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Assisted Living: Everything You Need To Know

Senior housing & living

An assisted living facility may be an ideal choice if you or your senior loved one need more personal care services than you can receive at home or in an independent living facility, but you don’t need the round-the-clock medical care and supervision of a nursing home.

Assisted living allows older adults to live independently in a supportive environment due to physical and functional health challenges. Seniors don’t need to worry about household chores, as the staff at the assisted communities handles tasks, such as housekeeping, yard maintenance, cooking, and laundry. Many communities also offer additional support, including medication management, dressing, eating, and mobility assistance.

However, with the number of senior living homes growing everywhere, it is important to know which one is best for your senior. Each assisted living facility is unique so it is significant to know how to be able to choose one according to your senior’s needs and budget.

To do that, it would be great to know what is involved in finding a good assisted living facility. This typically involves the type of care, the cost, the different services in a facility and how you could find one around you.

Find the Nearest Assisted Living Facilities

What is Assisted Living?

Assisted living is a part of long-term senior care services that provides a combination of personal care, health care, and housing designed to respond to individuals who need assistance for activities of daily life in a way that promotes maximum independence.

These services can be provided in freestanding communities, integrated with skilled nursing homes, as components of continuing care retirement facilities, or at independent housing communities.

Assisted living communities provide multi-faceted residential settings that provides 24-hour supervision and assistance, personal care services,  health-related services, designed to:

  • Minimize the need to relocate
  • Accommodate residents’ changing needs
  • Maintain residents’ dignity, privacy, choice and safety
  • Encourage family and community involvement

Difference between Assisted Living and Nursing Homes

The primary focus of assisted living is to help residents with activities of daily life, such as bathing, cooking, taking medicines. Emergency medical care is available through the usual channels, while some assisted living facilities have a resident nurse or even an onsite health clinic.Still, assisted living facilities don’t have skilled nursing staff.

On the other hand, nursing homes, also known as skilled nursing care centers, are mainly for older adults with intensive medical needs. A 2005 AARP study showed that nearly half of nursing home residents suffered from dementia, while over half spent most of their time bebdriiden or in a wheelchair. The medical care must be available 24 hours a day, every day[1]. Nearly a quarter of people in nursing homes stay for less than three months.[2]

Demographics in the US and Canada

​There are more than 28,900 assisted living communities with about one million licensed beds in the United States. The average number of licensed beds in an assisted living facility is 33. About 14.3% of these communities have a dementia care unit or floor designated 8.7% only serve seniors with dementia.[3]

More women than men seek assisted living facilities. According to the Assisted Living Federation of America, the ratio of women to men is 7:1 in assisted living communities. [4]The costs for assisted living grew 2.4% from 2017 to 2018, for a monthly median rate of $3,942 in the USA.[5]

From Statistics Canada, almost 17% of Canadians are 65 years or older. This is seen to increase to 20% by 2024. From this data, 6.8% aged 65 years and older are living in senior living facilities.[6]

But almost 30% among Canadians aged 85 years and older are living in nursing homes or senior residences. They are currently studying the need for more senior living facilities as the 65-year-olds from assisted living facilities would soon transition to long-term care facilities.[7]

Assisted Living Care Types

There are several assisted living care type according to the needs of seniors or those who need medical or personal care assistance. Some may need full-time care, while others need extensive medical care and some simply need to live in a community for companionship purposes. Each facility is designed to serve different kinds of needs like home care, long term care and assisted living.

You can also choose an assisted living facility based on the physical settings that appeal most to you or your loved one. Following are the categories of residential assisted living facilities you can choose from:

Apartment-Like Living

Many assisted living communities are in large complexes where seniors can rent or even buy an apartment. This type of facilities offer communal dining and shared activities, like gym, library, etc. 

Small Group Homes

These type of assisted living facilities offer a more homelike environment, housing just 4-25 people. The majority of these smaller places are in residential neighborhoods, where seniors can rent single rooms, enjoy in common spaces, and have meals together.

Specialized Care

Many assisted living facilities provide specialized services for certain medical conditions, such as Parkinson’s disease, diabetes, and depression. But the majority of these facilities providing specialized care offers dementia care. 

