About Senior Assisted Living
If your loved one is in need of help performing some of his or her daily activities, then assisted living might be the right choice for their needs. Some help that might be provided to an individual in an assisted living community include meal preparation, bathing, hygiene, incontinence care, dressing, and more. Assisted living communities typically have semi-private and private room options with common spaces for socializing, shared dining, transportation services, beauty shops, and more. In some instances, specialized care may be provided for seniors with special conditions such as dementia or Alzheimer's disease as well as other common medical conditions.
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What is Assisted Living?
Residences offering assistance and hospitality services to seniors who require help with daily activities but who are still able to live independently fall into the category of assisted living facilities. These facilities most frequently include private communities and apartment complexes. Living arrangements include furnished or unfurnished rooms, private or shared studios or one-bedrooms and sometimes dormitory-style bedrooms.
Also known as boarding, adult congregate care, or domiciliary care, assisted living is an option for those who require some basic assistance with daily living - it is the next step for individuals who need slightly more support than living completely independently. These communities promote independence while offering a helping hand and life-enriching services. Considered a long-term care option, assisted living facilities must be certified, registered or licensed depending on the state.
According to a 2013-2014 report by the Centers for Disease Control (CDC) there are more than 835,000 Americans residing in these types of facilities, a majority of which are white females over age 85. The average length of stay for assisted living residents is just over 2 years according to research conducted in 2009 in conjunction with oversight by several national senior housing organizations. The next step after assisted living is typically nursing home care as individuals require more assistance and care as they age.
What Services Does Assisted Living Include?
The basic services offered in assisted living facilities can vary. Generally, these services can include:
- Transportation services
- Social, educational, recreational or religious activities
- Assistance with medications
- Housekeeping and laundry
- Daily living activities (bathing, dressing, grooming and other personal care)
- Dining and meal preparation
- Health, wellness and exercise programs
- Supervision and 24-hour emergency response
There are several services that can be provided in conjunction with an assisted living facility that go beyond those listed above, such as skilled nursing care. Some assisted living facilities specialize in Alzheimer's, Diabetes, Depression or Cardiovascular programs and have designated wings for residents with these conditions. The services offered at facilities can vary based on location or State, so it is important to discuss the extent of care needed during the initial consultation.
Assisted Living vs. Nursing Home Care
To have access to a wide range of personal, medical and health services, nursing homes are a good choice for those requiring more care than an assisted living facility provides. A nursing home offers medical staff, physicians and physical therapy in addition to meals and assistance with daily living. These services typically include nursing care, 24-hour supervision, three meals a day, and assistance with everyday activities.
As an example, if a resident requires intravenous medications, wound care, or occupational, physical, speech or respiratory therapy or treatments, they would most likely require a level of care beyond assisted living and be better suited for a nursing home with a skilled nursing unit. The length of stay at a nursing home can vary from a few days to a few months or longer depending on the resident's needs.
Assisted Living vs. Home Care
Preference, abilities and cost are the most determining factors in choosing the right care. Without the ability to maintain everyday tasks, individuals may benefit from the 24-7 access to support that an assisted living facility provides. That said, home care allows the individual to stay functioning at home while a home health aide or nurse makes daily visits that can extend as long as 24-hour care. Home care can surpass assisted living costs if a lot of specialized services are needed in the home. An individual with more care needs can often pay less monthly when choosing to relocate to an assisted living facility.
What Is the Cost and How Do I Pay?
Considered a long-term care option, assisted living expenses are most frequently paid for out-of-pocket or by a combination of other methods such as Social Security, pensions, Veterans benefits, insurance, home equity, and various savings. According to a survey conducted by CareScout in June 2017, the national average cost per month for a private one-bedroom in an assisted living facility was $3,750. This figure is expected to rise to over $5,000 in the next ten years.
Long-Term Care Insurance
Long-term care insurance is a policy that is purchased through a private insurance company. Similar to health insurance policies, the price varies greatly depending on age, general health and amount of coverage. Coverage could be denied for people with pre-existing conditions such as Alzheimer's disease or Parkinson's disease. Not all insurance will deny based on these conditions so it is important to explore different insurance companies.
Medicaid is a Federal and State health insurance program for those with low income and limited assets. Administration of the program varies by state, according to the Centers for Medicare and Medicaid Services (CMS). Medicaid does not cover the costs of assisted living but may pay for services used in conjunction with a facility such as visits from a home health aide to help provide care and to delay the need to move to a more specialized facility such as a nursing home. Unlike Medicare, Medicaid has strict eligibility requirements.
Medicare is a federal government program for those 65 or older with low income and limited assets. It generally does not pay for assisted living but it will cover skilled nursing or home health services that may be used while living at an assisted living facility.
Aid and Attendance Benefit for Veterans
According to the VA website, the Aid and Attendance benefit (A&A) benefit is a special benefit for war era veterans and their surviving spouses. It is a tax-free benefit designed to provide financial assistance to help cover the cost of long-term care in the home, in an assisted living facility or in a nursing home. This benefit is for those who live in a nursing home or are mentally or physically incapacitated, or require the regular attendance of another person or caregiver in at least two of the daily activities of living. To learn more about the eligibility requirements and to apply for these veteran benefits visit VeteransAid.org online.
In situations when costs aren't covered through other means, paying via private funds is an option. Sources of private funds for assisted living include retirement accounts and 401Ks, savings accounts, annuities and insurance plans (including life settlements), trusts and stock market investments. Home equity and bridge loans can also be used when transitioning to an assisted living facility or increasing care services. Social Security is used by over half of those in assisted living as their primary means of paying for housing, and this can be an ideal solution for those who are receiving most of their care, including transportation, medication, and meals, through these facilities.
Assisted Living Regulations
Assisted living communities are not regulated nationally like nursing homes. Each state has its own laws, regulations and licensing standards. In some states, as many as 25 hours of training are required for the caregiving staff while other states have no training requirements.
It is important to observe the staff and residents carefully when visiting an assisted living facility - that alone can offer much insight into what the quality might be like. When researching assisted living homes or communities, read agreements carefully and ask questions such as:
Further Reading on Assisted Living
- What to Look Out for When Touring an Assisted Living Facility
- Misconceptions about Assisted Living Communities
- Assisted Living Needs Assessment
- The ABC's of Assisted Living: Key Terms Every Caregiver Needs to Know
- Continuing Care Retirement Facilities: Understanding Services, Contracts, and More
- More on How to Pay for Assisted Living
There are many benefits to choosing assisted living such as socialization, safety, meals, transportation and less worry for the family. While assisted living isn't the answer to every elder's needs or budget, it is an option that can contribute to a healthier, happier and longer life in the elder years.