Assisted living will “deliver on its promise” by providing services consumers want, experts say

The evolution of the assisted living model has made resident needs more challenging, exacerbated workforce shortages, increased regulatory complexity, inadequate funding and accessibility, and increased the need for consumer support, education and advocacy, said to industry experts.

Together, these factors have limited the ability of the industry, the nation’s largest residential long-term care provider, to adequately provide assistance and promote life, which has had negative impacts on aging and well-being, according to one study. Health matters commentary.

In the commentary, Sheryl Zimmerman, MSW, PhD, executive director of the Center for Excellence in Assisted Living at the University of North Carolina at Chapel Hill (CEAL@UNC); Robyn Stone, DrPH, LeadingAge senior vice president of research and co-director of the LeadingAge LTSS Center @UMass Boston; Paula Carder, PhD, director of the Institute on Aging at Portland State University, Oregon; and Kali Thomas, PhD, associate director of health services research in the Center for Equity in Aging at Johns Hopkins School of Nursing, presented recommendations in four areas – workforce, regulatory and government, consumer needs and roles, and financing and accessibility – to to help assisted living ‘delivers on its promise’.

“Current assisted living provides assistance and enables aging with a good quality of life – but not for everyone,” the authors concluded. “It is time to focus on ways that enable assisted living owners and operators to provide care and service in a way that consumers desire – assistance in meeting needs combined with the highest quality of life attainable through autonomy, flexibility , dignity and choice”

The authors called for policies to expand the workforce, increase wages and training, set workforce standards, enable greater use of third-party services, encourage uniform data reporting, and provide incentives to owners and operators to facilitate access for people with lower incomes.

According to the authors, nearly 1.7 million older adults required residential long-term care in 2018, with more than half (918,700) living in assisted living. In 2022, 24 national experts said the industry was at a crossroads and called for assisted living to be reimagined due to financial, regulatory and workforce issues, along with the rising needs of residents.

Although the assisted living model’s ability to address complex care needs is limited, the needs of residents are significant. According to the commentary, up to 70% of assisted living residents have cognitive disabilities; one-third to one-half of assisted living residents have been diagnosed with Alzheimer’s disease and related dementias; 25% have depression, more than a quarter have six or more. chronic conditions, and 11% have a serious mental illness.

“In many ways, assisted living has been a natural experiment, exposing people to different types of environments over time,” the authors wrote. “The evolution from early models to current options has not been planned or coordinated, and numerous forms of assisted living now exist.”

According to the authors, states use 182 licensing classifications that can be combined in 350 different ways to oversee assisted living, causing “widespread confusion.”

The philosophy of assisted living aims to tailor services to the needs and preferences of residents. “In reality, however, as the field has developed and the acuity (health needs) of residents has increased, there has been both a shortage of assistance and a shortage of livelihoods,” the authors wrote, noting that the necessary support is not always available and that aging place is not always feasible.