What is assisted living (AL)?
A Scandinavian model for senior care, now known as assisted living, made its way into America’s care system in the 1980’s. According to a 2012 report by AARP, there is no standard definition for assisted living (AL). Although individual states and residential facilities can give their own definition of AL, the term most often means that help is provided with meals, social support, medications, dressing and/or bathing and the like with 24-hour per day supervision. The Assisted Living Federation of America (ALFA) (2013) defines assisted living as “a long-term care option that combines housing, support services and health care, as needed”. The focus of AL is on maintaining dignity, respect, and independence of older residents.
In 2010, there were more than 51,000 licensed residential care settings (including assisted living) that reported more than 1.2 million beds (AARP, 2012). A study published by the National Center for Assisted Living (NCAL) cited 31,100 assisted living facilities serving 733,400 persons in 2010.
What is the typical assisted living resident like?
The average age of those in assisted living facilities is 86.4 years (MetLife, 2012). According to the National Center for Assisted Living (2013), the typical resident needs help with at least one activity of daily living (ADL), and most are over the age of 85. More females (76%) live in assisted living settings than males (26%). Thirty-seven percent of persons in AL receive help with more than three ADLs (NCAL, 2012). More than half of persons in AL facilities have some type of cognitive impairment (Alzheimer’s Association, 2009). A growing percentage of persons in AL facilities have Alzheimer’s disease.
What types of services are provided?
Some of the usual services provided in a licensed AL include:
• Assistance with eating, dressing, bathing, toileting
• Access to health services
• Medication management
• Dining services
• 24 hour staffing and security
• Emergency call systems
• Exercise and wellness facilities
• Social and recreational activities
• Housekeeping and laundry
• Access to banking
• Chaplain or religious services
• Memory care
How do I know if I need assisted living?
There are a variety of reasons why persons might choose an assisted living setting. Some people move to AL because they want more socialization than living alone, they want to be nearer to their adult children but do not reside with them, or because they can no longer manage at home. The person in an assisted living facility generally needs some help with activities of daily living, but does not need skilled nursing care. So, AL might be right for you if you wouldn’t be able live at home any longer without help, but you still don’t need to be in a nursing home or need the help of a nurse around the clock. You may be able to do many things on your own but maybe you have difficulty with dressing, meal preparation, or managing your pills.
How do I decide which senior living community to choose?
There are a variety of senior living options, of which assisted living is but one. Often, family members will help you decide which option is best for you, but you should look at all your choices. You should pick a place that offers the services that you need. Cost and location are additional considerations. It is also good to ask about the staffing ratios, what nursing care is available, and what happens if you later need a higher level of care than the AL provides. ALFA provides a Guide to Choosing an Assisted Living Community. This includes a helpful checklist that can be downloaded from their website.
How much does it cost to live in an AL facility?
The cost of AL depends on where you live. Keep in mind that most assisted living is paid for privately, meaning out-of-pocket, and not by insurance. According to MetLife’s Market Survey of Long-term Care Costs (2012), the national average base rate for assisted living was $3,550 per month. This means that a person who lives in an assisted living facility can expect to pay an average of $42,600 per year. Of course this also varies depending on the number of extent of services with which the resident needs help. The base rate generally includes specific services, but each additional service beyond that may add an extra monthly fee. Compare this to an average nursing home rate for a shared room at nearly $84,000 per year for a person needing Alzheimer’s care (MetLife, 2012) or a national median cost of $270 per day in a nursing home that provides 24-hour per day nursing care (Genworth Cost of Care Survey, 2013).
Are there alternatives to assisted living facilities?
So, are there other options besides going to an assisted living facility if you are an older adult who needs a little help? The answer is yes. Adult day services are one community option. Also, many home care agencies offer companions, homemaker aides, or nursing assistants to help people age in place at home. Most of the time, getting these services means a minimum number of hours per day must be paid for. The national average hourly rate for home health aides was $21 in 2012. Homemaker or companions who provide “hands-off” care such as running errands, shopping, housekeeping made a median of $19-20 the same year (Genworth, 2013).
This is where unique options for assisted living services at home are needed and can save consumers money. Senior Care Central offers persons needing assisted living in the home the opportunity to have more control over their care situation at a much lower cost while getting professional, quality care. Imagine that you could set the hours that you want to have a caregiver in the home, and that caregiver could be a nursing student who has a higher level of education than most home health aides. This care option may cost you half the price charged by a home health care agency. SCC’s model promotes aging in place on your own terms and lets you link with caregivers online, browse profiles to choose caregivers you want to contact, and make your care arrangements directly with them.
