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How to Choose an Assisted Living Facility

26 December 2023

An assisted living facility serves as an alternative for older adults who are still capable of independent living and desire to uphold their quality of life while managing their daily affairs autonomously. Moving to an assisted living facility is a complex and personal decision. Such a solution may be appropriate for people who feel lonely and are interested in social activities and cultural enrichment.

The differences between an assisted living facility and a nursing home

  • An assisted living facility is intended for people who are capable of living independently, whereas nursing homes primarily serve individuals who are unable to manage their own care at home
  • In an assisted living facility, residents have the option to live independently or with a spouse in their own residential unit. Nursing homes typically have shared rooms where two or more residents may reside together

If you are uncertain about which of the two residential options is better suited for you, seeking guidance from a geriatric doctor can be beneficial.

Key considerations when selecting an assisted living facility

  • License: Assisted living facility operators must hold a license obtained from the person in charge of the assisted living facilities in the Ministry of Welfare. Additionally, they must adhere to the terms and conditions outlined in the license, which are designed to protect the residents in every respect.
  • Location: You might prefer selecting an apartment that is in close proximity to the area you are familiar with or near your family and friends
  • The quality of the apartment: Assisted living facilities offer a range of apartment types, each varying in size and providing diverse living conditions. Assisted living facilities vary in the availability of public areas, with some having more communal spaces than others. Consider your preferred conditions, and examine available options
  • Available services: Each facility offers different options for entertainment; some provide communal dining rooms or cafeterias, while others include maintenance and cleaning services either as part of the monthly fee or as separate options. It is recommended to take an initial tour to form an impression of the range of services and conditions available
  • Price: Assess the pricing based on your financial capabilities and determine if you are eligible for assistance from sources such as National Insurance or private insurance.

Throughout your lifetime, you have changed your place of residence in response to the evolving needs of yourself and your family. Over time, as your children have grown up and left with their own families, your house has become too large for your current needs. Furthermore, following your retirement from work, a significant amount of leisure time is at your disposal. You and your family members may be considering the most appropriate housing option at this stage in your life, while you remain independent and mobile, but looking for a living arrangement that will suit you the most and allow you to uphold your well-being among people who share similar circumstances.

An assisted living facility is a housing alternative, intended for independent older adults, who seek to preserve their quality of life. It offers a supportive environment where their physical and mental well-being is safeguarded, allowing them to lead their lives independently. The decision to move to an assisted living facility is a complex move, encompassing numerous inquiries and apprehensions that arise from the prospect of leaving one's familiar home for an unfamiliar environment.

This is a very personal decision. If your beloved home no longer meets your changing needs, it is time to consider moving to an assisted living facility; For instance, if you are feeling lonely, and particularly, if you have been widowed and you are afraid to be on your own. If you think that living in an apartment house where the majority of residents are of a similar age can provide assistance, an assisted living facility may indeed serve as a solution and even serve as a form of replacement for family and friends who have passed away over the years.

If you appreciate social activities, lectures, cultural enrichment, etc. and you would like someone to organize such events for you, an assisted living facility can provide these activities, allowing you to participate without the need to worry about purchasing tickets or making arrangements.

An assisted living facility can play a substantial role in safeguarding your well-being, enhancing your lifestyle, and offering a convenient and enjoyable way of living while preserving your independence throughout every stage.

However, it is not advisable to delay the decision to move to an assisted living facility because if you postpone the decision and your level of independence declines over time, an assisted living facility may no longer be suitable.

Assisted living facilities include residential units and services such as: security 24/7, a health clinic, a nurse, and a doctor, as well as a dining room, housekeeping, and laundry services, and more. The eligibility criteria for entering an assisted living facility include the requirement of residents' independence. In nursing homes, on the other hand, older adults reside at various functional levels. There are frail or mentally frail residents, who require constant medical care 24/7 and reside in a nursing home with a caregiver.

Residing in a nursing home is intended primarily for people who cannot take care of themselves, whereas residing in an assisted living facility offers a combination of security, protection, and an enriched social and cultural experience.

Assisted Living Regulations 2020 (Hebrew)

In assisted living facilities, the residents reside alone or with a spouse in a residential unit (an apartment in diverse sizes); In a nursing home the rooms are shared by two residents or more.

Another distinction between an assisted living facility and a nursing home is that an assisted living facility is usually private, while many nursing homes offer the option of financial assistance from the Ministry of Health. Additional information on code hospitalization.

An assisted living facility is designed both for individuals and couples, who can live together in a shared residential unit. The primary advantage of an assisted living facility is that it coordinates the medical and social services that older adults require under one roof.

Furthermore, an assisted living facility offers social activities, classes, cultural and leisure activities, a gymnasium and more. These services are available within a community where individuals of similar age and shared interests reside. Certain facilities have a swimming pool, golf, etc. This allows for the establishment of a routine that encourages residents to be active and avoid being bored and preoccupied with health issues, leading to deterioration and to melancholy typical of older age.

As part of the comprehensive service provided by assisted living facilities, it also offers activities designed to enhance the physical and mental health of the residents.

An assisted living facility could be a suitable solution and even provide a sense of replacement for family or friends who are no longer present. The companionship of new friends within the facility forms a supportive community, allowing for the celebration of holidays and birthdays together.

The assisted living facilities are tailored to the requirements of the older individuals and offer diverse services, including housekeeping, along with a medical staff providing constant medical care around the clock.

