4.0. BASR 12-23-1997 - Laserfiche WebLink

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ASSISTED LIVING In the broadest sense, assisted living could be described as a program approach that emphasizes consumer values, a residential setting and care service capacity to facilitate"aging in place." This definition incorporates the underlying premises around which consensus exists: a consumer orientation, a residential setting and some available services. The rationale for this level of consensus is straightforward. First,because older adults do not want to leave their own homes, the setting must be as much like a private home as possible. Second, availability of services is a strong motivation to move into congregate housing. Finally, both the setting and services have to be consumer friendly to be market competitive. While a variety of assisted living models exist, the models can be categorized as one of three types: housing with services, assisted housing and nursing home replacement. The type of assisted living that Guardian Angels is planning for its Lake Orono campus is assisted housing. Because assisted housing emphasizes easing the impact of communal aspects of congregate living (e.g., meal services, scheduled use of community space, scheduled personal care services, etc.), individual autonomy often is viewed in terms of group norms. Clients are encouraged to make decisions that fall well within acceptable ranges for the group as a whole. This model typically fills a gap between housing options where residents are able to direct and usually arrange their own services and settings where occupancy is dictated by service need. This model emphasizes the need for oversight and the role of staff in ensuring needs are identified and services provided. Typically, the setting (not the services) is licensed, often resulting in more restrictive building codes and fewer residential features. For example, more support services spaces- such as an activity room, medication storage area and central staffing area - are built in. There is more emphasis on safety features and less emphasis on the amenity level of units. However, wood trim, upholstered furniture, indirect lighting and other residential treatments are used to soften the feeling of the building. Assisted housing has more service capacity. Personal care services are routinely available, including assistance with bathing, grooming, walking, eating, taking medications and toileting. In-house staff often deliver all of the hotel-type services and many of the personal care services. External staff such as home care and home health aides deliver complex personal care and perform any nursing-related tasks. Pricing mechanisms typically include shelter and a basic package of services. Additional services are offered via individual contract. From the provider's point of view, the assisted housing model may be a mixed blessing. Marketing units may be easier, and residents have a high desire to remain where they are. But assisted housing may require more expensive construction, licensure and more intensive management skills. ipAdditionally, service funding is a significant issue, particularly for low- and moderate-income residents.