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The Line Between Independent Living And Assisted Living Levels Of Care Is No Longer Distinct

When I started in the senior industry over 15 years ago, “independent living” at a senior living community meant that the senior could take care of him or herself. He or she might require some assistance with meal preparation and housekeeping; however, the senior had to be able to ambulate on his/her own. In the worst case scenario, a walker might be used. The resident also had to bath, toilet, eat, transfer, and dress without help. With today’s emphasis on having a senior “age in place” in their his or her own apartment, I’ve witnessed independent living become the new assisted living.

While this change has been evolving for years, I have noticed that the process of assessing the a prospective resident for independent living has become much more lenient. There are so many ancillary services that can be brought into the senior’s independent living quarters apartment that it resembles assisted living or a nursing home without the licensure. Here are some examples of the services that can be brought into independent living and the typical costs:

Morning and evening assistance – $18.00 per 20 minutes – includes getting the senior out of bed, helping with hygiene and dressing (not bathing)
Bathing – $24.00 per 30 minutes
Escorts to meals and activities – $9.00 per escort
Medication Set-up – $37.00 per week, Medication Reminder – $8.00 each
Laundry – $9.00 per load
Routine safety checks – $6.00 each
Other services such as live in companions can be hired starting at about $200 per day.

But if a senior needs additional help with activities of daily living (bathing, dressing, toileting, walking, eating, and transferring), the price increases. Extra housekeeping and additional meals can be purchased (in independent living, one meal is usually provided).

While I cheer the concept of aging in place in an independent living apartment, it is imperative that each individual be assessed appropriately from a personal needs and financial standpoint. Two brief stories to illustrate:

1. I recently completed a consultation for a couple who wanted to move to a high end independent living community that provided services like those mentioned above. They both needed some assistance with ambulation, meal preparation, and escorts to meals and activities. It actually would cost them less to move to an assisted living community where such aid help with their activities of daily living would cost them less on a personalized package basis.*

2. I was surprised when I heard that one community was seriously considering admitting – as a candidate for independent living – a woman who needed some serious nursing care. A home care nurse would intermittently come in and out of the resident’s apartment to administer care when, technically, the woman was really a candidate for nursing home care. This individual needed total assistance with almost all of her activities of daily living.

My point is that you need be aware that while some independent living communities are offering personalized, a la carte care services that resemble assisted living, these packages lack a serious component: Independent living does not offer any type of 24-hour supervision. There are no CNAs or nurses present in independent living unless you hire them. Therefore, if your loved one falls or needs help immediately, at most what they might get is a call to 911.

Do you recall the Glenwood Gardens incident?

*Assisted living has also changed drastically from what I knew when I started in the industry. It began as an offshoot of independent living. Standby assistance was provided with bathing, dressing toileting, transferring, walking and eating. That’s all it was. The assistant just stood by and provided additional assistance. Now, much more hands-on care is available, which at times replaces the need for the lowest level of nursing care, or intermediate care. Assisted living can run anywhere from $4,500 per month to $7,000 per month, depending upon how much help a person needs and how the community is licensed. Some assisted living communities charge a basic rent then add on to the cost for ala carte services depending on how much help and individual needs. Others will use a point system to develop a personalized package and determine the cost. Many times, the latter is less expensive than the former.

For all of your senior living options, contact Andrea Donovan Senior Living Advisors.