Today I am featuring the second part of Barbara's interview on assisted living with Laurene HartmanBarbara Friesner – Do all assisted living communities provide for someone with dementia?Laurene Hartman – By and large, the answer to thatquestion is yes. Most assisted living providers do have separateneighborhoods where they care for more moderate to advanced residentswith cognitive issues. At Sunrise, we believe it’s not enough thatsomeone with cognitive, or more severe cognitive issues is in a secure,safe setting. We believe it’s also how they’re treated, it’s how webest manage their situations, and how we educate the families to reallybe able to get the most out of their love one in this very tryingjourney. So it’s a real, real strong presence in our community.BF – And I think that’s something Sunrise does particularlywell – that it’s a place where someone with cognitive issues is livingand not just a place where they’re “warehoused”. I think its importantthat when you’re going to look at a community, you look at theReminiscence area – whether you think you could possibly need it foryour loved one or not.LH – You really want an environment that will bringthe individual back to life, because there are so many things that allof these people contributed to life and they enjoyed doing and youknow, we want to bring those things back to life. We want to breathelife back into those families and their loved ones, and you know again,live versus exist.BF – You mentioned the different levels of care. Whatpoint would they need the higher level of care and what do the levelsconsist of?LH – The different levels go from medicationmanagement up to and including total activity of daily livingassistance. We can feed that resident, brush their teeth, comb theirhair, pick their clothing – we can provide total Activities of DailyLiving (ADL) care. Same thing in Reminiscence area. We can care formost residents till end of life. However, that’s not necessarily truefor all assisted living communities so that’s extremely important tocheck out before your loved one checks in.Also . . . Someone that has a true skill need would then have to gointo a nursing environment and that might include someone on aventilator, has a feeding tube, needs continuous intravenous therapy.Those are circumstances that require a skilled nurse 24-hours a day,and we in the state of New Jersey, in so far as assisted living’s go,are not licensed to care for that type of resident.However, some of those circumstances are temporary. Someone mightneed a feeding tube temporarily because of a surgical procedure. Theywould recover, go to rehab, and return to their home at Sunrise, orwhatever provider. So again, if some of those things were permanent,they would require a skilled nursing environment. Remember, a nursing home is a medical model, assisted living is a social model, and that’s really the definition.BF – Whether because of health or finances, is there apoint when a resident can’t stay in an assisted living any more, and ifso, then what?LH – We do everything in our power so they don’thave to move – as I’m sure, do most communities. If that’s notpossible, the administrators, my executive director, and more oftenmyself, we will help families find the appropriate environment. Justlike when they started their journey for finding an assisted living, ithas to be the right fit, and we want to give families choices. Soagain, I am a big part of that process with my families, I have strongrelationships in the community with all of my colleagues and all of theproviders since I’ve been at that community almost nine years.Again, it’s important to find the right community. That means thecommunity that will meet their needs for as long as your loved one isthere and people who will find the right environment based on the needsof a particular resident should the community no longer be able toaccommodate them.