Things You'll Need:
- Local Yellow Pages
- Internet access (as available)
- Note pad, pencil or pen.
- Contact information for local assisted living licensing department.
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Step 1
Identify dedicated Alzheimer's/dementia communities or programs in your area - or the area of the loved one in need:
The simplest source for this is typically the local Yellow Pages under "Assisted Living". However, not all assisted living communities offer Alzheimer's care, so see if this is listed as a service in the ad. A better resource (as available) may be the internet. Web links provided in the "Resources" section of this article can help locate an Alzheimer's specific community or program by zip code - and often provide more detail (such as community size, price, and services). Identified communities typically then also have their own website, which can provide additional information about the community or company of which they are a part. As available, try to identify and tour at least THREE communities providing Alzheimer's care. Even if you like the first one you see, seeing others will help you either confirm or change your decision. Some assisted living communities are completely dedicated to housing and care of individuals with Alzheimer's, however most are traditional assisted living communities offering AD care as an additional service within a dedicated wing or unit of the community.
NOTE: 90% of assisted living communities are private pay and do not participate in Medicare, Medicaid, or traditional insurance plans. When available, some Long Term Care insurance plans may cover assisted living services. Most care is paid through equity gained on the sale of the loved one's home. The "Tips" section of this article provides information on the average cost for care, as well as a link reference for State-by-State information. -
Step 2
Contact the community and schedule a tour:
A good community will answer your call within three rings, identify themselves by name (and/or staff member name) and offer to schedule a community tour within 24 hours, or your earliest convenience. If you need to leave a message, expect a call back within 24-hours. During the initial call, a program director or marketing rep should attempt to gather basic, relevant information about your loved one, followed by a brief review of both general and SPECIFIC services to meet their needs - including basic pricing information. Be wary of communities that are unprofessional, non-responsive, or attempt to "sell" you over the phone. A tour is the only reasonable request that should be made of you at this time. -
Step 3
Assess staffing levels and training:
During the tour, request information on both levels and training for all staff working directly with Alzheimer's residents. The industry standard ratio for staffing is 8:1 (meaning one full time staff member for every eight residents). This ratio may be lower during the night (typically 12:1 or 16:1) when residents are sleeping. All staff working with residents with Alzheimer's should typically complete between 8-20 hours per year of specialized training. Perhaps the biggest factor in assessing staff is to observe their interaction with residents during the tour. Do they treat them with respect (calling them "Mrs.", "Mr.", or by first name)? Avoid those who use "baby talk". Do they make eye contact and connect on a calm, "personal" level? Avoid those who are cold or "bossy". Finally, ask about staff turnover rates - particularly for the program director. These are high turnover jobs, but the more staff who have been employed 2 years or longer, the better. -
Step 4
Assess community programming:
Review the philosophy, approach, and activities provided to residents each day. These should be BOTH scheduled and unscheduled, and involve the residents in all aspects of the community. Programs that include residents folding laundry, setting the table, or general cleaning are not getting "free labor" - but correctly incorporating "real life" activities that make residents feel productive and useful. Scheduled group activities should be small (typically less than 10 residents), simple, and include both in and "out of the community" events. Avoid communities that HAVE THE TV ON THROUGHOUT THE DAY, allow residents to sleep in the lounge for hours on end, and don't differentiate activities from those offered to non-AD assisted living residents. -
Step 5
Review the physical layout and design of the community:
A good Alzheimer's community should be "Safe, Directional, and Therapeutic".
Safety: Should have a secured (locked) entrance and "backup" system - such as a radio frequency bracelet for residents to wear. Exit doors should be "disguised" by painting to match interior walls and decor. Facilities with a central kitchen should have a "secret switch" to prevent residents from turning on stoves, dishwasher, disposal, etc. when not in supervised use. Hot coffee pots, etc. should not be left on and unattended. Indoor windows should not open more than 4". Outside fences should be 8' high (vs. the standard 6'), and outside furniture should be bolted down (to prevent using to get over the fence). The best facilities are located on the ground floor, or have enclosed/secured balcony's if present on higher floors.
Directional: Hallways should never "end" but be circular, allowing wandering residents to always return "home". Colors and decor should change every 40-60 feet, allowing residents to recognize their "neighborhood" from others. Name plates and/or "Memory Boxes" should be placed on or near room doors - allowing residents to identify their individual room. Within resident rooms, bathrooms placed "kitty corner", or otherwise visible from the bed, allow residents to see and locate the toilet as needed, including during the night.
Therapeutic: "Lifeskill" stations should be available throughout the facility, such as a "nursery", "office" or "clothing closet", that will allow residents to engage in their own chosen, unscheduled activity vs. becoming bored, confused, or anxious. Overall decor should use solid vs. patterned colors in carpet, wall coverings, and window dressings - as patterns can be confusing and disorienting. Dark colors should be avoided, especially in carpet - which can look like a "hole" to some residents, and they will attempt to avoid. There should be abundant natural lighting to support normal sleep rhythm and maintain good mood. -
Step 6
Review move-in process for selected community, including all agreements, resident rights, and handbook.
Once you've selected a community, be sure to read all agreements and other information provided by the community prior to move-in. While moving a loved one from their long time home can be a difficult experience, taking the time to review all community information will save you time in the long run, and answer most of the questions you would have. Prior to signing any agreement or related documents, write down or email the administrator or program director any questions you may have. Keep a copy of all responses for your records.
Comments
starlet67 said
on 6/17/2009 Very helpful info for families dealing with Alzheimer's Disease.5*
ajcarle said
on 3/5/2009 Thank you. Glad you found it helpful!
listenhere101 said
on 2/22/2009 great article. 5 stars!