According to the National Institute on Alcohol Abuse and Alcoholism, substance abuse affects about 17 percent of adults over the age of 60. The most common forms of addiction in this age group are alcohol and prescription drug abuse. While some of these individuals have had substance abuse problems for many years, others develop their addiction late in life. 

For those that develop addictions later in life, health-related problems and life-changing events are usually the catalysts. Some factors that often contribute are retirement, death of a loved one, financial stressors, and health decline. Individuals over the age of 65 have a significantly harder time metabolizing substances like drugs and alcohol, so the effects of addiction can be much worse and lead to more significant health problems sooner than they would in younger people. 

In some cases, addiction is the direct result of being prescribed medication that they become dependant on. Benzodiazepines, as‌ ‌well‌ ‌as‌ ‌opiates, are the most common types of addictive medicines prescribed to seniors.

As seniors age and become unable to live on their own, assisted living is a popular option. But having an addiction adds an extra set of challenges and variables for loved ones to consider.

What is Assisted Living?

Assisted living facilities are long-term residential care communities specifically for people who need assistance with the activities of daily living or who have a disability that prevents them from living totally independently. In addition to housing, these communities provide minor health care services, assistance with personal care, meals, and community activities. While assisted living facilities all provide the same basic functions, each one is a bit different from the next – some provide more involved assistance and plan community events while others only provide assistance with the activities of daily living. 

Unlike nursing homes, assisted living communities are not intended for seriously ill individuals, those that need extensive levels of physical assistance, or who are permanently bedridden. While support services in these communities are ideal for individuals who need some extra help with tasks like getting dressed and showering, they don’t have the resources for round-the-clock care. For residents who need regular care for an illness or injury but are still fairly independent, home health aides can be hired to supplement the care provided by the facility’s staff.

The Cost of Assisted Living

In the 2018 Genworth Cost of Care Survey, the median cost for assisted living in the United States is listed at about $48,000 per year. While that breaks down to about $4,000 per month, various factors such as the location and size of the facility, the number of services needed, and additional features can all impact the price. Additionally, some facilities require residents to pay extra fees for transportation, fitness center use, and other optional amenities, while others include them in the price of rent. 

Benefits of Assisted Living for Seniors with Addiction

Image of patient and doctor during screening visit.

Addiction in seniors isn’t a widely discussed issue, and as a result, most assisted living facilities do not openly advertise their ability to help those who are struggling. However, assisted living communities can be great environments for individuals battling addiction. Below are some of the most notable benefits:

Supportive Environment: One of the biggest issues for seniors, especially those who have suffered a loss, is that they are isolated and alone, relying on a substance to cope with their feelings. Assisted living facilities are full of people who interact and do things as a community. This includes other residents and staff members who orchestrate and participate in events and just spend free time together. 

Supervised Medications: In most assisted living facilities, all medications are in a locked cabinet that only staff has access to. This means your loved one will only be getting the correct dosage of medication when they are supposed to get it. 

Trained Staff: In some cases, assisted living communities will have staff on hand who have been trained to help those with substance abuse problems. This might include a counselor, nurse, psychologist, or social worker.

Limited Alcohol Access: Seniors struggling with an alcohol addiction can benefit from controlled menus at meals. Most assisted living facilities don’t serve alcohol with meals, and if they do, seniors are consuming it under the supervision of staff in a controlled environment. Staff will be privy to those who can’t consume alcohol and ensure it isn’t served. 

Exercise and Wellness Programs: The exercise and wellness programs available at assisted living facilities can benefit all residents, but may be especially helpful for those struggling with addiction. Physical activity has been shown to reduce addictive cravings and can help improve overall health.

Transportation: Some seniors with addiction may need to visit an off-site counselor or outpatient rehab facility. Assisted living communities can provide transportation to and from medical appointments, making it easier for residents to get the help they need.

