Assisted Living: Your Definitive Guide for 2022

Assisted Living: Your Definitive Guide for 2022

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What is assisted living?

By Marlena del Hierro, last updated August 8, 2022

Assisted living is a type of long-term residential care for seniors who need some help with daily tasks like laundry, transportation, and medication management. Most senior communities are assisted living communities as it is the type of care that most seniors need. You might see that some communities refer to themselves as “retirement homes,” “senior residences,” or other terms, but the services they provide are usually assisted living services.

Assisted living facilities offer seniors room and board, 24-hour (non-medical) care, housekeeping, laundry services, social engagement, wellness programs, and much more. This 24-hour non-medical care typically includes helping residents with the activities of daily living (or ADLs): bathing, dressing, toileting, etc. Assisted living communities can be large, hotel-like properties, or more intimate single family homes (often called board and care or residential care homes). The terminology a community uses can vary slightly due to preference or state regulations; for example, you might see assisted living communities  sometimes referred to as long term care facilities. The types of services, amenities, and community atmosphere and culture, will vary from property to property, but the basic premise of helping older adults with ADLs every day is consistent.

The aging process is different for everyone. As people experience increased daily care needs, cognitive decline, social isolation, and/or the desire for a maintenance-free lifestyle, assisted living communities can be the best option. Although assisted living staff will have an individualized care plan in place for each resident, it does not mean constant monitoring or a lack of privacy. Assisted living can be the perfect balance for seniors who want to be independent, but also need some day-to-day assistance and care.

What does assisted living typically look like?

Assisted living communities vary widely in size and style. Some might be smaller and more casually cozy, while others aim for the vibes of a luxury hotel. Typically, though, assisted living communities are comprised of communal areas (including dining rooms, libraries, game rooms, etc.) and private rooms. You could share your room with a roommate, or have your own suite, complete with kitchenette. Meal times are often communal, but in many communities you'll have the option to dine in your room, or enjoy snacks at your leisure.

An example of an assisted living dining area. Photo credit: Bethany Retirement Community.

 

Typically you’ll be able to bring in some of your own furniture, as well as your art, family photos, and other home decor. Assisted living communities want their residents to feel at home. Assisted living communities might offer studios, one bedroom, or even two bedroom units to residents.

An example of a resident’s room. Photo credit: Ascension Living Resurrection Village.

 

Most assisted living communities will also have outdoor spaces, though they may be as simple as a modest patio or as grand as large gardens.

An outdoor space. Photo credit: Symphony Residences of Lincoln Park.

 

Assisted living communities might also offer theaters, exercise rooms, indoor and/or outdoor pools, chapels, salons, and private event rooms where you can hold family gatherings and celebrations. These amenities just depend on the size and style of the community.

Read our article on assisted living resident's rights to learn more of what you can expect from this type of community.

How does assisted living differ from other types of senior living?

Assisted living vs skilled nursing facilities (SNFs)

Often, families start their senior living search by looking for “nursing homes.” Although the public still uses the term “nursing home,” within the senior care industry it is all but obsolete. If any senior housing fits the term “nursing home,” however, it is Skilled Nursing Facilities. While assisted living provides help with daily living, SNFs offer much more involved medical care.

Most SNF residents spend the majority of their time sedentary: they might be bed or wheelchair bound with limited mobility. They need daily skilled nursing care, such as help with a feeding tube, that an assisted living community could not provide. The majority of seniors don’t need the level of care SNFs provide, or only need it for a short period of time while recovering from an accident or surgery.

Assisted living vs. independent living

Seniors who choose independent living communities typically require very little, if any, daily assistance. Unlike in assisted living, independent living residents can get around, cook, bathe, clean, and manage the majority of their life without extra help. 

Independent living often provides day-to-day social activities and communal amenities, similar to gated communities or large condo associations. Living spaces are usually larger, apartment-style quarters with full kitchens, outdoor areas, private rooms, etc. Some senior communities (CCRCs) offer independent living units as well as assisted living and even memory care, allowing residents to age in place, or for spouses who need different levels of care to live on the same property together.

Assisted living vs. memory care

Memory care is designed to provide a safe and stable environment to residents who have been diagnosed with Alzheimer’s or dementia. If your loved one only has occasional lapses in memory, and has not been formally diagnosed, they likely do not require memory care just yet, and would be better served by an assisted living community. Memory care communities offer activities designed to promote cognition and provide a routine environment that helps to alleviate the anxiety that confused residents might feel. They also tend to be secure in order to keep residents safe from wandering.

