Ombudsman Maija Aikens discusses the differences between Nursing Homes and Assisted Living Homes, the differences in who they serve, licensing/size of home, the services provided, and provides tips on how to select a home for a family member.
Ombudsman Maija Aikens discusses the differences between Nursing Homes and Assisted Living Homes, the differences in who they serve, licensing/size of home, the services provided, and provides tips on how to select a home for a family member.
Good morning. This is Kitty Glomski along with
Brooke:my cohost Brooke Mainville
Kitty Glomski:from Region 9 Area Agency and Aging and another episode of Let's Talk About Aging.
Brooke Mainville:We have Maija Akins with us Welcome back, Maija.
Maija Aikens:Thanks, Brooke. It's great to be here.
Brooke Mainville:So last May, we discussed what an ombudsman does on behalf of long-term care residents as well as advocacy, education, and programs. Today's focus is on the difference between nursing home, assisted living, and the type of care and services they provide at both. How do you research on these facilities? How do you find inspection reports? So Maija, what are some of the key responsibilities of a long-term care ombudsman?
Maija Aikens:As a long-term care ombudsman, I visit residents in licensed care settings such as nursing homes, homes for the aged and adult foster care homes. During those visits, I talked to residents and help them better understand their rights and empower and support residents to embrace their rights.
Brooke Mainville:What are some of those things you talk about with the residents?
Maija Aikens:A lot of the time I'll simply go in and talk to residents and ask them how they are, how they like their home, and try to identify and resolve any concerns they may have.
Brooke Mainville:Can you tell us about the nursing homes, home for the aged, and adult foster care homes in our region? We cover 12 counties. Our service area is Alcona, Alpena, Arenac, Cheboygan Crawford, Iosco, Montmorency, Ogemaw, Otsego, Oscoda, Presque Isle and Roscommon. What types of care and services would these types of homes provide?
Maija Aikens:In those 12 counties, there are about 2,300 licensed beds between the nursing homes, homes for the aged, and adult foster care homes, depending on what level of care you may need in Region 9.
Brooke Mainville:That seems like a lot of beds. Do you mind explaining more about nursing homes? It seems like that's the one most people are familiar with.
Maija Aikens:Nursing homes primarily provide inpatient skilled nursing care, so skilled being the key word in this, and related services to patients who require medical nursing or rehabilitative services, but does not provide the level of care or treatment available in a hospital. Nursing homes provide 24 hour services. Some nursing homes provide specialized care. For example, if you need a ventilator, there are nursing homes with ventilator units, or if you need extra memory care. There are memory care units that are secure for residents that need that extra care. There are many nursing homes that do not provide any specialized services, so it's important to do your research and choose a home that fits your needs. Many nursing homes provide skilled care and therapy. For instance, wound care or IV therapy, but not all nursing homes. And, nursing homes serve adults of all ages, which isn't necessarily the case for homes for the aged and adult foster care homes. There are residents in nursing homes that are in their twenties, and there are residents in their nineties. You can be any age and utilize nursing home services if you qualify. There is an admission criteria to qualify for nursing home care. Some nursing homes are federally certified and have federal rules and regulations that they follow, and all nursing homes are state licensed, which comes with a whole other set of rules they have to follow.
Brooke Mainville:So where can someone find the rules and regulations?
Maija Aikens:If you have questions about the rules and regulations, there are a lot. So you should contact your local ombudsman, which would be me for Region 9.
Brooke Mainville:How does a nursing home differ from homes from the aged? How many of those do we have in our Region 9 service area?
Maija Aikens:We only have two homes for the aged in our region currently, compared to the 21 nursing homes. The State of Michigan Licensing and Regulatory Affairs defines homes for the aged as licensed homes that provide room and board, protection, supervision, assistance, and supervised personal care to residents age 55 or older. You will notice the age requirement for homes for the aged is different than adult foster care homes and nursing homes.
Brooke Mainville:What kind of care does home for the age provide?
