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Residential Care
Residential care (also called facility care) may be the best option when an older adult can no longer live safely in their own home or if they would benefit from being a part of a community living environment. For those that like to plan ahead, downsizing and moving to an independent or continuous care community when care needs are still low can have multiple benefits as well.
What is residential care?
Residential care refers to various community-based living options for older adults at different care levels, offering the main alternative to aging at home. It's more than simply providing a place to stay—it offers safety, companionship, and often personalized care designed to meet individual needs.
Common types of residential care facilities
Light Care Level
Independent living or retirement communities
- Independent living or retirement communities are designed for older adults who are mostly independent but prefer a community environment. They offer meal services, housekeeping, recreational activities, and transportation.
- Level of Care:Minimal assistance; their focus is on light support and socialization rather than medical care.
Continuing care retirement communities
- Continuing care retirement communities combine independent living, assisted living, and skilled nursing care on a single campus. They provide a spectrum of light to intensive care, allowing residents to move between different levels as their needs change.
- Level of Care:Flexible; from minimal to intensive medical care.
Moderate Care Level
Adult family homes
- Adult family homes are small, home-like settings offering personal care, meals, and activities. They provide assistance with activities of daily living like dressing, personal care, medication management, and some medical care, depending on the home.
- Level of Care:Varies; typically lower than assisted living but more personalized due to smaller staff-to-resident ratios.
Assisted living facilities
- Assisted living facilities provide help with activities of daily living like bathing, dressing, medication management, and meal preparation. Social activities, housekeeping, and transportation are also provided.
- Level of Care:Moderate assistance; not equipped for intensive medical care.
Specialized & High Care Level
Memory care facilities
- Memory care facilities focus on specialized care for individuals with Alzheimer's disease or other forms of dementia. They offer a secure environment, structured activities, and specially trained staff. These can also be care units housed within an assisted living or nursing home.
- Level of Care:High-level supervision and assistance; designed for safety and cognitive support.
Nursing homes
- Nursing homes provide 24/7 medical care, rehabilitation services, assistance with ADLs (activities of daily living), medication management, and specialized therapies (e.g., physical, occupational, speech therapy).
- Level of Care:High level of medical care; suitable for those with serious health conditions or recovering from surgery.
Hospice care facilities
- Hospice care facilities are end-of-life care focusing on comfort, pain management, and emotional support for individuals with terminal illnesses.
- Level of Care:Specialized palliative care; often includes family support services.
Planning for future needs
Your loved one may have minimal care needs today, but that could change in the future. As you search for care, consider how each facility could support your family with future needs.
Your loved one may have minimal care needs today, but that could change in the future. As you search for care, consider how each facility could support your family with future needs.
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Home away from home
If your loved one is worried that a facility would feel too impersonal or overwhelming, consider an adult family home. They offer many of the same benefits of a larger facility, but are run out of an actual home in a residential neighborhood with only 2-10 residents. The environment can feel quite homey!
If your loved one is worried that a facility would feel too impersonal or overwhelming, consider an adult family home. They offer many of the same benefits of a larger facility, but are run out of an actual home in a residential neighborhood with only 2-10 residents. The environment can feel quite homey!
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Staff matters
As you look at residential care options, consider the staff. Ask about the ratio of staff to residents, especially for nurses and aides, required qualifications, and ongoing training. More staff typically indicates increased levels of care and attention. High staff turnover can be a red flag, but keep in mind consistent staffing is an industry-wide challenge.
As you look at residential care options, consider the staff. Ask about the ratio of staff to residents, especially for nurses and aides, required qualifications, and ongoing training. More staff typically indicates increased levels of care and attention. High staff turnover can be a red flag, but keep in mind consistent staffing is an industry-wide challenge.
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When is residential care a good option?
How do you know if this is the right path for your loved one? Here are some considerations that should help you pursue the right kind of support for the season you're in.
Residential care is best for...
