Mostly at the urging of their adult children, many seniors choose to move to senior communities where some help is available.
These are usually called Assisted Living facilities (AL). When it is too difficult to keep up the family home or an elderly client of yours becomes too isolated after the loss of a spouse, AL can be a good choice.
No doubt you, the financial advisor have helped them consider the expense and the consequences or benefits of selling the family home. And they likely would not move if they could not afford the monthly cost of being in AL. However, there are things every advisor should know about AL so you can properly advise your clients.
The marketing departments of these homes can be very aggressive about promoting the benefits of AL. Indeed may of them are well appointed and have numerous convenient amenities. What they don’t tell you are the hidden disadvantages. Having interfaced with many of these facilities in our work at AgingParents.com and AgingInvestor.com as consultants to families, we want you to be fully informed of what they can and can’t do.
First, AL homes are not nursing homes, and they do not provide nursing or health care. If there is a nurse on staff at all, which is not required of any of them, the nurse is there to evaluate residents’ suitability, hear resident concerns, consult with staff and make referrals. It is not to provide direct care, even in an emergency. The nurse in such a facility, seeing an emergency, will call 911, just as any layperson might do.
These homes are not licensed to offer health care. Assistance with things like bathing, dressing, walking, bathroom, eating and getting in and out of bed are the limit of the help they can provide.
Next, these homes do not provide full staffing at night. If your client is forgetful or wanders around at night and her family shares this with you, AL may not be the best choice. Some people hire additional help privately to watch their loved ones in AL more closely, especially at night and this arrangement can work well. However, it is a significant additional expense and must be paid on top of the regular monthly charges of assisted living. We know of one resident whose family was spending $12,000 a month for the combination of AL and outside supplemental caregiving.
Finally, any home whether it is AL or any other place where care is delivered should be held accountable for the safety of your client who may become a resident there. No one is going to check on your aging client every hour in AL. Falls can happen anywhere, including a so-called “supervised environment”. The concept of AL was originally meant to give all levels of care but today that is not the case. The law requires separate licensing of any unit or facility that offers skilled nursing. Even when it is given on the same campus as AL, skilled nursing facilities are a separate entity from AL.
If you are talking to any client about the possibility of AL, be sure that your client is educated and that the family does not have unrealistic expectations of AL. The expense of these places is one consideration. The overall plan for the future of taking care of a client’s needs is another. Help your client be a wise consumer.