Assisted Living

Assisted Living

What is Assisted Living?

1. What is an assisted living facility?

An assisted living facility provides daily non-intensive care for seniors. The actual facility may include just a separate room and bathroom on a floor with other assisted living rooms. Seniors also could have their apartments in a complex and live more independently. Assisted living facilities do provide long-term care, but not to the same extent as a nursing home provides care. Seniors live at an assisted living facility as part of residential care, but they are not completely independent as in senior housing. At an assisted living facility, older adults do much of their daily activities themselves, but they receive more care for getting their medicines, help with housekeeping, organized activities, the provision of meals, and help with personal care. The precise availability of services differs from place to place.

1.1 What are the main differences between Assisted Living and other types of living senior care facilities?

Assisted Living Facility vs. Nursing Home

While an assisted living facility provides mainly assistance with activities of daily living and a wide range of social activities, a nursing home provides more intensive medical care and full-time monitoring. Nursing homes are especially appropriate for seniors with neurological disorders and major health concerns or injuries. Nursing homes also provide easy access to care from doctors and physical therapists. Seniors may stay at a nursing home for the short-term during rehabilitation or as long-term patients, while people stay at assisted living facilities indefinitely. An assisted living facility can also be transitory, as a further decline in health may necessitate a move to a nursing home.

Assisted Living Vs. Senior Living (Senior living community)

A senior living facility, also known as a senior living community, is usually an independent living community that is just for seniors. Residents may be able to pay extra to arrange for housekeeping and laundry assistance, but seniors must take care of themselves. Since they are in a community with other seniors, staff arrange social activities for them to interact with one another may even include field trips. The communities do not provide medical or personal care assistance, but individual residents could hire their private caregivers. At an assisted living facility, there is some personal care and care with medication allocation and similar services.

Assisted Living Vs. Retirement Homes

A retirement home is a facility just for seniors in which people live together in a single residential institution. It houses multiple residents in one home or building facility. The range of services differs from one facility to another, but residents typically enjoy a relatively independent living situation. They can leave the facility on their own and return as they would desire. They also live in a community just with other seniors. An assisted living facility provides more care than residents would find at a retirement home.

Assisted Living Vs. Retirement Community

A retirement community, also known as independent living, provides a home or apartment within a community of other seniors. Older adults who live in a retirement community are independent and can typically take care of themselves. Often, they even have kitchens in their residences, although there may be cafeteria or restaurant meal options in the community. Assisted living facilities usually provide all meals instead of allowing kitchens in rooms, although this varies by facility. Assisted living facilities also provide personal care and some medical maintenance care.

Assisted Living Vs. 55 and Older Community

A 55-and-older community is also known as a retirement community or independent living, except that the age range is for those 55-years-old and over. It has all of the features of independent living, but it has a specific age range for residents. Assisted living facilities may or may not have a specific age range. Many assisted living facilities start taking older adults who are 60 years old and older.

Assisted Living Vs. Continuing Care Retirement Community

A Continuing Care Retirement Community (CCRC) is a campus that has multiple levels of care. This would include independent living options, assisted living, nursing homes, or other combinations of a variety of levels of care. Often, CCRCs contain facilities for a variety of levels of care from more to less independent. An assisted living facility can be a part of a CCRC, but it would not be a CCRC as a standalone facility.

2. Who is Assisted Living for?

Who is Assisted Living for?

Assisted living facilities cater to people of different ages and care needs. Assisted living facilities classified as Adult Residential Care Facilities are usually for people under 60-years old. Residential Care Facilities for the Elderly are for older adults who are 60 years old and older. Seniors can start considering moving to an assisted living facility just for seniors around the age of sixty.

Many different people may find an assisted living facility to be the right place for them, including the following:

  • Seniors with mobility issues;
  • Seniors in the early stages of neurological disorders;
  • Seniors who need care but have family living far away;
  • Seniors who are fall risks;
  • Seniors who miss taking their medication;
  • Seniors who are lonely and need help taking care of themselves;
  • Adults with disabilities;
  • Seniors with consistent health issues; and,
  • Seniors who do not get proper nutrition while living alone.

3. What are the different levels of care provided in assisted living facilities?

What Are The Different Levels Of Care Provided In Assisted Living Facilities?

The levels of care vary between states and facilities. Seniors can generally find three levels of care.

Level One Care

Lovel one care refers to the lowest level of care that support staff needs to give to residents. Seniors in this level of care do the following:

  • Use a device to walk around or walk around on their own;
  • Need assistance with fine motor skills due to limited range of motion in fingers;
  • Provide the majority of their own personal care;
  • May need assistance or supervision with higher risk tasks, such as bathing;
  • Go to the bathroom alone;
  • Need reminders and allocation of medical needs; and,
  • Do not need major medical interventions.

