senior woman using walker in assisted living facility home

Assisted Living: The Complete Guide 2021

That time may come when it may not be safe for older adults to live independently. Medical conditions like limited vision, difficulty walking, and also complicated health issues may make an assisted living facility a good option. Before researching ‘ assisted living facilities near me ‘, it is a good idea to understand what they are and what to look for when choosing an assisted living home. Therefore, in this post we will review:

  • What is an Assisted Living Facility?
  • What’s the Difference Between Assisted Living Facilities and Other Senior Living Options?
  • Assisted Living Home – What to look for
  • How Much Does Assisted Living Cost?
  • Does Medicare Pay for Assisted Living?
  • Does Medicaid Pay for Assisted Living?
  • Tips – Finding Assisted Living Facilities Near Me

 

What is Assisted Living?

Assisted living is housing designed for those who need some medical and personal care. Hence, seniors may need help with activities of daily living (ADLs) such as bathing, toileting, or dressing.

Although residents may need some help, most assisted living facilities strive to have home-like environments.  Depending on the community, residents may have an individual room or shared quarters. Frequently, seniors personalize their living quarters with their own furniture and décor.

There is also a large range of amenities and services offered at assisted living facilities. Accordingly, these amenities and services may enrich their lives and enable seniors to live as independently as they can. Commonly they include communal areas for community activities and also games.

An assisted living facility can be perfect for someone who needs some help but also wants to maintain independence.  Most residents stay active and connect through exercise, planned activities, and also by eating together at the dining hall.

 

Although services will vary from facility to facility, assisted living facilities usually include:

  • Assistance with personal grooming. For example, showering and getting dressed
  • 24-hour emergency care or supervision
  • Laundry and housekeeping
  • Medication management
  • Some medical services
  • Nutritious meals, including accommodations for special diets
  • Recreational and social activities
  • Transportation (some facilities may be more limited than others)
  • Coordination of care, including scheduling medical appointments and follow-ups
  • You may find some facilities that offer more skilled care, for example, diabetes management, catheter care, oxygen management, or ostomy care.

 

 

 

senior woman sitting on bench with dog in front of assisted living home

 

What’s the Difference Between An Assisted Living Facility and Other Senior Living Options?

An assisted living home is a good choice for those who:

  • Do not need a lot of medical care
  • Need help with minimal tasks. For example, bathing, dressing, medication administration, or benefit from having prepared meals in a dining area
  • Seniors who want to maintain their independence for as long as possible and want privacy, but need access to care
  • Those who can’t live independently at home but don’t need the total care provided by a nursing home

 

Assisted Living Facility vs. Independent Living

For independent living, the housing is built with senior challenges in mind. The community is friendly for aging adults. For example, housing or apartments are often compact, easier to navigate, and with little maintenance. While residents live independently, many communities offer amenities, activities, and services.

An assisted living home is a better option for those who need some assistance. For example, seniors will benefit by getting help with personal care, transportation, or medication management. In contrast, independent living is usually a good choice for those who are pretty independent.

 

Note: Home health care is when needed services are brought to the individual, where they live. To learn more about home health care, read our post Understanding Home Health Care.  In this post, we review what services may be provided and what to expect from home health care.

Assisted Living vs. Nursing Home

A nursing home is sometimes also called a skilled nursing facility. A nursing home provides a high level of care for patients.

These patients have significant medical conditions and require medical care. However, the care they need does not require hospitalization. A skilled nursing facility can provide either short-term care or long-term care.

Long-term residence in a nursing home is typically for those with serious health conditions. These health conditions usually require continuous nursing and personal care. Commonly nursing homes are ideal for:

  • Most long-term residents need medical care. They also need help with such things as medication management, toileting, bathing, and dressing.
  • Seniors in a nursing home usually require more medical care than is typically provided in assisted living facilities.
  • Services provided in a nursing home include 24-hour supervision, nursing care, care coordination, nutritious meals, personal care, and also rehabilitative services.
  • Nurses are available around the clock for supervision and to provide skilled care such as IV therapy, wound care, and other health services.

