Assisted Living and Memory Care Facilities

Few people want to go to a nursing home. Today there are options available in addition to in-home care that help you or a loved one from having to go into a nursing home. Assisted Living Communities and Memory Care Facilities have become a very popular way to receive long-term health care without going into a nursing home.

What is Assisted Living?

Assisted living is a residential option for older adults who need some help with everyday tasks but don’t need the round-the-clock medical care of a nursing home. You keep your own apartment or room, your privacy and much of your independence, with support available when you need it.

Most residents get help with activities of daily living (ADLs), the basic self-care tasks most of us take for granted. These include bathing or showering, dressing, using the bathroom, grooming and moving around safely.

Assisted living communities also typically offer:

• Meals, often served in a shared dining room
• Housekeeping and laundry
• Medication reminders and management
• Transportation to doctor appointments and errands
• Social activities, outings and wellness programs
• Staff on site 24 hours a day for safety and emergencies

Many communities have a nurse on staff or on call, but the level of health care varies widely. Each state sets its own rules for what assisted living can provide, so ask any community exactly what services it offers and what happens if your needs increase. Some also have separate memory care wings for people living with Alzheimer’s disease or other forms of dementia.

Assisted living may be the right fit if you need more help than you can comfortably get at home or in an independent living community, but you don’t need the skilled nursing care and supervision a nursing home provides.

Memory Care in Assisted Living Communities

Many assisted living communities include a separate memory care unit, often called a neighborhood or wing. Memory care is designed for people living with Alzheimer’s disease or another form of dementia who need more supervision and support than standard assisted living offers.

These units are usually secured to prevent wandering, a common and dangerous symptom of dementia. Staff typically receive specialized dementia training, and daily routines are built around structure, familiarity and activities that help residents stay engaged.

You’ll also find standalone memory care communities in many areas. Like assisted living, memory care is regulated at the state level, so staffing, training requirements and services can vary. Ask how staff are trained, how the community handles changing behaviors and what happens if your loved one’s needs eventually exceed what memory care can provide.

Who Should Consider Assisted Living?

There are several reasons people choose assisted living. Sometimes an older person or couple chooses assisted living primarily as a residential choice. While they may be living primarily independently, they enjoy the peace of mind knowing that there is help around the corner if something happens. Plus, they enjoy the social aspect of assisted living as opposed to being alone in their home.

Some assisted living facilities have independent living apartments attached to the facility. However, in assisted living, you have services available to help with activities of daily living (ADLs) twenty-four hours a day. Some assisted living facilities can perform simple supervision for those in early-stage cognitive decline). In some cases, assisted living facilities will include a wing for more advanced dementia care called a dementia special care unit (SCU).  

A quality assisted living facility will develop a personalized plan that meets your needs and accommodates your disabilities while giving you the freedom to do what you can for yourself. It is much less institutional compared to a nursing home environment.

Every state has its own specific licensing requirements for assisted living facilities. Usually, assisted living will provide the following:

• Care and services available as needed 24 hours a day
• Trained staff on duty on location at all hours
• Provides at least three meals per day based on your dietary needs
• Provides all services at one location
• Maintains arrangements with a nurse and physician to furnish medical care in an emergency
• Provides a detailed written record of services for each resident that the resident's doctor can access if necessary
• Provides on-site assistance with prescription medications

Services Available at Assisted Living Facilities 

The following services are common to most quality assisted living communities:

• Three meals a day served in a common dining area. Some facilities have restaurant-like menus for residents to choose from, depending on their dietary needs. In some cases, friends and family can join the resident in the dining room (usually at additional cost).
• Assistance with activities of daily living, including eating, bathing, dressing, going to the bathroom and bathroom hygiene, transferring in and out of bed to chair, to wheelchair (if necessary), and walking.
• Housekeeping services. The facility will clean, dust, and vacuum to maintain your apartment properly.
• Transportation services. Most facilities will transport to and from the doctor, for example. Many facilities will have group outings to stores and cultural events, which include transportation.
• Access to health and medical services as needed.
• Round-the-clock security. Keeping every resident and the staff safe is a prime concern. For facilities that allow some dementia supervision, this becomes even more important to prevent wandering outside the facility.
• Emergency call systems in each resident's living space. Many facilities provide a medical alert for residents to have with them at all times.
• Exercise and wellness programs, including physical therapy, are available.
• Medication management.
• Laundry services. Residents, if they are capable, can do their own laundry with on-site equipment.
• Social and recreational activities are available and become an essential aspect of assisted living. There are always many activities to choose from that residents can enjoy and socialize with other residents.
• Staff available to help with scheduled personal needs and address any unexpected issues that may come up. 

