"Aging out" of assisted living?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Are there any laws regarding what services MUST be given to a resident of an assisted living facility? As they decline, can their needs become so great that they may be asked to move to a nursing home?

On the other hand, can someone already on hospice care move into an assisted living facility rather than a nursing home/skilled care facility if they have their own private hospice care team already in place?

Trying to think a few steps ahead. Thanks.

You can get kicked out of an assisted living facility and often you aren't given much time.

How about if we move a parent into assisted living already on hospice and with our own private hospice care team (that we pay for)?

Doubtful, assisted living centers are only allowed to accept certain types of residents and that doesn’t include people who need assistance with daily life skills. Since hospice nurses aren’t under their suoerviisio or employment, that doesn’t change what the calculus.

There are some really nice hospice centers. I’d look into those

This is what I'm tryin to find out. Is this covered by law or just the regulations of the facility? Parent DOES NOT want to go into a nursing home but will consider assisted living environment. We want to figure out timing on the move if any. So is there a law governing what kind of needs are too much for the facility to accept, or do we just find one willing to let them in? And when?

There are licensing requirements, but there are facilities licensed for multiple care levels.

Though generally they are not housed in the same area. Independent, Assisted and Skilled (and Memory) are separate as each of those groups don't want to have to see all that the more advanced group is going through.

Depends on the facility. Larger places, certainly. My aunt and uncle were in a smaller place in West Virginia that did assisted living through hospice in the same location. My uncle lived with my aunt in the same unit until the end of his life. He passed away in a home-like environment surrounded by his family. It was really as good a set-up as they could have wanted.

Was this one of those independent homes that legally can have just a few people?

No. It was a full-fledged facility. I’m the one who did the research for the family. They told us they could handle assisted living through end of life, and that’s what they delivered.

So it was a continuing care facility.

[Anonymous]

Anonymous wrote:Op, how far away is your parent from needing hospice care? Is it a several years away or several weeks away situation? Continuing care facilities often only accept new patients who currently only need whatever is their lowest level of service. Also good facilities at any level often have waitlists.

If you want meaningful answers, you need to indicate the state and what your mom’s current needs are.

We don't know timing, that's the issue. Things could continue as they are for several years or decline rapidly (like our other parent). They can't live alone anymore, can't shower alone or cook safely, etc. They don't need to be in a nursing home but can't function if that makes sense. They can't safely get in and out of bed anymore but are lucid enough not to want to be in a nursing home.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Are there any laws regarding what services MUST be given to a resident of an assisted living facility? As they decline, can their needs become so great that they may be asked to move to a nursing home?

On the other hand, can someone already on hospice care move into an assisted living facility rather than a nursing home/skilled care facility if they have their own private hospice care team already in place?

Trying to think a few steps ahead. Thanks.

You can get kicked out of an assisted living facility and often you aren't given much time.

How about if we move a parent into assisted living already on hospice and with our own private hospice care team (that we pay for)?

Doubtful, assisted living centers are only allowed to accept certain types of residents and that doesn’t include people who need assistance with daily life skills. Since hospice nurses aren’t under their suoerviisio or employment, that doesn’t change what the calculus.

There are some really nice hospice centers. I’d look into those

This is what I'm tryin to find out. Is this covered by law or just the regulations of the facility? Parent DOES NOT want to go into a nursing home but will consider assisted living environment. We want to figure out timing on the move if any. So is there a law governing what kind of needs are too much for the facility to accept, or do we just find one willing to let them in? And when?

There are licensing requirements, but there are facilities licensed for multiple care levels.

Though generally they are not housed in the same area. Independent, Assisted and Skilled (and Memory) are separate as each of those groups don't want to have to see all that the more advanced group is going through.

Depends on the facility. Larger places, certainly. My aunt and uncle were in a smaller place in West Virginia that did assisted living through hospice in the same location. My uncle lived with my aunt in the same unit until the end of his life. He passed away in a home-like environment surrounded by his family. It was really as good a set-up as they could have wanted.

