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Assisted
living residences or assisted living facilities (ALFs) provide
supervision or assistance with activities
of daily living (ADLs); coordination of services by outside
health care providers; and monitoring
of resident activities to help to ensure their health, safety,
and well-being.
Assistance
may include the administration or supervision of medication, or
personal care services provided by a trained staff person.
Assisted living
as it exists today emerged in the 1990s as an eldercare
alternative on the continuum of care for people, normally seniors,
for whom Independent living
is no longer appropriate but who do not need the 24-hour medical
care provided by a nursing home. Assisted living is a philosophy
of care and services promoting independence and dignity.
Within the
United States assisted living
spectrum, there is no nationally recognized definition of assisted
living. Assisted living facilities are regulated and licensed
at the US state level. More than two-thirds of the states use
the licensure term "assisted living."
Other licensure terms used for this philosophy of care include
Residential Care Home, Assisted Care Living Facilities, and Personal
Care Homes. Each state licensing agency has its own definition
of the term it uses to describe assisted living. Because the term
assisted living has not been defined in some states it is often
a marketing term used by a variety of senior living communities,
licensed or unlicensed.
Types
As varied
as the state licensing and definitions are, so are the types of
physical layouts of buildings that provide assisted living services.
Assisted living facilities can range in size from a small residential
house for one residents up to very large facilities providing
services to hundreds of residents. Assisted living falls somewhere
between an independent living community and a skilled nursing
facility in terms of the level of care provided. Continuing
care retirement facilities combine independent living, assisted
living, and nursing care in one facility.
People who
live in newer assisted living facilities usually have their own
private apartment. There is usually
no special medical monitoring equipment that you would find in
a nursing home, and their nursing staff may not be available at
all hours. However, trained staff are usually on-site around the
clock to provide other needed services. Household chores are performed:
sheets are changed, laundry is done, and food is cooked and served.
Some homes even have a beauty parlor on site. Grocery service
is often available too. Where provided, private apartments generally
are self-contained; i.e., they have their own bedroom and bathroom,
and may have a separate living area or small kitchen. Registered
Nurses and License Practical Nurses are available by phone or
e-mail 24 hours out of the day, to ensure proper teaching and/or
education of staff available.
Alternatively,
individual living spaces may resemble a dormitory or hotel room
consisting of a private or semi-private sleeping area and a shared
bathroom. There are usually common areas for socializing, as well
as a central kitchen and dining room for preparing and eating
meals.
Typical resident
Statistically,
an assisted living resident needs assistance with an average of
three ADLs.
A typical
assisted living facility resident would usually be a senior citizen
man or a woman who does not need the intensive care of a nursing
home but prefers more companionship and needs some assistance
in day-to-day living. Age groups will vary with every facility.
The Assisted
Living Federation of America reports that the average age
of assisted living residents is 86.9 years (female average age,
87.3; male average age, 85.7). Female residents (73.6%) outnumber
male residents by almost 3 to 1. The majority (76.6%) of assisted
living residents are widowed, and just over 12% are still married
or have a significant other. The average length of stay for assisted
living residents is 28.3 months (the median is 21.0 months).
Residents
of assisted living facilities need not be concerned with daily
meal preparation, because a central kitchen and dining facility
typically provides three meals each day. The central dining facility
also allows for visiting with others without having to leave home.
This greatly reduces the isolation that elderly, disabled
people may suffer when living alone and who are afraid (usually
for physical reasons) to leave their homes.
Special needs
The residence
may assist in arranging the appropriate medical, health, and dental
care services for each resident. The resident generally chooses
his or her medical doctor and dental services.
Residents
who have periods of temporary incapacity due to illness, injury,
or recuperation from surgery often are allowed to remain in the
residence or to return from a rehabilitation center, skilled nursing
facility or hospital if appropriate services can be provided by
the assisted living residence. It is important to remember that
assisted living residences are a bridge between living at home
and living in a nursing home. Assisted living residences do not
typically provide the level of continuous skilled nursing care
found in nursing homes and hospitals.
More recently
built facilities are designed with an emphasis on ease of use
by disabled people. Bathrooms and kitchens are designed with wheelchairs
and walkers
in mind. Hallways and doors are extra-wide to accommodate wheelchairs.
These facilities are by necessity fully compliant with the Americans
with Disabilities Act of 1990 (ADA) or similar legislation
elsewhere.
The socialization
aspects of ALFs are very beneficial to the occupants. Normally
the facility has many activities scheduled for the occupants,
keeping in mind different disabilities and needs.
Many ALFs
also serve the needs of the mentally
ill community, primarily people with some form of dementia
including Alzheimer's disease,
but also others as long as they do not present an imminent danger
to themselves or others. In the United States, legislation enacted
by each state defines not only the level of care, but often what
conditions are prohibited from being cared for in such a home.
See also
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