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55+ Community, Independent Living or Assisted Living? Understanding Your Options

ByRuth Ellison

At some point, many of us start to wonder whether our current home will still fit our lives in five or ten years. Maybe the stairs feel steeper, the yard takes more work, or you would simply like more people around. The good news is that there are more choices than ever, from age-restricted neighborhoods to communities with care on site.

This guide explains the main options in plain words, how people usually pay for them, and the questions worth asking before you decide. Rules and services vary by state, so treat this as a starting point.

Start Before You Have To

Harvard Health suggests researching early, before a move becomes urgent. Looking around while you are healthy gives you time to compare, visit more than once, and include family in the conversation. The first step is to be honest about how much help you need today, and how much you might need later.

The Main Options, Explained

55+ Communities

These are age-restricted neighborhoods or buildings with apartments, condos, townhomes or cottages. Many offer shared amenities such as a clubhouse, pool or fitness center, and many welcome pets. They generally do not include personal care. Prices vary widely.

Independent Living

Independent living is for people who can take care of themselves but would like someone else to handle cooking and cleaning. Residents usually have a private apartment and get community dining, housekeeping and activities. Some offer transportation. Nursing care is usually not included.

Assisted Living

Assisted living is for people who need some help with daily tasks, such as bathing, dressing or managing medicines, but who do not need the round-the-clock medical care a nursing home provides. Residents usually have their own room or apartment and share common areas. According to MedlinePlus, services may include meals, housekeeping and laundry, 24-hour supervision, activities and transportation. States license assisted living and decide which services are required, so what you get depends on where you live.

Memory Care

Memory care communities offer 24-hour care in a secure setting with staff trained to support people living with Alzheimer’s disease and other dementias.

Continuing Care Retirement Communities (CCRCs)

A CCRC, sometimes called a life plan community, offers several levels of living on one campus. A resident might move from independent living to assisted living to skilled nursing as needs change. CCRCs usually charge an entry fee plus a monthly fee. The entry fee is often large, and it may or may not be refundable, so read that part of the contract closely.

Nursing Homes

Nursing homes, also called skilled nursing facilities, provide round-the-clock nursing care, meals and rehabilitation such as physical therapy. They are for people who need ongoing medical care or are recovering after a hospital stay.

How People Usually Pay

  • Medicare does not cover long-term care. Medicare.gov explains that it does not pay for custodial care (help with daily activities) in a nursing home, assisted living or at home when that is the only care you need.
  • Most people pay for assisted living themselves, according to the American Geriatrics Society’s Health in Aging Foundation.
  • Medicaid may help with long-term care for people who qualify, depending on state rules. Some states also use Medicaid to help pay for assisted living for people with limited resources.
  • Long-term care insurance is another option some people buy ahead of time.

If selling your current home is part of the plan, our sister site has a guide on deciding between an estate sale company and doing it yourself.

Questions to Ask on a Visit

Try to visit each place on your shortlist, talk with the manager and, if you can, with residents. Questions worth asking include:

  1. Is the community licensed by the state? Can I see recent inspection reports?
  2. How long has it been in business?
  3. How many staff work each shift, and what training do they have?
  4. Is someone on duty 24 hours a day? What happens in an emergency?
  5. What exactly is included in the monthly fee, and what costs extra?
  6. How and when can fees go up?
  7. What happens if my care needs change? Would I have to move?
  8. Can I see a sample menu, an activity calendar and the different room types?
  9. Is the building easy to get around, with ramps, elevators and grab bars?

For nursing homes, you can look up quality and inspection information on Medicare’s website. For assisted and independent living, Harvard Health notes there is no federal comparison site, so check with your state licensing agency and the Better Business Bureau.

Where to Get Free Help

  • Eldercare Locator: call 800-677-1116 to find your local Area Agency on Aging, which can point you to housing and care options near you.
  • Long-Term Care Ombudsman: every state has an ombudsman program that advocates for residents of nursing homes and assisted living. The National Consumer Voice lists them by state.
  • Before you sign: contracts, especially CCRC contracts, can be complex. It is wise to have a family member or a qualified elder law attorney review one before you sign.

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