Small assisted living facility issues?

Is your brother open to discussion or is it a done deal? They probably have the staffing figured out, but I’d be concerned with the social opportunities and compatibility with the other two residents. With a larger facility, there are more things going on and more residents to find friends with. My aunt went to a facility with six beds, unfortunately the ladies already there had formed a “high school” type clique and iced her out. The staff tried and my cousin tried, but things never got better.

Everything has already been done; he's going shortly. If things don't work out I believe my father can be moved back to the large facility. Yes, the few social interactions could be an issue.

I hope it works out for your father. It’s difficult to know just the right place for placement. If your brother is monitoring his progress, he’ll know if the move was wise.

With my cousin, she wasn’t really into socializing with other residents, though she was prior to dementia. Direct and individual attention from staff was very important though. She couldn’t really report her issues, so having attentive, one on one care mattered a lot. She was in a small AL facility within a smaller Memory Care unit of about 15 residents. She received excellent care.

I hope you can discuss the situation with your brother.

My 67 yo niece has traumatic dementia, and needless to say was many years younger than others in her first Memory Care location, which was very disturbing to her. They were also a "medicate for everything" facility, so she was on far too much medication, and they could not or would not accommodate her lifelong need to snack throughout the day (and she is thin as a model.) Her kids found a small (3 resident) family-run Memory Care residence where she is flourishing - healthy food and cookies are available 24/7, she is off most meds, they have a fenced yard where she can walk as much as she wants, since they are with her 24/7 they know every sign of an oncoming "meltdown" and can work to avoid it. My daughters who are nurses (one with 10 yrs MC experience) will be visiting her this week - we'll see what they have to say.

So don't automatically reject a smaller place - as your Dad's dementia advances, it may be just perfect for him.

Thank you. I'm not at all rejecting the small place; it's just that I can see a number of possible issues. Issues that would not be present in a larger facility. There are a lot of factors, too. We'll just have to see.

My mom had dementia and I was her caregiver/decision maker. Is this small facility a licensed and monitored facility? Is it a care home that flies solo without regulation? Staffed 3 shifts 24/7?

Yes. It licensed and staffed 24/7 although I don't know what credentials they have or how many will be onsite at any given time. I guess they will be aides and there will be one there at anytime. I will know shortly.

Most states regulate the operation of adult care facilities. The facilities are required by law to meet certain requirements, such as supervision of residents, medication administration, proper diet, etc. In some states, you can view the record of the facility, their inspections, corrections, etc. online.

Yes, that's true but it appears that requirements are not always met and there's not enough inspectors and enforcement is not sufficient to make sure that the requirements are met in the future. I am interested in what issue might come up in small residential facility versus the larger ones.