“Independent living” and “living independently” sound similar but actually have different meanings for older adults. Living independently simply entails continuing on as always in your own home, whereas independent living represents a choice within the range of senior living communities.
If you’re considering a move to independent living for the amenities, convenience and sense of togetherness it offers, experts in geriatric care and senior life describe what that entails and where it fits among senior living community options.
Senior Living Levels
“Senior living is kind of an umbrella, more of an overarching term that incorporates the aspects of independent living, assisted living and memory care primarily,” says Kevin Bowman, executive vice president of community operations at Brookdale Senior Living, the largest senior living provider in the U.S.
Traditional nursing home facilities tend to fall outside the senior community realm. “Sometimes we think of skilled nursing as a bit separate, as some senior living providers don’t provide skilled nursing services,” says Bowman.
Here are basic categories of senior residence types, with some overlap among them:
— Independent living. For active older adults with little to no need for personal care or assistance, independent living settings such as apartments or villas offer meals, services, activities and social gathering sites that promote ease, convenience and a sense of community for residents. There may be an onsite or on-call health care provider available.
— Assisted living. For older adults with health or mobility issues requiring more support, assisted living residences offer services such as medication management and assistance with personal activities such as toileting, grooming and dressing. Services typically include meals, housekeeping, laundry and transportation. Activities that foster mental and physical stimulation and social engagement are a major focus in assisted living.
— Group homes. Also known as adult family homes, these relatively small residences are located in regular neighborhoods, where licensed caregivers provide meals and assistance with personal activities like hygiene and dressing for about six to 10 older adults, frequently with some level of cognitive impairment. Often, these are single-level homes to make mobility easier and avoid fall risks from stairs.
— Memory care. Memory care may be necessary for older adults with cognitive impairment or dementia. Safety and security are a paramount concern in memory care residences. Staff or team members undergo additional training and development to work with these residents and provide tailored activities and programs to connect with them wherever they are cognitively and emotionally day to day.
— Continuing care retirement community. Also known as life plan communities, CCRCs represent a specific product line encompassing a spectrum of residence and care levels that can range from independent living through assisted living, memory care and skilled nursing facilities. CCRCs represent a significant financial investment, typically requiring an upfront membership fee known as a buy-in.
Senior Living Community vs. Independent Living
Senior living community is a loose term for residential arrangements where older adults age in place among peers. Independent living facilities could be a standalone apartment building, or part of a larger community. Similarly, assisted living may be a standalone facility, as well. They both fall on the senior-living continuum.
How does independent living differ from a senior living community? “We get asked that a lot,” says Dr. Ardeshir Hashmi, section chief at Cleveland Clinic’s Center for Geriatric Medicine. “A senior living community has many dimensions to it. It has a whole spectrum of services. It may include, in fact, independent living.”
On the other hand, “Independent living is exactly as the name suggests,” Hashmi says. “You have a living domain, living quarters. But it doesn’t help with what we call activities of daily living.”
Being able to manage your personal care, but also instrumental activities of daily living — managing your medications and finances, being able to drive, cook and grocery shop, making phone calls on your own — is a threshold for independent living, Hashmi explains.
“If you’re at that level where you’re pretty independent with all those things, yes, independent living can basically be your home,” Hashmi says. “You’re not going to get help with any of those things if you don’t need that at this point.”
“Independent living is a type of housing,” says Sandy Markwood, the CEO of USAging. “They may be apartments, they may be villas or they may be small cottages — it’s basically moving into a community where it makes your life easier.” You don’t have to mow the lawn, housekeeping services are available and you may feel less isolated than when living entirely on your own.
Why Choose Independent Living?
“You have an extra level of security,” Markwood adds. “Usually, there are a lot of social activities. In addition to that, you may be provided one meal a day, or at least there’s a restaurant or meals on the campus. It’s a much more designed type of living situation.”
People may move locally to an independent living residence. “They want to downsize,” Bowman says. “They don’t want to live in that 3,000-square-foot home where they raised their family and children. For them, it’s an option to be able to have an independent living community in their neighborhood.”
For self-sufficient older adults who still crave social connection, independent living can epitomize the best of both worlds.
