I just moved Mom about a month ago to Assisted Living. The main problem there is the food. Many are not eating because things are not cooked for people who have not many teeth. People there are not eating everything cause things are not cooked enough. Veggies are crunchy instead of soften steamed. Egg salad with crunchy celery, you see them picking out of. How do we fix this problem? Has anyone else seen this like I have. My Mom loves mashed potatoes and gravy, this place maybe once a week. Can I go to a state level for help?

I am going to be frank and blunt about this, okay. I have been doing CNA WORK IN THIS GREAT NATURAL STATE FOR 18 YEARS AND I HAVE NEVER MADE OVER $11.00 AN HOUR IN THESE NURSING HOME FACILITIES HERE IN ARKANSAS. NOT JUST ARKANSAS; THE GOVERNMENT NEED TO UPGRADE CNA'S WHO'S ACTIVE CERTIFIED LICENSE ARE TO BE PROMOTED TO HIGHER LEVELS IN THIS LINE OF WORK. WILL DISCUSS MORE AT A LATER DAY.

Are staff members at assisted living communities with memory care allowed to lock individuals out of their room from breakfast until after dinner at bedtime?

Is it lawful for an assisted living facility to rent to you and charge you rent while you are being asses by your long term insurance? I have been living in an assisted living facility since the 26th of May and Kanawha insurance Co. has nor let me know if I qualify or not; yet. I am using up my savings almost completely while I hear.

dose any one know if a nursing home can keep medications when you check out. I just flew my mom home from a terrible facility and they kept all her medication including her insulin and heart medication that is used threw out the day. she could have had a heart attck or when into diabetic coma with out it. thank god she did not. I dont know what to do now

This sounds like a disaster to me. So sorry to hear about all the frustrations Albalynn. I don't know what State you are in. You could consider getting a Conservatorship. Then you will have more say in your mom's treatments. As long as your mom is not diagnosed with Dementia, she has final say. Try to speak to other residents' families there and find out what there experiences are. If you are not happy, file a written complaint with the State regarding the facilities medication practices. Hope this helps you a little.

My mom is 94 and has been in a beautiful assisted living facility for a year and a half. My problems have been with the doctors. We used the house physician so that we did not need to transport my mom, who would not want to go anyway. He kept changing around her meds, not letting me know or consulting me on her condition or reason for administering the meds and I had to look into it when I noticed a change in my mom's condition. He would visit her once a week, which was not necessary, and I was told we would not be charged because it was just a courtesy. Long story short, she fell twice due to medication mismanagement regarding her blood pressure pills, they made her dizzy. She was put on antidepressants by a house psychologist I did not authorize to treat her, which caused her to have psychotic episodes. I was finally able to find a doctor who would visit her at the facility and got her meds under control. I notified both doctors to stop treating my mother. I got a bill from the house doctor from last January, when she was admitted, for all his visits, which I was told would not be charged to me, and which my mother said he did nothing, just walked in and walked out. I reported him to Medicare for fraud and abuse. The new doctor prescribe a low dose antidepressant which I was fine with. I again noticed a change in my mom, when I called to go over her meds with the nurse, I was told the antidepressant dose was double, I asked by whom? She gave me the name of the house psychiatrist who had no authorization to treat my mom. I also reported him to Medicare and made sure my mother was taken off his patient list. He said the facility put her on his list. So now I have new issues. She had a mild heart attack, fell, broke her hip, had a partial hip replacement, went to rehab in a skilled nursing facility, and the doctor there sent her back to the assisted living facility with his orders. I tried to get our doctor to change them asap, but she was delayed for a few days. My mother suffered adverse effects due to these medications which the facility nurse refused to discontinue, my mother almost died. Once her meds were adjusted by our doctor and myself, she bounced back the next day. It frustrates me that we have no rights as to medication and treatment, the facility will not honor my right to refuse treatment, the nurse said they need to follow the doctors orders. I got a call from the nurse their at 3:30 in the morning because my mom was in pain and she could not give her a TYLENOL because the ones she had for her from our doctor were for 500 mg and the order she had on file was from the rehab doctor for 650mg, which she did not have. I had to actually drive over there, at 3:30 in the morning, to give my mother, who was sound asleep when I got there by the way, a Tylenol because the nurse said she would lose her license. This is insanity. Patients need to have rights and these doctors need to be stopped from having so much control over the facilities.

