Assisted Living Options for People Struggling with Addiction

According to the National Institute on Alcohol Abuse and Alcoholism, substance abuse affects about 17 percent of adults over the age of 60. The most common forms of addiction in this age group are alcohol and prescription drug abuse. While some of these individuals have had substance abuse problems for many years, others develop their addiction late in life.

For those that develop addictions later in life, health-related problems and life-changing events are usually the catalysts. Some factors that often contribute are retirement, death of a loved one, financial stressors, and health decline. Individuals over the age of 65 have a significantly harder time metabolizing substances like drugs and alcohol, so the effects of addiction can be much worse and lead to more significant health problems sooner than they would in younger people.

In some cases, addiction is the direct result of being prescribed medication that they become dependent on. Benzodiazepines, as‌ ‌well‌ ‌as‌ ‌opiates, are the most common types of addictive medicines prescribed to seniors.

Assisted living facilities are long-term residential care communities designed for people who need assistance with the activities of daily living or who have a disability that prevents them from living totally independently. In addition to housing, these communities provide assistance with personal care, meals, community activities, and basic health care services like first aid and emergency care. While assisted living facilities all provide the same basic functions, each one is a bit different from the next – some provide more involved assistance and plan community events while others only provide assistance with the activities of daily living.

Unlike nursing homes, assisted living communities are not intended for seriously ill individuals, those that need extensive levels of physical assistance, or those who are permanently bedridden. While support services in these communities are ideal for individuals who need some extra help with tasks like getting dressed and showering, they don’t have the resources for round-the-clock care. For residents who need regular care for an illness or injury but are still fairly independent, home health aides can be hired to supplement the care provided by the facility’s staff.

According to the 2020 Genworth Cost of Care Survey, the median cost for assisted living in the United States is approximately $51,600 per year. While that breaks down to about $4,300 per month, various factors such as the location and size of the facility, the number of services needed, and additional features can all impact the price. Additionally, some facilities require residents to pay extra fees for transportation, fitness center use, and other optional amenities, while others include them in the price of room and board.

Assisted living communities are not substance use rehabilitation facilities, and as such, their services revolve around general well-being rather than addiction recovery. However, seniors who have dealt with addiction in the past and no longer need acute recovery care may be well-suited for assisted living. Ideal candidates for assisted living facilities will still be fairly independent and able to spend the majority of their day without the assistance of a staff member.

Assisted living communities offer help with the following:

• Bathing
• Toileting
• Daily grooming
• Housekeeping chores
• Medication management
• Transportation for appointments and personal errands
• Basic mobility

If you or your loved one needs help with the above ADLs and is otherwise independent, assisted living can be a good choice. It is a secure environment and will naturally limit one’s access to illicit substances. However, if regular addiction support is needed, be sure that the ALF will allow regular visits from an outside counselor. It’s rare that addiction treatment, or any mental health counseling, is a standard service at assisted living facilities.

Individuals who are in relatively good health and are capable of taking care of themselves without any additional assistance aren’t good candidates for assisted living since they’ll be facing high fees for care that they do not need. These individuals should consider an independent living community or active adult community instead. Those who need 24-hour supervision should consider a skilled nursing community.

It’s important to note that any addiction services provided by senior living staff, regardless of the facility type, will not be as intensive as those provided at a dedicated rehabilitation facility. Because of this, assisted living communities and other senior care communities are not appropriate as the first step to recovery. But, they can be a great source of ongoing support for someone who has battled addiction in the past.

Addiction in seniors isn’t a widely discussed issue, and as a result, most assisted living facilities do not openly advertise their ability to help those who are struggling. However, assisted living communities can be great environments for individuals battling addiction. Below are some of the most notable benefits:

Supportive Environment: One of the biggest issues for seniors, especially those who have suffered a loss, is that they are isolated and alone, relying on a substance to cope with their feelings. Assisted living facilities are full of people who interact and do things as a community. This includes other residents and staff members who orchestrate and participate in events and just spend free time together.

Supervised Medications: In most assisted living facilities, all medications are in a locked cabinet that only staff has access to. This means your loved one will only be getting the correct dosage of medication when they are supposed to get it.

Trained Staff: In some cases, assisted living communities will have staff on hand who have been trained to help those with substance abuse problems. This might include a counselor, nurse, psychologist, or social worker.

Limited Alcohol Access: Seniors struggling with an alcohol addiction can benefit from controlled menus at meals. Most assisted living facilities don’t serve alcohol with meals, and if they do, seniors are consuming it under the supervision of staff in a controlled environment. Staff will be privy to those who can’t consume alcohol and ensure it isn’t served.

Exercise and Wellness Programs: The exercise and wellness programs available at assisted living facilities can benefit all residents, but may be especially helpful for those struggling with addiction. Physical activity has been shown to reduce addictive cravings and can help improve overall health.

Transportation: Some seniors with addiction may need to visit an off-site counselor or outpatient rehab facility. Assisted living communities can provide transportation to and from medical appointments, making it easier for residents to get the help they need.

Because no two assisted living communities are exactly alike, it’s important to visit several different facilities and get a good feel for what life is like there. While they may offer similar amenities, you’ll likely find that some are a better fit for your loved one than others.

