Some Cool Information
Navigation Long Term Health Care and Assistance
Types of Senior Living
Independent Living (IL)
If home upkeep and maintenance have become overwhelming, then an independent living facility is a great option. In a nutshell, this type of senior living is designed to simplify things by providing meals, housekeeping, transportation, and social activities, plus an apartment/suite/cottage. However, care is not included. If care is required, you or a family member or friend would have to arrange, hire, and pay the caregiver who is not part of the staff at the independent living community. Who would do best in independent living? The person who no longer wants to maintain a house; the person who wants and needs socialization; the person who doesn’t want to cook all their meals; the person who no longer wishes to drive or rely on friends and family for doctor appointments and shopping.
Assisted Living (AL)
Assisted living communities are designed to provide all of the services in IL, plus an apartment or suite, and additionally offer residents assistance with ADLs (activities of daily living) such as bathing, grooming, medication monitoring, and reminders. In other words, ALs can provide care, and they have their own staff who provide this assistance. However, there are limitations on the amount of care that can be provided. For example, as per the NYS Department of Health, the senior must self-transfer, occupy a wheelchair only occasionally, accept direction from others in times of emergency, and cannot have a medical condition that requires 24-hour skilled nursing and medical care. Assisted living may be a good option for the senior who can no longer safely live in their own home but who is still able to and wants to maintain some independence. Who would be the best fit for assisted living? The person who likes Independent Living, no longer wants or can no longer maintain the upkeep of a house; the person who needs socialization; the person who requires basic assistance with activities of daily living, such as help with putting on socks, shaving, reminders to take medications, etc., would be the best fit.
Special Needs Assisted Living Residence (SNALR)
This type of senior living or memory care is a fancy way of saying it is a place for aging adults with dementia, such as Alzheimer’s disease. In New York state, assisted living facilities that have this license must provide a separate, secure area for those with advanced cognitive impairment. Facilities may choose to separate residents for safety and to provide specialized services and an environment tailored to their specific needs, often with features like enclosed courtyards and alarms to prevent wandering. A separate, secured area is necessary when an individual’s degree of dementia requires a secured environment. There are also standalone senior living communities that specialize in assisting those with dementia, and all of their residents have some form of cognitive impairment. Who would benefit the most from an SNALR location? Seniors who have memory disorders such as Alzheimer’s disease, Frontotemporal dementia, vascular dementia, Lewy body dementia, Parkinson’s disease dementia, alcohol-related dementia, and additional cognitive decline would be best suited for this type of senior living.
Enhanced Assisted Living Residence (EALR)
An EALR includes everything an assisted living offers (meals, housekeeping, transportation, social activities, apartment) plus more medical oversight. In New York state, an aging adult may live in an EALR if they chronically require physical assistance from another person to walk, climb, or descend stairs, are dependent on medical equipment and require frequent assistance from medical personnel—nursing care (i.e., vital signs, eye drops, injections, catheter care, colostomy care, wound care, as needed) is provided by staff, or have chronic unmanaged urinary and bowel incontinence. For those seniors living in an EALR, aging in place is available. Who would be the best fit in an enhanced assisted living environment? The senior who requires assistance walking, transferring, stair climbing, and descending; the senior who needs assistance with all ADLs plus requires nursing care; the aging adult who needs 24-hour medical care and meets certain criteria to stay in an EALR. Essentially, enhanced assisted living offers significantly more comprehensive care assistance than a standard assisted living community.
Continuum of Care Retirement Community (CCRC)
A CCRC is a community that usually includes access to independent living, assisted living, and memory care, plus skilled nursing, all on the same campus, typically offering a lifetime contract to residents. Residents transfer among the levels of care as needs increase. There may be a large buy-in fee, and on top of that, residents also pay a monthly fee. Usually, entering into a CCRC agreement requires the senior to be independent and initially move to the independent living portion of the campus or enter the assisted living portion, but may not have priority access to the skilled nursing portion. Benefits of a CCRC include peace of mind for both residents and their families and the ability to age in place without moving to a different facility when needs change.
