Are you worried about your aging parent? Perhaps your loved one fell at home a few months ago, or maybe you have noticed that they are not taking their medication as prescribed. These are common concerns that can keep you up at night as you struggle to find the right way to keep your loved one healthy and happy.
However, it can be difficult to start the process of searching for assistance. The senior care industry is large, and anyone can feel lost or overwhelmed in the fray. Fortunately, we have compiled everything you need to know about a common and very helpful senior living option that could benefit your aging loved one: assisted living.
What Is Assisted Living?
There are more and better senior living options available today than ever before. The industry has evolved to provide specific assistance and support to seniors who are living with different challenges and abilities. The majority of senior living options fall into four categories: independent living, assisted living, memory care, and skilled nursing. However, assisted living is often the most versatile and popular choice for older adults.
Assisted living offers around-the-clock caregiver oversight and assistance in a community that promotes wellness and enhances independence.
But of course, there is so much more to assisted living communities than the additional support residents receive. Residents in an assisted living community enjoy a maintenance-free lifestyle with access to amenities that include a robust dining program, engaging events and excursions, regular housekeeping services, access to community transportation, and on-site features like a salon, theater, library, and other gathering spaces.
Assisted living is all about enhancing independence by supporting residents when they need it. Residents make their own decisions about everything from what to order on the community menu to what events they will or won’t participate in. Residents have autonomy over their home, entertaining guests and visitors throughout the day and even overnight if they would like. Residents enjoy controlling their finances, religious preferences, and family involvement.
Many communities allow residents to bring along pets, as well as to consume alcohol or use tobacco in designated areas.
Benefits of Assisted Living
Assisted living is a popular senior living option because it is effective. Residents and family members see the benefits of assisted living daily. Though not all residents come to assisted living for the same reasons, most of them end up staying because of the service, the support, and the opportunities available within a few steps of their apartment door.
The benefits of assisted living include:
- Personalized assistance and support, which can help to reduce the risk of falling
- Planned activities, events, and trips that are all designed to enhance whole-person wellness and give residents the chance to connect with neighbors
- Better and more consistent socialization; recent research from the Centers for Disease Control and other sources has found that isolated and lonely seniors are more likely to experience negative health consequences ranging from dementia to heart disease to premature death
- Peace of mind that comes with knowing someone is always available to assist in case of emergency
- Easy access to health and wellness resources, including many on-site visits from local medical professionals
- Concierge services to assist with answering questions or offering friendly assistance
- Use of amenities such as theaters, libraries, walking paths, on-site salons, and more
What Does Assisted Living Provide?
Assisted living communities provide luxury amenities and supportive services designed to enhance wellness for the residents who live there. Caregivers are there around the clock to provide personalized assistance as well, giving residents a friendly helping hand with tasks ranging from showering to housekeeping. Nurses are also there to develop and oversee personalized care plans, ensuring residents receive the types of support they need to stay as healthy as possible.
In short, assisted living is the ideal solution for many seniors who might feel lonely or unsafe at home or who are simply looking to say goodbye to household chores.
Residents in assisted living communities can enjoy:
- Personalized care plans, developed by the clinical team with resident and family input
- Personalized support and assistance with activities of daily living, such as dressing, bathing, medication management, and grooming
- Caregivers available around the clock to offer verbal reminders or hands-on assistance with tasks and to support residents in emergencies or times of crisis
- Luxury amenities and a maintenance-free lifestyle, including services such as transportation, housekeeping, and laundry
Activities of Daily Living
Activities of daily living (ADLs) are the tasks or skills someone needs to independently care for themselves. For example, basic ADLs include dressing, grooming, bathing, eating, and moving around. These ADLs are often used to evaluate a person’s functional status. If a resident needs significant hands-on assistance for more than one ADL, they could require a higher level of care at their assisted living community.
Residents often require different types of support or assistance to complete ADLs well. Assistance could include:
- Offering verbal cues or reminders
- Setting up tasks, such as a caregiver putting a toothbrush and toothpaste on the bathroom sink for the resident to take it from there
- Providing hands-on assistance, such as buttoning a shirt for the resident
Instrumental Activities of Daily Living
Instrumental activities of daily living (IADLs) are tasks or chores people do daily to care for themself or their home. These tasks are not as self-care-focused as ADLs, and they typically require more planning, judgment, critical thinking, or other cognitive skills. Examples could include tidying up the home, planning meals, and managing medications.
