Decision Time: Asst Living or Nursing Home?

jkom51September 5, 2011

This is an article everyone who may become a caretaker or has POA for an elderly relative, should read. So many of us are facing this difficult decision, and don't know how to evaluate a potential caretaker situation.

Assisted Living or a Nursing Home?

NYTimes June 10, 2011

(Full link below: NYTimes allows free access up to 15 articles per month)

(Excerpted) "When families can no longer keep an older adult in his own home (the almost universal preference) and are investigating congregate living, "that's everyone's first thought," said Lisa Gwyther, the veteran social worker who directs the Duke Family Support Program in Durham, N.C. "Everyone says, 'My mom doesn't belong in a nursing home,' so they think assisted living, regardless of her medical needs or prognosis."

But assisted living won't work for everyone, either. The author consulted Ms. Gwyther and Dr. Hawes for guidance on which older people are likely to do well there and which will need the greater supervision and higher staff ratios a good nursing home can offer."

Here is a link that might be useful: New Old Age Blog: Asst Living or Nursing Home guidelines

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Another good article. I always cringe when I hear someone say they've promised their parent that they will never place them in a nursing home. None of us knows the future. We have no idea how our loved one's health or mental abilities will deteriorate. It's unfair to the loved one and unfair to yourself to make a promise you simply may not be able to keep.

My mother lived in two assisted living situations, but eventually she needed to move into a memory care unit. What the article says about staff numbers and incontinence care is true. As my mother's dementia progressed, she withdrew more and more from the planned activities. So she ended up spending most of her day napping or sitting in her apartment alone. However, once she moved to memory care, she enjoyed a day full of various activities. That was because the staff to resident ratio was better. The staff got everyone up & dressed and herded off to breakfast. Then they were ushered into the great room for activities. They never spent hours alone.

All that to say that promising to keep a loved one out of nursing homes or dementia wards may not actually be in their best interests.

    Bookmark   September 7, 2011 at 7:20PM
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I'm so grateful to my mother, who always said, "Someday I may need to go to a nursing home. If I need to go and if I am in my right mind, I will be gracious and accepting." That day came. She wasn't at full mental capacity, but she was indeed gracious and accepting. What a woman!

    Bookmark   September 8, 2011 at 10:38AM
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I don't understand the decision...assisted living or care home? Assisted living cost a good deal of money depending on the care you need, housekeeping, laundry, etc.. Most people I know could not afford one. The ones I have been to furnish lunches, someone checks on you if you don't show up for at least one meal a day. You can go shopping if you can still drive. It's more for people who are alone with no family around. It's the kind of place I would go to if I could no longer drive.

A care home has staff that helps you get out of bed and get you dressed. They change you depends, give you medication on time.

    Bookmark   September 9, 2011 at 7:13PM
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One problem with asst. living is that a patient may be just fine this week, but next week be unable to remember whether or not they had breakfast or took medication or what! It's that sort of problem that a NH would usually be aware of sooner than in the usual assisted living facility.

Minor health problems can also be handle in a NH situation. Assisted living may not be able to, or want to, then it's a unneccessary trip to the hospital.

    Bookmark   September 9, 2011 at 7:42PM
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There are assisted living homes that have the care home on the grounds. One woman I knew loved her assisted living. she had a bedroom, a very small kitchen between that and the living room. She had her own private entry way and a parking place just outside the door. She said it was fine until she got sick then she had to go to the care home section until she was well. That was very expensive.

I know a couple who retired to an assisted living residence, they had the option to live in the large building or in a duplex that was on the grounds. No mowing or upkeep on the outside, they could still eat in the dining room and someone would check up on them if they didn't check in at the main building once a day.

    Bookmark   September 10, 2011 at 3:57PM
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