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The False Choice Holding Back California’s Assisted Living System

You shouldn’t have to choose between getting the health care services you need and living in a home-like environment. And most California families considering assisted living think they will have access to both.

Unfortunately, California’s assisted living system does not adequately address residents’ health care needs. California’s assisted living rules were written with the assumption that residents would need assistance with routine daily activities, but would not require ongoing health-related services. Now, however, many residents need health-related services in the facility, but the system has not kept pace.

The false choice between the social model and health care expertise contradicts the goal of aging in place: to age with choice and independence, along with access to needed services.

The failure to update the system results from the mistaken belief that health care expertise would convert the home-like “social” model of care to an institutional medical model. But California’s assisted living residents deserve both the dignity envisioned by the social model, and necessary health-related services. The system’s failure actually increases institutionalization: by excluding health care expertise from assisted living facilities, California makes it more likely that people will have to move into nursing facilities to have their needs met.

As more and more California assisted living residents age and as their care needs progress, the false choice between the social model and health care expertise is no longer a workable option. Other states are actively implementing various methods to meet residents’ needs. California should join the conversation of how to integrate health care expertise appropriately into assisted living.

Justice in Aging is committed to ensuring older adults in assisted living facilities receive high-quality care in an environment that feels like home. In a series of issue briefs, we explore how California’s assisted living system falls short in addressing residents’ health care needs.

Please see our dedicated assisted living project page for more information and resources, like the following:

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