Assisted living vs. in-home care

In-home care is just what it sounds like, care that takes place in your own home. In-home care can be divided into two categories: home care and home health care. Home care provides services similar to what you’ll find in assisted living: help with ADLs, cleaning, meal prep/delivery, transportation, and other chores or errands. Seniors who want to stay in their own home for as long as possible often seek out home care. Home health care, in contrast, provides medical supervision, usually after hospitalization or injury. Home health care providers can bring services like physical therapy, medical tests, administration of medicine/shots, and wound care to you at home. Even if a senior already lives in an assisted living community they might be able to, depending on their communities capabilities, have home health care services come to them in their community, so that they don’t need to move out as they recover from surgery or illness. Similarly, a family might request additional home care support for a senior in assisted living, for more 1:1 attention or companionship.

How much does assisted living cost?

According to our data, the national average for assisted living costs in 2021 was $3,931 per month. That comes to about $47,172 a year. That may sound like a big number, but once you add up all current living costs, you may be surprised that there are often notable savings.  

Keep in mind that this is an average, and that the numbers used to calculate it spanned a wide range. There are a few factors that go into this cost, location being perhaps the most important: the cost of care varies widely across the country and from urban to rural areas. Additionally, the personal care services provided and the amenities available will change the cost from community to community.

The costs of assisted living cover the room, three meals per day, 24-hour supervision, housekeeping, and daily non-medical assistance as part of your monthly fee. Once you add up housing, meals, healthcare, social activities, and other amenities, the cost of assisted living might actually be comparable to living at home, especially when compared against home maintenance, property taxes, and other monthly expenses. 

There are also many ways to find that perfect balance of price, services, and comfort. There are a wide range of communities, from the basic to the luxurious. It is possible to choose an assisted living facility that fits your budget without skimping on care and amenities. 

CityView Senior Living, Los Angeles, CA
Photo credit: CityView Senior Living, Los Angeles, CA

 

How to pay for assisted living

Most families pay for assisted living with private funds: retirement funds, pensions, and personal savings. After private funds, home equity is one of the most common ways to pay for assisted living.  Equity is the money saved up in your house: you can either sell your property for a lump sum to cover costs, or take out a line of credit backed by the property to supplement your needs. Similarly, reverse mortgages are a kind of slow liquidation of home equity. With a reverse mortgage, you get a monthly payment for your house that slowly turns the money you’ve put into it into cash that can go towards assisted living expenses.

Even families that live comfortably can feel some “sticker-shock” at the price of assisted living. If you’re unsure if assisted living can realistically fit into your budget, look into the many financial aid options available. Many communities offer special payment plans, programs, and other strategies to help your loved one live in their ideal community. Below are some other types of benefits that might be able to help either with the cost of assisted living itself, or with hospital stays and healthcare.

  • Long-Term Care Insurance LTI acts like a regular insurance policy and picks up the expense of assisted living under whatever the terms were when you signed up for the policy.
  • Medicare does not pay for assisted living. There are other ways it can help with hospital stays, rehab, and memory care, however. While Medicaid can help with some of the costs of care, half of Medicaid’s funding comes from the federal government and half from your state, so details of coverage and co-pays vary tremendously from state to state. To learn more about what Medicare and Medicaid do and do not cover, take a look at our pieces on both:
  • Veterans’ Benefits Most veterans are eligible for senior living costs through the VA. Take a look at our piece on VA benefits to learn more.

Deciding how to pay for assisted living or any kind of senior living care for yourself or a loved one can be as challenging as finding the right care was in the first place. Before you commit to one method to cover costs, be sure you know all of the options you may be eligible for.

Assisted living communities by state

What type of care does assisted living provide?

Assisted living provides assistance with the activities of daily living, or ADLs. Medical professionals and assisted living staff use ADLs to evaluate how independently someone can live.

  • Personal hygiene This activity includes not just bathing and grooming (brushing your teeth and hair, trimming nails., etc.) but also whether you can handle glasses, contacts, and hearing aids.
  • Toileting/continence This ADL refers to one’s ability to recognize the need to go, reach the toilet, and wipe effectively, as well as the ability to sit and stand back up.
  • Dressing refers to one’s ability to not only get dressed independently but also to recognize what clothing is appropriate for the weather or setting.
  • Eating means feeding yourself (and drinking) without spilling.
  • Mobility (often called “Transferring”) refers to the ability to change from one position to another (from sitting to standing, getting out of bed, etc.) as well as walking.

