What is the difference between assisted living and a nursing home?
An assisted living community provides communal living, often with planned activities, housekeeping and laundry, transportation, meals, exercise and wellness programs, opportunities to socialize with other residents, and assistance with activities of daily living. These can include bathing, toileting, eating, and dressing, and may also include things like medication reminders. Some have special wings for residents who develop Alzheimer's or dementia.
In a nursing home, residents are under the 24-hour care of licensed or registered nursing staff (in a skilled nursing facility) or of certified nursing assistants (in an intermediate care facility). Some examples of reasons seniors might need skilled nursing would be if they were bed bound, needed a respirator, or had wounds that were not healing and required daily care.
Two years ago, when my father had a stroke, that followed 2 years of fighting colon cancer, the doctor told us that it was time for hospice care...the hospital almost tossed him on the street the next day. I had to find him a place quickly, and chose what was billed as an assisted living place, but turned out to be a nursing home. Dad, who was sharp as a tack until 2 days before he died, was put into half of a hospital room, with a curtain between him and the neighbor, who kept the TV on almost 24/7, at full volume, and would snooze, then wake up if I turned it off, to turn it back on. He had the window, so Dad had only a view of his own closet. He was bed-ridden, and had to ring for a nurse to change him, or to help him dress, or get into his wheelchair, or to help him downstairs, so he could have a smoke. I paid $6,000 of my parents' money, for him to be there for a month, while we decided what to do next,. Within the first 2 weeks, he would beg me to bring him his gun, so he could kill himself. The nurses were over-worked and understaffed, so they ignored when he rang his bell, and left him in a dirty diaper for hours. They ignored his plaintiff requests to go outside, and one nice day, he spent 3 hours sitting in front of the elevator, and none of them would take him downstairs for some fresh air...but the night male nurse discovered he smoked, and took to stealing my dad's cigarettes during his shift. It was a TERRIBLE place! I moved him out after 3 weeks, and they refused to refund the 4th week's rent, telling me "it wasn't their fault" that I changed my mind! HUH?
Meanwhile I found an assisted living place, out of the city (Chicago), in the suburb I live in...a Sunrise Community. I was able to put Dad in a studio apartment, with a hospice-supplied bed, but his own furniture, including his computer, in the room with him; and the window was right next to his bed, so he could always look out! And I moved Mom, who had developed dementia (Dad covered for her for years, I think), into a studio across the hall, and paid the same amount of money for both studios, that I had paid per month for half of a room in that nasty nursing home!
Dad passed soon after that, but Mom is still there. She has her own furniture, TV, and a tiny 1-bedroom apartment, with a bedroom and a living/sitting room, and a bathroom. She gets cleaning service, laundry service, and 3 meals a day served in the dining room, which is like a restaurant, only you never need money down there...and no tipping is EVER allowed! I pay extra for the 24/7 nurses to give her the 6 meds, since she either forgot them, or took more than one day's worth in one day. But she has made friends, looks forward to 3 times weekly BINGO, and they have a lending library, so she can read. There are lots of rockers out front, and only 2 floors of apartments, so there is LOTS of personalized care! Mom is truly happy where she is, and so am I! I sold her house, though at a bit of a loss, but I have the money in the bank, and will try to make it last as long as she does.
So to answer the question, nursing homes, which take Medicaid, are generally under-staffed and over-worked, and provide little or grudging or no care. And you have to get on a waiting list to get in on the Medicaid pay-plan, other wise you have to private pay, and still get lousy service, as we did for my Dad. Assisted living places DO NOT take Medicaid, and are private pay only...but the people who work at the Sunrise Communities are angels, who treat the elderly with love and respect, even when they are being difficult. And yes, there is a "Reminiscence" area in the back, where Mom may need to move eventually, but she will still have her furniture, clothing, and other things important to her, with her, and she will always have a window!
The main difference between assisted living facilities and nursing home facilities is medication administration. In most states assisted living facilities are not allowed to administer medications under any circumstance. In a few states a third party vendor is allowed to come in and administer the medications. I consider this practice of 3rd party administration to be a poor decision due to the lack of oversight and follow up, should there be a negative side effect or if things simply get worse with an acute issue. All the assisted living facilities can do is call 911. Nursing homes on the other hand can monitor and provide skilled assistance continuously.
I am an administrator / consultant of long term care facilities and can help you with any questions you may have about your specific situation. Contact me through www.nursinghomehelpcenter.com and I can provide you with all the information you need to make a wise decision that you will look back on in a positive manor.
