What is Assisted Living?

Assisted living most commonly refers to residential senior care services that provide 24-hour non-medical assistance with Activities of Daily Living (“ADLs”) for the elderly. These assisted living elder care services include personal care such as bathing, dressing, and grooming. It also includes assistance with medication management, meals, housekeeping, transportation and supervision. Many assisted living facilities focus on Alzheimer’s and dementia care, known as Memory Care. The majority of assisted living facilities are paid for privately, and do not accept Medicare or Medicaid.

Assisted Living Cost

The national median rate of assisted living per month is $3628, according to a 2016 cost of care survey by Genworth Financial. Of course, that could be higher or lower depending on where you live and how much care your loved one may need. That comes to about $43,000 a year, far less than in-home round-the- clock assistance. Learn more about how to pay the costs of assisted living.

Assisted Living Definition

Assisted living is defined as: “housing for elderly or disabled people that provides nursing care, housekeeping, and prepared meals as needed.” Learn more about the assisted living experience.

Assisted Living vs. Nursing Home

What is the difference between assisted living and nursing home? Good question. While many people use Nursing Home and Assisted Living interchangeably, they are actually two different types of housing options. Nursing Homes, or Skilled Nursing Facilities, provide 24-hour medical care, while Assisted Living provides 24-hour non-medical care. Nursing Homes are licensed and reimbursed by Medicare or Medicaid, while Assisted Living primarily private pay (some exceptions do apply). Nursing Homes tend to be more like Hospitals while Assisted Living tends to be a more home-like community. Learn more about the different types of senior housing.

Assisted Living Regulations

Each state has a regulatory department that oversees Assisted Living facilities. They also do periodic evaluations (at least once every five years) to make sure that the facilities meet the requirements set in place to ensure the safety of the residents. Each local district licensing office has a file on every facility in its district. As a consumer, you have the right to view the public file upon request. Learn more about assisted living regulations.

Assisted Living Medicaid

Medicaid is available to people with limited income and has more coverage for long-term care costs than Medicare. It covers personal care (such as help bathing, dressing, etc.), home health care, adult day care, and assisted living care among other things. However, it has specific health and financial eligibility requirements. In particular, if your financial resources are above a certain limit, you will be required to use those resources first. It’s also important to know that eligibility and what is covered varies by state. In California, for example, Medicare benefits are provided under the Medi-Cal program. The plans provided through Medi-Cal vary by county. They are all required to provide a core set of benefits through the Affordable Care Act, but access to long-term care may vary. There are multiple ways to apply, including online, but if you have any doubts about what plan might be best for you, it’s a good idea to apply in person at your local county social services office, or get advice through a financial adviser or your local Area Agency on Aging. Learn more about Medicare, Medi-Cal, Medicaid, and more.

Interesting Facts About Assisted Living

Average cost in U.S.: $3,628/ month
Average cost in California: $4,000/ month
Highest average cost in U.S.: Washington D.C. ($6,700/ month)
Average length of stay in U.S.: 36 months
Number of U.S. assisted living communities: 31,200
*Source: Genworth - Compare Long Term Care Costs Across the United States

Find Assisted Living By City
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Assisted Living Care, Services and Amenities
Assisted Living Services

As stated above assisted living communities are residential senior care options that provides non-medical assistance with activities of daily living (“ADLs”). According to Investopedia there are “There are six basic ADLs: eating, bathing, dressing, toileting, transferring (walking) and continence. A person's ability to perform ADLs is important for determining what type of long-term care — for example.”.

In addition to providing assistance with ADLs, most assisted living communities offer central dining, exercise programs, housekeeping services, transportation options and care supervision. Assisted living residents typically live in their own private or semiprivate apartments depending on their preference. Care needs for assisted living residents are assessed regularly in case there is a change that requires staff notification. Assisted living communities feature activities schedules filled with events to suit a variety of preferences. Families are encouraged to visit assisted living communities where their loved ones are residing. Loved ones are invited to special events and holiday parties designed for community residents.

Happiness also comes from a supportive and compassionate staff, independence and affordability. In many ways it's like a marriage. There are many choices, more now than ever, and so when selecting the right assisted living for you or your loved one, care, patience and research should be the number one priority.

Why Choose Assisted Living?
Assisted Living SCosts

Assisted living is a type of senior community that allows you to have your own personal space, with care in place right there should you need it.

That makes an assisted-living community a great choice for a loved one whose health may be good now, but may require some extra care and assistance as time goes on. It’s always a relief for families to have a system in place should anything change down the road.

Your loved one can start their senior housing experience with an individual apartment, allowing them to live as independently as they’d like, while also taking advantage of social connections, activities and fitness offerings the community may offer. In addition, things like cleaning, meals and laundry would be taken care of.

But the best part is if something unexpected should happen, healthcare and assistance is available immediately, without having to make another move or locate services that can help. So if you needed to add assistance with eating, dressing or medication management, it would be taken care of seamlessly.

The national median rate of assisted living per month is $3628, according to a 2016 cost of care survey by Genworth Financial. Of course, that could be higher or lower depending on where you live and how much care your loved one may need. That comes to about $43,000 a year, far less than in-home round-the-clock assistance.

When choosing an assisted living community, be sure and factor in things like staff to resident ratio, activities and amenities available and sample a meal on your tour. It’s also a great idea to talk to other residents. You can request a meal for yourself and a loved one with a group of residents as well.

But one of the best ways to check out a place is a short-term or respite stay for your loved one. Many assisted-living communities encourage these stays, so your loved one can get a better sense of the community and what they have to offer.

Featured Articles

Everything You Need to Know About Assisted Living in San Francisco - This is a guide to Assisted Living in San Francisco.

