So, getting right into it, the State of Utah’s Health Facility Licensing, Certification, and Resident Assessment site has an excellent Health Facility Information tool, that has several highly useful features.

First, there is a simple, but helpful .pdf document that describes the different types of senior care facilities in Utah, and how they are defined.   For assisted living, there are:
Assisted Living Facility Type I   and Assisted Living Facility Type II.

Assisted Living Facility Type I allows that a resident lives in a licensed facility that provides safe and clean living accommodations and three meals a day.   Resident requires minimal assistance with the Activities of Daily Living (ADL’s), as well as several other criteria that I have displayed here.

Assisted Living Facility Type II allows residents to age in place in a licensed facility, and also has it’s own set of criteria, and guidelines that I have displayed here.  You may pause the video at any point to examine these definitions for each type of assisted living and other health facilities in Utah.

http://health.utah.gov/hflcra/facinfo/HFLevelsOfCare.PDF

The next tool I would like to quickly show you is the facility listing data provided by the State of Utah.  Uses may search listings for facilities alphabetically, or by county, and then by Facility Type.

http://health.utah.gov/hflcra/facinfo/factype.php

For this example, I will choose Wasatch County, and then Assisted Living Type II, and then view the information about the facility.   Information provided includes the type of facility, address and phone number, county, number of licensed beds, and when the facility was licensed.

This information is somewhat basic at this time, however, it does provide an accurate and unbiased way to further your research, and to find facilities in both urban, and rural areas in Utah.

Ok, thank you for watching our tutorial on using trusted, state-sponsored data and resources to find senior care and assisted living in Utah.   Thanks again!

More Information on Assisted Living Directory:
http://www.assisted-living-directory.com/content/utah.htm

My mother-in-law is dying.   How quickly that happens is anyone’s guess.  What she has going for her, or against her depending on your point-of-view, is that she is a feisty fighter, and she wants to live.  After all, she has quite a lot to live for.

My “MIL” – short for Mother-in-Law, just turned 81.  She has worked almost her entire life, and just recently retired at age 80.   She was a dedicated, hard-working wife, mother, and employee.  Her husband passed away about 10 years ago, so she has become incredibly independent and self-reliant.   She has a loving extended famlily sith daughters, sons, and a handful of awesome grandchildren.   Life should be getting good for her right about now.

It didn’t happen that way.   Around the time she turned 80, she was diagnosed with Cancer.   Anyone who is in their 8th decade would probably be done shortly after such a diagnosis, but she fought, did chemo, exercised, and cussed out this cancer thing – and apparently won the battle..but not the war.   Up until this past July, she seemed to be getting back to normal, and clear of Cancer.   We had a wonderful family vacation, and took her along with us.   She partied like a rock-star, and wore the rest of us out with her energy.

Fast forward a few months later, and she can hardly move, and is bedridden in a skilled nursing facility.  A whole new cackle of heath issues have surfaced, and we believe, without the doctor’s official confirmation, that her new issues are a result of the harsh effects of chemo.  She has now taken on Myositis, which, in sum, has made her too weak to even lift her arms, swallow, or breathe properly.  She’s on a feeding tube, oxygen, and hasn’t had a solid meal in 2 months.   There’s many other problems, but the Myositis is at the top of the serious-meter.

My wife is the one I am worried about.

My wife is a wonderful, dutiful, and loving daughter.  She has called her mom every week for as long as I have known her, and for the past 3 months, she has called her daily, and has made several trips to see her.   She worries, frets, and cries for her mom to be better, or to be comfortable (delicately saying that the ‘end’ wouldn’t be a bad thing at this point).   My wife, and I live on the other side of the country from “MIL.” We have a 6-year old son, and one on the way.  We both work full-time.

We are soundly and squarely now members of the “Sandwich Generation” caring for an aging parent(s), and young kids simultaneously.  Being ‘sandwiched,’ and not able to help an aging parent effectively has caused a roller-coaster of emotions in our family, and a feeling of helplessness.

Guilt.

