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class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Special_needs"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.3</span> <span>Special needs</span> </div> </a> <ul id="toc-Special_needs-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Interaction" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Interaction"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.4</span> <span>Interaction</span> </div> </a> <ul id="toc-Interaction-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Locked_units" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Locked_units"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.5</span> <span>Locked units</span> </div> </a> <ul id="toc-Locked_units-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Cost_increases" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Cost_increases"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.6</span> <span>Cost increases</span> </div> </a> <ul id="toc-Cost_increases-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Ongoing_Issues" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Ongoing_Issues"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.7</span> <span>Ongoing Issues</span> </div> </a> <ul id="toc-Ongoing_Issues-sublist" class="vector-toc-list"> <li id="toc-2011_Miami_Herald_investigation" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#2011_Miami_Herald_investigation"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.7.1</span> <span>2011 <i>Miami Herald</i> investigation</span> </div> </a> <ul id="toc-2011_Miami_Herald_investigation-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-2013_Frontline_investigation" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#2013_Frontline_investigation"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.7.2</span> <span>2013 <i>Frontline</i> investigation</span> </div> </a> <ul id="toc-2013_Frontline_investigation-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Comparison_between_assisted_living_and_personal_care" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Comparison_between_assisted_living_and_personal_care"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.8</span> <span>Comparison between assisted living and personal care</span> </div> </a> <ul id="toc-Comparison_between_assisted_living_and_personal_care-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-United_Kingdom" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#United_Kingdom"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>United Kingdom</span> </div> </a> <ul id="toc-United_Kingdom-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-See_also" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#See_also"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>See also</span> </div> </a> <ul id="toc-See_also-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>References</span> </div> </a> <button aria-controls="toc-References-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle References subsection</span> </button> <ul id="toc-References-sublist" class="vector-toc-list"> <li id="toc-General_references" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#General_references"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.1</span> <span>General references</span> </div> </a> <ul id="toc-General_references-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" title="Table of Contents" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" 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class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Betreutes_Wohnen" title="Betreutes Wohnen – German" lang="de" hreflang="de" data-title="Betreutes Wohnen" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-el mw-list-item"><a href="https://el.wikipedia.org/wiki/%CE%A5%CF%80%CE%BF%CF%83%CF%84%CE%B7%CF%81%CE%B9%CE%B6%CF%8C%CE%BC%CE%B5%CE%BD%CE%B7_%CE%B4%CE%B9%CE%B1%CE%B2%CE%AF%CF%89%CF%83%CE%B7" title="Υποστηριζόμενη διαβίωση – Greek" lang="el" hreflang="el" data-title="Υποστηριζόμενη διαβίωση" data-language-autonym="Ελληνικά" data-language-local-name="Greek" class="interlanguage-link-target"><span>Ελληνικά</span></a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%93%D7%99%D7%95%D7%A8_%D7%9E%D7%95%D7%92%D7%9F" title="דיור מוגן – Hebrew" lang="he" hreflang="he" 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href="https://ja.wikipedia.org/wiki/%E3%82%A2%E3%82%B7%E3%82%B9%E3%83%86%E3%82%A3%E3%83%83%E3%83%89%E3%83%BB%E3%83%AA%E3%83%93%E3%83%B3%E3%82%B0" title="アシスティッド・リビング – Japanese" lang="ja" hreflang="ja" data-title="アシスティッド・リビング" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Mieszkalnictwo_wspomagane" title="Mieszkalnictwo wspomagane – Polish" lang="pl" hreflang="pl" data-title="Mieszkalnictwo wspomagane" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-simple mw-list-item"><a href="https://simple.wikipedia.org/wiki/Assisted_living" title="Assisted living – Simple English" lang="en-simple" hreflang="en-simple" data-title="Assisted living" data-language-autonym="Simple English" 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id="mw-content-subtitle"></div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Housing facility for people with disabilities</div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">For the 2003 film, see <a href="/wiki/Assisted_Living_(film)" title="Assisted Living (film)">Assisted Living (film)</a>.</div> <style data-mw-deduplicate="TemplateStyles:r1251242444">.mw-parser-output .ambox{border:1px solid #a2a9b1;border-left:10px solid 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rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><table class="sidebar sidebar-collapse nomobile nowraplinks plainlist"><tbody><tr><th class="sidebar-title" style="background:#ccccff;display:block;margin-bottom:0.5em;"><a href="/wiki/Disability" title="Disability">Disability</a></th></tr><tr><td class="sidebar-content"> <div class="sidebar-list mw-collapsible mw-collapsed"><div class="sidebar-list-title" style="background:#ddf; text-align:center;;color: var(--color-base)">Theory and models</div><div class="sidebar-list-content mw-collapsible-content"><div class="hlist"> <ul><li><a href="/wiki/Disability_studies" title="Disability studies">Disability theory</a></li> <li><a href="/wiki/Ableism" title="Ableism">Ableism / Disablism</a></li> <li><a href="/wiki/Medical_model_of_disability" title="Medical model of disability">Medical model</a></li> <li><a href="/wiki/Social_model_of_disability" title="Social model of disability">Social model</a></li> <li><a href="/wiki/Models_of_disability" title="Models of disability">Other models</a></li></ul> </div></div></div></td> </tr><tr><td class="sidebar-content"> <div class="sidebar-list mw-collapsible mw-collapsed"><div class="sidebar-list-title" style="background:#ddf; text-align:center;;color: var(--color-base)">Education</div><div class="sidebar-list-content mw-collapsible-content"> <ul><li><a href="/wiki/Mainstreaming_(education)" title="Mainstreaming (education)">Mainstreaming</a></li> <li><a href="/wiki/Individualized_Education_Program" title="Individualized Education Program">Individualized Education Program (IEP)</a></li></ul> <div class="hlist"> <ul><li><a href="/wiki/Special_needs" title="Special needs">Special needs</a></li> <li><a href="/wiki/Special_education#Special_schools" title="Special education">Special school</a></li> <li><a href="/wiki/Special_education" title="Special education">Special education</a></li> <li><a href="/wiki/Learning_disability" title="Learning disability">Learning disability</a></li></ul> </div></div></div></td> </tr><tr><td class="sidebar-content"> <div class="sidebar-list mw-collapsible mw-collapsed"><div class="sidebar-list-title" style="background:#ddf; text-align:center;;color: var(--color-base)">Therapy</div><div class="sidebar-list-content mw-collapsible-content"><div class="hlist"> <ul><li><a href="/wiki/Physical_therapy" title="Physical therapy">Physical</a></li> <li><a href="/wiki/Occupational_therapy" title="Occupational therapy">Occupational</a></li> <li><a href="/wiki/Speech%E2%80%93language_pathology" title="Speech–language pathology">Speech</a></li></ul> </div></div></div></td> </tr><tr><td class="sidebar-content"> <div class="sidebar-list mw-collapsible mw-collapsed"><div class="sidebar-list-title" style="background:#ddf; text-align:center;;color: var(--color-base)">Societal implications</div><div class="sidebar-list-content mw-collapsible-content"><div class="hlist"> <ul><li><a href="/wiki/Disability_rights_movement" title="Disability rights movement">Disability rights movement</a></li> <li><a href="/wiki/Inclusion_(disability_rights)" title="Inclusion (disability rights)">Inclusion</a></li> <li><a