What is the difference between assisted living and a nursing home? My dad doesn't seem to get much care in assisted living.

My dad got pneumonia in march. My sister took him to the hospital. He was in there a couple weeks then went to rehab at same facility he is in now. He had some co nfusion then but they cultured urine in rehab section and gave him antibiotic and he cleared up. He met a couple ladies he liked. He wanted to stay. He got apt there. He was social butterfly. He knew someone from his church in there. My sister wanted him to come home but she wanted him to be happy too. Then the hallucinations started. He wanted to go back to hospital for a med adjustment. They bounced him right back. Wouldnt even do a beain scan ir urine culture. The apt/ al / didnt want him to go to the hospital. Social worker at hozpital told them he refused to go back in his apt. He is afraid in there. So they had a meeting and moved his bed and stuff to a room. My sister said its ok. Then he got out of hodpital and spent one night in room. In morning we went in for a meeting. He signed papers. He was still confused. She asked who would most likely become poa. I said we will share. My dad agreed. I signed papers too. I didnt really look at fee schedule well enough. She said its al level 3 so extra. So altogether almost 300$ a day. Only room for bed his recliner and his desk. He can leave with 30 days written notice. I will look around but hate to stress him out. He is confused and hates change. Gets lost a few doors away from his room. This is all happening since march. We got to get his furniture out of apt by may 31 or he has to oay rent there also for june. I guess i got to get a long term care lawyer to see if he belongs in long term. He pays 4500$ a yr for long term care ins. And i guess i got to get a lawyer to be poa. I dont know. And can my sister and i share poa? I think there is alot of empty rooms. Any suggestions appreciated. Thank you all for your help

Both of my parents are now in assisted living (ages 89 & 90). Luckily it is affordable for them. In our area they are in two separate apts - studio for dad and tiny apt for mom. The cost for both is what your dad is paying for one. I always speak to the DON about medical concerns. She humors me most times, so I then go to the assisted living director, and/or the CEO. They want those beds full and usually take care of things. I also call the nurse practitioner when necessary. She humors me at times, but staff seem to jump to attention when I call the NP (outside agency). Move him to a better facility. Outside looks are always deceiving. Our folks deserve the best care we can find.

Rndaughter, what's your sister's take on all this? How long had your father been living with her, and when was the first admission to hospital with the pneumonia?

It sounds to me as though you've walked in to a complete sh*t-storm and there's a lot to put right, but the first step must be information gathering so that you've got a really good handle on the medical history and then the time line of events. If your father is currently confused/hallucinating/demented as you suspect, he can't give you POA, at least not for the time being, so you and your sister are going to have to join forces and rely on being his next-of-kin.

What a terrible mess, hope you find a clear pathway forward very soon.

Thanks everyone for all your help. I will take him to a neurologist if he will let me to test for dementia. In house dr at als said aricept probably wont help but i think it might. This was all new onset change if MS. I will take him to urgent care too to see if uti. Last time he had one he was confused. This all started with pneumonia. He was living with my sisterm. Then he went in hospital. And they let a student cath him. He was bleeding alot in bag. Then confusion started. Lungs cleared ul and they quickly sent him to rehab at a nh type place. They discovered he had uti. Gave him antibiotics and his confusion cleared up. He is very social and liked it there so he rented apt there. Then he decided to leave his dr and use in house dr so he wouldnt have to drive as much. They changed some meds. Confusion set in and hallucinations. He went back in the hospital. The hospital didnt really do any tests . It seems like as soon as they found out he lived in apt inside nh facility. They wanted to bounce him right back. I asked them to check him for stroke n uti and they said he is ok. They tested urine for bacteria but wouldnt send culture. My dad refused to go back in his apt because he was afraid in there. Was hallucinating. They had a meeting and moved his bed to assisted living. I dont think my dad realized what he signed. 300$ a day. I think he thought he was going in nh and his long term care ins would pay. I am going to apply for poa. They changed his meds back to what they were but he is still confused. They keep saying he is just getting used to new room. But i still think its uti or dementia. I hope my dad will let me take him out to doctors. He is combative right now. Thank you all for any suggestions.

I respect your preference not to give personal information, but without knowing anything about your father's health and care needs it's very difficult to see whether this is a rubbish ALF and you should find him a better one, or whether your father needs the higher level support of a Nursing Home.

What does his ltc insurance cover? Does the insurance provider also recommend facilities? That might be somewhere to start, if you're prepared to shop around.

Meanwhile - by change in mental status, I assume you mean an acute medical problem? I'd stay with him until you can get medical attention for him, or if need be take him to the ER/urgent treatment centre.

How long has he been in this AL? What sort of screening took place before he was accepted? Does this AL have trouble filling rooms? There are AL's that NEED to fill spaces and will accept residents that should really be in long term care. Maybe this happened to your dad?

You are asking too much of an AL. A lot of ALs u keep ur own PCP. Nurses usually do 8 hrs and are on call the other hours. Moms AL could get a urine sample and test for a UTI but they couldn't culture it. Als are not LTC facilities. They r residences.

A NH will cost Dad twice as much as he is paying. Unless ur Contract says you must use the ALs doctor take your Dad to another doctor.

An AL can’t test for dementia or see if he had a stroke, that is beyond their capabilities. If you think he’s had a stroke, he needs to go the hospital! His primary care physician can do preliminary tests to see if he has dementia but for an accurate diagnosis, you really need a neurologist. An AL cannot and does not provide this kind of specialized care. An AL is not a hospital or medical facility.

How did this facility come to be the one he is in? They can differ. They can be different in states and parts of the state. They are different in that many are for profit and others are more subsidized generally by a religion. They should have a doctor who comes regularly to see patients. However if a resident needs to see a doctor for more specific concerns the resident may have to go to that doctor's office. There should be an employee who oversees concerns.

There generally is a big difference between an AL and a nursing home. Residents in a nursing home are in need of much more care. Often they may no longer be able to walk without much assistance. In an AL facility many residents use walkers or canes. This may not be the case in a NH. I am sorry you are finding such difficulty. I think you may need to communicate more specifics as to the needs of your father. Is he content at all with this facility?