One of the most upsetting things that my wife has been feeling lately is an enormous degree of guilt – guilt that she can’t help her mom more, and can’t be with her to comfort her, and keep her company during this difficut, end-of-life journey.  This guilt, from a logical standpoint, shouldn’t exist.  I have tried to explain to my wife that there is nothing more that we can do, really, within our power, schedules, and financial situation.  We can’t make $1000 round-trip visits every month, also taking the time off of work and the missed income that would result from that.  It’s not fair for us to be absent from our young child during his first-grade year at school, and there’s no magic wand that could be waved once she got to her mom that would make her situation better. It’s an unfortunate truth – we have responsibilities here that we can’t abandon.

We’ve also nudged, encouraged, and strongly suggested to our MIL that she move away from her home to be closer to one of her kids – so when this day came, she would already be close to family that can help care for her.  She refused, and now -being on a feeding tube, she is not mobile, and has to stay put.

Anger.

My wife has felt anger as well.  She’s angry, at times that her mother didn’t make better decisions regarding her care, her personal affairs, and health.   She’s angry that her mom worked her butt off until she was 80, when she could have retired much sooner, and now has no time to enjoy her retirement.    Angry that very few of her friends, neighbors or ‘churchmates’ have bothered to visit her, or ask how she is doing.  Angry that she has refused to consider a supportive living environment like assisted living until just very recently, and now she is too sick to move out of the mediocre-at-best skilled nursing place she is in now.  She’s angry, at times, that her mom is so stubborn, and continues to suffer, and won’t go peacefully.   This sounds horrible, but, to see MIL with no hair, tubes coming out her everywhere, unable to even enjoy the sensation of tasting food any more, there is absolutely no quality of life any more – you might understand.   There’s been very little hope that this will change for the better.

She’s angry at times that she has to watch all of this unfold from the sidelines.

Hope

We have felt hope, at times during this process.  There have been several times where we have spoken to MIL on the phone – sounding so horrible and unable to speak clearly – that we have thought that she may only have days left in her “life account.”  Then, a day later we will speak to her again, and she is almost spunky, clear-spoken, and may have actually stood up next to her bed (with a little help from the nursing staff).   Is she getting better?  Will she surprise us?  Are we giving up on her too soon?

Love

In the end, we have to stop and realize that all of the emotions and feelings that have come up during this process is only because we love MIL deeply.   She is such an important part of our family, and it is sad, and seemingly unfair that her physical presence with us will be coming to an end.  We feel guilty for not showing our love more, angry that we have no control, and hopeful that there will be a resolution and that her suffering will stop – whatever road that may take.

For now, I try to remind my wife that we are human – not superhuman -  and that her mom does know how much we all love her.   We’re doing our best, and that’s all anyone can ask of us.

*** The inspiration for this article was inspired, in-part, by reading Alzheimer’s – My Mom is My Hero – Lisa Hirsh’s story of her growing love and frindship for her aging mom who is suffering from Alzheimer’s.

We believe that these video tutorials help, since often-times this valuable information is not easy to find, or buried in a sea of other, not-so-trustworthy information and websites.

So, getting right into it, the Wyoming Department of Health has a fairly new tool, or section that allows users to look up inspection reports for facilities in Wyoming – which include assisted living; hospice facilities; nursing homes – and quite a few other categories.   Users can also filter their search by county, and city.

For this example, I will choose nursing home as my facility type, and then Fremont County, and choose a facility.  From there, basic information about the facility comes up first, and then information on Current, and Previous year surveys are displayed, and can then be opened for further information.  A summary of any deficiencies and plan of correction are displayed, and the date the survey was completed.

This inspection report search tool looks to be a fairly new addition to the Department of Health, and is not complete yet, but there is still some excellent information to help you to learn more about specific facilities throughout Wyoming.

Next, the Department of Health also offers a simple Healthcare Facility Directory section for Wyoming, and the information can be downloaded in Excel or PDF format.   This is a very comprehensive list of facilities in Wyoming, and should be considered a trusted and unbiased source of information to help with your research.   This list also includes nursing homes, adult day care, and assisted living.  Assisted Living Directory also provides a facility directory for Wyoming.

Lastly, for those of you wishing to open an assisted living facility in Wyoming, I would like to quickly highlight the facility licensure and certification section, which includes a great flow chart that describes the general process for facility licensure, as well as the assisted living license application and survey fees.

Ok, thank you for watching.  I hope this has been a helpful tutorial on finding assisted living and senior care in Wyoming, as well as investigating inspection and survey reports.  Thanks again!