“It’s a congregate-living setting where the residents or members have little or no need for care services or care reminders,” Bowman says. “Many of our residents in independent living communities still have jobs, are still driving, playing golf and living very active and robust lives.”
Programs, activities and amenities offered in independent living settings — which may include full-scale restaurants or meal services — make life easier and fuller for some residents. “They’re living there for convenience’s sake,” Bowman says. “Maybe they don’t want to cook. So they’re having meals provided and they have that sense of belonging to a larger community.”
With all these services, might younger adults be attracted to independent living residences? There’s no age minimum, Bowman says, but his organization caters to a certain demographic. “We do typically serve older people and that’s where we want to focus our efforts,” he says. “Our population is generally residents at least 65 to 105,” and some residents may be 105-plus.
Independence With a Little Help
“Living independently implies that you’re living in your own home,” says Nancy Avitabile, owner of Urban Eldercare, a geriatric care management practice in New York City. “Independent living implies that you’re in a residential setting but not receiving care. However, some independent living residential settings will allow people to age in place,” adds Avitabile, who is past president of the Aging Life Care Association.
“One of the primary things about independent living, at least in our area, is essentially: You’re living in a community,” Avitabile tells families looking into options. “It’s basically like having an apartment with your meal plan, and some amenities, the recreational services and all the stimulating programs.”
For residents dealing with health conditions, “There’s medical care in the building, but none of it is mandatory,” Avitabile says. “That makes it different from assisted living. And you have more control, ultimately, if your independent living facility allows you to age in place, then ultimately you can bring in your own caregivers. You can decide on how you want to do your med management and so forth.”
Getting just enough extra care is possible, despite the emphasis on independence. “Generally, a resident can contract out,” Bowman says. “Quite often, our independent living residents will have companions that live with them in their homes, who come and stay with them for a period of time in their independent living apartment. We try to make that as seamless as possible, to help people with that transition.”
Aging-in-place safety features like bathroom handrails may already be built in or can be added. “That’s something we’re able to provide for independent living residents, anytime someone asks: Can you make my apartment more accessible or easier to work in?” Bowman says. “Absolutely — we are really good at accommodating those requests.”
If you want a wider array of choices and care levels, “senior living is all of the above,” Avitabile says. “That could be assisted living, memory care, independent living and sometimes there could even be a nursing home on the same property, (although) typically not within the same building.”
Transitioning to Assisted Living
If your abilities change and you start needing help with these essential activities, then the possibility of assisted living may arise, Hashmi notes. “The senior living community will have that as an option,” he says. “So you’ll have the full spectrum. Portions of that will be independent living when you’re completely independent and there will also be a portion where services are provided with some of these things.”
If your level of care needs keeps going up, such as help with basic personal needs like grooming and toileting, “even the assisted living portion may be a little bit of a stretch,” Hashmi says. If so, he says, nursing home type of care may be more appropriate.
“A senior living community may or may not have that level of care,” Hashmi says. “So they may at that point ask you to transition. However, what they may have is a memory unit. It’s a super-specialized assisted living facility. You’re still getting assistance, but you’re getting assistance with things like safety; making sure you’re not wandering.”
Depending on their scope, some senior living providers offer increasing levels of care in a single location. Senior living communities can be sprawling properties complete with shuttle transportation. For instance, Avitabile says, a married couple might have one member still in independent housing who can visit their spouse in the skilled nursing facility on the same campus.
Independent Living Costs
Cost of senior independent living includes the residence itself along with services and amenities such as dining programs, cleaning, home and grounds maintenance, laundry, fitness centers, game rooms, movie theaters, educational and cultural offerings and transportation to community activities.
Independent living costs are about 30% to 50% less than assisted living costs in a given area. Monthly costs range from $1,800 (Missouri) to $4,014 (Delaware), according to calculations from AssistedLiving.org, based on Genworth Financial’s reported assisted living costs for 2021. (Genworth is an insurance company that focuses on financial issues of aging, such as long-term care insurance.)
Cost of senior living communities in general varies by residence type — independent living, group home, assisted living, memory care — as well as their scope, care levels and housing costs in the surrounding area.
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What’s the Difference Between a Senior Living Community and Independent Living? originally appeared on usnews.com