A National Study of Assisted Living for the Frail Elderly: Final Summary Report. Can ALF Residents Age in Place?


The answer depends on one’s concept of aging in place. For example, in most ALFs, a resident could move from relative independence (e.g., needing or wanting only meal preparation, housekeeping, and staff that can respond to emergencies) to a more complex stage at which the resident needed help with bathing, dressing, and managing medications and used a wheelchair to get around. If this “span” or change in needs were the definition of “aging in place,” then the admission and retention policies of ALFs suggest they were willing to allow residents to age in place.

On the other hand, if aging in place meant that the average consumer could select an ALF and reasonably expect to live there to the end of his or her life, regardless of changes in health or physical and cognitive functioning, then the answer must be “no.” In most ALFs, a resident whose functional limitations necessitated help with transfers or whose cognitive impairment progressed from mild to moderate or severe or who exhibited behavioral symptoms would be discharged from the facility. The same is true for a resident who needed nursing care for more than two weeks.

Thus, there is a limitation in terms of the ability of ALF residents to age in place.

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