We constantly open and close chapters in our lives. From new careers, marrying a life partner, rekindling old or new friendships to finding a new home. Opening up a new life chapter can be scary, exciting, easy, and difficult. For seniors moving away from their long-beloved home into an Assisted Living Facility, the initial thoughts can be scary rather than exciting. For seniors with a disability, the thoughts can be even more thought-provoking. Not knowing where to begin can be difficult rather than easy. Rest assured – we help open the new chapter of your life with excitement that will seemingly rid you of your anxieties regarding assisted living for seniors with disabilities.
Seniors with disabilities often find themselves in a rut when pondering where they fit in when considering a new home. Questions that arise may sound similar to:
Can I continue living on my own or is it time to consider having a little extra help from time to time?
Which type of environment will be best for me to continue living my best life while still maintaining as much independence as possible?
Will I still be able to do all the things that I enjoy in my daily life and routine?
Will I be able to afford the cost?
Several options exist for seniors with disabilities when thinking about the next transition away from their home. Above all else to consider aside from cost, location, and amenities is simple and clear – your safety and ability to live your life doing the things that are important to you. By the end of this article, you should feel rest assured that despite your disability as a senior, there are several Assisted Living Facility options that can be tailored specifically to your situation, lifestyle, and needs.
Living Options for Seniors with Disabilities
Safety is a must when thinking of your next home, especially for seniors with disabilities. As a natural part of aging, there are things that we can and can’t control to help manage our health better. Things that we can’t control are sudden new health complications that can lead to new disabilities and things that we can control are our health habits that help promote a stronger body. Along the same vein, we can make a choice to live in a more accessible and environmentally friendly home with necessary social support to prevent falls, help with activities we can no longer do ourselves, and assist with the administration of medications.
Take a moment to reflect on three variables that can help guide your decision of where your next home may be – your physical abilities, social support system, and day-to-day activities that are difficult or strenuous to do yourself. Options below depict different types of transitional living homes that seniors consider based on the three variables listed above:
Senior retirement communities: You’ll find this term from time to time but the description itself is all over the place. In short, ‘senior retirement communities’ can be considered a large umbrella to categorize communities that include residents that are independent community dwelling seniors. Meaning, seniors that live in these communities can get around the community easily, drive, can easily walk a mile or more without difficulty, do all of their self-care activities by themselves without a second thought, and have little to no medical related health complications.
Senior Apartments: Senior apartments are apartment complexes, condos or facilities that offer private, separate residences designed for seniors aged 55 year of age or older. Residents that stay in senior apartments are also expected to be completely independent, do not require any assistance for their daily activities, can typically cook all of their meals, perform their own grocery shopping, handle all of their medications, and sometimes are still in the workforce. Residents in this type of living environment remain quite active in the community.
Independent Living Facilities: Used interchangeably with senior apartments, independent living facilities are reserved for seniors that can carry on with their regular day to day activities without difficulty. No staff are present to assist with any activities for their residents. Residents that remain in independent living facilities include seniors that also get around the community without difficulty.
Assisted Living Facilities: A community aimed at serving seniors who need help with personal self-care activities and health services but do not require 24-hour monitoring skilled nursing care for long periods of time. Residents that reside in this type of environment receive regular care for personal hygiene, toileting needs, getting dressed, assistance with meals, and medication management.
Assisted Living Facilities for Seniors with Disabilities
Without a doubt, if you are a senior with a disability, it’s best to consider an Assisted Living Facility rather than the other options listed above. If you need an extended amount of help such that your own health is at risk if someone isn’t always attentive to your health needs, a skilled nursing facility may actually be a better option. The biggest difference between an Assisted Living Facility and a skilled nursing facility is that skilled nursing facilities are for seniors that require continuous 24-hour supervision for medical monitoring. Many seniors that reside in Assisted Living Facilities currently live with chronic disabilities or newly diagnosed disabilities. Let’s look at some facts to see how you compare:
Approximately 38 percent of residents of Assisted Living Facilities receive assistance with three or more personal self-care activities.
Most residents have been diagnosed with one or more chronic conditions such as hypertension, Alzheimer’s and dementia, osteoporosis, heart disease, depression, arthritis, and diabetes.
