Assisted Living Discharge to Nursing Home Vs Adult Family Home?

As a long-term care consultant for seniors and their families, I have visited many different types of facilities. But my favorite type of facility to visit is adult family homes. 

a recent conversation with a fellow health care provider made me realize there is truly a need to educate other health care professionals about what a Adult Family Home is, what is within the scope of practice or individual providers and other agencies.

. For myself  I take this issue seriously due to lack of public awareness of what is offered at Adult family homes. Companion service is not what an Adult Family Home structure is. Perhaps it is simply room & board in your state. Under Washington, we are an alternative to Skilled nursing. there is a wide range of services that can be and are RN Delegated. We are License to care for 6 adults or less. As long as our providers skill level is there and of course we do not work outside of our scope of practice. That is why some homes can do IV infusion, wound therapy, wound care etc.. no not just companionship. For our home we employee two RN’s and work with Home Health agencies both public and private. This is to ensure our clients have the highest level of care. We also have clergy and pharmacists at our finger tips.

Our clients’ needs are addressed much better, seamlessly and faster due to our small population; allowing for true one on one care, unlike larger facilities.

When appropriate I call in Hospice and we manage End of Life under the direction of Hospice Physicians. As for Medication. Again with in Washington State,  Medication management and Delegation is a routine. I am not sure what your state laws are but in my state, individuals are allowed to make their choices, it is up to the home or facility to decide if they want to hire in other nurses or discharge client. I myself have been participating with Hospice for over 15 years on and off as duty calls. My residence are allowed the comfort and dignity of  dying at home. I cannot imagine caring for someone and when they have need of services to discharge them into unfamiliar territory.

We involve all the appropriate persons including family at bedside, have superior symptom management and are able to be personable and professional. This is not simply Companion services.  Should you want more information or education RE: Adult family home in Washington State I would be happy to share the Washington State Administration codes and direct you to DSHS aging and disability offices.

Again I would like to point out that Nurses, Aides, Certified Nursing Assistants, E.M.T. and therapist we employ never work outside of our scope of practice and as for our insurance rates well they are certainly NOT small due to the nature of what we do and the amount of Liability we must carry if we choose to step up for clients and do what’s necessary, hire who is needed and care for residence like our own parents; which means to do the right thing  and care for them until the end in our home. I applaud other homes that go to this length to care for venerable adults and stand by individuals and families that make the choice that this is the right choice for them.  passionate

 a recent conversation with a nurse made me realize there is truly a need to educate other health care professionals

this being said; there is a wide variety of services and care levels at different homes, do your homework, check residence, get input past and current families. there is always a Pinto & a Cadillac. hard to generalize that they are both cars 

There are over 2,200 adult family homes in Washington State

Adult family homes have many things in common, but they are each unique in their individual decor and house size. Some are ultra fancy, some are tailored for country type folk, while some are modern and are bursting with color.

Each provider, like the differences you find in the decor of the homes, is individual in their personalities. Some are laid back, others are very vivacious; you will find that some are calm, quiet houses, while others are teeming with activity.

When you enter an adult family home, the first thing you will notice is that the adult family home smells wonderful. They take pride in making delicious homemade meals. Oftentimes, when you come into the homes, you’ll be greeted by the aroma of fresh baked bread, rolls, or muffins, not to mention the varieties of home made soups, baked chicken, roasts or casseroles, whose fragrance fill the air.

Adult family homes do not have overwhelming chemical smells like nursing homes. They have a smaller ratio of clients to serve, and clients are cared for in a much timelier manner, reducing odors.

The caregiver ratio is much smaller than in traditional institutional settings. (The caregiver to client ratio is 1:5 or 1:6.) This gives the caregiver and the client much more individualized time together. Careful personalized attention can be given to the individual senior living in this care setting. Bathing, dressing, putting on lotion and powders, not to mention the warmed up bathroom and the occasional dryer warmed towels for the client are all done in a manner that preserve the seniors' dignity. Oftentimes, I hear caregivers laughing with their residents while giving them a shower, and I have even heard some singing.

Many seniors bring their furniture from home, pictures from their living room walls, bedspreads, photo albums, and their own beds even. Having a piece of home with them helps them to feel more at home. I have been in several adult family homes that even paint the rooms the residents’ favorite color. Of course the amount of furniture you can bring depends on the size of the room.