href="/wiki/Normalization_(people_with_disabilities)" title="Normalization (people with disabilities)">Normalization</a></li> <li><a href="/wiki/People-first_language" title="People-first language">People-first language</a></li> <li><a href="/wiki/List_of_disability-related_terms_with_negative_connotations" title="List of disability-related terms with negative connotations">Pejorative terms</a></li> <li><a href="/wiki/Sexuality_and_disability" title="Sexuality and disability">Sexuality and disability</a></li> <li><a href="/wiki/Disability_and_women%27s_health" title="Disability and women's health">Women's health</a></li></ul> </div></div></div></td> </tr><tr><td class="sidebar-content"> <div class="sidebar-list mw-collapsible mw-collapsed"><div class="sidebar-list-title" style="background:#ddf; text-align:center;;color: var(--color-base)">Personal assistance</div><div class="sidebar-list-content mw-collapsible-content"> <ul><li><a href="/wiki/Unlicensed_assistive_personnel" title="Unlicensed assistive personnel">Unlicensed assistive personnel</a> (<a href="/wiki/Activities_of_daily_living" title="Activities of daily living">ADLs</a>)</li></ul> <div class="hlist"> <ul><li><a href="/wiki/Accessible_toilet" title="Accessible toilet">Accessible toilet</a></li> <li><a href="/wiki/Assistive_technology" title="Assistive technology">Assistive technology</a></li> <li><a class="mw-selflink selflink">Assisted living</a></li> <li><a href="/wiki/Mobility_aid" title="Mobility aid">Mobility aid</a></li> <li><a href="/wiki/Orthotics" title="Orthotics">Orthotics and braces</a></li> <li><a href="/wiki/Accessibility" title="Accessibility">Physical accessibility</a></li> <li><a href="/wiki/Prosthesis" title="Prosthesis">Prosthetics</a></li> <li><a href="/wiki/Universal_design" title="Universal design">Universal design</a></li> <li><a href="/wiki/Web_accessibility" title="Web accessibility">Web accessibility</a></li></ul> </div></div></div></td> </tr><tr><td class="sidebar-content"> <div class="sidebar-list mw-collapsible mw-collapsed"><div class="sidebar-list-title" style="background:#ddf; text-align:center;;color: var(--color-base)">Socioeconomic assistance</div><div class="sidebar-list-content mw-collapsible-content"> <ul><li><a href="/wiki/Social_Security_Disability_Insurance" title="Social Security Disability Insurance">Social Security Disability Insurance</a></li> <li><a href="/wiki/Supplemental_Security_Income" title="Supplemental Security Income">Supplemental Security Income</a></li> <li><a href="/wiki/Ticket_to_Work" title="Ticket to Work">Ticket to Work</a></li> <li><a href="/wiki/Disability_Living_Allowance" title="Disability Living Allowance">Disability Living Allowance</a></li> <li><a href="/wiki/Disabled_Students%27_Allowance" title="Disabled Students' Allowance">Disabled Students' Allowance</a></li> <li><a href="/wiki/Disabled_Persons_Railcard" title="Disabled Persons Railcard">Disabled Persons Railcard</a></li> <li><a href="/wiki/Freedom_Pass" title="Freedom Pass">Freedom Pass</a></li> <li><div style="display: inline-block; line-height: 1.2em; padding: .1em 0;"><a href="/wiki/Assured_Income_for_the_Severely_Handicapped" title="Assured Income for the Severely Handicapped">Assured Income for<br />the Severely Handicapped</a></div></li> <li><a href="/wiki/Ontario_Disability_Support_Program" title="Ontario Disability Support Program">Ontario Disability Support Program</a></li></ul></div></div></td> </tr><tr><td class="sidebar-content"> <div class="sidebar-list mw-collapsible mw-collapsed"><div class="sidebar-list-title" style="background:#ddf; text-align:center;;color: var(--color-base)"><div class="hlist"><ul><li>Groups</li><li>Organizations</li></ul></div></div><div class="sidebar-list-content mw-collapsible-content"> <ul><li><a href="/wiki/National_Telecommuting_Institute" title="National Telecommuting Institute">National Telecommuting Institute</a></li> <li><a href="/wiki/Society_for_Disability_Studies" title="Society for Disability Studies">Society for Disability Studies</a></li> <li><a href="/wiki/Disabled_Peoples%27_International" title="Disabled Peoples' International">Disabled Peoples' International (DPI)</a></li> <li><a href="/wiki/Visitability" title="Visitability">Visitability</a></li> <li><a href="/wiki/WeThe15" title="WeThe15">WeThe15</a></li></ul></div></div></td> </tr><tr><td class="sidebar-content"> <div class="sidebar-list mw-collapsible mw-collapsed"><div class="sidebar-list-title" style="background:#ddf; text-align:center;;color: var(--color-base)"><a href="/wiki/Parasports" title="Parasports">Parasports</a></div><div class="sidebar-list-content mw-collapsible-content"><div class="hlist"> <ul><li><a href="/wiki/Special_Olympics" title="Special Olympics">Special Olympics</a></li> <li><a href="/wiki/Paralympic_Games" title="Paralympic Games">Paralympic Games</a></li> <li><a href="/wiki/Deaflympics" title="Deaflympics">Deaflympics</a></li> <li><a href="/wiki/Invictus_Games" title="Invictus Games">Invictus Games</a></li></ul> </div></div></div></td> </tr><tr><td class="sidebar-content"> <div class="sidebar-list mw-collapsible mw-collapsed"><div class="sidebar-list-title" style="background:#ddf; text-align:center;;color: var(--color-base)"><a href="/wiki/Disability_culture" title="Disability culture">Culture</a></div><div class="sidebar-list-content mw-collapsible-content"> <ul><li><a href="/wiki/Disability_in_the_arts" title="Disability in the arts">Disability in the arts</a></li> <li><a href="/wiki/Disability_art" title="Disability art">Disability art</a></li> <li><a href="/wiki/Disability_in_the_media" title="Disability in the media">Disability in the media</a></li></ul></div></div></td> </tr><tr><td class="sidebar-below" style="border-top:1px solid #bbf;padding-bottom:0.4em;border-bottom:1px solid #bbf;"> <ul><li><div class="hlist"><ul><li><span class="noviewer" typeof="mw:File"><span title="Category"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/16px-Symbol_category_class.svg.png" decoding="async" width="16" height="16" class="mw-file-element" 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template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Disability_sidebar" title="Template talk:Disability sidebar"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Disability_sidebar" title="Special:EditPage/Template:Disability sidebar"><abbr title="Edit this template">e</abbr></a></li></ul></div></td></tr></tbody></table> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:NordiaAssistedLivingJan212022_03.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/5/58/NordiaAssistedLivingJan212022_03.jpg/220px-NordiaAssistedLivingJan212022_03.jpg" decoding="async" width="220" height="165" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/5/58/NordiaAssistedLivingJan212022_03.jpg/330px-NordiaAssistedLivingJan212022_03.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/5/58/NordiaAssistedLivingJan212022_03.jpg/440px-NordiaAssistedLivingJan212022_03.jpg 2x" data-file-width="4000" data-file-height="3000" /></a><figcaption>Assisted living facility in Israel</figcaption></figure> <p>An <b>assisted living residence</b> or <b>assisted living facility</b> (<b>ALF</b>) is a housing facility for people with <a href="/wiki/Disability" title="Disability">disabilities</a> or for adults who cannot or who choose not to live <a href="/wiki/Independent_living" title="Independent living">independently</a>. The term is popular in the <a href="/wiki/United_States" title="United States">United States</a>. Still, the setting is similar to a <a href="/wiki/Retirement_home" title="Retirement home">retirement home</a>, in the sense that facilities provide a group living environment and typically cater to an older adult population. There is also <a href="/wiki/Caribbean" title="Caribbean">Caribbean</a> assisted living, which offers a similar service in a resort-like environment (somewhat like assisted vacationing). </p><p>The expansion of assisted living has been the shift from "care as service" to "care as business" in the broader <a href="/wiki/Health_care" title="Health care">health care</a> system predicted in 1982.<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> A consumer-driven industry, assisted living offers a wide range of options, levels of care, and diversity of services (Lockhart, 2009) and is subject to state rather than federal regulatory oversight.<sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> What "Assisted living" means depends on both the state and provider in question: variations in state regulatory definitions are significant and provider variables include everything from <a href="/wiki/Philosophy" title="Philosophy">philosophy</a>, geographic location and <a href="/wiki/Auspice" class="mw-redirect" title="Auspice">auspice</a>, to organizational size and structure. Assisted living evolved from small "board and care" or "personal care" homes and offers a "social model" of care (compared to the medical model of a skilled nursing facility). The assisted living industry is a segment of the senior housing industry. Assisted living services can be delivered in stand-alone facilities or as part of a multi-level senior living community. The industry is fragmented and dominated by for-profit providers. In 2010, six of the seventy largest providers were non-profit, and none of the top twenty were non-profit (Martin, 2010). Information in this edit is from an article published in 2012 that reviewed the industry and reports results of a research study of assisted living facilities.<sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p><p>In 2012, the <a href="/wiki/U.S._Government" class="mw-redirect" title="U.S. Government">U.S. Government</a> estimated that there were 22,200 assisted living facilities in the U.S. (compared to 15,700 <a href="/wiki/Nursing_home" title="Nursing home">nursing homes</a>) and that 713,300 people were residents of these facilities.<sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> The number of assisted living facilities in the U.S. has increased dramatically since the early 2000s. </p><p>In the U.S., ALFs can be owned by for-profit companies (publicly traded companies or limited liability companies [LLCs]), non-profit organizations, or governments.<sup id="cite_ref-CDC_LTC_2013_5-0" class="reference"><a href="#cite_note-CDC_LTC_2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> These facilities typically provide supervision or assistance with <a href="/wiki/Activities_of_daily_living" title="Activities of daily living">activities of daily living</a> (ADLs); coordination of services by outside health care providers; and monitoring of resident activities to help to ensure their health, safety, and well-being. Assistance often includes administering or supervising <a href="/wiki/Medication" title="Medication">medication</a> or personal care services. </p><p>There has been controversy generated by reports of <a href="/wiki/Neglect" title="Neglect">neglect</a>, <a href="/wiki/Abuse" title="Abuse">abuse</a>, and mistreatment of residents at assisted living facilities in the U.S. </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Canada">Canada</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Assisted_living&action=edit&section=1" title="Edit section: Canada"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Canada has differences in how assisted living is understood from one province to the next. In most provinces, the phrase is understood as less independent than in the United States. People often require help with more than one of the <a href="/wiki/Activities_of_daily_living" title="Activities of daily living">activities of daily living</a> or the more intensive ADLs like feeding or bathing. In the province of <a href="/wiki/Alberta" title="Alberta">Alberta</a>, "supportive living" is the distinct phrasing used for a type of care that is otherwise synonymous. The province's <i>Supportive Living Accommodation Licensing Act</i> is a comprehensive act with specific prescriptions governing care homes licensing, inspections, and more.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (January 2020)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading2"><h2 id="United_States">United States</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Assisted_living&action=edit&section=2" title="Edit section: United States"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Within the United States assisted living spectrum, there is no nationally recognized definition of assisted living.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (July 2016)">citation needed</span></a></i>]</sup> Assisted living facilities are regulated and licensed at the US state level. These regulations include staffing, training, and quality and safety standards. This is differentiated from nursing homes, which are regulated on a federal level and are generally held to more stringent standards.<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> More than two-thirds of the states use the <a href="/wiki/Licensure" class="mw-redirect" title="Licensure">licensure</a> term "assisted living." Other licensure terms used for this philosophy of care include residential care homes, assisted care living facilities, and personal care homes. Each state licensing agency has its definition of the term it uses to describe assisted living. Because the term assisted living has not been defined in some states, it is often a marketing term used by various senior living communities, licensed or unlicensed. Assisted living facilities in the United States had a national median monthly rate of $3,500.00 in 2014, a 1.45% increase over 2013 and a 4.29% increase over five years from 2009 to 2014.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (January 2020)">citation needed</span></a></i>]</sup> </p> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:All_Saints_Assisted_Living_-_panoramio.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/5/59/All_Saints_Assisted_Living_-_panoramio.jpg/220px-All_Saints_Assisted_Living_-_panoramio.jpg" decoding="async" width="220" height="165" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/5/59/All_Saints_Assisted_Living_-_panoramio.jpg/330px-All_Saints_Assisted_Living_-_panoramio.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/5/59/All_Saints_Assisted_Living_-_panoramio.jpg/440px-All_Saints_Assisted_Living_-_panoramio.jpg 2x" data-file-width="4608" data-file-height="3456" /></a><figcaption>Assisted Living Facility in Wisconsin</figcaption></figure> <div class="mw-heading mw-heading3"><h3 id="Types">Types</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Assisted_living&action=edit&section=3" title="Edit section: Types"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1251242444"><table class="box-Unreferenced_section plainlinks metadata ambox ambox-content ambox-Unreferenced" role="presentation"><tbody><tr><td class="mbox-image"><div class="mbox-image-div"><span typeof="mw:File"><a href="/wiki/File:Question_book-new.svg" class="mw-file-description"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/9/99/Question_book-new.svg/50px-Question_book-new.svg.png" decoding="async" width="50" height="39" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/9/99/Question_book-new.svg/75px-Question_book-new.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/9/99/Question_book-new.svg/100px-Question_book-new.svg.png 2x" data-file-width="512" data-file-height="399" /></a></span></div></td><td class="mbox-text"><div class="mbox-text-span">This section <b>does not <a href="/wiki/Wikipedia:Citing_sources" title="Wikipedia:Citing sources">cite</a> any <a href="/wiki/Wikipedia:Verifiability" title="Wikipedia:Verifiability">sources</a></b>.<span class="hide-when-compact"> Please help <a href="/wiki/Special:EditPage/Assisted_living" title="Special:EditPage/Assisted living">improve this section</a> by <a href="/wiki/Help:Referencing_for_beginners" title="Help:Referencing for beginners">adding citations to reliable sources</a>. Unsourced material may be challenged and <a href="/wiki/Wikipedia:Verifiability#Burden_of_evidence" title="Wikipedia:Verifiability">removed</a>.</span> <span class="date-container"><i>(<span class="date">July 2016</span>)</i></span><span class="hide-when-compact"><i> (<small><a href="/wiki/Help:Maintenance_template_removal" title="Help:Maintenance template removal">Learn how and when to remove this message</a></small>)</i></span></div></td></tr></tbody></table> <p>As widely varied as the state licensing and definitions are, so are the types of physical layouts of buildings in which assisted living services are provided. A resident can have an apartment, condo, private room, or shared room. Some facilities offer furnished rooms. All residents will have access to a kitchen which may be personal or shared depending on the facility chosen.<sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> The average assisted living facility is in a commercial building, yet some assisted living services use large residential buildings, known as Residential Assisted Living homes, or "RAL". Residential Assisted Living homes can vary in price and amenities and can even be grouped into a separate term known as a Luxury Residential Assisted Living Home, or "LRAL". Assisted living facilities can range from a small residential house for one resident to extensive facilities providing services to hundreds of residents. Assisted living falls somewhere between an independent living community and a skilled nursing facility regarding the level of care provided.