While there’s no 100% absolute way to ensure your elderly parent or loved one doesn’t fall,
there are things that can be done to help minimize the risk. I’ll give you a quick checklist of
five steps to a safer home for a senior. Likewise, click here for some alternative ways to
steer clear of falls.
1. Furniture, accessories, and narrow pathways:
Is there furniture crowding a room or creating narrow pathways? Are there inessential
items or decorations all over the house? None of us like to throw things away and we all
know seniors love to keep antiques and knick-knacks, but sometimes they can pose a
hazard to elderly home safety. That old rug underneath the coffee table can trip you easier
than you think. Make sure there is nothing impeding easy travel throughout the house. A
straight path is the easiest path so there should be no navigating around corners or edges.
2. Doorsills and steps:
Now, these two sound like obvious culprits, but you’d be surprised how often they’re
underestimated. A quick remedy is to paint doorsills a different color or buy reflective tape
for the edge as a reminder that they’re there. This goes for the edge of stairs as well.
Confirm that there’s no loose carpeting, unstable wood, or erosion of any kind on steps or
doorsills. Also, make sure any area with a step or uneven surface is very well lit.
This one is perhaps the easiest of all. Double-check that all areas of the house are well lit,
with bulbs at least 60 watts or higher in each socket. Remove all exposed cords and make
sure any lamp or light-switch is within easy reach. If the lamp closest to a favorite reading
chair is hard to reach while sitting, move it closer. Also, check that there is no risk of any
lamp falling or being tripped over. Again, lamps should remain within reach, but still out of
Keep a telephone, within easy reach, in each room. This prevents your elderly loved one
from feeling compelled to rush to a ringing phone. Not only can getting up too quickly cause
light-headedness or dizziness, but it can also cause an elderly person to lose focus on their
surroundings and mistakenly fall in an easily preventable situation.
Bathroom floors and shower tubs can get slippery, we know this. To combat slipping,
guarantee there are either bars affixed to the wall or a counter to grip while getting up and
down off the toilet and in and out of the shower. Also, purchase adhesive grip-tape for the
tub bottom and again, provide adequate lighting throughout the bathroom. Shower rugs
can also slip so place double-sided tape on the bottom of the rug to impede the rug’s
If you are worried about a loved one, these are very easy and painless steps to minimize the
risk of in-home falls. As mentioned before, however, there is no 100% way to prevent accidents so medical alert systems provide a great backup. Not only do they give you peace
of mind when you’re not around your loved one, but they make the wearer feel safe as well.
Jacob Edward is the manager of Senior Planning in Phoenix Arizona. Senior Planningis geared towards helping
seniors and the disabled with finding and arranging types of care, as well as applying for state and federal
IRC’s interview with Chad Jukes. Chad lost his limb while serving in Iraq and now is a prolific mountain climber. Follow his upcoming climb in Ecuador with the Range of Motion Project (ROMP) in July on our social media. Dan Easton, our Social Media Director for IRC, will also be climbing with Chad and the elite ROMP team.
Churches tend to focus—rightly so—on spiritual care for parishioners, but what if your church also had a healthcare ministry? Health-related concerns affect the majority of individuals at some point in their lives. Whether it’s facilitating healthcare clinics, hosting seminars by medical professionals, or helping congregants navigate the complex healthcare system, A Ministry of Care explores a variety of ways for any church to become a place where people can be ministered to in spirit, mind, and body. Advanced practice nurses Cynthia Russell and Kristen Mauk guide you through the steps toward starting and sustaining a health-oriented ministry in your church. Pastors, church board members, or motivated lay members can take advantage of the professional tips and advice shared in this handbook in order to better care for the physical well-being of the members in their church and the community beyond.
Cynthia A. Russell
Dr. Cynthia A. Russell is dean and professor of nursing at Holy Family
University, School of Nursing and Allied Health Professions in Philadelphia,
Pennsylvania. Prepared as a psychiatric mental health clinical nurse
specialist, she is also a certified health and wellness coach. She is the
mother of five children and grandmother to four.
Kristen L. Mauk
Dr. Kristen L. Mauk has nearly forty years of teaching and clinical
experience in rehabilitation and gerontology. She is a professor of nursing
and the graduate program director at Colorado Christian University. Dr.
Mauk is the mother of eight children.
According to the CDC, nearly 800,000 persons in the United States have a stroke each year. This is about one every 4 minutes, resulting in over 130,000 deaths annually. Stroke is simply defined as an interruption to the blood supply to the brain and is caused by a clot or hemorrhage. It can be a devastating problem for survivors, resulting in changes in mobility, cognition, speech, swallowing, bowel and bladder, self-care, and general functioning to varying degrees. Some people recover completely after a stroke, but others experience lifelong challenges.