Seniors don't have to share rooms in adult family homes. But if they choose to do so, adult family home providers are careful to ensure that there is a good match with the roommate. If you prefer your own private bathroom, some adult family homes offer those too.

Activities in the home are individualized to meet each senior’s preferences. Some seniors enjoy more activities and are encouraged to visit the senior centers, go on outings, attend church, or other social clubs, do light cooking and gardening. While other seniors enjoy a good book, watching TV, visiting with the caregivers (there is actually a lot of time for this), or just watching the birds through the kitchen window.

Caregivers have a chance to get to know each client’s individual tastes. If a client doesn't particularly like roast beef, accommodations will be made. You don't find nursing homes that will change a meal based on a single client’s wish. Many adult family homes have their residents help with the menu planning, so everyone gets to participate. Snacks are purchased with the specific individuals in mind. Each aspect of the care is tailored to the individual.

Perhaps the most important thing of all is that caregivers are with your loved one for more than just a shift. There is continuity of care. The person, who manages your loved ones care in the home, is more than likely the one who sleeps in the bedroom right next to them at night. The relationship becomes more personalized. Changes in the clients’ status are detected earlier, because a caregiver has taken time to notice. The staff turnover is minimal. A senior feels more comfortable confiding health problems with a friend rather than a staff member that he doesn't really know.

I could continue, because there are so many more things that make an adult family home a wonderful choice for long term care. If you have any questions, please feel free to contact us. 

do you know about mobile Dentistry?

Mobile Dentistry
Tom Seal, DDS and his staff visit private residences, assisted living facilities, hospitals and nursing homes to deliver dental care for home-boundwww.paths-afh.com patients around the area.  Using state of the art diagnostic oral devices they are able to do oral cancer screenings and perform oral biopsies.  They will also note existing restorations, identify periodontal status, and factor in all existing conditions and medications to provide comfort and function.  Depending on the patient’s health history, Dr. Tom Seal and his staff will monitor for infection and provide cleanings, fillings, dentures, and most extractions without the client ever needing to leave their own home.  Dr. Tom Seal and staff have worked with several community health centers, hospitals, nursing homes, assisted living facilities, and substance abuse rehabilitation facilities.  The State of Washington sent Dr. Seal and other mobile dentistry providers to the national geriatric dental conference to be trained in meeting the dental needs of the elderly population.  With this information we are able to deliver established standard of care practices to enable the people we serve.  If we can assist you in the care you provide, please call our office at (425)823-9000.

Defining Oral Neglect in the Institutionalized Elderly
Concerns about patients receiving insufficient care in nursing homes resulted in the Omnibus Budget Reconciliation Act of 1987 (OBRA 1987).  In 2009 the Delphi survey technique was used to develop a professional definition of oral neglect.  The panels’ definition of oral neglect in the institutionalized elderly was established and consists of twenty-nine oral diseases and conditions, each of which is associated with a specific time period to establish neglect and comprise a diagnostic stage.  This definition provides a utilitarian means to enforce the OBRA 1987 legislative expectation concerning federal funds payments to nursing homes.  If your facility does not receive federal funds, the definition and categories provide you with a standard of care to evaluate the severity of your patients’ dental needs.  Included is the Final 2009 Consensus Definition of Oral Neglect for the Institutionalized Elderly.  As a geriatric dentist we can assist your facility in improving, attaining and maintain the highest practical physical, mental and psychosocial well-being of these elderly patients, in symbiotic association with your staff. 


Final 2009 consensus definition of oral neglect for institutionalized elderly.
ORAL NEGLECT IS PRESENT WHEN:
any one of the following 29 oral diseases or conditions is present at the specified diagnostic stage.

Oral Disease or Condition    Diagnostic Stage   
Subjective symptoms category
Swallowing dysfunction    Mild
Pain    Moderate
Chewing dysfunction    Moderate
Halitosis    Moderate
Change in taste    Moderate
Dry mouth    Moderate
Objective soft-tissue category   
Oral/facial swelling    Mild
Fixed red lesion    Mild
Fixed white lesion    Mild
Tumor    Mild
Pigmented lesion    Mild
Candidiasis    Moderate
Cuts or abrasions    Moderate
Bleeding    Mild
Objective conditions in dentate patients category
Coronal caries    Mild
Root caries    Mild
Abscess    Mild
Root tip retained    Mild
Poor oral hygiene    Moderate
Periodontitis    Moderate
Broken tooth    Moderate
Gingivitis    Severe
Gingivitis hyperplasia    Severe
Objective conditions in edentulous patients category
Lost denture    Not applicable
Broken prosthesis    Mild
Epulis fissuratum    Mild
Poor prosthetic hygiene    Moderate
Papillary hyperplasia    Moderate
Ill-fitting prosthesis    Moderate
AND
the following “time-to-qualify-as-neglect” criteria were exceeded for the stage of any one of the oral diseases or conditions present:
Stage of the Oral Disease
or Condition    Detected-to-
Diagnosed Phase    Diagnosed-to-
Care Phase    Total Time for
Oral Neglect
Acute    3 days     +    5 days    =    8 days
Chronic    14 days    +    21 days    =    35 days

Medicaid reimbursement rates for seniors, so low that many won't accept them

Independent of most ADLS or High functioning Seniors needing more help! These are the Clients that would benefit from Assisted Living (due to not needing much care giving support & being quite independent) Assisted living does not take Medicaid payment.

   Independent of most ADLS or High functioning Seniors needing more help! These are the Clients that would benefit from Assisted Living (due to not needing much caregiving support & being quite independent) Assisted living does not take Medicaid payment.

