A National Study of Assisted Living for the Frail Elderly: Final Summary Report. A. What is Assisted Living


Assisted living means different things to different people, but there is general agreement on the key aspects of what constitutes assisted living. For example, one commonly accepted definition has been offered by Kane and Wilson (1993):

Any residential group program that is not licensed as a nursing home, that provides personal care to persons with need for assistance in daily living, and that can respond to unscheduled needs for assistance.

The key philosophical principles or tenets that distinguish assisted living are:
  • Services and oversight available 24-hours a day
  • Services to meet scheduled and unscheduled needs
  • Care and services provided or arranged so as to promote independence
  • An emphasis on consumer dignity, autonomy and choice
  • An emphasis on privacy and a homelike environment

A similar but more expansive definition was specified by the Assisted Living Quality Coalition. This coalition is a group representing consumer groups (the Alzheimer’s Association and AARP) and provider associations (the American Association of Homes and Services for the Aging [AAHSA], the Assisted Living Federation of America [ALFA], the American Seniors Housing Association, and the American Health Care Association [AHCA]/National Center for Assisted Living [NCAL]). According to the Coalition, an assisted living setting is:

A congregate residential setting that provides or coordinates personal services, 24-hour supervision and assistance (scheduled and unscheduled), activities, and health related services; designed to minimize the need to move; designed to accommodate individual residents’ changing needs and preferences; designed to maximize residents’ dignity, autonomy, privacy, independence, and safety; and designed to encourage family and community involvement.

Philosophically, assisted living represents a promising new model of residential long-term care, one that blurs the sharp and invidious distinction between receiving long-term care in one's own home and in an "institution."

There is substantial agreement among provider and consumer groups about the key elements of the assisted living philosophy. Moreover, some, like the Assisted Living Quality Coalition, argue that some of these elements or principles distinguish it from other types of long-term care. There is less agreement on the degree to which the current industry embodies those principles. Determining this is one of the study goals.

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