Living in a Seniors' Assisted Living Residence
Assisted living is for adults who are able to direct the services they need and live in a semi-independent environment. Residents will receive housing, hospitality services and at least one and no more than two personal assistance (prescribed) services.
Entering an Assisted Living Residence
Assisted living operators must operate residences in a way that does not jeopardize the health or safety of the residents. Operators cannot house people who are unable to make decisions on their own behalf or who cannot be safely accommodated (for example, persons who cannot self-evacuate in an emergency). Therefore operators of publicly subsidized and private-pay residences must screen residents for the ability to make the decisions necessary to function safely in assisted living.
Assisted living is intended for people who are able to choose and direct the personal assistance services they need. Operators must fully inform prospective residents about the services available in the residence. It is then up to the prospective resident and the operator (and, in a publicly subsidized residence, the case manager) to decide whether the operator can meet the resident’s service needs and the resident can live safely in the residence.
Assisted living residents need to be able to:
- determine whether they are able to manage on their own in the supportive environment of the assisted living residence;
- make decisions about the services they will receive;
- function safely when they are alone in their assisted living units, including recognizing an emergency and calling for help or following directions;
- name a person the operator can contact if there are concerns about their ability to function safely in assisted living.
Before moving in, residents also need to understand they will be expected to seek other accommodation if they are no longer able to make decisions that allow them to function safely in assisted living.
Operators must ensure that prospective residents are eligible for assisted living and appropriate for the services offered and features of the particular residence. They must screen residents for entry and exit from the residence.
At the time of entry, operators must provide information to residents about:
- the need to be able to make decisions in certain key areas of function.
- the hospitality and personal assistance services offered.
- features of the residence that accommodate people with physical disabilities.
- the emergency response system.
- the residence’s evacuation plan.
Health Authority Case Manager's Role
Health authority case managers assess individuals who wish to enter a publicly subsidized assisted living residence and refer eligible people to residences that may be of interest. A case manager may also be involved if a person who already has a case manager when living in the community enters a private-pay assisted living residence.
Before Moving In
Before someone enters a seniors’ assisted living residence, they and their families may want to consider the following questions:
- Does the residence have units that will accommodate two spouses entering assisted living?
- What restrictions are there regarding smoking in the residence?
- Are pets allowed?
- What is the residence’s internal complaint policy?
- How many meals are provided? are snacks provided?
- Will the residence accommodate any food allergies, intolerances or preferences?
- Does the residence provide furnishings or are the units to be entirely furnished by the residents?
- How long will an operator store a resident’s belongings after he or she leaves the residence?
Most of these items should be covered in written information provided by the operator before a person enters a seniors’ residence. Operators are required to have new residents sign an occupancy/residency agreement.
Once in an Assisted Living Residence
Assisted living operators must ensure that assisted living services are delivered in a way that does not jeopardize residents’ health and safety. Residents may continue to reside in assisted living as long as:
- they continue to be able to make decisions related to key areas of function, in order to live safely in the semi-independent environment of the assisted living residence — unless a spouse lives with the resident and is willing and able to make decisions on their behalf;
- they continue to be able to express their wishes so as to be understood by staff or by a spouse living with them who can communicate with staff on their behalf;
- they do not behave in a way that jeopardizes the health and safety of others; and
- their care needs do not exceed what can be provided in assisted living.
Operators must take reasonable ongoing steps to assure themselves that residents meet the above criteria.
Regardless of what seniors’ assisted living residence a resident is in, the following is expected at every residence:
- all residents are 19 years of age or older
- units are lockable and there is a space to lock valuables
- common space is available for residents’ use
- if taking medications, residents can choose what pharmacy to use (though an operator may encourage use of a common pharmacy)
- the residence has a food permit if required, or those preparing meals have FoodSafe certification
- residents are involved in the process to develop a personal service plan that identifies their needs and goals
- the resident’s rent covers (i.e., they should not be charged extra for):
- meal service;
- linen laundry service and use of laundry equipment for personal laundry;
- light housekeeping;
- 24 hour emergency response system; and
- social and recreational activities.
Operators of seniors' assisted living residences must:
- provide a safe, secure environment
- provide a “watchful eye” over residents, to ensure their health and safety
- respect the privacy of residents and their personal information
- engage residents in personal services planning
Temporary Changes in Health
If a resident encounters a brief episode of decreased physical or mental functioning (while recovering from an injury, an acute illness or an exacerbation of a chronic illness) and can remain safely in an assisted living residence, the operator may assist the resident and their family to arrange for professional care on a short-term basis. In most instances, including early discharge from an acute care hospital, the health authority may provide home care nursing services, just as for any other person living in their own home in the community.
Similarly, short-term professional care may be provided to residents who require palliative care or, as set out in a transition (exit) plan, to those who are awaiting transfer to a community care facility.
Transitioning Out of an Assisted Living Residence
Residents cannot continue to be housed safely in assisted living if:
- they are no longer able to make decisions related to key areas of function, unless a spouse lives with the resident and is willing and able to make decisions on their behalf;
- they are no longer able to express their wishes so as to be understood by staff or by a spouse living with them who can communicate with staff on their behalf;
- they behave in a way that jeopardizes the health and safety of others;
- their needs exceed what can be provided in assisted living; or
- they can no longer safely evacuate in an emergency.
If it is concluded that a resident can no longer be housed safely in a particular assisted living residence, he or she will need to move to a more appropriate setting. Depending on the circumstances, the resident could move to an assisted living residence that provides additional services (e.g., wheelchair-accessibility or both scheduled personal assistance and unscheduled personal assistance), to a family home or a community care facility. To assist with the transfer, the operator must develop a transition plan in consultation with the resident and their family, physician, support network and health authority case manager (if involved). The transition plan sets out the resident’s relocation plan, who is responsible for the arrangements and what additional services will be put in place in the intervening period to ensure the resident’s health and safety is not in jeopardy while awaiting transfer.
During the transition period before moving, a resident may reserve or purchase additional services from the operator, including short-term professional care.
If a health authority case manager assesses the resident as being eligible for placement in a community care facility, the local health authority may also provide additional services to support the person while they await transfer, just as it would if the person were living in their own home.