Article by Amy Carlini, Department of Family Services
(Posted 2026 March)
There may come a point in your life when you or your family members decide it’s no longer practical or safe for you to live in your home anymore. Perhaps the stairs have become too much, or the narrow doorways and hallways won’t accommodate a wheelchair. Maybe you need help managing your medications, doing your laundry, shopping, and preparing meals. There are many services available to help you to “age in place” and remain in your home if you wish, but another option is moving to an assisted living facility. This form of communal living can be more cost effective than paying for home nursing care, and it offers new opportunities to make friends, participate in group activities, learn new hobbies, and go on outings. Most important, it can offer peace of mind to your family members, knowing that you are safe and cared for.
In Fairfax County, there are many high-end assisted living facilities that give the appearance of living in a 5-star luxury hotel. If you take a tour, most will encourage you to try their food, served in in-house restaurants and prepared by respected chefs. Most facilities have well-equipped gyms. Some even have golf simulators. Other amenities include movie theaters, art rooms, hair salons, and pet areas.
Luxury assisted living facilities may be worth the cost, which in this area can average around $6,000 per person, per month, for a room and meals in addition to thousands of dollars more each month for care (totaling close to $12,000 per month). They offer many programs and services, but before you make the commitment to move into one, you should have realistic expectations. There are many things assisted living facilities are NOT:
- Nursing Facilities. “Nursing homes” or skilled nursing facilities are under the direction of a physician and care is supervised by a registered nurse. Therapists such as physical, occupational, and speech, provide restorative or maintenance functions for residents. In assisted living, facilities are not under the direction of a physician and may or may not have nursing staff. While assisted living facilities provide basic care such as bathing, dressing, housecleaning, and medication management, it is rare to find one with a doctor on staff. Some places contract with medical personnel who make “house calls,” but for the most part, you will need to determine your own medical needs, make your own doctor’s appointments, and visit their offices for medical care.
- Able to Provide Acute Care. There are certain levels of care that may include administration of IV antibiotics, wound care, etc. that an assisted living facility will require you to receive in a hospital or skilled nursing facility. There are licensing regulations that forbid them from providing some specific care services in the facility. Even if your family members are willing and able to come to your facility and provide these services for you, the facility may not allow it. While you are hospitalized, they will likely continue to charge you a monthly fee.
- All-Inclusive. Not all the amenities are included in the monthly fees. Hair salons and outings may cost extra. Some facilities will help you arrange transportation but will not pay for it. Some have meal plans that only include a limited number per week. You will most likely be responsible for purchasing your own incontinence supplies (disposable briefs), personal items, furniture, clothing, and more. Make sure to obtain a complete list of out-of-pocket costs and thoroughly read through the admissions contract. These are private businesses that have the discretion to create policies around a lot of things (levels of care, fees, etc.) so it’s important to understand “the rules” before signing.
- Permanent. There is no guarantee you can live in an assisted living facility for the rest of your life. Even if you eventually choose to receive hospice care, there are situations where a facility will not allow you to stay, or will not allow you to return after a hospitalization, requiring you to go to a hospice facility or skilled nursing facility instead, because of the level of care or specific services you may need.
Are you considering moving to an assisted living facility? Are you already living in one and need assistance with a care issue? The Northern Virginia Long Term Care Ombudsman Program is part of a nationwide network established under the federal Older Americans Act to provide consumer information and help residents resolve problems related to care. Call 703-324-5861, Monday-Friday, 8 a.m.-4:30 p.m., or send an email to NVLTCOP@fairfaxcounty.gov.
Another resource, if you’re comparing facilities, is the Virginia Department of Social Services website where you can search for specific assisted living facilities and view the most recent inspection reports: dss.virginia.gov/facility/search/alf.cgi.
Do you want to try living in your home as long as possible with in-home assistance or home modifications? Call the Department of Family Services Aging, Disability, and Caregiver Resource Line, 703-324-7948, Monday-Friday, 8 a.m.-4:30 p.m., to find out what services you may be eligible to receive from DFS or what services and classes are available for a fee.
If you can afford it, a luxury assisted living facility can be a great option. It can feel like living with good friends in an exclusive resort while being pampered and entertained. But it’s important to do your research, and be well aware of the limitations and of your rights as a resident.
This article is part of the Golden Gazette monthly newsletter which covers a variety of topics and community news concerning older adults and caregivers in Fairfax County. Are you new to the Golden Gazette? Don’t miss out on future newsletters! Subscribe to get the electronic or free printed version mailed to you. Have a suggestion for a topic? Share it in an email or call 703-324-GOLD (4653).