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Stepping stones in care needs: assisted living combines help and social life

by Carol Bradley Bursack, Editor-in-Chief

Assisted living centers are attractive to many people who are isolated in older homes, with neighbors they no longer know and yards that are too much work. Not everyone wants to make this move, but many do it anyway, if only because they must have help at hand for emergencies. Often, once a period of adjustment has been endured, elders thrive in these communities.

Assisted living centers come in many sizes and provide varying services, though the central reason for their existence is to provide a place where people who need some help in their daily routines, but not the type of nursing care that nursing homes provide, can live. For many people, assisted living is a step they take before entering a nursing home. However, for others, health never requires the transition to a nursing home. Enter the assisted living facility.

Some assisted living centers are in residential homes 

One attractive aspect of assisted living is the variety of forms these centers take. Some are residential homes where the owners care for perhaps four to six elders. Rural areas often offer this type of assisted living, and these smaller homes are very popular with folks who like to wheel their chair out to a garden or view crops growing in fields they can no longer harvest. Many of these rural homes offer access to farm animals and have an abundance of pets.

For people who don't want a country atmosphere, many communities have city homes that offer the same type of service -- family style living with just a few seniors who need minimal help. Whether the home offers country living or a city neighborhood atmosphere, small residential assisted living centers suit many elders very well.

Larger centers offered varied services, amenities

Larger assisted living facilities often resemble swank retirement centers. In fact many retirement centers have assisted living facilities as part of their compounds. These vary in what they offer, and of course the swankiest of them are very expensive.

There are a couple of centers in my community with gourmet chefs for community meals, nice kitchens for home cooking, gyms and spas for health and comfort and garages for cars, as well as buses for group transportation. These facilities have waiting lists comprised of people who used to head south to retire. It's hard to comprehend, when touring some of these places, that they actually are assisted living centers. One of them has a locked Alzheimer's wing, which can seem startling as you tour the building thinking you are in a resort.

Most centers aren't quite this plush. But they do offer group meals, many choices when it comes to food, kitchenettes, rooms for physical therapy and other health services and the trump card for assisted living centers - the chance to socialize with peers.

Socialization brings new life to many

While many seniors dig in their heels and say they want to stay in their own homes until they die, they often find themselves isolated and lonely. Watching TV all day and microwaving dinners can get old. Depression can set in and inertia makes the idea of a move unthinkable. This doesn't happen to all elders staying in their own homes, and I'm not implying it does, but many do find that the changed neighborhoods, and the fact that getting around is harder than it used to be, makes for a dull life.

My mother-in-law, Alice, was a person who got so lonely in her condo that paranoia was setting in. She had other health issues and we had to move her directly into a local nursing home, but I think of her when I think of success stories with assisted living or nursing homes.

When we walked Alice into the nursing home the first day, I expected a period of adjustment. I tried to show her, by looking out the window, that she had the same view she had from her condo - just a block away. I tried to point out her condo, as well. All of my good intentions were to reaffirm that the move wasn't so very far. But she would have none of it. She was so glad to be among these nice people that she fairly bloomed . She didn't care about a familiar view. I believe she finally felt safe.

I've seen the same response with other elders when they've left their home of many years and gone into assisted living. The energy of social activities, the assurance that there are people around to help if you need it, the company at meal time - all of these things can have a very positive effect.

Review the contract before signing on the dotted line

People often are confused about what services assisted living offers. There's good reason for this. First, assisted living centers aren't regulated in the same way nursing homes are. They have much more freedom to determine what kind of services they will offer. Also, they do not generally offer health care services, but they often contract with in-home agencies who do offer these services.

The idea is to check to see what kinds of services are covered in the contract you sign. Then, ask about added services such as personal care, transportation to doctor's appointments and special diets. You'll want to be clear on what is in the contract and what is going to cost extra.

For many people, assisted living is a first step away from their completely independent lives. For others, it's one more step along the journey of needing some care, one step up from having someone come to their house from an in-home agency. Assisted living centers are here to stay, and continue to advance the services offered, whether in the standard contract or as add-ons. Competition will see to that.