Your CarePatrol Senior Advisors share their knowledge and experience when considering placement in an Assisted Living home. Learn more about Assisted Living care to help you make the right decisions for you and your loved ones.

How Will We Pay For Assisted Living?

The average cost of assisted living is about $4,500 per month, but can be as low as $1500, or as high as $8,000.  These prices include rent and care costs, but do NOT include the cost of health insurance or medications, clothes or other personal items.  Included items are meals, utilities, upkeep of facility, real estate taxes, and other expenses usually associated with living at home.

Most people pay their assisted living costs from two sources: their monthly income and their assets like the sale of their home, IRA, bank savings, CDs, stocks, etc.  It is not an uncommon scenario for a family to clear about $120,000 from the sale of the house (after minor repairs, real estate agent fees, etc.).  If $2,000 per month income is available after insurance and medications are paid for, average assisted living costs can be covered for about four years.

Veterans Benefit:

Another source of payment available to veterans and their spouses is called the Aid and Attendance benefit.  If the resident or their spouse has served in the military during a wartime period, they may be eligible.  We strongly advise our clients to use a trusted company to help them apply for this benefit.  This will help ensure they actually get the benefit and expedite the beginning of payments.  Unfortunately, we have heard some very sad stories from families who did not use a service to help them apply for this benefit.  Call us for details.


Most assisted livings are private pay, meaning the resident must pay the cost directly.  Health insurances like Medicare, Human, and Aetna do not cover the cost of assisted living, just like they don’t pay one’s mortgage payment or the cost of a hotel stay.  The only time insurance will pay for assisted living is if the resident has a long-term care insurance policy.  


Medicaid, a welfare program, will pay for some assisted living situations.  Generally speaking, in Virginia the individual must make less than about $1210 per month and have less than $2,000 in assets.  A UAI (Uniform Assessment Instrument) must be completed by an authorized assessor in order to determine if a resident will qualify for Medicaid services.  Your first step is to call your city or county’s Department of Social Services (Go to and locate the button “Find Local Office”).  In Virginia assisted living facilities that accept payment from Medicaid are called “Auxiliary Grant” (AG) communities. Residents who cannot ambulate (walk) on their own or who have more advanced cognitive issues will not qualify for AG facilities but will instead need to be placed in a nursing home that accepts Medicaid.

If you have questions, don’t hesitate to call us.  Our help is provided at no charge to you and we won’t share your information with anyone.  You’ll be surprised at how good you’ll feel having solid information to make an informed choice!

How Much Does Assisted Living Cost?


The short answer is, between $1,500 and $8,000.  The long answer starts with, “It depends.”

Communities usually have three charges.  The first is a one-time “community fee” that ranges from $0 to $5,000, but is usually in the $2,000 range.  This fee is NOT an ANNUAL fee but simply a one time, up-front cost.  What is it used for?  Costs associated with getting the room ready (new carpet, paint, cleaning, etc.) and administrative tasks (e.g. paperwork required by Virginia’s Department of Social Services, a community’s corporate paperwork, etc.).

The second cost is rent.  This cost depends on the size of the room, and how nice the community is.  Certain neighborhoods demand higher prices.  Typically, newer communities cost more.  A small studio is less expensive than a large two-bedroom apartment.  A private room is more expensive than a semi-private room (a room or apartment that is shared with another resident).  Sometimes there is a price difference based on the location of the room in the community.  So, for instance, a room closer to the elevator or main room may be more expensive than one further away.

Care is the final factor in determining how much assisted living will cost.  Communities charge for care a variety of ways.  Some include a great deal of care in their base price (rent).  These communities may include as little as medication management, or as much as med management, bathing, dressing and grooming.  The initial rent cost is usually higher in these communities because they include these services.

