Monday, April 1, 2013

I am being told parent will have to leave their assisted living facility--what do I do?

I am being told parent will have to leave their assisted living facility--what do I do?

By Bob Gregory

Most people are shocked to find out that their parent is being asked to leave their Assisted Living Facility and equally as shocked to find out that the facility has the right to ask them to leave.  It is not uncommon that a resident is asked to leave, but the circumstances under which they are asked to leave tell the real tale.  First, Assisted Living Facilities do have the right to ask a resident to leave and there are a several reasons they may do so, which we will discuss.  Second, most will give you an opportunity to work through any issues as they are in business to provide a service for a fee and they value their residents.  Generally, reasons a resident may be asked to leave can be grouped into two main categories: Service Issues and Non-Service issues.  It’s the second category you don’t want your parent to fall into but we will discuss both so you have a better understanding.

Service Issues:

Help Walking
I have written many times that not all ALFs provide the same level of service and therefore, their resident qualifications differ.  ALFs are not Nursing Homes/Skilled Nursing Facilities and they do not offer those types of services.  Some come very close but there is a line (legal) they do not cross.  Once your parent reaches the point that they need medical care beyond that provided by an ALF, you will certainly be notified that your parent needs to be moved.  The caregivers at ALFs are skilled at recognizing the need for increased medical services and they will notify you as soon as they feel it is imperative a change in facility is needed.  You should still consult your parent’s physician to confirm your parent needs to move and to Alzheimer’s that the ALF is not equipped to handle.  It can be other issues as well, so seek medical advice and recommendations.  Additionally, even if your parent’s physician feels it may be a bit premature, keep in mind the doctor doesn’t spend as much time with your parent as the caregivers at the ALF and they may see a more immediate need.  You will also save yourself a lot of heartache if you don’t force the issue for your parent to remain in their present facility if you are being told they need to go!  Most facilities give enough notice that you will have time to find the right Nursing Home and make a smooth transition in order to minimize the stress on your parent and yourself as well.address the medical reason behind the need.  Many times it is a result of an increase in severity of Dementia or

Non Service Issues:

This is the category you do not want your parent to fall into!  Most often this has to do with your parent’s behavior and not their medical condition, although sometimes one can cause the other.  If your parent becomes disruptive, abusive to residents and staff (physical or mental) or conducts themselves in a despicable manner, they will be told to leave.  It is always shocking for most children of elderly parents to hear and for the rest of the population as well.  To think that sweet Grandma or Grandpa could ever conduct themselves so offensively as to be kicked out of an Assisted Living Facility is mind boggling—but it happens!  If you are notified that your parent’s behavior warrants being evicted, you need to do some investigating. 

The Agony of Waiting
The Agony of Waiting
(Photo credit: drewleavy)
  Hold a conference with the ALFs director and caregivers to get a good understanding of the issues, when they began and the opinion of the ALF as to why the behavior.  This is your first step to understanding the situation and getting a time reference as to when the issues began.  You may find it started when your parent moved in or some change in personnel or residents.  I assure you the facility will have already done a complete review of the case as they do not like to lose residents.  They will be ready with specific examples, times and the cause of the behavior (at least in their opinion).  Make sure you ask for time to resolve the behavior and see if they are willing to work with you.

  Have a heart to heart conversation with your parent. I suggest you do that off-site so they feel more comfortable being open with you.  Become a listener and not a debater as your parent explains their behavior.  It is very easy to try and offer counterpoints to issues your parent may discuss, but wait until they’ve had an opportunity to fully explain themselves.  You will find your parent more focused on fewer issues if you do not debate as they may feel it is necessary to interject more reasons to justify their behavior.  Let them speak freely and for as long as they wish and I assure you a theme will arise out of the discussion.  Hopefully you will be able to address the issues and keep your parent in their “home”.  Be very careful how you discuss the accusations and facts presented by the ALF so you don’t create a situation where your parent isn’t willing to reconcile.  However, you need to get your parent’s side of the story as well as their reaction to the ALF’s “findings”.

  Get your parent to their physician immediately to see if there is a medical reason behind the behavior that the ALF did not recognize.  Certain drugs can cause patients to become belligerent and unruly so you will need to make sure that is not the cause.  Also, the lack of medication can do the same.  The caregivers will see to it your parent gets the pills and takes them, but if they later spit them out, mental health can cause issues so medication may be all that is needed to alleviate the problem.  Seek medical advice! they won’t know until the behavior changes.  Also, certain changes in

  Hold a post-investigation conference with the Director and appropriate staff.  If you are attempting to reconcile, it is imperative your parent attend and conduct themselves properly.  This is your opportunity to relay your findings during your investigation with your parent and your parent’s doctor and reconcile the issues presented by the ALF.  If you are successful and your parent remorseful, your parent may get a second chance to be part of the ALF community again even if it is on a trial bases.  Generally, a medical condition is recognized by the ALF so most of the time the Non-Service reason a person is asked to leave is willful misbehavior - so don’t get your hopes up.

Assisted Living Facilities value their residents and thus it is uncommon that a resident is told to leave the facility unless it is due to a Service Issue.  However, there are those rare times when Non-Service Issues cause an ALF to tell a resident to leave.  If you find your parent is one of those rare exceptions, keep in mind that the facility is looking out for the welfare of its residents and staff and they don’t take this action lightly.  I also caution you not to make your home or that of a sibling a short term fix until another facility can be found.  This may be just the result your parent seeks with their disruptive behavior.  Finally, there are drugs that can be prescribed if your parent’s physician deems it necessary to help your parent.

If would like a list of Assisted Living Facilities, Nursing Homes or any other type of Senior Facility, I hope you will consider
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Bob Gregory is an advocate for Seniors and is one of the founders of At, we are dedicated to helping families get the Elder Care help they need without having to provide their personal information! If find you need an assisted living facility or other type of senior facility, please consider

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