My mom has been living in an apartment with our support (transportation, groceries, etc). But she's getting weaker and we all agree (her included) that it's time to move to assisted living. She's 93. Our best guess is she has 2-3 years left (but you never know) and we want them to be as good as they can be, which to me means finding the best place. We have 3 seemingly nice choices in our community. All relatively new and and all seem very nice. I've asked for input from others from friends and from FB community groups and I get such varying comments. "I'd never put my mom there, we had an awful experience. She was terribly neglected." to "That place was fantastic. My mom had a wonderful experience. Staff was great." - all about the same place at the same time. Etc, etc. I know I'm overthinking it and majoring in the minors. Any advice on how to make your best decision? My dad was in assisted living (different state) and skilled care nursing home for 3 years, so I'm familiar. He had dementia and had specific needs. It's harder this time with mom who doesn't have the specific needs and is very capable mentally. She's been declining physically the past few years so we see a trend. I would just appreciate any tips on how to make the decision and also how to effectively advocate for your parent once they are there. Also any ideas for keeping on top of things- I'd love to put in a nanny cam type of thing where you can just check in on her ... but I know, I know... over worrying, invading her privacy for my peace of mind, etc. Gosh, hard to let go of this. I know we can always move her, but as with many elderly, she hates change. Anyway, enough rambling. Thanks in advance for any help.
So for me, I would go see for myself. Are the residents clean. Residents seem happy. No smells. The staff friendly. Rooms bright and clean. The facility bright and clean. Maybe Mom and you have lunch at each one.
My Mom was in a small AL were the residents were not separated. So Dementia residents mixed in with people that still had their minds. There were some residents that I felt should have moved onto skilled nursing. Since ur Dad was in one, you know that ALs are limited in their care. They don't have the aides or nursing staff that skilled nursing does. Some families don't understand this and expect the staff to do things they are not required to do. People need to realize that Mom or Dad will not get that one on one care that they would give.
Ask the places for references, and call them. Of course they'll give you names of people who are really happy with the place, so make sure you ask them to tell you something they weren't happy about and how the place handled it. Ask about the food -- does their LO like it? (That's huge, since meals are the highlight of their days.) Ideally you want someone whose loved one has been there for a while, not just a couple of months.
Ask about communication -- does the place communicate well about the LO's situation? Do they welcome visitors at any time? What level of independence do they expect from the residents, and do they make accommodations for varying levels? For example, do they encourage the residents to come to activities, and if they don't, do they just give up or find ways to get them out of their rooms?
Go with the vibe you get, too. I had to put my mom in memory care, and I looked at a place that on the surface looked spectacular, but they had all the residents crammed in front of a TV in a fairly small common room. They also had a resident who was developmentally disabled and didn't belong in a memory care, but her parents(!) were in the assisted living wing and they decided to put the daughter in memory care. Totally different needs from what a MC resident needs, and that takes away attention from the properly placed residents. I also don't like places that use TV as a babysitter, so even though the place was 1/4 mile from my house and looked like a five-star hotel, I didn't go with it.
Since Mom's still with it, definitely involve her in the decision making, too, but at some point, let go of the worries. You're smart enough not to put her in a dangerous or abusive situation, so trust your judgement.
When interviewing the facilities/communities, I got all of the info and amenities like podiatry, hairdresser, PT in house, in-house doctor/nurse visits monthly, dermatology, psychiatry and I asked “what does mom have to do to get kicked out?” This helped me see the parameters. It is assisted living and they do have transfers to hospice if needed and a memory care unit if she begans to wander. I chose Atria because of the price, amenities, food is delicious, clean, friendly people no matter what job they do, and the entry fee is transferable to any Atria if we have to move and want mom to move…or if this Atria isn’t doing well (not likely but nice to not have to shell out more entry fees)
mom loves it, she is independent, she has wonderful tablemates, she has privacy and safety. The flu shots were give and it was apartment to apartment. I got a fax number (FaxBurner) so I can get messages and requests to the nurses staff in writing. I am involved when I need to be and they know my name. Mom and I will talk and she will forget to ask for a Tylenol. This allows me the ability to advocate for her via fax.
The list of “tools” I use have made mom’s time with Atria a good experience for her and me. I put events on the calendar for Alexa to announce to mom so she can have more activities in her life.
