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Assisted Living

Assisted living is for people who may need some help with their Daily Activities of Living (ADLs), but not as much assistance as a nursing home provides or the medical care of a skilled nursing facility.

Generally, several levels of care are offered with residents paying more for higher levels of care.

Residents usually live in their own apartments or rooms with shared common areas.

Retirement Homes

These facilities range in size from as few as 25 residents to 120 or more.

Assisted living facilities are more residential in appearance than the hospital look of nursing homes and skilled nursing facilities.

These communities are designed for seniors who want an independent lifestyle but need some assistance.

Most assisted living communities also provide at extra cost housekeeping, access to health services, staff available for personal needs, 24-hour security, an emergency call system, exercise programs, medication management, laundry service, and social and recreational activities.

Some assisted living communities also have Memory and Alzheimer’s care units.

Types of Assisted Living Spaces

The types and sizes of assisted care housing vary as do the costs.

These include:

• Shared rooms

• Private rooms

• Studio apartments without kitchens or partial kitchens without cooking facilities

• Studio apartments with small kitchenettes

• One bedroom apartments with kitchens.

• Upscale multi-bedroom apartments.

The living space may be furnished or unfurnished. Even if the living space is furnished some assisted living facilities allow residents to bring their own furnishings to make the room feel more like home.

The living spaces are generally smaller than those intended as general housing.

Assisted Living Services

Assisted living residences provide supervision and assistance with Activities of Daily Living (ADLs) such as meals, bathing, coordination of services with outside health care providers, and monitoring of resident activities to help to ensure the resident’s health, safety, and well-being.

Assistance may include the administration or supervision of medication.

Other services may be provided by a trained staff person or an outside provider which you hire at additional cost.

Residents can continue to use their physicians and dentists or they can choose new ones. The staff can assist in arranging appointments or finding appropriate medical and dental care services.

Although assisted living facilities help their residents with ADLs, this is not at any time when the resident wants or needs it.

A schedule is created based on the resident’s needs and staff availability.

Assisted living facilities closely monitor their residents’ health by setting up a schedule that the resident and staff follow.

For example, an Aid may give a bath several times a week, but not every day. Or help a resident out of bed in the morning and back into bed at night.

If greater levels of personal care are needed, an outside in-home care company is normally hired and paid for by the resident.

Housekeeping, laundry and linen service are normally part of the monthly rent or fee.


Two or three meals in a common dining room are included in the monthly rent or fee.


Assisted living communities generally offer activities such as exercise classes, group dinners, day trips, art classes, and more, allowing for regular socialization and new friendships in any community.

Common activities in most communities include:

• Art Classes

• Day Trips

• Shopping Excursions

• Dances

• Aerobics

• Religious Services

• Movie Nights

• Bingo

• Tai Chi

• Musical Performances

Assisted Living Versus In-Home Care

An AARP study found that 90% of seniors wish to stay at home and Age In Place versus go into another senior care option.

With in-home care your loved one stays in their own home and receives individual one-on-one care versus the shared care of assisted living.

In-Home care is flexible and can be scaled up or down depending on the level of care needed at the time. Therefore you only pay for the services you need at that time.

Care can be as little as 4 hours a day at a cost of about $104 a day to 24 Hour and Live-in care.

Live-in home care costs are less than the cost of assisted care at around $384 a day for the care needs of one person or $504 a day for two people to receive care.

24 Hour in-home care is about $576 a day for the care needs of one person or $624 a day for two people to receive care.

With in-home care your love one also has less exposure to infection:

According to the CDC, over 4 million Americans are admitted to or reside in nursing homes and skilled nursing facilities each year and nearly one million persons reside in assisted living facilities. Data about infections in long-term care facilities (LTCFs) are limited, but it has been estimated in the medical literature that 1 to 3 million serious infections occur every year in these facilities. Infections include urinary tract infection, diarrheal diseases, antibiotic-resistant staph infections and many others.

Infections are a major cause of hospitalization and death with as many as 380,000 people die of these infections in LTCFs every year.

Over 50% of family members are now more likely to choose in-home care for their loved ones than they were prior to the COVID-19 pandemic, according to a recent survey by Transcend Strategy Group.

Assisted Living Versus Nursing Home

Assisted living communities generally do not provide 24-hour supervision, medical care, or the more extensive specialized medical care that nursing homes with skilled nurse center services provide.

Often, if 24 hour care is needed, additional care from an outside care agency is required at additional cost.

Similar to nursing homes, assisted living communities also offer planned activities.

Nursing homes and assisted living communities differ in their appearance. While a nursing home looks institutional because of the type of care provided, an assisted living usually resembles an apartment community.

Assisted living communities provide their care services in the patient’s residential unit or room.

Assisted Living Costs

All assisted living facilities have a monthly fee for rent and services.

Some assisted living faculties have a one-time non-refundable entrance fee. These entry fees vary considerably across the country and by the type of faculty.

Entry fees can start at $100,000 and can be much higher. Most people use the proceeds from the sale of their home to finance the entry fee.

There are high-end assisted living faculties where you purchase your unit in a condo/coop type of arrangement. There is still a monthly fee for services with this type of assisted living facility.

