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.