When you hear the phrase “assisted living,” you would naturally make assumptions about the amount of assistance you'll receive at such a facility. You may be surprised to discover that it might not be quite what you’re imagining.

A local couple was looking for a place to live and receive care as the husband’s dementia progressed. They decided to tour several local assisted living facilities (ALF’s).

At the ALF’s they visited in Ashland and Medford, they were told exactly what they were hoping to hear. They were assured that the ALF could manage their care needs as the dementia progressed. In the meantime, they would receive assistance with medication management, help with dressing, reminders for meals, assistance with showering, and making sure all was well at the end of the day. This almost convinced them to put down a deposit at one ALF and move right in.

After doing a bit more research, they discovered that the amount of time that anyone would be able to actually devote to their care needs was minutes a day. Staff caregivers were not going to spend large chunks of time in their apartment. If you consider the logistics of how facilities are staffed, you’ll understand why. There might be two caregivers available for a large number of residents. It’s just not feasible that they’d be there exactly when needed, or stay with them for long time periods. In fact, if the care needs are fairly high, it might not work at all. In that case, having a privately hired caregiver/companion for some time each day would be one way to make this choice more workable.

You owe it to yourself to read this article in Consumer Reports, August 2017, on assisted living around the country. This is not an isolated case of Ashland being a small town, and that’s why this is happening. www.consumerreports.org/elder-care/elder-care-and-assisted-living-who-will-care-for-you. Not being prepared for increasing care needs, and believing that assisted living is the ultimate answer, could lead to more problems down the line.

There is one thing you can do to make living at an ALF more workable, in addition to hiring your own care providers. If there is a diagnosis of dementia or cognitive impairment, you might need to consider that this could be the next step along the line, but not the last place to live. Knowing that some portion of the population at any ALF has this diagnosis explains why people might “outgrow” this option at some point. We’ve all heard about people “eloping” (yes, that’s the term) from a facility, getting lost and not returning. These are not secured facilities and people can come and go as they wish.

It’s possible that you will not be informed that you might need to receive a higher level of care and monitoring than they are offering. However, if the ALF finds they can no longer meet your level of needs, or if your behavior is causing problems for the staff or residents, you might be asked to find a new community. Unfortunately, many people are not prepared for this eventuality, and find themselves at a loss as to their next place to live.

If assisted living is your choice for your next step, please have realistic expectations. Be reasonable about what you will receive in the way of care during the course of a usual day. Consider providing for additional caregivers, if this is financially feasible. And if dementia is the main medical condition, please prepare in advance where you would live when and if the ALF no longer suits your needs.

Many couples remain in assisted living beyond when it meets their care needs as they don’t want to separate from one another. If dementia care is needed, keep in mind that Village at Valley View (http://villagevalleyview.com) has “enhanced rooms” set up for couples who wish to remain together.

Many residents enjoy their lives in our local assisted living facilities. You will have the ability to socialize every day, which is vitally important. You will have three cooked meals, and who doesn’t need that? And you will have some amount of care available to you. But don’t be too surprised if, with a diagnosis of dementia in particular, you find yourself having to move once more.

— Ellen Waldman is a certified aging life care professional. Submit questions about aging and Ashland-area aging resources and column suggestions to her through her website, www.SeniorOptionsAshland.com.