Continuing-Care Communities

Some assisted living communities are connected to nursing homes or are part of continuing-care facilities. This type of assisted living centers provide multiple levels of care, from nursing home care to independent living. Residents can move from one level to another according to their changing healthcare needs and personal preferences. 

Services Offered in Assisted Living Facilities

Assisted Living is more for those who need assistance to their daily tasks but not for full-time nursing care. Each facility offers different services. So it is important to check if most or all of the following services are offered:

  • One to Three Meals in a Day
  • Personal care, including dressing and bathing
  • Housekeeping and laundry
  • Monitoring of medication
  • 24-hour emergency care
  • Access to medical services
  • Social and recreational activities
  • Exercise and Physical activities
  • Transportation arrangements
  • Physical and Mental Assessments
  • Routine Skilled Nurse and Doctor Visits

The different facilities listed in Live your retirement have identified the different services they can offer. Live your retirement can get a list of services offered in the facility for you. Besides that, we can also provide a list of attractions and other facilities near their listings like hospitals, malls, and parks.

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Assisted Living Costs

The cost of having your senior in an assisted living facility is usually less than a full-time home care services or long-term care.

Use the following tool to figure out assisted living cost details by state and region. The tool displays average costs for different types of assisted living.

Type of care Average Cost in Region
Skilled Nursing Facilities Private Room Annual Rate: $91,279.20
Skilled Nursing Facilities Semi-Private Room Annual: $77,573.45
Assisted Living Facility Monthly Rate (2 bedroom): $5,699.17
Assisted Living Facility Monthly Rate (1 bedroom): $5,048.10
Assisted Living Facility Monthly Rate (Studio): $4,361.03
Registered Nurse Per Visit Rate: $134.31
Licensed Practical Nurse Per Visit Rate: $121.60
Home Health Aide Hourly Rate: $22.63

The rates differ according to location, facilities, and services. Based on the National Center for Assisted Living reports, ​the national median monthly and annual rates for assisted living are $4,000 and $48,000, respectively. Depending on population and location, the rates go lower or higher. Nearly 16.5% of assisted living residents rely on Medicaid to cover the cost of their assisted living services.[8]

On average, residents of retirement communities, including assisted living, pay between 1 500$ to around 3, 500$ monthly.[9] The cost varies depending on the province your facility is based and the level of care you choose.

Same in the US, some cities can offer a lower or higher rate. The standard rate would usually include housing and personal care and then additional fees for all other services.

Here are the general factors that would define the cost in an assisted living facility:

  1. Location
  2. Choice of Space: Shared room, individual room, studio or apartment type
  3. Services available in the facility

Though Medicaid does not cover lodging or housing costs. For some states, Medicaid does not cover services in assisted living. Thus most assisted living are paid by family members or by the senior's personal savings.

For those who have served at least 90 days of active  duty, the Department of Veterans Affairs covers assisted living care for veterans and spouses of veterans. Check your senior veteran if they may be eligible for it.

Rates in US States Average Cost
South Dakota $3,500
Utah $3,350
Idaho $3,475
New Hampshire  $4,675
Florida $3,500
Montana $3,900
North Carolina  $3,693
Wyoming $4,235
California $4,500
Alabama $3,271
Rates in Canada Provinces Average Cost
Alberta 2 798 $
British Columbia 2 747 $
Manitoba 2 378 $
New Brunswick 2 000 $
Nova Scotia 2 137 $
Ontario 3 204 $
Yukon  3 300 $

Check our blog on Why Assisted Living Costs Are More Affordable Than You Think

Free Resources for Assisted Living

There are many free online resources for assisted living facilities for those who need help and advice.

This Caring Home: This resource provides educates about creating a dementia-friendly environment for residents as well as caregivers by exploring a virtual home. It provides guidance on proper techniques throughout the home on safety measures for residents dealing with dementia.

Assisted Living Federation of America: Assisted Living Homes offers free literature on a wealth of assisted living facilities topics. For example, what questions one may ask before moving into an assisted living facility.

Residential Care | Caregiver Center | Alzheimer’s Association: Assisted living facilities may or may not accommodate your specific needs. This resource has Alzheimer’s Navigator™, which is a free online tool to guide you. You can use free Community Resource Finder tool to search for local residential care facilities.

Wellness Resource Room – Assisted Living Facilities: This website provides individuals and their families with a lot of information required to choose an assisted living facility. A free online assisted living finder helps you to find the right assisted living facility for your unique needs.