Level Two Care

Residents with more care needs require a higher level of care. Continuing decline in health and abilities from this level of care may mean that residents need to go to a nursing home. Residents requiring this level of care usually need help with the following:

  • Walking around;
  • Getting out of or into bed;
  • Putting on clothes;
  • Showering;
  • Attending to personal hygiene;
  • Going to the bathroom;
  • Remembering some small things; and
  • Managing long-term illness.

Level Three Care

The third level of care relates to providing memory care. Progression into this level of care may signal the need for a transition into a skilled nursing facility or a special facility within the assisted living residence. Residents in this category usually need help with the following:

  • Early onset memory loss;
  • Mobility;
  • Remembering to take medication;
  • Experiencing sundowning;
  • Anxiety; and,
  • Basic personal care.

4. What are the assisted living services?

What Are the Assisted Living Services?

Services available at an assisted living facility vary widely between institutions. These are some of the primary services that places offer.

  1. Bathing: Bathing can be a dangerous activity for seniors because of the increased risk of a fall. At an assisted living facility, staff can help seniors in and out of the shower, supervise them in the shower, and even assist them with the bathing process.
  2. Toileting: While some seniors in assisted living may not need help with toileting, some facilities do offer the service. This can include help getting on and off of the toilet or help keeping clean for seniors who struggle due to mobility issues.
  3. Dressing: For those with arthritis or difficulty putting on their clothes, staff at assisted living facilities can help them get dressed. They can make sure they put on clean clothes, assist them with putting them on their level of care, and help them with buttons and zippers.
  4. Grooming: For seniors who have difficulty grooming, assisted living can help. Staff can help them brush their hair, brush their teeth, do their nails, or even put on their makeup. The availability of grooming services varies by location.
  5. Housekeeping: Light housekeeping is a part of the services that many assisted living facilities offer. This may include dusting, vacuuming, sweeping, wiping surfaces, and other simple tasks so that seniors do not have to do it.
  6. Laundry: Residents in assisted living usually do not need to worry about doing their laundry. Although it might be a separate fee, staff at the facility handle laundry for residents. Seniors with problems bending over, reaching, or carrying heavy items especially find this service helpful.
  7. Entertainment: As part of a social program in assisted living, facilities design activities for residents to promote socialization, cognitive stimulation, and entertainment. This could include board games, movies, and a wide range of activities unique to each facility.
  8. Meal preparation: In assisted living facilities, residents typically do not cook their own meals. Instead, the staff prepares and serves meals to all of the residents. Facilities can curtail food to meet dietary requirements. This is especially helpful for seniors who have a limited ability to cook for themselves or to get groceries.
  9. Mobility: Mobility issues are common among the elderly. Some seniors may need help walking around in general or going long distances, such as to the dining hall. Staff can help seniors move safely around their units and to other areas in the facility.
  10. Transferring: Those with mobility issues in assisted living may need help getting in and out of bed or a chair. Facilities offer services to help transfer residents to or from sitting and laying down positions for greater safety.
  11. Security: Assisted living facilities offer 24/7 security for residents. This may include a security check and log of all guests, monitoring whether the resident is at the facility, and providing regular security services.
  12. Home maintenance: As a resident of an assisted living facility, seniors do not have to repair their units. Maintenance staff on-site handle all repairs.
  13. Skilled nursing care: Assisted living facilities that are a part of a Continuing Care Residential Facility also have access to skilled nursing units. Even some standalone assisted living facilities have some skilled nursing care for lower-order healthcare issues.
  14. Memory Care: Some assisted living facilities have memory care units, while others may allow residents with early-onset symptoms. Trained staff deliver assistance with tasks that those with memory issues need. Memory care units help those with more advanced stages of memory loss disorders.
  15. Transportation: Many assisted living facilities can also aid in transportation of seniors for errands like doctor appointments. The facility coordinates the arrangements and the time for pick-up and drop-off so that seniors do not need to do it.
  16. Medication distribution: Nursing staff at assisted living facilities manage medication for residents. This helps seniors take their medications on time with documented evidence that they do so. It also helps seniors who may have any confusion with their medication or memory issues.
  17. Fall prevention: Assisted living facilities have installations and layouts within the units that eliminate typical fall risks that seniors may encounter in their own homes. They also have grab bars and other devices built-in to improve safety. Assessments of mobility needs and training in fall prevention also help decrease the risk of falls in assisted living facilities.
  18. Physical Therapy: Although not typical, some assisted living do provide physical services for their residents.

5. What to expect at Assisted Living?

What to Expect at Assisted Living?

Understanding what a typical day is like at an assisted living facility can help seniors and their loved ones determine if it is the right place for them. Seniors should keep in mind that what a typical day means varies widely by the facility and the services individual seniors need.

