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Supervision and Assistance
What Supervision and Assistance Can You Expect to Receive in Assisted Living?

Supervision and assistance offered in assisted living facilities provide residents with help with activities that consist of daily living requirements and needs. These services, monitored by health care assistants and staff, contribute to ensure a resident's health, safety, and well-being. The facility assists in arranging for medical, health, and dental care for each resident. The resident chooses his medical doctor and dental services.

Assisted living facilities offer a residential setting that provides personal care services, 24-hour supervision and assistance, activities and health-related services, designed to:

  • Minimize the need to relocate
  • Accommodate individual residents' changing needs and preferences
  • Maximize residents' dignity, autonomy, privacy, independence, choice, and safety
  • Encourage family and community involvement

Assisted living communities are an elder care alternative for people who do not need the 24-hour medical care provided by a nursing home. Assisted living promotes independence and dignity.

What Type of Assistance?

Assisted living staff offer assistance and supervision
Staff offers Assistance

Assisted living may offer assistance that includes administering services by a trained staff person.

Personal care services include:

  • Staff available to respond to both scheduled and unscheduled needs
  • Assistance with eating, bathing, dressing, toileting, and walking
  • Access to health and medical services, such as physical therapy and hospice
  • Emergency call systems for each resident's apartment
  • 24-hour supervision
  • Services that promote quality of life and independence
  • Medication management or assistance with self-administration of medicine
  • Coordination of services by outside health care providers
  • Supervision and assistance for residents with cognitive impairments and disabilities
  • Social services
  • End of life assistance

Assisted living communities offer a less-expensive, residential approach to delivering many of the same services available in skilled nursing, either by employing personal care staff or contracting with home health agencies and other outside professionals.

Additional services and amenities:

  • Three meals a day served in a common dining area
  • Housekeeping services
  • Transportation
  • 24-hour security
  • Exercise and wellness programs
  • Personal laundry services
  • Social and recreational activities
  • Recreational and spiritual activities

Every state regulates and licenses assisted living facilities their level. More than two-thirds of the states use the term "assisted living." Other terms used are the residential care home, assisted care living facilities, group care homes, and personal care homes. Each state licensing agency has its definition of the term.

What Type of Supervision?

Supervision through Basic Health Monitoring

The 2010 CDC National Survey of Residential Care Facilities found that 98% of facilities offered basic health monitoring such as blood pressure and weight checks (see the graph below).

Does this facility provide basic health monitoring, such as blood pressure and weight checks?
Responses of not ascertained (< 1%) and are not shown.
Source: 2010 CDC National Survey of Residential Care Facilities Survey (Facility Responses)

The primary health monitored 85% of the time by facility employees and other times by staff personnel (possibly care aides or health care workers working with the resident directly).

If basic health monitoring services are provided, are they provided by paid facility employees, other types of workers, or both?
Responses of legitimate skip (4%), and not ascertained (< 1%) and are not shown.
Source: 2010 CDC National Survey of Residential Care Facilities Survey (Facility Responses)

Supervision through Technology

Technology is being used more to help monitor residents

Special medical monitoring equipment is available in some senior living facilities but usually not the continual real-time surveillance systems used in a nursing home. Instead, one finds technology that detects a person's movement and activity. The technology sensors recognize unusual occurrences and identify emergencies without sacrificing resident privacy. Once detected, an alert goes to the facility staff to check on the resident. These systems accomplish safety and independence without the use of cameras or microphones.

The oversight of an attentive and caring staff cannot be replaced by technology. These systems aren't designed to replace staff, but instead work together to maximize resident safety and independence.

Technology Assistance for Brain Fitness

Some assisted living facilities offer wireless notepad devices to help residents exercise their minds and keep sharp. Even in Alzheimer's and Memory Care facilities, notebooks support the residents living with memory loss to use computerized brain games as a technique to interrupt further loss. These technologies exercise minds for brain fitness to enhance mental acuity and awareness. Seniors enjoy using the technology because the games blur the distinction between fun and therapy.

Technology Assistance for Mobility and Health

Mobile health technology that use smartphones and tablets offer applications in the devices and assist in exercise programs and track calorie intake. They are also used to keep in touch with medical professionals.

Some iPhone apps monitor blood glucose levels for residents living with diabetes, give nutrition advice and weight management tips, and send alerts if a resident wanders off the premises. In most cases, the apps are small and hard to read.

The technology works with the human touch factor to improve a quality of life for residents.

What if the Resident's Medical Needs Change?

Assisted living facilities receive no "medical" licensing, and persons requiring tube feeding, treatment of open bedsores or in need of 24-hour nursing care are not permitted to reside there. A few number of assisted living facilities have permits to care for residents on hospice. And some assisted living facilities have "campuses" with skilled nursing buildings or wings or beds available to provide more hands-on skilled nursing care.

Some facilities offer specialized services to persons with dementia if they meet certain licensing requirements. Make sure that the facility has experience in providing dementia care and meets all of the state licensing standards to provide dementia care.

Residents with temporary incapacities due to illness or injury can stay there or return from a rehabilitation center, skilled nursing facility or hospital if it offers appropriate services for care.

The newer facilities built today, emphasize ease of use for disabled people. The design of the bathrooms and kitchens meets the needs of residents in wheelchairs and using walkers. The hallways are extra-wide to accommodate the needed equipment and the codes are fully compliant with the Americans with Disabilities Act of 1990 (ADA).

What are the Qualifications for Staff?

Each state has different staffing qualification requirements. Typically an assisted living administrator must take a 40-hour certification program, pass a simple state exam, and obtain 40 hours of continuing education every two years. Staff must receive at least 10 hours of training at the facility within 4 weeks of employment, and at least 4 hours annually thereafter. For facilities advertising dementia care, 6 hours of orientation specific to dementia care within the first 4 weeks and at least 8 hours annually of in-service training. Read more about assisted living staff and adminstrators.

Qualifications: Administrators must be 21 years of age and possess a high school diploma or equivalent for facilities of 15 beds or less. For facilities of 16 to 49 beds, the administrator needs 15 college credits; and for facilities of 50+ beds, 2 years of college or 3 years' experience, or equivalent education and experience. Staff must only be 18 years of age and pass the criminal background check. Because ALFs are non-medical facilities, there is no requirement for RNs, LVNs or CNAs or any medically trained personnel. Check with the facility on the qualifications of the current administrator and key staff.

Carol Marak
Carol Marak

After seven years of helping her aging parents, Carol Marak has become a dedicated senior care writer. Since 2007, she has been doing the research to find answers to common concerns: housing, aging and health, staying safe and independent, and planning long-term.