Mel Rising Dawn Cordeiro
I work at an assisted living facility, which I will be referring to here on out as just “AFL.” Recently, it has come to my attention that people, other medical professionals included, really have no idea what it is that assisted living facilities do. There is actually a set of requirements one must meet in order to qualify to move into and remain in an ALF. In order to simplify things, I’ll start with what we are not.
ALFs are not nursing homes. Yes, people who need help within their daily lives live here, but the help they need is minimal. We are not here for chronic disease management. We do not monitor vital signs, unless there is a complaint of illness. We are not in charge of giving you a complete shower, but we don’t mind washing your back or other hard to reach places for you. We do not have nurses on staff in the middle of the night. We do not carry medical supplies, other than what is necessary for staff to do their job. We cannot supply you with adult hygiene products. We cannot supply you with bed linens, as we only provide towels and face towels. That being said, our staff consists of registered nurses, licensed practical nurses, certified medication technicians and certified nursing assistants.
Basically, ALFs make sure you eat three meals a day, receive the proper medication if you are on the medication administration program, are mentally and physically stimulated and that you are taken care of medically if you are not feeling well. Patients are expected to be able to take care of the bathroom and hygiene needs within reason. Patients, and in some cases their families, are expected to provide their own hygiene products, such as soap, shampoo, deodorant, toilet paper and incontinence products. Some patients can, and will, take care of their own medication administration. This is true even for the memory care units, with the exception of self medication administration.
The goal of an ALF is to help you live your best life as independently as possible. If that means you need “outside services,” for example, if you require help beyond what staff can provide, that’s okay, too. Patients are within their rights to reach out to other care providers, such as home care companies, for additional services. ALFs will provide you with transportation, if requested, to and from appointments, as well as on scheduled days for shopping trips. Patients without a mental health diagnosis, which in this case would mostly consist of dementia, are allowed to have their vehicle on site, parked within a designated area. Patients are free to come and go as they please. They can choose their own physicians, book their own appointments and have visitors. They can even order take out if they so choose.
This is slightly different with those living in the memory care unit. They cannot come and go as they please, have a car on site or be in charge of booking appointments with their doctors. Memory care patients are still allowed to leave the unit, so long as they have either an escort, be it family or staff. This is a safety requirement. Visitors are always welcome to come.
ALFs still adhere to state and federal regulations. We must still comply with HIPAA privacy laws. An example of this is patients must sign a release for their photos to be taken and used within the facility and on social media. Nurses and medication technicians are not allowed to give any medication or medical treatment, think powders and creams, without an order from a doctor. ALFs are still subject to yearly state surveys to make sure we are compliant with all regulations.
People who live in ALFs are not here for management of chronic conditions. They are here often for safety reasons, such as experiencing increased falls at home and it is no longer safe for them to be alone. This is the main point that separates ALFs from nursing homes.