Assisted living is designed for people who need help with activities of daily living, such as dressing, bathing, feeding, and medication management. Other qualifications include being able to move independently and being medically stable. Assisted living isn’t intended for people who need medical care around the clock. If your loved one needs more support than assisted living can provide, memory care or skilled nursing care may be a better match.
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Seniors who qualify for assisted living typically need help with non-medical daily activities but are otherwise independent.[01]
Needing help with activities of daily living (ADLs), such as bathing, toileting, feeding, and medication management, is the most common requirement for admission to an assisted living community.
Communities often use a senior’s ADL needs as a guide to determine the level of care they need. For example, a community might determine that someone who needs help with two ADLs has a low level of care. They may classify someone who needs help with four ADLs as a moderate level of care.
When it comes to the level of care provided, each community is different, stresses Amy McLoughlin, who has supported families for 10 years at A Place for Mom.
“Most assisted living communities accept residents who require a moderate level of care. Many will also offer memory care units for those with cognitive impairment. Some communities even offer enhanced assisted living for those with advanced medical needs,” McLoughlin explains, although this is unusual.
You may hear the phrases chronic and stable, medically stable, or predictable and stable used to describe your loved one’s condition. Basically, this means that any ongoing medical conditions are under control.
For example, if someone has high blood pressure, they’re considered stable if they’re able to control it through medication. As long as the senior continues taking their medicine and remains largely independent, they’re stable. Caregiving staff can assume that the senior is OK when alone in their room or attending an activity and that there isn’t a need for constant medical attention.
McLoughlin says many communities accept seniors beginning at age 60 or 65 and notes that communities do sometimes accept younger residents on a case-by-case basis. Not all communities accept residents under 55, even if they have a condition such as Parkinson’s disease and need assistance with several ADLs.
Age requirements can also be good for community culture. Many assisted living communities organize activities based on residents’ interests. While age isn’t the only factor that influences what someone is interested in, it can be easier to identify a group’s shared interests when most members of the group have had similar cultural and historical experiences.[02]
In most cases, an assisted living community will expect residents to be able to move mostly independently. This can include using a walker, if the walker allows the senior increased independence. Some communities do provide help with transferring, such as from a bed to a wheelchair, but not all communities provide the same amount of help.
Some communities have a specialized lift to help seniors into their wheelchair, McLoughlin notes. In some states, however, lifts are against regulations, so residents should be able to move around their apartment and community common areas without assistance.
Sometimes needing a lot of help to move means assisted living isn’t the right fit. For example, if a resident consistently needs two caregivers to get out of bed, that’s a sign the resident may need more help than assisted living can offer. The community might decide to move the resident to their on-site skilled nursing area, where more assistance is available and the risk of falling is lower.
Is assisted living the right fit?
Let our free assessment guide you to the best senior living options, tailored to your needs.
Seniors who are unable to move independently, who need 24/7 medical care, and who need the support of multiple types of professional caregivers typically don’t qualify for assisted living. In some cases, an assisted living community may determine that they aren’t able to care for someone who has complex medical conditions.
While assisted living does provide 24-hour supervision and care, it’s generally for personal care rather than medical care. If your loved one needs medical attention around the clock, a nursing home is likely to be a better fit because nursing homes are equipped to provide medical care at all hours.
Assisted living communities are regulated at the state level and often set their own admissions criteria to ensure each resident gets the care they need and to balance the needs of all residents.
Because assisted living licensing varies by state, some communities are permitted to provide more medical care services than others.[01] Some states have limits on the number of hours of care a senior can receive. Other states may limit how many caregivers can help a resident at the same time.
Assisted living communities assess potential residents physically and cognitively before they move in. Your loved one can also expect regular assessments once they’re a resident, both on a recurring basis and as needed when there’s a change in health status, such as after surgery or a hospital stay.
“Depending on the senior’s care needs, the assessment could be as simple as a quick conversation or as involved as connecting with a medical case manager when transitioning from a hospital or rehab,” says McLoughlin. “It’s the assessment that determines exactly which care services the senior will receive each day.”
Here’s a breakdown of what an assessment usually looks like, according to McLoughlin.
Seniors can expect a review of their medical history, including:
A cognitive assessment can help determine any decline or impairment. Some communities conduct a functional assessment to see how a senior performs ADLs. Lastly, a senior’s mental health may be evaluated for the following:
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Sometimes, assisted living isn’t the best fit. This can happen for a variety of reasons, but a senior’s acceptance usually centers around whether the community can provide the care they need. Thankfully, there are other senior living options for seniors who don’t meet the qualifications.
Seniors who have Alzheimer’s disease or another form of dementia may be comfortable in an assisted living community during the early stages of their illness. However, not all assisted living communities can provide the safety and structure needed as this condition progresses.
Memory care communities are specially designed to prevent accidents caused by wandering. Additionally, caregivers usually receive specialized memory care training to help manage dementia behaviors.
McLoughlin recalls a senior couple she once worked with. The man hoped that assisted living would be the right fit for his wife, who was recovering from a broken hip. However, someone in the assisted living community noticed that the wife was aggressively negative about the idea of rehab. While initially difficult for the husband to accept, memory care was the best fit because his wife’s aggression turned out to be a symptom of dementia.
A nursing home provides the highest level of care available outside of a hospital setting. It’s a good fit when a senior needs more care than an assisted living community is licensed to provide. Compared with criteria for assisted living, nursing home admission criteria are more medically focused. For example, McLoughlin notes, a nursing home is a better fit when someone:
In some cases, a stay in a nursing home may be temporary, and families can consider assisted living later if their loved one’s condition improves.
“The most common thing that keeps a senior from being accepted into assisted living has to do with wound healing,” McLoughlin explains. “This is usually in the case of those having been previously hospitalized or in rehab. Sometimes pressure ulcers or surgical wounds will require specialized medical care, such as a wound VAC. Assisted living typically requires wounds to be in a healing stage before allowing the senior to move in.”
If you’re unsure how to start looking for an assisted living community for your loved one, consider reaching out to one of A Place for Mom’s Senior Living Advisors. They’ll get a good understanding of your care needs and match you with an appropriate community.
“Families that work with A Place for Mom have the luxury of only being connected with communities that are both a good care and financial fit,” McLoughlin says. Best of all, this service comes at no cost to you and your family.
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