Retirement Home vs. Assisted Living: What’s the Difference?

Updated

Certified Care Manager, Aging Life Care Professional, and National Master Guardian Emeritus

As people age and their families seek alternative living options, retirement homes and assisted living are usually at the top of the list. Most aging adults say they prefer to age at home, but staying at home has advantages and disadvantages. Cost, access to services, and safety are all driving forces for decision-making.

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Sometimes an older adult wants to eliminate the responsibilities and headaches of owning a home.  The increased social opportunities that senior living can offer are appealing. Other times a general decline in functioning and inability to perform activities of daily living prompts families and their loved ones to look at assisted living which can provide more supportive care.

Overview: Retirement Homes vs. Assisted Living

The term retirement home has a meaning that has changed over the years as more diverse and creative housing opportunities are being developed. Many other names can describe a retirement home: independent senior living, retirement communities, continuing care retirement communities, 55+ communities, apartments for seniors, shared housing, and co-housing communities. Each one is slightly different, but the one thing they have in common is an emphasis on independent living.

Assisted living, on the other hand, is a much tidier description of a licensed residential community with built-in supports. Almost without exception, any assisted living residence across the country will have a similar structure of care. The difference between assisted living communities is the cost.

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Retirement homes vs. assisted living: who are they for?

When people are functioning well and are in reasonably good health, they sometimes look at retirement homes as a step towards slightly more supportive care. It is possible to stay in a retirement home for many years, but eventually, some people will need some version of assisted living.

For older adults who stay home and hire care to come to them, the cost and management of that care could become too challenging. In that case, they may opt for assisted living over a retirement home since a retirement home won’t have the support services they require.

Retirement homes: who are they for?

If you reside in a larger city, you could potentially have several choices of types of retirement homes. Cost can sometimes be a deciding factor, but amenities and social environment can also play a part. Retirement homes are for people who:

  • Feel isolated and want more social interaction with others. Over time communities change, people die, and living at home can get lonely.
  • Are tired of home and yard maintenance. Almost anything can be hired out these days, but managing workers, ensuring that the work is timely and done well can be stressful. Most retirement communities manage home maintenance problems and provide yard care as part of the monthly fee.
  • Want the activities and transportation that are often a part of any retirement community.
  • Want lower-cost options like home-sharing and independent senior living. The newer concept of multi-generational apartment dwelling is gaining steam with options for in-home care or completely independent living.

Assisted living communities: who are they for?

Assisted living is generally for people who need assistance, as noted by the name. In particular, assisted living is for people who:

  • Need ongoing help with bathing, dressing, hygiene, and transfers. Support is flexible (but more help usually means a higher cost) with once a day to several times a day.
  • Can afford to pay for this type of care for years if necessary
  • Like lots of amenities like movies, cultural trips, a gym, transportation, diverse activities, book clubs, and lectures. Not every assisted living will have every option, but most have a wide range of social events.
  • Want access to a nurse and need their medications managed and dispensed.

Retirement Homes vs. Assisted Living: Type of Care Received

Depending on the setting, the type of care received in a retirement home will be hard to pin down. We will examine the different kinds of retirement homes and what type of care you can expect.

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Retirement homes: type of care received

A lot of the options under the umbrella of retirement homes are flexible for those who are aging in good health and wish to be surrounded by communities.

Independent senior living

Independent senior living usually refers to senior living that is in the same building as assisted living or a continuing care retirement community.  If this is the case, there are typically a few more amenities than you might find in other situations. Meals, activities, housekeeping, and transportation are standard.

55+ communities

55+ communities are as diverse as mobile home parks to expansive and expensive Sun City-type settings. In either case, you can expect there will be no care support services available except for those you arrange. However, you most likely will have yard care, activities, and possibly transportation.

Home sharing

Home or house sharing is a totally private transaction between the person who owns the home and the people they choose to share it with. Possibilities include renting from the owner or as a group purchasing a home together. Most of these situations are entirely independent, so there is no option for care that you don’t arrange yourself.

Co-housing

Co-housing communities are often multi-generational, but many are for seniors only. Co-housing is like a small community of homes on the same property but with a shared communal dining space and group responsibilities. Co-housing can be expensive since you are purchasing a home in the community. Generally, there will be no care support.