I own an assisted living facility. It is a regular home for able to care for 6 residents. There are many like that. We have had people with Parkinson, stroke and cancer and dementia. We are not allowed (by State law) to provide medical care, but are able to provide Hospice, due to a Hospice waiver. Residents have either a share of private room in a regular home like setting.

I looked into an assisted living memory care residence and before the person who was suffering from dementia ever got accessed, I had paid $1600. to the residence. How can I get my money back? Isn't there a law against keeping funds before being accessed?

If someone is a resident of an Assisted Living and needs a 45 day Nursing home stay who do I give me income to?

This article is helpful and provides some necessary concerns. An additional point that is important is that the senior should not jeopardize the wealth they have built into the home to support their assisted living experience. The senior should seek alternatives to sacrificing their home.

to eliteseniors, I know you are working for the ALF's community, and you want to put these facilities in the best possible light, but surely you must realize that probably 90% of the people in the USA simply cannot afford these faclilities. So your comment "In an ALF - you can expect to pay $3000-$4000 per month for a very nice facility - that is HALF the cost (of a SNF)" is not really helpful information.
Of course the AL's are less exp than the SNF's.
The problem is, BOTH facilities are MUCH too expensive for seniors who are living on about $2-3,000 per month right now.
Remember, an AL which costs (in 2014 rates) about $4,000 per month is Too Expensive for someone who is currently living on $2-3,000 per month.
Even if they can sell their home and net $120,000, that is barely 3 years worth of AL costs.
And, the AL does not provide about $10,000 per year of other items which a resident might need (additional meals, Depends, toiletries, Medicare premiums, prescriptions, orthopedic shoes, eyeglasses, hairdresser, phone bill, taxi ride to worship services). They will need these items as well as have to pay their AL rent for another 10-15 years.
There are vast numbers of "in-between" middle class seniors, who do not qualify for Medicaid yet, but who do need help, and there is simply no place for them to go. So, they are living in their own homes and not living very well, and probably wearing out their local child, who wishes the ALF's would not charge so very much money. I am in a large Midwest city.

Nanlinjoe, your comment about your mother saying "I don't have any other choice." really hit me hard emotionally. I have been so angry toward my mother and her life choices that have negatively affected me throughout my life. Her constant neediness just wanted me to disown her. Those words made me realize how alone and afraid she is. I would never want to hear those words from my mother because of my own emotional pain. It is not so much the forgiveness I embrace, but knowing she is still a human being that needs help and guidance in her care. Thank you for helping me look at a different perspective in my role as her adult daughter.

Assisted living facilities are a great alternative to nursing homes if the patient is still quite independent and just needs some assistance with daily activities, but not really immobile or needing constant care. I also read something that really made sense for me about AL: it's for the elderly who are often left alone at home with no one to talk to or just spend time with. I think we often think that you have to be sick to be in a care facility, but sometimes you just need companionship and care that are not available at home anymore. Just remember that if you're going to choose a care facility, make sure you personally visit the place to check how they run things.
-iWilliams

Does anyone know of a care facility in central florida that has in-house dialysis services where a patient does not have to be transported out for their dialysis treatment? Please help, time is running out!

There is absolutely an inherent lack of information and transparency around assisted living facilities online, thank you for publishing this guide.

Earlier this year, we launched GoldenReviews because I believe we can improve senior care by providing invaluable insights that improve seniors' lives.

