An assisted living residence or assisted living facility (ALF) is a housing facility for people with disabilities or for adults who cannot or who choose not to live independently. The term is popular in the United States, but the setting is similar to a retirement home, in the sense that facilities provide a group living environment and typically cater to an older adult population. There is also Caribbean assisted living, which offers a similar service in a resort-like environment (somewhat like assisted vacationing).
Assisted living exemplifies the shift from "care as service" to "care as business" in the broader health care arena predicted more than three decades ago. A consumer-driven industry, assisted living offers a wide range of options, levels of care, and diversity of services (Lockhart, 2009) and is subject to state rather than federal regulatory oversight. What "Assisted living" means depends on both the state and provider in question: variations in state regulatory definitions are significant and provider variables include everything from philosophy, geographic location and auspice, to organizational size and structure. Assisted living evolved from small "board and care" or "personal care" homes and offers a "social model" of care (compared to the medical model of a skilled nursing facility). The assisted living industry is a segment of the senior housing industry and assisted living services can be delivered in stand-alone facilities or as part of a multi-level senior living community. The industry is fragmented and dominated by for-profit providers. In 2010, six of the seventy largest providers were non-profit and none of the top twenty was non-profit (Martin, 2010). Information in this edit is from an article published in 2012 that reviewed the industry and reports results of a research study of assisted living facilities.
In 2012 the U.S. Government estimated that there were 22,200 assisted living facilities in the U.S. (compared to 15,700 nursing homes) and that 713,300 people were residents of these facilities. The number of assisted living facilities in the U.S. has increased dramatically since the early 2000s.
In the U.S., ALFs can be owned by for-profit companies (publicly traded companies or limited liability companies [LLCs]), non-profit organizations, or governments. These facilities typically provide supervision or assistance with activities of daily living (ADLs); coordination of services by outside health care providers; and monitoring of resident activities to help to ensure their health, safety, and well-being. Assistance often includes the administration or supervision of medication or personal care services.
Assisted Living Options
COVID-19 Care Facility Admission Information
Protecting our most vulnerable residents and patients from the risk of transmission of COVID-19 is a top priority for Island Health. Residents of Assisted Living, Long-term Care, and Respite are at a high risk of suffering severe outcomes due to COVID-19, and as such, there are isolation procedures in place for these settings. These policies have been designed in consultation with Island Health’s Medical Health Officer and the Provincial Health Officer.
About Assisted Living Services
Assisted Living services support your independence and help you continue to live in the community. Island Health provides Assisted Living in partnership with private and non-profit facility operators, often in cooperation with the Independent Living BC program. For more about Assisted Living in British Columbia, please visit the Office of the Assisted Living Registrar.
Publicly subsidized Assisted Living is for seniors and people with physical disabilities who need a safe environment to live and help with daily tasks. It includes:
- Rental accommodation
- Hospitality services (meals, housekeeping, recreation supports, emergency response)
- Personal care assistance
For more information and to apply for this service, see Assisted Living services.
Publicly funded Assisted Living units are in high demand. Placement is based on the urgency of the individual’s care needs.
To be considered for Assisted Living, clients:
- are at risk if they remain in their current environment
- have difficulty with meal preparation and housework
- require daily assistance with personal care such as
medications, bathing and dressing
- are capable of making decisions safely (for example, finding their way around the building, participating in care planning, asking for help if they need it and taking direction in an emergency)
- are able to communicate with staff and others
- are able to make their way around in familiar places on their own
- are willing to accept assistance with personal care and attend meals in the dining room
- do not show any behaviours that could affect the health and safety of others.
People who are able to make decisions on their own behalf can:
- function safely with the supports available in the residence
- recognize the consequences of taking risks
- find their way within the residence
- find their way back to the residence
- communicate effectively (verbally or non-verbally) so they are understood by others
- participate in the development and regular review of their care plan, or make their needs known to the person they live with who then participates in the development of the care plan
- recognize an emergency, use an emergency response system or summon help, and take direction in an emergency situation.
What if my health changes?
YOU MAY CONTINUE TO LIVE IN AN ASSISTED LIVING RESIDENCE AS LONG AS:
- your health condition is stable
- you can make decisions on your own behalf (or live with a spouse who is willing and able to make decisions on your behalf)
- your care needs, including end-of-life care, can be met in Assisted Living.
YOU WILL NEED TO MOVE TO A MORE APPROPRIATE SETTING IF:
- your health condition declines permanently
- your care needs to increase significantly
- you are no longer able to make decisions on your own behalf
If that happens, your case manager will be able to help you through the process.
For more information, read the Home and Community Care Guide: Planning for an unexpected interruption in care.
Selecting an Assisted Living Residence
After your case manager does an assessment and agrees you are eligible for Assisted Living, you will want to find an Assisted Living residence that is right for you. Your case manager may help you select the most appropriate place based on your needs. You may also visit the Assisted Living Locations page to get an overview of your options.
Because vacancies at each Assisted Living residence vary, we cannot guarantee or accurately predict when a space will be available. Some Assisted Living operators also offer private units at a market rental rate. You can contact an Assisted Living operator directly about private options.
The amount you pay each month for publicly subsidized Assisted Living depends on your income.
- The cost is 70% of your monthly after-tax income, up to a maximum amount
- If you receive disability benefits from the Ministry of Housing and Social Development, you pay a fixed client rate.
You make these payments to the Assisted Living operator each month, along with a small BC Hydro surcharge.
What services are included?
- A private lockable unfurnished suite that you furnish with your own belongings
- Common dining room and social spaces
- Two nutritious meals a day (lunch and dinner) in a common dining room
- Weekly light housekeeping of your suite
- Weekly laundering of your linens (sheets and towels)
- Recreational activity programs
- 24-hour emergency response system
- Scheduled personal care assistance appropriate to your needs which may include help with bathing, grooming, dressing, and medication management, as discussed with your Case Manager
What other costs am I responsible for?
- BC Hydro surcharge
- Security / damage deposit
- Tenant household insurance
- Foot care
- Companion visits
- Travel to medical appointments
- Purchase of groceries (breakfast, snacks)
We welcome your feedback and respond to complaints as part of our commitment to provide the highest quality of care. If you have a complaint regarding your care in Assisted Living services please speak with the health care provider or manager first. If you have a complaint that remains unresolved, the next step is to contact the Island Health Patient Care Quality Office.
Assisted Living Registrar
The Office of the Assisted Living Registrar for British Columbia investigates complaints about the health and safety of Assisted Living residences. If you have any concerns about the safety and security of an Assisted Living residence, or the health and safety of a person who lives there, you should first talk with a staff member. If the concern is not resolved, you can make a complaint to the Assisted Living Registrar.
More information is available from the Office of the Assisted Living Registrar at 1-866-714-3378.
When caring for a loved one, there's no such thing as too much information. Hopefully, these links can provide even more information on caring for your loved one and their specific needs.
Older Adults Information
- Want some help downsizing, moving or setting up? Move Seniors Lovingly
- Canadian Senior Years
- National Seniors Council
- Canadian Association on Gerontology
- Canada 55+ Games
Alzheimers and Dementia Support
- Veterans Affairs Canada
- Ontario Disability Support Program
- Government Support - Find your local LHIN (CCAC)
- Interim Federal Health Program
- Ontario Assistive Devices Program