9 Things to Know About Assisted Living for Seniors
A move to Assisted Living is not in most seniors' plans, but it may become necessary. For this reason, it is important to understand what it is, who it is for, and what the costs and benefits are.
Most older adults fear losing their independence, and most want to remain in their homes. But the reality is that over 20% of U.S. adults over 85 need help with daily living activities. Often family members do not live close by or cannot assist with personal care. This percentage doesn't address the number of aging seniors living alone and experiencing isolation.
An assisted living facility can provide for these varying needs and support dignity and autonomy for assisted living residents. Assisted Living strives to enable an engaged, healthier, and happier life. Let's look at seven key things you need to know.
Things to Know About Assisted Living for Seniors #1: What is Assisted Living for Seniors?
Things to Know About Assisted Living for Seniors #5: What are the Benefits for Other Family Members?
Things to Know About Assisted Living for Seniors #6: What is the Cost of Assisted Living?
Things to Know About Assisted Living for Seniors #7: How do People pay for Assisted Living?
What is Assisted Living for Seniors?
Assisted Living is a type of housing designed for seniors who need help with daily living activities (ADLs). These seniors do not need the constant nursing care of a nursing home or skilled nursing facilities but need some support to navigate their day and maintain their well-being.
An assisted living facility does not provide skilled medical care but does offer limited nursing care to help with managing medications and medical conditions. Personal care assistants or certified nurse assistants help with overall personal care needs. While nursing and medical care are not available 24/7, there is a much greater focus on attractive and home-like settings, social and recreational opportunities, and overall enhanced quality of life than found in a nursing home.
A good assisted living community will help residents live independently while reducing isolation and enhancing their quality of life. There is a wide range of assisted living options available, and it is essential to research the different types and find one that best meets your or your loved one's needs and preferences.
What Does an Assisted Living Community Look Like?
There is no typical assisted living community, and while most offer similar core services, they come in all shapes, sizes, floorplans, and prices. These facilities or smaller group homes offer private apartments, a private room, or shared rooms and apartments. These living communities provide a home-like setting; most assisted living residents bring their personal furniture for their own apartments or rooms, and most bathrooms are private.
While most seniors desire their own apartments, these assisted living residential facilities include a range of common areas for dining, communal gathering, and other varied activities. Many facilities provide residents with exercise spaces, a beauty salon, a craft room, a restaurant, and possibly a theater or library.
The designs of many facilities allow residents to maintain their independence and privacy and ensure residents have easy access to a community of peers and activities. Assisted senior communities range from small residential homes to large apartment buildings. They may be part of a sprawling campus. From modest to upscale, older to new, there are options for all tastes and most budgets.
According to the National Center for Assisted Living (NCAL), there are approximately 28,900 Assisted Living Facilities in the U.S., licensed for one million residents. The average size is 33 suites or apartments. There is a tremendous variety, but these are not your old-time nursing homes. Most are designed to be appealing and more like a home or resort.
What Services and Amenities do Assisted Living Communities Offer?
Assisted Living provides necessary care services and can accommodate many senior care needs. Assisted living care services include medication management and personal care support. This includes help with dressing, showering, using the bathroom, and other daily care needs.
Some residents need minimal support, and others need limited nursing care. But all appreciate having help close by if needed. Unlicensed caregivers or certified nursing assistants provide personal care, and one or more nurses are usually on staff.
Assisted living facilities offer other services and amenities, such as meals, housekeeping, laundry services, and transportation. Support services and security are available 24/7.
In addition to services provided by internal staff, outside providers often visit Assisted Living homes to support the residents beyond their primary care needs. The National Center for Assisted Living reports the following extra services are available at Assisted Living Facilities in the U.S. by percentage. These are usually covered by insurance.
83.6% pharmacy/pharmacist
82.8% dietary and nutritional support
71.4% therapy (physical, occupational, or speech therapy)
67.7% hospice
66.1% skilled nursing care (through home health)
55.0% of mental health or counseling
51.1% of social work services
In addition, medical care is offered in many Assisted Living facilities by outside Primary Care Providers who visit regularly.
