Nursing homes and assisted living centers are - KCTV5

Nursing homes and assisted living centers are not created equal

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For families across Kansas and Missouri struggling to choose the right facility to care for an aging loved one with Alzheimer's or dementia, a crucial part of the decision is understanding the differences between nursing homes and assisted living.

It is a dilemma Mitzi McFatrich deals with every day as the executive director of Kansas Advocates for Better Care, a non-profit advocacy organization assisting nursing home residents and their families.

"There are so many of us that are aging, and a good portion of those people are going to have Alzheimer's and dementia," she said. "How are we going to meet their care needs?"

People often confuse nursing homes and assisted living centers, but the two are not created equal.

A nursing home provides medical care to Alzheimer's and dementia patients, with registered nurses on-site eight hours a day. In Missouri and Kansas, assisted living centers employ RNs on a limited basis.

Because nursing homes receive Medicare funding, there are strict federal and state regulations on staff training, the number of employees required per shift and the level of cleanliness. There is zero federal oversight for assisted living centers; very few state rules.

Medicare often pays a large part of a patient's nursing home bill. In assisted living centers, a resident's family must foot the entire cost.

While a nursing home agrees to become a permanent residence for people no matter their medical condition, a person who's Alzheimer's or dementia worsens can be discharged from an assisted living facility.

The director of education, programs and public policy for the Alzheimer's Association - Heart of America chapter, Michelle Niedens says these care centers can evict a resident in as little as 30 days.

"There's often an over promising; ‘We can handle your mom and dad, through the entire disease course,' that is, until some major bump occurs and then the game gets changed," Niedens said.

According to McFatrich, facilities will say, "We can no longer meet this person's needs. And that's what they use in order to discharge someone."

That discharge or eviction can affect a family's ability to find their loved one a new home.

"The next facility, assisted living, nursing home; they're going to look at you and say 'Gosh you're a behavioral challenge. I don't think so,'" Niedens said.

Even if a new residence is found, the transition from once place to another often takes a serous toll on an ailing senior's health.

Even if a new residence is found, the transition often takes a serious toll on an ailing senior's health.

"One of the things that is referred to is what's often called ‘transfer trauma,'" McFatrich said.

"It can be very traumatic if it's not handled well," Niedens said, "and most of the time I think it's not handled well."

"Including leading to death?" KCTV5 investigative reporter, Stacey Cameron asked.

"Including leading to death," Niedens said.

That scenario played out earlier this year in Kansas. When staff members could no longer handle him, a man in his mid-70s was evicted from an assisted living facility. While a new residence was found for him, the trauma proved to be too much. He passed away nine days later.

Stories like his have senior advocates pushing for legislation in Jefferson City, MO, and Topeka, KS, to prevent evictions from assisted living until a safe residence can be found.

"From the consumer side, I think we really want to see that happen," McFatrich said.

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