Assisted Living Facilities and Senior Living Communities: The Marketing Pitch vs Reality

Jan 13, 2014 by

Have you ever gone on a tour of an Assisted Living facility or Senior Living community? I have toured many and I often come out thinking, “Gee, this sounds great. Sign me up”, and I am not even a senior.

The assisted living facilities and senior living communities’ leasing directors are incredibly friendly, the marketing materials are presented beautifully, some of the newer facilities are very big and fancy, with high ceilings, long halls, large restaurant style dining rooms, fabulous décor, and meals prepared by their own “culinary teams” which sound delicious and nutritious. Sometimes I have even met their chefs.

Additionally, assisted living facilities and senior living communities offer a substantial list of scheduled activities, which often include massage therapy, spas, Internet cafes, woodworking shops, full service hair salons, libraries, chapels, and a variety of educational, social, recreational, and spiritual programs and interesting outings. Living in a senior living community can sound like you are joining country club.

Further, many senior housing facilities offer assistance with daily cares and medications through progressing levels of care depending on the senior’s individual needs and then, provided by their ‘trained and competent’ staff. Upon admission to the assisted living facility, the nurse assesses each person to determine how much care they might need and then writes a service plan which, again, all sounds perfect and worry-free for my aging parents.

Even though assisted living communities seem to “promise the moon”, it is important to look deeper into the reality of how the assisted living facility operates and meets the specific and individual needs for your senior. While senior living communities do have an increasingly important role with our aging population, it is important to build a realistic relationship with the assisted living facility and know when senior living communities are not necessarily the best fit for all seniors.

Typically, assisted living facilities and senior living communities work best for seniors who are more independent, enjoy socialization, and who can direct their own cares and who can afford to pay the increasing cost of assisted living, especially as more long term care is added as they age.

In reality, assisted living facilities are expensive and the additional cost of care often adds up quickly and unexpectedly. Also, the care services promised by the senior facilities are not always well delivered.

In reality, I have seen, at times, a high turnover of staff, shortage of staff, and under trained or inexperienced staff at assisted living facilities. And, I have seen communication breakdown around the individual senior’s care plan among the staff, especially between shift and staff changes.

I have found that without close supervision from a family member and or a professional senior care manager who is advocating for the family, that promises made by the senior facilities do fall through the cracks and/or are lacking.

Even though many promises are made, the reality is that a fair amount of time, energy, and oversight by the family is needed to make sure what you have been promised and what you think you are paying for is actually happening.

I have experienced through my clients and their stories many examples of lack of follow through, staff shortages, miscommunication and other reasons that the actually daily personal cares aren’t being delivered as the family expected or as written in their care plan and that the family was paying for each month.

For example, there was a couple that moved into an assisted living facility and each was evaluated to be at a certain level of care with the associated services and costs for that level. When we asked the couple specific questions about the staff coming in to help, such as with dressing, they said it wasn’t happening. We communicated with the facility to find out what their records for services delivered reflected and we were never shown the documentation that supported the level and costs they were being charged. The assisted living facility did adjust the care plan and associated cost to reflect the actual assistance the couple was receiving and needed.

An example of lack of follow through with a services was noticed by a family several times when they came into their parents’ apartment and found their father sleeping on a bed without sheets. Weekly bed changes are part of the daily housekeeping services, and the base rental rate. Their father had never mentioned it to any one or asked for help. The family just happened to stumble upon his uncovered bed on multiple occasions.

Another time, a mother told her daughter over the phone that no one had vacuumed her apartment for a while. When the daughter contacted the assisted living facility, they said their housekeeper was no longer working there and they are looking for a new one. Meanwhile, they had not had a housekeeper for a few weeks already and the facility didn’t know when they would be getting one. Later the daughter found out that the facility maintenance supervisor was now coming occasionally to vacuum in the interim. Not surprisingly, the family never saw any reimbursement on their bill for services not being delivered.

Another example, one resident in an assisted living facility was a high fall risk, and her facility care plan said that they would provide assistance with toilet transfers every 2 hours. Though this sounds like a great service, in reality, it was nearly impossible for the assisted living staff to follow through with this plan. First of all, they were not sufficiently staffed to check on the woman every 2 hours, and often when the staff came in, they poked their head in the door asking the woman if she wanted to go to the bathroom. The woman often said “no”, because the staff person seemed to be in a hurry and she didn’t want to be a bother. It was difficult for the senior to understand that this was a service she was paying for anyway.

Another example, a woman was to be escorted by staff to the dining room for meals and to activities as part of her service plan and her additional daily cost at the assisted living. In reality, the woman said no one was coming to get her, so her husband was pushing her in her wheelchair down the long hall, to the elevator and then to the dining room for meals. This did seem to work out ok, even though they were paying for escort services, until the husband fell in the elevator and he fractured his lower spine. He then needed more assistance and was put on a higher cost per day care level at the assisted living facility too.

One final example, at an assisted living facility, the resident was encouraged by the facility to push her neck pendent to call for help when she needed to use the bathroom, for safety reasons. While it sounds like a great idea, in reality it didn’t work, because it often took over 20 minutes for a staff person to show up and she just couldn’t wait that long. Again, the typical reason was, ‘’we are busy with other residents and we are under staffed”.

Assisted living facilities and senior living communities’ are playing an increasingly important role in our aging population. If you choose to move your senior into an assisted living facilities or senior living communities, do your homework, and due diligence before you make the commitment. Be aware that assisted living facilities and senior living communities are not the answer to all your families’ or seniors’ problems and may not even be the best setting for your family member either.

However, choosing the senior housing experience can be successful with close supervision and oversight by the family and or a senior care manager as your hired advocate. Knowing some of the realities, rather than expecting all the initial promises made at the marketing tour, will facilitate the best transition and ongoing successful aging experience at the various senior living communities.

1 Comment

  1. Karen Gray

    Thank you Cathy for this huge insight into the Assisted Living world! All I can say is that your examples rang so true with my parents’ situation. My parent’s health declined much quicker than we anticipated in Assisted Living – I wish we had moved them into a permament nursing facility much sooner. Thanks again for speaking the truth. – Karen

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