Maija Aikens:The care that homes for the aged may provide include assistance with activities of daily living, which may include bathing, getting ready for the day, getting dressed, eating, going for a walk, and using the restroom and the administration of medication. Homes for the aged can provide any of these services, but it's usually for an extra cost. Homes for the aged cannot provide continuous nursing care to residents. It is not a nursing home and it does not provide the same level of care.
Brooke Mainville:How many residents typically live in the homes for the aged?
Maija Aikens:Homes for the age has 21 or more residents, and that's how it's licensed. Usually there is a private living space with options for congregate meals and group activities. You usually have your own apartment or you share an apartment, and then there are other places throughout the building for meals and activities. Now, because homes for the age are larger, it sometimes seems more like an apartment complex or more like a nursing home, but it's supposed to be more of a home-like environment.
Brooke Mainville:What are the payment options for the homes of the aged?
Maija Aikens:You pay for room and board and it's private pay. Medicare and Medicaid do not pay for room and board. There are some services through Medicaid that may pay for some care, but you must qualify for those. If you want to learn more about those services, you should contact your local Area Agency on Aging, or the local Ombudsman. So our last is adult foster care homes or AFC homes. How does that differ from the previous two? You already discussed the age difference. Adult foster care homes are a little different than homes for the age, so adult foster care homes. Or AFCs, like you said, are residential settings that provide 24 hour personal care protection and supervision for individuals who are developmentally disabled, mentally ill, physically handicapped or aged who cannot live alone, but who do not need continuous nursing care.
Brooke Mainville:Like what is the typical size then of an adult foster care home?
Maija Aikens:Adult foster care homes are smaller than homes for the aged. We have a family home that is three to six residents, small group home with three to 12 residents, and then a large group home with 13 to 20 residents. So the maximum number of residents you can have in an AFC is 20 compared to the 21 or more at homes for the aged.
Brooke Mainville:How do services of an adult foster care home compare to home for the aged?
Maija Aikens:Some adult foster care homes are specialized. Some are memory care homes. A lot of community mental health homes are adult foster care homes that are specialized for individuals with developmental disabilities or mental health needs. They offer the same services as homes for the aged, but the licensing type is different along with the protections for the residents. The type of rules in the homes for the aged are different than in the adult foster care homes, and the type of rules even vary from a small family home to a large group home.
Brooke Mainville:Are there age restrictions for AFC homes like there are for the homes for the aged?
Maija Aikens:No, any adult of any age can live in a nursing home or adult foster care home, whereas you must be 55 or older to live in homes for the aged.
Brooke Mainville:Overall, it seems like the big difference between the three types are age, size, licensing types and service provided. Previously you discussed how someone can go about researching and choosing a home.
Maija Aikens:When you want to choose and research a home, you want to consider what's important to you. Whether it's nursing care, the food that you're eating every day, the physical therapy, the specialized units, like the memory care event units, if you're close to your family, whether you want to be closer or further away. You never know when choosing the home that fits best with your needs, it's important to do research on all of your options. Medicare.gov has a nifty tool called Care Compare, where you can search nursing homes by location and compare the quality of care they provide and their staffing. There is also a statewide search for adult foster care in homes for the aged facilities through the licensing and regulatory affairs website to compare other assisted living homes in your area.
Brooke Mainville:Is there anything else that residents or family could or should do to research their options?
Maija Aikens:Honestly, they can just talk to people. They can talk to their friends and family, people in the community, ask them about what places they might suggest. They can call different nursing homes. It's never a bad idea to get in touch with each place on your list. Ask questions about how many people live there, what it costs. Find out about waiting lists. You can go on visits to these nursing homes make plans to meet with a director and nursing director. Talk to other residents that live there and see what they enjoy or dislike about the home. Don't be afraid to ask questions during your visits. There are so many options for finding out more about these homes.
Brooke Mainville:What kind of questions should residents or family members be asking on these visits?
