Residential Care Facilities
When the option to keep an Alzheimer’s patient in the home is no longer feasible or desirable, care in an institutional setting must be considered. The availability of residential care in the community differs with the extent of skilled care needed by the person with dementia. Nursing Homes and Assisted Living Facilities offer custodial care; however, only nursing homes can offer skilled medical care to the Alzheimer’s patient.
Assisted Living Facilities
Assisted Living Facilities (ALF’s) are privately owned facilities which provide room, board and limited personal services (such as help with bathing and dressing) as well as access to available community services. ALF’s can range in size from a few residents to a facility housing as many as several hundred older adults. ALF’s also vary considerably in monthly rent, types of services offered, and physical amenities. Some ALF’s accept certain low-income adults who are certified eligible for state-supported assistance as determined by the Department of Children and Families. All ALF’s are licensed by the Florida Agency for Health Care Administration and are required to meet minimum standards. A higher level of licensure allows those ALF’s licensed for Extended Congregate Care to offer more extensive care to residents. ALF’s usually are appropriate for persons in the early to middle stages of Alzheimer’s disease.
It is Florida law that all direct care staff of ALF’s that advertise that they care for Alzheimer’s disease or related disorders patients must complete four hours of special training (Level I). All ALF employees who work directly with Alzheimer’s patients must have eight hours of training (Level II). This law is a positive step in the evolution and development of specialized dementia care. When searching for a facility, it is wise to check that this training has been completed by the staff.
For a complete listing of the ALF’s in Florida’s Pinellas and Pasco counties:
- Contact the Agency for Health Care Administration (AHCA) at 727-552-1133. Residents of other Florida counties can call AHCA toll-free at 1-888-419-3456.
- Visit the AHCA web site and select Facility Locator.
- Brochures and free reference guides to residential facilities are available at the Helpline at 1-800-96-ELDER, (1-800-963-5337). For inquiries from outside of the area call 727-217-8111.
At some point the needs of the Alzheimer’s patient may be too great to continue care at home or in an assisted living facility. It is upsetting to the family members, as well as to the patient, when the time of transfer to a nursing home becomes necessary. The patient will adjust better to the new environment if familiar items are included, i.e., personal possessions and selected items, photographs, family albums, and special items of clothing.
A nursing home, also called a skilled nursing facility, health and rehabilitation center or health care center, offers room and board with 24 hour awake staff and care. Skilled care is available 24 hours a day and most facilities of this type will be able to care for persons who require significant care. Nursing homes are licensed and inspected by the Florida Agency for Health Care Administration and are required to meet minimum standards. Results of the inspections provide a rating of the nursing home which assesses the quality and performance at the time of the state’s annual inspection. By law, nursing homes are required to post the state’s most recent inspection report. Nursing home facilities may be appropriate for persons in the middle, late and end stages of the disease.
For a complete list of nursing homes in your Florida county:
- Call the Agency for Health Care Administration (AHCA) at 727-552-1133 locally in Pinellas or Pasco County, Florida, or toll-free at 1-888-419-3456.
- Visit the State of Florida’s website and click on “Find Facility or Provider” to search for licensed nursing homes and assisted living facilities.
Evaluating A Facility
The Pasco-Pinellas area of Florida has grown tremendously in terms of the number of residential care facilities that have Alzheimer’s specific care units or specialized care of some type for dementia patients. Many facilities have waiting lists, so it may be better to explore options before a crisis arises. This allows for a more thorough evaluation without the pressure of having to make an immediate decision.
When selecting a residential care facility it is important to seek recommendations and to visit the facility several times to determine the quality and suitability of the care. Consider talking to family members of current residents about their experience with a facility.
Here are some questions Alzheimer’s caregivers should ask when evaluating a facility:
- When a facility advertises a “special care unit,” ask what makes it “special.” This should include information about dementia training (both past and on-going) for employees, specialized activities and a calm environment.
- Request to see the most recent facility inspection report. This document is public information, must be posted in a visible area, and highlights the kind of care provided.
- Question how many direct care staff are available during days, evenings, nights and weekends; as this will help determine how much individual attention your family member will receive.
- Find out whether the facility offers a cognitive assessment as part of the screening. Such an assessment helps assure the family and the facility that the residence is capable of meeting the individualized needs of the resident.
- Determine if the facility is secure to safeguard potential wandering.
- Ask whether dementia residents are separated or integrated with other residents, and consider which type you prefer.
- Discuss with staff what the program’s philosophy and goals are with regard to resident independence and functioning.
- Ask questions about the staff’s ability to care for your loved one as the disease progresses, as not all places will be able to provide care throughout the progression of the disease.
- Identify the facility’s plans for maintaining and involving family in the care, support, and problem-solving of the patient.
Finding the right residential care setting to meet the needs of the person with dementia can be challenging and time consuming. There are private businesses which assist persons with finding a suitable ALF or nursing home. Call several before doing business with one. In most cases, placement agencies do not charge the consumer, but get paid by a facility when there is a placement or for marketing the facility. Some transport the potential resident to various facilities, while others provide information about facilities and allow the individual to make contact directly. Some will even assist with the actual move after selection has been made. The consumer should keep in mind that no placement agency represents all the residential facilities available in Pasco and Pinellas counties.
Comprehensive Assessment and Review for Long Term Care Services (CARES)
This Department of Elder Affairs (DOEA) program, serving all Florida counties, provides pre-admission assessment and case management for individuals considering nursing home placement. A CARES assessment is required for individuals making application for Medicaid payment to a nursing home. However, a private pay person contemplating entering a nursing home can have CARES staff assist with long term care decisions.
A CARES nurse and social worker evaluate an individual’s health care needs in consultation with a physician and recommend services that seem best suited to those needs if a non-nursing home placement is seen as appropriate. The CARES program will also assist in providing non-nursing home placement or in-home services if the nursing home pre-admission assessment indicates that the individual can be diverted from the nursing home or that the nursing home stay could be short-term. For more information call:
Pasco and Pinellas
DOEA CARES Unit
For contact information for the DOEA CARES Units serving other Florida counties, call the state Elder Helpline at 1-800-96ELDER or 1-800-963-5337.
Long-Term Care Ombudsman Council
The Long-Term Care Ombudsman Council is a group of citizens appointed by the Governor of Florida. The members investigate and resolve problems and grievances of persons residing in nursing homes, assisted living facilities and/or adult foster homes.
Agency for Health Care Administration (AHCA)
The Agency for Health Care Administration is responsible for licensing assisted living facilities (ALF’s) and nursing homes in Florida. AHCA also investigates complaints regarding the conditions and the quality of care provided in nursing homes and assisted living facilities. Status of licenses and latest facility inspections can be obtained, and you may order publications such as the printed Nursing Home Guide for Central Florida (or other areas).
Pasco and Pinellas
Agency for Health Care Administration