Other communities calculate care costs on a point system.  Points are usually based on how long the community thinks it will take the care giver to provide the level of care needed.  For instance, bathing help for one resident may mean that the CNA (Certified Nursing Assistant) simply stands outside the bathroom.  That might be worth one care point.  For another resident, the CNA may have to completely help them with the bathing process, from getting in and out, to washing their hair and body, to drying off. That may be five care points.  Points are assigned for each of the ADLs (activities of daily living which usually include ambulation, toileting, bathing, dressing, grooming, transferring, eating) and the sum of these points determines the level of care.

Once we’ve toured you to communities that make sense for you, choose your two favorite communities to do an assessment, which is required by law. You can either bring your loved one to the community or the community will send someone to the home or facility to do the assessment.  Assessments are not intrusive, and usually consist of simply asking questions and looking at medical records (if your loved one is in the hospital or skilled nursing facility).  This assessment will help the community give you an actual number for the care costs, which in turn will help you make a decision.  

Your final monthly costs are then the sum of the cost of the room you’ve chosen plus the care costs.  But don’t forget the one-time community fee!

If you have any questions, don’t hesitate to call us!  Our help is provided at no charge to you and we won’t share your information with anyone.  You’ll be surprised at how good you’ll feel having solid information to make an informed choice!

How Can Medicare Affect Senior Housing?


The Medicare program has been affected the past few years by the implementation of The Affordable Care Act of 2010 and the I.M.P.A.C.T. Act of 2014. These legislative changes were designed to move the risk of care costs from the Federal Government to healthcare providers. These adjustments mostly affect what is referred to as “straight” Medicare, not the Advantage Plans that insurance companies offer.  It does, however, affect the “gap” policies that insurance companies offer to pay the charges that Medicare does not cover.

Each year the rules that healthcare providers and insurance companies are required to follow change, so be sure to review your coverage every year. The commonality of the complicated changes each year is an idea called value purchasing. By focusing on each patient, a concept referred to as Patient- Centered care, the expense of healthcare can be reduced by shorter stays in hospitals and rehabs, fewer visit by home health professionals, and more responsibility for Primary Care Physicians, who should know the patient’s needs the best.

The entire system is based on family care, meaning the primary caregiver is a family member who provides unpaid custodial care at home for as long as each patient needs it. Custodial care is the assistance with activities of daily living, largely affected by the need to move about and accomplish personal care tasks. When a willing competent caregiver is available the system works well. Potential gaps include seniors living alone, spouses too frail to provide the family-care solution, or other family members unavailable due to careers.

Senior Housing, Independent, Assisted, and even Nursing Homes provide the meals and transportation required, as well as housecleaning.  Most provide or have available caregivers to replace the anticipated family member for care requirements.  When this is needed for short terms it is referred to as respite care.  Longer periods can be called long-term care, but a more common terminology for the assistance needed is Assisted Living. The industry has responded with a system that only requires a 30-day notice to leave.

With the peak of 10,000+ Baby Boomers joining Medicare daily still a few years away, it is highly probable that this effect will not change. The custodial care options are paid for privately, and not covered by Medicare. Therefore, caregiving by family or hired as homecare or Assisted Living care does not add cost to the Medicare system. Planning for the probable years that care will be needed is very important. CarePatrol is here to help even if there has not been a plan before. If Long Term Care Insurance has been purchased already, it eases the situation.

What is a Competent Caregiver?

Hospitals and rehabs discharge seniors to family but are required to ensure the discharge is safe. AARP said in 2013 that 40 million family caregivers provided 37 billion hours of care worth an estimated $470 billion. The American healthcare system relies on 80% of care being provided by family caregivers. In addition to the loss of income often associated with taking time off from work to provide the care, a 2016 study found caregivers spent $6954 out of their own pockets during the caregiving episode. Dementia patient caregiving is not temporary.

The assumption in all this is that the caregiver is available, willing, competent, and adequately trained for the role. Each patient being discharged has different needs, capabilities and strengths. Each caregiver has strengths and weaknesses as well, plus the duration, scope and intensity of the needed caregiving varies by individual situation. Often the need to make decisions and the emotional and technical challenges become stressful. Yes, very few healthcare facilities use a caregiver-assessment process for discharge.

