During the aging process, everyday tasks that were previously staples of independent living can become insurmountable for older adults.
Cooking a nutritious meal, for instance, once a source of passion and creativity, now poses a mental and physical burden to execute. Even a simple morning routine like bathing transforms into an endeavor, overshadowing a once-effortless start to the day.
Many older adults need guidance, supervision or minimal assistance to carry out their daily activities, but they are still able to move on their own and don’t have severe cognitive deficits. In these cases, assisted living is an effective choice for senior care.
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 communities can support older adults with everyday tasks while offering social interactions 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.”
Unlike senior home care, assisted living is provided in a new living residence, not the home a senior already lives in. It’s important to keep in mind that most assisted living communities 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.
Assisted living communities 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 communities 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 communities 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,” he says.
[SEE: The Advantages of Assisted Living.]
How Does Assisted Living Differ From Nursing Homes?
Understanding long-term senior care options can be perplexing, given the wide array of choices available. Think of senior care like a ladder; each rung of the ladder represents the various levels of senior care. As you climb the ladder to more comprehensive care, seniors can still access the levels of care below. But at the lower rungs, the higher levels of care are not typically available. Assisted living is a lower rung of care, and nursing home and skilled nursing care are some of the highest (and most expensive) rungs on the ladder.
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 in addition to assisted living services 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 Community
An assisted living community can provide a wide array of services, Sorensen says. These services 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.)
— 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.
With the various levels of care offered in assisted living, you will need to do some homework to find the community that will best serve your or your loved one’s needs when the time comes to find an assisted living community. You can check the websites of assisted living communities for available services and amenities and contact them to ask about tours and pricing.
[READ: How Long Does It Take to Get Into Assisted Living.]
Assisted Living Communities Can Relieve Family and Caregiver Stress
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 professor of clinical 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 community 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 30,600 assisted living communities in the U.S., according to the American Health Care Association/National Center for Assisted Living. Those communities provide 1.2 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 the licensing of these communities. 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 communities:
— 40.8% West.
— 28% South.
— 22.6% Midwest.
— 8.6% Northeast.
Overall, 56% of assisted living communities are chain-affiliated, according to NCAL. That means they comprise 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 communities, Sorensen says. She suggests checking with state health departments. For example, in New York state, assisted living communities are regulated by the Department of Health, she notes. The department audits and surveys assisted living communities 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 community. 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.
Podles also 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 employees 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 communities, 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 community can vary wildly, with $4,500 to $6,500 monthly being a common range.
A 2021 survey from Genworth Financial (the most recent data available) found that the median annual cost for an assisted living community in the U.S. is $54,000 annually, up from $51,600 the previous 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 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 community, 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 costs of these communities.
Medicaid is a joint state and federal program that covers more than 93 million people in the U.S., including:
— Low-income adults.
— Children.
— Pregnant women.
— Elderly adults.
— People with disabilities.
A limited number of assisted living communities 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 communities 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 medications 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:
— Assisted living communities.
— 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 communities may not be a high enough level of care for many elderly individuals.
Seniors often enter skilled nursing facilities or nursing homes as their next highest level of care after assisted living. Many senior care facilities have both assisted living and nursing home wings, which allows for a seamless transition should a senior’s needs increase. Nursing homes offer both skilled nursing care, like catheter management and IV medications, as well as custodial needs, such as extensive help with daily activities or personal hygiene.
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.
More from U.S. News
Decorating Tips for Assisted Living
Best Exercises for Preventing Falls in Older Adults
Top Superfoods for Older Adults to Boost Health and Longevity
Understanding Assisted Living originally appeared on usnews.com
Update 06/30/23: This story was previously published at an earlier date and has been updated with new information.
