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#4 What is Assisted Living?
Steve Landers MD, MPH
June 18, 2024
Landers StratAGEy Newsletter #4 6/18/2024
What is Assisted Living?
Assisted living is a popular care and housing choice for seniors, but its true nature can be puzzling. This is highlighted in a recent Health Affairs article titled "Does Assisted Living Provide Assistance And Promote Living?" Authored by long-term care experts, including corresponding author Dr. Sheryl Zimmerman from the University of North Carolina at Chapel Hill, the piece urges a critical examination of assisted living facilities. If these distinguished experts are asking tough questions about assisted living, all of us should be!
As the article points out, there's significant variability in the care and services provided across facilities, which can result in a mismatch between what residents and their families expect and what they actually receive. Contributing to this variability are differing state regulations and a plethora of licensure categories—for example, New York State alone has forty-five different facility licenses! The authors propose policy changes aimed at bolstering the workforce, enhancing regulatory effectiveness, educating consumers, and improving access and affordability.
I’m left thinking about key questions regarding any given facility's offerings: Are there nurses, and what type? How accessible are they, and what are their responsibilities? What about aides and personal care workers—are they sufficiently available and supported to care for the most vulnerable? How often do residents need to privately hire and personally finance additional aide services? The availability of health and wellness services, including therapists, fitness programs, doctors, home health and hospice care, also varies greatly, as do social programs and luxury amenities. Often, these differences stem from regulatory variations, strategic business decisions, budget limitations, and widespread workforce shortages in care-related fields.
My main takeaway from the article, if you've seen one assisted living facility, you've truly only seen one facility. Seniors and their families must thoroughly research facilities, ideally making decisions proactively rather than hastily, to understand the specific services and limitations of each option. Clear communication by providers about what they can and cannot offer helps minimize disappointments. The policy recommendations to improve these dynamics should be carefully considered. On one hand some variability can be a strength in terms of more choices and flexibility for local and regional differences, and on the other hand thoughtful standardization, transparency, and access for seniors with less means could help a lot of people. These are critical issues facing our rapidly aging country.