Was this one of those independent homes that legally can have just a few people?

No. It was a full-fledged facility. I’m the one who did the research for the family. They told us they could handle assisted living through end of life, and that’s what they delivered.

So it was a continuing care facility.

So is "continuing care" a legit label for this, and is there a license for "continuing care"?

[Anonymous]

My grandmother was allowed to stay in assisted living as long as we provided 24/7 support we paid for.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Are there any laws regarding what services MUST be given to a resident of an assisted living facility? As they decline, can their needs become so great that they may be asked to move to a nursing home?

On the other hand, can someone already on hospice care move into an assisted living facility rather than a nursing home/skilled care facility if they have their own private hospice care team already in place?

Trying to think a few steps ahead. Thanks.

You can get kicked out of an assisted living facility and often you aren't given much time.

How about if we move a parent into assisted living already on hospice and with our own private hospice care team (that we pay for)?

Doubtful, assisted living centers are only allowed to accept certain types of residents and that doesn’t include people who need assistance with daily life skills. Since hospice nurses aren’t under their suoerviisio or employment, that doesn’t change what the calculus.

There are some really nice hospice centers. I’d look into those

This is what I'm tryin to find out. Is this covered by law or just the regulations of the facility? Parent DOES NOT want to go into a nursing home but will consider assisted living environment. We want to figure out timing on the move if any. So is there a law governing what kind of needs are too much for the facility to accept, or do we just find one willing to let them in? And when?

There are licensing requirements, but there are facilities licensed for multiple care levels.

Though generally they are not housed in the same area. Independent, Assisted and Skilled (and Memory) are separate as each of those groups don't want to have to see all that the more advanced group is going through.

Depends on the facility. Larger places, certainly. My aunt and uncle were in a smaller place in West Virginia that did assisted living through hospice in the same location. My uncle lived with my aunt in the same unit until the end of his life. He passed away in a home-like environment surrounded by his family. It was really as good a set-up as they could have wanted.

This is what we're looking for. Did the place have multiple licenses or like one umbrella license? How do we find a list of facilities with the appropriate license(s) to contact?

What state are you in?

Maryland.

What is your mom’s current condition? Remember this is anonymous. We are just trying to give you useful info.

[Anonymous]

Look into Continuing Care Communities (CCRCs). Does she have good financial resources?

You can use a service like “A Place for Mom” to help in your search. Note that they are relentless once they get your phone number.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Are there any laws regarding what services MUST be given to a resident of an assisted living facility? As they decline, can their needs become so great that they may be asked to move to a nursing home?

On the other hand, can someone already on hospice care move into an assisted living facility rather than a nursing home/skilled care facility if they have their own private hospice care team already in place?

Trying to think a few steps ahead. Thanks.

You can get kicked out of an assisted living facility and often you aren't given much time.

How about if we move a parent into assisted living already on hospice and with our own private hospice care team (that we pay for)?

Doubtful, assisted living centers are only allowed to accept certain types of residents and that doesn’t include people who need assistance with daily life skills. Since hospice nurses aren’t under their suoerviisio or employment, that doesn’t change what the calculus.

There are some really nice hospice centers. I’d look into those

This is what I'm tryin to find out. Is this covered by law or just the regulations of the facility? Parent DOES NOT want to go into a nursing home but will consider assisted living environment. We want to figure out timing on the move if any. So is there a law governing what kind of needs are too much for the facility to accept, or do we just find one willing to let them in? And when?

There are licensing requirements, but there are facilities licensed for multiple care levels.

Though generally they are not housed in the same area. Independent, Assisted and Skilled (and Memory) are separate as each of those groups don't want to have to see all that the more advanced group is going through.

Depends on the facility. Larger places, certainly. My aunt and uncle were in a smaller place in West Virginia that did assisted living through hospice in the same location. My uncle lived with my aunt in the same unit until the end of his life. He passed away in a home-like environment surrounded by his family. It was really as good a set-up as they could have wanted.

