ASSISTED LIVING OPTIONS
For some older adults, assisted living facilities (ALFs) offer a place to live that allows the chance to remain somewhat independent, yet provides residents various levels of assistance. ALFs help those people who cannot live completely on their own in the community but do not need nursing home care. For example, a person living in an ALF might need help with bathing and dressing, but otherwise is mobile and independent.
Cultural and geographic differences
The Health Care Systems Committee of the American Geriatrics Society has developed a position paper that will help older adults and their families/caregivers decide whether assisted living is right for their situation. It will help caregivers decide which ALFs are able to provide the best care for their loved one and guide ALF stakeholders toward provision of this care.
Be aware that all ALFs are not created equal. They differ in the services provided and by the criteria residents must meet to live in that ALF. It is important to know that ALFs are less regulated by state and federal agencies than are nursing homes. This is because in most states Medicaid does not pay for the ALF stay (the resident usually pays). However, by law, the following services must be provided or coordinated by an ALF:
- 24-hour staff to oversee and meet scheduled and unscheduled needs
- Provide and oversee supportive services (such as services that help with a person's activities of daily living)
- Health-related services, social services, meals, housekeeping and laundry, recreational activities, and transportation.
In the United States, most of the large multi-facility providers are publicly owned and managed as for-profit businesses. There are exceptions; the largest operator in the US is the Evangelical Lutheran Good Samaritan Society, a not-for-profit organization that manages 6,531 beds in 22 states, according to a 1995 study by the American Health Care Association.
What You Need to Know About Choosing an Assisted Living Facility
- Ask About Services Provided. Ask carefully about all of the services provided in order to find a good "match" between the resident and the facility. What does the resident need, and is the ALF able to meet this need? For example, does the ALF provide help with dressing and bathing? Will they make sure the resident takes his or her medications on time and correctly?
- Ask About Staffing. Are there registered nurses, practical nurses, and/or nursing assistants? Is the staff knowledgeable about geriatric care, such as medication safety, falls prevention, incontinence care, skin care, and changes that can signal acute illness? Is there a primary care provider (a physician or geriatric nurse practitioner) experienced in geriatrics available to help direct the staff in providing resident care?
- Ask About a Care Plan. Within 30 days of admission, a qualified licensed practitioner (a physician or geriatric nurse practitioner) should evaluate the resident's physical, medical, and psychosocial needs. They should also review all medications that the resident is taking (prescriptions, over-the-counter medications, vitamins, and any herbal remedies). Using this information, the licensed practitioner can create a care plan that will guide the staff in meeting the resident's needs. Family, the resident, and any caregivers should review the plan and be aware of the responsibilities of the family and of the ALF for the resident's well-being and care.
- Ask About Other Health Care Needs. Is the ALF tied to other facilities and providers, such as hospitals, home care, and rehabilitation facilities? For example, if a resident needs physical therapy after a fall, can the ALF staff help arrange for this special care? Is the ALF tied to Programs of All-inclusive Care for the Elderly and other Medicare insurance options?
There are many resources available that provide information about specific assisted living facilities by state, city, and name of the facility. A good place to start is the website of the Assisted Living Federation of America ( HYPERLINK "http://www.alfa.org" www.alfa.org), where you can find a wealth of information about ALFs. Remember, "do your homework" to find the right ALF for your loved one.