Caregiver burden is defined as a negative reaction to the impact of providing care. If they do not have the knowledge and skills, they can inadvertently harm their loved one. Medication errors, family conflicts, and a risk of elder abuse from the stress are just some of the possible results. The negative effect on the caregiver from neglecting their own health to risking injury and lack of sleep should be considered. Navigating the complicated healthcare system for another and monitoring side effects are part of the caregiver expectation.

In addition to personal care such as assisting for toileting, showering, and transferring in and out of beds and chairs, the financial decisions and instrumental activities of daily living are often overwhelming, especially if it is a spouse of an elderly person who may have health issues of their own. CarePatrol addresses all these situations with a proprietary discharge system that considers the needs of the patient and the needs of the caregiver (or if there is no caregiver). Even with increasing chronic needs for dementia patients, our plan works.

A competent caregiver can provide 24/7 appropriate care to specific patient needs for the duration of time he or she will need it. A competent caregiver is someone who recognizes when they need help, how much help they need, and is willing to make the financial sacrifice to accomplish the goal. Hospitals and rehabs should recognize the holistic needs, not just the medical needs, and discharge safely. This may include finding the assisted living, memory care, in-home care or independent living communities needed. That is the mission at CarePatrol.


What Exactly is Assisted Living?


When the parents of the Baby Boomer generation were raising their families, the average lifespan for Americans was 67.  For the small minority who did not live with their children as they reached old age, communities had rest homes or retirement homes. When the Older Americans Act and Medicare/Medicaid became law in 1965, the added healthcare created buildings known as nursing homes. While a few smaller board and care homes remained, federal government funding made nursing homes the new normal.

Increased institutionalism over the next couple decades opened an opportunity for a more homelike setting that also provided healthcare. The goal of the least restrictive environment became known as assisted living and quickly was influenced by the hospitality industry. Those three attributes – housing, healthcare and hospitality – resulted in the first public companies in the rapidly expanding assisted-iving industry in 1995.  In July of 1999 the Supreme Court issued a ruling in the Olmstead case insisting on access to community-based care versus institutional care.

Today’s assisted living industry is preparing for those Baby Boomers born between 1946 and 1965. Unlike their parents, whose lifespan ended a year or two after retirement, Baby Boomers expect 13 years of retirement. The post-retirement that comes from the increased longevity means those age 75+ is who the growth is focused on.  In 1970, less than 8 million Americans were 75 or older.  50 years later, before the first Baby Boomer turns 75, we have over 23 million in that age group.  By 2030 there will be 34 million Americans over age 75.

The number of assisted living communities around the country has grown dramatically along with the aging population. The demographics are undeniable as the growth is poised to increase even faster. This type of living provides a homelike apartment, meals, housekeeping, transportation, activities and includes utilities.  It adds hands-on care, medication administration or management, and other personal services including emergency response.  A variety of nursing services are available based on licensing in each state.

The socialization aspect of assisted living that is often missed is the serious health concerns that come from chronic loneliness. Studies have shown the positive effect socialization has on the immune system, sleeping patterns, and even blood pressure. In many markets the newest assisted living communities are more like cruise ships on land and provide almost a party atmosphere.  One-third of all seniors over 65 live in the four most populous states of California, Florida, Texas and New York. Investors in senior housing, however, see opportunity in all the states.

Alarming Myths About Senior Living


It is human nature to believe myths about senior living, but it can also lead to needless worry and hinder positive aging and safety.  After working with thousands of families we collected some common ones that often start from a false perspective about aging. “To be old is to be sick” ignores the huge improvement in rates of chronic disease and disability. “You can’t teach an old dog new tricks” does not account for the high degree of neuroplasticity human brains have. “The horse is out of the barn” ignores payoffs from healthier lifestyles.