What to Look For When Choosing an Assisted Living Facility for Seniors with Addiction

Because no two assisted living communities are exactly alike, it’s important to visit several different facilities and get a good feel for what life is like there. While they may offer similar amenities, you’ll likely find that some are a better fit for your loved one than others.

While visiting, don’t hesitate to ask staff members any questions you might have. Be on the lookout for things like:

  • Staff Certifications: Check with the facility to see if any staff members are certified to work with individuals battling addiction.
  • Medication Guidelines: Ask what the policies and procedures are for medications. Ideally, all medication will be stored in locked cabinets with staff administering the proper dosages throughout the day.
  • Counseling Services: Find out if the facility offers on-site counseling services or if your loved one will have to visit an off-site practitioner. Having a counseling resource nearby can be helpful when individuals feel as though they’re struggling with their addiction.
  • Transportation Services: If your loved one will have to work with an off-site counselor, it is essential that they have affordable, reliable transportation through the ALF to get to their appointments. 
  • Group Program: What group programs does the facility offer? Group activities are great for encouraging seniors to socialize, and some facilities might even offer support groups for people who are battling addiction or facing issues like a loss.
  • Alcohol Restrictions: Does the facility allow residents to consume alcohol on site? Each assisted living community is a bit different when it comes to this – some don’t allow alcohol on site at all, others serve it at special events, while others have no restrictions at all.
  • Mental Health Resources: Good mental health is vital for all seniors, but it is especially important for individuals battling addiction. Find out what kind of support and resources are available to help promote mental health.

What to Consider Before Choosing Assisted Living for Someone with a Substance Abuse Disorder

Who Should Use Assisted Living?

Ideal candidates for assisted living facilities will still be fairly independent and able to spend the majority of their day without the assistance of a staff member. 

Assisted living residents are able to receive help with:

  • Bathing
  • Toileting
  • Daily grooming
  • Housekeeping chores
  • Medication management 
  • Transportation for appointments and personal errands
  • Basic mobility

Who Shouldn’t Use Assisted Living?

Individuals who are in relatively good health and are capable of taking care of themselves without any additional assistance aren’t good candidates for assisted living since they’ll be facing high fees for care that they do not need. There are adult living communities that may be better suited for these individuals.

Those whose addiction or other factors have led to serious debilitating illnesses are also not good candidates for assisted living since these communities do not have the staff or resources to offer extensive levels of assistance or 24-hour supervision.

It’s also important to note that any addiction services provided by assisted living staff will not be as intensive as those provided at a dedicated rehabilitation facility. Because of this, assisted living communities are not appropriate as the first step to recovery. But, they can be a great source of ongoing support for someone who has battled addiction in the past.

Specifically, assisted living isn’t for individuals who:

  • Are permanently bedridden
  • Can not safely maneuver or follow instructions in emergency situations
  • Are unable to perform the majority of their personal care tasks
  • Rely on medical equipment that they can’t maintain or operate themselves
  • Have active tuberculosis
  • Have late-stage Alzheimer’s or dementia
  • Have a serious medical condition that requires around the clock care

Financial Support Options for Assisted Living

Image of senior couple reviewing documents

Unfortunately for many families, the cost of assisted living is beyond what they can comfortably afford from month to month. But assistance from sources such as Medicaid, Medicare, the Department of Veterans Affairs, and Social Security can help. 

Medicaid

For those who have limited resources and are in need of healthcare coverage, Medicaid provides programs and aid in various forms. In addition to standard Medicaid coverage, several waiver programs are available throughout the country for those who specifically need long-term care and help recovering from addiction. 

When it comes to regulations for waiver programs and eligibility guidelines, every state is a bit different. However, the majority of states offer Home and Community-Based Services (HCBS) Waivers, and 1915 Waivers, which are the most common form of waivers used for assisted living. Other states offer similar programs with different names. 

Medicaid programs also provide qualified individuals with access to counseling and mental health services, including programs specifically created for individuals with substance abuse disorders. These programs are available nationwide and can be of great help to those who need them. To learn more about what programs are available in your state, contact your local Medicaid office. 

