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Vital Signs

Spring 2006

Choosing Assisted Living Facilities Requires Research

Right placement can help sustain an older person's independence and social interaction

The number of elderly- men and women 65 years or older-will double by the year 2030, to 70 million Americans. As the babyboomer generation heads toward this extraordinary milestone, the demand for appropriate facilities to help care for them also will dramatically increase.

Already there has been a mushrooming of what are known as assisted-living facilities that provide some support to senior residents- help with taking medications, for example, or with bathing or dressing-but not the higher level of around-the-clock care that would be found in a skilled-nursing facility. Most definitions of assisted living include 24- hour staffing, housekeeping, meal preparation and some level of personal care.

The goal of assisted living is to sustain the relative independence of residents for as long as possible. "The longer an older person can stay independent, the better," notes Sonja Rosen, M.D., UCLA geriatrician. "These are living environments where people generally function at a relatively high level and are able to do as much for themselves as possible. They can have social interaction and be involved in activities. It can be a wonderful situation because it really is a community. That is very important-when older people have lost their friends and their spouse and are alone at home, they start to deteriorate."

When considering assisted-living facilities, prospective residents and their families need to shop to see what feels like the best fit. In addition to taking a tour of the facility, tasting the food and speaking to the director, staff and some residents, they should ask about the services that are provided and the facility's policy regarding functional decline. Some assisted-living facilities are equipped to care for more dependent residents; others are not. Though an assisted-living residence may be a warm and welcoming environment, the transition can be difficult, says Helen Lavretsky, M.D., UCLA geriatric psychiatrist. "It is a critical, life-changing event," she says. "Even though it is meant to foster independence, it still represents one of the many losses that older adults face, such as the loss of health, loss of wealth, loss of mobility."

The transition can be eased somewhat by advanced planning. "If one plans ahead of time, it is less of a shock because the decision becomes one that the individual has made, rather than one they have been forced into," says Dr. Lavretsky. A physician experienced in the treatment of older adults can help families evaluate the physical and psychosocial needs of the patient and assist with choosing the most appropriate facility.

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