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If you’re exploring long-term residential care for an adult with disabilities, you might wonder whether assisted living is a good fit. While typically designed for older adults, some assisted living facilities do serve younger adults with intellectual, developmental or physical disabilities — though services, eligibility and availability vary widely by state.
“When assisted living facilities say they serve adults with disabilities, they often mean older adults with physical needs — not younger people with intellectual and developmental disabilities (I/DD),” says Carrie Hobbs Guiden, senior executive officer of chapters and community at The Arc. “Acceptance is almost always case-by-case, and even then, the person has to meet strict eligibility requirements.”
Here’s what to know about assisted living for people with disabilities, including how it works, how to pay for it and how to find a facility that meets your or your loved one’s needs.
Key takeaways
- Assisted living can work for some adults with disabilities, but access is limited and varies widely. Many communities primarily serve older adults, and younger individuals with intellectual or developmental disabilities often face strict eligibility rules or must explore alternatives like supported living or group homes.
- Costs are high and coverage is complex. Medicaid waivers, veterans benefits and long-term care insurance may help cover care services (not housing), but many families still rely heavily on private pay and long-term planning.
- Finding the right fit requires research, advocacy and person-centered planning. Touring facilities, verifying staffing and licensing, and actively involving the individual in decisions helps ensure care supports independence, dignity and quality of life.
What is assisted living for adults with disabilities?
Assisted living facilities are licensed communities that provide housing, meals, and help with daily activities of daily living (ADLs) such as bathing, dressing, and managing medications. Many also offer extras like on-site nursing, physical or occupational therapy, transportation and social activities. While typically associated with older adults, some states allow younger adults with disabilities to qualify for assisted living — often through Medicaid Home and Community-Based Services (HCBS) waiver programs or other state-supported programs.
“Families searching for housing options for a loved one with I/DD won’t get far using terms like ‘assisted living,’” says Hobbs Guiden. “That language is rooted in aging services. Instead, look for terms like ‘supported living,’ ‘group homes,’ or ‘adult family homes.’ The vocabulary isn’t just confusing — it reflects two entirely different systems that rarely speak to each other.”
Assisted living may be a good fit for adults with disabilities who:
- Need help with ADLs but not 24/7 nursing care.
- Prefer a community environment with meals, activities and support.
- Are aging with a disability, such as Down syndrome, and may experience early-onset conditions like dementia.
However, access is not guaranteed. Many assisted living facilities have age minimums or only accept private-pay residents. “Most assisted living facilities aren’t built with people with I/DD in mind — especially younger adults,” Hobbs Guiden adds. “Many won’t admit anyone under 65, and others will turn people away if they have behavioral support needs, even if those needs are manageable.”
“…look for terms like ‘supported living,’ ‘group homes,’ or ‘adult family homes.’”
— Carrie Hobbs Guiden, senior executive officer of chapters and community at The Arc
How much does assisted living cost — and who pays for it?
The average cost of assisted living in the U.S. is about $5,900 per month, according to Genworth’s 2025 Cost of Care Survey. Costs can vary widely based on where you live, how much care is needed and the type of housing (private vs. shared).
Here are common ways families pay for assisted living:
- Medicaid HCBS waivers: Many states offer waivers to help cover personal care costs, but not room and board.
- Veterans benefits: Programs like VA Aid and Attendance and the Community Residential Care (CRC) program can help eligible veterans access support services in residential settings.
- Long-term care insurance: Some policies cover assisted living if the person needs help with two or more ADLs.
- Out-of-pocket: Many families use savings, Social Security, pensions or help from relatives.
- Supportive Living Programs (in some states): For example, Illinois offers a Medicaid-funded program for adults 22+ with physical disabilities that pays for care services — but not housing.
Even with these options, paying for care remains a challenge. A 2025 brief from The Harkin Institute warns that long-term care costs have nearly doubled since the early 2000s, and most families can’t afford them — especially those without high incomes or live-in caregivers. The brief also notes that Medicaid is hard to qualify for, and people without family advocates may be left with no support at all.