Nursing homes and assisted living communities are usually a taboo subject, so the majority of families and residents simply do not post senior care reviews online.

To tackle the issue, we proactively seek out families’ and residents’ experiences with nursing homes, assisted living, in home care and independent living facilities.

We aim provide an inside look at over 110,000 senior care providers and we encourage you to rate it forward and share your experience.

I am in the process of finding Independent Living for my mother near our home. We all want to remember our parents when they were younger. We don't want to face the fact that they are in need of care that we the children can no longer provide. We have to face reality and know they may need into Independent or Assisted Living. There are many parents who do not want to move into one of these places. This is a decision that a parent or loves one has to make. It may turn out that the Care Giver has to make the decision for them. If the Care Giver can do a thorough search for these special facilities, the person needing the care can visit these sites. This will help them to think about the kind and good things they have seen and feel much better about making the decision. After having lengthy conversations with my mother's Health Advocate, it is highly important to consider the living and safety environment within the person's home, does the person have any neighbors or friends, and is the person safely driving a car? The person in need of care may be a very safe driver, however, drivers around her may not be. It only takes one serious auto accident to loose a loved one. I have come to realize that moving my mother into a Senior Apartment does not help to take care of her needs. My personal feeling is that 55+ apartments are for people who can still completely take care of themself. Surprisingly enough, it may cost less to live in Independent/Assisted Living. If you do a serious search, there are prices for these facilities that are very reasonable. It is highly advisable that a person move into Independent Living and live there as long as possible. I have found that most places for Independent Living also have Assisted Living and cost is normally $1K more. If a person in care has done an excellent job in saving their money, the advice given above for exhausing it to receive financial assistance from the State for continued care is highly advisable. I hope this information has been helpful. God bless each of you who are in the process of finding Independent and Assisted Living for your loved one.

my dad is currently in a nsg home. we are very displeased with the care and the entire situation. he does not have enough money to pay 3,ooo.oo monthly. does ms medicaid pay any???

Dear Aging Care Community:

We were responding to this comment in the original posting on "Assisted Living Facility Questions & Answers"

What's the Difference Between Assisted Living (ALF) and a Nursing Home (SNF)?

"Assisted living does not provide medical care, such as treatment for specific conditions or diseases like Parkinson's disease or hospice care. The assisted living facility will assess the elder to decide what kind of care his or her needs require. Nursing homes, on the other hand, are designed to house and assist individuals who have health conditions that require constant monitoring and the availability of medical personnel. "

Here in the State of Florida (the assisted living capital of the entire United States) - this is not true. Patients/residents CAN receive medical care while living in assisted living. What matters is the level of care each patient is at when ENTERING the assisted living facility - even if it is a HIGH level of care. This includes patients who are diabetic, have parkinson's disease or alzheimers/dementia, and who are on dialysis - all serious medical conditions that can be treated in assisted living. (and many others as well) If a patient can assist with transfer (even if in a W/C or bed-bound), does not have a vent/trach tube, and does not have a wound which is a stage 2 or greater - they can enter assisted living and receive the nursing care that they need.

In this day and age - few people qualify or need to go to a traditional nursing home (SNF - skilled nursing facility) - that is why assisted living facilities were created - to divert the patients who DO NOT NEED to be in a nursing home to a place where they can still be monitored, be given medication managment, receive medical care, have their medication, meals, housekeeping, physician care and transportation provided - among many other services. 30 years ago - assisted living was scarce - there was only a choice of hospital, home, or nursing home. Today ALF's give families the modernized option of a place that is much more home-like and can still provide the care that the patient needs - at many different levels - from someone who is completely independent - to someone that needs a little assistance with bathing/dressing - to someone who is on 3x weekly dialysis - who is completely incontinent and needs maximum care. ALF can accomodate all of these and many other situations.

As well as the standard license, an assisted living facility may choose to apply for an Extended Congregate Care (ECC) License. The ECC license is a specialty license that enables a facility to provide, directly or through contract, services beyond those permissible under the standard license, including acts performed by licensed nurses, and supportive services defined by rule to persons who otherwise would be disqualified from continued residence in a facility licensed under this part. This provides even more nursing care.

In large and small facilities (licensed exactly the same - regardless of size - they are held to the same standards whether they have 6 beds or 600) hospice care can be added if recommended by the attending physician. The patient can remain in the assisted living facility until death if that is their choice - they DO NOT have to move to a skilled nursing facility (traditional nursing home). Of course - if a serious medical issue occurs: ie: falling and breaking a hip, pneumonia, etc... they will go to a hospital and then short term nursing/rehab until they recover - then return to their assisted living facility (their home).

There are guidelines within each contract for assisted living in Florida which state they must "hold the bed" of a patient who has entered a short term nursing/rehabilitation facility - or hospital. It is your responsibility as an informed caregiver/consumer to look at this when signing the contract. (You have to have the power of attorney / health care surrogacy to make decisions and sign legal documents for a patient). The resident (or their power of attorney/responsible party) will be required to continue to pay the monthly fee until the bed hold is ended, as described in the written agreement; or until the resident or their legal representative tells the facility in writing that the resident will not return; or if a medical condition prevents the resident from telling the facility and the resident has no legal representative to speak for them. Yes - this means you still have to PAY for the bed in the ALF while they are in another health care facility - Medicare is paying for that other facility - or Medicaid in some instances - not the family and not the patient - so you will never be paying the ALF and the hospital or SNF.

Short term nursing/rehabilitation and hospital services ARE covered by Medicare. No ALF in the country accepts Medicare for payment - it is not covered. However, several facilities accept Medicaid programs and VA benefits based on eligibility. If someone has a long term care policy - that is also highly beneficial and is accepted at nearly every single ALF in the country.

*** of course these guidelines can be different in different states - we highly recommend checking with your individual state ***
______________________________________________________________

Let us not forget the cost differences between these facility types as well. In a SNF - one here in Florida can expect to pay an approximate cost of $7000-$8000 per month - if the patient does not qualify for Medicaid benefits - this means OUT OF POCKET. Even if someone has $100K + in savings - that can quickly go in a SNF. In an ALF - you can expect to pay $3000-$4000 per month for a very nice facility - that is HALF the cost. ALF's are available below this monthly cost as well - depending on the care of the patient, private or semi-private room, geographic area, etc... Please contact us with specific questions - there is much too much information to list here.

Many families do not even know what the guidelines are or that their loved one can live in a much better situation and receive the care that they need. Assisted living is HOME-LIKE - skilled nursing will always be INSTITUTIONAL. That is why patients are afraid to go there - and they fight it until the end - because they are scared and do not want to spend their last days locked up in a hospital-like environment. Part of our job is to educate the patient and their family on the choices available to them - once they see that if they are eligible a much better choice exists today they see "this isn't so bad! this is nice! look at all the activity going on here! there are people like me!" etc... Their fear subsides and they are open to making a positive move in their life where they can get the care they need but still retain as much independence as possible. They can go out for the day or holiday with their family, or just go out to lunch - family can visit every day if they want - the choices are boundless - in a traditional nursing home they ARE NOT. You are the responsibility of the facility and you have to receive a doctor's note to even go out to lunch - which must be arranged in advance. These are just a few highlights of the advantages of ALF - we couldn't possibly write them all here - but want you to know that a much more wonderful place can exist for your your loved one - and we are here to help educate you on the choices that you as a family have.