The good news is that there is hope and quality of life after stroke. In my research with stroke survivors, I discovered 6 phases that survivors reported as they made the journey through rehabilitation towards recovery. These steps can be used to see where a person is in the recovery process, help us understand how they may be feeling, and help guide the way we interact with them.
Agonizing: In this first phase of the process, stroke survivors are in shock over what has happened to them. They can’t believe it, and may even deny the warning signs of stroke. The important task during this time is survival from the stroke itself. Call 911 if you see the warning signs of facial droop, arm weakness, or speech difficulties.
Fantasizing: In the second phase of the stroke process, the survivor may believe that the symptoms will all go away. Life will return to normal, and there is a sense of the problem being unreal. Time takes on a different meaning. The way to help is to gently help them recognize reality, and without taking away hope for recovery.
Realizing: This is the most important phase that signals a turn in the recovery process. This is when the survivor realizes that he/she may not fully recover from the effects of the stroke and that there is work to be done to rehabilitate and reclaim life. Common feelings during this phase of realizing are anger and depression. The way to help is to encourage the person to actively engage in rehabilitation. The real work of recovery is just beginning.
Blending: These last 3 phases in the process of stroke recovery may be occurring at much the same time. This is where the real work of adaptation to life after stroke begins. The survivor begins to blend his “old life” before stroke with his new life as a stroke survivor. He/she may start to engage in former activities even if it requires adaptations to be made. He/she will be actively engaged in therapy and finding new ways to do things. The way to help is to promote education. This is a time when survivors are most ready to learn how to adjust to life after stroke. Listen to your rehab nurses, therapists, and physician. Be active in the recovery process.
Framing: During this phase, the individual wants to know what caused the stroke. Whereas in the Agonizing phase they were asking “why me?”, now they need to the answer to “what was the cause?” Stroke can be a recurring disorder, so to stop a subsequent stroke, it is important to know the cause. Interestingly, if the physician has not given the survivor a cause for the first stroke, patients often make up a cause that may not be accurate. Help the survivor to learn from the health care provider what the cause of his/her own stroke was. Then steps can be taken to control those risk factors.
Owning: In this final phase of stroke recovery, the survivor has achieved positive adaptation to the stroke event and aftermath. The survivor has accomplished the needed grief work over the losses resulting from the stroke. He/she has realized that the effects may not go away and has made positive adjustments to his/her life in order to go on. Survivors in this phase have blended their old life with the new life after stroke and feel better about their quality of life. While they still may revisit the emotions of the prior phases at times, they have accepted life as a survivor of stroke and made good adjustments to any changes that resulted. They feel that they have a more positive outlook on life. At this point, survivors can use their experience to help others cope with life after stroke.
Dementia is a chronic or progressive syndrome that affects a person’s thinking, memory, comprehension, orientation, language, learning capacity, judgment, and calculation. People with dementia slowly lose their cognitive abilities, which leads to a decline in their social behavior and emotional control. Dementia develops when the brain is injured or damaged, such as what happens to individuals with Alzheimer’s disease.
According to the Alzheimer’s Association, over five million Americans are currently dealing with Alzheimer’s dementia. An estimated 80% are seniors aged 75 and up. If proper care, attention, and medication are not prioritized, the total can balloon to 13 million by 2050. Medical and health facilities are doing every means possible to address the situation.
If your senior family member has dementia and living at home or is under assisted living care, your best contribution is to care for your loved one properly. Here are tips to help you out.
Ask simple questions.
Someone with dementia will find open-ended questions confusing and intimidating. Instead of asking “what” questions, try to rephrase them to “yes-no” questions. For example, instead of asking, “What time would you like to take a bath today?” try asking, “Would you like to take a bath at 4 pm?”
Keep your words simple and clear.
Allow your loved one to help with daily tasks.
When dementia progresses, your loved one may find it difficult to remember and focus on tasks. You can help him or her maintain daily activities and skills and stay active. Allow him or her to assist you with simple activities such as setting the table, making the bed, and gardening. Help your loved one remember tasks and things by placing memory aids, such as signs and labels, all over the house.
Take your loved one to lunch.
Keeping senior loved ones with dementia socially active is essential. Have lunch together at his or her favorite restaurant. Go to a place where he or she used to frequent when communication wasn’t yet a problem. Make your loved one feel special and important.
Hold and touch your loved one.
Your touch is very powerful and reassuring. Hold your loved one’s hand or stroke his or her face now and then. Let him or her feel your love and support.
Most important of all, ask for help. Talk to a caregiver or get in touch with an assisted living care facility.
About the Author
Melissa Andrews is the Content Marketing Strategist forParadise Living Centers, an assisted living center for seniors with locations in Paradise Valley and Phoenix, Arizona. In her spare time, she enjoys cooking and going on hiking trips with her siblings and cousins.