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Shopping for Assisted Living

Assisted Living Primer

WebMD Feature

Mom is getting on in years, and she's not getting around as well as she used to. She dreads the thought of being stuck in a nursing home, and so do you; but where else can she go?

What's called "assisted living" may be the best option for an older person who doesn't need round-the-clock nursing care, but who needs some help with daily activities and occasional medical attention.

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At the moment, however, the definition of assisted living is vague -- and in many people's minds, it's just a euphemism for a nursing home. There are some generally agreed-upon differences, but "there's no standard model" for assisted living, says Lauren Jones of AARP.

That means shopping around for a place for your older loved one to live can be a confusing experience.

"I think the biggest question right now is figuring out what assisted living is," says Bradley Schurman of the Assisted Living Work Group (ALW), a group of doctors, nurses, consumer advocates, and industry representatives appointed by the US Senate Special Committee on Aging to develop national standards for assisted living.

An assisted living facility could be "a trailer in the back of somebody's yard," Schurman says, or "500 apartments in a gleaming tower in downtown New York." That's how widely definitions and regulations differ from state to state.

What's more, "costs vary greatly," Jones says -- typically ranging from $1,000 to $3,000 a month.

The ALW recommendations are due to be presented to the Senate in April 2003. Until national standards are put in place, shopping for an assisted living arrangement will be a headache, unless you know what you're doing.

Assisted Living vs. Nursing

Jones says the main difference between assisted living and a nursing home is "the level of care someone needs." She says a nursing home would be the right choice for someone who doesn't need to be in a hospital, but who needs fairly constant nursing care. An assisted living facility typically offers more independence and less intensive medical care.

Paul Willging, the newly appointed president of the Assisted Living Federation of America (ALFA), has another take on the difference between assisted living and nursing homes. He was, until taking his current job, the president of the American Health Care Association, which represents nursing homes in the U.S.

He says it all comes down to "customer focus."

"Nursing facilities have had a tendency to look at the government as their customer," he says. That's because Medicare and Medicaid usually pick up a resident's tab.

In his opinion, nursing homes are not able to cater to a resident's individual preferences because they are overregulated by the federal government. These regulations decide when residents take their meals and even how often they bathe. Assisted living, he says, allows residents to make these decisions for themselves: It's a matter of being asked vs. being told.

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