Morning Routine

These could be a normal part of the morning routine:

  • Wake-up;
  • Get out of bed either with or without assistance;
  • Shower and get dressed either with or without assistance;
  • Either make breakfast or go to the dining hall for breakfast;
  • Attend a morning group exercise class or go fora walk; and,
  • Engage in a social activity.

Afternoon Routine

These are common elements of an afternoon at an assisted living facility:

  • Make lunch or have lunch in the dining hall;
  • Run errands or go on a pre-designated outing through arranged transportation; and,
  • Spend time socializing with the other residents.

Evening and Night Routine

This is what seniors can expect to do in the evening and night at an assisted living facility:

  • Have dinner either in their residence or in the dining hall;
  • Enjoy a movie with the group or do another activity;
  • Take time alone to unwind or watch television before bed; and
  • Go to bed either with or without assistance.

5.1 What are the Advantages and Disadvantages of Assisted Living?

Seniors and their families should take the time to consider the advantages and disadvantages of assisted living facilities, along with other options, before making a decision.

Advantages of Assisted Living

  1. They provide care for residents who need assistance with basic functions.
  2. Assisted living gives seniors a community to help ease social isolation.
  3. Facilities provide meals for those who do not want to cook or cannot safely do so.
  4. Residents get monitoring of their health and security.

Disadvantages of Assisted Living

  1. Residents have less freedom compared to living independently.
  2. Some residents may not want to leave their homes or alter their daily routines.
  3. Assisted living can be expensive.
  4. Facilities do not have extensive medical care.

6. What are the some of the largest Assisted Living chains?

There are hundreds of different Assisted Living facilities that differ from each other in terms of quality, level of care and available services. Before choosing an Assisted Living facility for you or your senior loved one, make sure you make extensive research and read reviews about the facilities you are considering. Here are some of the nationwide Assisted Living facilities serving older adults in the U.S.

Atria Senior Living

Date established: 1996
Number of locations: 127

Atria Senior Living ranks is an award-winning provider in assisted living. It utilizes in-house chefs and even offers short-term stays, a rarity among assisted living facilities. This facility focuses on amenities and privacy for residents.

States located: Atria has locations the following states.

  • Alabama
  • Arizona
  • California
  • Colorado
  • Connecticut
  • Florida
  • Georgia
  • Illinois
  • Indiana
  • Kansas
  • Kentucky
  • Maine
  • Maryland
  • Massachusetts
  • Michigan
  • Nevada
  • New Jersey
  • New York
  • North Carolina
  • Pennsylvania
  • Rhode Island
  • South Carolina
  • Tennessee
  • Texas
  • Virginia

Services offered: You can find the following services at Atria Senior Living.

  • Bathing
  • Grooming
  • Personal care
  • Dining
  • Security
  • Gym access
  • Housekeeping
  • Laundry
  • Transportation (medical)
  • Transportation (non-medical)
  • Unit repair
  • Medication disbursement
  • Coordination with medical care team
  • Mobility assistance
  • Social activities
  • Safety monitoring
  • Memory care

Belmont Village Senior Living

Date established: 1998
Number of locations: 34

Belmont Village aims for a one-to-one staffing ratio so that each resident gets the care they need. It also has awards for its workplace culture and partners with top universities to rely on research to center its care practices.

States located: Belmont Village Senior Living has locations in Arizona, California, Georgia, Kentucky, Florida, Illinois, Tennessee, and Texas.

Services offered:

  • Grooming
  • Bathing
  • Personal care
  • Dining
  • Security
  • Gym access
  • Housekeeping
  • Laundry
  • Transportation (medical)
  • Transportation (non-medical)
  • Unit repair
  • Medication disbursement
  • Coordination with medical care team
  • Mobility assistance
  • Social activities
  • Safety monitoring
  • Memory care
  • Chronic disease management
  • Physical therapy
  • Occupational therapy
  • Speech therapy
  • Skilled nursing

Pacifica Senior Living

Date established: 1978
Number of locations: 88

Pacifica Senior Living has been rated as one of the best senior living places in the country. It offers both independent living and assisted living options.

States located: Pacifica Senior Living has locations in the following states.

  • Arizona
  • California
  • Florida
  • Idaho
  • North Carolina
  • Nevada
  • New Mexico
  • Oregon
  • South Carolina
  • Texas
  • Rhode Island
  • Utah

Services offered: The services at each Pacifica Senior Living facility varies, but these are some of the core services it offers.

  • Bathing
  • Grooming
  • Personal Care
  • Toileting
  • Transportation (medical)
  • Transportation (non-medical)
  • Mobility assistance
  • Dining
  • Social activities

Oakmont Senior Living

Number of locations: 51

Oakmont Senior Living focuses on providing an upscale experience to provide comfort to seniors. Facilities are on large campuses with views to facilitate its pampered lifestyle.

States located: Oakmont Senior Living operates in California and Nevada.