Not worrying about home maintenance or housekeeping: As older adults age, maintaining a home, garden, and other responsibilities can become stressful and expensive. Residential care eliminates these burdens, allowing them to focus on their well-being.
Nutrition and meals: Most residential facilities provide nutritious meals, relieving older adults of the need to plan, shop, and cook. This ensures they maintain proper nutrition and avoid unhealthy weight loss.
Social and emotional well-being: One of the biggest advantages of residential care is the social environment, where older adults can build friendships and engage in activities that boost cognitive and emotional health. This is especially beneficial for those who might otherwise live alone and could be an opportunity to help an older adult reconnect with friends who are already living in these communities.
Streamlined access to care as an older adult's needs change: In case of a health event, transitioning to higher levels of care is simpler in a facility. The environment remains consistent while the facility adjusts the care needed, reducing stress for both the resident and family members. A great option for both the present and future.
Relief for family caregivers: Residential care provides peace of mind for family caregivers, ensuring loved ones are safe and cared for. This is particularly important for caregivers juggling work, children, and aging parents, helping prevent burnout as care demands increase.
But remember...
Residential care can be quite costly: While residential care can be expensive, as an older adult's care needs increase, it can become more cost-effective than hiring full-time in-home caregivers. The facility environment may also be more efficient in providing care.
Moving is hard, period: Downsizing or moving into residential care can be emotionally difficult, especially for someone who has lived in their home for a long time. It may feel like a loss of independence, so approaching the transition with patience and empathy is essential, and discussions may take time to unfold.
Access to lifelong learning
Try your hand at ballroom dancing, learn about meditation, or take in a poetry lecture with an English professor from a local college. Many residences offer diverse and enriching classes and events for residents to enjoy.
Try your hand at ballroom dancing, learn about meditation, or take in a poetry lecture with an English professor from a local college. Many residences offer diverse and enriching classes and events for residents to enjoy.
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A way to stay together
It can be really hard for an older couple when one person has significantly higher care needs or cognitive decline that the other. Continuing care facilities offer a way for couples to live in the same place instead of being separated.
It can be really hard for an older couple when one person has significantly higher care needs or cognitive decline that the other. Continuing care facilities offer a way for couples to live in the same place instead of being separated.
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Services at your fingertips
Your loved one can get their hair done or have a check-up with their primary care doctor without leaving home! Many residential facilities bring in personal care or medical providers on-campus so that residents can enjoy stress-free appointments.
Your loved one can get their hair done or have a check-up with their primary care doctor without leaving home! Many residential facilities bring in personal care or medical providers on-campus so that residents can enjoy stress-free appointments.
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By the Department of Health & Human Services
A comprehensive checklist to help you evaluate individual facilities.
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Paying for residential care
Paying for residential care can feel overwhelming, but there are resources to help. Learn about average monthly costs and ways to pay for residential care through insurance.
How much does residential care cost?
The cost of residential care varies widely depending on the type of facility, location, level of care required, and additional services provided. Here is an overview of average costs for different types of residential care in the United States as of 2024:
Independent living communities: $1,700 to $4,600 per month
Adult family homes: $2,700 to $7,500 per month
Assisted living communities: $3,800 to $9,600 per month
Memory care units: $4,000 to $9,000 per month
Nursing homes: $5,300 to $15,000 per month for a semi-private room; $6,500 to $16,600 per month for a private room
Hospice care: Often covered by Medicare, Medicaid, or private insurance; out-of-pocket costs can vary but are generally lower because hospice care focuses on comfort rather than curative treatment.
Paying for residential care
The cost of care and whether insurance or the government can cover it depends on your plan and where you live. Here are the most common ways to pay:
Medicare: Medicare Part A covers nursing facility care on a short-term basis at an approved facility with a qualifying inpatient hospital stay. It also covers ongoing conditions requiring skilled nursing care.
Medicaid: Medicaid-certified nursing homes that provide skilled nursing, rehabilitation, or long-term care are covered by Medicaid. Facilities are required to provide dietary, personal hygiene, room maintenance, and other services in addition to medical care.
