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Senior Housing – 4 Options to Consider

When thinking of housing option for seniors there are a continuum of options available today. These range from independent living right up to memory care. Let’s look at each level of care individually. All options discussed are private pay. Medi-Cal (Medicaid in other states) only covers skilled nursing (SNF) facilities in California and a handful of communities who are part of the assisted living waiver program (ALWP). There is a long wait list for SNF and ALWP rooms.

Independent living (IL)

IL communities may exist on their own or may be part of a community that offers a continuum of care which may include IL coupled with assisted living, memory care and/or skilled nursing. An IL community is characterized by offering residents room, meals (1-3- per day), weekly housekeeping, laundry services, utilities (often including basic cable TV and internet) and a robust activities calendar with exercise classes, games, events and outings. Residents are often on the younger side – in their 70’s – range 60-85. Residents must be able to live independently as there is no care offered. If care is needed down the road caregivers can be brought in at extra cost for a few hours a week to full time 24 hour care. The costs for care range from $27-30 on average – from an agency – the safest way to contract for care. Independent living units range from $2500 to $5500 a month.

Assisted living (AL)

Assisted living offers all of what is offered in IL but includes “care”. By care we mean help with ADLs (activities of daily living). ADLs include bathing, dressing, grooming, toileting/continence and transferring from the bed and chair. Assisted living also offers meal preparation – usually offering 3 meals a day and snacks as part of the basic package. Often assisted living communities offer residents a base rate for the room and care is added on using a points or dollars system. More care can be added over time. Regular assessments of the resident determine how care costs change over time. Assisted living communities with care included start at $5000 a month and range from $5000-$8000 a month. The staff ratio is usually about 1 staff member per 6 residents. Staff is on duty 24/7. AL communities have a hospice waiver and bed bound waiver so that clients can remain here to the end of life.

Memory Care (MC)

For residents with Alzheimer’s or Dementia there are stand alone communities devoted to their care or a locked area may be part of an assisted living community. Memory care units are often brightly colored to help alz/dementia patients better distinguish their surroundings. There may be a memory box outside the door or a picture of the resident to help residents remember where they live. A specialized calendar of events brings these residents activities that help with cognition. Caregivers have had an extra layer of training to help them service these residents. They are often called upon to help with activities such as to help with feeding assistance. Residents often share rooms as it helps with their socialization. Memory care facilities range from $4500 to $13,000 a month with the average being $7000 a month. MC communities have a hospice and bed bound waiver just like AL communities so residents can stay here to the end of life..

Board and Care facilities (B&C)

These are typically 6 bed facilities that offer assisted living and memory care support. They are homes that have been converted to facilities hence this is a homelike setting. Alz/dementia residents do well in the small board and care as there is less stimuli to cope with – less confusion for the resident. There is also a higher ratio of staff to residents – 2 staff for each 6 residents. The staff handle both care and meal prep/serving. Some B&C have awake night staff. Others have a staff member assigned to night duty but they are only awake if summoned by a resident ringing a bell or call button. Board and cares are less expensive than AL communities ranging from $3500 to $6500 a month with the average being $5000. Residents receive help with their ADLs as well as room, housekeeping, laundry, utilities and limited activities – usually puzzles, bingo and exercise classes. These homes may have a hospice waiver and bed bound waiver. This means clients can also remain here to the very end of life.

Article written by Sue Gibson of CarePatrol. At CarePatrol we help families find assisted living, independent living, memory care and board and cares for their aging loved ones. We check the care and violation reports to only recommend safe options. We tour with the family to be there to ask and answer questions. Ours is a free community service. We also follow up 2 days, a week and a month after placement to be sure all is well. There are 150 of us across the country and we are trained Certified Senior Advisors (CSAs). We can be reached at and at 1 415 656 6869.

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