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  • Dr. Brindusa Vanta, MD

Assisted Living for Seniors With Disabilities

Many seniors develop diverse disabilities that can impair how and where they live. There are also those who have lived with a disability through adulthood, causing existing issues to compound in aging and affecting suitable housing and care options.


Often, seniors with disabilities experience reduced choices over where to live, who to live with and what care to receive. Disabled seniors may be encouraged to receive care in an institutional setting, such as a nursing home, rather than receive suitable care in a less restrictive setting, such as an assisted living community. However, the Americans with Disabilities Act required better housing options for those with disabilities. The law set out a requirement for equal housing opportunities for disabled Americans. Since its creation, housing options for people with disabilities have improved significantly.


Assisted living can provide a less restrictive housing option for disabled seniors. Individuals can live as part of a community, which can help to increase social bonds and life enjoyment. Facilities typically offer a range of enrichment activities and generally have diverse on-site amenities. Compared to nursing homes, there are often more choices with regard to residents’ accommodations, such as private or shared rooms, in-room cooking facilities, separate living areas and pet friendliness. Services are generally tailored to meet individual needs, with an emphasis on maintaining elder dignity and helping seniors to live as independently as possible.


This guide details assisted living for seniors with disabilities. It covers costs of assisted living, potential sources of funding, what to look for when choosing a facility and other possible housing solutions. It also lists disability resources for each state.


Common Disabilities That Impact Seniors

A significant number of people go through life with some form of disability. Unfortunately, the risk of having a disability also increases with age. Disabilities may include physical, sensory, intellectual, cognitive and mental limitations. Some disabilities may necessitate minimal extra support for a senior to live independently. On the other hand, other issues may demand around-the-clock care or constant supervision.


Intellectual Disabilities

Although seniors with intellectual disabilities will have had specific development issues since their youth, evidence suggests that such seniors have a greater risk of aging-related issues being undiagnosed. There’s also a greater risk of health needs not being addressed. Furthermore, some intellectual disabilities can make a person more predisposed to secondary conditions as they age. Seniors with intellectual disabilities are more inclined to become frail quicker than their counterparts without intellectual disabilities.


Older adults with intellectual disabilities are especially vulnerable and may require an advocate or guardian to ensure they receive appropriate care. Vulnerability is worsened by the fact that their primary caregivers may be family members who are also aging alongside the senior with intellectual limitations.


Sensory Disabilities

Sensory disabilities are those that affect any of the senses. These include sight, sound, touch, taste and smell. A lack of spatial awareness can also be a sensory disability. Causes of sensory disability are wide-ranging. They may result from lifelong neurological conditions, develop in aging, be caused by an injury, or be triggered by illness.


Per the CDC, sensory issues are significant for older Americans, with around 1 in 6 seniors experiencing some degree of vision loss and 1 in 4 experiencing hearing impairment. Approximately 25% of older Americans have a loss of feeling in their feet, which can affect balance and result in injury. Sensory issues increase with age, and studies suggest that around 2 in 3 older Americans have two or more sensory challenges.


Physical Disabilities

Physical disabilities affect a person’s physical functioning, such as walking and breathing. They can impact mobility, stamina and dexterity and have a wide range of causes. Studies indicate that mobility issues are among the most common disabilities among U.S. seniors. This can affect many aspects of a person’s life, including being able to attend medical and social appointments, go grocery shopping, complete domestic chores and perform personal care. People with limited dexterity may be unable to perform everyday activities such as preparing and eating meals, completing forms, bathing and fastening clothes.


Research also suggests that individuals with congenital or adult-acquired physical disabilities are more susceptible to developing chronic health conditions as they age than their able-bodied peers.


Mental Disabilities

According to the World Health Organization, mental health conditions affect around 15% of all people aged 60 and older. The most common types of mental disabilities among the elderly population are dementia and depression.


