11 Signs It Might Be Time for Assisted Living

If your loved one is starting to have trouble completing activities of daily living (ADLs), such as dressing, bathing, and using the toilet, this could indicate the need for more care such as that provided in an assisted living community. The need for this type of help is common. Approximately 13.8% of adults aged 75 and older needed personal care assistance in 2024, according to data from the Centers for Disease Control and Prevention (CDC). ^[01]

Linda Lagesse, 78, served as her husband’s sole caregiver for nearly four years. An inability to assist with ADLs motivated her to contact A Place for Mom’s Senior Living Advisors to find assisted living for her husband. “I bathed him. I dressed him. I tried to help him get exercise,” Lagesse recalls. “I was exhausted. It just got to be a lot.”

If your loved one lives at home, you may notice they’re lacking energy or resources to shop for groceries and may even be losing interest in cooking. This can negatively affect nutrition, leading to unintentional weight loss or gain. If your loved one has health conditions that require a specialized diet, such as low- or no-salt, they may struggle to properly nourish themselves. In assisted living communities, residents typically enjoy nutritious meals based on dietary needs, without having to cook.

Dining in assisted living is flexible, too. You can find the following features and options in most assisted living communities:

• Complete nutrition and ingredients that touch on every food group
• Fresh fruit, healthy snacks, and drinks available at any time
• Daily menu with always-available options
• The option to select a special meal plan that accounts for diabetic, low-sodium, kosher, and other diets
• Dining rooms designed to foster conversation during meals

Errors in medication management can pose a serious danger. According to the CDC, adverse drug events cause more than 600,000 emergency department visits each year among adults aged 65 and older.^[02]

Maureen Bradley, a former executive director for senior living communities who now supports new Senior Living Advisors at A Place for Mom, notes that medication management is an excellent service that assisted living provides.

Staff in assisted living communities can remind residents to take their medications on time or administer medications if needed.

“It’s very important to find out how medication management is administered, as there are subtle differences from one community to the next,” says Bradley. “For example, some communities require that residents use a certain pharmacy because that makes it easier for the communities to track and store medications. Also, in terms of cost, some of the communities include medication management in their base pricing and others charge for it separately,” she says.

Read more:An Overview of Medication Policy and Procedure in Assisted Living

Is assisted living the right fit?

In general, residents of assisted living communities are mostly independent, but they may need help with brushing their teeth, taking their medications, showering, or completing other activities. Your loved one may also choose assisted living for socialization and mental stimulation.

Barbara Levison, a geriatric care manager and the president of Florida’s Aging Life Care Association chapter, urges families and caregivers to educate themselves on the various types of care available and the many differences between those options.

“If your loved one is experiencing cognitive decline and needs constant supervision, then they would need memory care as opposed to an assisted living facility,” says Levison. “Also, if it’s difficult for them to hold a conversation, they would be more comfortable in a memory care facility where residents have similar abilities.”

If your loved one has advanced medical needs, a nursing home may be more appropriate. “Each community makes its own determination about how much care is too much,” says Bradley. “Some common medical conditions that are beyond the normal scope of care for assisted living include advanced dementia, any conditions that require a permanent IV, serious or multiple wounds, and comorbidities, which is multiple serious medical conditions at once,” she says.

If your loved one lives alone at home, they may have minimal interaction with other people their age, and this can lead to loneliness and depression. Assisted living residents, however, often form social connections with each other, staff members, and even community pets.

“They’re also exposed to people of different generations in the form of staff and visiting family and friends,” says Bradley. “Many communities are pet friendly, which allows folks the chance to enjoy furry friends. Even if a resident doesn’t have a dog of their own, for example, they can enjoy their neighbor’s.”

These friendships and connections can help prevent senior isolation, as well as increase your loved one’s likelihood of participating in enriching activities. Assisted living communities encourage residents to get involved with activities such as fitness classes, happy hours, and game nights.

Read more:Beyond Bingo: The 50 Best Activities for Seniors in Assisted Living

Daily chores and home upkeep may eventually become stressful for your loved one and their caregivers. Home repairs can be complex and expensive and may be unsafe for some to attempt. If you notice that your loved one’s home is increasingly disorganized or unclean, this could signal that assisted living might be the right move.

Assisted living communities relieve residents of these responsibilities by providing services such as:

• Vacuuming and dusting
• Bed-making
• Bathroom cleaning
• Laundry assistance
• Community maintenance
• Trash removal
• Sidewalk and driveway clearing
• General landscaping and maintenance

Your loved one may have a bedroom upstairs that’s becoming difficult to access, smaller hallways that aren’t wheelchair- or walker-friendly, or a bathtub with sides that are too high to step over easily.

