Assisted Living Facilities have been showing up on every corner over the past few years. They are a great alternative for people who can’t keep up their own house but don’t need to be in a nursing home. Most are very nice and allow their residents much more freedom and privacy than nursing homes. Hospice sees patients in both facilities.
If you have read this blog much at all, you know that the relationship between hospices and nursing homes is, shall we say, strained. This is not true in Assisted Living Facilities, but that doesn’t mean there isn’t a problem.
If you have been approached by your Assisted Living Facility about hospice care, the discussion probably included the phrase, “hospice can help you stay here longer.” Which is often a thinly veiled threat that, if you don’t accept this help, you will be forced to move to a nursing home. I’m not here to talk about the ethics of that threat. I assume we are all smart enough to see the problems there. I want to talk about the assumption that hospice really can help you live safely at the Assisted Living Facility.
To a point, hospice can help you remain in your ALF apartment as your disease progresses. Unfortunately, many ALFs seem to think that hospice can help you stay there no matter what. That’s just not true. There is a time when a nursing home is a better choice. None of us want to admit that time has come, but there is a limit to the amount of care an ALF can give even with hospice involved.
Here’s the rub. Most hospices are shy about telling you that it is time to move out of the Assisted Living Facility because the facility is the one that referred you to them in the first place. The ALF is referring you and probably a few others in the building to the hospice as an effort to keep their apartments full. A hospice that starts encouraging patients to vacate their apartment will be a hospice that stops getting referrals from that facility. It is a very hard spot for hospices. Again, I’m not here to discuss the ethics of this situation because they are probably clear to everyone. (Patient safety is priority number one. Right?)
All I’m doing here is trying to let you, the patient/family, know that neither your Assisted Living Facility or your hospice is a good unbiased judge of when you are no longer safe to live in assisted living. You have to make the call on your own. The reality probably is that if you are asking the question, you know the answer. Nobody wants to live in a nursing home, but sometimes it is the best/safest place you could be.