Dementia

An estimated 10% of senior Americans have dementia, with Alzheimer’s Disease being the most common form of dementia. Alzheimer’s Disease currently affects around 6.5 million Americans aged 65 and older. As the population grows older, the prevalence of Alzheimer’s is expected to increase.


Depression

Statistics indicate that around 2 million older Americans experience depression. Sadly, certain situations, such as bereavement, can mean the disease is overlooked in seniors, especially for those who are isolated. Older individuals also tend to have limited knowledge of the illness, which can prevent people from seeking the support they need.


Other Issues Concerning Mental Disabilities for Seniors

Research indicates that around 40% of seniors in nursing homes have mental disabilities, including depression, anxiety, dementia and personality disorders. However, various mental health issues may be undiagnosed within the aging populace. Some conditions may be triggered or exacerbated by an individual’s environment, and physical symptoms may be worsened by a mental health condition.


What To Look for in Assisted Living Communities for Seniors With Disabilities

Assisted living communities provide a safe and comfortable environment where seniors can age alongside their peers. Communities generally offer a maintenance-free lifestyle, and staff members typically take care of domestic chores and meal preparation in addition to assistance with daily activities and personal care tasks. Facilities often offer an enrichment program to fulfill holistic wellness needs.

Communities may provide services that promote health, such as regular nurse wellness checks, pharmaceutical services, on-site lab work and transportation to medical appointments. Facilities usually offer tailored care plans to ensure individuals receive the necessary support. Seniors with disabilities should also look for specific amenities and services.

Assisted Living for Seniors With Intellectual Disabilities

  • Staff members trained to care for seniors with intellectual disabilities, such as communication techniques and behavioral development

  • Staff members trained to administer medication

  • Around-the-clock on-site staffing

  • Regular wellness checks to ensure health conditions are detected as soon as possible

  • Secure living environment

  • Use of assistive technology, such as text-to-speech software (and vice versa), memory aids and speech-activated devices

  • Ability-appropriate social and activity programs

  • Criminal background checks for all staff members and safeguarding policies to reduce the risk of abuse and exploitation of vulnerable individuals

Assisted Living for Seniors With Sensory Disabilities

  • Staff members trained to care for seniors with sensory disabilities

  • Use of assistive technology, such as screen-reading software, loop systems and weighted blankets

  • Regular checks and maintenance of assistive devices such as hearing aids and glasses

  • Special programming geared toward sensory stimulation

  • Environment designed to stimulate the senses

  • Use of therapies, such as sensory integration, massage, water and music therapy

  • Diverse menus

  • Staff members who can communicate using American Sign Language for seniors with hearing issues

  • Safety adaptations, such as flashing alarms for deaf seniors and grab rails for seniors with balance issues

Assisted Living for Seniors With Physical Disabilities

  • Staff members trained to care for seniors with physical disabilities, such as assistance with transferring, walking and personal care

  • Physical and accessibility aids, such as grab rails, ramps and shower benches

  • Wheelchair accessibility and nonslip flooring throughout

  • Regular maintenance of mobility devices, such as frames, scooters and wheelchairs

  • Single-level community or elevator access for an easy-to-navigate environment

  • Inclusive activity programs

  • On-staff or visiting physical and occupational therapists

Assisted Living for Seniors With Mental Disabilities

  • Staff members trained to care for seniors with mental disabilities, such as communication techniques

  • Activity program that includes cognitive stimulation and memory recall

  • Easy-to-navigate environment with clear sign-posting and prompts such as memory boards or boxes

  • Ability to include personal items in rooms to make the environment more familiar

  • Specialized lighting to reduce the effects of sundown syndrome

  • Professional counseling, psychotherapy or psychiatric services, as needed

  • Around-the-clock resident monitoring

  • Secure facility

  • Use of a Snoezelen room or other sensory stimulation aids

  • Menus designed for brain health

How To Choose an Assisted Living Community for an Older Adult With Disabilities

It’s important to compare assisted living communities before making a final decision. Keep in mind that seniors may require assistance with more than one disability.