<sup id="cite_ref-:0_8-0" class="reference"><a href="#cite_note-:0-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Continuing_care" class="mw-redirect" title="Continuing care">Continuing care</a> retirement facilities combine independent living, assisted living, and nursing care in one facility. </p><p>People living in newer assisted living facilities usually have private apartments. There is usually no special medical monitoring equipment that one would find in a nursing home, and their nursing staff may only be available at some hours. However, trained staff are usually on-site around the clock to provide other needed services. Household chores are performed: sheets are changed, laundry is done, and food is cooked and served as part of the base rent and included services.<sup id="cite_ref-:0_8-1" class="reference"><a href="#cite_note-:0-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> Depending on their disclosure of services, assisted living services may include medication management, bathing assistance, dressing, escorts to meals and activities, toileting, transferring, and insulin injections by an RN.<sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> Some assisted living providers also offer amenities like exercise rooms or a beauty parlor on site. Grocery service is often available, too. Where provided, private apartments generally are self-contained; i.e., they have their own bedroom and bathroom and may have a separate living area or small kitchen. Registered nurses and licensed practical nurses are available by phone or e-mail 24 hours a day to ensure proper teaching and/or education of staff is available. </p><p>Alternatively, individual living spaces may resemble a <a href="/wiki/Dormitory" title="Dormitory">dormitory</a> or hotel room with a private or semi-private sleeping area and a shared bathroom. There are usually common areas for socializing, as well as a central kitchen and dining room for preparing and eating meals. </p><p>Since assisted living facilities are not federally regulated they follow the States Fair Housing Act. Several of the assisted living residents are not familiar or do not understand this act. Legal advocates and long term care ombudsman can be utilized to ensure residents are getting the best care possible based on this act. This information should be communicated to all residents to ensure there is no discrimination in the facility.<sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Typical_resident">Typical resident</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Assisted_living&action=edit&section=4" title="Edit section: Typical resident"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1251242444"><table class="box-One_source plainlinks metadata ambox ambox-content ambox-one_source" role="presentation"><tbody><tr><td class="mbox-image"><div class="mbox-image-div"><span typeof="mw:File"><a href="/wiki/File:Question_book-new.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/en/thumb/9/99/Question_book-new.svg/50px-Question_book-new.svg.png" decoding="async" width="50" height="39" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/9/99/Question_book-new.svg/75px-Question_book-new.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/9/99/Question_book-new.svg/100px-Question_book-new.svg.png 2x" data-file-width="512" data-file-height="399" /></a></span></div></td><td class="mbox-text"><div class="mbox-text-span">This section <b>relies largely or entirely on a <a href="/wiki/Wikipedia:Articles_with_a_single_source" title="Wikipedia:Articles with a single source">single source</a></b>.<span class="hide-when-compact"> Relevant discussion may be found on the <a href="/wiki/Talk:Assisted_living" title="Talk:Assisted living">talk page</a>. Please help <a class="external text" href="https://en.wikipedia.org/w/index.php?title=Assisted_living&action=edit">improve this article</a> by <a href="/wiki/Help:Referencing_for_beginners" title="Help:Referencing for beginners">introducing citations to additional sources</a>.<br /><small><span class="plainlinks"><i>Find sources:</i> <a rel="nofollow" class="external text" href="https://www.google.com/search?as_eq=wikipedia&q=%22Assisted+living%22">"Assisted living"</a> – <a rel="nofollow" class="external text" href="https://www.google.com/search?tbm=nws&q=%22Assisted+living%22+-wikipedia&tbs=ar:1">news</a> <b>·</b> <a rel="nofollow" class="external text" href="https://www.google.com/search?&q=%22Assisted+living%22&tbs=bkt:s&tbm=bks">newspapers</a> <b>·</b> <a rel="nofollow" class="external text" href="https://www.google.com/search?tbs=bks:1&q=%22Assisted+living%22+-wikipedia">books</a> <b>·</b> <a rel="nofollow" class="external text" href="https://scholar.google.com/scholar?q=%22Assisted+living%22">scholar</a> <b>·</b> <a rel="nofollow" class="external text" href="https://www.jstor.org/action/doBasicSearch?Query=%22Assisted+living%22&acc=on&wc=on">JSTOR</a></span></small></span> <span class="date-container"><i>(<span class="date">July 2016</span>)</i></span></div></td></tr></tbody></table> <p>An assisted living resident is a resident who needs assistance with at least one of the <a href="/wiki/Activities_of_daily_living" title="Activities of daily living">activities of daily living</a>. </p><p>A typical assisted living facility resident would usually be an <a href="/wiki/Older_adult" class="mw-redirect" title="Older adult">older adult</a> who does not need the level of care offered by a nursing home but prefers more companionship and needs some assistance in day-to-day living. Age groups will vary with every facility. There is currently a transformation occurring in long-term care. Assisted living communities are accepting higher and higher levels of care, and nursing homes are becoming a place for those undergoing rehabilitation after a hospital stay or needing extensive assistance. Many assisted living communities now accept individuals who need help with all activities of daily living. </p><p>The "Overview of Assisted Living Report" from 2010 stated that 54 percent of assisted living residents are 85 years or older; 27 percent are 75–84 years old; 9 percent of residents are between 65 and 74 years; and 11 percent are younger than 65 years old. 74% of assisted living residents are female; 26 percent are male.<sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Special_needs">Special needs</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Assisted_living&action=edit&section=5" title="Edit section: Special needs"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1251242444"><table class="box-One_source plainlinks metadata ambox ambox-content ambox-one_source" role="presentation"><tbody><tr><td class="mbox-image"><div class="mbox-image-div"><span typeof="mw:File"><a href="/wiki/File:Question_book-new.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/en/thumb/9/99/Question_book-new.svg/50px-Question_book-new.svg.png" decoding="async" width="50" height="39" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/9/99/Question_book-new.svg/75px-Question_book-new.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/9/99/Question_book-new.svg/100px-Question_book-new.svg.png 2x" data-file-width="512" data-file-height="399" /></a></span></div></td><td class="mbox-text"><div class="mbox-text-span">This section <b>relies largely or entirely on a <a href="/wiki/Wikipedia:Articles_with_a_single_source" title="Wikipedia:Articles with a single source">single source</a></b>.<span class="hide-when-compact"> Relevant discussion may be found on the <a href="/wiki/Talk:Assisted_living" title="Talk:Assisted living">talk page</a>. Please help <a class="external text" href="https://en.wikipedia.org/w/index.php?title=Assisted_living&action=edit">improve this article</a> by <a href="/wiki/Help:Referencing_for_beginners" title="Help:Referencing for beginners">introducing citations to additional sources</a>.<br /><small><span class="plainlinks"><i>Find sources:</i> <a rel="nofollow" class="external text" href="https://www.google.com/search?as_eq=wikipedia&q=%22Assisted+living%22">"Assisted living"</a> – <a rel="nofollow" class="external text" href="https://www.google.com/search?tbm=nws&q=%22Assisted+living%22+-wikipedia&tbs=ar:1">news</a> <b>·</b> <a rel="nofollow" class="external text" href="https://www.google.com/search?