In this issue:
"Finding The Right Assisted Living Facility"
Part Two of Susan's Nine Part Series
The Story of The Magnificent Mrs. M.B.
Susan's California Seminar Tour "RAISING UP Your Parents"
Coming To Your Town Soon.
Its Free For Adult Children, Caretakers and Seniors
August 13, 2010
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Finding The Right Assisted Living Facility
In part two of the series on
assisted living I am covering how to find the right assisted living
facility. Remember, these are tips that I am providing.
There is no substitute for having toured each facility,smelled, seen and touched the operations.
I have done this from Los Angeles to San Diego and Ventura County. If
and when the time comes, I will make sure to refer you to the best place.
As I said in my last newsletter,"looks can be deceiving." A nice looking
facility in a nice neighborhood can be a nightmare and facility in a
sketchy looking neighborhood, a godsend.
If you don't feel like reading this newsletter, but have questions about Assisted Living or other elder care issues, call me at 1(888) 422-6070 or email me, susan@mymomnpop.com.
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Location
Most families want their loved
one within a 
very short distance from their work or home. Residents with frequent visitors generally fare better (physically and emotionally)
than residents without visitors.
Also, if an emergency arises, the family
or friend can be there immediately.
As for neighborhoods, generally
quieter is better. Of course, there are exceptions; for example, some
persons may prefer a facility within easy walking distance to stores
or restaurants, and won't mind if the facility is on a busy street.
Prospective residents and their
families shouldn't be overly impressed by the neighborhood in which
a facility is located. A good facility may be located in an undesirable
neighborhood and vice versa. I am a huge proponent of a facility that
looks like it is in a sketchy neighborhood, but the quality of care
and cleanliness of quarters is 5 stars.
Visiting to
Determine Quality of Care
The prospective resident and her
family members should visit each assisted living facility under consideration,
and then carefully look, listen, and smell. Are the residents up and
dressed, and engaging in activities? Is the general atmosphere warm,
pleasant, and cheerful?
Do residents look well groomed? Does the staff
treat residents with respect?
The prospective resident and family
members 
should talk to current residents and their visitors.
The residents
and visitors should know better than anyone else the facility's pluses
and minuses. I always arrive early to my appointments for tours and
sit and speak with the residents.
I ask them point blank whether or
not they like living there. Most individuals are very candid. Also,
when I bring family for a tour, I usually schedule it for lunch time
so that they can judge for themselves whether the food is delivered
hot and whether the residents are promptly assisted if they need help
with eating.
I also make unscheduled visits
during a weekend, and at night. This enables me to see whether the residents'
needs are met during the weekends and nights, when many facilities maintain
a smaller staff.
The focus should be on the facility's
services rather than the attractiveness of the facility itself. Some
facilities have lavish furnishings (particularly in the lobby) but show
little interest in the well being of their residents.
Of course, a facility's appearance
has some significance. Particularly important are residents' rooms.
If residents can furnish and decorate their own rooms, the facility
will feel more like a home. If, on the other hand, all rooms have the
same institutional decor, residents are more likely to feel depressed
and/or dissatisfied.
Questions for
Facility Staff Members
It's hard to ask questions if
you don't 
know what you want. In situations like this, the salesperson
tends to have the upper hand.
Since the consumer may not know which
questions to ask, the salesperson feels free to present a sales pitch
about services that may not be important.
A person looking for an assisted
living facility should think of what she would want or appreciate, and
then ask facility staff whether the facility can meet her requests.
Assume, for example, that a prospective resident wants to be able to
invite friends for a long-standing card game on Tuesday afternoons,
or needs assistance for a daily walk around the block.
The facility's
response to these requests will be helpful in two ways. First, and most
obviously, the response will let the prospective resident know whether
the facility can meet her request. Second, the response will give the
prospective resident a good idea of the facility's attitude towards
residents and residents' requests.
If the facility seems willing to
meet individual requests, it's a good sign. On the other hand, if
the facility staff seems hostile to or baffled by an individual request,
the prospective resident probably is better off looking at other facilities.
In addition to questions about
personal needs and preferences, the resident or family members should
ask more general questions about how the facility operates-for example,
who at the facility is responsible for certain tasks, and who will respond
to complaints?
Information about staff training
and turnover is extremely important. I actually think it is the most
critical question one can ask. Better facilities will provide meaningful
training for direct-care staff, and will have employees who have been
at the facility for several years.
