Table Of Content

Absita June 2006 Digitized by the Internet Archive 2016 in https://archive.org/details/supportiveliving2006albe Table of Contents Purpose 1. 1 2. Why is a provincial supportive living framework needed? 1 3. What is supportive living? 2 4. What principles should guide current and future supportive living? 2 5. How is supportive living different from home living and facility living? 3 6. Framework summary table 4 Resident Needs 4 Building Features CJ1 Hospitality Services cn Health and Wellness Services cn Summary 7. In 5 LEVELS OF SUPPORTIVE LIVING IN ALBERTA 6 DEFINITIONS 7 Supportive Living Framework Purpose 1. The main objectives ofthis framework are to describe supportive living in Alberta including clarifying roles and responsibilities and using common terminology. The principles that should guide current and future supportive living developments, and a series ofrelated terms and definitions are also included. Four levels ofsupportive living are described here according to theirbuilding features, hospitalityservices, health and wellnessservices, andresidentneeds. Given thatthe nature ofsupportive living is to respond to individual needs and maximize choice, it is not possible to describe all ofthe possible combinations ofhousing, support services and care that exist now orthat will exist in thefuture. Thisframeworkwill need to be updated as the supportive living concept continues to evolve and mature. The framework should be adopted by all key players as a meaningful and useful tool to helpwith planning and operations. Theframework does notaim to prescribe what housing operators should orcan provide, orthe criteria that should be used to determine entrance and exitcriteria. Supportive living operators and service providers are expected to complywith relevant legislation, regulations, bylaws and rules established by municipalities, and the Governments ofAlberta and Canada. Contractagreements may also include other practices thatare not in legislation. 2. Whyis a provincialsupportive living framework needed? All levels ofgovernment, regional health authorities, management bodies, other housing operators, developers, planners, health service providers, potential residents and their families will all benefitfrom a common framework. Oneframework means: Common terms and definitions can be referred to when working with partners on developing supportive living options. Plans and programs can be developed based on a clear understanding ofroles and responsibilities. Referral guidelines can be clarified and consistently applied. Residents and theirfamilieswill be ableto match the resident’s needs with appropriate building features, hospitality services and health and wellness services. 3. Whatis supportive living? Supportive living is both aphilosophyand an approachfor providing serviceswithin a housing environment. It provides a residential setting where people can maintain control overtheirliveswhile also receiving the supportthey need. Buildings and common areas are specificallydesigned to meetresidents’ needs and to supporttheirsafety and security. Supportive living options can serve the needs ofa wide range ofclientswho need support to live as independentlyas possible, including seniors and adults with developmental or physical disabilities. However, there are also limits towhatsupportive living can provide. Forexample, individualswho have complex care needs and require access on a 24-hour basisto a registered nurse may not be appropriatelyaccommodated in supportive living. There are a numberofbenefitsfor individuals who live in supportive living and fortheir families. Ifa range ofsupportive living options is available locally, people have the option ofstaying close totheirfamilies and friends to have theircurrentand future needs met. Supportive living provides services including meals; activities and social events that can help maintain and improve qualityoflife and overall health and well-being based on the changing needs ofthe individual. Currently, there are about21,000 supportive living spaces in Alberta. These spaces are in lodges, enhanced lodges, assisted living, designated assisted living, group homes, adultfamily living, and familycare homes. They are in buildings owned and/oroperated bygovernment-supported management bodies or by privatefor-profit and non-profitor voluntary housing operators. 4. Whatprinciples shouldguide currentand future supportive living? Currentand future supportive living developments should be based on the following principles: 1. Supportive living options recognizethe individualityofeach resident and his or herchanging needs. 2. Communitieswill striveto have a range ofsupportive living options thatcan meet the service and affordability needsforlocal residentswanting to stay in orneartheir own communities. 3. All orders ofgovernment, regional health authorities, housing operators, and other stakeholderswill workcollaborativelyto develop and deliversupportive living options. 4. To maximize choice and flexibility, health, housing and social service providerswill worktogetherand with residents and/ortheirfamilies when coordinating and collaborating on a person’s housing, care and service options. 2 5. To the extentthey are able, Albertans are responsible forthe costs associated with theirsupportive living accommodation. Provincial accommodation assistance will be targeted to those who need it most. 6. Regional health authorities are responsible forfunding professional health services and personal care services to address individuals’ assessed unmet needs. 7. The provincial government is responsibleforsetting overall policies and strategies, legislation, and funding in areas ofits responsibility, while operational decisions will be made atthe local level, consistentwith provincial priorities and accountability requirements. 