Assisted Living – Assisted Living – Encouraging Autonomy, Encouraging Autonomy,

Independence and Independence and

Remaining in PlaceRemaining in Place Long Term Community Care Long Term Community Care

Coalition Coalition

& &

The Coalition of The Coalition of Institutionalized Aged and Institutionalized Aged and

DisabledDisabled

The Who, Why and What of TodayThe Who, Why and What of Today

Introduction to the workshopIntroduction to the workshop

Who was selected to participate Who was selected to participate

Why these topics are timely & appropriate Why these topics are timely & appropriate

What information will be coveredWhat information will be covered

Long Term Care Community Coalition / The Coalition Long Term Care Community Coalition / The Coalition of Institutionalized Aged and Disabledof Institutionalized Aged and Disabled

Who are we?Who are we?

– LTCCC= Long Term Care Community LTCCC= Long Term Care Community CoalitionCoalition

– CIAD= The Coalition of Institutionalized CIAD= The Coalition of Institutionalized Aged and DisabledAged and Disabled

What is Assisted Living?What is Assisted Living?

Generally, assisted living residences provide a combination of housing and supportive services for seniors who don’t need to be in a nursing home (for round-the-clock nursing and medical care) but do require more personal care and health services than independent living provides.

Consumers are excited about Consumers are excited about Assisted LivingAssisted Living

Assisted Living has the promise of:Assisted Living has the promise of:

Choice and controlChoice and control

IndependenceIndependence

Continuing to participate in the outside Continuing to participate in the outside community community

Services that minimize the need to moveServices that minimize the need to move

Why Providers might find it hard to Why Providers might find it hard to meet “the promise”meet “the promise”

Some residence rules may limit ability Some residence rules may limit ability to make decisions and make choicesto make decisions and make choices

Making things easier for staff may Making things easier for staff may limit freedomlimit freedom

Staff shortagesStaff shortages Family might not like residents Family might not like residents

making decisionsmaking decisions Staff may not know how to encourage Staff may not know how to encourage

autonomy or independenceautonomy or independence

Why Providers might find it hard to Why Providers might find it hard to meet “the promise”meet “the promise”

Physical layout may inhibit independence and Physical layout may inhibit independence and autonomyautonomy

Regulations may not seem to permit resident Regulations may not seem to permit resident choice such as taking risks or residents remaining choice such as taking risks or residents remaining if they grow more dependentif they grow more dependent

Fear the resident will be hurt if they make certain choices

Why Providers might find it hard to Why Providers might find it hard to meet “the promise”meet “the promise”

Fear the resident may not understand the Fear the resident may not understand the consequences of their actionsconsequences of their actions

Fear of a lawsuit Fear of a lawsuit

Other more independent residents may not like Other more independent residents may not like dependent residents remainingdependent residents remaining

Staff may not know how to care for frailer Staff may not know how to care for frailer residentsresidents

Consumer IssuesConsumer Issues

Residents/consumers may be Residents/consumers may be afraid of getting hurt or feel they afraid of getting hurt or feel they cannot be independentcannot be independent

Residents/consumers may feel Residents/consumers may feel overwhelmed when faced with overwhelmed when faced with selecting an assisted living selecting an assisted living residence, or negotiating the residence, or negotiating the world of assisted living – feel world of assisted living – feel that or family “know better”that or family “know better”

Benefits to Fulfilling the Promise Benefits to Fulfilling the Promise of Assisted Livingof Assisted Living

Autonomy Autonomy

Decision Making Decision Making PowerPower

Risk taking Risk taking

Independence Independence

Aging-InAging-In

The promise is not being keptThe promise is not being kept

Three-year studyThree-year study

Methodologies Methodologies

Results Results

Thinking of Moving to an Thinking of Moving to an Assisted Living Residence?Assisted Living Residence?

Fostering Autonomy & IndependenceFostering Autonomy & Independence

LTCCCLTCCCCIAD CIAD Presented by Presented by

Cynthia Rudder, Richard Mollet and Geoff LiebermanCynthia Rudder, Richard Mollet and Geoff Lieberman

““A guidebook for finding choice & A guidebook for finding choice & independence”independence”

Written for the consumer to educate them, NOT to Written for the consumer to educate them, NOT to sell them on any one type or idea of assisted living. sell them on any one type or idea of assisted living.

It focuses on independence on the elder!It focuses on independence on the elder!

More of a workbook for those considering assisted More of a workbook for those considering assisted living residences. living residences.

Who should use this book?Who should use this book?

Empowering Seniors/DisabledEmpowering Seniors/Disabled

Book is written directly to Book is written directly to the senior/disabledthe senior/disabled

Knowledge is power. The Knowledge is power. The contract, admission contract, admission agreement, and government agreement, and government regulations and laws regulations and laws establish rights. establish rights.

““A guidebook for finding choice & A guidebook for finding choice & independence”independence”

Explore OptionsExplore Options

Planning AheadPlanning Ahead

Your Needs, Wants and QuestionsYour Needs, Wants and Questions

““Do You Need Help …..?”Do You Need Help …..?”

““Is It Important for You To …..?”Is It Important for You To …..?”

Questions to Ask? Questions to Ask?

What to Look For? What to Look For?

Aging-InAging-In

What Do You Need ….?What Do You Need ….?

