How does Shoreline assisted-living differ from an Adult Family Home with respect to dementia, Alzheimer's, memory care and other conditions?

Assisted living is not as rigorous a category of business that an Adult Family Home is. Assisted living can be quite a number of levels – from basic domestic services – to extreme, 24-7 caregiving for a resident. Adult Family Homes, on the other hand, have some specific requirements that make it easier for everyone to understand how good a fit a Adult Family Home would be for their loved one. Before even visiting your first prospective Adult Family Home, you can have an excellent idea of just what to expect, because the laws – at least in Washington State – are pretty specific about what an Adult Family Home can and cannot, must and must not, offer within the walls of any one residence. Here are some of the most important factors, including what can be said of what is called ‘memory care’, the whole range of dementia conditions that need a special kind of attention.

Memory care in an Adult Family Home

Most Adult Family Homes in the State of Washington seek to have retired nurses as their preferred background of caregivers working for them, and that’s pretty easy to understand. A few decades of experience in the intense job of nursing in, for example, a hospital would make a retired nurse, if anything, overqualified to work in an Adult Family Home. She might even be bored with the work, although entering into retirement would make it a great transition.

Most Adult Family Homes know that, because of the nature of their ‘market’, many of their residents can be expected to have potential memory challenges. Even in my fifties, I feel I have become somewhat forgetful. I expect to be far more so in a few decades, if I reach that age. Memory care is an essential ingredient here because it’s also a question of safety as well as comfort. Safety, because if you wake up in the middle of the night and forget completely where you are, the caregiver will need to know there is a problem, and having an intimate knowledge of the resident means being able to respond in a way unique to that resident. Comfort, because each resident – and their loved ones who placed them in the home – can know that there is more of a ‘family’ environment rather than a simple ‘place to live’. Both security and comfort combined give the resident a better life, a longer life, and a happier one.

A limit on the number of residents at an Adult Family Home

There is no low limit to the number of residents in a nursing home. I know, my own father lived in one for about two years, and there were hundreds of others living there, too. It took over a year for him to feel like they really knew who he was, as the staff changed regularly, there were about fifty caregivers, any one of which could be looking after him. With type I diabetes, he felt he was constantly explaining to a new person what his unique health issues were. So, nursing homes, while perhaps being more affordable, come with their own challenges.

An Adult Family Home in Washington State may have a maximum number of residents in any one dwelling. Why would they put such a limit on number of residents, you might ask! Well, that number ensures that any one resident can achieve a deeper connection with a much smaller number of caregivers which, in itself, makes each resident more comfortable. What’s more, the caregivers themselves have but a handful of residents to get to know. It would not take long for each caregiver to get to know each resident intimately. Let’s say there is a crisis at three AM, and the (retired nurse, remember) rushes to the side of a resident in need. Without having to look up the ailing resident’s health paperwork, she will already know this, and in particular, what medications the resident is on, and will therefore be able to make a good decision quickly. So, the limit on the number of residents, although considered onerous by some managers of Adult Family Homes, works to their benefit, too, because with only six residents, there is a lot of services that are more practicable which otherwise would not be.

Food flexibility at an Adult Family Home

In the typical nursing home, with hundreds of residents potentially, it’s harder to offer every single resident exactly what they would like to eat every day of the year. There are simply too many people to take care of. Some food flexibility is available in a nursing home because of the number, however. It can prepare a number of different meals at each mealtime, knowing that the variety itself would be enough to most residents. In an Adult Family Home, however, the small number of residents means the food preparers could, if they wanted to, offer a supremely flexible food plan to each resident. Gluten free is a bit challenging if you are trying to provide 100% gluten free, but organic – or mostly organic – is relatively easy, especially today where there is a growing availability of farmer’s markets, clearly marked organic produce in almost every city in the country.

Memory care is also about relationships

Just before a family visit to an Adult Family Home I once visited myself, I noticed one caregiver reminding a resident of the names of his grandchildren who were about to visit. Remembering names is one of the toughest challenges of seniors suffering from memory loss, and that personal connection with a small number of caregivers truly is a big deal for such a resident.

More next week!