Aging in place and negotiated risk agreements

Area of Science:

• Gerontology
• Healthcare Management
• Palliative Care

Background:

• Assisted living residences (ALRs) aim to support residents aging in place, reducing the need for higher care levels like nursing homes.
• Negotiated risk agreements (NRAs) are tools to accommodate resident choices and manage risks within ALRs.
• While many states regulate aging in place, few offer specific guidance on NRAs and their impact on service plans.

Purpose of the Study:

• To explore the role of ALRs in facilitating aging in place through adaptive services.
• To examine the function and regulatory landscape of negotiated risk agreements (NRAs) in assisted living.
• To discuss the integration of upstream palliative care to manage resident decline and support quality of life.

Main Methods:

• Review of assisted living regulations concerning aging in place and NRAs.
• Analysis of the concept and application of upstream palliative care.
• Discussion of legal and ethical considerations regarding NRAs for cognitively impaired residents.

Main Results:

• ALRs that adjust services enable residents to age in place more effectively.
• NRAs can facilitate aging in place but often lack clear regulatory guidelines.
• Upstream palliative care offers a framework for managing decline while respecting resident autonomy.

Conclusions:

• Adaptive service models in ALRs promote aging in place.
• Clearer guidelines are needed for NRAs, especially concerning residents with cognitive impairment.
• Integrating palliative care principles is crucial for supporting residents with changing needs and end-of-life preferences.