As our loved ones age, so do their needs, and everyone’s aging journey looks different. Some older adults are able to live out their retirement years playing golf and enjoying relatively few health problems. In contrast, others require a degree of assistance, dictated by health and safety concerns. The spectrum of senior housing options makes it so all older adults can find a senior care or housing level that works for them, no matter where their needs fall.
From aging in place with caregivers’ help to assisted living, there are many options that enable seniors to remain as independent as possible while receiving care. Some seniors find it possible to stay in their family home with some outside help; others choose to join a community of seniors in an assisted living setting. For seniors who need a more secure environment or cannot care for themselves, memory care and skilled nursing facilities may be appropriate solutions.
The many choices for senior housing can be overwhelming. The following comprehensive senior housing guide will provide you with more information about your options in today’s senior housing market, along with the information you need to make an educated decision about the right senior living option for your loved one.
In this section, we explain the three main players in residential senior living: independent living communities, assisted living communities, and memory care communities. Though the different senior living types each offer a different level of support and care, all three offer community living and a maintenance-free lifestyle. Read on to learn more about these types of senior living and for whom they can be the right fit.
Independent living is a good option for older adults who are ready to transition to senior living but are still active and do not yet need any daily assistance. Seniors who choose independent living can look forward to maintenance-free living and the convenience of on-site amenities and social opportunities. As the first step in the spectrum of senior living, independent living communities do not offer any personal care services or medical care.
Independent Living Services and Amenities
Independent living communities are intended for seniors who are still relatively active and social, and thus a limited number of services are available. Independent living communities may provide housekeeping and linen services for individual units, interior maintenance of all common areas, and exterior maintenance. Transportation services may also be provided. Personal care services and assistance with any of the activities of daily living (ADLs) are not available in independent living. Anyone in need of those services is better suited for assisted living.
Independent living communities do typically offer quite a few amenities to support residents’ social and active lifestyles. All independent living communities will have an on-site dining room serving prepared meals, and some may also have a cafe or coffee shop where residents can purchase items a la carte. Many have fitness facilities, including indoor or outdoor pools and group fitness classes. On-site, residents can partake in planned activities like art classes or attend scheduled events like visiting lecturers and concerts. The number and type of amenities available can vary significantly between different facilities.
Who Should Consider Independent Living
Independent living is designed for older adults who are ready for a maintenance-free lifestyle but who are still active and can live independently. Seniors who can take advantage of on-site amenities and activities will get the most benefit from independent living. It’s also a good choice for older adults who would otherwise live alone and can benefit from the built-in socialization that comes with community living. Independent living communities do not offer any personal care service or medical care, so those who need regular assistance should consider a different type of senior living.
Independent Living Costs and How to Pay
Independent living costs can vary dramatically depending on location and the quality and quantity of services and amenities offered. According to Caring.com, independent living costs from $12,000 to $42,000 per year, putting the high-end communities at approximately $3,500 per month. Independent living communities tend to be about 30-50% less expensive per month than assisted living, as independent living does not provide the same array of services as assisted living.
Because independent living communities do not provide medical or custodial care, Medicare and Medicaid do not provide any coverage. However, those with a long-term care insurance policy may have coverage for some services received while in independent living, like prepared meals and transportation services.
Read our Comprehensive Guide to Independent Living to learn more.
Assisted living is a type of residential senior care well-suited for seniors who need some assistance with their activities of daily living, but do not need any regular medical care. Residents have access to staff around-the-clock for emergency assistance and receive assistance with their daily tasks, including eating, dressing, and bathing. Assisted living residents only receive the care that they need, enabling them to retain their independence as much as possible while also having help available whenever it is required.
Assisted Living Services and Amenities
The services offered in assisted living focus on the activities of daily living, which include essential daily tasks such as bathing, dressing, eating, grooming, and transferring (walking). Residents of ALFs have access to as much assistance with ADLs as they need, but can also live as independently as they wish. Along with ADL assistance, ALFs offer other personal care services, including housekeeping and linen services, laundry, and transportation.
