Living Options for Older People
Reasons Older People Evaluate Living Situation and Consider Alternatives
- House & yard maintenance – more than you want
- Living alone is isolating and inconvenient
- Health problems make independent living a struggle
- No longer driving
- Require significant help & can’t afford in home care
What You Should Know
- There are many living arrangements and housing possibilities
- The range of options is constantly changing
- Learn about your choices and consider alternatives
- Evaluate the best option for you and your family
- Narrow the choices by…
- Knowing your preferences – or those of your love one
- Understanding level of need for assistance
- Reviewing financial resources
Living Options: Factors to Consider
- Amenities
- Style of living wanted?
- Level of comfort desired?
- Attractive and in good repair?
- Availability & desirability of meals?
- Location
- Is it convenient?
- A safe neighborhood?
- Reasonably close to family members?
- Transportation accessibility?
- Quality of Care
- Do current residents…..
- …appear to have needs met?
- …seem content?
- …interact with staff and owners?
- Do staff & residents interact with respect?
- What is staff-to-resident ratio?
- Staff training?
- What do current residents/families say?
- Do current residents…..
- Policies
- Are there restrictions on behavior (alcohol/smoking)?
- Pets allowed?
- Guests welcome? (including overnight)
- Formal visiting hours?
- Flexibility in meal times?
- In a shared setting, how are responsibilities determined?
- How are rate increases handled?
- Safety
- Are there requisite safety equipment (ie; smoke detectors or fire extinguishers)?
- A sprinkler system?
- Sanitary conditions?
- Secure doors and locks? Emergency call service? Someone on duty 24 hours?
- Around the clock nurse?
- Safe accessibility for those with physical disabilities?
- Medications and medical care handled properly?
- Business Practices
- Is facility currently licensed and operating legally?
- Has facility license ever been revoked?
- Any recent inspection reports?
- Can you get references?
- Transportation offered for appointments and shopping?
- Review activities calendar – outings?
- Freshly cooked meals? Snacks provided?
Housing Possibilities
Independent Living (or minimal assistance)
- Modification of existing home
- Senior Retirement Communities
- Home-sharing
- Accessory Apartments
- 55+ Communities
- Continuing Care Retirement Communities (CCRC)
For Those Needing Assistance with Everyday Activities
- Existing Home with In – Home Care
- Retirement Communities with In- Home Care
- Assisted Living
- Small Residential Group Homes
- Nursing Homes
Definitions and Overview
Senior Retirement Communities
Services:
- More often referred to as Independent Living, Congregate Living or Senior Apartments
- Designed for independent senior adults who want
- to enjoy a lifestyle filled with recreational,
educational and social activities with other
seniors, or - for seniors able to live on their own, but desire
the security and conveniences of community
living
- to enjoy a lifestyle filled with recreational,
- Communities generally provide meals, local transportation, planned social activities, laundry facilities, etc.
- Can be “Age Inclusive” or “Age Exclusive”
Cost/Payment Options:
- Price generally dependent on local market
- All private- pay, but some senior apartments subsidized
- Plans can include meals, housekeeping &/or transportation
Regulation:
- These communities not licensed – no formal regulations
- Rules often set & governed by management company
Care:
- Health care not provided with your normal fees
- May bring in home health aide or nurse for assistance
- Some communities now offering fee-for-service, contracted non-medical home care by private companies
Assisted Living
Services:
- Provides special combination of residential housing, personalized supportive services & usually healthcare
- Purpose is to maximize independence
- May offer same services as Independent Living, with added assistance of personal care and transportation
- Transportation to medical appointments – standard
- Meals– at least one time daily – standard – may or may not include kitchenette
- Designed to meet the needs of those requiring help with activities of daily living
- ADL’s – Feeding, dressing, bathing, transfers, toileting, ambulation and often medication management
- These communities are often free standing, but sometimes affiliated with a CCRC, a Retirement community, or a Nursing Home.
Care:
- Although level of care varies, most provide assistance with dressing, grooming, bathing, and other daily activities
- Most larger facilities provide round-the-clock nursing services but not all
Cost/Payment Options:
- Prices depend on the number of services provided; base price plus a la carte services
- Most plans include meals, laundry, housekeeping (although meals may be limited)
- Private Pay only – some long-term care insurance policies may cover Assisted Living
Regulation:
- Facilities are regulated and licensed at state level.
- No Federal regulations exist
Small Residential Group Homes
Services:
- Designed for seniors requiring more care than available in Assisted Living but 24 hr. nursing not necessary
- Also designed for seniors who prefer a more home-like setting in a residential neighborhood
- Homes typically house 8-10 seniors in single or double rooms
Care:
- Staffing may be 1 to 4 during day time hours
- Awake staff at night
- All meals provided
- Transportation often NOT provided
- Typically will not do two person assists
Regulation:
- Often licensed and regulated by the State
- Some States require licensing only if 3 or more residents
- Typically no nurse on call
Nursing Homes
Services:
- Designed for seniors who are in need of 24-hour nursing care
- Facilities provide many of same residential components mentioned, ie; room and board, personal care, protection supervision –may offer other types of therapy
- Onsite medical staff sets facilities apart from other types of senior housing
Care:
- 3 levels of care provided –
- Basic Care; required to maintain ADL’s. Includes personal care, supervision and safety.
- Skilled Care; requires the services of a RN for treatments and procedures. Also includes professional specialties
- Sub- Acute; Comprehensive inpatient care designed for acute illness, injury, or chronic illness. This care generally more intensive and requires frequent patient assessment/review
Regulation:
- Licensed and regulated by State Departments of Public Health and individually certified by State for Medicare and Medicaid.
- Health care is supervised and authorized by a physician.
- They must also meet federal requirements.
