How To Choose Assisted Living and Personal Care Communities

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For individuals who need some assistance with daily activities, assisted living and personal care communities are an important retirement living option. The living environments and amenities offered by communities vary widely; however, all communities provide residents with some level of daily assistance, which generally includes meal and housekeeping services.

Assisted Living communities have proliferated in recent years, and the offerings continue to expand. The growth in the market has created an unprecedented number of options for seniors and their families who are considering assisted living.

With so many choices, there is undoubtedly a perfect community for every individual, but the large diversity of options can leave consumers feeling overwhelmed and lost amidst industry terminology. The following information provides an introduction to the assisted living marketplace. Industry professionals can offer more specific information about their residences, and, perhaps most importantly, guided tours of their communities.

Assisted Living as a Retirement Option
According to the LeadingAge, there are 36,451 licensed assisted living facilities in the United States; these facilities are home to over a million Americans. To demonstrate the dramatic growth in the assisted living industry, the Family Caregiver Alliance (FCA) notes that “Between 2000 and 2002, the number of licensed assisted living and board and care facilities increased from 32,886 to 36,399 nationally, reflecting the trend towards community-based care…” As the population continues to grow, LeadingAge estimates that 12 million seniors will need long-term care by 2020. Not only are there increasingly more seniors, but today’s seniors are much more likely than their predecessors to leave their home environment to seek a community that offers social stimulation, conveniences and amenities, and various care options.

Services and Amenities
Assisted living communities offer housing and a variety of supportive services delivered by qualified staff members. As opposed to independent living communities, health care services are available at assisted living communities. The Assisted Living Federation of America (ALFA) notes that assisted living is “a unique transition from independent living without care” that “helps seniors enjoy an improved quality of life with independence and care combined.” In order to fill the needs of their residents, assisted living communities generally offer some assistance with the activities of daily living. Activities of daily living include eating, bathing, dressing, transferring, toileting, medication management, and walking. Survey data from the National Center for Assisted Living (NCAL) reports that 81% of assisted living residents need assistance with one or more of the activities of daily living. Most communities offer three meals a day served in a common dining area. Many also offer some type of assistance with transportation. Housekeeping and laundry services are standard offerings. Staff members are available to meet resident needs 24 hours a day. Most communities are equipped with security systems and emergency call systems are often available in all residences. For residents with more acute health care needs, such as Alzheimer’s or other forms of dementia, special units and/or specially trained staff members are often available.

In addition, communities offer a wide range of social activities to stimulate resident contact. Standard activities include religious services, educational programs, games, clubs, and entertainment. Many communities also offer exercise and wellness programs. Often, activities are catered to and driven by resident interests. Community amenities vary widely but can include private units, state-of-the-art facilities, beautifully decorated common areas, barber shops and beauty parlors,pharmacies, physical therapy services, recreation rooms, libraries, gardening areas, and fitness centers.

Types of Communities
Consumers will quickly find that assisted living communities come in a variety of shapes and sizes. Assisted living communities are also commonly called residential care facilities, personal care homes, retirement homes, or community residences. Assisted living also makes up part of the continuum of care offered by continuing care retirement communities (CCRCs).

Assisted living communities range in size from large communities with 100 or more residents to small homes with 15 or fewer residents. From converted family homes to sprawling campuses, consumers will find communities to fit every resident’s needs and preferences.

Payment Sources
Although Medicare does not cover the costs of assisted living, there are a variety of payment sources available. The National Center for Assisted Living (NCAL) reports that “certain services are paid under Supplementary Security Income and Social Services Block Grant programs.” Individual’s who meet income qualifications may also be eligible for assistance through their state Medicaid program. Some communities also offer internal financial assistance programs. State and local governments may offer subsidies for rent to income-eligible seniors. Contact the local Area Agency on Aging for more information on subsidies and other payment assistance programs.

Long-term care insurance policies provide another financing option for assisted living. Most of these policies will cover the costs of assisted living. Some of the costs of assisted living are also reimbursable through individual health insurance policies.

