How do you know which to choose: a better ALF or Skilled Nursing Facility?

What a great question, one many families ask often. We suggest families check out and tour both various care types. State regulations can dictate what is “appropriate (or allowed)” for assisted living care, so touring is a great place to start. If you’re mom requires assistance with activities of daily living (dressing, bathing, toileting, etc), regardless of whether or not she uses a wheelchair, assisted living tours will be important to see if her needs can be met there. Many families find AL to be more cost effective for caring for seniors, especially if there isn’t a skilled care need for their loved one, such as wound care. As for memory care, again state regulations vary from one state to the next. During your tours, we encourage you to ask questions about how they deal with seniors with memory loss. They can explain their program to you specific on how they meet those needs. 

The new ALF sounds very nice, and if they offer an extensive range of add-ons it may be that they expect to provide continuing care. So that's promising.

But how new, exactly? And if it's brand spanking new, does it belong to an organisation with existing facilities that you can also go and check? The thing is, a clean slate has advantages but there's also a lot to be said for a reliable track record.

The thing to check about your mother's memory issues is a) how fast they're changing and b) has she been assessed and their cause identified? If it's been possible to rule out dementia as such, she probably won't need memory care. But it's important to think this point through, because you don't want to have to uproot her again once she's just settled down nicely.

So - I would look very hard several times at a new facility, and ideally go and visit some longer established ones, too. When you're considering the best options for a lady of 93 you can't afford to think "time will tell."

Hi Countrymouse, the new ALF is new to that town only, they have many previous existing facilities in the state and others too, so it is established and has a good record. That is why I'm leaning towards that one. Also, brand new means they have all of the current hurricane protection that the older facilities don't have yet, or will have to update and remodel. So that is a huge plus. I looked at many other facilities and this one seems to be it.

I guess I'm just looking for a second opinion on what to do.

I think the "How do you know when Memory Care should be considered when the only issues are balance, weak legs and occasional short term memory" is a question for the professionals looking after her, also the professionals who may be looking after her in the future. Is there someone in the ALF she is in you have any confidence with as regards advice? Can you discuss it with her doctor? Could you visit the new ALF, which sounds on the surface as a good idea, and ask them if she meets their criteria and is likely to be able to stay there long enough to make the move worthwhile? Could you also visit a Memory Care and ask them if you mum is a suitable candidate.

Where I am (in Canada) professionals assess and decided what level of care is needed. Then we are given three choices and when a bed/room opens up in one of them the move is made. The health care system is heavily government subsidized. It has worked well for my mother. There are many private pay assisted living facilities as well and mother was several years in those. Once she needed a higher level of care, she was assessed and placed in an ALF specialized to her needs. Now she is in an NH where she will remain till the end.

I guess what I am saying is consult the professionals as to the best placement for your mum. Good luck and let us know your decision and how it works out,

I had to smile, Mary - I've been round several facilities over time, but I must admit I never had to check "hurricane proof" off my list!

If you've done all your research and you're happy, go for it! Has your mother had a chance to look, too?

How do you protect someone from falls? So far she hasn't broken anything.