Independent Living -- or Assisted Living?

8 answers | Last updated: Sep 23, 2016
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 Answers

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.

SEE ALSO: Find Assisted Living Near You

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.

Community Answers

Kay paggi answered...

Your grandmother is to be commended for recognizing that she may need more assistance in the future than she does now. The best solution is to find a retirement community that has both IL and AL apartments but not in separate areas. There are some communities that are licensing all their rooms as AL so residents can move in while independent, and change to more assistance when they need it without having to change apartments. This is ideal.

The differences between IL and AL are fluid, or murky. Assisted Living must meet certain criteria to be licensed, Independent living has no criteria. There are some independent communities in TX that offer everything assisted living communities do, including a home health agency in the building, all meals, housekeeping, laundry service, activities, transportation. These communities are priced higher than other independent settings, but less than most assisted living ones.

Since your grandmother is currently independent, an independent setting may seem more attractive, but some strictly IL are unable to offer assistance if she needs it later. This would force her to move again. Another alternative is to move into assisted living community that will add no "˜level of service' fees until she needs them.

Beware of communities that have both IL and AL in the same building, but in separate areas. Generally the residents of IL are reluctant to visit friends in AL. When a resident moves from the IL area into AL, they not only change their apartment but also lose their friends, and the activity schedule is often different. It's pretty much like moving to a different community because everything changes.

Bottom line "“ look for a flexible setting. Visit possible communities more than once, and talk to residents there and their families. Ask staff how long they have worked there. Staff turnover in this industry, especially among the aides, is 300% annually. The best communities retain their staff longer and are able to provide a more stable environment. I wish you well in your search.

Daughter-in-charge answered...

From the point of view of a caregiver who made (with her father's agreement) this decision three years ago, and recently had to make another decision: the two answers above give excellent guidelines and I concur.

Three years ago my father and I chose a lovely retirement residence that offered "levels of care." It was/is beautiful, resort-like, had its own restaurant (order from the menu at all meals), and residents lived in their own apartments complete with kitchens, weekly housekeeping and laundry services, plus a full range of services and activities. They were as independent as they wanted to be, and when they needed additional care it was added discreetly and seamlessly. The rent is month-to-month, requiring only 30 days notice in order to move out. Most important to me, it was non-institutional: gorgeous grounds, tasteful interiors, beautiful and welcoming common areas. It felt more like a resort than a "senior residence."

Things change, and I had no idea how quickly. A month ago my dad was fully-functioning and, if not happy all the time, proud to be still independent. He was forgetful and seemed to be losing track of things, but still able to manage his own affairs. He is 95 and decided (reluctantly) on his last birthday to turn his car keys and car over to me.

Two weeks ago this all started to fall apart. I had to engage the first level of care and medication management, but thought that the three levels on offer would be sufficient to take care of his needs. He became increasingly confused and finally started wandering outside, which is a no-no in such places because they do not want to have to lock doors.

Faced with this, convinced that it was worth everything to keep him where he was, I was considering bringing in outside caregivers to watch over him. But after visiting a wonderful Alzheimers/Dementia facility nearby (run by the same company) I realized that this was the best option. He has been there since Wednesday and I haven't seen him (per advice of the people there, who told me to wait a week or two) but all reports are that he is adjusting well. We moved his own furniture on Friday and I hope that is making him more comfortable.

All things considered, I still think we made the right decision three years ago, choosing a place that gave him a good quality of life for that time. This last move was not nearly as traumatic as I would have expected, and was also the best decision. Things change, and you never know, but things are well in place to respond to unexpected eventualities. Good luck to you and your grandmother.

Jcsscs answered...

How much does it cost in Independent Living per month?

Mary salinas answered...

I would like to know how much assisted liveing cost per month.

Jwallacecoyne1 answered...

Need independent cost for month

A fellow caregiver answered...

your information certainly helps. I an currently live alone in my own home and fully care for myself. With a amputated leg I am in a wheelchair much of the time at home, still drive and can only walk a short distance. So the question is I may need assistance in the near future. What type of residence should I apply for? Thank you Betty

A fellow caregiver answered...

I am looking for independent living . A senior apt. at a low cost