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February 27, 2012

Skilled Nursing Facilities (SNF) vs Assisted Living Facilities (ALF) vs Independent Living (IL) vs Continuing Care Retirement Communities (CCRC)
Monica Trivedi


Skilled Nursing Facilities (SNF) vs Assisted Living Facilities (ALF) vs Independent Living (IL) vs Continuing Care Retirement Communities (CCRC)
The aging community today has more options than ever before when it comes to long-term care. For many their ultimate goal is to preserve their health in order to stay in their private home as long as possible.

Independent Living (IL) communities provide housing for seniors who for all intents and purposes live, as the name implies, independently. Many of these communities consist of private homes or apartments and offer only minimal assistance with home maintenance. The underlying goal of many of these communities is to eliminate the social isolation that plagues many seniors as they become older.

Skilled Nursing Facilities (SNF) provide the most comprehensive care of all the senior house options. Also known as nursing homes, SNFs are often a last resort for many seniors. SNFs can can provide the 24/7 support that is needed for those in declining health who need more intensive medical interventions. Skilled nursing facilities can also be a good referral source for assisted livings. Many nursing homes now offer post-acute rehabilitation and some residents are able to regain enough functional mobility after and injury or illness that assisted living may be a viable option for housing.

The Continuing Care Retirement Communities (CCRCs) may offer aging seniors the most options. The goal of these communities is to provide all levels of living and care to help ease the transition when failing health dictates a move to a higher level of care. Many CCRCs are private pay communities and after an initial lump-sum deposit, the cost for all levels of care remain the same. The goal of these settings is to provide a sense of community while helping aging seniors to keep living independently as long as possible.

AL Advocacy
Over the course of the years, several agencies have been developed to further the interests and protect aging Americans. Without the support of these groups assisted living would not be what it is today and what it has the potential to be in the years to come.

CCAL-Advancing Person-Centered Living
Founded in 1995, CCAL is the only national assisted living consumer organization. Its goal is to promote and foster person-center living practices by advancing policies and research. Ultimately, helping to create a a life centered on personal preference and values that stress dignity, choice, self-determination and individuality regardless of where they live and what services and supports they may need. Some of CCALs accomplishments since 1995 include:

- Operated the only national telephone Helpline to assist consumers and healthcare professionals with questions, problems and advocacy needs related to assisted living. An internet component to the Helpline was added in 2000.

- Published a consumer booklet, Choosing Assisted Living: Considerations for Making the Right Decision.

- Served as the co-facilitator for the U.S. Senate Special Committee on Aging on an eighteen-month national initiative to develop assisted living recommendations

- Pilot tested an innovative Community Partnership (CP) project, to build and strengthen collaborative relationships among residents, staff, and family members in assisted living communities.

Assisted Living Federation of America (ALFA)
ALFA describes itself as the is the shared voice of resident-centered, consumer-driven senior living and the seniors and families served. Through outreach, advocacy and media, ALFA informs the public and policymakers about the critical role senior living communities play to champion quality of life for seniors. It's interesting to note that ALFA does not condone the use of the term Assisted Living Facility In fact, they believe that several commonly used terms are taboo in the industry. For example, they believe the terms house, residence or community should replace the phrase assisted living facility. In addition words like unit or bed should be replaced by room or suite; or admissions and discharges should be replaced with move-in or move-out.

American Assisted Living Nurses Association (AALNA)
AALNA's goal is to promote effective nursing practice in assisted living such that nurses as well as residents benefit. It is the only association dedicated exclusively for assisted living nurses. The organization is run by volunteer nurses whose goals include sharing best-practices, promoting the professional growth of AL nurses through education, research and public policy, and developing a network of AL nurse.

National Center for Assisted Living (NCAL)
The NCAL is the assisted living branch of the American Health Care Association. Its goal is to serve the needs of the assisted living community through advocacy, education, research, professional networking and quality initiatives. In addition to national advocacy, NCAL also fights for state-specific efforts

The Future
As the baby boomer generation ages, the need for sustained long-term care is going to be vital. Individual states which regulate ALFs may need to Assisted livings facilities will continue to be an integral part of the continuum of care. Each state will need to continue to enforce and establish new regulations to ensure the safety and well-being of society's most vulnerable. Perhaps one of most critical issues facing the future of assisted livings is funding. With economic hardships hitting most or all Americans, states will need to continue conversations surrounding financial aid for the elderly.

As seniors continue to age in place, assisted living facilities will need to continue building strong relationships with outside agencies such as hospice and home health agencies. Each of these levels of care may be vital for helping a resident remain in the assisted living even when their health is declining. Without such agencies, the transition to skilled nursing centers is a realistic possibility for many.

Resources:
- http://www.genworth.com/content/products/long_term_care/long_term_care/cost_of_care.html
- http://portlandassistedliving.com/?page_id=2
- http://www.ncbi.nlm.nih.gov/pubmed/18162565
- http://www.ahrq.gov/research/apr08/0408RA17.htm
- http://www.susmaninsurance.com/index.php/2011/05/the-evolution-of-assisted-livingresidential-care/
- http://www.rwjf.org/pr/product.jsp?id=26795
- http://www.cms.gov


Reprinted by permission
Assisted Living History -- The Evolution of Assisted Living Facilities
http://www.assistedlivinghistory.com

Of Interest:
The History of Assisted Living (AL)
Long Term Care
Medical Social Workers



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