Serving our Clients with Compassion and Dignity.


About Adult Care Homes

Most seniors strive to stay in their own home for as long as they can. This can become difficult or unsafe though, for a variety of reasons. When this occurs, adult care homes are a wonderful option to consider. Written here is a brief overview of this care setting as well as basic guidelines to help you select one if needed.Adult care homes are licensed care settings in a residential neighborhood They provide a homelike setting while at the same time providing for the care needs of the residents. These settings are required to meet a multitude of regulatory standards and are inspected annually to assure compliance. The owners, providers, and care givers have training and experience requirements as well. Inspection reports and any complaint history are designated as Public Disclosure Records and are available for your review at any homes affiliated County office.
 

In adult care homes the services and care are provided in the course of day to day routines and activities. This homelike atmosphere provides a family-style quality of life. It is a safe and secure setting while at the same time an affordable setting.


Adult care homes are identified as Class or Level 1, 2 or 3 homes. Some homes are able to provide very complex care. And some are specialized homes such as ventilator homes. The license ( which is posted in a conspicuous public place in the home ) designates what Level the home is. The higher the Level for the home, the more experienced the care giver requirements are and the more challenging the care needs are that the home is able to meet.


There are basic services offered in adult care homes which include nutritious meals, medication assistance, socialization and activities, assistance with bathing, dressing, toileting and mobility. Each resident has a plan of care which is developed and updated by the provider to reflect his current abilities, care needs and services. The family and care givers may have input into this but the resident’s choices and rights remain first and foremost.


Before visiting any adult care homes it is important to sit down and take a good honest look at what the “needs” and “wants” are. Only from that honest viewpoint can you begin to find what you are looking for. Be sure you also consider the location of the home ( for relatively easy access by those who really will visit.) Consider too the monthly costs. At this writing most adult care homes in this Tri-County area have base rates around $2300 per month. This varies a bit though from home to home. Most homes also have a list of additional services that generate additional costs beyond the base rate. An example would be urinary incontinence care which might carry an additional monthly cost of $150. A typical price range for someone moving into foster care is between $2300 and $3000 but again , the rate varies depending on the specific care needs of your loved one.


You will be signing a contract with the home that you choose. Be sure you read it carefully and understand it. One of the most commonly overlooked and/or misunderstood parts of a standard adult care home contract is regarding terminating the agreement. This issue comes up for example if a resident has such a significant change in medical condition that he needs licensed nurse care around the clock in a nursing facility, or, when the resident dies. Both of these unfortunate situations do occur sometimes. A typical contract will require 30 days written notice for a planned move and it will also require a 15 day paid period following a move one cannot plan such as again, a significant change in medical condition or death. These are standard arrangements in adult care homes, Residential Care facilities, Assisted Living facilities and also in apartments in the general community. Please do not be personally offended or angry with the provider for following a standard business contract.


If finances are of concern and you’re just not sure whether there are adequate funds to meet the monthly expenses, we suggest you consult with the Medicaid office in the County that the resident lives in. There have been numerous changes in this complex program, so be sure to consult with these experts. They will have the answers you need. The following County phone numbers are to front desk phones and you will be forwarded on to the appropriate person.


Clackamas County: 503-655-8640
Multnomah County: 503-988-3646
Washington County: 503-640-3489


Most people residing in long-term healthcare settings outlive their personal funds. Be sure to talk with any home you are considering about how things would go if that happened for your loved one. Do they currently carry a Medicaid contract or would they obtain one at the point of need for your relative? Or would your relative be asked to relocate? These are important questions, and answers, in your decision making.


In Oregon there is a Resident’s Bill of Rights that outlines and affirms that a persons rights continue even if one is in a healthcare setting. You will receive a copy of these Rights at the time of admission. You will also receive other information and forms including a copy of the “ House Rules”. These address topics such as meal times, pets, smoking, visiting hours and the like. Fire and Evacuation drills will also be discussed. These drills and the residents participation are required monthly in all healthcare settings in Oregon. You will also receive information about the Oregon Ombudsman program, a program dedicated to protecting the rights of all healthcare setting residents. You will see a poster about this on the public postings board in each home identifying the assigned Ombudsman and their phone number. Weekly menus and other informative materials will also be posted there.


