Hearing the band play on.  Seeing an opportunity to attend a day of the Assisted Living Federation of America (ALFA) annual Conference and Expo in Orlando -- I had to go -- hoping to see what's new and different.  These have been a difficult few years for this for-profit industry, with expansion constrained by a difficult lending climate, with filling capacity challenged by later move-in dates and shorter stays, with the need to do more innovative marketing to entice prospects -- and with those that do move in having both higher expectations along with greater frailty and other issues commensurate with age or need. This year I was surprised to hear talk of the need for wireless networks throughout buildings (and being deployed -- see ESCO's CareConnect, for example), that new residents are arriving with their laptops in tow. Given the age range as a result of older move-ins, there was also a continuing focus on memory care, safety and wellness.

Assisted living cost structures are outrageous. Perhaps you saw it -- the New Old Age article about one family's encounter with ballooning costs in Assisted Living (year-over-year cost growth of 5.2% nationwide), now an 18% (additional $12,000) hike proposed for this 72-year-old gentleman because he 'needed the next level of care.' Then there's the nursing home story I heard recently of a woman who has been 'private pay' in a nursing home to the tune of $100,000/year for years -- because she had the ability to pay. She spends her days reading books in the hallway. Or another -- 12-hour/day non-facility companion aides to 'watch' and prevent wandering on top of $4600/month 'assisted living' charges, bringing the total expenditure to $11,000/month.  Another example: a locked memory care unit in a wealthy town, where a studio apartment starts at $7400/month. All of them have 'prices' of care completely out of proportion to the labor and actual delivery of the care itself. From the Times article: "The institutions often urge families to approach assisted living a bit more realistically." Yes, realism would be good -- regular meetings and clarity on future costs would also be good. "It’s important for people to remember that their loved one is moving into assisted living because they need services," said David Kyllo, executive director of the National Center for Assisted Living. "They’re not moving in because of a change in address. It’s needs-driven."  I find that to be a rather snippy comment on the circumstance of a family understandably appalled by price hikes.