Assisted Living Facility Considerations
Wedeveloped this module under a contract from the U.S. Department of Health and Human Services, Health Resources and Services Administration. The Department of Health and Human Services, Office of Women’s Health, funded this work.Disclaimer:Some of the views expressed in this presentation module are solely the opinions of the author(s) and do not necessarily reflect the official policies of the U.S. Department of Health and Human Services or the Health Resources and Services Administration, nor does mention of the department or agency names imply endorsement by the U.S. Government.
Visit and observe many assisted living facilities.Ask numerous questions.Talk about the specific needs of the person living with dementia.Good resource:The Good Caregiver**Kane RL and Ouellette J.The Good Caregiver. New York, New York. Penguin Press
What are the rules for entrance?What criteria are there for severely physically/mentally disabled individuals?What medical records will you need to provide?What financial records will you need to provide?
What happens if the person living with dementia chooses to leave?What rules will the person have to follow?What must he/she sign?What level of disability due to dementia can the facility handle?Will some types of behavior result in discharge?How often do the fees increase?How do they care for people with dementia?What happens if a resident runs out of money?
Part I: Costs & Fees
What does it cost for room and board?Does the facility require a deposit in addition to a monthly fee?What does it cost for the basic service package?Are bathing, dressing and feeding included?What does the facility base its fees on?What happens if the facility charges for basic services the resident does not need?Can the resident supply some of their own basic services to avoid facility cost?Are any charges based on a disability assessment?
Part II: Costs & Fees
Are the rates based on a certain amount of time or by the services provided?How much personal care does the facility include in the quoted price?What do services like hair dressers, medications, laundry, and personal care supplies cost?What is the basis (and charge) for greater levels of required care?How much incremental care is available?Does the facility provide these services on a temporary or a long-term basis?
How long have the staff worked in the facility?Do they have a significant turnover in staff?Does the facility use many temporary workers?Does the facility have an activities director?What are his/her qualifications?What kind of activities do they offer?Do outside groups from the community come into the facility?Does the staff have any training in dementia care?
Is the facility’s activities program designed as leisure or rehabilitation, and is the schedule flexible?Can the facility accommodate different routines?Can residents control their daily schedules, including what time they get up or go to bed, when, and with whom they eat, or when they bathe?Can a resident have his/her own car/parking space?Does the facility provide transportation to doctor’s appointments, leisure activities, and shopping?Can the facility prepare special meals that take into account residents’ cultural and other preferences?
Can residents store food in their units?Do residents have access to sufficient cooking facilities?Do residents participate in the development of their own care plans?Do the residents look happy and content?Are the units clean? Are there cleaning services?How is laundry handled?Can residents lock their units?Do residents get their own mail?
Part I: Medical Care
Does one doctor (or practice) handle the medical needs of the residents, or is each resident expected to find a doctor to help manage their own care?Does the nursing staff:Supervise medications?Weigh residents?Make regular assessments of specific physical problems (such as blood pressure)?Oversee changes in medical treatments?Assist with bathing and dressing?
Part II: Medical Care
How do they manage medications?If residents can’t manage their own medications, how are their medications managed?Who is responsible for safe medication use?Is there an extra charge for medication management?Does the facility help get medicine?How much nursing care is available?When and how can a resident request nursing care?How are levels of care established for each resident? How much nursing care is available?When and how can a resident request nursing care?
What kind of training and experience does the facility require of its staff?For the Director of Nursing?For the Administrator or Director?For Personal Care Workers?For Memory Care Workers?Who has had formal gerontology or geriatrics training?Does the staff have experience working with people with cognitive impairment?
Part I: Meeting Needs
Who decides when a resident’s level of care has changed and how to respond to it?Are caregivers involved in talking about changes and how to respond?Are caregivers called when there are changes in care routines?Who is notified when a change is noted?How do they assess and manage emotional issues (like anxiety, grief, and aggression)?
Part II: Meeting Needs
Does the facility have a system in place to make regular observations and respond to changes?What is the cost for extra care? Can they arrange it?Can residents select private individuals for their care, or must they use care staff provided by the facility?Can the facility provide aides or do you hire your own?Can you pay for part-time services of an aide who is already on staff?Do you hire through an agency or can you hire independently?Is there a liability waiver for independent staff?
Customs and Traditions
Does the facility pay attention to customs and traditions of its residents?Foods, holiday celebrations, special festivalsDo they encourage different customs and traditions?Is there special attention given to a specific ethnic group?Do most of the residents come from one group?Does the facility organize programs around specific groups and related practices or events?Do any staff speak the native language of the potential resident?
Is there a separate area for residents with memory issues?What are the criteria for entry into these units?What training do staff in these special units receive?What is different about the care given in these units?What training do the staff have for working with persons living with dementia?
Does the facility have a nursing home nearby that is run by the same company?Do they refer residents to a certain nursing home when they need more care?What is the facility’s financial relationship to the nearby nursing home?What is the impact of having a nursing home so close to the Assisted Living Facility?
All assisted living facilities must follow rules/regulations.Those rules vary from state to state and some states may offer more protections to residents than others.The federal government does not regulate them.Some states have records on violations and sanctions.Contact the Aging and Disability Resource Center in your area to see what information is available.Call your local Area Agency on Aging or use the Eldercare Locator: 1-800-677-1116.