Residents in assisted living communities receive support with IADLs in many ways, including but not limited to the following:
- Medication management services can decrease the risk of medication errors.
- Residents can take advantage of transportation services when they need to run errands or visit their physician.
- Meals are prepared by chefs and served three times daily in the dining room, providing nutritional support and eliminating the need for residents to grocery shop or prepare meals for themselves.
- Housekeeping and laundry services give residents the chance to use their time and energy for other opportunities around campus.
- Maintenance services allow residents to not worry about details such as changing light bulbs or hanging new art pieces.
- Assisted living nurses communicate with physicians and other clinical team members to advocate for residents, look out for their best interests, and follow up appropriately as needed.
What Assisted Living Doesn’t Provide
Assisted living provides around-the-clock support from trained caregivers. However, it does not provide skilled nursing interventions. Seniors with more complex medical needs might need to seek short- or long-term care in a skilled nursing facility.
Assisted living communities do not provide skilled nursing interventions such as:
- Complex wound care
- IV therapy
- Catheter care
- Short-term rehabilitation
- Care designed for adults living with developmental disabilities
Further, though assisted living communities often offer physical therapy, occupational therapy, and speech therapy services on-site, these services are considered “outpatient” or “in-home.” In contrast, therapy services received in a skilled nursing setting are considered inpatient.
What Do Assisted Living Communities Include?
Assisted living residents enjoy living in an apartment or cottage home of their own within a vibrant community. Friendly neighbors are often right down the hall or a few floors below. Most assisted living communities are rooted in hospitality and luxury, so residents receive outstanding service and attention similar to what they might expect at a five-star hotel.
Assisted living communities are found almost everywhere across the country, from small rural towns to large cities. Most are tucked into neighborhoods and become a part of their greater community.
Who Can Live in an Assisted Living Community?
Older adults who could benefit from clinical oversight and caregiver support are an excellent match for assisted living. These seniors find peace of mind knowing someone is nearby to respond in case of an emergency and to offer them a helping hand with activities of daily living they may struggle with.
Most assisted living residents need some type of assistance but do not require constant supervision or complex medical care. They may live with chronic pain or a medical condition that causes a slight decline in their overall independence, but they are still quite independent and want to be a part of a social community.
How To Find a Good Assisted Living Community
Finding an assisted living community you or your loved one will enjoy for years to come can seem overwhelming at first. However, doing a little bit of research online and then asking the right questions during community tours can help make your decision easier.
Start with location.
As with any real estate purchase, location matters. You’ll want to find an assisted living community that is in a favorite neighborhood or city, is convenient for family members to swing by and visit, and is near local shopping, dining, and other essential businesses.
Ask about short- and long-term needs.
You or your loved one might be living with a diagnosis that will cause decreased mobility or abilities in the long term. Be sure you address this with the communities you are looking at. How much care and support (likely at an additional cost) can those communities offer?
Talk about care and support.
Ask if the community you are looking at has a philosophy of care or a mission statement about the community culture. See if it aligns with your preferences and values.
Tour and observe.
Once you are in the community on a tour, you can get a good feel for the community’s culture. You’ll meet with key staff members, look at available floor plans, and have the chance to see how residents go about their days and how they interact with one another.
During your tour, you can ask to see a menu and events calendar. Sometimes, you can even schedule a time to join in a meal or event, which is a great way to get a glimpse into what life is like there. Observe residents and the environment while you are there to see if everyone seems healthy, happy, and well cared for.
A tour is also a great time to inquire about staff training and ongoing education. You can also ask to review state licensing reports.
Types of Assisted Living Communities
Assisted living communities can be standalone buildings where everyone is an assisted living resident, or they can exist as a part of a continuum of care on a campus. For example, it is common to have an assisted living community on the same campus as a memory care neighborhood. Sometimes, assisted living communities can be a part of a “life plan community,” where there are multiple lifestyle options available on one large campus.
The Difference Between Assisted Living and Other Senior Care Options
Assisted living is one of the most flexible and diverse parts of the senior living continuum of care, serving residents for many years. Other types of senior living options include:
- Independent living
- Supportive living
- Memory care
- Personal care
- Home care
- Nursing homes
Independent Living vs. Assisted Living
Independent living communities are for the active adult who wants a maintenance-free retirement lifestyle with opportunities for more socialization. Independent living communities feature luxury amenities and services but do not have around-the-clock caregivers or provide access to nursing services.
Assisted living communities often share amenities and services with independent living communities, but they come with the bonus of added caregiver support.
