Assisted Living: How Will You Choose?

My spouse’s parents spent time in assisted living facilities. I’ll provide some of the experience. G’s father had Parkinson’s and her mother Alzheimer’s and she’s 92 and is currently in a specialized facility. Dealing with these illnesses has been instructional. In fact, G is currently visiting her mother and we were discussing the current situation last night.

G’s parents preferred to stay at home, but in both of their situations it became apparent that a higher level of care was necessary. Grown children may say they can deal with this, but in our experience it may be far more difficult than one anticipates. G cared for a grandmother who had dementia and lived to 96. She knew what to expect. 

Making difficult choices is beyond the ability of some. 24 hour coverage is daunting. G’s parents, particularly her mother, resisted any care giver brought in, and even a chef hired to make custom meals. A lot was attempted to keep her in her home, as she wished. A CCTV camera installed in the main living area indicted that something needed to be done and was helpful when family discussions occurred. Management by committee is not a good method. The information supported the research that began in earnest, about 8 years ago.

One thing of great importance is a facility with multiple levels of care. Both parents were moved as their diseases progressed.  It would be best to avoid this disruption, which can be quite stressful for everyone. G’s father’s Parkinson’s was not initially diagnosed and became apparent only after a year in a facility. It may seem to begin as dementia, but as the disease progresses the diagnosis can change. Even simple swallowing, talking and walking can become very difficult, necessitating specialized care. That required a move to a different facility.  

G’s mother was the luckier because when it became obvious that her dementia required specialized care the family had the experience gained with the care of the father. They chose a facility which could provide a range of care and could accommodate Alzheimer’s patients should that be necessary, and it became so.  “Ro” has moved once in four years because some things about facilities are difficult to uncover until one is a resident. I’d say it is best to plan and prepare for a relocation should it become a necessity. She’s in a facility today which will be for life. No further relocations are planned or anticipated. She was placed on hospice care once, but has rebounded. She is in a gradual, steady decline. She’s comfortable and happy and has come to like her place which is cheerful, has good food and gracious staff. However, all of the facilities investigated had limitations, and that includes coverage by staff.

Location is important, too. Some geographical areas are more expensive but one of G’s brothers is about 90 minutes away and can visit frequently as he desires. G visits 3 or 4 times a year, each for 10-14 days. There are nearby hotels and restaurants where G can stay, have outside meals with mom, and so on. We’ve found it is beneficial for family members to have the opportunity to decompress. Ergo the nearby hotels.

Frequent, quality contact is important. An experienced care giver was retained to spend time with Ro about 4 hours a day, 5 days a week. The caregiver provides an extra level of quality care and is an independent monitor. The caregiver keeps G informed beyond the information provided by staff. There are conversations about every other day. The caregiver takes Ro to doctor’s appointments, to the mall and other locations for walks and to restaurants. Ro does enjoy the facade of shopping and outdoor walks. Restaurants provided an added variety to meals. 

These facilities have medical staff and Ro’s has two doctors on retainer. They are available for prescriptions, patient observation and consultation if something occurs, etc. They can support the patient’s other doctors and specialists and provide the family with frequent medical assessments. 
I’d suggest to plan for the median costs, but include a caregiver should that become desireable. Loneliness is chronic and frequent discussions even with a dementia patient can keep those synapses firing and may be restorative. After G spends a few days with her mother, Ro seems rejuvenated.  If G had her choice she would live nearby, but that isn’t practical, and G’s siblings decided upon the area in which the facility resides. It is 2500 miles distant.