Nursing Homes and Assisted Living Dilemma

For family members across Kansas and Missouri, struggling to choose the right service to take care of an aging beloved with Alzheimer’s disease or dementia, an important aspect of the decision is understanding the differences between nursing homes and assisted living. It is a dilemma Mitzi McFatrich deals with every day as the executive director of Kansas Advocates for Better Care, a non-profit advocacy organization assisting elderly care service residents and or their family members. “There are so many of us that are aging and a large number of those individuals are going to have Alzheimer’s disease and dementia,” she said. “How are we going to fulfill their care needs?”

nursing_homesPeople often mix up nursing homes and assisted living facilities, but the two are not exactly the same. A nursing home provides health care to Alzheimer’s disease and dementia patients, with RNs on-site eight hours a day. In Missouri and Kansas, assisted living facilities employ RNs on a limited basis. Because assisted living facilities receive health insurance funding, there are strict state and government regulations on staff training, the number of employees required per shift and the level of cleanliness. There is zero government oversight for assisted living centers; very few state rules. Medicare often pays most of a patient’s elderly care service bill. In assisted living facilities, a resident’s family must shoulder the whole cost.

While a nursing home service agrees to become a permanent residence for individuals no matter their disease, a person who’s Alzheimer’s disease or dementia worsens can be discharged from an assisted living service. The director of education, programs and public policy for the Alzheimer’s Association, Heart of America chapter, Michelle Niedens says these care facilities can evict a resident in as little as 30 days. “There’s often an over promising; ‘We can handle your mom and dad, through the whole disease course,’ that is, until some major bump occurs and then the game gets changed,” Niedens said. According to McFatrich, facilities will say, “We can no longer fulfill this person’s needs. And that’s what they use in order to release someone.” That release or eviction can affect a family’s ability to find their loved one a new house.

Age Friendly Assisted Living Centers

The middle-agers are coming of age, which means a large section of the population is now approaching or in retirement. An older demographic means a different atmosphere for many cities and most of all, different needs. Housing, transport options and community service needs are not the same for senior citizens as they are for, say, families or middle-age professionals. Making sure cities are able to properly provide senior citizens is important. With the population bubble of middle-agers attaining retirement age, the number of 65 and older is expected to grow; all the while, growth in the under-24 age bracket is reducing.

Economist Charles Colgan talked recently in Wells, observing that the quickest growing section of the population usually is the 65 years and older. Maine is not alone in dealing with an aging inhabitants, of course, and to that end, the AARP and World Health Organization have been working to make the Global Network of Age Friendly Communities. Regionally, Saco is positioned to become the area’s first such group. The town started this process with an evaluation of its present condition and what could be done to make the town more “age friendly.” Topics up for conversation included community contribution, health employment, interaction, outdoor areas, transport and real estate, among others. By gathering to evaluate the present condition of the town in regards to elderly people, the town is taking a practical advancement in being an eye-catching place for individuals to come and stop working and perhaps even more important, for long-time residents to age in place.

assisted-living-centersSimple developments like including more bus runs to and from food markets and medical care facilities, street developments and wheelchair-accessible community areas can make a big difference in enhancing individuals’ total well being. Bigger changes like cost-effective senior housing and cost-effective assisted living centers can also allow senior citizens to remain in their communities even after they can no longer care for a single-family home. Making these accommodations, especially in assisted living centers, not only makes the community more pleasant to them, but also to their loved ones. Improvements such as those community areas and transport also benefit the entire community.

Alzheimer’s Awareness and Assisted Living Centers

As assisted living centers across the country reach out to areas during World Alzheimer’s disease Awareness Month, care facilities in The Woodlands have one big concept for group members: They are here to help. Autumn Leaves in of The Woodlands Memory Care, in particular, is featuring its childcare and respite care programs, which offer daily stays at its facility from Monday through Friday. The day-stay program is offered to Woodlands-area citizens absolutely free on Fridays, Executive Director Luis Carillo said.

assisted_living_centers“We are dedicated to individuals that are working with harmful dementia-related diseases day in and day out,” Carillo said. “We focus not only on care-giving for specific types of dementia, but also with actions that help with socializing, exercises and religious actions.” By providing programs like day stays, care providers and close relatives are given a chance to rest and recover. They also allow future residents to ease into the conversion process of moving completely into assisted living centers, Carillo said.

