Frank Conversations And Clear Contracts Can Prevent Legal Issues
 Many people think of aging in place as remaining in their own homes—the place where they’re most capable of expressing themselves and maintaining personal control over their own lives. But there’s a difference between a house and a home. An environment where residents can enjoy a sense of community and maintain as much independence as their capabilities allow, even if that’s in a nursing home setting, can also be “aging in place.”
 “Aging in place is as much an issue of dignity, self-determination, and independence as it is of location,” said Paul Willging, Senior Associate at the Johns Hopkins Bloomberg School of Public Health and former President/CEO of the Assisted Living Federation of America. “It reflects an attitude and environment that enhances the ability of seniors to maintain personal control over their own lives, which is much more important than simply maintaining a spot in terms of location.”
 But what happens when a resident in, say, an assisted living facility becomes increasingly frail, and has outstripped the capacity of the facility to provide appropriate support? The person can’t “age in place” at that location anymore. That has been a dilemma for many assisted living facilities, and none of the possible resolutions are particularly palatable:
Allow the resident to remain without providing services;
Allow the resident to remain and continue to provide services, which would affect overall price competitiveness;
Cross-subsidize within the facility—the less frail pay more so that services are available to the more frail; or
Force the resident to move out.
 Unfortunately, many families assume that an assisted living facility is a place where Mom or Dad can age in place forever; but if often doesn’t work that way. And the option that the facility is likely to choose is the one that appears most brutal: Force the resident to move out. The important step that is often missing is the frank, honest discussion upon admission that there will perhaps come a point where Mom or Dad’s condition will lend itself to a transition somewhere else.
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