Exploring Personal Care

Today I would like to explore Personal Care Living, formally known as Assisted Living.  This level of care is the in-between stage that comes after independently living in your home or apartment but before the need for skilled long-term care.

Personal Care settings offer 24-hour nursing staff, prepared meals, laundry services, housekeeping services, medication administration, health monitoring and activities.  Sounds kind of like long-term care living, but there is a big difference.  Residents at this level of care are still able to mostly perform their own activities of daily living like bathing, dressing, using the bathroom, things like that.  The nursing staff that is on duty are mostly certified nursing assistants and medication technicians who are all overseen by a registered nurse.  The ratios of patients to staff are less than that of a long-term care setting.  These ratios are less because the demand for one-on-one care is significantly less in Personal Care.  That is not to say that additional help will not be provided by staff.

Typically, there are three level-of-care tiers to determine the costs of living in Personal Care.  Residents who are only requiring meals, laundry services, housekeeping services and medication administration will be less expensive than a resident in this setting that needs more assistance with their care.  A resident that is already using all the first-tier options but in addition needs assistance throughout the day to manage problems with incontinence will bump them up to the next tier.  If a resident is using all of the previously mentioned services but in addition to that needs assistance with bathing and dressing each day, that will put them in the highest-tier level.  You need to examine the different tier levels at whatever facility you are looking at to determine which one you would fall into.  The cost of Assisted Living across the country ranges from $1,500 to $5,000/monthly with the average probably somewhere around $2,500-$3,500 per month.

In my opinion, if you are considering looking at admission for Personal Care and you are already at that highest-tier level of care, you should seriously consider a long-term care setting.  Most residents that reach the third-tier level are not able to stay in Personal Care for much longer.  Typically their condition is deteriorating and more extensive care is needed than can be provided in Personal Care.   In addition to this, a move to a new setting can be very difficult and confusing for older adults.  It can cause increased confusion, agitation and depression.  It can take as long as 1-2 months for them to adjust to their new setting.  The last thing you want to do is move them twice in a short period of time.  Some older adults never recover from something like that.  They feel unsettled, unwanted and almost punished in some way for having to be moved again.  As a result of that, the family then feels as though they have not done what is best for their loved one.

This decision should not be taken lightly nor should it be made alone.  This should be a discussion for you along with the people closest to you.  Talk openly about why this could be the best course to take, discuss why the move is needed and explore other possible options that might be available.

If you are a child trying to figure out what is best for Mom or Dad, make sure you are including them in your discussions.  If you have concerns about their living arrangements, express those concerns openly, honestly and respectfully.  Unless you are dealing with an advanced stage of dementia where communication will have no positive outcome, these conversations need to take place no matter how uncomfortable it may be.  Always try to put yourself in the other person's shoes and try to figure out how you would want to be treated.  Trying to find a solution to problems together as a family will increase your chances for success significantly.

Communication is key to Aging with Ease!