What Are Assisted Living Residences?
Generally, assisted living residences provide a combination of housing and supportive services for seniors who do not require round-the-clock skilled nursing or medical care, but who do require more personal care and health services than independent living provides.
Assisted living facility settings vary widely — from small homes to big apartment buildings. Many are stand-alone assisted living residences, while others are connected to independent housing and/or a nursing home on the same campus.
Accommodations and services also vary. Some residences provide apartments with kitchenettes, while others offer private or shared rooms. In one residence, services may be limited to housekeeping and personal care, such as help with bathing and dressing; meanwhile, another may also offer other services such as physical therapy or transportation. Typical services include meals that are served in a common dining room, personal care, housekeeping, and activities.
Explore Your Options
We encourage you to explore the whole spectrum of long-term care options. Do you still live at home? If so, before deciding on assisted living, find out whether you could get home care, housekeeping, or other services — and what they would cost. These services could help you stay in your own house or apartment. Your own home is familiar, and it’s where you have the most freedom to lead your life as you want.
Maybe you are still able to live independently but want the companionship that communities offer. If so, here’s another option to consider: independent living, also called retirement communities, congregate living, or senior apartments. Independent living typically provides seniors with recreational, educational, and social activities. Although such residences may also provide laundry, linen, meal service, and transportation, they almost never offer any personal care of health services.
Plan Ahead
Many people have to choose an assisted living residence in the midst of a crisis, so they don’t have time to weigh their options. But it’s best if you can prepare ahead before any health crisis forces you to make a quick decision.
Your first consideration in choosing an assisted living residence should be the services offered and whether they will meet your needs, preferences, and budget. Find out if:
- You will get the help you need when you need it?
- Can you choose something that is not on the menu?
- Does the activities program offer activities you enjoy?
- What housekeeping services are available and are they included in the monthly fee?
Next comes price. Assisted living can be expensive. Monthly fees may be the same for everyone, or set based on which services you need. But fees can rise at any time, and extra services may raise them, especially if they include hourly charges for assistance. The management of some residences also charges an entrance fee or requires a refundable security deposit. Some private long-term care insurance policies cover some of the costs associated with long-term care, but Medicare does not. Certain states may cover some services under Medicaid.
Make Many Visits
Try to make several visits to at least a few assisted living settings to decide which will best meet your needs and desires. Research your options by speaking to family, friends, and other resources in your area. The local area Agency on Aging which exists in many communities throughout the country, can provide information about how to find high quality assisted living.
Try to visit a given residence at various times of the day — including at least one unannounced visit on an evening or weekend. Also, try to visit during at least one meal, so you can taste the food.
Here are some questions to ask the staff:
- Who draws up the Resident Service Plan (an individualized list and schedule of which services each resident receives, and when)? How involved is the resident and family in this process?
- If monthly fees are based on a service formula, how often is it reassessed? When fees rise, how far in advance do you notify residents?
- How stable is the residence financially? Ask for a copy of their annual report. Do a search on the Internet to see what reporting there has been on the company.
- Who decides about transferring residents within and outside the residence? Is a nursing home affiliated with or attached to the residence, and if so, may I visit it?
- How are grievances handled? Is there a Resident Council? Is there a Family Council? Who runs the councils?
- How does the waiting list work? Is there a probationary period after a resident moves in?
- What happens in a medical emergency?
- What is the criteria for discharge?
Try to be realistic about your needs. If you must rely on others to help you do certain things, you may not be able to lead quite as independent a life as you once did. It’s possible that you’ll have to balance what you want (your preferences) with what you need.
Related Resources
A Checklist for Moving to Assisted Living
Thinking of Moving to an Assisted Living Residence? Fostering Autonomy & Independent. Coalition of Institutionalized Aged and Disabled (CIAD) and the Nursing Home Community Coalition of New York State (NHCC)
