Choosing an assisted living community is an important decision. The right community can help your loved one stay safe, maintain independence, and enjoy a good quality of life.
Everyone's needs are different. Some people may need help with everyday tasks but still be fairly independent, while others may need more supervision or medical support. It's also important to think about how those needs could change over time.
What is assisted living?
Assisted living is a residential setting for older adults who need help with daily activities but don't require the 24-hour medical care provided in a nursing home. Assisted living communities may help with things like:
- Personal care like bathing and getting dressed
- Taking medications
- Preparing meals
- Housekeeping and laundry
- Transportation
- Getting around safely
- Activities and social opportunities
The services available can vary from one community to another, so it's important to ask what each community provides (and what costs extra!).
Understand the different levels of care
Not every community offers the same level of care. You may come across several types of senior living:
Independent living is for people who are largely independent but want things like meals, housekeeping, transportation, maintenance, and social activities.
Assisted living is for people who need help with daily activities but don't need around-the-clock care.
Memory care provides extra structure, supervision, and safety for people living with dementia or other cognitive impairment. These communities may have a more secure environment and specially trained staff.
Nursing homes provide 24-hour nursing and medical care for people with more complex medical needs.
Some communities offer several levels of care in the same location. This can make it easier for a resident to move to a higher level of care if their needs change.
Think about your loved one's needs
Before you start visiting communities, make a list of the help your loved one needs now and what they may need in the future. “The right community should meet your loved one’s current needs while also allowing for changes in care over time,” says Aubrey Knight, MD, chief of Geriatrics at Carilion Clinic. Consider:
- How well they can walk and get around
- Whether they need help bathing, dressing, using the bathroom, or getting in and out of bed or chairs
- Whether they need help managing medications
- Whether they can safely prepare meals and manage household tasks
- Any memory problems or dementia
- Whether they may wander or get lost
- Any chronic medical conditions, ongoing treatments, or medical equipment needs
- How often they see a doctor or need to go to the hospital
- Their hobbies, interests, and daily routines
- How much social interaction and family involvement they want
Ask about care that’s available
Once you've found communities you're interested in, call and ask questions about the care they provide. Find out:
- What level of care do you provide?
- How do you assess a resident's care needs and how often?
- What happens if my loved one's needs increase?
- Is a nurse available, and when?
- How are medications managed?
- Can residents receive home health, hospice, therapy, or private-duty care?
- What happens if a resident needs to go to the hospital and then return?
If your loved one has dementia or may develop memory problems, ask whether the community provides memory care and what happens as dementia progresses.
Pay attention to staffing and safety
The people providing care can make a big difference in your loved one's experience. Ask about staffing during the day, evening, and overnight. You can also ask how the community handles falls and other emergencies and how quickly families are notified when a resident's condition changes.
During your visit, notice how staff interact with residents. Do they seem respectful and attentive? Do they know residents by name? Do residents appear comfortable asking for help?
Consider the cost
The monthly rate you see advertised may not tell you the whole story. Ask for a complete list of costs and find out how much you could pay if your loved one's care needs increase. Ask about:
- The monthly base rate
- Additional care or service fees
- Admission or community fees
- Annual rate increases
Knowing the full cost can help you compare communities and avoid surprises later.
Look into financial help early
Paying for assisted living can be challenging. “Start exploring financial resources early. Eligibility requirements and application processes can take time,” notes Dr. Knight.
Private health insurance and Medicare generally don't pay for ongoing assisted living but may cover certain medical services received at the community. They may also cover qualifying short-term care in a nursing facility.
Long-term care insurance may help depending on the policy. Check your coverage before choosing a community and ask about benefit amounts, waiting periods, and lifetime limits.
Medicaid may cover certain long-term care services for people who meet eligibility requirements. Coverage varies depending on the program and setting.
In Virginia, the Auxiliary Grant may provide financial assistance to eligible people living in participating assisted living facilities.
Make sure it feels like home
Cost and care are important, but so is your loved one's quality of life. When you visit a community, look for opportunities for residents to stay active, connected, and involved in things they enjoy. Ask yourself:
- Are there activities that match my loved one's interests?
- Do residents have opportunities to socialize?
- Are there exercise, wellness, or educational programs?
- Can residents participate in outings?
- Can residents maintain familiar routines and hobbies?
- Are there opportunities for residents to make their own choices?
- Is the space welcoming and comfortable?
It's also important to think about family involvement and any cultural or spiritual preferences that are important to your loved one.
Visit before you decide
A website or brochure can only tell you so much. Visiting a community in person can give you a much better idea of what everyday life is really like. As you tour, ask yourself if you could picture your loved one feeling comfortable and at home there.
You don't have to make this decision on your own. Your loved one's primary care doctor can help you think through their needs and refer you to a geriatric clinic if appropriate.
Other resources:
