"Assisted living" has become a catch-all phrase that means a facility that provides residents with assistance in one or more of the basic Activities of Daily Living (ADLs), as they are now called.

The basic ADLs are:

  1. Getting in and out of beds and chairs
    2.) Dressing
    3.) Toileting
    4.) Bathing or showering
    5.) Feeding and
    6.) Coping with incontinence

The staff at an assisted living facility may perform tasks, such as doing laundry, cooking and serving food, washing dishes, cleaning the living areas of the residents, changing beds, and assisting with other basic daily tasks. Some facilities provide medication management and more personal attention based on a person's needs for help. Medical personnel are usually available at all times, although they may not always be on the premises.

In general, assisted living facilities are considered a medium point along the spectrum of care needs that ranges from independent living to full-time nursing care. Assisted living facilities provide a spectrum of care depending on residents' needs. Some residents may need help with bathing, dressing, and toileting, while others may only need help in rising from chairs and getting around the facility. Some assisted living facilities are located in a complex that has gradations of care as a person's needs increase, culminating in a move to a nursing home on the same grounds. Others are "stand alone" assisted living facilities (ALFs).

In general, assisted living facilities are considered a medium point along the spectrum of care needs that ranges from independent living to full-time nursing care.

In many assisted living facilities, the residents have a bedroom, bathroom and small kitchen and living room. Others are more communal-with shared kitchen, dining, and recreational areas and semi-private bedrooms and bathrooms.

Depending on the level of care an individual needs and the amenities of the facility, pricing may vary considerably. It also varies from state to state and within states as well.

The Genworth 2014 Cost of Care Survey noted that the United States national median price of living in an assisted living facility is $3,500 per month. The report said the median price increased by 1.45% since 2013, and projected an annual growth rate of 4.29%. It emphasized that the cost of an assisted living facility varies based on the residents' requirements for help.

...most assisted living residents are more than 85 years old...

According to the National Center for Assisted Living (NCAL), which is "the assisted living voice" of the American Health Care Association (AHCA), most assisted living residents are more than 85 years old, female, and have several chronic conditions that render them incapable of performing all the Activities of Daily Living unassisted.

Unlike nursing homes, which must provide data to the Centers for Medicare and Medicaid Services for assessment of effectiveness and comparison purposes, assisted living facilities are state-monitored. Robert Mollica, Senior Program Director of the National Academy for State Health Policy in Washington, D.C., notes in a report that state standards are not uniform. Most states post licensing regulations on web sites and provide online access to their licensed facilities. Some states have online surveys and complaint portals to monitor the quality of the services that assisted living facilities are providing. However, resident outcomes and data are not collected or available for comparison either within a state or from state to state.

The consumer interested in assisted living must do most of the groundwork in determining a facility's suitability. However, assisted living facilities are a valuable resource along to the spectrum of care available to the aging.

Information about assisted living in general is available from the U.S. Department of Health and Human Services' Administration on Aging (AoA), under the "Elders and Families" and "Housing Services" sections of the web site. The site also provides guidance on the standards consumers should keep in mind when shopping for an assisted living facility. The consumer interested in assisted living must do most of the groundwork in determining a facility's suitability. However, assisted living facilities are a valuable resource along the spectrum of care available to the aging.

Sources

Administration on Aging. Assisted Living. Available online at: http://www.aoa.gov/eldfam/Housing/Housing_Services/HH_Assisted_Living.asp.

Genworth 2014 Cost of Care Survey. Executive Summary. Available online at: https://www.genworth.com/dam/Americas/US/PDFs/Consumer/corporate/131168-032514-Executive-Summary-nonsecure.pdfhttps://www.genworth.com/dam/Americas/US/PDFs/Consumer/corporate/131168-032514-Executive-Summary-nonsecure.pdf.

Mollica, R.L. (2006). Residential Care and Assisted Living: State Oversight Practices and State Information available to Consumers. Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services. Available online at: http://www.ahcancal.org/ncal/resources/Documents/AHRQ_study_2006r.pdf. AHRQ.

National Center for Assisted Living. Resident Profile. Available online at: http://www.ahcancal.org/ncal/resources/Pages/ResidentProfile.aspx.

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