5. How is supportive living different from home living and facility living? In Alberta, there are three streamsthatare often referred towithin the continuing care system: The home livingstream includes people who live in theirown homes, including but not limited to singlefamilydwellings, apartments, condominiums, and other seniors’ independent living options. The supportive livingstream combines accommodation or housing and hospitality serviceswith othersupports and care. Supportive living operators are responsible for coordinating and arranging hospitality services and may coordinate or provide personal care and othersupportservices. The facilitylivingstream includes long-term carefacilities (e.g., nursing homes and auxiliary hospitals)that provide carefor individualswhose health needs are such that they are unable to remain at home orin a supportive living situation. CONTINUING CARE SYSTEM Home Living Supportive Living Facility Living | In homeliving, individuals are largely responsibleforand capable ofarranging any care and assistance thatthey may need. Theycan access publiclyfunded health services through home care orothercommunity-based health programs orthey can purchase personal and othersupportservices privately. Compared with home living, supportivelivingprovides: Basic hospitality services such as meals (at leastone main meal perday), housekeeping, laundry, and life-enrichmentserviceson site and arranged bythe housing operator. Acommon area for meals, social functions, etc. Asafe and accessible environment. 24-hour, 7 days a week, safetyand security. 3 Supportive living meetsthe needs ofa wide range ofpeople, but notthose who have highly complex and serious health care needs. People with the highestand mostcomplex needs are served primarily in facility living. Supportive living is alsotypically unable to serve individualswho exhibit unpredictable behavioursthat putthemselves and/orothers at risk. Compared to supportive living, facilityliving: Caresforresidentswith medical conditionsthat may be serious, chronic and/or unpredictable and require access to registered nursing services on a 24-hourbasis. These professionals are able to respond tothe need for unscheduled assessments and prescribe interventions. Provides24-hourregistered nursing care from nursing staffthatare ableto respond immediately and on a sustained and unscheduled basis. Has specialized physical design and infrastructure to address highlycomplex needs. Is governed bythe NursingHomesActorthe HospitalsAct 6. Framework summary table Theframework identifiesfourdistinct levels ofsupportive living in Alberta: - Residential Living Level 1 Lodge Living -Level 2 Assisted Living - Level 3, and Enhanced Assisted Living - Level 4. The one-pageframeworksummarytable on page 6 includes a detailed description of residentneeds, buildingfeatures, hospitalityservicesand health andwellnessservices that correspond with each ofthefourlevels ofsupportive living in Alberta. Resident Needs The purpose ofthis section ofthe framework isto describe the range ofneeds ofpersons residing in supportive living. As resident needs increase, so doesthe level ofsupportive living service. Consistentwith the conceptof“unbundling” health and housing services, supportive livingfacilities are nottypically limited to serving onlyone level ofresident needs (e.g., only Residential Living - Level 1 or Lodge Living - Level 2). In fact, services can often be modified orenhanced based on the resident’s changing needs. In most supportive living settings, residents applydirectlyto the housing operatorfor tenancy. In the remaining cases (“designated” spaces), entry into supportive living is based on an assessmentofresident needs and is a collaborative process between the regional health authority and the housing operator. It is recognized thatthere may be some riskstothose individualswho exercisetheirchoice to live in a given supportive living spacewhen their needs exceed the level ofservices thatcan be provided. 4 Building Features The purpose ofthis section ofthe framework is to describe the minimum requirements for common areas that must be available within a supportive living site and to describe the ideal in terms ofresidents’ suitefeatures. A numberofsupportive living spaces are located in olderfacilities: therefore they may not be able to meetthe expectations associated with new constmction. Hospitality Services The purpose ofthis section ofthe framework is to describe the services that the housing operator is responsibleto co-ordinate and/or provide to residents. When a service is identified as “may be available” the housing operator may or may not have the ability or capacityto co-ordinate orprovide this service to its residents. Ifa service is identified as “available” the housing operator has the capacity to provide the service to residents who wantor need the service orto co-ordinate its delivery by anothervendor. When a service is identified as “provided”the operator supplies this service to residents. The services listed in each ofthe fourlevels are not meantto be “prescriptive” meaning that residents musteitherneed, wantor payforsome orall ofthese services. An operatoris also notrequired to make available or provide all ofthese services to their residents in orderto be classified as a certain level ofsupportive living. Upon move-in, residents and operators are expected to have a common understanding ofwhat services may be available, are available and are provided, and the related costs. Health and Wellness Services The purpose ofthis section isto describe the roles and responsibilities ofthe health care system (both publiclyfunded and privately purchased services) in relation to individualized case management, assessmentofneeds and the provision ofservices to address the unmet needs ofsupportive living residents. Summary 7. In The agreed upon terms, definitions, descriptions, and roles and responsibilities that are included in thisframeworkare the basis on which supportive living options in Alberta can now be identified. All levels ofgovernment, regional health authorities, housing operators, developers and planners, service providers, and residents and theirfamilies can now referto one documentwhen assessing what is already in place and what is needed. Supportive living has grown dramatically in recentyears and this expansion is expected to continue. Thisframework is intended to provide the compass bywhich future supportive living developments are created to best meetthe needs ofa wide range ofAlbertans. 5 ALBERTA IN LIVING SUPPORTIVE OF LEVELS