If you are thinking about a senior housing option, chances are you have some particular reasons for doing so. Perhaps you want more social connection, you need more care, or want to be free of homeownership responsibilities.
As you do your long-term planning, it can help assess your financial situation and your health status. Even a healthy person can have an accident or acute illness, which changes the trajectory of decision making. Personal preference also plays a part in what senior housing option appeals to you most.
Understanding your options will help you make an informed choice. A decision now may change later as your health or financial status changes. If you’re working on this ahead of time, it’s best to learn what kinds of options exist and what you can reasonably plan for ahead of time.
1. Independent Living With Assisted Living
Independent senior living is often part of an assisted living community. For example, one or more floors of a senior building might be dedicated to independent living, with the other floors are for assisted or memory care. It can be rather intimidating to have all these different options in one community, but there are some specifics to keep in mind when considering independent living with assisted living in the same area.
In this case, all meals, housekeeping, transportation, and recreational activities are provided. Some senior living communities may also feature physician services on site. Independent senior living is also privately paid, much like rent. With both services in one area, the transition from independent living to assisted living or even memory care may be less stressful.
However, with independent living, you will not have nursing or aide assistance available. If you need help with certain things, you must arrange it yourself. The same goes with medication management. These things are important to keep in mind when looking at independent living as a first option.
2. Independent (Active Adult)
This type of independent living can be a bit different from independent living with assisted living, as these communities include a wide variety of choices, settings, and environments.
They can include things like the following:
- Mobile home parks exclusively for older adults.
- Lavish active adult communities that include golf, swimming, pickleball, gyms, and lots of other amenities.
- You buy your property in most of these active adult communities. Most are equipped with age-in-place features like grab bars and single level living.
- The community handles maintenance and lawn care.
Keep in mind that since you are in your own home, you will have to pay for private caregivers or qualify for home health when you need help. In most cases, there are no on-site health providers.
Co-housing originated in Denmark in the 1960s and has gained in popularity in this country. The appeal is the shared nature of the community and the fostering of social connections. Co-housing developments follow a similar pattern of organization and governance, as communities can consist of several individually owned houses or cottages on a shared piece of land.
With co-housing however, you’ll have a common space where you can socialize and share meals. As a result, many co-housing communities are multi-generational. Some are for seniors only. Much like renting an apartment with a roommate, all residents share in the responsibilities for the management and maintenance of the community. Governance is cooperative in nature and usually follows a consensus model of decision making.
Co-housing communities can exist in both rural and urban settings, which can be a boon for those seeking to change up any current living situations. However, with these communities, you may be asked to purchase a property upfront—which can be quite costly.
Like the other options mentioned above, if you need care, you will have to make those arrangements. Co-housing communities do not provide medical services.
4. Home Sharing
Home sharing is gaining in popularity for several reasons and is not completely dissimilar to co-housing. It is affordable, makes use of large homes after the kids have moved out, and offers support and social connection. If several people are sharing the costs of one house, the savings are significant.
There are some downsides, however:
- If you need assistance to stay independent, you will have to make those arrangements yourself.
- Disagreements over noise, visitors, and household responsibilities may cause conflict.
- If you end up having to leave due to an illness or injury, you may be responsible for the remainder of your lease.
- You are living in close quarters with other people and sharing a kitchen and other responsibilities. It is similar to living with roommates.
- If the homeowner decides to sell, you are on your own to find other housing.
5. Continuing Care Retirement Communities
Continuing Care Retirement Communities (CCRCs) are large care communities that allow you to stay in the same place as you age. CCRCs have independent, assisted, memory care, and nursing care. As you need more care, you move to the community that meets that need.
CCRCs have various payment options, including a buy-in with additional monthly fees or rental and everything in between. It is best to have an attorney look over any contract before signing. CCRC contracts can be quite complex. If you invest a large sum as a buy-in, you want to make sure there is a refund if you don’t like the place later.
The main appeal of a CCRC is that you don’t have to decide where to go if and when you need more care. The transition can be easier and less stressful. Many CCRCs have in-house physician services, home health, and aide assistance, with some CCRCs providing more upscale options like pools, gyms, golf, exercise classes, and more.
6. Subsidized Senior Housing
Most subsidized senior housing is available through programs administered by the Department of Housing and Urban Development (HUD). These programs can vary in their kind of development and criteria for qualifying for an apartment, but on the whole are options for lower-income seniors.
Depending on who the developer and funder are, some housing complexes have case managers to help connect seniors to resources in the community. Generally, these housing communities are independent, and many have long waiting lists, depending on where you live. Applying early is recommended.
7. Assisted Living
Most people are very familiar with the assisted living concept. According to the American Health Care Association, there are approximately 28,900 assisted living communities across the country with more being built every day. For many families, assisted living provides additional support to older adults who are unable to function independently.
Finding care for aging adults can be a challenge both if there are very few options and too many. Assisted living costs can be relatively high, depending on where you live and the level of care you need. Most communities start with a base rate and then add pricing depending on how much assistance you need transferring, help with bathing and grooming, or reminders to attend meals. If you have a long-term care insurance policy, it might pay for a portion of the cost.
Like some of the options mentioned above, assisted living communities typically provide all meals, transportation, activities, medication management, aide service, and some nursing. Residents can contract for additional private aide service or qualify for home health to help supplement services. With assisted living, nursing availability can be limited.
Assisted living communities are adapting to the changing needs of seniors. Each state governs how assisted living communities are managed and the criteria for admission. There is no uniform federal oversight for assisted living.
8. Memory Care
Memory care communities are usually inside assisted living communities as a separate unit. Some, however, are free standing. Memory care is for people with cognitive impairment due to dementia, neurological disorders, or mental health issues. If someone cannot be managed at home or in assisted living, memory care might be the best option.
People move to memory care from any of the housing options we have discussed. In most cases, people who move to memory care need tight supervision, specialized care, and additional staff time to help prevent any potential agitation. But with memory care, activities are tailored to people with cognitive impairment. Safety is also a main priority, as memory care communities are locked and secure to deal with wandering behavior.
9. Nursing Home Care
Nursing home care is the highest level of residential care available. Nursing is offered around the clock and staff can do procedures like injections, IV medications, catheter, wound, and diabetic care.
At times, there is no other choice but to go into a nursing home. All other housing options may not provide the medical care needed to keep you or a loved one safe. Nursing homes are very expensive due to this high level of care, and many people end up having to qualify for state Medicaid to pay for the costs.
It is possible to improve in a nursing home to the point where you can then go back to assisted living or home with support. But, if people need a high level of ongoing medical help, they may stay in a nursing home for their remaining years.
10. Staying Home
Not everyone decides to move to a different senior living option. Most people tend to prefer to age in place. And some people have the financial resources to stay at home through the end of life. If you have functional decline and medical needs, it can be challenging, but not impossible to stay home as you age. The main factors to consider are home safety modifications, nursing, and aide support.
For many people, the deciding factor in moving from home to another supportive senior housing option is financial. At some point, the cost of staying home and retrofitting a home with extra safety features can exceed the cost of more convenient supportive housing.
The Many Available Senior Housing Options
The variety of senior housing options is continually changing to adapt to older adults and their families’ needs and preferences. Examine your priorities, long-term financial situation, and health to get an idea of what appeals to you before you need it. That way, you and your family can make an informed and lasting choice.
- “What is Co-housing?” Cohousing.org, www.cohousing.org/
- “Information for Senior Citizens.” HUD.gov, www.hud.gov/topics/information_for_senior_citizens
- “Facts and Figures.” American Healthcare Association, www.ahcancal.org/Assisted-Living/Facts-and-Figures/Pages/default.aspx