What Are My Options?

Assisted Living

While assisted living centers have been available the United States for many years, the growth and availability of assisted living has had a dramatic increase since the early 1990s. Assisted living is a residential alternative that promotes maximum independence for each resident through a combination of supportive services and assistance. The definition of assisted living from one state to another may vary and so will the cost and types of service.

Assisted living centers vary in size, style and the optional services they may offer. Small family style living or the larger complex of units can be found in the United States. Some facilities are operated by nonprofit organizations, while others are proprietary. In addition, some facilities may be co-located or affiliated with a hospital or nursing facility.

An assisted living center is any institution, rest home, boarding home, place, building or agency that is maintained and operated to provide personal care and services which meet some need beyond basic provision of food, shelter and laundry in a free standing, physically separate facility which is not otherwise required to be licensed.

In general terms, an assisted living center is required to provide assistance with daily living activities, including eating, bathing, dressing and personal hygiene; three meals a day; supervision of self-administration of medications; laundry service including personal laundry; housekeeping; and 24 hour staffing.

Housing Highlights - Assisted Living

Assisted living communities are designed for individuals who cannot function in an independent living environment, but do not need nursing care on a daily basis. Assisted living communities usually offer help with bathing, dressing, meals, and housekeeping.

Assisted living residences are:

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 congregate housing (housing with meal service) and a skilled nursing facility. In these settings:

Residents are semi-independent physically or mentally, or frail persons who need frequent assistance;
Services offered include, personal care assistance, health care monitoring, limited health care services and/or the dispensing of medications;
State licensing and regulation by state social welfare agencies is required.

Important because they promote independence by meeting residents' supportive needs while preventing inappropriate institutionalization.
Known by various other names. The most common are: personal care homes, sheltered housing, residential care, homes for adults, managed care, catered living, board and care, and domiciliary care.

Who Resides In Assisted Living Residences?

Assisted living housing is often deemed necessary when you have difficulty performing daily tasks and have no one to help you. Some indicators are:

Needing help preparing meals, bathing, dressing, toileting, or taking medication
Needing assistance with housekeeping chores or laundry
Requiring some health care assistance or monitoring
Needing transportation to doctors, shopping, and personal business
Feeling frequently confused or experiencing memory problems

Independent Living

Independent Living is an residential living setting for elderly or senior adults that may or may not provide hospitality or supportive services. Under this living arrangement, the senior adult leads an independent lifestyle that requires minimal or no extra assistance. Generally referred to as elderly housing in the government-subsidized environment, independent living also includes rental assisted or market rate apartments or cottages where residents usually have complete choice in whether to participate in a facility's services or programs.

Congregate Housing

Congregate Housing is similar to independent living except that it usually provides convenience or supportive services like meals, housekeeping, and transportation in addition to rental housing.

These are multiunit housing buildings (private rooms or full apartments) that are restricted to persons over a specified age and that include supportive assistance. Typically, monthly charges include rent and supportive services. Congregate housing does not require licensure or certification by a public agency as personal care services (help with eating, bathing, dressing, grooming, toileting, transferring) are not provided or included in the monthly charge. Congregate housing residents may contract privately with community home care agencies to receive personal care and home health care services. Monthly charges may be priced at market rates or subsidized with government assistance.

Continuing Care Retirement Community

A continuing care retirement community (CCRC) is a community which offers several levels of assistance, including independent living, assisted living and nursing home care. It is different from other housing and care facilities for seniors because it usually provides a written agreement or long-term contract between the resident (frequently lasting the term of the resident's lifetime) and the community which offers a continuum of housing, services and health care system, commonly all on one campus or site.

Nursing Home

Residential Board and Care Homes

Residential Board and Care Homes are small residential family homes which provide 24-hour custodial care for four to six residents. All custodial care, meals, and activities are provided by live-in full-time staff. Most are licensed to accept non-ambulatory residents and have been constructed with these residents needs in mind (e.g., wheelchair accessible bathrooms and inside/ outside ramps).

Board and Care Homes

Board and care homes go by many names (including personal care homes, residential care facilities, assisted living, and domiciliary care). In exchange for rent, generally they provide room, meals, laundry and house-keeping, and regular contact with staff to ensure that "all is well." The daily contact with staff is what distinguishes "board and care" homes from the more familiar boarding houses. Your parent would share this home, of course, with a number of other residents.

Visit the home with your parent before a decision is made. Look at the private room your parent may occupy. Ask lots of questions about the services and evaluate the staff. Ask for references and check the home's record with the local or State licensing agency.

Consider these issues:

Will your parent have privacy and independence?
Is common space available?
How much will it cost, including add-ons to the rent?
Is it near public transportation, places of worship, and shopping?
Can your parent's special dietary needs be met?
Does the home comply with local licensing, fire, and zoning laws? Is it licensed by the State?
What are the arrangements for sharing bathrooms?
Will your parent have to climb stairs?
Are there security locks on each room?
Will your parent have access to a telephone?
Are pets allowed? Who will care for them?

Living Options

Communities by State

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