Assisted Living vs. Supportive Living
Assisted living offers similar services to supportive living, but supportive living communities typically take Medicaid payments and often do not offer the same luxury amenities and services that assisted living communities do.
Assisted Living vs. Memory Care
Memory care communities, sometimes called dementia care communities, are specialized versions of assisted living made specifically to support those living with Alzheimer’s disease or another type of dementia. These communities share similar hallmarks to assisted living, such as around-the-clock caregiver assistance, but all interventions and environments are designed to support those living with cognitive decline.
Personal Care vs. Assisted Living
Personal care is a designation offered to senior living communities in specific states. Not all states offer personal care communities. In the states that do offer personal care, assisted living and personal care are often used interchangeably, though the license requirements differ.
Personal care communities allow more skilled nursing care in the community.
Assisted Living vs. Home Care
Seniors have the option of staying at home instead of moving to a senior living apartment. Home care agencies can provide visiting caregivers who come to the home during scheduled times to assist with personal care tasks or household chores such as grocery shopping, meal preparation, or light housekeeping. However, these scheduled visits are often billed hourly and can get quite expensive quickly, especially if the senior needs 12- to 24-hour care.
Assisted Living vs. Nursing Home
Skilled nursing facilities, sometimes referred to as SNFs or nursing homes, are more clinical environments. Most similar to a hospital, these communities offer care for complex conditions, chronic pain, or intense rehabilitation or recovery.
Assisted living communities feel more like home than a hospital. These communities feature caregiver support and personalized assistance with activities of daily living but do not provide complex skilled nursing tasks.
When Is It Time for Assisted Living?
It is never too early to begin looking at assisted living communities. Unfortunately, many seniors and their family members wait until a health crisis or emergency forces their hand. The transition is more exciting and smooth when the senior has the opportunity to research and tour multiple communities before choosing one for themself. In addition, moving to assisted living sooner than later means your loved one has plenty of time to enjoy and benefit from the amenities, services, and care offered at their new home.
Not sure if it is time to start looking for assisted living? Here are a few signs that it is time to begin your search:
- A fall at home in the past three months
- Increased stress or frustration over managing their medication schedule
- Expressed feelings of loneliness
- Increased depression or anxiety
- Decreased attention to personal hygiene
- Difficulty managing chronic pain
Who qualifies for assisted living?
Residents who need support or assistance with at least one ADL are typically ideal candidates for assisted living. However, residents in assisted living communities are quite diverse, coming to the community with different preferences, abilities, and challenges.
Before moving into an assisted living community, a representative from the community typically will assess the resident. This is the first step to getting to know the resident and beginning a relationship. The assessment might include looking at:
- How the senior performs their ADLs and what they need assistance with
- How the senior manages their medication schedule
- The senior’s vision and hearing
- The senior’s cognitive health
- The senior’s overall health, including a medical history summary
Can admission to assisted living be denied?
Sometimes, assisted living services might not be right for a senior. During the assessment process, the team might see that the needs of a senior are simply too high for the assisted living staff to meet or that there are significant cognitive health concerns that could make living in an assisted living community unsafe.
Seniors who might not be a good fit for assisted living include:
- Bedridden seniors
- Seniors who have cognitive decline concerns, including safety worries like wandering or behavioral challenges
- Seniors who have needs that require skilled nursing oversight, such as wound care concerns, feeding tubes, IV needs, or tracheostomies
Is Assisted Living Right for My Loved One?
Assisted living communities are vibrant and busy places full of friendly caregivers and neighbors. Of course, no senior living community is a one-size-fits-all solution. There are plenty of factors to consider when looking at assisted living for your loved one.
Who should consider assisted living?
Assisted living can be an ideal match for a senior who could use the peace of mind that comes with knowing a caregiver is always around to help out. Seniors who could benefit from personalized assistance or support, as well as seniors who could use additional socialization opportunities in their day, are often quite successful in assisted living communities.
Who should consider other options?
Assisted living might not be right for someone who is fully independent or someone who needs skilled nursing interventions. Assisted living offers an excellent “in-between” option.
How do I know what services my loved one needs?
You can determine if assisted living could be best for your loved one by considering these questions:
- Are they lonely or do they wish there were more people around to connect with each day?
- Could they benefit from assistance with some activities of daily living?
- Could rightsizing their living space be a relief?
- Could they benefit from maintenance-free living?
- Are they worried about emergencies and having to deal with those alone?
