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When looking for assisted living communities for an elderly loved one, families may come across the phrase, “levels of assisted living,” which refers to the different services and levels of care provided in an Assisted Living Facility (ALF).  

Prior to residents’ admission into an assisted living facility, nurses will conduct a needs assessment to determine the level of care and attention needed for Activities of Daily Living (ADLs) such as bathing, feeding, dressing, and toileting. The results are documented and stored using the facility’s long term care software, after which the nurse will create a personalized care plan for each resident.  

Depending on the state, type of license, certification, and the facility’s administrator license, an assisted living facility will cater to different services and levels of care, taking into account the housing and service programs for the residents. Therefore, we will first look at several factors that indicate what levels of care a facility provides:

  • The Floor Plan: An open and spacious floor plan demonstrates that a facility gives less intensive care, as the residents have more independence and mobility. This means they have more freedom to roam internally and externally within the facility’s parameters. 

Alternatively, a central area where the clinical staff congregates and moves between—a nurse’s kiosk, staff lounge, front desk, and the resident’s rooms—indicates the space is designed for higher levels of care, because the staff needs to move between the areas more frequently. Such a floor plan is designed for convenience, allowing the clinical staff to move more easily between the areas. 

A nurse assessing the levels of assisted living care with a resident.
Levels of assisted living refers to the different services and levels of care provided in an Assisted Living Facility (ALF).
  • Staffing Numbers: How a facility organizes its staff is another indicator of the level of care provided by a facility. Facilities with higher levels of care tend to have larger teams providing more care and support to their residents. On the other hand, facilities that offer less intensive care typically have a smaller team, as the residents are more independent and do not need as much assistance. 

It is also worth noting that trained clinicians are adept at multi-tasking and providing assistance for various levels of care. This is made easier if a facility has implemented an efficient long term care software system, allowing caregivers to move freely between residents while providing exceptional care. This is a natural outcome of having fast access to accurate resident information.   

  • Building Size: Similar to the facility’s floor plan, the size of a facility can also indicate what level of care is provided. If there are various departments and wings across different floors, this indicates a facility provides less intensive care assistance, as the staff is more dispersed and residents require less help in the facility.  

Determining the Levels of Care Using a Level of Care Chart 

When a nurse conducts an assessment, they will use a level of care chart as a guideline to determine the level of care a resident needs for ADLs and Instrumental Activities of Daily Living (iADLs). Similar to ADL activities, iADLs are everyday activities that require more complex planning and thinking. The level of care chart organizes ADLs and iADLs into an easy-to-view table with the recommended level of care required and emergency responses. 

Level of care charts will typically assess the following ADLs:

  • Bathing
  • Dressing
  • Ambulating/Walking
  • Toileting
  • Eating
  • Taking medications
  • Communicating

They will also identify iADLs like housekeeping, socializing, mental status, and family concerns. When caregivers determine where a resident falls on the level of care chart, they will measure the residents using a level of care chart to decide which care assistance is needed. 

Of course, assisted living facilities vary in the levels of care that they provide. The different levels of care are:

A nurse assisting a resident to an appointment, as stated in his level of care chart.
A level of care chart determines what level of assistance residents need.

Level 1: Minimal Assist (Low Level of Care)

Residents who need a low level of care only need occasional assistance and support in one or more ADL/iADL. These residents live relatively independently, with caregivers providing low supervision, such as reminding the resident to take medication, assisting with travel to and from appointments, and helping to participate in social or recreational activities. 

Level 2: Stand-By Assist (Moderate Level of Care) 

Residents who need a moderate level of care will need more assistance with ADLs and iADLs compared to those in Level 1 above. The level of assistance will vary depending on the resident’s needs, as some residents can perform certain ADLs better than others. For example, a resident may be able to feed themselves without assistance but not use the bathroom independently because they cannot lift themselves onto and off the toilet. 

Level 3: Total Assist (High level of Care) 

Residents who require a high level of care need extensive and frequent assistance. Typically, residents will have severe mental or physical ailments, which impact their ability to live independently. In such cases, these residents may need around-the-clock assistance from multiple caregivers to support them. They will typically need assistance administering medications, performing medical treatments, help with all ADLs, and management of behavior changes.

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Why Use a Level of Care Assessment Tool Assisted Living 

Before seniors move into an assisted living facility, they should research the different options and levels of care at each potential destination. This will give them a better understanding of which services to look for when choosing an assisted living facility for their loved ones. 

Seniors and their families can benefit evaluating the results given by an online level of care assessment tool assisted living facilities use to assess the levels of assisted living care. These tools use assisted living levels of care questionaries and are quick, convenient, and easy to complete, as families can fill them at home prior to visiting an assisted living facility. 

Level of care assessment tools are handy because they offer personalized results based on the participant’s answers. This means that once the results are determined, the participant can see the suitable options and the level of care their loved ones need. If families do not want to take an online assessment, they can look at online level of care charts similar to those used by nurses in assisted living facilities. 

When families view the level of care charts, they can easily recognize specific symptoms, behaviors, or needs in their elderly relatives. Thus, a level of care chart is also a valuable tool for families to identify what level of care their loved ones need and whether or not they can provide the proper support and assistance.  

Moving into an assisted living facility is a big step, and it may be traumatic for seniors or their families. Hence, the more informed they are, the better prepared they will be for the levels of care for the elderly provided in assisted living facilities. 

Providing the Relevant Levels of Assisted Living Information

It is not surprising that seniors will need more long term care services and support as they age. However, not all seniors are as willing to seek help, which can put them in danger. 

A nurse helping a resident after using an online level of care assessment tool to assess the level of care needed.
Online level of care assessment tools helps assisted living facilities to assess the levels of assisted living care.

In many cases, family members become the primary caregivers of seniors as they age and decline in health. If the senior requires a low level of care, this can be manageable. The problem arises when the senior’s health rapidly deteriorates and they come to require a high level of care. 

In such cases, family members quickly find they are ill-equipped and untrained to provide the right level of care, putting strain on themselves and the senior. For this reason, seniors and their families need to know where to find the relevant information on what levels of assisted living care assisted living facilities can provide.

It is also essential for assisted living facilities to stay one step ahead by providing the necessary tools and information so that potential residents and their families can find and the support that they need. 

For more on recent trends in long term care, read our blog and subscribe to the LTC Heroes podcast

Cindy Wong