In the senior housing market, the biggest segment of growth is in building assisted living units.  Assisted living is the level of care for seniors between being in an independent apartment in a retirement community and 24/7 skilled nursing care. Most of the expansion is happening in the assisted living ‘market’, so it seems due to high occupancy rates.

Seniors who once moved on to skilled nursing can now stay in assisted living with the addition of other services. The cost of add on services (home care visits by a nurse or nurse practitioner) are on top of the average 3000 to 6000 dollar a month price tag. Extra help with transfers and medication management for example will add on to the price.  

Although assisted living facilities differ by state, services offered can include:

  • Assistance with daily living activities (bathing, dressing, eating, toileting, etc.)
  • Central dining programs that include three meals a day
  • Educational activities
  • Emergency call systems in private and common areas
  • Exercise activities
  • Health services and medication administration( an add on) 
  • Housekeeping and maintenance
  • Organized recreational activities
  • Personal and/or nonpersonal laundry services
  • Social services and religious activities
  • Transportation arrangements
  • Wellness programs
  • 24-hour security

That may seem like a very comprehensive list, but someone still has to be managing the overall picture and that still falls to a family member. A useful resource with links to information for adult children caring for frail parents and the realities of what still has to be done can be found at:

But what happens when you or your loved one falls outside of the boundaries of what assisted living can provide.  And I do not mean just financially.   Evictions…It a sad commentary but a reality of the limitations of care.  You or your family could be served with a 30 day eviction notice and no where to go. 

The problem, as pointed out in this excellent Kaiser Health news article: is that there is no uniform way to protest these kind of decisions. 

Often, there’s little that residents or their families can do about evictions. Assisted living is governed by states, and regulations tend to be loosely drafted, allowing facilities considerable flexibility in determining whom they admit as residents, the care they’re prepared to give and when an eviction is warranted, said Eric Carlson, directing attorney at Justice in Aging, a legal advocacy organization.

More regulation is needed as the proportion of seniors in assisted living grows.  The only real resource suggested is to contact your long term care ombudsman through a local government office.

I know that the average active senior reading this (unless they themselves have elderly parents), is saying not me – not yet.  But keep this in the back of your mind when viewing the slick promos for all the amenities these same places can offer.