Written by Lawrence Robinson, Joanna Saisan, M.S.W., and Monika White, Ph.D. Edited by SSM
Originally posted by helpguide.org
Whether your search for senior housing is prompted by a serious medical condition or the desire for a lifestyle change, finding the right place to live can be challenging and stressful for both you and your family. However, the earlier you assess your current needs and how those needs may evolve over time, the more choices and control you’ll have. By learning about the different types of senior housing available, you can make the choice that’s right for you and ensure you enjoy a happy, healthy and fulfilling home environment as you age.
What is senior housing?
Aging is a time of adaptation and change, and planning your future housing needs is an important part of ensuring that you continue to thrive as you get older. Of course, every adult is different, so the senior housing choice that’s right for one person may not be suitable for you. The key to making the best choice is to match your housing with your lifestyle, health, and financial needs. This may mean modifying your own home to make it safer and more comfortable or it could mean moving to a housing facility with more support and social options available on site. It could involve moving to a retirement community, an apartment building where the majority of tenants are over the age of 65, or even a nursing home.
When deciding on the senior housing plan that’s right for you or your loved one, it’s important to consider not only the needs you have now but also those you may have in the future:
Physical and medical needs. As you age, you may need some help with physical needs, including activities of daily living. This could range from shopping, cleaning, cooking, and looking after pets to intensive help with bathing, moving around, and eating. You or a loved one may also need increasing help with medical needs.
Home maintenance. If you’re living alone, your current home may become too difficult or too expensive to maintain. You may have health problems that make it hard to manage tasks such as housework and yard maintenance that you once took for granted.
Social and emotional needs. As you age, your social networks may change. Friends or family may not be as close by, or neighbors may move or pass on. You may no longer be able to continue driving or have access to public transportation in order to meet up with family and friends. Or you simply may want to expose yourself to more social opportunities and avoid becoming isolated and housebound.
Financial needs. Modifying your home and long-term care can both be expensive, so balancing the care you need with where you want to live requires careful evaluation of your budget.
Preparing yourself for change.
Whether you’re considering home care services or relocating to a retirement home, planning your future housing needs means facing up to some loss in your level of independence. Understandably, the prospect of losing independence can be overwhelming for many older adults. It can bring feelings of shame, embarrassment, fear, confusion, and anger.
But it’s important to remember that you’re not alone in this. Most of us over the age of 65 will require some type of long-term care services. And there’s nothing to be ashamed about in admitting you need more help than you used to. For many of us, independence is recognizing when it’s time to ask for help.
Communicate your needs with family and loved ones. It’s important to communicate with family members your wishes and plans, and listen to their concerns. For example, long distance family members might think it’s better for you to move close by so that they can better coordinate your care. But you may prefer to stay near friends. Clear communication from the outset can help avoid misunderstandings or unrealistic assumptions.
Be patient with yourself. Losses are a normal part of aging and losing your independence is not a sign of weakness. Allow yourself to feel sad or frustrated about changes in your housing situation or other aspects of your life without beating yourself up or labeling yourself a failure.
Be open to new possibilities. Your loved ones may offer suggestions about senior housing options or other ways to make your life easier. Rather than dismissing them out of hand, try to keep an open mind and discuss the possibilities. Sometimes, new experiences and situations can lead to you developing new friendships or finding new interests you’d never considered before.
Find a way of accepting help that makes you comfortable. It can be tough to strike a balance between accepting help and maintaining as much of your independence as possible. But remember that many people will feel good about helping you.
What are your senior housing options?
There is a broad array of housing options available to seniors, from staying in your own home to specialized facilities that provide round-the-clock nursing care. The names of the different types of housing options can sometimes be confusing, as the terminology can vary from region to region. For example, the term “assisted living” can mean one thing in one state or country and something slightly different elsewhere. However, in general, the different types of senior housing vary according to the amount of care provided for activities of daily living (ADL’s) and for medical care. When researching a senior housing option, make sure it covers your required level of care and that you understand exactly the facilities offered and the costs involved.
