Are all assisted living facilities depressing or is it just my perspective?

When I visited facilities for my 97 yr old mother who needed assisted living, I first checked out the ones with IL, AL, and memory care combined. I loved the first one, it was like a three story resort, with a bar and nightly entertainment, pool, gym, large fancy dining room with gourmet meals, etc. They even had 9 ambassadors who help the new resident feel welcome (I've earmarked that one for myself down the road, LOL). The residents (mostly on the Independent level) seemed happy and active. However, for my mother who isn't into fancy, and is not a people person, I chose an AL one with only 65 residents and hardly any of the amenities of the resort. I could picture my mother who is still mentally sound with some memory issues being so confused trying to navigate the large facility, being overwhelmed by the menu, unable to participate in the exercise activities, and operating the elevator, etc.

Where she's at now is somewhat depressing. And she hasn't made much of an effort to join in and make friends (with the exception of bingo and meals). She calls them "those old strangers". She isn't happy there. So, did I make a bad decision? I don't think so. She has never been happy. She's sweet and I love her with all my heart, but this is where she belongs.

She'll be 98 next week. When I asked what she wanted for her birthday, she said, "A home and a husband." I'm afraid that's a request I can't fulfill. Funny thing though, when she had a home and a loving husband four years ago, she just wanted to die.

Keep looking. Finding the right place for a loved one is not simple. I found one for Mother, and fell in love with it immediately. Set up meetings with the right people, watch how the staff there interacts with the residents, and interview them during the process.

There are services out there that will help you find a place (AgingCare has told me I cannot list the one I used directly), they are out there. Search the internet.

And yes, if you choose to see it that way, Assisted Living can be viewed as "God's waiting room". However the right one can be really a blessing for your loved one. Ours was for Mother, and they had her involved right away, even though she said No at first. The important thing here is keeping our loved ones involved and around others like themselves. Isolation is a real problem for our elderly. Good luck the right place is out there waiting for your Dad.

They're all depressing, some try to cover it up better then others.

I live not far from one, EMSis there often, and the talk from some who live there and take public transit are those that have died or those trying to move out while still alive.

Thanks for all the input, everybody. Some good advice/suggestions/reminders. You all are the best! I visited another place yesterday that had a bar for happy hour! :) Actually this one was nice, but may still be out of the question. I'll see what the attorney has to say.

In the meantime, there was an opinion piece in the New York Times this past week, "How Not to Grow Old in America," which I found to be an interesting read:

https://www.nytimes.com/2019/08/29/opinion/sunday/dementia-assisted-living.html

Thanks again.

It's easy to think of AL/NHs as a waiting room people live in to die. Because, honestly, is that what they are? That doesn't make AL or nursing homes bad. I'm grateful that elders have a place that (hopefully) takes good care of them in their final years/months. (I know, there are horrible ones, which are an abomination to the human race.)

I had a dear family friend, the sweetest woman. When she was quite elderly, she lived alone in a tiny, barely heated old house. She only had one friend, my mom. She had severe scoliosis and could barely walk. There's no telling how or what she got to eat. It was heartbreaking to see her live that way. Finally, her daughter moved her to a nursing home.

My sister and I went to visit her, with my sister barely managing to hold herself together to see our friend in a nursing home. I admit I hated to see her in the *cue spooky music* nursing home. But then I noticed she'd gained weight, had good color in her face, had good food to eat, had a warm room and a comfortable bed, and people around to support this bright, sweet woman. She's gone now, but at least in the end she didn't die alone.

Yeah, not all AL/nursing homes are quality, but sometimes being in a facility is so much better than the alternative.

I live in assisted living because due to a spinal injury I can't walk but I hate it even though this one is considered as being one of the best. I think they do all they can to make it appear pleasant and like home but for me it is hell. The people are all very old, feeble and most have dementia so it is impossible to make intelligent, inspiring, motivating interesting friends. The activities are for people of grammar school age. There are tons of rules and regulations (I ignore most as they are ridiculous). The food is overcooked and awful. For some people, living like this is pure bliss. For someone like me, nearly 86, with a photographic mind, still driving and going out to eat alone, working two jobs I love (50 years and l4 years), just finished six years of college, writing a book, going swimming, and always seeking new goals and new adventures and other excitement, I am a fish out of water. I have my pussy cat living with me which helps, and my car, but otherwise I can't stand being here but where would I go? The staff people are nice and I am friends with them but they are not allowed to socialize. So I stay to myself and do all kinds of things to enrich my life but that is only me - probably the only person here like that.

