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Assisted Living

Assisted living communities are perfect for seniors who need personalized care. They provide an environment that allows people to live their life fully while also giving them access to many of the services they may need due to illness or disability, including medication management and assistance with things like using the bathroom, dressing, grooming, laundry, housekeeping, and cooking meals. Transportation services in assisted living communities can even help people get around town for errands and other activities, if needed.

In an industry that doesn’t get the attention it deserves, assisted living centers have the reputation of being somewhat of a no-man's-land: home to people who are either too old to care for themselves or too ill to be fully discharged from skilled nursing care. However, that reputation is changing because assisted living centers have stepped up in both the quality of care and in meeting residents’ needs.

States vary slightly in how they define “skilled nursing” in the context of an assisted living center, but at the heart of any robust assisted living program is a partnership between a facility’s administrative staff and helping professionals – nurses, therapists or social workers – who work with those who move from acute care settings into assisted living.

People moving into assisted living are generally elderly – often well into their 80s or 90s – and how they present initially may be quite different from how they present several months or years later. That’s why it’s important for staff to be aware of a resident’s condition on an ongoing basis. Allowing residents to stay with no one being apprised of their condition can lead to some ugly situations, such as unnecessary worsening of health and even death.

Frequently Asked Questions

What does a nurse do at an assisted living facility?
Assisted living nurses assess residents at the beginning of their stay and on an ongoing basis. They administer medication (or supervise its administration by nursing assistants), create service plans for individual residents, and evaluate the continued appropriateness of the plan. Assisted living nurses can also play a role in reducing re-admissions to hospitals.

The role of the assisted living nurse often involves coordinating healthcare services from different sources. While some states are restrictive about the nursing services that can or must be delivered by assisted living staff, others allow additional services to be provided by outside organizations. There is one service universally allowed: hospice care. Assisted living facilities may maintain ties with trusted home health organizations for various other services and also maintain relationships with physicians who provide long-term care rather than acute care.

Registered nurses may be licensed to provide care in assisted living facilities. Some states allow intermittent skilled nursing services or a set number of service hours per week. Other states allow facilities to apply for waivers to retain residents whose needs they are confident they can continue to meet. Some states license high acuity assisted living, in which seniors who need more care can remain at their assisted living community.

How much do assisted living nurses make?
According to the U.S. Bureau of Labor Statistics, the average annual salary for a licensed practical nurse (LPN) working as an assisted living assistant in the United States is $66,413 a year as of January 17, 2022. This amounts to $31.93 per hour or $1,277 a week, assuming 2,080 hours worked per year (40 hours per week for 52 weeks). The lowest 10 percent of LPNs working as assisted living assistants earn an average of $18,520 annually ($8.57 an hour or $414 a week), and the highest 10 percent earn an average of $109,300 ($47.42 per hour or $2,341 a week).

What is the difference between a nursing home and assisted living?
The main difference between nursing homes and assisted living is that nursing homes provide medical and personal care in a clinical setting, while assisted living communities primarily provide personal care in a home-like, social setting. Though both types of senior care provide assistance with activities of daily living (such as bathing, dressing, and eating), assisted living services do not include the same level of medical care as nursing homes or other types of more robust long-term care. However, since it maximizes quality of life, promotes independence, and is often less expensive than staying in a full-service care facility, assisted living has become an increasingly popular alternative to nursing home care over the last decade.

Rehabilitative services are often provided to patients in a nursing home setting. Patients who have undergone a stroke or surgery, among others, receive physical and occupational therapy daily as they recover. Once they are deemed strong enough and stable, most patients leave a skilled nursing facility to go home or into assisted living.

What are the five levels of care in assisted living?
States generally do not dictate levels of care within the assisted living industry. Each community is allowed to outline their own levels of care and the needs that make up each level. There are usually two to five levels of care within assisted living, including residential living, skilled nursing, memory care, assisted living, and rehabilitation.

Lower levels of care are typically for residents who need only minimal assistance, such as those who are able to ambulate without assistance and who are independent in their daily hygiene and care. They may require assistance with showering, but they manage their toileting needs without incontinence products. Nurses may take blood sugar levels and perform other regular tests at the community, but these residents do not require complex medical monitoring.

Higher levels of care are for residents who have difficulty ambulating independently and who need help walking or wheeling from place to place. They may not be able to dress themselves, bathe themselves, or manage their toileting or incontinence without assistance. These residents may display signs of dementia and may require more verbal or physical cueing to make decisions or manage their day successfully. They also may require complex medical monitoring, and they could have increased fall risks.

RNs, CNAs, and LPNs connect to local facilities that are ready to fill nursing jobs immediately through the Nursa app.
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