Urban Research Monitor
Assisted Living: A Promising Answer for Senior Housing?

Arriving at a precise definition of assisted living is difficult because it is simultaneously a care philosophy, a building type, and a regulatory category. In his essay in Aging, Autonomy, and Architecture: Advances in Assisted Living, Victor Regnier defines it as a long-term care alternative that involves the delivery of pro-fessionally managed personal and healthcare services in a group setting that is residential in character and appearance. Assisted living's underlying philosophy, as all of the essays in Advances in Assisted Living make clear, is to provide a combination of personal assistance and medical care that allows residents to maximize their privacy, their autonomy, and their ability to age in place. The contributors to this book write that the environment (or architectural surroundings) in which elderly people live out their final days is critical to their ongoing independence.

Although it still serves only a small portion of the overall senior market (less than 3 percent of those not living in nursing homes, according to the Joint Center), assisted living is the fastest-growing option for providing long-term care for the frail elderly. The major benefit of this care form, say editors Schwarz and Brent, is that it offers these seniors a broad set of choices by separating the nursing component from the room-and-board component. They assert that by unbundling care services from housing, older people can receive a continuum of care without moving to more dependent care facilities.

Advances in Assisted Living propounds high expectations for its preferred care model. Its contributors suggest that assisted-living settings should have the "residential qualities of a home," provide a therapeutic setting that "promotes wellness and supports residents in coping with the stresses that accompany their conditions," offer an environment that can be "adjusted as residents age in place," and be a "place that makes the world right again." This emphasis on residential care outcomes (autonomy, independence, and feeling of "hominess") as opposed to traditional care inputs and outputs (such as number of beds and residents served) is what makes assisted living an appealing concept. However, whether it can live up to its utopian ideals for more than a small number of consumers is something else again.

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