Over the past several years, assisted living has proven to be a unique long-term care option, with its own balance of benefits and challenges. The appeal of assisted living is that it makes it possible for residents to direct their own care, negotiate their risk, and dictate how they will utilize meals, activities, and other amenities provided by the assisted living community. This allows for assisted living to look and feel more like the resident's own home.
It can be a challenge to ensure the welfare of the residents while protecting their independence. The care staff must promote the resident's autonomy and self-directed care, while helping to provide a safe environment and provide for their changing health needs.
One area of struggle is recognizing and reporting changes in condition. It seems counter-intuitive to document and report these kinds of issues because the residents live in private apartments. However, most states require the senior housing community to have a system in place to become aware of a resident's changing condition and to report significant changes to the resident's family and physician. Some states require documentation of attendance at meals and a monthly summary of each resident with weight, medication, and activity level changes. Once the care staff has identified a change, they must then adjust the individual service plan to meet the new needs of the resident. The resident has to choose to accept the new service plan. Some states require assisted living centers to show they have adequate numbers of staff appropriately trained to address these needs.
Assisted living residents are permitted and encouraged to come and go, and they sometimes drive a vehicle. They may choose to leave with a relative who isn't approved of by other family members, and they may receive visitors without anyone's permission. The balance between risk and choice are integral to assisted living. While you must allow a resident to come and go, you must also have documentation that they are safe to do so and have a plan to respond if the resident does not return appropriately.
Regulations regarding a resident's independence vary from state to state. In some states, the assisted living community is required to assume a resident can take their own medicine and the staff is not allowed to give them any kind of test to determine if they are fit to do so. In other states, there must be documentation showing that the assisted living community has assessed a resident's ability to understand and follow directions before allowing him or her to self-medicate. However it is always the responsibility of the assisted living community and the staff to ensure the resident is allowed to function at the highest level of independence possible.
Assisted living has become a popular option for seniors that are no longer safe at home, or wish to live in community. As a result, the number of assisted living communities is growing to meet this increasing demand. As the growth in assisted living continues, there will always be the pressure to balance independence and safety. It is critical to go above and beyond the actions required by the regulations to meet the need of the resident, while helping avoid the regulatory impact on assisted living.