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Assisted Living Facilities:
An Introduction
By Emily McDowell
What is assisted living? The Assisted Living Federation of
America (ALFA) defines assisted living as "the housing
and health care alternative combining independence with personal
care in a warm, dignified, community setting." An assisted
living facility is a viable option to consider if a loved
one needs help with certain activities, from meal preparation
to bathing, yet doesn't want or need to be completely dependent
upon a caregiver.
All accredited assisted living facilities provide room and
board, 3 meals a day, 24-hour security and emergency assistance,
housekeeping, laundry services, and social activities. In
addition, they are equipped to provide help with the basic
ADLs (Activities of Daily Living). These include dressing,
eating, mobility, hygiene, bathing, toileting and incontinence,
using the phone, and shopping. At some facilities, all of
these services are included in the basic fees, while others
charge supplemental fees.
Assisted living facilities do not provide regular nursing
or rehabilitation services, such as those offered by a nursing
home. Residents of an assisted living facility typically live
in one- or two-bedroom units, with private bathrooms, that
are furnished with the resident's own furniture. Couples can
stay together, and residents can choose to live alone or with
a roommate. At a nursing home, by contrast, the atmosphere
is far ranging, from institutional, with many beds in a single
large area, to hotel-like accommodations.
Assisted living facilities are community-oriented and inclusive,
with structured social and recreational activities. When you
evaluate a facility's "fit" for a loved one, make
sure you consider the type of community it offers, its quality
of care, safety, and value. On your visits, try to view the
facility through the eyes of a resident: can you "picture"
living there? Also, try to make several visits at varying
times of day and stay overnight if possible. This way, you
can get the best impression of a resident's experience.
Choosing an assisted living facility is somewhat akin to
choosing a college for your child. There are thousands of
these facilities nationwide, and they vary immensely in terms
of fees, services, size and layout, and type of community
offered. The average bill for basic assisted living service
can range from $5,400 to $100,000 or more per year, and the
vast majority of residents pay the bills out of their own
pockets. According to the Public Policy Institute's Fact Sheet
on Assisted Living (March 1999), the average annual income
of assisted living residents is $31,000. Moreover, the majority
of these residents are not receiving additional public or
private financial assistance.
Choosing a facility--or even discussing this option with
loved ones--is an extremely difficult process. Experts recommend
beginning your search early if you can: six months to a year
before the anticipated move will give you ample time to weigh
your choices and thoroughly evaluate your options. Also, keep
in mind that the best facilities often have waiting lists
of two or more years, so it's definitely to your advantage
to shop around and add your name to a list long before you're
confronted with an immediate need.
The ALFA site www.alfa.org
features a nationwide directory of assisted living facilities,
searchable by location, type of services offered, price, and
more. You can also find listings of facilities at www.assistedlivingonline.com.
Many assisted living facilities have extensive Web pages,
making it easier to narrow down your choices from home. You
can also use the Eldercare locator service to help you find
assisted living resources by calling (800) 677-1116.
Other recommended resources include www.retirementliving.com,
which includes nationwide listings of various types of retirement
communities and senior housing, as well as tax resources for
the elderly and a "virtual marketplace" where you
can buy books, products, and services tailored to the needs
of seniors. Also check out www.retirenet.com
for more listings--nationwide and in Canada, Mexico, and the
U.K. The Website of the Massachusetts Extended Care Federation
(www.mecf.org)
lists facilities within Massachusetts only but contains valuable
educational information about long-term care options and related
topics.
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