Assisted Living For Dementia Patients

An assisted living facility might be an option for Alzheimer's/dementia patients who don't yet require skilled nursing. And it might be an option, as well, for the spouse who can no longer do all the care-giving.

Applicants must meet certain guidelines, such as a specific score on a mental status exam. In addition, an applicant may also have to undergo an assessment procedure, to determine if the level of care is adequate, or appropriate. This enables doctors to assess whether any other factors are contributing to the patient's dementia - including whether medications and dosages are correct.

If an applicant is accepted, a written care plan is developed. It's not set in stone, though...it should be reviewed once the first month, and every three months afterward. And it's important to review it again if there's a change in the resident's condition.

If you're considering an assisted living facility, visit several!

Here's a checklist for you...

• Is the facility licensed, if required by your state? There's little state or federal oversight of these facilities. So always make sure there are safety requirements in place.
• What's the environment like? Many people with Alzheimer's experience agitation, and need a safe place to wander around. So look for common space areas, and at least one enclosed outdoor area.
• What kind of activity program is in place? Ask to see the activity calendar. Look for a wide variety of activities, providing social interaction, mental stimulation...and fun.
• What's the staffing ratio? A good rule of thumb is two certified nurse's aides (CNAs) for every ten residents during daytime, with one CNA per ten residents at night. 
• What training do staff members get? Does it include interactions with an instructor, group discussion, and role-playing? Or is it simply watching videos?
• Does the facility have a special Alzheimer's unit? Dementia patients generally do better in a unit (or facility) specifically for them. The best choice is a special care unit, where staff has received additional, specialized training.

WARNING! Don't be fooled by words...especially the words "special care unit." While some facilities do provide additional staff training, others simply add a locked door.

BUYER BEWARE! Contracts are similar to those for apartment leases. Some facilities offer month-to-month agreements, while others ask for a year-long commitment (which lets you lock in the monthly fee.) However, because the progress of dementia varies so much from person to person, a year-long agreement may cause an expensive problem if the patient unexpectedly needs nursing home care. If you sign a year-long agreement, be sure the contract has an escape clause, allowing someone to move out with reasonable notice if he/she needs a higher level of care.

Many facilities cost as much as nursing homes. But neither Medicare nor Medicaid covers it. Long-term care insurance may pay all or part. But, without it, assisted living residents generally pay themselves.

Does the whole process seem frightening? It doesn't have to be.

At The Law Offices of Alice Reiter Feld & Associates, we're Elder Law attorneys...and we help families with decisions like this every day. In fact, over the past 33 years, we've helped thousands of South Florida families deal with this issue...as well as comprehensive estate planning, wills, trusts, powers of attorney, long-term care planning, asset preservation, and issues with Medicaid or the VA.

If there's a way to save you money, we'll find it. And we're just a phone call away.