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Introduction

If you’re an elderly adult who lives alone but would benefit from assistance with daily activities like grooming, medication, meals and other services, you may be just beginning your search for more information about assisted living. Likewise, if your loved one needs help with daily activities or memory support in a safe and supervised environment, you’ve got your own set of questions.

That’s why this guide to assisted living is so important. We’ve done the research for you, so you can find out everything you need to know before making senior living decisions that will affectyou and your family members.

In this guide, you’ll learn about different types of assisted living, costs and options available tohelp pay for your apartment and services. We’ll explore amenities and services you’ll find in most assisted living communities. We’ll even take you step-by-step through how to choose an assisted living community, and how to make your final choice.

What is Assisted Living?

Assisted living communities allow seniors to live in a residential, homelike setting and enjoy an independent lifestyle while receiving non-medical assistance with daily living activities such as bathing, dressing, grooming and medication management.

Assisted living communities typically provide 24-hour staff supervision, prepared meals, housekeeping services, transportation and care plans tailored to each senior’s individual needs. Even though assisted living communities provide only non-medical care, they generally have at least one nurse who assesses each resident’s needs and creates an individual care plan for assistance with daily activities.

Here’s what you’ll find at most assisted living communities.

  • Private or semi-private apartments. Assisted living communities typically offer private or semi-private apartments with a kitchen or kitchenette and private bath. Apartments or rooms may be equipped with a call system and safety features like handles or rails in the bathroom and shower.

  • Prepared meals. Most assisted living communities offer three daily meals, generally served restaurant-style in a dining room. Some also offer a 24-hour accessible area for snacks and beverages.

  • Personal care services. Staff members assist with bathing, grooming, medication management and other daily living activities.

  • On-site or on-call nurse. Most assisted living communities have a nurse on-site or on call, sometimes 24 hours a day.

  • Housekeeping services. Residents generally receive weekly housekeeping services such as vacuuming, cleaning bathrooms and kitchens.

  • Activities and events. Assisted living communities generally provide activities and events that include exercise programs, educational seminars on topics like elder law or health and wellbeing, movie nights, outings and musical events.

  • Transportation. Assisted living communities often provide scheduled transportation for residents to medical appointments, shopping trips or other outings. Residents may also continue to drive their own vehicle if they’re able to.

When is it Time to Consider Assisted Living?

If you’re still active and independent but could use some help with daily activities, an assisted living community may be just what you need. For example, if you’re ready to go about your day once you’re up and dressed but have trouble navigating the shower or making breakfast, assisted living services such as daily meals and help with bathing can free your time for more enjoyable activities.

Does your loved one live alone? You may worry about safety issues like falls or injuries. Or, maybe you live with your spouse, and their daily activity needs may have become overwhelming. Still, the decision to leave the home that you’ve lived in for decades is a scary decision that can cloud your judgment.

It helps to ask yourself several questions to determine whether it’s time to consider an assisted living community.

1. Do you need help with daily activities? 

  • Are you no longer able to bathe and groom yourself consistently? If so, does this keep you from socializing or visiting places you enjoy?

  • Have housecleaning and home maintenance duties become difficult and exhausting?

  • Do you sometimes forget to take medications or have trouble staying on track with your medication schedule?

2. Are you able to prepare daily, nutritious meals?

  • Are you no longer able to shop regularly for groceries or make nutritious and healthy meals?

  • Do you sometimes skip a meal or eat unhealthy foods because you don’t feel like cooking?

  • Are you unable to meet specific dietary guidelines ordered by your doctor? 

3. Is the cost of in-home care starting to outweigh the cost of assisted living?

  • How much do you currently spend on in-home care for bathing, medication management, grooming, cooking and housekeeping?

  • How does that total cost compare to what you would pay for assisted living, which can include these same services tailored to your routine and needs? You can compare in-home care with assisted living costs using this financial resource locating tools.

4. Are you unable to drive to doctors’ appointments, the grocery store, pharmacy or social events safely?

  • Has your doctor advised you to stop driving at certain times or completely?

