Assisted living facilities are a rapidly expanding source of supportive housing with services that is increasingly being marketed as a source of long-term care. In the view of many, such facilities represent a promising new philosophy and model of long-term care, one that blurs the sharp and invidious distinction between nursing homes and community-based long-term care and reduces the chasm between receiving long-term care in one's own home and institution (Kane and Wilson, 1993; Manard et al., 1991). In this model, consumer control and choice are central to the philosophy of "assisted living." Further, assisted living, at least conceptually, is distinguished by a flexible service arrangement, in which there is no set "package" of services but facilities provide services to meet scheduled and unscheduled needs of residents, according to a contract. Indeed, the ability of consumers of control both key features of the environment and to direct services, under a "negotiated" or "managed risk" model, and to receive care and supervision in a "homelike" setting are considered hallmarks of the philosophy of assisted living. Moreover, assisted living facilities are increasingly being seen as an important source of care for persons with Alzheimer's disease and other dementias.
Despite this growing interest in and use of assisted living, relatively little is known about the role and performance of assisted living facilities and the degree to which they represent a viable option for family members and elders with dementia. In order to facilitate more effective studies of assisted living and to generate information that will help families and elders make more informed choices, we conducted a study of how family members define quality when their loved one with dementia is in an assisted living facility. This paper reports on the results of that study. Section 1 presents the background and goals of the study. Section 2 describes the study methods. Section 3 presents a summary of what families said about quality and assisted living, as well as about other topics, such as what they perceived as barriers to care. Section 4 discusses our conclusions.