You are right, some ALs are downright miserable!!! I don't know how they can stay open. But there are definitely some that are wonderful, bright, active, happy places! My dad was in one of these and had to move out into a residential care facility and begs me to go back to the AL! He really loved it there and blossomed socially. Keep looking, every facility has it's own personality.

Hi S...

Wow, you bring up a very important point! I remember almost twenty years ago when my dear aunt, older sister of my mom, was having difficulty living in her own apartment alone. I reminded her of the option to have someone come stay with her at night as that was her difficult time and she had a two bedroom apartment she had lived in for years alone. She wanted no part of that. After a few bouts with needing the fire department to come help her get up as she was falling, one time she ended up in the hospital and then needed to go to a rehab place.

I remember that day touring the local rehap place, nursing home, you name it place. It was TERRIBLE! We were there on Father's Day, believe it or not. My special needs daughter still quite young, was along. I remember my horror when I saw a young person on a gurny getting his weekly bath there. I could not imagine my daughter nor my dear aunt having to be there and told my mom that it was a terrible place I wouldn't wish on anyone but my worst enemy if even them!

So I was on a mission to find a better place for my aunt and found a local assisted living facility. I viewed it and it seemed pretty nice to me. Well, after getting my aunt in there, she didn't like it and wanted to be back in her own apartment. Since I had my daughter and husband, I could not volunteer to stay with her in her beloved apartment and no other family volunteered to do so either as perhaps they could not realistically do that either. Not happily, my aunt moved to the nice local assisted living facility. As I recall, my daughter was in kindergarten or first grade. We would always go visit my aunt on Sunday late in the afternoon. But my aunt was not happy with us. She wanted us to come earlier and better yet, take her out of there. My aunt was not married and had no children although she was an excellent school teacher for many many years.

There really was not a good solution to help my beloved aunt. At the time, my husband had lost his job and I had just found a full time job myself to help us get by difficult times. So I was in no means to have my beloved aunt come live in our home. My husband reminded me that if she was falling where she had lived for about thirty years, she was bound to fall in our home if unassisted alone and we were not prepared to have that happen. I suppose he was correct although at the time I felt bady saying the nice assisted living place near us was much better of her options.

My dear aunt moved there and didn't like it at all, but for all including herself, it was the very best place for her. Yes, it was costly. Yes, she resented being there. But it allowed her to have a few more decent years in my opinion. Now my own mom talks about going there. Unfortunately, she is much worse off than how my aunt ever was so if she could even go there, it would be on the not so pretty bottom floor I visited once. I doubt anyone would desire to be there and my aunt never ended up down there.

I have no real answers on a good situation for our loved ones. It is difficult to deal with changes for all of us. What I have learned is that when I cannot live here in my home and my daughter and husband are not able to help me do that either, we all might need to move there. Knowing what I know now, I do not think it will seem like such a bad place to me like it was to my aunt. I can only wish for that and for all of us here to make the most of what we have each day.

One more point that I thought of. My son in law' s late grandmother lived to 99 years of age! She lived in her later years at a lovely AL. She loved the place so much that one particular time her family was due to come to take her out to dinner. She told them "Don't come today because I don't want to miss the big party at the AL today." THAT IS HOW MUCH DEDE LOVED THE ASSISTED LIVING! I saw this lovely Assisted Living myself, personally taking a tour of it and seeing how happy Dede was there. I can attest to the fact that it was beautiful!

My oh my, you hit the nail on the head! I’ve been to several. Never liked what I seen going on. I’ve seen heartbreaking things. They are understaffed, untrained and uncaring!!!! Oh yes I know there are one or two thrown in that do care. But they can’t do it all.. I’ve been there at all different times, all night, all day. Had to remind the staff that hey my father is here and you haven’t checked him for 3 1/2 hours now... As she puts her phone away!!!
But everyone of the places were shameful. My father was in a so called Dementia Care facility. Some of the staff never heard of dementia let alone be trained. And he paid out pocket for his little awful, depressing room!!!!
Just wanted to add that I would never Have placed him there. Wanted to keep him in his home and take care of him. My sister had POA. Put him there while I was at work. Then threw the key away. Sorry to say he fell three times that I know. Broke his neck in three places, told them but no incident report was done. Had surgery and died in that horrid place. Begged to take him home and she said No.
Prayers and blessings to you in your decisions.

