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What You Need to Know about Assisted Living - Kathy Cameron, Chair, CCAL Board of Directors

What is Assisted Living?

Assisted living is a residential care option for individuals who typically can no longer live independently. It provides or coordinates services to meet residents’ individualized needs in ways that promote their independence and reflect their personal choices.

There are more than 26 designations that states use to refer to what is commonly known as assisted living, and there is no single uniform definition. The definition that CCAL and a large number of national organizations support is as follows: "Assisted living is a state-regulated and -monitored residential long-term-care option. Assisted living provides or coordinates oversight and services to meet the residents' individualized scheduled needs, based on the residents' assessment and service plans and their unscheduled needs as they arise."

Service provisions must include but are not limited to:
• 24-hour awake staff.
• Provision and oversight of personal and supportive services.
• Health-related services (e.g., medication management services).
• Social services.
• Recreational activities.
• Meals.
• Housekeeping and laundry.
• Transportation.

A resident has the right to make choices and receive services in a manner that promotes dignity, autonomy, independence, and quality of life. These services are disclosed and agreed to in the contract between the provider and resident. Assisted living does not generally provide ongoing, 24-hour skilled nursing care.

What Does Assisted Living Look Like? The wide range of assisted-living facilities available doesn't adhere to a single model or design. One facility could be a high-rise building housing several hundred individuals, or it could be a small home with just a few. Living accommodations can include a full-size apartment or a single room. In some facilities, services are limited to meal preparation, housekeeping, medication reminders, and minimal assistance. In others, more intensive services, including help with administering medications, on-site nurses, and regular assistance with daily activities such as bathing and dressing are available.

How Can I Identify a Good Assisted-Living Community? Regardless of the size or look of the community, the foundation of a quality assisted living residence lies in its philosophy, practices, administration, and staff. You want to be sure that the administration’s philosophy and practices are truly resident-centered. You also want to know that they have well-trained, qualified direct care staff and have sufficient numbers of them to meet residents' promised and unscheduled or emergency needs. The environment should be warm and inviting, with administrators, staff, residents, and family members interacting in a caring, respectful manner. For more information on choosing a facility, check out the CCAL's Choosing an Assisted Living Facility: Considerations for Making the Right Decision.

Who Lives in Assisted-Living Residences? There are approximately 1 million assisted-living residents living in more than 36,000 facilities nationwide. The majority of individuals move into assisted living because of a significant change in health condition. Approximately two-thirds of residents come to assisted living from home. The rest come from hospitals, nursing homes, and other assisted-living facilities.

What Are the Costs/Fees? Approximately 90 percent of individuals pay for assisted living out-of-pocket or through other private funding. Monthly payments can range from $1,500 to $6,000 and up, depending on geographic location, unit size, and services provided. Shared units, if available, generally cost less.

Is Assisted Living Covered by Medicare, Other Government Programs, or Private Insurance? Medicare, the federal health insurance program for older individuals, does not cover assisted living. Forty-one states currently use Medicaid waiver monies for some low-income individuals to support assisted-living expenses, but the majority of assisted living is private pay. Increasingly, long-term-care insurance policies include coverage for assisted living. There have been some payment issues from insurance companies for residents in states that do not have an appropriate assisted-living licensing process. Be sure to check the status of your state.

The Consumer Consortium on Assisted Living educates consumers, trains professionals, and advocates for assisted-living issues. It is currently the only national consumer education and advocacy organization focused on the needs, rights, and protection of assisted-living consumers, their caregivers, and their loved ones.

Helpful Tools and Resources

ADVOCACY PARTNERS

Alliance for Aging Research is a private, non-profit organization that is the nation's leading citizen advocacy organization for improving the health and independence of Americans as they age.

American Health Assistance Foundation is a non-profit organization that funds research into cures for Alzheimer’s disease, macular degeneration and glaucoma, and provides the public with information about risk factors, preventative lifestyles, available treatments and coping strategies.

