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Does My Loved One Need Assisted Living or a Nursing Home?

In my time as an Assisted Living Owner/Operator, I have worked with many individuals and families who are at various stages of exploring long term care for themselves or a loved one. One scenario comes up time and time again that is one of the most distressing situations for everyone involved - mom is scheduled to be discharged from rehab in 2 days and she cannot go home...should we be looking at a Nursing Home, or Assisted Living?

Here in Rhode Island, the choices are pretty straightforward if the person in question is not a good candidate for in-home care - Assisted Living (or Memory Care, which is a subcategory of Assisted Living), or a Nursing Home (also known as Skilled Care). But how do you know which one is the best fit for you or your loved one? What are the differences between the two?

Assisted Living vs. Nursing Home...

Assisted Living at its core is amenity based, with a limited level of assistance provided. This can include assistance with bathing, dressing, toileting and medication management, as well as meals, housekeeping, laundry and activities. Residents tend to require only occasional assistance with the activities of daily living, however those with more significant medical issues like diabetes, mild dementia, and even visual impairment can still take advantage of what Assisted Living can provide.

A Nursing Home is also known as Skilled Nursing, and is a medical provider of care for those with significant health needs that require 24 hour skilled staff. These communities provide care for those who have significant mobility impairment or are in a state of health that needs 24 monitoring. Nursing Homes are also significantly more expensive than Assisted Living and tend to not emphasize a familiar residential environment the way Assisted Living does.

Which One Does My Loved One Need?

Assisted Living is generally not considered to be medical, and therefore providers can choose to limit what levels of care they provide, even though the Assisted Living regulations may permit a higher level of need. An Assisted Living provider can choose, for example, not to accept residents that are in a wheelchair, or have a diagnosis of dementia or Alzheimers, even though in certain circumstances it is permissible for them to do so. It is important to ask many questions of an Assisted Living provider to uncover why they may feel your loved one is better suited for Memory Care or a Nursing Home, rather than traditional Assisted Living.

It's also important to not assume that your elder loved one can only go to a Nursing Home. For us, the key criteria for whether someone can live with us at Commonwealth House involves capability of self-preservation (can they identify the exit in an emergency), and whether they are at risk of elopement (walking away from the community in a manner that puts them at risk). Often times, prospective residents with significant needs can still be good candidates for Assisted Living.

Where Do I Find Out More?

Your discharge planner or geriatric care planner can help you understand which providers you should be focused on for your loved one's transition to long term care, but if you see a community that really resonates with you and looks like it would be perfect fit, don't be afraid to call and ask! You may find out that your loved one is welcome and would thrive there!

If you are not sure what level of care your loved one needs, please call me at 401-216-9260. Although I am not a certified health care professional, I do have quite a bit of experience helping Rhode Island families navigate the RI senior care maze and find the best possible situation for their elder loved ones!

Thank you and I appreciate you reading my post!



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