In the United States, most of the large multi-facility providers are publicly owned and managed as for-profit businesses.[10] There are exceptions; the largest operator in the US is the Evangelical Lutheran Good Samaritan Society, a not-for-profit organization that manages 6,531 beds in 22 states, according to a 1995 study by the American Health Care Association.[14]
In Canada, such privately run for-profit and not-for-profit facilities also exist. Because of cost factors, some provinces operate government-funded public facilities run by each province's or territory's Ministry of Health or subsidize the cost of the facility. In these care homes, elderly Canadians may pay for their care on a sliding scale, based on annual income. The scale that they are charged on depends on whether they are considered "Long Term Care" or "Assisted Living." For example, l in January 2010 seniors living in British Columbia's government-subsidized "Long Term Care" (also called "Residential Care") started pay 80% of their after-tax income unless their after-tax Income is less than $16,500. The "Assisted Living" tariff is calculated more simply as 70% of the After-Tax Income.[22] As seen in the province of Ontario, there are waiting lists for many long-term care homes, though, so families may need to resort to hiring home health care or paying for a stay in a private retirement home.[23]
In most western countries, care facilities for older adults are residential family care homes, freestanding assisted living facilities, nursing homes, and continuing care retirement communities (CCRCs).[8] A family care home is a residential home with support and supervisory personnel by an agency, organization, or individual that provides room and board, personal care and habilitation services in a family environment for at least two and no more than six persons.[9]
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However, elderly care is focused on satisfying the expectations of two tiers of customers: the resident customer and the purchasing customer, who are often not identical, since relatives or public authorities, rather than the resident, may be providing the cost of care. If residents are confused or have communication difficulties, it may be very difficult for relatives or other concerned parties to be sure of the standard of care being given, and the possibility of elder abuse is a continuing source of concern. The Adult Protective Services Agency, a component of the human service agency in most states, is typically responsible for investigating reports of domestic elder abuse and providing families with help and guidance. Other professionals who may be able to help include doctors or nurses, police officers, lawyers, and social workers.[41]


I go to an assigned clients house. I begin the day by making breakfast and starting laundry, after breakfast I wash the dishes. I usually sit with the client for awhile after that set up medicine and remind them to take it then ask what the plan for the day is. Go to grocery or run errands for the client if needed, I hang up laundry , vacuum, clean bathroom and take out trash. Every client has different needs. My days aren't the same all the time.
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