My ex is in an AL facility in Omak WA. It is great. He has been there over 3 years. His money gave out at about 2.5 years. Because he had been private pay for 2 years he keeps his room. I like the place. My late Aunt in Dallas TX. was in a great place too. I would call her and she would say "Can I call you back? We are playing poker, bingo, etc. Both places smell good, the decor is better than my house. They have/had the equivalent of a studio apt. Both places have alcoves with books and jigsaw puzzles.

No, they are not. They are what a person makes of them.

What makes it "depressing" is that you know this is the last stop for your loved one, and there are a lot of emotions involved. Some residents are more with it than others. I visited 13 facilities in a three-county area and some have a better vibe than others. I went with my gut and narrowed it down to two. Not sure how, but mom qualified for AL, which was more like a hotel. My mom had significant physical problems along with advanced dementia, so she was unable to take advantage of the many activities offered. She ended up in the attached SNF within 5 months. I have to admit, it was tough to visit her in either place. Now that she's gone, however, I am proud of the thorough research I conducted and the facility I selected. It's just one of the parts of life you suffer through and do the best you can.

Well....my mom is now in her FOURTH one since I got her, and I have found that some of the reasons I have had to change her out is not her fault.  Some of them are.  She is a manipulator.  I told her on this last none that if it went South, it was on HER because she chose it.  She has been there all of 6 weeks now, and she hates it.  Sorry!

There are many independent living facilities that allow the occupant to have someone come in and provide help with bathing, dressing or medications. My husband, who had vascular dementia, and I lived in one such facility until he died of stroke. They also had, for a fee, physical therapy. The van that took people to various activities--movies, lunch out, concerts, etc., had wheelchair access. The reason we were there was that I wanted to be able to travel and know that he would not starve--but I enjoyed the facility and the people that I didn't move out for 3 years after he died--and then only because of the cost. I still visit during Happy Hour several times a year and may go back once I have seen all of the world I want to see.

It's always a Difficult Decision. I'm a physician myself. I'm Late Middle-age and Single. (Guess I'm a Cynical Grouch.) I have no siblings, either. When my Late Father begged me to move back here to care for him, I did so. But, then-I sort of bulldozed him into going into AL-after almost two years of caregiving. He was Frail-but walking and talking (he did have falls.) Actually-it was a floor of AL with more care (a little like a NH.) He went willingly so I could Get a Life. I visited him every day-our house isn't too far away. I let Hospice in the picture towards the End, because I needed to for him to have bedrails (considered restraint.) He lasted about two months from when he went in-and, it wasn't Cheap. With Hospice, they can't normally go to he Hospital. Wish I'd cancelled it when he got sick. I guess I could have just hired a full-time caregiver here at home. It's been several years, and I feel Guilty and Alone. My Mother, BTW, Died of Cancer in her Fifties, many years ago.

Oh boy. I understand completely. My dad worked for the Chrysler Missile division of NASA. He had grown weak because of COPD. He needed help with meals and in the shower. I'm his daughter and he refused to let me help. I understand. I would feel terribly embarrassed if my son had to help. But to answer your question, yes. I hated him being there. He had no deminta. He read the paper every day. He knew every person in the presidential cabinet. He had no one to talk to till I got there. My dad was a WWII vet. This is best they have to offer those of the greatest generation. I wish I had an answer. We need to do better.

Have you asked your Dad to be a part of choosing an A.L.F? He may do better in a small family facility instead of a large one. There are waiting lists for many of the good facilities. ( I've worked in the activities dept. in several facilities. They usually have a variety of activities at various levels of skill offered for anyone who wishes to attend. No one can force your Dad to join any game or activity. Fyi there are memory care groups for those with Alzheimer's, Dementia, Developmental disabilities or stroke victims. They are not playing silly baby games, but are actually participating in therapeutic activities geared for them. Most facilities offer fun outings for more active residents. I used to take them to casinos, lake cruises, plays, restaurants, concerts, farmers markets, shopping, and much more.) If your dad is an introvert he can say no to anything he doesn't want to do. He has legal rights to choose what he wants to do.)

If the OPs dad is NJ too then AL is probably not an option because AL there is self pay. For 2 years if I recall correctly. But maybe moving to NY would help?

Continued from last post:

Check out https://dailycaring.com/senior-housing-options-overview/ for the various options in "senior" living.

The ones you say are "...way out of budget. $135K entrance fee; $8K/month..." are 'Continuing Care Retirement Community' residences. The AL places mom used to check out in her area were mostly this type. I often wondered why the big up front cost when none of it is used for the huge monthly fee! I still don't know what they do with that money, but would NEVER consider one of them. Sure, they plan to keep you to the end (no need to move facility when moving to MC and/or NH), but still!!! Many ALs has a MC wing, so that eliminates moving to a new facility.