Does Your Parent or Loved One Need Assisted Living?

It is never easy to consider that a parent or loved one is declining and may need help and assistance. Is it the right time? 

We often avoid thinking about a loved one's declining health. That denial is normal; however, part of the problem is that your parent or loved one is also usually in denial about their need for help and assistance.

All of us value our independence. Few of us want to be dependent on others for anything, much less personal needs. However, is it essential to notice the signs of declining health due to an illness, accident, or the impact of aging, so your loved one is kept safe.

You can start by looking for signs. You may notice unpaid bills sitting on the table. Perhaps there is spoiled food in the refrigerator. You might notice your loved one has lost weight, is less talkative, has bruises from potential falls (which are usually denied), and maybe they are getting out of the house less often.

When you see them walk, they seem more unsteady on their feet. Maybe their hygiene has changed. Are they wearing the same clothes over and over? 

Your loved one may seem depressed, maybe lonely. Maybe they are calling you in the evening and seem scared to be alone. Do they seem confused and act in unusual or inappropriate ways?

Is your loved one's home age and disability-friendly? 

Do you feel like your parents or loved ones are safe in their home?

You may have tried in-home care. What is the caregiver telling you about your parent or loved one? There are times when being at home is no longer the best way to maintain overall health and safety. There are times when a person needs the social interaction that an assisted living community can provide.

Cost of Assisted Living Near You

Like anything else, there are huge variations among assisted living communities. Plus, the costs vary between the various facilities. You can find the average cost where you live by using the LTC News Cost of Long-Term Care Services Calculator.

The calculator can provide you with a baseline average cost in your state and even in your region, which can help as you budget, plan, and consider possible coverage options such as Long-Term Care Insurance.

Finding the Right Assisted Living Facility - Comparing Costs

As you start your search, try not to be overwhelmed by all the options. Remember, amenities matter much less than the residents and staff. The quality and friendliness of the staff is a major consideration when selecting a facility.

Your parent or loved one may tell you they don't like any option you show them. However, you know them, and you know what they like and don't like. Understand that their obstinance is perfectly normal. While this doesn't mean you should ignore their input, if everything you suggest is not acceptable to them, it doesn’t mean they actually dislike everything you are showing them.

You can tell a lot about an assisted living facility from the people who live and work there. Generally, a community with an active social atmosphere, where the residents are friendly and the staff is caring and warm, will be the right fit. Make sure that, overall, you feel the community is a place where they will fit in and develop new relationships.

Faith plays an important role in many people’s lives, and moving into assisted living doesn’t mean leaving that behind. Some communities are affiliated with a church, synagogue or other religious organization, and their values may shape daily life, from shared prayer to holiday celebrations and meal traditions.

Even communities without a religious affiliation often have a chapel or quiet space for worship and reflection. Many host regular services, Bible studies or visits from local clergy, and some offer transportation to nearby places of worship so residents can stay connected to their own congregations.

If faith matters to you or your loved one, ask about it during your visit. Find out what services are offered, how often they’re held and whether residents of all faiths are welcome. Feeling spiritually at home can make the transition to a new community much easier.

Assisted Living Communities: Staff Considerations

Here are a few things to consider when considering the staff at assisted living facilities:

• Do they have time to speak with you, or does it seem rushed?
• Do they appear genuinely interested in you?
• Do they interact warmly with current residents?
• How do they handle emergencies? Did you notice any emergency when you were visiting, and how was the staff reacting?

What to Look for With Assisted Living Residents

Things to look for when visiting a facility and seeing and watching the residents:

• Do they seem happy? Facial expressions can tell you a lot.
• Do they seem to enjoy interacting with one another and with the staff?
• Do they look like they are properly taken care of or just being warehoused?

Other Items to Consider in an Assisted Living Community

• Does the facility offer activities you or your loved one is interested in?
• Are there hobbies or activities available on-site, or available transportation to outside ones? 
• Does the facility have important amenities such as a gym, recreation center, library, or chapel?
• Is the food appealing? How many menu options are available, and how do they vary? Is in-room eating available? Did you or your loved one try the food?
• How are health problems handled? How does the facility handle both emergency and non-emergency problems?
• If new medical conditions or physical problems develop, at what point will they suggest your loved one move from the facility? 
• Is the facility in compliance with state and local licensing requirements? 

Assisted living is usually considered an intermediate stage between independent living and nursing home care or memory care facilities. If a person only needs minimal assistance and is fairly independent, then an independent living facility might be a better option. Some assisted living facilities have connected or nearby independent living facilities. 