  • Have you been in any traffic accidents or near-misses while driving?

  • Do you ever become anxious or confused while driving?
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Is Assisted Living Affordable?

The cost for an assisted living community is based on a number of factors, such as where you live, the level of care required and the different services provided by the community. Click here to find out your state’s daily, monthly and annual median assisted living costs. The good news is that more than 400 programs provide financial assistance for elder care.

You’ll find a list of resources you may be able to use help pay for assisted living below. You can also learn more about these programs, along with many others here.

Here’s a sampling of common types of financial resources for assisted living.

  • Long term care insurance. This insurance policy pays for all or a portion of long-term care. However, if you don’t already have long-term care insurance but have an immediate need for assisted living, most insurers don’t issue new policies to those currently in need of long term care.

  • Veterans’ benefits. Veterans and surviving spouses may be eligible for the U.S. Department of Veterans Affairs Aid & Attendance benefit, a monetary amount in addition to any pension an eligible veteran is receiving. For an overview of eligibility requirements and benefits amounts, click here or call Veterans Affairs at (800) 827-1000 for more information.

  • Medicaid. In 2017, 43 states and Washington, D.C. offered some level of Medicaid assistance for individuals in assisted living or another form of non-nursing home, residential care.

    For example, in Massachusetts, MassHealth/Medicaid pays for personal care for residents in assisted living through that state’s Personal Care Attendant program. In many states, low-income residents could be eligible for financial assistance for assisted living.

    For an overview of Medicaid benefits for assisted living and a state-by-state guide, click here. You can also find answers to questions about Medicaid and how to spend down to receive benefits here.
  • Companion apartments. Some assisted living communities offer shared apartments to lower rent. These apartments have common areas and may have private bathrooms for each resident.

  • Selling or renting your home. If you don’t plan keep your home in your family, proceeds from selling your house can help pay for assisted living costs.

  • Life insurance benefits and conversions. Depending on your life insurance policy, you might also be able to convert the value of your policy to cash you can use to pay for several years in an assisted living community.

  • Reverse mortgage. If you plan to remain in your home while your spouse goes into assisted living, a reverse mortgage, which allows you to convert equity in your home into cash, may be an option.

Find more financial assistance options here.

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Talking With Your Loved One About Assisted Living

If you’re the spouse or family member of a loved one in need of help with daily activities, you’re probably wondering how to go about bringing up the idea of assisted living.

Here are some suggestions for having “The Talk” with your loved one.

1. Talking with a loved one about moving to an assisted living community may be met with denial, defensiveness and anger. Avoid responding defensively or punitively to your loved one’s emotions. Let your loved one know that they still have control and input on any decision.

2. If possible, introduce the idea to your loved one gradually. Provide them with brochures and resources that they can review privately. Be patient with the process and don’t push or make demands.

3. Have empathy for the fact that your loved one leaving their long-time home is a huge decision tied with the fear of losing independence. Reassure your loved one that you will be there for them with support and guidance.

4. With your loved one’s permission, ask a family friend, minister or care manager to participate in the discussion.

5. Discuss the safety aspects and other benefits of assisted living, such as opportunities to socialize and relief from yard work, housecleaning and cooking duties. Offer to visit assisted living communities with your loved one and ask for their input about what they would like in a senior community.

Finding the Right Community

While assisted living communities have common characteristics, each is unique when it comes to assistance services, staffing, amenities, payment structures and other factors. Here is how to start your search and a list of questions to ask.

How to find assisted living communities

  • Search the Internet. Browse websites of assisted living communities in your area to get an idea of the different communities, cost and services.

  • Friends and family. Ask friends and acquaintances for assisted living community recommendations. What has their experience been like before?

  • Contact several communities. Call or e-mail several assisted living communities for brochures and more information about price ranges, services, amenities and payment structures.

What do I need to know about payments and fees?

The different types of payment structures and fees you’ll encounter as you search for assisted living communities can be confusing. Here’s a quick overview.

