Oregon Senior Referral Agency Association Raising Industry Standards since 2004
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Older adults risk cognitive damage and memory loss after surgery. The condition is called post-operative cognitive dysfunction (POCD). POCD affects about half of adults 60 years and older after surgery.
Is assisted living right for you or your parent? Yes…or maybe No.
Yes! Because today’s assisted living isn’t like the dreaded “old-folks home” of yesteryear.
And No! Because not every assisted living matches you, your needs, or preferences. They all seem to offer the same things.
Look below the surface and compare the details. This article looks “under the hood” of assisted living. What it is and what it isn't.
Here are the 5 basics that professional referral agents know. You should know them too.
You often hear assisted living described as the “alternative to a nursing home.” This is only somewhat true. Assisted livings are not medical facilities.
Assisted living is more like independent retirement. Both offer a “hotel-style” of living. But, assisted living facilities hire in-house staff to provide hands-on help with daily living.
Think of assisted living as a bridge. They span the gap between independent living and nursing homes where complex medical care is provided.
Older adults choose assisted living when they want independence but have help available if needed. These residents can direct their own care, value autonomy, and like having choices.
Assisted living facilities are licensed by the State Department of Human Services. They’re inspected every two years for compliance with Rules and Regulations.
Inspection reports are public information. Every community must keep their report in a binder, on-site, and easily accessible.
If you’re a consumer, don’t be shy. Ask to see it.
In between inspections, any complaints of abuse or neglect are inspected within 24 hours. You can check Complaint Records online.
Imagine a building. There’s the floor and the ceiling. Some buildings have low ceilings and some have tall ceilings.
In assisted living, the State sets the minimum requirements of care. That’s the floor or foundation. But each facility sets its own ceiling of care.
State-mandated basic services include:
Each facility determines how much care they’re able or willing to provide.
Examples:
Example 1 - Community “A” will assist or guide residents with transfers from bed to walker, if no lifting is needed. Community “B” will assist with transfers when 2 caregivers are needed, lifting is required, or a mechanical device is necessary.
Example 2 - Community “A” will pass oral medications on a regular schedule. They’ll also provide regular diabetic glucose testing and give regular injections. But, they’ll require residents use pre-measured insulin pens. Community “B” will provide full sliding scale diabetic injection care.
Also, a community’s “ceiling” can fluctuate. Fluctuations are based on overall acuity of care at any given time.
For instance, a community that typically provides sliding scale diabetic care, may decline any new diabetic applicants. The nurse or administrator may decide there’re too many current residents needing a lot of care. They want to ensure their ability to meet the needs of residents.
Please note: the State restricts many medical care tasks in assisted living. These care tasks require licensed nursing. Residents in assisted living must be medically stable with predictable care.
The State sets minimum requirements for care, but it doesn’t mandate staffing ratios (as of this writing). Each assisted living community is expected to staff according to the total acuity of care in the building.
Oregon does not require caregivers be licensed CNAs. Front line caregivers or personal attendants must pass criminal background checks. And facilities must provide on-the-job training and regular ongoing education related to aging.
Please note: residents share 1 caregiver with 13-20 other residents. The average staff to resident ratio is 1:15 (hopefully).
Every assisted living community has its own “culture” or personality. The mix of residents, their backgrounds and interests, the current administrator, and team determine the culture.
Before moving your parent to an assisted living, visit several times. Meet the staff, residents, and resident families. Attend events and social gatherings.
Consumer-Driven Services
Assisted living services continue to evolve. Many communities strive to meet today’s consumer expectations of choice, amenities, and aesthetics. Flexible dining and expanded menus are examples.
But don’t be fooled. Lovely surroundings, fancy amenities, and extra services don’t always equate to five-star care.
Consumer-Driven Services
Assisted living services continue to evolve. Many communities strive to meet today’s consumer expectations of choice, amenities, and aesthetics. Flexible dining and expanded menus are examples.
But don’t be fooled. Lovely surroundings, fancy amenities, and extra services don’t always equate to five-star care.Each facility determines how much care they’re able or willing to provide.
Professional referral agents have experience and insider knowledge. They network and build relationships. Referral agents know a community’s history, staff turnover, compliance, and culture. Agents preview and pre-qualify communities. They’ve done the research, so you can relax.
Ed’s mom, Ethel, is having major surgery. The family’s wondering about how to help when she gets back home. It’s confusing. Ed’s brother Stan thinks mom’s health insurance will pay for Home Health and they’ll do all the care. Ed’s pretty sure that’s not right.
Ed is correct. Home Health will not provide the full care Ethel will need. But Stan’s almost right too because home health is covered by medical health insurance. But home health does not provide day to day care.
Let’s clear up the confusion.
Home health care services are prescribed by a doctor after a hospital admission or inpatient rehabilitation stay. Medicare covers home health services for a limited amount of time or visits. Services are brought to the patient at home; wherever home is. It’s intended for short-term recovery.
Licensed health professionals follow up with a patient at home and provide services like nurse oversight, social work visits, speech therapy, physical or occupational therapy, wound care, and medication or injection monitoring. Sometimes home health services will include a bath assistant.
Home health care helps patients make a full recovery and it’s assumed they’ll return to normal activities.
When Ethel comes home after her surgery and skilled rehabilitation, she’ll have home health follow up. But her stamina will be poor; she’ll tire easily. Ethel will need someone to help with the activities of daily living such as shopping, cooking, housekeeping, laundry and, transportation. She might also need a little support with dressing, bathing and, medication reminders.
Ethel’s family plan to help out. But they work full time so they’ll hire an in-home care caregiver.
Seniors and their families can hire professional in-home caregivers in a variety of ways.
Caregivers are available through:
Click here for a comprehensive overview about getting in-home care.
Carefully review the pros and cons of each.
In-home care services range from light supportive care and companionship to full nursing services. In-home care agencies are licensed by levels of care they can provide.
In-home care services are usually paid out-of-pocket. Some long-term care insurance policies have an in-home care benefit. Medicaid may also cover some in-home care for low-income seniors.
If you’re paying out-of-pocket, no doctor’s orders are needed. If you’re accessing in-home care through a long-term care insurance policy, there may be required physician forms.
Costs for in-home care range, on average, from $15/hour to $37/hour. If complex medical care is needed, prices will be higher.
Most in-home care agencies have minimum service contracts. Most will require a 2-5 hour, per day, minimum for 3 days per week.
After a lot of discussions, Ethel’s family put together a safe and appropriate plan for her return home. They decided to share time and tasks. They’re each taking turns spending the night and staying over on weekends. Stan, who runs his own company, can’t commit to staying with mom. Instead, he’s contributing financially towards the cost of hiring a caregiver from an in-home care agency.
The agency has a trained and experienced caregiver who’ll come for eight hours on Mondays, Wednesdays and, Fridays to help Ethel.
Everyone hopes Ethel will regain her strength and get back to normal. If that doesn’t happen, Ethel and her family will consider other living options. It might be more cost effective financially, emotionally and socially for Ethel to move to a senior living community.
When it’s time, Ed will call a Senior Referral Agency. He knows he can trust the recommendations of an Oregon Senior Referral Agency Association member.
For more information, referrals and help making senior living decisions,