&q=%22Assisted+living%22&tbs=bkt:s&tbm=bks">newspapers</a> <b>·</b> <a rel="nofollow" class="external text" href="https://www.google.com/search?tbs=bks:1&q=%22Assisted+living%22+-wikipedia">books</a> <b>·</b> <a rel="nofollow" class="external text" href="https://scholar.google.com/scholar?q=%22Assisted+living%22">scholar</a> <b>·</b> <a rel="nofollow" class="external text" href="https://www.jstor.org/action/doBasicSearch?Query=%22Assisted+living%22&acc=on&wc=on">JSTOR</a></span></small></span> <span class="date-container"><i>(<span class="date">July 2016</span>)</i></span></div></td></tr></tbody></table> <p>The residence may assist in arranging the appropriate medical, health, and <a href="/wiki/Oral_hygiene" title="Oral hygiene">dental care</a> services for each resident. The resident generally chooses their medical doctor and dental services. </p><p>Residents who have periods of temporary incapacity due to illness, <a href="/wiki/Injury" title="Injury">injury</a>, or recovery from surgery often choose assisted living as a supportive option to help them recover quickly so they can return home. In the case of these short-term respite stays, assisted living residences act as the bridge between hospital and home. </p><p>Short-term respite stays in assisted living are also an option for families when the primary caregiver goes out of town or cannot provide the needed care. </p><p>More recently built facilities are designed to emphasize ease of use for disabled people. Bathrooms and kitchens are designed with <a href="/wiki/Wheelchair" title="Wheelchair">wheelchairs</a> and <a href="/wiki/Walker_(tool)" class="mw-redirect" title="Walker (tool)">walkers</a> in mind. Hallways and doors are extra-wide to accommodate wheelchairs. These facilities are by necessity fully compliant with the <a href="/wiki/Americans_with_Disabilities_Act_of_1990" title="Americans with Disabilities Act of 1990">Americans with Disabilities Act of 1990</a> (ADA) or similar legislation elsewhere. </p><p>A study was done on how much functional assistance residents need on a day to day basis. The results are as follows, 77% of residents need assistance with bathing. 69% of residents need assistance with walking. 61% of residents need help with dressing. 51% of residents need assistance getting out of bed. 48% of residents need assistance toileting. 26% of residents need assistance eating.<sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> </p><p>The socialization aspects of ALFs are very beneficial to the occupants. Usually, the facility has many activities scheduled for the occupants, keeping in mind different disabilities and needs. </p> <div class="mw-heading mw-heading3"><h3 id="Interaction">Interaction</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Assisted_living&action=edit&section=6" title="Edit section: Interaction"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The shift to an acute care facility frequently results in a disturbance to the typical social routines of older individuals. This disruption can intensify the decline in their social connections and autonomy, amplifying feelings of loneliness and isolation.<sup id="cite_ref-ReferenceA_13-0" class="reference"><a href="#cite_note-ReferenceA-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> </p><p>Maintaining connections within social networks is crucial for individuals residing in assisted living facilities, and it plays a vital role in reinforcing their sense of identity. Facilities typically provide both organizational and environmental factors.  A study found a variety of scheduled group recreational activities such as arts and crafts, culture clubs, yoga, music therapy, prayer, and spiritual reminiscence, were offered. Additionally, the facilities in this investigation were designed with open-plan layouts, outdoor gardens, and easily accessible areas for gatherings, potentially fostering engagement and interactions among residents.<sup id="cite_ref-ReferenceA_13-1" class="reference"><a href="#cite_note-ReferenceA-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Locked_units">Locked units</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Assisted_living&action=edit&section=7" title="Edit section: Locked units"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1251242444"><table class="box-One_source plainlinks metadata ambox ambox-content ambox-one_source" role="presentation"><tbody><tr><td class="mbox-image"><div class="mbox-image-div"><span typeof="mw:File"><a href="/wiki/File:Question_book-new.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/en/thumb/9/99/Question_book-new.svg/50px-Question_book-new.svg.png" decoding="async" width="50" height="39" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/9/99/Question_book-new.svg/75px-Question_book-new.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/9/99/Question_book-new.svg/100px-Question_book-new.svg.png 2x" data-file-width="512" data-file-height="399" /></a></span></div></td><td class="mbox-text"><div class="mbox-text-span">This section <b>relies largely or entirely on a <a href="/wiki/Wikipedia:Articles_with_a_single_source" title="Wikipedia:Articles with a single source">single source</a></b>.<span class="hide-when-compact"> Relevant discussion may be found on the <a href="/wiki/Talk:Assisted_living" title="Talk:Assisted living">talk page</a>. Please help <a class="external text" href="https://en.wikipedia.org/w/index.php?title=Assisted_living&action=edit">improve this article</a> by <a href="/wiki/Help:Referencing_for_beginners" title="Help:Referencing for beginners">introducing citations to additional sources</a>.<br /><small><span class="plainlinks"><i>Find sources:</i> <a rel="nofollow" class="external text" href="https://www.google.com/search?as_eq=wikipedia&q=%22Assisted+living%22">"Assisted living"</a> – <a rel="nofollow" class="external text" href="https://www.google.com/search?tbm=nws&q=%22Assisted+living%22+-wikipedia&tbs=ar:1">news</a> <b>·</b> <a rel="nofollow" class="external text" href="https://www.google.com/search?&q=%22Assisted+living%22&tbs=bkt:s&tbm=bks">newspapers</a> <b>·</b> <a rel="nofollow" class="external text" href="https://www.google.com/search?tbs=bks:1&q=%22Assisted+living%22+-wikipedia">books</a> <b>·</b> <a rel="nofollow" class="external text" href="https://scholar.google.com/scholar?q=%22Assisted+living%22">scholar</a> <b>·</b> <a rel="nofollow" class="external text" href="https://www.jstor.org/action/doBasicSearch?Query=%22Assisted+living%22&acc=on&wc=on">JSTOR</a></span></small></span> <span class="date-container"><i>(<span class="date">July 2016</span>)</i></span></div></td></tr></tbody></table> <p>Many ALFs also serve the needs of people with some form of <a href="/wiki/Dementia" title="Dementia">dementia</a>, including <a href="/wiki/Alzheimer%27s_disease" title="Alzheimer's disease">Alzheimer's disease</a> and others with <a href="/wiki/Mental_disabilities" class="mw-redirect" title="Mental disabilities">mental disabilities</a>, as long as they do not present an imminent danger to themselves or others. The sections of the building where these residents live are often referred to as memory care. In the United States, legislation enacted by each state defines not only the level of care, but often what conditions are prohibited from being cared for in such a home.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (January 2020)">citation needed</span></a></i>]</sup> </p> <ul><li>In California, these units are not "locked" they are secured by alarms, delays, keypads needing a code, etc. However, they are not locked units like a <a href="/wiki/Psychiatric" class="mw-redirect" title="Psychiatric">psychiatric</a> ward.</li></ul> <p>Many ALFs will work to accommodate a person with severe forms of Alzheimer's by having separate private units. These specialized care areas are part of the main building but are secured so residents with Alzheimer's cannot leave and possibly do harm to themselves. These care areas usually house fewer people, and more attention from the caregivers is provided. </p><p>The units, usually called locked units, focus on applying <a href="/wiki/Cognitive" class="mw-redirect" title="Cognitive">cognitive</a> and mental activities to help keep the mind fresh. Since there is no cure for the disease, the goal is to work at prolonging or delaying the illness. If one is not engaged in an activity, one's memory will deteriorate more rapidly. </p> <div class="mw-heading mw-heading3"><h3 id="Cost_increases">Cost increases</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Assisted_living&action=edit&section=8" title="Edit section: Cost increases"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Assisted living facilities, initially established to support older Americans in their later years, have become increasingly focused on maximizing financial gains at the expense of their residents' well-being. Over the period from 2004 to 2021, the median annual cost of assisted living has outpaced <a href="/wiki/Inflation" title="Inflation">inflation</a> by 31%, increasing to $54,000 per year.