Many assisted living facilities also offer amenities for residents to enjoy, such as a fitness center, arts and crafts room, or formal dining room for dinner parties. Some may also have an on-site beauty parlor or barbershop, outdoor common areas, a library or computer room, and more.
Who Should Consider Assisted Living
Assisted living is a good option for older adults who are starting to have more difficulties living independently. This includes those struggling with mobility or fine motor skills, seniors who recently suffered an injury or health emergency, and seniors in the very early stages of memory impairment. Some signs that a loved one may be a good fit for assisted living include unpaid bills, noticeable weight loss, and a noticeable decline in cleanliness or hygiene. Assisted living communities can provide both seniors and their families with peace of mind knowing that staff is on-site around-the-clock to help residents in case of an emergency.
Assisted Living Costs and How to Pay
Assisted living costs an average of $4,300 per month in the United States, though costs can vary significantly between different states. In most cases, a community’s stated cost per month is all-inclusive, including all care services, meals, and housekeeping and maintenance fees. However, be sure to find out what is and is not included in a community’s monthly cost before signing any contract agreement.
There are financial assistance programs available to help cover the cost of assisted living, the most notable of which is Medicaid. In most states, assisted living services are covered under a 1915(c) waiver program, commonly referred to as Home & Community Based Services (HCBS) waivers. These waiver programs enable seniors to choose their preferred care environment, like an assisted living community, rather than having to default to nursing home care. Additional financial assistance options include long-term care insurance and the Aid and Attendance benefit for veterans.
Visit our Assisted Living Near Me page to learn more about this type of senior living.
Memory care, sometimes referred to as Alzheimer’s care, is a specialized form of senior living specifically for seniors living with advanced memory impairment. Seniors living with Alzheimer’s and dementia often have very different needs, both physically and emotionally, than other older adults. Dedicated memory care communities offer services and activities tailored to meet the needs of the memory-impaired, and all staff must be trained in how to best work with and support seniors with these cognitive conditions.
Memory Care Services and Amenities
Memory care staff is available 24-hours a day to assist residents with any of their personal care needs. This includes assistance with ADLs, housekeeping, and laundry, and transportation services. Additionally, many memory care communities offer specialized activity programming intended to stimulate and engage residents. These programs may include music therapy, gardening groups, puzzle clubs, and more. While memory care communities may have fewer lifestyle amenities than independent and assisted living communities, they do have enhanced safety and security measures, such as monitored entry and exit points and community-wide use of personal medical alert systems.
It’s important to note that while memory care staff is well-trained to care for seniors with memory impairment, most are not medical professionals. Memory care communities do not offer regular medical care beyond basic first-aid and medication management services. Seniors in need of regular skilled care and around-the-clock access to a doctor are better suited for skilled nursing facilities.
Who Should Consider Memory Care
Memory care is an appropriate choice for seniors who are in the mid-to-late stages of Alzheimer’s or dementia. It’s possible for seniors in the early stages of memory impairment to continue living at home with family caregivers, or even in an assisted living facility. But, in most cases, the disease will progress to the point that makes it infeasible for the person to remain in their current home. Some families decide to transition their loved one to residential memory care after a dangerous incident, such as wandering.
Memory Care Costs and How to Pay
Memory care costs 20-30% more than assisted living, mainly due to the specialized staff training and enhanced safety and security measures of these communities. Given that the average cost of assisted living is $4,300 per month, one can expect to pay approximately $5,375 per month for memory care. Keep in mind that this is the national average, so costs in your state may be different.
Unfortunately, Medicare does not cover residential memory care. There are other financial assistance options available, notably Medicaid’s Home & Community Based Services (HCBS) waivers. HCBS waivers will not cover room and board in a residential memory care community, but it will cover the cost of services received, making the overall expense more affordable. Other sources of financial assistance include long-term care insurance and reverse mortgages.
Visit our Memory Care page to learn more about this type of senior living.
