How To Choose an Assisted Living Facility/Community

By Marguerite Adams, RN

An assisted living environment is an alternative senior living option that promotes maximum independence for each resident through a combination of services and assistance. While assisted living centers have been available for many years, the growth, usage, and availability of these centers have increased dramatically since the early 1990s. With more options now available, hopefully that special community that is right for you is just around the corner. However, finding the "perfect" place for you or your loved one can prove to be extremely confusing. The information below is meant to help those in need make an informed decision. Industry professionals can offer specific information about their residences, and even assist with guided tours of the communities.

Is assisted living the right retirement option?

According to the American Association of Homes and Services for the Aging (AAHSA), there are 36,451 licensed assisted living facilities in the United States with more than 1,000,000 elderly adults living in these facilities. With the onset of the "Baby-boomers," the AAHSA estimates that 12 million seniors will need long-term care by 2020. The seniors of today will be more likely to leave their own homes to find a community that offers a more social atmosphere, promotes independence, provides various amenities and offers potential care options.

Assisted living is a type of senior housing that allows elderly residents to lead more active, independent lives than they can find in traditional nursing homes. These homes are an intermediate step between fully independent living, where a person does not require any assistance with the activities of daily living, and nursing homes that provide 24-hour care.

Assisted living residences are:

  1. Housing environments which provide individualized health and personal care assistance in a home-like setting. The level of care available is between that provided in a group setting and a skilled nursing facility. Residents range from those that are semi-independent physically or mentally, or frail persons who need frequent assistance. The services offered include personal care assistance, health care monitoring, and limited medication assistance. Activities of daily living include eating, bathing, dressing, transferring, toileting, and walking. Most facilities offer three meals a day available in a dining area. Transportation, housekeeping, and laundry are available. Twenty-four hour staffing is provided along with security and emergency call systems. For those residents with more difficult health care needs such as Alzheimer's or other forms of dementia, special units and/or specially trained staff are provided in some assisted living facilities.
  2. Important because they promote independence by meeting residents' supportive needs while preventing inappropriate institutionalization.
  3. Designed for individuals who cannot function in an independent living environment, but do not need nursing care on a daily basis.

What is the facility like?

Once someone starts researching assisted living facilities, they will find a variety of locations, shapes and sizes. They can be called residential care facilities, personal care homes, retirement homes, etc.

The size of the facility can range from 100 residents to as few as 15 or less. You can find them in restored family homes to large multi story buildings. The type of facility that meets the needs of your loved one or yourself may be just around the corner.

Cost of Assisted Living

Assisted living can be more affordable than one imagines. When the figures are initially presented, they seem very intimidating, but once you include all the amenities and services included, you may even come out slightly ahead of living at home. According to 2009, costs average:

ExpenseMonthly Costs at HomeMonthly Assisted Living Costs
Security/Emergency Services$150Included
Food and groceries$494Included
Utilities and Maintenance$655Included
Health/Personal Care$495Included
TOTAL$2741 (average)$2714


While Medicare does not cover assisted living, one may find other 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." State Medicaid is also an option for those who meet the required financial qualifications. Some communities may offer rent subsidy programs to income eligible seniors. To find out if one may meet your need contact the local Area Agency on Aging for more information. Some individuals opt to have long-term care insurance policies. Most of these will cover the costs of assisted living. Some of the costs are also reimbursable through health insurance policies.

However, most of the costs of assisted living are covered through private payments by the residents and families. The above table shows the average costs in today's market. There are more affordable or subsidized options in most areas. Always look for the available sources in the area of residence and for the services that meet the need of any given situation before choosing an assisted living home.

The assisted living facilities in your area have professionals who can assist with describing services and possible solutions to one's needs. They will also be able to show the community to you first hand.

Choosing an Assisted Living Facility

Before choosing an assisted living community, remember to carefully understand the options available. First, know the needs of the individual needing assistance. Would they be comfortable in a community that is large or small? What types of social activities does he or she enjoy? What particular services are needed by the individual? What are the payment options, and can the individual meet the obligation? If you can answer these questions, and locate several facilities to visit, the initial search is done.

Request brochures from the potential communities. Most communities will provide copies of the resident agreement or contract, a packet including the services and amenities, detailed prices, floor plans available, admission and discharge criteria, and community rules. This information will help further narrow one’s search for potential residences.

Always visit the facilities before making a final decision. During these visits, talk with staff members and residents and tour the community. If possible, make several visits at various times of the day to get a complete feel for the everyday life in the community. Having a meal at the facility would also be advisable.

Ask questions of the residents and staff members, and be certain you get the answers you want. The staff members should be aware of all the activities, meal times, and explicit details of the community. Any information about costs should be available. View the Assisted Living Checklist to assist with questions to cover during the visit.

More and more assisted living communities are becoming available each year. They can offer a little, or a lot, of help in a home-like setting. Once an informed decision is made, new residents can feel confident that their individual care needs will be provided for in an atmosphere that is conducive to their continued independence.

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