Homes are in the same economical pinch as other industries higher out go and less income. Regardless of income we are responsible to pay for Mortgage, taxes, utilities, supplies and Employees, payroll takes,  professional service fees and consumables i.e. groceries, house hold items  and fuel.
I would think you would have to be quite large of offset the negative revenue this creates.  DSHS more likely to pay for in-home services thru the COPES program (this may not be the best situation for client.) It leaves many seniors at risk; it is very unfortunate set of circumstances due to the platform many seniors and left vulnerable.
 The Bigger question to me is why Medicaid rates for same services rendered? Medicaid payments differ from  SNF to AFH they pay, AFH much lower rates for same services rendered?
 Families get angry when they realize options aren’t there for loved ones.
 I have had families contact us for placement circumstances such as, loved one lives in Assisted living and either the Assisted living cannot offer services now needed sue to increased dependency of ADL assistance lack of custodial ability or health decline they may be paying the Maximum but do not want to pay for care and services, they express they want to pay less and get more services or on the other hand they have simply ran out of funding and AL does not accept Medicare.
 Why can Skilled Nursing take these individuals? Simply put rates are higher for custodial care for these individuals and there area adds on services such as PT/ OT therapies and evaluations. That can be performed at AFH Thru Home Health services.  The facility is large enough there can be a private pay / Medicaid ratio.
 Physician’s Groups Can no longer operate taking New Medicare (due to low rate) people are frustrated about this too.
 I can only advocate family and community involvement, Medicaid COPES or in home services to fill in the gaps
 For myself I can only take Few Medicaid payments, I usually do this only for Hospice clients. I know from experience that they will have other services available to them thru Hospice.
This is baffling: ask your self, "Could you operate a facility without funds?"
$42.00 day reimbursement  (provide services of 24 hours care,)
$11.00 day Bed hold
things to think about: how much is a cheap hotel room 1 night how much does it cost to have a bath aid? health monitoring? Meals? what do Utilities cost.Laundry service? the list does on.
 Senior Care Options on LinkedIn Please share your ideas
Someone needs to work with families,” he says. “What kinds of long-term care facilities are the best at achieving those goals? Doctors would not likely know about that.”
Doctors should help facilitate this decision, primarily by recruiting other experts to assist the families in times of crisis, frustration and confusion. In choosing a long-term care facility for their loved one, families need to consider quality, accessibility, availability, location and amenities; and most doctors would not know about these criteria, he says.
“When people come to me for advice about finding a nursing home, I ask them, ‘Why do you need a nursing home?’” he says. “’Do you need to put [a senior] in an institution? [Have you considered] home care, respite care, adult day care?’”
As he argues in “The Good Caregiver,” in the case of a senior relative who is released from a hospital or medical center after surgery, families may mistake a hospital discharge planner for an advocate. Kane says that realistically the discharge planner cannot serve as a family advocate because his or her decision is based on an institutional requirement to remove a patient from a facility in less than 24 hours.
Kane explains that the only part of senior housing and the continuum of care in general that is truly fully regulated is the nursing home. He describes the continuing care retirement communities and assisted living facilities as “wide open.” He says that, with an assisted living facility, there is no assessment, no medical assessment, no in-depth examination of a senior’s functionality and primarily a word-of-mouth style of referral for families. He says most people are not “well-informed” about this.
Assisted living has developed into a highly variable form of care. “If you go to an assisted living facility, you don’t know what you are getting,” he says. “Amenities vary for people as well as admission, discharge and pricing criteria.”
Still, an American Health Care Association (AHCA)’s National Center for Assisted Living (NCAL) annually publishes its Assisted Living State Regulatory Review. Its 2011 Regulatory Review, available on its website. at these summarizes state rules on licensee, definition, disclosure, facility scope of care, third party scope of care, move-in/move-out requirements, resident assessment, medication management, physical plants, residents allowed per room, bathroom requirements, life safety, Alzheimer’s unit, staff training for Alzheimer’s care, staffing education/training, administrator education/training, continuing education requirements and Medicaid coverage. The Department of Health and Human Services’ “Assisted Living and Residential Care Policy Compendium,” the latest one being in 2007, also cites regulations on assisted living services providers.
All 50 states and the District of Columbia regulate the industry. In 2010 and 2011, 18 states are updating their policies in the aforementioned areas, most especially in Alaska, Arizona, Florida, Georgia, Hawaii, Idaho, Iowa, Kentucky, Maine, New Jersey, New Mexico, Oregon, Pennsylvania, South Carolina, Texas, Utah and Washington State.
In 2010, the Long-Term Care Community Coalition (LTCCC) published an Overview of State Survey and Enforcement Laws, Regulations and Policies for Assisted Living, finding that state departments of health or social services oversee assisted living facilities.
With respect to assessments, NCAL’s provider-members have adopted what is known as a “person-centered” focus to evaluate each senior patient’s individual needs.
Yet, Terri Corcoran, board secretary, public relations chair and staff publication co-editor of the Well Spouse TM Association, a nonprofit association of spousal caregivers based in Freehold, N.J., agrees that social workers and discharge planners, not doctors, can best assist with a family’s decision to place an aging relative in long-term care.
“Get as many facts as you can,” Corcoran says to families with seniors in need of care. “Doctors cannot really assist, aside from presenting the facts of the illness and the basic needs the patient will have for continuing care.”
Corcoran, a senior who for the past seven years has provided care at home for her physically and mentally disabled husband, says a family’s decision about long-term care depends on the level of ability to cope.
“You can’t generalize,” she says, when asked theoretically about an overwhelmed elderly woman who would have to provide care for a senior-citizen husband with functional, health and behavioral problems. “Each situation is different. It depends on how much a caregiver can physically and mentally manage, and how much help they get, either from other family members or from paid home health aides.”
Corcoran says some caregivers have careers and do not have the time and energy to provide the needed care, which isn’t her case.
“Some people have careers and they are not wired that way [to provide care],”
she says. “It’s a very difficult decision and you can never say never,” adding that long-term care may be an option after years of care giving at home.
“Not only are [families] not well-informed but [doctors, long-term care facilities] are also not aware of internal conflicts [within a family],” he says. “You bring a lot of baggage to the table [when you decide to place a senior in a long-term care facility

