For many older adults, advancing in age means facing a time when living alone is no longer feasible. Certain aspects of daily living become more challenging, and you may find that you need assistance to do things like caring for your home and yourself.
But what does assisted living mean and what can you expect? There are many types of senior care facilities available, and navigating the differences between them can be challenging in the wake of health complications. Here, we explore the basics of what you need to know about assisted living, including how these facilities can support older adults with difficult tasks while offering social contact and stimulating activities.
What Is Assisted Living?
Assisted living, also known as a residential care setting or a personal care home, is dynamic — both in terms of what it can offer and what the term “assisted living” actually means.
“The definition of assisted living can mean many things in the housing world,” explains Roxanne Sorensen, an aging life care specialist and owner of Elder Care Solutions of WNY, a case management consultancy in Buffalo, New York. “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.”
Assisted living facilities can be large or small, privately owned, corporate, not-for-profit or for-profit. They can also differ by state and by the individual’s need level. Whatever the assisted living definition is in your region, these facilities all offer some level of care or support to older adults who are unable to manage cooking, bathing or getting dressed independently, among other activities.
As a whole, these facilities emphasize aging with dignity and choice, adds Brian Doherty, president and CEO of the Massachusetts Assisted Living Association. “Continually evolving to meet the needs of today’s seniors, assisted living residences also offer activities, meals, health and wellness programs, social connections and a vibrant community — all within steps of your front door.”
Unlike senior home care, assisted living is provided in a new living facility, not the home a senior already lives in. It’s important to keep in mind that most assisted living facilities don’t consist of apartments; rather, residents live in 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 adds.
[SEE: The Advantages of Assisted Living.]
How Does Assisted Living Differ From Nursing Homes?
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 (more on that below).
Basically, assisted living is for people who can live independently but need help with cooking, cleaning and other routine activities. Assisted living does offer help for individuals who need help getting dressed or using the restroom, but these seniors usually only require minimal assistance or may not need help every time.
Nursing homes, on the other hand, provide a greater level of care and may be better suited for:
— Those who have serious health conditions, such as dementia.
— Individuals who aren’t ambulatory.
— People who have suffered a serious stroke.
— Seniors who are completely dependent on assistance for activities of daily living.
Most nursing home residents “have ongoing physical or mental conditions that require constant care and supervision,” according to the National Institute on Aging. Residents may require multiple staff to help them or require a lift system, and they may be bedbound.
A nursing home setting might also be best for someone who needs frequent or daily medical care or who can’t move around as well as they once could.
[Read: 24 Gift Ideas for Nursing Home Residents.]
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 that are supported by licensed staff on a 24-hour basis. An individual service plan is a document that contains each resident’s goals, based on their personal preferences and their behavioral and health history. It will typically list the activities of daily living, such as bathing, dressing, toileting and ambulation, Sorensen says. This plan helps assisted living staff provide services and arrange activities suited to the resident’s aims 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.
You can check the websites of assisted living communities and contact them to ask about visits.
[READ: How Long Does It Take to Get Into Assisted Living.]
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,” explains Dr. Tanya Gure, section chief of geriatrics and associate clinical professor in internal medicine at the Ohio State University Wexner Medical Center in Columbus.
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.
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, and 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, the NACL notes. While Medicare.gov offers starred ratings for nursing homes, they don’t have a similar rating system for assisted living facilities, Sorensen says.
Sorensen suggests checking with state health departments. For example, in New York state, assisted living facilities are regulated by the Department of Health, she says. The department audits and surveys assisted living facilities to ensure they are adhering to state rules and regulations. U.S. News also rates senior living facilities based on customer satisfaction survey data.
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. Residents 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. 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, such as memory care, and the programs available should meet the needs of the individual.
“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,” Podles says.
How Much Does Assisted Living Cost?
The issue of assisted living costs 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 2021 survey from Genworth Financial found that the median annual cost for an assisted living community in the U.S. was $54,000 annually, up from $51,600 per year. They estimate that 2023 costs are around $57,289, though the official report will not finalize for a few more years. 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 a potential resident 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, (residents) are asked to leave,” she explains. “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, a national, government-funded health insurance program for adults over the age of 65, does not cover the cost of assisted living. However, it might cover the cost of certain health care expenses incurred while you’re already living in an assisted living facility, such as wound care administered by a registered nurse or a doctor.
Most private insurers also don’t cover the cost of assisted living, but you may be able to find some long-term care insurance plans that will cover some of the cost of these facilities.
Medicaid is a federal program funded by states and the federal government. It’s administered by states and covers nearly 92 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 participate 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,” Sorensen explains. “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 over a potentially multiyear 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 have 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.
What Are the Limitations to Assisted Living?
While assisted living is a great option for those who need some assistance with their activities of daily living, assisted living facilities are not a high enough level of care for many elderly individuals.
Other options may include:
— Skilled nursing facilities. Medicare often does provide short-term coverage for a skilled nursing facility admission. These facilities have licensed medical professionals on-site and offer round-the-clock medical care.
— Nursing homes. These facilities are similar to skilled nursing facilities but focus on offering support with daily activities, only without skilled nursing care. Medicare does not cover nursing homes in general, and they are sometimes referred to as “custodial care.”
To determine what level of care is right for you or your loved one, speak with a primary care doctor or a geriatric medical provider to request a functional health assessment.
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Understanding Assisted Living originally appeared on usnews.com
Update 03/09/23: This story was previously published at an earlier date and has been updated with new information.