Understanding the Assisted Living Experience? - This is article describes the experience you can expect when moving into an Assisted Living Community.

The Cost of In-Home Care vs. Assisted Living - A guide on figuring out how to make the decision on assisted living vs. in-home care.

Downsizing for a Move to Assisted Living - A guide on tips for transitioning from your home into an assisted living community.

Finding the Right Assisted Living Situation For a Family Member - Tips on finding the right assisted living facility that fits your needs.

Top 12 Question to Ask While Touring Assisted Living Facilities

  • What is the ratio of staff to residents?
  • What is the staff turnover rate?
  • What types of training do the staff members have?
  • Is there staff available to provide 24-hour assistance with activities of daily living (ADL’s) such as dressing, eating, bathing and toileting?
  • Can meals be provided at a time the resident prefers, or are there set times for meals?
  • Does the community have any special amenities or services worth mentioning, such as a beauty parlor, fitness room, therapy pool, etc.?
  • Are residents actively encouraged to participate?
  • Is there someone on staff who coordinates home healthcare visits from a nurse, physical therapist, etc., if needed?
  • Are services such as hospice and physical therapy available? If so, is there an additional charge? If so, how much?
  • Is transportation offered to residents for doctor’s appointments? Is the transportation wheelchair/disabled-friendly? Is there a fee? If so, how much?
  • Are incontinence supplies included in the price? If not, what is the cost?
  • Are visitors allowed at any time, or are there specific visiting hours? If you have specific visiting hours, what are they?
Check out more questions here: Questions to Ask On Your Community Tour

Other Types of Senior Living
Senior Living

There are four types of Senior Living properties that offer these assisted living services: Board and Care Home, Assisted Living, Memory Care, and Continuing Care Retirement Communities.

Residential Care Homes are single family homes spread throughout the area. Pros: They are usually more budget friendly, have an intimate setting, and have higher staff to resident ratios (industry average 1:6). Cons: They do not have amenities, much socialization opportunities, or fine dining services.

Assisted Living Communities are purpose built properties often appearing to be a large apartment complex from the outside. Pros: They have many amenities, robust social programing and therapies, and typically offer better dining experiences. Cons: They are expensive and often have lower staff to resident ratios (industry average 1:16).

Memory Care Communities are either purpose built properties or wings within Assisted Living communities. Most large Assisted Living communities have Memory Care wings which offer 20-30 private and shared rooms to seniors. Pros: They typically have staff training in Alzheimer’s and dementia caregiving, and have higher staff to resident ratios (sometimes as low as 1:5). Cons: They are very expensive and not all “training” is equal.

Continuing Care Retirement Communities (CCRCs or LifeCare) communities are purpose built properties meant to care for seniors when they are more independent. The concept was created to enable a new way to “age in place”. These properties have different living options that support seniors at a healthier stage all the way through very high levels of care (including medical needs). Pros: They offer a new “age in place” solution. Cons: They are very expensive with initial buy-in fees in the hundreds of thousands to millions of dollars.

Top 15 Largest Assisted Living Companies

Seniorly.com lists hundreds of assisted living communities throughout the United States. There are many different companies that manage these communities from local mom and pops to large nationwide chains. Below is a list of the 15 largest assisted living providers in the U.S.:
Brookdale Senior Living
Atria Senior Living Group
Sunrise Senior Living
Five Star Senior Living
Enlivant
Capital Senior Living Corporation
Elmcroft Senior Living
Life Care Services
Leisure Care
HCR ManorCare
Genesis Healthcare
Integral Senior Living
Benchmark Senior Living
Gardant Management Solutions

Assisted Living Reviews and Ratings

Seniorly.com has aggregated reviews and ratings on assisted living communities from across the web. While nothing can replace the experience of touring a community, reviews and ratings can help you narrow down options. In California, we also aggregate assisted living community inspection reports from the Department of Social Services Community Care Licensing Division.

Assisted Living vs. Homecare

According to AARP, 87% of seniors say they want to age in place. It's easy to understand that many seniors would rather live out their golden years at home than in an assisted living community. It's a comfortable, private and familiar place. However, depending on the circumstances, an assisted living may be the smarter alternative to receiving home care. Just keep in mind that not all senior assisted living facilities are created equal. Some provide resort-like amenities, such as retirement residences, while others focus on health care and health management, like skilled nursing facilities. There are major differences in cost, as well. And, the move will most likely be to smaller quarters. This means the bulk of what has been collected over the years, such as furnishings, mementos and other personal effects, will have to be left behind. This can be one of the most difficult and traumatic aspects of leaving your home for assisted living, for each item may carry significant meaning and letting go means life is changing in a big way.

Assisted Living Regulatory Agencies By State

Click here to see a list of links to the regulatory agency in each state that is responsible for overseeing assisted living operations in their respective state.

Remember, as a consumer, you have the right to view the public file upon request. Items you should expect to see in the public file include:

  • the most recent inspection report
  • any complaints a facility has received within the last two to three years
  • the facility’s Plan of Operation
  • the waiver application and/or approval for hospice care (state by state)
  • any Advisory Notes regarding the facility.

Complaints may be filed by anyone – a resident, a resident’s family member or friend, or by a staff member. When reviewing a public file, be particularly aware of any complaints that allege abuse of patients or those that suggest any violations of resident rights. Check to see if there is a pattern of any one of more similar complaint.

Seniorly.com recommends you do your own evaluations too. Once you have reviewed the public files of your top choices and are ready to make a personal visit, you should have a checklist of items to be looking for as you tour the facility.

Meet the administration and ask to meet a current resident if possible. Plan at least one visit at a mealtime. Visit more than once, at various times of day to see how different staffing shifts relate to the residents.

A thought while you wait ...


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