A level of care in senior living refers to the amount of medical and personal support a resident needs daily. Levels of care can range from independent living to skilled nursing care or even continuing care retirement communities (CCRCs). So, how does one find the Goldilocks of senior living, a level of care that isn’t overcare, leading to a loss of independence, or undercare, which poses safety risks?
Undercare may be more common than overcare, says Laura Liggett, a dual-certified nurse practitioner in Pittsboro, North Carolina, and associate professor at American Sentinel College of Nursing & Health Sciences at Post University.
“This is due to many of the individuals I care for lacking resources or being unaware of the resources available to them. They try to make do with what they have, which leads to injuries and hospitalizations,” she explains.
Overcare, on the other hand, can be costly, especially for individuals on a fixed income.
“Moving an individual to a skilled nursing facility with 24-hour care costs more than keeping them at home, where they may only need help with chores,” Liggett says. “This leads to a loss of autonomy for the individual on top of the financial strain.”
Read on to learn more about the levels of care for senior living, the types of senior living options and 2026 senior care trends.
[READ: Long-Term Care Facilities: Types and Costs]
2026 Senior Care Trends
The population of adults ages 65 and older is projected to grow significantly over the next two decades.
“The 85-and-up population is expected to more than double, which is the group most likely to need higher levels of care,” says Samir Shah, New York City-based CEO of CareScout Services, which helps families navigate longer-term care planning and finances.
As a result, senior living in 2026 is shaped by both demographics and individuals’ needs and expectations.
The aging-in-place movement
In 2026, understanding the levels of senior living is especially important in the context of the aging-in-place movement, where older adults aim to remain in their homes or communities for as long as safely possible. Often, a lower level of care, like what you would find in assisted living, is not the final stop. About 60% of assisted living-level residents transition to higher levels of care, Shah says.
“Aging isn’t a one-decision journey,” he adds.
Innovative community design and technology
Aging in place — specifically within the senior living residence of your choice — is increasingly dependent on thoughtful design and flexibility, says Jennifer McDermott, a Chicago-based principal and global practice director with Senior Living Interiors at global design firm HKS.
“From a design perspective, spaces must be adaptable, intuitive and supportive of changing mobility and cognitive needs,” she notes.
Senior living communities are also embracing technology, ranging from Amazon Alexa, which can help older adults program medication reminders or order groceries, to AI-driven safety monitoring. Communities may also rely more on AI to track resident preferences, activities and patterns.
“Communities are exploring tools like virtual reality for cognitive engagement and memory care programming, passive monitoring systems that support safety without feeling intrusive and smart-home features that improve accessibility and independence,” McDermott adds.
Financial support
The cost of senior living continues to rise.
“Assisted living costs increased 10% in 2024 to a national median of $70,800 annually, and nursing home care rose 7% to 9% depending on room type,” Shah says.
Given these costs, there are bills currently being proposed, like the WISH Act, to address the financial burden of aging and explore the cost of living when most older adults are retired or no longer employed, Liggett says. The WISH Act aims to support individuals aging at home by providing monthly benefits to those with functional disabilities.
Compare Senior Living Levels of Care
Senior living levels of care differ mainly by the type of medical support provided, the amount of assistance with activities of daily living (ADLs) (grooming, toileting and eating) and instrumental ADLs (housekeeping, financial and medication management) and how much that level of care costs. Use the table below to compare senior living levels of care in 2026.
| Level of Senior Living | Medical Support | Assistance with ADLs | Assistance with IADLs | Ideal For | Cost |
| Independent living | Minimal; mostly emergency response systems | Minimal; residents are mostly independent | Light support with transportation, housekeeping or meals | Active older adults who want a maintenance-free lifestyle with social engagement | $3,000-$4,000 per month |
| Assisted living | On-site staff, such as nurses or nurse assistants, to help with medications and routine monitoring (of vital signs, for instance) | Minor to moderate ADL assistance, such as getting out of bed or getting in and out of the bathroom | Support with transportation, laundry and housekeeping | Older adults who need some help with activities and oral medications but who do not need 24/7 medical support | $5,900 per month |
| Memory care | Specialized staff trained in Alzheimer’s disease and dementia care; unit security measures | Partial or full assistance with ADLs, depending on cognitive needs | Assistance with IADLs as part of a structured cognitive treatment plan | Older adults with Alzheimer’s disease, dementia or cognitive impairment | $7,505 per month |
| Skilled nursing, nursing home or long-term care | 24/7 licensed nursing care with additional therapy services, such as physical therapy | Up to full ADL assistance | Focus is on medical and personal care | Older adults with complex medical conditions, frequent hospitalizations or severe functional decline | $9,277 per month for a semi-private room, $10,646 per month for a private room |
| Continuing care retirement community | Varies by tier | Varies by tier | Varies by tier | Older adults seeking a one-stop community with flexibility | Varies based on the fee model |
Sources: Genworth and CareScout’s Cost of Care survey, U.S. News
[READ: How to Choose the Right Senior Living Facility: A Checklist]
Independent Living: The “Lifestyle” Choice
Independent living is a level of senior care where older adults live in a community or apartment setting with minimal medical support and with a focus on a convenient lifestyle and social engagement.