Assisted Living Programs (ALP)
These are assisted living facilities in New York that accept Medicaid. They offer amenities like assisted living communities, including activities and meals, but often do not accept physically and/or cognitively frail seniors.
Assisted Living Residence (ALR)
These are assisted living facilities in New York that do not accept Medicaid; they are private-pay only. Most of the assisted living facilities in New York and the Managed Residential Communities (MRCs), also called assisted living in Connecticut, have a policy that if your funds run out, you must leave the community unless there are special programs in place.
How to Pay for Senior Living
There are many ways to pay to live in a senior living community. Below are some options. Before proceeding, please consult with an elder law attorney, financial advisor, or certified accountant.
- Income & Savings – Pension, IRA, savings account, money under the mattress, etc.
- Long-Term Care Insurance – Depending on the policy, LTC insurance may pay for assistance with activities of daily living in an assisted living or enhanced assisted living residence, such as bathing, dressing, and assistance with medication management.
- Veteran’s Benefit – Aid & Attendance. This is a benefit paid by the VA to veterans, veteran spouses, or surviving spouses for applicants needing financial help for care. For 2025, to receive the VA Aid and Attendance benefit, a wartime veteran or surviving spouse must first be eligible for the VA pension, meet specific medical needs for assistance with daily activities or have significant vision impairment, and be under the 2025 VA net worth limit. The benefit may be up to approximately $2,358 per month for a single veteran without dependents. Eligibility criteria include pension eligibility where the senior must already qualify for the basic VA pension, service requirements where the veteran must have served at least 90 consecutive days of active duty, with at least one day during a wartime period, and have an other-than-dishonorable discharge; medical need where the aging adult must need regular, personal assistance with at least two activities of daily living (ADLs) such as bathing, dressing, or feeding, or have significant vision impairment; and net worth where assets must be below the 2025 net worth limit of $159,240.
- Home Equity – Using the money from the sale of a house to pay for senior living.
- Selling a Life Insurance Policy – You may be able to convert a life insurance policy to pay for assistance with ADLs, but the policy value will be reduced.
- Reverse Mortgage – If at least one homeowner is staying in the home, and this person is at least 62 years old, you may be able to use a reverse mortgage or a Home Equity Conversion Mortgage (HECM) to pay for care.
- Family & Friends – Hey, you never know.
- NYS Department of Health Voucher Program – This program is officially called the Special Needs Assisted Living Residence (SNALR) Voucher Program for Persons with Dementia. Many senior living facilities in New York participate in this program. The program subsidizes care costs for individuals with Alzheimer’s or related dementia in specialized senior living facilities (SNALRs). This program allows residents to remain in the senior living community by covering a portion of the regional average private pay rate, up to 75%. Residents must have a formal diagnosis of dementia, be in a participating SNALR, and meet specific income and asset criteria, such as not being eligible for Medicaid.
- Community Medicaid – For care only.
- Some assisted livings have affordable housing where a few apartments are priced lower than the rest and are more affordable.
- Senior Living Line of Credit, also known as a senior living bridge loan, is a type of loan where the bank is the source of funds. Before the house sells, funds are sent directly to the assisted living. It’s important to research lenders, compare high interest rates and fees, and understand the specific terms and repayment obligations before applying.
- Tax Credits – Many of the expenses associated with caring for a loved one living in senior living are tax-deductible. Reductions in taxes mean there are more financial resources available to put toward the cost of care in a senior living facility.
When Is Moving to a Senior Living Facility the Best Option for My Loved One?
