaid facilities are our only option. freqflyer, I completely agree with you... this is an eye opener!!! I realize now that we need much more retirement savings than I originally thought. Since seeing my MIL get dementia this young (65) I've realized I need to plan for the unexpected save for additional retirement years. Especially since we have no guarantee that our SS will even be there by the time we're old enough to collect.
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Lesanne, Yes our community was a "Supportive Living." This means (in Illinois) that we were Medicaid or private pay. Same rooms, same services.
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Lesanne, your "survey sample" is very limited, yet you've concluded that "all the residents look drugged" based on these very limited observations. Widen your search; try different communities, do research to get background information on the facilities, then continue your search.

The situations in which most residents seemed apathetic to me are those in rehabs, when they're rolled in wheelchairs down to the exercise room and wait with nothing else to do until their PT time arrives. But that's not AL.

There's a little booklet that's available for free, sometimes at libraries in their free literature stand. I can't recall the specific title but it's something about living facilities, and lists countless facilities in the area. That would be a starting point.

Your local senior center might have these little booklets available for free distribution.

The observations you've made on number of rooms, level of activities (very important) are factors to research. Also inquire about staff to patient ratio, resident pets or pet therapy, music therapy, whether food is prepared on site (very good) or frozen and trucked in (not as good).
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Lesanne, keep looking. What you described sounded more like rehab/long-term-care than Assisted Living... maybe that term gets interchanged with each other. My Mom's long-term-care was like what you had described with patients in wheelchairs, Geri recliners, and sitting in regular chairs either dozing or looking zoned out. But there were a variety of ages as some younger folks were recovering from strokes or serious accidents.

Please remember, with a certain stage of dementia there comes delirium, and that only can be controlled by some type of calming medicine which will make one very sleepy.

The 4-star resort feel you thought about with Bingo and Shuffle board does exist but at a high price. Example, my Dad was very frugal his whole life, so it was easy for him to enter into such a place and have his own 4 room apartment. The building next to his is Assisted Living with the same 4-star feel where each tenant has their own studio apartment. Seeing this is an eye opener to save like crazy for your retirement and very senior years.

You have to remember that Medicaid is helping pay for a place for your Mom, and said monies come from Federal and State taxes. And each State is different on what it spends. I wouldn't mind having my taxes raised to make for better living arrangements for those on Medicaid, but not everyone would think the same.
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Thank you Jeanne and Rockinrobin for your feedback. I will definitely keep looking! I hope I didn't come across as prejudice against the elderly and disabled. I was genuinely concerned by the residents "lifelessness" and need for a higher level of care. Glad to know this isn't the norm for assisted living! RockinRobin you described exactly what I thought it would be like in AL. Is that going to be attainable on Medicaid?
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The second place we looked at was much smaller and had very few activities. Again all the residents were older. The administrator said their youngest resident was 79. The residents did seem alert and content which was good. This was also a Medicaid facility but I found it strange that they had over 100 rooms and only 39 residents. When I asked why they were so under crowded she could not answer. It was also concerning that they had cookies and pastries out for "tea time", which was apparently everyday at 2:30. (MIL is a diabetic)
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Lesanne, I worked in an assisted living for 10 years and it was nothing like you described. Yes there were a few people that had to be escorted to the dining room in a wheelchair but by the most part, they were active. The average age in an AL is the mid to upper 80's. People are living longer now. Our folks went on shopping trips, did Silver Sneakers or water exercise at the Y, staffed our general store, participated in Wii bowling tournaments and more. They volunteered in the community, Went to museums, attended worship and lived full lives. I can't speak to the places you toured, but it sounds like they were keeping the people longer than they should have. Keep looking.
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Lesanne, I can sure understand why you are discouraged. Keep looking. No, not all assisted living facilities are as you describe this one. But most probably don't quite match what you had in mind, either.

One huge obstacle here is your mother's age. My son needed rehab last year after a motorcycle accident. The rehab unit was in an assisted living facility. He was the youngest resident we saw there by 30 years! His saving grace was that he knew he would only be there for weeks, not the rest of his life. He struck up a few conversations with some of the older men, but mostly he enjoyed lots of visitors and relied a lot on electronic communications. Your mother will have the disadvantage of being among the youngest but without my son's resources to entertain himself. See if your state's agency on aging can offer any suggestions about places that may cater more to younger people, like your mom.

What you describe may be a very poor quality place. Maybe they do keep the residents over-medicated. Maybe they do neglect them.

But some aspects of your description are not that uncommon even in "good" places. Residents often sit in their wheelchairs in the common areas. This gives them a chance to interact with others occasionally, and it ensures that they are safely under the observation of staff. Some (many) of them doze off. It does not necessarily mean they are drugged. It is often the nature of their disease. I guess I'm saying it MAY not be as bad as it looks.

Most places -- nursing homes or assisted living -- have lots of activities available. But not usually around the clock. There may be two activities in the morning, one in the afternoon, and maybe one in the evening. And of course not all residents choose to attend them.

As for memory care -- that seems to vary widely from one facility to another. Your mother may never need that level of care. (It is mostly needed if the resident wanders, or has behavior that is disruptive to other residents.) Usually more than half the population in a general care center have dementia and they get along fine in a mixed population.

Keep looking for a care center suitable for your mother. Try to discover if there are any facilities that have younger populations.
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