By Mary J. Dyck, PhD, RN, LNHA, Associate Professor, Mennonite College of Nursing at Illinois State University, and Meadows Communities Board Member
The typical Assisted Living (AL) resident is 84 years at admission with an average length of stay between 18 and 30 months. Most commonly, residents require assistance with medications. The purpose of this article is to define Assisted Living in Illinois and discuss questions in choosing ALFs.
Assisted living facilities (ALFs) are residences for older adults who are at risk if they live alone. These are residential facilities for individuals who need assistance in caring for themselves, but do not require nursing care. In Illinois, mandatory services include meals, housekeeping, laundry, and assistance with activities of daily living. ALFs and supportive living facilities are similar. ALF residents pay for their apartments and services, while in supportive living facilities, Medicaid may pay for the apartment and services.
Maximizing each individual’s independence and dignity are an important focus of AL as functional decline is common. One way to measure independence is through activities of daily living (ADLs) and instrumental ADLs (IADLs). ADLs include personal care activities, such as bathing, dressing, grooming, transferring, and eating. IADLs include home management activities, such as telephone use, transportation, grocery shopping, meal preparation, cleaning, medication administration, and financial management.
Many families have been surprised at how ALFs can be quite different in terms of services provided. A common unmet need is for professional nursing services, including evaluation of medication usefulness and side effects, care management, and health teaching.
While many facilities provide assistance with medications, less than half offered professional nursing services to assess usefulness and side effects of medications and treatments. Monitoring of medications and treatments can avoid long-term problems. Prevention of acute and chronic medical problems is important to a quality experience in AL.
In order to be admitted to an ALF, the individual must be an adult and at least 80 percent of the residents must be 55 years or older. Three additional requirements for admission to an ALF and continued residence in an ALF include the following:
- The services that you require must be provided or secured by the facility.
- The level and/or type of services that you require are services for which the facility is licensed.
- Appropriately skilled staff in sufficient numbers must be available to provide the services.
ALFs may deny admission to individuals for a number of reasons. Individuals who require significant hands-on nursing care may not qualify for admission. Common issues for admission denials include total assistance with two or more activities of daily living (e.g. bathing, grooming, and dressing) and treatments that cannot be self-administered or administered by a nurse (e.g. routine insulin injections for diabetics or catheter insertion/replacement).
In preparing for a possible admission of a family member to an ALF, one must find a match between the needs of the family member and the services that are offered by the ALF. First, what are the needs of the family member, both ADLs and IADLs? What chronic health problems has the individual experienced? Does the individual require professional nursing care? Has a health care professional completed a functional assessment? If so, what needs are indicated? Second, what services do area ALFs provide? Does the ALF have an RN on staff? Which facilities match with the needs of your family member? Be selective in choosing the best match for your loved one.
Dr. Mary Dyck serves on the Board of Directors of Meadows Mennonite Retirement Community. For more information about senior living, you may contact Holly Hall, Senior Director of Marketing at Meadows Communities, 309-268-1501. Meadows Communities offers a full range of senior living options — Independent Living, Independent Living–Plus!, Assisted Living, Skilled Nursing Care, Memory Care, Respite Care, and Achieve! Wellness and Rehab Therapy — with two locations: Meadows Mennonite Retirement Community in Chenoa and Meadows at Mercy Creek in Normal. Visit www.meadowscommunities.org to learn more.
References available upon request