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.
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.