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Common Terms

  • Assisted Living Home – An assisted living facility that provides resident rooms to ten or fewer residents. A health care institution other than a hospital or a nursing care institution that provides resident beds or residential units, supervisory care services, personal care services, directed care services or health-related services for persons who do not need continuous nursing services.
  • Adult Foster Care Home – A residential setting that provides room and board and adult foster care services for at least one and no more than four adults who are participants in the Arizona long-term care system and in which the sponsor or the manager resides with the residents and integrates the residents who are receiving adult foster care into that person’s family.
  • Adult Foster Care Services – Supervision, assistance with eating, bathing, toileting, dressing, self-medication and other routines of daily living or services.
  • Assisted Living Center – An assisted living facility that provides resident rooms or residential units to eleven or more residents.
  • Assisted Living Facility – A residential care institution, including an adult foster care home, that provides or contracts to provide supervisory care services, personal care services or directed care services on a continuous basis.
  • Assessment – A written analysis of a resident’s abilities; preferences; and need for supervisory care services, personal care services, or directed care services.
  • Activities of Daily Living – Bathing, dressing, grooming, eating, mobility, transfer, and toileting.
  • Healthcare Institution – Every place, institution, building or agency, whether organized for profit or not, which provides facilities with medical services, nursing services, health screening services, other health-related services, supervisory care services, personal care services, directed care services and includes home health agencies.
  • Nursing Care Institution – A health care institution that provides inpatient beds or resident beds and nursing services to persons who need continuous nursing services but who do not require hospital care or direct daily care from a physician. Nursing care institution does not include an institution for the care and treatment of the sick that is operated only for those who rely solely on treatment by prayer or spiritual means in accordance with the tenets of a recognized religious denomination.
  • Nursing Services – Those services that pertain to the curative, restorative and preventive aspects of nursing care and that are performed at the direction of a physician by or under the supervision of a registered nurse licensed in this state.
  • Residential Unit – A private apartment, unless otherwise requested by a resident, that includes a living and sleeping space, kitchen area, private bathroom and storage area.
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What questions should we ask when touring a home?

  • Is the facility licensed?
  • Who owns the facility and what is their experience?
  • What are the admission requirements?
  • What is the monthly cost of care?
  • Do they require a deposit?
  • Do we have to sign a contract?
  • How long can a resident stay in the facility?
  • Are there any added expenses, other than the cost of care?
  • How many people is the facility licensed for?
  • What is the resident to staff ratio?
  • Does the facility have an awake staff?
  • What are the qualifications of the owners, manager and care givers?
  • How does the facility keep records of each resident? (food intake, medication log, etc.)
  • How often are showers given?
  • Are medications under lock and key?
  • Are residents allowed to leave the facility with family or friends?
  • What’s the typical resident profile? (alert versus confused)
  • What are the visiting hours?
  • How many people share one bathroom?
  • Does the facility provide transportation?
  • Is the bathroom handicapped equipped?
  • Can a resident have their own telephone line in the room?
  • Do they allow pets?
  • Who does housekeeping/ laundry?
  • Are the residents allowed to bring personal belongings?
  • Are meals prepared in the home?
  • Do they have a well balanced menu?
  • Do they have substitute meals for residents who don’t like what’s being served?
  • Are the residents dressed appropriately?
  • What time do residents go to bed and get up in the morning?
  • Does the facility have a house-call physician?
  • What kind of activities does the facility provide?
  • Is there an on-call beautician?
  • Can residents receive personal mail?
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The 7 Stages of Alzheimer Disease

