In assisted living, responsibility is shared among the provider, resident, family and other involved parties in providing agreed upon services and accepting the consequences of important decisions and behaviors.

Independent living relies on medical providers, residents and families to negotiate a unique mix of services to address needs and respond to the decisions of individual residents. While most services are offered by the assisted living caregivers, a successful service plan may draw on the resources of home health agencies, a hospice, physicians, physical therapists family members or volunteers to help a resident. Staff is responsible for addressing clearly predictable or observable needs. They offer alternatives to promote health and safety and provide the agreed upon services described in resident service plans. Providers must structure services to offer choice, demonstrate flexibility and creativity in supporting resident preferences and provide services in ways that protect each resident’s dignity and privacy. Caregivers have an important responsibility to balance the rights and comfort of all residents in the assisted living community.

Residents need to provide candid information about their needs, preferences and changes in their condition when they wish the staff to provide related services. Without this information, staff cannot responsibly plan to meet needs or recommend appropriate service alternatives. Residents have the right to make important decisions and choices, and must accept responsibility for the consequences. Finally, because independent living is a community setting, the behavior of each resident has an impact on others living in the community. Each resident shares the responsibility for showing common courtesy, tolerance and respect for his or her neighbors.

Aging in place is a goal to help individuals remain for as long as they wish in a setting that has become their home. As individual needs increase, the staff reevaluates the service plan, consults experts, creates options and supports a resident’s stay until this is no longer possible.

There are some risks associated with living in an assisted living center with the choice of privacy and independence.

The following are safety issues you may want to consider before entering an independent living environment:

• Private Apartments: All apartment doors are generally closed and can be locked. Residents have their own keys. Safety handles open the doors from inside the apartment even if the door has been locked. Staff carries master keys in case emergency entry is necessary. Apartments are equipped with emergency call systems for residents to call for unscheduled assistance.
  Risk: Doors are frequently closed and staff does not routinely check on residents (unless safety checks are part of a resident’s service plan). An emergency call system is available in each apartment and bathroom, but a resident may not always be within easy reach of a pull cord. Falls, health crises or accidents may occur without caregivers knowing or being alerted immediately.
  
  
• Unsupervised Access to Snacks and Common Areas: Many assisted living communities offer unsupervised access to a variety of snacks. Residents are free to keep food and beverages in their apartments. Residents have unsupervised access to common areas of the building.
  Risk: A resident may disregard a physician-ordered diet or take a food to which he or she may be allergic.
  
  
• Restraint-free Policy: Residents at the center are free to pursue activities and come and go from their apartments and from the building as they please, unless a specific plan for supervision is in place. By state law, assisted living communities may not use a physical restraint except in the case of extreme emergency while awaiting emergency assistance. A variety of creative methods can be developed to minimize the danger from falls if these are a particular concern.
  Risk: A resident may leave and become lost if he or she is confused or unfamiliar with the neighborhood. Someone with a car may drive unsafely or an individual may be at increased risk of falling if he or she is unsteady on his/her feet.

If you ever have a concern about safety you should talk to the Administrator, Resident Services Coordinator or a nurse. Caregivers will help you plan and recommend services to enhance safety.

Risks Associated with Individual Choices

If staff identifies a serious potential hazard, we will work with you to plan a safe alternative. If a resident chooses to do something that continues to present a serious danger to his or her well-being, staff will usually ask the resident and family to participate in a discussion about the risk, the alternatives and the consequences. After reaching a consensus, the resident may be asked to sign a Managed or Negotiated Risk Agreement. The agreement describes the risks, alternatives chosen by the resident, responsibilities of all parties involved (including the provider) and the consequences that may result.