CarlaCB Asked October 2015
Question about assisted living, can anybody help?
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If you have (or have had) a family member in assisted living, please help me understand how it works with medical appointments. Are residents taken to their appointments by assisted living staff? If so, is this an added charge to their monthly bill?
My mother has a slew of medical appointments, tests and procedures. My therapist tells me that if she were in assisted living, they would take care of that. I don't believe that, or I believe that if they do, they would charge extra for it.
Can anybody help with this?
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He is tired, and just is not happy. Yes, he is on an antidepressant. I have expressed my concern about this to daughter, but too bad she just does not seem to care.
So, back to the question. Yes, a geriatrician and dentist will see them regularly at the facility. But, any specialists must be arranged by family, and attended by family if there is dementia as in my Mom's case. The transportation to doc would be covered in L's fees, but I cannot imagine the wait since many people are transported at the same time. Worse than riding a bus, expect there is door to door service. But how many hours will he be out for a half hour appointment? What is doc is running late, and the transport comes to pick up and resident still waiting to see the doc. If outside appointments are necessary other transporation and attendance at appointments should be arranged by family, IMHO.
My Mom toured one place with me and loved the thought of not having to go through all the prep, driving, waiting rooms etc. with the doc appointments. Not to mention the bingo, activities room, dining room and beauty shop. I can't wait to get her in this place. It would make her life sooooo much easier.
One place rolls all services into the monthly bill while some include so many trips per month but one way or the other you will pay for the services.
It seems to me that your Mom has a ridiculous amount of docs. I can't imagine trying to keep up with all that. Are they all really necessary? Between my Mom and Dad they have about 4 doc appts per month. It's doable but still a huge hassle at their age.
In NC, all of the AL facilities that I came across, provide transportation to and from the doctor appointments, tests, dental appointments, eye exams, etc. This was true with regular AL and Memory Care AL.
The facility maintains a notebook of the resident's medical records, charts, prescriptions, etc. and they take it with them to the appointments and have the doctor review and sign off on the medications, renew prescriptions, etc. They will make the appointments, if the family wants them to or the family member can. I meet them at the doctor's office. They transport the resident to the appointment and stay with them for the appointment, even MRI's and other tests. If needed they buy the resident lunch or snacks. This was part of the monthly fee and there was no extra charge for this service. The rep from the facility and both go into the exam room and discuss her progress, condition, etc.
Sometimes the transporter would have conflicts and have to reschedule an appointment, but that has not happened but once with my cousin at her current place. I was given the option of doing the transporting if I wanted, but since she is in a wheelchair and they handle that better than me, I allowed them to reschedule, since it was not an urgent matter.
In all of the AL facilities that I saw in NC, each patient had their own physician. The facility did not have a resident physician.
My mother can carry on a conversation quite well - it's just learning new things, especially technical things, she has trouble with. And her logic isn't quite where it needs to be to converse with her doctors. For example, she had a very low blood count a few weeks before her appointment, at the same time as she was having bad bleeding from her hemorrhoids. She told the doctor she wasn't having any bleeding, and when I reminded her about the hemorrhoids, she said "oh that was a long time ago". Not realizing it was only a few weeks before and the blood test had been run at just about the same time. That sort of thing.
I believe assisted living places vary a lot in the level of patients they take. I have heard that some don't allow wheelchairs or even walkers but I've seen some that do.
Right now my mother is seeing a lot of specialists in addition to her geriatrician (who is making all these referrals). A gastroenterologist, nephrologist, neurologist, cardiologist, dermatologist, and now a hematologist. She's suffering from anemia and they can't figure out why, so she's on her third round of diagnostic tests. She's also having some kidney function abnormalities. She needs to see a dermatologist for recurrent skin cancers on her face (we live in Florida). Her eyes are okay now, but there was a long series of retina specialist appointments because she detached a retina in a fall. She has twice-yearly evaluations with a neurologist and neurosurgeon because she has a shunt in her brain for hydrocephalus. She sees a cardiologist a few times a year because she's had stents put in her arteries for blockages a few years ago.
My sister (who also takes Mom to a lot of the appointments) and I have tried to eliminate or at least delay some of these specialist appointments but it seems there is always a new health problem cropping up that requires a bunch of new appointments and specialists.
My mother is not mobile enough to take a cab or other public transportation, and she's not mentally competent enough to attend most appointments on her own. She will forget or deny symptoms, or will get the instructions wrong, or misunderstand what the doctor said. Somebody needs to be there with her to take notes and ask questions, and correct misinformation.
I found it hard to believe that this function could be turned over to assisted living staff (which my therapist insisted it could) without paying a hefty fee, at least. So thanks for confirming what I think I already knew.
There is generally a base rate, and then a menu of service levels, based upon the level of need, shower, ambulation, dressing, etc.
My mom is now in a NH. We pay for an ambulette to her rare doctor's appointments ($150. Round trip). Medicaid would pay for this if she wasn't private pay. An aide accompanies us, I meet mom and aide at the appointment. I can't manage mom, the wheelchair, bathroom AND talk to the doctor, I found.
There was scheduled transport included in the price. So if you had a doctor's appointment within a 10 mile radius, they would take you, gratis. My mom had the number of a cab company, but she never used it. Her anxiety about a cabbie getting lost was insurmountable.
We cut down on the number of doctors mom had. We ditched the cardiologist. Mom's CHF was well managed by geriatrician. She got the dentist via IL transport. She insisted on going to the eye doctor frequently until I discovered that she was worried about her macular degeneration (which was the "good" kind turning into the dry kind, because she had dry eyes. Unconnected, according to the doctor, and I was able to get her a chart that the doctor said would indicate if she needed to be seen, it's a grid of lines that predicts some if they appear wavy, I think.
The real question is, does your mom NEED a slew of doctors, or is going to doctor's an activity? Once my mom was in IL, she didn't worry so much about her health, except for her vision.