Health


      Services Provided
      The main difference between assisted living and independent living 
      residences -- usually housing complexes built or renovated for older 
      residents who are basically able to care for themselves -- is that 
      assisted living gives residents more help in meeting their daily needs. 
      While assisted living does not offer either the medical care or the level 
      of attention of a nursing facility, it does provide personal care in a 
      resident's living space and common areas, meals, household tasks and 
      extensive monitoring of each resident's physical condition.
      Personal Assistance. Most 
      people move to assisted living because they need help with one or more of 
      what are known as the activities of daily living (ADLs). ADLs include 
      eating, bathing, dressing, continence and using the toilet, walking and 
      getting in and out of a bed or chair.
      An assisted living facility will help a resident with any ADL -- but 
      not all the time, and not whenever a resident wants help. Instead, a 
      schedule will be developed that takes into account the resident's needs 
      and the staff's availability. For example, an aide might help a resident 
      get in and out of bed in the morning, once or twice during the day, at 
      bedtime and once again during the night. Or a resident will be given a 
      full bath three or four times a week, but not every day.
      When you consider a particular assisted living residence, ask precisely 
      what it offers for the specific ADLs with which you need assistance. If 
      the facility offers you the kind and frequency of assistance you need, 
      make certain that care is spelled out in the written residence agreement 
      you and the management sign.
      Health monitoring. In 
      addition to help with daily activities, assisted living facilities monitor 
      a resident's health. That does not mean nursing or other active treatment 
      of a medical condition. Rather, it means keeping track of and helping the 
      resident take the correct dose of medications, helping the resident with 
      self-administered health aids such as prostheses and oxygen, providing 
      emergency call systems and checking on a resident's well-being during the 
      night.
      Most assisted living residences have a nurse on duty to check on any 
      resident who has health difficulty or whose physical condition seems to be 
      changing, and to refer the resident for medical care if it seems 
      necessary. Health monitoring may also include coordinating care with the 
      resident's primary care physician and keeping track of a resident's 
      medical appointments. Also, most facilities provide or arrange 
      transportation to and from those appointments.


      
        Strict Rules Aren't for Everyone
        Assisted living offers close monitoring of residents' physical 
        conditions. This includes keeping track of medications, checking on 
        residents at night, and making sure residents eat properly. Assisted 
        living facilities accomplish this by setting up schedules that staff and 
        residents must follow. Sometimes, these schedules and rules are too 
        restrictive for a competent, independent-minded person.
        Depending on your needs, including your need to be left alone, 
        independent living plus home care might fit your personality better than 
        assisted living -- even though you and your family will have to take 
        charge of organizing your care.
      Meals. For many people, 
      one of the most attractive things about assisted living is that meals are 
      provided. These facilities have a kitchen and a common dining room where 
      at least two and usually three meals a day are served. The cost of meals 
      is included in the resident's rent or fees. Residents are freed from 
      shopping, cooking and cleaning up; they are assured of nutritious food; 
      and they are brought together for the informal social exchange of a meal 
      with other residents.
      There are several things to check about an assisted living residence's 
      food service. First, find out how many meals a day are included, and 
      whether they are all full, hot meals. Then check on the quality of the 
      food; it won't do you any good if you won't eat it. Try several meals in 
      their dining room, and see if the residents seem interested in their food 
      and in each other.
      Housekeeping. Assisted 
      living facilities provide laundry and housekeeping services. What that 
      housekeeping includes, however, can vary considerably. Find out how often 
      a resident's bedding and bath linen are laundered. Does the facility do a 
      resident's personal laundry as well? Is there an extra charge for personal 
      laundry? How often (and how well) is an individual room or apartment 
      cleaned?
      Social activities and exercise. 
      It is one thing to assist residents with the basics of daily life such as 
      dressing and bathing; that help is guaranteed in a contract with an 
      assisted living residence. It is another thing entirely to help residents 
      lead mentally, physically and socially active lives. This is not a matter 
      of contract, but of the quality and style of service at a good residence. 
      Most facilities plan group activities such as guest lectures and exercise 
      classes, as well as regular gatherings for the residents to visit among 
      themselves. The best facilities also help individual residents participate 
      in these activities to the extent possible and provide alternatives -- an 
      assisted walk around the hallways, for example, or a one-on-one chat in a 
      resident's private room -- when it's not feasible to participate in a 
      group.
      There are several ways to get a sense of the quality of group and 
      individual activities at a particular facility. You can always take a look 
      at what is scheduled for any given week, but it is also important to visit 
      during one of these planned activities to see if residents participate and 
      seem to enjoy doing so. As for more individual attention, find out whether 
      there are any rules against staff spending non-scheduled time with 
      residents, and on all your visits, watch how the staff interact with 
      residents: look for a friendly, relaxed manner on everyone's part.
      Costs
      Most assisted living spaces are rented, not purchased. The major 
      exception is assisted living as part of a continuing care community.
      Basic Rent
      Rent depends on the size of the living space. A small room with no 
      cooking facilities will cost much less than a spacious one-bedroom 
      apartment with full kitchen. The rent also varies with the amount of 
      services and staff provided, the location and the overall condition of the 
      facility. Some facilities offer more than one type of rental agreement: A 
      limited contract may include fewer meals and less personal assistance than 
      an inclusive or extensive agreement that includes all the services the 
      facility has to offer. Given all these variables, rent for an assisted 
      living unit generally runs 50% to 100% higher than for a comparable 
      independent living unit in the same facility, but it will still be 
      one-third to one-half the cost of a nursing facility of the same quality, 
      in the same area.
      Rent Increases
      As with any other rental housing, you must consider how much your rent 
      may go up over time. A lease can guarantee the rent for a year or two. 
      After that, rent increases are completely within the discretion of the 
      facility's ownership, unless a yearly limit is included in your rental 
      agreement. If there is no limit, check the facility's record of rent 
      increases over the previous five years. If they have raised rents in large 
      chunks, you have to consider whether they will price you out of your 
      apartment in years to come.
      Additional Fees
      Some assisted living facilities charge fees in addition to rent. There 
      may be a one-time non-refundable entrance fee, and there may be a fee for 
      certain services not included in the basic assisted living contract, such 
      as extra or delivered meals, extra housekeeping service, local 
      transportation fees or personal care beyond the standard level of care 
      offered in the facility.

Services Provided

Strict Rules Aren't for Everyone

Costs

Basic Rent

Rent Increases

Additional Fees

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