On a regular basis, my senior clients will tell me that they are considering moving to an assisted living facility. When I ask why they are considering doing so, their answers are often extremely varied. Some will say they are lonely in their homes and want social interaction. Others will say that they are having greater difficulty managing and maintaining their own homes. Some will often have misconceptions about what an assisted living facility is and the costs of residing there.
While the physical structure and amenities provided in an assisted living facility may vary based on the costs associated with residing in each facility, they all have many similar features and amenities.
Generally, an assisted living facility is a residential option for seniors who require some assistance with their activities of daily living, such as bathing, dressing, cooking, toileting and walking. The care necessitated is greater than what would be provided in an independent living facility; however, for most residents, it is a level of care that is less than that provided in a nursing home, which provides round the clock medical care and skilled nursing. The goal of most assisted living facilities is to provide a safe and secure environment with dining and entertainment options while also providing access to medical care and transportation.
Each resident in an assisted living facility has his or her own private residential unit, thus, said resident can socialize as much as or a little as he or she wants. Some assisted living facilities provide residents with small efficiency kitchens, while others just provide a bedroom and a living area without any kitchen.
Each facility has its own unique characteristics and amenities. Some have fine dining options, as well as expanded social, recreational and entertainment areas and amenities, while others may have more limited amenities and options available.
The most common characteristics found in assisted living facilities are as follows:
• Either one-three prepared meals served in a common dining room;
• Assistance with activities of daily living;
• Medication management;
• House cleaning services;
• Laundry services;
• Transportation services;
• 24 hour security;
• Fitness programs; and
• Social and recreational programs.
Additionally, the cost for each residential unit will vary by a number of factors such as:
• The size of each unit;
• Whether it will be provided furnished or not; and
• Are there one or three prepared meals per day being provided?
One expense that is virtually always extra is the cost for any additional assistance and care with activities of daily living. This is an expenditure that is generally always provided at a charge based on the care required in an amount above the basic room rate.
Another factor that may distinguish assisted living facilities is whether or not the facility has a special unit for its residents that need care because they are suffering from impairment of their memory (a memory care unit). Whether or not the facility has a locked memory care unit is often an important consideration for those that have memory care issues and needs. Again, those needing to be in the locked memory care unit will often find that the cost of each room is greater than in the regular part of the facility as greater care is needed for each resident.
It should be noted that in New York, one can be in an assisted living facility and still be eligible for community Medicaid services (Medicaid home care). Thus, Medicaid will pay for the additional care needed from an aide by the resident of the assisted living facility if one is eligible for the program. Your monthly expense for the unit is not paid for by Medicaid (unless you reside in a facility that accepts Medicaid for said cost); however, a home care aide is provided with the cost being paid for by Medicaid. Additionally, by enrolling in a pooled community trust, the Medicaid recipient would be able to protect most of his or her income.
Additionally, if you have a long-term care insurance policy, the policy may provide benefits for the cost of any additional care (an aide) that you may require in the facility.
Finally, whether or not an assisted living facility is the right place for you may depend on your answer to the following:
• Are you feeling lonely in your home and do you crave daily social interaction and companionship?
• Are you no longer able to maintain your current residence and are the total costs to reside in your current residence greater than those in an assisted living facility?
• Do you require greater care at home than you currently have or can be provided to you?
• Does living at home raise safety and security concerns?
• Do you need transportation services?
If you have answered any of the above in the affirmative, you may be someone who should consider assisted living as an option or perhaps seek additional care at home. The decision is clearly one that is personal in nature.
Anthony Enea, Esq. is a member of Enea, Scanlan & Sirignano, LLP, with offices in White Plains and Somers. He can be reached at 914-948-1500. He is a past chair of the elder law section of NYSBA and past president and founding member of the New York chapter of the National Academy of Elder Law Attorneys. He practices exclusively in elder law, wills, trusts and estates and guardianship proceedings.