Do you Need Help ….Do you Need Help ….

– ADL’s ADL’s

– IADL’s IADL’s

– Getting placesGetting places

– Staying Involved in the outside Staying Involved in the outside Community? Community?

What Do You Want?What Do You Want?

What is important to you as you get What is important to you as you get help?help?– Maintaining routines?Maintaining routines?– Hobbies and other activities?Hobbies and other activities?– Going place outside the residence?Going place outside the residence?– Staying involved with your community?Staying involved with your community?– Being involved in your medical Being involved in your medical

treatment? treatment? – Being able to remain in the residence Being able to remain in the residence

you you are living in even if you need more are living in even if you need more help? help?

Questions to AskQuestions to Ask

Ask staffAsk staff

Ask residentsAsk residents

Ask family and friends of Ask family and friends of residentsresidents

What to Look For On a VisitWhat to Look For On a Visit

EntranceEntrance Individual UnitsIndividual Units HallwaysHallways NeighborhoodNeighborhood Staff Interaction Staff Interaction

with residents and with residents and othersothers

Lighting, Layout, Lighting, Layout, and Physical and Physical Conditions Conditions

Outside AreasOutside Areas Pets Pets Dining RoomDining Room BathroomsBathrooms Common AreasCommon Areas

DiscussionDiscussion

This book is written for the This book is written for the senior/disabled. How do you senior/disabled. How do you think families will/should be think families will/should be involved?involved?

How Would You Use This How Would You Use This Book?Book?

Resident’s Guide for Resident’s Guide for Assisted LivingAssisted Living

Maintain Your Independence, Choice, & ControlMaintain Your Independence, Choice, & Control

Book 2Book 2

How Is This Book Different?How Is This Book Different?

For those already living within an assisted living For those already living within an assisted living facilityfacility

Focuses on residents’ ability to Focuses on residents’ ability to Maintain Control Maintain Control Decision-Making Power Decision-Making Power Autonomy Autonomy Age-inAge-in

Goals and AimsGoals and Aims

Encourage a positive dialogue between Encourage a positive dialogue between Consumers & Providers Consumers & Providers

Encourage residents to evaluate current Encourage residents to evaluate current residenceresidence

Enact changeEnact change

Evaluating Current ResidencesEvaluating Current Residences

Independence Independence

Choice Choice

Decision-Making / Risk-TakingDecision-Making / Risk-Taking

Aging-in / Staying-in Aging-in / Staying-in

““My residence needs changes”My residence needs changes”

What can a resident do by her/himself?What can a resident do by her/himself?

What can a resident do with others?What can a resident do with others?

Enacting Change – By SelfEnacting Change – By Self

– Make informed Make informed decisions decisions

– Tell People What Tell People What Matters to You Matters to You

– Take part in your Take part in your resident service plan resident service plan

– Just do it!Just do it!

– Speak with StaffSpeak with Staff

– Know your rights Know your rights

– State your grievances State your grievances effectively effectively

– Use an AdvocateUse an Advocate!!

Enacting Change - with othersEnacting Change - with others

Residence CouncilsResidence Councils

– Becoming Active on an Existing Council Becoming Active on an Existing Council

– Starting your on Residence CouncilStarting your on Residence Council

Encourage Positive DialogueEncourage Positive Dialogue

Providers Providers

Residents Residents

How this Guidebook Empowers How this Guidebook Empowers ResidentsResidents

Gives them a process for evaluation and making Gives them a process for evaluation and making changechange

Don’t have a Resident Council? Consider Forming Don’t have a Resident Council? Consider Forming OneOne

Your Resident Service Plan Your Resident Service Plan

It’s Not Just About Healthcare It’s Not Just About Healthcare

Do your part!Do your part!

Exercise Exercise

Risk-TakingRisk-Taking

Think about an elderly or disabled Think about an elderly or disabled person who is heavily dependent.person who is heavily dependent.

Make a list of the things that this Make a list of the things that this individual might want to do that you individual might want to do that you think is risky.think is risky.

Add to this list things that this person Add to this list things that this person might want to do that would not be might want to do that would not be allowed in an assisted living allowed in an assisted living residence.residence.

Exercise Exercise Look at this list. Put a check next to Look at this list. Put a check next to

those things you consider those things you consider unacceptable risks. Put a cross next unacceptable risks. Put a cross next to those things you consider to those things you consider acceptable risks.acceptable risks.

Discussion: discuss reasonsDiscussion: discuss reasons Why might an individual want to do Why might an individual want to do

those things you consider an those things you consider an unacceptable risk?unacceptable risk?

What are the possible benefits to the What are the possible benefits to the individual of doing these things?individual of doing these things?

How do you think you would How do you think you would use this booklet?use this booklet?

Additional ResourcesAdditional Resources

• www.assisted-living411.orgwww.assisted-living411.org• www.aarp.orgwww.aarp.org• www.aoa.govwww.aoa.gov• www.aahsa.orgwww.aahsa.org• www.alfa.orgwww.alfa.org• www.ccal.orgwww.ccal.org• www.eldercare.govwww.eldercare.gov• www.caregiver.orgwww.caregiver.org• www.ncal.orgwww.ncal.org• www.ltcombudsman.orgwww.ltcombudsman.org