Long-term care insurance: This coverage varies widely, but often can help pay for assisted living, memory care, and nursing homes, including both skilled and non-skilled care. If you have LTCI (as it's commonly referred), take a look at your policy and contact your insurance company to learn more about your coverage.
Self-pay: Families use a combination of retirement income, personal savings, stock investments, or funds from selling a home or other assets to cover the costs of residential care. They may also receive financial help from relatives to contribute to these expenses.
Research insurance
Research the type of insurance your older adult either currently has or is eligible to receive (e.g. Medicare, Medicaid, long-term care insurance, etc). They each have unique qualifications, and some health conditions can provide financial coverage. You may also be able to request an assessment if an older adult does not qualify with a condition.
Research the type of insurance your older adult either currently has or is eligible to receive (e.g. Medicare, Medicaid, long-term care insurance, etc). They each have unique qualifications, and some health conditions can provide financial coverage. You may also be able to request an assessment if an older adult does not qualify with a condition.
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By Genworth
Find care cost info for your location and compare prices across care types.
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Finding residential care facilities and additional resources
Here are some helpful resources to find residential care options near you as well as a list of the nation's top senior living facilities.
National directory and referral services
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AssistedLiving.org Aggregates the best assisted living facilities by city and state for localized recommendations.
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A Place for Mom A senior care referral service that helps families find senior living options, such as assisted living, independent living, memory care, and home care. Free for families.
Top-rated nationwide residential care options
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Sunrise Senior Living Highly regarded for its person-centered care approach, particularly in memory care.
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Brookdale Senior Living The largest national provider, well-regarded for its range of care options, strong focus on wellness, and health care integration.
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Atria Senior Living Known for resident engagement, offering innovative activities and a strong focus on improving the quality of life for residents.
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Five Star Senior Living Known for its warm, hospitality-driven approach to care. They offer a comprehensive range of services and emphasize wellness programs.
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Belmont Village Recognized for its strong integration of research-backed care methods, with a focus on safety and comfort.
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Benchmark Senior Living Highly rated for its personalized care approach, strong community engagement, and commitment to quality programming.
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Continue exploring
Not sure which would be the best fit? Compare all 3 options in our Comparison chart
In-Home Care
Adult Day Centers
Residential Care
Care provided by a trained caregivers or home health aides for an individual or couple in their home. In-home care supports older adults with daily activities and provides family caregivers a needed break (respite care).
Supervised out-of-home care for older adults in external settings. Older adults come during the day to socialize, enjoy activities, exercise, and dine with friends. Some centers may offer additional services like laundry. Participants live at home, but this can allow family caregivers to work during the day or take some regular time off.
Also called facility care, this broad category of care includes senior living communities, assisted living, and nursing homes. Residents live on-site and enjoy a range of services and benefits, which usually include housekeeping, activity/exercise classes, and/or meals.
Care can be provided part-time, full-time, overnight, and on weekends. In-home care usually requires a 4 hour minimum shift.
Programs are usually available on weekdays as a half-day or full-day. Nights and weekends are not typically options.
Facilities providing care support may offer more flexible part-time hours since they can serve multiple residents in a shift; up to 24/7 care available in some facilities.
Customized services based on need, from companionship and chores to help with bathing and mobility, up to 24/7 medical care. However, intensive or round-the-clock medical care at home can become prohibitively expensive for many families, especially if it's long-term.
Supervised setting for older adults who need light to moderate care support, such as transfer assistance, basic personal care, and medication management. There are also adult day health programs that offer higher levels of medical care, but these are less common.
Range of care levels offered depending on facility type: from light housekeeping all the way to 24/7 medical care. Continuous care facilities allow residents to transition between care levels without leaving the community.
This can be a more affordable option when care needs are light to moderate. Full-time care at home becomes expensive.
Lower hourly rate of care than an in-home caregiver, which makes it a good option for care during weekday hours.
While this type of care is expensive, once overnight or 24/7 care is needed, it is often more affordable than in-home care.