Users will be able to search for  care by county in Alabama, and by care type.   Each facility listing will display some basic information about the facility, including the location and contact information.   A .pdf with a deficiencies report is also available with most facilities, detailing any issues or citations that may have happened during an inspection.

Another interesting item that is included is a section called “Other Files” which will give you a ‘total score’ for the facility, from 1 to 100.   A great way to see how a facility that you are interested in ranks in comparison with other facilities.

Information provided through the Department of Health should be considered an additional, trusted, state-sponsored way to enhance your research into senior care in Alabama.

 More Information:

http://adphnotes.state.al.us/hcfweb.nsf

http://www.assisted-living-directory.com/content/alabama.htm

The information provided is somewhat basic, but it does provide a solid starting point for researching facilities.  Information that they provide includes the facility name, license information, number of beds, administrator or owner name, as well as the facility’s address and contact information.

Currently, it says that there are over 14,000 assisted living ‘beds’ in the state of Tennessee, and 236 facilities.

In addition, our video will explain how people interested in opening their own assisted living facility in Tennessee may start the application and certification process.  We’ll provide a link to the actual application (.pdf) as well.

The information provided from this tutorial should serve as a trusted, unbiased, supplemental way to enhance your research of facilities and any pertinent information regarding assisted living and long-term care in Tennessee.

Pages referenced in this Video Tutorial:
http://health.state.tn.us/hcf/Facilities_Listings/facilities.htm

http://health.state.tn.us/Downloads/PH-3501.pdf

http://www.assisted-living-directory.com/content/tennessee.htm

Many people simply do a search for facilities, and trust the information offered by the ever-growing number of commercial senior sites out there (some that are very questionable as to who is behind them, and what their goals are, and the information they present). There are, however, some very good sites out there, and whichever site you use, it is always wise and advisable to ‘double check your facts’ and find trusted ‘second opinion’ sites to find out the scoop on facilities you are interested in.

That’s why we have created this video tutorial highlighting two incredibly useful, and unbiased (non-commercial) sites that will help you to further your search for assisted living and senior care possibilities in Iowa, and to also learn about those facilities in terms of their inspection reports and any citations or complaints that they may have received. We like to do this in a video/screen shot format, since, we think that many people will just ignore links posted to these sites, or those may be easy to overlook.

The information that we present and discuss in our video is the same information that some questionable ‘referal-type’ sites try to present to families as if it were secret, hard-to-find information that is only accessible to ‘experts’ with the necessary ‘connections’ to get their hands on it.

It’s not a secret, it’s not difficult, and it is free to the public to access.  Our video will show you how.

Additionally, there are those who might not be as comfortable whizzing through the internet doing research, so our video tutorial will help to walk you through these sites step-by-step to find the most valuable and pertinent information for the facilities in Iowa that you are interested in.

The sites and pages featured and discussed in our video tutorial are http://www.iowahealthcare.org/aspx/facilitysearch.aspx

 https://dia-hfd.iowa.gov/DIA_HFD/CTLEntitySearch.do

http://www.assisted-living-directory.com/content/iowa.htm

Assisted Living Directory has no relationship with the two sites featured and highlighted in this video tutorial.

For more information:

http://www.ncdhhs.gov/dhsr/acls/star/search.asp
http://www.ncala.org/find/
http://www.assisted-living-directory.com/content/north-carolina.htm

In March 2012, I asked the care advisors at Seniorliving.net to help me to find care for my mother-in-law, who lives in eastern Pennsylvania. Here is how it has gone, and the back-story:

My mother-in-law, who is 82, has been the model of health and ‘good living’ as long as I have known her.  She has lived in eastern Pennsylvania for over 50 years, and worked at the same job and company for about the same amount of time.  She finally retired last year.

This fireball of a woman was dealt a serious health blow last year, when she found out that she had advanced Uterine Cancer.   It had spread to many parts of her body, and the outlook was not great for her.   Long story short, she went to Michigan to do chemo, and all of the yucky things that go along with that, and amazingly, she looked like she was beating it!   She did so well that last summer, we invited her to join us for our family vacation at the beach to celebrate.  She was back to being her highly energetic, talkative flurry-of-activity that she had always been – the woman that we know and love was back..or so we thought.

