What’s After Assisted Living?

After Assisted Living, What’s  Next?

Many times, the older adult who moves to assisted living community will live out their lives in that community.  If they have chosen a community wisely, they will age in place and receive the care they need as their needs develop.  The majority of residents will find friends and activities to enrich their later years.  But for some residents their future needs may exceed the services the senior community offers.  If that happens, what’s the next step?

There are a few common reasons people leave assisted living to go on to another type of care setting.

• A degenerative memory issue like Alzheimer’s disease or dementia
• An unstable medical condition like pneumonia or stroke
• An inability to navigate hallways or activity rooms due to mobility issues
• The development of care needs which require a higher acuity of care and services

Options offering higher levels of care are:

• Skilled Nursing Facility: A highly medical or hospital-like environment with registered nurses on site twenty-four hours/day.  A resident may have needs requiring the diligent attention of a medical professional; or the person may require treatments or therapies only available from licensed health care staff.  Skilled nursing facilities have designated Medicare beds that are reserved for those who are rehabilitating from strokes, heart attacks or fractures.  There is usually a long term care section where patients are living out their lives while receiving skilled nursing care.  Nursing homes do have dining and activity rooms, activity programs and the benefit of Social Services on site.
• Adult Family Home: This may be an excellent option for someone who is becoming frail of body or frail of mind. These private homes are licensed to care for three to six individuals.  An array of home types and homes with varying skill levels and care abilities exist.   Some homes are quite elegant and comfortable.  Some are modest and cozy.  Though social activity may be limited, there is a great deal of individualized care available.
• Secured Dementia Community: Many residents with advanced Alzheimer’s disease will become disoriented to time and place.  They may wander out or confuse day for night.  A secured dementia care community will have the trained specialists crucial for the care of a resident with these concerns.  The exit doors are monitored or alarmed.  Special activities, that don’t require short term memory, are provided.  Services like incontinence management are available.  The buildings are designed with special adaptive features such as special lighting and walkways, to make life easier and safer for these residents.

How will you know if your loved one needs to take the next step?  Often times, the assisted living community staff will begin to notice a decline.  Sometimes a health crisis like a stroke or heart attack occurs and your family member may not be able to return to assisted living from the hospital.  The care staff, at the assisted living, will tell you it’s time to consider a different care setting.

If you have not been closely involved with your loved one during this change you may not clearly understand the reasons for a “move.”  Ask a lot of questions, but know that the resident’s best interest and healthcare needs should be paramount.  Communities do not like to lose residents and they will do whatever it takes, within reason, to accommodate the health care needs of your family member.

Supporting a family member faced with this move is crucial.  A change in setting is always difficult to maneuver.  Be gentle when preparing your loved one for another move.  There is grief and loss associated with all moves.  Being an advocate and working closely with the staff in each place will make for a smoother transition.  We would all like to “age in place,” but without a crystal ball we can’t really know if or when life changing events will dictate the next step.