People unfamiliar with the Senior Living industry often think intuitively that “Independent Living” means a house or ordinary apartment building. However, the name was coined to contrast with Assisted Living, as Independent Living has no caregivers hired or managed by the facility. Its residents are “independent” of caregivers, and building management is “independent” of regulators. But this situation has evolved somewhat. Let’s talk about how Independent Living fits into the broader Senior Living industry.
Distinguishing Differences to Assisted Living
Both Independent Living and Assisted Living are apartment buildings surrounding a centralized dining room, with a meal plan. Both have an activities director and transportation to doctors’ offices and grocery stores. But the distinguishing difference is that Assisted Living communities are licensed health care facilities and have caregiving services hired and directed by the community. Independent Living communities are not allowed to provide any caregiving services because they are not licensed.
Outside Caregiving Services
However, most Independent Living communities have rented out an office to an outside caregiving agency that does have a license to provide residents help with activities of daily living. In the Austin, Texas area, these outside caregiving agencies have names like Halcyon Home, ComForCare, Brookdale Personal Services, and SeniorMinded Home Care. In combination with the outside agency, an Independent Living building can perform probably 80 percent of the services an Assisted Living can do.
Limits on Outside Caregiving Services
But there are a couple of critical differences as well. First, in Independent Living, the services provided must be schedulable. Spontaneous changes to the schedule are challenging in an Independent Living setting, unlike in an Assisted Living setting. Second, you are now dealing with two different organizations, which makes communication and coordination more difficult. For example, sometimes, the dining room staff might notice something is off with a resident. This information doesn’t always filter over to the caregiving agency, and signals get missed. Third, and surprisingly, it is sometimes an advantage for Independent Living buildings to not be regulated. For example, I know of a quadriplegic resident barred by regulation from living in Assisted Living because they are deemed “bed-bound.” Independent Living communities are governed by fair housing laws and aren’t allowed to even ask about disabilities. So long as the outside agency can meet that resident’s needs, they are free to stay.
Nicer Buildings and Amenities
Generally, Independent Living buildings have nicer amenities in comparison to Assisted Living. In Independent Living, there are almost always full kitchens, including stoves, and the apartments are bigger. Two-bedroom apartments are much more common in Independent Living. Sometimes there are pools and movie theaters, and occasionally washer/dryers in the apartments. In Assisted Living buildings, the kitchenettes generally only include a small refrigerator, sink, and microwave, and common areas are less enticing.
Independent Living is cheaper than Assisted Living. In Austin, the most affordable Independent Living apartments usually are around or just under $2,000 per month (depending on sales incentives). This price includes all utilities, three meals a day, an activities schedule, and limited transportation services. This price does not include the services of the outside caregiving agency. One-bedroom apartments in Independent Living in Austin run $2,500 to $3,500 per month, with the most expensive going for over $5,000. Two-bedroom apartments run from $3,200 to $4,500, with the most expensive being over $7,000.
Now nothing is cheap in the Senior Living industry. But Independent Living can be $1,000 to $2,000 less expensive than Assisted Living. This price savings can buy a lot of outside caregiving services. Therefore, from a price perspective, Independent Living can be a more affordable alternative to Assisted Living. But this can be false savings if a resident can’t live safely. So you must remember the requirement for care to be schedulable in Independent Living. This is particularly true if a resident is developing dementia because their care needs and behaviors may make them unsuitable for such an unsupervised environment.
In Austin, we have 31 Independent Living communities. They have, on average, about 144 apartments, almost twice the size of a large Assisted Living community.
I often get asked about the pricing services for outside caregiving agencies. This is hard to characterize because every outside caregiving agency has a different pricing scheme. For example, some caregiving agencies will charge a $10 fee for every pass of medication, which is $30 per day if you have three medication management visits. Others will charge a $450 fixed fee per month for up to three passes per day. Often a caregiving agency will break up the visitation charge into 15-minute increments, but sometimes they charge by the task. A load of laundry may be a $12 fixed price in some places or combined into an hourly charge elsewhere. But compared to the four-hour minimum charge for a visit to someone’s home, the flexibility and price of outside caregiving agencies are generally a good deal.
I will also note that licensed Home Health agencies, which are different from caregiving agencies, also come into Independent Living communities and provide Physical and Occupational therapies and short-term nursing services. Even Hospice can come into Independent Living buildings, though that is less common than in Assisted Living or Memory Care settings.
In comparing residents in the two facilities, one reason for many people to prefer Independent Living is that the overall cognitive health of its residents is better. Therefore there are more candidates for friends and socialization. Of course, 15% to 25% of people in Independent Living have cognitive challenges. Some residents have stayed there long enough that dementia developed after they got there, or they may have simply developed a mild case of “the forgetfuls.” In other cases, new residents and their families are not yet able to recognize the beginnings of memory loss. Nevertheless, cognitive decline is substantially less than in an Assisted Living, where it afflicts probably 50% to 75% of the residents.
There are plenty of residents with walkers in Independent Living, so don’t think that having a walker means you must go to Assisted Living. But severe mobility problems are a good reason to go to Assisted Living because people with severe fall risks generally don’t get enough oversight in Independent Living.
I hope this introduction to the Independent Living segment of Senior Living has been helpful.
My name is Michael Gill of Texas Senior Living Locators. If you need help finding an appropriate solution in Assisted Living, Memory Care, or Independent Retirement Living in the Austin area, please give me a call at (512) 630-7133.