While there are other payment options available, the vast majority of assisted living costs are covered through private payments by residents and families. The nationwide average cost for an assisted living residence is $2,524 per month or $30,288 annually, according to the AAHSA.

These figures are averages only and do not account for more affordable or subsidized options that are available in most areas. Individuals should investigate all available payment sources and obtain specific information on standard rates and fees for additional services before choosing an assisted living community.

Financial and insurance experts can provide more detailed information about all the available payment sources. Additionally, professionals at assisted living residences will be able to offer information about assistance programs and subsidized units available at their communities.

Choosing a Community
Before choosing a particular assisted living community it is a good idea to carefully review several of the available options. First and foremost, consider the needs and desires of the potential resident. Would they like a large community or a smaller home? What types of activities and amenities do they enjoy? What payment options are available, and what communities fit into the price range? Begin the initial process of narrowing the search by reviewing local communities and answering these simple questions. Use the comprehensive housing search engine found on our home page to locate communities.

After narrowing the focus of the search, request brochures from potential communities. Communities can also provide more specific information such as the resident agreement or contract, a list of services and amenities, detailed prices, staffing information, admission and discharge criteria, and community rules. Reviewing this information will help to further narrow the field of potential communities.

The most important part of the decision-making process is visiting the potential communities. During these visits, talk with staff members and residents and tour the entire facility. It is advisable to visit a facility more than once, during different times of the day, to get a complete feel of the lifestyle at the community. If possible, have lunch with current residents.

While talking with residents and staff members, ask a copious amount of questions, and be sure to receive satisfactory answers. Staff members should be able to provide specific information about the community’s features and services. Information about costs and payment sources should be readily available and straight forward. The checklist below provides sample questions to cover during the visit. With the answers to these questions, making a final decision on the appropriate assisted living residence should be easy.

Assisted living communities are becoming an increasingly popular option because they can offer a little, or a lot, of help in a home-like setting. After making an informed decision, new residents can feel confident that their individual care needs will be provided for in an atmosphere that is conducive to continued independence.

Assisted Living Community Checklist

Obtain answers to the following questions while reviewing assisted living options

Is the community location appealing?
Is the outside of the building well maintained?
Are the common areas clean and inviting?
Is the floor plan easy to understand?
Are the hallways and rooms designed to accommodate wheelchairs and walkers?
Are staff members professional and approachable?
Do staff members provide a care plan for each resident?
Are staff members available 24 hours a day to provide assistance with activities of daily living?
Does a physician or nurse visit residents regularly?
Are residents socializing?
Do residents appear happy?
Talk with the residents. How do they like the community and the staff?
Request a daily schedule or calendar. Are there regular activities available?
Are housekeeping and transportation services available?
Are there emergency response systems in bathrooms and/or individual units?
Are three meals provided every day?
Is there a contractual agreement detailing all services, fees, and admission and discharge policies?
Are additional services available should they become necessary?
Request an itemized list of charges. What are the specific costs for services?
Are there any government, private, or corporate programs available to help cover the cost of care?

Adapted from the checklist provided by the Assisted Living Federation of America (ALFA). Visit for more information

Additional Resources

American Association of Homes and Services for the Aging (AAHSA)
Association is committed to creating the future of aging services by providing an association of member providers who people can trust.

Assisted Living Federation of America (AFLA)
National association dedicated exclusively to professionally-operated assisted living communities for seniors.

Consumer Consortium on Assisted Living (CCAL)
The only nonprofit, consumer-based organization nationwide focused on the needs, rights, and protection of assisted living consumers, their caregivers, and loved ones.

Family Caregiver Alliance (FCA)
Alliance offers a wide array of services and publications for caregeiver needs, including consumer publications. Although the organization is based in California, much of the information is applicable nationwide.

National Center for Assisted Living (NCAL)
The assisted living arm of the American Health Care Association (AHCA), which is the nation’s largest organization representing long term care.

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