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How are they managing their medications?
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Fall risks, spoiled food, or other threats to wellbeing
Are they experiencing any memory loss?
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I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
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VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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Mostly Independent
Your loved one may not require home care or assisted living services at this time. However, continue to monitor their condition for changes and consider occasional in-home care services for help as needed.
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Kaptagat, what lack of compassion! And for someone they presumably knew well! Do you suppose they were trying to make a point that she needed to be in AL? Or what? Good grief! One more thing to ask about when you're looking for a long-term care residence.
Several years ago while Mum was in IL she got a severe nose bleed that she couldn't control. She went to the reception area looking for help and a nurse from the AL was there. She would/could not help her at all. Meanwhile, Mum was bleeding uncontrollably all over the floor. It was quite a scene. The staff director emerged from her office and told both the nurse and the receptionist not to help Mum because she was IL and 'should know what to do'. Eventually another resident called 911 for an ambulance and Mum spent the next few days in the hospital. I was horrified that staff and nurses watched Mum bleed but would not even help to pick up the phone. As I said at the time, a person on the street would have received better care.
Since independent living facilities are aimed at older adults who need little or no assistance with activities of daily living, most do not offer medical care or nursing staff. As with regular housing, though, you can hire in-home help separately as required.
EVERYONE wears scrubs and everyone is getting called "NURSE" these days...even the Housekeepers. That is why some hospitals and nursing homes have gone to color-coding their staff. For example: Navy Blue for Nurses, Light Blue for CNA & Medication Aides/Technicians, Gray for Housekeeping, Orange for Physical and Occupational therapy, Pink for Pharmacy..... The staff wears solid colored scrub pants and they either wear solid color scrub tops or scrub tops with floral or geometric or other designs as long as their assigned color as the primary color in their scrub top. (And NO Pink Panther or comic strip characters or cartoon characters or Super Heroes, etc...unless you work in Pediatrics.)
Independent living is just that. You need to be able to fully care for yourself. Assisted living is slightly different. And its just that, Assisted. Here where I live the AL have one RN that is there during the day and on call 24/7. She does not have one on one with the residents. Her job is to oversee the CNAs and maybe an LPN who is the RNs backup. She is responsible for ordering the residents meds. To do monthly reports and every 3 months resident care evals. According to my daughter who applied for this job, they didn't offer her enough money for the responsibilities they expected. The RN is there if something happens to a resident. She determines if they r taken to the hospital. Yes, she could put a bandaid on a resident but not one of the CNA. Their job is to help with bathing, toileting, dressing, getting ready for bed.
If your LO needs more than her IL can give, then maybe they need an AL facility. In Frazzels case, her LOs IL gives extra help for a cost. Not all IL are like this. My Aunts IL does have these services but she will pay more for them. Her IL is hooked to an AL and a NH.
At the life-care community (formerly called CCRC) where we plan to move when the time comes, there is a Registered Nurse Practitioner on staff with an office in the main building. Independent living residents can consult with her. The AL and SNF staff don't go to the independent residences.
Please DONT CALL THEM NURSES, it’s an insult to those of us who actually are. They are “caregivers.” My mother’s place had a single LPN overseeing several “med techs.” They didn’t provide care and had to call the ambulance if someone fell.
Not at my dad's IL. You could have Home Health come in or pay for private nursing care. We did this when dad had cataract surgery and needed eyedrops post op twice daily as his memory wouldn’t help him to get it right. Expensive but worth it.
yes, @cwillie is giving great info, when my MiL left inpatient hospice when she "stabilized" and went to a skilled nursing facility, it was a big high rise facility in downtown Orlando, it had floors for independent seniors, assisted living floors, and a wing dedicated to skilled nursing. We were fortunate to have a wonderful admissions person who explained what each level of care Could and could NOT do, at the end my husband said if she "gets a paper cut I want ya'll on it", but skilled nursing was $11k a month, and we still had hospice paying for her meds and equipment, the $11k was just for the room/bathing/food/nurses, unfortunately my MiL only stayed there for 9 days before she passed, but we were well informed.
I would advise approaching the admissions coordinator and asking about the varying levels of care that are or are NOT offered, and make of list of things you would like to be covered and if that facility is not able to provide them, can they provide you a list of nearby facilities that will.
I've been doing a little bit of reading on this subject and have discovered this is part of a very grey zone that leaves nurses in a precarious position. While a nurse is protected under good samaritan laws if she helps a stranger on the street those protections do not extend to helping someone at work. At work nurses can follow a care plan as set out by a doctor or NP, but if helping someone they are not contracted to help they place themselves in a difficult position.... suppose that the wound under that "bandaid" becomes infected or is the result of something that needed medical investigation the nurse could be sued for negligence or lose their license to practice.
This problem is exacerbated by the fact that too many IL and AL facilities are accepting residents that require a greater level of care than they are licensed to provide, both because the families are looking to avoid the higher cost of more skilled care and the management is concerned about filling every bed, so the poor nurses see people daily whose needs are greater than they can possibly accommodate.