Senior Care & Aging in Place
Some seniors prefer to age in place, or remain in their own home as they age rather than move to residential senior living. While some seniors can get by with minimal assistance from a family member or friend, others rely on professional senior care to ensure they remain safe and healthy while aging in place. Below, we explain four senior care options for adults who choose to age in place.
In-home care encompasses a range of services and supports that one receives in the comfort of their own home. It may involve assistance with ADLs, transportation services, companionship, or a combination of the above. The services one receives can be customized for their needs, but in-home care does not include any medical care beyond basic first-aid.
Home Care Services
Home care services include personal care services, such as assistance with ADLs, transportation, medication management, and housekeeping. Home care aides can also provide companion care services, which may involve playing games with the client, reading to them, accompanying the client on errands, and spending time with them to stave off loneliness. Ultimately, home care services can be customized for each individual client, but it’s important to be clear with the aide about what is and is not expected of them.
Who Should Consider In-Home Care
In-home care is a good option for seniors who need assistance with their ADLs, but do not need help around-the-clock and want to remain in their own homes. The companion care aspect also makes it a good option for seniors who live alone and want a companion to accompany them on errands or simply spend time with them to keep them stimulated. It’s important to note that home care aides are not nurses and cannot provide any medical care. Thus, in-home care is not a good fit for seniors who need regular medical care.
Home Care Costs and How to Pay
In-home care costs approximately $25 per hour in the United States. For 20 hours of care per week, that comes out to $2,037 per month. The overall cost of in-home will depend on how often the client needs care. For example, a senior who only needs 2 hours of care per day, or 14 per week, will face a cost of $1,426 per month. On the other hand, someone in need of 10 hours of care per day, or 70 per week, faces a much higher cost of $7,129 per month.
Because in-home care is considered custodial care, Medicare and Medicaid do not cover it. However, some states’ HCBS waivers may cover in-home care, and seniors and their families may also use private options like long-term care insurance and reverse mortgages to help pay for in-home care. Additionally, Medicare may cover in-home care personal care services if they’re delivered in tandem with home health care services.
Home Health Care
Home health care is a form of skilled nursing care delivered to a patient in their own home. Compared to in-home care aides, home health care aides must hold higher nursing credentials and have more medical training. This form of care is oftentimes short-term, following an injury or illness, or it may be used instead of placing a loved one in nursing home care.
Home Health Care Services
Home health care services are often delivered by a trained nurse or nurse’s assistant, so they can provide more skilled care than personal care aides. Home health care services include post-surgery care, physical and occupational therapy, medication administration (including injections), and more skilled nursing services. Since this type of care is one-on-one, the care plan can be tailored specifically to the individual’s needs.
Who Should Consider Home Health Care
Home health care is typically ordered by a doctor and is often meant to resemble the care one would receive in an inpatient setting like a nursing home. Seniors who are recovering from an injury or serious illness and need monitoring, medication assistance, and/or therapy services are good candidates for home health care. Some families may also choose home health care for an elderly loved one facing ailing health who would otherwise need to transition to a nursing home.
Home Health Care Costs and How to Pay
Home health care costs an average of $26 per hour in the United States, which comes out to $2,080 per month for 20 hours of care per week. If the patient needs around-the-clock care, in-home health care becomes much more expensive. For 24 hours of care per day, seven days a week, the average monthly cost is $17,472, over twice the average nursing home cost.
There are financial assistance options available to help pay for in-home care, most notably Medicare. Medicare will cover in-home health care with no cost to the patient so long as a physician recommends home health care. However, it’s important to note that Medicare only covers care if it’s “intermittent” or part-time, and the program will not pay for around-the-clock in-home health care.
Respite care is a form of short-term care that provides temporary relief for primary caregivers, giving caregivers the freedom to travel, work outside of the home, visit friends, or simply take a break from their caregiving responsibilities. This type of care is very flexible, and can take place in the senior’s home, in a residential care facility, or in an adult day care center. Depending on the caregiver’s needs, they can use respite care for just a few hours one time, or for several weeks continually.
