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Assisted Living Facilities

August 3, 2010

Assisted living (AL) is a form of long-term care that promotes self-direction and participation in decisions. As a model of supportive housing, assisted living emphasizes independence, individuality, privacy, dignity, and choice. It was initially developed to fill the gap between community-based services that support seniors living at home and nursing homes. Assisted living generally places a greater emphasis than nursing homes on preserving “home-like” qualities such as control over one’s personal space. Assisted living is growing rapidly, both because it offers an attractive option to seniors seeking assistance while maintaining independence, and because of the costs associated with traditional long-term care institutions.

Defined broadly, assisted living is any group residential program not licensed as a nursing home that can respond to unscheduled needs for assistance. The spectrum of assisted-living services includes such diverse options as congregate housing, residential-care facilities, board-and-care homes, and adult foster care homes. The package of services can be tailored according to consumer needs and preferences.

“Assistance” in these facilities can be defined as help with any “activity of daily living,” which includes bathing, grooming, administration of medications, transferring (help with moving), toileting, laundry, cleaning and meal reminders. Keep in mind that AL facilities can be very different and offer varying degrees of services. One facility may offer only limited assistance, while another may offer more comprehensive care. AL is most appropriate for the individual who needs some assistance but is not ready for a nursing home.

Are there assisted-living facilities especially for people with Alzheimer’s?
Assisted-living facilities for people with Alzheimer’s disease are often referred to as “Special Care Units” or SCUs. SCUs are staffed with individuals who are specially trained to work with people who have Alzheimer’s. As such, the environment is designed to be very safe and comfortable, and the activities are designed to benefit the person with Alzheimer’s.

SCUs can differ in the level of care they provide along the continuum of the disease. For instance, some assisted living facilities will accept people with Alzheimer’s until they need skilled care (nursing home care) whereas others will only accept people who are in the early stages of the disease.

What do I look for in a Special Care Unit (SCU)?
Some of the specific characteristics to look for in SCUs are:

What questions should I ask?
1. Do you accept people with Alzheimer’s disease? If so…

2. How many levels of care do you have and how are they categorized?
3. Aside from the monthly fee, are there any additional costs involved?
4. What does the monthly payment include?
5. What happens when the family runs out of money? Do you accept state funding (Medicaid)? If not, what happens?
6. How many nurse’s aides are scheduled on each shift? How are weekends handled? What is the ratio of caregivers to residents?
7. Is transportation included?
8. What are your limitations regarding the needs of the person?
9. Do you allow wheelchairs?
10. Do you allow oxygen?
11. Do you take people who have incontinence problems?
12. What is your procedure for handling death and dying?
13. Do you provide hospice care services, or does the patient need to be transferred to a nursing home?

How do I pay for assisted living?
Although some facilities accept state funding (Medicaid), assisted living is ordinarily paid for privately.

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