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.
As widely 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 resident 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 staffs 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.
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.
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 for 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.