Was this one of those independent homes that legally can have just a few people?

No. It was a full-fledged facility. I’m the one who did the research for the family. They told us they could handle assisted living through end of life, and that’s what they delivered.

So it was a continuing care facility.

So is "continuing care" a legit label for this, and is there a license for "continuing care"?

Yes

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Are there any laws regarding what services MUST be given to a resident of an assisted living facility? As they decline, can their needs become so great that they may be asked to move to a nursing home?

On the other hand, can someone already on hospice care move into an assisted living facility rather than a nursing home/skilled care facility if they have their own private hospice care team already in place?

Trying to think a few steps ahead. Thanks.

You can get kicked out of an assisted living facility and often you aren't given much time.

How about if we move a parent into assisted living already on hospice and with our own private hospice care team (that we pay for)?

Doubtful, assisted living centers are only allowed to accept certain types of residents and that doesn’t include people who need assistance with daily life skills. Since hospice nurses aren’t under their suoerviisio or employment, that doesn’t change what the calculus.

There are some really nice hospice centers. I’d look into those

This is what I'm tryin to find out. Is this covered by law or just the regulations of the facility? Parent DOES NOT want to go into a nursing home but will consider assisted living environment. We want to figure out timing on the move if any. So is there a law governing what kind of needs are too much for the facility to accept, or do we just find one willing to let them in? And when?

There are licensing requirements, but there are facilities licensed for multiple care levels.

Though generally they are not housed in the same area. Independent, Assisted and Skilled (and Memory) are separate as each of those groups don't want to have to see all that the more advanced group is going through.

Depends on the facility. Larger places, certainly. My aunt and uncle were in a smaller place in West Virginia that did assisted living through hospice in the same location. My uncle lived with my aunt in the same unit until the end of his life. He passed away in a home-like environment surrounded by his family. It was really as good a set-up as they could have wanted.

Was this one of those independent homes that legally can have just a few people?

No. It was a full-fledged facility. I’m the one who did the research for the family. They told us they could handle assisted living through end of life, and that’s what they delivered.

So it was a continuing care facility.

So is "continuing care" a legit label for this, and is there a license for "continuing care"?

https://aging.maryland.gov/Documents/WhatisContinuingCare082514.pdf

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Are there any laws regarding what services MUST be given to a resident of an assisted living facility? As they decline, can their needs become so great that they may be asked to move to a nursing home?

On the other hand, can someone already on hospice care move into an assisted living facility rather than a nursing home/skilled care facility if they have their own private hospice care team already in place?

Trying to think a few steps ahead. Thanks.

You can get kicked out of an assisted living facility and often you aren't given much time.

How about if we move a parent into assisted living already on hospice and with our own private hospice care team (that we pay for)?

Doubtful, assisted living centers are only allowed to accept certain types of residents and that doesn’t include people who need assistance with daily life skills. Since hospice nurses aren’t under their suoerviisio or employment, that doesn’t change what the calculus.

There are some really nice hospice centers. I’d look into those

This is what I'm tryin to find out. Is this covered by law or just the regulations of the facility? Parent DOES NOT want to go into a nursing home but will consider assisted living environment. We want to figure out timing on the move if any. So is there a law governing what kind of needs are too much for the facility to accept, or do we just find one willing to let them in? And when?

There are licensing requirements, but there are facilities licensed for multiple care levels.

Though generally they are not housed in the same area. Independent, Assisted and Skilled (and Memory) are separate as each of those groups don't want to have to see all that the more advanced group is going through.

Depends on the facility. Larger places, certainly. My aunt and uncle were in a smaller place in West Virginia that did assisted living through hospice in the same location. My uncle lived with my aunt in the same unit until the end of his life. He passed away in a home-like environment surrounded by his family. It was really as good a set-up as they could have wanted.

Was this one of those independent homes that legally can have just a few people?

No. It was a full-fledged facility. I’m the one who did the research for the family. They told us they could handle assisted living through end of life, and that’s what they delivered.

So it was a continuing care facility.

