top of page

Assisted living only to a point: Read the fine print.

How to get your loved one the extra support they need

By Kevin Smith

Assisted living can be a viable choice for seniors who aren’t able to do everything for themselves anymore yet do not require the clinical care that nursing homes provide. Over the past decade, many families have helped elderly loved ones move to the more structured environments that assisted living facilities provide.

What families often don’t realize (or haven’t read in their contract) is that assisted living facilities provide a finite scope of services to support residents’ daily needs. These include cleaning services, making a bed, meal service (dining or room service), mail delivery, etc. Some assisted living facilities do provide at extra cost assistance for daily living needs such as bathing, dressing, grooming, medication reminders, etc.

If you’re closely monitoring your situation (or that of a loved one) and have determined they require more support time than their assisted living contract provides, know that you do have choices.

First, has your loved one’s medical condition deteriorated significantly? Do they now require help to get out of bed or move with a walker or wheelchair? If the answer is yes, make an appointment with her/his physician to re-assess their needs and adjust their plan of care.

This is the time to evaluate whether your or a loved one’s current assisted living community has the supports (and quality controls) in place to meet their higher-level needs. It’s also a great time to have a heart-to-heart conversation with your senior. How do they perceive the services they’re receiving at the assisted living facility?

If more hours of hands-on support are required, you have the right to select who provides these services. Here in Massachusetts, many assisted living facilities contract with independent home care agencies to serve their residents. Separate from these agreements, many agencies also have independent private-pay contracts to serve clients in retirement communities and assisted living facilities.

Option 1

Are you satisfied with how the facility’s aides and/or nurses currently serve your loved one? Are you confident they’ll be able to provide the same quality with more hours? Are the aides employed by the facility able to provide additional service beyond their required tasks ? If you can answer ‘yes’ to these questions, you may consider paying the facility to provide an agreed-upon number of additional hours of personal health aide or clinical nursing staff time.

Option 2

Are you uncertain about or do not have the level of care and quality that the assisted living facility’s aides and nurses are providing? You always have the option to choose a home care agency and pay them directly for services.

If you are considering Option 2, there are many quality licensed home health care agencies in Massachusetts to chose from, including ours.

Best of Care is a proud member of a professional home care association that can help you find an agency in Massachusetts: The Massachusetts Home Care Aide Council (


bottom of page