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  • Michelle Varela

Factors to Consider When Choosing Assisted Living

Nationwide 28,900 assisted living facilities have nearly 1 million beds, according to the most recent data available from the National Center for Assisted Living.

They vary widely in size, from fewer than 10 residents to more than 100, with an average capacity of 33. More than half of assisted living facilities are part of national chains with the rest independently owned.

Most facilities provide some basic health care services, according to the organization.

  • Access to a pharmacy: 83.6 percent

  • Dietary and nutritional guidance: 82.8 percent

  • Physical, occupational and/or speech therapy: 71.4 percent

  • Hospice care: 67.7 percent

  • Skilled nursing care: 66.1 percent

  • Mental health services or counseling: 55 percent

Social worker services: 51.1 percent

Some offer specialized services for people with dementia, sometimes called memory care. A little more than 14 percent of assisted living facilities have a special memory care unit, wing or floor, and another 8.7 percent accept only dementia patients.

Some also offer services tailored for people with intellectual and developmental disabilities or particular medical conditions such as Parkinson’s disease.

How Independent Living Differs From Assisted Living

At first glance, independent living might not seem all that different from assisted living. Both are for seniors who do not require skilled nursing or are not experiencing memory issues. Both promote active senior lifestyles as much as possible. And the amenities for both are often similar. However, assisted living offers an enhanced level of care, whereas independent living mostly just provides a place to live along with amenities and maintenance-free services.

Assisted living residents may need help with activities of daily life that aren’t otherwise available in standard retirement communities. Medical needs are fulfilled in assisted living, and a staff member is usually available for help if needed. The distinction is important: Independent retirees may not want to pay more for care they don’t require, and seniors with true needs must be confident the community they choose can provide assistance

What to Know About Assisted Living Facilities

But not all assisted living facilities are created equal. Calling all 28,900 assisted living facilities in the U.S. the same is like calling all colleges the same: Sure, they serve the same general population and support the same general goals, but they vary widely in size, culture, specialties, cost, perks and, yes, even dining.

"Just as each resident is unique, each assisted living community is unique,” says LaShuan Bethea, executive director of the National Center for Assisted Living, which represents about 4,000 assisted living communities nationwide.

“It is important to make sure the assisted living community will be able to meet your loved one’s clinical needs, community standards and budget,” Bethea adds. “Family members should talk to loved ones prior to the search for an assisted living community to understand their personal preferences, as well as their finances. This will help guide loved ones in determining w

Important Factors in Choosing Assisted Living

What factors are crucial when choosing a community? Asking the right questions will help you make up your mind and find the retirement community that best fits your lifestyle. When you’re searching for a retirement home, you should evaluate it based on factors like location, access to health care, accessibility, security, lifestyle, cost, and more

Here are some key aspects to consider:


Naturally, you need to keep your loved one as close as possible. This will make visits easy and be helpful when arranging transportation to family events. Look first at the assisted living communities within a 40-minute drive. Spending close to two hours on drive time will significantly reduce your ability to schedule meaningful visits.

Think about other family members as well. Is this home in a good location for other family members to visit?

If you're torn between two facilities that are the same distance away, consider the location itself. Ask yourself:

· Is it in a safe neighborhood? If your family member has Alzheimer's or dementia, what would happen if they "escaped"?

· What's the traffic like on holidays?

· How close is this home to your parent's preferred hospital or primary doctor?

· Is access to a place of worship important to your parent? Will they be able to attend the ceremonies that matter to them?

The Size of a Community Matters.

Pick a senior care community that will be a good fit for your parent. Your loved one might prefer a small home with just a few other seniors and a small staff.

Your family member may benefit most from a one-on-one situation with access to close, personalized care.

Tour the assisted living community and consider the amenities offered, such as:

· Recreation rooms

· In-house salons, barbers or other hygiene professionals on staff

· Chapels


If you want a fine meal served to you every day, or if you simply know there will be times you won’t want to cook, dining services will be a huge factor in choosing a community. Are there a dedicated chef and waitstaff preparing and serving you meals, or is food mass-produced, like in a cafeteria? And what if you just want a quick snack or a cup of coffee in the middle of the day? These are important considerations as you investigate senior living communities.

The Greater Community

What opportunities for exercise, cultural pursuits, sightseeing, religious services, entertainment, and just plain fun are available in the neighborhood and the metro area as a whole (which you may not know that well if you are moving from another part of the country)? An independent living community shouldn’t be just a self-contained unit but, rather, an extension of the greater community around it as well.

