Skilled Nursing or Assisted Living or Adult Care Home

The question now becomes, “What does my loved one require”. There is sometimes only a fine line that separates an inappropriate resident from one facility or another. Let us help you.

Here are some questions to consider when deciding on what level of care your loved one may need:

Is 24/7 supervision necessary? Since nursing homes offer 24/7 nursing staff, a resident who requires more supervision may fare better in a nursing home than an assisted living. Remember that Skilled Nursing Facility Portland Arearesidents in an assisted living facility often reside in private apartments where it is more difficult to provide 24-hour supervision.  However, supervision is much better in an Adult Care Home in a home-like environment.

Is the resident easily re-directed? If the resident can be redirected to an appropriate behavior without much effort, an Adult Care Home or an Assisted Living Facility maybe a good choice.

Is the resident able to perform most or all of his/her activities of daily living? If the answer is yes, an Adult Care Home or an Assisted Living may be an ideal setting for someone who can perform daily tasks but suffers from memory impairment.

Is the resident able to communicate his/her wants and needs? Again, if the answer is no, a skilled nursing facility may be a better option. The inability to communicate may threaten the safety of someone living in a private apartment or suite, but everyone is different.  We should talk about it.  Give us a call.

Adult Day Care Programs

In light of the fact that many Americans are trying to “age in place,” adult day programs are becoming more and more popular. These programs provide day care-like settings for adults suffering from many ailments including dementia and Alzheimer’s Disease. These programs are geared for participants who need supervision or socialization while their primary caregiver works, runs errands or just takes a break from their duties. Some programs are accredited by Medicare and Medicaid and can provide the same services as a skilled nursing facility without the overnight stays.

Some skilled nursing facilities that offer dementia programs may also offer day programming opportunities. Usually the program is held within the dedicated dementia unit and participants interact with a facility’s permanent residents.  There are also Adult Day Care places unaffiliated with skilled nursing facilities.

Traumatic Brain Injury Programs

Traumatic Brain Injury centers specialize in the care of patients who have memory deficits as a result of a traumatic injury or stroke. Most of the patients are younger and the onset of the injury was sudden. These facilities are few in number as compared to skilled nursing facilities or assisted livings and stringent criteria must be met for admission. Most of the patients involved in programs are in need of increased safety awareness and help with short-term memory loss. Some of their symptoms, such as poor memory, poor decision-making, impulsivity and disorientation, mimic those of dementia. The hope for many is for some of their cognition to be regained, but the outcomes are individualized and full or even partial recovery may not be possible.


For all of the options listed above, entering into the setting armed with as much information as possible is the best line of defense. This very well may be the hardest decision you will ever make and touring the facilities will help make an informed decision. When touring any facility or program, here are some questions to consider:

  • What security measures are in place to ensure safety?
  • What happens if my loved one declines in health, either physically or cognitively?
  • What will happen when the private funds are depleted? Are there alternative programs to help pay for room and board?
  • What types of activities will my loved one be able to participate in?
  • Is there any type of rehabilitation program available to help with the decline of activities of daily living?
  • What are the visiting hours?

When touring the memory center, be sure that you take note of several key factors that will help the facility become home:

  • Do other patients have personal belongings in their room to help remind them of their home?
  • Is it clean and free of odors?
  • Is the staff respectful to the other residents?
  • Do the residents appear neatly dressed?
  • Does it appear as if the residents are having a good time?

The transition from home to an Adult Foster Home, an assisted living facility or a skilled nursing facility is sometimes difficult. Do not be surprised if your loved one is agitated, confused and persistent about returning home. This is common and will most likely subside as they become acclimated to their surroundings. Speak with the nurse or administrator about visitation guidelines or suggestions during those first few days. You may find that some facilities will ask that you not visit until the resident has had the opportunity to adjust to his/her new surroundings.

Most memory care centers will not only focus on the well-being of the resident, but also that of the family. Be sure to ask if there is a support group that is hosted at the facility or one which they can refer you to. These groups will help ease the guilt and hopelessness that may accompany the transition. If you have questions about the resources available in your area, contact the Alzheimer’s Association.

Choosing a long-term care setting for your loved one may be the most difficult decision you will ever need to make. We have put this together to help you make an informed choice and find the best possible care for someone suffering from memory disorders.  In any case. . . . . .we need to talk.
Contact us: call 503-639-7157 or by email here