Prayers to you.
All I can say is be very carefull. Because what may seem so great and wonderful may not be what it seems. You may want to go to Sunrise facility and check on your family member often. I worked for sunrise assisted living. And the place seemed perfect when I first started. But as time went on I noticed more things that were happening that shouldn't. And Sunrise is well known for not telling you everything when it comes to certain things that may be going on with your family member. I have worked for regular Nursing homes and have seen the same kind of reputation. Just be warry and cautious. Yea it seems nice because they send the residents out and do more things with the residents. But sometimes I've noticed that the employees will lie to you about what they did or where they went. To me it's all scamm to get more money from the family members. Yea they make it look extravigant and they want you to believe that your family member is in like a Five star Hotel. But be cautious! Take it from an employee who use to work for the company. It's a load of crap if you ask me. There always short employees, and they do over work there employees. The (Care Manager) has alot of duties that are impossible to do in one shift. But the company wants you to believe that no, The care manager can do all the duties. don't believe everthing you hear from that company. If you look them up online, you will find that there have been several lawsuits against the company, and alot of x-employees complaining about how there short staffed and overworked. Google it, you'll see for yourself. They don't allow us to be apart of a union because they don't believe in it. Yet that's what they need for there employees. The pay stinks. These residents pay a ton of money to live in these facility and yet a care manager who does all the work doesn't get much. How does that make sence? You should sit down with one of the employees you may know well that cares for your family member. Ask them what they do and how much they get paid. If there willing to tell you.
I'm sorry you feel so mistreated by your employer, or former employer? But I do go to see Mom at least 3 times a week, morning, afternoon, and evening. I've been there while she is eating, and helped her spoon food when she can't do it and drops it on herself. I've been there while she is getting her medications from the nurse-techs. I've been there at night when she is sundowning. All I can say is I stand by my original posting. The Sunrise that my Mom is in provides excellent service. I have chatted at length with many of the employees there, one-on-one in many cases. No, they are not paid enough, for all they do there...but then who is? But the loving care that they provide for my Mom goes above and beyond what they are paid to do! I'm grateful that I was able to move my Mom into the Alzheimers wing this past Easter, so that now she is in a much smaller "community", and she very much enjoys the scheduled activities, and making "friends", as much as she is able to. She's happy where she is, and that makes me happy too.
I have had good results in mom assisted living place but she is unhappy. No place will make her happy as she was unhappy since she lost my dad. She was lonesome at home and is in the home also. She has lots of things to do but refuses to do it. Mom has always been hard to get along with but now she is worse. Trust me as to say I have tried to keep her happy and it is impossible. she can't accept that she can't live alone and never will. Tried to tell her to try some of the activities but she jsut get nasty reply back to us.
To respond to Aaron's post - in California the medication dispensing issue does not seem to hold true. My father is in an assisted living facility and they are able to dispense medication. Now that he is more advance in his dementia and experiencing more medical problems, the primary issue is the requirement that the facility automatically call for a hospital transport under certain conditions, even though he has a very clear DNR. Once he became eligible for hospice services and there was room on the hospice waiver, that problem was solved because now the facility would call hospice (and me, of course) first. Thus we can prevent him undergoing unnecessary treatment and the trauma of an ambulance ride and ER visit except if he is in pain they cannot manage through hospice.
I have both of my parents 92 and 87. One with ALZ and the other with dementia. They live 6 hours away from me and the stress of driving back and forth to tend to them and cook their meals (bagged and frozen)has finally taken it's toll on my and husband and me. I have found a wonderful place near me that IS NOT a nursing home. It is assisted living that only takes residents with memory issues. They will give out meds and do everything else that I see a depressing nursing home doing. It will be a battle, but in the long run, I know I am doing the best thing!
This is for the person who has a depressed parent who refuses to get involved in activities. I am a masters in counseling student, and currently researching mental health in relation to ageing adults. May I suggest your parent may need some therapy for depression associated with grief. Sometimes ageing adults are put on anti-depressants and not given therapy. Therapists help by impowering the client and medications can't do that. There are many training clinics at universities like mine that offer very low cost counseling services. THe cost is low, because it gives students like myself training under a licesed Marriage and Family Therapist. Our clinic charges 10 dollars a visit, and doesnt accept insurance. It is similar to how doctors work an internship in emergency rooms under other experienced doctors guidance. Check the Universities closest to where you live. Find out if they have a training clinic that offers counseling to the public.
