Assisted Living or Residential Care, How To Choose?

Residential Care Homes For Seniors

While some dementia patients require 24-hour care, the condition of many dementia patient’s is not severe enough to warrant the around-the-clock medical care supplied by traditional nursing homes. To better serve the portion of the dementia population that does not require constant care, residential care facilities provide another viable option.

Residential care for seniors, usually referred to as an assisted living facility or residential care facility, is becoming an increasing popular option across the U.S.

As of 2019, over 35,000 residential care facilities provide care for over one million dementia-afflicted seniors nationwide.

Assisted living facilities can be a better choice for dementia patients who don’t need constant supervision and care. These facilities offer an alternative style of care for seniors who require some assistance with daily chores and activities, such as preparing meals, housekeeping, medication management, bathing and dressing.

Residential care facilities are not licensed by the state as nursing homes, they're licensed as RCFE's (Residential Care Facility for the Elderly). Consequently, residential care facilities do not operate under the same federal rules as nursing homes because they are non-medical facilities. Instead, RCFE's are governed by the laws of the state the facility is located in.

In response to the rapid national growth of residential care facilities, and to address the increasing demand for dementia care units for seniors with Alzheimer’s disease and other forms of dementia, many states are expanding their regulations for assisted living facilities.

Up to an estimated 50 percent of residents of assisted living facilities experience some type of cognitive impairment. As a result, many assisted living facilities are now offering dedicated dementia care services. However, there is currently no minimum staffing requirement for facilities that specialize in dementia care.

Because people with dementia are considered a “high-care needs group,” facilities that provide residential care for seniors should be adequately staffed to meet the needs of residents who require dementia-care services for the term of their stay. Here you should exercise extreme care when choosing an assisted living facility for dementia care of your parent.

You must make certain the staff is sufficiently trained and the facility has specialized services in place to meet the needs of your loved one. In fact, a residential-care facility with a specialized dementia-care unit should have increased staffing relative to the rest of the facility. However, because state laws can vary so much, assisted living facilities can have varying policies in regards to the types of residents they will accept and the kinds of services the facility provides.

Some assisted care facilities are dedicated solely to the care of dementia patients, whereas other facilities may accept a broader range of residents and have a dementia-care section on site within the larger facility. Additionally, different facilities may have radically different “move-in and move-out” criteria, so it is crucial that you understand what these criteria are when screening a residential care facility.

Some assisted living facilities will offer an “aging in place” service where they provide additional care services as the patient’s condition and needs change. However, any increase in services will usually also result in an increase in cost. Bear in mind, the cost of care in a residential facility is typically a major factor in making a placement decision, and costs will vary significantly between facilities and states.


Typically, costs for assisted living facilities is covered by private funding and Social Security disability benefits. However, there are private insurances that will cover the cost of care and Medicaid may pay for a portion of care. Veterans’ healthcare benefits may also be available to those who have served in the armed forces. Typically, residents in an assisted living facility will continue to see their own personal caregiver or healthcare provider.


To make it easier for family and friends to visit, be sure to take the facility’s geographical location into account when considering residential care for seniors. Being able to make regular visits helps many families feel more at ease with their choice of facility. This will allow you and other family members to stay actively involved and ensure your loved one is receiving the quality care you expect and your parent deserves after placement.

Final Considerations

There are a few final considerations to keep in mind when selecting an assisted living facility. Independent expert research suggests that location is a major factor in choosing a facility. Research also shows that regular family visits contribute to the overall wellbeing of your loved one.

Be sure to consider all your options in regards to cost. Factor current as well as future costs into your decision to help determine what is and will remain financially viable for your family over the long term.

After you have chosen a geographic area and calculated your financial limitations, call all the facilities that have made it onto your list and ask the facility directors the same set of screening questions. The answers to your questions will aid you in deciding which facilities will make it onto your short list of places to visit in person to decide which ones best fit both your and your parent’s needs.

By Care Homes Direct Editorial Team

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