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Published February 02, 2013, 08:21 AM

Minding Our Elders: What is assisted living?

Mom really should have help bathing and someone should monitor her medications. Even dressing is getting to be a chore because of severe arthritis. The problem is that the facility wants to charge more to provide these services. I thought this kind of care is what assisted living is about. – Greg

By: Carol Bradley Bursack, INFORUM

DEAR CAROL: My mother has lived in a very nice assisted living facility for several years, though she’s been quite independent. It’s a 300 mile drive for me to visit her, so I can only visit occasionally. I have a sister who lives within 25 miles and visits once a week. Mom seems to enjoy her friends and this facility is home to her. However, my sister says that now Mom really should have help bathing and someone should monitor her medications. Even dressing is getting to be a chore because of severe arthritis. The problem is that the facility wants to charge more to provide these services. I thought this kind of care is what assisted living is about. – Greg

DEAR GREG: The terms that describe senior living situations change with the times and can be quite different depending on where people live. In some parts of the country, your mom’s current living situation would be considered independent living, with her increasing needs requiring that she transition to assisted living. The monthly fee increases with the added care services.

In other parts of the country, assisted living is a type of communal living where meals are provided, group activities are offered and someone is available in case of an emergency. If in-unit care is needed, as is your mom’s case, then additional charges apply, depending on services. The confusion lies in labeling more than services, since in either case, increased care involves increased fees.

I’d suggest that you, your sister and your mom seriously talk about Mom’s increased care needs, realities and preferences so you can decide how to get them met. Since your mom enjoys her current home, you’ll likely want to keep her there as long as possible. The facility likely has limits even with in-unit care, so while you are working this through you may want to inquire about their capabilities when it comes to skilled nursing care. If you learn more about the limits of this assisted living facility, you’ll be better prepared to plan for your mom’s future.

Likely, the terms for your mother’s current care are spelled out in the contract that she or a family member signed when she moved in. If you and your sister re-read the contract for the facility and still think they shouldn’t be raising the fee for her increased care needs, then one or both of you may want to follow up with the facility administration. After talking with them, if you still feel that the facility is under-serving your mother according to the contract, you can ask for help from the long-term care ombudsman for that area. You can find this contact online at www.ltcombudsman.org. When you type in the nursing home’s Zip code you’ll be led to your representative. State websites should have this information, as well.

Carol Bradley Bursack is the author of a support book on caregiving and runs a website supporting caregivers at www.mindingourelders.com.

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