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Assisted Living Facilities for Seniors

Often times, home modifications and in-home assistance such as Meals on Wheels or regular visits from in home providers aren't quite enough for a senior in need of assistance...and yet a nursing home isn't what is needed or wanted either. This is where assisted living facilities enter the picture.

Residential Care Facilities for the Elderly (RCFEs) most commonly referred to as "Assisted Living Facilities (ALFs), Residential Care Homes, Board and Care Homes or Rest Homes" provide personal non-medical care and supervision with a focus on providing assistance with the activities of daily living. There are approximately 700 RCFEs of varying sizes and types operating in the Sacramento area.

Assisted living facilities are licensed by the State of California and provide services to seniors age 60 and over. Assisted Living Facilities must meet care and safety standards set by the State and are licensed and inspected every five years (if in compliance ) or on an annual basis (if not in compliance) by the Department of Social Services, Community Care Licensing (CCL).

These facilities are intended for people that find it difficult to live alone but are not in the need of 24 hour nursing care and as such are not licensed as nursing homes. Being that that these facilities do not provide medical care they are not required to have physicians, registered and / or licensed vocational nurses and certified nursing assistants on staff.

While the assisted living facilities for seniors vary in amenities, environment, physical layout and services, many seniors living in these find that with the daily assistance provided, they are able to maintain a much larger degree of independence then in a nursing care facility.

Property Type Overview:

You can find several types of senior assisted living facilities. Many were built in apartment-like configurations, while more and more we are seeing campus layouts with communities that offer a variety of retirement care options including nursing care. These larger facilities typically have 100 or more residents.

The typical accommodation consists of a private apartment with meals, assistance with activities of daily living, medication management and housekeeping being provided by the facility.

Assisted living services for seniors can also be found in single family homes commonly referred to as "board and care facilities" or "residential care homes" that most resemble one's own home. These smaller facilities typically have between 6 and 15 residents.

The services of an assisted living facility for seniors are designed so that they intrude as little as possible in the daily lives of its residents. The facility may provide a combination of personal, supportive, and basic health services, depending on the needs of the individual. Assisted living facilities attempt to reduce the need for residents to relocate because of changing needs.

Smaller home based facilities offer their residents an intimate family like setting. People that seek personalized care, enjoy the company of others and a feeling of camaraderie often prefer a smaller facility.

Larger facilities can offer a wider variety of activities and a more extensive food services and menu than found in a small residential facility. People that prefer a wide variety of activities yet treasure their privacy may find a larger facility to be more suited for them.

Services Provided:

The majority of assisted living facilities have these services available for those who need them:

  • Meals, typically in a hotel style dining room

  • Transportation

  • Emergency response monitoring

  • Laundry

  • Housekeeping

  • Beauty and barber services

  • Recreational and educational activities

  • Day trips

Assisted living facilities can provide assistance with:

  • Bathing

  • Personal hygiene

  • Grooming

  • Dressing

  • Walking

  • Medication dispensing for residents to self-administer

  • Dietary planning

Assisted living facilities for seniors are designed to bridge the gap between independent living communities and health care and skilled nursing care that is provided in a nursing home. For the individual who may no longer be able to live alone in his or her own home, assisted living can be a way for the senior to maintain as much independence as possible while receiving support in areas needed for health, safety and comfort. An assisted living facility also provides a community of peers for the senior.

Health Care / Medical Services Provided to Residents:

Although most assisted living facilities provide some level of health care, they are not specifically designed for the individual who needs medically based daily care. The primary focus is to provide 24 / 7 assistance with activities of daily living.

Seniors in the early to middle stages of dementia or Alzheimer's are usually accepted by assisted living facilities, providing the facility can provide appropriate safety measures. These facilities do not treat residents who have health care needs including tube or intravenous feeding or treatment of bedsores and other acute conditions.

Assisted living facilities usually work with the senior and family to develop a plan that is tailored to the needs of the resident. Although these plans detail the needs of the individual upon admission, good facilities update the plan as needed to accommodate any changes in the senior's needs.

While assisted living facilities do provide recreational, social, and educational activities and resources, you won't find these, especially recreation, at the level you would in active senior communities.

Physical description:

Choices for assisted living housing vary and may include:

  • Studio apartments

  • Suites

  • Rooms in single family homes (residential care homes, board and care homes)
Typical Costs:

Most of the cost of assisted living housing and services are paid for by the individual.

The facilities are required to use an admission agreement which contains rules and policies regarding residency, services, visitation and the rights of the residents. The admission agreement will also state what the monthly rate is, how it is determined for the specific resident and how often and how the rates can be changed.

The monthly rate charged will vary according to the size of the unit and the geographical location, the level of care provided. Additional fees for memory, dementia, Alzheimer's and hospice care will also be charged.

The monthly rate usually is a flat amount with additional charges for additional care or services provided. The added charges are based on the level of service required as determined by the facility which usually uses a "point system". Review the admission agreement to determine exactly what level of services are provided and what changes in care levels would result in additional charges.

Typical costs in California range from $2,500 to over $6,000 per month. The national average is roughly $36,000 per year for basic assisted living services.

Medi-Cal does not pay for residential care in California and Federal Supplemental Security Income provides very limited funding for this type of care.

Some health care services may be partially reimbursable under private health insurance, but only if they are medically necessary and prescribed by the individual's health care provider. However, reimbursable expenses are usually limited with most of the expenses being paid for out of pocket.

For the senior who maintains relatively stable health and who requires a minimum of medical care, assisted living housing offers an opportunity to remain independent far longer than he or she may have been able to within his or her own home.

And for seniors who no longer have friends or family near them, assisted living facilities can bring a welcome sense of community.

Consider the following when visiting various assisted living facilities:

Review the most recent inspection report.

Review any substantiated complaints that have been filed on the facility within the past year. Obtain an explanation for the nature of the complaint and their measures taken to eliminate future problems of the nature cited in the complaint.

Review the training program for the staff. Ask if their training goes beyond the minimum required by the State of California. Obtain a description of the additional training provided.

Review the staffing schedule for the facility. Examine the ratio of staff to residents during day, evening and overnight hours. The State does not have a minimum staff to resident ratio. Facilities are only required to have staff sufficient to service the residents. At night, facilities with 15 or fewer residents are required to have one person on site on call. Assisted living facilities with more than 15 residents are required to have one person on site that is awake and monitoring the facility and an additional staff member within a 10 minute drive time.

Ask how many staff left during the past two years and the reasons for their departure.

Discuss management of incontinence (schedule of cleaning and checking on residents).

Discuss the nature of transportation to and from medical and other health care appointments