Alberta Continuing Care Association (ACCA): Edmonton-based ACCA is a voluntary, non-profit association of owners and operators of continuing care operating more than 120 facilities and an additional 40 home care and support organizations across Alberta. The member organizations provides contracted care to Albertans in the continuing care system.

New Brunswick Association of Nursing Homes (NBANH): It has over 60 members that offer residential care, assisted living and home support to seniors living in New Brunswick. The members are private care providers who deliver contracted care services for New Brunswick's two regional health authorities.

Assisted Living Laws and Regulations 

Canadian government introduced the Community Care and Assisted Living Act in 2004, replacing the Community Care Facility Act. The Act provides licensing for community care centers that offer care to vulnerable people in child and youth residential and adult and senior residential settings. The act also outlines a new registration process for assisted living residences that accommodate seniors with disabilities who receive housing, personal assistance services, hospitality and can direct their own care.[10]

The act mandates that assisted living facilities protect the health and safety of residents. They must value the perspectives of stakeholders, that is, residents and their families/caregivers. They are also responsible to investigate complaints using a remedial approach, ensure transparency and accountability in its administrative practices.[11]

Each U.S. state has its own laws and regulations for assisted living communities. For instance, in some states, around 25 hours of training are required for caregiving staff while other states have no staff training requirements.[12]

If you want to familiarize yourself with your rights and the legal obligations involved in assisted living communities in your state or city, click here

Choosing an Assisted Living Facility

With the array of assisted living facilities available, the amount of choices can be overwhelming. You can ease the process by differentiating these facilities on the basis of the following important criteria:

Quality

When looking for an assisted living facility, it's important to first know the state regulations where you'd like to place your senior. This will help you look for the legal qualifying side of these facilities. Also, include checking the qualification of the owner or administrator of the facility for senior care. This will assure you that the facility and the management are qualified to give your senior the services needed for assisted living.

Size of the Community

If you know the ideal facility your senior want, look around for the best match. There are facilities that have very few residents to as big as 500 community members. Ask your senior what type of community they want to live in.

Community Age and Condition

It is important to know what services are offered so your senior will either feel at home or live with his or her peers. Each facility has a minimum age requirement for acceptance.

If you're a senior or family needing care is too young or too old among the other facility residents, it may cause more damage or problem rather than help. If your family member wants to simply find companions to live a happier life, then maybe you shouldn’t put them in a facility with rehab or long-term medical care residents.

Services Offered

As stated above, each facility is unique. The level of service and services offered vary according to each. There are facilities that could offer 24-hour supervision because they have fences or have close quarters. While there are those who are part of a bigger complex that may not offer the same type of surveillance.

Some can offer regular social activities but other locations may not be able to do so because there are only a few housed in the facility. Depending on the needs of your senior, list the compatible facilities you can find and pay a visit to check the facilities.

Payment Plans

Some assisted living facilities asks for annual payments. Some offer different payment plans. Ask and know what are the different options they could offer you and include to ask if they accept Medicaid coverage for some of their services.

Evaluation

Learn if the facilities you're eyeing to offer a physical or mental evaluation for your senior. This would increase their care quality level if they do. It means they care enough to let you know if your senior is learning, making progress or not. Check how often do they do evaluations or check-ups.

Capacity for Emergencies

Understanding that your senior may need sudden medical attention, check if the facilities have medical personnel on standby or have emergency services available all the time.

Check Licence

Each facility is usually licensed at the state level in the US. In Canada, the regulations of these facilities are governed by federal, provincial or municipal laws. Once you have chosen a few facilities, check each one's license. Sometimes, different services offered in a facility is offered by a third party. Any assisted living facility would be able to provide you with their license and explain third-party involvement if there’s any.

Find the right governing body in your place and talk to them before placing your senior in any facility. Besides the license relating to operating as an assisted facility, also check their other certificates and permits. When was the last time they have issued fire safety certificates? Is the facility environment certified to accommodate senior care? Visiting and touring around the facility will help you learn more and answer your questions.

Once you have decided to move your seniors in any assisted living facility, here’s our checklist for seniors moving into an assisted living home.

