In Oct. of 2014, the Center for Excellence in Assisted Living (CEAL) sponsored The Future of Assisted Living: Consumer Preferences and the Era of Healthcare Reform in Washington, D.C.: Those who attended the seminar consisted of 35 assisted living stakeholders. This conference was held to discuss the issues that would define the future of assisted living. Attendees represented various factions of the assisted living community, including:
- The residents themselves
- Family members of residents
- Health care professionals
- Managed Care and Accountable Care Organizations
- Medicaid staff members (at the state level)
- Individuals active in the disability community
- Assisted living providers
In the Pay-for-Performance Health Reform Landscape, the Evolution of Assisted Living is Essential
In order to remain a viable choice for senior care, the assisted living industry needs to continue its progression toward making itself more attractive to Accountable Care Organizations (ACO) and Managed Care Organizations (MCO). According to CEAL, there are four matters that can make an assisted living provider attractive to these organizations:
1. State Regulations
Professor David Grabowski, Ph.D. was the keynote speaker for the roundtable. Grabowski is Harvard University’s professor of health care policy. CEAL released a white paper in April of 2015 that is based on the data and information gathered from Grabowski, the panelists and the attendees during the convention.
1. State Regulations
While there are various federal laws that impact assisted living communities, states are primarily responsible for overseeing the elder-care facilities within their jurisdictions. Attendees to the CEAL conference support continued state regulation of assisted living facilities; however, they also suggested that these regulations should:
- Support collaborations between the state and the provider.
- Remain evidence based while reflecting the best practices in assisted living. These practices should include verifying credentials for personnel, embracing innovation and providing person-centered care.
- Allow seniors to age in place through community based models like assisted living without walls.
- Implement a survey process emphasizing education and collaboration as opposed to correction or punishment.
Hiring informed, dedicated and educated staff members is essential to every assisted living community. The seniors who reside in these communities still need assistance with daily activities. According to the Centers for Disease Control and Prevention (CDC), 62 percent of these seniors need help bathing, nearly 50 percent need help dressing and approximately 40 percent need assistance using the toilet. Employing qualified personnel who have completed caregiver training courses ensures that staff members are knowledgeable about caring for residents. Furthermore, implementing a program designed to keep staff members abreast as to the ever-changing landscape of senior care through caregiver continuing education courses can help ensure that residents receive the most up-to-date care possible.
The costs related to assisted living should be equivalent to the costs for skilled nursing. Affordable private-pay options should be offered for middle class seniors; in addition, stakeholders need to:
- Create partnerships with supporters like AARP to maintain affordability.
- Follow regulations, creating the potential for reimbursement for Medicaid through MCOs and ACOs.
- Develop ways to fill the need for affordable senior living through modern concepts like assisted living without walls.
- Inform consumers about the need to fund their own care.
In order to reduce some of the costs associated with assisted living, communities need to participate in ACOs and MCOs. To accomplish this, data must be collected and shared across settings. The data collected needs to:
- Focus on data related to medical and health care as well as individual goals, preferences and psychosocial needs.
- Address quality measures and outcomes.
- Provide data sharing and ensure effective communication techniques among stakeholders.
Additional Themes Discussed During the Conference
Throughout the seminar, attendees also discussed emerging themes related to the field of assisted living. The themes discussed include the need for assisted living facilities to:
- Use technology as a means to foster quality care and coordination, provide affordable services, offer easy accessibility and enhance the work life of staff.
- Provide services in a variety of settings to address the increasingly diverse characteristics of seniors. These characteristics include age, lifestyle, culture, disability level, patient preferences and care needs.
- Focus on assisting the individual without causing any disturbances to the home environment.
- Offer a variety of services within the assisted living model. Services that range from hospitality through meeting each resident’s health care needs.
- Meet the evolving preferences of the consumer by partnering with community researchers and home health organizations to create new assisted living models.
- Focus on providing services centered around the individual in his or her home and community.
- Educate consumers about informed decision making, privacy of personal information and the importance of planning ahead to fund long-term care.
- Support regulation that fosters evidence-based practices promoting risk reduction as well as those supporting the freedom of choice and managed risk.
- Adapt to ongoing changes in physical environments and operating models.
The Traditional Concept of Senior Care is Changing
The traditional concept of the nursing home model of care is on the decline. Seniors are moving toward other housing options, assisted living facilities fall within these alternative housing options. One example of the changes being seen in assisted living communities includes Innovative concepts designed to enrich the lives of seniors. For example, the CEO and founder of Aegis Living, Dwayne Clark, states that he wants the residents in his community to feel as if they are on vacation. In 2012, Aegis Living created a 1950’s replica of Madison Park. This nostalgic rendition of Madison Park is being created for the community’s memory care residents who have dementia since individuals with this condition resort to long-term memories.
Technology Enhanced Senior Care
There are several technologically advanced personal care products available that promise improved health and quality of life for the senior population. From computer systems with the ability to keep track of vital signs and medications to wireless networks providing mobile support to seniors in assisted living communities. All of these advancements make it clear that the future of assisted living looks bright for the resident and the facility.
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