Demystifying Assisted Living

According to AARP, approximately one million Americans live in assisted living communities today.  This unique and relatively new incarnation of the “old-style” board-and-care homes is often misunderstood, and confused with other levels of long-term care.  If you or a senior loved one is considering a move to assisted living community, it is important to understand the what assisted living really is and how to find the right community for you.

What is Assisted Living?

Jessica Strom Federman
Jessica Strom Federman

Your mom needs help bathing and getting dressed.  Knowing that someone is dispensing your uncle’s prescriptions safely and having them refilled is a load off your mind.  Having a safe haven for your husband, who suffers from dementia and tends to wander, brings you peace-of-mind.

Assisted living provides residents with assistance with activities of daily living (ADLs) including bathing, dressing, toileting, transferring (moving from bed to a chair, for example) and eating.  Additionally, these residences generally offer an important service called medication management, where the staff holds, dispenses and reorders all medication on behalf of the resident, decreasing the risk of a dangerous medicine-related incident caused by incorrect medication administration by the senior.  Assisted living communities provide three nutritious meals daily, as well as snacks; activities; transportation to shopping and medical appointments (staff tends to schedule medical appointments, as well).  Qualified professionals, including registered nurses (RNs), licensed practical nurses (LPNs), certified nursing assistants (CNAs), medical technicians, provide 24-hour assistance and care and emergency response services to residents, who typically live in apartment-style homes, or private or semi-private accommodations.  An individual care plan should be developed to meet the unique needs of each resident within a short period of time, typically one to four weeks.

Assisted living communities can stand alone, or they may be a part of a retirement community or affiliated with an independent living community or nursing home.

How Much Does Assisted Living Cost? Fees for assisted living can vary, depending on what services and amenities are included; for example, some offer medication management services as an included service, others may charge an a la carte fee or include it as part of an “upgrade” to the basic package.  Depending on the fee structure of the community you select and the size of the room or apartment you choose, monthly fees can average $3,000 to $5,000 or more.  This doesn’t include the cost of medication and other personal bills.  In my experience, most assisted living communities are “private pay,” meaning residents cover the cost using their own funds.  Some long-term care insurance policies will cover a certain amount of dollars per day up to a pre-determined number of years or amount; check with your long-term care insurance carrier for the details of your policy as it pertains to assisted living.  Rarely does Medicaid cover the cost of assisted living; subsidy offerings and eligibility requirements vary by state.


How do I choose the right Assisted Living community?


As you visit communities, be sure to visit your final selection(s) multiple times.  Spend some time getting to know the other residents (they’ll often give you an unabashedly honest opinion of the community); enjoy a meal in the dining room and take part in some of the activities.  Some communities may offer an opportunity to spend a night or two to get a real idea of what daily life there is like.

Beyond the “field research” mentioned above, check the community’s credentials.  Every state is different regarding licensure and regulations, but it’s important to check into the community’s reputation and standing with licensing bodies.  If you’re not sure where to start, begin with your Area Agency on Aging, the number for which you can find in the phone book.

Additionally, there are countless “checklists” that will give you a starting point in terms of important questions to ask while you search.  Below you’ll find links to reputable senior living industry organizations, which provide questions and other information to consider as you look at your options

Assisted Living Federation of America (ALFA)

American Association of Homes and Services for the Aging (AAHSA)

Searching for an assisted living residence can be a daunting process, even more so if you’re under constraints of time and circumstance.  Many individuals, organizations and agencies have done a lot of the legwork for you; find the information they can provide to you so that you don’t have to re-invent the wheel.  If you have questions about how to conduct an assisted living search, or whether you or a loved one might be an appropriate assisted living candidate, please don’t hesitate to contact me at

Resources/Works Cited

AARP: American Association of Retired Persons.

Centers for Disease Control and the National Center for Health Statistics.  “Activities of Daily Living.”  13 Mar. 2008.

Bischoff, RN, BSN,  Jason,  Kelly Timmer, RN, BSN, Cindy Walton, RN, BSN, Connie White,

RN, BSN, Karen Zulkowski, DNS, RN, CWS.  “Perspectives of the Ideal Assisted Living Facilities from Depression Era Nurses.”  Rural Nurse Organization.  Fall 2001.  13 Mar. 2008.

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