It is the perennial story: a parent, a widow or widower, can no longer live at home because of a form of dementia. They need what has come to be called a “memory care” facility. That used to mean going to a nursing home, but there are alternatives now. For more seniors the option is “assisted living,” often called memory care. There is a wide range to choose from in the Detroit – Metro area with new ones opening frequently.
Families will tour the assisted living facility. They will be greeted by a fresh attractive environment that promises a private room in a nice apartment style setting. Music from decades ago wafts from speakers in the gathering area. Some residents are watching an old Black and White classic film. The elders living there look clean and content. Pictures from long ago decorate the halls and resident rooms have pictures of themselves and family in their rooms.
What could possibly go wrong in this memory care paradise?
A recent article published in both Kaiser Health News (KHN) and the New York Times pointed out the dangers found in assisted living facilities. Loss of memory is not the only problem residents have. Many also have what is called in the Alzheimer’s arena “difficult behaviors.” In other forms of dementia, such as Fronto-temporal, difficult behaviors are the preeminent problem.
According to KHN difficult behaviors are potentially fatal in the assisted living paradise. Here are three common, avoidable problems that elders experience in assisted living facilities:
- Dangerous building conditions. Un-monitored doors should be locked. Persons with dementia often have the problem of wandering. In a memory care facility they will open any unlocked door and go through it. If it leads to an unlit stairway they will fall down the stairs. If it leads to outside it may lock behind them and they will wander off to their peril.
- Lack of sufficient staff. Elders are in assisted living facilities because they need assistance. Many frail elders also have physical problems. Some are prone to falls, some have suffered a broken hip from a fall. If they don’t get assistance with walking or transferring they will fall again with even worse results.
- Dangerous Residents. Everybody knows that many forms of dementia are accompanied by “difficult behaviors.” Many times these lead to violent or aggressive outbursts with the result that another resident, a frail elder, will suffer injury.
The KHN article observed:
“Aggressive behavior, a hallmark of dementia, is a major problem in assisted living facilities. One national study, published in 2016, found that 8 percent of assisted living residents were physically aggressive or abusive toward residents or staff.”
According to the report the problems in assisted living facilities is exacerbated when they are not subject to government oversight.
“[] the rules for assisted living remain looser than for nursing homes. The federal government does not license or oversee assisted living facilities, and states set minimal rules.
The government does not publish quality measures as it does for nursing homes. Inspections usually are less frequent, and fines are generally far lower than what a nursing home might incur for a similar mistake.”
The article is called “Assisted Living’s Breakneck Growth Leaves Safety Of Dementia Patients Behind.” You can find it here.
You can also read it on the New York Times website
What can you do when looking for a facility? In Michigan if it is licensed as Adult Foster Care or a Home for the Aged, you can check the state records and the office of the Michigan Long Term Care Ombudsman. If it is not licensed, and most in Michigan are not, you are best advised to make your own investigation. Try to speak to families who have a member in residence. What problems have they had? Discuss the problem of difficult behaviors with the admission person and determine their policy. If they have one, is it in writing? Can you review it?
After you make placement in any assisted living facility be vigilant for any signs of injury including a change in mental state, e.g. being fearful or withdrawn. If you see a problem investigate. If you have to move your elder you will have a case for full refund of deposit and the requirement of 30 day notice. Hopefully you will not have the problem of suing the facility for negligent care that seriously harmed your family member.
