Assisted Living

Also known as: Assisted Living Facility, Assisted Living Home, Senior Living

Last Updated: October 20, 2020

Written by the Open Caregiving Team. Editorial review by Joyce O. Murphy RN, MSN.

What is assisted living?

Assisted living facilities are residences for people with disabilities or older adults who need assistance with their daily activities but do not need around the clock care from nurses.

Who is a good fit for assisted living?

Your loved one may benefit from assisted living if they:

  • Can ‌get around on their own or with little help.
  • Need assistance with their ADLs such as bathing, dressing, toileting, eating.
  • Are lonely or no longer drive.
  • Need help to clean and operate household items safely.
  • Have trouble structuring their days.
  • Are showing early signs of memory loss and forgetfulness.

Your loved one may NOT be a good fit for assisted living but ‌may benefit from a nursing home if they:

  • Are bedridden, wheelchair bound or need a lot of assistance getting around.
  • Need continual medical attention from a doctor or nurse.
  • Need rehabilitation or therapy services because of a recent hospital stay, injury, or illness.
  • Are showing signs of advanced Alzheimer’s or Dementia.
  • Have a chronic wound, colostomy, tracheostomy, or need insulin injections.

When should you consider an assisted living facility?

It may be a good time to consider assisted living facilities for your loved one if they:

  • Begin having frequent falls and other accidents in their home.
  • Are no longer up to ‌maintaining a house and managing their home bills.
  • Do not eat a healthy diet.
  • Do not maintain personal hygiene.
  • Start getting lost in familiar places.

It may be a good time to consider assisted living facilities for your loved one if you:

  • Are experiencing physical struggles to care for them.
  • Feel burned out due to caregiving and unable to keep going at the current pace.
  • Think ‌you are no longer capable of offering the care they need.
  • Think caregiving is causing your relationships with your loved ones to suffer.
  • No longer can keep your work and personal obligations to your employer and family.
  • Can no longer afford to have multiple in-home supports.

What services, care and amenities does assisted living provide?

Assisted living homes offer your loved one a secure, safe place to live where they enjoy the company of others and round-the-clock care.

Services typically provided at assisted living facilities include:

  • Meals and snacks
  • Medication monitoring
  • Personal care and help with ADLs
  • Cleaning and laundry
  • Exercise and wellness activities
  • 24-hour support and access to care
  • Limited health care services
  • Transportation to outings and stores
  • Social and recreational events

Some assisted living homes may offer:

  • An Alzheimer’s disease or dementia (memory care) program
  • A diabetes program
  • A depression program
  • A heart program
  • Art and pet therapy
  • Community Outings
  • Music Lounges
  • Computer labs or WiFi access

How much does assisted living cost?

Assisted living costs vary by state. Research from Genworth Financial shows the national average cost for assisted living facilities in 2019 was $4,051 per month. For a full breakdown of each state’s average, review this Senior Living chart. To see how the costs compare in your zip code see Genworth Cost of Care Calculator.

There are 3 main pricing models that assisted living facilities offer:

  • All Inclusive Model: Groups together everything that a resident may need into one monthly bill. Based on the facility, some medical care and optional purchases will be billed in addition to your monthly bill.
  • Levels of Care (tiered pricing): Offers different tiers of care to address varying levels of needs. Each tier offers a variety of services and care options grouped together, along with a specific number of monthly care hours. The highest tier would be for someone who needs extensive care, and the lowest tier would be for someone who needs minimal care.
  • Fee for Services (a la carte): Only charges residents a monthly fee for room and board and food, with additional care and services coming at an extra cost. While this model is the cheapest on the surface, the extra care and services can add up to more than the other payment models.

The fee per service and levels of care models allow flexibility for residents who do not need all the services. Often the all-inclusive price offers a discount on paying for every service separately. The best plan for your loved one depends on which services they need and what level of care they ‌require.

How can my family pay for assisted living?

There are several options for paying for assisted living care. It’s a good idea to learn about your loved one’s options before visiting facilities.

