What is "Assisted" about Assisted Living

[lovinme43]

I have been in assited living for 15 of my 20 years in nursing. For the life if me, there is nothing assisted in assisted living. Most people in "independent living" are assisted living, those in "assisted living" are nursing home, those in nursing homes are ready to die.

We get these families in that want a miracle:

- if your mother never took a bath/shower at home, exactly how do you expect us to give her one.

-If your father was beating you up at home, what makes you think he won't beat us up here.

what are your horror stories?????????????????

Most assisted livings, the caregivers (CNA'S) are overworked and underpaid as well as the nursing staff. We as managers should do as much as we can to help. Show them appreciation in anyway possible. let the know that it is not "us vs. them" but "WE are all in it together". Because without nursing the building would fall apart.

Thankful to be working!!!!!!!!!!!

[IowaKaren]

I hear ya.

[brandy1017, ASN, RN]

Yes I agree, especially related to the violent people we deal with. I don't agree that its dementia, you're right, many of these people were probably violent their whole life and why would they change in their old age! Only get worse until frailty sets in and incapacitates them!

[DebblesRN, ASN, BSN, RN]

I get what you're saying. My grandmother recently moved to an ALF. She is pretty much self sufficient, but needs a little help with her showers (mainly just someone to help her get in and out--she does the rest), and she was tired of making her own meals, taking care of bills, laundry, etc. She is 84 and has the beginnings of dementia, but is mostly pretty sharp, pleasant, and non-violent, thank God. I handle her medications, and my mom is POA, so my mother, older sister, and I keep tabs on her, go there frequently, and make sure she has all of her necessities. Her roommates however (one shares a bedroom with her, then there are two other ladies down the hall) are all VERY needy and decrepit. I was surprised they were at an ALF. One lady falls--every day--and is mean as heck, the other one cannot walk and has to have someone take her everywhere, dress, bathe, etc. The other one pees and poops EVERYWHERE and is nutty to the point we had to get my grandma a new room. She would wake up at night and her roommate would be in the bathroom smearing poop on the walls.

I thought ALF was for the elderly that were mostly able to do for themselves, just needed a little help. Guess that's not the case as we are learning.

[CNA1991, CNA]

I remember, when In was clinicals for my CNA certification. It was AWFUL! You could always hear people crying, the families would always come in and yell at the nursing staff, and the poor facility did not have nearly enough workers and nurses even had to do CNA work because they were so short staffed. I remember, there was a woman who could not speak english and was very violent. On top of that, she had memory problems as well and her mind was completely gone. She would wet herself and when they tried to change her, she would fight everyone. They needed a whole team of CNAs and Nurses to distract her so that they could change her. I remember one time they asked me to help, and she grabbed me by the wrist and started slapping me on the back and face. She was strong so no one could peel her off me also everyone was afraid to hurt her. Eventually, I had to leave after I broke free because the problem was too advance for a student to deal with. Everyone who worked there was constanly on edge of losing their license because each person had more responability than was almost possible. I am so happy the people I am taking care of now are very sweet and greatful for everything. I have an easy job compared to some, because the facility I work for is very well mantained and managed and I have one person at a time to focus on. The families do tend to misunderstand what is and is not possible out of the CNAs and Nurses at times.

[Quickbeam, BSN, RN]

I blame the owners of ALFs who oversell their level of facility to seniors and then allow them to deteriorate without appropriate care. I worked with ALFs throughout my region on driving cessation (as a public health crisis). I'd see people living in ALFs who had absolutely no business being there--profound dementia, dirty, unfed...needing SNFs.

I'd confront the management staff and wow, it was like working with used car salespeople. Their sole purpose is keeping a high census, any way possible.

I think ALFs are cheap to build and are terribly oversold. They pay as little as possible for staff and the really compasionate caregivers are overwhelmed by the population realities.

(/off soapbox/)

[Ruby Vee, BSN]

my mother was in assisted living until she started wandering this past summer. they didn't have the staff to keep track of her, so now she's in a dementia unit. i had no idea what an assisted living was until my mother needed one. she was able to feed, bathe, dress and toilet herself but couldn't keep track of her medications. the wonderful people at the alf kept track of her medications and gave them to her, reminded her about meal times and made sure that she sat down and ate her meals. they reminded her to bathe, helped her pick out an outfit to wear every day and did her laundry for her. they made sure she was dressed and ready for church at 9:30 every sunday morning, and reminded her that the ladies from church were coming to pick her up. as her memory got worse and worse, they reminded her where her room was and let her introduce me over and over and over. they made sure she had a package to open on christmas morning even though she'd already opened all the packages we sent her. when i was visiting last january and it snowed while mom and i were napping in her room, one of the aides called her son to dig my car out of the mess the snowplow left behind. and the next day, when i was snowed in at my hotel and thought i wasn't going to be able to visit mom that day, another aide sent her husband to come pick me up on a snowmobile . . . that was a heckuva lot of fun! when i ran into one of the aides in the local cafe at breakfast after her night shift, she introduced me to her husband and sons and the next morning when the cafe was closed, she cooked me breakfast right along with everyone else's.

mom's alf was a lifesaver for our family, and those people treated me so well! mom said she loved every one of them. i have nothing but good things to say about the alf and the people who work there. they're my heroes because i know i couldn't do what they do!

[VivaLasViejas, ASN, RN]

I've worked in assisted living on and off during the past decade, and I can tell you that the acuity in AL---like everywhere else---is going nowhere but up. Ten years ago I wouldn't even think of admitting a sliding-scale diabetic; today, I have eight of them in my building. Ten years ago we also didn't do two-person transfers, hospice, catheters, or wounds classified higher than Stage I; today, we have all of those and then some!

It's inevitable; about the only residents we don't take are those with severe dementia who wander, who are on ventilators, or who need mechanical lifts. But I'm sure that time is coming.......best to be ready. :)