How To Find Assisted Living for Seniors With Disabilities

Reviewed by: Dr. Brindusa Vanta, MD

The U.S. Census Bureau projects that by 2030, when everyone from the baby boomer generation will be aged 65 or older, U.S. demographics will shift so that 1 in every 5  people will be of retirement age. Unfortunately, an aging population means more people will be living with age-related and other disabilities. A 2014 report published by the Association for Behavior Analysis International stated that the number of seniors and other individuals living with disabilities is expected to double within the next 20 years, leading to an increasing number of people in need of supportive housing and other services.

Seniors and other individuals with disabilities often don’t have much choice in where they live, which can result in them moving to expensive nursing facilities or other less-preferred options. The American Disabilities Act was in part developed to help this situation and demand equal housing opportunities for those with disabilities.

One such option for seniors with disabilities is assisted living, which allows them to live in more homelike settings than a nursing home while still having assistance and support 24/7. Residents live in their own private or semiprivate apartments within a supportive atmosphere that encourages ongoing independence. Assisted living facilities generally tailor support services to match the resident’s unique needs, so seniors with disabilities get the help they need to thrive.

We created this resource for seniors with disabilities who may want or need to move to an assisted living facility to help them and their families make informed decisions. We provide an overview of common disabilities impacting seniors, discussing the benefits of assisted living, the care provided and how to choose the ideal facility to meet a disabled senior’s current needs.

Using 2016 Behavioral Risk Factor Surveillance System data, scientists from the Center for Disease Control and Prevention determined that disabilities are more common among adults aged 65 and older. Approximately 2 in 5 older adults in this age group have 1 of the six functional disabilities identified in the report, including: 

• Seeing
• Hearing
• Mobility
• Cognition
• Self-care
• Independent living 

Of the six disabilities, mobility issues, such as difficulty walking or climbing stairs, impacted seniors most. However, many aging adults also have seeing and hearing impairments. While these impairments fall under physical and sensory disabilities, intellectual and mental disabilities may also affect seniors and make a move to assisted living a good option.

Intellectual disabilities can cause difficulties in learning new skills, problem-solving, retaining information, adaptive functioning, such as communicating, performing activities of daily living and maintaining independent living. People with intellectual and developmental disabilities are living longer, so it’s becoming more common for them to reach senior age.

Seniors with intellectual and developmental disabilities (IDDs) may become frail at younger ages. Other processes of aging also may occur faster. Unfortunately, the early onset of impairments related to aging may result in not meeting inclusion criteria for geriatric health services or social services for seniors based on their chronological age. According to the Journal of Intellectual Disabilities, older adults with IDDs can be individuals aged 40 or older with health and functional decline associated with aging.

Older adults with IDD may also be more prone to developing dementia and Alzheimer’s disease. Although Alzheimer’s and other dementia are classified as neurocognitive disorders, they often share similar symptoms as IDDs, making them difficult to diagnose and potentially delaying appropriate support.

Developing physical disabilities as you age is common, with mobility the most common physical disability among older adults. Mobility impairments may simply be slight trouble walking or may be severe enough to require assistive devices, such as walkers or wheelchairs.

Chronic illnesses may lead to other physical disabilities, such as foot problems and arthritis, that can further impact mobility. Issues with mobility can increase an older adult’s risk of falls, which increases the risk of hip fractures and other injuries, further affecting mobility.

Certain sensory disabilities crossover as physical disabilities, including hearing and visual impairments. Physical disabilities lower quality of life and may lead to more frequent hospital admissions, the need for residential care and premature death.

Besides aging into a physical disability, some older adults may be aging with a disability they developed when they were younger and causes physical impairments, such as cerebral palsy, multiple sclerosis or a spinal cord injury. Older adults with physical disabilities may have an increased risk of health problems compared to those without disabilities.

Many common mental illnesses can cause disturbances in thinking, behaviors, problem-solving and emotional state. Although mental health disorders may occur at any age, seniors are especially vulnerable to depression and anxiety. They may also experience eating disorders and suicidal ideation.

Age-related issues such as chronic health problems, mobility loss and Alzheimer’s can all impact seniors’ mental health, potentially causing co-occurring illnesses. For example, arthritis and cancer can trigger depression. Because 49.6% of adults aged 65 or older have doctor-diagnosed arthritis and age 66 is the median age of cancer diagnosis, it’s not surprising that clinical depression symptoms are prevalent in older adults. 

A combination of factors such as chemical imbalances in the brain or other biological issues, life experiences and family history may cause mental health disabilities. Age-related illnesses, isolation, loss of income, decreased autonomy and loss of income can also increase a senior’s risk of developing a mental disability.

ALFs for seniors with disabilities should have the appropriate amenities and services to ensure they can live as independently as possible while still receiving the care they need. Assisted living may include private rooms or apartments or have shared housing, and residents typically eat together in a group setting. Services vary based on the individual’s needs, making this a solid housing option for those with disabilities. Below are some amenities and services seniors should look for based on specific types of disabilities. 