Most assisted living facilities have several cost plans you can choose from:

Extensive or Life-Care Contracts: This plan provides housing, residential services and amenities, including unlimited use of care services, with little to no increase in the monthly fee. This type of plan has a much higher entrance fee.

Modified Contracts: Generally with a lower monthly fee and entrance fee than the Life-Care plan, with the same basic services, but only some of the care services are included in the monthly fee. The resident pays for additional services beyond the contract as they are needed.

Fee For Service or La Carte Contracts: This type of contract includes the same basic services as Life-Care and Modified contracts but requires residents to pay for all care related services as needed. These contracts have a lower entrance fee and monthly fees, but there is a risk of higher costs as services are required.

According to the 2015 Genworth Financial cost of care survey, the average monthly fee for a one bedroom unit in an assisted living facility in Massachusetts is $5,300 per month.

The monthly base rate for Massachusetts assisted living is higher when compared to other New England states and more expensive compared to the national average.

The average cost of assisted living in Greater Boston is $5,850 per month, higher than the rest of the state and the national average.

There can also be additional costs for services above the basic services and needs above the care services the assisted living provides.

Unique HomeCare Services has many clients in assisted living facilities we provide personal care services as their needs are above what the facility provides.

It is important to plan for increases in the monthly fee.

Choosing An Assisted Living Home

A good place to start is to ask your doctor for recommendations.

Once you have a list of Assisted homes of interest, consider what is most important to you or your loved one:

• Personal Care

• Meals

• Activities

• Religious Connection

• Special Care Units for Dementia Patients

Identifying your most important needs will help you narrow down your list.

Call each assisted living home and asks questions about the number of residents, cost, waitlists, etc.

Plan a visit to each facility and meet with the director.

Look for indicators of quality of care such as handicap access warm interaction between staff and residents, and residents who look happy and well-cared for.

Questions To Ask During Your Assisted Living Visit

Contracts, Costs, and Financing:

• Is there an entrance fee?

• What is the monthly fee?

• What is included in the monthly fee?

• Can the monthly fee change and how often?

• What notice is given in a monthly fee increase?

General Questions:

• What is the patient to staff ratio?

• Are personal care services and specialized services offered?

• Are there resident policies you must follow and will you get a written copy of these policies?

• Is transportation services available?

• Are there extra charges for other services?

• Will you get in writing their services, charges, and fees before you move in?

• Is the location close enough for friends and family to visit?

• Is there a person on staff assigned to meet social service needs and can you meet them?

Safety Questions and Observations:

• What safety and security measures does the facility use?

• Is there information about how to report concerns about the care and safety of residents?

• Is there information about how the facility responds to concerns that are reported?

• Is there a backup generator or alternate source of power in the event of a blackout?

• Is the place well-lit and are the exits marked?

• Are there handrails and grab bars in the bathrooms and hallways?

• Are all common areas, resident rooms, and doorways designed for wheelchairs?

• Does the floor plan make sense?

Quality of Care Questions and Observations:

• Are care plan meetings held with residents and family members at times that are convenient
and flexible whenever possible?

• Is the facility free from unpleasant odors?

• Are the common areas clean and well kept?

• Is the temperature comfortable for residents?

• Are the noise levels in the dining room and other common areas comfortable?

• Is the furniture sturdy, yet comfortable and attractive?

• Does the relationship between staff and residents appear to be warm, polite, and respectful?

• Do staff refer to residents by name?

• Do residents seem to participate in the activities?

Quality of Life Observations:

• Do residents have a choice of food items at each meal? Do they serve foods you like?

• Do they provide for special dietary needs such as low-salt or no-sugar added diets?

• Does the facility have outdoor areas for resident use?

• Do residents help plan or choose the available activities?

• Does the staff look nice and happy? Do they smile or look miserable as if they do not want to be there?

Visit A Second Time

It is good to visit the assisted living home a second time on a different day of the week and at a different time than your first visit.

About Unique HomeCare Services

Our headquarters in Norwood, Massachusetts serves the Greater Boston communities in Suffolk, Middlesex, Norfolk, Bristol and Plymouth counties.

Unique HomeCare Services provides private in-home care for elders, those with Alzheimer’s or Dementia, and people who are recuperating from illness, injury, or surgery.

We provide both short-term and long-term in-home care needs from as little as one 4 hour day a week to 24 Hour Care and Live-In Care.

We offer a full range of in-home personal care services including Bathing, Personal Hygiene and Grooming, Dressing Assistance, Toileting and Incontinence, Feeding, and Medication Reminders.

We also provide support services such as Case Management, Accompaniment to Appointments, Nutrition and Meal Management, Light Housekeeping and Laundry Services, Bed and Wheel Chair Transfers, and Shopping and Running Errands.

It is our pleasure to assist our veteran clients with VA Aid and Attendance Benefit approval at no cost.

We have an extensive Directory of Online Senior and Caregiver Resources for the information you need.

To schedule a no cost and no obligation In-Home Assessment to determine the home care needs and get a quote, please call us to speak to a Case Manager at (800) 296-9962 or fill out our Free Quote Contact Form.