What Should I Look For in an Assisted Living Community?
Finding the assisted living community that you and your loved one will feel most comfortable in takes some time and effort. You can begin by searching for licensed assisted living communities in your desired location and then narrowing down your choices from there based on your specific needs, preferences, and interests. Knowing the right questions to ask and observations to make can help you make a confident decision.
Contracts, Costs, and Finances
Finding an assisted living community that meets your financial needs and budget should be one of the first steps you take toward narrowing down your list of potential communities. Each assisted living community bills residents differently, though the most common way is to bill residents each month with a fee that covers their rent, access to amenities, and most fees. Here are a few additional questions to consider:
- How much do more advanced living options cost?
- Can a contract be terminated and if so, what is the refund policy?
- What are the community’s billing, payment, and credit policies?
- What is included in the monthly contract and monthly fee?
- What costs might be billed in addition to the monthly fee?
- How does a resident handle their finances in the community? Can a family member assist as needed?
Assisted Living Staff
Next, take a look at the team members working in the communities you are researching. Team members include caregivers, nurses, housekeeping staff, dining staff, life enrichment staff, concierge staff, and more. Each team member should have a passion for serving seniors and be trained in senior care best practices. Here are a few questions to ask while you are speaking with a potential community:
- How is your staff turnover?
- Is there a specific staff-to-resident ratio you try to maintain?
- What training opportunities do team members receive? What topics are they educated on?
- Are team members available to meet scheduled and unscheduled needs?
Assisted Living Community Design
The design and environment of the assisted living community are important factors to consider as you make your decision. Make sure you choose a community that can accommodate your loved one’s needs now and for any future changes, as well as a community that is designed to support independence as much as possible in individual homes and throughout the greater community. Here are a few questions to consider:
- Is the floor plan comfortable and easy to navigate?
- Are apartments and community spaces accessible for wheelchairs or other mobility devices?
- Are elevators readily available throughout the building?
- Is there plenty of natural light?
- Are cabinets and shelves easy to reach?
- Is the community clean, beautiful, and welcoming?
Medication and Healthcare
Assisted living offers residents support for their medication schedules and help with many other healthcare needs. Make sure you ask what type of assistance is available for medication management; some communities offer medication reminders, whereas others offer full management services. It is a good idea to inquire if there are physical and occupational therapists on-site for outpatient sessions and if there is a visiting physician who takes office visits in the community. You can also ask if there is a preferred pharmacy and how medications are delivered and reordered.
Features of Individual Units
Your loved one’s living space is an important part of their assisted living experience. Be sure you look for a community that features a variety of floor plans to meet your needs and budget and offers high-end finishes and conveniences. Look for a community with:
- A 24-hour emergency response system
- Private bathrooms
- Kitchenettes equipped with a refrigerator and sink
Residents typically bring furnishings to their apartments, but you might want to ask if communities have complimentary telephone and cable hookups and services.
How To Choose the Right Assisted Living Community
You can make a confident decision about an assisted living community by focusing on the health and safety measures offered, the quality of life available, and other features.
Health and Safety Considerations
When looking at assisted living communities, be sure to evaluate the health and safety features offered. Here are a few things you might want to review:
- Diet and nutrition — do menus offer choice, and can the community accommodate any prescribed diets or allergy restrictions?
- Home safety — is accessibility a priority, and is it easy to reach someone in case of an emergency?
- Fall prevention — are features such as low-pile carpeting and wide walking paths included?
- Transportation services — are community vehicles accessible and able to accommodate any mobility device or needs?
- Physician access — are appointments available on-site or via community transportation routes?
- Personal assistance and support — does the community include personalized care plans that outline types of assistance, resident goals, and medical care?
Quality of Life and Happiness Considerations
Assisted living communities should be places where residents thrive thanks to socialization and connection with others. During your tours, review:
- What types of events, activities, and excursions are offered in the community
- How often those events are offered
- If the events look interesting to your loved one
- If the community allows and welcomes pets
- If there are generous visiting hours, including overnight visits
- If the community regularly hosts family events
- If there are spaces where your loved one can host large groups of family members or friends
Moving Parents To Assisted Living
Once you decide which assisted living community is best, it is time to begin planning the move. This might mean starting the conversation about assisted living, but hopefully, you have already involved your loved one in the process of choosing their new home. If so, at this stage, you can focus on building their confidence and validating their emotions as they prepare for the transition.
