Assisted Living Facilities

Consumer's Guide 

DEFINITIONS 
The statutes and regulations of Virginia provide legal definitions of many words and phrases involved in assisted living services. Since it is likely that some or all of these terms will appear in admission contracts consumers should understand what they mean. These definitions include:
 
ACTIVITIES OF DAILY LIVING (ADLs)
This term refers to those chores and tasks people do every day in maintaining their personal health and hygiene. Such activities include bathing, dressing, toileting, transferring, bowel and bladder control and eating/feeding. Deficiencies in ADLs is used in determining the level of care an individual needs. 

ASSISTED LIVING
As stated above, Virginia regulations define two levels of assisted living; residential living and assisted living. The distinction between the two is made in reference to the amount of assistance the resident needs, as measured by their "ADLs" and "IADLs". 

Residential Living: means a level of service to those who may have physical or mental impairments and require only minimal assistance with activities of daily living. 

Assisted Living: means a level of service to those who may have physical or mental impairments and require at least moderate assistance with activities of daily living. 

AUXILIARY GRANTS
In Virginia, individuals who need assisted living care, and also meet low income and resource requirements, can receive state aid to help pay for their assisted living care. The payment is very low compared to the cost of assisted living and thus it is hard to find a facility willing to accept an auxiliary grant as full payment. This is especially true in northern Virginia but less true of more rural areas of Virginia where the cost of living is much lower. The section of this booklet 'Paying for Assisted Living Care' gives more information on auxiliary grant eligibility. 

HOME CARE (or IN HOME CARE)
Simply means health or personal care provided in ones home. It can mean personal care and/or skilled nursing care. Care can be provided by a home health care aide, a visiting nurse, or other home care practitioner. How often and how long home health care is provided depends on need and the ability to afford service. 

INDEPENDENT LIVING FACILITIES
Refers to facilities for seniors who require very little assistance, or none at all. These facilities are similar to apartment living, and do not provide individualized support services to each resident, although they may have a meal service or coordinate services for individuals. Living in ones own home, without assistance, is also independent living. 

INSTRUMENTAL ACTIVITIES OF DAILY LIVING (IADLs)
Instrumental Activities of Daily Living are those chores and tasks people perform in maintaining their lifestyle and personal finances; included in IADLs are such matters as cooking, housekeeping, money management, and similar life maintenance matters. 

MINIMAL ASSISTANCE
Means dependency in only one activity of daily living or dependency in one or more of the instrumental activities of daily living as documented on the Auniform assessment instrument@. Applies to the level of care provided by a facility licensed for residential care. 

MODERATE ASSISTANCE
Means dependency in two or more of the activities of daily living as documented on the Uniform Assessment Instrument. Applies to the level of care provided by a facility licensed for assisted living care. 

NURSING CENTERS 
Nursing Centers (also called "nursing homes") are distinguished from assisted living facilities because they provide medical services to patients. Nursing homes provide assistance in the activities of daily living but the emphasis is on medical or therapeutic needs provided under the supervision of a registered nurse. 

UNIFORM ASSESSMENT INSTRUMENT (UAI)
Means the Virginia Department of Social Services designated assessment form that documents an individual's deficiencies in ADLs , and IADLs. It also reviews health care needs and particularly those health needs, which would rule out the appropriateness of assisted living care. There is an alternate version of the UAI, which may be used by private pay residents. This alternate UAI does not include some social and financial information necessary for assessment of the resident for auxiliary grant eligibility.


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