 

Assisted Living vs. Memory Care

Memory care facilities provide special 24-hour care for those with Dementia. Sometimes Memory Care facilities are referred to as Alzheimer’s care or Dementia care facilities.

These facilities focus on caring for those seniors with memory issues, and there is also a focus on improving the quality of life. In addition, these facilities provide a safe environment because they cater to needs associated with memory loss.

Because people with Dementia tend to wander, memory care facilities implement special safety measures. For example, they usually have alarmed doors or elevators that need a unique code.

Memory care offers a secure, structured environment. They also have set routines intended to lower stress for people with Alzheimer’s or Dementia. Some assisted living facilities may also provide dementia care, so it is essential to ask to ensure your needs can be met.

 

Note: To read about the various types of senior housing, read our post Senior Living: The Complete Senior Housing Guide 2021. This post reviews home health care, independent living, residential care homes, assisted living, nursing homes, memory care, respite care, and adult daycare.

 

 

 

two senior couples at assisted living home happy sitting talking

 

 

Assisted Living Facilities – What to Look For

Before looking for an assisted living facility, consider what services you need and what is important to you. Think about what you need help with.  For example, showering, dressing, toileting, meal preparation, or medication reminders.

Some questions to consider include:

Questions about the Facility and Building

  • Is the facility licensed?
  • Does the building appear clean and also well-maintained? Is the décor attractive?
  • Are elevators easily accessible? Is the facility also easy to navigate with a cane, walker, or wheelchair?
  • Does the building seem safe with good lighting, non-skid floors, and also with secured carpets?
  • Is the building secure, including a security system and fire safety system?
  • Does the facility seem appropriately heated or cooled? Also, what temperature do they maintain?
  • Do the residents appear well-groomed and happy? In addition, are they appropriate as your new housemates?
  • Where is the dining hall? Is it easy for residents to get to?
  • How many meals are provided every day? Are snacks also available?
  • Will special nutritional requirements be accommodated?
  • What activities are planned?  Where do residents go to participate in social and recreation activities? Also, are residents usually encouraged to attend?
  • Are any pets allowed in the facility?

 

Questions about the Rooms and Living Arrangements

  • What types and sizes of rooms are available?
  • Are the rooms private?
  • Do kitchens or kitchenettes come in each room?
  • Can residents eat in their own room?
  • Does each room have a private bathroom?
  • Do the resident rooms and bathrooms have handrails and call buttons?
  • Are the resident rooms big enough for your needs?
  • Do the doors and windows have safety locks?
  • Is everything in the room easy to access? For example, cabinets and shelves. In addition, are handrails placed as needed?

 

 

 

woman in scrubs staff at senior living facility sitting talking with two seniors

Facility Policy and Process Questions

  • What is the facility visitation policy?
  • Is there a process in the event of a medical emergency?
  • What are the billing policy and payment options?
  • Are there any programs available to help pay for staying at the facility or with any of the services?
  • What transportation is provided? Does it include trips to doctor appointments and social activities?
  • Is there a medication policy?
    • Do they use a specific pharmacy?
    • Will my medications still be covered by my insurance?
    • Is self-medication allowed, or are all medications administered by staff?
    • What happens if a new medication is prescribed?
    • Do the staff obtain medication renewals?
  • Who makes dental or doctor appointments, including follow-ups?
  • Does a doctor or nurse monitor residents regularly or for checkups?
  • Does each resident have a plan of care?

Service and Staffing Questions

  • What type of care is provided to the residents?
  • Are staff available to help? For example, with
    • showering
    • toileting
    • incontinence
    • dressing
    • eating
    • laundry
    • getting around (mobility)
    • using the phone
    • housekeeping
    • hairdresser
    • transportation
    • getting medications (from the pharmacy), and also taking medications
  • Is there varying level of care options?  In addition, are different costs associated with each level of care?
  • If more care is needed, are additional services available? For example, nursing care, physical therapy, or post-operative care?
  • What staff will be providing services? What type of training do they have? Also, are they licensed or certified?
  • How do residents notify staff if they need help?
  • Is there trained staff to provide special care for residents with confusion or Dementia?

