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. (August 2011)
An assisted living residence or assisted living facility (ALF) is a housing facility for people with disabilities or for adults who cannot or choose not to live independently. The term is popular in the United States but is similar to a retirement home in the sense that facilities provide a group living environment and typically cater to an older adult population. There is also Caribbean assisted living, which offers a similar service, in a resort-like environment (like assisted vacationing).
Assisted living exemplifies the shift from "care as service" to "care as business" in the broader health care arena predicted more than three decades ago. A consumer-driven industry, assisted living offers a wide range of options, levels of care, and diversity of services (Lockhart, 2009) and is subject to state rather than federal regulatory oversight. What "Assisted living" means depends on both the state and provider in question: variations in state regulatory definitions are significant and provider variables include everything from philosophy, geographic location and auspice, to organizational size and structure. Assisted living evolved from small "board and care" or "personal care" homes and offers a "social model" of care (compared to the medical model of a skilled nursing facility). The assisted living industry is a segment of the senior housing industry and assisted living services can be delivered in stand-alone facilities or as part of multi-level senior living community. The industry is fragmented and dominated by for-profit providers. In 2010, only six of the seventy largest providers were non-profit and none of the top twenty was non-profit (Martin, 2010). Information in this edit is from an article published in 2012 that reviewed the industry and reports results of a research study of assisted living facilities.
In 2012 the U.S. Government estimated that there were 22,200 assisted living facilities in the U.S. (compared to 15,700 nursing homes) and that 713,300 people were residents of these facilities. The number of assisted living facilities in the U.S. has increased dramatically since the early 2000s.
In the U.S., ALFs can be owned by for-profit companies (publicly traded companies or limited liability companies [LLCs]), non-profit organizations, or governments. These facilities typically provide supervision or assistance with activities of daily living (ADLs); coordination of services by outside health care providers; and monitoring of resident activities to help to ensure their health, safety, and well-being. Assistance often includes the administration or supervision of medication, or personal care services.
There has been controversy generated by reports of neglect, abuse and mistreatment of residents at assisted living facilities in the U.S.
In Canada, there are also some differences in how assisted living is understood from one province to the next. In most provinces, the phrase is understood as less independent than it is in the United States. People often require help with more than one of the activities of daily living or the more intensive ADLs like feeding or bathing. In the province of Alberta, "supportive living" is the distinct phrasing used for a type of care that is otherwise synonymous. The province's Supportive Living Accommodation Licensing Act is a comprehensive act with specific prescriptions governing care homes licensing, inspections and more.