As they age, seniors with intellectual disabilities capable of independent decision-making may occasionally need additional assistance from care providers. Things to look for in assisted living for seniors with intellectual disabilities include: 

• Medication reminders
• Assistance with personal care
• Dedicated memory care with enhanced security to prevent wandering
• Staff training in intellectual disorders

Sensory disabilities are a form of physical disability that impacts the senses, including sight, sound, touch, taste and smell. Things to look for in ALFs for seniors with sensory disabilities include: 

• Activities that take sensory disabilities such as poor sight or hearing into account
• Well-lit environments to help with sight impairments
• Large display clocks for visual impairments
• Dining staff trained in preparing foods based on taste impairments
• Staff training in sight and hearing disabilities

Physical disability is one of the primary reasons seniors seek assisted living. The degree and type of physical impairment impact the amenities and services you might need. Common things to look for in assisted living for seniors with physical disabilities include: 

• Staff training in hearing, sight or mobility impairments
• Hallways and doorways wide enough for walkers and wheelchairs
• Safety features such as grab bars in bathrooms, walk-in showers, handrails in hallways, etc.
• Level walkways in outdoor areas
• Access to physical and occupational therapy services

Seniors struggling with depression, anxiety, eating disorders and other mental ilnesses  may consider moving to ALFs for the safety and security of knowing staff is always nearby to lend a hand. The stability, sense of belonging and structured social and recreational programs designed to keep seniors active and social can also help prevent mental health issues. Things to look for in ALFs for seniors with mental disabilities include: 

• Daily therapeutic and recreational programming to help reduce symptoms of depression, anxiety and other mental health disorders
• Three nutritionally balanced meals to support the nutritional needs of seniors with eating disorders
• 24/7 staffing to ensure help is always available to notice and report red flags
• Access to mental health services such as visiting social workers and psychiatrists
• Staff training in mental health disorders
• Proximity to outpatient mental health services through a hospital or specialty clinic

When choosing an ALF for an older adult with disabilities, your primary concerns should be safety and your loved one’s happiness. It’s essential to be realistic about their needs, including how their disability might impact their future needs. Make a list of facilities you think might check all the boxes and then plan on visiting each one in person before making a decision.

Having a list of questions to ask the ALF helps you determine which facility would best serve the needs of a disabled senior while still providing an environment they enjoy. Consider the following questions to get an overall feel for each facility and make informed decisions based on lifestyle preferences and care needs:

• Does the ALF make any exceptions on age restrictions for disabled adults?
• Are there additional costs involved based on a specific disability?
• How are caregivers trained to handle residents’ disabilities and unique needs?
• Are additional care services or therapies available on-site to accommodate specific disabilities?
• Can meals be tailored to a resident’s dietary needs, including taste impairments?
• Are rooms and hallways designed to accommodate wheelchairs and walkers?
• Do units have good natural lighting to help with vision impairments?

Assisted living facilities services can change over time. It’s essential that you confirm with the ALF that it has the necessary supports and that staff have received appropriate training to help senior residents with disabilities.

The cost of disability-friendly assisted living facilities should be the same as other ALFs. According to Genworth’s 2021 Cost of Care Survey, the average cost of an assisted living facility nationwide is $4,500 per month. However, this amount can significantly vary by state. For example, the average cost of assisted living in Rhode Island is $6,826, while the average in South Dakota is only $3,350. 

Monthly rates generally include rent, utilities and group amenities such as meals and transportation. Amenities like housekeeping or laundry services sometimes have a separate cost. Personal care, such as help with activities of daily living like grooming, bathing, medication management, etc., may or may not require an additional fee. Services like physical or occupational therapy are also usually add-on amenities. 

Because each facility may calculate fees differently, the best way to get an accurate picture of the overall cost is to ask a prospective facility to perform an assessment of the potential resident.

Although assisted living can be an ideal housing option for disabled seniors, not all of them may have the financial means to pay for these facilities. Many programs exist that offer financial assistance, but some may not cover assisted living. The following list provides an overview of various programs, what they offer and how to apply.

Medicare is a national health insurance program for seniors aged 65 or older or younger with a qualifying disability. If you already receive disability benefits, you may qualify for Medicare. Unfortunately, Medicare doesn’t cover assisted living facilities, homemaker services like cooking and cleaning, personal care assistance or meal deliveries. However, it may cover home health services with a doctor’s certification that you’re homebound and require occasional skilled nursing care or ongoing speech-language pathology, physical therapy or occupational therapy services. 

You can apply for Medicare online or through your local Social Security office during one of three enrollment periods. If you’re aged 65 or older and receive Social Security benefits, you’re automatically enrolled in Medicare Part A (hospital insurance). You can sign yourself up for Part B (medical insurance) or wait if you’re still working and receive medical coverage through your employer’s group health plan. Sign up for Medicare online or call (800) 772-1213 to sign up over the phone. Deaf and hard-of-hearing seniors may call (800) 325-0778.

Medicaid is a federal and state health insurance program that provides free or low-cost coverage for low-income seniors aged 65 or older or younger with a disability. Although state Medicaid programs vary, most states cover assisted living costs, and home health services are mandatory benefits for seniors on Medicaid. However, Medicaid doesn’t pay for room and board in assisted living in any state. It may cover meal preparation, homemaker services, medication administration and recreational activities. 

