At some point, everyday tasks that are just part of independent living can become unmanageable for older adults. Cooking a nutritious meal, for instance, once a source of passion and creativity, now poses a mental and physical burden. Even a simple morning routine like bathing becomes a huge endeavor, overshadowing a once-effortless start to the day.
For older adults who need some support and assistance to carry out their daily activities but are still able to move on their own and don’t have severe cognitive deficits, assisted living is a good option for senior care.
“The biggest misperception about assisted living facilities is that they are nursing homes and focus just on an individual’s medical needs,” says Steve Salaman, Chicago-area director for Brookdale Senior Living, a continuing care retirement community with facilities nationwide. “There is quite a bit of hospitality and high-quality food along with activities to make their life more enjoyable in assisted living communities.”
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.
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:
— Eating and nutrition
— Housework
— Life and household management
— Mobility issues and getting around
— Personal hygiene, such as bathing, grooming, dressing and toileting
— Shopping and meal prep
This long-term care option can be a huge benefit to seniors who can’t or don’t wish to live independently but who don’t need as much medical care as you’d find in a nursing home.
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 studios, shared rooms or one bedrooms. 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 work out,” Sorensen says.
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.
[READ: A Checklist For Finding the Best Assisted Living Facility]
Qualifications for Assisted Living
Who qualifies for assisted living? Many assisted living facilities require a pre-admission assessment to determine whether a person is a good fit for the facility or whether they may require more support and help that only skilled nursing care can provide. Specific qualifications that they look for:
— Care needs and requirements
— Cognitive function
— Financial capability
— Health status
— Level of independence
— Medication requirements
When a resident is struggling with activities of daily living and there is a need for on-call assistance, they may need to transition from assisted living to skilled nursing care,” Salaman says.
[SEE: The Advantages of Assisted Living.]
How Is Assisted Living Different from a Nursing Home?
Understanding long-term senior care options can be challenging, given the wide array of choices available. Assisted living is a lower level of care, and nursing homes and skilled nursing care are some of the highest — and most expensive.
Assisted living is for people who need some help with cooking, cleaning and other routine activities and tasks, such as getting dressed or using the restroom.
Nursing homes, on the other hand, provide a greater level of medical care in addition to assisted living services. They may be better suited for people who:
— Have serious health conditions, such as dementia
— Aren’t ambulatory
— Have suffered a serious stroke
— 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 be confined to a bed and may require multiple staff or a lift system to help them. A nursing home setting might also be best for someone who needs frequent or daily medical care or who has limited mobility.
Services Provided by Assisted Living Facilities
An assisted living community can provide a range of services, Sorensen says. These services can include:
— Diverse social, spiritual, recreational and educational programs
— Individual service plans that are supported by licensed staff on a 24-hour basis
— Resident dining, serving three meals daily
— Medication management
— Weekly housekeeping, laundry and linen services
— Emergency 24/7 call system with on-site nurse response
— Transportation
The Different Levels of Care at Assisted Living Facilities
Assisting living facilities offer various levels of care, which determine how involved caregivers need to be with their residents. Communities often have a few levels of care so residents can move up or down as their health permits. Levels of care provided may vary by geographical location.
Each facility has its own approach to matching residents with the ideal level of care, which makes it difficult to generalize across such a widely variable industry, but it’s typically broken out into lower levels, higher levels and memory care.
[Read: How to Finance Assisted Living]
Lower levels of care
Lower levels of care are for residents who need less assistance. These residents can walk on their own, even if they use a cane or a wheelchair to get to the dining room or activities. 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, 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 for care with additional support.
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 a 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 parent organization for three not-for-profit life plan communities, as well as Ingleside at Home, which operate 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 you 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. You can also reach out to the communities for available services and amenities and to ask about tours and pricing.
Benefits of Assisted Living
Assisted living communities offer myriad benefits for both residents and their families. The benefits for residents often include:
— Support. Communities provide assistance with daily tasks, such as light housekeeping and managing medication.
— Activities. Social activities help combat loneliness and isolation and 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. 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 more successfully, boosts their cognitive abilities and can even help prevent falls.
“Assisted living can alleviate some of the stress that an older adult may experience while 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.
For families, assisted living communities can help remove or reduce the anxiety associated with having a loved one who needs more care than they can provide.
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.
Limitations of 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.
Assisted living may not be the best fit for seniors who:
— Require extensive help with daily tasks, like needing full assistance with getting dressed or eating.
— Have medical conditions that require help with medication management or treatment, like severe heart failure or kidney disease.
— Need 24/7 medical supervision to ensure personal safety, like those who are at risk for wandering, aspirating or falling out of bed.
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 a loved one, speak with a primary care doctor or a geriatric medical provider to request a functional health assessment.
How Much Does Assisted Living Cost?
The cost of assisted living 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 2023 survey from Genworth Financial found that the median annual cost for an assisted living community is $64,200, up from $54,000 in 2021. 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, Sorensen says.
In addition, depending on the level of care that’s needed and the specific services being purchased, the average monthly cost of an assisted living facility was $5,350, according to Genworth Financial.
“But, should care needs increase, you could also be adding $250 to $1,500 a month on top of the base fee,” says Steve Handel, the chief operating officer for Caring.com, an online resource for those caring for aging parents, spouses and other loved ones.
Does Medicaid pay for assisted living?
“Most assisted livings are private pay, and when the funds run out, residents are asked to leave,” Sorensen 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.”
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 does not cover the cost of assisted living. However, Medicare might cover the cost of certain health care expenses incurred, such as wound care administered by a registered nurse or a doctor, while you’re already living in an assisted living community.
How to Find the Best Assisted Living Facilities Near You
U.S. News has rated assisted living communities in your area based on criteria such as safety, caregiving, staff, food and dining, activities and more. Search for assisted living facilities near you and use this checklist to find the best ones.
There are about 30,600 assisted living communities in the U.S., according to the American Health Care Association/National Center for Assisted Living (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.
Assisted living communities vary from small to large, 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.
More from U.S. News
Questions to Ask During Medicare Open Enrollment
Should You Take a Gut Health Test?
Fatty Liver Disease: Signs, Causes and Treatment
What Is Assisted Living? Everything You Need to Know originally appeared on usnews.com
