Who Qualifies for Assisted Living: Requirements for Residents

As individuals grow older, they may reach a point where they are still leading active and independent lives but need assistance in handling some day-to-day tasks. Transitioning from independent living to an assisted living facility may be a good solution for getting the care needed while maintaining as much autonomy as possible.

An assisted living community is a type of residential care facility that provides support and assistance to those who require help with certain parts of day-to-day living but do not need the intensive medical care provided in nursing homes.

“Assisted living promotes independence, purpose and dignity for the more than 1.4 million American seniors who live in one of the more than 31,000 assisted living communities across the country,” says Paul Williams, vice president of government relations for Argentum, an assisted living trade organization in Washington, D.C.

These facilities may provide services such as:

— Assistance with personal hygiene, such as bathing or dressing.

— Continuous 24-hour on-site staffing to handle any emergencies.

— Housekeeping and home maintenance.

— Life management, such as helping to schedule appointments.

— Meal service.

— Medication management.

— Transportation to and from activities and tasks, including doctor appointments or shopping.

Beyond caring for physical needs, assisted living communities cultivate an atmosphere that promotes overall wellness, providing for social and intellectual needs as well. Residents typically have their own private or semi-private living spaces, such as apartments or suites, while also having access to communal areas for socialization and recreational activities or hobbies.

[READ Long-Term Care Facilities: Types and Costs]

Requirements for Assisted Living: Who Is Eligible?

Eligibility is determined by a number of factors and varies from state to state.

“Eligibility for assisted living care is a collaborative approach between the resident or their family, the assisted living community care team and the resident’s health care provider,” Williams says.

Common criteria for qualifying for basic assisted living may include:

— Ability to mainly live independently, but with assistance.

— Can walk or use a wheelchair alone or occasionally with assistance from another person.

— May have certain medical conditions but are considered medically stable.

— Need only minor, not full-time, nursing assistance or other care.

Some assisted living facilities may offer enhanced services designed for individuals who want to “age in place” but need further help with various tasks, such as:

— Assistance with movement, such as walking, using stairs or sitting and standing.

— Assistance needed with medical equipment, such as diabetes equipment, blood pressure monitors or CPAP (continuous positive airway pressure) machines.

— Assistance needed to manage chronic urinary or bowel incontinence.

There are also some communities that provide specialty care designed for those with Alzheimer’s disease or other forms of dementia.

“Depending on what the facility offers, there is usually a basic level of care that addresses assistance with day-to-day activities, but there may also be plans that include higher levels of care that provide additional assistance with the more complex activities of daily living,” Williams says.

[Read: 11 Signs Your Aging Parent Needs Senior Care]

Who Does Not Qualify for Assisted Living?

Not everyone qualifies for assisted living, and it essentially comes down to whether or not you are able to live safely and operate within the environment of the community.

Some common reasons someone may not qualify are because they:

— Need around-the-clock supervision to ensure their safety, like those at risk of falling out of bed or those who wander.

— Are chronically bedridden.

— Require full-time medical care that the assisted living community cannot provide.

— Have a medical condition that requires continuous monitoring.

— Refuse or are unable to comply with their care program, such as medication maintenance, which can result in harm to themselves or others.

[READ: Assisted Living vs. Home Care: What’s the Difference?]

How Do Assisted Living Facilities Assess Qualification?

Assisted living facilities typically assess an individual’s qualification for residency based on several factors to ensure that they can provide appropriate care and support.

“Assisted living is regulated at the regional level, so each state has its own set of admission standards,” says Lisa Newcomb, executive director of the Empire State Association of Assisted Living in Clifton Park, New York.

While specific criteria varies depending on state and local regulations, common qualifications considered during the assessment process include:

Activities of daily living (ADLs): ADLs include tasks such as bathing, dressing, eating, toileting and mobility. Facilities may assess an individual’s ability to perform these activities independently or with assistance to gauge their level of care requirements.

Cognitive functioning: Assessment of cognitive abilities — including memory, judgment and problem-solving skills — helps determine whether the individual requires specialized memory care services or support for conditions like dementia or Alzheimer’s disease.

Financial considerations: Assisted living communities may also evaluate a prospective resident’s financial situation to ensure that they can afford the cost of care. This may include reviewing income, assets, insurance coverage and exploring various financial assistance options.

Medical history and medication management: A review of the resident’s medical history, current medications and any ongoing medical needs is typically conducted to ensure that the facility can provide appropriate medical supervision and assistance with medication management.

Physical health assessment: Facilities may evaluate an individual’s current physical health, including mobility, chronic conditions and overall functional abilities. This assessment helps determine the level of care needed and whether the facility can adequately meet the individual’s needs.

Psychosocial evaluation: Facilities may assess an individual’s emotional well-being, social support network and preferences for activities and social engagement to ensure that the resident’s social and emotional needs are addressed.

What Happens Once You Qualify for Assisted Living?

Once you qualify, it is a matter of getting the appropriate paperwork to the facility and sitting down to develop a personalized care plan, also known as an individual service plan.

The facility’s staff will also go over amenities offered, fees associated with care and moving in and out policies. You may be required to pay a deposit, but that will depend on the facility’s fee policy.

It is important to work with your team — which typically includes you, your health care providers, any family you include and representatives from the facility — to develop the best care plan for you.

“These plans outline the specific services and support that a resident will receive based on their needs and preferences,” Williams says. “Typically, there is an assessment of your physical, cognitive and psychosocial needs. Your likes and dislikes will also be taken into account. This allows the assisted living care team to ensure the care plan meets your unique needs and preferences.”

Once you begin living at the facility, typically there are periodic evaluations to make sure the care plan is still the best fit for your needs. Also, residents are observed on a continuous basis to make sure any noticeable changes are brought to the attention of your health care provider and any family involved.

How to Find the Best Assisted Living Facilities Near You

With more than 31,000 assisted living communities in the U.S., it can be overwhelming to find the best assisted living facility for you or your loved one.

The first step is to figure out your needs, preferences and financial situation. From there, you can begin your search with the U.S. News & World Report rankings of the 2024 top-rated assisted living communities for seniors.

It may be helpful to ask others in your community — such as your health care providers, friends, neighbors, clergy or others — for recommendations based on personal experience.

Once you have found a few potential matches, it’s important to visit, observe and ask questions. Try and get a feel for how the facility is run, how satisfied and happy residents seem and if you can see yourself in the environment.

Bottom Line

Assisted living offers a balance of independence and support that can be adjusted based on your ongoing needs. Eligibility varies from state to state and depends on factors such as your overall health and if you are a good fit for what the facility offers.

The level of care provided can range from basic assistance with daily activities to more comprehensive support for complex needs, including memory care for those with dementia or Alzheimer’s disease.

Collaboration with your health care team, family and facility representatives is crucial to create a personalized care plan, which will take into consideration your physical, cognitive and psychosocial needs. Periodic evaluations and routine observation allow staff to ensure the care plan works for your changing health and emotional status.

Assisted living facilities aim to promote autonomy, dignity and a good quality of life for their residents while also ensuring they provide the necessary support to maintain people’s well-being and safety.

More from U.S. News

Nursing Homes vs. Assisted Living: What Are the Differences?

Assisted Living vs. Home Care: What’s the Difference?

11 Signs Your Aging Parent Needs Senior Care

Who Qualifies for Assisted Living: Requirements for Residents originally appeared on usnews.com

Update 05/09/24: This story was previously published at an earlier date and has been updated with new information.

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