Things were going well until the fall of 2011, when she apparently started having some extreme weakness, and swelling in her body.  My mother-in-law lives alone, in the same house that she has lived in since the dawn-of-time (her time), and so this was creating some real difficulties for her.   The weakness progressed to the point that she couldn’t lift her arms to open the blinds, or get things out of the cabinets and cupboards.

My mother-in-law is proud, and tough.  She doesn’t like to whine or complain, so she didn’t really tell anyone what was going on.   We didn’t find out the seriousness of her health until a neighbor went to check on her, and she was on her back ‘scootching’ from room-to-room…too weak to walk.

She immediately went to the hospital, where they found out that she had Dermatomyositis – which is a pretty serious autoimmune disorder.   We are not sure where this came from, but we think it may have been an unfortunate effect from the chemo.

To make matters worse for her, her weakness and swelling got to a point that she could no longer swallow (any attempt would send it down the wrong tube).   So, for the past month, she has been on a feeding tube.

She was moved from the hospital to a skilled nursing center, and we had high hopes that with time, she would slowly get better.  That has not been the case, as she has not shown any signs of improvement.

We received a call from the nursing facility asking us to start thinking about our “Plan B” to get her out of there.  Apparently, if she doesn’t make progress, insurance won’t continue to pay, and thus, she’ll need to find another place to live, and to recuperate.

So, we were quickly thrust into a scramble to find her an assisted living home that will take her.

Not an easy task, given her situation, and health.   We have learned that most assisted living facilities will not take a new resident if they are on a feeding tube.  Our options were all-of-a sudden seeming very limited and very confusing.

My wife was frazzled, and really at a breaking point with worry, and trying to figure out what to do with mom.   We considered bringing her out to where we live, but mom’s current health, and with the feeding tube, wouldn’t allow much travel.

I finally proposed that we give one of the Senior Care Advisor services on my site a try, so we contacted Seniorliving.net.   I thought, well, if they can really help us, and save us time (my wife and I both work full-time, and we have a small child, so our time and energy resources are limited), all the better.   Additionally, I’ll be able to really see what happens when families use the services on my site.   I’ve never gotten a ‘complaint” about the senior care advising and consultant services listed on my site, and have received quite a bit of good feedback, but it’s always been a little bit of a mystery as to exactly what happens.

After I contacted Seniorliving.net, I received a very prompt response from Tami, who has worked with them for quite some time.   She was never push, and was very flexible to my schedule in terms of figuring out a time to talk, and discuss the situation, and options.   I absolutely loathe pushy companies, so this was a relief to me.

We finally figured out a good time to connect via phone, and Tami asked all of the important questions about my mother-in-law.   Immediately, I knew that Tami was extremely familiar with assisted living and long-term care regulations and laws.    Once she heard that my mother-in-law was on a feeding tube, she immediately let us know that assisted living was probably not an option, since this was beyond what assisted living could offer in the 3 states we were looking in as possibilities.  Tami recommended that we look at nursing homes, and skilled nursing..

Tami took the time to ask us about my mother-in-law’s insurance and financial situation, and let us know when her Medicare would end, and that Medicaid wouldn’t kick in until the majority of her personal assets were used to pay for care (this is an unfortunate state that our national health-care system is in, in my view).  She asked if my mother-in-law has long-term-care insurance, and we believe she does (she doesn’t even know what she has, since she has just retired, and her benefits have changed – so, we have had to make trips to her house to sort through her paperwork for her, which hasn’t been easy since all of her extended family lives in other parts of the county.)

Once Tami had a handle on our situation, she told us that she would research options for us in the areas that we were looking in, and get back to us shortly.  Within a day, she had presented us with a solid list of facilities in each area that match what we need for my mother-in-law.

This saved us a huge amount of time and mental energy.  It was always great to know that Tami was available to answer questions, or do further research.   Tami has always made herself easily accessible to us, and she has taken the initiative to check in with us periodically as we are touring the facilities that she sent us.  Never once has it been overbearing or obnoxious, and there has never been a sense of trying to ‘sell us’ anything.   Our best interests, I believe, have always been in Tami’s, and Seniorliving.net’s own interests.

At this point, we have not decided on a facility for mom.   We are still in the touring process, and still monitoring her health to see what type of move she can handle.