Assisted living communities can help residents with all of these activities of daily living in addition to laundry, meals, transportation, and medication management, while still affording them the independence to pursue their hobbies and interests every day. 

What are some services and amenities provided by assisted living communities?

While some seniors fear leaving their own homes and moving into assisted living, many report that after making the transition they are happier: it is easier to socialize and get out of the rut they might have been in. It’s been proven that maintaining social connections is essential to keeping senior minds sharp and healthy. It also helps to stave off depression and other mental problems, which can be a serious issue for older adults. 

Though your loved one may currently seem more than content with the familiarity of their own home, the ability to easily enjoy meals with friends, learn new skills, and interact with their peers daily often becomes a priceless, life-extending amenity. What assisted living offers is quality of life and connection.

Seniors enjoying a game. Photo credit: Vintage Coventry.

 

Some common activities that assisted living communities might offer are art or exercise classes, shopping trips, dances, movie nights, bingo, religious services, day trips to museums and other sites of interest, and live music/performances. 

Assisted living amenities might include a salon or spa, swimming pool, gardens, fitness centers, game rooms, and more. These amenities will vary of course, from community to community, but whether the community is large or small, basic or luxurious, assisted living staff are committed to making residents feel at home and providing access to the hobbies and activities that are important to them.

 

We figured finding a place close to us that would have the amenities my father needed would not be easy. He had spinal stenosis and the only pain relief he got was swimming every day in the pool in his condominium complex.  We thought it would be close to impossible to find a place that housed an indoor swimming pool...We were pleasantly surprised to find that these communities had changed a lot over the years.

Tami Rogers


 

Photo credit: Maplewood at Mayflower Place

 

A beauty salon. Photo credit: Brookdale Lakeview

 

How do you know when it's time to move to assisted living?

It’s hard to know when to start considering assisted living. Oftentimes, family members are forced to find an assisted living community after their older loved one experiences a medical emergency. It's much easier and less stressful to find and move into an assisted living community on your own time frame however, and many seniors do plan their transitions proactively. Making a proactive decision about assisted living, before an emergency forces the issue allows you can take your time touring communities and choosing one that will suit you or your loved one’s needs.

Some signs that it is time to consider assisted living include noticing that your loved one is less mobile than they used to be, have trouble keeping themselves and their home clean, or seem to be losing track of bills and communication. If your loved one doesn’t bounce back from illness or injury the way they used to, or if they’ve lost a noticeable amount of weight (accompanied by an empty fridge or pantry full of expired food), it is time to talk to them about moving someplace where their daily needs can be met and they can live life more fully and comfortably. Read our assisted living moving guide. 

How should you evaluate and choose an assisted living community?

Now that you know what to expect from an assisted living community you can start your search. It might help you to create a list of must-have features and nice-to-haves. Much like house-hunting, or maybe like selecting a college, moving to a senior community is just another life change. You can enter your zip code below and start looking for assisted living communities near you and filter by your desired services and amenities. Our search bar can also connect you with a Seniorly Partner Advisor who can help you through the entire process, from scheduling tours to making sure move-in day goes smoothly. 

Find assisted living communities near you

Once you’ve got a shortlist of properties you’d like to tour, you can start thinking of questions to ask. 

Each state has its own licensing agency responsible for inspecting and certifying each assisted living community. Here is a full list of regulating agencies by state, as well as a full list of certifications you should always ask to see. Always ensure the senior living community is completely certified with a reliable, upbeat staff of managers, nurses, caregivers, and other personnel. When asking questions, there should be no hesitation to prove total compliance of regulations. Take a look at our list of over 70 questions you might want to ask the community.

Beyond these important considerations, you should pay attention to whether the property seems well-kept, the staff seem friendly, and the residents seem happy. 

Read our articles on traits to look for and how to evaluate assisted living communities to get even more in depth advice on selecting a community that’s right for you.

Assisted Living FAQs


What is the difference between assisted living and a nursing home?