<sup id="cite_ref-Rau_14-0" class="reference"><a href="#cite_note-Rau-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> </p><p>There are approximately 31,000 assisted living facilities in the United States, with four out of five operated for-profit. Half of all operators within the industry are achieving annual returns of 20% or more, exceeding operating costs by a substantial margin. These exceedingly <a href="/wiki/Profit_margin" title="Profit margin">high-profit margins</a> are unprecedented even within other <a href="/wiki/Healthcare_industry" title="Healthcare industry">healthcare industry</a> sectors.<sup id="cite_ref-Rau_14-1" class="reference"><a href="#cite_note-Rau-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> </p><p>Assisted Living Facilities have the option to offer Medicare- and Medicaid-covered services, such as home health or personal care, to their residents. These services are similar to what individuals would typically receive in a private residence. ALF providers aiming for Medicare or Medicaid reimbursement for home health services need to comply with federal home health agency standards. ALFs can enter into contracts with Medicare or Medicaid providers to deliver covered home health, personal care, and other specified LTSS within their facilities for participating residents.<sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> </p><p>With an estimated 850,000 older Americans residing in assisted living facilities, the higher rents and the increasingly prevalent <a href="/wiki/Ancillary_revenue" title="Ancillary revenue">ancillary fees</a> pose a significant housing and healthcare challenge for an elderly demographic that often struggles to address their needs.<sup id="cite_ref-Rau_14-2" class="reference"><a href="#cite_note-Rau-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Ongoing_Issues">Ongoing Issues</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Assisted_living&action=edit&section=9" title="Edit section: Ongoing Issues"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Instances of mistreatment, encompassing physical, sexual, verbal, psychological, emotional abuse, neglect, and financial exploitation, may manifest within an Assisted Living facility. Such mistreatment is characterized by the deliberate ill-treatment of a resident and can be perpetrated by the facility itself, fellow residents, or an external party with access to the resident's personal information. A study conducted to evaluate these concerns in the Assisted Living community revealed that verbal and physical abuse emerged as the primary category, with 28% of residents reporting experiences of abuse.<sup id="cite_ref-tandfonline.com_16-0" class="reference"><a href="#cite_note-tandfonline.com-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="2011_Miami_Herald_investigation">2011 <i>Miami Herald</i> investigation</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Assisted_living&action=edit&section=10" title="Edit section: 2011 Miami Herald investigation"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>A <i><a href="/wiki/Miami_Herald" title="Miami Herald">Miami Herald</a></i> article covering the newspaper's 2011 investigation into assisted living facilities in <a href="/wiki/Florida" title="Florida">Florida</a> was nominated as a finalist for the <a href="/wiki/Pulitzer_Prize" title="Pulitzer Prize">Pulitzer Prize</a>.<sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> The newspaper's investigation found that: </p> <ol><li>"The safeguards once hailed as the most progressive in the nation have been ignored in a string of tragedies never before revealed to the public,..."</li> <li>"That the Agency for Health Care Administration, which oversees the state's 2,850 assisted-living facilities, has failed to monitor shoddy operators, investigate dangerous practices or shut down the worst offenders," and</li> <li>"As the ranks of assisted-living facilities grew to make room for Florida's booming elderly population, the state failed to protect the people it was meant to serve."<sup id="cite_ref-18" class="reference"><a href="#cite_note-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup></li></ol> <p>The investigation found dozens of incidents of gross mismanagement and <a href="/wiki/Criminal_behavior" class="mw-redirect" title="Criminal behavior">criminal behavior</a> at assisted living facilities across Florida, a state of 20 million people, popular with American retirees. The newspaper requested the release of state documents related to the deaths of over 300 people in assisted living facilities between 2003 and 2011 but was denied these documents. Still, the newspaper's investigation found no less than 70 people who had died due to the "actions of their caregivers."<sup id="cite_ref-19" class="reference"><a href="#cite_note-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> The deaths were found to have resulted from the mismanagement of assisted living facilities and by the practices of their staff and managers who drugged residents, deprived them of basic necessities such as food and water, abused residents verbally, psychologically and physically, and neglecting their needs. </p><p>Long-term care ombudsmen, whether volunteering or employed independently, function outside the scope of Assisted Living Facilities. They actively support and defend the well-being and rights of residents within these environments. Ombudsmen conduct regular, surprise visits to these facilities, where they observe conditions, listen to resident concerns, and strive to resolve issues on the residents' behalf. Beyond addressing complaints, they empower residents by providing information on their rights and options, considering the impact on their quality of life. Mandated by the Older Americans Act, ombudsman services are directed by residents, confidential, and offered free of charge. These advocates also work towards policy changes that enhance the overall well-being of individuals in long-term care settings.<sup id="cite_ref-tandfonline.com_16-1" class="reference"><a href="#cite_note-tandfonline.com-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> Needs of residents being addressed can be as small as a change in the lunch menu or needing a new pair of glasses. 60%- 70% of the residents do not have family to ensure they are being well cared for. However, there is a large need for ombudsmen in the assisted living facility community.<sup id="cite_ref-20" class="reference"><a href="#cite_note-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="2013_Frontline_investigation">2013 <i>Frontline</i> investigation</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Assisted_living&action=edit&section=11" title="Edit section: 2013 Frontline investigation"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>On July 30, 2013 <i><a href="/wiki/Frontline_(U.S._TV_series)" class="mw-redirect" title="Frontline (U.S. TV series)">Frontline</a></i> ran an hour-long program<sup id="cite_ref-21" class="reference"><a href="#cite_note-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> with help from <a href="/wiki/ProPublica" title="ProPublica">ProPublica</a><sup id="cite_ref-ProPublica_22-0" class="reference"><a href="#cite_note-ProPublica-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> detailing some tragedies that happened in assisted living. </p><p>Currently, around 750,000 people inhabit assisted living facilities nationwide. The industry is largely controlled by for-profit chains with a focus on both resident care and shareholder satisfaction. There are disparities in care standards, training, and the definition of 'assisted living' across different states. Unlike nursing homes, assisted living facilities operate without federal regulation<sup id="cite_ref-23" class="reference"><a href="#cite_note-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> An accompanying written brief cites deaths of residents, facilities that are understaffed, employees that are inadequately trained, and that an overall "push to fill facilities and maximize revenues has left staff overwhelmed and the care of residents endangered." </p><p>A related article by <i>ProPublica</i> (Thomson and Jones, July 29, 2013) states that a facility operated by <a href="/wiki/Emeritus_Senior_Living" title="Emeritus Senior Living">Emeritus Senior Living</a> "...had been found wanting in almost every important regard. And, in truth, those 'specially trained' staffers hadn't been trained to care for people with Alzheimer's and other forms of dementia, a violation of California law." It goes on to say, "The facility relied on a single nurse to track the health of its scores of residents, and the few licensed medical professionals who worked there tended not to last long," but also that "During some stretches, the facility went months without a full-time nurse on the payroll." <i>ProPublica's</i> article claimed the problem was not specific to one facility and that "State inspectors for years had cited Emeritus facilities across California." Emeritus replied to that claim, describing "any shortcomings as isolated," as well as that "any problems that arise are promptly addressed." The company cited their "growing popularity as evidence of consumer satisfaction." </p> <div class="mw-heading mw-heading3"><h3 id="Comparison_between_assisted_living_and_personal_care">Comparison between assisted living and personal care</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Assisted_living&action=edit&section=12" title="Edit section: Comparison between assisted living and personal care"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In <a href="/wiki/Pennsylvania" title="Pennsylvania">Pennsylvania</a>, personal care and assisted living are defined separately. </p><p>Personal care and assisted living in PA are regulated by the Pennsylvania Bureau of Human Services Licensing (a division of the <a href="/wiki/Department_of_Human_Services" title="Department of Human Services">Department of Human Services</a>).