Questions To Ask When Choosing an ALF for a Senior With Disabilities

In addition to touring a community, checking out its facilities and reading reviews, asking particular questions can help people decide whether a certain facility is the most suitable choice for them. Asking questions can help people obtain information that isn’t obvious from a facility’s website. Example questions include:

  • What training do your staff members have?

  • What experience do your staff members have with this particular disability?

  • Must staff pass criminal background checks?

  • What resident safeguarding policies do you have?

  • What is your ratio of staff to residents?

  • Can staff administer medications?

  • Do you have overnight staffing?

  • What services are included?

  • What additional services are available?

  • How often do you review care plans?

  • What programs do you offer for people with this disability?

  • How do you ensure social integration opportunities?

  • How do you try to meet physical, cognitive, emotional and spiritual wellness needs?

  • Is your facility fully accessible?

  • Do you offer accessible transportation?

  • What assistive technology do you offer?

  • What safety, security and emergency features does your facility have?

  • How often are health and wellness checks performed?

  • What happens if my loved one’s condition worsens?

  • Can you accommodate residents with multiple disabilities?

  • How do you communicate with family members?

  • How do you encourage family involvement?

Where To Find Assisted Living for Seniors With Disabilities

When researching suitable assisted living facilities for people with disabilities, it’s important to remember that services and amenities can change. Facilities may amend available services or stop providing certain services altogether. Assisted living communities may also add or remove amenities and change staffing policies. Always check for up-to-date information to ensure that facilities have the necessary support, services and staff training to accommodate seniors with specific disabilities.


How Much Does Assisted Living for Someone with Disabilities Cost?

Per Genworth’s Cost of Care Survey, assisted living costs an average of $4,500 per month in the United States. However, average rates can vary significantly between states, cities and regions. Costs also vary depending on factors such as facility amenities, specialized programming, staffing ratios and resident accommodations. Assisted living communities may also charge extra for add-on services that disabled seniors need.

Additional fees may be required for the following:

  • More frequent safety checks

  • Reminders to complete tasks

  • Medication administration and management

  • Clinical or rehabilitative services

  • Pharmaceutical and laboratory costs

  • Nurse or physician services

  • Counseling

  • Memory care neighborhoods

  • One-on-one care

  • Personal care services, such as bathing, toileting and dressing

  • Personal care supplies

  • Assistance with activities of daily living and instrumental activities of daily living

  • Ambulation and transferring

  • Transportation

  • Assistive technology

Other additional fees may include:

  • Charges for pets

  • Salon services

  • Excursions

  • On-site purchases at a store or cafe

  • Laundry

  • Wi-Fi and telephone calls

Financial Assistance for Disabled and Handicapped Seniors

Many seniors struggle to pay the full costs of assisted living, including base and add-on fees. Fortunately, there are several programs that can help eligible older adults cover at least some costs of assisted living. Some programs provide varying aspects of financial assistance for seniors with disabilities.


Medicare

While Medicare doesn’t directly cover any assisted living costs, it might cover the costs of medical services provided by the facility. These may include nursing services, medications, physician appointments and rehabilitation therapies. Medicare Advantage plans may cover additional services; policyholders should check their plans for further details.


How To Apply for Medicare

Eligible individuals can sign up for Medicare 3 months before their 65th birthday. Applications can be made online via the Social Security Administration’s website, by visiting a local SSA office or by calling (800) 772-1213.

Medicaid

Medicaid may cover certain costs of assisted living for seniors who meet eligibility criteria. Such criteria are typically related to an applicant’s financial situation and functional care needs. Some states directly include assisted living coverage as part of the state plan, while others provide funding via home-based and community-based waivers. Financial assistance doesn’t normally include room or meal costs, but it may cover a range of services including personal care services, assistance with everyday activities and transportation.


How To Apply for Medicaid

Seniors can apply for Medicaid online through the Health Insurance Marketplace or by contacting their state’s Medicaid agency.


