Key Differences Between Independent Living and Assisted Living

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It can be overwhelming to find a new living arrangement for an aging loved one, especially for those who are unfamiliar with the nuances of senior living options. In order to find the best fit, one must understand what types of housing and care are available and the key differences between them.

Senior care exists on a spectrum, and independent living (IL) is the least restrictive and assistive residential option. One step above IL is assisted living (AL). AL is also minimally restrictive, but as the name implies, this residential setting offers assistive services and supports. Let’s take a closer look at the differences and similarities between these two senior living options.

Living Spaces

The independent living category encompasses a wide range of housing arrangements, from apartment-style communities to housing co-ops. Generally, though, residents live in their own private dwelling spaces and have access to common areas where they can gather with other members of the community. Independent living can also be referred to as an active adult community, senior apartments, a retirement community, a 55+ community, or a retirement home. Because this option is designed for seniors who can still live independently, the features and amenities in the individual dwelling areas are comparable to those in a typical small home, townhouse or apartment.

The typical assisted living arrangement is apartment-style. Individual units may or may not be equipped with full kitchens. Assisted living communities with specialized memory care units for seniors with cognitive impairment often feature increased security measures (e.g. locked doors and extra surveillance equipment) and may not allow residents to have kitchens in their apartments, due to safety concerns.

Some specialized communities, called Continuing Care Retirement Communities (CCRCs) offer independent living, assisted living and higher levels of senior care all on the same campus to allow residents to easily transition between these settings as their needs increase.

Amenities and Care Services

Independent living communities aim to make their residents’ day-to-day lives a bit easier, thus enabling them to live on their own for as long as possible. The services IL provides are aimed at minimizing seniors’ daily responsibilities, not assisting with activities of daily living (ADLs). Landscaping, laundry and housekeeping services, on-site dining facilities, security surveillance, and a variety of activities and events are the typical offerings in IL settings. However, they do not have full-time staff dedicated to providing custodial or medical care.

“The main benefits of independent living communities are receiving help with meals and housekeeping/maintenance tasks, as well as having a centralized hospitality service building for socialization,” says Regina Wallace, director of the independent senior apartments program for the Hebrew Home at Riverdale in Riverdale, New York. “It’s not really about hands-on care in these communities.”

Assisted living, on the other hand, is geared more towards helping aging adults who need some assistance with activities of daily living (ADLs), such as bathing, dressing, doing laundry and taking medications. Staff members, including at least one medical professional (typically a certified nurse practitioner), are on call 24 hours a day in most AL residences. However, assisted living communities don’t provide intensive hands-on care or skilled nursing care for older adults with serious mental or physical ailments.

Both independent living and assisted living communities have recreation schedules that are unique to each facility’s residents and their abilities. Common activities include game nights, field trips, support and discussion groups, holiday celebrations, exercise classes and continuing education courses. They also provide transportation services for shuttling residents to and from doctor’s appointments, the grocery store and other errands.

Comparing the Costs of Independent and Assisted Living

Rent and utilities represent the primary cost for independent living residents, according to Wallace. Aging adults who live in communities that offer specialized recreational opportunities (e.g. private golf courses) may incur additional expenses in the form of membership and/or joining fees. Different meal plans are usually available for on-site dining, and additional costs may be involved depending on the mix of services and add-ons a senior opts for.

Just like in IL communities, AL facilities often use a base rate system that includes rent, utilities and some level of basic services, such as meals and housekeeping. Again, additional services will come with additional costs. According to Genworth’s annual Cost of Care Survey, the average monthly cost of a private one-bedroom apartment in an assisted living facility is $3,750.

Seniors who need specialized or one-on-one care that isn’t included in their rent contract can usually hire professional in-home care to supplement the services that the IL or AL community offers. Of course, this will increase costs, but the addition may enable a senior to remain in their home longer rather than move to a different setting with a higher level of care.

Ways to Pay for IL and AL

Besides differences in the levels of care these residential setting provide, the biggest disparity between independent living and assisted living is the financial resources that seniors and their families can use to cover the cost of living in these communities.

Since independent living communities don’t provide residents with medical services, Medicare, Medicaid, long-term care insurance and other financial aid programs won’t cover the cost. Instead, seniors must pay privately, using funds from Social Security benefits, pension income, retirement savings, life settlements, reverse mortgage funds, annuities and other personal funds.

