New to assisted living is this normal

Long Term Care Columnist / Guide · Oct 1, 2019

A lot depends on what your facility's acuity level is. If you've got mostly residents who are fairly independent, the workload is reasonable. But if you have a number of dependent residents who need help not just with ADLs such as bathing and dressing, but with feeding and 2-person transfers, ALF nursing is hellish. Unfortunately many ALFs now admit people who are well down the dementia road and they wander, are completely incontinent and sometimes combative; they also take in residents who would be much more appropriate for the nursing home. It's all about the Benjamins in assisted living. Proceed with caution.

LPN_Computer_Guy, LPN, LVN · Oct 18, 2019

On 10/1/2019 at 1:33 AM, VivaLasViejas said:
A lot depends on what your facility's acuity level is. If you've got mostly residents who are fairly independent, the workload is reasonable. But if you have a number of dependent residents who need help not just with ADLs such as bathing and dressing, but with feeding and 2-person transfers, ALF nursing is hellish. Unfortunately many ALFs now admit people who are well down the dementia road and they wander, are completely incontinent and sometimes combative; they also take in residents who would be much more appropriate for the nursing home. It's all about the Benjamins in assisted living. Proceed with caution.

I don't want to discourage you but unfortunately, assisted living facilities seem to have gotten worse over the years. From my experiences being a charge nurse as an LPN, if you have a good group of CNA's that are reliable and truly care about patients, then your shifts will go a lot smoother. The problem comes when you have one or two lazy CNA's who make it harder on everyone else. Assisted LIving Facilities are not for everyone but hopefully the one you're at will give you some valuable experiences for your nursing career.

David Peters, RN · Oct 18, 2019

In my area those ratios on an ALF would be pretty good.The ALF's in my area won't accept a resident who can't transfer on their own and there are continence and mentation requirements.

You are working with the elderly though and occasionally your acuity will increase. People in the early stages of dementia are eventually in the late stages of dementia. So patients who are in the process of losing their mobility, mentation and continence and shift to being innapropriate for an ALF sometimes faster than social services can find them a bed in a more appropriate facility. The Alzheimer's unit in my community has a wait list. I work in an SNF/LTC which often needs to take resident's from AFL's that progressed well beyond their acuity while they waited.

amoLucia · Oct 19, 2019

to Dave - your assessment is quite appropriate.

I do suggest that you change your screen name here. ABSOLUTE anonymity is improbable anywhere, but itwould do better to change it.

to OP - be aware that you will also most prob be dealing with families quite closely. SOME will be fine, but others will be HORRENDOUS. It most likely boils down to money and guilty consciences for them, so just a warning to be prepared for them.

Like PP Viva alluded to, ALFS depend on full census to keep revenue up. So your residents may or may not be appropriate LEVEL OF CARE for ALF community lifestyle. That makes all the world of difference.

Make sure you have your own malpractice insurance. (I say this to everyone who practices!)

Blackcat99 · Dec 8, 2019

The assisted living memory care when I work is a nightmare. They hire untrained workers who don't have a clue on how to deal with confused dementia residents. The staff frustrate the residents so much that the residents start acting out. We have residents who cannot transfer at all and some who have foley catheters etc etc etc. It is totally obvious that some of these residents need to be in a LTC facility. They accept everyone here even if they are violent and do not meet the requirements.