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Moving a parent or dear loved one into a long-term care facility is a difficult decision to make, but it’s often the best choice. Assisted living facilities provide the care and support needed to ensure your loved one is healthy, safe, and able to maintain an independent lifestyle, depending on their skills and needs. There are, however, specific abilities that seniors need to possess to live in an assisted living community.
Four abilities seniors need to live in an assisted living facility include the ability to ambulate independently (or with a cane, walker, or wheelchair), self-manage medical conditions (i.e., taking medication when needed, etc.), think clearly, and regulate their mood and behavior.
This article dives deep into the four most important skills required for seniors to live happily in an assisted living facility. Toward the end of the article, we’ll explain the differences between assisted living facilities and skilled nursing homes to help you decide which center is best for your loved one. Read on to learn more.
1. Independent Mobility (Walking or Moving Around)
Most assisted living facilities require that residents ambulate on their own, meaning they can walk or move around with little assistance. Using a cane, walker, or wheelchair is acceptable as long as they can do so independently.
Some centers have staff on-site to provide help with transferring residents from a wheelchair to a bed, but this isn’t always the case, so check the establishment’s eligibility criteria if this type of care is necessary for your loved one.
Many assisted living apartments or rooms have measures in place to ensure the safety of their residents. For example, they may have grab bars, walk-in showers, or non-slip mats in the bathroom.
If your loved one is preparing to enter an assisted living facility, check to see if they offer these accommodations — if not, see about providing your own.
For shower mats, I recommend the SlipX Solutions Accu-Fit Shower Mat, available on Amazon. This square shower mat fits most standard shower stalls and provides additional coverage than the average shower mat. It uses suction cups to secure the mat to smooth shower floors, and features drain holes to prevent standing water.
For grab bars, I recommend the HEINSY Suction Grab Bar, available on Amazon. This grab bar requires no drilling, so you can install it on any smooth, non-porous surface without damage. It can support up to 250 pounds and comes with a one-year warranty.
Bedridden seniors are not typically admitted to assisted living facilities because the level of care goes beyond the scope of what these centers can usually provide.
Seniors who are bedridden are better suited for skilled nursing establishments. These individuals need help with all activities of daily living (ADLs) — not just a few — which assisted living facilities aren’t equipped to offer. Bedridden seniors require full bathing support, regular turning to prevent blood clots and pressure ulcers, and oftentimes, help with nutrition, fluid intake, assistive devices, and/or medical equipment.
2. Self-Manage Medications and Chronic Conditions
The administration of medication isn’t a regular part of most assisted living centers’ model. However, many residents within these centers do take pharmaceuticals regularly, and there is on-site staff to help with reminders.
According to the Office of the Assistant Secretary of Planning and Evaluation, 98 percent of assisted living centers allow aides to assist residents with the self-administration of medication. They do not administer the drug to the residents but remind them and offer cues.
Nearly 85 percent of assisted living residents receive oversight and prompting to take their medications. So, while these centers help residents manage their medication routines, many do not have on-site staff trained to give medication. Some, however, do have doctors and/or pharmacists available to review pharmaceuticals and/or provide assistance concerning medication administration.
Therefore, any elderly adult living with a chronic illness must have the mental capacity to self-manage care for their condition independently if they wish to reside in an assisted living facility. For example, seniors with diabetes should be able to check their blood sugar and know when to take their insulin. Residents must be generally predictable and their health stable for this type of living environment.
Based on this information, seniors with extensive medical needs and those who require staff to store and administer their medications are not suited for an assisted living facility.
3. Clear Cognitive Abilities
Seniors suffering from severe cognitive impairment are not usually the best fit for assisted living environments, especially in cases of Alzheimer’s disease, dementia, or other progressive illnesses.
Assisted living communities aren’t secure facilities; residents have the ability to leave the property when and how they deem fit. The environment is essentially an apartment complex for seniors, with on-site staff to help with daily living activities.
Memory lapses and cognitive impairment can cause people to wander off, forget where they are or who they know, or show aggressive behavior towards others out of confusion. Residents with cognitive impairment could easily leave the property and find themselves in a potentially dangerous situation.
If your loved one is suffering from memory impairment, it’s best to seek out facilities that specialize in memory care. Assisted living centers do not typically have memory care staff on-site, nor do they have the resources to provide the level of care your loved one needs.
Memory problems often lead to other issues, so it’s important that your relative receives care from those trained to deal with these complications. For example, impaired memory function can lead to issues with swallowing. Therefore, your loved one may also require additional assistance and supervision when eating — another level of care that assisted living facilities may be unable to provide.
4. Ability To Regulate Mood and Behavior
Families of seniors with behavioral problems may believe that an assisted living community could help their loved one mitigate poor behavior. However, these centers do not usually offer clinical mental health services. Though they do provide amenities that create a therapeutic social environment that’s helpful and enriching for residents, it’s not enough for those who require clinical care for their behavioral health, especially if related to cognitive decline.
Most assisted living centers do not admit seniors with documented behavioral issues, especially if there is a history of problems at previous facilities. Though some behaviors may seem minor, they can escalate over time.
The following forms of conduct may make a senior ineligible for admission to an assisted living community:
- Regularly locking themselves in a room
- Avoiding all social contact
- Yelling, screaming, or cursing at staff or residents
- Refusing, hiding, or hoarding food
- Threats of physical harm toward themselves or others
- Physical violence
Some behaviors can become dangerous, and assisted living facilities don’t have the means to deal with such behaviors.