So is "continuing care" a legit label for this, and is there a license for "continuing care"?

Yes, but most only accept patients who don’t need any care at all at time of admission. And wait lists can be very long, sometimes years for the more popular (nicer) facilities. We were quoted two years by one and four by another in the Baltimore area. Fortunately my parents have already been on the wait list at the place with the two year wait, so it will only be about a four month wait from when they were ready to move in.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Op, how far away is your parent from needing hospice care? Is it a several years away or several weeks away situation? Continuing care facilities often only accept new patients who currently only need whatever is their lowest level of service. Also good facilities at any level often have waitlists.

If you want meaningful answers, you need to indicate the state and what your mom’s current needs are.

We don't know timing, that's the issue. Things could continue as they are for several years or decline rapidly (like our other parent). They can't live alone anymore, can't shower alone or cook safely, etc. They don't need to be in a nursing home but can't function if that makes sense. They can't safely get in and out of bed anymore but are lucid enough not to want to be in a nursing home.

See where your mom is on this list of ADLs.
https://twohearts.care/blog/the-activities-of-daily-living-checklist/

What do you mean by not being able to get in or out of bed anymore?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Are there any laws regarding what services MUST be given to a resident of an assisted living facility? As they decline, can their needs become so great that they may be asked to move to a nursing home?

On the other hand, can someone already on hospice care move into an assisted living facility rather than a nursing home/skilled care facility if they have their own private hospice care team already in place?

Trying to think a few steps ahead. Thanks.

You can get kicked out of an assisted living facility and often you aren't given much time.

How about if we move a parent into assisted living already on hospice and with our own private hospice care team (that we pay for)?

Doubtful, assisted living centers are only allowed to accept certain types of residents and that doesn’t include people who need assistance with daily life skills. Since hospice nurses aren’t under their suoerviisio or employment, that doesn’t change what the calculus.

There are some really nice hospice centers. I’d look into those

This is what I'm tryin to find out. Is this covered by law or just the regulations of the facility? Parent DOES NOT want to go into a nursing home but will consider assisted living environment. We want to figure out timing on the move if any. So is there a law governing what kind of needs are too much for the facility to accept, or do we just find one willing to let them in? And when?

There are licensing requirements, but there are facilities licensed for multiple care levels.

Though generally they are not housed in the same area. Independent, Assisted and Skilled (and Memory) are separate as each of those groups don't want to have to see all that the more advanced group is going through.

Depends on the facility. Larger places, certainly. My aunt and uncle were in a smaller place in West Virginia that did assisted living through hospice in the same location. My uncle lived with my aunt in the same unit until the end of his life. He passed away in a home-like environment surrounded by his family. It was really as good a set-up as they could have wanted.

Was this one of those independent homes that legally can have just a few people?

No. It was a full-fledged facility. I’m the one who did the research for the family. They told us they could handle assisted living through end of life, and that’s what they delivered.

So it was a continuing care facility.

So is "continuing care" a legit label for this, and is there a license for "continuing care"?

Yes, but most only accept patients who don’t need any care at all at time of admission. And wait lists can be very long, sometimes years for the more popular (nicer) facilities. We were quoted two years by one and four by another in the Baltimore area. Fortunately my parents have already been on the wait list at the place with the two year wait, so it will only be about a four month wait from when they were ready to move in.

This really depends on where you are. It can vary a lot.

[Anonymous]

My dad and mom were in a continuing care community in independent living. My dad had Parkinson’s and they stayed in independent living with private pay 24 hour care coming in to their apartment. It is a common set up. My dad could have moved to their skilled nursing facility but he wanted to be at home.

Remove the hospice option from your thinking for the time being - it is a kind of care, but can be provided anywhere. The important thing to figure out is what level of care your mom needs. And remember that at home with private pay home health aids is also an option if she has the money, or if assisted living believes she isn’t eligible due to her level of functioning.

[Anonymous]

Another way in which continuing care facilities differ is what happens when you need a higher level of care. Most will have separate units or floors for higher levels. of care. So your mom might still have to move to a skilled nursing floor/unit at some point.