If you are considering moving a loved one to a senior living community, it is a significant life transition, and it’s natural for emotions to run high during the process. Several factors should be taken into consideration to ensure the best possible fit for your aging loved one. For example, senior living is a good option when your loved one struggles with daily tasks like cooking or personal hygiene, their home is no longer safe, or they are isolated, and you or a family member is experiencing caregiver burnout. Signs such as frequent falls, poor nutrition, forgetfulness, and a general inability to thrive alone may indicate the necessity of a change to a senior living community. The best time to make the decision is before a crisis forces a rushed decision, allowing for a smoother transition and a better fit with a community that offers safety, support, and companionship.
If you are an adult caregiver, take a look at the list of signs below, and if the answer is yes to any of the following questions, it may be time to contact Aging Adult Transitions to consider senior living as the best option:
- Declining ability to perform daily tasks, such as if Mom or Dad needs help with activities of daily living (ADLs), for example, bathing, dressing, cooking, or managing medications. Is Mom mixing up her medications or forgetting to take all of her prescribed meds? Is Dad not showering and often looks unkempt, or are his clothes soiled?
- Safety Concerns at Home – If the home environment is no longer safe, perhaps due to falls, mobility issues, or potential hazards, then a move may be the best option. Has Mom fallen several times in the past few months due to wall-to-wall carpeting in the home? Is Dad no longer able to walk up the many stairs to the bedroom or bathroom due to pain?
- Social Isolation – If your loved one is spending too much time alone and has reduced participation in social activities, which can impact their mental and physical well-being, the advantage of social activities at a senior living facility is one of the best reasons to take the next step. Is Aunt Elizabeth watching television all day long? Is Uncle George avoiding his friends and family and just sleeping most of the day due to boredom?
- Cognitive Decline & Memory Loss – Increasing forgetfulness, confusion, or struggles with memory, especially if a condition like dementia is a factor, should not be ignored. This can be a serious matter for a senior who starts to wander due to dementia, such as Alzheimer’s disease. Has Mom left the house for hours, confused about where her house is or why she left in the first place, and been found by a neighbor miles away? Is Dad forgetting how to drive or driving on the wrong side of the street?
- Poor nutrition, such as issues with preparing meals or weight loss. Is Uncle Harold eating only junk food from the corner deli? Does Aunt Ruth have only expired food in the fridge?
- Caregiver Stress – If family members or caregivers are feeling overwhelmed, stressed, or experiencing burnout trying to provide care, senior living may be the best option. You’ve likely heard it before—caregivers often neglect their own health while focusing entirely on the person they’re caring for, sometimes becoming seriously ill themselves and needing assistance, even as their loved one remains safe.
In some situations, relocating a person with a chronic condition—such as Parkinson’s disease or moderate to late-stage Alzheimer’s, accompanied by behavioral challenges—to a senior living community may be a more suitable option than continuing care at home. For example, if the aging adult does not have someone able to serve as a caregiver at home on a daily basis, if the senior’s condition has advanced so much that the aging adult requires round-the-clock nursing, or if the home is not handicap-accessible, i.e., it is not a one-level home and does not have handrails or bathroom accommodations, then staying at home may not be practical.
What to do? Now is the time to have an open, gentle conversation with your loved one about the benefits of senior living, such as increased safety, companionship, and freedom from chores. Involve your loved one in the decision-making process (as long as there is no cognitive impairment) by visiting communities together with an Aging Adult Transitions representative, narrowing it down to two or three communities, and letting your loved one choose. Focus on the positives of the senior living community, such as the care support, the vibrancy of the staff and other residents, tasty food, etc.
If you are an aging adult and are thinking about senior living options outside of the home, below are some questions to ask yourself:
- Is there any potential health risk associated with being alone at home for a few days? For example, if there is a terrible winter storm, would I be safe? If the answer is yes, then independent living or assisted living may be the best option.
- Do I feel lonely but maintain overall well-being, or is there underlying anxiety about being on my own? If yes, then the increased sense of community and social interaction of independent living could be the best option.
