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Do most facilities prepare all meals, or will we still need to provide snacks/options for Mom?


I assume we buy her Depends, toilet paper, clothes, and incidentals?


Do they clean the bathroom? (She doesn't often flush the toilet, or put her Depends in the trash, etc.)


If she soils her bed at night, do they take care of that? Clean her up, clean her bedding?


How are her bills paid, would she get mail?


Do they make her take her meds?


Would we still need MedicalAlert for her falls? (She doesn't walk well, has a walker, but won't do her exercises.)


I am thinking of what WE do for her and what THEY would do for her instead. I realize that that she would be assessed somehow for the level of care she'd need at a particular facility - maybe this question can't really be answered her. I appreciate other experiences, thank you.

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Speak to the individual facilities to learn what they provide. It goes according to level of care and costs go up exponentially with care needs. Choose a few care facilities and visit. You will have your questions and they will have also some for you as to your Mom's assets, and etc. Basics are usually three meals a day and snacks, cleaning and checking, laundry once a week. Almost all care facilities in your area will have a web site with a whole lot of information, but your best information will come from a visit.
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drat55 Oct 2023
This brings up another question I have - would it be best to visit facilities BEFORE taking Mom for a visit to formally be assessed?

Thank you!
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Assisted Living facilities should DEFINITELY be visited prior to taking your mom for a formal assessment! How, otherwise, are you going to know if the AL meets your standards and budget?

AL is not likely to accept elders with incontinence issues that cause her to soil the bed regularly, and require linen changes and for she herself to be cleaned up. AL is designed for fairly independent seniors who need some assistance with Activities of Daily Living, like showers, help getting dressed, and even adult brief changes that aren't much more than that. My mother changed her own Depends when she lived in AL for 4 years.

Her AL had housekeeping that cleaned weekly, and disposed of trash daily, 3 hot meals a day from a menu, fresh fruit and cookie packets available 24/7 at the coffee bar, laundry once a week, doctors and lab tech's, xray tech's visiting the facility all the time, med delivery directly to the AL, etc. Mom had her own mailbox and key, and USPS mail was delivered daily.

She had her own studio apartment but 1 bedrooms were also available. She had a full size refrigerator, microwave, and set of kitchen cabinets just like a regular apt, just no stove. Cabinets were stocked with plates, cups, glasses, utensils, bowls etc. She had a coffeemaker and toaster too. The mini bus (no extra charge) took residents grocery shopping regularly for food and toiletries which the resident pays for, naturally.

I paid moms bills and the AL bill came to my email. Depends and wipes were on her dime, tissues and tp they supplied. Shampoo, soap etc she paid for, as well as prescriptions. She was on the prescription plan where the AL QMAPS administered meds to her at an extra cost of $400 a month back then. If her PCP at the AL wrote her a new RX, it'd be ordered, delivered and administered to her w/o my involvement at all.

Mom's AL required her to wear a necklace with a call button on it. She'd press it if she fell or needed help, 24/7. There were also pull strings by the bed and in the bathroom in case of an emergency. She was showered 2x a week on a schedule, dried and powdered too. As she required help getting dressed, she got that service too, all based on a point system. Rent included 12 care points. Each care service was 3 points. As her needs increased, her points needed to increase too and she was charged accordingly. I believe the highest care plan was $1200 extra a month, but she never reached that point before she had to segue into Memory Care.

The mini bus took residents to doctor appointments, shows, the mall, restaurants ( their lunch bill was added to their tab and I paid it w rent each month). The AL had Happy Hour with live bands on Fridays w dancing. Buffets with family invited on holidays. Gorgeous gardens to stroll. Physical therapy on site.

That about covers it. My recommendation is to avoid chain ALs and see if you can find privately owned facilities instead.

Good luck to you
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drat55 Oct 2023
Wow, had no idea there would be a fee for meds! She takes a few pills morning and evening - she CAN manage that on her own, but doesn't want to.

Any tips on figuring out if a facility is privately owned? And why do you make that recommendation?

Thank you.
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drat, where I live, AZ, ALs will and do provide care for bed bound seniors. They charge for levels of care that include daily housekeeping, laundry, Med management, etc. It is expensive but, it provides what the person needs to be kept clean and safe.

Please, do go visit facilities. Make an appointment the 1st visit and then pop in a couple of times unannounced and walk through the facility. I found that tours only showed the best face and the real face could be quite different.

I, highly recommend, board and care facilities that do hospice. They have a better staff to residents ratio, they are much smaller and cost a lot less. This allows for extras if the finances are there, meaning companion sitters, etc. If mom isn't social or into activities these are a great option. No sense paying for amenities that won't be used.

Take your time and do the research, it pays off. But, do not hesitate to move her if the 1st choice isn't a good fit.

Best of luck, placing a parent is the hardest thing I have ever done, be prepared for the pain, it helps to know how difficult it truly is.
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If mom has trouble with mobility I suggest you look at a few to "feel the vibe" then pick 2 which to take her at another date
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Assisted Living is just that, they assist. They are not skilled nursing. Think of it as Mom is going to an apartment. What ever she needs to live in an apartment, she will need in an AL. She will bring what furniture will fit, towels, bedding, toiletries, toilet paper and tissues and her Depends. There should be a little kitchenette with a microwave and small frig. She can have her favorite dishes, flatware and glasses. If she has favorite snacks, there is a place to put them. The nice thing is, she gets 3 meals a day and where Mom was, snacks. There are enough holiday and birthday parties, there's always cake. Her room will be cleaned by housekeeping. Her laundry will be done.

