Choosing an assisted living facility isn't always easy. There are many factors to consider, including what size community will be the best choice. Larger facilities typically point to corporate chains while smaller facilities are usually privately owned. Which is the perfect size for living out the golden years?

Perfection Is up for Definition

When it comes to picking the perfect assisted living community, size does matter. The National Center for Health Services partnered with the Centers for Disease Control and the U.S. Department of Health and Human Services to study how sizes of facilities affect long term residential care for elderly residents.

In a 2012 study of long-term care providers of both small and large assisted living facilities, researchers found that overall, residential care providers, large and small, offered many of the same services, including health-specific programs for individuals requiring additional support, such as early-onset dementia and depression. They also noted some differences.

Requirements for classification as a small assisted living facility were that between four and 25 beds were offered. Large facilities offered between 26 and 50 beds, with some even larger, holding over 50 beds. Smaller facilities outnumber larger ones by almost twice as much; however, a majority of individuals (70%) chose the larger facilities to call home.

Here are some reasons why researchers believe the larger facilities draw in more residents. Despite the majority of residents, it doesn't mean larger facilities are the perfect size for everyone. That is still an individual decision.

Long Term Care in a Large Assisted Living Facility

For the most part, larger facilities are able to offer more routine screenings for cognitive impairments. They are also more apt to provide certain onsite dementia-specific programs if impairments are found. Because assisted living facilities are not nursing homes, these early intervention type programs can be highly beneficial in catching dementia while still in the early stages, which offers a good window of opportunity to slow down the progression of the disease.

Researchers also found that the larger assisted living facilities were able to provide more dental, mental health, therapeutic, and hospice services than the smaller communities. Having these services more readily available may be considered a tremendous benefit if these services cannot be easily provided for independently. However, this may be of little concern for some individuals who choose to remain with the familiar healthcare and dental professionals they have been using for years.

As the demand for assisted living communities continues to rise alongside the increase in the elderly population across the globe...

Larger facilities were typically older than the smaller ones. Many of the large assisted living facilities (78%) had been in operation for 10 or more years compared to the smaller facilities (49%). This led to the discovery that more of the smaller facilities were of newer construction. As the demand for assisted living communities continues to rise alongside the increase in the elderly population across the globe, it only makes sense that residential communities should see such an expansion. This statistic of growth in newer small communities may just point to a rising trend in the demand for a more intimate setting of smaller assisted living residences as opposed to larger ones.

Long Term Care in a Small Assisted Living Facility

Researchers noted a growing trend in non-profit assisted living communities, particularly with the larger facilities. In fact 86% of all smaller assisted living facilities remained for profit. This means that more and more large communities are offering programs for lower-income families who need help meeting the demand of housing costs. For smaller communities, this could point to higher standards of care where the saying you get what you pay for holds true.

In non-profit communities, services are offered based on available funding from grants and donations. Smaller, for-profit facilities may not offer as diverse an array of services, but a higher quality of individualized care is associated with the smaller resident-to-employee ratio. It is almost like choosing a private school with a smaller teacher-to-student ratio as opposed to public school classrooms with less opportunity for one on one attention. With more individualized care, the need for large scale screenings diminishes.

Appropriate Licensing Is a Must, No Matter What the Size

The National Long-Term Care Ombudsman Resource Center is an advocacy organization dedicated to enhancing the lives of long-term care residents who choose assisted living communities as their place of residence. In an annual report that delves into the logistics of assisted living facilities, it was stated that licensure plays an important role, no matter what the size of the community. It helps determine what services an assisted facility will choose to provide. Yet it also benefits consumers who can better compare facilities and make informed decisions. By choosing to be licensed in one area, assisted living communities are saying to the public that they are confident their service will meet needs and expectations.

When choosing an assisted living community, size and licensing matters. Licensing offers peace of mind, knowing the quality of care sufficiently meets an approved core set of standards. The size of the facility is a personal choice, so it is wise for family members to tour different communities to get a better feel for each location before settling on such a major decision.

Sources

Caffrey, C., Harris-Kojetin, L., Rome, V., Sengupta, M. (November 2014). Operating Characteristics of Residential Care Communities by Community Bed Size: United States 2012. NCHS Brief, 170. National Center for Health Statistics. Centers for Disease Control and Prevention. U.S. Department of Health and Human Services. Available at https://www.healthlawyers.org/Events/Programs/Materials/Documents/LTC15/l_kyllo_sumner_nchs_data_brief_170.pdf. Last Visited April 4, 2016.

National Long-Term Care Ombudsman Resource Center. (April 2003). Policy Principles for Assisted Living. Available at http://ltcombudsman.org/uploads/files/support/PolicyPrinciplesforAL0403_0(1).pdf. Last Visited April 4, 2016.

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