Knowledge Gap for Families & professionals About Long-Term Care Choices

Most families making decisions about placing their senior relatives in long-term care are not well-informed and need a national awareness campaign about how to address such a choice and advocates to assist them, says a Minnesota doctor and university professor who has penned a new book to help them.
As he establishes in his 13-chapter book “The Good Caregiver: A One-of-a-Kind Compassionate Resource for Anyone Caring for An Aging Loved One,” Dr. Robert L. Kane, professor and chair in Long-Term Care and Aging at the University of Minnesota School of Public Health, says that families deciding to place their elder in a long-term care facility need help in understanding how to select the most suitable category of care and provider and advocates to guide them through the decision.
The book came out March 2011 and is one of many that he’s written over the years on the subject as well as a similarly-themed January 2011 article in the Journal of American Medical Association among his hundreds of writings.
“The Good Caregiver” was inspired in part by a group Kane founded known as Professionals with Personal Experience in Chronic Care (PPECC). In turn, he formed PPECC from a previous book, titled “It Shouldn’t Be This Way: The Failure of Long-Term Care,” he co-wrote with his sister in 2005, both of whom cared for their elderly mother.
The books deal with Kane’s and his family’s lack of preparedness in providing care giving for their mother and placing her in long-term care. The books, especially the latter of the two, are meant to guide and instruct caregivers on every step of the care giving and long-term care decision process.
In “The Good Caregiver,” Kane advises care giving lasts a long time, is expensive, isn’t for everyone, heavily involves families and requires realistic expectations on the part of a senior’s closest family members.
In 2000, the National Center for Assisted Living and the National Investment Center for the Senior Housing and Care Industries (NIC) both called for professional trade associations such as the American Health Care Association (AHCA), Assisted Living Federation of America (ALFA) and the American Senior Housing Association (ASHA) to mount an awareness campaign to inform families about long-term care options after releasing a study that then found a knowledge gap among Baby Boomers considering placement of their elders.
Such a campaign has yet to fully materialize, however.
To begin to fill the void for families, in 2007 Kane worked with a group of long-term care experts to develop a computerized system in the state of Minnesota — considered a pioneering state in terms of policy and laws regulating the industry in the last two decades – to help assess what services were needed to respond to frail older persons’ needs, especially in the area of Activities of Daily Living (ADLs).
The assessment contains the most important questions that families can ask providers to ensure they can serve their elderly relative and comply with the law. To create the assessment, Kane says he and the group asked 200 gerontologists to respond to scenarios created from the assessment elements to recommend the most appropriate long-term care placements for each generated case.
The project was backed by a grant from the Aging and Disability Resource Center Real Choices Systems Choices grant from the U.S. Department of Health and Human Services’ Center for Medicare and Medicaid Services (HHS-CMS) and the Administration on Aging (AoA).
Area Agencies on Aging, a family’s local social worker or a hired private social worker case manager as proper advocates for families. Families can also lean on such resources as the Aging and Disability Resource Center information system.
In the absence of social workers and public awareness, when asked if a family’s doctor or medical specialist could direct families, Kane says a doctor may not serve as an advocate but must be consulted to place a senior patient in a nursing home but in the case of, for example, an assisted living facility or a continuing care retirement community (CCRC).
“Someone needs to work with families,” he says. “What kinds of long-term care facilities are the best at achieving those goals? Doctors would not likely know about that.”
Doctors should help facilitate this decision, primarily by recruiting other experts to assist the families in times of crisis, frustration and confusion. In choosing a long-term care facility for their loved one, families need to consider quality, accessibility, availability, location and amenities; and most doctors would not know about these criteria, he says.
“When people come to me for advice about finding a nursing home, I ask them, ‘Why do you need a nursing home?’” he says. “’Do you need to put [a senior] in an institution? [Have you considered] home care, respite care, adult day care?’”
As he argues in “The Good Caregiver,” in the case of a senior relative who is released from a hospital or medical center after surgery, families may mistake a hospital discharge planner for an advocate. Kane says that realistically the discharge planner cannot serve as a family advocate because his or her decision is based on an institutional requirement to remove a patient from a facility in less than 24 hours.
Kane explains that the only part of senior housing and the continuum of care in general that is truly fully regulated is the nursing home. He describes the continuing care retirement communities and assisted living facilities as “wide open.” He says that, with an assisted living facility, there is no assessment, no medical assessment, no in-depth examination of a senior’s functionality and primarily a word-of-mouth style of referral for families. He says most people are not “well-informed” about this.
Assisted living has developed into a highly variable form of care. “If you go to an assisted living facility, you don’t know what you are getting,” he says. “Amenities vary for people as well as admission, discharge and pricing criteria.”
Still, an American Health Care Association (AHCA)’s National Center for Assisted Living (NCAL) annually publishes its Assisted Living State Regulatory Review. Its 2011 Regulatory Review, available on its website at http://biznik.com/click?u=http%3A//www.ncal.org/&t=http%3A//www.ncal.org, summarizes state rules on licensure, definition, disclosure, facility scope of care, third party scope of care, move-in/move-out requirements, resident assessment, medication management, physical plants, residents allowed per room, bathroom requirements, life safety, Alzheimer’s unit, staff training for Alzheimer’s care, staffing education/training, administrator education/training, continuing education requirements and Medicaid coverage. The Department of Health and Human Services’ “Assisted Living and Residential Care Policy Compendium,” the latest one being in 2007, also cites regulations on assisted living services providers.
All 50 states and the District of Columbia regulate the industry. In 2010 and 2011, 18 states are updating their policies in the aforementioned areas, most especially in Alaska, Arizona, Florida, Georgia, Hawaii, Idaho, Iowa, Kentucky, Maine, New Jersey, New Mexico, Oregon, Pennsylvania, South Carolina, Texas, Utah and Washington State.
In 2010, the Long-Term Care Community Coalition (LTCCC) published an Overview of State Survey and Enforcement Laws, Regulations and Policies for Assisted Living, finding that state departments of health or social services oversee assisted living facilities.
With respect to assessments, NCAL’s provider-members have adopted what is known as a “person-centered” focus to evaluate each senior patient’s individual needs.
Yet, Terri Corcoran, board secretary, public relations chair and staff publication co-editor of the Well SpouseTM Association, a nonprofit association of spousal caregivers based in Freehold, N.J., agrees that social workers and discharge planners, not doctors, can best assist with a family’s decision to place an aging relative in long-term care.
“Get as many facts as you can,” Corcoran says to families with seniors in need of care. “Doctors cannot really assist, aside from presenting the facts of the illness and the basic needs the patient will have for continuing care.”
Corcoran, a senior who for the past seven years has provided care at home for her physically and mentally disabled husband, says a family’s decision about long-term care depends on the level of ability to cope.
“You can’t generalize,” she says, when asked theoretically about an overwhelmed elderly woman who would have to provide care for a senior-citizen husband with functional, health and behavioral problems. “Each situation is different. It depends on how much a caregiver can physically and mentally manage, and how much help they get, either from other family members or from paid home health aides.”
Corcoran says some caregivers have careers and do not have the time and energy to provide the needed care, which isn’t her case.
“Some people have careers and they are not wired that way [to provide care],”
she says. “It’s a very difficult decision and you can never say never,” adding that long-term care may be an option after years of care giving at home.
“Not only are [families] not well-informed but [doctors, long-term care facilities] are also not aware of internal conflicts [within a family],” he says. “You bring a lot of baggage to the table [when you decide to place a senior in a long-term care facility

