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Many of the people who call me looking for care, have a story to tell about their loved one's experience at a big assisted living. A recent call broke my heart. A daughter told me the harrowing story of moving Mom into a well-known assisted living. The morning of day two she got a call from the facility to say that they could not get into her mom's apartment, since they could not locate the key since the previous evening. When she got there and opened the door, she found Mom on the floor under her wheelchair where she had been all night. She could not understand how nobody had called her when they realized they had lost the key to her Mom's room, even though they were paying staff to check on her Mom every two hours. I wish this was the only harrowing story I have heard in 30 years of nursing.
I worked for the original inventors of assisted living. I remember wondering how people would receive good care when everyone is locked into their own apartment.
What makes residential care homes different from assisted livings? I would say the main differences are size, staff-to-resident ratio, number of residents, and true personalized care.
Residential care homes from the outside look like a normal large home, in a normal neighborhood. This means life feels normal for your loved one. Abiding Joy Senior Care Home is a large ranch-style home, so no stairs or elevators to deal with. Everyone living with us has their own private suite that includes their own large bedroom with an attached bathroom. The suite looks and feels like the bedrooms and bathrooms that people spend their lives living in. This is comfortable and less confusing for your loved one. We have made the showers flat entry so shower chairs can roll in and out for safety. Grab bars have been added and doors widened to accommodate wheelchairs and walkers. I have been surprised at how many assisted livings do not have flat entry showers, which can make the difference between a wheelchair-bound person showering easily or not.
The next difference between Abiding Joy Senior Care Home and a large Assisted Living is the number of residents. We take only three residents at a time, unlike the 100 or more commonly seen at big assisted livings. Fewer residents mean that we can offer truly individualized care. Unlike a big facility we change our menu to reflect the preferences of our residents, get up and go to bed times are at the resident's preferred times, and activities are customized to resident preferences. When Dave's Grandma was in a large facility she got woken up at 6:00 am every morning because that was how they did it, unfortunately for her, she had not gotten up before 8:30 am in forty years. She like many residents was unhappy to be woken so early.
Long hallways do not exist in residential care homes. This means less falls, more socialization, and less confusion. Residents at Abiding Joy love that getting to meals is quick and easy. I have had several residents move in with more advanced dementia who can easily find their way around the house on their own, unlike when they were at a facility and never able to remember how to get to their room or the dining room.
Perhaps the most important difference is staffing. Large assisted livings have frequent staff turnover and constantly changing staff. They do their best to create continuity but that is hard to do when somebody different is caring for your loved one every shift. At Abiding Joy Senior Care Home your loved one is living in our home as part of our family. We are caring for them. Even those with advanced dementia after a short time get used to seeing us and recognize us as their caregiver. Our residents are fortunate that they have a Registered Nurse who lives with them. Many facilities do not even have a registered nurse in the building daily. Registered Nurses have the training to assess and recognize health changes. I remember how surprised I was at the first assisted living I worked at to find out that caregivers are not even CNA's. That person giving medications could quite literally have worked at a fast food restaurant yesterday and with very little training is now responsible for your loved one's care. One lady who lived with us for many years, moved in because her son, a surgeon, was upset that her big assisted living did not have an RN. He understood that without an RN, care would be lacking.
The other difference in staffing is the number of residents that each staff member is responsible for caring for. A staff-to-resident ratio of 1 staff person for 12 to 20 residents is common in assisted livings. Residential care homes tend to have one staff for six residents. At Abiding Joy Senior Care Home we never have more than three residents for a single staff person. Usually, since we are a family there are up to four staff to help with our three residents. What does this mean in practical terms? I have often visited facilities when the request for a staff member by a resident means a thirty-minute or more wait. Our residents wait less than 5 minutes and average less than 2 minutes. This means fewer falls for our residents and less frustration since they get help when they request it. Truly personalized care.
Since I am a registered nurse, I have the experience and skills to care for your loved ones changing needs - even providing care that is usually only found in a skilled nursing facility. I coordinate with other medical professionals to eliminate hassles for you. IV medications are not a problem, unlike at assisted living facilities where friends have had to hire me to give their parent their IV antibiotics. I routinely provide complex wound care, ostomy, and foley catheter care, and sliding scale insulin is just a part of our superior individualized care. Most facilities have difficulty giving narcotics. This makes hospice care problematic.
Abiding Joy Senior Care Home encourages residents to age in place. Many facilities do not have the staffing or licensure to provide care if your loved one can no longer evacuate in case of an emergency. Once this happens many assisted living facilities force their residents to move to memory care units. This is not necessarily in the resident's best interest.
Big assisted livings certainly look fancier than residential care homes. It can be easy to be drawn into the belief that fancy equals great care. Rarely is that true. The seniors that have lived with us over the last nine years love living in a normal home, with people of all ages to interact with, they love being a part of a family and being cared for by a registered nurse.
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