The bottom line is that we aren’t alone during this process.  We have a truly knowledgeable and caring expert at our side, and to us, that has been worth it’s ‘weight’ in Gold.

I’ll post further updates as we move forward.

Although many facilities are able to maintain a low number of deficiencies and violations from year-to-year, others may be repeat offenders, and at times, the violations may be severe (threatening to the safety and well-being of it’s residents). Facilities may eventually be shut down if they are not able to remedy the issues within their facilities.

We’ve put together this short video tutorial to show you how to look up this information about Florida facilities (which includes assisted living, adult family care, hospice, skilled nursing, and other long-term care options).

We’ve found that most families do not realize that this information is readily available (for free) on the FloridaHealthFinder website.  They also have a very user-friendly, interactive county map for facilities that gives a more visual experience when searching for facilities in Florida.

In addition, this video, and FloridaHealthFinder will show you how to search for care options by county, city, or facility type or license number. This may be especially helpful to families or caregivers looking for care in many of Florida’s smaller towns or rural areas.

We hope this video tutorial, and information is helpful for your research into the Florida assisted living & long-term care facilities that you are interested in, or are in the process of researching!

1)  Q: Please tell us about Providence Place assisted living, where your business is located, and how long you have been in the senior care industry (perhaps in terms of the “History” of Providence Place.)

Providence Place is an assisted living facility located in the city of Woodward, which is situated in the heart of northwest Oklahoma.  We are a free-standing, locally owned and operated, not for profit facility and are relatively new, having opened in September 2007.  The operation of Providence Place is under the direction of a local foundation and board with a wealth of experience in providing for the health care needs of the region, however, having previously operated the local hospital for many years.  Upon the transfer of the hospital operation, the foundation turned their attention to identifying and meeting other health care needs in the area.

Assisted living was quickly identified as a level of service that was absent, which forced local residents to move to larger cities for needed services, leaving behind the community and friends of a lifetime.  The need for assisted living services was met with the construction of a beautiful facility with 32 private apartments and spacious dining and commons areas.  Our residents receive three meals per day, all utilities except telephone service and weekly housekeeping and linen services, as well as scheduled activities and local transportation.  As needed, residents also receive assistance with medication administration and personal care.   Resident safety is a high priority, as well, safeguarded by such features as in-room and personal resident assistance call devices, fire alarm and sprinkler systems, security cameras and a safe room storm shelter.  Providence Place offers an independent, active lifestyle within a secure, caring community.

We often hear from families that the lack of adequate assisted living or senior care in smaller towns or rural areas can present a real challenge, and often times results in ‘shipping’ or exporting a family member out-of-town or state to a larger city.  I am happy that Woodward Place has helped it’s residents stay local! – ALD

2)  Q: Providence Place is located in Woodward, which is a relatively small town.   Have you found that there are challenges with operating in a smaller town (i.e. filling beds, marketing, or access to activities or things to do for your residents), as opposed to operating in a bigger city?
Woodward is a small city of approximately 15,000 but, as the hub of northwest Oklahoma business and activity, draws from a larger population of 75-100,000.  Any challenges which this relatively smaller population base may present in terms of occupancy is more than outweighed by the advantages presented by our location within a close-knit, caring community.  Generally a new resident at Providence Place finds they are in the company of lifelong friends and acquaintances among other residents and staff members.

Planning for activities in a smaller, rural community does require a great deal of creativity, for more reasons than the availability of fewer ready-made entertainment venues.  Many of our residents have farmed all their lives, working from before sun-up until after sundown, with little time to develop hobbies and other interests to pursue in retirement.  Fortunately, we have been blessed with a wealth of community volunteers who share their time and talents with our residents as part of our schedule of activities.

Volunteers must be crucial to your business, especially being a not-for-profit.   I imagine it is just as rewarding for the volunteers to be actively involved with their community! – ALD
3) Providence place, as you have mentioned,  is non-profit.   What, in your opinion, are some of the benefits, or advantages of operating a non-profit facility, and perhaps challenges, if any – as opposed to a facility that is for-profit?

Operating a not-for-profit facility does not mean that we don’t operate in a fiscally sound and responsible manner, as do all organizations which intend to remain in business and provide quality services.  We do have the advantage of being able to receive charitable contributions and are potentially eligible for certain grants and other funding sources not available to for-profit entities.  There are certain revenue sources which are closed to us, however, and we sometimes have to counteract the mistaken assumption that, because we are not-for-profit, we somehow don’t have to have funds in order to continue operating.