Senior housing option 1: Aging in place
Staying at home as you age has the advantage of keeping you in a familiar place where you know your neighbors and the community. There is a wide range of home care services that can help you maintain your independence within the comfort of your own home, from in-home care to day care. You may also be able to make home repairs or modifications to make your life easier and safer, such as installing a wheelchair ramp, bathtub railings, or emergency response system.
Staying at home may be a good option if:
- You have a close network of nearby family, friends, and neighbors
- Transportation is easily accessible, including alternate transportation to driving
- Your neighborhood is safe
- Your home can be modified to reflect your changing needs
- Home and yard maintenance is not overwhelming
- Your physical and medical needs do not require a high level of care
- You have a gregarious personality and are willing and able to reach out for social support
- You fall within the geographical confines of an integrated community, such as a 55+ or NORC (Naturally Occurring Retirement Community)
Aging in place is a less effective senior housing option once your mobility is limited. Being unable to leave your home frequently and socialize with others can lead to isolation, loneliness, and depression. So, even if you select to age in place today, it’s important to have a plan for the future when your needs may change and staying at home may no longer be the best option.
Senior housing option 2: Independent living
Independent living is a general name for any housing arrangement designed exclusively for seniors. Other terms include retirement communities, retirement homes, senior housing, and senior apartments. These may be apartment complexes, condominiums, or even free-standing homes. In general, the housing is friendlier to older adults—it’s more compact, easier to navigate, and includes help with outside maintenance. Sometimes recreational centers or clubhouses are also available on site.
You may want to consider independent living if:
- You see needing minor assistance with activities of daily living
- You’d like a place that does not require a lot of maintenance and upkeep
- You like the idea of socializing with peers and having activity options nearby
If you don’t want to live exclusively with others your own age, there are alternatives to an independent living community. You can consider moving in with a family member, or simply moving to a more accessible apartment or condo. The key is being in an area with good access to transportation, services, and social networks.
Senior housing option 3: Assisted living
Also known as residential care, board and care, congregate care, adult care home, adult group home, alternative care facility, or sheltered housing. In general, assisted living is a housing option for those who need help with some activities of daily living, including minor help with medications. Costs tend to vary according to the level of daily help required, although staff is available 24 hours a day.
Some assisted living facilities provide apartment-style living with scaled-down kitchens, while others provide rooms. In some, you may need to share a room unless you’re willing to pay a higher cost. Most facilities have a group dining area and common areas for social and recreational activities.
An assisted living facility may be a good choice if:
- You need more personal care services than are feasible at home or in an independent living retirement community
- You don’t need the round-the-clock medical care and supervision of a nursing home
What is a Continuing Care Retirement Community ?
Continuing Care Retirement Communities (CCRCs) are facilities that include independent living, assisted living, and nursing home care in one location, so seniors can stay in the same general area as their housing needs change over time. There is normally the cost of buying a unit in the community as well as monthly fees that increase as you require higher levels of care. It also can mean spouses can still be very close to one another even if one requires a higher level of care.
Senior housing option 4: Nursing homes
A nursing home is normally the highest level of care for older adults outside of a hospital. While they do provide assistance in activities of daily living, they differ from other senior housing in that they also provide a high level of medical care. A licensed physician supervises each resident’s care and a nurse or other medical professional is almost always on the premises. Skilled nursing care and medical professionals such as occupational or physical therapists are also available.
A nursing home may be a good choice if:
- Both your medical and personal care needs have become too great to handle at home or in another facility. This may be due to a recent hospitalization, or a chronic illness which has gradually been worsening.
- You need a higher level of care temporarily after a hospitalization, but it’s anticipated you will be able to return to home or another facility after a period of time.
Assessing your senior housing needs
When evaluating your senior housing needs, consider the following issues:
Level of care. No one can predict the future. However, if you or a loved one has a chronic medical condition that is expected to worsen over time, it’s especially important to think about how you will handle health and mobility problems. What are common complications of your condition, and how will you handle them? Are you already at the point where you need daily help?
