The ABCs of Assisted Living Care

illustration of senior couple on bench© iStockphoto/Thinkstock
Assisted living is a care option that’s often misunderstood and understandably so, as each state regulates them differently and each provider operates by different standards. Since choosing 24-hour residential care for a loved one is a life-changing decision, it’s best to know as much in advance as possible.

Though an official definition of assisted living is hard to come by, the general understanding is that it is a place where residents are given room and board, and varying levels of assistance with day-to-day tasks. That being said, you can’t fully understand what kind of care is provided within an assisted living community’s walls without knowing about ADLs and IADLS.

A is for ADLs.
ADLs are the activities of daily living—things like bathing, dressing, getting out of bed, shaving, grooming, or using the bathroom. IADLs are instrumental activities of daily living and comprise tasks like doing laundry, paying bills, shopping, meal preparation, managing medications, or basic communications (like calling a friend for a visit or making an appointment with the doctor).
Most of these tasks, other than medication management, do not require the expertise of a skilled medical professional, which is a key distinction between assisted living and a nursing home. Nursing homes are generally staffed with a higher ratio of skilled professionals. Assisted living communities generally have a nurse on duty to monitor the administration of medication and the direct care staff (the employees who are responsible for day-to-day care), but that is the usually the extent of their medical care component. When there is a health emergency or issue, most communities will call 911, the resident’s physician, or an emergency contact/family member, to meet the need.

Most assisted living facilities will provide one to two hours a day of assistance with ADLs to all residents who need it; this service is typically included with room and board as part of a basic monthly charge. For seniors who need more complex care services or constant supervision, assisted living may not be the best option, or you may need to fill in the gaps with private duty care. (In this case, you’ll need to check with the assisted living provider to determine whether bringing in such care is permitted.)

B is for budget.

When evaluating certain assisted living communities, be sure to ask how many hours of daily care are provided in the standard base rate, what the hourly rate for additional services would be, and how those additional hours are tallied and charged. Also, find out how the monthly rent and meals are charged; they may not always bundle these services.


C is for choose carefully.
Once you’ve selected an assisted living that seems to be the right fit, tour the community in person before you make the final call. Talk to the residents and staff, ask lots of questions, and if you can, have a meal or participate in activities there. This will give you a better sense of how the facility runs than what you’ll see on the website or in the brochure.

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