Key distinctions of independent living include:
— Lifestyle-focused amenities, such as pickleball courts or fine dining
— Social activities, such as book clubs or game nights
— Limited medical and personal care
“Concierge-style wellness programs are becoming more common, with communities offering coordinated services that may include fitness coaching, rehabilitation support, nutrition guidance and mental wellness programming,” McDermott says.
[Read: What Is Life Like in an Independent Living Community?]
Assisted Living: The “Supportive” Choice
Assisted living is a senior care option that provides personal support with daily activities while allowing residents to maintain independence in a community setting. Residential units are designed to handle increasing accessibility needs over time to support the resident remaining independent for as long as possible, McDermott says.
Key hallmarks of assisted living include:
— ADL assistance, such as help with dressing, grooming, bathing or medication management
— Person-centered care plans based on residents’ individual health and mobility needs
— IADL assistance with transportation, meals and housekeeping
Assisted living communities may use tiers or a points system to charge residents based on the number of minutes of care provided.
“The reason is that the acuity levels tend to change quickly,” Shah says. “This ensures communities are able to support residents as their health needs progress.”
McDermott says for families evaluating options, it’s helpful to look beyond the number of care tiers and ask how the community supports transitions between tiers.
“Communities that can adjust services without requiring residents to move often provide greater stability and comfort,” she says.
Skilled Nursing and Long-Term Care: The “Medical” Choice
Long-term care like skilled nursing facilities or nursing homes provide 24/7 medical supervision and full support for older adults with complex health needs, medical conditions or declining mobility.
Characteristics of skilled nursing and long-term care include:
— 24/7 medical supervision by licensed nurses
— Complex medical care, such as ventilator management, wound care, intravenous medications or intensive physical therapy
— Full assistance with ADLs if needed
There is a difference between using a skilled nursing facility for short-term post-acute rehabilitation vs. for permanent residency. Some older adults need short-term rehabilitation after surgery or a stroke, for example, and stay in a skilled nursing facility or short-term medical rehabilitation center for a few days up to a few months while they recover. In other cases, an older adult may need to stay in long-term care, like a nursing home, for the foreseeable future as it is not safe at a lower level of care.
However, what starts off as a short-term stay can end up being a longer-term one.
“I tend to see individuals going from assisted living to a skilled nursing facility in the short-term perspective after an injury or for wound care management who may require a couple of weeks of rehabilitation,” Liggett says. “If they continue to experience decline after the hospitalization or rehabilitation, then they may require long-term care in a skilled nursing facility.”
Memory Care: The “Specialized” Choice
Memory care is specialized care for older adults who have Alzheimer’s disease or other types of dementia, providing a secured environment and structured programs to support cognitive needs.
Key elements of memory care include:
— Secure environments to prevent wandering and elopement
— Specialized staff trained in Alzheimer’s and dementia care
— Amenities catered to cognitive needs, from brain-focused nutrition to sensory rooms and VR reminiscence therapy
Memory care is more expensive than standard assisted living because it requires a higher staff-to-resident ratio, specialized staff training and secure environments. The additional cognitive amenities and therapies also add to operating costs.
Continuing Care Retirement Communities (CCRCs): The “All-in-One” Option
A CCRC, or a life plan community, is a senior living community that offers multiple levels of care, from independent living to skilled nursing, in a single location. These spaces accommodate evolving levels of care without requiring residents to relocate, McDermott says.
Key features of CCRCs include:
— All levels of care on one campus
— Varying contract types and cost structures
— Continuity in social connections, as residents maintain friendships while accessing escalating levels of care as needs change
CCRC contract types may include:
| Type | Structure | Best For |
| Type A: Life care | All inclusive; entrance fee plus a monthly fee that covers all levels of care | Predictable long-term costs |
| Type B: Modified or fee-modified | Entrance fee plus a monthly fee that covers independent living and assisted living; higher levels of care are partially discounted | Some coverage for higher care but a lower upfront cost than Type A |
| Type C: Fee-for-service | Entrance fee plus a monthly fee for independent living; market price for higher levels of care | Paying for higher levels of care only as needed |
Choices to Make for Safe Independence
By evaluating how much assistance is needed with ADLs and matching that to a level of care, you’ll be able to find the optimal stage of senior living for yourself or your loved one. Always consult a medical provider when determining and coordinating a level of care to make sure it’s safe and ethical.
“Sometimes we need to get resources in the home to help them meet their needs, and other times we really need to consider more dependent care,” Liggett says.
More from U.S. News
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What Are the Levels of Senior Living? A 2026 Family Guide originally appeared on usnews.com
Update 02/19/26: This story was published at an earlier date and has been updated with new information.
