Independent Living -- or Assisted Living?

A fellow caregiver asked...

My grandmother is ready to move out of her home, but I'm not sure whether she needs assisted living or independent living. Independent living rooms cost less so she'd have more space (and her own kitchen). She is independent now, but has some mobility issues. Are there any guidelines that assisted living and independent living communities use to decide whether a resident can be in one place or the other? (She does not have dementia.)

Expert Answer

As Founder and Director of Circles of Care, Ann Cason provides caregiving, consulting, and training services to individuals and public and private organizations involved in eldercare. She is the author of Circles of Care: How to Set Up Quality Home Care for Our Elders.

The question of independent living vs. assisted living for your grandmother could partly be decided by location. It is nice if she is close to the family who will visit her.

You didn't say what her mobility issues are. Is she in danger of falling? Will she soon need a wheelchair? Might she need an escort to help her to the dining room?

There are places that offer independent living and can later add assisted living services for increased fees There are independent living facilities that have their own home care agencies.

But depending on the nature of your grandmother's mobility issues, independent living sounds nice for her. Independent living tends to have people who are suffering less from dementia and other illnesses. It is easier to make friends. The activities are geared to a higher level of function. Residents or more able to come and go as they please. It is nice to have a kitchen and do some cooking. Many independent living facilities have meal plans for so many meals a month for lower rates. Housekeeping is provided every week or two and laundry rooms are easily accessible. Some independent living places will wash the sheets and make bed once a week.

One thing to consider before signing is how far the room is from the dining room. Some establishments have very long halls to navigate. If mobility is poor, long walks might be more debilitating than energizing.

The other consideration is whether your grandmother needs one to one care a few hours a week. In assisted living, which can be very protective, the resident has to fit into the schedule and be apart of the general environment of care. This can be lovely, when coordinated, so that everyone knows you and you are surrounded by a feeling of friendliness or loving kindness. But there are some, who need more one to one assistance. This could be for social reasons, behavioral reasons or needing more trips out to see doctors, have nails done, see friends for lunch or coffee.

And finally, make sure that your grandmother can manage her own medication. Some can do it independenty, others can do it as long as it is laid out in little compartmentalized boxes. But some need it to be given. One of the main reasons that people need assisted living instead of independent is the need for management of complex medication schedules.

Assisted living, however, can be very nice and very protective.