Rina Hanel knows all too well the complications that close relatives and partners face when working with the severe facts of dementia. Her spouse Greg has been at Autumn Leaves in for the past year. “The greatest thing you have to do is agree to it,” Hanel said. “It can start with simple things like misunderstandings, failing to remember things, losing track of things and just advances from there. You really have to agree to what exactly is occurring to the person you love as there are so many people out there in denial.” Hanel said her spouse has adjusted well to Autumn Leaves and has been passionately referred to as The Hat Man because of his many preferred caps. Due to his sickness, he hardly ever talks but usually spends his time cheerful and silently monitoring his environment. Moving him to the service was a huge step, as the two have been wedded for more than 54 years. However, Hanel highlighted that she has no remorse. “I think the important thing is that he may not know me all the time,” Hanel said. “But I know him.”

Aging with Dignity and Assisted Living Centers

Recent studies suggest that more elderly people are hoping to forgo assisted living centers and assisted-living facilities in favor of living out their days in the comfort of their own home. A 2010 AARP survey found that nearly 90 percent of elderly people older than 65 want to “age in place,” or to live in their own home and community safely, independently and comfortably. While aging in place may be more achievable for healthy, active elderly people, elderly people with health issues are just as deserving of the independence and dignity that residing at home provides.

assisted_living_centersThat’s where home health care comes into play. In-home health care solutions can serve as a less expensive and more personalized alternative to residential care features for elderly people. Learning about home health care solutions can help in making the decision if in-home solutions are suitable for you or a loved one. When people think of in-home care for elderly people, they are often thinking of two different kinds. True home health care involves the administration of healthcare services by trained doctors, said Timothy J. Colling, vice chairman of the San Marcos-based A Servant’s Heart Care Solutions. “Strictly speaking, ‘home health care’ is a term that is reserved in the law for the provision of healthcare solutions in a home setting,” Colling said. “What that comes down to (are) factors that a doctor, typically a health professional or a physician or physiotherapist, provides something invasive or technically tricky, like changing a sterile wound.”

“Home care” differs from “home health care” in that the caregiver’s focus is on helping their client with “activities and everyday living,” or ADLs. Because the home caregiver serves as more of a companion than an in-home health professional, he or she is not required to have the same training and certifications as a home health care counterpart. Many home proper care agencies provide both kinds of senior care, while others provide one of the other. But, it still stands that for elderly people with serious conditions, assisted living centers are still the go-to place for them.

Assisted Living Centers Competition

Despite the state’s aging population, the common age of Ohio nursing-home citizens has decreased from 83.1 years to 77.3 in less than two years, according to a state-commissioned report. Several reasons underlie the pattern. On one hand, far more senior Ohioans who would have been in assisted living centers 20 years ago are in their own homes today, thanks to the state’s focus on less-expensive home-health services. Among Ohioans, at least 60 years of age who need help looking after for themselves, 55% obtained proper care in a seniors care facility this year compared with 91% in 1993. And the state now is based far less on nursing-home care than in the 90’s, when Ohio had one of the highest rates of nursing-home use and its State Medicaid programs per-capita nursing-home expenses were among the biggest in the country.

assisted_living_centersOhio’s rate has enhanced from 47th among states, to 24th, said Bob Applebaum, director of the Ohio Long-term Care Research Project at Miami University’s Scripps Gerontology Center. “It symbolizes an amazing success tale for the state,” he said. But a malfunction in the state’s healthcare system also is a factor in the lower regular age of nursing-home citizens, Applebaum said. The number of nursing-home citizens younger than 60 more than tripled between 1994 and 2012, from 4% to 12.7%. And 1 in 6 State Medicaid enrollees residing in assisted living centers was younger than 60 this year. That is an increase of 26% from 1997 and coincided with an 11% drop in the number of State Medicaid programs enrollees older than 60 in assisted living centers.

In the spring of 2012, there were 8,723 State Medicaid program enrollees younger than 60 in assisted living centers. Of them, 18.5% needed no assistance with “activities of daily living” such as showering, putting on clothes, eating and self care. Competition from assisted-living centers and home-health organizations also has forced assisted living facilities to keep prices down, Applebaum said. Ohio has kept speed with its growing inhabitants of elderly citizens with serious problems, but that growth is expected to speed up over the next 25 years, increasing in size.