Regular AL should not have that kind of fee, just a monthly fee. They may require a deposit, it varies from one place to another. The costs vary as do the services included. We looked into 3 places. One was a no go from the first viewing. The first place we looked at was newly opened and nice, but quite a bit more expensive and farther for me to travel to (close to YB's place, but he is/was working still and I handle/manage most everything, so between cost and convenience for me, I was not in favor of that place.) The place we decided on is about 10-15 minutes for me and after 2.5+ years is STILL less per month (~8K) than that first place was (that also was the cost of a shared space at that time, likely more $ now, 2 BR with shared bath, no way mom would like that!) The place we selected wasn't even open yet (old facility was torn down and rebuilt), so we couldn't "view" it, but we're happy with the place. OB is in the south and looked at a place there (ours is non-profit, his was for profit) and he questioned why so expensive here when his was only 3k/m for MC. I looked into it - that was the base price only and everything else was ala carte (meals, laundry, cleaning, etc.), plus the reviews I read were pretty negative.

Being in NJ, I suspect your AL costs will be a bit more than here in the NE (one web site shows it to be about $400/m more.) Some people prefer the Residential Care Homes, smaller home-like places which they say are sometimes less expensive than traditional ALs. I suspect facilities that have IL, AL and MC are subsidized a bit by having the levels of care in one place. VA facilities may be more like NHs, thus maybe not so homey or hotel-like, but should be less expensive.

If his income is limited and he has no assets, is it possible for him to qualify for Medicaid and have in-home services instead of moving (I have read this is an option, staying in the home and getting care rather than going to a Medicaid facility.) Is he a renter or does he own his own place? If he owns a home and can sell it, the proceeds can be used to private pay until the funds are used up, then he might qualify for Medicaid (choose the place wisely then, so to make the transition easier.)

If it has to be a facility, I would choose between AL and Residential Care home.

Check this site:

https://www.assistedlivingfacilities.org/directory/nj/

This page shows average cost of AL for the surrounding states.

I plugged in zip for your location, selected "Standard" and Continue. While this brings you to a page to request help, don't enter anything! Below that is a link to show you the facilities. Click that link and it lists 100 places within 12 miles. I would start by checking the web sites and calling before visiting 100 places! Eliminate those that are too expensive right away! Find the ones he might be able to afford and check the website carefully. Take notes, call and ask many questions, THEN narrow it down and visit some of the places.

PS - Even before checking/clicking the places listed, they each have a list of services - those in green are available and I see some Medicaid ones.
PPS It appears this site is geared to helping you find a place - I wouldn't enter any info into the panels offered, just check what is offered, check the places.

SZHNJ1023;

Start with alleviating some of your stress/running around. You say "Now I pitch in with shopping, bill paying, running errands, but it's difficult as he does not live around the corner from me..." While working, this will take a toll on you!

* Have his bills sent to you (or a PO Box.) Most places will change billing address without providing any kind of POA. They don't care where the bills go, so long as they get paid!
* Hopefully you have POA so you can access his assets. Technically if you are using his SS (only source of income) you should apply to be his rep payee. It requires making an appointment with a local SS office and filing and reporting yearly how the funds are used (no charge to do this and funds are used only for his benefit.) Once approved, they send the first payment as a check to you - you will need to set up a special rep payee account for that which only you can access and then can request electronic deposits. From there, you can set up all the accounts to be paid and when the bills arrive, schedule payments from the bill payer system. This is nice because you only have to set them up once and then just schedule payments - no more running to PO for stamps!
* For shopping and errands, try to consolidate them as best you can. There will always be times when an additional trip out is needed, but if you plan ahead, it saves time and gas money! I do this for myself, whenever possible.

The simple answer to your primary question is no, they are not all the same. There are those for profit, non-profit, VA, etc. Accommodations and services as well as cost and the residents can vary considerably and certainly will from one area of the country to another, sometimes even within a state. His limited income is likely limiting the choices, but although "The law firm recommended 3 that would be in line with dad's finances of SSA/VA benefits.", you can look around to see if there are others. As many have indicated, there are nice places and there are crappy ones. You might even want to recheck the ones you did already, as maybe it was an "off" day. Hopefully you know how much the SS/VA total is, so that you can check with prices on other places. The ones they suggested might have some kickback...

Mom's place is a combination IL/AL/MC and one has to go through the reception/dining areas to get to the elevator to MC. I have met and chatted with many residents who are from AL and/or IL. Most are quite pleasant and seem relatively happy. Most in the MC are also relatively happy (some who have regressed a lot may not seem to be, but there's a number of fairly cheerful people in her area!)