My mom just moved to an IL facility that is set up more like an AL facility. It is all one building, not separate apartment buildings; so her neighbor is literally in the room right next to hers. They have a common dining area, where they get 3 meals a day, weekly housekeeping, etc that is included in monthly rent.
For an additional charge, she has home health that comes 3 times a day to give meds and check blood sugars, and they can provide assistance with bathing, etc if needed. I think the RN has to be the one to actually give the insulin injections, or if the elder can inject themselves, the aide can draw up the dosing and basically do everything BUT give the injection. Oral meds are kept in a locked box that only the aides/nurse can access. The home health office is housed in the building so there are aides and a nurse there for most of the day, like 6am-7pm I believe. She has a life alert pendant in case there is an emergency and she needs immediate medical assistance.
In some cases, health insurance will pay for skilled nursing and PT assistance through home health, but mom's insurance said they don't pay for medication management, so she does have to pay the extra charge for that per month. Found out insurance will pay for PT a certain amount per month and weekly skilled nurse visits to do assessment, check vitals, etc.
The one mom is in is owned by Holiday Management. You might check to see if there is one in your area if you think something like that might be a good fit. From what they told me, they own senior facilities in many parts of the country.
At Moms independent living facility the staff wasn’t allowed to put hands on the residents. There were no nurses, no CNAs. If she fell, they’d have to call 911, couldn’t pick her up. Assisted living is a little more hands-on but not much. Even they told me if she fell and “it didn’t look like she was hurt” they could pick her up but really weren’t supposed to. The 1 nurse there would probably put a bandaid on her. So you need to define independent vs assisted ( they are not the same) and what the contract says. This was NY, maybe every state is different. Mom got lots more individual help at her independent living apt with an additional home health aid than she could have at assisted living.
I would assume that assisted living residents pay more than independent residents, so if nursing assistance is needed by independent residents I would expect there to be a charge. If such help is needed often, perhaps the resident would be better off with the assisted living contract.
BettyRae, what is it you want the nurses to do? Of course they can help with nursing duties, but if it is more than a one time thing then you are expected to pay extra for care. And if you are looking for assistance with things that are not nursing you will need to ask housekeeping or maintenance staff, or some places have a concierge.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
Do you suppose they were trying to make a point that she needed to be in AL? Or what?
Good grief! One more thing to ask about when you're looking for a long-term care residence.
If your LO needs more than her IL can give, then maybe they need an AL facility. In Frazzels case, her LOs IL gives extra help for a cost. Not all IL are like this. My Aunts IL does have these services but she will pay more for them. Her IL is hooked to an AL and a NH.
We were fortunate to have a wonderful admissions person who explained what each level of care Could and could NOT do, at the end my husband said if she "gets a paper cut I want ya'll on it", but skilled nursing was $11k a month, and we still had hospice paying for her meds and equipment, the $11k was just for the room/bathing/food/nurses, unfortunately my MiL only stayed there for 9 days before she passed, but we were well informed.
I would advise approaching the admissions coordinator and asking about the varying levels of care that are or are NOT offered, and make of list of things you would like to be covered and if that facility is not able to provide them, can they provide you a list of nearby facilities that will.
This problem is exacerbated by the fact that too many IL and AL facilities are accepting residents that require a greater level of care than they are licensed to provide, both because the families are looking to avoid the higher cost of more skilled care and the management is concerned about filling every bed, so the poor nurses see people daily whose needs are greater than they can possibly accommodate.
For an additional charge, she has home health that comes 3 times a day to give meds and check blood sugars, and they can provide assistance with bathing, etc if needed. I think the RN has to be the one to actually give the insulin injections, or if the elder can inject themselves, the aide can draw up the dosing and basically do everything BUT give the injection. Oral meds are kept in a locked box that only the aides/nurse can access. The home health office is housed in the building so there are aides and a nurse there for most of the day, like 6am-7pm I believe. She has a life alert pendant in case there is an emergency and she needs immediate medical assistance.
In some cases, health insurance will pay for skilled nursing and PT assistance through home health, but mom's insurance said they don't pay for medication management, so she does have to pay the extra charge for that per month. Found out insurance will pay for PT a certain amount per month and weekly skilled nurse visits to do assessment, check vitals, etc.
The one mom is in is owned by Holiday Management. You might check to see if there is one in your area if you think something like that might be a good fit. From what they told me, they own senior facilities in many parts of the country.
https://www.agingcare.com/articles/difference-between-independent-living-and-assisted-living-168142.htm
Why are they there?
What ARE they allowed to do?
Is there a charge for that?
I would assume that assisted living residents pay more than independent residents, so if nursing assistance is needed by independent residents I would expect there to be a charge. If such help is needed often, perhaps the resident would be better off with the assisted living contract.