What you need to know about assisted living

Don’t know what a residential facility is and how it differs from a nursing home? And what can you expect to pay? Here you will find a guide to this type of housing for the elderly.

What is assisted living?

Assisted living facilities represent a middle ground of housing for people who can no longer live independently but do not need the full-time medical supervision of a nursing home. They may be suitable for people who have difficulty moving, bathing, eating or dressing, or who have Alzheimer’s disease or other forms of dementia.

Assisted living facilities may look like luxury apartments or modest group homes, but they are staffed with assistants who can help residents shower, get out of bed, go to the dining room, take medications, or help with other daily tasks and needs. Meals, activities and cleaning are usually provided. Some facilities have trained nurses on site, but in many states those are the facilities are not required to have them ready, or not at all. Popular buildings – or specialist units within them, such as those for dementia – have waiting lists.

“The key is to start early,” says Eilon Caspi, an assistant research professor at the University of Connecticut. “You don’t want to wait for the crisis and then have 24 hours to make a decision.”

How do I know how much assisted living will cost me?

The monthly cost of living in a facility typically ranges from $3,000 to $12,000 or more. The costs are often split into two components: rent and a healthcare plan. Rents are set similarly to how landlords set them for apartments, with larger units in more expensive regions having higher rents and rent concessions being more likely when many units are vacant.

The cost of care plans is based on the amount of help the facility thinks residents will need, at least when they first move in. Most of them assign residents a ‘tier’ or ‘tier’ based on the extent of their needs, but some will itemize charges for specific services. It’s like the difference between a fixed price and an a la carte menu (except you can’t choose which approach you prefer within each facility). Assisted living units or facilities for residents with dementia are more likely to set one all-encompassing price, although many have tiers.

Make sure the rating of the facility reflects what the resident needs, otherwise the price may increase if more help is provided than expected. Check if the meals are priced separately.

What accusations might surprise me?

Facilities often have one-time upfront costs, such as moving costs or “community fees.” You should ask yourself if there will be additional charges for things that residents may need or use, such as nurse visits, cable television, or other forms of assistance. Such costs can quickly pile up if they are not detailed in the care plan. Some places will even charge you more if you get medication from a pharmacy other than the one they have a business relationship with.

It is worth checking a few months after the move to see if the care plan is more than the resident needs. If this is the case, ask for a price reduction to remove services that are not being used.

Is it better to choose a facility that charges a flat monthly fee, or one that bills for each service?

If you want predictability in your monthly bill, you’ll be safer with a facility that is comprehensive or charges per level or bundled services. This also applies if you need help with many things. If you don’t need much help, a la carte might be better. Some facilities have an independent living wing or a la carte pricing program, which may be best for those who need assistance only sporadically. If you need more help over time, you can move into the section or assisted living program and receive a care bundle.

What happens when a resident ages and becomes more vulnerable?

Care plans for those who need the most help can double or triple the cost for the most independent residents. Ask the institution to explain what is causing the price increases. Be honest with yourself and the institution about what you can afford if the bill rises, because it will. “You have to understand that your future is coming,” says Karen Van Dyke, a certified senior counselor in San Diego who helps families find the right facility for them.

Also make sure you understand the maximum level of care the place can provide. If you need more, you may have to move through the home. For example, in some places care is provided for people who occasionally suffer from memory loss or disorientation, but not for people whose dementia causes delusions, agitation or aggression. There are fewer legal protections against evictions in residential care centers than in nursing homes. Be realistic about your needs: No one wants to move into a nursing home, but it is dangerous for residents to stay in an assisted living facility that cannot care for them.

What happens if I run out of money?

You may have to leave. Most assisted living facilities are for-profit and have no legal obligation to retain those in need. About one in five facilities accept Medicaid to help pay the costs of providing care, but Medicaid does not cover rent for assisted living facilities, so even then you may be forced to leave. Some states or provinces will help cover the cost of housing if you have no savings and little retirement income, so it’s worth finding out if that’s available. (Call your local Area Agency for Aging for assistance.) Some facility owners accept lower rates for long-term residents, but this is an exception.

How do I find out how good a facility is?

While it’s easy to be impressed by fancy dining options, twinkling chandeliers and other building amenities, this is not a sign of quality care. If you’re considering multiple facilities, ask about the ratio of residents to residents—nights and weekends as well as during the day—and whether there are registered nurses in the building, and when they are there.

The person who runs the facility is often called the administrator or director. Ask how many times this position has been reversed. If a facility has had multiple managers in a few years, that’s a troubling sign for the quality of management and owners.

Which are better: nonprofit or for-profit assisted living facilities?

Researchers have found that profitable facilities in Minnesota And Florida They are more likely to be cited for violating state health orders, but nationally there is no solid evidence. There are good and bad facilities for both types of ownership: a small for-profit residence with a committed owner on site can provide better care than a mediocre nonprofit. Keep in mind that nonprofits generally aren’t cheaper than for-profit organizations: While they don’t have to provide returns to investors, they do operate like a business and need to earn more than they spend each month on capital improvements and to raise cash. avoid money. flow problems. Nonprofits often use the same pricing methods as for-profits, and many charge more.

What should I pay attention to during a tour?

Kristine Sundberg, Executive Director of Advocates of Elder Voice in Minnesota, a coalition of family members is telling people to watch how residents interact with a facility’s employees. “Are they active and busy, or do they slump in a chair and be ignored?” she said. You can aim to visit on weekends when staffing levels are often at their lowest. Ask the facility if families can place cameras in residents’ rooms so you can monitor them remotely.

Who can help me?

Along with consumer groups like Ms. Sundberg’s, there are some of the most knowledgeable independent experts ombudsmen for long-term carewho are federally funded advocates for residents of nursing homes and other facilities for the elderly. Every state has such a program with advocates assigned to certain regions. An Area Agency on Aging is another source. These agencies are local government or nonprofit organizations that each state designates to assist the elderly. They can help you understand your financial options and find facilities. You can find your agency via https://eldercare.acl.gov/Public/Index.aspx.

To review a facility’s history of violations, find the state agency that licenses assisted living facilities. In some states it is part of the health department, while others assign this task to their human services or social services department. After an inspection of a facility, a report is drawn up. Licensing authorities can publish inspection reports on their websites, although these are not always easy to find. It’s a red flag if an institution is repeatedly cited for the same problem.

Jordan Rau is a senior reporter at KFF Health News, part of the organization formerly known as the Kaiser Family Foundation.