54 percent of residents in Assisted Living Facilities are aged 85 years or older.
As high as 42 percent of residents have Alzheimer’s and dementia.
Up to 64 percent of residents in Assisted Living Facilities required assistance with two to six daily self-care activities.
Up to 93 percent of residents in Assisted Living Facilities required assistance for activities related to medication administration, laundry, using the phone, cooking, grocery shopping, and the ability to complete chores.
Understanding Disability in Seniors
Having a disability needs some exploration. Before labeling yourself as a person with a disability, it’s important to understand how ‘disability’ is understood and better yet, defined. Many experts that study disability have a difficult time agreeing on how ‘disability’ is actually defined or understood. Some definitions are rather simple and clear to grasp while others tend to be more obscure – largely overlapping with the same meaning at the end of the day. Let’s take a look at a few ways that ‘disability’ is understood in the research world:
Disability: Difficulties in self-care tasks or household tasks. How did this team of researchers identify what disability may look like in seniors? A person would be provided with a questionnaire that asks if you could perform the 12 activities either ‘independently’, ‘needed help’, or ‘could not do the task at all’:
Transferring from one seated surface to the next seated surface
Using the phone
Getting to places outside of walking distance
Disability: The inability to function at one or more of three categories of ‘impairments’, ‘activity limitation’, and ‘participation restrictions’. This definition was formulated by the World Health Organization and is considered more comprehensive and inclusive. This definition is usually the most widely accepted definition, sees definition not only as physical attributes of a person, and takes into consideration the environment as part of disability.
Impairments: are problems in body function or structure such as a significant deviation or loss. An example includes a paralyzed limb, loss of limb, tremors, forgetfulness, poor memory, general weakness of body, and more.
Activity: execution of a task or action by an individual. This category takes into account what things are difficult to perform such as ironing clothes, sweeping, getting dressed, or any task that you would do on a daily basis.
Participation: involvement in life situations. A little bit more on the obscure side, but this category looks at anything that isn’t being homebound. Are you able to attend a birthday party, can you volunteer within the community, are you going to the gym, are you able to make your regular health check ups?
Disability: Referred to consequences of chronic or newly acquired impairments on the functioning of specific body systems and on mental, physical, and sensory functions in terms of…
Impairment or inability and structural abnormalities in specific body systems
Disability or restrictions in basic physical and mental actions
Handicaps or difficulties in doing activities of daily living.
This team of experts came to conclude that ‘disability’ can actually be understood through one single and simple question, “For at least the past 6 months, to what extent have you been limited because of a health problem in activities people usually do?” Would you say you have been: severely limited, limited but not severely, or not limited at all?
If there’s anything that would be considered the cream of the crop for gray areas, arbitrariness, and being on a spectrum, understanding ‘disability’ would definitely be a top contender. Now that we have a better understanding of disability, let’s look at an easier way to see what disability can actually look like in real life among seniors.
Shuffling steps, loss of coordination, stiffness, difficulty swallowing.
Can choke or aspirate if eating, unable to open containers, difficulty shaving, hard to step into the shower.
Unable to drive a car and grocery shop. Sense of insecurity with coordination and eating, leading to embarrassment with going to potlucks with friends.
Decreased leg range of motion, chronic pain, general body weakness from hospital stay.
Limited walking distances, unable to dress pants, unable to complete stairs, need to sit down for a shower.
Unable to attend events or get around areas involving stairs, need wheelchair accessible places only.
Paralyzed limb, no sensation in limb, disorganized thinking, poor judgment, decreased speaking ability.
Unable to feed self, cannot administer own medication, poses self in danger if left alone, unable to pay bills.
Friends may unintentionally exclude from hanging out due to stigma. Embarrassment from incontinence and limited options for cleaning self in community.
Disorganized thoughts, visual and auditory hallucinations.
Self-restriction of medications, not completing self-hygiene, unable to concentrate on activities.
Unable to maintain a steady job. Fear of causing discomfort for people in the community. Friends and family may intentionally exclude from attending events.
Looking at Your Own Disability
It’s completely possible that you may or may not have a formal diagnosis of a medical condition, whether chronic or new. But, do you still experience difficulty doing some activities on your own? Rather than focusing too much on a medical diagnosis, the formal definition of ‘disability’, shift your attention to activities that you are unable to complete yourself or have great difficulty completing on your own.
