Staffing Levels In Assisted Living
The world of senior living and care is changing all the time. Only twenty short years ago, assisted living meant something completely different than it does today. Consumer demands and preferences are shaping what services are offered and pricing is available. Regulatory agencies and laws are shaping what services can be offered, those that must be offered, and regulating the overall quality of the services extended.
The adult care industry as a whole is adapting to the changing desires and needs of older adults. With advancements in medical technology people receive improved medical treatments, new medications come into the market, and people live longer and longer, and because of this the assisted living industry also is evolving.
The level of staff at a senior living community can vary widely. Some communities use a “per resident” formula. For example, in some communities there are somewhere between 12 to 16 residents per caregiver. Some other communities determine their staffing based on a system of the residents level of care. For instance, a nurse manager may work out the number of hours that are needed to meet all resident needs and schedule based on those numbers. In such instances, the community may add or change staffing levels, based on the intensity of services needed by current residents.
Many senior living communities internally use the term “resident mix.” This term describes how many of the resident require no care, light care, moderate care, or heavy care. Assisted living community managers plan their staffing based on resident needs. If a community does not monitor resident mix and plan according to meet residents’ needs, they will be in violation of regulation and could possibly be fined or lose the ability to admit new residents. If a community repeatedly violates regulations, they will lose their license.
The good news is that providers have become very adept at balancing the care needs of residents with their staffing levels. Oftentimes there are computer systems that monitor the amount of time each residents’ care requires, with specific care plans written and maintained for each resident. Care plans outline the specific needs of each resident, along with an accompanying list of tasks to meet each specific need.
Consumers may have higher expectations of senior housing and care providers than what can truly be offered. In general, consumers believe that a senior living in an assisted living community is taken care of completely, and that the management and staff of the community will meet that person’s every need. This is not the case. Family members, friends, advocates, or legally appointed responsible parties, need to be also involved in the process to make decisions regarding the older adult’s care. The community’s duty is to provide a place to live, meals, social interaction, and emergency response. Beyond that, the community may not be able or willing to provide a higher level of service. If an older adult is not able to advocate for himself or herself, then a legally-responsible party needs to be involved in defining and approving a plan of care.
A widely held belief is that an older adult needs more personal monitoring than he or she truly wants or needs. On average, at an assisted living community plans on offering between one and two hours of in-person care for each resident every day. This amount of time meets the needs of a large majority of older adults. Someone who is more frail may require more personal time from a caregiver. Not all assisted living communities are designed for people who require higher levels of care; and no assisted living community offers one-on-one care without charging substantial fees for this level of personalized care.
When considering senior living options, individual care needs are among the best indicators of what type of care a person needs. If a person is able to do well on their own for most of the day, then assisted living is likely an excellent option. If a person is a fall risk, needs sporadic helps during the day, or if a person has memory loss that prevents them from accomplishing daily tasks, then other services may be required. There are assisted living providers who specialize in care for elderly people with fragile health, and others that specialize in care for memory loss.
Staffing ratios during nighttime, usually from 8PM to 8AM, are equally important as staffing levels during business hours and in the early evening. If the community is caring for residents with higher care needs, they must staff accordingly. If current residents rarely need assistance at night, then staffing level may be more at one staff member per 50 to 60 residents.
Some communities offer a la carte services, or the senior community may desire to meet each resident’s need on an individual basis. The rates for individualized services are likely to be higher; this may also be an indication that the community will be willing to change their staffing ratios to meet the needs of their residents.
If a community offers levels of care, or the community chooses to only offer a certain type of care, or is not willing to change their staffing ratios, the older adult and their responsible party must realize that an additional move may become necessary to get the assistance required.
All assisted living providers are legally required to determine whether they can meet a specific resident’s needs. They are also required to discuss the plan of care with the older adult and their legally responsible party.
The older adult and their family must work with providers to ensure that all needs are being met. Housing providers do work to provide quality services however there is a limited scope they must work in. Assisted living communities cannot act as a guardian for the residents and as such, family or a legally-responsible party must remain involved. If that is not possible consider hiring a professional care manager.
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