How to Talk to Parents About Assisted Living
Ideally, you should begin speaking to your loved one about assisted living before you even start researching communities. They need to be actively involved in the process so that they can advocate for their own needs and preferences. Having them involved is empowering and can help to ease the transition once the time comes.
Remember that your loved one might become defensive or upset if you bring up assisted living options. It’s OK. You can validate those feelings and continue to engage them in the conversation over time. You likely won’t bring up assisted living just once. You’ll need to bring it up more than once as you continue the discussion over days, weeks, or months.
Beginning the conversation before a medical crisis or emergency room visit is ideal. This way, your loved one has time to help you research communities and begin the transition on their own time and not in a stressful hospital discharge situation.
Transition To Assisted Living
The transition to assisted living begins long before moving day. Take time to assist your loved one as they plan for what furniture to bring, what art to hang on the walls, and what else to bring to make the space feel like home. Work with the assisted living community to get a floor plan and dimensions of the new home so your loved one knows how much space they are working with.
Ahead of moving day, consider working with an experienced senior moving company to make the transition seamless. You’ll be able to spend time on moving day with your loved one as they get to know their new home, new community, and new neighbors. Team members will be stopping in to say hello and get to know your loved one as well. The first few days in a new community are busy, but soon your loved one will be more confident as they get to know their new home.
How Much Does Assisted Living Cost?
Assisted living communities typically charge a monthly fee to residents who live there. The monthly fee includes more than just a spacious apartment. It also covers all utilities, three meals per day (plus snacks), housekeeping services, laundry services, transportation services, and care.
Similar to real estate, assisted living monthly fee rates vary from location to location. However, Genworth reports that the national average for assisted living is about $4,500 per month. This number might seem large at first glance, but most seniors and their family members are pleasantly surprised to learn that it is quite affordable when they compare it to their monthly costs of living at home alone.
How To Pay For Assisted Living
When it comes to finding the right senior living option for yourself or your loved one, knowing how much it costs is an important part of the process. You need to be sure that the fees associated with the lifestyle option match your budget and financial plans. If you are searching for assisted living, it’s important to do your research so that you understand how fees can be allocated to residents, as well as what factors could affect the fees from community to community.
As you review assisted living with your financial planner, it is imperative that you not only review your loved one’s retirement funds and plan but also consider different ways to potentially offset the monthly fees for assisted living. It’s also important to realize that planning for additional care in the future is wise, especially if your loved one currently lives with chronic pain or conditions that could create the need for additional assistance down the road.
Assisted Living Financing
Not all assisted living fees need to be paid out of pocket. There are some ways to offset costs. The more you know about what type of assistance is out there — and what type of assistance does not apply — the better you can plan for your loved one’s future in an assisted living community.
For example, you can find some financial assistance, if eligible, through:
- Signing up for long-term care insurance
- Selling life insurance policies for a lump sum
- Using the equity of your loved one’s home by selling, renting, or applying for a reverse mortgage
- Securing a private mortgage or loan from a bank or private lender
- Taking out short-term loans to assist with bridging the payment between moving to assisted living and selling a home
- Taking advantage of Veteran Affairs (VA) benefits
Does Medicare or Medicaid Pay For Assisted Living?
Medicare is the primary healthcare insurance for the majority of American seniors. However, it is important to note that Medicare does not cover assisted living options, including memory care communities that operate under an assisted living license.
Medicare is typically associated with covering skilled nursing facility fees but only after a qualifying stay at the hospital. With that qualifying stay, Medicare will pay 100 percent of skilled nursing fees for the first 20 days and then 80 percent for days 21-100. There are 100 days available annually, and they do not have to be used consecutively.
For eligible seniors, Medicaid can be used to offset the cost of some assisted living services. However, the assisted living community must accept Medicaid as a form of payment, and not all communities do. Be sure to inquire if the communities you are looking at accept Medicaid payments if your loved one is eligible.
What Medicaid Does Cover in Assisted Living
Medicaid often pays for assisted living services via home and community-based services (HCBS) waivers. However, not all 50 states offer financial assistance to Medicaid-eligible residents for assisted living, non-nursing home, residential care.
If your loved one is eligible for Medicaid and an HCBS waiver, and if the assisted living community takes Medicaid payment, you might be able to pay a lower monthly fee with Medicaid covering the remaining amount.
Ready To Find the Right Community for You?
Assisted living communities are wonderful options for seniors who could benefit from additional support and socialization. Learn more about how to find a community by downloading our resource “Finding a Safe and Comfortable Senior Living Community.”