Assisted Living Fact Sheet

What is Assisted Living?

• A residential setting
• Promotes aging in place
• Supportive, health-related services
• Available 24-hours a day to meet unscheduled needs

Philosophy of Assisted Living

• Helps people maintain their optimal autonomy and independence
• Family-like environment
• Homelike environment (such as personal furniture, privacy)
• Strives to provide services in the way people are accustomed to

Assisted Living serves people who

• Need help with housekeeping chores, meal preparation, bathing, dressing, or taking medications
• Require some health care assistance or monitoring
• Need transportation and mobility assistance or monitoring
• Have periods of confusion or memory problems

Services provided

• Skilled nursing - nurse delegation from own staff or outside staff
• Meals Assistance with personal care activities
• Help with medications
• Transportation
• Shopping
• Housekeeping
• Laundry

Characteristics to observe in Assisted Living Facilities

• Staffing - inside or outside providers
• Numbers per resident - staff ratios
• Availability of licensed personnel - RN (registered nurse), LPN (license practical nurse)
• Level of training of aides - certified medication aides
• Supervisors of staff - licensed administrators

Staffing requirements for Assisted Living

• Facility shall maintain a sufficient number of staff with the required training and skills necessary to meet the resident population's requirements for assistance or provision of personal care, ADL's (activities of daily living), health maintenance, supervision and other supportive services.
• Facility shall have at least one staff person on the premises at all times when necessary to meet the needs of the residents.

Medication administration includes, but is not limited to:

• Providing medications to another person according to the "Five Rights."
  • The right resident, the right drug, the right dosage, the right route, and the right time.
• Recording medication provision.
• Observing, monitoring, reporting and otherwise taking appropriate actions regarding desired effects, side effects, interactions, and contraindications associated with the medication.

Resident Service Agreements

• Service plans and assessment must be very specific.
• Services must reflect the findings of the assessment.
• Services are congruent with those offered by the facility.
• Level of care must be specified. (Is the level of care beyond the facility's ability?)

Observations related to Assisted Living services

• Condition of residents
  
  • Clothing
    • Cleanliness
    • Fit
    • Appropriate to temperature - elderly tend to wear more clothing for warmth
  • Appearance
    • Hair cleaned and combed
    • Nails cleaned and trimmed
    • Skin - general condition
      • Dryness - alleviated by proper humidification in heating system
      • Lesions - possible diabetes, may lead to infection
      • Rash
      • "Bagginess" - possible weight loss
      • Bruises, cuts - note location, stage, pattern to determine abuse, neglect, or falling
• Behavior of Residents
  • General demeanor
    • Smiling, laughing appropriately or sad, crying
    • Eye contact - may be cultural issue
    • Communication pattern
  • General comments
    • Pleased with care, food choices, privacy, staff, etc.
      
• Recognizes and likes staff - calls them by name
  • Staff
  • Ratio of staff to residents is adequate to meet needs.
  • Appropriately trained staff are available to meet resident service needs.
  • Appropriate levels and numbers of staff are available at all times they may be needed.
  • Residents are receiving services from properly trained staff.
  • Appearance of staff
  • Visibility of staff in facility - Are staff clustered together, rather than with residents?
  • Responsiveness of staff to residents' calls.
  • Staff familiarity with residents
  • Manner in which staff address residents.
  • Manner in which staff discuss residents, especially "difficult" ones.
    
• Condition of facility
  • Cleanliness, lack of clutter, lack of odors
  • Safety
  • Environment appropriate to needs of residents
  • Amenities available - telephone, assistive devices
  • Privacy available for resident
  • Homelike atmosphere (unless there are issues of safety)
    • Facility pets
    • Common Areas - set up to facilitate socialization, warm and comfortable
      

Source: Dr. Linda Redford, Center on Aging, Kansas University Medical Center, at "Assisted Living Skills Training" sponsored by Nebraska Department of Health and Human Services, January 20, 1999.

Compiled by the Lincoln/Greater Nebraska Chapter of the Alzheimer's Association, 1999.