Economic and Care Challenges In Senior Living Communities: Perspectives from Older Adults and Their Families

Background and Purpose: The vast majority of older adults prefer to age in their homes and communities. The U.S. lacks a comprehensive system to provide long-term care (LTC) at home, meaning most people rely on out-of-pocket payments or Medicaid to remain in the community. Senior living communities (independent living, assisted living, and memory care) represent one of the fastest-growing sectors in long-term care (LTC), enabling older adults to remain in their communities while providing flexible, person-centered services aimed at enhancing quality of life, privacy, and autonomy. However, these communities are typically paid for out of pocket and can be prohibitively expensive for many older adults. For example, assisted living averaged $8,000 per month in 2025, placing this option out of reach for a significant portion of older adults. Affordable senior living communities are rare and becoming even more scarce. This qualitative study examines the economic implications of older adults forced to leave their affordable senior living community.

Method: This qualitative study interviewed 16 former residents and family members of former residents of a recently closed affordable senior living community in a large metropolitan city in the northwest. Recruitment materials were distributed through the local LTC ombudsman program. Semi-structured interviews were audio-recorded and transcribed verbatim. Data were collaboratively coded in Atlas.ti, and themes were identified using thematic analysis.

Results: Analysis identified four key themes. First, participants described the overall lack of affordable senior living options, particularly communities that were geographically close to family, accessible (e.g., located in walkable neighborhoods), and accepted Medicaid payment. Second, participants reported difficulty navigating the LTC landscape, including finding available options, planning for changing costs, and understanding eligibility criteria. They noted the need for knowledgeable LTC advocates in these situations. Third, there was significant costs in time and resources for family members who were often responsible for care coordination, touring new communities, and managing finances. Finally, participants highlighted the lack of policy protections for older adults, noting that organizations often prioritized profit over resident health and well-being.

Conclusions and Implications: These findings highlight critical gaps in affordable senior living and the LTC system, including challenges in access, navigation, and family burden. Senior living communities are a crucial part of the LTC continuum, yet older adults and families face great difficulty identifying affordable, conveniently located communities, understanding financial eligibility, and coordinating transitions. Our findings provide guidance for social workers and other stakeholders interested in advocating for older adults in need of LTC and their families. There is a substantial need for social workers and other advocates intimately familiar with the complex LTC system to support service navigation and LTC planning. Additionally, social workers should advocate for regulations or protections in senior living communities, such as increased transparency in management, limits on displacement, and affordability protections. Enhancing access to affordable senior living communities, strengthening advocacy, and implementing protective policies could improve quality of life for older adults and ensure their ability to age well in their communities.