The recent CBS investigative report regarding the cases of alleged neglect at a national assisted living chain held no surprises for me. I began my career in the elder care industry fifteen years ago when assisted living provided only “stand by,” assistance with activities of daily living (ADLS = bathing, dressing, toileting, transferring, walking, and eating). Several years ago, I made the observation that many of the assisted living communities were offering more “hands on” care to their residents. At the same time, I also observed that they were accepting residents who really belonged in intermediate nursing care or a skilled nursing community*. Being a former Admissions Director and with my current position as a senior living advisor, I thoroughly understand the current long term care market conditions.
The Admissions Director is the most important contact at a long-term care community. He or she is responsible for attracting and residents, while maintaining a high census. Many Admissions Directors also act as marketing liaisons. They provide your first impression of a long-term care community, and often are a direct reflection of the care your loved one is going to receive. They are also responsible for the initial assessment of the type of care that is appropriate for the senior. It is important to bear in mind that Admissions Directors are often commissioned salespeople. They are accountable to, “the powers that be,” for maintaining a high census. I can remember the terrible pressure that was exerted upon me by the management in order to keep filled the continuing care retirement community where I was working. Scarcely was a bed emptied before pressure came to fill it. The passing consolation that the seniors, “were called home by God,” just didn’t cut it in terms of lightening the pressure for quick turnarounds. I know that with a bad economy, the pressure is even worse.
My point is this. Don’t let someone “sweet talk” you into thinking they can take care of your loved one in an assisted living community when he or she really needs skilled nursing care. Many, but not all assisted living Admissions Directors will play up the aesthetics their community has to offer, as well as the absence of the stigma associated with placement in a skilled nursing home. The savings ($4,500 is the the average cost per month for assisted living in the Chicago metro area vs. $6,000-$9,000 for skilled nursing care) may be attractive in the short run. But you will only be placing your loved one at risk and facing another move when things don’t work out. In addition, keep your loved one’s long-term financial realities in mind. Assisted living communities are mostly private pay, with the exception of the Supportive Living Program, and don’t offer the advantage of Medicaid support, as do skilled nursing homes. I have heard many assisted living representatives say, “We can take care of your loved one from admission to the point of bringing in hospice.” Of course they can, at a cost that is equal or more than what you pay for skilled nursing care.
*Intermediate nursing care offers hands on assistance with bathing, dressing, toileting, transferring, walking, eating. There is a nurse available in the community on a 24 hour basis. During the past several years, assisted living has assumed many of the tasks involved with this level of care. Skilled nursing offers total assistance with the activities of daily living listed above and the resident normally has a serious health issue as well. For example, the resident may require a feeding tube or tracheotomy.
For all of your senior living needs, please contact Andrea Donovan Senior Living Advisors.