With that said, conflict isn’t uncommon in assisted living facilities. In 2013, the National Ombudsman Reporting System (NORS) reported almost 7,000 complaints from nursing homes and assisted living facilities regarding resident conflicts.
Despite its regular occurrence, assisted living staff are limited in what they can do to remedy conflict between residents from a moral, ethical, and legal standpoint. Therefore, the best solution is to avoid the issue altogether and prevent anyone with a past history of behavioral problems from residing in the facility.
If someone does reside in the facility only to later cause problems, their residency may be terminated. Most assisted living communities have information in their contracts regarding intolerable behavior. For example, any behavior that makes other residents or staff feel uncomfortable or otherwise unable to enjoy the accommodations or environment may be evicted from the facility.
If your loved one suffers from behavioral issues, it’s important to have them evaluated by a physician. Sometimes, changes in cognition and behavior may be due to progressive illnesses like Alzheimer’s disease or dementia.
Once you’ve determined the cause of your senior relative’s behavioral problems, it’s advised to seek out a community that specializes in behavioral care. Reach out to your state and local departments of health to find senior care facilities that can provide these services for your loved one. After receiving recommendations, do your research by reading reviews and checking out websites to learn more about the services and amenities available.
Assisted Living vs. Nursing Home for Seniors
Though the two are often confused with one another, assisted living and nursing homes (also known as skilled nursing facilities) differ greatly, particularly in terms of eligibility, level of care, and amenities.
| Care Provided | Assisted Living Facilities | Skilled Nursing Facilities |
| Social Lifestyle | ✓ | X |
| Independent Living | ✓ | X |
| Apartments | ✓ | X |
| 24/7 Monitoring | X | ✓ |
| Round-the-Clock Care | X | ✓ |
| Regular Medical Care | X | ✓ |
Assisted Living Overview
Assisted living facilities provide seniors with a sense of normalcy, by offering community and a regular social lifestyle. These centers are best suited for active, aging adults that require assistance with one or more daily activities, such as bathing, dressing, or eating. Most of these establishments provide residents with three meals per day, as well as housekeeping services, daily linen changes, home repairs, and lawn care.
Assisted Living Eligibility
Admission into assisted living centers typically requires that potential residents meet eligibility criteria, including the possession of specific skills. For example, many facilities require that seniors be able to ambulate without assistance and may not admit those with severe memory impairment.
Who Should Consider Assisted Living?
Assisted living is the ideal choice for relatively independent seniors who can no longer perform regular, everyday activities on their own. They may require assistance with bathing or toileting, for example, but still want to maintain a social lifestyle and enjoy participating in recreational activities.
These facilities are best suited for seniors who:
- Are in fine physical health, but may require more help in the future
- Do not currently require extensive, full-time medical assistance
- Need help with minor daily activities (i.e., bathing, dressing, toileting, eating, etc.)
- Cannot any longer perform home maintenance (i.e., lawn care, home repairs, etc.)
- Want to maintain an active, engaging social life
- Needs regular access to transportation assistance
What Are The Benefits of Assisted Living?
The major benefit of assisted living is that it gives residents a strong sense of community and allows them to maintain an independent yet safe way of living. Residents get to enjoy the privacy of their own “apartment” or rooms but can gather together in the dining hall or in communal areas when participating in recreational activities or during community outings.
Skilled Nursing Facility Overview
Skilled nursing facilities offer long-term medical care for seniors with serious or chronic health problems. These centers have the ability to administer medication, provide supervision, and round-the-clock care. They have doctors on-site and nursing staff available 24-7. These facilities cost more than assisted living communities due to the higher level of care.
Skilled Nursing Facility Eligibility
Residents looking to enter a skilled nursing facility meet the state’s criteria, meaning they must require a certain level of care as dictated by a physician. For example, they may accept patients with severe cognitive disorders, as long as they meet the state’s criteria for the required level of care or supervision. However, if a patient can ambulate on their own, feed themselves, and can administer their own medication, they may not require enough care to be accepted into a skilled nursing facility.
Who Should Consider a Skilled Nursing Facility?
A skilled nursing facility is best for seniors who require full-time care and monitoring, as well as long-term medical assistance. These facilities are best for those who require medical care but not hospitalization. Those with severe physical or cognitive health conditions may require 24-hour nursing and may be bedridden or need to use a wheelchair with the regular assistance of staff.
Skilled nursing facilities are best for seniors who:
- Need 24-7 supervision or medical care for chronic conditions or declining health
- Require regular administration of medication and cannot self-manage pharmaceuticals
- Cannot feed themselves or suffer from swallowing difficulties
- Have significant mobility limitations or are a fall risk
- Need extensive rehabilitation due to significant injury
- Require weaning off of assistive medical devices, such as a ventilator
- Have progressive conditions
What Are The Benefits of Skilled Nursing Facilities?
Skilled nursing facilities often provide amenities to keep residents healthy and socially engaged, and also encourage independence. However, the main focus of the practice is to provide medical care to treat long-term health issues. Licensed, trained medical staff are on-site at all times, so you can guarantee that your loved one is receiving the care they require.
Additionally, when recommended by a physician, care in a skilled nursing facility is often covered under Medicare and Medicaid.
While assisted living facilities have highly trained staff that can provide basic medical care and seek medical assistance when necessary, they are not always certified or licensed.
If your parents are in assisted living, you should set aside as much time as you can to visit them. By visiting them frequently, you’ll support your elderly parents and prevent feelings of frustration or sadness. Read my complete guide to learn more about the topic. How Often Should You Visit Parents in Assisted Living?
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