A frequent concern for someone considering assisted living is whether there is adequate nursing or medical monitoring and assistance. In order to promote a healthy independence for its residents, assisted living communities often provide residents with numerous coordinated services including health services. Many residents choose assisted living because they can no longer manage tasks like properly taking their blood pressure readings, diabetic testing or medications. Consumers in need of medical assistance like medication management need to be aware of the fact that health services offered in assisted living environments vary by state.

Because the acute needs of assisted living residents have increased over the last decade most advocacy groups feel that a facility should indeed have a nurse on staff, however, this is not a requirement in many regions.

Currently, assisted living is state-regulated and has no single uniform set of regulations. However, all states and communities do recognize and follow certain specific designations. These designations or service provisions include a 24-hour awake staff member, meals, personal and supportive services, social services, housekeeping including laundry, transportation and recreation.

Assisted living communities also provide health services such as medication management but that does not necessarily mean they provide a 24-hour nurse on duty. Some states require a round-the-clock nurse be available while some states still do not require a nursing staff at all.

When evaluating a community, always ask specific questions pertaining to the available nursing supervision offered and how qualified the staff is that will be administering medications. Certain states simply require that pharmacists or licensed nurses manage medications. This means they can delegate the task of dispensing medications to unlicensed staff who have completed a minimal eight-hour state approved course. There are many concerns that each manipulation of a medication, especially by a non-nurse, doctor or pharmacist, creates an opportunity for potentially dangerous errors to occur even when setup is done with the best intentions.

Because of this and other health concerns the national nonprofit consumer-based organization the Consumer Consortium on Assisted Living or CCAL , recommends that all communities, regardless of size, have at least a nurse on call 24-hours a day, whether the s...

By state law and by most assisted living (AL) residential community regulations, all applicants for a residential slot in an AL community have to undergo a pre-admission assessment not more than 30 days prior to moving in. This is a medical check-up to be performed by the residents own physician or one that works with the AL community.

1. Explain the purpose of the assessment

The purpose of the pre-admission assessment is to get a picture of the current state of health of the resident. This will help the community prepare for the transition of the resident as well as to prepare for his or her likeliest needs.

This medical examination need not be a stressful task for the patient, the relatives, or the doctor. If you have a relative who will be moving to an assisted living community, there are things that you can do to prepare for the check-up, and give the physician the information that he or she needs to adequately and accurately assess the patient.

2. Prepare all available medical records and medications of the patient.

All information about the patient including past and present medical history should be on hand for the assessment. Don’t rely on your or your loved one’s memory to recall medical events or facts. If you can, try to provide a one-page medical history for the doctor. Likewise, have a list of all current prescriptions on hand.

3. Open your home to the doctor’s visit.

If the patient has special needs associated with activities of daily living, it is important that the doctor also have an idea what these are. Show the doctor around the house and be sure to focus on areas the patient frequents. If special equipment or facilities have been installed, show these as well. It will even be helpful for the patient to show the doctor how he or she goes around the house and interacts with the physical environment.

4. Write down unique particulars.

Jean is one of our readers who sent me a message on LinkedIn . It’s a question about which I’m asked quite often, so I wanted to share it with the entire readership.

Ryan, thank you for the free material. I learned a great deal, very interesting report! Another question:I am curious, when do people start looking for a place for their parents? at the time of crisis? or is there a process that Baby Boomers are aware of, thus take an initiative early on?

It would be unfair of me to lead you all to believe there is a specific time to consider assisted living. For most of us, it’s not something that typically appears one day.

Assisted living becomes an option if your loved one cannot perform basic ADLs (activities of daily living) independently, or if their behavior could jeopardize themselves or someone else.

Basic and Complex ADLs

Activities of daily living are those activities that are essential to independent living. They consist of basic and complex activities.

Basic activities include:

• Feeding one’s self
• Using the bathroom appropriately
• Maintaining good personal hygiene
• Dressing appropriately for the season

Complex ADLs include:

• Cooking
• Shopping
• Effective communications
• Following directions
• Taking medications appropriately
• Money management

When Should You Start Thinking About Assisted Living?

The decision to begin evaluating assisted living is never an easy decision. And often, while your instincts will tell you it’s time to begin that process, your heart will tell you otherwise. I think as children, many of us viewed our parents as heroes. I know I did. And it was really hard to face the reality that they may need extra help.

In my experience and from that of the people I’ve met, the best time to consider assisted living is when your loved one’s ability to perform ADLs starts to deteriora...