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Assisted Living Facilities - An Overview

Page Reviewed / Updated - Nov. 2019

Assisted living facilities, sometimes referred to as residential care facilities, are long-term care facilities designed for seniors who need some assistance with their day-to-day activities. Residents of assisted living facilities still retain independence while receiving the assistance and care required in the areas in which they need. Most assisted living facilities provide a community atmosphere with group dining, planned social and educational activities, and other opportunities to socialize with other residents.

What Services Are Provided in an Assisted Living Facility?

Assistance with Activities of Daily Living: Assisted living facilities (ALFs) provide residents with assistance with the activities of daily living (ADLs). ADLs include basic tasks that one must perform every day, such as bathing, eating, dressing, and toileting. Services can be tailored to each resident’s individual needs, so they will receive assistance with any ADLs they need while still having the freedom to complete other tasks and spend time independently. Additionally, some basic health services such as medication management are sometimes provided, though skilled nursing care is not. 

Meals: Meal service is a standard amenity among assisted living facilities. The specifics of meal service varies between different facilities; some serve sit-down meals in formal dining rooms, others are cafeteria-style, and some may allow residents to have meals delivered to their rooms. The cost of three daily meals, plus snacks, is typically included in a facility’s monthly cost, though this can vary. 

Housekeeping and Maintenance: It is typical for assisted living facilities to have staff members who take care of cleaning and maintaining common areas and outside grounds, and who can also handle maintenance requests such as fixing a leaky faucet in a residents’ apartment. Laundry services are often provided, and some facilities may also offer housekeeping services for residents’ apartments, which may or may not cost an additional fee. 

Transportation: Assisted living facilities offer transportation to make it easy for residents to run errands such as going to the grocery store or visiting the dry cleaner’s, or to get out of the facility for some fun, like to see a movie. In the case of grocery shopping or activities like seeing a show at the local theater, group transportation is provided. Some facilities also allow residents to schedule private transportation for things like visiting family members or going to a doctor’s appointment.


Social Activities and Shared Amenities: To ensure residents can make the most of their golden years, many ALFs offer scheduled social activities, such as guest speakers, group outings, and even resident happy hours. Some may also allow residents to set up clubs to form social circles with those who share their interests, such as a gardening club or bible study group. Additionally, some facilities offer in-house amenities like fitness centers or libraries.

Who Should Consider Assisted Living?

While assisted living is a great option for many seniors, it isn’t the right choice for everyone. ALFs provide a middle-ground between independent living retirement communities and nursing facilities. A good candidate for assisted living is someone who needs help with some ADLs or is beginning to show signs that they will soon need help, but who can still live somewhat independently.

In some cases, those with memory impairment and related conditions can receive the care they need in an ALF, though it depends on the specific community. Some assisted living facilities have designated memory care units and specially trained staff to care for those with memory impairment, while others are not equipped to provide memory care. 

Who Should Not Consider Assisted Living?

If a senior is still completely independent and needs no assistance with activities of daily living, they are likely a better candidate for an independent living community where they will have less access to assistance and care, but more freedom. 

It’s also important to note that assisted living facilities are not skilled nursing facilities and cannot provide high-level medical care. If a senior requires frequent or around-the-clock medical care, they are not a good candidate for assisted living. 

What Do Top-Rated Assisted Living Facilities Have In Common?

No two assisted living facilities are the same, and different seniors will have different factors that matter most to them. However, many top-rated assisted living facilities have the following qualities in common:

  • Well-trained staff with clear educational, training, and conduct guidelines for employees.
  • Clean and safe facilities designed for older adults. Most facilities are able to accommodate mobility-impaired seniors. 
  • Management that communicates clearly with residents’ families and responds well to any concerns of residents or their families. 
  • An adequate number of staff members to ensure all residents are well cared for and apartments that are spacious enough for residents to feel comfortable. 
  • Resident-specific care plans and/or regularly updated records of residents’ health and wellbeing.

This list is not exhaustive, and the points mentioned above may not apply to all facilities due to size, the scope of care, and state regulations. However, asking to see a facility’s policies and speaking with a member of the management team is a good way to get a feel for if a facility is well run and reliable. 

How to Choose the Right Assisted Living Community for You or Your Loved One

It can be overwhelming to try and determine if an assisted living facility is the right fit for yourself or a loved one. The specific facility where one will be the happiest depends on their personal preferences, abilities, interests, and taste. 

The following suggestions are a good way to ensure that a facility is a good fit for you or a loved one:

Decide What Features and Amenities Are Most Important to You

As mentioned, what is the “right” assisted living facility will vary from person to person. To find a facility that best meets your needs, take time to think about what factors are most important for you or your loved one’s health and quality of life. Some top concerns may include:

  • Frequent patient-to-caregiver interaction and a low staff-to-patient ratio
  • Appealing meal options
  • A social environment with plenty of resident interaction and planned activities
  • Large resident apartments and/or certain must-have apartment amenities
  • Some light medical assistance, such as medication management 
  • Location close to friends and/or family 

This list will be different for every person, but getting clear on these things can help you narrow your search from the start and allows you to check for specific factors that otherwise may not come up in your research. 

Determine Your Budget

Long-term care is costly, and it’s important to make sure that you and/or your loved one is able to afford an assisted living facility over time. Do some research into the average cost of assisted living in your area and compile a list of facilities that are in your budget. Only looking at facilities within your set budget is a great way to narrow your search and avoid disappointment and stress down the line if you become very interested in a facility that is ultimately out of your budget. 

If assisted living is too costly for you to manage to pay out-of-pocket or with your existing resources, contact your local Area Agency on Aging to find out what assistance may be available to you. You can also read our guide to financial assistance and funding options for assisted living

Visit Facilities in Person

There is only so much information you can garner from a facility’s promotional materials. Whenever possible, try to visit facilities in person to get a feel for its atmosphere and daily operations. If you can, talk to current residents about their experiences. 

If it’s not possible to visit a facility in person, be sure to read as many reviews from former or current residents and family members or former or current residents to get some valuable insight from people with first-hand experience.

Top Rated Assisted Living Communities by City

  • North Dakota
  • ▸ Fargo