For many older adults, advancing in age means they’ll face a time when living alone is no longer feasible. Certain aspects of daily living become more challenging, and if you find that you often need assistance to do things like caring for your home and yourself, it might be time to consider moving into a senior assisted living facility.
But what does that mean, and what can you expect? Here, we explore the basics of what you need to know about assisted living facilities, and how they can help support older adults with difficult tasks while offering the social contact and activities that stimulate and support them.
What Is Assisted Living?
Depending on the state and the individual facility, the definition of assisted living can mean different things, and it may go by other names such as residential care settings or personal care homes.
“The definition of assisted living can mean many things in the housing world,” says Roxanne Sorensen, owner of Elder Care Solutions of WNY in Buffalo, New York, a case management consultancy.
“By and large, the concept of assisted living is simply that: Older adults move to a facility where they can receive assistance with the daily tasks of living,” she says. Sorensen is also an aging life care specialist, which is “a health and human services specialist who helps families who are caring for older relatives,” according to the Aging Life Care Association (formerly the National Association of Professional Geriatric Care Managers).
Whatever the assisted living definition is in your region, these facilities can be large or small, privately owned or corporate or not-for-profit or for-profit. But they all offer some level of care or assistance to older adults who are unable to manage the tasks of living on their own, such as cooking, bathing or using the restroom independently.
Unlike senior home care, this is provided in a new living facility, not the home they already live in. It’s important to keep in mind that most assisted living facilities don’t consist of apartments, but rather are one room or a shared room, Sorensen says.
Some family members are disappointed when they learn their loved one has to share a room and worry it will not work out. “But nine out of 10 times, it does,” Sorensen says.
[See: 10 Superfoods for Older Adults.]
What Is an Assisted Living Facility?
There are many different types of long-term senior care facilities out there, and it can get confusing to sort out which is the best one for you and how they differ. One thing that’s certain, assisted living facilities are not nursing homes, which are also sometimes called skilled nursing facilities.
Basically, assisted living is for people who can live independently, but need assistance with some of the tasks of daily living, such as cooking and cleaning.
On the other hand, nursing homes provide a greater level of care, such as help for those who need assistance in getting dressed or using the restroom. A nursing home setting might be best for someone who needs frequent or daily medical care, or who can’t move around as well as they once could.
Care Services and Amenities Provided in an Assisted Living Facility
An assisted living home can provide a wide array of services, Sorensen says.
Services at an assisted living facility can include:
— Individual service plans supported by licensed staff on a 24-hour basis. An individual service plan is a document that contains each resident’s goals, based on his or her personal preferences, behavioral and health history. It will typically list the activities of daily living, such as bathing, dressing, toileting and ambulation, Sorensen says. This plan will help assisted living staff to provide services and arrange activities suited toward the resident’s goals and needs.
— Resident dining serving three meals daily.
— Medication management.
— Weekly housekeeping, laundry and linen services.
— Emergency 24/7 call system with on-site nurse response.
— Diverse social, spiritual, recreational and educational programs.
— On-site pharmacy.
— Transportation.
There are different levels of care offered in assisted living, which means that when it comes time to find an assisted living facility for yourself or a loved one, you need to do some homework to find the facility that will best serve your needs.
A nursing home may be a better option for individuals who have serious health conditions, such as someone with dementia, an individual who isn’t ambulatory or a person who has suffered a serious stroke.
Most nursing home residents “have ongoing physical or mental conditions that require constant care and supervision,” according to the National Institute on Aging. You can check the websites of assisted living communities and contact them to ask about visits.
What’s an Assisted Living Community Like?
Assisted living communities can help remove or reduce the anxiety associated with having a loved one who needs more care than relatives can provide. “Assisted living can relieve some of the stress around an older adult living independently,” says Dr. Tanya Gure, section chief of geriatrics and associate clinical professor in internal medicine at the Ohio State University Wexner Medical Center.
Particularly for families where children live far away from their aging parents, having the option of moving a loved one into an assisted living facility can lessen the burden and worry for the family, and take pressure off other caregivers.
“Assisted living is part of the continuum of senior living options and is best suited for older adults who do not require complex medical care but would benefit from the support provided in a communal living environment,” says Brian Doherty, president and CEO of the Massachusetts Assisted Living Association.“Assisted living residences are highly flexible and supportive communities that offer staff support for activities of daily living.”
Where to Find an Assisted Living Community
There are about 28,900 assisted living communities in the U.S., according to the American Health Care Association/National Center for Assisted Living. Those communities provide nearly 1 million licensed beds. The average size of an assisted living center is 33 licensed beds, according to AHCA/NCAL.
Each state has its own regulatory agency that handles licensing of these facilities. More assisted living communities are located in the West and the South — popular parts of the country for many retirees to move to.
NCAL data show the following geographical distribution of assisted living facilities:
— 40.8% West.
— 28% South.
— 22.6% Midwest.
— 8.6% Northeast.
Overall, 56% of assisted living facilities are chain-affiliated, according to NCAL. That means they are comprised of two or more communities. The other 42% of assisted living communities are independently-owned. While you can look up starred ratings for nursing homes on Medicare.gov, there’s no similar rating system for assisted living facilities, Sorensen says.
