How Do You Know When Assisted Living is Right For You?

Edna had fallen once, breaking her pelvis, and spent six weeks in a rehabilitation community doing physical and occupational therapy to get her back to normal. It was difficult, painful work, but now, two years later, she has full use of her bones and muscles and no remaining symptoms of that terrible break. But still, she wonders how much longer she can remain living independently in her home, or at what point she needs to consider moving to a retirement facility.

There is a certain time in a senior’s life when he or she – or perhaps family members – start to wonder if they should consider downsizing and making this move. Perhaps the family home is just too big now; it was the perfect size when it was full of children and their friends, but it seems empty now, and it’s too much to maintain. Or perhaps a spouse has died, and the surviving spouse feels lonely and/or depressed. Or perhaps a single senior living alone has had a few problems, and you are wondering whether or when to bring up the subject.

Whatever the reason, it’s a time of life when moving to a retirement home or assistant living center may start to feel appealing – no maintenance care, the ability to come and go, increasing care as you need it, and a community of people around you. Or perhaps your children are pushing you to consider it, but you simply don’t want to leave your home. Here are some ways to know if it’s time to consider moving out of the old family home and into an assistant living facility.

First, understand the different levels of assistant care:

The first thing it might help your parent or parents to understand is that there are graduated levels of care, everything from completely self-sufficient apartments where residents come and go as they please, to one step up, where they might get minor assistance with driving, housework, cooking and with their medicines, to full-on nursing care should a fall or other medical conditions require it. Most residents move in when they are living independently, but they take comfort in the fact that as they need more care, it will be there for them.[i]

Here are Inside Elder Care’s definitions of different levels of senior housing and care:

  • Senior Communities – these are usually towns or neighborhoods that have an “over 55” restriction, where people live in their own homes and live fairly active lives between their personal activities and the opportunities set up in the community for things like recreational sports, book readings and crafts. The focus here is on healthy seniors – most of these communities are not prepared to see a senior through declining medical conditions.
  • Continuing care – These can also be called “progressive care” facilities and can accommodate those who wish to live independently as well as those who need special care. As their needs increase, they may move to areas in the facility meant to take care of those with more severe medical issues.
  • Assisted Living — The point of assisted living, really, is to let the senior enjoy his or her life without being bogged down with tasks – home and yard chores, for instance — they no longer can do or wish to do. Seniors will typically have their own apartment, with their own bathroom. There will be a small kitchen, a thermostat the resident can control, and access to all the common areas of the facility, such as the dining room and TV room.

Assisted living facilities are best for those who need basic assistance in housekeeping, personal health, bathing and grooming, grocery shopping and fixing meals, medication assistance or reminders, transportation to and from outside appointments or visits.

  • Skilled nursing facilities — Skilled nursing facilities, also sometimes called rehabilitation hospitals, offer different levels of care as needed. Many are separated into areas where people are recovering from falls, stroke or fractures and are having physical and occupational therapy, expecting to return to their homes, like Edna. Others with more serious conditions that require long-term nursing care – conditions that will not be cured, in other words – may become permanent residents in another part of the facility.


  • Long-term facilities – This is what we typically used to call a “nursing home,” where patients have ongoing inpatient nursing and custodial care and are not expected to be able to return home. Nurses here stay in close contact with their patients’ doctors to manage any needs or changes.

A chart here helps you compare the choices with the average costs and each one’s advantages.

Then, ask these questions to see up close what your parent or parent’s situation is:

If you are concerned that it is time for your mom or dad or partner to consider the options of assistant living, AARP[ii] offers some questions to ask:

  • Is their home still appropriate for their needs?
  • Are there any safety hazards in the home that can be removed or mitigated?
  • Would they need to update their home (with grab bars, an open shower or bath, a stairclimber) to make it manageable for them
  • Have they previously thought about eventually living somewhere else?
  • Do they need help with household chores? Are there things that simply go undone?
  • Does impaired vision affect their ability to drive, read, buy groceries, fill gas, cook for themselves?
  • Can they hear when someone knocks at the door or when their telephone rings?
  • Do they need help to get to their doctors’ appointments?
  • Are their prescriptions current, do they understand what medicines they take and keep up with that schedule?
  • Are they doing OK financially? (This may not be a welcome topic, but there are soft ways to bring it up that may get you some answers.)

Depending on the answers to those questions, simply ask if they’d like you to find out some of the options and get back to you. This generally is a win-win situation; they get the information but haven’t had to make a decision; you have successfully broached the subject and now have the go-ahead to seek more information. Don’t be a pest about it, like showing up with brochures the next day. Give it time, Research a few places on the internet, go to visit them, take notes about them, collect brochures, narrow down the choices to those you think are the best, and then sometime during a casual conversation, mention that you go the information you two talked about, and you’d be happy to tell them what you learned. But don’t forget that in all cases, it is their decision.

[1] Inside Elder Care, A Guide to Different Levels of Elder Care

[1] AARP, Home & Family Caregiving, Talking With Your Parents About Independent Living