How to Choose Assisted Living for Adults With Physical Disabilities

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Certified Care Manager, Aging Life Care Professional, and National Master Guardian Emeritus

The definition of an adult with a physical disability is a complex interplay between difficulty with function and the environment in which that person lives. Some physical disabilities are present since birth, and others are acquired later in life.

Most people probably think of physical disabilities as problems with lower or upper extremities that interfere with independence. But physical disability also includes hearing or vision loss, both of which significantly impact functioning and quality of life. 

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Physical disability is one of the main reasons people seek out assisted living. The degree of impairment is a crucial consideration. You want to ensure that the facility can not only take care of your loved one’s physical needs but improve their overall well-being.

Assisted living facilities across the country are adapting to the needs of a growing older population that continues to require help with physical disabilities. Some communities, in their eagerness to increase their numbers, may say they can handle your loved one’s needs. You will want to make sure this is the case in order to ensure a successful transition. 

How Do Assisted Living Facilities Serve Physically Disabled Adults?

Few people go to assisted living unless they need some kind of help with daily functioning. If you or your loved one don’t have any care concerns and are looking for increased social interaction and amenities like housekeeping and meals, other senior housing options such as independent living may be better.

The support offered at independent living facilities can vary depending on the care model, but many offer some form of supportive services. They draw the line at providing assistance with daily living activities, which is where assisted living comes in. 

Things to Look for in an Assisted Living Facility for Adults With Physical Disabilities

A good way to start this process is to list all of the daily tasks you or your loved one needs help with. You don’t want to waste precious time or resources looking for assisted living facilities that can’t or won’t work with your physical disabilities. If you are depending upon family or private caregivers to assist you during the day, consult with them to go over all of the tasks you need help with. 

1. Staff ratio

Staff ratio is the available number of staff members to residents. As you assess each assisted living facility, you will want to know whether you will need to augment care with privately paid caregivers. Every state dictates staff to resident ratios.

Call your local health department or area agency on aging to get that information. If the assisted living facility under consideration has staffing that exceeds the state requirement, that is probably good news.

2. Lift devices

If your loved one requires two people to lift them from the bed or a chair, they may need a lifting device or Hoyer. These mechanical or electrical devices allow one person to move someone from one position to another safely.

Many assisted living communities do not allow these devices, so you will need to check to see if the state where you live permits them. The exception might be if the patient is in hospice. 

3. Accommodations for activities

Activities are a vital part of the assisted living community. A sufficiently packed calendar of activities provides ways for residents to stay active, mentally engaged, and socially connected. People with mobility issues, eyesight, and hearing problems have just as much of a right to participate in activities as anyone else.

Ask about what accommodations they make for the physical disability your loved one has. An activities calendar that favors non-disabled residents will leave your loved one feeling left out and isolated.

4. Nursing availability

Nurses play a crucial role in the care of residents of assisted living. They do the initial assessment for admission, develop a plan of care, manage medications, coordinate with the primary health provider and family. Nursing, however, differs from the type of nursing offered in a nursing home.

In assisted living, the nurse does not typically provide a lot of hands-on care except checking vital signs, managing minimal medical tasks. Also, nurses may not be available overnight or on weekends. If your loved one has significant nursing needs, these might need to be filled by a home health agency.

5. Staff training

Aides are the staff that will be assisting you with everyday tasks that you need help with. If you are hearing or sight impaired, are their staff trained to assist you? What about mobility issues and safe transfer techniques?

An assisted living community may not require that all of their staff be Certified Nursing Assistants (CNAs), but you may want to ask how many are. CNAs are able to perform more medically oriented activities, depending on state requirements.

6. Complaints to the ombudsman

Every state has a federally mandated ombudsman program to handle assisted living and nursing home complaints. Call the program in your state to ask whether the assisted living you have an interest in has received complaints. 

7. Visit

An in-person visit can tell you a lot about a community. More than one visit is even better. Things to look for include cleanliness, staff interactions with residents, the activities calendar, common areas for gatherings, and the general layout of the building.

Depending on your physical disability, knowing what rooms are available is important. You might have limited options and a room that is at a distance from the dining area or other gathering spots may not be ideal for your situation. 

What Questions Should You Ask an Assisted Living Facility for Those With Physical Disabilities?

Having a list of pre-prepared questions will guide you during your search and allow you to make informed comparisons between facilities. When you make your final choice, you want it to be a good one with as few surprises as possible.

What is the age restriction?

Most assisted living communities have an age restriction. If you are a younger, physically disabled adult, there are assisted living options for young adults available, but they will be limited. This is especially true if you don’t live in a larger metropolitan area.

An assisted living facility that has an age limit of 55 years or older might be willing to be flexible if you are in your early 50s, but they may not accept someone in their 40s. It doesn’t hurt to ask for an exception. 

What is the base cost and are there any additional costs?

Assisted living communities designate a base rate for rent, including all meals, housekeeping, transportation, and activities. Some will have tiers of care where a certain number of hours of aide care are included in that tiered rate.

If your loved one’s care needs exceed what is allowed under their payment plan, you will need to arrange for that privately. Paying for assisted living is a concern for most people, so evaluate and budget for the care your loved one needs now and in the future. Account for any automatic yearly increases as well. 

What is your discharge criteria?

Don’t assume that you or your loved one with a physical disability can stay in assisted living indefinitely. Most assisted living communities have broad leeway on discharging residents but have to give 30 days’ notice before doing so. Unfortunately, 30 days is not a lot of time to find alternative housing so the best strategy is to be informed on what the discharge criteria is.

Chances are if someone with a physical disability gets to a point requiring the assistance of two staff members for all transfers, they will be asked to leave. By knowing the requirements you can work at putting whatever support services in place that you need to continue to stay as independent as possible.

Who addresses concerns and complaints?

There are few things more frustrating than not knowing who to go to with concerns about your loved one’s care. If you can, meet with the assisted living director and head of aide service to get a feel for their approach. Ask them how they handle changes in care plan and family or resident concerns.

What are your safety protocols?

This question wasn’t that relevant before, but it certainly has changed as a result of the COVID pandemic. Many assisted living communities open up visitation but then close to visits when there are COVID positive cases in their building. 

Even with an easing of restrictions, you have a right to know what the facility’s approach is to infection control in the building. If you are immunocompromised due to Multiple Sclerosis, an organ transplant, or any other condition that makes you vulnerable, you want to feel confident in the safety of the building. 

Assisted Living for Adults with Physical Disabilities

A physical disability should not be an impediment to a full and healthy life in assisted living. The challenges are real. But, with a focused effort on finding the right place, you or your loved one can have a successful move to assisted living.


Sources:

  1. Graham, Judith. “Assisted Living Kicks Out The Frail ’Cause ‘We Can’t Take Care Of You Any Longer” Kaiser Health News, 6 September 2018, khn.org/news/assisted-living-kicks-out-the-frail-cause-we-cant-take-care-of-you-any-longer/
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