Senior Housing Options
While a change in an individual’s functionality often initiates a move, many people simply decide they no longer want to stay in a home too large for their "empty nest", or that requires maintenance they no longer wish to provide. Increasingly, adults choose to move to senior living communities designed exclusively for older adults.
Once you decide to move, you may already know you will live with another relative, or in the age-in-place retirement home you bought years ago. But for many, it helps to understand the variety of senior living choices in today’s market.
The following is a list of residential options created especially for seniors. Bear in mind that some housing options and definitions will differ due to regional preferences, statutes and providers.
For those Able to Live Independently
Independent Living Communities offer individual apartments, cottages, and/or townhomes with areas for group socializing and dining. Residents are generally self-sufficient and require no special care, but choose to have certain services provided for them. Services may include meals, housekeeping, personal care, and social and recreational activities
Federally Subsidized Housing is made available through financing from the US Department of Housing and Urban Development (HUD). Low-income residents pay 30% of their income for rent; HUD pays the difference. Managing agents may offer social and recreational opportunities. Typically, on-site staff does not provide other services. Waiting lists for these facilities can be years long. Check for local programs through your state housing resources.
Congregate or Shared Housing is an apartment or home that is shared by a small group of older adults (typically four to ten residents) who have private sleeping quarters but share the rest of the residence. Sponsoring organizations may provide staff and services such as meals, laundry and cleaning. In some arrangements, residents share the housework and other responsibilities.
For Those Needing Assistance with Everyday Activities
Assisted Living is for those individuals who need assistance with one or more Activities of Daily Living (ADLs) but do not need ongoing nursing care. Typically services include assistance with bathing, dressing, grooming, meal preparation, housekeeping, etc. It may be available as a program within facilities providing independent living or sheltered care; or it may function in a stand-alone residential setting.
For Those Needing 24 Hour Nursing Care
Intermediate Care facilities provide 24-hour nursing care and assistance with activities of daily living, medication administration, restorative care, social services, therapeutic activities and case management.
Skilled Care facilities provide an intense level of nursing care as prescribed by the resident's physician on a 24-hour basis. This level of care is for persons requiring assessment and oversight by a registered nurse, administration of a medication regime that may involve monitoring and intervention, administration of medication or fluids by an intravenous route, tube feedings, rehabilitation and/or discharge planning.
For Those Seeking the Full Range of Care in One Setting
A Continuing Care Retirement Community (CCRC) provides a continuum of care and full range of options for residents. While communities may differ slightly, most will include independent apartments (sometimes cottages), a main dining room, a health care center and other common areas (library, lounge, exercise room, craft area, gift shop, etc.).
Services may be offered in bundled packages or on an a la carte basis. These can include meals, housekeeping and laundry services, transportation, social and recreational programs, assistance with personal care, and short-term and long-term nursing care. Some may be included in the monthly service fee, while others may be charged on a fee for service basis.
Life Care Communities are a special type of licensed housing. The distinguishing characteristic of the Life Care community is that both the resident and sponsoring organization signs a document called a Life Care Contract, with the full understanding that the Community will care for the resident for life. Serving as an investment for the future, a one-time entrance fee is typically required in addition to the monthly rental fee.
Additional Specialized Services
Adult Day Services are designed to meet the needs of functionally and/or cognitively impaired adults who, for their own safety and well being, can no longer be left at home alone during the day. Adult day care facilities such as assisted living and nursing facilities, senior or community centers offer protected settings, which are normally open weekdays during business hours and include a mixture of health, social and support services.
Memory Care is a specialized blend of programs and services that seek to best serve the cognitively impaired older adult population. Cognitive impairment includes Alzheimer's disease and other forms of dementia. The existence of cognitive impairment is determined by clinical evidence and standardized tests that reliably measure the person's impairment.
Hospice Care is a combination of at-home and facility-based services designed to help the terminally ill and their families live as comfortable as possible. Medicare will provide hospice benefits to patients who are diagnosed as having six months or less to live. Private insurance policies sometimes provide benefits for hospice care, usually offering payments for a limited time.
Respite is temporary or periodic care provided by a third party for people with disabilities, illnesses, dementia or other health problems while their caregivers take an occasional break. Respite care can be provided at home, in the community or overnight in a facility such as a nursing home or assisted living residence.
Short Term Rehabilitation bridges the gap between illness and recovery through a variety of treatments and therapies.