Assisted Living Facilities (ALF)
Assisted living facilities are congregate living facilities that individuals and couples can choose to live in once more assistance is needed with activities of daily living. These are not skilled nursing facilities (nursing homes). This latter group represents a very different type of congregate living where essentially everything is provided. An ALF offers a list of client services and patients can purchase what they need. They live alone in an apartment with nursing and rehabilitation services available. All meals are provided. We have helped many patients make this transition and continue to follow them in the ALF.
What is unique about this type facility is that the State of Florida has strict guidelines about wounds in this setting. In an arbitrary way, they have selected only one type of wound to regulate (pressure ulcers). All other wounds are ok and permittable in an ALF. If a patient has anything greater than a stage 2 pressure ulcer they have to leave and go to a higher level of care until healed. If they have a stage 2 pressure ulcer (a very minor wound) and it does not show improvement in 30 days, they must leave the facility. Therefore, early intervention in pressure ulcers is critical or patients can be removed from their home.
Unfortunately, the only higher level of care is a nursing home, moving the patient from an apartment to true institutional living. Finally, what the State does not understand is that in most cases the wound care is far worse in these facilities. Wounds often get worse and patients can be condemned to spend the rest of their lives there. As this very scenario led to my own Mother’s demise, we are passionate about getting such wounds healed and keeping patients in their homes. We work closely with the administration of ALF’s to accomplish this and truly consider ourselves their silent partners in the war against pressure ulcers in these facilities. Finally, we have developed legal interventions to re-classify some pressure ulcers into other categories to prevent the above scenario from playing out. Nonetheless, without prompt attention and intervention there we always be patients who are uprooted in this environment.