The prospective resident or family
members should ask about the training provided for direct-care employees.
State regulations set a very low minimum-only ten hours of initial
training, and four hours of annual continuing education. Training at
a better facility will exceed the state minimum.
Annual staff turnover rates of
100% or higher are typical for direct-care staff due to the difficulty
of the jobs and the generally low wages. The prospective resident or
family members should ask how long various staff members have been working
at the facility. It is a good sign if employees have been at the facility
for years rather than just months.
Limits of Facility's
Care
An extremely important issue is
the type of care that a facility does not intend to make available.
As discussed previously in Part 1, state regulations allow a wide array
of medical services to be provided at an assisted living facility. However,
in many cases, the regulations do not require that those services be
made available.
Prospective residents and their
family members 
often assume wrongly that a resident will be allowed
to stay in an assisted living facility for the rest of her
life, or at least until she becomes extremely ill.
This assumption may be true
in some
facilities, but often is false. From facility to facility, there
is a wide variation in the types of care that are made available. A
facility can base an eviction on its inability to meet a resident's
changed needs.
However, a facility's refusal to make available a certain
type of care can be attacked as illegally discriminatory under the Americans
with Disabilities Act. In refusing to retain a resident with a certain
medical condition, an assisted living facility may be discriminating
illegally based on the resident's condition. This refusal may be challengeable
in court.
At admission, of course, the goal
is to avoid future disputes and litigation. To this end, a prospective
resident or her family members should ask specific questions of facility
staff about the types of care that the facility will or will not make
available.
If, for example, the prospective resident is becoming unsteady
on her feet, she should ask about the facility's ability to provide
care for residents who need assistance walking or getting in and out
of bed.
Ideally, the admission agreement
will explain clearly what types of care can and cannot be provided at
the facility. Alternatively, a prospective resident or family member
can ask the facility for a separate list. The admission agreement will
be the subject of Part 3 of this series.
Administrators
and Admission Coordinators
In a small facility (e.g., with
six or fewer residents), 
the facility's administrator may also be
the
admissions coordinator and cook, and may provide much of the care. Questions will be
addressed to him out of necessity, because
there are
few other staff members.
A larger facility, however, likely
will have a full-time admissions coordinator or marketing director.
This will be the staff member who will come forward to meet and greet
prospective residents.
In a larger facility, the prospective
resident or family members should address questions to the admissions/marketing
employee, but also should ask to speak with the employee responsible
for day-to-day resident care.
This employee may be the administrator
or may have some other title. She will know more than the admissions/marketing
employee about how the facility operates, and it is her attitude that
likely sets the tone for the rest of the staff.
Fire Safety
In general, assisted living buildings
are not well constructed for fire control. Most assisted living buildings
were when fire safety construction standards were weaker than they are
now.
A minority of facilities
have installed sprinkler systems. Others are built with doors and walls
designed to protect occupants from fire until the fire department arrives.
Examining Official
Records to Determine Quality of Care
The prospective resident or her
family members should examine the assisted living facility inspection
records maintained by the Department of Social Services. The inspection
records summarize the findings of all inspections conducted at each
assisted living facility by the state.
The inspection records also note
any money penalties imposed against an assisted living facility in response
to particularly blameworthy conditions.
Unfortunately, inspection records
are not available on the Internet.
If you have any questions about finding the right Assisted Living Facility, just call or email me by clicking, susan@mymomnpop.com
The story of the
Magnificent
Mrs. MB is now posted on my website. The story will unfold every week. If you
want to travel with me on this fascinating, sometimes heartbreaking, often uplifting and insightful elder care journey,just click on http://mymomnpop.com
"Raising UP Your Parents"
My public seminar and expo for adult children, seniors and caretakers
Coming to your neighborhood soon...
Its all about the continuum of elder care and aging, covering everything from home care to understanding the difference between Alzheimer's and dementia. "Click Here" to be taken to my web page for the seminar and you can register for free. Huntington Beach, Irvine and Woodland Hills are coming in October and November.
As an elder law attorney and a former elder law professor, and as a gerontologist with a B.S. in speech pathology, I feel comfortable saying that this seminar accurately represents what you need to learn about the aging process. It can help prepare you for what lies ahead for you, or what you may be currently dealing with.
Don't forget to visit my website, MyMomnPop.com and read the latest blogs. They are filled with cutting edge information about the aging process, elder care, and more.
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