Do you really know what Palliative Vs Hospice care means?

palliative care is usually our motto here at PATHS, we are here for heavy care- end of life sever dementia and medically complex. when is it time to go from Palliative to Hospice?

Palliative care: specialized area of health care that focuses on relieving and preventing the suffering of patients. Unlike hospice care, palliative medicine is appropriate for patients in all disease stages, including those undergoing treatment for curable illnesses and those living with chronic diseases, as well as patients who are nearing the end of life. Palliative medicine utilizes a multidisciplinary approach to patient care, relying on input from physicians, nurses, chaplains, social workers, psychologists, and other allied health professionals in formulating a plan of care to relieve suffering in all areas of a patient's life.
palliative care is usually our motto here at PATHS, we are here for heavy care- end of life sever dementia and medically complex. when is it time to go from Palliative to Hospice?
This is a almost non defined line for me and my patients usually defined as continued decline or person's health despite a positive or progressive care-plan or the individuals wishes or family's goals change we then go into hospice
 Hospice is a type of care and a philosophy of care that focuses on the palliation of a terminally ill patient's symptoms. These symptoms can be physical, emotional, spiritual or social in nature. The concept of hospice has been evolving since the 11th century. Then, and for centuries thereafter, hospices were places of hospitality for the sick, wounded, or dying, as well as those for travelers and pilgrims. The modern concept of hospice includes palliative care for the incurably ill given in such institutions as hospitals or nursing homes, but also care provided to those who would rather die in their own homes. It began to emerge in the 17th century, but many of the foundational principles by which modern hospice services operate were pioneered in the 1950s by Dame Cicely Saunders. Although the movement has met with some resistance, hospice has rapidly expanded through the United Kingdom, the United States and elsewhere.
either way we celebrate each days joy.
When living at home “aging in place” using family and In home care is no longer the best option, due to increased needs of the individual consider Adult Family Home placement . Alternative to Skilled Nursing, often skilled nursing is not the biggest consideration (it can be coordinated at AFH thru physician) but most often it’s custodial care supervision and safety of the individual. Perhaps the need for a change is:   to many falls, cognitive or health decline. Stress on the elderly spouse. Difficulty coordinating professional services. Often we hear the word PLACEMENT and have visions of old fashion nursing homes, bright lights and linoleum floors. This is not at all what AFH are. We are Homes to care for loved ones with a complexity of health or behavior issues. We are the alternative to Skilled Nursing and often are for those who have lived in assisted living but now need more help. Our home is Dementia care Certified, Diabetes Certified, Delegation for Medication Certified, Geriatric Certified etc…We do long term care, palliative care and Hospice

