Senior Living Education - Arizona Senior Living
Is there a difference between an Assisted Living Facility and an Assisted Living Home?
The state of Arizona licenses each type of assisted living the same way. They are inspected annually and those surveys are made public. However, there are some significant differences.
Assisted living facilities are generally apartment style living, where the residents congregate for meals and activities. There is a large emphasis on socialization and activities as a part of a community. The personal care or services are provided in the privacy of the resident’s apartment and as care level changes, a resident can have increasing services provided and others would not know what care is being provided to the resident.
There are some potential limitations in this setting you will need to be aware of:
- Some residents may require two person assist with transferring or injections of insulin or other conditions that may disqualify that prospective resident from a particular community.
- Some individuals are also much more private or withdrawn by nature, and living in a community may drive them to isolate more.
- Caregivers are staffed in the facilities based on need, but the reality is that numbers of staff vary. Medical Technicians are typically responsible for medication management only, but they take the responsibility away from the primary caregivers so that they are more available in a timely manner to the residents
- Ratios are hard to explain or determine, but roughly one caregiver to 8-12 residents during awake hours and a reduction in staff numbers is seen at night.
- Costs generally are comprised of a basic rate for services and the cost or rent of the apartment. Then additional fees are added based on an assessment conducted by the facility and a corresponding level of care charge is added each month to the basic rent.
Assisted living homes, or adult group homes, are privately owned homes that are licensed by the state for the purpose of assisted living services. These provide a more intimate, residential setting for the individual. The capacity of these homes is typically a maximum of 10 individuals. Residents may have their own room or they may share a room with another resident. Many times couples reside together in a large bedroom or even a master bedroom suite. The homes are typically licensed at the highest level of care the state permits and many times, the residents live out the remainder of their lives with the support of hospice services in this setting. Care giver ratios are more likely 1 to 5 or even better in some homes. These assisted living homes provide all meals, snacks, activities and ancillary services and there is an all inclusive monthly rate. Activities are tailored to meet the need of the individual and can include games, music, exercise, movies, baking, or gardening. These activities are usually done in a group setting.
What is the difference between an Assisted Living Facility and a Nursing Home or Skilled Nursing Facility?
Both assisted living and nursing homes are licensed by the state of Arizona. However, in a nursing home, there are licensed nurses 24 hours/day whereas an assisted living home has certified caregivers.
Many seniors and their families are frequently under the impression that at some point, they will be forced to live in a nursing home and there is often a resistance to that idea. Consequently, too many seniors stay in their homes unsafely and they also miss the social opportunity that assisted living can provide.
Nursing homes are often seen as clinical or institutional, so seniors often avoid the move to a safer environment in the name of maintaining their independence. Assisted living facilities in general, are dedicated to that very concept. Rather than nurture a dependence on the staff as a nursing home would, assisted living staff provides the care the senior specifically needs as determined by their individualized service plan. For example, if the senior needs help with bathing and showering, but they can still manage their own medications, then that is built into the resident’s personal service plan. Many people need help in a few areas, but they don’t need 24 hour/day nursing care. Assisted living fills those very particular needs at a significant savings. Nursing home costs vary, but range typically from $150-$225/day. Assisted living costs can be bundled or broken out, but typically start around $65/day and can range up to $150/day. These are ranges in the Phoenix metro area and are intended to be a guideline.
What are the types and differences in retirement homes?
Retirement home is a broad term that often refers to a variety of senior living options that are available in our community. This term may refer to a senior independent living community where seniors live in their own apartment or villa and they enjoy a social, active community lifestyle. Apartments are often equipped with kitchens so that the senior may continue to cook and prepare meals, but they also take advantage of the dining room/restaurant that is part of the community. The emphasis for the seniors is lifestyle and socialization. They are beginning to relinquish some of the duties and responsibility of home management but they enjoy the options and freedom that independent living offers.
There are no caregivers available to the residents, however, in many instances, residents may employ private duty caregivers when they are in need for some minor help with their activities of daily living (ADL). This type of independent community is not licensed by the state department of health.
The term retirement home may also refer to an assisted living community. This community is in many ways similar to an independent community, but apartments may not be as spacious or there may only be a kitchenette available because one of the required components of assisted living is 3 meals/day are provided as well as snacks. Caregivers are available to the residents 24 hours/day and support each resident as directed by their individual service plan. There is a high degree of emphasis placed on socialization and activity to compliment the personal care each resident receives. The state department of health licenses these facilities and must inspect them at least annually. The facilities are required to meet a high degree of scrutiny and standards by the state. The Arizona Department of Health makes the results of the annual surveys public and each facility must have their most recent survey available to you at the facility if you request to view it.
The term retirement home may also refer to an assisted living home or adult group home. In the state of Arizona, assisted living can be received in a private or residential setting. Caregivers are available 24 hours/ day and they are licensed in the same manner by the state department of health. Care is very personal and this setting is best for someone who needs a lot of help with their activities of daily living (ADLs) or may prefer a small, family like setting. Meals are primarily home made and are served family style in most cases. Activities are sometimes done as a group, but are often intentionally done individually. The homes are also surveyed by the state annually and the results are made public and you may request to see their most recent survey at any time.
All of these types of “retirement” homes all have licensed facility managers that may or may not be the owners. Each home is staffed with state certified caregivers and the following services can be easily arranged as a complement to the primary care:
- visiting physicians
- in home services from home health care providers
- rehab therapy
- hospice care
Also, the state has identified a need for “specialty” homes that care for people who have mental health or behavioral health needs. There are specially licensed homes that we work with that have visiting psychiatrists, psychiatric nurse practitioners, and mental health counselors who we can guide you toward. Our extensive background in psychiatric and mental health nursing makes us uniquely qualified to help you with these very special needs.
What are the safety concerns that often influence when a person is ready for some type of senior living?
There are many safety considerations to keep in mind when making the decision to consider senior living and what kind of senior living best fits your loved one.
It is extremely important to take medications exactly as prescribed - right time, right dose and right medication. Seniors may have compromised cognitive ability or impaired vision and these factors can contribute to medication error. Missed doses or incorrect amount of medication can have a devastating effect as the senior may have a decreased capacity to tolerate a medication error. Medications that are taken for blood pressure control, symptoms of depression, anxiety, dementia or another neurological condition may increase their risk of falls by causing dizziness, confusion or impaired motor coordination.
Falls are the number one safety issue seniors face. For people over the age of 75, 25% of all fractured hips lead to death within 6 months of the injury due to surgery complications.Falls can be attributed to many issues:
- poor balance
- medication error
- poor eyesight
- a collection of personal items which clutter the living space
Assisted living can never promise to eliminate falling, but it can reduce the risk factors associated with falls and can provide 24 hour care in the event of a fall.
Impaired judgment and changes in medication also influence the decision to pursue senior living environments. Some other factors that can contribute this decision may be:
- senior may leave bills unpaid
- food is made that is easier to cook in a microwave but may not be very nutritious
- personal hygiene is much more challenging
- senior may have issues with incontinency will at times will minimize or restrict their fluid intake - dehydration and increased frequency of urinary tract infections are severe problems
- poor hygiene can also significantly contribute to incidence of urinary tract infections
- driving concerns exist when judgment is altered
- reaction times are lessened and speeds are considered erratic or unpredictable.
- getting lost is a reality even when the route is routine and well known.