Facility Care – Not Always a Bad Thing.
Facility care seems to be the taboo topic that nobody seems to want to address. Hi! How are you doing today? I hope this finds you healthy and well. This is the third installment in our series of planning your own care in advance. The question we are addressing is:
If you become incapacitated to the point where you can no longer care for yourself, what type of care do you want and who do you want to provide it?Food for Thought
The primary choices are:
In our last 2 articles, we discussed the first two options. Today we’re going to talk about facility care. The bottom line is that facility care (in today’s world) is not such a bad option.
The Way it Was Back When
Just the term “facility care” conjures up bad images, such as were common back in the 60’s and 70’s. I remember when I was a young child (late 60’s) my grandmother developed “hardening of the arteries” (aka dementia). Her disease progressed to the point where the decision was made to admit her to a Nursing Home.
Back then, these were institutional settings, complete with concrete block walls, little natural light and no attempt to recreate a home like setting at all.
Residents at the time may have pictured themselves as nameless victims in a sea of other helpless wanderers who were just parked in a warehouse-like setting, waiting to die – not a pleasant thought!
Facility Care Today
In my 30+ year career of practicing Elder Law, I have been in many facilities of various types and can report that they have come a long way. Fortunately there are many different types of facilities now – not just the bleak options that were available during my grandmother’s time. Here are a few of the options.
Independent Living Facility (ILF)
There are many reasons a person may choose to live in an Independent Living Facility. As discussed last week, a person may simply have outgrown their home. Your home may have been perfect back when the kids were little but now it’s simply way too big. You may have deferred maintenance, a yard too big to mow, upstairs bedrooms, split-level, or too many stairs to navigate. The end result is that your home is no longer a comfortable and functional place to live.
Independent Living Facilities provide a comfortable room or apartment with all of the basics you need. Most of them have common areas where meals are served and activities are enjoyed. Some have activity directors and offer a host of in facility and out of facility activities. With cooking, cleaning, and home maintenance off your to do list, this allows a lot of time to just participating in the activities that you really enjoy.
As with all of the options here, it is good to check around. Remember that not all independent living facilities are the same. Some offer little more than a place to stay. Others offer a host of bundled activities. Shop around to find one that fits your needs.
Assisted Living Facility (ALF)
If you need some assistance but can still provide for most of your own needs, an Assisted Living Care Facility may be right for you. This option is normally chosen when a person needs assistance with one or more activity of daily living (ADL) such as feeding, dressing, bathing, toileting, or transferring. Again you might be able to do most of these things but mainly just need help in one area.
Many of the newer Assisted Living Facilities are very nicely decorated and have a nice home like environment. Most don’t have cafeterias – instead they have dining rooms and chefs! While most ALF’s offer local transportation in the facility van, one resident stated “Yes I could go out to eat, but why? The food is better here!”
Most ADL’s offer different levels of care (which step-up pricing for increased care needs). In some, as your care needs increase, you can choose to receive more care.
Assisted Living Facilities vary a lot in appearance, care availability and activity options, so shop around and pick the one right for you.
Skilled Care Nursing Facilities (SNF)
If your health has declined to the point where you need 24/7 skilled care then a Skilled Care Nursing Facility may be right for you. These facilities are generally more expensive than the other two options because they are required to have 24-hour medical staff on site.
Since most residents of SNF’s have substantial physical or cognitive impairments, there has traditionally been less emphasis in these facilities on the niceties offered in the above options and more emphasis on medical care. Having said that however, in recent years many SNF’s are making much greater efforts to increase amenities and provide much nicer environments.
Some of these facilities have moved to a green-house cottage concept (here is a link to one I visit frequently) where there are several cottages on the campus – each cottage (9,000+ sq ft) houses 15 or so residents. Each resident has their own very nice room and very nice common areas. The common areas have a nice kitchen, large common seating area and 24 hour staff.
The bottom line is that SNF’s have evolved a lot. They are a far cry from the place my grandmother spent her last few months. I’m very thankful for that.
Why would you Choose Facility Care?
Only yesterday I was visiting with a friend who told me that his kids were grown and lived in another state. There was a lot of love in their family and he knew his kids would do anything for him – but they have jobs and are busy with their family and their lives.
He told me that if and when he needed more advanced care that he would definitely choose one of these levels of facility care. He would then know that he would receive the care that he needed and would not be burdening his family with providing the care, while doing everything else they need to do. When his family came to visit they could simply do that – visit.
The Effects of Covid and Facility Care
This is a personal choice to be made by every family. During this last year with the ravages of Covid-19, facility care has not been an easy choice for many families. Many families who have had loved ones in facilities have not been able to visit personally with them.
Hopefully now we are turning a corner on Covid, facility care will again be a better option in the future than it has been in the last few months.
Best wishes to you and your family as you select the right care option for you.
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