Assisted Living: History, Benefits and Financing
Caring for an aging loved one sometimes requires more than family members can provide. Unfortunately, as age takes its toll on seniors, it also affects their capability to perform functions that we naturally take for granted: bathing, dressing, cleaning, etc. It is for this reason that the concept of assisted living homes and communities exists.
An assisted living home or community is simply one that offers seniors the personal care and support they need while still maintaining independence. Daunting tasks, such as medication maintenance, meal preparation, and general housekeeping are handled by an experienced staff, leaving seniors to sit back and enjoy their retirement.
Prior to the 1970’s, seniors could either remain at home with their families or become residents of a full-fledged nursing home. The latter did not bode well for them, as reports of nursing home abuse were widespread back then. According to investigations, in fact, a large majority of nursing homes functioned as “junkyards” for the elderly. They lacked proper medical care and food, not to mention properly trained attendants.
By the early 1970’s, the tides finally began to turn. Legislative reform slowly helped transform the nursing homes of the past into fully functional and comfortable facilities. However, seniors still remained unhappy, many were not yet ready for institutional living. They wanted to maintain at least some independence.
In 1981, the first assisted living facility finally opened in Portland, Oregon. Unlike facilities in the past, assisted living the defined itself as senior housing with dignity and respect. Following its inception, assisted living became known as place for “health, housing, and hospitality”. Now, an assisted living facility can be found in pretty much every single community across the nation.
Defining Assisted Living
Assisted living is considered the best of both worlds. Seniors receive the necessary support and personal care they need to complete daily tasks (dressing, bathing, grooming, eating, walking, etc.) without sacrificing independence or privacy. Residents have the option to hang out, socialize, or enjoy their privacy. Different types of assisted living communities exist, but the general consensus is that they tend to be much more inviting and homely than the antiquating idea of nursing home.
Personal attendants remain on staff at all hours of the day to assist seniors with activities of daily living, including but not limited to bathing, dressing, toileting, eating, etc. A senior is NEVER left to fend for him or herself. Facilities also typically employ trained nurses who can treat minor to major medical conditions on-site; staff members always have transportation available in the event of life-threatening emergency.
Some assisted living communities permit seniors to maintain their own apartments and furnishings, which bodes well for their individuality. Shared rooms are usually an option, for more cost effective senior housing. Seniors often have access to their own private kitchens that with a microwave, a fridge, and a sink for snacks in-between community meals.
Who Needs Assisted Living
Assisted living best serves the needs of seniors whose declining health status prevents them from performing the activities of daily living as easily as they could before. Assisted living is an ideal fit for senior with minor medical concerns or disability. If the senior in your life currently lives by him or herself, there are a few signs that can indicate that it might be time to consider an assisted living facility:
- Unexplained Weight Loss– Weight loss can indicate a number of issues, including developing medical problems. Take a moment to check the fridge; empty cabinets or spoiled food can indicate they may be struggling.
- Bumps and Bruises- You may notice bruises, scratches, or scrapes that could mean mobility problems.
- Hygiene- Make note of their overall appearance. Is their hair clean and well-kempt? Are they able to change clothing daily without struggle? Are they showering often?
- Housekeeping- Does their home seem dirtier and messier than it used to be? Keep an eye out for crumbs and items on the floor as both could cause someone to fall.
- Memory- Memory loss is common in old age, make sure they are not struggling to keep up with doctor’s appointments, medications, or bills.
- Depression- Aging at home can leave some feeling lonely and isolated. Check in with your loved one occasionally to note any decline in happiness. Assisted living provides social situations that may alleviate these feelings..
If you are still unsure whether the senior in your life needs the services of an assisted living community, you might want to consider asking yourself the following questions:
- Are you, your family members and friends capable of assisting the senior with daily activities? Helping a senior can be very time-consuming and tedious; it often takes a toll on caregivers. Discuss your options and decide what is right for everyone.
- Has safety become an issue? If you worry your loved one might fall and not be able to get up, you may consider assisted living. Can you afford setting up in-house monitoring solutions?