Location and accessibility. Even if you are completely independent at this time, circumstances can change. It pays to think a little about your current location and accessibility of your current home. For example, how far is your home from shopping, medical facilities, or other services? If you can no longer drive, what kind of transportation access will you have? Can your home be easily modified? Does it have a lot of steps or a steep hill to navigate? Do you have a large yard that needs to be maintained?
Social support. How easy is it for you to visit friends, neighbors, or engage in hobbies that you enjoy? If it becomes difficult or impossible for you to leave your home, you’ll become isolated and depression can rapidly set in.
Caregiving Support. You will want to consider housing where both your current and future needs can be met. Even if family members can commit to caregiving, they might not be able to fill in all the gaps if physical and medical needs become extreme. The more thought you put into your future, the better chance your needs will be met.
Finances. Making a budget with anticipated expenses can help you weigh the pros and cons of your situation. Senior housing options like assisted living can be expensive, but extensive in-home help can also rapidly mount in cost, especially at higher levels of care and live-in or 24-hour coverage. You may be able to purchase insurance to offset some of the costs of long-term care. In the U.S., the Department of Housing and Urban Development (HUD) provides some housing options for seniors under a certain income limit, while Medicaid covers the bulk of nursing home care for those with limited income and assets.
Need a professional assessment? Geriatric care managers can provide an assessment as well as assistance with managing your situation, including crisis management, interviewing in-home help, or assisting with placement in an assisted living facility or nursing home. See the Resources section below to learn more about geriatric care managers.
Comparison of senior housing options in the U.S.
|Approx. cost per month||$1,500 – 3,500|
|Meals per day||Meal plan options|
|On site nurses||No|
|Approx. cost per month||$2,500 – 4,000|
|Meals per day||3+|
|On site nurses||Varies|
|Approx. cost per month||$4,000 – 8,000|
|Meals per day||3+|
|On site nurses||Yes|
Choosing senior housing
Key to Choice (PDF) – A guide to help you assess your lifestyle needs and evaluate the many housing and service options available to seniors. Includes samples of budgets and evaluations. (The East Metro Seniors Agenda for Independent Living Project)
Steps to Choosing Long-Term Care (PDF) – Guidance for choosing from many types of senior care, starting with in-home services. Includes help determining the right kind of care, how your needs may change over time, your long-term care choices, paying for care, and assessing different facilities. (Medicare.gov)
Information for Senior Citizens – A comprehensive look at senior housing from the U.S. government’s Department of Housing and Urban Development. Includes links to HUD-approved housing counselors and related government sites. (HUD)
Housing Associate Directory – A list of not-for-profit senior housing associations across America. (Reverse Mortgage Alert)
Types of senior housing
The Village: A Growing Option for Aging in Place (PDF) – Fact sheet about the benefits and challenges of the village model for aging in place. (AARP)
Eldercare Locator – Offers database of local housing options and community services for older adults and their families. Help is also available by calling 1-800-677-1116. (U.S. Administration on Aging)
Aging Life Care Association – Provides information about the geriatric care manager field and a searchable database of care managers. (Aging Life Care Association)
Low-Rent Apartment Search – Searchable database from The Department of Housing and Urban Development. (HUD)
Medicaid Rules – Learn about Medicaid eligibility and spousal protections. (Elder Law Answers)
Senior Housing 101: Senior Care Types Explained – Overview of some of the different types of senior housing options available. (A Place for Mom)
Understanding costs of senior housing
Medicare Coverage of Skilled Nursing Facility Care – Detailed information about Medicare coverage of skilled nursing care, as well as ways to get help paying for skilled care. (Centers for Medicare and Medicaid services)
Coping with loss of independence
Aging and Loss of Independence (PDF) – Tips on understanding and coping with a loss of independence. (Cornell University)
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