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Assisted Living: The Philosophical Challenges of Everyday Practice

University of Michigan, utzrl{at}umich.edu

Assisted living represents a philosophy to provide residential long-term care in a home-like environment that maximizes autonomy and independence for its residents. This article explores the question of whether providers achieve this philosophy in their everyday practice. Results are based on mail surveys and semistructured interviews with assisted living providers. Findings suggest that providers are united under a common philosophy yet struggle with how to provide care that balances their philosophical goals with more traditional business considerations. Management training—specifically, whether one is licensed as a nursing home administrator—is associated with poorer philosophical performance. Results also indicate that services and amenities are directly proportional to average monthly costs, but adoption of the assisted living philosophy, which presumably increases the quality of life for residents, has a far smaller impact on consumer costs. Results are discussed in terms of both practice and policy issues related to the industry.

Key Words: assisted living • philosophy of care • long-term care • health care administration • medical model

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