Getting a Parent Into Assisted Living in Long Beach

There is almost no middle in this city

Here is the odd thing about Long Beach. Of the 50 licensed homes inside the city, 38 are licensed for six residents or fewer and 11 for twenty five or more. Licensed for anything in between: 1. One. So the twenty resident house with a garden that families arrive imagining is, in this city, very nearly not a thing that exists.

That makes the first conversation simple, even if the answer is hard. Either your mother does better with six people and one caregiver who knows her, or she does better with a dining room, a calendar and a hundred neighbours. Both are legitimate. What does not work is choosing the big building because it looks like the pictures and then discovering she never leaves her room.

The honest tiebreaker is usually her, not the care. Was she social before? Did she run a bridge group, go to church on Sundays, know everybody at the market? Put her in the big one. Has she been quiet for ten years, uneasy with noise, happiest with one person at a time? A house of six will be kinder to her.

What the hospital gives you, and what it is worth

If this started at Long Beach Memorial, St. Mary or the VA on Seventh Street, you have been handed a printed list by a case manager with eleven other discharges that day. Read that list for what it is. It is the places that accept referrals from that hospital. It is not ranked, it is not vetted for you, and nothing on it has been matched to your father.

Work it in a specific order. First call and ask one question: do you have an opening now. Most will not, and that clears half the list in twenty minutes. Then, for the ones that do, describe your father honestly, including the parts you would rather soften. Wandering, night waking, refusing a shower, the fall three weeks ago. A home that says yes to a description you cleaned up will say no in person, and you will have lost two days.

Ask about a bed hold too. If your father goes back into hospital a fortnight after moving in, does he still have a room, and is it charged for. Ask before, not after.

How fast this really moves

A small home can take someone in a couple of days. A larger community moves at the speed of its move-in coordinator, and that person works business hours. If a discharge is set for Friday, Wednesday is already late.

Two things gate every admission, and both take time you are not expecting. A doctor has to complete a report on your parent's condition for the home, and there is usually a tuberculosis clearance. Ask the hospital to start both while your father is still an inpatient. It is far slower once he is home and you are chasing a clinic appointment.

Then there is money. A larger community usually wants a one-time fee plus the first month before the key turns. A small home usually wants a deposit. Ask for the number, in writing, before you drive over with a car full of clothes.

• The doctor's report and the TB clearance, started while your parent is still in hospital
• A written quote showing the base rate and the care charge separately
• What the deposit or move-in fee is, and what is refundable if this does not work
• Whether the room you are being shown is the room you are getting
• Who to call at the home after six in the evening

The part of the contract that costs people money

Larger communities price care in levels. There is rent for the apartment, then a care charge on top, set by an assessment that scores how much help your mother needs. The trap is not the starting number. It is the reassessment.

So ask these, and write the answers down. Who decides she has moved up a level. How often is she reassessed. What does each level cost. If she starts needing help with a shower twice a week, is that a level change or is it included. What does a second caregiver for transfers cost. Is medication management charged separately. Is incontinence care charged separately, and is that by supply or by visit.

Then ask what the rate has gone up by in each of the last two years, and ask for that in writing. A family that budgeted exactly to the quoted figure is a family that gets a phone call in month seven.

Where she lives decides how often you visit

This sounds sentimental and it is the most practical thing on this page. The person who actually visits is usually one adult child, two or three times a week, after work. Whatever adds fifteen minutes each way to that drive is the thing that quietly turns three visits a week into one.

So look at where supply sits. 90815 has 17 licensed homes in it and 90807 has 14. 90803, which is Belmont Shore, Belmont Heights and Naples, has 1. If you live down by the water, the realistic search runs inland, up toward the Traffic Circle and Bixby Knolls, or over the line into Lakewood and Cerritos. Better to know that in week one.

Widening out is not a compromise either. Across the Gateway Cities the state lists 159 licensed homes in 10 cities. You can see every one of them, named, with bed counts and licence numbers and work out for yourself what is genuinely within reach of your evening.

Before anyone signs

Read the section of the admission agreement that says when they can ask your parent to leave, and read it before you are relieved and tired and holding a pen. Ask the administrator to talk you through it in plain words. Ask what behaviour or what level of need would mean this home can no longer keep her. Ask how much notice you would get.

This is not a trick question or an accusation. Every licensed home has a ceiling on what it can handle, and the good ones will tell you exactly where theirs is. The homes to worry about are the ones that say they can handle anything.

What we do and how we are paid

We do the calling. We know which homes have an opening this week without ringing round for an afternoon, which ones will take a two person transfer, and which ones are quietly between administrators right now. We come on the tours and ask the awkward things, and we stay reachable after the move, when the real questions start.

Communities pay us when a placement works out. Your family pays nothing. That arrangement gives us a reason to want you to move somebody, so here is the counterweight: we say no to homes regularly, we will tell you when the sensible answer is a few hours of caregiving at home instead of a move, and we will tell you when what your father actually needs is skilled nursing, which is a different licence and not something we get paid for.