A senior living community is a residential setting designed specifically for older adults that provides housing, services, and amenities tailored to the needs and preferences of people in their later years. Senior living communities range from active adult communities for healthy independent seniors to continuing care retirement communities that provide a full spectrum of care from independent living through skilled nursing care on a single campus.
Understanding the different types of senior living communities, what they offer, and how they are paid for can help older adults and their families make informed decisions about housing and care options as needs change over time.
Types of senior living communities
Senior living communities are not one-size-fits-all. The term encompasses several distinct types of residential settings each designed for a different level of need and lifestyle preference.
Active adult communities Also called 55-plus communities or age-restricted communities active adult communities are designed for healthy independent older adults who want to live among peers in a maintenance-free environment. These communities typically offer amenities such as fitness centers, swimming pools, golf courses, social clubs, and organized activities but do not provide personal care or medical services.
Active adult communities range from modest apartment complexes to large master-planned communities with thousands of homes. Residents typically own or rent their homes just as they would in any other residential neighborhood. No care services are included — residents must arrange any needed care independently.
Independent living communities Independent living communities — sometimes called retirement communities or senior apartments — provide housing for older adults who are generally healthy and independent but who want the convenience, security, and social opportunities of a community designed for seniors.
Independent living communities typically offer private apartments or cottages along with common amenities such as dining rooms, fitness centers, libraries, and activity programs. Some communities include one or more meals per day in the monthly fee. Personal care and medical services are generally not provided though some communities can arrange home care services for residents who need them.
Assisted living facilities Assisted living facilities provide housing and personal care services for older adults who need help with activities of daily living such as bathing, dressing, grooming, medication management, and meal preparation but who do not require the around-the-clock medical supervision of a skilled nursing facility.
Assisted living facilities offer private or semi-private apartments along with meals, housekeeping, laundry, activities, and personal care assistance. The level of care provided varies significantly among facilities. Some assisted living facilities have specialized memory care units for residents with Alzheimer’s disease or other forms of dementia.
Memory care communities Memory care communities — sometimes called memory care units or secured dementia care units — provide specialized residential care for people with Alzheimer’s disease or other forms of dementia. These communities offer a secure environment with staff trained specifically in dementia care, structured programming designed for people with cognitive impairment, and safety features such as secured exits to prevent wandering.
Memory care may be offered as a standalone community or as a dedicated unit within a larger assisted living or continuing care retirement community.
Continuing care retirement communities Continuing care retirement communities — CCRCs — also called life plan communities — offer multiple levels of care on a single campus typically including independent living, assisted living, memory care, and skilled nursing care. The defining feature of a CCRC is the ability for residents to move between levels of care as their needs change without having to leave the community.
CCRCs typically require a substantial entrance fee — sometimes called a buy-in — ranging from tens of thousands to hundreds of thousands of dollars depending on the community and contract type. Monthly fees are also charged. In exchange residents are guaranteed access to higher levels of care if needed which provides significant financial and emotional security.
Skilled nursing facilities Skilled nursing facilities — also called nursing homes — provide around-the-clock medical supervision and personal care for people with significant medical needs or functional limitations. While technically a type of senior living community skilled nursing facilities are more commonly discussed in the context of medical care than residential living.
Amenities and services in senior living communities
The amenities and services offered by senior living communities vary widely by type and price point but may include:
- Restaurant-style dining with multiple meal options
- Fitness centers and wellness programs
- Swimming pools and aquatic exercise classes
- Libraries and computer labs
- Arts and crafts studios
- Walking paths and outdoor gardens
- Transportation services for shopping, appointments, and outings
- Housekeeping and laundry services
- Social and recreational activities and clubs
- Educational programs and lectures
- Spiritual and religious services
- Beauty salon and barber services
- On-site banking and postal services
- Guest suites for visiting family members
How senior living communities are paid for
The cost of senior living communities varies enormously by type, location, and level of service. Payment sources include:
- Private pay — personal savings, retirement income, investment accounts, and proceeds from the sale of a home are the most common payment sources for senior living
- Long term care insurance — policies that cover assisted living and memory care can significantly offset monthly costs
- Veterans benefits — eligible veterans and surviving spouses may qualify for VA pension with Aid and Attendance which can help pay for assisted living and memory care costs
- Medicaid — Medicaid covers skilled nursing facility care for eligible low income residents. In some states Medicaid also covers assisted living costs through HCBS waiver programs though availability is limited and waiting lists are common.
- Medicare — Medicare does not cover long term residential care in senior living communities. Medicare may cover short term skilled nursing facility care following a qualifying hospital stay.
- Bridge loans — short term loans that allow families to cover senior living costs while waiting for a home to sell or other assets to become available
Questions to ask when evaluating a senior living community
When evaluating senior living communities for yourself or a loved one consider asking:
- What levels of care are available and can residents move between levels as needs change?
- What is included in the monthly fee and what services cost extra?
- What is the staff to resident ratio and how is staffing handled on nights and weekends?
- How long has the community been in operation and who owns it?
- Is the community licensed and in good standing with the state?
- What is the community’s approach to memory care if applicable?
- What is the process for addressing concerns or complaints?
- What happens if a resident runs out of funds — does the community accept Medicaid?
- Can you speak with current residents and their families?
How to find senior living communities
Resources for finding and evaluating senior living communities include:
- Eldercare Locator — eldercare.acl.gov or 1-800-677-1116 connects older adults and families with local resources including senior living options
- Your local Area Agency on Aging — can provide information about senior living options in your community
- Senior living referral services — companies such as A Place for Mom and Caring.com provide free referral services that match families with senior living communities though they are paid by the communities they refer to
- State licensing agencies — your state’s health department or licensing agency maintains records of licensed senior living communities including inspection reports and any violations
- Commission on Accreditation of Rehabilitation Facilities — CARF — accredits continuing care retirement communities that meet quality standards
Key terms to know
- Senior living community — a broad term for residential settings designed for older adults ranging from active adult communities to skilled nursing facilities
- Active adult community — an age-restricted community for healthy independent older adults without care services
- Independent living — a residential setting for healthy seniors that provides housing and amenities without personal care services
- Assisted living — a residential setting providing housing and personal care assistance for seniors who need help with daily activities
- Memory care — specialized residential care for people with Alzheimer’s disease or other forms of dementia
- Continuing care retirement community — CCRC — a community offering multiple levels of care on a single campus
- Entrance fee — a large upfront payment required by most CCRCs when a resident moves in
- Life plan community — another name for a continuing care retirement community
Sources
- Administration for Community Living — eldercare.acl.gov
- National Center for Assisted Living — ahcancal.org
- LeadingAge — leadingage.org
- AARP — aarp.org
- USA.gov — Nursing Homes and Long Term Care
This article is for general informational purposes only and does not constitute legal or financial advice. Senior living options, costs, and availability vary significantly by location. Contact your local Area Agency on Aging for information specific to your area.