Americans have countless choices for long-term care facilities and services. One of the most commonly discussed care options is an assisted living facility.
More than 818,000 people live in assisted living facilities nationwide. This number is expected to grow as the population continues to age. Assisted living offers an appealing middle ground between in-home care and nursing home care. But what exactly is assisted living, and what does life look like in one of these facilities?
Below, we'll explore what assisted living is, how much it costs, and the services and amenities these communities offer. We'll also discuss the pros and cons so you can decide whether assisted living is right for you or your loved one.
If you already know an assisted living facility is on the table for you or a loved one, then consider using LTC News’s Long-Term Care Directory to search for assisted living options near you. This directory contains facilities and information from all across the country so you can compare your top options.
What Is an Assisted Living Facility?
Assisted living facilities are residential communities for aging adults who need daily help with long-term care or those who wish to live in a safe community with easy access to long-term care. The goal is to make care easily accessible while empowering residents to maintain a sense of autonomy despite their potential long-term care challenges.
Facility sizes vary from as low as 20 residents to as high as a hundred or more residents. Assisted living facilities can look very different. Some may resemble apartments or hotels where each resident has a private apartment or private room. Others may be more luxurious, resembling a resort where residents may have more space.
These spaces are designed to feel homelike, and residents are free to personalize their living spaces as they wish.
Assisted living facilities are best suited for those who need long-term care and wish to live in a secure, social environment. Spouses of individuals who need long-term care are also welcome to live with their spouse within an assisted living facility.
Assisted living offers the same or more care than is available at home but less than in a nursing home. These facilities provide a safe and supportive atmosphere for adults to age in place, pursue their hobbies, and enjoy time with loved ones.
What Services and Amenities Do Assisted Living Facilities Offer?
Assisted living facilities offer comprehensive long-term care support. Some of their most well-known services include:
- Help with activities of daily living such as bathing, continence, dressing, eating, toileting, or transferring.
- Meal services are provided multiple times a day based on a daily or weekly menu. Most facilities can make adjustments based on their residents' diets.
- Transportation services are available at most assisted living facilities. These services may bring residents to medical appointments, events, or group trips.
- Safety and security are an integral part of assisted living facilities. They ensure their residents' safety with 24/7 security, emergency response systems, and fall detection equipment.
- Housekeeping and maintenance staff help residents with basic chores and housekeeping, like tidying up apartments. They'll also handle any maintenance issues like water leaks or clogged pipes. This can help relieve stress and give residents more time to pursue their hobbies.
- Memory care units are available within some assisted living facilities. These units are designed with dementia and Alzheimer's patients in mind; they often have extra security and specialized staff members to keep residents safe and provide treatment unique to those with cognitive decline.
- Basic medical services: These might include medication management, monitoring vital signs, assisting with chronic condition management, and first aid.
- On-site visits from health providers: Doctors, nurses, or therapists may visit the facility regularly or on-call to provide consultations, administer treatments, and monitor residents' health.
- Coordination with off-site health providers: Assisted living staff often collaborate with residents' primary care physicians and specialists to ensure continuity of care and manage medical needs effectively.
- Referral services: Facilities may help residents access additional medical services like specialists, labs, or imaging scans at external providers.
It should be noted that while assisted living facilities provide some basic medical care, they cannot provide care at the level of a nursing home or hospital. In fact, providing hospital-level care would be in violation of their license.
Outside of long-term care services, assisted living offers many perks and amenities. Some common amenities include:
- Exercise and fitness classes such as yoga or aerobics to improve flexibility and movement. Many facilities also have recreation areas or gyms.
- Arts and crafts classes like painting, pottery, or knitting are common in assisted living facilities. These activities can help relieve stress and improve creativity.
- Games and puzzles can help improve memory, cognitive function, and social skills. Most facilities have a game room for residents to play cards, board games, and puzzles.
- Music and entertainment can boost mood and keep residents engaged. Assisted living facilities may plan concerts, movie nights, and facility events for residents to enjoy.
- Outings and group trips to museums, parks, or theaters are often a highlight of assisted living.
