In my last post, I described how I finally was able to move mom and dad to an assisted living facility (ALF). They did very well in their new home, though it took at least a month for them to adjust to the change. They had lived independently all their lives and now lived according to a facility schedule. Still, the advantages outweighed the disadvantages.
First, I want to point out that each facility is unique and although they share many common features, they also differ in important ways. That is one reason to tour as many as you can before making a choice.
The Gardens was a fairly large facility in the southeast US. They housed both independent units (sort of like motel units, or villas as they called them) and assisted living units. There were separate dining rooms for the independent units and the assisted living units. The residents of the independent units could choose the number of meals per month that they wished to purchase – from none to three meals per day. They could also bring in guests or come on an irregular basis, like to a restaurant.
The residents of the assisted living units ate most of their meals in the dining area, though they could choose a plan with 2 meals per day or 3 meals per day. My parents ate all their meals in the assisted living dining room. Assisted living residents had assigned seats in the dining room so the staff could be sure they had eaten.
The independent units all had a small kitchen with a refrigerator, stove, microwave, and an eating counter. The larger units had more bedroom and kitchen space and even two or more bathrooms. The assisted living units were all in one large building which had about 5 floors. To get to the upper floors, residents had to use one of two very slow elevators. The building was about 30 or 40 years old.
The rooms were pretty standard and included a kitchen area where one could install a college dorm sized refrigerator and microwave, and a bathroom. For double rooms, they had 2 single rooms connected by a doorway cut in between. Therefore, a couple would have 2 bathrooms and 2 rooms. They could be configured as 2 bedrooms, or as one living room and one bedroom. It was an efficient set-up and most people appeared satisfied with it.
The elevators were small and slow. The smaller of the 2 elevators would hold only 1 wheelchair (and person in it) and one or two other people or 1 walker. The larger one could hold 2 wheelchairs or 2 people in walkers and several without. The elevator doors were slow to open or close, perhaps to allow residents time to enter and egress — these were quite elderly people who very slowly walked or moved in their wheelchairs or walkers. They were set up so the doors would not shut on a resident who was still in the path of the closing door. The elevators also moved very slowly between the floors, so it could take 15 minutes or more to go all the way from the 1st to the 5th floors, stopping for 2-3 minutes on each floor.
Only the larger elevator would hold an emergency gurney such as used by EMTs to evacuate a patient who needed to ride in an ambulance. These same elevators were used to move a new resident’s furniture and boxes of belongings into the building. Therefore they requested no movers be there around meal times when residents were waiting to go up or down to the dining room.
I will describe some of the things I really liked and some things I didn’t like very well at this assisted living facility. First, I was very happy with the majority of the staff, from the top administrator on down. It was a good sized facility, so had a good sized staff as well. There were at least 4 nurses that I can recall, perhaps more. The facility was staffed with at least one nurse on each shift and during the daytime there were at least 2 and sometimes additional staff trained to dispense medications and do other tasks that nurses might otherwise do.
The nurse or trained assistant dispensed all medications. In addition they took care of insulin shots or other regularly needed shots or routine medical treatments. They were on call for emergencies and more than once I saw them treating a resident with a serious injury such as a fall with a lot of blood involved. Often they had to call an ambulance to transport a resident for unexpected events such as chest pains or falls.
The aides helped residents with ambulation, showers or baths, dressing, etc. according to their needs. Most of the aides were very cheerful, helpful and friendly. I believe the staff helped my parents adjust to the living situation quickly and watched over their care. The aides would tell the nurses if a resident needed attention to his toenails, fingernails, and other personal health issues.
There were some physicians who came and saw residents as patients on a weekly or monthly basis. While mom and dad kept their regular physician, they were able to see a podiatrist and an optometrist without leaving the facility. They also had an in-house beauty salon which was open every day.
They had an adequate kitchen staff that prepared meals for residents. Residents could choose from several options on the menu including several choices on desserts. Residents would choose at the time they were seated and their wait person would take the order to the kitchen and bring their meals. The wait person would notice if a resident didn’t eat and offer something else in its place.
In addition, there was an activities director, and one other person on the activity staff. There were 2 or more drivers for the transportation vans or automobiles. Residents could be taken to medical appointments between about 9 to 4 or so any day and special arrangements could be made for appointments that had to be earlier or later. Transportation was also provided for dad to visit mom when she was in the hospital, for shopping trips to the grocery store or special trips such as to the mall or out for dinner or lunch. There were activities scheduled every day including trips several times a week.
It was not necessary for a resident to own an automobile, but there was space provided for parking if they did. Most residents in the assisted living section did not have their own transportation, and probably more than half in the independent units also did not have their own transportation. The facility transportation was more than adequate for most needs.
To summarize – a large ALF had staff adequate to care for residents in their rooms, to transport them to medical appointments and recreational activities, nurses on hand 24 hours a day, a 5-day-a week beauty salon and physicians who practiced periodically in-house. The biggest disadvantage I saw to this facility was the slow elevators. I liked that they had so many amenities available. I will describe a smaller ALF where dad later resided in a future post.