(TBC...)

I found in my neighborhood a house converted to assisted living. It has a good reputation and doesn't look like an institution. The residents can sit on the front porch and watch children walk home from school, people walking their dogs, and most importantly the trees in the breeze. Many times when I visit though I see the ladies parked in front of an absolutely dumb tv show. Even the one lady who has a totally sound mind is sitting there watching garbage. Other times the staff is playing scrabble with one person and the others are scattered about sleeping in chairs. The lady with a sound mind often stays in her room with adult coloring books and magazines. She's grouchy and intelligent. The others are not up to her level of conversation and she loves to rile them by saying things like someone should shoot the squirrels. For my mom this place is the best I could find that she would think of as her home, but for the lady with a sound mind, I wonder. Your dad might like the activities and there might be more people in those places you visited who could converse with him than what I've witnessed at my mom's assisted living. Good luck with your hunt.

Remember some patients are not in the state of mind he is, and become aggressive towards staff, paranoid and violent, So mood elevators are used to keep them calm. Mine was in a stunning facility and acquired MRSA and went septic after they discharged him, but it had good food, window views, ponds and fountains but the care was sub par. The ones he’s at now is drab with terrible food and depressing BUT his therapy is stellar and drs and nurses know each patient. So do you want quality amenities or quality care? You can decorate his area and bring in nicer tv for him. Make your decision based on his care not how fancy the place is. It may be best he sticks to himself but suggest he have dinner in the dining area for change of scenery? Maybe a smidge of social interaction with others who want to play cards or chess is good? Mine won’t even walk up the hall to a small tv sitting room with coffee, so I hit Barnes and Nobles and he’s very much loving his crossword and word search books I got him plus it keeps his mind engaged. Make sure he’s got his favorite blanket, daily newspaper etc. Make the best environment you can for him and remind him how fortunate he is that he’s not like the others. Forcing him to see people down the halls IS DEPRESSING. Some of them are entertained with a simple cell phone with no service but it’s an outlet for that patient. Each patient has different needs, if they don’t keep them calm (which sometimes looks like zombies) he would otherwise hear them throwing things, cursing the staff, and subsequently being restrained. Create an atmosphere for him and read reviews on the places. Many elders have been dumped off and family doesn’t care or it’s gotten to be too much on them, so those patients are depressed and bitter and some just get crotchety in their old age. Don’t gauge the place by the patients drooling in the halls, but the staff and if you can make him happy in his own area, then he’ll be fine.

You see what you want to see.

There are some beautiful AL facilities, but the key in your case is that you are trying to find one "in line with Dad's finances or SSA/VA benefits." Benefits are never going to meet AL expenses. Nicer AL facilities are going to require additional money from patient or family. If none of you in the family is able or willing to supplement your father's benefits, your choices are limited.

My mother n law had dementia and lung cancer and we had to put her in a nursing home that handled end of life care. Needless to say it was 16,000 a month. Yup you read that right. 16,000 a month. Horrible facility. My brothers law got her out of there and brought her home to their house for the remainder of her life. She only lived 2 more weeks because she was at the end of life. But she was surrounded by family when she died.

Telling it like it is. I've have home caregivers who have worked facilities and hospice relay worse horrors of the institutions. You speak the truth for so many. Truly this is a passage that is difficult, expensive, heart wrenching and depleting. The best we can do is the best we can do. There are some very sage souls in this group... so we all have company in our isolation.

They can be. These facilities tend to start out with a higher percentage of younger residents and over time, the population ages. Also, the high cost of assisted living, encourages people to wait until they are much older and infirmed. I would look for a newer facility if at all possible.

It's a tough situation. My question, can you both put in an assisted living facility and also keep involved in programs outside the facility for seniors? I live in W. Los Angeles and there is a great senior facility, that many seniors go to for their fun activities & social environment. Is it possible to have the seniors transported to these type of facilities a couple of days a week, to be involved and participate in what they have to offer? If so, would that work for your father? Good luck with this.

Hi, it sounds normal for ALF to me. The activities help mental & physical needs, the grumpiness is kinda typical for elderly. I don't know what you expected. (Some days are better than what you saw, cuz the residents may have be ill or in pain on the day you visited). It may not be depressing to your dad, cuz he will have friends his own age to play cards with or hit on the old ladies!
Just make sure you like the nurses & aides, cuz they're the ones who will spend the most time looking after your dad. But remember, residents do die there, (natural causes of age)