Assisted Living Residents

 More than 650,000 Americans currently live in assisted living communities. The average age of a resident in an assisted living community is 85. Assisted living is appropriate for seniors who need some level of assistance with everyday activities such as meals, medication management, transportation, bathing. Some residents may suffer from Alzheimer’s or forms of dementia. Some residents may be frail and need assistance with mobility, incontinence or other challenges. Many residents in assisted living are under the care of Hospice.

What is an assisted living residence?

An assisted living residence is a special combination of housing, personalized supportive services and health care designed to meet the needs — both scheduled and unscheduled — of those who need help with activities of daily living.

What is the philosophy of assisted living?

10-point philosophy of care:

1. Offering cost-effective quality care that is personalized for individual needs
2. Fostering independence for each resident
3. Treating each resident with dignity and respect
4. Promoting the individuality of each resident
5. Allowing each resident choice of care and lifestyle
6. Protecting each resident’s right to privacy
7. Nurturing the spirit of each resident
8. Involving family and friends, as appropriate, in care planning and implementation
9. Providing a safe, residential environment
10. Making the assisted living residence a valuable community asset

Who lives in assisted living residences?

Currently, more than a million Americans live in an estimated 20,000 assisted living residences. assisted living residents can be young or old, affluent or low income, frail or disabled. A typical resident is a woman in her eighties and is either widowed or single. Residents may suffer from Alzheimer’s disease or other memory disorders. Residents may also need help with incontinence or mobility.

What does an assisted living residence look like?

Assisted living residences can range from a high-rise apartment complex to a converted Victorian home to a renovated school. Residences may be free standing or housed with other residential options, such as independent living or nursing care. They may be operated by non-profit or for-profit companies. Most facilities have between 25 and 140 units. There is no single blueprint, because consumers’ preferences and needs vary widely. Units may vary in size from one room to a full apartment.

How is assisted living regulated?

Licensing and other assisted living regulations vary from state to state contributing to the wide range of senior housing models considered assisted living. Most providers and their staff have special training as a result of either state requirements or company policy. Some states require special staff certification and training. Residences must comply with local building codes and fire safety regulations. The SC Department of Environmental Control regulates assisted living here in South Carolina. They can be contacted at (803) 898-3432, ask for the Divison of Health Licensing.

What types of services are offered in assisted living residences?

Services provided in assisted living residences usually include:
• Three meals a day served in a common dining area
• Housekeeping services
• Transportation
• Assistance with eating, bathing, dressing, toileting and walking
• Access to health and medical services
• 24-hour security and staff availability
• Emergency call systems for each resident (s) unit
• Health promotion and exercise programs
• Medication management
• Personal laundry services
• Social and recreational activities

What about costs?

Costs vary with the residence, room size, and the types of services needed by the residents. Across the nation, the median monthly rate per resident is $2,350 (source: 2006 Overview of Assisted Living) — generally less than the cost of home health services and nursing home care. A basic assisted living fee may cover all services or there may be additional charges for special services. Most assisted living residences charge month-to-month rates, but a few residences require long-term arrangements.

Who pays the bill for an assisted living residence?

Residents or their families generally pay the cost of care from their own financial resources. Depending on the nature of an individual’s health insurance program or long-term care insurance policy, costs may be reimbursed. In addition, some residences have their own financial assistance programs. Government payments for assisted living residences has been limited. Some state and local governments offer subsidies for rent or services for low income elders. Others may provide subsidies in the form of an additional payment for those who receive Supplemental Security Income or Medicaid. Some states also utilize Medicaid waiver programs to help pay for assisted living services.

How to find an assisted living residence?

• Call the national Eldercare locator service at (800) 677-1116. Calls are accepted between 9 a.m. – 5 p.m. Monday through Friday.

• In SC, Call SC DHEC at (803) 898-3432 to get a list of the licensed facilities in SC. You may also visit there  website at www.scdhec.net to find the listing online.

• Contact your local area agency on aging. These agencies are generally listed in the blue pages of your telephone directory.

• Check your library for the National Directory of Retirement Facilities.

Tips for Cutting Costs of Assisted Living

Responding YES to Questions Below May Help Make Assisted Living Affordable

  • Along the same line as hotel ratings, can you manage to be comfortable in a “3 star” moderate facility as opposed to needing a “5 star” luxury facility?
  • Are you able to forgo a room with special views, a location close to common areas, ground floor, or with a balcony and patio?
  • Are you willing to move to a facility that is in a lower traffic, possibly quiet urban setting with less nearby conveniences such as shopping center complexes?
  • Are you willing to relocate to an overall lower cost of living area that may be some distance from your current home?
  • Are you willing to reduce your square footage living requirements substantially, which may accommodate only a few special pieces of furniture?
  • Are you willing to share an apartment or room with a roommate or share a bathroom in a suite arrangement?
  • Will you consider moving to a new facility with no prior track record or established reputation but that may offer new residents special moving in rates?
  • Is family willing and able to share with some of the maintenance chores such as housekeeping, laundry and transportation?
  • Is family willing and able to purchase medications and supplies outside of facility at lower prices?
  • If you or your spouse is independent and in good health, will you consider living in the independent senior apartment area and bringing in outside help for the more dependent one?

Residential Care and Assisted Living: State Oversight Practices and State Information

South Carolina

Approach

The Department of Health and Environment licenses community residential care facilities. Facilities are licensed annually. General inspections and fire, life and safety inspections are done on alternate years. Facilities with a history of compliance and no complaints may have a general inspection every 3 years. Inspectors must have a college degree, and an RN is available to assist with clinical issues. Inspectors provide technical assistance during their site visits. Facilities may also request technical assistance independent of an inspection visit. Inspectors use a checklist during their reviews. The process includes interviews with residents based on the inspector’s observations.

Facilities must submit a plan of correction to the State licensing agency when issues of noncompliance are documented. Consultations are available as requested by facilities or as deemed appropriate by the State.

Facilities must have a written quality improvement program. The program must establish desired outcomes and the criteria by which effectiveness is accomplished; identify and evaluate the causes of deviation from desired outcomes; develop action plans to prevent future deviations; establish quality indicators; analyze appropriateness of care plans; review all incidents and accidents including resident deaths, infections, or other occurrences that threaten the health and safety of residents; and create a systematic method of obtaining feedback from residents and other interested parties on the level of satisfaction with care and services received.

Communicating with Consumers

The Department’s Web site includes licensing regulations, a list of licensed facilities (name, address, phone, contact person, license number and expiration date, and the licensed capacity), and information for providers. The provider documents include licensing procedures and requirements, information on criminal background checks, emergency evacuation requirements, level of care criteria, changes in medication administration training, a self-inspection guide that tracks the regulations, special care disclosure requirements, staff orientation and in-service checklist, a request for consultation form, and frequently asked questions.
The Office on Aging hosts a Web site with a searchable database of all the services available in the State. Selecting assisted living (community residential care facilities) from the drop down menu produces the list of facilities with descriptions of the services available. Each listing has a link to an array of information that sometimes varies from facility to facility. The information includes a description of services available, location, area served, intake requirements, client information (conditions, age group, sex, grievance process), fees and payment sources accepted, hours of operation (service availability), address and phone number, and additional information about eligibility and affiliated programs or agencies.

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