There may come a time when your family decides that your aging loved one would be safest in a senior living community. The most common type of residential senior living community in the United States is assisted living. It’s easy to see why, too: they offer just the right level of care for many seniors, allowing them to get assistance when they need it and live autonomously when possible.
Here’s what you need to know about qualifications for assisted living facilities, including if your parents qualify.
Qualifications for Assisted Living: Do You Meet Them?
Most assisted living communities typically have the following requirements for potential residents:
- Need assistance with activities of daily living (ADLs) like toileting, bathing, and grooming
- Have a way to pay for senior care services; can be covered by long-term care insurance or another method
- Do not require 24/7 medical care/not bedridden
- Do not have severe cognitive impairments like advanced dementia
- Be considered stable or not in precarious health
- Pass the community’s health assessments
- Meet all other facility policies
When is Assisted Living Not the Right Choice?
Many families choose assisted living communities because they provide the right level of care to their aging loved ones. There are times, however, when an assisted living facility is not the right choice.
Someone may not be the right fit for assisted living if they:
- Have significant medical needs. If someone’s medical condition is severe enough, they may not qualify for assisted living. Someone requiring specialized care provided by 24/7 on-site staff members would be better suited for a skilled nursing facility.
- Have significant memory impairments. Someone with advanced Alzheimer’s disease, Lewy body dementia, or another medical condition that affects memory is better suited for a memory care facility.
- Only want to live communally. If someone can live independently without needing help with daily activities, they would be better suited for an independent living community.
Qualifications for Assisted Living FAQs
What qualifies you for assisted living?
The ideal assisted living resident for most assisted living facilities:
- Is an older adult. Most assisted living communities have a minimum age requirement, often between 55 to 65.
- Needs personal care assistance. Assisted living addresses personal care needs. That means assisted living residents need help with grooming, dressing, meal preparation, medication management, and more.
- Has no severe memory impairment or disability. Someone with severe memory issues or who requires advanced medical care has needs above what most assisted living communities can provide.
- Does not have severe behavioral problems. Intense behavioral issues can be beyond the scope of what assisted living staff members can safely manage and may present safety concerns for both staff and other residents.
What disqualifies a person from assisted living?
Each community will have their own specific criteria and judge potential residents on a case-by-case basis. Failure to meet admission criteria can mean automatic rejection of a potential resident‘s application.
Common factors that contribute to denied admission for assisted living include the potential resident:
- Requiring extensive medical care, such as wound care, that far exceeds scope of standard assisted living services.
- Not meeting minimum age requirements.
- Living with severe cognitive impairment, to the point that staff members cannot guarantee the potential resident‘s safety.
- Having a medical history suggesting that their health is precarious/can not be considered stable.
Will Medicaid pay for assisted living?
Medicaid can cover some of the costs associated with assisted living, most often medication management and personal care assistance. Room and board is typically not covered, although coverage can vary by state.
What certifications should an assisted living community have?
Specific certification requirements for assisted living facilities can vary by location. That said, licensing should be consistent with all state regulations and can include certifications for both the staff (e.g., certified nursing assistants) and facility (e.g., Accreditation Commission for Health Care, CARF accreditation).
Should you choose assisted living or a nursing home?
Whether someone should live in assisted living or skilled nursing care depends on the prospective resident’s needs, specifically their functional abilities.
Someone who needs assistance with activities of daily living is better suited for assisted living. Someone who has intense medical care needs is better suited for a skilled nursing facility (nursing home).
What if my parent is denied admission to assisted living?
If your parent is denied admission to an assisted living community, the best course of action is to learn why their admission application was denied. You may learn it was due to an error, or you may find that your loved one does not meet the community’s specific eligibility criteria. In this case, you may need to explore other senior living options to ensure your loved one gets proper care.
What other senior living options exist?
Assisted living is just one of many senior living options available.
Besides assisted living communities, which can provide assistance with everyday tasks, your family’s other senior care options include the following.
Long-term residential care facilities:
- Independent living communities. Independent living is ideal for people with a personal preference of living amongst their peers and who can live independently (i.e., do not have medical care or personal care needs).
- Memory care units. Memory care communities are ideal for individuals living with cognitive impairment due to Alzheimer’s disease or similar medical condition.
- Skilled nursing care communities. Skilled nursing care communities are for people living with severe memory impairment or who require 24/7 medical care.
- Continuing care retirement communities. People who have chronic conditions that progress over time, like dementia, may benefit from continuous care retirement communities, which alter the level of care provided to residents as their needs evolve, all on a single campus.
Short-term care and non-residential care services:
- In-home care. In-home services are for people who would benefit from assistance with daily tasks but have a personal preference to live at home rather than in a residential care community.
- Respite care. Respite care offers family members a break from caregiving duties.
- Adult day care. Adult day care offers seniors care services while family caregivers are away at work.
Have an open discussion with your loved one about their needs, so you can determine if they meet the qualifications for assisted living facilities or if another type of senior living community is the best choice.
Disclaimer: Each person’s situation is unique. This article is for general informational purposes only and is not intended to take the place of medical, financial, tax or legal advice.