Nursing Home vs Adult family home

As a long-term care consultant for seniors and their families, I have visited many different types of facilities. But my favorite type of facility to visit is adult family homes. There are over 2,200 adult family homes in Washington State
Adult family homes have many things in common, but they are each unique in their individual decor and house size. Some are ultra fancy, some are tailored for country type folk, while some are modern and are bursting with color.
Each provider, like the differences you find in the decor of the homes, is individual in their personalities. Some are laid back, others are very vivacious; you will find that some are calm, quiet houses, while others are teeming with activity.
When you enter an adult family home, the first thing you will notice is that the adult family home smells wonderful. They take pride in making delicious homemade meals. Oftentimes, when you come into the homes, you’ll be greeted by the aroma of fresh baked bread, rolls, or muffins, not to mention the varieties of home made soups, baked chicken, roasts or casseroles, whose fragrance fill the air.
Adult family homes do not have overwhelming chemical smells like nursing homes. They have a smaller ratio of clients to serve, and clients are cared for in a much timelier manner, reducing odors.
The caregiver ratio is much smaller than in traditional institutional settings. (The caregiver to client ratio is 1:5 or 1:6.) This gives the caregiver and the client much more individualized time together. Careful personalized attention can be given to the individual senior living in this care setting. Bathing, dressing, putting on lotion and powders, not to mention the warmed up bathroom and the occasional dryer warmed towels for the client are all done in a manner that preserve the seniors' dignity. Oftentimes, I hear caregivers laughing with their residents while giving them a shower, and I have even heard some singing.
Many seniors bring their furniture from home, pictures from their living room walls, bedspreads, photo albums, and their own beds even. Having a piece of home with them helps them to feel more at home. I have been in several adult family homes that even paint the rooms the residents’ favorite color. Of course the amount of furniture you can bring depends on the size of the room.
Seniors don't have to share rooms in adult family homes. But if they choose to do so, adult family home providers are careful to ensure that there is a good match with the roommate. If you prefer your own private bathroom, some adult family homes offer those too.
Activities in the home are individualized to meet each senior’s preferences. Some seniors enjoy more activities and are encouraged to visit the senior centers, go on outings, attend church, or other social clubs, do light cooking and gardening. While other seniors enjoy a good book, watching TV, visiting with the caregivers (there is actually a lot of time for this), or just watching the birds through the kitchen window.
Caregivers have a chance to get to know each client’s individual tastes. If a client doesn't particularly like roast beef, accommodations will be made. You don't find nursing homes that will change a meal based on a single client’s wish. Many adult family homes have their residents help with the menu planning, so everyone gets to participate. Snacks are purchased with the specific individuals in mind. Each aspect of the care is tailored to the individual.
Perhaps the most important thing of all is that caregivers are with your loved one for more than just a shift. There is continuity of care. The person, who manages your loved ones care in the home, is more than likely the one who sleeps in the bedroom right next to them at night. The relationship becomes more personalized. Changes in the clients’ status are detected earlier, because a caregiver has taken time to notice. The staff turnover is minimal. A senior feels more comfortable confiding health problems with a friend rather than a staff member that he doesn't really know.
I could continue, because there are so many more things that make an adult family home a wonderful choice for long term care. If you have any questions, please feel free to contact us.