Continuing care retirement communities (CCRCs)

CCRCs offer a continuum of care that begins with independent senior living all the way to nursing home care. Most CCRCs require a significant buy-in along with monthly fees. If you are in the independent portion, you may have access to the amenities we mentioned for independent senior living but no care services. 

Assisted living: type of care received

There is little variability in the type of care received in assisted living. The only difference would be memory care which is under the umbrella of assisted living. 

  • Aides are available in assisted living to help with daily living activities like dressing, bathing, accompaniment to meals, transfers, and hygiene. 
  • Nursing care is typically limited to medication management and minor medical issues. A nurse is not usually available 24/7. 
  • Assisted living communities put great emphasis on amenities like activities, transportation, meals, and snacks.
  • A growing trend with assisted living communities is offering in-house physician services. Mobile medical groups come to assisted living to meet with residents, so they don’t have to leave. Opting for this service may mean giving up your regular primary care physician. The other health-related service is home health. Some assisted living communities partner with a specific home health company that may have an office on site. 

Retirement Homes vs. Assisted Living: Costs and Paying for Care

Paying for the cost of care is, for most families, a complex and often stressful decision. People are living longer, and the cost of care continues to rise. 

Retirement homes: costs and paying for care

Since there are so many types of retirement homes, the cost of care will vary significantly. For example, co-housing costs could range from $100,000 to $300,000 or more depending on where you live. Independent senior living is usually a monthly rate and can range from about $2000 a month to $4000 a month or more. Again, where you live, and amenities will influence the cost.

Home sharing, 55+ communities, and apartment costs will range widely. The average cost of a  Continuing Care Retirement Community is $329,000, but costs can exceed $1 million, and then there are monthly add-on fees.  

Most people pay for retirement homes using funds from selling a single-family home, savings and retirement funds. Long-term care insurance may not pay for a retirement home because they provide no actual care.

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Assisted living: costs and paying for care

Our assisted living cost comparison can give you a good idea of the cost of assisted living in your state. According to Genworth, the median monthly cost of assisted living is $4300. But, you can see in our cost comparison that in some states, the cost far exceeds that amount. Most assisted living communities charge a base rate and then add on costs depending on the level of care you need. 

Paying for assisted living is not unlike paying for a retirement home, except that a long-term care policy can defray some of those costs.  Without a policy, families can sell their primary residence, tap into retirement funds and savings.

Retirement Homes vs. Assisted Living: Admissions Process

The admissions process for retirement homes and assisted living is very different. For one thing, retirement homes are not always licensed by the state and don’t have to meet staffing ratios or other mandated care requirements. Basically, if you can afford a retirement home, you can move into one. You always have the choice of paying for additional care through an in-home company if you need it.

Assisted living, on the other hand, will have an admissions process to determine whether you are appropriate for their community. You can expect the following procedure.

  • Admissions forms, including a resident agreement that outlines the initial care you need and the cost of that care. 
  • A medical history and physical assessment, which are provided by the resident’s primary care physician. Most communities require that this assessment be completed within one month of moving in.  
  • The assisted living nurse will complete a functional assessment, including the prospective resident’s ability to bathe, dress, transfer, and walk. 
  • A cognitive assessment determines if the resident is safe to reside in assisted living or if they would be more appropriate for memory care. 

Retirement Homes vs. Assisted Living: Finding Care

Finding care for a retirement home vs assisted living will be different due to the various names that retirement homes go by. If you can, search online for the specific type of retirement home you want: independent senior living, co-housing, 55+ community, shared housing, continuing care retirement community or apartment living. 

For assisted living, you may want to retain the services of a senior placement specialist or a geriatric care manager who may have first hand experience with different communities. Ask friends and neighbors and healthcare providers for recommendations. 

Retirement Home vs. Assisted Living

A choice between a retirement home and assisted living can be a challenging one to make. The question is whether you want the experience of more independent living or are you on the cusp of needing more care? Most people prefer to maximize their independence and choose one of the many retirement home options available. But when the time comes for additional support, assisted living can be the best choice.


Sources:
  1. “Cost of Care Survey,” Aging and Your Finances, Genworth, 12 February 2021. Genworth.com.
  2. “How Continuing Care Communities Work,” Family Caregiving, AARP, 24 October 2019, Aarp.org.
  3. Li Cain, Sarah. “Co-housing Communities: What They Are and Considerations to Make,” Real Estate, Bankrate, 20 November 2020, Bankrate.com.
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