She suggests checking with state health departments. For example, in New York state, assisted living facilities are regulated by the Department of Health, Sorensen says. The department audits and surveys assisted living facilities to ensure they are adhering to state rules and regulations.
[Read: 24 Gift Ideas for Nursing Home Residents.]
How to Find an Assisted Living Community in Your Region
Location is important when it comes to finding an assisted living facility. Considerations include proximity to family and whether the resident wants or needs to move to a different state. He or she may want to move to be closer to an adult child or grandchildren, says Christine L. Podles, the chief operating officer for Ingleside, the umbrella organization for three not-for-profit life plan communities in the metropolitan Washington, D.C. area.
It’s a good idea to start looking for an assisted living community and to engage with staff and residents well before moving day. Even with COVID-19 restrictions, you should be able to arrange virtual visits. When it comes to location, consider whether the person wants or needs to move to a different town or state.
Podles notes that there are different options within assisted living, and the programs available should meet the needs of the individual. While not all assisted living facilities or life plan community offer memory care, it is an option to explore depending on the needs of your loved one, she says.
“In memory care assisted living, the program may include music therapy, poetry writing, art, movement, and recreational therapy, with staff trained in the best practices in dementia care,” says Podles.
How Much Does Assisted Living Cost?
The issue of assisted living cost is a major hurdle for many families, Sorensen says. Each state is different in how it administers assisted living facilities, and cost ranges can differ significantly from region to region.
In addition, depending on the level of care that’s needed and the specific services being purchased, the monthly cost of entering an assisted living facility can vary wildly, with $4,500 to $6,500 monthly being a common range.
A 2020 survey from Genworth financial found that the median annual cost for an assisted living community in the U.S. was $51,600 annually, up from $48,612 a year. It can be hard to predict how long you’ll need to live in such a facility, so you’ll need to budget your retirement savings carefully.
One factor to consider is whether the person can financially afford to stay in assisted living over the long term, Sorensen says. “Most assisted livings are private pay and when the funds run out, they are asked to leave,” she says. “Families should ask if there is a reduced rate or if Medicaid is accepted. If you have a limited budget, then a sole private pay facility is not for that person.”
Does Medicare or Medicaid Pay for Assisted Living?
Medicare and most private insurers don’t cover the cost of assisted living, though you may be able to find some long-term care insurance plans that will cover some of the cost of these facilities.
In some cases, Medicare, which is a national, government-funded health insurance program for adults over the age of 65, might cover the cost of certain health care expenses incurred while you’re living in an assisted living facility, such as wound care administered by a registered nurse or a doctor, but it does not cover the cost of the assisted living facility itself.
Medicaid is a federal program funded by states and the federal government. It’s administered by states and covers nearly 77 million people in the U.S., including:
— Low-income adults.
— Children.
— Pregnant women.
— Elderly adults.
— People with disabilities.
A limited number of assisted living facilities in each region participates in the Medicaid program, Sorensen says. Each state determines a set amount of assisted living beds that can participate in the program.
“The person has to apply for Medicaid, meet the income and asset limits and also qualify medically,” she says. “We need more Medicaid beds as people are outliving their monies.”
Bottom line: Assisted living facilities can be expensive, and you’ll need to figure out how to finance the cost of assisted living over a potentially multi-year stay.
Are There Veterans’ Benefits for Assisted Living?
If you’re a veteran, you may be eligible for a wide array of benefits through the Veterans Administration.
According to the U.S. Department of Veterans Affairs, benefits the VA provides for sick or disabled vets include:
— Around-the-clock nursing and medical care.
— Help with daily tasks, like bathing, dressing, taking meds and preparing meals.
— Comfort care with assistance managing pain.
— Support for caregivers who may need skilled help or to take a break.
Care settings can include:
— Nursing homes.
— Private homes where a caregiver supports a small group of individuals.
— Adult day health centers.
— Veterans’ own homes.
To be eligible for these services, you must be signed up for VA health care. You can access these services if VA officials determine you need a specific service to help you with your ongoing treatment and personal care, and if the service, or space in a care setting, is available near you.
You may need to pay a copay for some covered services. To learn how to access these services, contact your VA social worker or call the toll-free hotline at 877-222-8387. You can also visit the geriatrics section of VA.gov.
[SEE: 11 Red Flags to Look for When Choosing a Nursing Home.]
What You Should Know About a Facility’s COVID-19 Policies
Whether it’s a stand-alone assisted living facility or assisted living residences at a life plan community, it is important that they adhere to COVID-19 guidelines from the Centers for Disease Control and Prevention, Centers for Medicare & Medicaid Services and local health departments, Podles says.
Equally as important is the communication between the community, its residents and their loved ones. “Ask how and when updates are being shared,” she says. “At our communities we set up dedicated hotlines for our residents and their families to answer any questions they may have regarding COVID-19 procedures and policies.”
Since vaccines are available, check on the percentage of residents and staff who have been vaccinated. “Ask if they are able to offer the vaccine onsite for both staff and residents,” she says.
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What Is Assisted Living? originally appeared on usnews.com
Update 02/02/22: This story was previously published at an earlier date and has been updated with new information.