You can apply for Medicaid by visiting healthcare.gov. If you don’t already have one, you’ll be required to create an account before applying through the Health Insurance Marketplace. Unlike regular health care, you can apply for Medicaid at any point in the year, not just during open enrollment.

Anyone applying for Medicaid should be aware that it can be a long process and extensive documentation of your finances is needed. You should also be prepared to provide evidence from a physician that attests to your medical need for assisted living and addiction recovery.

Medicare

Medicare is a federally-funded program that does not directly cover the costs of assisted living or other long-term care facilities, but may be used to cover any qualified healthcare costs an individual incurs while residing in an assisted living facility. This includes the cost of addiction treatment and recovery as long as certain conditions are met. For Medicare to cover this treatment, it must be deemed necessary by a physician and care must be provided by a Medicare-approved provider or at a Medicare-approved facility.

When it comes to long-term care, Medicare is usually utilized to pay for in-home health care or skilled nursing facilities. While it’s available for all people over the age of 65, it’s also available for those who have qualifying disabilities.

So, even though these funds can’t be used to pay for assisted living directly, they can be put towards other costs to free up money that pays for the rent at these facilities.

Social Security

Social Security is supplemental income awarded to individuals with disabilities who are unable to continue working and were previously employed. It isn’t awarded for any one specific use, so it can be put towards the cost of living in an assisted living facility or to cover the cost of addiction treatment.

This website breaks down the qualification process for Social Security, provides helpful contact information for Social Security representatives, and will assist you in the application process.

Is Addiction a Disability?

If drug or alcohol abuse has caused serious physical damage, it may be possible to get disability benefits from social security. However, you can not receive social security benefits based on substance abuse alone.

Veteran’s Benefits

The U.S. Department of Veterans Affairs offers several benefits to help veterans cover the cost of living at an assisted living facility. 

Basic Pensions

Basic pensions are available to veterans over the age of 65 who are considered low-income or meet other specific requirements. Veterans who receive this pension can use the funds however they wish, making it an excellent source of financial assistance for assisted living care.

The VA Form 21P-527EZ, “Application for Pension” is the easiest way to apply for the basic pension online. Once the paperwork is completed and the required documents are collected, mail the application to your local Pension Management Center

Those who prefer to apply in person can visit the local regional benefit office, where staff can assist with the process. To find your local office, use the VA Facility Locator.

Veterans Alcohol and Drug Dependence Rehabilitation Program

The VA offers its own alcohol and drug rehabilitation program for any veteran enrolled in the VA health care system. Located in the VA medical centers and clinics, the programs offer medical, social, vocational, and rehabilitation therapies for those battling addiction. 

For more information on these programs, contact your local VA medical facility. You can use the VA Location Finder to locate a facility near you.

Aid & Attendance

For veterans who require the assistance of another person to perform the activities of daily living, Aid & Attendance can help ease the financial burden of assisted living. In order to be eligible, a physician must document the need for this assistance. While the funds are awarded to those that need certain services, the funds don’t have to be used for anyone specific purpose. 

Veterans don’t need to be suffering from a service-related injury or illness to receive aid and attendance, but they must be eligible for the basic pension. The best way to apply for these benefits is by visiting the official VA website to get the necessary forms and learn what documents will be required before contacting the Pension Management Center in your state.

Residential Care

The VA is available to help veterans locate and learn more about the long-term care options that are available. Additionally, the VA operates its own state-run veterans’ homes that can provide assistance for those that need assisted living while battling addiction.

To find out more about residential care options in your state, contact your local VA Regional Benefits Office or call the VA Health Care Benefits number at 877-222-8387.

Locating Assistance 

Researching assisted living facilities for your loved one is an emotionally taxing and stressful experience. But the team at Caring.com is here to ensure that you don’t have to do it alone. Our experienced team of advocates is available to help seniors who are struggling with addiction find the best assisted living facility for them. To get started, call a Caring.com Family Advisor toll-free at 800-973-1540.