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Assisted Living: Our Goal and Philosophy of Caring
When disability sets in and people can no longer live in their
own homes even with assistance, other residential options must be
considered.Often the alternatives available have not focused on the
resident's needs and wishes. While many older and disabled individuals
would prefer to remain in their own homes until the very end of
life and avoid nursing home placement, oftentimes alternatives are
not fully in keeping with the individual's desires.
Assisted Living is a work in progress. It is based on principles
and ideals that are not yet fully realized. Nevertheless, central
to this model of providing residential long-term care is the central
importance of customer satisfaction. The following is the philosophy
of assisted living as a goal that all residential facilities providing
housing with long-term care support services should attempt to strive
towards:
Philosophy of Assisted Living
"Assisted Living's philosophy is to provide physically and cognitively
impaired older persons the personal and health-related services
that they require to age in place in a homelike environment
that maximizes their dignity, privacy, independence and autonomy.
Assisted living maximizes dignity, privacy and independence
by providing a range of personal and health-related serves
designed to accommodate and support the needs and preferences
of individual tenants in private residential units. To meet
the goal of tenant autonomy, assisted living emphasizes individuals'
rights to make decisions about their own care and to take
responsibility for certain risks that may result from those
decisions, consistent with the individual's capacity to make
decisions and the provider's exercise of prudent risk management
through negotiated risk agreements. Autonomy is reflected
in opportunities for self-governance, protection of individual
rights, the exercise of autonomy within the context of bounded
choice and negotiated levels of risk agreed to by the individual
and management."
Keren
Brown Wilson, Assisted Living: Reconceptualizing Regulation
to Meet Consumers' Needs and Preferences. AARP: Washington
DC. 1996. Pp. 10.
UPDATE OF CONGRESSIONAL ACTIVITIES RELATED
TO ALF AND OTHER RESIDENTIAL OPTIONS
May 16, 2001
1. STRICTER ALF REGS MAY HURT RESIDENTS, SAYS U.S. NEWS
COVER
A cover story in this week's U.S. News and World Report
Magazine suggests that new state regulations for assisted
living in Alabama may actually hurt the residents they mean
to help. The rule, which was implemented "after at least two
people with dementia died when they wandered from other assisted
living facilities [ALFs]" could force residents with dementia
out of assisted living facilities and into nursing homes,
according to the U.S. News. The article, part of the larger
cover story on alternatives to nursing homes, sketches the
aging-in-place dilemma in assisted living and suggests that
both in Alabama and in other states, stricter discharge rules
may be depriving the elderly of the best situation for them.
"There are two fears about assisted living," Rosalie Kane,
a professor of public health at the University of Minnesota
told the magazine. "One is that the facility will evict you
if you need too much care. The other is that it won't." Go
to http://www.usnews.com/usnews/issue/010521/health/alabama.htm
for the full article.
2. NEARLY HALF THE STATES HAVE UPDATED ALF REGULATIONS
THIS YEAR
Twenty-four states have modified their assisted living licensure
requirements since last year, according to a report recently
issued by American Seniors Housing Association (ASHA). In
addition, five states have changed their continuing-care retirement
community (CCRC) regulations in the past year, according to
the report. The recently released fifth edition of the Seniors
Housing State Regulatory Handbook contains updated data on
all state regulations from approximately April 2000 to April
2001, according to an ASHA spokesperson. Reports are available
through ASHA's Web site at http://www.seniorshousing.org
or by calling 202/237-0900.
3. SENATE AGING COMMITTEE TAKES A SECOND LOOK AT ASSISTED
LIVING INDUSTRY
At a Senate Special Committee on Aging hearing on assisted
living facilities, Chairman Larry Craig (R-Idaho) said that
the committee had taken the proper action by taking another
look at the industry. There is now some discussion about the
need for a national guidelines and standards. See website:
http://www.seniors.gov/articles/0501/assisted-living.html
4. SENATOR CALLS FOR MODEL STATE REGULATIONS IN ASSISTED
LIVING
In order to solve the growing problem of patchwork state
regulations for assisted living providers, Senator Ron Wyden
(D-Oregon), in last week's Senate hearing on the industry,
called for the development of a "model state regulation."
This would, he said, "lay out a set of baseline consumer protections
for older people and at the same time encourage the kind of
flexibility that the industry needs in order to be creative
and innovative." In the hearing, Wyden suggested that states
could then be penalized for not adopting the model regulations
within a determined period of time. It is not yet clear whether
or when Wyden would convene a group to develop the regulations,
or who would participate. The Consumer Consortium for Assisted
Living (CCAL) has partnered with the American Bar Association
Commission on Legal Problems of the Elderly toward this goal
and, depending on funding, "we're ready to start tomorrow,"
Karen Love, executive director of CCAL told BAL Weekly. CCAL
will likely work with Wyden's staff on the standards, said
Love. The National Center for Assisted Living will also likely
get involved with CCAL's initiative, said Dave Kilo, vice
president of the center. Meanwhile, the Assisted Living Federation
of America (ALFA) is currently pursuing its own plans for
model regulations, Ed Sheehy, ALFA's vice president of state
legislative and regulatory affairs, told BAL Weekly. ALFA
is surveying its state affiliates to find out what parts of
their own state regulations they feel are exemplary, said
Sheehy. ALFA will then use this information to "try to distill
some language that best incorporates and reflects the spirit
and philosophy of assisted living," said Sheehy. ALFA then
plans to present this information at their regulator's summit
this September.
5. CONGRESSIONAL BILL INTRODUCED TO REDUCE TAX DEDUCTIONS
FOR ADULT FOSTER HOMES
There is a bill that provides for expanding the exclusions
from taxable income to cover payments for all foster care,
without regard to age. Placement can be made by either a government
agency or a private agency that's under contract by the state.
This is still pending, and subject to change even if it passes
and is signed into law by the president. The bill from Rep.
Thomas’s, House website. Last week the House Ways & Means
Committee passed H.R. 586 which appears to expand the exclusion
of foster care payments to include adult foster individuals
placed by non-profit organizations licensed by the state -
a big change if it passes.
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