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Choices in Senior Housing

Written by SeniorsResourceGuide.com Staff

Deciding where to live as one ages presents new challenges for many seniors and their families. Anticipating and planning for this stage of life is difficult because how well we will age and how long we will live is unpredictable. Average life expectancy is lengthening, increasing the potential for chronic health conditions that may threaten independence. The most important factors for evaluating housing options is becoming familiar with the variety of senior housing choices and the health and mobility criteria for living in these various types of senior housing levels. In this list we have also included Adult Day Care and Respite Care because this is often the first level of care before a senior moves into Senior Housing.

Another important factor to consider is that many senior housing locations have long wait lists. Starting your search early before the actual need arises is very good advice. You can often put your name or a loved one's name on a wait list with minimum or no deposit. We highly recommend that seniors and their families plan ahead and hopefully avoid a crisis of senior housing.

Below is a list of the common definitions of types of senior housing:

Active Independent Living
Active independent living communities refers to retirement communities designed for active seniors. These communities usually feature low-maintenance apartments, condominiums, town homes, or ranch-style residences. Most commonly these communities do not offer meal plans, housekeeping or other care levels. These communities may be designed around recreational activities such as golf, swimming, boating, or fitness. Many of these types of communities have age restriction covenants. Most active independent living communities are private although some apartment style buildings may have some income-qualifying units available that are affiliated with Section 8 or HUD programs for low-income seniors or people with disabilities.

Continuum of Care
Continuum of Care retirement communities offer several care levels at one location, from retirement housing through assisted living and skilled nursing. Continuum of Care can also be known as Continuing Care Retirement Community (CCRC) or Life Care Community. The locations are often designed with a campus-style environment that may include villas, apartments/condos, assisted living and skilled nursing services. Some may require an endowment fee that entitles residents to use assisted or skilled services when needed throughout their lifetime. Residents "purchase" their villa or condo and then pay monthly maintenance fees. As your health needs change, you can move through the levels of care at the community. Payor sources accepted are private pay and some insurance plans.

Retirement Communities
Retirement communities offer apartment living on a rental basis. Communal dining and a full range of activities are available. Housekeeping, laundry, and assisted living services are typically available. Retirement Communities are designed specifically for the elderly and often have age restriction requirements. Typically there are studio, one-bedroom or two-bedroom rental apartments with full kitchens, and private baths. Services can include meal plans, transportation, housekeeping, laundry and maintenance. Onsite amenities can also include formal libraries, computer stations, swimming pools, gardens, and other social gathering spaces. Rates are monthly and typically based upon the size and location of the apartment. Payor sources accepted are private pay and some insurance plans. Some apartment style retirement buildings may have some income-qualifying units available that are affiliated with Section 8 or HUD programs for low-income seniors or people with disabilities. These units typically have long wait lists.

Section 8 or HUD Housing for Seniors

Certain senior housing properties are designated as income qualifying for seniors and/or persons with disabilities. These properties typically have long wait lists and sometimes-limited number of units available.

Assisted Living
Assisted living facilities offer an independent environment with 24-hour personal assistance. Within this type of senior housing there are freestanding large facilities, smaller personal care boarding homes, or continuum of care facilities all offering assisted living. Services usually include communal meals, housekeeping, social activities, and assistance based on personal needs. Assisted Living apartment-style rooms may have a kitchenette and private bath. Some offer companion accommodations. Amenities vary but may include meal plans, cable television, local phone, housekeeping, laundry, maintenance and transportation. Within an assisted living one must consider Activities of Daily Living (ADLs). Depending on the seniors need, one should inquire about assistance with bathing, grooming, dressing, toileting, eating and ambulation. Rates vary from an all-inclusive to base rates dependent on levels of care. Payor sources usually accepted are private pay and insurance.

Personal Care Boarding Homes
Located in residential areas, the personal care boarding home is a localized term used in some regions of the United States to designate a smaller type of assisted living residence. This type of senior housing is typically a ranch style home located in a neighborhood with an average between five and eight residents whose needs are met by a 24-hour staff. Homes should be licensed by the state Health Department to provide assisted living services. The "home-like atmosphere" provides very good care ratios. Pricing depends on location, amenities, and room occupancy of private verses semi-private rooms. There is usually a shared dining room and all residents share the major living areas of the home. These types of homes typically offer some social activities. Payor sources usually accepted are private pay and insurance.

Skilled Nursing
Skilled nursing facilities are licensed to provide 24-hour medical services by registered nurses and other professionals for the chronically ill not requiring hospitalization. This is the highest level of nursing care available outside of hospitalization. This level of care is typically found in a nursing facility or a transitional care unit in a hospital. Daily rates typically include a furnished bedroom and a private or shared bath, meals, activities, transportation, phone service, cable television and all personal/nursing care. Payor sources usually accepted are Medicare, Medicaid, VA, some insurance plans and private sources.

Alzheimer's Assisted Living
Alzheimer's assisted living provides 24-hour assistance with dressing, bathing, meals, medication monitoring, and transfer assistance. These large and small facilities have secure areas both inside and outside where residents are free to move about. These communities are either licensed assisted living facilities that specialize in delivering care to persons' with dementia or a unit of a skilled nursing facility. Communities are typically bedroom-style rental units with common areas for dining and activities. Many are locked for residents' safety. Staff is usually specially trained for the special needs of this population. Services may include meal plans, cable television, local phone calls, housekeeping, laundry maintenance and transportation. Rates also vary from all-inclusive to base rates with levels of care/point system for care. Payor sources usually accepted are private pay and insurance.*
* If you are a Veteran look into the income qualifying Aid and Attendance Pension Program from Veterans Affairs

Alzheimer's Skilled Nursing
Alzheimer's skilled nursing provides long-term, 24-hour nursing care. This is the highest level of nursing care available outside of hospitalization. Some facilities accept only "non-wandering" Alzheimer's patients. Payor sources usually accepted are private pay and insurance.

Short Term Intermediate Assistance

Respite Care
Respite Care is a short-term stay that typically includes care overnight. Larger senior housing locations can provide respite care as rooms are available. Most typically they will have fully furnished accommodations for senior for a short period of time. Rates usually quoted on a daily basis and are typically inclusive of all services and amenities.

Adult Day Care
Adult Day Care is most commonly provided by organizations on a daily or weekly basis. Services can be short or long term and provide a break for caregivers. Typically these service are used by families caring for a senior family member in their home. Services typically include a place to rest, one or two meals and snacks and activities for the day.