- Am I reliant on family members, such as my spouse or children, for everyday needs, including transportation to medical appointments? If so, assisted living could bridge the gap in needs.
- Do I have an underlying medical condition that requires ongoing attention? Enhanced assisted living can help if you have a serious diagnosis, especially if that diagnosis is likely to get worse.
- Has my doctor or local clergy expressed concern about me continuing to live alone? If the answer is yes, consider assisted living.
- Have I been neglecting any daily tasks such as cooking, cleaning, or bathing? Do I worry that these basic activities could be dangerous and lead to a fall or other concern? If so, assisted living or enhanced assisted living can offer help and peace of mind.
Resources
State & National Resources
Aging Adult Transitions is proud to share this list of trusted state and national organizations offering a range of services to support you and your family:
A nonprofit, nonpartisan organization dedicated to empowering people 50 and older to choose how they live as they age.
Aging Life Care Association (ALCA)
ALCA’s goal is to advance professional geriatric care management through education, collaboration, and leadership.
The ALS Association is leading the fight to treat and cure amyotrophic lateral sclerosis through global research and nationwide advocacy while also empowering people with Lou Gehrig’s disease and their families to live fuller lives by providing them with compassionate care and support.
Resources for individuals, families, and caregivers who are navigating Alzheimer’s disease.
Alzheimer’s Foundation of America
Provides support, services, and education to individuals, families, and caregivers affected by Alzheimer’s disease and related dementias nationwide, and funds research for better treatment and a cure.
A leading nonprofit health organization that provides diabetes research, information, and advocacy in the US.
A national health agency providing research, publications, and support to reduce the likelihood of disability and death from cardiovascular disease and stroke.
Association for Frontotemporal Degeneration (AFTD)
A nonprofit organization dedicated to improving the quality of life for people affected by frontotemporal degeneration and driving research toward a cure.
New York City’s leading expert on Alzheimer’s and dementia caregiving, working directly with community partners to develop information, tools, and training to support individuals and families affected by dementia.
Centers for Medicare & Medicaid Services
Comprehensive information on Medicare and Medicaid, including ratings of skilled nursing facilities.
Connecticut Department of Aging and Disability Services
A state entity that works to improve the quality of life for older adults and individuals with disabilities by supporting programs and services focused on aging.
Connecticut Department of Public Health
Regulates assisted living by establishing the definition of assisted living services, setting licensing and registration requirements for assisted living agencies and residential communities, and enforcing regulations for staffing, resident care standards, and safety.
Advocacy for the rights of people living in long-term care communities.
Information on Medicare, including an evaluation of skilled nursing facilities.
National Committee for the Prevention of Elder Abuse
General information about elder abuse and lists community resources.
Resources and options for older adults and families.
National Hospice & Palliative Care Organization
NHPCO is the largest nonprofit membership organization representing hospice and palliative care programs and professionals in the United States. The organization is committed to improving end-of-life care and expanding access to hospice care with the goal of profoundly enhancing quality of life for people dying in America and their loved ones.
National Multiple Sclerosis Society
The society’s mission is to mobilize people and resources to drive research for a cure for multiple sclerosis.
New Jersey Department of Health
An entity created to help prevent disease, promote the well-being of residents, and ensure access to quality healthcare services by focusing on areas like infectious disease control, health promotion, emergency preparedness, health equity, and the regulation of healthcare facilities.
New Jersey Division of Aging Services
Provides programs and services for older adults and people with disabilities, information on long-term care, the State Health Insurance Assistance Program for Medicare guidance, and various financial assistance programs to support independence and well-being.
New York State Office for the Aging
New York State Department of Health
This is the governing body overseeing licensed assisted living communities and provides information on hospitals, nursing homes, assisted living programs, assisted living residences, enhanced assisted living, special needs assisted living (dementia), and much more.
The Department of Veterans Affairs is responsible for allocating benefits to veterans and their dependents. It contains information on education, compensation, insurance, health, and more.