Statistics on independent living communities and assisted living communities

The number of CCRCs being built continues to expand as the population ages. Table 2.1 gives the number of CCRCs and the distribution of independent living communities (ILCs) and assisted living communities (ALCs) as of 2014.

Of the CCRCs, 52% are faith-based, with only about 2% described as fraternal organizations. Some states regulate CCRCs, although the focus of oversight in states with explicit regulations is concentrated primarily on the financial aspects rather than the protection of consumers/resi- dents. Most states regulate assisted living and skilled nursing levels of care. Interestingly, Ohio, with the second-highest number of CCRCs (150), has no state regulation of CCRCs.

Independent versus assisted living

Both independent living and assisted living levels of care are part of the CCRC model. However, there are communities in the United States that solely offer independent living, whereas others offer only assisted living. Some communities offer a combination of the two levels. The primary difference between assisted living and independent living is the level of care provided. Neither ALCs nor ILCs offer the 24/7 skilled nursing that is provided in nursing homes.

Table 2.1 Number of communities by type

Communities

Units

Nonprofit (%)

For profit (%)

CCRC

1,900

676,000

81

19

ILC

1,500

179,000

2.3

97

ALC

22,000

851,400

22

78

Source:

LeadingAge Ziegler

150. 2014. Retrieved from

https:/ /www.

leadingage.org/uploadedFiles/Content/Members/Member

Services/LZ_100/LZ150-2014.pdf.

An ILC is senior housing that provides a safe and secure living environment but does not provide assistance with ADLs or medication assistance. Independent senior living residents are primarily able to live on their own with the option of limited assistance (provided by third-party home healthcare providers, if needed) and without around-the-clock supervision. However, other amenities are offered or provided, such as recreational and educational activities, dining services, light housekeeping, transportation, exercise programs, emergency alert systems, and onsite hair salons. They may be a part of the total package or may require separate fees to be used. An ILC is less costly than other levels of care and is appealing to older adults who are less able or willing to care for a home. Housing options can range from onsite garden homes that residents can rent or purchase, stand-alone senior apartments, and large senior-living complexes that have designated sections for independent living residents. ILCs are largely unregulated so that residents do not have to meet state-mandated physical or mental health criteria, except those required by the individual community or corporation that owns the community.

An ALC is designed to provide residents with assistance with daily activities such as medication, eating, bathing, dressing, and toileting. It was conceived as an alternative to nursing homes for residents who need assistance but do not require constant medical care, as is typical in skilled nursing facilities. In contrast to nursing homes, ALCs were intended to look like homes rather than clinical settings. They were designed as a resident-focused model that allowed the resident to preserve their autonomy, independence, and dignity while still being cared for. The terminology used to describe attributes of the assisted living community helped to sustain the perception of not being in a medical facility. The individuals are residents rather than patients, with their living quarters described as apartments rather than rooms. Use of the term "community" in contrast to "facility" helped to make the resident feel less institutionalized during the relocation process into continuing care.

In the development of the assisted living model, medical, physical, and psychosocial needs of the residents were treated as equal considerations. The development of the assisted living model was centered around the necessity of each resident maintaining dignity, privacy, and autonomy. Ensuring a resident-centered design for each of these attributes allows residents to maintain a perception of independence, in contrast to nursing homes in which these components become secondary to the medical needs of residents and more of a "staff-centered" environment. Table 2.2 details the percentage of residents in ALCs that need assistance with various activities of daily living (ADLs) and instrumental activities of daily living (IADLs).

Table 2.2 Most common ADLs and IADLS for residents in ALCs

Activities

Percentage of residents in ALCs needing assistance

Meal preparation

87

Medication management assistance

81

Bathing

64

Dressing

39

Toileting assistance

26

Transferring

19

Eating

12

Source: Assisted Living Federation of America. 2013. What is assisted living? Retrieved June 15, 2013, from http://www.alfa.org/alfa/ Assisted_Living_Information.asp.

 
Source
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