But, if your Mom suffers from Dementia, an AL may not be a good choice. She may need memory care. The AL will evaluate her for care and be honest. If they feel they do not have the ability to care for her, they will recommend MC.
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You got a lot of good answers here, I just want to add one thing that I didn't know until I last-minute went to one facility, and it was crucial (someone else here mentioned it) as she can quickly decline as my mother did: Ask each facility how they handle things when she can no longer transfer out of bed or to bathroom, and when she needs end-of-life care. Most will tell you that they don't handle 2-person assists and at some point, your mom will need that. Then you are stuck moving her again. And if the CNAs/ helpers are overwhelmed by her needs, you will hear about it and they can ask you to move at any time. I suggest finding an AL that will provide hospice care through their own or a separate hospice company (at a more-costly level than general AL) prevents you from having to move her into a SNF (nursing home) when she cannot transfer or has memory issues. A private nursing home (SNF) in my area is 16-17K (we did not want her in a Medicaid SNF). In the AL facility my mom is in now she gets all the features of a SNF, it is half that. Still costly but... we did not have to move her far (only upstairs to the hospice wing). The AL she is in is not licensed as SNF but frankly, she gets far better care IMHO than the SNF I have seen.
All that said--my mother was at home as long as possible with a paid caregiver for 2 hours a day to do all that cleaning etc stuff and it was far cheaper and she was happier.
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You can also look for facilities that are faith-based and non-profit. Here in MN, my MIL is in Presbyterian Homes (they are regional). They've been around as long as I can remember and have an unwavering excellent reputation. They see the care as a mission, therefore they are far more invested in the quality of life for their residents. They are also supported by larger organizations with funding. Here there are also facilities that are Catholic, Lutheran and Jewish. My MIL has never been a Presbyterian, so one's faith does not matter to the facility.

Whatever facility you consider, make sure to ask how long the lead admins have been in their positions. If there seems to be a lot of turnover in the upper ranks, this is a red flag. Turnover in the lower ranks is happening everywhere so take that with a grain of salt.

Look for facilities that have a continuum of care (AL to MC to LTC to Hospice) so that your LO never has to "move out" when a higher lever of care is required. Also, make sure the facility has Medicaid beds. My MIL is in LTC on Medicaid. This is different than a county Medicaid-only facility (much different!) Don't put your LO in any facility that doesn't accept Medicaid.

You can join Nextdoor.com (a non-anonymous intranet of your actual neighbors and local communities) and make a Recommendations Wanted post. You will get lots of good, first-hand and unvarnished input from people who have LOs in local facilities.
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WearyJanie Dec 11, 2023
agreed! Make sure they except Medicaid. In our area, the nicer AL facilities that accept Medicaid required a two-year self-pay before you could transition into a Medicaid room. Also, in our area, it was impossible to find out any prices without actually going into the facility and getting a folder. I don’t know why they make it so hard to find out the prices. I am almost sure. I missed some good options while I was trying to find a place. A place for mom was of no help to us.
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A point I forgot to answer "How are her bills paid, would she get mail?"

The AL will not pay her bills. If she cannot do it, then u will need to. She should not have that many if she has no home. Her rent and electric should be combined. She may have to pay for cable and a phone line, maybe WiFi. Good question for the director. I used an antenna for Moms TV and she had no use for WiFi.
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Most als are on a scale. Whatever their intro rate is could be go up by double once things like toileting, bathing, meds and transfer come into play.

They proviide meals. They clean the toilet once a week. My dh’s ccrc has an in house medical alert that summons cans.
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At my mom's AL, they have 3 meals in the dining room at an assigned table with 3 other ladies. Seating at 730, 1130, 430. I know there is coffee all day in one of the common areas, but for snacks you are on your own. If they don't feel like going to meals, they can be delivered but cost $4.50 for the service. Unless they are sick and TELL you to stay in your room.

They can do blood draws and UTI tests.

Yes, she pays for her own depends and other toiletries and TP, etc.

Housekeeping comes once a week. Perhaps the LNA could pick up her depends and throw them out and flush the toilet. For my mom, they have a list of things to do for her. She gets charged extra for the level of extra care she needs.

Does she often soil her bed at night? Nightly? A couple times a week? I don't know how my mom's place would handle this. It's a biggie.

Every apartment has a mailbox outside the door and the receptionist makes deliveries every day. I have mom's bills sent to me and she just gets personal mail at her place.

Many people get their meds from the nurse. I don't know that they "make" any take their meds but they do encourage it. The facility uses a pharmacy that comes in and fills the meds for the nurses to distribute to the residents who pay for that service. I was very happy to give up that job.

This place has their own alert necklaces or bracelets that they are supposed to wear at all times to push in case of a fall, emergency, or just needing help. They can be worn in the shower so they should stay on all the time.

PT is on site so if the places you look at have PT, they can evaluate your mom and maybe get her stronger.

Weekly laundry. I wish they did it more often. With incontinence you have to have a lot of clothes to make it for a week.

Activities - a variety of things are available. Bingo, music entertainment, chair exercise class, crafts, painting, cards, etc.

I would ask around for suggestions. Some facilities are known to be better than others by the locals. I'd pick out the one you like and bring her to that one for an evaluation. Keep it simple.

Best of luck.
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