A big advantage of assisted living communities is that they’re designed to meet the needs of seniors with features such as:

• Wide doorways and walkways
• Walk-in showers
• Personal alert systems or alarm cords in the apartment
• Nonslip flooring

“Even for people who may not need those features today, it’s wise to choose communities that offer them in case needs change over time,” Bradley says.

In Bradley’s opinion, it’s time for assisted living when the need for help outweighs the resources available.

“As we age, we start to need help with ADLs, basic housework, and home maintenance,” she says. “At first, family and friends can be asked to help. It even makes sense, for a time, to consider home care as a means of support. But at some point, the cost of assistance, be it financial or just a time drain on the family, becomes too great. At that point, it makes sense to consider assisted living.”

Answering the following questions can help you determine if you need the support that assisted living can provide for your loved one:

• Are you or other family members missing time at work or sacrificing other obligations to care for your loved one on a regular basis?
• Does your loved one need overnight support?
• Is the cost of an in-home caregiver becoming a financial burden for your loved one or other family members?
• Is your relationship with your loved one becoming strained as you focus more on your responsibilities as a caregiver?

“Even though caring for a loved one can be incredibly demanding and difficult, it’s also hard to let go,” says Bradley, referring to the start of a loved one living in assisted living. “This is a very common occurrence. I’d recommend that caregivers plan to visit their loved ones regularly but make a concerted effort to keep the visits social in nature. That can be having lunch, playing bingo together, enjoying a movie, going for a walk or any number of other activities. When I was an executive director, I used to say to family members, ‘Let us be the caregivers. That’s what you’re paying us for. You just concentrate on being the daughter again.’”

Assisted living questions? Get expert help

Seeking counsel from your loved one’s doctor can give much-needed insight. For Lagesse, this meant reaching out to her husband’s cardiologist and his primary care physician, both of whom supported her in moving her husband to assisted living.

Just as a doctor’s opinion can comfort a caregiver, it can also boost a senior’s confidence and enthusiasm in the decision to move to assisted living. Seniors are more likely than younger people to trust their doctors.^[03]

Read more:How to Speak to Your Parent's Doctor

Caregiving may take a toll on you or another family caregiver before either of you realizes it.

“One of my friends stayed with my husband so that I could get away for a couple of days,” Lagesse recalls. “When I got home, he met me at the front door and said, ‘Linda, you cannot continue to do this. This is too much.’ That was really the turning point. It was eight days later that my husband ended up back in the hospital. I knew I had to do something. I couldn’t continue to do what I was doing.”

Levison encourages families to act sooner rather than later if they think it’s time for assisted living. “In my experience, families and caregivers often wait until things are progressing to a breaking point before looking for assisted living options,” she says.

Read more:Becoming a Family Caregiver: Costs and Support

If coordinating care for your loved one has become a struggle, this too may signal the need for assisted living. For instance, before his move to assisted living, Lagesse’s husband experienced frequent health issues that continually landed him in the hospital. “He kept getting sick, which meant that he was not getting the care he needed from me,” she says.

In addition to the emotional and physical toll of these hospitalizations, her husband’s regular appointments with many doctors and specialists became overwhelming.

Assisted living communities help coordinate care for residents. Doctors, physical therapists, and other health professionals may even provide their services within the community. For residents who wish to continue to see their own doctors and care providers, many communities provide transportation to nearby clinics.

Bradley notes that assisted living care staff are in frequent communication with a resident’s physician. “Assisted living facilities excel at care coordination,” she says. “They’re often better at keeping physicians informed than families or home caregivers were. This is because they have regulations or systems in place where they fax accident and incident reports to the doctor, as well as medication records, just by regular course.”

Read more:Person Centered Care and It's Role in Assisted Living: A Guide

If you think it’s time to talk with your loved one about assisted living, the following steps can help you navigate this discussion and potential move:

• Bring up the idea with your loved one and other family members. Share specific concerns, such as missed medication doses, difficulty bathing, falls or near-falls, signs of loneliness, or growing caregiving demands. Listen to what your loved one wants and expect the conversation to continue over time.
• Identify the support your loved one needs. Consider the type of support your loved one could use most, such as help with daily activities, medication management, meals, transportation, home upkeep, social connection, and overnight or emergency support. Also find out your loved one’s preferences for location, budget, and the routines they would most want to maintain in an assisted living community.
• Tour assisted living communities and ask how each one could meet your loved one’s current needs. Use an assisted living touring checklist to compare services, apartment features, staff support, activities, dining, and costs. Ask how each community would handle a potential increase in your loved one’s needs.
• Get help comparing local options. A Place for Mom’s Senior Living Advisors can help you find assisted living communities that match your loved one’s needs, preferences, and budget, then help you arrange tours.