Questions to Ask An Assisted Living Facility

While touring an assisted living community, try to absorb as much information as possible to prepare yourself when it comes time to make your choice. Here are some important questions to get you started:

Staff

  • What is the staff-residents ratio at the community?
  • What is the turnover rate of staff?
  • What training do the community provides to its staff members?
  • Is there a Licensed Vocational Nurse, Registered Nurse or Certified Nursing Assistant?
  • Are staff members available 24-hour to assist with activities of daily living?

Living Spaces

  • Do the community’s residents can choose between a private or shared room?
  • Can residents personalize their own rooms or apartments?
  • What furnishings does the community provides?
  • Does each room has an attached private bathroom, or are bathrooms shared?
  • Are the rooms designed for easy navigation through wheelchairs and walkers?
  • Do rooms have 24-hour emergency response systems?
  • Is cable and Internet included in the rooms? If yes, how do they charge for it?
  • Is there is a kitchen with a sink, refrigerator, and cooking element? Can residents keep food in their rooms or apartments?
  • Does the community allows pets? If yes, what kind?
  • Is housecleaning for personal spaces included in the price? If not, what is the cost?

Food

  • How many meals are provided every day?
  • Does the menu remain the same or vary from day to day?
  • Is there set times for daily meals?
  • Can visiting family members and guests have a meal with residents? If so, is there any charge involved?
  • Do they provide meals  tailored to a resident’s specific needs?
  • Can you sample meals cooked at the facility on the tour?

Common Spaces

  • Are there common spaces for residents?
  • Are there any outdoor spaces available?
  • Do they allow smoking allowed?
  • Does the community offers any special services, such as a beauty parlor, fitness room, swimming pool, etc.?
  • Can residents do their own arts and crafts, gardening, or other hobbies?
  • Is there a media room?

Activities

  • What types of activities does the community provides to residents?
  • Do they post any schedule of events and activities?
  • Do the residents actively participate in the events?
  • Can residents communicate with the surrounding community?
  • Do they take residents go on regular outings?
  • Do they invite volunteers into the community?
  • Do they provide live entertainment? If yes, how often and what kind?

Medication & Health Care

  • Does the community allows self-administration of medication?
  • Is there someone on staff who coordinates home healthcare visits from a nurse, physical therapist, etc., if required?
  • Are services including hospice and physical therapy available? If so, what are their charges?
  • What is their procedure to handle resident’s medical emergency?
  • Do they offer transportation for doctor’s appointments?
  • Is the transportation disabled/wheelchair-friendly?
  • Do they provide a detailed written plan of care specific to each resident?
  • Does the community regularly assesses a resident’s needs and provide the same?

Assisted Living Facilities by State or Province

Assisted Living Facilities by Popular Cities

The Most Affordable Cities For Assisted Living

Rank City State Cost
1 Wilmington NC $3,692
2 Tucson AZ $3,774
3 Tampa FL $3,812
4 Mesa AZ $3,856
5 Orlando FL $4,132
6 Baltimore MD $3,950
7 Fayetteville NC $4,045

References

  1. Ari Houser. October 2007. AARP, Public Policy Institute: Fact Sheet, aarp.org
  2. 2011 National Survey of Customer and Employee Satisfaction in Nursing Homes. Skilled Nursing Care: Fact vs. Myth, careconversations.org
  3. ​National Center for Health Statistics. 2015-2016. Number and Size of Assisted Living Communities, ahcancal.org
  4. February 23, 2016. Assisted Living Statistics – A Deeper Dive into the Demographics, asccare.com
  5. Kristin Lam. April 23, 2019. Rising senior living costs in 2019, usatoday.com
  6. The Daily. January 25, 2019. Canada's population estimates: Age and sex, statcan.gc.ca
  7. Rochelle Garner, Peter Tanuseputro, Douglas G. Manuel and Claudia Sanmartin. May 16, 2018. Transitions to long-term and residential care among older Canadians, statcan.gc.ca
  8. Genworth Cost of Care Survey. 2018. Assisted Living: Finance, ahcancal.org
  9. Life Insurance Canada News, Long Term Care. August 13, 2015. How Much Does Assisted Living Cost?, lsminsurance.ca
  10. Community Care & Assisted Living Act, gov.bc.ca
  11. Assisted Living Registry, gov.bc.ca
  12. Assisted Living Laws by State: Know Your Rights, assistedliving.com