Assisted Living Care: What to Expect

Assisted living care is intended to allow seniors to maintain the greatest level of independence possible while receiving assistance with particular daily activities. Many retirement communities offer assisted living care in order to provide a living environment in which seniors can truly ‘age in place.’

Assisted living services can be customized to ensure that each resident’s care is appropriate in meeting their current needs. At the same time, increasing needs in a particular area can be accommodated to ensure consistency in lifestyle and maximum well-being.

The General Environment

Assisted living communities typically accommodate between 40 and 120 residents, although this varies depending on the size of the particular community. Each resident (or couple) lives in their own studio, one-bedroom or (rarely) two-bedroom apartment and they have their own set of keys to come and go as they choose. Meals are provided in a restaurant-style dining room, which encourages social interaction, and residents can typically select their meals from among several different options.

Other public areas of the community often include a library, fitness room, activities room, beauty/barber salon, theater, private dining room and café or bistro. Exterior doors are left open and unlocked during regular business hours but visitors are often asked to check in to maintain residents’ security.

Assisted Living Care

Assisted living services are typically offered at different levels and/or by a point system. All residents are assessed by a licensed nurse prior to moving in, which ensures that their current needs can be provided in accordance with the community’s state licensing. Fees for assisted living care are typically added to the monthly base rate charged for the accommodations, housekeeping, maintenance, activities and transportation. Assisted living services typically include the following:

Medication management – Medications are stored, administered and re-ordered by the Assisted Living Director and staff

Bathing assistance – Varies from stand-by assistance (to ensure safety entering and exiting the shower) to full assistance with washing/hygiene, drying, etc.

Dressing assistance – Varies from stand-by assistance (to ensure safety/balance) to selecting appropriate clothing options and physically assisting with putting on and taking off clothing

Grooming assistance – May include assistance with brushing/combing hair, shaving, brushing teeth, etc.

Toileting assistance – May include stand-by assistance (transferring safely on and off the toilet), reminders, assistance with incontinence products, hygiene after toileting and infrequent accidents

Transferring assistance – May include stand-by or one-person assistance with moving from bed/chair to walker/wheelchair and/or escorting to/from meals, activities, etc.

Additional services may include personal laundry (laundering of bed linens and towels is included in weekly housekeeping), pet care, scheduling medical appointments and interacting with family members.

When Is Assisted Living Care No Longer Appropriate?

Assisted living communities are state-licensed to provide a particular level of care that cannot be exceeded in meeting residents’ care needs. In some cases, residents must relocate to another care setting in order to ensure their own safety, security and well-being, as well as that of other residents. The following circumstances usually require a higher level of care than assisted living communities can provide:

Wandering, aggressive and/or inappropriate behaviors characterized by an increasing level of dementia or Alzheimer’s (though many memory care communities are able to handle this)

Inability to transfer without the assistance of two persons (this poses a safety concern for employees)

Incontinence that cannot be managed with reminders/products and a toileting schedule

Sliding-scale diabetes requiring close monitoring and insulin injections administered by a licensed nurse at varying intervals

Intubations including in-dwelling catheters, feeding tubes, colostomy care (unless home health care can be provided by a contractor visiting the community on a regular basis)

Written by gerontologist Sara Shelton