The concept of “aging in place” has become popular over the years as lifespans have lengthened. Aging in place usually means living with a fair degree of independence in the community rather than in a residential facility. Traditionally, this has taken the form of living at home with or without help from family or home health services.

While many prefer this arrangement, health problems can make aging in place at home impractical, too expensive or even unsafe. A logical option for many in this situation may be assisted living.

To purists, assisted living does not fit the definition of aging in place since it takes place in a facility outside the home. However, taken in a broader view, this senior lifestyle is more like living at home when compared to traditional nursing homes. Assisted living is designed to feel more like a home than a hospital room and promotes the resident’s dignity, choice, independence, and privacy.

The Evolution of Assisted Living

As assisted living has evolved, these facilities have experienced more and more residents suffering from serious health conditions. Under the original assisted living model, such residents would be forced to move to locations better equipped to handle their more medically intensive needs.

This could be particularly traumatic for residents since the move to assisted living was intended by many to avoid a traditional nursing home.

Innovative providers in the assisted living industry responded by providing more services to help deal with such issues as memory impairment, incontinence, and support needed with activities of daily living like dressing and bathing.

While such changes were popular with older adults, this evolution in assisted living has presented some complications.  

The Limits of Independence

The degree of independence for an assisted living resident depends on the amount of care required. For example, some privacy must be sacrificed when staff members need to enter apartments to provide services. Despite the necessity of such interactions, a resident may still have difficulty giving up their expectation of privacy.

Financial Pressures

One of the original attractions of this senior living approach was its affordability compared to nursing homes. This was a popular feature since most assisted living facilities function on a private pay basis rather than insurance reimbursement. Of course, as health declines, more support is needed.

If the facility offers such services, they are usually available on an a la carte basis resulting in higher costs for residents with greater needs. Some facilities accept Medicaid Waivers which can help those who qualify. However, for most, the risk of running out of money as healthcare costs rise can be a genuine concern.

Facility/Resident Fit

The choice of a particular assisted living facility comes down not only to location and cost but also to fit. Fit represents the match between a resident’s overall needs to the facility’s ability to meet those needs.

Since a resident’s requirements evolve over time, an ongoing assessment of a facility’s ability to meet those needs must occur. For example, if a resident suddenly requires special therapies not offered by the facility, moving to a new facility may be necessary.

The Challenge of Dementia

Dementia challenges the capability of many assisted living facilities since only 14.3% provide support for this class of afflictions. Therefore, older adults and their families concerned about dementia should screen potential facilities based on support services offered in this area.

The Future of Assisted Living as an Aging in Place Option

Most older adults move to assisted living with the intent of making it their last move. To increase the likelihood of a long-term stay, attention needs to focus on finding facilities that offer a wide breadth of quality services. The challenge for the assisted living facility is to provide these services at an affordable price while maintaining a home-like atmosphere that preserves independence and privacy.

Striking the right balance increases the likelihood that residents can live in a less institutional environment yet still have access to a broad array of services that will allow them to successfully age in place in an assisted living environment.

What does ‘aging in place’ mean to you? Do you think it’s possible to age in place in an assisted living community? Would you consider such an option? Why or why not?