You might have never considered working in assisted living; however, this nursing specialty is more relevant now than ever before, and its significance will only continue to grow. In the United States, the population aged sixty-five or older will soon outnumber children for the first time in US history. Who will care for this population when they can no longer live independently? Sure, many will live with family and friends, but many simply won’t have that option or will prefer not to depend on loved ones for their care. For this growing segment of the population, assisted living facilities offer the ideal balance between autonomy and safety, encouraging residents to live as independently as they can while still assisting with all other daily activities that residents can no longer carry out on their own.
Whether you are a new nurse trying to decide on a career path after graduation or an experienced nurse ready for a change of pace and scenery, this guide covers everything you need to know about assisted living nursing.
What Does AL Stand For?
The abbreviation AL stands for assisted living; similarly, ALF stands for assisted living facility. Assisted living refers to services offered to people who need help with daily care, although not as much as the care required by people living in nursing homes. Since residents are relatively independent, they often live in their own apartments or rooms and share common areas.
According to the National Center for Assisted Living, there are currently 28,900 assisted living facilities throughout the United States, with nearly one million beds combined. Some of these facilities are privately owned, but most are part of national chains.
Although ALF logistics vary by state and even by facility, in general terms, these facilities house from fewer than ten to over one hundred residents and offer a variety of services, including the following:
- Meals
- Housekeeping and laundry
- Assistance with personal care, such as bathing and dressing
- Medication management
- Around-the-clock supervision and emergency care
- Some medical services
- Social and recreational activities
- Exercise and wellness programs
What Does Assisted Living Mean in Medical Terms?
By definition, assisted living refers to helping people with basic activities of daily living (BADL), such as personal hygiene, dressing, going to the toilet, transferring or moving about, and eating, as well as instrumental activities of daily living (IADL), such as managing finances, taking medications, preparing food, housekeeping, and doing laundry. However, most assisted living facilities also offer basic healthcare services.
- 83.6% have access to a pharmacy.
- 82.8% offer dietary and nutritional guidance.
- 71.4% provide physical, occupational, or speech therapy.
- 67.7% include hospice care.
- 66.1% provide skilled nursing care.
- 55% offer mental health services.
- Approximately 14% have special memory units.
- 8.7% specialize in dementia patients.
- A small percentage are geared towards people with intellectual or developmental disabilities or specialize in particular medical conditions.
What Is an Assisted Living Unit in a Hospital?
Assisted living facilities are separate from hospitals. When residents require medical attention beyond the scope of the attention provided by AL nurses, they are transferred to hospitals. Residents often return to ALF when their acute health concerns are resolved; however, in other cases, residents’ medical needs after a hospital transfer surpass the services that ALFs offer, so they must transfer to a nursing home or must remain in the hospital setting.
What Does a Nurse Do in an Assisted Living Facility?
Assisted living facilities often have multiple nursing professionals working under one roof, including registered nurses (RNs), licensed practical nurses (LPNs), certified nursing assistants (CNAs), and even nurse practitioners (NPs). Nurses help promote residents’ health and wellness and optimize function and infection control. Nurses may also be responsible for assessing potential new residents to determine whether their needs align with the services that assisted living facilities offer. However, each of these assisted living healthcare workers also has particular duties.
What Is the Role of a Registered Nurse in an Assisted Living Facility?
Registered nurses at assisted living facilities often work as head nurses or directors of nursing. Here are some of the responsibilities of a registered nurse at an assisted living facility:
- Supervising LPNs and CNAs
- Organizing work schedules and assigning tasks
- Managing resident care, including creating care plans, administering medication, preparing IVs, drawing blood, giving injections, and monitoring vital signs
- Monitoring residents and assessing the effectiveness of care plans
- Communicating with residents’ families
What Is the Role of LPNs and CNAs in an Assisted Living Facility?
Under the supervision of physicians and RNs, LPNs monitor patients, update health records, and administer first aid. In addition to RNs, LPNs also help supervise CNAs, who in turn assist patients with daily living tasks and provide basic care.
How to Become an Assisted Living Nurse?
Becoming an assisted living nurse simply requires an LPN or RN license and, in most cases, a basic life support (BLS) certification. However, a greater percentage of healthcare workers in the assisted living setting are CNAs. According to the U.S. Bureau of Labor Statistics, 15.8% of all CNAs work in assisted living, whereas only 5.07% of LPNs work in this setting, and only 6% of RNs work in nursing and residential care facilities combined. Furthermore, the number of nurse partitioners in this setting is even lower.
That said, the more experience and knowledge a nurse acquires, the better they will perform in an assisted living nurse role. Nurses who work or wish to work in this setting should stay up to date on the best gerontological nursing practices, assisted living nursing administrative practices, health promotion and disease prevention, and infectious disease management.