  • Moving into senior living will cause me to lose my independence.
  • Talking with my family about this will only alarm them.
  • The government will take care of my estate.
  • Medicare will pay for all my long-term care needs.
  • People lose their memory as they age.
  • I’m not well, so exercise is a NO-NO.
  • It’s best that I wait until I can’t care for myself.
  • Using a walker only makes me dependent.
  • The food is bound to be terrible.
  • I don’t need my vision and hearing checked annually.
  • There won’t be anything to do in these places.
  • People become less productive and creative as they age.
  • I can’t take my pets with me in senior living.
  • Falling happens to other people, not me.
  • Communities are more expensive than homecare.
  • All communities are the same.
  • Frailty can’t be reversed with exercise and nutrition.
  • Senior living is only for old people.

All these myths are not true, but may fit your perspective. If they do, give us a call for a free tour of the “right places” for your personalized needs and wants. Being productive again and safe living is often attitudinal. Life experiences and expertise can be important to others. Positive lifestyle changes –  socially, behaviorally, and physically, often make an enormous difference in daily life. Reduce the worry for you and your children by having a plan that uses real facts, not false myths.

Board and Care Homes – a Great Option for Seniors


For seniors who prefer to live in a smaller setting, a board and care home may be a good option. These facilities are residential houses that have been outfitted and staffed for a small group of seniors to live in a family-like setting. Board and care homes go by many different names, depending on the area they are located. In some states, they are most commonly referred to as group homes or residential care homes. In California, “board and care home” is the most commonly used terminology.


What’s Included?

Board and care homes are meant for seniors who need some assistance with daily activities but do not require skilled nursing assistance. The level of care provided is similar to what’s offered at assisted living communities. Typically, all three meals and snacks are included in the cost of rent. Most homes include cleaning and laundry services as well. Caregivers are on standby to assist with activities like eating, medication management, toileting, and personal grooming.

Licensing requirements vary by state. In California, licensing is handled by the Community Care Licensing Division of the California Department of Social Services. Your CarePatrol representative will be able to help you find a reputable board and care home that meets your loved one’s needs.


How is it Different?

Assisted Living facilities tend to be more well-known than board and care homes because they house more residents – often 50 to 200 or more. They also have a robust activity program.    Also, food is served in a main dining room.  These are the main 3 differences between the two types of facilities. There is no standard definition for board and care homes throughout the United States. In California, a board and care home is a senior living facility licensed to care for 6 to 20 residents who need some assistance, but do not require ongoing skilled nursing care.

Outside of California, the requirements and terminology do change a little. So keep that in mind if you live out of state, or you are helping a senior loved one who lives in another state. Residential care home, group home, and personal care home are all terms that refer to essentially the same thing.


What Should We Look Out For?

Board and care homes are a great option for seniors who are transitioning from independent living to long-term care. While researching options available in your area, make sure any board and care homes you look at meet the following criteria:

  • It has a cozy environment that feels more like a home than an institution.
  • It has adequate staffing so that all residents get plenty of attention.
  • Residents are able to relax and spend the day how they choose.

Now, board and care homes are not the best option for all seniors. It’s important that you consider assisted living facilities as an option as well. Typically, assisted living facilities differ from board and care homes in the following ways:

  • Assisted Living options have more amenities and planned recreational activities.
  • Board and care homes typically have shared kitchen and living spaces whereas some assisted living residents have their own full apartment or attached kitchenette.
  • The smaller population at board and care homes can make it more difficult for seniors to find friends.

No matter what type of assistance your loved one needs, your local CarePatrol representative can help you find the perfect fit. Set up a time to talk with us if you have questions about board and care homes, assisted living, or any other concern.

Can Guilt Be Dealt With?


Guilt is a common emotion that Wikipedia calls “a cognitive experience that a person has when they compromise their own standards or have violated a moral code they were taught”. Psychologists say we start feeling it before age 5, and it is nearly always concerning other people. Understanding its origin will help you deal with situations where it raises its head inappropriately.