Outside Providers visit Assisted Living Residents
Beyond providing for essential physical care needs, these care communities and the community staff aim to provide opportunities for an engaged, active lifestyle with social interaction and activities. You might find book clubs, crafts and games, social gatherings, trips to movies and concerts, and exercise and wellness programs. Prepared meals are provided; for many seniors, dining is a significant focus and highlight of the day.
As with Independent Living Communities, the range and quality of activities and food service vary, so it is vital to visit and compare.
What are the Benefits to Assisted Living Residents?
Assisted Living is designed to support residents in maintaining their independence and autonomy. Other benefits of assisted Living include:
Social connections with their community
A sense of safety and security
Opportunities for engaging in activities
Help with activities of daily Living (ADLs)
Support for chronic health problems
Enhanced overall health
Transportation to or on-site medical appointments
Improved nutrition and movement
Opportunities for new friendships, social and recreational activities, and learning opportunities can improve the quality of life of assisted living residents. The physical, emotional, and cognitive health of residents often improves. Sharing the day with friends can make life more enjoyable and fulfilling.
What are the Benefits for Other Family Members?
When a family member provides significant care or other support for a loved one, the toll can become substantial. Assisted Living staff can support families to keep their loved ones healthy, safer, and hopefully happier. With this comes relief from some of the worry, greater peace of mind, and the opportunity to focus more on enjoying their time together.
Most assisted living facilities offer opportunities to participate in social and recreational activities as a family.
When assisted Living is the right choice, it can provide a tremendous sense of relief for families. Assisted Living can help preserve the quality of life for older adults and their families.
What is the Cost of Assisted Living?
The cost of assisted living communities can vary depending on the location, apartment size, services, amenities, and level of care needed. Assisted Living is usually more expensive than independent living facilities but less than nursing home care.
Assisted living facilities charge a monthly fee for rent, utilities, meals, and included services. Most also charge a monthly fee for personal care services. The cost of care can vary, so it is essential to understand how this is calculated. And remember, care needs may increase over time, so plan for increases when considering financial resources and financial fit.
According to Genworth's Cost of Care Survey, the average cost per month for Assisted Living Facilities in the United States is $4635.00 per month. Prices can vary by region, amenities provided, and other factors. When comparing these costs versus staying home, include all costs to maintain a home, groceries, transportation needs, and care and housekeeping needs. Most seniors will resist a move; looking at realistic expenses is essential. See our two articles - Is Your Home a Candidate for Aging in Place? and Advantages and Disadvantages of Aging in Place.
In addition to monthly fees, many assisted living facilities charge a one-time entrance or community fee ranging from $2,000 to $100,000 or more. The higher entrance or buy-in fees are usually part of a CCRC and are all often partially refundable; understand the fine print!
Pro tip!
There can be a significant difference in the calculation of care costs from one community to another. Unless the care and medication management costs are included in the monthly rental fee, be sure to have a care assessment before making a final decision!
With a completed care assessment, the staff members can determine the cost of care at that time.
Care needs and costs will likely change over time, but it is essential to understand where you are starting from. Ask about the types of changes in conditions that may be coming that would increase that cost. Also, look at the highest possible level of care cost. You don't want to be surprised!
Financial Planning for later life needs is essential!
How do People Pay for Assisted Living?
Many older adults and their families looking for assisted living services are surprised to learn that Medicare does not cover assisted Living. There are limited assisted living options available for those eligible for Medicaid benefits. Unfortunately, most of the living facilities covered by Medicaid are nursing homes. The majority of assisted living facilities are private pay.
Purchasers of long-term care insurance can typically use the benefits for assisted Living provided there are documented activities of daily living needs. The majority of adults, however, have not purchased policies.
Veterans or their surviving spouses eligible for VA Aid and Attendance benefits can use that monthly benefit to defray assisted living costs. Additional options include a life settlement or some other financial vehicle.
Assisted living expenses are significant. But suppose there is a need for ongoing personal care, medication management, and easy access to many healthcare services and wellness programs for many aging adults. In that case, the overall cost will be less than staying home with in-home care.
Can Individuals with Dementia Live in an Assisted Living Facility?