Read: How to Pay for Independent Living

Because AL communities provide a greater amount of assistance, there are more options available for helping cover costs. Residents can pay to live in AL by using savings and the personal funds listed above, as well as certain long-term care insurance policies and Aid and Attendance benefits from the U.S. Department of Veterans Affairs. Medicare does not cover assisted living, but Medicaid offers some financial assistance for low-income seniors. Keep in mind that Medicaid eligibility and coverage rules vary from state to state.

Read: How to Pay for Assisted Living

The U.S. Department of Housing and Urban Development (HUD) offers low-income seniors help with paying for both independent and assisted living through the Housing Choice Voucher (formerly Section 8) and Section 202 programs respectively. However, because of high demand for these programs, the waiting lists are often very long.

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8 Comments

There seems to be a transitioning paradigm coming down the road. Anyone looking into assisted living should be SURE that the place can accommodate someone who may be sliding towards skilled nursing but is not there yet. For example, my mom's ALF does NOT have: roll-under sinks; roll-in shower (she has to step over a small dam but she can barely lift her leg 1/2") or grab bars or even a towel bar next to the sink (there's a grab bar behind the toilet, however, which might be helpful if a resident decides to change it up and sit backwards some day). The microwave is high enough that frail, elderly little ladies can't heat up a cup of tea. The windows are super-heavy to open, and the wood-slat blinds impossible to lift. The thermostat is small and digital, and Mom has to press her "panic button" if she just wants the temp changed. How hard would it have been to put in a large-print Honeywell like they were all used to at home? Bottom line: when looking at an ALF, imagine what your elderly relative might be like in a few years at the rate they're "progressing," and see if there are building design issues that might force them into a nursing home when they're not really needing skilled nursing but maybe could stay in an ALF if it were better designed.
My Mother is 89 years old. I tried caring for my mom at home, but it nearly hospitalized me. Then, I found a good Independent Living facility with an In-house Caregiver. This was great and affordable, until it was apparent the independent living facility was too much walking for my Mom. If you choose this for your parent, make sure you read the fine print. Many Independent living facilities usually require a three month minimum commitment (non-refundable) and will sign anyone up with funds. After I took my Mom out of Independent Living, I did not want to make another costly mistake, so I researched elder care options extensively. I'm happy to say that I hit on Residential Care Homes and strongly urge everyone to look in to these State Licensed Residential Care Homes. They are springing up everywhere in California, are affordable, and in many cases are half the price of Assisted Living and Independent Living, with MUCH MORE hands-on care. The reason is, there are only 5-6 residents in a home. (these are real homes in a neighborhood) with 1-2 caregivers 24/7. Check your state and local Ombudsman for a list. Also some services as the one advertised in this article may help you find one. I visited 9 homes before I found the best one for my mom's likes and dislikes. Follow your instincts and check online to see if they have any infractions and lawsuits. When you visit these homes, make sure the caregivers are caring and kind, and able to disperse meds. I was very fortunate to find a spotless Residential Care Home with a nurse on staff. They even take my mom to the doctor at no extra charge. BTW, one price should include everything except special needs for your parent; i.e. Briefs, or in my mom's case, she likes a glass of white wine with dinner. As far as In-Home Caregivers, Vs Residential Care Homes. Residential Care Homes are usually less expensive when you calculate the cost of food and fuel of keeping a parent at home with Caregivers. A good State Licensed residential home gives three nutritious meals a day with snacks and I needed to get back to work. As many of you know, stopping work to care for a parent depletes your savings and earning capacity as the years go by. Also, it felt invasive to always have a caregiver in my home. Having cared for my Mom for 8 years, I finally hit on a wonderful Residential Home last year and it's working out great. Plus, my mom is around people her own age and her attitude has improved, and so has mine. I'm sure being around me 24/7 was not fun for her. I was always tired and never had energy to enjoy her, as her daughter. I was more like an employee. Also, since she had Dementia, she did not understand why I was exhausted all the time. Caring for a parent at home is harder than caring for a baby. I urge you to call your local Ombudsman for a list of Residential Care Homes in your area.
I appreciate this information. My mother is elderly, but still active and independent. She wants to be around more people her age, so I'm helping her do some research on independent living. Your explanation of the differences between independent and assisted living facilities was most helpful.