Respite care can be scaled to the senior’s needs. It may include basic supervision and companionship, assistance with ADLs, transportation services, or even skilled nursing care. If medical services are required, it’s crucial to work with a respite care provider who is also a certified nurse or physician.
The cost of respite care depends on several factors, including location, the type of care required, and how much care is needed. For example, basic daytime care involving supervision and companionship will cost about the same as adult day care. The cost of respite care involving skilled medical services will be much higher, similar to the cost of home health care. In cases where the senior needs medical care, Medicare may cover the cost of respite care. If personal care assistance is required, a Medicaid waiver program may help cover the cost.
You can learn more about this type of senior care by visiting our Complete Guide to Respite Care Services for Family Caregivers.
Adult Day Care
Adult day care offers short-term, daytime respite for caregivers of seniors. Unlike respite care, overnight care is not an option with adult day care. Adult day care centers are typically open during normal business hours, making this an appealing option for family caregivers who have a day job in addition to their caregiving.
Adult day care centers can assist seniors with some basic health needs like first-aid and medication reminders, but the caregivers cannot provide medical care. In general, adult day care is a good fit for seniors who need some supervision and minor assistance throughout the day, but who do not need around-the-clock care. As a group environment, adult day care gives seniors ample opportunities to socialize.
In the United States, adult day care costs an average of $1,603 per month. Because it is custodial care and not medical care, it is not covered by Medicare. However, Medicaid in some states does cover adult day care, typically under an HCBS waiver.
Other Senior Care & Senior Living Options
Continuing Care Retirement Communities
Continuing care retirement communities (CCRCs) provide a continuum of care, from independent living to skilled nursing and memory care. This enables seniors to remain in the same community as they age and their needs progress. It’s an appealing option for older adults who are ready to transition to senior living but want to avoid having to move again in the future, or for couples who have different care needs but want to live in the same community.
CCRCs typically have several different buildings or areas that make up the community, with different care levels separated into different areas. One building may house independent living residents who are more active and social, while another may be for residents with memory impairment and have more staff on-site and enhanced safety and security. The amenities and services available will also be different for the different levels of care; for example, residents in the independent living area will not have access to aides to assist them with ADLs, but assisted living residents will. It’s usually an easy transition to move from one area of care to another.
CCRC costs typically depend on the level of care one needs. Usually, one can expect the prices to be similar to other senior living facilities in the area (i.e, an assisted living resident in a CCRC will pay a similar monthly fee as a senior in a dedicated assisted living community). Some CCRCs may also have a “buy-in” or entrance fee in addition to the recurring monthly cost.
Skilled Nursing Facilities
Skilled nursing facilities, also called nursing homes, represent the highest level of care in the spectrum of senior care. These communities provide around-the-clock, skilled care from trained medical professionals, as well as short-term rehabilitation services like physical and occupational therapy. Often, someone transitions to a nursing home after being treated in a hospital for an illness or injury. Unlike other senior living options like ALFs and CCRCs, nursing homes focus entirely on resident health rather than lifestyle. Thus, these facilities tend to offer fewer amenities and activities than other types of senior living.
Because of the high-level medical care provided in nursing homes, costs are high. Genworth Financial reports that the average monthly cost for a shared room in a nursing home is $7,756 per month, while a private room costs an average of $8,821 per month. Medicare does cover a portion of nursing home costs, but only for short-term stays (the benefit runs out entirely after 100 days in a nursing home). Medicaid provides the most comprehensive nursing home benefit of the available insurance options, but exact coverage and eligibility vary between different states.
Visit our nursing homes guide to learn more about this type of senior care.
How to Get Started in Your Search for Senior Housing
Understanding the wide range of senior care and senior living options is the first step to selecting the best fit for yourself or a loved one. If you want to learn more about senior care providers and senior living communities in your area, visit our Assisted Living Near Me page. There, you can enter your zip code to see the senior living communities in your area, with address information and photos.