The Daily Star, Oneonta, NY - otsego county news, delaware county news, oneonta news, oneonta sports

October 19, 2009

My Turn: Exactly what is assisted living?

This week's "My turn" column is by Pat Breuer, executive director of Hampshire House.

An increasing number of families these days are forced to grapple with the problem of the appropriate place for older relatives to live.

Usually these older relatives are the parents, very often just the mother, and usually the family member that does the grappling is one of the daughters. Whatever one may think of the fairness or not of this, these are the facts.

Demographics and statistics dictate that wives will outlive their husbands, and practical realities of life have shown that it is the daughter of the surviving spouse upon whose shoulders it falls to take care of that surviving spouse.

And so we see women, usually in their mid- or late 50s, all over the country, combing the Internet; walking their fingers through the Yellow Pages and asking their friends and relatives "What services are available?"

The older relatives in need of this kind of help usually don't acknowledge it or want to leave their homes. They have often been in that home for many, many years, have a number of friends and neighbors around them (although a decreasing number as time goes on) and are familiar with the neighborhood and house, with all its pleasures and problems.

It's only when their children, friends or other relatives see problems develop and foresee more-serious problems in the future, that the need to search for an alternative living situation becomes urgent.

These problems can include such things as leaving the stove on all day with food on it that starts to burn and sets off the fire alarm or draws the fire department; wandering outside inappropriately dressed and at inappropriate times; losing or misplacing items such as hearing aids, dentures, money, keys, etc., any of which makes it hard or impossible to go on with the ordinary routine of daily living.

This is when the older relative needs help with the "activities of daily living," which is what an assisted living facility does.

Assisted-living facilities, also called adult homes, in New York are licensed by the state to provide assistance with the activities of daily living, which include bathing, dressing, eating, toileting and medication management.

The residents of these facilities are usually frail, elderly people, with an average age of 85 years, in need of assistance with one or more of these activities of daily living, but they do not need the level of care that requires them to be in a nursing home.

If a person actually requires medical care and continuous nursing care, he or she would not be eligible to enter an assisted living community, but rather would go to a nursing home.

It often happens that when an older person suffers a fall and, perhaps, a broken hip, he or she may go to a hospital and then a nursing home and, after a stay at the nursing home for rehabilitation, be discharged into an assisted living community if it would be impractical or unsafe to return to their home.

Assisted-living communities are called "social models," not "medical models," because the residents live in a community where their social needs, such as bathing or dressing, are taken care of but any medical needs are not taken care of by the assisted-living facility.

The assisted-living facility will provide medication management, ensuring that the right pills are taken at the right time; will schedule visits and provide transportation to doctors or other needed medical resources; and will provide "case management," closely observing and monitoring the health and condition of the resident, keeping detailed records in order to determine if the resident can be adequately cared for or needs to move to a more-intensive level of care, such as a nursing home.

In an assisted-living facility, after time, which can be a couple of weeks or sometimes a couple of months, the older relative settles in, looks around and starts to enjoy life again!

Pat Breuer is the executive director of a local adult home community, Hampshire House, at 1846 County Route 48 in Oneonta. She can be reached at

To write for "My turn," contact Daily Star Publisher Tanya Shalor at or 432-1000, ext. 214.