<p>Also called skilled nursing, a nursing home is a better option for seniors who need considerable, 24/7 daily care, or memory issues. Assisted living communities are best for those who are largely self-sufficient, active, and are looking to simplify their lifestyle, with a little extra help.</p>

What is the average age of an assisted living resident?

<p>According to the <a href="https://www.ahcancal.org/Assisted-Living/Facts-and-Figures/Pages/default.aspx">National Center for Assisted Living (NACL)</a>, more than half of all assisted living residents are 85 years old or older. The assisted living age range tends to be between 65 and 85, though there are exceptions, of course.</p>

Are pets allowed in assisted living facilities?

<p>Many may ask <a href="https://www.seniorly.com/resource-center/health-and-lifestyle/are-pets-allowed-in-assisted-living-communities">are pets allowed in assisted living facilities?</a> In many assisted living communities, residents are welcome to bring their pet with them. Check with each community to discuss their particular pet policies.</p>

Do assisted living communities offer emergency services?

<p>Though all assisted living communities should have First Aid and CPR certified staff on-site at all times, most don’t have full-fledged emergency services, though they should provide 24-hour emergency ready staff.</p><p>Instead, they are trained to call the nearest emergency hospital or community for quick assistance while providing basic care until help arrives.</p>

What if an assisted living resident has a medical emergency?

<p>Though some higher-end communities may have emergency services on-site, the majority of communities will immediately call the closest ER for assistance.</p><p>Certified staff will be at your loved one’s side to provide basic care and first aid while waiting for additional medical professionals. Staff will also immediately call the listed emergency contact to inform them of the incident.</p>

Is there always a nurse on-staff at assisted living?

<p>It depends. Some will have a full-time nurse on-staff to oversee Certified Nurse Assistants (CNAs), aides, and nursing assistants, as well as monitor any residents needing specialized care. Other communities will instead employ on-call, visiting or part-time nurses.</p><p>Either way, the majority of day-to-day medical care responsibilities is done by CNAs, aides, nursing assistants, and other care staff. All communities should provide 24-hour certified emergency ready staff.</p>

Is there a doctor on-staff at assisted living?

<p>Usually, no. Though some higher-end communities may have full-time doctor on-staff, most call doctors in only if needed. Others may have set hours that a local doctor will have on-site “office hours,” or residents will go off-site for all doctor’s visits.</p>

Do assisted living communities offer memory care?

<p>Though some assisted living communities offer specialized memory care services, the majority do not. Instead, research specific memory care communities so you and your loved one can find the community that perfectly fits their needs.</p>

Is medical care included in the cost of assisted living?

<p>It depends. At least some medical care like basic health monitoring and medication management, etc. is often included in the monthly costs, or as part of a monthly “care services” fee.</p><p>However, any additional medical care such as physical therapy, immunizations, emergency care services, injuries, etc. will cost additional fees.</p><p>As this can differ, do talk to each community for details on their specific policies.</p>

Are assisted living communities wheelchair accessible?

<p>All communities should be certified as wheelchair accessible throughout. Cane, walker, and wheelchair accessibility should be a cornerstone of every assisted living community's design, with ramps, handrails, and other features meant to accommodate mobility issues and other disabilities.</p>

How is the food in assisted living?

<p>No matter the community, all food should be nutritious, warm, and served three times a day. However, the more a community costs per month, the more likely it is to have higher quality and more varied food options.</p>

Are visitors allowed at assisted living communities?

<p>Of course, all family and friends are welcome to visit residents. However, due to security reasons, you will likely need to check-in at the front. There may also be specific visiting hours, so check with each community.</p>

What are the housing options in assisted living communities?

<p>No matter what, all communities should offer clean and comfortable housing options.</p><p>From there it can greatly vary, often depending on price. Housing options can range from a shared studio space, to two-bedroom apartments with a kitchenette, and anything in-between.</p>

Do assisted living communities offer transportation services?

<p>The majority of assisted living communities will offer transportation services off campus. However, whether they charge a fee for transportation, or what kind of transportation is offered, will vary.</p><p>Many communities will offer transportation to off-site doctor’s appointments, or other appointments. They also often offer regular shopping or day trips. However, talk to each community for specific details.<strong>&nbsp;</strong></p>

What is typically NOT included in the cost of assisted living?

<p>Though this can vary, services like cable, ER visits, additional meals, physical therapy, and other additional medical services are not usually included. Talk to each community about their specific rates.</p>

Is assisted living worth the cost?