- Pet therapy is when animals like dogs or cats visit the facility for the day. Residents are free to spend time with the animals, which may help improve mood and reduce stress.
How Much Do Assisted Living Facilities Cost?
In 2024, the median base cost of assisted living facilities is $4,376/month or $52,082/year. These numbers came from LTC News's Cost of Care Calculator, which compiles cost data from facilities nationwide.
It’s important to note that prices can vary drastically by state, city, or even facility. In the most expensive states like Massachusetts, medians can rise to $6,000/month. Meanwhile, more affordable states like Utah or Nevada can be as low as $3,500/month.
Assisted living facilities may also add surcharges ranging from $500 to $2,000 on top of base costs. These surcharges are based on how many extra services residents need, with memory care being the most expensive. Facilities with excessive amenities will also cost more than facilities that offer basic ones.
It’s also worth mentioning that traditional health insurance, Medicare, and Medicaid do not cover assisted living facilities. Only Long-Term Care Insurance will cover assisted living. This means individuals without Long-Term Care Insurance will pay out-of-pocket for assisted living facilities.
The bottom line is that not everyone pays the same amount for assisted living. You could lower your assisted living costs by planning with Long-Term Care Insurance, choosing a facility in a more affordable location, or choosing a facility without extravagant amenities.
What Are the Pros and Cons of Assisted Living Facilities?
There are countless benefits of assisted living, including adaptable care, improved sense of community, and safety, just to name a few. However, those benefits don't also come with drawbacks. Below, we'll list some upsides and downsides of living in an assisted living facility.
Pro – Assisted Living Facilities Have Flexible Long-Term Care Options
Assisted living facilities are great options for individuals experiencing a wide range of long-term care needs. In general, to thrive in an assisted living setting, an individual would need some help with activities of daily living but not extensive medical care – such as care in a nursing home or hospital.
Needing help with activities of daily living can look very different depending on the person. Most assisted living facilities are accommodating regardless of how much personal care an individual needs.
Some people may need help only with bathing or getting dressed. Others may need stand-by assistance, which is when a caregiver remains present in case hands-on care is needed. Stand-by care can help prevent injuries and promote independence.
Some individuals may need extra help due to an accident or their progressing condition. The staff will adjust to meet their needs and help with any activity of daily living or household responsibilities they may have.
Con – Prerequisites to Live in Assisted Living Facilities
Assisted living facilities are great once you're in; however, it can be difficult to gain admission to one.
The admission process for residency in an assisted living facility generally involves several steps. Assisted living facilities use this process to ensure the facility can meet the individual's needs and live safely and comfortably within the community.
Here's a breakdown of the typical process:
Initial inquiry and tour: This stage usually involves contacting the assisted living facility, expressing your interest, and scheduling a tour of the facility.
Pre-admission assessment: Upon interest, the facility will conduct a comprehensive assessment to determine if the assisted living facility is the appropriate setting for the individual's needs. This assessment typically involves:
- Medical history review: Examining medical records and diagnoses to understand current health conditions and medication needs.
- Functional assessment: Evaluating the individual's ability to perform daily activities (ADLs) like bathing, dressing, eating, and toileting.
- Cognitive assessment: Assessing memory, orientation, and decision-making abilities.
- Social and emotional assessment: Evaluating social interaction skills, emotional well-being, and potential adjustment to the community setting.
- Financial assessment: Evaluate if the individual has the financial means, either through Long-Term Care Insurance or income and assets, to pay for the facility on an ongoing basis.
Care plan development: Based on the assessment results, the facility staff, in collaboration with health professionals and potentially the individual and their family, will develop a personalized care plan. This plan outlines the specific services and support the individual will receive to maintain their well-being and independence within the facility.
Review and approval: The facility management will review the assessment results, care plan, and any contractual agreements before making a final decision regarding residency.
In other words, assisted living isn’t for everyone. They do not provide excessive skilled or medical care found in a nursing home or hospital.
