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Not that long ago, there were basically two options for senior living: living independently in one’s own home or apartment, and full-time skilled nursing care. The assisted living concept was created to provide an additional option bridging the two.
Assisted living is a community-based long-term living arrangement designed for seniors who need some help with the activities of daily living (ADLs), but who want to preserve as much independence as possible. Typically, the help seniors get in assisted living facilities is individualized to meet each resident’s needs and desires. Depending on the situation, services can be added or removed as circumstances and choices dictate.
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No single description can paint a complete picture of what assisted living is. One community may look like a modern high-rise apartment building. Another might look like a quiet suburban townhome community. Still another may resemble a resort hotel or a country club. But we can make some generalizations. Seniors who live in assisted living communities typically will have their own private apartment-style living quarters, with convenient shared services on-site and nearby. Services usually include meals, social and recreational activities, and varying levels therapeutic and medical assistance. Another generalization: residents of assisted living communities are overwhelmingly satisfied with those communities and the lifestyles they afford.
There is no single national standard that defines what assisted living communities must provide. Providers are licensed at the state level, so the requirements of what it takes to offer assisted living services varies from state to state. Just as you would with any product or service you buy, ask any provider you are considering what is included with the basic monthly fees and what services are available at extra cost. It’s also a good idea to check with your state’s licensing authority to learn what your state’s standards are.
You might hear the term “continuum of care” associated with the assisted living concept. Some senior-focused communities say that they offer the complete continuum of care, from independent living to 24-hour skilled nursing care. If independent living is at one end of the continuum, and full-time skilled nursing care at the other, you might deduce—correctly—that assisted living is in between the two. It is a “happy medium,” if you will.
If you ask US seniors what is most important to them, maintaining as much independence as possible is a nearly universal answer. As we age, we might remain largely healthy and vigorous, yet still find one or more of the ADLs increasingly difficult to manage on our own. Sometimes a spouse, family member or friend is able to help us. But if not, should skilled nursing care should be the only alternative? In hindsight, it seems obvious it should not. Yet, before assisted living was developed, those were basically the options.
You will hear the term continuum of care used most often in the context of senior living communities that include separate but adjacent sections offering independent living, assisted living, and 24-hour skilled nursing care. These appeal to seniors and their loved ones who know that the senior adult can remain within one community setting and maintain the optimal balance of independence and assistance as time goes on.
The cost of assisted living is typically billed monthly. Many communities offer tiered pricing, so that residents who need or want fewer services can pay less, with costs increasing as more services are included.
Those who are now living independently but explore assisted living as a potential option for the future often find that the cost seems high. But they usually are not making an apples-to-apples comparison. Far from being “just an apartment,” assisted living includes many living expenses you might take for granted.
Daily meals are usually one of those expenses. Many people vastly underestimate their monthly costs for food. Not only are residents of assisted living communities spared the expense of buying food for their meals, they are spared the time and effort of shopping for and cooking all of their meals.
Utilities, such as electricity, water and gas service are also typically included, as are maintenance of the grounds and the living quarters themselves. Then, too, there are some benefits of assisted living whose costs are difficult to quantify, such as greater measures of safety, security and community. So while it’s true that costs among different communities themselves can vary widely, when comparing the cost to independent living, be sure to take all that is included into account.
We can, however, make some generalizations about costs. According to Genworth’s 2016 Cost of Care Survey, the median average cost for assisted living in the US is $3,628 per month, or $43,539 annually. The level of services provided and other factors can cause the costs of communities in the same area to vary widely. Cost will also vary by region. Where the general cost of living is higher, the cost of assisted living will most likely be higher as well.
Most people pay for assisted living through their own financial resources. This might mean using some combination of a pension or annuity, plus savings and investments. Sometimes financial help from one’s children or other family members comes into play.
Seniors who own the home they live in might see that asset as an ideal way to finance the cost. They may, for instance, choose to sell their home outright and use the proceeds to pay for assisted living. Or they may rent the home. A third option is a reverse mortgage, which allows one to borrow against the equity of the home while retaining ownership of it. If you decide to use your home or other real estate you own as a means to finance your care costs, be sure you understand all of the details and ramifications of such an arrangement.
For many, long-term care insurance offers a good way to finance a comfortable lifestyle at the facility of their choice. Do your homework, though, because several factors can affect your long-term care insurance costs and benefits. Some government programs, such as veterans’ or Medicaid benefits, may help pay for care, though that help may be somewhat limited. Medicaid policies vary greatly from state to state.
Few people factor senior living care into their long-term financial planning. While there are understandable reasons for this, the more you plan, the more options you will have should the need arise. Still, chances are there are assisted living communities near you that will meet the needs and budget of you or your loved ones.
The services offered by assisted living providers will vary depending from community to community. Some communities offer services in a range of tiers and fees, so the services you receive can be customized to your needs. In general, basic services provided will include:
