3 Key Differences between Independent Living and Assisted Living


The distinction between independent living and assisted living can seem practically non-existent for those who are unfamiliar with the nuances of the variety of housing and care options available to older adults. But determining the best living situation for an elderly loved one means understanding the key differences between these two types of communities.

Living space

The independent living category encompasses a range of housing arrangements, from apartment-style communities to housing co-ops. Generally though, residents live in separate dwelling spaces and have a common area 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, a retirement home or a Continuing Care Retirement Community (CCRC).

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

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. Landscaping and housekeeping services, meal preparation, security surveillance, and a variety of activities and events are the typical offerings in independent living. Most independent living communities do not have full-time staff dedicated to providing medical or nursing care. "The main benefits of independent living communities are receiving help with meals and housekeeping tasks, as well as having a centralized hospitality service building for socialization," says Regina Wallace, director of the independent senior apartments and assisted living program for the Hebrew Home at Riverdale, a geriatric service organization based in Riverdale, New York. "It's not really about hands-on care in these communities."

Assisted living is geared more towards helping aging adults who need some assistance with activities such as bathing, doing laundry and keeping track of their prescription medications. Staff members—including some kind of medical professional (typically a certified nurse practitioner)—are on-call 24 hours a day in most assisted living residences. Certain facilities also contain special memory care units designed for individuals with mild or moderate dementia. Assisted living communities don't provide intensive hands-on 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. Common activities include: game nights, field trips, support and discussion groups, holiday celebrations, exercise classes and continuing education courses. They also provide transportation services to shuttle residents to and from doctor's appointments, the grocery store and other errands.

Ways to pay and other financial considerations

Rent represents the primary cost for independent living residents, according to Wallace. Aging adults who live in Continuing Care Retirement Communities (CCRCs) or communities that offer specialized recreational opportunities (e.g. private golf courses) may incur additional expenses in the form of membership and/or joining fees.

In assisted living, seniors who need specialized care that isn't included in their rent contract will incur additional costs if they have to hire a professional caregiver for assistance.

Besides differences in the level of health-related help offered to residents, the biggest disparity between independent living and assisted living is the access to financial resources that seniors and their families can turn to in order to help cover the cost of living in these communities.

Since independent living communities don't provide residents with medical care services, government-run healthcare financial aid programs (e.g. Medicare and Medicaid) won't cover the cost. Instead, seniors must use Social Security, pension income, retirement savings and other personal funds to pay for an independent living residence. For more information on financial considerations in independent living, see How to Pay for Independent Living.

Assisted living costs can be covered by using savings and personal funds, certain long-term care insurance policies, Aid and Attendance benefits from the Veteran's Administration, life settlements, reverse mortgage funds and annuities. Medicare's coverage of assisted living care is very limited—generally only paying for a short-term stay to help an individual recover from a temporary illness or surgery. Medicaid also offers some financial assistance, but the rules vary from state-to-state. For more information on financial considerations in assisted living, see How to Pay for Assisted Living.

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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.

Walter K.