How Long Does It Take to Become an Assisted Living Nurse?
Becoming an assisted living nurse could take as little as one year through an LPN program or two to four years through an RN program. Additional training and certifications could take as little as a day or as long as several years of specific work experience and continuing education.
New nurses interested in assisted living would benefit from accepting a position in an assisted living facility straight out of school and pursuing a certification after a minimum of two years of work experience. Aside from most certifications requiring work experience, employers will often cover part or all of the certification costs.
What Is Assisted Living Nursing Like?
One way to visualize assisted living nursing is to understand residents’ average needs and overall profiles.
- On average, residents require assistance with 2.8 daily living activities.
- 50–75% of residents need assistance with medication management.
- ALF residents are less likely to need assistance with eating, transferring, and going to the toilet than nursing home residents. However, they are likely to need help with bathing and dressing.
- 17% of residents are in good physical health but suffer from cognitive impairment.
- 9% suffer from chronic illnesses which compromise their ability to function.
- 14% are impaired in more than one way.
- 66-81% of residents have dementia, depression, or other mental illnesses.
- 45% are not impaired in any way.
- Residents live approximately two years in ALFs. 35% of residents will move on to nursing homes, 15% will transfer to hospitals and not return, and 28% will die after this time.
Is Nursing in an Assisted Living Facility Hard?
Each type of healthcare facility has different challenges. One challenge that is particularly notorious in assisted living is understaffing. Over half of assisted living facilities have reported a deterioration in their workforce situation since 2020. 81% of assisted living facilities have recently experienced staffing shortages, and over half of facilities are actively recruiting personnel, including CNAs, LPNs, RNs, dietary staff, and housekeeping staff.
However, this challenge can also be seen as an advantage since finding employment in assisted living should be relatively easy for nurses and nursing assistants. One excellent way to work in this setting while maintaining a flexible schedule and earning higher-than-average pay is to work per diem. Through a per diem staffing app, nurses can request shifts in different assisted living facilities to help them decide if this nursing role is right for them.
Why Choose Assisted Living Nursing?
Although working in assisted living has its challenges, it also has many advantages for nurses.
- Job security: There is such high demand for assisted living nurses that these healthcare professionals are sure to find work quickly. Furthermore, with an aging US population, this demand will only increase.
- Autonomy: Assisted living nurses are more autonomous than acute care nurses. In fact, RNs are usually the highest medical authority in these facilities.
- Relationships: As opposed to hospitals and outpatient care facilities where patients come and go, in assisted living facilities, nurses interact with the same residents every day, allowing them to build close relationships with them. Nurses will also be able to develop closer bonds with coworkers whom they work with much more closely than they would in other healthcare settings.
- Routines: Work is much less chaotic in assisted living than in other healthcare settings. Nurses can carve out effective routines and follow them day after day.
- Fulfillment: Nurses in assisted living can significantly contribute to the residents’ overall wellbeing, and seeing residents thrive under their care can be very fulfilling.
What Makes a Good Assisted Living Nurse?
Certainly, the more nursing experience and knowledge assisted living nurses have, the better they will perform in their chosen field. That said, there are many non-medical skills that AL nurses should also develop to be truly exceptional. Here are some tips for new nurses to excel in the assisted living setting.
- Develop social skills: Remember that nurses will see the same residents day in and day out for approximately two years. Spending time talking to residents and getting to know them will not only help nurses make better decisions regarding residents’ healthcare but also improve residents’ quality of life significantly. In order to strengthen nurse-resident relationships, nurses should strive to develop patience and compassion.
- Hone your communication skills: Nursing always involves a complex web of communication. Nurses must communicate with patients, their families, and other healthcare team members. Furthermore, nurses in assisted living facilities are usually the team leaders, making them primarily responsible for effective communication among all the actors involved in residents’ care.
- Perfect organizational skills: With all the residents and staff members that nurses need to supervise and with the numerous responsibilities they have on their plates, assisted living nurses must have strong organizational skills. A single RN could create and manage all patients’ care programs, plan schedules for and supervise other nurses and CNAs, and coordinate with other staff, hospitals, and family members, among other duties. The only way to stay afloat is to master organizational skills.
- Stay positive and encourage residents: Many myths about aging negatively affect seniors’ outlook and quality of life. Suppose nurses bust these myths and share evidence-based information about aging with residents. In that case, residents’ could feel significantly more confident in their abilities to take care of themselves and make their own decisions regarding their care. This confidence and autonomy will improve residents’ mental health and overall quality of life.
Is Assisted Living Nursing for You?
Now that all your questions about assisted living have been answered, you are better prepared to decide whether you want to pursue a career in this nursing specialty. If you are still undecided, continue learning about other nursing specialties and remember that working per diem is an excellent way to obtain hands-on experience in different nursing settings.