“Medicaid is a state and federal partnership and the main game in town for when it comes to facility-based care and access to home and community-based services for people with disabilities and aging adults,” says Nicole Jorwic, chief program officer at Caring Across Generations, speaking during a May 2025 webinar hosted by The Harkin Institute.
As a caregiver to her 35-year old brother with autism, Jorwic knows the limitations firsthand. “They [Medicaid waivers] were built to delay nursing home entry for older adults, so even when Medicaid is technically available, the system still doesn’t quite fit.” That’s why it’s critical to explore state programs, talk with care managers and plan ahead.
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How to choose the right assisted living facility
Choosing an assisted living facility for people with disabilities takes time, careful research and, whenever possible, the involvement of the person receiving care.
Begin by contacting your local Aging and Disability Resource Center (ADRC) or Area Agency on Aging. These organizations can help you understand available services, apply for Medicaid waivers and identify facilities that may be a good match.
However, directories are not always reliable. Jennifer Szakaly, a certified care manager and founder of Caregiving Corner in North Carolina, says families should be cautious. “In our experience, the information isn’t always up to date, which can be very frustrating for families trying to find care quickly,” she explains.
Here are some important steps to guide your search:
- Assess care needs: Does your loved one need help with mobility, behavioral support, or medication management? Ask whether staff are trained to work with specific disabilities, such as autism, cerebral palsy or dementia.
- Visit in person: Touring in-person allows you to observe the environment, staff interactions and daily routines. Be wary of places that limit or require advance notice for visits.
- Ask about staffing: What is the caregiver-to-resident ratio? Are night shifts fully staffed? For residents with higher needs, a ratio of at least one caregiver for every five residents is recommended.
- Check state licensing and inspections: Look at public records for violations, complaints or issues flagged in recent inspections.
- Understand the financial picture: Ask what is included in the base monthly cost and what services may require extra fees.
- Include your loved one in the decision-making process. Use visual aids or communication tools if needed. Work together with the care team to develop a person-centered plan that respects your loved one’s preferences and goals.
“We can’t plan for someone without involving them at every step,” Hobbs Guiden says. “That means visiting potential living arrangements together, noticing their reactions and observing how others engage with them.” She recommends families use The Arc’s Center for Future Planning and LifeCourse tools to guide conversations with their loved one, explore what matters most to them and make more informed, person-centered decisions.
Changes shaping the future of care for people with disabilities
As the demand for long-term care services continues to rise, policymakers are beginning to address the gaps that affect adults with disabilities under age 65. New initiatives aim to make care more accessible, better coordinated and more responsive to individual needs.
- Connecting disability and aging services: In 2024, Tennessee passed the Disability and Aging Act, combining its aging and disability services into one system. This makes it easier for families to find coordinated support across different life stages and reflects a growing awareness that many people with disabilities live well into older adulthood.
- Shifting away from institutional care: Illinois launched its Transformation Initiative in 2023 to increase community-based housing options for people with I/DD. The plan includes closing outdated institutions and replacing them with smaller, more integrated residential settings that promote independence and dignity.
- Acknowledging early-onset dementia: The 2020 update to the Older Americans Act expanded eligibility for caregiver support programs. Families of adults under 60 with younger-onset dementia, including many individuals with Down syndrome, can now access services such as respite care, caregiver education, and support groups through the National Family Caregiver Support Program.
While these efforts mark important progress, access is still limited. According to the Kaiser Family Foundation, more than 710,000 people are on waiting lists for Medicaid HCBS, and 73% of them are individuals with I/DD. Until funding and capacity improve, many families will continue to face long delays and difficult choices.
“We can’t plan for someone without involving them at every step. That means visiting potential living arrangements together, noticing their reactions and observing how others engage with them.”
— Carrie Hobbs Guiden
One final tip about assisted living for adults with disabilities
Assisted living can be a safe and empowering option for adults with disabilities who need daily support but not 24-hour medical care. Finding the right fit often requires time, planning and a strong advocate.
As Jorwic says, “The biggest thing that family caregivers need is a system, so that care can be a choice, not the only option.”
By starting early, asking informed questions and including your loved one in the decision-making process, you can help them find a place where they feel respected, supported and truly at home.