- Is the senior able to transport themselves when necessary? Deciding whether your loved one can drive or navigate public transit systems can be difficult. There are a number of community services that can help, however, assisted living offers daily transportation services.
Assisted Living vs. Nursing Homes
One question needs to be addressed: what is the difference between assisted living and nursing homes? It is an important question to ask and an even important one to answer. Simply put, nursing homes tend to be far more involved, although far less individually inclined. Instead of a large ‘community,’ seniors often occupy beds in a medical facility that provides 24/7 personal and medical care.
- Residents: Residents of nursing homes typically fall in two categories: seniors with serious medical conditions and seniors recovering from illness, injury, or treatment. Seniors in assisted living communities are far more diverse in terms of medical needs, personal preferences, and services required.
- Cost: A private room in a traditional nursing home costs anywhere between $5000 and $15,000 a month whereas a private room in an assisted living facility costs anywhere from $2500 to $5000 per month. However, Medicare and Medicaid cover 98.5% of nursing home stays while coverage for assisted living depends on individual cases.
- Medical Care: Nursing homes offer professional medical service at all hours of the day. While assisted living facilities certainly offer nursing assistance and emergency transportation, they typically do not have a physician on staff to deal with more severe conditions.
- Community: Assisted living centers offer a smaller, cozier and more community-oriented environment ideal for making friends, socializing, and having fun. Nursing home centers are much more hospital-like with far less amenities or common social areas.
- Advanced Memory Care: Unfortunately, assisted living centers do not offer the type of specialized care needed to handle seniors suffering from advanced stages of dementia or Alzheimer’s. Although some assisted living facilities offer programs for seniors with cognitive decline, advanced patients are better fit for a traditional nursing home or memory center.
Assisted Living Amenities
A great benefit of assisted living is the wide array of amenities available. These services allow seniors to live fun and exciting lives that engage their hobbies and helps foster a sense of friendship with others.
- Delicious Meals: Seniors get access to three meals a day served privately or in a common dining room. Assisted living communities offer a diverse menu that can accommodate any dietary, religious, or lifestyle preference. Many facilities also offer frequent grocery trips, for seniors looking to fill their private fridges.
- Assistance: Personal attendants stand ready at all hours to help seniors take a bath, get dressed, visit the lavatories, take a walk, consume medications, access computers, go shopping, and more. Many of these services are optional, allowing seniors to choose services as they need them.
- Housekeeping: Seniors at an assisted facility need never worry about cleaning. Assisted living offers housekeepers that maintain public areas, perform laundry duties, change bed liners, vacuum floors, wipe down tables, wash out tubs, and more. Seniors get to focus on having fun and relaxing instead.
- Physical Fitness: Seniors are typically offered a variety of strength, balance, stretching, and endurance-related exercise regiments. The types of activities available differ, but some of the common types include walking, swimming, playing golf, playing tennis, treadmill runs, weight training, dancing, and even playing video games.
- Social Activities: Social activities keep seniors emotionally healthy. The average assisted living center hosts a wide array of social activities, including: cooking classes, art classes, movie nights, pizza parties, book clubs, prayer services, bingo, dances, sing-a-longs, group therapy sessions and many more.
- Transportation: Transportation services are provided for doctor’s appointments and other essentials, but seniors also have access to regularly scheduled trips to local cultural events, sporting events, churches, temples, and more.
- Security: Although assisted living is by no means a locked facility, semi-strict security is maintained for the protection of seniors. The types of security measures differ, but some include limited video camera monitoring and a limited number of security guards. Caregivers can rest assured knowing a caring staff is always available to monitor their health and ensure their safety.
Cost is a huge consideration when it comes to deciding whether or not to choose assisted living. Unfortunately, the government provides very few subsidies for assisted living; many of the costs are likely to come directly out of your own pockets. Even more troubling is the fact that the average monthly rent for assisted living is approximately $3,022 per month, or about $36,000 a year. Some states offer programs through the Office of Aging that could help. Most facilities offer a tier-based structure, meaning prices are based on the level of services the senior in your life needs. You can tailor services and amenities to fit any personality!
