​As the National Center for Assisted Living (NCAL) marks its 25th anniversary this year, we have a unique and exciting opportunity both to celebrate what assisted living has become during this time for millions of older adults and to look ahead to the next 25-plus years. 

I am incredibly proud of and grateful for the extraordinary dedication of owners, operators, and frontline caregivers who make this important care possible every day. Assisted living is unique; it is a purpose-built model that offers independence, care, and support with everyday activities in a homelike setting.

Assisted living exists because aging brings new, different needs. In supporting those needs, it is essential that we continue to respect a person’s right to choice, connection, and self-direction—because this is what people want. The assisted living model was created to support individuals in ways that respect who they are and how they want to live. Residents choose assisted living to extend independence with the right support in place to help them live fully, safely, and with dignity.

By design, assisted living delivers many of the social determinants of health that lead to better outcomes and stronger quality of life. Stable housing, nutritious meals, meaningful social connection, and access to coordinated services are built into the model. Within a residential environment that feels like home, assisted living promotes engagement, purpose, and continuity of life—elements that are just as important as any clinical intervention.

For 25 years, NCAL has proudly represented this vision at the national level. We have been the national voice ensuring that this model is understood and protected. Through collaboration with state and federal policymakers and with the support of our members, NCAL has helped ensure that assisted living is recognized as a distinct and essential part of the larger long term care continuum.

But, as with most things, change is inevitable. There is an evolution in aging and how we care for future assisted-living residents. The needs and wants of the aging population are shifting while the desire for choice, connection, and individual support remains the same. Care delivery and who we care for will look different as we move into the next 25 years. 

Intentional Use of Technology

We like to think of technology as something that will impact the future, and it will. However, technology is no longer just a future consideration for assisted living; it is already shaping how communities operate and how care is delivered. What stands out to me is not only the technology itself, but how intentionally providers are using data and innovation to strengthen operations, improve the day-to-day experience of residents, and clearly demonstrate measurable outcomes.

As expectations become more integrated with health care, assisted living providers are not waiting to be pushed forward. Many are leading the way—adopting wearables, strengthening care coordination, and using technology to support independence rather than replace human connection.

AI is one technology that is already being utilized in some communities and will continue to become more common as it evolves. Therapy tools are an example of how it is currently being used. In Illinois, the Eagle Ridge of Decatur community partnered with its therapy provider to use AI-enabled tools that generate objective data on balance, gait, and mobility. This is not about novelty. It is about better information—information that is already helping reduce falls and support resident independence. 

AI is only one piece of a much larger shift. Communities are also exploring virtual reality, advanced therapy tools, and other technologies that generate actionable data. That data matters. It tells you where you are, where risk exists, and where improvement is needed. Used appropriately, technology is a lever for improving care.

Expanding Affordable Assisted Living Options

The next wave of older adults will be larger, need more support, and have fewer financial resources to pay for care. If assisted living is going to remain a viable option for this population, affordability must be addressed directly and urgently. We know what is coming, and we have collaborative work to do to prepare. 

Our 2023 NCAL white paper, The Importance of Expanding Affordable Assisted Living Options and Proposed Solutions, lays this out plainly. Family caregivers are declining while demand for assisted living is rising. In parallel, many older adults are aging with limited savings, increasing the risk that they will not be able to access the care they need when living at home is no longer possible.

The white paper does not just diagnose the problem; it points to solutions. Expanding affordable assisted living will require intentional public-private partnerships and better use of state-level grants, programs, and financing tools.

Medicaid must also be part of the conversation. Today, one in five assisted living residents relies on Medicaid for care, yet the program covers services only, not room and board, leaving a significant gap that limits access for low- and moderate-income individuals.

Simply put, if we do not act, affordability will become a defining barrier to assisted living just as demand accelerates. Ensuring access to the right care, in the right setting, and at the right time must include assisted living—and it must include solutions that make assisted living financially attainable.

Supporting Workforce Efforts

An increase in demand by an aging population brings the need for more caregivers. NCAL, along with the American Health Care Association (AHCA), have been supporting and continue to support providers 
in this area. AHCA/NCAL are advocating for state and federal policies, among many areas of focus, as well as legislation that supports workforce development, promotes long term care careers, and attracts more workers. 
We are also developing resources to support our members’ efforts in recruitment and retention, including the following:

• Caregivers for Tomorrow: This is a nationwide effort to drive policy change to strengthen and expand the long term care workforce through innovative, sustainable solutions. The goal is to advance policies and legislation that will help build the caregiver pipeline and drive qualified professionals to long term care and senior living. 

• Careers in Caring: This is a program that offers AHCA/NCAL member providers information and resources to help successfully recruit care professionals. 

This is not all we are doing on the workforce front, but these are important initiatives. NCAL will continue to support assisted living providers in their efforts to recruit and retain the best caregivers, because our residents and our future depend on it. 

Incentivize Innovation through Rational Regulation

Meeting future demand for assisted living will require a regulatory environment that supports balance, innovation, and partnership. Expanding access, strengthening the workforce, and encouraging new development—particularly for affordable assisted living—will depend on policies that recognize the diversity of residents, communities, and care models across the country.

Assisted living serves individuals with a wide range of needs, preferences, and desired levels of independence. Regulation is most effective when it reflects that diversity rather than assumes a one-size-fits-all approach for residents or operators. Flexibility upheld by accountability allows providers to tailor services, deploy staff more efficiently, and use technology in ways that strengthen quality and access.

Progress depends on regulation that allows providers to adapt—using staff more effectively, deploying technology appropriately, and tailoring services to individuals. Flexibility does not mean compromising quality; rigidity stifles innovation and customization, two things residents and families love about assisted living.

At the same time, regulation must continue to protect resident safety while preserving independence, privacy, and choice. Assisted living works best when individuals can opt in to services based on their needs rather than be subject to blanket requirements that limit autonomy.

The path forward is about balance—supporting safety and quality improvement while enabling innovation, efficiency, and resident-centered care. NCAL remains committed to working alongside policymakers and stakeholders to promote rational regulation that reduces unnecessary costs, improves outcomes, and creates an environment where assisted living can continue to evolve to meet future needs.

The Future Is Bright

I truly believe assisted living will continue to evolve and successfully meet the needs of future residents. The areas highlighted here are not exhaustive of everything providers will face as we move forward, which will require continued vigor for and dedication to the profession and the residents we serve. 

As providers and the profession continue to evolve, NCAL will be right there. We have a unique opportunity to expand and enhance how we serve our residents. Together, we will continue advancing quality, expanding opportunity, and ensuring that this unique model remains a powerful, person-centered solution for the next generation of older adults. 

The path ahead is bright, and NCAL remains steadfast in supporting the profession for the next 25 years and beyond. I am grateful for the support we have received and look forward to moving forward together, stronger than ever. 

LaShuan Bethea is the executive director of the National Center for Assisted Living (NCAL).