<p>Though the initial sticker shock of monthly assisted living fees is understandable, once you factor in all of your loved one’s current expenses including rent, bills, food, transportation, medical care, etc. many find that assisted living is comparable, if not actually cheaper.</p><p>Also, the peace-of-mind in knowing your loved one is happy and content in a safe environment that prioritizes their well-being is often priceless.</p>

Are there additional fees for assisted living?

<p>It wholly depends on the community, but some communities will charge extra for auxiliary medical care costs, physical therapy, housekeeping, additional meals, cable, day trips, transportation, meal delivery fees, etc. Ask each community about what fees are included and which are additional.</p>

Are there upfront fees for assisted living?

<p>Many communities do require one-time upfront fees. This often acts as a deposit to reserve your spot in the community. It is typically not refundable and often costs around $1,000.</p>

Why do assisted living costs vary so widely?

<p>Every community offers unique services. Though all communities should be 100% certified and offer stellar care and comfort, some will offer more on-site amenities, housing options, and services than others. Location can also play a large part in cost differences.</p>

Do I need to tour the assisted living community?

<p>Though it’s not required, we always recommend you tour any assisted living community under serious consideration. This is the best way to ensure it’s the perfect fit for your loved one. It’s not uncommon for brochures, ads and online descriptions to be deceiving.</p><p>Experiencing the community in person not only will provide an accurate picture of the comfort, social life, staff, location, amenities, etc., it also allows you to look for major safety or cleanliness issues that are impossible to detect otherwise.</p>

Should my loved one come on the assisted living tour with me?

<p>If possible, we strongly recommend you bring your loved one on the tour with you. After all, they’re the ones that will be living there!</p><p>Even if you suspect they’ll be impartial or apathetic to the final decision, sometimes actually seeing them inside a particular community can help signify whether it truly fits as their new home.</p>

How many communities should I tour before choosing one?

<p>Typically, people usually explore about two to four communities before finding “the one.” The ability to compare multiple communities is a helpful tool for many. However, there’s really no right answer. If the first place you tour feels just right, go for it. If you feel the need to explore every assisted living community in the state before making the decision, that’s okay too.</p>

How do I schedule a tour at an assisted living community?

<p>The best way to tour is with a<a href="https://www.seniorly.com/agents"> local senior living expert</a>. They are not affiliated with any property and therefore do not have any agenda. You will want to find out if that expert is earning a percentage of rent from each property.&nbsp; If the expert will only arrange tours where they get a commission, we recommend you use their services, but also do your own shopping around.&nbsp;</p><p>Finally, though every community may be different, typically you can set up a tour by visiting the community's website and scheduling a tour online or calling them directly.</p><p>Make sure to ask for and choose a time when the community is active. This will help provide an accurate depiction of the community.</p>

What should I expect on an assisted living tour?

<p>Typically, tours take anywhere from 45 minutes to 2 hours. However, all tours should be tailored to your loved one’s specific needs and desires. You should never feel rushed on a tour and all questions should be happily answered.</p><p>At the start of the tour, expect to sit down and discuss exactly what you and your loved one are looking for in an assisted living community in terms of comfort, activities, finances, medical care, and more.</p><p>Then you’ll be taken around the entire community where you can expect to see residences, activities, dining halls, medical centers, etc. We also suggest staying for a meal to gauge food quality, and see the community during (what should be) an active, social time.</p>

Who should I meet on an assisted living tour?

<p>As many staff members and residents as possible. Try to meet the head of marketing, security, and nursing or medical care. Just know that it’s often lower level staff and residents that your loved one will be interacting with on a daily basis.</p><p>Talk to and observe the care staff, housekeepers and medical team. Are they friendly and helpful towards the residents? Also talk to current residents about how they enjoy living in the community. They can provide priceless insight into what everyday life is like.</p>

What should I look for on an assisted living tour?

<p>Keep an especially earnest eye out for safety or sanitation issues. Are all rooms and communities completely accommodating for seniors with mobility issues? Do you notice strange smells or stains? Do all residents appear to be well cared for?</p><p>Also, pay attention to daily activities and levels of socialization. Does it match the lifestyle of your loved one? Can you imagine them feeling at home there?</p>

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Marlena del Hierro is VP of Partnerships at Seniorly and holds an MA in gerontology

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