Assisted Living Centers Difficulties

You will find loads of things to research when it comes to finding the right assisted living center. It’s not too much to ask for family members to give their support in the task; it could be good for their spirits. It’s important for the community’s supervisors to keep that in the front of their thoughts when trying to determine where to spend their efforts and energy. Otherwise, it’s merely a place where bodies and minds waste slowly away. Of course, there are a lot of strong reasons to consider an assisted living center. A good assisted living center will encourage your family members to keep their personae active, let alone the convenience of having direct access to directed health care and therapy.

Kemper HouseHowever, a look at the other side of any assisted living center can put individuals on guard. There’s always the likelihood that there are individuals who do not care for older loved ones as well as they should. This aspect is often the center of lawsuits and a damaged reputation. When you do go through the search, the needs of your older loved ones need to be specifically considered in relation to a large sampling of facilities, so that any problems can be identified and moved past.

One more piece that should be regarded is how a personal price range will impact that decision. Regular assisted living centers certainly are not cheap and bracketing out options is reliant on the financial situation. Understanding what will be provided is just another way to guarantee less stress for everybody. Making the effort to check everything out is definitely the best use of your energy and effort in this situation. After all, it’s certainly worth the persistence for everyone who has ever thought about the care of aging family members and where they live.

Whenever thinking about assisted living centers, there happen to be a number of problems that must not be neglected. The ability for the right center to be a pleasant and fun is paramount in allowing your loved ones enjoy the fantastic years. The other side of that will be a place entirely without goodness and convenience and should definitely be avoided. Still, a primary look at the price range is most definitely the best way to go about things.

Financial Considerations for Assisted Living Centers

Assisted living is an alternative living arrangement for senior citizens requiring moderate care, including help with activities like eating, getting dressed, bathing, and using the bathroom as opposed to the more intensive care provided in nursing homes. This type of care serves as an intermediate between in home care for the elderly and the elder care provided by a nursing home. Facilities for this type of living may be in connection with retirement communities, nursing homes, home medical care agencies, or complexes for senior citizens, or they may be separate facilities. This type of elder care is known by many names, such as residential care, board and care, congregate care, and personal care.

assisted_living_centersAnother aspect of assisted living centers to think about is cost. Assisted living is generally less expensive than elderly care service, but more expensive the in house care for the elderly. The usual range is anywhere from $10,000 per year to over $50,000 per year, so it is important to know what you can afford and how much each service costs. Another thing to know is that there may be fees not included in the basic rate. It will be helpful to figure out how much extra you will have to pay to live in a certain house. Insurance may help cover some of these expenses, but usually, charges are covered primarily by the elderly people who decide to live in these homes or family members responsible for them. Some assisted living centers also offer financial assistance programs, which you may want to inquire about.

Medicare does not cover the expenses of these homes or the senior care provided there. Medicaid is the joint federal and state program that helps elderly people and people with disabilities pay for medical care when they are unable to afford it. It may cover the service component of assisted living in certain states. It is important to consider the different options in elder care. If cost is a concern, it may be helpful to consider in house care. This type of senior care may provide sufficient care for your needs in the comfort of your own house. If the degree of senior care provided by in house care or an assisted living service does not meet your needs, consider an elderly care service or nursing home.

Assisted Living Centers Oversight

The US Senate approved a bill that is designed to stiffen management of Florida’s nearly 3,000 Assisted Living Centers approved by a 38-0 vote. “It’s a work that we’ve all put a lot of attempt on,” said Sen. Eleanor Sobel, sponsor of HB 646. The Bill was  prompted by a 2011 Miami Herald research that exposed years of misuse, neglect and even loss of life of ALF citizens, said Sobel, D-Hollywood. “Legislation failed in the 2012 session,” Sobel said during the bill’s second reading. “We have a more focused strategy this year. We are trying to better implement present rules. I know this bill considerably enhances the lives of over 80,000 citizens in ALFs in Florida.”

assisted_living_centersThe bill, she said, would consist of these measures:

Change the fine structure for assisted living centers and make charges more foreseeable and fair. Fines would be specified rather than making the amount up to the Agency for Health Care Administration or AHCA, which manages the state’s ALFs. Bigger features would pay larger charges than small ALFs.

Clarify when AHCA must revoke a certificate or place a moratorium on a problem ALF.

Require a research of AHCA’s examinations to figure out if different personnel continually implement licensure requirements to help make sure the administration of the same requirements.

