Do you remember what you were doing the last week of April 2020? For many, life had slowed dramatically as COVID-19 lockdowns were in effect across large parts of the country. Extended social isolation took a toll on millions while communities awaited effective vaccines.
Tragically, the earliest months of the pandemic claimed many lives, especially among older adults and vulnerable nursing home residents. Yet a new study finds an unexpected result: seniors living in congregate senior living communities—such as continuing care retirement communities (CCRCs or life plan communities)—were significantly less likely to die from COVID-19 than similarly aged peers living outside congregate settings.
After vaccines became available, residents of congregate communities including independent living, assisted living, and memory care showed excess mortality rates that were comparable to—or in some cases lower than—those of non-congregate-dwelling seniors.
Impact of COVID in senior living communities
The study, sponsored by the National Investment Center for Seniors Housing & Care (NIC) and conducted by the National Opinion Research Center (NORC) at the University of Chicago, examined excess mortality among people age 75 and older across a variety of living arrangements. The analysis included those living at home and those in congregate settings such as independent living, assisted living, memory care, and skilled nursing facilities. CCRCs, which provide a continuum of care from independent living through skilled nursing, were included in a secondary analysis.
Researchers analyzed 2020 data from 3,817 senior living communities across Colorado, Connecticut, Florida, Georgia, and Pennsylvania, representing roughly 503,000 seniors age 75 and older. Their findings highlighted several key patterns.
More complex care needs, higher COVID death rates
Residents with greater medical and care needs experienced higher COVID-related mortality. Consequently, the largest share of deaths among congregate settings occurred in memory care and skilled nursing communities.
This outcome aligns with expectations: memory care residents often live with cognitive impairment and may need assistance with daily activities, which complicates infection control when residents cannot reliably follow hygiene or distancing guidance. Skilled nursing residents generally have the most complex health needs and require round-the-clock clinical care; they are typically older and in poorer health than residents of other congregate settings.
Because of these preexisting vulnerabilities, nursing home residents were particularly susceptible to severe COVID complications and accounted for a substantial portion of pandemic deaths.
Independent living maintained the status quo
The study found encouraging news for independent living communities, whose residents tend to be younger and healthier than those in care-focused settings. Statistically, independent living residents had similar mortality rates to same-age seniors living in the broader community.
This is important because many independent living residents worried they might face higher infection or death risk simply by living in a congregate environment. The NORC analysis indicates that, at least in terms of mortality during 2020, independent living did not increase seniors’ risk relative to their county peers.
Many senior living communities remained safe
While the pandemic’s toll on older adults was severe, the NORC data also showed that many senior living communities effectively protected residents even before vaccines were available. A significant share of communities reported no COVID-related deaths in 2020:
- 67 percent of independent living communities
- 64 percent of assisted living communities
- 61 percent of memory care communities
- 39 percent of skilled nursing facilities/nursing homes
Benefits of congregate living communities during COVID
The study identified several advantages that congregate living provided during the pandemic compared with living alone in the community. First, many communities implemented strict infection-control procedures and lockdowns to limit exposure while still meeting resident needs.
Instead of making frequent trips to grocery stores, pharmacies, or other public places, many residents received meals, groceries, and medications delivered to their doors. Communities also adopted creative ways to maintain social engagement and activities within safety guidelines, which helped reduce loneliness and isolation for residents compared with seniors living alone.
Critically, residents and staff in many senior living settings were prioritized for early vaccine distribution once authorization occurred. That priority led to faster and higher vaccine uptake within congregate communities, allowing vaccinated residents to resume more normal routines sooner and relieving some of the pandemic-related stress and isolation that affected many older adults living independently.
Good news for the senior living industry
The pandemic understandably stoked fear among seniors and their families, and some residents chose to leave congregate settings. However, the NORC findings indicate that most types of senior living communities were as safe as—if not safer than—community-dwelling alternatives. Combined with the practical supports these communities provided during lockdowns and the advantage of earlier vaccine access, many residents experienced a level of protection, care, and social connection that helped them through a difficult period.
These outcomes help explain why senior living occupancy recovered by the end of 2022 to pre-pandemic levels, with demand in some segments, such as assisted living, exceeding supply. Increasingly, older adults and families are recognizing the health, social, and safety benefits that well-run senior living communities can offer.