<sup id="cite_ref-24" class="reference"><a href="#cite_note-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> Up until January 2011, the terms "assisted living" and "personal care" were considered interchangeable. At that time, Pennsylvania began licensing assisted living facilities separately from personal care facilities.<sup id="cite_ref-25" class="reference"><a href="#cite_note-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> </p><p>Chapter 2800 of the 55 <a href="/wiki/Pennsylvania_Code" title="Pennsylvania Code">Pennsylvania Code</a> defines assisted living as "a significant long-term care alternative to allow individuals to age in place," where residents "will receive the assistance they need to age in place and develop and maintain maximum independence, exercise decision-making and personal choice."<sup id="cite_ref-26" class="reference"><a href="#cite_note-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> </p><p>Likewise, Chapter 2600 of the 55 Pa. Code defines personal care as "A premise in which food, shelter and personal assistance or supervision are provided for a period exceeding 24 hours, for four or more adults who are not relatives of the operator, who do not require the services in or of a licensed long-term care facility, but who do require assistance or supervision in activities of daily living or instrumental activities of daily living."<sup id="cite_ref-27" class="reference"><a href="#cite_note-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup> </p><p>The differences between the two levels of care are broken down into three categories: </p><p><b>Concept –</b> Assisted living residences permit residents to age in place, meaning that even as their health care needs increase, they will not have to relocate to another senior living home to receive that care, such as skilled nursing. </p><p><b>Construction –</b> Assisted living residences must provide residents with a private room with a lockable door, a private bathroom, and a small kitchen. Personal care homes are not required to offer these amenities. </p><p><b>Level of Care –</b> Assisted living residences must ensure that residents receive skilled nursing care if their needs surpass standard assisted living services.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (January 2020)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading2"><h2 id="United_Kingdom">United Kingdom</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Assisted_living&action=edit&section=13" title="Edit section: United Kingdom"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Assisted living is known as <b>extra-care housing</b> or <b>retirement living</b>, allowing residents over 55 or 60 to live independently. They are offered a self-contained flat or <a href="/wiki/Bungalow" title="Bungalow">bungalow</a> and have staff available 24 hours a day to provide personal care. Staff help wash, dress residents, take medication, and do domestic duties such as shopping and laundry; they also prepare and serve meals to residents if provided. Residents are often asked whether to own or rent their properties independently; the average cost ranges from £500 to £1,500, depending on where the resident lives. </p><p>Assisted living accommodations often include a scheme manager or team of onsite support staff, nurses, and care staff, 24-hour emergency alarm systems, and communal lounges to socialise with other residents. Assisted living housing is regulated by the <a href="/wiki/Care_Quality_Commission" title="Care Quality Commission">Care Quality Commission</a> (CQC).<sup id="cite_ref-28" class="reference"><a href="#cite_note-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Assisted_living&action=edit&section=14" title="Edit section: See also"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Aging_in_place" title="Aging in place">Aging in place</a></li> <li><a href="/wiki/Eldercare" class="mw-redirect" title="Eldercare">Eldercare</a></li> <li><a href="/wiki/Food_preferences_in_older_adults_and_seniors" class="mw-redirect" title="Food preferences in older adults and seniors">Food preferences in older adults and seniors</a></li> <li><a href="/wiki/Retirement_home" title="Retirement home">Retirement home</a></li> <li><a href="/wiki/Group_home" title="Group home">Group home</a></li> <li><a href="/wiki/Retirement_community" title="Retirement community">Retirement community</a></li> <li><a href="/wiki/Transgenerational_design" title="Transgenerational design">Transgenerational design</a></li> <li><a href="/wiki/Assistive_technology" title="Assistive technology">Assistive technology</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Assisted_living&action=edit&section=15" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-1"><span class="mw-cite-backlink"><b><a href="#cite_ref-1">^</a></b></span> <span class="reference-text">Starr, P. 1982. The Social Transformation of American Medicine. 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Commentary: Is assisted living in the United States well served by regulations requiring reporting detailed operational data that are then posted on the Internet? Journal of Aging and Social Policy, 21, 243–245.</li> <li>Mar</li></ul> <p>tin, A. 2010 March/April. 2010 largest AL providers. Assisted Living Executive, 10 - 19. </p> <ul><li>Starr, P. 1982. The Social Transformation of American Medicine. New York: Basic Books.</li></ul> <p><br /> </p> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><style data-mw-deduplicate="TemplateStyles:r1236075235">.mw-parser-output .navbox{box-sizing:border-box;border:1px solid #a2a9b1;width:100%;clear:both;font-size:88%;text-align:center;padding:1px;margin:1em auto 0}.mw-parser-output .navbox .navbox{margin-top:0}.mw-parser-output .navbox+.navbox,.mw-parser-output .navbox+.navbox-styles+.navbox{margin-top:-1px}.mw-parser-output .navbox-inner,.mw-parser-output .navbox-subgroup{width:100%}.mw-parser-output .navbox-group,.mw-parser-output .navbox-title,.mw-parser-output .navbox-abovebelow{padding:0.25em 1em;line-height:1.5em;text-align:center}.mw-parser-output .navbox-group{white-space:nowrap;text-align:right}.mw-parser-output .navbox,.mw-parser-output .navbox-subgroup{background-color:#fdfdfd}.mw-parser-output .navbox-list{line-height:1.5em;border-color:#fdfdfd}.mw-parser-output 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generation</a></li> <li><a href="/wiki/Unlicensed_assistive_personnel" title="Unlicensed assistive personnel">Unlicensed assistive personnel</a></li> <li><a href="/wiki/Young_carer" title="Young carer">Young carer</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Support for caregivers</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Carers%27_rights" title="Carers' rights">Carers' rights</a></li> <li><a href="/wiki/Caregiver_stress" title="Caregiver stress">Caregiver stress</a></li> <li><a href="/wiki/Distress_in_cancer_caregiving" title="Distress in cancer caregiving">Distress in cancer caregiving</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" 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</div></td></tr><tr><th scope="row" class="navbox-group" style="background-color: #bbbbff; box-shadow: inset 1px 1px 0 #000055, inset -1px -1px 0 #000055;;;width:1%">Approaches</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Individualized_Education_Program" title="Individualized Education Program">IEP</a></li> <li><a href="/wiki/Inclusion_(disability_rights)" title="Inclusion (disability rights)">Inclusion</a></li> <li><a href="/wiki/Learning_disability" title="Learning disability">Learning disability</a></li> <li><a href="/wiki/Mainstreaming_(education)" title="Mainstreaming (education)">Mainstreaming</a></li> <li><a href="/wiki/Physical_therapy" title="Physical