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In the Beginning…
As my grandma used to say, “In order to know where you’re going, you gotta know where you came from.” It’s the same with the assisted living industry. In order to make the most accurate prediction of where it’s headed we have to take a look back to how it all started and how it has continued to evolve up until now.
When I use the term “assisted living”, I’m referring to the modern deinstitutionalized industry.
This movement toward more community-integrated smaller facilities and away from nursing homes and skilled nursing facilities, began in the 1970’s as a result of public outcry against poor institution conditions and a desire to keep disabled loved ones in communities and out of crowded nursing homes. Out of necessity, this spawned a whole new field in the late 1990’s known as the assisted living industry.
When I use the term “assisted living”, I’m referring to the modern deinstitutionalized industry. This movement toward more community-integrated smaller facilities and away from nursing homes and skilled nursing facilities, began in the 1970’s as a result of public outcry against poor institution conditions and a desire to keep disabled loved ones in communities and out of crowded nursing homes. Out of necessity, this spawned a whole new field in the late 1990’s known as the assisted living industry.
Whereas in prior years facilities in the community were just an alternative to eldercare in institutional settings, now residential facilities are being modified to house residents with all sorts of disabilities ranging from Alzheimer’s to paraplegia. Modern advances in medicine and technology are giving the disabled population freedom to thrive and enjoy the amenities of communities all over the world. From ranches in rural America to that three bedroom townhome just outside of downtown, facilities are popping up everywhere. Oh, and if you were wondering, almost any type of residential building can be deemed a facility with the proper preparation.
The generic term is “assisted living facility” but, truth be told, there are all sorts of names for facilities in in this field including but not limited to: Group Homes, Residential Care Facilities, Community-Based Residential Facilities, Residential Care Apartment Complexes, Supportive Living Communities, and the list goes on. These were all designed to provide residents with assistance with ADLs or activities of daily living including getting dressed, preparing meals, bathing, medication management, and up to a certain amount of hours of medical care per week depending on which type of facility. They are the middle ground for those for whom independent living is not appropriate, but who don’t need 24-hour medical care or rehabilitation in a nursing home.
Assisted living is more a system of thought or philosophy in how care is to be administered, and how dignity and independence is to be fostered, a way to meet the spiritual and emotional needs of residents. It is a means of institutional reform and cost-effective community support. In many states, Medicaid Waiver programs have been developed to provide access to home-based care to the indigent population with long term care needs. This includes both elders and younger adults with physical and intellectual disabilities as well as terminal illness.
The current healthcare crisis combined with an aging baby boomer population in America has created the perfect storm for community based facility operators to provide a valuable service and make a tidy profit in the process. Some reports have stated that health care spending in the U.S. is expected to top 19% of the Gross Domestic Product by the year 2023! Do you realize there are upwards of 75 million people in this country between the ages of 51 and 69? Couple this with new government mandated insurance coverage and it becomes pretty obvious that there have to be some changes in this broken system. Some tough decisions have to be made and cuts will take place out of necessity. You can research more about the state of the industry on http://ahcancal.org. I post tons of info relevant to the current state of the industry.