From the moment your dad entered the hospital, a hospital employee (typically called a discharge planner or case manager) started working on a discharge plan. It’s likely that the case manager will eventually make their way to you, the adult child, and ask you what you plan to do with your dad now that he can’t really manage all alone.
There is a good chance the options in front of you include either an ALF or SNF. But what exactly do those terms mean?
Let’s break it down.
ALF
An ALF is short for “assisted living facility.” This is a facility structured much like an apartment complex. Assistance with ADLs, (I’ll come back to that one) is provided discreetly by trained staff. Along with ADL assistance and medication management, an ALF generally offers three meals a day, housekeeping and laundry services, an activity program, and a whole lot of peace of mind.
Who can live in an ALF?
The answer to this question varies from state-to-state based on regulations. In general, people living in an ALF require some assistance with two or more ADLs. An ADL is an “activity of daily living,” such as bathing/showering, dressing, managing medications, grooming, transferring with some assistance, escorting to meals or about the community. ALFs are primarily private pay.
SNF
For individuals in need of the skilled services of a nursing staff and regular invasive treatments or procedures, an SNF, or “skilled nursing facility,” is indicated. You might call an SNF a nursing home. There are various pay structures for SNFs, so you must be aware that Medicare will not pay for long-term stays in any type of living environment. Individuals living in an SNF will have to spend all of their assets before qualifying for state assistance programs (check with the admissions office at the SNF for help applying for Medicaid).
When sickly older people are in the hospital, physicians and case managers generally think an SNF is the only answer when, in fact, many seniors and their families could easily consider an ALF. Check into ALFs for your mom or dad. Get an assessment by the ALF to determine the best type of living situation for right now.