Overall, the benefits of operating a not-for-profit assisted living community greatly outweigh any slight disadvantages.  One of the most important benefits of operating in a not-for-profit environment, I believe, is the opportunity we have to work with a foundation and board of trustees composed of local members who are passionate in their dedication to this community and region.  Their commitment leads them to freely volunteer their time and talents toward assuring the success of Providence Place, which is an invaluable asset to us.
4) Your facility is smoke and pet-free.    Some facilities pride themselves on allowing pets, and even go as far as promoting ‘pet therapy.’   On the other hand, I am sure that many people would appreciate having a 100% smoke and pet-free option for senior care.   Do you feel that being smoke and pet-free has been beneficial and well received with your residents?

By keeping our premises smoke free, we believe we are providing the healthiest environment possible for our residents and staff members.  In addition to the long term health consequences to the smoker, some of our residents have conditions which would be adversely affected just by the presence of cigarette smoke within the building.   We’ve actually had very few residents for which our smoke free policy has presented any difficulty and have even had a few for which the policy has given them the incentive to follow through on a long-standing resolve to stop smoking.

Our pet free policy is an outgrowth of our commitment to providing the highest quality services to our residents.  Unfortunately, it is sometimes the case that residents in assisted living are unable to provide for all of the care needed by their pets.  Rather than have staff members’ time divided between care of our residents and of their pets, we prefer that they focus their time exclusively on the needs of our residents.  We do not, at this time, provide pet therapy but would not rule out the possibility of adding it at some time in the future if the our residents’ needs and desires dictated.

5)  I noticed that you promote ‘Personalized individual care as residents’ needs change.’  Does this mean the same thing as ‘aging in place?’ 

Many of our residents move to Providence Place needing nothing much more than a secure environment and the companionship of other active seniors.  They also benefit from good, home-style food and are relieved from household chores and home maintenance duties.  As time progresses, they may need more assistance, however, often times beginning with help in taking their medications accurately.  Some may need assistance with bathing or dressing or other personal needs, at some point, or may simply need reminders for daily activities or safety checks to verify their well being.  At Providence Place we can provide all these services as they are needed, while supporting and encouraging our residents’ continued independence.

True ‘aging in place,’ which is generally accepted to mean remaining in one location through end of life, is not always possible at Providence Place as we do not provide skilled nursing services.  In some instances, coordinating with a resident’s family and other providers, we are able to help a resident remain in their home here through a terminal condition.  Our residents’ comfort and safety are our primary concern, however, so we routinely monitor our residents’ needs.  At any time we feel we cannot safely and effectively provide nursing or other services a resident will need for a prolonged period of time, we work with the resident and family to help them locate an appropriate setting in which all their needs will be met.

6) Debra, what is one of the most significant or important things that you have learned about operating an assisted living facility in your time being an administrator of Providence Place?

With my time spent in daily contact with residents at Providence Place, I am even more convinced that the greatest needs for our senior adults are no different than for any of us, no matter what our age.  We all need good food, a safe environment, the companionship of friends and family and something to look forward to each day, whether that is a job, an organized activity or simply knowing we will have someone to talk to throughout the day.  We usually enjoy all these benefits as we go through much of our life and spend each day working and raising our family.  Unfortunately, as we age, the ability to meet these basic needs can be lost due to issues such as the death of a spouse and friends, distance from other family members and loss of physical mobility.  Poor nutrition, isolation and depression can be just as debilitating as any other disease or condition.

Assisted living is uniquely designed to help senior adults replace that sense of security and of belonging to a community of family and friends they may have lost.  Without downplaying the value of providing adequate nutrition, accurate medication administration and assistance with activities of daily living, I sometimes feel that the most important thing we are providing our residents is the sense of belonging to a big, happy, active family again.  I certainly feel that my job as administrator of Providence Place supplies me with these same benefits.

Debra, thank you for taking the time to share your wonderful experience, insights, and expertise with me.   I am sure your knowledge will be extremely helpful to anyone considering assisted living in Woodward – or anyone who is wanting to learn more about what assisted living is, and can offer!