We all age at a different rates and face different health challenges as the years march on.
That means that navigating health care decisions later in life isn’t always a straightforward journey. One of those decisions may be trying to decide when it’s time to move from independent living to assisted living.
Independent Living vs. Assisted Living: What’s the Difference?
There’s a distinct difference between independent living and assisted living.
Independent living
Independent living communities are “designed for older adults who are generally able to live independently but want the convenience and social opportunities of a community setting,” explains Tina R. Sadarangani, a board-certified primary care nurse practitioner and assistant professor at NYU who specializes in the care of older adults.
They are often built as stand-alone homes in a neighborhood.
“The environment is supportive but not medically focused,” Sadarangani adds.
These communities tend to offer social events, exercise classes, group travel options and other activities that foster “mental and physical engagement to enhance general wellness and quality of life as people age,” says Dr. Deena Goldwater, a cardiologist and geriatrician who serves as vice president of care delivery at Welcome Health, a Southern California-based primary care practice specializing in aging.
Independent living, which usually comes with age requirements, is typically less expensive than either assisted living or a nursing home. The median cost for independent living is $3,065 per month, according to SeniorLiving.org’s median monthly cost figures.
[READ What Are the Levels of Senior Living?]
Assisted living
“Assisted living is ideal for older adults who need help with daily activities such as bathing, dressing, medication management and meal preparation but do not require the intensive medical care provided in a nursing home,” Sadarangani says.
Residents may live in a private apartment or a shared room, and meals may be served in a communal dining room where residents can also socialize and interact. Services and amenities often depend on the location of the assisted living community and the type of resident it caters to.
There are pros and cons of assisted living, namely that it tends to cost more than independent living but less than a nursing home. There are wide variations in costs based on services provided and geographic location.
On average, you can expect to pay about $5,350 per month for assisted living, according to Genworth Financial’s 2023 Cost of Care Survey. That’s significantly more than the average for independent living, but considerably less than the median national average of $8,669 for a semi-private room in a nursing home or $9,733 monthly for a private nursing home room, as reported by Genworth Financial.
When to Make the Move: Signs to Watch For
“The right time to move from independent living to assisted living varies based on individual circumstances,” Sadarangani says.
Family members, caregivers or friends may often be the first to spot warning signs that independent living may not be the optimal situation.
Signs that it may be time to move from an independent living situation into an assisted living community include:
— A worsening of medical conditions, an increased number of falls and overall increased frailty
— Difficulty managing domestic finances or other money problems
— Difficulty keeping the house clean or personal hygiene
— Depression or social isolation
Sample Scenarios
Below are a few possible scenarios that help illustrate when it may be time to consider moving.
1. Recently lost a spouse
A senior who has recently lost the spouse who was primarily responsible for taking care of the housework, meals and shopping will likely have to consider moving. The surviving spouse may struggle to cook or clean adequately while also being lonely after the death of a partner.
2. Developing multiple medical problems
When a senior develops multiple or serious medical problems, such as Parkinson’s disease, it often hastens the discussion of when to move to assisted living. As chronic conditions progress, the senior will need more day-to-day help.
3. Signs of memory loss
For many seniors, the time to move comes along with signs of memory loss or reduced cognitive facility, especially if there’s a formal diagnosis of Alzheimer’s disease or another form of dementia. If this is a situation your family is facing, you may want to consider a memory care facility, which offers specialized therapies and support for people who have dementia or are experiencing cognitive decline.
4. Caregiver burnout
Some families find they must move a loved one into assisted living when they begin to experience caregiver burnout. Seeking respite in an assisted living facility may help families and caregivers enjoy a better quality of life while providing improved care for the senior.
[A Guide to Senior Apartments and Where to Find Them]
The Benefits of Assisted Living
Assisted living communities offer a wide range of benefits to seniors.
Greater ease with completing tasks
Most assisted living communities have a range of on-site amenities, including dining options, laundry services and a salon or barbershop. Having all of these services available makes life easier and safer for many seniors, as they won’t have to risk driving off-site for errands or routine self-care services.
Opportunities for socializing
Not only do these communities offer the convenience of on-site amenities, but they also provide residents with options for social engagement through various activities and events that foster community and prevent isolation and loneliness.
Isolation and loneliness are detrimental to health, but in a community of other seniors, your loved one may find enriching social connections with other residents.
Improved fitness and mobility
Staying fit improves your ability to maintain independence and mobility for longer, and most assisted living facilities put a lot of effort into making sure their residents have access to fitness classes and other means of exercising for better health.
[READ: Best At-Home Chair Exercises and Balance Exercises for Older Adults]
Reduced health care costs
While assisted living communities can be expensive, moving into one may actually save you some money in the long run if it means you won’t need as much health care.
