What to know about assisted living facilities for those with Alzheimer's disease

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Assisted living helps people with daily care but does not provide as much assistance as a nursing home.

People who receive assisted living typically reside in their own rooms or apartments within a facility and share common areas. Most assisted living facilities offer private apartments for couples or single adults.

The services and levels of care assisted living facilities offer can differ by facility and state. They may offer services such as:

• regular meals
• housekeeping and laundry
• personal care assistance
• help with medications
• security and constant supervision
• social and recreational activities

Some facilities may also offer services such as skilled nursing care. The staff will have access to the facility if the adult residing there calls for help and is unable to open the door or if a concerned child, relative, or friend asks the staff to check in on them.

Assisted living may be a suitable option for someone with Alzheimer’s disease who has difficulties with independent living but does not yet require round-the-clock skilled nursing care from a nursing home.

Vs. care home

Assisted living facilities differ from care homes or board homes.

Care homes are typically small, private facilities. They usually hold 20 or fewer residents in private or shared rooms. Assisted living facilities range in size from 25 to more than 100 residents.

In a care home, staff provides similar services to those offered in assisted living facilities. Care typically includes meals, personal care, and 24-hour access to staff for assistance. Care homes do not generally provide medical care.

Assisted living facilities may offer different levels of care, which people may pay more for if they require extra services.

Vs. nursing home

A nursing home focuses more on medical care compared to assisted living facilities and care homes.

A nursing home will offer:

• nursing care
• 24-hour supervision
• all means
• assistance with everyday activities
• rehabilitation services, including speech, occupational, and physical therapy

It can be difficult to decide when a person with Alzheimer’s disease needs help. In some cases, a person may recognize that they are struggling to cope and ask for assistance. Others may not request help and may not realize or admit that they need care.

A person may require extra support, such as assisted living, if they:

• are not bathing regularly
• find it challenging to manage their medications
• have difficulty preparing meals safely
• find housework and home maintenance challenging
• experience significant memory and other cognitive problems
• have difficulty managing hygiene
• have significant weight loss or gain
• are changes in their mood
• are socially isolated
• have experienced falls

There are various care options available for people with Alzheimer’s disease. A person may choose a type of care depending on the level of assistance required, lifestyle preferences, and other factors.

Types of care include:

• Assisted living: Assisted living is typically suitable for people who need daily care but do not require round-the-clock, long-term medical care.
• Nursing homes: Nursing homes focus on medical care and typically include round-the-clock nursing care as well as assistance with personal care and everyday activities.
• Memory care: Memory care facilities focus on the specific needs of people with Alzheimer’s disease and other dementias. They may form part of another residential facility.
• Life plan communities: These are communities that provide different levels of care, such as assisted living and nursing homes. A person can move through different levels of care as their needs change.
• In-home care: There are different levels of in-home care. Someone with Alzheimer’s disease may require different services, which a person can provide in their home rather than in a residential care environment. These include companionship, personal care, and medical care from a healthcare professional.
• Adult day centers: Day centers can offer personal care, health services, and recreation during the day for people with Alzheimer’s disease who live at home. This may be helpful for caregivers who work during the day or need a break from providing care.

There are various ways a person can find options for assisted living. These include:

• Referrals: A person can speak to friends, family members, and colleagues for referrals and recommendations for community services.
• Online results: Individuals can search for local care facilities online.
• Healthcare professionals: A person can speak to doctors, nurses, and other healthcare professionals who may be able to recommend assisted living service providers.
• Community resources: Local chapters of the Alzheimer’s Association, community organizations, and faith-based community groups may be able to help with information and resources on assisted living options.

There are also various resources available. As recommended by the National Institute on Aging, these include:

• Medicare: A person can use the Medicare Care Compare tool to find and compare care facilities in their state or area.
• Eldercare Locator: Individuals can search the Eldercare Locator, a public service of the Administration for Community Living for help finding care in their area or call 800-677-1116
• Area Agency on Aging: A person can contact their local Area Agency on Aging, social services, local and state offices on aging, or tribal organization.
• LongTermCare.gov: Individuals can visit LongTermCare.gov for information on housing options and local services for older adults.

Once a person has found some options for assisted living, they can take steps to screen facilities and find a care provider they can trust.

According to the Alzheimer’s Association, it may be helpful to assess the following when choosing an assisted living facility:

• Staff training and experience: A person can check whether staff at the facility is trained in caring for people with Alzheimer’s disease and whether they have experience and verified credentials.
• The general environment: Individuals can visit the facility to get a feel for the overall environment, including the living spaces, and to see how staff and residents interact.
• Services provided: A person can assess the services a facility provides and whether these meet the needs of someone with Alzheimer’s disease.
• Care plans: Individuals can ask about how the facility creates and reviews care plans and whether they involve the family and caregivers.
• References: Someone can request references from family members of residents at the facility to ask about their experiences and possible concerns.
• Background checks: A person can inquire whether the facility conducts background checks on their staff.

Several questions a person can ask staff at an assisted living facility can help them make the best choices for their circumstances.

These include:

• Does the facility provide medical care?
• How often are healthcare professionals on site?
• Does the facility personalize care to meet a person’s specific needs?
• Are the staff trained in caring for people with Alzheimer’s disease?
• What is the ratio of residents to staff?
• Is there a specific unit for people with Alzheimer’s disease?
• Does the facility offer therapies, such as physical and occupational therapy?
• Does the facility offer planned activities?
• Does the facility provide supervised transportation for shopping and appointments?
• What services are included in the fee?

Helping a person with Alzheimer’s disease move to an assisted living facility can be a stressful transition for them and their caregivers.

According to the National Institute on Aging, steps caregivers can take to help with the adjustment include:

• being an advocate for the preferences and needs of the person with Alzheimer’s disease
• getting to know and talking with the staff of the assisted living facility
• contacting a mental health professional to cope with feelings about moving a person into assisted living, such as loss and guilt
• listening to and being supportive of the concerns of the person with Alzheimer’s disease
• checking in on the person regularly to see how they are adjusting

According to the Alzheimer’s Association, the national average cost for basic services in an assisted living facility is $64,200 per year.

Most families pay for the costs of care out-of-pocket, as Medicare does not cover the cost of long-term residential care.

Government programs may be able to assist with financial support for Alzheimer’s care. These include:

• the Centers for Medicare & Medicaid Services’ Program of All-Inclusive Care for the Elderly (PACE), which may cover a portion or all of the costs of care for a person with dementia
• Benefits.gov, which is a resource where people can search for federal benefits that may help with financial support
• the BenefitsCheckUp, a service of the National Council on Aging, can help people find state and federal benefit programs for people with Alzheimer’s disease
• Medicaid, which may cover some types of long-term care for people who meet the eligibility requirements
• the Department of Veterans Affairs, which provides coverage for long-term care for some veterans

A person with Alzheimer’s disease may require assisted living in the early stages of the condition. Assisted living provides daily care but not the same high level of medical care as a nursing home.

Assisted living facilities can provide personal care, housekeeping and meal services, and supervision. For people who require round-the-clock medical care from healthcare professionals, a nursing home may be a more suitable option.

Caregivers or family members can help choose the best facility for the needs of the person with Alzheimer’s disease by researching and screening local facilities. Healthcare professionals, social and community services, and online resources can help a person find an assisted living facility.