Assisted living
Assisted living residences or assisted living facilities (ALFs) 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 may include the administration or supervision of medication, or personal care services provided by a trained staff person. Assisted living as it exists today emerged in the 1990's as an alternative on the continuum of care for people who cannot live independently in a private residence, but who do not need the 24-hour medical care provided by a nursing home. Assisted living is a philosophy of care and services promoting independence and dignity. There is no nationally recognized definition of assisted living. Assisted Living facilities are regulated and licensed at the state level. More than two-thirds of the states use the licensure term "assisted living." Other licensure terms used for this philosophy of care include Residential Care Home, Assisted Care Living Facilities, and Personal Care Homes. Each state licensing agency has its own definition of the term it uses to describe assisted living.

Types
As varied as the state licensing and definitions are, so are the types of physical layouts of buildings that provide assisted living services. ALFs can range in size from a small residential house for three residents up to very large facilities providing services to hundreds of residents. People who live in newer assisted living facilities usually have their own private apartment. There is usually no special medical monitoring equipment that you would find in a nursing home, and there nursing staff may not be available at all hours. However, trained staff are usually on-site around the clock to provide other needed services. Where provided, private apartments generally are self-contained; i.e., they have their own bedroom and bathroom, and may have a separate living area or small kitchen. Alternatively, individual living spaces may resemble a dormitory or hotel room consisting of a private or semi-private sleeping area and a shared bathroom. There are usually common areas for socializing, as well as a central kitchen and dining room for preparing and eating meals.

Typical resident
Statistically, an assisted living resident needs assistance with an average of three ADLs. A typical assisted living facility resident would be a woman in her mid- to late 80's who does not need the intensive care of a nursing home but prefers more companionship and needs some assistance in day-to-day living. Residents of assisted living facilities need not be concerned with daily meal preparation, because a central kitchen and dining facility typically provides three meals each day. The central dining facility also allows for visiting with others without having to leave home. This greatly reduces the isolation that elderly, disabled people may suffer when living alone and who are afraid (usually for physical reasons) to leave their homes.

Special needs
The residence may assist in arranging the appropriate medical, health, and dental care services for each resident. The resident generally chooses his or her medical doctor and dental services. Residents who have periods of temporary incapacity due to illness, injury, or recuperation from surgery often are allowed to remain in the residence or to return from a rehabilitation center, skilled nursing facility or hospital if appropriate services can be provided by the assisted living residence. It is important to remember that assisted living residences are a bridge between living at home and living in a nursing home. Assisted living residences do not typically provide the level of continuous skilled nursing care found in nursing homes and hospitals. More recently built facilities are designed with an emphasis on ease of use by disabled people. Bathrooms and kitchens are designed with wheelchairs and walkers in mind. Hallways and doors are extra-wide to accommodate wheelchairs. These facilities are by necessity fully compliant with the Americans with Disabilities Act of 1990 (ADA) or similar legislation elsewhere. The socialization aspects of ALFs are very beneficial to the occupants. Normally the facility has many activities scheduled for the occupants, keeping in mind different disabilities and needs. Many ALFs also serve the needs of the mentally ill community, primarily people with some form of dementia including Alzheimer's disease, but also others as long as they do not present an imminent danger to themselves or others. In the United States, legislation enacted by each state defines not only the level of care, but often what conditions are prohibited from being cared for in such a home.

Caring to Help Others Manual A Training Manual for Preparing Volunteers to Assist Caregivers of Older Adults