By Janice Martin, Owner of Senior Liaison of Central Florida
I got a call from a daughter who had received a 45 day move out notice from the assisted living community where her father lived because dad needed more care than they could provide. After learning more about the circumstances, I explained that his needs could indeed be met in assisted living. However, he needed a community with a higher level of licensing. There are actually different licenses that dictate how much hands-on nursing care a community can provide.
A Standard License is suitable for those needing minimal assistance with activities of daily living. Most communities have this license. The care is provided by CNAs and caregivers and does not require a nurse in the building. Too often, people realize after moving to a community with a standard license that neither a caregiver nor a nurse may change a bandage regardless of the size of the bandage. The restrictions of the license will not allow them.
A Limited Nursing License (LNS) will have nurses in the community, but not necessarily 24 hours a day. They are permitted to apply and change bandages, assist with oxygen, casts, self-maintained catheters, glucose testing and more. The highest level is an Extended Congregate Care License (ECC). They can do everything a standard license and LNS license allows, plus provide total help with all activities of daily living and any nursing service permitted within the scope of their license that’s authorized by a physician. Those who believe their loved one needs a nursing home are surprised to learn that the care can often be met in an LNS or ECC license community. However, although caregivers and CNAs are in the building, none are required to have a nurse 24/7. Often, the nurse is at home on call from 10PM to 7AM.
Let’s get back to my earlier example. The community where her father lived has a standard license. I suggested two communities with an LNS license and what made one community different from the other. It was not the quality of care, but the culture of the community. One had more active residents and participation than the other, which I understood was important to her father.
She visited both LNS communities. She also stopped into a standard license community that was close to her home, but she was not familiar with their license nor anything else about them. However, the community is shiny and newer than the others, with residents who are more active because they don’t have as many care needs as residents in an older community. However, the truth is at the end of the day the community is not licensed to provide any more care than where her father currently lived. The daughter was wowed by the way it looked and ignored the limits of the care that could be provided. A few months from now, if her dad declines, she may find herself in the same situation and may need to find a new community because her dad’s needs are again not being met.
As another example, a husband called because his wife was in rehab and due to be discharged. He is unable to provide the advanced care that she needs at home, and he didn’t know where to look. I suggested a short term stay at an LNS community with 24 hour nurses in the building where she could continue to receive therapy with the goal to possibly returning home. Sadly, she was denied after the nurse met with her and observed that she does not meet the assisted living admission criteria, regardless of the license level, of being able to transfer without any devices, or to stand, bear weight, and pivot.
However, another placement company inappropriately referred a community to him that has a standard license. He visited the community and was told that they would accept her despite the fact that they had not met with her to witness her actual care needs. The community made their determination on what they were told, not observed. I tried in vain to help the husband understand that the standard license community could not possibly meet her needs and suggested other options beyond assisted living. Sadly, he listened to their promises and decided to move her there because the community is “so pretty.”
It does not matter what the community looks like! Don’t look at the shiny features, the fancy lobby, and chandeliers. Consider their license and if they can truly meet your loved one’s care needs. Look at the other similarly licensed communities and compare apples to apples.
If you are looking for a new car and one car dealer says their car has all the fancy features you want but lacks in the important safety features, you may not understand that it will not meet your family’s needs unless you have someone with qualified knowledge to educate you. If you go to another car dealer and they tell you their car has all the important safety features, but doesn’t have all the bells and whistles, which one will be more important to you for the safety of your family? One might be prettier and shinier than the other and the cost may be about the same, but which one will you want for your precious family’s protection? Listen to someone with unbiased knowledge of the differences.
Choosing an appropriate assisted living is a very important decision. Please make certain your decision is based on solid facts that truly fit your loved one’s care needs and not the pretty features.
Janice Martin is an author, educator, and an unbiased specialist on senior living options and the owner of Senior Liaison of Central Florida Inc. She assists families in locating senior options either at home or to a community and has written “The Complete Guide to Assisted Living: Everything You Need to Know Before, During, and After a Move” available on Amazon.com. For more information, call 352-477-1866 or visit seniorliaisoncfl.com.
Senior Liaison of Central Florida
352-477-1866 | seniorliaisoncfl.com
seniorliaisoncfl@gmail.com