You will need to determine what Level of care and Level of home your loved one needs. This is done by determining exactly what his care needs are and the extent of assistance he needs in the six main categories of Activities of Daily Living.


The six categories/activities of daily living (commonly known as ADL’s) are:


Nutrition/Diet/Eating
Dressing/Undressing
Personal hygiene/Grooming
Toileting Mobility/Transfers
Cognitive/Behavior Management


The ability to perform the ADL is evaluated by these guidelines/definitions:


Independent = Doesn’t require the help of another person to do any part the task. Assistance = Requires the help of another person to do part of the task. Dependent = Requires the help of another person to do all parts of the task.


To determine which level of home/care is needed, go through the 6 ADL’s listed above and determine for each one the amount of assistance needed. Now total those up. (There are additional details that may influence the home level needed such as RN task delegation, medication administration routes, etc. but these are too detailed to list here. This guideline is generally quite accurate.)


Level 1: The resident may need assistance in up to 4 ADL’s
Level 2: The resident may need assistance in all ADL’s The resident may be dependent in up to 3 ADL’s
Level 3: The resident may be dependent in 4 or more ADL’s


Now that you know the level of home needed, it’s time to put your search plan together. Start by looking at the enclosed list of homes in the area of your interest Make a photocopy of that page and turn it into a worksheet. Next begin calling the homes you’ve identified by location. Ask if there is a vacancy. If there is, move on to your specific questions (see also our list of suggested questions). The provider will have questions of you as well, including the care need information. When you have finished your conversation, decide if this home and provider appeals enough to you to go visit. If so, set an appointment to do just that. When that visit is done, you will almost always have a distinct feeling (and usually within about five minutes or so of your arrival at the home) as to how suitable that home will be.


We recommend you continue this process until you have connected with three (or four) homes that you would consider placement in. At this point, contact the affiliated County office and go inspect the Public Disclosure Records for those specific homes. Eliminate any unsatisfactory homes. What you have now are some very good options to consider. To make your final decision, we recommend you do an unannounced drop-in visit as your second and perhaps even third visit to any home/s you are considering placement in. (Please avoid mealtimes though as a courtesy to all as that would be quite disruptive. Most homes have the typical mealtimes of 8AM, 12 Noon and 5PM.) This is also a good time to take someone with you who might have wanted input, objectivity, and/or interest.


When you have completed these above steps, you have narrowed the options down to one or two that are extremely likely to be a successful setting for your loved one. If at all possible, allow your loved one to be a part of this final decision making.


Once the decision is made, begin the actual arrangements for placement. The provider will have forms for both you and the physician to complete.


They will also require a pro-rated payment from the date of move in to the end of the month. (From then on payments are due on the first of the month.) If there is a Power of Attorney, Living Will or other important legal document, the provider will want a copy of it for the chart. You may begin moving personal and furniture items in on an agreed upon date. It is best for everyone if this is done prior to his arrival.


Adjusting to changes in his health, home and life are challenging adjustments to make. The first few weeks can be difficult so we recommend you keep as much familiar for your loved one as you can. Also, visit by phone or in person frequently. Be supportive and a good listener. This is a time of grieving so your love and support are critical to the transition. If there are angry or harsh words directed at you, please know that can be a part of grieving and again, be loving and supportive. If there is problem solving to do, help with that—this is a new page in his life and it will have a few wrinkles at first. If you can go for drives or out for a meal together, do so. Even a drive up window milkshake can be very enjoyable. (The care giver can help him in and out of your car as needed). You will find this is a time of mixed feelings and change for both of you. Nurture yourselves. This will truly ease as you work at continuing to enjoy your time together.


We hope you have found this information helpful.. If you have further questions though or just need to talk something through, please feel free to contact us at All About Seniors, Inc. / 503-659-3815.