While visiting, don’t hesitate to ask staff members any questions you might have. Be on the lookout for things like:

Unfortunately for many families, the cost of assisted living is beyond what they can comfortably afford from month to month. But assistance from sources such as Medicaid, Medicare, the Department of Veterans Affairs, and Social Security can help.

For those who have limited resources and are in need of healthcare coverage, Medicaid provides programs and aid in various forms. In addition to standard Medicaid coverage, several waiver programs are available throughout the country for those who specifically need long-term care and help recovering from addiction.

When it comes to regulations for waiver programs and eligibility guidelines, every state is a bit different. However, the majority of states offer Home and Community-Based Services (HCBS) Waivers, which are the most common form of waivers used for assisted living. Other states offer similar programs with different names.

Medicaid programs also provide qualified individuals with access to counseling and mental health services, including programs specifically created for individuals with substance abuse disorders. These programs are available nationwide and can be of great help to those who need them. To learn more about what programs are available in your state, contact your local Medicaid office.

You can apply for Medicaid by visiting healthcare.gov. If you don’t already have one, you’ll be required to create an account before applying through the Health Insurance Marketplace. Unlike regular health care, you can apply for Medicaid at any point in the year, not just during open enrollment.

Anyone applying for Medicaid should be aware that it can be a long process and extensive documentation of your finances is needed. You should also be prepared to provide evidence from a physician that attests to your medical need for assisted living and addiction recovery.

Medicare is a federally-funded program that does not directly cover the costs of assisted living or other long-term care facilities, but may be used to cover any qualified healthcare costs an individual incurs while residing in an assisted living facility. This includes the cost of addiction treatment and recovery as long as certain conditions are met. For Medicare to cover this treatment, it must be deemed necessary by a physician and care must be provided by a Medicare-approved provider or at a Medicare-approved facility.

When it comes to long-term care, Medicare is usually utilized to pay for in-home health care or skilled nursing facilities. While it’s available for all people over the age of 65, it’s also available for those who have qualifying disabilities.

So, even though these funds can’t be used to pay for assisted living directly, they can be put towards other costs to free up money that pays for the rent at these facilities.

Social Security is supplemental income awarded to individuals with disabilities who are unable to continue working and were previously employed. It isn’t awarded for any one specific use, so it can be put towards the cost of living in an assisted living facility or to cover the cost of addiction treatment.

The U.S. Department of Veterans Affairs offers several benefits to help veterans cover the cost of living at an assisted living facility.

Basic pensions are available to veterans over the age of 65 who are considered low-income or meet other specific requirements. Veterans who receive this pension can use the funds however they wish, making it an excellent source of financial assistance for assisted living care.

The VA Form 21P-527EZ, “Application for Pension” is the easiest way to apply for the basic pension online. Once the paperwork is completed and the required documents are collected, mail the application to your local Pension Management Center.

Those who prefer to apply in person can visit the local regional benefit office, where staff can assist with the process. To find your local office, use the VA Facility Locator.

The VA offers its own alcohol and drug rehabilitation program for any veteran enrolled in the VA health care system. Located in the VA medical centers and clinics, the programs offer medical, social, vocational, and rehabilitation therapies for those battling addiction.

For more information on these programs, contact your local VA medical facility. You can use the VA Location Finder to locate a facility near you.

For veterans who require the assistance of another person to perform the activities of daily living, Aid & Attendance can help ease the financial burden of assisted living. In order to be eligible, a physician must document the need for this assistance. While the funds are awarded to those that need certain services, the funds don’t have to be used for any one specific purpose.

Veterans don’t need to be suffering from a service-related injury or illness to receive aid and attendance, but they must be eligible for the basic pension. The best way to apply for these benefits is by visiting the official VA website to get the necessary forms and learn what documents will be required before contacting the Pension Management Center in your state.

The VA is available to help veterans locate and learn more about the long-term care options that are available. Additionally, the VA operates its own state-run veterans’ homes that can provide assistance for those that need assisted living while battling addiction.

To find out more about residential care options in your state, contact your local VA Regional Benefits Office or call the VA Health Care Benefits number at 877-222-8387.

If you or a senior loved one struggles with addiction or substance abuse, you need all the help you can get. Aside from the specialized care provided by assisted living facilities, the correct information, support, and resources can make all the difference in their journey to recovery.

Below, we have compiled a list of online resources that provide educational information, support, and products for seniors struggling with addiction and those who love them.

• https://www.addictioncenter.com/addiction/elderly/
• https://www.drugabuse.gov/publications/substance-use-in-older-adults-drugfacts
• https://www.genworth.com/aging-and-you/finances/cost-of-care.html
• https://www.medicaid.gov/medicaid/home-community-based-services/home-community-based-services-authorities/home-community-based-services-1915c/index.html
• http://healthcare.gov
• https://www.ssa.gov/planners/disability/qualify.html#anchor3
• https://www.vba.va.gov/pubs/forms/VBA-21P-527EZ-ARE.pdf
• https://www.benefits.va.gov/PENSION/resources-contact.asp
• https://www.va.gov/find-locations/
• https://www.va.gov/pension/aid-attendance-housebound/
• http://www.va.gov/vaforms
• https://www.va.gov/geriatrics/guide/longtermcare/Nursing_Home_and_Residential_Services.asp
• https://www.va.gov/directory/guide/division.asp?dnum=3