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.
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.
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.
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.