A very useful tool that you can complete all on your own asks you a series of 18 questions on a scale of 1-6.
Usually did with no difficulty
Usually did with little difficulty
Usually did with some difficulty
Usually did with a lot of difficulty
Unable to do
Usually did not do for other reasons
Examples of the questions include:
Doing light housework (such as washing dishes, dusting, etc.)?
Participating in community activities such as religious services, social activities, or volunteer work?
Lifting or carrying something as heavy as 10 pounds, such as a bag of groceries?
Managing your money, such as paying bills?
Moving in and out of bed?
Using the telephone?
Bathing or showering?
Using the toilet including getting on and off the toilet?
Climbing several flights of stairs?
When completing the questionnaire, the higher score indicates that you need more assistance with activities – a higher chance of having a disability with activities. How can this specific tool help guide your decision when transitioning to an Assisted Living Facility? Letting the staff know during your assessment period when moving into a new Assisted Living Facility will help ease the process to keep you safe in your new unit. The more honest you are with your limitations, the safer you are within your new home, and the longer you’ll be able to maintain your health for a meaningful life.
All You Need to Know about Assisted Living Facilities
As you become more aware and knowledgeable about your own disabilities as a senior, understanding the structure of navigating the Assisted Living Facility world is your next step before choosing your new home.
Finding an Assisted Living Facility: Using this database, you can kick start your search for an Assisted Living Facility that suits your budget and needs. Simply enter in your city, state or zip code and click the ‘search’ icon. A large list of facilities will populate along with personal reviews, photos, star ratings, summary of the facility mission, amenities, and address.
Cost of Assisted Living Facilities: The affordability of an Assisted Living Facility is not to be underestimated and overlooked. It gets quite pricey and because you are paying a large buck for your new home, you want to become as educated as possible. This read helps you understand how to best pay for an Assisted Living Facility while saving as much as you can.
Cost of Care by Zip code: You can enter the city, state, or zip code that you plan on residing. A cost breakdown will be provided from the latest year by way of hourly, daily, monthly, or annually. This tool is great because it not only provides the average cost for an ALF, it provides you with other average costs as well such as homemaker services, home health aide, adult day cares, and nursing homes.
Facts and Figures: Big into numbers and seeing data to help make an informed decision? This will be the right link to browse. Here, you can browse all 50 states and find helpful facts that will be shared regarding ALFs from region to region. You can find the average age of residents in each state, what percentage of residents have some form of dementia, and a percentage of ALFs that provide each service.
Consumer Checklist: Want to make sure you have all of your questions answered? Print out this link and it has a list of several questions to ask during your tour. You can cross out questions that are irrelevant prior to the tour or check off all the boxes for the questions that are most relevant to you.
Making a Successful Transition: One of the most useful links. How much prepping is too much prepping? If you want to make your transition easier make sure you use this link. This link provides what you should bring when moving in, making the emotional transition, having moving day helpers, and general advice for friends and family members.
Quick Fact Sheet: Short on time? No problem! This link provides useful visuals to gain a fair understanding of ALFs in a fast manner. Consider this your cheat sheet for the exam.
Pets in Assisted Living Facilities: Have a someone to accompany you in your move? It’s common among senior residents living in Assisted Living Facilities and also heavily welcomed! Take a quick read here to understand the guide to Assisted Living Facilities that accept pets with open arms.
Final Advice for Assisted Living for Seniors with Disabilities
Turn that page with confidence as the new chapter in your life is right around the corner. Although there continue to be unknowns, you’ve prepped yourself, educated yourself, and understand what your new abilities are. Rather than focusing on seeing yourself as a person with a disability and limiting the things that you aren’t able to do, move forward into the chapter by continuing to do as much as you can safely with vigor. The only way to beat ‘disability’ is to continue living your life and actively doing the things you love.
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Koob Moua, OTR/L, has a doctoral degree in occupational therapy. He works in a hospital setting to help people return to their lives after experiencing severe physical trauma, disability, or a new medical diagnosis through rehabilitation. On his free time, he advocates for his profession by publishing academic journals focusing on self-management of chronic diseases.