Medicaid

  • The most common way Medicaid can help pay for assisted living is through your state’s Home and Community-Based Services (HCBS) Waivers or 1915(c) Waivers.
    • Although not every state offers these waivers, most do and others are adding them each year. For a full list of state Medicaid waiver benefits that can help you pay for assisted living, find your state on the chart at the bottom of this PayingforSeniorCare page.
  • One other Medicaid program that may help pay for assisted living is the State Plan Personal Care or Personal Assistance Services.
    • This benefit pays for personal care and can apply to assisted living communities. To learn more about your state’s program, see this PayingforSeniorCare chart.

Veterans Affairs

The VA administered Aid and Attendance Benefit can offer financial assistance for veterans who need help to pay for assisted living.

  • The Aid and Attendance Benefit will cover around $1,900 for a single veteran and $2,250 a month for married veterans.
  • Since the application and approval process can be lengthy, start the process earlier rather than later.
  • For more information, review the Aid and Attendance Benefit program homepage.

If you are eligible for both Medicaid and the VA Aid and Attendance Benefit, ‌speak with a VA care manager and your state’s Medicaid office to learn which program offers your loved one more assistance.

Non-Medicaid State Programs

Some states offer non-medicaid related programs to help aging adults pay for assisted living. These either directly pay for care or provide cash benefits that apply to assisted living costs. Review the chart on PayingforSeniorCare for a list of states and their programs that help pay for assisted living.

Medicare

Original Medicare does not cover assisted living. It may cover approved medical care costs that are needed while in an assisted living facility. Some Medicare Advantage plans have a Long Term Care choice that may help cover the cost of assisted living. If you have a Medicare Advantage plan, reach out to your insurance provider to find out what help they may offer.

Assisted Living Loans

Assisted living loans help families pay for the cost of assisted living. An example would be to get a loan while you are waiting for money from selling a home. Other situations in which you may want to consider assisted living loans are:

  • If you are waiting on veteran benefits.
  • If you will be paying for assisted living over a longer period of time than the facility requires. This may be an alternative to a reverse mortgage.

Long Term Care Insurance

For those who have long term care insurance, your plan should cover part of the assisted living costs. It’s wise to talk with your insurer before committing to a facility.

How can I find an assisted living facility near me?

  • Reach out to your local Area Agency on Aging for a recommendation on assisted living facilities near you.
  • Ask family, friends and community members for recommendations based on their past experiences.
  • Search LeadingAge for non-profit assisted living facilities in your community that are LeadingAge members.

Tips for choosing an assisted living facility

Before visiting each facility it may be helpful to answer these questions:

  • Do the services provided by the facility match your loved one’s needs?
  • Is the location close enough for family or friends to visit?
  • Does the size of the facility allow for the level of interaction your loved one desires?
  • Do the online reviews make you more or less comfortable with the facility?

Once you narrow down the possibilities, visit each assisted living facility to make the best decision.

Checklist for visiting assisted living homes

Certifications/Financials

  • Is the facility certified by Medicare or Medicaid, and is the certificate up to date?
  • Is the facility administrator’s license up to date?
  • Is it a for-profit or non-profit organization?
  • Is the management of the organization willing to speak with family members when needed?
  • Do the monthly costs seem reasonable relative to other assisted living facilities in the area?
  • Are all services included in the monthly costs or are there additional fees?
  • Is the contract clear and informative?
  • Does the assisted living facility perform a resident assessment when joining the facility and on a regular basis after that?

Residents

  • Are the residents dressed properly for the current weather indoors and outdoors?
  • Are the residents enjoying themselves and having regular interaction with the staff?
  • Does the food they are eating look appetizing and healthy?
  • Are there a diverse group of residents living there?

Facility

  • Do the rooms offer privacy for the residents?
  • Are there any strong odors?
  • Are there safety features inside and outside the rooms including grab bars, handrails, stability mats in the shower and emergency call buttons?
  • Are pets allowed to live in the facility?
  • Are there plants and comfortable furniture to create a pleasant setting?
  • Is the dining room comfortable, clean, and roomy?

Staff

  • Do the staff refer to the residents by name?
  • Is the ratio of staff to residents reasonable?
  • Have most of the staff and directors worked there for a while?
  • Does the staff happily assist residents with their activities of daily living?

Offerings

  • What are the visiting hours and can families participate in any activities?
  • Do they accommodate residents who want to participate in religious gatherings?
  • Is there an ongoing event and activity schedule?
  • Do they offer special meals for health or religious reasons? Do they post a weekly menu that has variety?

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