U.S. Department of Housing and Urban Development (HUD) Public Housing Programs

Public housing programs provide affordable housing for low-income seniors and people with disabilities. While programs don’t provide funding for assisted living facilities, seniors with disabilities may find two programs helpful:

  • Supportive Housing for Persons with Disabilities (Section 811)

  • Supportive Housing for the Elderly (Section 202)

Each provides rental assistance for supported housing.


How To Apply for Public Housing

People should contact their local Public Housing Agency or their local HUD field office to apply for public housing programs.


Housing Choice Voucher Program

Previously known as Section 8, the Housing Choice Voucher Program can help low-income individuals pay for their rent. Vouchers may be used to pay the rent portion of assisted living fees.


How To Apply for the Housing Choice Voucher Program

To apply for the Housing Choice Voucher Program, individuals should contact their local Public Housing Agency. Alternatively, they can contact their local HUD field office.


Local Resources

Additional funding options may be available in particular areas. These may include:

  • Local Rural Development agencies for assistance in rural locations

  • Local government programs that support people with disabilities

  • HUD-approved housing counselors can find local housing assistance for disabled seniors

Other Housing Options for Seniors Living With Disabilities

Assisted living is one of several housing options for seniors with disabilities. Certain housing environments will be better suited to individuals to meet both their care needs and preferences.


Adult Family Homes/Care Homes for Seniors With Disabilities

Adult family homes or care homes for seniors with disabilities provide necessary support services in an intimate setting. Residents live in a smaller home with just a few other people. Homes are typically situated in regular residential neighborhoods. This care setting is often suitable for those with higher-level needs, as there’s generally a higher staff-to-resident ratio than in assisted living facilities. Some homes offer specialist services, such as skilled nursing, bariatric care and memory care, in a more family-like setting than a nursing home. Caregivers can sleep on-site. Homes generally don’t have the same range of amenities as a larger assisted living facility, although residents can generally access a communal lounge and garden and join diverse activities.


Nursing Homes for Seniors With Disabilities

Nursing homes offer the highest level of care and may be a suitable option for seniors with intensive care needs or severe limitations. They offer skilled nursing services and around-the-clock supervision and monitoring. This may make them especially suitable for seniors with respiratory needs, late-stage dementia or acute psychiatric disabilities. Nursing homes may also be the most appropriate option for seniors who need palliative or hospice care.


In-Home Care for Seniors With Disabilities

Seniors with disabilities who can live alone with the provision of support services may be suitable candidates for aging in place. Individuals can remain in the familiarity of their own homes with a range of services to enable safe and comfortable living. Services may include home-delivered meals, accessibility adaptations, personal assistance from visiting caregivers and transportation. Such type of care may be more appropriate for those with mild to moderate disabilities.


Continuing Care Retirement Communities (CCRCs) for Seniors With Disabilities

Also referred to as a life plan community, a continuing care retirement community is generally suitable for seniors who have mild to moderate limitations. It is especially ideal for those who can live independently but like the safety net of having flexible services available if their support and care needs change. It can also cater to couples who wish to remain living together despite needing different levels of care. Services can be tailored to provide appropriate care for each party. Communities offer maintenance-free living in diverse types of accommodation with access to amenities and social programs. As needed, residents can increase services or move to other parts of the community to receive assisted living, memory or nursing home care.


State Resources for Disability Assistance

Most states have a dedicated agency or department responsible for providing resources to disabled individuals. Organizations typically act as a one-stop-shop for information, referrals and assistance related to care options, housing, financial aid, programs and support services.

A serious disability can make it hard to find care and a supportive environment for your loved one. And, choosing assisted living for someone with a disability may not be the first solution that comes to mind. Finding the best place can be overwhelming and challenging to decide.


Caring.com provides information on the common types of disabilities, financial costs, and housing options to help families make informed decisions. Read more about it here: https://www.caring.com/senior-living/assisted-living/assisted-living-for-seniors-with-disabilities/.

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