Assisted living and board-and-care facilities are a popular and rapidly increasing segment of housing for seniors. However, what many people don’t know is that assisted living facilities are “non-medical” models of care—not requiring nurses or any medically trained personnel onsite daily. This misunderstanding can create real problems for those residents with multiple complex and chronic medical issues.
There are about 7,500 assisted living (AL) facilities in California. They range from small, six-bed residential homes to larger facilities with 100-plus beds. The larger facilities typically have the decor and ambiance of an upscale hotel, rather than an institutional medical facility. Regardless of size, they all have a few things in common:
- They’re less expensive than skilled nursing facilities;
- They’re predominantly private pay;
- They’re regulated by the Dept. of Social Services and Community Care Licensing Division;
- There’s no current rating system to help consumers make informed decisions when selecting an assisted living facility for their loved one; and
- They don’t have the strict regulation and record keeping that the Departments of Public Health and Health Care Services require skilled nursing facilities.
According to the National Institutes of Health, assisted living facilities to provide care to a large number of older adults, including many with complex health problems. The most common reasons for entering AL are dementia and functional impairment, but most residents (94%) have at least one chronic medical condition, with 76% having two or more chronic conditions.
Families often don't have realistic expectations. The marketing person makes promises about what's available. However, families don't know to ask questions about the staffing levels, the supervision, and how medications are administered. Loved ones don't realize it’s not a nursing home, and that it doesn’t have skilled nursing care.
The reality of this lower level of care may result in loved ones receiving a midnight call, that Mom got confused, wandered away from the facility and is now lost. Or that Mom’s fallen and broken a hip.
In San Diego, seniors and family caregivers can access reliable information on how safe and well-operated assisted living facilities are from the San Diego County-funded Choose Well program. It’s the first rating system of assisted living and board-and-care facilities of its kind in the state. It’s a guide to selecting a residential care facility on a website, where the information can be easily accessed.
Reference: San Diego Union-Tribune (May 9, 2018) “The key thing to know about assisted living”