For anyone with substantial medical needs or who has a significant cognitive decline, a nursing home or dedicated memory care facility would be a better option. 

Assisted Living Needs Assessment

Before a person moves into an assisted living facility, they will assess the potential resident and develop a service plan for the person. A staff nurse will assess the level of care the individual requires and whether they qualify for care under their license and ability to provide the care.

In some situations, the facility will determine that the facility is not appropriate. It could be due to the level of cognitive ability; in some cases, the level of care that the person requires is more than what is available at the facility. 

The staff nurse will administer a careful, in-person evaluation of the senior's physical and cognitive health. Some facilities will review medical records or doctor's statements; however, their own assessment is the primary consideration for admission approval.

This assessment is crucial since it determines admission and determines the level of care a potential resident requires, the facility's available services, and the associated costs. The process is also instrumental in creating a senior's plan of care.

The nurse's assessment will review and rank these areas:

• Behavior
• Chronic illnesses
• Communication skills
• Dietary needs

Plus, they will grade the individual's ability to perform their activities of daily living (ADLs) and any need for assistive devices (wheelchairs, walkers, shower chairs, etc.).

A determination will be made if the person can manage their medications independently or if they will need help with taking their medications properly. 

Major areas of assessment include:

Orientation

• Is the individual aware of people, places, and time?
• Does the person suffer from confusion and have difficulty recalling details? Do they require prompting to perform routine activities?
• Is there a history of poor judgment that would create the possibility of unsafe behaviors adversely impacting other residents and staff?

Bathroom Needs

• Can the individual manage toileting independently, including getting on and off without hands-on assistance and performing normal hygiene without another person's help?
• Is the individual continent of bowel and bladder, or do they need and can they manage protective and/or assistive devices independently?
• Does the person need occasional reminders or prompting to go to the bathroom?
• Are there intermittent episodes of incontinence, and if so, do they use protective garments?
• If the person requires assistance to manage bowel and/or bladder needs, do they require hands-on help or stand-by assistance?
• If the person needs hands-on help, will they require a two-person lift/assist when toileting?

Fall Risk and History and Mobility

Will the facility assess if the person has never experienced a fall, has had a fall recently or has had multiple falls in the last three-month period? 

If a person has limited independence, what types of mobility assistance will the person require? Are their physical limitations? Will a person need a wheelchair, quad cane or walker, or other devices? With such a device, can the person safely move around the facility without risk?

Assisted Living and Memory Care: Final Thoughts

Far from being a last resort or something that should be dreaded, being a part of an assisted living community can ideally be a joy for residents, who otherwise might struggle to feel social connection and get the assistance and care they need.

This is possible when you plan ahead and prepare thoroughly to find a facility that is the right fit for your family member or loved one. By helping them to identify what will help them feel happy and secure, you can identify facilities that meet and exceed those needs.

Find Assisted Living Communities Near You on LTC News

The LTC News Care Directory is a comprehensive directory of care facilities and organizations across the country, including Puerto Rico and teh U.S. Virgin Islands.

To get started just click the link above and search for assisted living facilities in or near your zip code. It’s a great way to start your research process! And for all things long-term care, check out the LTC News Resource Center, which has educational resources for every stage of your journey!

Using Long-Term Care Insurance to Pay for Assisted Living or Memory Care

If you or your loved one owns a Long-Term Care Insurance policy, now is the time to put it to work. Many families pay out of pocket for months without realizing the policy they’ve paid premiums on for years could be covering much of the cost.

Most LTC Insurance policies cover assisted living and memory care, though some older policies may be limited to nursing home care. Benefits typically begin when a doctor or nurse certifies that the policyholder needs help with at least two of six activities of daily living or needs substantial supervision due to a severe cognitive impairment such as Alzheimer’s disease. Many policies also have an elimination period, a waiting period before benefits start, so filing early matters.

Tell the admissions director about the policy. Let the community know up front that your loved one has Long-Term Care Insurance. Experienced admissions staff work with insurance companies regularly and can provide the care plans, assessments and billing records the insurer will need. Some communities can even bill the insurance company directly.

Get help with the claim. Filing an LTC Insurance claim can feel overwhelming, especially when you’re already managing a move and a loved one’s changing health. LTC News can help. LTC News partners with Amada Senior Care to walk you through the claims process, help you understand the policy’s benefits and make sure nothing slows down the payments your family is entitled to, all without cost or obligation — File a Long-Term Care Insurance Claim.

Don’t let valuable benefits go unused. Have you checked whether your loved one has a policy, and do you know what it covers?