There are diverse types of assisted living facilities available:

  1. An assisted living facility built as a neighborhood: a residential complex that includes buildings and shared public spaces
  2. An assisted living facility in a “village”: a sort of village with detached apartments and a garden

Each residential type offers a variety of apartment sizes to choose from: studio apartments, or 2-3 bed apartments, complete with a bathroom and a toilet. Certain assisted living facilities offer larger apartments and even expansive penthouses.

Some will offer furnished apartments, while in others you will have the option of furnishing the flat according to your personal tase.

An assisted living facility is designed, in principle, for fully functional, independent older adults. Only a portion of assisted living facilities provide residents with the opportunity to remain in their accommodation even when they experience a decline in functional ability and become frail. These assisted living facilities have nursing wards available for individuals to transition to, either with or without a caregiver.

Every assistant living facility which has at least 250 apartments is obligated to operate a nursing ward. However, the person in charge of assisted living on behalf of the Ministry of Welfare has the authority to exempt a facility from this obligation if they are convinced that all the following conditions have been met:

  • There is a nursing ward in close proximity to the facility
  • There is an arrangement for hospitalizing residents from the assisted living facility in the nursing ward
  • There are exceptional circumstances not to establish or activate a nursing ward

Guidelines for choosing an assisted living facility

  1. Legal license to operate an assisted living facility: It is important to get to know the Assisted Living Act of 2012, which has been enacted to regulate the relations between the residents and the operators of assisted living facilities in Israel. According to the law, these operators must hold a license from the person in charge of assisted living within the Ministry of Welfare and comply with the license terms which aim to protect the residents in various aspects, including medical care, financial matters, security, and more. It is important to point out that the fundamental license terms include the appointment of a multidisciplinary staff, which includes nurses, social workers, doctors, and supervision of their professional training, as well as of the facility’s manager. According to the law, each of the internal, as well as the external workers, should be authorized by the person in charge of assisted living. An assisted living facility is classified as an independent living option within the community and requires a valid license.
    Nevertheless, it is important to emphasize that the law does not require the assisted living facility to obtain a license from the Ministry of Health or be subject to supervision by them. Since the Ministry of Health imposes strict conditions for granting a license, when choosing an institution that has been granted a license, it is an indication that the facility maintains high standards, and its healthcare and nursing services are of high quality and safety. In any case, it is crucial to check whether the facility has an available and accessible clinic, as well as a nursing ward.
    Further reading on the assisted living regulation of the Ministry of Health (Hebrew)
  2. Location of the assisted living facility: As in any house moving, you may wish that your apartment in the assisted living facility is in close proximity to the environment you are familiar with and love, as well as close to family and friends.
  3. Quality of the apartment: Assisted living facilities offer a variety of apartments, in a variety of sizes and living conditions. Certain assisted living facilities have extensive public spaces, while others provide more limited ones.
  4. Services that are provided in an assisted living facility: Every facility offers different entertainment and cultural possibilities; some have a shared dining room or a cafeteria. Some facilities offer regular maintenance and housekeeping services as part of the monthly fees or separately.
    In addition to the health clinic, some facilities offer alternative medicine services.
    Since every assisted living facility offers different services, it is important to make a preliminary visit to the facility you are interested in. This allows you to assess the apartments, services, and conditions and form an informed opinion.
  5. Price: An assisted living facility is usually financed by the residents. It is advisable to check the prices according to your financial capabilities, explore funding options and determine whether you may be eligible for assistance from the National Insurance, or private insurance, among others.

Paying the assisted living facility: monthly maintenance fees and deposit

The price range of assisted living facilities is very wide and contingent on the chosen facility, the area, the company that owns the facility, the available services, etc.

The payment is composed of several factors, primarily including a deposit from which a specific amount is deducted each month, along with a regular monthly payment.

The payment method

Entails a high one-time payment deposit (often requiring residents to sell their apartment to meet the fee). The deposit amount typically ranges from 0.5 million NIS to 3 million NIS. Three percent is deducted annually from this sum.

It is important to note that according to the law, when a resident moves to another location or passes away, the facility's management is obligated to refund the remaining balance of the deposit to the resident or their heirs. The calculation of the deposit balance involves deducting the eroded amount from the original deposit over the years.

In addition to the deposit the residents also pay a maintenance fee covering the ongoing costs of the activities, the medical services, and other associated costs. The regular amount changes according to factors such as the provided services, apartment size, location, and the prestige of the facility. Typically, it ranges from several thousands to tens of thousands. This sum is usually Indexed so it varies every year. It is important to note: according to the law, the maintenance fees can be raised in accordance with the agreement signed with the resident.

on this route the residents pay a monthly rent and maintenance. This sum is usually significantly higher than the deposit route. It is a suitable option for individuals who do not own a property and can finance their stay in the assisted living facility through pension benefits or with the assistance of family members who contribute the required amount on a monthly basis.

A significant, one-time payment is required, from which a certain percentage is deducted on a regular basis until the original sum is depleted.

When considering different facilities, it is important to verify if they provide exclusive deals and benefits for members of various organizations, such as state pensioners. Since these deals often involve significant amounts, it is crucial to carefully review the agreement terms and conditions, including the presence of exit points and any potential fines for leaving the facility.

Signing the assisted living resident agreement with the assisted living facility

Upon signing an agreement with the assisted living facility, it is essential to receive a residential agreement document that clearly outlines the payment breakdown expected from the resident, along with the terms and conditions pertaining to termination or cancellation (terms of discharge). The residents should receive a well-organized document that clearly explains the guidelines for behavior within the facility, the provisions regarding caregivers staying in the residential units, and other relevant information.

The residential agreement document must clearly outline the conditions for termination, as well as the resident's rights regarding the apartment they have rented in case of hospitalization or admission to a nursing home.