therapy">Physical therapy</a> <ul><li><a href="/wiki/Driver_rehabilitation" title="Driver rehabilitation">driver rehabilitation</a></li></ul></li> <li><a href="/wiki/Special_needs" title="Special needs">Special needs</a> <ul><li><a href="/wiki/Special_school" class="mw-redirect" title="Special school">school</a></li> <li><a href="/wiki/Special_education" title="Special education">education</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="background-color: #bbbbff; box-shadow: inset 1px 1px 0 #000055, inset -1px -1px 0 #000055;;;width:1%">Rights, law, support</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Rights</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Ableism" title="Ableism">Ableism/disablism</a></li> <li><a href="/wiki/Disability_rights_movement" title="Disability rights movement">Disability rights</a></li> <li><a href="/wiki/List_of_disability-related_terms_that_developed_negative_connotations" class="mw-redirect" title="List of disability-related terms that developed negative connotations">Pejorative terms</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Law</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Accessibility_for_Ontarians_with_Disabilities_Act,_2005" title="Accessibility for Ontarians with Disabilities Act, 2005">AODA</a></li> <li><a href="/wiki/Americans_with_Disabilities_Act_of_1990" title="Americans with Disabilities Act of 1990">ADA</a></li> <li><a href="/wiki/Convention_on_the_Rights_of_Persons_with_Disabilities" title="Convention on the Rights of Persons with Disabilities">Convention on the Rights of Persons with Disabilities</a></li> <li><a href="/wiki/Declaration_on_the_Rights_of_Disabled_Persons" title="Declaration on the Rights of Disabled Persons">Declaration on the Rights of Disabled Persons</a></li> <li><a href="/wiki/International_Classification_of_Functioning,_Disability_and_Health" title="International Classification of Functioning, Disability and Health">International Classification of Functioning, Disability and Health</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Services</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Services_for_mental_disorders" title="Services for mental disorders">Services for mental disorders</a></li> <li><a href="/wiki/Services_and_supports_for_people_with_disabilities" title="Services and supports for people with disabilities">Services for disabled people</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Support</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Disability_Living_Allowance" title="Disability Living Allowance">DLA</a></li> <li><a href="/wiki/Ontario_Disability_Support_Program" title="Ontario Disability Support Program">ODSP</a></li> <li><a href="/wiki/Disabled_Persons_Railcard" title="Disabled Persons Railcard">Rail</a></li> <li><a href="/wiki/Social_Security_Disability_Insurance" title="Social Security Disability Insurance">SSDI</a></li> <li><a href="/wiki/Supplemental_Security_Income" title="Supplemental Security Income">SSI</a></li> <li><a href="/wiki/Disabled_students_allowance" class="mw-redirect" title="Disabled students allowance">Students</a></li> <li><a href="/wiki/CNIB_Foundation" title="CNIB Foundation">CNIB</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Activist groups</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Council_for_Canadians_with_Disabilities" title="Council for Canadians with Disabilities">CCD</a></li> <li><a href="/wiki/Disabled_Peoples%27_International" title="Disabled Peoples' International">DPI</a></li> <li><a href="/wiki/Movement_for_the_Intellectually_Disabled_of_Singapore" title="Movement for the Intellectually Disabled of Singapore">MINDS</a></li> <li><a href="/wiki/Reach_Canada" title="Reach Canada">Reach Canada</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="background-color: #bbbbff; box-shadow: inset 1px 1px 0 #000055, inset -1px -1px 0 #000055;;;width:1%">Structural and assistive</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Accessible_toilet" title="Accessible toilet">Accessible toilet</a></li> <li><a href="/wiki/Activities_of_daily_living" title="Activities of daily living">Activities of daily living</a></li> <li><a href="/wiki/Assistive_technology" title="Assistive technology">Assistive technology</a></li> <li><a href="/wiki/Independent_living" title="Independent living">Independent living</a></li> <li><a href="/wiki/Mobility_aid" title="Mobility aid">Mobility aid</a></li> <li><a href="/wiki/Orthotics" title="Orthotics">Orthotics and braces</a></li> <li><a href="/wiki/Unlicensed_assistive_personnel" title="Unlicensed assistive personnel">Personal Care Assistant</a></li> <li><a href="/wiki/Accessibility" title="Accessibility">Physical accessibility</a></li> <li><a href="/wiki/Prosthesis" title="Prosthesis">Prosthetics</a></li> <li><a href="/wiki/Universal_design" title="Universal design">Universal design</a></li> <li><a href="/wiki/Web_accessibility" title="Web accessibility">Web accessibility</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="background-color: #bbbbff; box-shadow: inset 1px 1px 0 #000055, inset -1px -1px 0 #000055;;;width:1%">Social issues</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Augmentative_and_alternative_communication" title="Augmentative and alternative communication">Augmentative and alternative communication</a></li> <li><a href="/wiki/Emotional_or_behavioral_disability" title="Emotional or behavioral disability">Emotional or behavioral disability</a></li> <li><a href="/wiki/Invisible_disability" title="Invisible disability">Invisible disability</a></li> <li><a href="/wiki/Disability_and_disasters" title="Disability and disasters">Disability and disasters</a></li> <li><a href="/wiki/Disability_and_LGBT_identities" class="mw-redirect" title="Disability and LGBT identities">Disability and LGBT identities</a></li> <li><a href="/wiki/Disability_and_religion" title="Disability and religion">Disability and religion</a></li> <li><a href="/wiki/Disability_and_poverty" title="Disability and poverty">Disability and poverty</a></li> <li><a href="/wiki/Disproportionality_in_special_education" title="Disproportionality in special education">Disproportionality in special education</a></li> <li><a href="/wiki/Sexuality_and_disability" title="Sexuality and disability">Sexuality and disability</a></li> <li><a href="/wiki/Youth_and_disability" title="Youth and disability">Youth and disability</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="background-color: #bbbbff; box-shadow: inset 1px 1px 0 #000055, inset -1px -1px 0 #000055;;;width:1%">Disability studies</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Models_of_disability" title="Models of disability">Models of disability</a></li> <li><a href="/wiki/Inspiration_porn" title="Inspiration porn">Inspiration porn</a></li> <li><a href="/wiki/Bodymind_(disability_studies)" title="Bodymind (disability studies)">Bodymind</a></li> <li><a href="/wiki/Crip_(disability_term)#Crip_theory" title="Crip (disability term)">Crip as verb</a></li> <li><a href="/wiki/Neuroqueer_theory" title="Neuroqueer theory">Neuroqueer theory</a></li> <li><a href="/wiki/Deaf_studies" title="Deaf studies">Deaf studies</a></li> <li><a href="/wiki/Eugenics" title="Eugenics">Eugenics</a></li> <li><a href="/wiki/Disability_anthropology" title="Disability anthropology">Anthropology</a></li> <li><a href="/wiki/Geography_of_disability" title="Geography of disability">Geography</a></li> <li><a href="/wiki/Disability_studies_in_education" title="Disability studies in education">Education</a></li> <li><a href="/wiki/List_of_disability_studies_journals" title="List of disability studies journals">Journals</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="background-color: #bbbbff; box-shadow: inset 1px 1px 0 #000055, inset -1px -1px 0 #000055;;;width:1%">Arts, media, culture, sport</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Disability_culture" title="Disability culture">Disability culture</a></li> <li><a href="/wiki/Disability_art" title="Disability art">Disability art</a></li> <li><a href="/wiki/Disability_in_the_arts" title="Disability in the arts">Disability in the arts</a> <ul><li><a href="/wiki/Disability_in_children%27s_literature" title="Disability in children's literature">Disability in children's literature</a></li> <li><a href="/wiki/Disability_in_horror_films" title="Disability in horror films">Disability in horror films</a></li></ul></li> <li><a href="/wiki/Disability_in_the_media" title="Disability in the media">Disability in the media</a></li> <li><a href="/wiki/Parasports" title="Parasports">Parasports</a> <ul><li><a href="/wiki/Deaflympics" title="Deaflympics">Deaflympics</a></li> <li><a href="/wiki/Paralympic_Games" 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