Surprisingly, assisted living is more affordable than many would imagine. It is important to realize that assisted living covers the costs that seniors are already assuming, like housing, food, and utilities. If your loved one requires some assistants, housekeeping as well as personal care or daycare services can really add up. Keep in mind is that rent at assisted living facilities most often includes: a room with bathroom, laundry services, housekeeping, transportation, food/beverages, entertainment, and assistance with personal care services, such as dressing of bathing.
- Medicare Benefits– Medicare offers limited options for assisted living. Technically, Medicare does not cover any assisted living costs, but some services or programs may be covered. For instance, Medicare Part B offers access to physician services; something that might be applicable, assuming the facility you choose features an on-staff physician.
- Medicaid Benefits- Some forms of Medicaid pay up to about 10% of all assisted living expenses; unfortunately, the rest must be paid out-of-pocket. The good news is that more and more states across the U.S. are adopting Medicaid waiver programs that permit seniors to use more of their Medicaid funds for paying assisted living costs.
- SSI Benefits- A limited number of assisted living facilities accept Supplementary Security Income. You will have to check with facilities in your local area to determine whether they accept SSI. Keep in mind that SSI income isn’t usually enough to cover all the expenses, seniors should prepare for some out-of-pocket costs.
- Veterans Benefits- There happens to be a benefit known as the Aid and Attendance and Housebound Improved Pension benefit that is offered through the Department of Veterans Affairs. This program entitles a veteran to a stipend of up to $2019 that can be used for assisted living, though not every veteran is eligible.
- Long-Term Insurance- If long-term care insurance is an option, you are already 10 steps ahead of everybody else. This special form of insurance covers long-term care for seniors who can no longer handle activities of daily living (ADLs). Keep in mind that the senior must have already purchased and set up this insurance sometime in the past.
- Senior Living Line of Credit- This is a relatively new option that permits loved ones to obtain a line of credit to help cover assisted living for the seniors in their life. It usually offers up to $50,000, which admittedly is only enough to cover about a year and a half. However, it is meant to be used in conjunction with out-of-pocket expenses. Note also that you must also make monthly payments back to the company that provides the loan.
Making the Transition Easier
The last step in the process is all about making the transition easier. You must understand that moving from a completely independent setting to an assisted living one is not easy for someone. There will be an adjustment time before things start to feel like home. Here are a few tips that may help:
- Visit: Visit the assisted community as often as possible prior to the official move date. Stop by the cafeteria and grab a meal, visit the billiards room and play a quick game. You can even take a minute to chat with staff and residents to get a idea of daily life there. This will help your loved one become more comfortable with the environment, they even make some friends in the process!
- Duplication: Try duplicating the family home as much as possible. One aspect of moving that causes difficult for anybody is the change in appearances. Position their favorite items as they would be at home: glasses on the night table, bible on the desk, etc.
- Coax and Encourage: Support your loved one and encourage them to participate! Sometimes, seniors isolate themselves immediately after a move; an apprehensive attitude impairs their ability to form new relationships. Encourage him or her to step into the community and do things.
- Step Back: Avoid stifling development by always being present. Take time away so that the senior can build confidence and acquire independence. It’s tempting to hold a senior’s hand through the entire process, but the most you should do is gently coax and support them. Nothing more, nothing less.
The idea of assisted living is relatively new, however, it has become extraordinarily popular. It is important to recognize a community that encourages seniors to maintain their independence while protecting health and promoting happiness. The move can be the beginning of an amazing end-of-life experience where they get to take classes, enjoy outings, hang out with friends, and much, much more. At the end of the day, it’s all about ensuring that your senior gets the care, service, and happiness they deserve.
About the Author: Victoria K. Stickley is a copywriter, editor, and senior content manager based in the Dallas area. Her graduate education in counseling and research has helped immensely in her writing as well as the care she provides for her grandparents. She currently provides support and resources to senior care websites as she learns and experiences senior care first-hand.