Office of the Assisted Living Registrar

Services Offered in Assisted Living Residences

An assisted living residence offers three key components: housing, hospitality services and personal assistance services.

Operators must ensure that all three components are:

provided in a manner that does not jeopardize the health and safety of residents;
respectful of and responsive to residents’ preferences, needs and values;
designed to promote maximum dignity and independence for residents; and
involve family and friends to the extent requested by the resident.

Operators must comply with the provincial Health and Safety Standards in the delivery of assisted living services.

Housing

Assisted living includes many types of residences. Assisted living in apartment-style buildings includes private self-contained bachelor, one-bedroom or two-bedroom suites with full or modified kitchens. Accommodation in a home could be a bedroom with a lockable door and an ensuite or shared bathroom. All residences include common dining and recreational space where people can eat together and socialize.

Residences with assisted living units include retirement communities, mixed-use buildings with complex care, and purpose-built assisted living residences. Some are stand-alone assisted living residences while others operate as a campus of care.

Assisted living residences are generally situated near amenities such as shopping, pharmacies, health units, community centres and public transit. Residences are also located in different neighbourhoods, so residents can remain close to their family and friends.

Housing Combinations: Campuses of Care

A campus of care involves more than one level of care (independent living, supportive housing, assisted living and/or complex care) in one building or group of buildings. A campus of care allows seniors to age in place by providing a mix of housing and levels of support that address changing needs. By combining different housing and assistance options, such as private-pay housing and publicly subsidized assisted living, operators may be able to reduce operating costs.

Assisted living units do not all need to be in one place in the residence. They can be spread throughout the building to give residents a choice in location, size of unit, etc.

It is quite common for larger assisted living residences to have a combination of publicly subsidized and private-pay assisted living units.

An operator can house assisted living residents who require personal assistance and supportive housing residents who don’t in an assisted living residence.

Hospitality Services

By law, assisted living operators must offer five hospitality services:

meals — one to three meals a day plus snacks. Meal services provide balanced and adequate nutrition for residents; safe practices are followed in meal preparation and delivery; a dietary plan is established for each resident who has food allergies, intolerances, and special or therapeutic dietary needs; and appropriate professional advice (e.g., from a registered dietitian) is obtained for the menu plan and when preparing meals in accordance with special and/or therapeutic diets.
housekeeping — light housekeeping is provided at a frequency to meet residents’ health and safety needs.
laundry — laundering of flat linens once a week. Laundry services produce sanitary flat linens; clean laundry is stored in a sanitary manner; linens are changed at intervals necessary to avoid health issues; and if residents do their own personal laundry, equipment is provided.
social and recreational opportunities — leisure pursuits, social interaction and community involvement.
a 24-hour emergency response system — provides residents with the ability to summon emergency assistance 24 hours a day.

Some operators may provide additional hospitality services, such as escorts to doctor’s appointments.

Operators provide hospitality services either through their own staff or through a contract with third parties. Regardless of how the five hospitality services are delivered, operators must comply with the Health and Safety Standards [PDF 272 Kb].

Personal Assistance Services

Assisted living is modelled on home support: operators provide the same types of services people would expect to receive from unregulated care providers in their own home in the community. Some residences provide only scheduled personal assistance, e.g., bathing. Others also accommodate residents’ unscheduled personal assistance needs, e.g., toileting at night.

There are six personal assistance service areas:

regular assistance with activities of daily living, including eating, mobility, dressing, grooming, bathing and personal hygiene;
central storage of medication, distribution of medication, administering or monitoring the taking of medication;
management of cash or other property of a resident;
monitoring of food intake or of adherence to therapeutic diets;
structured behaviour management and intervention; and
psychosocial rehabilitative therapy or intensive physical rehabilitative therapy.

By law, assisted living operators must offer help with at least one (but no more than two) of the personal assistance areas at the prescribed level. For seniors, the two personal assistance areas usually offered at the prescribed level are help with activities of daily living and with medications. Operators may offer all six personal assistance service areas at the support level.

Personal assistance services are provided either by the operator’s own staff or through a contract with a third party. Regardless of how the personal assistance services are delivered, operators must comply with the Health and Safety Standards [PDF 272 Kb].

Additional Services

Some operators may provide additional hospitality services, such as escorts to doctor’s appointments, washing of personal laundry, and hairdressers. For more information about what services are offered in private-pay assisted living, contact the operator directly. For publicly subsidized assisted living, contact your health authority case manager.

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