The answer to this question depends on the assisted living facility and the level of care that the person with dementia needs. Some assisted living facilities include a separate wing or memory care neighborhood or floor where people with Alzheimer's disease and other dementia can live more safely and receive specialized care. See our detailed article on Memory Care.
That said, many residents of Assisted Living have varying degrees of cognitive decline, and many assisted living residents with dementia can do quite well. Consider the following.
Can the individual navigate through their day with no more than occasional reminders and prompts?
Can the person still carry on a conversation with community staff and fellow residents and understand and follow instructions?
Do you consider the individual safe from risks of wandering, getting confused or upset, and leaving the community?
Is the assisted living facility small enough to be easy to navigate?
If the answer to the above considerations is yes, the senior can likely thrive in an Assisted Living Community, especially if it is relatively small and easy to adapt to.
If there is an expectation of continuing cognitive decline, selecting a facility with Memory Care or additional services on-site is vital to facilitate a possible transition later.
When touring assisted living facilities, ask about their experience caring for people with cognitive decline and what type of support and services they offer to residents with dementia.
Realize that policies vary among senior living providers, and some assisted living facilities will accept a resident with more significant needs. It is not always clear-cut, and I've often worked with individuals whose families resisted a move to memory care, not realizing the degree to which their loved one struggled with anxiety, confusion, or social isolation in Assisted Living.
What to Look for When Visiting Assisted Living Communities?
When researching and visiting assisted living facilities, there are several key things to look for.
The friendliness and helpfulness of the staff.
The overall atmosphere of the community.
The cleanliness and condition, inside and out.
The level of care that is offered.
The safety of the facility.
The staff-to-resident ratio.
The cost of rent and care.
The social and recreational programs
The dining program and menus
Is this a good personality and preferences fit?
Will the location allow family and friends to visit easily?
Do you feel comfortable with the leadership team?
Is there a plan to help new residents become comfortable?
Senior Living options should offer a clean, safe, and friendly environment for residents and staff. The residential facility should also provide a variety of activities, programs, dining, and senior care options to meet the need of all residents.
Perhaps the most crucial consideration is the staff and residents. Each community has a different culture; look for one that feels welcoming, where staff members interact warmly with the residents. Look for residents that are friendly, approachable, and seem engaged!
Pro Tip!
Allow enough time on your visits or tours to interact with as many community members as possible. Take time to ask questions of residents, family members, and staff that you encounter during your visit.
Most people will be happy to share their opinion or experience. Speak several for a more accurate picture, and look for a resident who seems to be someone you would enjoy getting to know!
If concerns are shared, raise this with staff. And do allow for the possibility that someone you observe or speak to is having a bad day.
Recognize that no senior care community will be perfect. There have been many staffing challenges at most facilities, and service failures will likely happen despite best intentions.
Speak to the Executive Director and Director of Nursing/Wellness. You do not want to speak only to the Sales Counselor you are meeting with. Ask how they ensure the concerns of residents are addressed in a timely manner. Look for a Director who is also empathetic to a loved one's concerns. With any team member, look for a commitment to the well-being of its residents and staff!
Pro Tip!
Ask friends and professionals you trust for referrals. If a decision must be made quickly, consider seeking a referral to a local, feet-on-the-ground Senior Living Referral or Placement Agency, that can help guide you through the selection process. A local placement professional should have more of an insider's perspective on most facilities and can help match on budget, preferences, and location.
These services are typically free to the resident, can save time, and help avoid mistakes. If the Agency's services are free to the consumer, a fee is paid by the selected senior care community if the client moves in. As a result, a referral agency may not include options that they do not contract with. Confirm they can show you a wide range of options.
In Closing
As we've seen, Assisted Living provides residents with independence and privacy in their living space. While not as private as staying in one's home or in Independent Living, sometimes these options are no longer feasible. Assisted Living can provide the personal care, services, and community older adults may need to live a whole and active life.
If a decision is not urgent, return to your top choices a few times at different times of the day. If possible, participate in a meal or activity. Look for a vibrant community that provides excellent senior care, and feels like a good new home.