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| What is an assisted living community? |
Assisted living is a long-term care option for seniors who need a level of assistance higher than that of a retirement community, but not as extensive as a nursing home or hospital. It provides an independent senior housing lifestyle with customized assistance while still enabling seniors to have control over their own lives and the activities in which they participate. Assisted living facilities – which can be found as part of a continuing care retirement community (CCRC), nursing home, or as independent communities – maintain a focus on independence, not dependence.
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| How does assisted living differ from other levels of care? |
Assisted living is a unique combination of independent living and care. Unlike nursing homes and other medical facilities, assisted living residences enable seniors to maintain a sense of independence and involvement in a social community, while at the same time providing assistance with daily life and peace of mind that comes with a professional support team. Assisted living facilities employ a 24-hour staff to monitor scheduled and unscheduled needs.
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| Who is best suited for an assisted living community? |
Assisted living communities are suited for senior residents who need assistance with their activities of daily living (ADLs), such as dressing, bathing, shopping, cooking, and housekeeping. The Assisted Living Federation of America (ALFA) reports that a typical resident is a woman in her eighties who is either widowed or single. Assisted living is also a good option for some residents living with disorders such as Alzheimer’s, mobility limitations, incontinence, or other conditions that may become more common in one’s senior years.
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| What types of supplemental services do many assisted living communities offer? |
While most assisted living communities have 24-hour supervision and service for three meals a day, a variety of additional quality-of-life services may be available in your residence of interest. Along with assistance with activities of daily living (ADLs), residents may be able to take advantage of the following services: health care management and monitoring; medication reminders; on-site social and spiritual activities; recreation and exercise facilities; wellness programs; security; laundry service; and transportation arrangements. In addition, supervision for persons with Alzheimer’s or other mental disabilities can usually be arranged.
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| What types of living accommodations are available in assisted living facilities? |
Across the country, assisted living residences vary in size, design, and accommodations, typically in compliance with local, state, and federal regulations. According to the Assisted Living Federation of America (ALFA), facilities can range from high-rise apartment complexes to converted homes, from a single room studio to a full apartment, from private to semi-private units. The National Center for Assisted Living’s (NCAL) 2000 Survey of Assisted Living Facilities reports that 25 percent of residences had kitchenettes, with 19 percent having full kitchens. The NCAL also reports that the average assisted living residence is comprised of 30 beds and 23 residents.
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| What are typical costs? |
As reported by the 2006 MetLife Market Survey of Assisted Living Costs, the costs associated with assisted living averaged $2,968 per month, or $35,616 yearly. That’s up 2.2% or $63 from 2005 and 17.6% from 2004. Just as assisted living residences vary, so too do their costs, which depend mostly on the size of units, services offered, and location, according to the National Center for Assisted Living (NCAL). MetLife reports that rates range considerably by region, with North Dakota the lowest ($1,742 monthly) and the Bridgewater, New Jersey area the highest ($5,197 monthly). Many long-term care insurance policies offset some of the cost, however, the NCAL reports that most assisted living expenses are covered by the family of residents, since the majority of seniors do not have such long-term coverage. Medicare does not cover assisted living but, under certain circumstances, some state and local governments offer subsidies for rent or service for income-eligible seniors, according to the Assisted Living Federation of America (ALFA). Supplement Security Income (SSI) may also help alleviate some of the cost, while some residences participate in Medicaid, grant programs, or other assistance.
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| What are senior housing contracts? |
Many continuing care retirement communities typically offer three types of housing contracts, and are divided into three groups. Type A–life care contracts–guarantee residents lifelong care without significantly increasing monthly fees. Modified contracts, also known as Type B, offer a specified number of days in assisted living or nursing homes, then charge for additional care beyond that determination. Type C communities offer fee-for-service contracts that require resident pay more depending on their level of additional care.
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| How are assisted living communities licensed? |
According to the Assisted Living Federation of America (ALFA), regulations and licensure requirements vary from state to state. It’s important to do your research to see if your state requires residences to be licensed and, if so, whether your residences of interest have complied. Also, many states require special training and staff certification, including a licensed or certified administrator; ask to see credentials, if applicable. The National Center for Assisted Living’s 2007 Assisted Living State Regulatory Review found that several states have added facility requirements relating to fire safety, increased incident reporting, emergency preparedness, disease control, and emergency power generators.
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| How important is it to find out about a community’s philosophy of care? |
Experts at the Assisted Living Federation of America (ALFA) stress that an integral part of your decision-making process is in understanding an assisted living community’s philosophy of care. When making a major life decision such as choosing an assisted living residence, it’s important to be an informed consumer. Confirm that residents are afforded respect, comfort, privacy, religious freedom, the right to voice grievances should they arise, maintenance of personal finances, and control over health care decisions. Additionally, inquire about internal regulations regarding pets, alcohol, smoking, and other quality-of-life issues, to see if they correspond with your personal preferences. It is also wise to visit the facilities more than once, sometimes unannounced, and observe the interactions between staff and residents.
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| Will Medicaid cover senior housing? |
According to the Center for Excellence in Assisted Living, the expansion of Medicaid home and community-based waiver programs has made it possible for an increasing number of Medicaid-eligible seniors to receive services in assisted living. Today, 41 states reimburse assisted living services through Medicaid—double the number of states from 10 years ago. Still, only about 8 percent of assisted living residents are covered by Medicaid, and the majority of beneficiaries are concentrated in a few states.
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