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1993.06.30 :  Policy Synthesis on Assisted Living for the Frail Elderly

Contact:  HHS Press Office (202) 690-6343
June 30, 1993

       New "assisted living" arrangements are growing as a long term
care option, an HHS study shows, and older persons prefer these
arrangements to the more expensive option of nursing homes when
intensive medical care is not needed.  
       The findings are included in Policy Synthesis on Assisted
Living for the Frail Elderly, released today by HHS Secretary Donna
E. Shalala.
       Assisted living arrangements combine housing with services
for frail elderly and other persons with disabilities.  It provides
an opportunity for people to live independently in a homelike
setting while receiving needed personal care.  Surveys have shown
consistently that elderly persons prefer to stay in their own homes
or reside in congregate living settings over living in nursing
homes.
       The report, which was prepared by Lewin-VHI, Inc. under
contract to HHS' Office of the Assistant Secretary for Planning and
Evaluation, shows how assisted living has grown as a long term care
option in recent years.
       Nationally, there are an estimated 30,000 assisted living
arrangements serving as many as one million elderly and other
disabled persons.  Generally, they are less regulated than such
medically oriented facilities as nursing homes and hospitals.

       "Assisted living is an example of the good news in aging,"
said Secretary Shalala.  "States, local governments, private
corporations and the frail elderly themselves have creatively met
the need for care at reasonable cost while maintaining the
individual's dignity and independence."
       Other reports by the American Association for Retired Persons
(AARP) and the National Academy for State Health Policy (NASHP)
confirm this trend and highlight the growing interest in assisted
living.
       From a federal perspective, assisted living is an option that
the frail elderly and their caregivers need to be aware of, the
study says.  At the same time, there is a question of how much
regulation is needed and appropriate for this type of care.
       The Lewin-VHI report notes that, since assisted living seeks
to serve a highly vulnerable population, federal and state oversight
may be needed to ensure safety and compliance with quality
standards.  On the other hand, too much regulation could subvert
provider innovation, infringe on tenant autonomy and foster an
institutional rather than a homelike environment, the report says.
       Innovative programs in assisted living are found in Oregon,
New York, Florida, Washington state, Maryland, Virginia, New Jersey,
Maine, Rhode Island, Connecticut and New Hampshire.
       "The current system and supply of home and community-based
services is inadequate to meet the demand," said Dr. Fernando
Torres-Gil, assistant secretary for aging.  "Given the strong
preference of older persons to remain in their own homes and
communities, the assisted living model represents a promising
alternative to institutionalization."