Maybe Assisted Living Facilities aren't like college dorms after all... or are they..

Parent Cafe
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<p>I had visited some senior citizens assisted living facilities with my dad, and though that some of the nicer ones (that didn’t have a nursing home component) reminded me of college all over again-- People with the same schedule, of the same general age, interests, scheduled meals and activities, etc. I was ready to move in myself. However, this article has caused me to rethink it just a <em>bit</em>. I’ll post the beginning of the article and the link to the full thing. Look what we parents have to look forward to…</p>

<p>(from the AP newswire)
O.C. Asst. Living Facility Sued for Dead Rat in Senior’s Mouth-
90-yr.-old Man Possibly Ingested Rat Poison</p>

<p>SANTA ANA, Apr. 6, 2007 - Staffing was so inadequate at a California senior center that a rat crawled into an Alzheimer’s patient’s mouth and died there before staff noticed, a lawsuit claims.</p>

<p>The lawsuit, filed Thursday on behalf of 90-year-old Sigmund Bock, alleges that administrators at the Paragon Gardens Assisted Living and Memory Care Community in Mission Viejo overbooked their facility to receive corporate bonuses, but cut back on staff to increase profits. </p>

<p>“The facility so literally ignored the needs of their residents … as to allow vermin in the form of a rat to become lodged in the mouth of Sigmund Bock and die therein,” the lawsuit alleges. </p>

<p>(full story)</p>

<p><a href=“http://abclocal.go.com/kabc/story?section=local&id=5190226[/url]”>http://abclocal.go.com/kabc/story?section=local&id=5190226&lt;/a&gt;&lt;/p&gt;

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<p>egads jym…I read that one too! grooooossss!</p>

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<p>I once read an article about the social dynamics at assisted living centers. OMG it was HIGH SCHOOL all over again. There were queen bees, popular “boys,” ostracized “kids”…it was really scary…</p>

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<p>Oh, geeeeeez. we are in the middle of a discussion about this subject (assisited living-not dead rats. ewwww) with regard to 90 year old father-in-law. Bizarre family dynamics are in full flower. We have to decide this week.</p>

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<p>The dead rat case may represent an individual who needed more extensive care than is possible in an assisted living facility. I would think that an individual who could not recognize and respond in a rational way to that situation would be in need of skilled nursing care.</p>

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<p>Marian,
This facility apparently lists itself as an “Assisted Living and Memory Care Community”. With the “memory care community” rubric, I would assume that they have some varying levels of skilled nursing care for their dementia patients, stopping short of meeting the multitude of rules and regulations necessary to be qualified as a nursing home. I would hope that if they felt they were unable to provide the level of care this gentleman needed, they would have arranged to have him transferred him elsewhere. I have to wonder how long he was left on his own for them to find him with the dead rat functioning as his appetizer or afternoon snack!!</p>

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<p>Have you ever been to one of the senior living communities?! OMG is right! I’ve seen it with my own eyes. <em>Any</em> male becomes popular in that there are so few of them around. There are definitely real jealousies that take place over the fact that a particular woman “gets the guy.” We are talking 80 and 90 something year olds here! </p>

<p>But ugh, jym that story was just…horrifying!</p>

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<p>I used to work at an assisted living facility which was really swanky (thousands of thousands of dollars a month this place charged) and I worked in the area which was solely for those with Alzheimer’s…</p>

<p>You can do a Google search for things about most any upscale place, but here are some things to look for…</p>

<p>Double check and make sure that every CNA is just that, a CNA. Some places try to save money and instead of having a Certified Nursing Assistant, they will have a Caregiver. A Caregiver has not certification and they are normally paid squat and have squat for training. </p>

<p>Ask for proof as to how many actual nurses are on staff and ask for proof of their hours. Some folks will try to dupe you. They, meaning the heads of some of the departments, will call a Caregiver a nurse or they will call a CNA a nurse. Do not fall for that. You find out for sure who is a CNA and who is a LPN or LVN or RN and so on. Ideally, if you have a parent with any form of dementia at all, you want a place which has nurses 24/7 on top of CNA’s. </p>

<p>Ask for the CNA to resident ratio and also ask for the Nurse to Department ratio. Any place worth their salt should be able to tell you that with no trouble at all. If they hesitate ask for proof, because they might be trying to dupe you.</p>

<p>The only other thing I can think of right off the top of my head is to ask and see what form of security the place has. See if they have someone manning the front desk for a really fair amount of hours a day. And, please ask about a wander guard. A wander guard is a little, harmless, device which precludes those with dementia and the like from wandering out the door. And, if they wander out the door a little alarm sounds and someone will help them. Ideally a good place will have security present after the receptionist goes home. </p>

