Does Assisted Living Provide 24-Hour Care?

Assisted living communities provide 24-hour supervision for residents — having a caregiver awake to supervise residents at all times is why many families choose assisted living. Still, it can be difficult to understand what exactly this means.

“I think there is a lot of confusion between 24-hour care and supervision,” says Rachel Levy, who spent 20 years in management positions at senior living communities before joining A Place for Mom. She explains that in many cases, the differences between care and supervision comes down to the community’s staff.

“24-hour care means that a registered nurse (RN) or licensed practical nurse (LPN) is available at all times. This is typical for skilled nursing facilities where they’re handling more medically complex residents who could have overnight needs,” Levy says.

“24-hour supervision would mean the supervision [comes] from a certified nursing assistant (CNA) or med tech,” Levy explains.  “In this situation, it would limit what kind of resident a community could take if the overnight shift did not have someone qualified to handle their medical needs.”

It’s important to note, though, that some states don’t require a CNA. In these cases, a nurse’s assistant or a home health aide may provide care.

In general, assisted living communities can provide caregiver assistance with activities of daily living (ADLs) 24/7. This includes help with bathing, toileting, and dressing. Assisted living communities generally aren’t licensed to provide the level of 24-hour medical care that you’ll find in a nursing home.

Depending on how some communities are licensed, an assisted living community may be able to provide 24-hour care from an LPN or RN. Still, the nurses on staff would only be able to provide care that is within the limitations of a community’s license. These communities may be better equipped to handle a medical emergency. However, it’s important to ask about the limitations of the nursing staff. Their role in assisted living will still be different than a nurse’s role in a nursing home.

Another thing to consider is the staff-to-resident ratio in the community.

“It’s important to ask what staffing looks like on the 11 p.m. to 7 a.m. shift as well as the qualifications of the staff,” Levy notes. “Since there’s typically less staff during that time (since most residents are sleeping), it’s good to know who is there and the limitations of what they can do.”

Read more:Staff-to-Resident Ratios in Assisted Living: A Detailed Look

Is assisted living the right fit?

Assisted living communities quiet down for the night, giving residents the peace they need for sleep. Levy says there’s a big difference going from day to night in assisted living.

“I’ve stayed in assisted living communities overnight, and the main difference is that there are less people. Night staff make rounds and help residents who may need assistance during the night. They also do a lot of organizational and prep work for the day shift. It’s like a well-oiled machine with how the process works.”

Assisted living communities tailor the assistance they provide overnight just as they do during the day. Caregivers will make rounds to see that all residents are safe throughout the night. Levy notes the following additional examples of the overnight supervision provided at assisted living:

• Checking on new residents or residents returning from a hospital more frequently
• Helping residents with toileting needs
• Assisting with showers for residents who prefer to bathe at night

Sometimes communities use a mix of staff and technology to supervise residents overnight. Levy says that some communities may use things like wander-guard technology or bed monitors, especially for residents experiencing cognitive decline. However, Levy says it’s more common to find bed monitors in skilled nursing facilities.

Read more:What Are the State Requirements for Assisted Living Communities? An Overview

Assisted living questions? Get expert help

In some cases, seniors may need more care overnight than an assisted living community can provide. Many times, this comes down to what kinds of advanced care services a community is licensed to provide. Assisted living communities are licensed on a state level, whereas nursing homes follow national guidelines.

“State regulations are very clear about what services can and can’t be provided by an assisted living community,” Levy says. She encourages families to ask any community they’re considering about when a nursing home may be necessary.

Levy notes that a nursing home may be needed if a resident:

• Has an advancing medical condition
• Needs constant one-on-one help
• Can’t adopt a sleep routine
• Requires help with medications in the middle of the night
• Needs overnight diabetic care
• Has stage three or higher wounds
• Is diagnosed with failure to thrive, where a senior experiences weight loss, decreased appetite, poor nutrition, and inactivity^[01]

If you think your loved one would do well with the 24-hour supervision offered in assisted living, A Place for Mom’s Senior Living Advisors can help. They work with families to find communities that meet a senior’s care needs, preferences, and budget. Best of all, this service comes at no cost to your family.