Managing Expectations

As care managers, many people who come to us are in need of an assisted living facility for their loved ones. Most of the time, we work with families on not only the selection of the best option but also, the emotional and physical logistics of making the move.  This involves expectation setting around what the reality of assisted living is like as one progresses and requires more care. When people come to us prior to an assisted living move, we help them understand what an assisted living can and can not do so they are not caught off guard when they are told that their parents may need to move to memory care or that the family will need to hire private duty care on top of the assisted living facility costs. 

However, it is not uncommon for us to get calls from family members who have loved ones in assisted living and are being told they need to add more care in one way or another, and they are confused and frustrated by the extra cost that they did not see coming. Most of our clients are already concerned about how long they will be able to pay for assisted living, and adding extra care costs to that certainly depletes the finances at a more rapid pace.

A recent client of ours called after he and his mother had made the difficult decision of deciding to move his father who had a diagnosis of early onset Alzheimer’s disease into a memory care assisted living from his home. His mother was having an increasingly difficult time managing him. He was getting up at night, pacing and had fallen several times. This was not a decision that was taken lightly, and they had toured several facilities before selecting the one they felt would best be able to meet his needs.

About two months after the challenging and mentally exhausting task of getting this gentleman to the assisted living and settled, my client was being called on an almost daily basis from the facility. There were reports of his dad behaving inappropriately around other residents, wandering at night time into other resident’s rooms and falling. After a few weeks of these calls, the facility told my client that he would have to hire 24 hour private duty care on top of the monthly assisted living costs since they did not have the staff to stay close enough to keep him from falling. Prior to moving in, my client was promised that the facility did hourly checks on his father, but this wasn’t enough to prevent them from being liable if he were to fall and sustain an injury. Considering my clients mother remained living in her home and was in good health, the funds to pay for assisted living were already tight, adding more cost to the care was not manageable. As a result, we assisted in guiding our client to select the best possible nursing home where his dad could be better cared for, and where he would quickly need to apply for MassHealth to pay for the cost of the nursing home.

Unfortunately, this scenario is one we see on a regular basis. The executive office of elder affairs has recently started requiring assisted living facilities provide a residency agreement cover sheet to be signed prior to moving in to assisted living which I will provide here: https://massnaela.com/wp-content/uploads/2019/01/Residency-Agreement-Cover-Sheet.pdf.

We encourage you to take a look and become educated prior to a move! As always, we are here for families and elders to help navigate through the choppy waters of elder care!

Happy Summer,

Jennifer