I attended a grand opening of a new independent/assisted living complex this past week with my friend Mattie and my mother in law. They are springing up all over Lexington faster than mushrooms in springtime here in Kentucky.

Medicaid does not help pay for this way for seniors to live and have their health and personal care needs met.

Costs range from approximately $3500 (studio single occupancy with no health or personal care assistance) to approximately $7500 (two bedroom single occupancy with health and personal care assistance). The costs do not include real medical care, mind you. That will cost extra but hopefully Medicare will cover most of it. I hope Medicare is still solvent when I am in my 80’s and 90’s. I am sixty now.

Are there going to be enough seniors with adequate incomes to fill all these places being built is the big question around here. Surely the developers did their due diligence and market analysis. Independent and assisted living facilities do not have to obtain a certificate of need from the state before they can open, unlike nursing homes, hospitals, and adult day centers like ours. Not that the certificate of need means that there really is a need. It just means some lawyers did a good job of convincing a judge who knows nothing of the healthcare industry or of the people who need healthcare that there is a need for a new whatever. It adds layers of time, energy, and expense to the process of opening up a new facility, and gives back nothing in return.

And if an existing facility has to relocate, as we have to do, we must get permission from the certificate of need office. In order to obtain an emergency relocation request, they want us to notify all of the other adult day centers that our clients need a new place to be, and only if they refuse to take them is it considered an emergency.  I can’t think of a better way to put an adult day center to death. And after they have buried us, they want to jump on our grave by inviting competing adult day centers to object to our relocation request by hiring lawyers to fight us. The normal relocation request process takes three months!

It is not enough that we have done all that is required to obtain a license, and have had our license renewed. The licensing is from the Office of the Inspector General.

Enough about that. It is in God’s hands. Back to the subject of cost for care. I always process things through the ‘what do I want for myself filter’ to determine whether it is good or bad for other people. Here is what I want for myself, and why: I want to be living with or very near a dear and trustworthy family member. If I live with my son, for example, the money I would have spent on an assisted living apartment could be given to him to use as he sees fit. It seems wasteful to me to give it to some big company that builds these places rather than giving it to my son. I have long term care insurance to help pay for the bathing, dressing, etc. that might need to be done. I want to go to an adult day center like Aging With Grace during the day. Who wants to sit around the house all day watching television? And statistics show that adult day centers with nursing services improve health outcomes.

And do you think that the people who work in the assisted livings are going to do a good job of taking care of you? Really? Each senior is so unique, and takes a long time to get to know, and even longer to get to know intimately, which is necessary for giving good care. Take my mother in law, for example. She has lived with us since June on this go round. She was with us a year in 2011-2012. And before that she lived with us in 2007-2008 right before her leg was amputated. She has an artificial lower leg. And the other day, at the assisted living grand opening, it kept falling off! It has never done that before, but life is full of surprises like that. When we got home I inspected it closely and discovered there was a bolt that had become unscrewed. That bolt is what held the leg to the ‘sock’ that fits around where her leg was amputated. So I screwed it back in, and now it is fine. But the next time that happens, I will know what to do immediately. She has many other health issues that I am still learning to help with. How can the staff of an assisted living get to know so many people and help them adequately when they only work there a few hours a day? That is another reason I like an adult day center for myself. The family and the staff at the adult day are consistent. But life is full of surprises, as I said. My son may sicken and die, adult day centers may get evicted because not enough people joined to pay the rent. In the end, I have to trust God.

May your coming week be blessed.

DG