I recommend independence for mom in Atria. We lived together for 8 months before she moved to assisted living and I think she is enjoying her assisted living because it is hard for family members to live together. I get to be a advocate daughter and she gets to have privacy and independent. She chose this place out of the 3 I had scheduled for us to visit. It has been a good experience (except for the turnover of staff during covid). Most staff have been there 8 plus years.
I have items sent to her via Amazon and she gets her teas, dry mouth lozenges, creams. i got her a DVD player and the staff set it up for her.
She is checked on several times a day with trash pick up, medication management, and if she doesn’t go to a meal, they check on her. I am pleased.
All of this has been prayerfully done. Mom and I prayed about it and all the doors were opened for this place. I am glad she is happy with her home.
I’m a State Ombudsman.
Five Stars ratings Mean Nothing.
People with loved ones in a facility will mostly give you compliments about said facility. Otherwise, they would be admitting they put their loved one in a mediocre place.
The key is to stay proactive. Keep your nose into everything. Ask questions. Do not fear retaliation.
When looking for places over the years, one thing I made sure to look for was a view from a window in her room, where she could watch people with pets and see the weather and seasonal changes. And that detail was really important with covid, as I could have window visits with her, which was the highlight of every day for her.
The other thing I'd like to point out is that since your mom is still mentally sharp it would be good to know if others in whatever home you choose have the ability to be friends with her. At the assisted living place I visited yesterday, they mentioned that they had a professor there who had no one to talk to, since all the others have dementia and can't enter into the sorts of conversations he'd like to have.
Good luck with your search.
But when we were looking, I scouted out several places on my home, did the tour and narrowed down the choices. My mom was very hesitant and it was a challenge to even get her to go look. So I knew I didn't want her to see anything negative, as that would really send her back to " just let me go home by myself and whatever happens, happens."
So I narrowed it down to 3, and we toured. We ate lunch and talked to the ladies. Got an activity schedule and attended one, and talked to more residents. The residents will give you the lowdown.
Since your mom is still with it mentally, ask her what is more important to her in a place. Where would her apartment be, is it far to go to dining room, activities.
In my mom's place they had a resident council, that came around welcoming new people, giving them advice etc. They would come around to new residents and get them involved in whatever was going on.
Every one has a line on what makes a place "bad". Food? Communication with staff? How fast maintenance happens.
Activities?
While there have some people around since she went to live there in early 2020, there have been a lot of staff changes both in hands on everyday people, and administrators. So you might want to base your decisions on more the policies and procedures than the actual staff as they might not be there in a month.
Clean and well maintained, with multiple opportunities to socialize, decent food, is more important than shiny new to me.
Now, I'd also look as to how they handled the covid crises, outbreaks, lockdowns etc
I would suggest that you carefully analyze both your expectations and your mother's. Also consider what services will be important to your mother's needs. This involves her emotional needs as well as simple physical care. Write everything down in bullet lists. Also consider the attitudes you expect between residents and staff. "Gentle persuasion" to one person may be "aggressive" and "pushy" or "bossy" to another.
Even the concept of "neglect" is a very personal one. If you expect that staff will check in on your Mom every half hour or so but the facility only does a check if a resident misses a meal you will have some issues. Sometimes, for a person of your mother's age and medical issues it is better to pay more for a regular nursing facility rather than Assisted Living. In "Assisted Living" it is usually assumed that the resident is capable of most of the tasks of daily living and requires little monitoring or supervision. In nursing facilities there is more interaction between staff and residents. For my uncle, who required no medications, it was still a better choice to place him in nursing care because he had difficulties with motor skills and hearing problems that required a higher level of supervision/interaction.
Do discuss your preference for a nanny cam when you visit your list of potential residences. The staff can give you pointers on what they allow and what approaches have worked well for others.
Also, don't be too put off by those who will insist that all such places are horrible and not an option. They are simply wrong. Whatever bad experiences or (worse) unfounded prejudices on which they base their opinions, there are many really good facilities. Those people are not going to step in and take care of your mother when her needs become more than you can meet. You are taking the right steps. I only wish we had looked ahead and found a place for my Mom when she was still sufficiently "there" to make a sound decision. I know that our visits with Mom in her last 4 or 5 years would have been much more joyful if we had visited her in a nice, clean group residence instead of her increasingly dirty and disorganized home. The change will be much easier for your mom to accept now. We waited too long and when she really NEEDED residential care she was no longer able to understand what she needed.