Learning About Assisted Living

Assisted living is a long-term care option for seniors. When the medical care provided by a nursing home is more than is needed, but the resources in a retirement community are not enough, a person can opt for assisted living. Assisted living is a combination of housing, personalized support services, and healthcare designed to provide 24-hour assistance and supervision if needed.

Because each resident’s needs are different, assisted living residences provide a variety of services with varying levels of assistance for seniors. Services offered may include:

• Three meals a day served in a common dining area
• Medication management
• Housekeeping and maintenance services
• Transportation
• Assistance with personal care, such as bathing, eating, dressing, using the toilet, and waking
• Access to health and medical services
• Exercise and educational facilities
• Laundry and linen service
• Social, recreational, and religious activities

The residential setting of an assisted living facility can range from an apartment complex to a renovated brownstone to a converted school. The units are typically either studios or one-bedrooms that are furnished or unfurnished and include a private or shared bathroom and a kitchen.

Regulations and licensing requirements vary from state to state. One study conducted in 2000 by the National Academy for State Health Policy found that 29 states and the District of Columbia have a licensing category or statute using the term assisted living. Most states have information about their assisted living licensing requirements and regulations accessible through the Internet.

How Much Is It and Who Pays?

The cost of assisted living varies according to the room size and types of services needed, and is highly variable across regions. In a document last updated in 2005, the US Department of Health and Human Services estimates that yearly costs range from $10,000 to more than $50,000 with an average monthly charge just below $2,000. Similar studies from 2007 (MetLife) show costs higher by about 50% for those without dementia and considerably higher if Alzheimer’s care is needed. Bathing and dressing assistance, medication management, and (in a few facilities) meals can add substantially to these costs. According to a survey conducted by the National Center for Assisted Living (NCAL), three-quarters of assisted living residents paid for their housing from personal funds or with family assistance. Almost a quarter of residents received help with the cost from Medicaid and Supplemental Security Income (SSI). A little more than 3% of residents had funding through long-term care insurance policies and managed care programs.

What Should I Look For in Assisted Living?

The Consumer Consortium on Assisted Living (CCAL) offers the following general steps for selecting an assisted living facility on their website:

• Make an accurate and honest assessment of your needs, including physical, financial, and lifestyle. If you are not sure how to begin, contact a private geriatric care manager. Visit the National Association of Professional Geriatric Care Managers' website for a referral ( http://www.caremanager.org ).
• Visit as many facilities as you can. This will help you to get a sense of what is available in your area.
• Consider the proximity of the facility to those who will visit you.
• Narrow down your selection to the top two or three choices, return to those facilities and speak with residents and staff. Ask lots of questions. Try some of the services offered, like eating a meal or taking an exercise class.
• Ask for a copy of the resident agreement or contract.
• Ask to review the licensing or certification inspection reports.
• Call the local long-term care ombudsman’s office (the person who investigates complaints) and ask if there are complaints about the facilities you are interested in.
• Make an unannounced visit to the facility. Visit at different times of the day and weekend.
• Choose the facility that comes closest to your needs.

If you want to continue to live independently but require assistance with some activities of daily living such as bathing, dressing, meal preparation, managing medications, and housekeeping, assisted living may be right for you. The NCAL finds that more than a million seniors have chosen assisted living because it provides security and independence, privacy and companionship, and physical and social well being.