There have been dramatic changes over the past 50 years in the way the United States cares for seniors. Once the exclusive responsibility of the family, long-term care has developed into a system that includes formal community caregivers such as home care agencies, facility providers such as nursing homes and assisted living facilities, and informal caregivers such as friends or family members.
What Is Assisted Living Like Today?
Sara Robertson has been working in her family’s assisted living communities since 1998 and has seen how long-term care has transformed both nationally and locally. No longer are assisted living facilities run under the old military model of efficiency, where shared hall bathrooms, bingo, and processed cafeteria food were commonplace.
Today, assisted living is a place where you can feel at home and be treated like family, says Robertson, who co-owns The Arbors with her cousin Amie Hanrahan. There are plants and pet therapy, gardening areas and elegant dining rooms, wellness clinics and social clubs, endless menu options and customized personal care.
According to the Kaiser Family Foundation, which put together a timeline of long-term care in the United States, long-term care has transitioned from the era of nursing homes to the era of community-based services to the era of health reform.
The Era of Nursing Homes
The Era of Nursing Homes started in 1935 with the enactment of the Social Security Act (SSA). Under the SSA, federal dollars were made available to states to provide financial assistance to low-income seniors. However, the funds weren’t distributed to anyone living in public institutions, which spawned the creation of the private nursing home industry.
During this era, long-term care facilities are built around the old military model of efficiency. Much like older hospitals, nursing homes had narrow hallways and small double rooms. By 1967, states were required to govern the licensing of nursing home administrators to prevent fraud and abuse in nursing homes.
The Era of Community-Based Services
The Era of Community-based Services started in 1974 with an amendment to the SSA that authorized federal grants to states for social services programs, including homemaker services, protective services, transportation, adult day care, training for employment, nutrition assistance, and health support. Regulations were also put into effect at skilled nursing facilities regarding staffing levels, staff qualifications, fire safety, and delivery of services.
The early stages of Robertson’s family’s involvement in senior housing started in 1979, with the construction of housing for the elderly and affordable family housing. Shortly thereafter, Wilbraham Commons was built, laying the groundwork for pursuing assisted living.
Similar changes were happening across the nation, with the SSA allowing states to offer home and community-based services that were not strictly medical in nature. Assisted living communities started offering activities programs, plants and pets became part of the scene, and private bathrooms became the norm.
The Era of Health Reform
Today, Americans are living in the Era of Health Reform, which starts in 2010 with the Affordable Care Act and continues with the first of the nation’s baby boomers turning 65 in 2011.
Robertson says one of the biggest changes she’s seen in recent years is due to advances in technology.
“Technology is changing everything, including the senior living industry,” she says. “Resident medical records are now tracked through software, as are safety checks, resident visits, medication management, and all the personal care components. There are even apps for knowing what activities residents attend.
“When we opened The Arbors 1998, and up until about a year ago, we did every task manually,” she says. “For us, it really helped us know and understand what our customers want and need.”
Another change across the assisted living landscape is the movement toward person-centered care. High-quality assisted living communities provide hands-on human touch, lots of activities, and care directed toward the individual — which is a long way from the nursing homes of yesteryear.
“The idea of focusing on each individual, rather than the building as a whole, really improves the resident’s life and experience,” Robertson says. “We want to ensure their personal care needs are specific to them. Everyone is important and should feel that connection with our resident care aides.”
If you’re considering moving to an assisted living facility, you’re probably wondering what it would be like to actually live in one. Find out in our eBook, What Is Assisted Living Really Like?