  • Stage 1: No Impairment – (normal functions) – The person does not experience any memory problems. An interview with a medical professional does not show any evidence of symptoms of dementia.
  • Stage 2: Very mild cognitive decline – (may be normal age-related changes or earliest signs of Alzheimer Disease) – The person may feel as if he or she is having memory lapses — forgetting familiar words or the location of everyday objects. But no symptoms of dementia can be detected during a medical examination or by friends, family or co-workers.
  • Stage 3: Mild cognitive decline – (early-stage Alzheimer can be diagnosed in some, but not all, individuals with these symptoms) – Friends, family or co-workers begin to notice difficulties. During a detailed medical interview, doctors may be able to detect problems in memory or concentration. Common stage 3 difficulties include:
    • Noticeable problems coming up with the right word or name
    • Trouble remembering names when introduced to new people
    • Having noticeably greater difficulty performing tasks in social or work settings Forgetting material that one has just read
    • Losing or misplacing a valuable object
  • Stage 4: Moderate cognitive decline – (Mild or early-stage Alzheimer Disease) –  At this point, a careful medical interview should be able to detect clear-cut symptoms in several areas:
    • Forgetfulness of recent events
    • Impaired ability to perform challenging mental arithmetic — for example, counting backward from 100 by 7s
    • Greater difficulty performing complex tasks, such as planning dinner for guests, paying bills or managing finances
    • Forgetfulness about one’s own personal history
    • Becoming moody or withdrawn, especially in socially or mentally challenging situations
  • Stage 5: Moderately severe cognitive decline – (Moderate or mid-stage Alzheimer Disease) – Gaps in memory and thinking are noticeable, and individuals begin to need help with day-to-day activities. At this stage, those with Alzheimer’s may:
    • Be unable to recall their own address or telephone number or the high school or college from which they graduated
    • Become confused about where they are or what day it is
    • Have trouble with less challenging mental arithmetic; such as counting backward from 40 by subtracting 4s or from 20 by 2s
    • Need help choosing proper clothing for the season or the occasion
    • Still remember significant details about themselves and their family
    • Still require no assistance with eating or using the toilet
  • Stage 6: Severe cognitive decline – (Moderately severe or mid-stage Alzheimer Disease) – Memory continues to worsen, personality changes may take place and individuals need extensive help with daily activities. At this stage, individuals may:Stage 7: Very severe cognitive decline – (Severe or late-stage Alzheimers disease) –  In the final stage of this disease, individuals lose the ability to respond to their environment, to carry on a conversation and, eventually, to control movement. They may still say words or phrases. At this stage, individuals need help with much of their daily personal care, including eating or using the toilet. They may also lose the ability to smile, to sit without support and to hold their heads up. Reflexes become abnormal. Muscles grow rigid. Swallowing impaired.
    • Lose awareness of recent experiences as well as of their surroundings
    • Remember their own name but have difficulty with their personal history
    • Distinguish familiar and unfamiliar faces but have trouble remembering the name of a spouse or caregiver
    • Need help dressing properly and may, without supervision, make mistakes such as putting pajamas over daytime clothes or shoes on the wrong feet
    • Experience major changes in sleep patterns — sleeping during the day and becoming restless at night
    • Need help handling details of toileting (for example, flushing the toilet, wiping or disposing of tissue properly)
    • Have increasingly frequent trouble controlling their bladder or bowels
    • Experience major personality and behavioral changes, including suspiciousness and delusions (such as believing that their caregiver is an impostor)or compulsive, repetitive behavior like hand-wringing or tissue shredding
    • Tend to wander or become lost
  • Stage 7: Very severe cognitive decline – (Severe or late-stage Alzheimers disease) –  In the final stage of this disease, individuals lose the ability to respond to their environment, to carry on a conversation and, eventually, to control movement. They may still say words or phrases. At this stage, individuals need help with much of their daily personal care, including eating or using the toilet. They may also lose the ability to smile, to sit without support and to hold their heads up. Reflexes become abnormal. Muscles grow rigid. Swallowing impaired.
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What are the 3 levels of Care in Assisted Living?

  • “Directed care services” means programs and services, including supervisory and personal care services, that are provided to persons who are incapable of recognizing danger, summoning assistance, expressing need or making basic care decisions.
  • “Supervisory care services”means general supervision, including daily awareness of resident functioning and continuing needs, the ability to intervene in a crisis and assistance in the self-administration of prescribed medications.
  • “Personal care services”means assistance with activities of daily living that can be performed by persons without professional skills or professional training and includes the coordination or provision of intermittent nursing services and the administration of medications and treatments by a nurse.
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