Require that houses with at least one mental health patient acquire a specialized certificate for restricted psychological health insurance coverage make and make certain the service has a plan for a resident’s psychological health care. The present need is three psychological health patients.

Ensure all ALFs offer a two-hour pre-service training for new service workers.

Supporters compliment a need for AHCA to develop an ALF ranking system by Nov. 1. Physicians would also be needed to make a customer guide website with a supervised opinion area to be available by Jan. 1. The community would be able to add feedback which would “capture the energy of competitors to enhance the quality of care and solutions in ALFs.” The invoice would also require ALFs to notify new citizens that it is unlawful to get back against citizens who make a complaint to a long-term care ombudsman, deal with examinations and charges.

Technology and Senior Care

Technological innovation has already made waves in senior care through the use smart-sensor systems that can observe residents’ motions, nearly removing the need for a room-by-room check in the morning. Eight in ten assisted living residents need help handling their medicine, according to the National Center for Assisted Living, and medicine management is placed to be the next focus for time saving performance through a new technology coming to market: digital pills. But that is not all they can do. Imagine a regular day in a senior care setting. Care providers visit the bedrooms of all citizens who get medicine. They provide the medicines and then wait around several minutes for each resident to take them, one by one, guaranteeing the amounts are not neglected or lost.

technology_and_senior_careBut what if the care provider simply left the daily amount and move along to the next resident, not having to worry about awaiting each individual to take each pill? Enter: digital pills. The development was released by Proteus Digital Health and obtained U.S. Food and Drug Administration acceptance last July 2012. The technologies are now being promoted for at-home use in Britain and will be getting in U.S. medical centers later this year, which could have wide significances for senior care. “Our electronic health reviews program is designed to help individuals better handle their care each and every day,” says David O’Reilly, primary product official. “Whether it nudges to help individuals keep on track with their schedule or better advised caregivers and physicians, the program will provide significant benefit to those who are suffering from way of life changes as a result of getting older.”

The digital pill works as part of a system to monitor and observe a person’s consumption of medicine as well as vital symptoms and activity. On standard, seniors use five to six prescriptions, according to a 2007 study released in the Journal of Internal Medicine. The digital pill has the ability of being integrated into medicine themselves, or being taken as a placebo pill along with medicine. Once digestive function starts, the pill, which contains an electronic indicator about the size of a grain of sand, goes to work. It sends data through a wearable patch, via Bluetooth straight to a family member’s or caregiver’s mobile phone or computer, allowing that individual to know the medicine has been taken, whether the individual is up and about, and even health alerts.

Realities in Assisted Living Centers

Assisted living centers are places where people, who are less than independent but not in need of full time care, are provided with guidance or support in the activities of daily life. It is a proper care option typically employed by the elderly who do not require the 24-hour health care typical of an elderly care facility. It gives seniors help in housing, support services and health care, on a needed basis. The setting is similar to a person’s own home; however, assistance is provided in the form of meals, housekeeping, entertainment and other lifestyle support. The senior gets the security of having assistance when needed and residing in a structured environment, while maintaining an overall stage of independence. Options include staying in a separate apartment or condominium type residing quarters, or if more assistance is required, staying in a dormitory. The stage of interaction with staff varies, depending on the stage of need.

assisted_living_centersOne of the major drawbacks for those seeking assisted living is the cost. The median monthly cost for assisted living is $2,575. While this may be comparable to assisted living centers prices, covering the expenses is much more difficult. Medicare A and B, the traditional sources of funding for a senior’s care, do not offer comprehensive protection for long term, ongoing care in an assisted living center. Medicare A, which pays for hospital coverage for seniors, may provide partial coverage for care in an assisted living center for rehabilitation following hospitalization, but will only last up to 100 days. Coverage will decrease throughout the 100 days. Medicare B, which covers physician care, will not provide any coverage for assisted living expenses separate from treatment by a doctor. Private insurance is the most effective way to pay for assisted living care.

Medicaid, a state and federal program which provides health care for low income individuals, may cover some assisted living expenses. However, the availability of State Medicaid programs coverage will vary by state, and likely will be decreasing coverage rather than expanding in the coming years. In contrast, traditional assisted living centers are covered by Insurance coverage if the senior stays in Insurance covered certified house after a qualified hospital stay (at least three days).