What Do You Need to Know About Assisted Living?

    May 06,2015

    By Martha Jo Patterson

    After watching the PBS Frontline Special "Life and Death in Assisted Living" I wanted to provide advice on some things you need to know about moving your parent into a care or retirement living facility. I have more detailed information in my indispensable Alzheimer's Resource Kit at

    A. When you Tour the Facility they want your parent to move in because they have a room to fill.

    The person giving the tour is a marketing person. For facilities the most important thing is having rooms filed, I once overheard the marketing director of a facility tell the new person who was going to work at this facility that each new resident had a value to the company of $250,000!!! As a consumer we must always beware.

    Look around try to see in the places they don't want you to see, use your nose and your ears. You may smell or hear something that concerns you. When you tour a facility it is like touring a model home, they want you to see everything as perfect.

    B. Ask What Can the Facility Legally Do?

    There are three levels of facilities and each can do different things:

    1. Independent Living: These facilities are apartments or homes for people 55 and older. They typically have a meal plan, and transportation services. They can not provide any medical care. Many now have a Home Care Agency or "Home Health Agency" that providesNON Medical Care, and many to increase their profits "require" you to use their people. People pay a premium to live in these facilities based on promises of care. If the facility is licensed as an independent it is just a fancy apartment nothing more.
    2. RCFE: Residential Care Facilities For the Elderly these are licensed to provide NON Medical Care. There are two types facilities with under 15 beds (Board and Care) and those over 15 beds. If your parent has difficulty walking and is susceptible to falls you need to find out what would happen if there is a fire. How many rooms are there on a floor, how many staff could they get everyone out? Ask them how they will prevent the fall. Most facilities with over 15 beds charge extra to help a resident bathe, and for medication management. Medication Management is merely a reminder service, in order to actually dispense medication (set up the pills by how often and how many, or give injections) the person must be a Registered Nurse, Nurse Practitioner, or Doctor.
    3. Skilled Nursing Facility: These are licensed to provide Medical care, and are required to have Registered Nurses on staff, they are equipped to care for people with Medical needs.

    C. Someone needs to check on your loved one, no matter where they are living.

    If you have placed a loved one in a facility, each time you visit you need to make sure they are not showing any signs of bedsores, or other injury. If your loved one has dementia they cannot accurately report what is happening to them so you need to listen for anything that seems off. I had a client whose mother was being mistreated by a caregiver, my client noticed her mom always looking for someone, her mother started talking about an incident in her childhood where she was bullied like it was happening daily. I was able to help my client put together what was happening, and we were able to have her mom moved.

    D. Plan Ahead!

    The other day a widow and her children all who knew my dad came into my office in Orange, California. They were impressed that I was Certified as an Elder Law Attorney by the National Elder Law Foundation. They knew me well, yet had checked me out, so they knew very few people specialize in Elder Law. They were worried about their mom, their dad had just passed away, and they were afraid that mom would need care in a facility soon as her health was failing and she was having trouble walking.

    I talked about the Elder Care Journey and how it is very important that everyone plan for two things avoiding probate and taxes, and for what happens if you don't die but need help with daily care and paying your bills. I told them that in my office I do things differently than other attorneys. Most Estate Planning Attorneys put together great plans for someone who goes from healthy and vigorous to falling asleep and never waking up. I wish that for everyone who comes in my office, but I have learned through both my personal experience and that of others that you must plan for a journey that involves Long Term Care.

    I help many families like this one with an Estate Plan which will protect Assets, the widow will be able to qualify for the Aid and Attendance Benefits since her husband was a World War II veteran, when she needs assistance with two activities of daily living and is paying most of her income for her care. If the widow needs Skilled Care I have made sure her home and the Vacation/Rental Home in Big Bear are protected and that she will qualify for Medi-Cal. My hope is that the plan I have prepared is like putting a jacket in your suitcase when you travel in August, you don't plan to use it (no one wants to leave their home), but if you do you have plan that will protect you just as your jacket would keep you warm and dry if a sudden rain storm hit.

    As I asked her if she had a Will or old Trust she had a very old will, at that point her son asked "should we (pointing to the others) get a Trust too? I wish this was the first time someone in their sixties asked that question. Boomers think there is no sense of urgency in providing for their demise. They make the biggest mistake people make they PUT OFF PLANNING. The answer to these "children" all who had children and some had grandchildren was yes you need a Trust too, the youngest has been struggling with a business that has barely survived the economy, and said "I don't have enough to worry about". I told him that was not true, if he did not plan he would leave a mess for his kids (he was divorced).

    My tips for today: Don't put off planning, and plan for both avoiding probate and taxes and the big What If: What if you don't die but live with Disability, Disease of Dementia. (I have a book by that name). So Don't WAIT ANY LONGER, call me today to "get your affairs in order"

    Go Back