When I was trying to help my parents choose between senior living options, I visited many facilities from totally independent communities through assisted living facilities. It took me awhile to realize there were legal differences between types of communities and that these facilities were licensed by the state. The definition and requirements therefore differs by state.
Assisted Living Facilities are licensed and inspected by the state health department but Independent Living Facilities generally are not. Today I am going to explore various Independent Living Options that I have seen and just touch on how they differ from Assisted Living Facilities
One can be totally independent just by staying in the home you raised your family in. Or many seniors choose to downsize but remain independent in a smaller house or apartment after retirement. This option provides no extra supports other than those available in the community, but with Senior Centers and Home Health/Support options, this may be the choice for many people. Indeed until recent years this was about the only choice until the senior needed the full support of a nursing home.
A fairly recent option is the choice of an age restricted Senior Community. This was my personal choice since I was moving to be closer to my children. I still wanted my own home, my car and my own yard. But, I didn’t want to be on a street where I was the only person at home in the daytime.
I found a senior living community with a clubhouse for activities, a pool, about 100 housing units (townhouses) and a calendar of activities for each month. We have an exercise room, a television living room and a large dining area that we use for activities and catered dinners once a month.
We do not have meals provided. We have no health facility or nurse that is available to come when we need help. We live as independently as we did when we were younger except that our neighbors are available to take part in activities and companionship.
Independent Senior Communities with Meals or Transportation, etc.
There is another type of independent living that I visited when trying to get my parents to move to a more supportive type of housing. These independent living communities have other amenities in addition to the clubhouse and pool. Most have a dining room serving up to 3 meals per day depending on the meal plan the resident chooses. They are not health care facilities and are not licensed by the state health department. However, many are affiliated with home health care or visiting nurses organizations.
In addition, most of these communities also provide some transportation for their residents to go shopping or to medical appointments. Transportation may be limited to certain days or times of day (say 10 am to 2 PM) for medical appointments depending on the community.
People who live in these independent communities may need more care and oversight than the people who live in communities like my own. However, some residents continue to be independent and cook all of their own meals in their own apartments. They often keep their own cars and only use the provided transportation for activities such as a trip to the park or dinner out with their friends. These communities tend to be more expensive than the totally independent housing communities without meals or transportation. But they are still far less expensive than an assisted living facility.
Even though home health is available in an independent living community, there is no one who is legally responsible to watch over the overall health of all the residents in the community. When I was choosing housing for my parents, I worked with an Eldersource counselor. She reminded me that because my parents were suffering from health issues and dad had Alzheimer’s disease, I needed to look at facilities that were licensed by the state health department. That is, I needed to look only at assisted living facilities or something similar (around here sometimes called “enhanced independent living facilities”) and not at totally independent communities.
Another important issue is “medication management” or the process by which the resident or a representative counts out the resident’s medications on a regular basis. This includes making sure the resident takes the proper medications at the right time each day. In an independent living facility, medication management is the resident’s responsibility.
If the resident in an independent living community is unable to take his medications as required, he might hire a home health service to send someone out to either count the pills into a pill counter or additionally to distribute the medications one or more times each day. This is a cost the resident would pay separate from his fees at the independent living facility. And it is provided by a licensed medical entity that is separate from the independent residential facility although they may be affiliated.
Sometimes an Independent Living Community is affiliated with an Assisted Living Facility and may be on the same campus. They may share transportation options, activities, the clubhouse and/or the kitchen and dining areas.
Assisted Living Facilities
Assisted living facilities help residents with any activities of daily living such as bathing or dressing that they might need help with. (This same help would only be available from a separate home health care company if one is living in an independent facility.) But, more than that, the assisted living facility is responsible for the health and well-being of their residents. Independent living facilities do not have any responsibilities over the health of their residents.
Thus if a resident in assisted living did not come out of their apartment by for meals each day, someone would go in to check on them. If a resident of an independent community doesn’t come out, no one is keeping track. A neighbor may notice and knock on the door or whatever, but it is not the responsibility of the community to do so.