You’re Never Too Old to Rock ’n’ Roll
Senate Examines Link Between Physicians and the Drug Industry
New Bill Protects Seniors From Financial Fraud
Tips for Choosing Assisted Living as an Alternative
Assisted Living Is a Freedom of Choice
Around Town: Happenings of Note
Along
The
Boomer Trail: Banning Butts From the Screes
Senior Moments: Letting Go Is Often Hard to Do
Klockwork: In Recognition of the Greediest Generation
Dutch Treat: A Disciplined Copilot and Piracy on the Indian Ocean
What You Should Know About Assisted Living
By
Michael A. Piekarz
& Stephen Baetge
Staff Writers
Many
people are confused about what exactly assisted living entails, and
many facilities provide healthcare comparable to that available in
nursing homes. Other assisted living facilities are nothing but glorified
board and care homes with little service beyond three daily meals
and a little supervision.
In shopping for an assisted living facility, consumers need to have their eyes
wide open and be prepared to ask some hard questions about just what assisted
living entails.
Making that determination about what constitutes assisted living is very important
to an increasing number of seniors and their families. According to statistics
provided by the California Assisted Living Association (CALA), approximately
6.5 million people nationally require assistance with the activities of daily
living.
In California alone, assisted living communities care for more than 150,000 seniors.
Assisted living usually refers to some type of long-term care facility for the
elderly or disabled, people unable to get around on their own and who may need
help with some of the activities of normal daily living.
There are a growing number of residents, however, who are completely able to
care for themselves but simply prefer the convenience of having their meals in
a central cafeteria and having a nursing staff on call.
Unfortunately there is a huge variance in what is provided or expected of facilities
which operate under the umbrella term of assisted living. A recent report by
professor Catherine Hawes of Texas A&M University found a huge variance from
state to state.
Thirty-nine states authorize eviction when a facility’s services do not
meet a resident’s needs. Unfortunately, state law generally allows a facility
to choose whether it will meet a resident’s healthcare needs or whether
it will evict the resident instead.
Only half of all our states require facilities to employ or contract with a nurse.
In most of these cases, however, the nurse is rarely at the facility. Instead,
he or she only reviews care plans or facility policies.
Only 19 states have an hourly minimum for the training of direct care workers.
Five states require 12 or fewer hours of training, four states require from 13
to 24 hours and 10 states require 25 or more hours. In 28 states, assisted living
employees with limited training can administer medication.
While the report was primarily intended to assist state policymakers in addressing
the issue of assisted living, Hawes stated, “It can also be useful to consumers
as they try to understand what assisted living is and is not and whether it can
meet their needs and preferences.”
In California, an assisted care facility is usually synonymous with an assisted
living facility (ALF). It must provide supervision and assistance with the activities
of daily living. Residents may receive healthcare from a home health agency provided
the agency and the facility have entered a protocol regarding their respective
responsibilities.
Assisted living facilities are not allowed to admit or retain residents that
have communicable tuberculosis, need 24-hour nursing care or who require assistance
with all activities of daily living. In addition, people who are unable to turn
unassisted while in bed, those with severe bedsores or infections or those who
require feeding or tracheotomy tubes are also not allowed to reside in an ALF.
Not all medical conditions preclude ALF residency. Residents who require oxygen
administration, some forms of pressure breathing therapy, injections or those
who suffer from incontinence can be accommodated provided they or an appropriate
healthcare professional can provide the treatment.
The State of California can waive some of these limitations if the new or existing
resident receives care from a visiting hospice agency. A waiver requires that
the ALF and hospice agency have an agreement regarding the resident’s care
plan. In addition, if the resident has a roommate, the roommate must agree to
allow the hospice caregivers into the room.
If the facility has a nurse or licensed healthcare provider on premises, it can
honor a resident’s “do-not-resuscitate” request if the nurse
is present during the emergency that requires resuscitation.
More importantly, the State of California can order the relocation of any resident
whose needs exceed what can be provided under a facility’s license. An
ALF can also force a resident to move if a reappraisal determines that a resident
has a need not previously identified and the ALF and the appraiser both believe
that the facility is not appropriate.
Staff members in California ALFs are required to have 10 hours of initial training
and four hours of continuing education. The training covers many topics including
the aging process, policy and procedures and resident’s rights. Those providing
the training must either have a healthcare license, a relevant college degree
and experience or be a facility administrator with at least two years of experience.
Direct care staff members must be trained in first aid. If the facility is licensed
for 16 or more residents, then one staff member is designated to be primarily
responsible for first aid, emergency medical service and for assisting residents
with self-administered medication. Those facilities that claim specialization
in Alzheimer’s care must have staff additionally trained to assist residents
with dementia.
Finally, staffing must be adequate to meet residents’ needs. Assisted living
facilities with 16 residents or more must have one staff member on call. If the
facility houses 16 to 100 residents it must have one staff member awake at the
facility and another on call capable of arriving within 10 minutes. If there
are 101 to 200 residents, the facility must have one staff member awake at the
facility, one on call and one on call capable of arriving within 10 minutes.
All California assisted living facilities are subject to the same minimum licensing
standards, but they are free to exceed those standards. The best way to find
out if a facility is suitable is to visit the facility and to check with the
appropriate regulatory agencies.
This page and its contents ©2008
Metropolitan News Company, Inc.
