This is the fourth in a series of articles intended to demystify the experience of living in a retirement community.
Your spouse requires help bathing and dressing, and it is getting to be too much for you to manage his or her pill regimen. Sometimes you look in the cupboard and you're reminded of an old TV show in which a woman is trying to prepare a meal with the only two ingredients on hand - spaghetti noodles and chocolate sauce.
Your children have suggested assisted living. But what exactly is that?
AARP says, "Assisted living residences are aimed at helping residents remain as self-sufficient as possible with the assurance of assistance when needed. A combination of housing, meals, personal care and support, social activities, 24-hour supervision and, in some residences, health-related services is usually provided."
Assisted living generally implies living in an apartment very much like an independent living apartment (although typically with a microwave in the kitchen rather than a full stove and oven).
In Arizona, assisted living centers have to follow a large number of very specific rules. They must provide three nutritious meals a day and a snack - and dinner and breakfast can not be more than 14 hours apart. Menus must be dated and posted at least a week ahead of time.
The facility has to ensure that "daily social, recreational, or rehabilitative activities are provided" that meet "residents' preferences, needs, and abilities." A calendar of activities must be posted at least a week in advance.
Residents must be provided "encouragement and assistance to preserve outside support systems" and "social interaction to maintain identity and self-worth."
The site must provide daily newspapers, current magazines, "and a variety of reading materials." These are typically made available in common areas, often onsite libraries.
The site must provide a "hazard-free outdoor area with shaded protection where residents may walk or sit."
Interestingly, it is required that the facility must be free of odors.
Assisted living sites must "conspicuously post" resident's rights, and provide residents with information about how to resolve grievances.
The sites are required to keep on file the name and contact information for a family member or other representative who can be notified if any problems arise and who can make decisions on behalf of the resident if necessary.
The regulations spell out three different levels of care, and a site may not accept as a resident someone who requires a higher level of care than it is licensed to provide.
The three levels of care are as follows.
The first level is "supervisory care," which means that residents are able to handle without assistance basic activities like bathing, dressing, and eating meals provided, and also need very little help managing any medicines.
The second level is "personal care," which means that they may need some nursing services, have one or more medical conditions that require monitoring, need help managing medicines, and need assistance with activities such as bathing, dressing, and walking.
The third level is "directed care," which means that the individual is "incapable of recognizing danger, summoning assistance, expressing need or making basic care decisions." Residents may need extensive help with bathing, dressing, getting to meals, and so forth. They need to be monitored frequently because of physical or cognitive limitations.
Of the four communities in the Prescott, Arizona area visited for this series, Good Samaritan, Las Fuentes, and Granite Gate all offer all three levels of care; Alta Vista offers the first two but not the third.
When people move into an assisted living facility, a service plan must be prepared within 14 days. It is developed with input from the resident and/or the resident's representative, and specifies the level of assisted living service and any medical services that the individual will be receiving. It is signed by the resident/representative and by site staff.
The law provides many protections; it is still important to be attentive in choosing a site.
AARP offers a checklist to use when considering assisted living sites at http://assets.aarp.org/external_sites/caregiving/checklists/checklist_as....
The Arizona Department of Health Services offers its own explanation of assisted living and a checklist at http://www.azdhs.gov/als/guides/achbro.pdf.
You can see licensing information and inspection reports at http://hsapps.azdhs.gov/ls/sod/SearchProv.aspx?type=AL. (Good Samaritan's site in Prescott is listed under the unit's name, which is Willow Wind.)