Career Nurse Assistants' Programs, also known as the National Network of Career Nursing Assistants, promotes recognition, education, research, advocacy and peer support development for nursing assistants in nursing homes and other long term care settings.

Children of Aging Parents is a nonprofit, charitable organization whose mission is to assist the nation's nearly 54 million caregivers of the elderly or chronically ill with reliable information, referrals and support, and to heighten public awareness that the health of the family caregivers is essential to ensure quality care of the nation's growing elderly population.

The Employee Assistance Professionals Association is the world's largest, oldest, and most respected membership organization for employee assistance professionals.

Faith in Action brings together volunteers from many faiths to work together to care for their neighbors who have long-term health needs.

National Association of Professional Geriatric Care Managers represents health and human services specialists who help families care for older relatives, while encouraging as much independence as possible.

The National Association of Senior Move Managers is a not-for-profit, professional association of individuals who assist older adults and families with the physical and emotional demands of relocating, downsizing, or modifying their homes.

National Association of Women Business Owners is the voice of America's 10.4 million women-owned businesses. Since 1975, NAWBO has helped women evolve their businesses by sharing resources and providing a single voice to shape economic and public policy.

National Capital Chapter of the National Multiple Sclerosis Society is committed to providing comprehensive support services to help people with MS and their families better cope with the consequences of the disease.

The National Family Caregivers Association educates, supports, empowers and speaks up for the more than 50 million Americans who care for loved ones with a chronic illness or disability or the frailties of old age.

National Gerontological Nursing Association is dedicated to the clinical care of older adults across diverse care settings. Members include clinicians, educators, and researchers with vastly different educational preparation, clinical roles, and interest in practice issues.

NCCNHR: The National Consumer Voice for Quality Long-Term Care is a non profit consumer advocacy organization dedicated to quality long-term care. Consumer focused resources are available including a comprehensive guide to choosing a nursing home; Fact sheets on resident rights and how to get quality care; as well as a clickable map consumers can use to find resources in each state, such as long-term care ombudsmen who resolve grievances and promote systemic change, citizen advocacy groups who work for long-term care reform in their communities and states, and state inspection agencies.

The Rosalynn Carter Institute for Caregiving works to establish local, state and national partnerships committed to building more effective long-term care systems and providing greater recognition and support for America's unsung heroes - the millions of caregivers, both family and professional, who provide us all with models of selfless service and hope for the future.

SAGE (now known as Services & Advocacy for GLBT Elders) is the world's oldest and largest non-profit agency dedicated to serving lesbian, gay, bisexual, and transgender senior citizens.

Society of Certified Senior Advisors educates professionals in the field of aging, awarding the CSA credential to those who successfully complete designation requirements.

SERVICE AND PRODUCT PARTNERS

The CareGiver Partnership is a direct to consumer provider of approximately 1,800 of the most commonly used products for home healthcare including incontinence, nutritional, diabetic, wound care, daily living, personal care and arthritis.

Disposables Delivered provides professional guidance, superior products and discreet home delivery to those who must deal with incontinence on a personal level or in helping another.

Pope Institute is a national health care consulting firm specializing in helping families plan for elder care and disability needs.

HELPFUL RESOURCES

AARP Senior Housing Help
The AARP has a section on senior housing choices.

Family Caregiving 101 is designed to provide caregivers with the basic tools, skills and information they need to protect their own physical and mental health while they provide high quality care for their loved one.

The National Long Term Care Ombudsman Resource Center advocates for residents’ rights and quality care.

Nursing Home Compare - This tool on the Medicare website at displays quality measure data, deficiencies and other information about nursing homes. It is organized by state and county to help you search for facilities near you or anywhere in the country.

The U.S. Administration on Aging offers government-based
resources for senior living choices.

Strength for Caring lists of some of the more common housing solutions and explains the benefits, services, and the types of support (medical, daily needs, healthcare, etc.) you can expect.

The Veterans Administration's Aid and Attendance Program can provide veterans and surviving spouses financial resources towards home health care, nursing home stays, or assisted living options.