Assisted living offers quality of life with independence, companionship, and social involvement. Assisted living is a housing option for older persons who need help with activities of daily living (ADL) yet wish to remain independent as long as possible. Little or no medical care is provided. Housing, personal care, support services, health care, and social activities are provided in a home-like setting. Assisted living usually offers these services:

• 3 meals a day

• Help with ADL—bathing, dressing, grooming, toileting, eating, walking

• Housekeeping and maintenance

• Linen and personal laundry

• A 24-hour emergency communication system to use for an emergency or to call for help

• 24-hour security

• 24-hour supervision

• Transportation arrangements

• Social, educational, recreational, and spiritual services

• Help with shopping, banking, and money management

• Some health services

• Exercise and wellness programs

• Medication (drug) management or help taking drugs

• Supervision for persons with Alzheimer’s disease (AD), dementia, and other disabilities

Living areas vary. A small apartment has a bedroom, bathroom, living area, kitchen, and laundry area (Figs. 30-1 and 30-2). Some people just want a bedroom and bathroom. Box 30-1 lists the requirements and features of assisted living units. Box 30-2, p. 466 lists environment requirements.

Fig. 30-1 A living area in an assisted living apartment.

Box 30-1

Requirements and Features of Assisted Living Units

• A door that locks; the person keeps a key

• A telephone jack

• A 24-hour emergency communication system in the person’s room

• A window or door that provides natural light

• Wheelchair access

• Lighted common areas

• A window or door that allows safe exit in an emergency

• A mailbox for each person

• A bathroom that provides privacy:

• A sink in the bathroom or in the next room (sink is not used for food preparation)

• A bathtub or shower that has a shower curtain and non-slip surfaces

• Ventilation or a window that opens

• Grab bars for the toilet and bathtub or shower

• Other assistive devices needed for safety and identified in the service plan (p. 468)

• Smoke detectors

• A fire sprinkler system

• A bed (frame and mattress) that is clean and in good repair

• Adequate general and task lighting

• An easy chair

• A table and chair for meals

• Adjustable window covers that provide privacy

• A dresser or storage space for clothing and personal items

• Appliances for food—sink, stove, refrigerator with freezer, and storage for food and cooking items

Box 30-2

Environment Requirements

• The ALR is clean, safe, orderly, odor-free, and in good repair.

• The ALR is free of insects and rodents.

• Garbage is stored in covered containers lined with plastic bags. Bags are removed from the ALR at least once a week.

• Hot water temperatures are between 95° F (Fahrenheit) and 120° F in areas used by residents.

• The hot and cold water supply meets hygiene needs.

• Common bathrooms have toilet paper, soap, and cloth towels, paper towels, or a dryer.

• Clean linens are handled, transported, and stored to prevent contamination.

• Soiled linen and clothing are stored in closed containers away from food, kitchen, and dining areas.

• Oxygen containers are stored according to the manufacturer’s instructions.

• Cleaning solutions, insecticides, and other hazardous substances are stored in their original containers. They are in locked cabinets in rooms separate from food, dining areas, and drugs.

• Pets or animals are controlled to protect residents and maintain sanitation.

• Employees have access to a first aid kit.

Assisted living residences (ALRs) also are called assisted living facilities (ALFs). Some are part of retirement communities. Others are separate facilities. State laws and licensing requirements for ALRs vary. Resident’s rights are part of such laws.

See Promoting Safety and Comfort: Assisted Living.

PROMOTING SAFETY AND COMFORT

Assisted Living

Safety

Residents have the same diseases and illnesses as persons at home, in hospitals, and in nursing centers. They are at risk for infections. This includes sexually transmitted and other communicable diseases. Follow Standard Precautions and the Bloodborne Pathogen Standard when contact with blood, body fluids, secretions, excretions, or potentially contaminated items and surfaces is likely.

Purpose

People choose assisted living for many reasons. People are living longer, and there are more older people than before. Men and women lose life partners through death or divorce. Some remarry; others do not. Some persons have never married. Today’s older persons had some birth control options. Many had small families. And the United States is a mobile society. Children grow up and move away from their families. For these reasons, many older persons live alone. Often there is no family nearby to help them.

ALR residents

ALR residents usually need some help with one or more ADL:

• Personal care—bathing, dressing, grooming, elimination

• Meals—cooking, eating

ALR residents do not need 24-hour nursing care. And they are not bedridden. Some persons have chronic illnesses or are cognitively impaired.

Mobility is often a requirement. The person walks or uses a wheelchair or motor scooter. The person must be able to leave the building in an emergency. Stable health is another requirement. Only limited health care or treatment is needed.