To Be Safe, Know Facility’s Limitations

Looming over any assisted living decision is this question: What if you get worse?

When that happens, one of three things is likely to occur. You might be able to stay where you are, with extra services brought in; you might have to move to a different wing, or you might - not to put too fine a point on it - get kicked out.

Consider the story of Bill Tandy, 83, of Spokane, and his daughter, Su Sawyer.

Several years ago, Tandy was in an independent living wing at a local retirement community. He began to develop early signs of Alzheimer’s disease.

“At the time, we thought he was fine, but in retrospect I can see that dementia had already started to set in,” says Sawyer. “He got to where he couldn’t handle his own meds (medications). I said, ‘Couldn’t you send somebody over a couple of times a day to help him with his pills?”’

But staff members said they couldn’t do that in the independent-living wing. So after six months, Sawyer had to move her father to the assisted-living wing of the same facility. There, he was helped with his pills.

“But then he began to get lost and not be able to find his room,” says Sawyer. “He was up at all hours of the night. His dementia increased, and they began to not be able to handle him.”

The staff tried to work with him, but he became increasingly difficult. Finally, the situation reached a crisis point.

“He began to frighten other residents,” says Sawyer. “All the halls look alike, and he began to open doors that weren’t his. They’re 80 percent women, and you’ve got a guy going into women’s rooms, and that’s frightening. They were not set up for dementia, and they didn’t understand dementia.”

So after only about four months in that wing, the center kicked him out, this time for good.

“They gave him 24 hours to get out,” says Sawyer. “They just got frustrated. They didn’t give him the standard 30 days because they were afraid they couldn’t do it for another 30 days.”

Sawyer, in a panic, had to find a place right away. Like most Alzheimer’s patients, her father didn’t actually need skilled nursing, so she didn’t want to move him to a nursing home.

Instead, she moved him into an adult family home that specialized in dementia. She was not satisfied with that, so about a year ago she found a better solution.

She moved him into the Alzheimer’s special-care wing at the Park Place Retirement Community in the Valley.

“They have apartments, but they don’t have kitchens,” says Sawyer. “They provide all the meals, they help with bathing and dressing, and they provide help with daily activities. They keep them oriented.

“It’s big enough that he can move around, and they have a 24-hour staff. Frequently, with Alzheimer’s, he can be up all night. So far, I have no complaints.”

Sawyer says her father’s situation is not unique, and as president of the Eastern Washington Chapter of the Alzheimer’s Association, she is in a position to know.

She says her organization often hears from people looking for a place for a parent to live. Sometimes, these are what she calls “panic placements.” More commonly, a resident is given 30 days notice.

Right from the beginning, it is important to know a facility’s limitations. That, above all else, is the advice of Linda Miel, the Eastern Washington long-term care ombudsman for the Spokane Neighborhood Action Program (SNAP).

“It’s important to understand exactly what level of care that facility can provide,” says Miel. “Keep in mind that moving from one place to another - all that transition - is hard on seniors.”

The industry is moving toward something it calls “aging in place” - offering several different levels of care in the same facility.

Many facilities tout aging in place, but the phrase can mean different things at different facilities. Often, a resident going from independent living to assisted living must move to a different wing.

Only about half of the facilities in the area have Alzheimer’s wings, so if dementia sets in, it may be time for a move.

More facilities are adding Alzheimer’s wings as the industry recognizes both the need and the market.

Of course, other medical conditions can affect a resident’s independence.

Maybe the resident can no longer get in and out of bed without help. Maybe she requires help with feeding. These kinds of problems may be more than a facility is able or willing to handle.

When shopping for a facility, be sure to ask about these policies.

If you or your aging parent are asked to leave, or to move, the first thing to do is to make certain the facility is fulfilling its obligation.

“I would look at the contract and see what they said they would supply when the person came in, and compare it with what they say they are willing to do now,” Miel says.

If there is a discrepancy or conflict, Miel’s office at SNAP can help. Call 456-7133.

Another option is hiring outside help - a home health aide or a nurse - to provide care in the apartment. Some residents do this on a temporary basis, while recovering from surgery, for instance. Others use it as a long-term solution, although it can be expensive.

And finally, at the end, some residents bring in outside help for the process of dying.

“You can remain here the rest of your life,” says Charles Yeaton, administrator of The Academy, a Spokane facility. “We have people who are under the care of Hospice. If they choose to die here, they can do that.”

, DataTimes ILLUSTRATION: 2 Color Photos

MEMO: This sidebar appeared with the story: ONLINE For more detailed information on assisted living facilities available in the Inland Northwest, visit The Spokesman-Review’s Web site at www.virtuallynw.com.