Are you confused about what an assisted living facility is and how it differs from a nursing home? And what can you expect to pay? Here is a guide to such housing for older people
What is assisted living?
Assisted-living facilities occupy the middle ground of housing for those who can no longer live independently but do not need the round-the-clock medical supervision provided in a nursing home. They may be right for people who have trouble walking, bathing, feeding, or dressing, or who have Alzheimer’s disease or other forms of dementia.
Assisted living facilities may look like luxury apartments or modest group homes, but they have staff with AIDS who can help residents bathe, get out of bed, go to the dining room, take medication or other daily activities and needs. Food, activities, and housekeeping are usually provided. Some facilities have trained nurses on site, but many states do not require facilities to prepare or have them at all. Popular buildings – or special units within them, such as those for dementia – have waiting lists.
“The key is to start early,” said Elon Caspi, assistant research professor at the University of Connecticut. “You don’t want to wait for a crisis and then have 24 hours to make a decision.”
How do I find out how much assisted living will cost me?
Monthly costs for living in a facility typically range from $3,000 to $12,000 or more. Charges are often split into two parts: rent and a care plan. Rents are set in the same way that landlords set them for apartments, with larger units in more expensive areas having higher rents and rent discounts more likely if many units are vacant.
The cost of the care plan depends on how much support the facility residents think they will need, at least when they first enter. Most of them assign residents a “tier” or “tier” based on the extent of their needs, but some will itemize charges for specific services. It’s like the difference between a prix fixe and an a la carte menu (except you can’t choose which method you prefer within each convenience). Assisted living units or facilities dedicated to dementia residents are more likely to charge a comprehensive price, although many have tiers.
Make sure the facility assessment reflects what the resident will need, or it may increase the price if it provides more support than expected. Check if the food is priced separately.
What complaints can surprise me?
Facilities often have a non-recurring initial charge, such as a move-in fee or “community fee”. You should ask if there are additional charges for things residents need or may use, such as nurse visits, cable television, or other types of assistance; Such charges can quickly accumulate if not detailed in the care plan. Some places even have a business relationship with a pharmacy if you get it.
It’s worth checking a few months after moving in to see if the care plan exceeds residential needs. If so, ask for a price reduction to remove services that are not being used
Is it better to go with a facility that pays a fixed monthly amount or bills for each service?
If you want predictability on your monthly bill, you’re safer with a facility that’s all-inclusive or that charges by tier or bundled service. This is also true if you need help with many things. If you don’t need a lot of help, a cart might be fine. Some facilities have an independent-living wing or a program with carte blanche, which may be best for those who need only sporadic assistance. If you need more help over time, you can transfer to an assisted living section or program and receive a care package.
What happens when a resident ages and becomes infirm?
Care plans for those who need the most support can double or triple the cost for the most independent residents. Ask the facility to explain the reason for the price increase. Be honest with yourself and the facility about what you can afford if the bill goes up, because it’s going to happen. “You realize your future is coming,” says Karen Van Dyke, a certified senior counselor in San Diego who helps families find the right benefits for them.
Also make sure you understand the highest level of care the venue can provide If you need more, the house can force you to move out. For example, some places will care for people who have occasional memory loss or confusion but not those whose dementia causes confusion, agitation or aggression. Assisted living facilities have fewer legal protections against eviction than nursing homes. Be realistic about what you need: No one wants to move into a nursing home, but it’s dangerous for residents to live in an assisted living facility that can’t care for them.
What if I run out of money?
You may have to leave. Most assisted living facilities are for-profit, and there is no legal obligation to keep them unaided. 1 in 5 benefits Medicaid helps pay for the cost of providing care, but Medicaid doesn’t cover rent in assisted living facilities, so you may be forced to. Some states or counties will help cover housing costs if you have no savings and little retirement income, so it’s worth finding out if this is available. (Call your local area agency on aging for help.) Some facility owners will accept lower fees for longtime residents, but those are exceptions.
How do I find out how good a facility is?
While it’s easy to be daunted by fancy dining options, sparkling chandeliers and other building amenities, none of them are markers of quality care. If you’re considering multiple facilities, ask about the ratio of resident help — nights and weekends as well as weekends — and whether the building has licensed nurses and when they’re there.
The person who runs the facility is often known as the administrator or director. Ask about how many times this position has been turned. If a facility churns through several administrators in a few years, that’s a troubling sign about the quality of its management and owners.
Which is better – nonprofit or for-profit assisted living facilities?
The researchers found that for-profit facilities in Minnesota and Florida were more likely to be cited for violating state health regulations, but that was not the case nationwide. Both types of ownership have their pros and cons: A small for-profit facility with an on-site owner may provide better care than a mediocre nonprofit. Be aware that nonprofits are generally less expensive than for-profits; Although they are not required to provide returns to investors, they are run like a business and must earn more than they spend each month for capital improvements and to avoid cash flow problems. Nonprofits often use the same pricing method as for-profits, and many charge more.
What should I look for while traveling?
Christine Sundberg, executive director of Elder Voice Advocates in Minnesota, a coalition of family members, asks people to watch how residents engage with staff at a facility. “Are they active and busy with things, or are they sitting in a chair, being ignored?” she said. You can also aim to visit on weekends, when staffing is often lighter. Ask the facility if it will allow families to install cameras in residents’ rooms so you can keep tabs on them remotely
Who can help me?
Besides consumer groups like Sundberg, the most knowledgeable independent experts are long-term care ombudsmen, who advocate for federal funding for nursing home residents and other facilities for the elderly. Each state has such a program with advocates assigned to specific regions. An area agency on aging is another source. These organizations are local governments or nonprofit organizations that each state designs to help older people. They can help you understand your financial options and find benefits. You can identify your organization through it https://eldercare.acl.gov/Public/Index.aspx.
If you want to check a facility’s violation history, find the state agency that licenses the assisted living facility. In some states, this is part of the health department, while others assign this task to their human services or social service agency. A report is written after inspecting a facility. Licensing agencies may publish inspection reports on their websites, although they are not always easy to find. It’s a red flag if a facility is referenced repeatedly for the same problem.
Reprinted from this article khn.orgA national newsroom that produces in-depth journalism about health issues and is one of KFF’s core operating programs – the independent source for health policy research, polling and journalism.