Maija Aikens:It all really depends on what the resident and family wants to know and what's important to them. I would ask about staffing, food, any citations that the home may have received in the past. Ask about activities, what their daily schedule might look like. Again, whatever is important to the resident, that is what they should be asking about. I would recommend making a second visit without calling in advance. Try another day of the week or time of day, so you will meet other staff members and see different activities, stop by at a mealtime. Is the dining room attractive and clean? Does the food look tempting? All things to consider.
Brooke Mainville:Those pop-in visits could be a enlightning and helpful. You mentioned citations. Are those reports public? If so, how can someone find those reports?
Maija Aikens:AFCs and HFAs are inspected every two years whereas nursing homes have an inspection annually. You can ask to see the current inspection report and certification of any nursing home you're considering. Every licensed home will have these reports readily available for you to view. You can also visit the Licensing and Regulatory Affairs- LARA website and search any licensed home in your area and find the recent reports electronically. All reports are available to the public.
Brooke Mainville:So what is the website to Laura?
Maija Aikens:You can visit the licensing and regulatory affairs at www.michigan.gov/lara.
Brooke Mainville:As part of your role, you do the elder abuse initiatives for Region 9 AAA. What are you doing this year, Maija?
Maija Aikens:We're going to be hosting the Annual Elder Abuse Prevention Conference in Otsego County this year at the Otsego County Commission on Aging this fall. Stay tuned for more information about that event.
Brooke Mainville:That is exciting because that is our first one back since Covid and it'll be at the newly constructed Otsego Commission on Aging. How can someone contact you, Maija?
Maija Aikens:Please contact me at 989-358-4630 if you have any questions or you can email me at akinsm@nemcsa.org. That's aikensm@nemcsa.org, and I'll get back to you right away. Maija, this was enlightening. You never know when you might need one of these homes. I appreciate you taking the time to discuss these different types of homes and how someone can research them and find inspections in our region. So until next time, thank you so much, Maija. Thanks, Brooke.
Kitty Glomski:This is Kitty Glomski and Brooke Mainville, with the Calendar of Events. On the second Wednesday of April. That's April 12th, the MMAP program has a New to Medicare presentation starting at 10 o'clock on Zoom. This is a virtual presentation. This is information for anyone that is new to Medicare, is starting Medicare due to disability or has questions and wants to know how Medicare works. Then afterwards you get to meet one on one with a counselor and talk about your personal situation. To register, you can call 1-800-803-7174 or contact your local Senior Center, your Commission or Council on Aging, and they can make the appointment for you.
Brooke:For the calendar events for April, I have a Diabetes PATH taking place at the Rogers City Senior Center and Community Center. That's April 21st through June 2nd from 1:00 to 3:00. That's a in-person Diabetes PATH. We have a in-person Caregiver Conference that is taking place Monday, April 24th from 10:00 AM to 4:00 PM. There will be complimentary breakfast and lunch as well as speakers and vendor tables and door prizes and raffles. So that's a great one not to miss. And again, that's in person at the Roscommon Banquet Center. And I have one more. It's a virtual option for our caregivers, and that is our Caregiver Webinar taking place, April 14th from 1:00 to 2:00 on a Friday, and the topic is Parkinson's disease. Again, that was April 14th from 1:00 to 2:00. So those are the three: I have a Diabetes PATH in Rogers City, a in-person Caregiver Conference in Roscommon, and a Caregiver Webinar series online via Zoom. To register for these events, please contact me at 989-358-4616. Again, that was 989-358-4616, or go to our website at www.nem csa.org and you can find the information there. Thank you.
Kitty Glomski:So this is Kitty Glomski and Brooke Mainville asking you to join us again next time on Let's Talk About Aging.
Carla:Let's Talk About Aging is a production of the Region 9 Area Agency on Aging, 2569 US 23 South, Alpena, Michigan 4 9 7 0 7. This Podcast was supported, in part, by grant number 90MPPG0039 from the US Administration for Community Living, Department of Health and Human Services, Washington, DC. Podcast music provided by Groove Music, selection titled"Modern Logo," created by Vadym Kuznietsov and can be found at https://elements.envato.com/modern-logo-ZVHFBJ6