They also have a community to uphold and want to make sure anyone who is admitted will not only be safe for other residents, but will have the opportunity to thrive in their new environment. While this process is necessary, it could prevent some people from entering assisted living facilities.
Pro – Socialization and Improved Sense of Community
One of the best parts about assisted living facilities is the community and opportunities for social interactions.
Socializing and creating connections is an essential part of our overall well-being. Studies have shown that those without vital social networks or those suffering from social isolation are 50% more at risk of developing dementia.
Assisted living provides opportunities for social interaction at every part of the day. Residents live near each other and may see each other in passing. Many facilities host different group events and group excursions where residents can get to know each other. Some also have dining halls for meal services, where residents can chat over their meals.
Con – Less Privacy and Sense of Independence
A big fear and concern around moving into a facility is the loss of independence. Aging is a natural part of the human experience, but for many, the loss of independence isn't an easy adjustment.
Moving into a caring community like an assisted living facility can make individuals more aware of their handicaps. In addition to these realizations, for some residents, this could be the first time they've lived in an apartment in several decades. It may be hard for these people to get used to being around people so often after living alone or with family for decades.
Some facilities also have rules around curfews or visiting hours, which can take some time to get used to after living rule-free for so long. However, these rules aren’t usually strictly enforced. This reflects a focus on respecting resident autonomy and promoting independence within the facility's boundaries.
There may be some exceptions for rare cases where individuals with cognitive decline may have extra rules for their safety. However, this is not the norm, and decisions go on a case-by-case basis.
Any spouses living with their spouse but not in need of care are not subject to the same restrictions as residents.
It's crucial to review the specific policies of the assisted living facility regarding independent spouses. Some facilities may have limitations on overnight guests or require additional security measures like signing in and out when leaving the facility.
Pro – A Safe, Secure, and Controlled Environment
Finally, assisted living facilities offer a safe and controlled environment, which can give residents and their families peace of mind.
All facilities take massive safety precautions, including security, staffed care providers at all times, and emergency support systems.
There's little risk of residents hurting themselves doing chores or home maintenance because the staff takes care of it for them. If there is a medical emergency, staff are already on site and can care for residents within minutes of being alerted about a problem.
Con – Assisted Living Can Be Expensive
One of the main downsides to assisted living facilities is that care can be very expensive, and traditional health insurance or Medicare does not cover assisted living.
As mentioned earlier, assisted living facilities have a base cost and then add surcharges based on the amount of assistance the resident needs. Some facilities use the tier method, which could force individuals to pay for more care than they would utilize.
These tiers generally include:
- Base Rate: This rate covers the essential costs of living in the facility, including housing, meals, basic amenities, and recreational and social activities.
- Additional tier 1: Assistance with limited activities of daily living (ADLs) like bathing, dressing, or eating.
- Additional tier 2: Assistance with more ADLs and potentially some basic skilled nursing care services.
- Additional tier 3: More comprehensive assistance and frequent skilled nursing care.
That being said, assisted living covers the cost of both housing and long-term care services. It’s important to factor in the housing and maintenance side of things when looking at how much the total cost of assisted living is.
An Overview of Assisted Living
To recap, assisted living facilities provide a supportive environment for aging adults to live in and access long-term care. With a wide range of services and amenities, these communities strike a balance between independence and support.
These facilities work well for many people; some benefits they offer are safety, security, socialization, and easy access to care. A few downsides are the cost, lifestyle adjustment, difficult admissions process, and limited intensive medical care.
If you’re considering an assisted living facility for yourself or a loved one, you may be interested in more of LTC News’s long-term care resources.
- Find Long-Term Care Near You – LTC News’s Long-Term Care Directory can help you find and compare long-term care facilities and providers near you.
- Your Guide to Assisted Living: Facility Services, Costs and Search Tools – This guide can help you dive deeper into the world of assisted living. It will give you the tools and information you need to determine if assisted living is right for you or a loved one and show you how to choose the highest quality facility in your area.
- Assisted Living Facilities vs. Nursing Homes: What’s The Difference? – This article explores the differences between assisted living facilities and nursing homes so you can decide what’s best for yourself or your loved one.