While I love this site and spend more time on it than I should, it would be helpful to remember responses are nation wide and sometimes even world wide. I am sure some of the differences in what people have experienced is due to the state they live in. ALF, like all licensed long term facilities are regulated by state, not federal government. Every state can be a little if not a lot different. I live in the state of Missouri. In Missouri there are 2 levels of licensing for assisted living, level one and level 2. 99% of facilities are licensed for level one. 9 out of 10 of these do not take Medicaid (no one takes Medicare). Assisted living level one requires "pathway to safety" without assistance. This means if the elder hears a fire alarm they understand what that means, can transfer out of bed or chair without assistance and guide themselves to the exit. And they have no skilled nursing needs: dressing care, colostomy care, frequent assessments for heart or lung disease. Let's be honest, for most of us if our parents could do this we wouldn't be on this site. Assisted living 2 can admit patients who do not meet pathway to safety but the facility meets different state required staffing regulations. I have called every facility in the st. louis metro area. Many of the admit people don't even know their licensing status but they will only take elders who meet pathway to safety in spite of being a level 2 facility. The handful of level 2 facilities that do take more complex patients are for memory care. The cost is 6-7k a month and it is private pay only. Assisted living is a very broad term that doesn't really give accurate information for people looking for resources in a certain state/region. My other personal complaint is Adult Family Homes. These are not possible in Missouri and many other states.(but I certainly wish they were). It might be helpful if people posting with different experiences could clarify where they are located. I hope this is helpful.

Elite: I HAVE done my research and HAVE ACTUAL EXPERIENCE DEALING WITH 6 elderly relatives business affairs in 3 different facilities. Two of those facilities "claimed" to provide on-going care as the person aged then sent the resident to the ER on trumped up medical problems and "filled their room" while they were hospitalized!!!! My relatives were forced into nursing homes because that's the only place with an opening. Never mind that we continued to pay their rent on the apartment during the hospitalization. ALFs are all different - some DO provide hospice care, some do not. Some DO accept medicaide, some do not. I don't appreciate any condescending tone in the comments here- these "senior services COMPANIES" are often the PROBLEM!!!! They are out for REVENUE and don't care about the patients/residents. Many of the people who participate in this on-line community have ACTUAL REAL LIFE experiences with ALFs, doctors, nursing homes and "senior services companies" - they've shared that here for the benefit of others, being told their input - real life experience - is WRONG is just..... WRONG.

this is not accurate information - an ALF (assisted living facility) does give medical care and hospice care, can accept people with medical diagnosis such as parkinsons or alzheimers/dementia, etc...and treat it, and almost everyone qualifies unless they are VERY physically sick - such as wheelchair/bed bound and cannot assist with transfer, vent/trach tube, and a few others - as long as the person is at a certain level when ENTERING the ALF - they can decline and still remain in care there - ie: hospice. There is no reason to transfer to a skilled nursing facility (nursing home) - as is commonly misunderstood. Please do your research or contact a senior services company who knows what they are talking about and can give you accurate information.

Thank you very much for the info I have never had to deal with anything like this before so I didn't know what to think. I totally agree with the highway robbery of these senior citizens. Just looking over some of the bills for the absurd charges to begin with has my head spinning!!! Glad we are getting her out of there. Thanks again. Have a great day!

When I did research for my Mom, I spoke with 4 assisted living facilities and none of them charged a security deposit. They DID want "move-in" fees of about $1500 (OMG!!!!)) - which were non-refundable. It was a 'service' where would send someone to her home, evaluate the furniture that she'd need, pack her clothes, furniture, small appliances, move it and unload it all in her new apartment. We didn't go for that, we did it for her. These places are so damned expensive that move-in fees and the like are highway robbery!! From a practical standpoint, these folks can't do too much damage and the administrators (or the corporations that own the facilities) don't want to deal with refunds - it costs time and labor.

Does anyone know if assisted living facilities require a security deposit? A family member is being moved from an assisted living facility to a nursing home and that person was not entitled to get aid in paying rent etc. When we asked about a security deposit the facility worker said there wasn't any security deposit. I didn't think this sounded right. We can't find any paper work on this. Does this sound correct? If not, how else can we find out without going through the place itself? Any info will be helpful.

