In her 82nd year, Adele Gatto’s mind didn’t betray her, her body did. Weakened by multiple sclerosis and time, she needed help. Seven months ago she found it at an assisted-living facility in Sunrise, Fla.
At Springtree Walk, aides help with bathing, eating and cleaning.
“It’s better than home,” she says. “I feel safe here.”
In bureaucratic buzz, Gatto lives in an “adult congregate living facility,” an ACLF. A bridge between a private home and a nursing home, it offers help for those who need a hand with routine daily chores but aren’t sick or frail enough for a nursing home.
Probably no other option for elders offers so many permutations-good and bad.
Assisted-living facilities range from small homes to converted motels to elaborate facilities built specifically for that purpose.
Unlike nursing homes, generally infused with federal money and thereby highly regulated, these operate more freely.
They can house as few as six, as many as a few hundred.
They can be freestanding or attached to an active retirement community, the idea being that as people grow frail, they can move into the assisted living section. They need not leave friends or familiar surroundings.
At their best, these assisted-living arrangements are spanking clean with decent food, stimulating activities and a considerate staff.
At their worst, they are shabby quarters serving bad food to people whose only pastime is a blurry TV in a community room.
When “Maryann” needed to place her combative father, she checked out a half-dozen facilities in South Florida:
In one kitchen, loaves of white bread for sandwiches.
In one lobby, listless residents sitting idle by a broken TV.
In one building, the overpowering reek of mildew and urine.
The fees: As much as $1,200 a month.
The Hallandale, Fla., woman kept looking. She found other places that offered far more for the same amount of money.
“There’s no substitute for looking,” she says. “You need to see what’s going on.”
In many cases, you get what you pay for. But not always.
Those familiar with the business say fancy frills aren’t what’s important.
“I tell people, look at the aides,” says Ruth Hirtz, a geriatric care manager and member of Long-Term Care Ombudsman Council in Broward County, Florida. The council investigates complaints.
“Are they friendly? Do they smile? How do they interact with the people? In the end, that’s what’s going to make a difference.”
Here are other things you should know while you search:
– Assisted-living facilities do just that: Assist. If health problems develop or worsen, the resident must move. Staying ambulatory is key. A bed-ridden patient can’t remain.
– Some assisted-living facilities advertise special programs for people with Alzheimer’s or dementia. Ask what’s “special” about the program. It should also be in writing.
– Long-term care is a business. Barter, especially at assisted-living facilities where the money mainly comes from private pockets.
“One woman told me she wanted $1,000 a month; I told her I could only pay $900,” says Ellen Cavanaugh, of Sunrise, Fla., who needed to place her Alzheimer’s-afflicted mother-in-law. “The woman said fine.”
For Gatto, assisted living costs less than what she paid to remain in her apartment.
Widowed and disabled by MS, she needed a full-time aide at home. That cost $1,800 a month.
Food bills totaled $200. Utilities, another $100. Her monthly expenses reached about $2,200 a month.
Now she pays $1,700 a month for assisted living.
She didn’t want to go into a more expensive nursing home, nor did she need to.
“Nursing homes should be a last resort,” says Edith Lederberg, director of Broward County’s Area Agency on Aging.
“We should do everything we can to help people maintain some level of independence.”
At Springtree Walk, Gatto has her own spacious bedroom and private bath. The room is filled with furniture from her home in Hollywood, Fla.: A green wooden bed, a brown chest of drawers.
She shares a living area and small kitchen with three other women. In the living area, a TV and a cluster of chairs encourage socializing.
Gatto eats mainly in the group dining room. Before each meal she wheels her chair to the nursing station, where her medication is kept and monitored.
Three days a week she plays bingo, her favorite pastime.
“I have nobody,” says Gatto, a widow, whose only daughter died 12 years ago.
“I was wondering where I was going to wind up. I still wonder.”
Her brother, Bruno Alencikas, of Titusville, Fla., is relieved to know she’s settled in and looked after.
At 75, he has a heart condition and can’t travel to see her.
“Before when I called, she never laughed,” he says. “Now she laughs and jokes. I can tell she’s happier.”
