assessment

irene912 · March 19

Anyone know how an assessment is performed for assisted living? It's possible my LO won't qualify & will need memory care. Just don't know what to expect. Really hope we can try assisted living but not sure what is done to assess. Just really trying to prepare myself mentally. My LO is progressing fast & am hoping memory care is a little further down the road.

M1 · March 19

Hi Irene. In general on the boards, there's a saying that by the time most families recognize the need for any form of "assisted living," the loved ones are generally way past "assisted living" and usually need memory care. So don't be surprised if that's the recommendation. Typically we all tend to view our loved ones through rose-colored glasses and with the skewed perspective of what they used to be capable of: not very realistic in terms of where they are now and where they will be in the future.

In general, an assessment will look at things like their ability to perform their own activities of daily living like bathing, dressing, toileting, and getting themselves to meals and activities. Whether they are safe in a space without constant supervision.

You would do well to prepare yourself for memory care. I'm a bit leery of places that may offer you an assisted living spot with the full knowledge that it's unlikely to work and that you'll need to make a switch to memory care in short order: almost a "bait and switch" game. There is real commercial competition out there that enables this.

You should go to the assessment armed with questions about ratio of staff to residents, staff dementia training, availability of on-site services (everything from hair care to podiatry, medical, psychiatric, and dental), criteria for expulsion, and whether/how residents are allowed to age in place, including use of hospice.

Keep us posted how it goes.

irene912 · March 19

Thank you so much. My mom is needing more help these days. That is a fear of mine too, placing her in AL, then having to move soon. But I guess we can see how mom does if they offer AL. Another thing is, I"m not sure the mem care at the AL we've chosen is best for mom. I've looked at another that may be an option. The other facility is all dementia care, the whole facility, not just a unit.

M1 · March 19

Perhaps it would be worth your while to have her assessed at both places? In general i think highly of places that are all dementia care.

harshedbuzz · March 20

Care needs to be appropriate for mom when she's struggling the most-- not some aspirational reach she might achieve at her best time of day with prompting.

If your gut thinks she might not pass the assessment, I'd skip the 2nd move entirely. Especially if the AL's affiliated MCF isn't as good as the other. It is not uncommon for places to approve a PWD for a trial in AL knowing the PWD will fail, and they'll be transferring to MC soon.

The other piece to this is that a hospitality model AL will be populated by individuals who could potentially resent having a PWD included at their table for meals and activities and react unkindly. My aunt was bullied in AL and accused of cheating because she couldn't recall rules for games.

HB

irene912 · March 20

https://alzconnected.org/discussion/comment/202773#Comment_202773

You're right. Thank you for your input.

Emily 123 · March 20

Irene,

My mom did ok for a while at a ‘whole facility’ combined AL/MC (the MC had a separate pod, but all used the common areas during the day). She's much better taken care of and is happier at a MC that has 18 other residents in her 'area'. The other place was a chain of very attractive but hospitality-style AL's with an MC unit (named after the founder's mother) that touted itself as dementia focused care. It had fobbed entry to the facility, so allowed a mixed population. Once she needed more than basic support they dropped the ball (they lost their RN Director and never replaced her with a nurse, and care went downhill fast). They were not staffed to provide the care my mom needed, and if she told them ‘I’m fine’ they left her alone despite a care plan built to ensure hygiene was maintained. I suspect it was mainly because they were understaffed and didn't want to deal with her resistance. Just be forewarned that you'll need to look closely at how many staff for how many people. They may have a good staffing ratio in their official MC, but have minimal staff at night for the other 60 moderate dementia patients, and corners will be cut. If they are not staffed to support more than the basics your loved one will still need some executive ability for that kind of model to work.

irene912 · March 21

https://alzconnected.org/discussion/comment/202836#Comment_202836

Thank you

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