Martin Koppenhoefer <dieterdre...@gmail.com> writes:

> How would you call this:
> http://www.berkretirement.com/LivingOptions/RetirementLiving ?

That looks like two related facilities, one that is probably
"independent living" (meaning own appt, meals/housekeeping provided),
and one nursing home, with the idea that if you move into the lower-care
place, you can more easily and comfortably transition to nursing care
later.  These sorts of places should be tagged as two places; they are
usually distinct.  They are also called in aggregate a "continuing care
community".

http://www.mass.gov/elders/housing/ccrc/

> This kind of facility (retirement home) comes in lots of different styles
> and prize/luxury ranges, often these are combined nursing homes (i.e.
> according to what you require, you will either have nursing home care or be
> able to do more stuff on your own and have more independence).

Yes, but I'm pretty sure you move from the retirement wing to the
nursing wing when you need services that the assisted living or
independent wing cannot legally provide.  I've seen that happen
regularly with a similar place that has "assisted living" in one
building and "nursing home" in another on the same campus.   One feels
like apartments with staff; the other nearly a hospital.

> I've been to a lot of these facilities (as well as hospitals, nursing
> homes and psychiatric hospitals etc., in the majority for elderly
> people) in Germany some time ago as part of my civil service. The
> range of what I found there was huge, from really nice places to
> almost prison feeling (including bars on the windows and staircases).

I am surprised at bars, but maybe that's the psychiatric hospital.
There is also 'secure memory unit' in both ALR and nursing home for
Alzheimer's patitents at risk of wandering.  Usually the point is to
keep people from wandering while appearing as nice as possible.

> Maybe the example above would fall under "assisted living"? Actually,
> researching superficially (or at least not very profoundly) in the web, it
> seems as if "assisted_living" is a poorly defined term in general, and can
> mean a lot of thinks,

In en_US, and especially in Massachusetts, "Assisted Living Residence"
is very well defined;

  
http://www.mass.gov/elders/housing/assisted-living/assisted-living-program-overview.html
  http://www.mass.gov/elders/regs-stats/housing/

I think the place you linked to, at its lower level, is not an ALR or
they would have said it.  Meaning they don't do "self-administered
medication management" or assitance with showering and don't have an ALR
license.  Assistance is likely limited to cooking/cleaning - the kinds
of housekeeping that anyone might have, and for which no professional
license is needed for the workers.

> including group homes, people living in their own
> homes and having someone looking after them from time to time, etc..

That may be true in en_X for X != US.  This is the usual problem of the
normal interpretation of words that are used by the speaker more
formally.  In the US, "assisted living" is a term usually defined by the 
government.

> The OSM wiki has this definition for at least 5-6 years: "A residential
> facility like group_home, but the looked after are more independent (e.g
> have own flats). Usually conceived for people with "slight" disabilities
> (e.g. residential care home for eldery people)"

That's not really the right definition in the US.   I know that at least
Vermont and Texas have similar laws to Mass about assisted living
(slight detail differences, but conceptually very close).


So this comes down to being difficutl world wide. I agree with the
notion of the definitions and not getting hung up on the terms.
Overall, I'd suggest

 senior_age_restricted_housing: no special staff compared to any other
 apartment, but you have to be >= 55 or 65 and not have children living
 there.

 indepdendent_living: apartment with meals and housekeeping, but staff
 do not need a medical-type license.  No help with pills or showering.
 People expected to manage their own issues.

 assisted_living: as above, but help is available e.g. to hand you your
 pills from a locked box on schedule and call the children if you don't,
 and help with showering, escorts to meals.  Staff needs some sort of
 "personal care assistent" licensing, which is much less than a nursing
 certification but more than "housekeeper".  Staff expects residents'
 children to manage their issues for some people, others to self-manage.
 usually own apartment.

 nursing_home: hospital like.  24-hour nursing staff.  usually 2 beds to
 a room.

 continuing_care_community: used to tag the campus of a place that has
 at least nursing_home and one other of the above.

as the catgories.  All of the above typically have signs.  Plus

 group_home: house typically in a regular neighborhood with several
 people with some kind of issues, but who don't fit the pattern above.
 Staff present, but counselors more than medical.  Almost never has a
 sign.

and also

  hospice: facility that is sort of like nursing_home, but private rooms
  and much nicer trying to seem home-like.  People go there when they
  are dying and have decided to stop treatment and just manage pain.  A
  place for the family to visit during the final days or weeks.
  eg: http://www.vnacarenetwork.org/services/hospice/rose

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