When home care is no longer an option, many people consider placement in an Assisted Living Center ("ALF"). Assisted Living facilities typically provide room, board and 24 hour supervision to seniors or frail individuals. Assisted Living Centers are generally for those who are too ill or frail to be at home, but not impaired enough to need the services of a nursing home or hospital. A point to recognize is that ALF's do not provide health care services to their residents. The care and services provided are assistance and supervision to individuals who are trying to maintain a level of independence.

Costs and sources of payment

Costs of assisted living services vary greatly. Some facilities are geared for lower income individuals and others cater to the wealthy. The average cost is approximately $2,000 per month. Reimbursement can come from a number of sources. Long term care insurance sometimes covers assisted living as a benefit. Some States provide coverage through the SSI benefits (California does not allow SSI benefits to cover ALF costs). Currently the majority of payments come privately through family and an individual's savings.

Some ALF's charge an all-inclusive fee: others have a base fee with additional services that may be chosen on an ala carte basis.

Who resides in an Assisted Living facility?

According to the AARP, the typical resident of an assisted living facility is an 83 year old woman. She has been admitted to the facility from her home environment and is expected to remain in the facility for 26 months at which time she will move to a nursing home.

Why might one need to leave an ALF?

When an individual becomes too ill or too frail to live independently in an ALF, arrangements need to be made to move to another facility. (Statistics show that 25% of the individuals admitted to an ALF will expire there). Typically individuals who are unable to stay in an ALF go to a nursing home. Occasionally individuals will move between a hospital setting, a nursing home setting and an ALF as they experience periodic episodes of illness and recovery.

Specialized Assisted Living Centers

Some ALFs specialize in caring for frail or aged individuals with specific needs. A typical specialized service is caring for individuals with Alzheimer's Disease or other dementias. Facilities of this type typically cost more than a generic ALF since additional supervision and protective measures are required to care for these individuals. Often these specialized facilities will be offered in conjunction with or on the same campus as a generic ALF. What happens in an ALF?

While some facilities provide minimal services, most ALF's provide a program of activities designed to intellectually and physically stimulate the residents. Nursing aides, activities professionals, nutritionists and other health care workers provide services. In most States, licensed nurses and other independently licensed staff are not present and do not provide services although some residents may contract privately for limited nursing services. There are no national standards or policy making organizations which survey facilities for quality issues.

State regulations usually dictate minimum standards and licensure, if any. In California, ALF's are regulated by the Department of Social Services (as opposed to the Department of Health and Human Services which regulates nursing homes and hospitals).

Quality

There are no national standards or policy making organizations which survey facilities for quality issues. State regulations usually dictate minimum standards and licensure, if any. In California, ALF's are regulated by the Department of Social Services (as opposed to the Department of Health and Human Services which regulates nursing homes and hospitals).