 

 

empty hallway at assisted living facility

 

 

How Much Does Assisted Living Cost?

The cost of living in an assisted living home varies greatly. Consequently, costs depend on the facility’s geographic location and also what services are provided.

Genworth compiles survey results annually. Click here to help calculate the approximate cost of care in your area.

The calculator allows you to compare the costs of:

  • getting in-home care
  • the cost of assisted living facilities, and
  • you can also look at the cost of a nursing home

Nursing home care is generally the highest costing because it provides the most care.

 

Cost of Care Survey

To find the approximate cost, we used the Genworth 2020 cost of care survey. The average USA national cost for an assisted living facility is $4,300 per month.  On the other hand, the national monthly average is $7,756 for a semi-private room in a nursing home. Below we show the state averages for the monthly cost of assisted living facilities and nursing homes.

STATE ASSISTED LIVING FACILITY NURSING HOME (Semi-Private Room)
USA — National $4,300 $7,756
Alabama $3,150 $6,540
Alaska $6,633 $37,413
Arizona $3,900 $6,844
Arkansas $3,500 $5,931
California $5,000 $9,247
Colorado $4,575 $8,517
Connecticut $6,300 $12,927
Delaware $6,690 $12,349
District of Columbia N/A $12,471
Florida $3,700 $8,669
Georgia $3,500 $6,722
Hawaii $5,000 $12,015
Idaho $3,675 $8,669
Illinois $4,575 $6,235
Indiana $4,382 $7,133
Iowa $4,073 $6,570
Kansas $5,090 $6,692
Kentucky $3,699 $7,330
Louisiana $3,639 $5,536
Maine $5,942 $9,642
Maryland $5,000 $10,190
Massachusetts $6,085 $12,623
Michigan $4,200 $8,973
Minnesota $4,283 $11,026
Mississippi $3,713 $7,057
Missouri $3,000 $5,080
Montana $4,213 $7,665
Nebraska $4,188 $7,194
Nevada $3,595 $9,262
New Hampshire $6,650 $10,646
New Jersey $6,650 $11,254
New Mexico $4,050 $7,406
New York $4,800 $12,319
North Carolina $3,800 $7,300
North Dakota $4,096 $12,167
Ohio $4,350 $7,148
Oklahoma $3,750 $5,323
Oregon $4,659 $10,114
Pennsylvania $3,955 $10,038
Rhode Island $4,950 $8,669
South Carolina $3,988 $7,298
South Dakota $3,638 $7,011
Tennessee $4,039 $7,072
Texas $3,998 $5,019
Utah $3,400 $6,388
Vermont $5,310 $9,779
Virginia $4,850 $7,665
Washington $5,750 $9,581
West Virginia $4,000 $11,376
Wisconsin $4,400 $8,684
Wyoming $4,175 $8,258

Source: Genworth’s 2020 Cost of Care Survey

 

 

 

 

pink piggy bank with dollars how to pay for assisted living

 

Paying for Assisted Living

 

Paying Out of Pocket

Seniors usually pay out of pocket for at least some of the assisted living costs. Accordingly, the money may come from investments, retirement accounts, savings, or other sources of income.

Paying out-of-pocket may be an option for those who have enough savings or financial support. Usually paying out of pocket means seniors can keep their assets.

 

Selling Your Home

Some seniors can no longer live in their homes. Therefore, they may want to move into an assisted living facility.

Older adults can use the money from the sale of their homes to cover the cost of the assisted living facility. The amount of money one has after selling their home depends on several things. For example:

  • the selling price
  • costs of selling the house, and
  • whether there is a mortgage. Also, any mortgage will need to be paid off from the proceeds of the sale.

 

Does Insurance Cover Assisted Living?

Private health insurance typically does not cover the cost of assisted living. However, it would be best to talk to your insurance company to confirm what may be covered, because every plan is different. You should also ensure there is coverage for medical care provided by the facility. Some Medicare Advantage plans may cover assisted living costs, hence, confirm with your plan because it varies by plan.