As older family members age the time for assisted living is rarely planned for. The assumption is it won’t be needed and if it is, other family members will step in as caregivers. In some families there are even promises made that placement will not happen, often made during times of great health. Physical frailty or cognitive decline eventually brings up the potential for discussion.

Early turmoil comes while making the decision that it is time for placement. Despite family desire to care for a loved one at home and simultaneously remain in the workplace and maintain all other commitments, it becomes overwhelming. Physician or clerical advice that it is time may ring true mentally but emotionally the guilt can get mixed with anxiety and even fear.

Acknowledging and expressing those emotions head-on is the best way to deal with guilt. If you don’t have trusted confidants to bounce things off, a business exists that allows just that. You can contact a Life Guide at Lifeguides partnership with CarePatrol will match you up with a guide who has been through the process you are facing. CarePatrol provides for two free sessions and you’ll feel better. It will also be easier to take action after talking through it.

Even after working with a CarePatrol placement professional to find the safe and appropriate senior living community for your family, the guilt may not fade away nearly as fast as you would prefer. Your LifeGuide will still be at the other end of the phone to share your feelings with in a confidential and stress reducing way. Guilt, like all negative emotions, can be dealt with. Having a professional team on your side helps.

The Payback Decade


For most people, the decade between age 75 and 85 is when the body communicates that it is payback time for all the things done to it earlier in life. When those body parts complain they often use the communication method of pain. Medical care continues to improve, so average life span has moved from 75 in 1989 to 81 today. A normal human response to pain is to move around less, attend fewer social outings and request pain medications. That results in an impaired immune system and possible falls as movement and socialization are key parts of the immune system and muscular support.

The good news is that frailty is reversible. The beauty of assisted living is that the movement and socialization are disguised as FUN. Before you or your loved ones hits the age of the payback decade, establishing a plan designed for maximum health and satisfaction is wise. Pain relief can be addressed with non-prescription ways that help overall health. Many people find themselves in the “sandwich” generation. Elderly parents to care for, growing children that still need attention, career considerations, and dealing with all the unknowns of the rapidly changing systems. Doctors and documents become keywords. Estate planning, tax and risk avoidance, and trusts or wills can’t be put off any longer.


When is Aging in Place Wrong?


Studies indicate over 80% of seniors want to spend the rest of their life in their home, a concept called aging in place. Most companies, agencies, and senior care professionals work toward that goal. There are however some exceptions to aging in place as the desired lifestyle.  The first is safety, and the second is social.  A reminder of Safety Or Social is SOS, the universal call for help. Let’s examine twenty areas of concern that need to be addressed for safety:

  1. Forgetting to take medications – or taking more than the prescribed dosage (or sharing)
  2. Diagnosis of an identified dementia or Alzheimer’s – forgetfulness
  3. Spoiled food that doesn’t get thrown away – poor diet or forgetting to eat
  4. Dirty house, extreme clutter and dirty laundry piling up – decline in grooming
  5. Missing important appointments, especially doctor’s appointments
  6. Unexplained bruising, or continual skin tears that invite infection
  7. Trouble getting up from a seated position or trouble getting out of bed
  8. Difficulty with walking, balance and mobility – unexplained dents on a car
  9. Uncertainty and confusion when performing once-familiar tasks
  10. Expenditures for un-needed repairs or purchases – changes in activities
  11. Infrequent showering or bathing – use of perfumes to mask
  12. Stacks of unopened mail – late payment notices – bill collectors

While each of those 12 are of great concern there are situations that make out-of-home placement an urgent priority for the safety of the senior:

  1. Wandering from home (or driving and not remembering how to get home)
  2. Frequent medication mistakes, especially if medications are for a disease
  3. Unsafe behavior like leaving the stove on or front door unlocked.
  4. Cannot afford an in-home caregiver for an adequate number of hours
  5. Physical abuse of spouse, caregiver or self-neglect
  6. Lack of adequate fluids or nutrition
  7. Increased falls
  8. Signs of depression

While safety is key, the last item (depression) is often a link to a need for social interaction. The National Institute on Aging reported studies that show social relationships are consistently associated with bio-markers of health and social isolation constitutes a major risk factor for morbidity and mortality. Those without adequate social interaction were twice as likely to die prematurely. Social isolation impairs the immune system and boosts inflammation. Even worse, in our society people are reluctant to admit to loneliness. Seniors want to participate in social activities and need to be with other people, but the opportunities are often reduced and a resulting focus on self then moves thoughts to negativity. In these cases, they can become trapped in their home by a lack of mobility and loss of family and friends.  The social interaction in communal living like independent and assisted living communities often helps. If your family has an SOS, call us at CarePatrol.  Our free community service finds an immediate solution.


Tips for Moving Loved Ones into Assisted Living


After all the researching, tours and talking with loved ones you are now ready to help them move into the community you all felt was the best fit.

Now the real challenge and worry can come into place for the new resident.  They have had many first-time nerves like the first day of kindergarten, wedding day, or bringing their first child home from the hospital.  All these first will be no different than the feeling they get when moving into their new home. It can be really tough on your loved one getting to know everyone, not doing or saying something wrong to those new friends, and of course the realization of knowing you are never going back to your old house.

With this in mind we wanted to share a few suggestions to you that will help your loved one handle this new step into a great community, and what all can be done to help with what they may be feeling.

Help your loved one be fashionable.  Showing up in a new outfit or with updated accessories can really help them feel confident and comfortable.  Take them out to a local store and work with them to find the new popular color and combination that really fits them and is currently in style.  These new items or outfit might just spark a great conversation which breaks the ice and gets them talking about all different things.

Another great tip is to help them find a friend that has common interests as they do.  Talking to the community about this can really help and they should be able to guide you in the right direction to match those common interests.  Ask that your loved one be able to sit next to that person or persons who they share interest, hobbies or whatever it may be to get them talking and enjoying their time together.  The more friends they make in a short time will help get them into more activities, which help them meet even more people which adds to them enjoying their new home.

Don’t let them be in a rush to make a snap judgement on their new home or new friends.  It’s not going to be easy for them at first and not everything will be perfect or go the way they want.  As with any new situation you need to get comfortable with how things are done, adapt and let the community get to know them and how they like things done.  Encourage your loved one to try the new things, explain how they like things done and find the happy middle when possible.  Once they have been in the community for a while and gotten to understand how things work, then you can talk more in depth about the situation and if it will work out for them in the long run.

Another great suggestion is to make your loved one’s new home feel like home, and as close to what they are use to as possible.  Don’t just move boxes in and leave, help them unpack and take as many boxes away as possible.  You want their apartment to feel as comfortable as it possibly can be and be comfortable that first night when they go to bed.  Make sure you have the bed pillows and some of the little things in place to help them sleep better and wake up relaxed.  You can also take pictures of their old house and how everything is set up before moving the items, and then set them up the same way as before.  They are use to things in certain places, so don’t shake it up for your liking, but set it up as they have always liked it.

Lastly, the most important thing might just be having the first meal with them in their new home.  By doing this you will add a little bit of comfortability to their stressful situation, and you can get to know a few of the other residents as well.  Definitely ask the community to sit with a few residents and not just go over on your own.  By doing this your loved one will be able to get to know a couple other residents without being thrown in deep to the new community setting.  A lot of communities will provide you with some free meal passes, so take advantage of that and in the first month or two make sure you stop in to visit, have a meal with your loved one and meet their new friends while hearing about the exciting things they have been doing.

Hopefully by doing these tips your loved one will have a successful first few days and months in their new home, and want to stay and make the most of their new house and life!