Help! My dad has been staying with my family since Jan of this year and this was suppose to be temporary. We have juggled the kids around to make space and my dad has gotten worse. He doesn't get coffee or do anything (not even bath). We don't have the money to put him is asst living and he only makes Social Security.

... and... Nan, she might feel unhappy even if she's at home especially with a history of depression. You don't say how long she's been there - it might take a good six months before she's adjusted. Could it be that she's saving her worst moods for your visits? My mom did that - very happy and congenial with others but unloaded to me; it's because she felt she could let her guard down and vent to me. I went with some other visitors once and listened to their banter from the hall and she was happy as a lark! I let it go for 15 minutes then popped in to join them. Mom was fine but as soon as the friends left she started up again. Is your mom doing the same? I hope so because it means she's not as unhappy as you might fear.

Nan - After a year and a half I still go through the same feelings that you described above. Trust your intuition and know that your mom is in the best place possible. If having her in your home would turn you into a shrew then it's best for BOTH of you that she live somewhere else. When you do see her you're able to be the loving and attentive daughter she needs. Believe it or not, visits 3-4 times a LOT. Since my Mom moved my brothers and their spouses have been to see her 3 times - 3 TIMES in a year and a half!! It's awful but there is nothing I can do; they just don't care. The relatively low number of residents per house is really in your mom's benefit; she'll get the attention and focus she needs from the staff and the management's willingness to help with medicaid when the time comes is really important. It can be a lot to wade through and they should be pros. I stressed over it for weeks and wish I'd had someone else to handle it. It's also a HUGE benefit that she can stay in the same place with familiar routine and staff. Such change at an advanced age can really throw off our elders.

You moved your mom because you know it's the right time. I knew it too whether I admitted it or not at the time. A few months after the move Mom's arthritis began to get really bad and because she was in assisted living they helped her adjust to the limitations and to use a wheelchair. If she were at home, she'd be calling me and expect me to stay and help "until she got better".... I'd still be there and I'd be a miserable wack job. If your mom is facing a decline then having professionally trained people to help meet her needs is critical. They can be more objective and she'll be more likely to accept their treatment and help than she would family. Trust that you did the right thing. Trust that you're a good daughter and that she knows you love her.

I have a lot of guilt and anxiety for moving mom into a very nice assisted living facility, which she initially agreed to. Her house is for sale. I now am second guessing myself-----should I have let her live at home with12 or more hours of in-home aides---which charge $16-18/hr on weekdaya and $21/hr on weekends. Her money would run out much more quickly and then when she needed a nursing home, Medicaid would pay but I worry about the quality of care since I read so much about elder abuse,
bed sores, restraints in chairs most of the day, etc. The assisted living place that she is in now has promised to transfer her to their nursing home or altzeimer's home when she runs out of money and will help her apply for Medcaid. Mom has some depression and anxiety and is treated by the psychiatrist. She also has issues of back pain and foot pain. While the care is probably above average, it is understaffed with
1 RN and 1 Caregiver per shift. Mom's house has 16 residents and there are 2 other houses with the same quota. Mom gets very anxious if the medication aide is late in giving out meds. It kills me when my sister asked her if mom was happy there and m om's reply was, "I don't have any other choice." I have the space for mom to ,live with me but I work part-time and mom is very needy. When I get home exhausted from work and just want to chill before cooking dinner, it woluldn't happen and I would eventually lose my temper with her and feel even worse. I do visit her 3-4 times/week and take her out sometimes and to family events, as does my sister. She has more visitors than most of the other residents but she still is unhappy and it breaks my heart!!
Does anyone have a similar situation and words of advice? THANKS!!

DEB - The best way to find such an assisted living center is to call around. Most of the time, they'll send someone to evaluate your elder to see if they can accommodate their needs. Most of the people in my mom's assisted living facility were in wheelchaird and 40% needed help transfering to/from bed and toilet.