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Assisted living facilities


Assisted living facilities are residences for older adults who are still active but need help with some activities of daily living. This article explains what assisted living facilities offer, the differences between them and skilled nursing facilities (nursing homes), and when a person should consider moving into an assisted living facility. It then lists some key factors in choosing a facility, average costs, and some ways to pay.

About assisted living facilities

Assisted living facilities are residences for older adults who are still active but need help with some activities of daily living (ADL), such as bathing or managing their medications. Each person usually has their own room and shares common areas with other residents. 

Assisted living facilities typically offer three meals a day, 24-hour on-site staff, and recreational activities such as outings, games, and movies. Residents are often able to cook their own meals in their apartment kitchens. Many facilities also offer health care services such as counseling and physical therapy.1 The average length of stay in an assisted living facility is just over two years, and about 60% of residents move on to skilled nursing facilities (nursing homes).2

Assisted living facilities are staffed with trained care aides, but the training requirements vary from state to state. All assisted living facilities provide services from registered or licensed practical nurses; however, some have nurses present on a regular basis, while others have them on call. Many assisted living facilities have special training for residents with dementia.3

Assisted living versus skilled nursing facilities 

While many people refer to both assisted living facilities and skilled nursing facilities as “nursing homes,” there are important differences between the two. People are suitable for assisted living if they still have some degree of mobility and independence and do not need continual medical monitoring and care. Medical professionals are available, but extensive medical care is not provided.

Skilled nursing facilities, by contrast, are hospital-like facilities for people who need 24-hour monitoring and care. Nurses are on-site at all times, and doctors are either on-site or on call. A person has to qualify to enter a nursing home by meeting their state’s criteria for a health status called “Nursing Home Level of Care”, or NHLOC.

When to consider an assisted living facility

People receiving care from family caregivers may want to consider moving to an assisted living facility if:

  • The person can’t carry out some ADLs and family members are unavailable, unwilling, unable, or lacking the confidence to provide caregiving
  • The person is expressing or showing signs of loneliness or isolation
  • The person has dementia and is starting to behave aggressively or to wander
  • The person’s care needs have become too high for family caregivers to manage safely
  • Family caregivers have reached the point of serious caregiver stress

Caregivers and family members should keep in mind that the person receiving care has the legal right to refuse to move out of their home.4 This is the case even if family members believe that the person is a danger to themselves—for instance, if they are prone to falling. The person with medical power of attorney can only decide where the person lives when the person is unable to make or communicate their own decisions. The only way that a caregiver can force a mentally capable person to move into a care facility is by becoming the person’s legal guardian.5

Choosing an assisted living facility

Many factors go into deciding which assisted living facility is right for the person receiving care. The selection process should be started as early as possible. The extensive checklist provided by the non-profit group Argentum (formerly ALFA) is a very useful guide to the process. Some major factors to consider include the following:

  • The person’s impressions of the facility during visits 
  • Location
  • Affordability
  • Type of care and amenities offered
  • Quality and training standards, including elder-abuse training
  • Range of apartment options
  • Meal quality
  • Visitor access

Costs and ways to pay

As of 2022, the average price range for assisted living facilities was $2,500 to $4,000 a month,6 with memory care units costing an average of $7,000 a month.7

Most assisted living is paid for privately, through personal savings, sale of the home, or a life-insurance policy, etc. These facilities are generally not covered by Medicare, but they may be covered by Medicaid if the person receiving care has a low enough income or has used up all of their own money.8 However, only people in facilities that participate in the state-funded Medicare program will be able to apply for these benefits. 

Long-term care insurance policies usually will start paying for care if the policyholder is unable to do at least two activities of daily living and has paid out of their own pocket for a certain amount of time (typically 30, 60, or 90 days).9

Related information

Adult day care

Balance care responsibilities

Caring for an older adult with depression

Caring for someone with limited mobility

Create a care plan

Durable power of attorney


Overview of home health assistance

Investigate long term care options

Nursing homes and memory care

Paying for long term care

Skilled nursing facilities (nursing homes)

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