Semi-Independent Living

Semi-Independent Living also called Assisted Living will be at a time when the folk(s) have difficulty performing their daily routines and tasks (sometimes called Activities of Daily Living or ADLs) and will need to be in a housing environment that provides some basic levels of support.
Here are some typical signs that Mom/Dad may start exhibiting that are indicators that they are going to need some assistance:

• Do they need help preparing meals, bathing, housekeeping, and dressing?
• Do they need assistance with medications, monitoring or other health care matters?
• Do they require help with transportation for shopping, doctors, personal, social or recreational matters?
• Are they experiencing memory problems or sometimes get confused?

The Semi-Independent condition/state for a person can be problematic for all of those involved for a couple of different reasons. First of all here is a human being, your parent, who has for all his/her adult life been responsible and caring for others and of themselves. And now there are signs that their independence is diminishing. Secondly, somehow someone is going to have to look after Mom/Dad. Who? How? Where?

Assisted living is the 24/7 (24 hours, 7 days) care of an individual for Activities of Daily Living (ADL's) of meals, personal hygiene, medication, transportation and other support services. This can be in the home or these services can be provided in another assisted living environment.

Providing a parent at home assistance with their ADL activities can be an burdensome and sometimes thankless task for the caregiver. Traditionally eldercare given in the home has been overwhelmingly done so by women This is not to say that there are not opportunities for rich and wonderful family rewards in store. It is well to evaluate the needs of the parent and the realistic abilities of the family to properly provide for those needs in the home.

Providing care in the home for a parent can sometimes be accomplished with additional help. This may involve the hiring of a person(s) to assist Mom/Dad with their ADLs. This person may be a part time or full time employee and they may or may not live on the premises. These factors are determined on an individual basis.

If and when the time arrives to consider moving the folks from the home, the objective is to assess their living, care and housing needs at present and also discover what options are available as their needs change and how to discern when those needs have changed. This is something that may need to be re-evaluated from time to time depending upon circumstances at any given time. The objective should be to find a means by which Mom/Dad can, with assistance, continue living as independently as possible.

Having discussions with the folks about what they would want should they need assistance before they need it will save everyone a great deal of stress and "second-guessing" in the future. This may not always be possible. Discussion, thought and planning are always best when done before a "crises" or emergency dictates a course of action.

Depending on the inter-personal relationships in particular family it may be a good idea if the folks put their wishes in writing stating specifically what type of care and/or facility they wish to live in. This can prevent second-guessing and acrimony with other family members about the care Mom/Dad should receive.

Assisted-Living or Assisted-Care Facilities
These are typically Licensed Facilities that can range from a large private home (Board and Care) to a substantially larger complex. They can offer private or semi-private rooms. They will have shared areas such as dining and recreational rooms and offer meals, housekeeping and social activities. Some will offer other services such as assistance with bathing, dressing and other routine functions and they may offer medication administration.

If it has been determined that the option for Mom/Dad is an assisted living facility it is recommended that some facilities be visited. This checklist can be used to evaluate these facilities. Whenever possible the folks should be involved as much as possible. They are the ones who will be living in this facility and they should have the opportunity to talk with residents and staff.

• What kind of accommodations are offered? Private room, semi-private, Bathroom, meals, etc.
• What types of services are provided - i.e., transportation?
  By the facility?
  By other agencies?
• What is the rate? What services are included? Are there "extra" charges?
• What kind of activities and recreation are available? How often?
• Is there flexibility in their schedule?
• What is the level of involvement of Mom/Dad? Will they have input into the daily activities if they so choose?
• What kinds of personal items can be accommodated? Furniture etc.
• Is the location of the facility conducive for frequent visits from family and friends?
• Does the facility seem safe? Do the bathrooms have handrails, are hallways and stairs well lit? Is there fire safety equipment - sprinklers, alarms, smoke detectors? Is there a way to quickly, efficiently call for emergency help? What is the neighborhood like?
• Do facilities in your state require licensing and frequent inspections? Ask to see the latest inspection report.
• Does the facility accept Medicare and Medicaid?
• How close is Mom/Dad's doctor - hospital or HMO?
• What happens in the event that Mom/Dad need additional assistance later on? Is that assistance available at the facility or will they have to move?

Looking for an Assisted Living Facility for the folks might seem a daunting task. But you are not the first to do this and good references can direct you in the right direction. Discuss this housing situation with your parents and their friends and acquaintances. Doctors, health care and social workers can be good sources for referrals. Talk with your friends and co-workers. You can also get good advice from churches and senior centers. The Local Area Agency on Aging can help with housing referral services - (ELDERCARE LOCATOR 1 800 677-1116).

FINANCIAL CONSIDERATIONS

Typically the costs for Assisted Living residence will range from $1,000 to $3,000 a month and up. The fee varies do to type of accommodations and services provided and the location. Be certain to find out what is covered by the fee and the cost of "extras" if any.

In most situations the family will bear all or most of the cost of Assisted Living. However some states do have programs that provide assistance through Medicaid. This is best determined by contacting your local social service or housing service agency - check the Blue Pages in the phone directory.

Continued Care Residential Community
As noted in the section - Independent Living - residence in a CCRC is an option that was determined, most likely by the folks, to be a good consideration. This is something that is thought out and planned with the idea that assisted living would someday be a necessity.

A requirement for residence is good health when first moving in. These "Life Care" facilities can be expensive. However over a period of time they may be a good choice due to the assisted forms of care and service that are provided later on.

To learn more about Assisted Living options contact the Assisted Living Federation of America, 10300 Eaton Place, Suite 400, Fairfax, VA 22030, 703/691-8100 or www.alfa.org.

1.Housing Intro
2.Independent Living - At Home
3.Independent Living - Other Options
4.Semi-Independent Living
5.Dependent Care
 

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DISCLAIMER: This guide is not intended or meant to be legal advice. This guide and various chapters are intended only as informational and educational background references. Laws governing legal, financial and medical matters vary from state to state. Always consult with an attorney when dealing with such matters.