Ronny-
I didn't know the difference between NH & AL.  My thoughts are NH  got
such a bad reputation that marketing experts changed the name and
perhaps sold the concept with--- bring your own furniture & memories.
They took away the sterile look.
Each of these places seem to have glowing brochures..
Prices very.  It is good to go visit them.  Each one seems to have their
own criteria for acceptance.
In Tx and I believe in most other states the home is not touched for
funds,  You might get busy finding out information..call the Alz Org .
I went to an Alz group meeting and got info on an Elder Lawyer.  It's
not easy ferreting out all you need to be aware of.

Florence

Ronny,

Excellent question. I have worked in both Assisted Living and in a Skilled
Nursing Facility and there is quite a difference.

Assisted Living buildings come in lots of different shapes and sizes. They
fall under the category of Boarding Homes and the rules are different then
that of a full scaled Nursing Home.

Typically Assisted Living are for people who are pretty high functioning and
don't need the level of nursing care that is seen in Nursing Homes.  There
are, however, exceptions.  The Assisted Living building I work for
specializes in dementia care and we are able to keep almost all people with
us until they pass away.  Currently we have several residents who are under
hospice care and will stay with us until the very end.

Many Nursing Homes (or SNF - Skilled Nursing Facility) are basically a
landing place between hospital and home for many people.  Grandma falls at
home, breaks her hip and goes to the hospital.  The insurance company says
that Grandma can only stay in the hospital for X number of days before she
is discharged.  Grandma lives alone and is not capable of caring for
herself, that is where a SNF comes into play.  They can provide Physical
Therapy, and Occupational Therapy and works with Grandma to help her become
as independent as possible.  Best case scenario, after a month of therapy,
grandma goes home as independent as ever. In some cases though, Grandma does
not get better and sometimes ends up staying in a SNF until she passes away.

The other aspect of a SNF is that they have more Nurses on staff, 24 hours a
day, while an Assisted Living usually has Nurses on Duty for about 10-12
hours a day. Many AL buildings do not provide IV therapy or Tube Feedings,
that would be something you would see more in a SNF.

As far as payment goes, most Assisted Living buildings (not all) are pretty
much private pay while a SNF accepts both Medicare and Medicaid.  An
excellent place to check on the care given at both AL's and SNF's is the
Medicare website. They have statistics and survey results on both, and you
can compare what is offered before you place a loved one in either.

When you are considering placement, your best bet is to contact places early
and start touring and doing research. On the Medicare website are some
questions that are fairly standard that most families should ask before
choosing a home for someone.

Hope this helps. All aspects of long term care can be a bit of a maze, but
with a little research, input from other Caregivers at your local AD support
group, and asking tons of questions, you can usually find what you are
looking for.

Patty

Ronny, one website that may interest you is that of Paul Premack, a Texas
attorney that is certified as an Elder Law Attorney.  He stores archives of
his columns and publishes a "Senior Texan Legal Guide" that is in plain
English (okay, plain English Texas style  :-) and is very helpful.
www.premack.com
---------
Dear Mr. Premack: We are in late August already, and I'm looking back at
your column from last February about Medicaid's plan to take away the homes
of people in nursing homes. What is the current status of that plan? -- SP
The Medicaid Estate Recovery Program (MERP), which was expected to come into
effect by September 1, has been delayed while the federal government (via
the Center for Medicaid Services) reviews and comments on the proposed Texas
plan.
(column continues)
http://premack.com/columns/2004/2004-08-17.htm
-----------------
I've found his columns to be a valuable resource.

Karen

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