During the aging process, everyday tasks that were previously staples of independent living can become increasingly difficult 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 becomes an endeavor, overshadowing a once-effortless start to the day.
But what does assisted living mean, and what can you expect? Here, we explore the basics of what you need to know about assisted living, including how these communities can support older adults with daily tasks while offering social opportunities and stimulating activities.
[READ: Having the Conversation With a Loved One About Senior Living.]
What Is Assisted Living?
“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.”
These tasks, known as activities of daily living, include:
— Personal hygiene, such as bathing, grooming and dressing.
— Eating.
— Toileting.
— Moving and getting around.
— Shopping and meal prep.
— Housework.
— Life and household management.
This long-term care option can be a huge benefit to seniors who can’t live independently but who don’t need as much medical care as you’d find in a nursing home.
As a senior’s care need change, however, these communities may also offer graduated services, says Joanna Fuller-Crawford, CEO of Perfect Care Nursing, an in-home care provider offering skilled and unskilled support in and around metro Atlanta.
“Some assisted living facilities offer different levels of care as clients progress, such as memory care units or hospice,” she explains.
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.
As a whole, these communities emphasize aging with dignity and choice, says 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 notes.
[SEE: When Is It Time to Move From Independent to 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. Assisted living is a lower rung of care, and nursing homes and skilled nursing care are some of the highest (and most expensive) rungs on the ladder.
Assisted living, as mentioned, is for people who need help with cooking, cleaning, other routine activities and tasks such as getting dressed or using the restroom.
Nursing homes, on the other hand, provide a greater level of care in addition to assisted living services. They 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 require extensive assistance with activities of daily living, such as feeding.
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 these seniors 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.]
Assisted Living Services and Levels of Care
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. This plan typically outlines the services the community care team provides on a regular basis, such as assistance with 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.
— Transportation.
All assisted living facilities offer care services, which they typically structure as “levels of care.” The definitions of these levels — how much care is included within each level — vary from community to community, though regulatory bodies do govern how much care can be provided.
“Generally speaking, communities may have two to four levels of care,” says Haidy Andrawes, center administrator at Park Vista Assisted Living in Fullerton, California. “These levels are determined based on the amount of support and care needs provided to the resident by the care staff.”
Although higher levels of care can increase the monthly cost of assisted living, they “can also assist with meeting the resident’s future needs in the same setting as their care progresses throughout the continuum of care,” she notes.
Each facility has its own approach to matching residents with the ideal level of care for individual needs, which makes it difficult to generalize across such a widely variable industry.
The following three categories, though, are typical:
— Lower levels of care.
— Higher levels of care.
— Memory care.
Lower levels of care
Lower levels of care are for residents who need less assistance. These residents can walk on their own, with a cane or use a wheelchair to get to the dining room or activity sessions. Residents at this level also have no memory loss and can advocate for themselves.
They might need assistance with certain tasks, such as buttoning buttons or tying shoes when getting dressed in the morning, because arthritis in the fingers can make these dexterous movements challenging. Residents can usually manage their own hygiene, grooming and toileting.
A nursing aide or other caretaker likely assists to make sure they’re taking the right medications at the right time and monitoring any medical conditions. This level of care is less intensive for caregivers, and the resident may pay less for this type of assistance than those who need more support.
[READ: How Long Does It Take to Get Into Assisted Living.]
Higher levels of care
Seniors who need higher levels of care in assisted living may require hands-on assistance when getting around, such as an arm to guide them or an aide to push their wheelchair. They may need more one-on-one assistance in bathing, grooming, toileting and getting dressed.
They may have some memory loss or need more guidance from caregivers. Decision-making may be more difficult for them, so often a caregiver will help them manage complex tasks and take medications. A caregiver may also see to other health needs. Typically, these caregivers will have some sort of medical training, but they may not be able to offer full nursing care, like what you would receive in a nursing home.
Residents at this level may have more complex medical needs and may be at higher risk of falling or other safety concerns. This type of care requires more intensive one-on-one assistance. Some facilities may employ registered nurses for these roles. As a result, this level of care tends to be more expensive.
Memory care
Some assisted living communities also include a memory care wing or floor where people who have Alzheimer’s disease or dementia can get the focused support and assistance they need. Staff typically have a higher level of training in the specific needs of residents with memory problems.
Memory care units also offer programs designed for residents, says Christine L. Podles, chief operating officer for Ingleside, the umbrella organization for three not-for-profit life plan communities in the metropolitan Washington, D.C., area.
“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,” she explains.
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. U.S. News provides a searchable database of assisted living communities in your area (more on that below). You can also reach out to the communities for available services and amenities and to ask about tours and pricing.
What Is the Cost of Assisted Living?
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.
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.
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. As care needs increase, you could also be adding $250 to $1,500 a month on top of the base living fee, says Han Hwang, executive vice president of partner sales and success for Caring.com, an online resource for those caring for aging parents, spouses and other loved ones.
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.”
Medicaid is a joint state and federal program that provides health insurance to low-income individuals. 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.
“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.”
Keep in mind that Medicare, a federal program providing health care coverage for those over age 65, among other groups of people, does not cover the cost of assisted living. However, Medicare 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.
Medicare also doesn’t cover memory care facilities, says Gregg Ratkovic, chief business officer with eHealth, a health insurance broker and online resource provider headquartered in Santa Clara, California.
“However, Medicare will typically pay for things like cognitive assessments, home safety evaluations and hospital stays. Prescription drugs can be covered under Medicare Part D plans or Medicare Advantage plans with drug coverage.”
Other programs, such as veterans benefits, may also be available.
Benefits of Assisted Living
Assisted living communities offer an array of benefits, for both residents and their families.
The benefits for residents often include:
— Support. Communities provide assistance with daily tasks, such as light housekeeping or managing medication.
— Activities. Not only do social activities help combat loneliness and isolation, they can improve seniors’ quality of life. Depending on the facility, residents can engage in shared meals, arts and crafts, games, lectures, concerts and field trips.
— Convenience. Assisted living facilities often provide meals, as well as property maintenance and laundry services.
— Transportation. Residents can get rides to and from the grocery store and doctor appointments.
— Safety. In addition to the activities mentioned above, these communities may also offer educational courses and exercise classes designed to keep residents mentally stimulated and physically fit. Staying engaged in their health helps seniors age well, boosts their cognitive abilities and can even help prevent falls.
For families, 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.
How Do I Find Assisted Living Facilities Near Me?
We’ve rated assisted living communities in your area based on criteria including safety, caregiving, staff, food and dining, activities and more. Search for the best assisted living facilities near you.
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 39 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.
In general, assisted living communities can be large or small, privately owned, not-for-profit or for-profit. Overall, 56% of these 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.
What Are the Limitations to Assisted Living?
While assisted living is a great option for those who need some assistance with daily activities, 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 allow 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.
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What Is Assisted Living? originally appeared on usnews.com