Another option is an independent senior living community without any nursing care. Typically these are elderly friendly units with some light housekeeping provided and meals at a on site “restaurant” included. They tend to include extra bedrooms to house a caregiver and might have a relationship with a nursing agency. Again, in the Baltimore area, these units tend to cost the same as continuing care facilities base fees. Say $300,000 to $500,000 with monthly fees starting at around $6000. At continuing care, you pay much higher monthly fees when needing higher level of care and at independent living with no higher levels, you would pay base fees and then whatever you pay a private nurse.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Op, how far away is your parent from needing hospice care? Is it a several years away or several weeks away situation? Continuing care facilities often only accept new patients who currently only need whatever is their lowest level of service. Also good facilities at any level often have waitlists.

If you want meaningful answers, you need to indicate the state and what your mom’s current needs are.

We don't know timing, that's the issue. Things could continue as they are for several years or decline rapidly (like our other parent). They can't live alone anymore, can't shower alone or cook safely, etc. They don't need to be in a nursing home but can't function if that makes sense. They can't safely get in and out of bed anymore but are lucid enough not to want to be in a nursing home.

I would find a facility that has assisted, skilled and memory. Get her into assisted now. It sounds as if you don't have a Dx for hospice care at this point. I guess your concern is WHAT IF she needs hospice and she's in assisted living, then needs it. At that point, what would you do????

At my grandmother's facility where she was in independent, if something happened, they would take her over to skilled, then bring her back to her apartment when she was better.

I guess the bigger question I have is if you can afford assisted living PLUS 24/7 care for her there while on hospice, can she afford to have 24/7 care at home? Then you have control.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Are there any laws regarding what services MUST be given to a resident of an assisted living facility? As they decline, can their needs become so great that they may be asked to move to a nursing home?

On the other hand, can someone already on hospice care move into an assisted living facility rather than a nursing home/skilled care facility if they have their own private hospice care team already in place?

Trying to think a few steps ahead. Thanks.

You can get kicked out of an assisted living facility and often you aren't given much time.

How about if we move a parent into assisted living already on hospice and with our own private hospice care team (that we pay for)?

Doubtful, assisted living centers are only allowed to accept certain types of residents and that doesn’t include people who need assistance with daily life skills. Since hospice nurses aren’t under their suoerviisio or employment, that doesn’t change what the calculus.

There are some really nice hospice centers. I’d look into those

This is what I'm tryin to find out. Is this covered by law or just the regulations of the facility? Parent DOES NOT want to go into a nursing home but will consider assisted living environment. We want to figure out timing on the move if any. So is there a law governing what kind of needs are too much for the facility to accept, or do we just find one willing to let them in? And when?

There are licensing requirements, but there are facilities licensed for multiple care levels.

Though generally they are not housed in the same area. Independent, Assisted and Skilled (and Memory) are separate as each of those groups don't want to have to see all that the more advanced group is going through.

Depends on the facility. Larger places, certainly. My aunt and uncle were in a smaller place in West Virginia that did assisted living through hospice in the same location. My uncle lived with my aunt in the same unit until the end of his life. He passed away in a home-like environment surrounded by his family. It was really as good a set-up as they could have wanted.

Was this one of those independent homes that legally can have just a few people?

No. It was a full-fledged facility. I’m the one who did the research for the family. They told us they could handle assisted living through end of life, and that’s what they delivered.

So it was a continuing care facility.

So is "continuing care" a legit label for this, and is there a license for "continuing care"?

Yes, but most only accept patients who don’t need any care at all at time of admission. And wait lists can be very long, sometimes years for the more popular (nicer) facilities. We were quoted two years by one and four by another in the Baltimore area. Fortunately my parents have already been on the wait list at the place with the two year wait, so it will only be about a four month wait from when they were ready to move in.

This really depends on where you are. It can vary a lot.

I don’t think it varies alot in more populated areas of Maryland.