“Moving into assisted living earlier can offset higher costs associated with hospitalizations, one-to-one care or the decline that occurs when one doesn’t optimize their best health,” says Angela Stewart, vice president of clinical services with Touchmark, a Beaverton, Oregon-based senior living company with communities for 55-and-older adults across the country.
Improved quality of life
These benefits often have a greater impact if a senior moves in earlier rather than later, as that can provide the opportunity to get excited about new possibilities. When done right, a move to assisted living can be a powerful experience for the whole family.
“Moving to a community that meets your social, mental and physical needs may not only improve your quality of life, but it might even improve your health,” Goldwater says.
How to Find an Assisted Living Facility and Plan a Move
There are many assisted living facilities, and it’s not always clear how they differ from one another, which makes finding the right assisted living facility for your loved one a challenge.
Here are a few tips to help make it simpler:
— Start your search early. Waiting until a loved one urgently needs more care adds to the stress of finding a good place for them. Instead, start early and learn what options are available in your community.
— Consider future care needs. Some communities offer tiered care options, so your senior needs to move only once but can access all the care they will need in the future. That can be an attractive option for many people, as chronic health conditions progress over time.
— Put yourself in their shoes. Tour each community you’re considering, and ask lots of questions of staff and residents. Try the food and attend events to learn what it’s really like to be a resident there.
— Get all the details about fees and services. Before signing a contract, be sure to read all the fine print and understand what your financial responsibilities would be. Consider whether the facility is affordable for you and your loved one.
— Check for local resources. Assisted living can be very expensive. Medicare doesn’t cover it, but there may be other options that can help defray some of the costs. Talk with an expert in your area to learn about any local assistance programs that may be available to your family member.
How to Ease the Transition to Assisted Living
Transitioning to assisted living isn’t always easy, and some seniors may resist the move because they see it as a loss of independence and agency. But it doesn’t have to be, and being ready to address your loved one’s concerns head on can help make that transition easier.
Prepare for difficult emotions
“Moving to a senior living community is a significant life change, and having the time to adjust to the idea, tour facilities and even meet current residents can make the process smoother and less stressful,” says Esther Cromwell, founder and CEO of Avendelle Assisted Living in Raleigh, North Carolina.
When having these conversations, keep in mind:
— You don’t have to do it all at once. You can make small inroads before you sit down for a really big talk.
— Try to do most, if not all, of this sort of communication in person. This way, you can pick up on body language and other nonverbal clues about how your loved one is really feeling.
— Listen carefully to the answers. Really listen to what your loved one is saying, and aim to ask open-ended questions that allow them to bring up any issues or concerns.
Talk about senior care options
Some tips for approaching your loved one about moving into assisted living:
— Start with a general discussion of what life is like at home for your loved one. Ask about safety issues or challenges they might be having and if these can be easily remedied, such as by installing extra handrails around the bathtub. Look into making that happen for the short term until a decision about future care can be made.
— Ask if your loved one wants help. They may be struggling in silence with housekeeping, laundry, running errands or other daily chores and hoping you’ll offer assistance or find them some help.
— Ask if your loved one feels lonely. One of the biggest upsides to moving to assisted living is the big increase in social stimulation. Community dining and activities can be a big help if a senior is feeling lonely.
— Be empathetic. Try to understand how difficult these conversations can be.
Some families find that speaking with an expert about senior care options can be beneficial as well.
Some experts who can help families decide the right time to move include:
— Your loved one’s doctor
— Financial advisor
— Attorney
— Social worker
— Family counselor
— Local senior care nonprofit organizations
Do your homework
Before you even start the conversation, it’s important to write down your own concerns and the points you want to get across to your loved one. Then follow these steps:
1. Research options for a good fit, so you have some suggestions at the ready as the conversation evolves.
2. Visit each place you’re considering. It’s important that you experience what it would be like to live there. Meet the residents and the staff to gauge how comfortable and welcoming the place is.
3. Talk to the staff during those visits and get a sense of how they care for people, their training and background and whether you can see your loved one thriving in that environment.
4. Discuss your loved one’s preferences in the context of this new information and see if there’s a match.
These conversations aren’t always easy, but negative feelings and difficult situations can be alleviated by doing your homework, starting the conversation early and talking often about what’s coming down the road for aging loved ones.
Explore Top-Rated Assisted Living Facilities with U.S. News
You can begin your search for assisted living facilities in your area today by exploring the top-rated communities via U.S. News’ comprehensive online database. That listing relies on data collected in 2024 during a survey of more than 3,500 senior living communities nationwide.
The survey, which gathered more than 400,000 responses from residents and family members, asked about their satisfaction with aspects of the community such as safety, caregiving, management, staff, food and dining and activities. These ratings recognize communities that excel at providing highly satisfactory services and making residents feel safe and well cared for.
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When Is It Time to Move From Independent to Assisted Living? originally appeared on usnews.com
Update 08/21/24: This story was previously published at an earlier date and has been updated with new information.