Hancock Financial (John Hancock) today announced the results of its 2011 cost of care study, which found that long-term care (LTC) costs have continued to increase, but not as much as other goods and services.

John Hancock Financial (John Hancock) today announced the results of its 2011 cost of care study, which found that long-term care (LTC) costs have continued to increase, but not as much as other goods and services.
The study, conducted by LifePlans Inc., based in Waltham, MA, surveyed more than 11,000 providers, including nursing homes, assisted living facilities, and home health care agencies, in key cities across the country.  Its findings revealed that the national average annual cost of care in the U.S. is $85,775 for a private room in a nursing home; $75,555 for a semi-private room in a nursing home; and $39,240 for an assisted living facility. The average cost of care received at home was approximately $20 per hour.
To understand how long-term care costs are trending over time, John Hancock calculated a 9-year average based on a comparison of data gathered from providers across the country for John Hancock's 2002, 2005, 2008, and 2011 Cost of Care Surveys.  These 9-year average annual increases in the cost of care in various settings, closely track the long-term average annual rate of inflation, which is 4.1%.(1) Specifically:
■The 2011 average cost of a private nursing home room ($235 a day/ $85,775 annually) has risen an average 3.5 percent per year

■The 2011 average cost of a semi-private nursing home room ($207 a day/ $75,555 annually) has risen an average 3.2 percent per year

■The 2011 average cost for a month in an assisted living facility ($3,270 a month/ $39,240 annually) has risen an average 3.4 percent per year

■The 2011 average cost for a home health aide ($20 hourly/$37,440 annually) has risen an average 1.3 percent per year

"The ongoing effect of the recession on the nest eggs of so many individuals underscores the importance of planning for the future," said Marianne Harrison, President of John Hancock LTC.  "John Hancock believes that long-term care insurance is an integral component of any prudent financial plan.  Our cost of care studies are intended to help people better understand and prepare for their future long-term care needs."
About the 2011 John Hancock Long-Term Care Cost of Care Survey
The John Hancock Cost of Care Survey was conducted by LifePlans, Inc. based in Waltham MA, in 2011 and released in April of 2011. The survey represents the costs of more than 11,000 providers across the U.S., including nursing homes, assisted living facilities, adult day care centers, and home care agencies. The 9-year average trending results are based on a comparison of data gathered from providers across the country for John Hancock's 2002, 2005, 2008, and 2011 Cost of Care Surveys.
About John Hancock Financial and Manulife Financial Corporation
John Hancock Financial is a unit of Manulife Financial Corporation, a leading Canadian-based financial services group serving millions of customers in 22 countries and territories worldwide. Operating as Manulife Financial in Canada and in most of Asia, and primarily as John Hancock in the United States, Manulife Financial Corporation offers clients a diverse range of financial protection products and wealth management services through its extensive network of employees, agents and distribution partners. For more than 120 years, clients have looked to Manulife for strong, reliable, trustworthy and forward-thinking solutions for their most significant financial decisions. Funds under management by Manulife Financial and its subsidiaries were Cdn$475 billion (US$478 billion) as at December 31, 2010.
Manulife Financial Corporation trades as 'MFC' on the TSX, NYSE and PSE, and under '0945' on the SEHK. Manulife Financial can be found on the Internet at http://www.manulife.com/.
The John Hancock unit, through its insurance companies, comprises one of the largest life insurers in the United States. John Hancock offers a broad range of financial products and services, including life insurance, fixed and variable annuities, mutual funds, 401(k) plans, long-term care insurance, college savings, and other forms of business insurance. Additional information about John Hancock may be found at http://www.johnhancock.com/.
Long-term care insurance is underwritten by John Hancock Life Insurance Company (U.S.A.), Boston, MA 02117 (not licensed in New York) and in New York by John Hancock Life & Health Insurance Company, Boston, MA 02117. Group long-term care insurance is underwritten by John Hancock Life & Health Insurance Company, Boston, MA 02117.
(1) As measured by the Consumer Price Index for All-Urban Consumers (CPI), over the 50-year period ending 12/31/10.

SOURCE John Hancock Financial