 

Does Long-Term Care Insurance Cover Assisted Living?

Usually, long-term care insurance will cover assisted living costs. The specifics of what and how much is covered will depend on your policy. The intent of long-term care insurance is to cover the costs associated with chronic disability or aging.

It’s best to confirm assisted living is a covered benefit. In addition, confirm how much of the cost is covered and also whether you need to meet any qualifications. Qualification, for example, may include needing help with two or more activities of daily living.

 

Does Medicare Pay for Assisted Living?

Medicare doesn’t typically cover the cost of an assisted living facility. In addition, Medicare does not cover the cost of residency (e.g., room or board) or for daily custodial care. Custodial care means help with things like showering, dressing, or eating.

However, Medicare-covered health services provided would be covered. For example, health services that would normally be covered for a Medicare beneficiary in a different living situation. Therefore, medical services provided by the facility like skilled nursing care or physical therapy should continue to be a covered benefit.

A Medicare Advantage plan may provide additional coverage. It is a good idea to call the plan and ask.

 

Does Medicaid Pay for Assisted Living?

Some seniors may qualify for Medicaid. Medicaid is a low-income combined federal and state program. Medicaid covers the costs associated with medical care and may also cover some long-term care. However, eligibility and what types of services are covered vary by state.

Usually, personal care and nursing services are covered benefits. However, room and board are not usually covered by Medicaid. Consequently, many states have additional Medicaid programs that help with long-term care costs.

In many states, Medicaid will provide financial assistance for assisted living for seniors who qualify. Typically this Medicaid coverage is through a waiver program,  known as the Home & Community-Based Services (HCBS) waivers.

Waiver programs provide expanded coverage. In addition, HCBS waivers are available to give seniors more long-term care choices rather than going into a nursing home. However, HCBS waiver options and availability vary between states. Therefore, it is a good idea to look at your state’s Medicaid program for information on coverage for assisted living services.

 

Does the VA Pay for Assisted Living?

The VA does not pay for assisted living rent or basic services in an assisted living facility. However, for eligible veterans, the Veteran’s Aid and Attendance benefit can help pay for assisted living. This benefit is intended to help elderly or disabled veterans access the care they need. For example, an assisted living facility.

 

 

pretty young woman and senior man sitting at table women searching computer for assisted living near me

 

Tips for Finding Assisted Living Near Me

Most states have numerous assisted living communities to choose from.

There are organizations and online tools to help get information on the different types of long-term care facilities in your area.

  • The Community Resource Finder is a joint project with the Alzheimer’s Association and AARP. This tool helps you search for senior housing, home care, and search other programs in your area.
  • The US Administration on Aging’s resource website, Eldercare Locator, provides information about local resources. Resources include housing options for older adults. Plugin your zip code and see what is available in your area. Contact your local Area Agency on Aging for information about senior housing and long-term care in your area.

 

Housing Resources for Seniors

Check out these housing resources which may be available for seniors or people with disabilities:

  • Housing Choice Voucher Program – This is a federal program that helps very low-income families, seniors, and also people with disabilities afford safe housing in the private market.
  • Use the HUD Resource Locator, identify your location, then click on ‘Affordable Elderly and Special Needs Housing’.
  • Eldercare Locator – This locator provides information about your local resources. Find your local Area on Agency, they can help find housing options for seniors.

 

 

Summary

An assisted living facility provides seniors with their own living area (like an apartment or a room in the facility) and common areas that encourage socialization. Assisted living facilities usually have staff available 24/7 and offer various services like meals, laundry, help with showering, dressing, and medication management. Prices vary by geographic location and what services and amenities are offered. It is a good idea to compare multiple facilities by asking questions and visiting them to make sure they meet your needs. Many people pay out of pocket to live in an assisted living home, but long-term care insurance or Medicaid may also help cover the cost.

 

References

NIH, National Institute on Aging, Residential Facilities, Assisted Living, and Nursing Homes

 

AARP, Assisted living Facilities: Weighing the Options.


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