On-Site Services and Amenities

Here’s where choosing a retirement community becomes specific — what does a community offer to help you live the life you want to lead? Amenities such as hair salons, libraries, gardens, music rooms, housekeeping, exercise classes (more on that next), laundry services, and a concierge distinguish great communities from merely adequate ones.

Exercise and Wellness

Active seniors want plenty of exercise and wellness options, and the best retirement communities should deliver those options. Yoga, tai chi, and strength training classes geared toward seniors keep residents fit. Community features such as exercise rooms and swimming pools also facilitate movement that promotes a healthy lifestyle.

Infection Control and Prevention

Although the COVID-19 situation is always changing, virus variants are still a threat for seniors. Outbreaks of infectious conditions, such as the flu or respiratory syncytial virus, also remain an ongoing challenge for any residential setting. While pandemic-specific restrictions have eased, how facilities limit exposure and spread of infectious diseases is an important factor to consider.

“Since vaccines and treatments are largely available now, assisted living options remain plentiful,” Bethea says. “Assisted living caregivers must remain vigilant and adhere to infection control best practices – but this is part of the new normal all congregate settings and aspects of society must adjust to in order to keep COVID at bay.”


Retirement communities vary on their pet policies. If you do not currently own a cat or dog, this might not be an issue, but for seniors with a furry companion who might have to choose between bringing it to their new home or giving it away, pet policies are a big factor to consider.

Help When it’s Needed

Some active seniors who do not require much, if any, daily assistance like the peace of mind of a community that offers assisted living. They know that if they need help moving furniture or carrying groceries or after a fall, it will be available. If this is you, think about a community that features both independent and assisted living options.


If you plan on keeping your car, be sure the community you choose allows it and offers easy parking. No independent senior wants to be homebound, so if you aren’t driving yourself, ask about a community’s shuttle services and nearby public transportation.

When transitioning to assisted living, you'll find certain services invaluable to your family member and yourself. Look for an organization that places individual service high on the list of priorities. Beyond a close, personal relationship with staffers, you might look for a home that offers:

· Transportation to worship every weekend and every major religious holiday

· Transportation to doctor appointments

· A full staff of fully trained registered nurses

· Access to physical therapists and fun physical activities all year long, not only during good weather

· Counseling services, for your loved one's peace of mind

· Financial counseling and services to help pay bills

Also, ask about the transition to higher care when needed. Choose a senior living community, or assisted living facility, that works closely with skilled nursing homes, so you'll be prepared for that eventuality

The Activities You Are Interested In

A move to a retirement community should give you the ability to better enjoy activities and hobbies. If an otherwise clean and well-run community doesn’t offer activities that you are interested in — art classes, music, gardening, movie nights, cultural outings, and so on — you risk becoming bored in a hurry.

Family Focus

If your grandkids are in town and are an important part of your life, be sure the community you choose welcomes them. Some communities — even with full apartments — may restrict family visits, so be certain you know the policies before you make a decision.


Costs cannot be overlooked when choosing a retirement community. You may have an idea of how much you are willing or able to spend, but you also may need to be prepared to spend more for the amenities you seek.


Be sure to observe staff members and residents interacting with one another. You want to live in a community that is full of friendly neighbors and helpful team members who want to get to know you and create meaningful relationships.


Finally, choose an assisted living community that allows plenty of social opportunities and outings for the residents. You should be able to make meaningful friendships and social relationships with other seniors and staff. It will make your time enjoyable!

Look for communities that provide:

· Social meal times with fun events

· Opportunities to spend relaxing time with others in a "rec room" setting

· Outdoor benches, gazebos, and picnic tables for close discussions during good weather

Transitions to Next-Level Care

The idea of moving from total independence to a residence with care can be daunting, so it's natural to resist considering graduated care. Doing so, however, is worthwhile. If the assisted living facility is part of a larger community offering a range of facilities including nursing homes, this can make an eventual transition easier if and when assisted living is no longer enough.

Certain assisted living facilities may have enhanced licensing. These Enhanced Assisted Living Residences, or EALRs, have additional certification that allows residents to age in place. An EALR can accommodate residents who require physical assistance from another person to walk or climb stairs, for instance, or who are dependent on medical equipment and require frequent assistance. Not every state has EALRs, but some may offer variations.

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