Check with your state’s Medicaid office to see if you or your loved one is eligible for benefits. Qualifying usually depends on age, income, assets and/or whether you're disabled. Apply for Medicaid by contacting your state Medicaid agency or fill out an application through the Health Insurance Marketplace.

You can apply for a spot in public housing for an affordable apartment as a low-income senior or individual with a disability. Public housing ranges from single-family homes to high-rise apartments. Eligibility is based on your annual income, U.S. citizenship or eligible immigration status and whether you’re a senior or disabled person. To live in public housing, a disabled senior must be able to live independently or utilize home care and/or home health care to provide assistance.

To apply, contact a public housing agency in your state or the local HUD Field Office. Either you or a Housing Authority representative must complete your application. Someone from the public housing authority may visit your current home to determine how well you upkeep it and interview you and your family members, if applicable. You may be required to provide documentation such as birth certificates and tax returns to verify the information provided on your application. 

Rental assistance or subsidized housing provides income-based housing designed to be affordable. Some state programs offer rental assistance in facilities that provide support for seniors and disabled persons. HUD has an inventory of units by state for seniors and disabled persons to find facilities that offer subsidized housing in their area. Housing can also include senior apartments. 

To see if you qualify and apply, contact a public housing agency in your state. HUD has a search tool you can use to find an apartment or home with reduced rent in your area and landlords who accept housing vouchers. You or a Housing Authority representative must complete your application for rental assistance or subsidized housing. Someone from the public housing authority may visit your current home, and you may be required to provide documentation to verify the information provided on your application. 

Formerly known as Section 8, the Housing Choice Voucher Program helps low-income seniors and persons with disabilities pay for rental housing. This HUD program includes single-family homes, apartments and townhouses. Vouchers may pay for a portion of the rent or all the rent. Your local public housing agency decides if you are eligible for a Housing Choice Voucher based on income, whether you're a senior or disabled and other local factors. Each state or city may have different eligibility rules for housing programs. 

Contact a public housing agency in your state or your local HUD office to apply. You or your local public housing representative must fill out the written application. You must provide information about your income, assets, bank and other local agencies to determine whether you qualify and the amount you get. Housing must meet health and safety standards for the public housing authority to approve the unit. The housing authority must inspect the rental before you sign your lease to ensure it’s worth the rental price. 

Local Rural Development offices provide help to seniors with disabilities in rural areas. For example, Rural Community Development Initiative Grants help nonprofit housing and community development organizations, federally recognized tribes and low-income rural communities support housing and community facilities in rural areas. These grants help disabled seniors by funding projects that provide them with housing, such as new assisted living facilities. Rural Development programs can assist seniors with home and daily living activities. 

Local county or city governments or a HUD-approved housing counselor can also help you identify other assistance programs available in your area to help seniors with disabilities obtain affordable housing. HUD’s nationwide network of Housing Counseling Agencies helps senior homeowners and renters make responsible choices while addressing their unique housing needs. 

Assisted living may be the right choice for you or your loved one if you require limited assistance to manage daily living with your disability. However, it might not be the best option if you’re still able to live independently or prefer to age in place at home. Other senior living options provide various levels of care, so different types of senior living works for people based on their disability. Because different ones work for different people, it’s crucial to compare your options before making a decision. 

Adult family homes, also referred to as board and care homes or residential care homes, are usually single-family homes modified to accommodate the needs and safety of older adults. They provide a more home-like environment with fewer residents, usually between two and nine. Residents get a private or semiprivate bedroom and share the rest of the home. Live-in caregivers generally provide personalized care, with some specializing in very individualized care, including meeting the needs of seniors with Alzheimer’s or specific disabilities. This higher level of care and the smaller size makes these senior living environments ideal for meeting the needs of seniors with disabilities. 

Nursing homes provide the highest level of care of all senior living options, making them great for seniors with disabilities who can no longer live independently and require around-the-clock medical care. While medical services vary significantly among nursing homes, common services include: 

• Skilled nursing care
• Wound care
• Physical, occupational and speech therapies
• Orthopedic care for bone, muscle and joint problems
• Intravenous therapy
• Breathing treatment

Seniors with disabilities may receive specialized treatment based on their unique needs. All nursing homes have physicians on-call to ensure swift response to acute needs. 

In-home care includes personal and medical support provided in the home for individuals wanting to age in place but unable to manage the tasks of daily life. This form of assisted living occurs in a private, family environment that promotes greater independence and control. Home care isn’t a good option for seniors with disabilities who require around-the-clock care or as a long-term solution for those with limited income or savings. However, it’s a fantastic option for those who don’t need 24/7 care and want the flexibility to choose their housing situation. 

CCRCs offer a full continuum of care, from independent living through skilled nursing facility care, making them ideal for seniors with disabilities whose care needs will likely change in the future. This senior living option offers the bonus of knowing your long-term care needs will be met without moving to another community each time your needs increase. CCRCs can be an especially good choice for seniors with disabilities they know will worsen with age, giving them some control over where they’ll live.