Thanks to Oregon's Medicare Waiver program, the over-65 sector is the fastest growing population in the state. According to "Oregon Live," the state, in an attempt to match this growth, has become a national leader in building assisted living facilities. Unlike nursing home care, assisted living is defined by the Assisted Living Federation of America (ALFA) as a combination of housing, supportive services, personalized assistance and health care that supports the needs of those who need help with daily living. If you want an assisted living facility in Portland, download ALFA's checklist before contacting facilities. Additionally, assess your budget versus wants and needs. Then compare that to a facility's basic service package and additional charges.
Assisted Living in Oregon
Oregon's Department of Human Services defines assisted living as any wheelchair-accessible facility that provides housing and supportive services for six or more residents. Residents have private apartments, ranging in size from studio upward to two bedrooms. Each apartment unit should have a kitchenette and a private bathroom with a wheelchair-accessible shower. Assisted living facilities must be licensed and regulated by the Department of Human Services, Seniors and People with Disabilities. While facilities can be stand-alone, they can also be part of a continuous care campus. In addition, Oregon's more inclusive definition dictates that the facility offer and coordinate a range of supportive services available on a 24-hour basis to meet the activities of daily living, health, and social needs of the residents.
Considerations
While many facilities listed on the database site Assisted Living Facilities are licensed by the state of Oregon, some are not. Unlicensed facilities frequently are smaller, remain under the radar of the state and don't necessarily hire licensed care providers. ALFA recommends during your search for assisted living that you visit each site several times, at different times of day. Additionally, look for licensed facilities that are members in good standing with ALFA. Members that are licensed have committed to a facility that operates under standards of excellence. Also, duties of direct caregivers vary from one facility to another, and staff-to-resident ratio will be lower in assisted living facilities than in nursing homes.
Features
According to Oregon's Department of Human Service's Consumer Guide to Assisted Living and
Residential Care Facilities, all assisted living facilities should provide care for people who can no longer live independently, but who wish to maintain some degree of independence within a safe residential environment. While assisted living facilities generally don't provide the same degree of security as nursing homes, they do offer a basic level of service. This service should include 24-hour supervision, meals, dietary services and help with mobility, bathing, dressing, eating, toileting, incontinency management and behavioral symptom. Services should also include health services with medication management, recreational activities, laundry and linen services, housekeeping, maintenance and transportation. While this is the ideal, facilities vary in how they interpret "defined services." You should evaluate each facility in person, and visit multiple times at different times of day. Additionally, talk with residents and question staffers.
Costs
While MetLife 2009 Market Survey reports the average national cost of assisted living at $3,131 monthly, the average cost of assisted living in Oregon is $2,400 per month, with costs between $1,300 and $4,500 per month, based on facility and services. In Portland, the average rate is slightly less than the state average. As of 2009, the average was $2,200, with a range of $1,600 to $2,700 a month based on a survey of four facilities. Again, rates differ based on size of facility, room size, types of services needed and optional special services.
Financial and Financial Aid
Oregon is considered a model and one of 37 states that implements a Medicaid waiver funding system for assisted living. Because Medicare does not generally cover assisted living, most residents shoulder the financial burden. If assisted living is a residential shift for you and your spouse, consider the expense a permanent living cost. Because many middle- to low-income elderly can't afford the expenses, the Oregon Assisted Living Medicaid Policy acts as a safety net. It also allows states to cap assisted living expenses and the number of assisted living beneficiaries who can qualify. The system is not without its flaws. One complaint is that the waiver system doesn't completely cover room and board, and the portion that it does cover is unreasonably low. If you're applying to the Assisted Living Medicaid Policy, be aware of potential loopholes and what expenses you might be required to subsidize.
References
- MetLife: The 2009 MetLife Market Survey of Nursing Home, Assisted
- Assisted Living Federation of America: Checklist for Evaluating Assisted Living Communities
- State of Oregon Senior and Peoples With Disabilities: Choosing a long-term care setting:
- Oregon Department of Human Services: Consumer Guide to Assisted Living and Residential Care Facilities
- Aging and Disability Services: Multnomah County: Assisted Living Facilities
- Assisted Living Facilities: Oregon Assisted Living Facilities
