What is an assisted-living facility?

About one out of every 300 Americans resides in an assisted-living facility. Assisted-living facilities are designed to help the sick, impaired, disabled or aging adult with basic tasks like dressing or bathing while also striving to preserve an individual's maximum personal independence and self-reliance. This type of residence is designed (and appropriately equipped) to assist residents primarily with the everyday challenges of living that many of us take for granted: reading the small print on medication labels, cooking and eating meals, and staying on top of household cleaning and laundry.

There seem to be about twice as many definitions for assisted living facilities: "residential care," "retirement residences," "adult foster care", "personal care," and "enriched housing program," simply to name a few. When selecting an assisted living option, be sure that what's being portrayed is what you're seeking. Often, these terms are used interchangeably with different types of personal care, like nursing homes.

Assisted-living homes are not nursing homes-even though your sense of balance may not be what is it used to be doesn't mean the time has now arrived for bedside care and near-constant supervision. Assisted-living facilities do not offer around-the-clock care-nursing homes do that. But a person who is no longer completely capable of caring for himself or herself (or just requires a bit of assistance from a friend or relative) may be appalled at the idea of moving into an "old folks' home." Assisted living also enables aging adults who are experiencing the early stages of Alzheimer's or suffer from dementia related to advanced age to be given care as needed, and not around the clock.

With over 20,000 distinct assisted-living facilities in the United States, there is no collective "look" or blueprint. A facility may have on-site beauty salons and barbershops, horse stables, or swimming pools. Or, none of these amenities may be available within an assisted-living residence. What they do share are common caregiving features. So it may be that one facility offers rooms that are similar to those at the Chelsea Hotel, while another facility flaunts accommodations akin to large multi-roomed condominiums; both will make available similar services such as laundry or meal preparation, on a per-fee basis.

Assisted living is a senior living option that combines housing, support services and health care, as needed. Assisted living is designed for individuals who require assistance with what are called activities of daily living (ADL). These include:

• Personal hygiene and grooming
• Dressing and undressing
• Feeding
• Functional transfers
• Voluntarily controlling urinary and fecal discharge
• Elimination
• Walking/Ambulation

Assisted living facilities typically do not care for those needing continuous nursing care; however, you may find such residents in these facilities. Typically they started living there needing the basic ADL assistance. Facilities and residents alike often do not want to part company even as the resident’s condition worsens. It is not uncommon to find advanced dementia and Alzheimer’s residents in assisted living facilities.

Who Pays?

The resident pays typically on a month-to-month lease. The basic rate may cover all services or there may be additional charges for special services. Some states offer "home and community-based waivers" that allow low-income residents to live in assisted living. Long-term care insurance will also pay though relatively few people choose to purchase it.

There are 36,000+ assisted living communities nationwide serving more than one million seniors and they are regulated in all 50 states. All settings offer 24-hour care and supervision for those who need assistance.

Assisted living communities provide many of the services as the Continuing Care Retirement Community – meals, housekeeping, transportation, security, exercise and wellness programs, laundry, social and recreational services.

Many assisted living facilities are built in proximity to hospitals so that there is quick access to health and medical services. They may offer emergency call systems, medication management and other health and safety options.

An assisted-living facility is defined as housing that provides regulated nursing care with assistance available for housekeeping and meal preparation. Such environments are usually long-term, but may be used for shorter periods, e.g. after hospitalization when such assistance is needed for shorter, defined stays.

While some government reimbursement is available, most assisted-living fees are private pay and outside of the purview of 3rd party insurance, with the occasional exception of long-term care insurance. Most assisted-living facilities provide various levels of service. Assistance is standard for activities of daily living (bathing, dressing, eating etc.) and medication administration, but may require additional fees for laundry services, shopping, etc. In the assisted-living environment, a prescription is needed for all medications, including those available over-the-counter (traditionally without a prescription). Usually transportation to physician office visits and the like is provided, but some transportation may incur a fee as well.

Assisted-living facilities can be not-for-profit or for-profit and may or may not be available to the general public. For example, some assisted living facilities are part of Continuing Care Retirement Communities (CCRC's), e.g. Moorings Park in Naples, Florida. In that particular setting, their beautiful Orchid Terrace assisted-living facility only allows residents of Moorings Park access to their premium assisted-living services.

When evaluating an assisted-living facility, take a tour and ask about whether there is a medical director who is a geriatrician. Sit down and have a meal at the facility. Finally, talk to some of the residents. While Assisted-living facilities sometimes have dementia units, most are dealing with very cognitively intact residents who will be happy to share their experiences.

Assisted Living Facilities, or ALFs, are residential facilities that provide basic food and shelter for people who are no longer able to provide these for themselves. Care in ALFs is not covered by Medicare or Medicaid, but is specifically covered by some long-term care insurance policies. Some ALFs only provide assistance with basic self-care while others may additionally provide medication administration and medical monitoring, such as blood pressure measurements or blood sugar testing.