Are Assisted Living Facilities Set Up to Adequately Care for Patients with Alzheimer's?

By the late 1970s it was becoming apparent the institutionalized setting of nursing homes was no longer acceptable for all aging seniors and their families. As advances in medicine allowed seniors to age in place, many were balking at the idea of nursing home placement. With rumors of mistreatment and neglect surrounding long-term care gaining more and more publicity, the need for change was evident.

The concept of assisted living facilities was born in the early 1980s to bridge the gap between living at home and residing in a nursing home. Since 1981, it is estimated that over 50,000 facilities dedicated for the elderly only that have been built in the United States that are not skilled nursing facilities.

The aging community today has more options than ever before when it comes to long-term care. For many their ultimate goal is to stay out of a nursing home as long as possible.

Independent Living (IL) communities provide housing for seniors who for all intents and purposes live, as the name implies, independently. Many of these communities consist of private homes or apartments and offer only minimal assistance with home maintenance. The underlying goal of many of these communities is to eliminate the social isolation that plagues many seniors as they become older.

Assisted living facilities (ALF) offer a housing alternative for older adults who may need help with dressing, bathing, eating, and toileting, but do not require the intensive medical and nursing care provided in nursing homes.

Skilled Nursing Facilities (SNF) provide the most comprehensive care of all the senior house options. Also known as nursing homes, SNFs are often a last resort for many seniors. SNFs can can provide the 24/7 support that is needed for those in declining health who need more intensive medical interventions.

A growing concern in recent years is assisted living facilities getting in the business of caring for residents with Alzheimer's disease. Assisted living facilities that previously would not take a resident with Alzheimer's disease are now actively marketing for these residents. The problem is these facilities are not increasing their staffing or supervision capabilities. Alzheimer's disease is a medical condition which requires medical attention and specific training in awareness, treatment, diagnosis, and injury prevention.

According to the National Center for Assisted Living, there are over 36,000 licensed assisted living facilities nationwide with an estimated one million residents. "They're becoming mini-hospitals. The trouble is assisted living facilities were not designed to deal with residents with significant medical needs. These facilities were designed for social models, not medical care models," said Chris Murphy, co-founder of Consumer Advocates for RCFE (Residential Care Facilities for the Elderly) Reform.

Beware of the assisted living facility that advertises they have "special" Alzheimer's or memory care units without also having a skill nursing unit and registered and licensed practical nurses on duty 24 hours a day. Make the facility prove they have the medical staff to care for your impaired loved one. Stop by for a visit after midnight or on weekends to evaluate for yourself the staffing levels during every shift. Caring for these patients requires special knowledge and training in the care for Alzheimer's disease. Ask staff members what training they have received by their employer.

Please remember assisted living facilities have no federal guidelines or requirements like hospitals and/or nursing homes.

What can you do?

When evaluating an assisted living Alzheimer's unit look for the following:

1. Determine whether the facility follows the standard of Alzheimer's care, or commonly called, care practice recommendations and are recommended and supported by the Alzheimer's Association

2. Check to see the facility's Mission Statement and if it states a commitment to dementia and Alzheimer's care. The Mission Statement should state the goals of the facility and how they plan to get there.

3. Validate their Alzheimer's training. Training can't be a one day seminar or video tape; it has to be ongoing. Recommended are 12+ hours of initial training and additional hours of training each month. Each staff member should also be updated on each resident. Most often the staff has no idea about the residents' backgrounds, family history, medical conditions, needs, safety precautions and other needs. When they are short-staffed, neglect surfaces.

4. Ensure that the staffing/patient ratio is acceptable. The staffing patterns should ensure that residents with dementia have sufficient assistance to complete their health and personal care routines and to participate in the daily life of the residence.

5. Check for the level of staff communication with a resident's family. This is critical to helping a family understand the progression of the resident's disease.

6. Ask the staff the following obvious Alzheimer's related questions. (If they can't answer them fully or to your acceptance level, look further):

a. What are the causes of Alzheimer's disease?

b. What are the Symptoms?

c. How is it diagnosed?

d. How is it treated?

e. What are the dangers associated with the disease?

7. Check to see if they have procedures to deal with events that take place when caring for Alzheimer's patients. For instance, they should have a fall prevention program for the simple reason that, because of age, Alzheimer's and medications, people living in assisted living facilities are at risk for falling.

~ For the complete guide go to www.alz.org and look for Dementia Care Practice Recommendations for Assisted Living Residences.

If you or a loved one suffers from inadequate care, an injury or wrongful death due to nursing home or assisted living facility neglect or abuse, you are not powerless. You have legal options. Rich Hitz as Carlson & Burnett, LLP can counsel you and your family and help you fight for compensation. Contact Rich at 402-952-4179 to set up a free consultation.

Resource: "Watchdog: Hazards, training, background checks among problems at troubled assisted-living facilities" by Lily Leung, The Orange County Register

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