Services offered: Services differ based on location, but seniors can expect the base services below at each one.

  • Bathing
  • Grooming
  • Personal Care
  • Toileting
  • Transportation (medical)
  • Transportation (non-medical)
  • Mobility assistance
  • Dining
  • Social activities
  • Medication disbursement

Anthology Senior Living

Number of locations: 60

Anthology Senior Living focuses on amenities and activities to keep seniors active. Customer service and enrichment activities set this community apart.

States located:

  • Connecticut
  • Illinois
  • Indiana
  • Kansas
  • Kentucky
  • Michigan
  • Missouri
  • Ohio
  • Pennsylvania
  • Texas
  • Utah
  • Virginia

Services offered:

  • Grooming
  • Bathing
  • Personal care
  • Dining
  • Security
  • Gym access
  • Housekeeping
  • Laundry
  • Transportation (medical)
  • Transportation (non-medical)
  • Unit repair
  • Medication disbursement
  • Mobility assistance
  • Social activities
  • Safety monitoring
  • Memory care
  • Skilled nursing
  • Spa services
  • On-site library

Arbor Terrace Senior Living

Date established: Arbor Terrace Senior Living has been around for more than 30 years.
Number of locations: 47

Arbor Terrace Senior Living places an emphasis on the integration of the staff into an enjoyable living experience. Staff receives regular training and education to bring residents the best experience they can. It has a specific Dining with Dignity program to make sure that the dining options are a memorable and social experience.

States located:

  • Florida
  • Georgia
  • Illinois
  • Maryland
  • New Jersey
  • North Carolina
  • Pennsylvania
  • South Carolina
  • Tennessee
  • Texas
  • Virginia

Services offered:

  • Bathing
  • Grooming
  • Personal Care
  • Transportation (medical)
  • Transportation (non-medical)
  • Mobility assistance
  • Dining
  • Social activities
  • Memory care
  • Exercise classes

Wickshire Senior Living

Number of locations: 19

Wickshire Senior Living strives to integrate older adults with the community. This occurs through activities that engage seniors with the community and hiring staff that have a deep level of knowledge about their community

States located:

  • Florida
  • Georgia
  • Illinois
  • Indiana
  • Kentucky
  • North Carolina
  • Ohio
  • Oklahoma
  • Wisconsin

Services offered: Wickshire Senior Living uses a concierge model of services, but these are some of the basic services it provides.

  • Personal care
  • Memory care
  • Social activities
  • Dining
  • Exercise class

Cedarhurst Senior Living

Date established: 2007
Number of locations: 52

Cedarhurst uses a model that focuses on individualized care, services, and activities. The facilities craft available options based on the needs of each resident to provide a personalized living experience.

States located:

  • Georgia
  • Illinois
  • Indiana
  • Kansas
  • Kentucky
  • Missouri
  • Oklahoma
  • Wisconsin

Services offered: Cedarhurst implements a concierge model for services that differ based on the location and person. These are the standard services.

  • Personal care
  • Dining
  • Social activities
  • Exercise classes

7. Questions to Ask Assisted Living Facilities

Questions to Ask Assisted Living Facilities

These are some of the questions seniors and their loved ones need to ask before committing to a facility:

  1. What kind of training does your staff have?
  2. What is the staff-to-resident ratio?
  3. Do residents have opportunities for off-campus activities on a regular basis?
  4. What is the menu for the week?
  5. What services do you offer?
  6. Are there doctors or nurses available at the facility?

8. How to Pay for Assisted Living?

The average monthly cost of an assisted living facility is $3,628. Any facility would take private pay. Medicare only pays for medical services and short-term rehabilitation stays. It does not cover long-term care, such as in an assisted living facility. Medicare will continue to provide health insurance coverage while the resident lives at the facility. Medicaid also does not typically pay for lodging at assisted living facilities, but seniors can check their individual states’ plans. Long-term care insurance may provide funding for assisted living, depending on the policy.

9. Frequently Asked Questions about Assisted Living

1. Do assisted living facilities have to meet federal regulations?

One of the reasons that services and experiences differ between assisted living facilities so vastly is due to the lack of federal guidelines on the definition of an assisted living facility. Instead, individual states may have rules and regulations, primarily involving infrastructure and fire safety.

2. Can residents leave an assisted living facility?

So long as residents do not have a court order in place, seniors can come and go as they wish from an assisted living facility. Those with mobility issues made need assistance or to arrange transportation to do so safely.

Sources

1. Does Medicare pay for assisted living? – AARP

2. ATRIA INDEPENDENT AND ASSISTED LIVING

3. Pros and cons of assisted living – Consumer Affairs

4. What’s the Difference With Levels of Care in Assisted Living? – The Arbor Company

5. California Department of Aging

6. Continuing Care Retirement Community