  • Monthly fee. Some assisted living communities charge one all-inclusive monthly fee that includes things like the cost of your apartment, daily meals, some personal care services, utilities and access to community amenities and services. Others charge a monthly fee with additional charges for services that can add up quickly. 

    Although the monthly fee may increase over time, benefits of a monthly fee can include no long-term lease and the option of short, respite stays for unexpected circumstances such as recovery from an illness.
  • Buy-in. Some senior communities combine independent living, assisted living, skilled nursing and possibly memory care units in what’s known as a continuum of care model. This means that when your loved one’s needs become greater than the current level of services received, the resident can move into a more suitable residence and receive a greater level of services.

  • Community services fee. This is an additional, one-time or recurring fee that some communities charge for access to community amenities.

Determining what’s important to you or your loved one

If you’re considering moving to assisted living, you’ll want to look at not only the assistance offered but also the community as a whole. If you’re searching for a loved one, keep them involved during the search by talking with them about which factors are most important to them. Are they social and enjoy going to poker night each week? Or maybe they have a pet dog they would like to move in with them.

Amenities and services to consider:

  • Amount of assistance with daily activities. How many hours of assistance will the resident receive daily? Is there an extra fee for additional hours?

  • Safety and security. Is there an emergency call system in the apartment or room? Are there staff members present around the clock? What plans does the community have for emergency evacuations and natural disasters?

  • Meal options. Find out how often meals are served and in what setting, such as a restaurant-style dining room, and whether multiple meal options are offered such as a sandwich and salad instead of main entrees. Is there an in-room tray service option?

  • Nurse on staff. Is a nurse on-site or on-call 24 hours a day?

  • Pet policy. Does the community allow pets? If not, can family members bring a loved one’s pets to visit?

  • Events and activities. Does the community offer educational seminars about elder law, health, taxes, and other topics of interest to seniors? What about health and wellness programs, spa days, shopping and other outings, musical or cultural events and religious services or ceremonies?
  • Companionship. Are there opportunities for you or your loved one to socialize with other residents through exercise, board games, movies, classes, outings and community settings such as outdoor seating, a sunroom or courtyards?

  • On-site amenities. Many senior communities have beauty salons, barbers, movie theaters and gardening areas for residents to enjoy. Find out if these amenities cost extra or are included in the community’s monthly fee.

How to Compare Communities

The best way to compare assisted living communities is to visit as many as you can to gauge what you’ll receive for the cost and the overall well-being of residents.

Key factors to compare:

  • Do residents seem happy and engaged?

  • Is the staff caring and friendly toward residents and visitors?

  • Is the residence clean and well-lit?

  • Do apartments offer adequate privacy?

  • Are there security and fire safety systems?

  • Do rooms and bathrooms have handrails and call buttons?

  • Are there plenty of homelike common areas such as living rooms, libraries and outdoor spaces?

  • What is the staff-to-resident ratio?

  • Is the community licensed and in compliance with state regulations?

  • Does the community offer units or residential neighborhoods that offer memory care programs? If your or your loved one’s needs become too great for assisted living, does the community’s team work with hospice, home health or skilled nursing to find a solution that better meets your needs?

To assess your assisted living visits, bring along a copy of this AARP checklist for assisted living.

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Making your Assisted Living Choice

Take your time comparing communities. After all, the one you choose will be your or your loved one’s new home. Make sure you choose a pricing structure that you’re comfortable with and understand, and don’t be shy about asking administrators to explain all costs and fees.

Once you’re ready to make a decision, meet with the assisted living community’s team to assess your loved one’s needs and put together a service plan tailored to your or your loved one’s routine and lifestyle.

The last important step is signing a contract. Make sure the contract states the arrangements, all costs and services, care and resident rights. Before you sign, take the contract home to review with family members and also run it by a financial adviser and an attorney.

No assisted living community is the same. By using the questions outlined in this guide, you’ll be able to decide on which one will best fit your loved one’s needs.