Differences between independent living and assisted living

One of the questions we are asked most often when working with families and their older loved ones is about the differences between independent living and assisted living.  There are some important distinctions to be aware of when choosing what is best for your older loved one and few people know where to start.  Generally, there are four key areas to consider when evaluating living choices between independent living and assisted living.

Medical and care needs

Independent living is a good choice for families when their loved one is completely independent with their normal daily activities of living. These activities include dressing, bathing, cooking, cleaning and being able to leave home on their own.  It is also good for independent couples who are simply looking to downsize.  Often, people are still driving and are able to easily get to the grocery store, pharmacy or a doctors appointment.  Assisted living is suitable for older adults who need extra help with those daily activities and cannot or do not want to live alone.  With assisted living, a staff member is typically right there at the push of a button or a phone call which can give older adults and their families peace of mind.

Differences in communities

Some independent living communities offer amenities such as gyms, pools and a concierge but do not offer many other services.  Additional services can certainly be brought in but carry extra costs.  Besides offering a higher level of care and health services, assisted living communities usually offer a variety of activities, classes and fitness programs to engage residents.  They also provide meals, snacks, social activities and include services such as utilities, wi-fi and cable TV.  It is important to honestly evaluate and understand the level of independence and care needs of your older loved one before looking at communities and remember to take their interests and hobbies into account.  Many assisted living communities offer classes such as art or writing poetry or have activity groups such as book clubs.  Some independent communities do have social clubs and activities so it is important to ask.

Differences in services

Similar to the differences in communities, the levels of service are also important to understand.  Assisted living offers a much wider array of services, health care support and help with activities of daily living (ADLs) like dressing and grooming.  They also offer other support such as help with medication management, meal preparation and transportation assistance.  Independent living communities usually offer some basic amenities but they may be limited so it’s important to ask and understand what services are available in the community.

Financial considerations

Cost is always a factor in determining any type of move to an independent or assisted living community.  Assisted living is generally more expensive due to additional levels of staffing, care services and meals and tend to have one monthly cost for everything.  Although independent living costs are generally lower, other factors do need to be considered such as utilities, meals and whether external services need to be brought in such as physical therapy, housekeeping or home care services.  There are a lot of cost calculators available online to help determine monthly expense expectations with either option.

Medicare cannot be used to pay for assisted living or independent living but in certain states like Vermont, Medicaid programs can help pay for some assisted living costs based on meeting certain income and other qualification criteria.

In addition to calculating monthly costs, it is important to look at income sources whether it is from Social Security, annuities, investments, pensions or the sale of a home.  There are also other sources of funding such as long term care insurance policies or whether the older adult is a veteran or spouse of a veteran. The Veterans Administration offers variety of different programs for help with assisted living costs depending on military service time and other criteria.

Other factors

Another factor to understand is whether an independent living community is 55+ apartments or if there is an ability to easily transition to assisted living as care needs evolve.  If the community is a 55+ apartment only community, there is a potential move that could occur if care needs evolve to require more assistance or if there is a sudden change in health status.  Home care services can be brought into an independent living community but add to monthly expenses.  Increasingly, communities are offering both independent and assisted living in the same location.  This can be a good option if the family member is independent today but their care and services needs are starting to change.  It is also a good option from a social perspective as it often does not require a move or to make new friends and acquaintances.

One last consideration is the level of family involvement.  Everyone wants to be able to see their older loved one regularly and whenever they choose, but often family members are quite far away, live in a different state or even a different country.

The National Council on Aging has a more detailed overview of the subject:  https://www.ncoa.org/adviser/local-care/assisted-living/assisted-living-vs-independent-living/