As people get older, sooner or later they find themselves faced with the decision of where the best place to live might be. The topic becomes even more pressing after the death of a spouse or a medical scare. As some older adults prepare for a change in living accommodations, they still want to maintain their independence; but because of an illness or disability, living alone is no longer an option. For others, a fixed income makes it difficult to maintain a home with all its upkeep. All these reasons and many others make senior living communities the best choice for many older adults. However, it’s important to know the difference between the two common entry levels of senior living communities as you contemplate your next move.
Many older adults are able to live independently yet choose not to do so for various reasons. Perhaps they’re unable to financially afford to live in their own home or the upkeep has gotten too difficult to keep up with, or maybe they want the social interactions that are available in a senior community. For these and numerous other reasons, many older adults choose to move into an independent living community.
Independent living communities offer a fairly active and independent lifestyle while also providing social opportunities to connect with other people who are in their same age group and who share common interests. By being able to relinquish chores such as meal planning/preparation, laundry and housekeeping and having access to a calendar of organized activities, seniors are given the opportunity to enjoy their retirement without the responsibilities of owning their own home.
Because independent living communities are designed for “independent” seniors, the features and amenities provided in each private, individual living space are comparable to those one would see in a small home or apartment. These living spaces generally include a small living area and full-service kitchen giving them the opportunity to prepare and host their own dinners when they want, while often offering multiple communal dining experiences as well.
Some seniors may be cognitively or physically unable to live on their own. They may be developing or living with chronic health conditions such as heart disease or diabetes. They may be facing the cognitive decline associated with Alzheimer’s or some other form of dementia. For reasons such as these and many others, the best option for many older adults is an assisted living community.
In an assisted living community, older adults have their own living space (may be private or semi-private), typically an apartment-style set of rooms, while also having access to additional care and assistance as needed. Staff is available 24/7 to help residents with activities of daily living (ADLs), from the basics such as toileting assistance and help with dressing and grooming to scheduling doctor’s visits and transportation to those appointments. Although additional care is available, residents are encouraged to be as independent as possible.
Assisted living communities also tend to staff one or more full-time medical personnel, such as certified nursing assistants who receive training geared to the needs of older adults, an RN or LVN, or a doctor, all trained to provide emergency medical care should the need arise. Some assisted living communities also have specialized memory care units that provide expert care to those who have more advanced cognitive issues. Often a dedicated wing within the community, these units offer advanced security measures such as secured entrances/exits and extra surveillance equipment. Due to safety concerns, apartments in memory care units generally do not have kitchens.
Choosing Between Assisted Living and Independent Living
Trying to find the best living option for yourself or an aging family member can seem overwhelming at times, but with the right information, it can be much easier. For many, especially those who are making their first move into a senior living community, independent living or assisted living is generally the first place they start looking. Independent living is the least restrictive of all senior community options followed by assisted living which offers more support and assistive services.
This chart should make the comparison easier if you are trying to make a choice between assisted living and independent living.
|Independent Living Communities||Assisted Living Communities|
|Living Accommodations||Accommodations can range widely including cottage, townhome, condo or apartment.||Accommodations generally consist of an apartment with a small kitchen, living area, and private bed and bath.
Accommodations may be private or semi-private.
|Meals||Up to three meals a day may be offered, generally at an additional cost when available. Multiple dining options may be available.||Three meals are served in a communal dining area, usually at no additional cost.|
|Housekeeping Services||Weekly housekeeping services may be offered, often at an additional cost.||Housekeeping and laundry services are generally included at no additional cost.|
|Caregiving Services||Someone needing specialized care or one-on-one care will need to arrange for this supplemental care through a third party at an additional cost.||Caregivers are available around the clock. Someone needing specialized care or one-on-one care will need to arrange for this supplemental care through a third party at an additional cost.|
|Medication Management||May or may not be provided||Provided at no additional cost|
|Medical Personnel Available||May or may not be provided||Full-time medical personnel are on site or on call at all times.|
|Assistance with ADLs||Not provided||Available around the clock.|
|Activities||Social outings and events are planned. Some communities have a full calendar of daily events.||Various activities are scheduled on a daily basis focused on keeping the residents busy throughout the day.|
|Transportation||Transportation to and from doctor’s appointments and other errands may be available.||Transportation to and from doctor’s appointments and other errands is often available.|
|Payment Sources||Mostly private pay. Some federal funding may be available through Section 202 for low-income seniors, but waiting lists are long.||Mostly private pay. Some communities accept Medicaid and Medicare. Services may be covered by long-term care insurance and Veterans benefits.|
|Average Price Range||Between $1,500 – $3,500 per month||Between $2,500 – $4,000 per month. Memory care will run substantially higher.|
|Other Names for These Communities||Retirement Communities, Retirement Villages, 55+ Communities, Senior Apartments and Congregate Care Communities||Assisted Care Communities and Personal Care Homes|
The biggest difference between independent living and assisted living within a larger senior care community is the full-time medical and custodial care that is provided for those who choose the assisted living option. Additionally, some amenities such as meals and housekeeping services are generally included in the cost of care for assisted living; whereas, it may come at an extra cost for independent living.
Although assisted living communities provide assistance with ADLs, they do not provide intensive hands-on care or skilled nursing care. Should an older adult have serious physical or mental ailments that require more intensive care, a nursing home or skilled nursing community may better suit their needs. Residents may also opt to arrange for this care through a third party at an additional cost and remain in the assisted living community.
In the end, the choice between independent living and assisted living is often determined by the needs of the senior. Many senior living communities offer both independent and assisted living. Some also offer higher levels of care, such as memory care and skilled nursing as well. Knowing that care needs often change, it’s a good idea to take this into consideration as you consider your options.
When you have narrowed your choices down to a few communities, be sure to ask each of them about the services that are included in the monthly rate and which services can be obtained at an additional cost. Tour the communities and be sure to ask as many questions as you need to feel confident you’re making the right decision for yourself or someone you care about.