<p>I really cannot think of anything else as of right now. Except for the obvious things. Do a surprise visit for starters. Do not give anyone time to prepare anything when you are hunting about for an Assisted Living Community. Drop by all out of the blue like and try and see what kind of cleanliness standards the place has. If you can smell wee wee, you might want to skip out. That means that there is a lot of incontinence to be had and that folks are not trying to be patient with the residents who have mobility impairments. You do not want that, for it leads to bedsores. </p>

<p>I know this is a long post, but I am just speaking from my heart about this topic in order to try and be helpful.</p>

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<p>When I read about that case, I wondered if it might be like the “finger in the taco” case–someone set it up to get $$$.</p>

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<p>Mildred-
Thank you very much. Your post will be e-mailed to all the sibs this morning as we try to determine what is best for my father-in-law.
Mafool</p>

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<p>There are different types of assisted living facilities. Unfortunately for me, I have negative stories about both types.</p>

<p>The ones for Alzheimers patients are called “assisted living” because they do not provide the type of medical care given in nursing homes. My mother-in-law had advanced Alzheimers and was in one of these for several years before she passed away. I do not know if it is typical of all of them, but, although it looked physically beautiful, the staff did not spend the time necessary with each patient. (It was very expensive.) My mother-in-law could not even hold a spoon or feed herself, and needed to be fed. My father-in-law spent much of each day at the assisted living and fed her at least one or two meals a day. On the infrequent occasions he could not be there, another family member tried to be there to feed her. Each meal took 30-45 minutes, and the staff would have spent a much shorter time feeding her, so that she would not have eaten enough if a family member was not there. My sister-in-law, who spent a lot more time there than I did, observed that the people in a similar condition to my mother-in-law who did not have someone visiting often and feeding them did not seem to live very long. I am not sure if this is typical of most or all Alzheimer’s facilities, but it is something to check for.</p>

<p>My mother is in a regular assisted living. Many of the people are “with it” mentally but are frail or need assistance. There are a lot of activities, and she actually likes it there, after an initial adjustment. However, just like daycare, there is a lot of staff turnover and things are not always done correctly. My mother is in fairly good health, considering her age, but she takes a large number of different medications for various conditions (seven pills in the morning and two at night). Yesterday she told me that they had “run out” of one of the medicines that she takes twice a day for three doses. It is a very important one and missing it could lead to dire consequences for her, which I will not go into here. She had noticed when it was first missing (in the evening) and complained, but it still took a whole day for them to get it from the pharmacy, so that she did not get it until the morning of the second day after she brought it to their attention. It does not make sense that they ran out since the medications are ordered on a monthly basis. (I am going to call and complain later when the nursing supervisor is there.) Another time they tried to give her a pill that was not hers. These mistakes frighten me, because many of the patients are not as “with it” as my mom, and do not know which pills they are supposed to take or not supposed to take. Also, we are paying $7 extra per day for them to administer her medicine, on top of the very expensive basic fee. </p>

<p>Both of these places are considered to be good, so I guess these mistakes happen at most places except perhaps some very exceptional ones.</p>

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<p>It certainly sounds like the facility in the article is a combined assisted living and skilled nursing facility - usually they have seperate areas if a combined facility. It also sounds as tho this patient/resident was in the SNF part.</p>

<p>ALF’s have many and varied circumstances - and it is really advisable to interview and research everything that you can about how the facility is run and available resources.</p>

<p>It is never easy to realize that an elder needs these types of services and to make the right choice. I wish you the best of luck in your search and decision.</p>

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<p>We went through this with FIL (blind, early Alzheimers w/limited mobility). We cared for him in our home until he required more skilled care than we could manage. It’s never easy making these decisions, but doing your homework can help you find the best situation for your family. Ask lots of questions and trust your instincts. You have received great suggestions here as for what to look for. We became discouraged many times during our search for the right place but we kept looking and shed tears of relief in the parking lot when we found the right one.</p>

<p>Something to consider is what happens in the event that the resident’s health deteriorates and more skilled care becomes necessary. If the facility also has a SNF will they automatically be transferred to that wing? If the facility is assisted living only, will the financial resources still exist to start over and get them into a good skilled facility? What happens when the $ runs out, does the facility accept Medicaid? These are just a few questions to keep in mind.</p>

<p>After going through this process in our family, we came away more firmly convinced that parents should never forego saving for retirement to send the kids to colleges they can’t really afford. We often say the best gift my FIL ever gave us was the freedom to choose a wonderful nursing home for him because he had saved the resources in his retirement fund to finance it.</p>

<p>Best wishes.</p>

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<p>Just an observation…Isn’t is interesting that this thread, that began as a rather grim, yukky one, has turned into very a positive, helpful one. In many other cases, threads start out with a helpful topic and then are run aground. Is ther a lesson here?</p>

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<p>Hmmmm… the comment I posted didn’t “register” even though it posted. Do positive compliments throw off the system?? :D</p>