Traditionally nursing home care was the only option for long-term senior care. It was not until the mid-1980s that different assisted living communities started to emerge in the United States. These communities were thought to be a shift from the institutional setting that were strict with regulations and gave patients and families few options of choice. These assisted living variations can offer very desirable features and have shown great patient satisfaction.There are many factors to consider when deciding on your future living arrangements which can make the decision difficult. Below is information on many different senior living options to assist in your choice of
which option is right for you.
Costs related to the different senior living options discussed can vary greatly dependent on the residence, apartment size, and types of services needed. There are often monthly rates that will cover rent and additional charges for special services. Additional charges may include entrance fees, deposits, and fees for other services such as personal assistance, housekeeping and laundry, though many providers include those services as well.
- Aging in Place
Aging in place is defined as remaining in the community with a certain level of independence as opposed to residential care.
This can take place in your original home or as part of an assisted living option described below. Aging in place has become very popular as it has many benefits. Seniors feel a connection to their community and retain a sense of familiarity. It has also been shown in studies to increase the senior’s wellbeing.
- Independent Living
This option allows the senior to continue their independent lifestyle as long as they require minimal or no assistance. This option can take place in a government-subsidized building, rental houses or apartments, or the senior’s original home.
- Assisted Living
Assisted living facilities make up a large part of senior living in the US. Facilities are normally a housing facility with self-contained rental units that are professionally managed. These facilities are generally occupied by higher-income seniors as along with monthly rent which covers shelter, there are also extra fees charged for personal care and/or nursing services. These facilities offer similar supportive services as congregate care however add personal assistance, nursing services along with some health care services. They do not offer 24 hour skilled nursing care. Some assisted living facilities only offer spaces for Alzheimer patients while others have dedicated sections for Alzheimer patients.
Assisted living facilities are primarily owned for profit.
- Nursing Home/ Skilled Nursing Home
Nursing homes are normally institutional type buildings that provide medical care for chronic conditions, short term convalescent and/or rehabilitative care. Seniors that are physically and cognitively impaired make up the majority of residents. Most nursing homes are owned by for profits; however they are usually licensed and regulated by the state.
- Alzheimer’s Care (Special Care Unit)
Special Care Units (SCUs) are normally housed in a special wing of an assisted living community. These SCUs frequently have additional security, cueing devices to assist seniors, and other special features.
SCUs are state licensed and provide specific programs to meet the population’s unique needs. Staff of SCUs are specifically trained in dealing with patients that are affected by dementias. These units are usually equipped to provide different levels of care depending on the senior’s level of dementia. However, some SCUs are only equipped to handle seniors who are in early stage dementias.
- Naturally Occurring Retirement Communities (NORC)
Naturally Occurring Retirement Communities are when large numbers of people that are aging in place concentrate into certain neighbourhoods, apartment buildings, or housing complexes.
Since these areas were not intentionally designed for a senior population they lack essential health and other support services that seniors require to age in place. Programs have been developed to meet the health and support needs of NORCs. These coordinated supportive service programs (NORC-SSPs) have coordinated residents, health and service providers, government agencies and charitable organizations to allow for the variety of services needs to encourage independence and healthy living.
- Continuing Care Retirement Community (CCRC)
Continuing Care Retirement Communities incorporate different types of senior living such as congregate living, assisted living and nursing home care operating on a specific site. These communities may offer different levels of assistance such as independent living, assisted living and/or nursing home care.
CCRCs differ from other housing options because they are run on a contract basis and normally have a large entrance fee.
- Congregate Housing
Congregate housing is normally made up of a multi-family apartment building with self-contained rental units whose target market is independent seniors. Monthly rent is charged for each unit. Available support services offered are normally housekeeping, meals, security, transportation, social activities, recreation, service and health related counselling. Health services are not offered in congregate housing and they may or may not be licensed by the state.
- Shared Group Housing
Shared group housing is typically a large single family home occupied by multiple seniors. In order to take advantage of this option the senior must be relatively independent. They have a private bedroom and shared common areas. Residents are responsible for the homes upkeep and common home tasks, while contractors are normally used for other work. Shared group homes are usually taken care of by a manager that may or may not reside in the house. They are owned by for profits and may or may not be licensed by the state.
- Low Income-Affordable Options
- Section 202 Supportive Housing for the Elderly Program
The first low income option is the Section 202 Supportive Housing for the Elderly Program. This is the only federally funded housing program and it is designed specifically for older persons. Generally, eligibility is restricted to persons who are at least 62 years of age and have incomes below 50 percent of their area’s median income. The units are typically one-bedroom apartments with kitchen and bathroom and include features such as non-skid flooring, grab bars, and ramps to help older persons remain safer and more independent as they age.
Many Section 202 facilities provide access to supportive services such as home meals that are home delivered, housekeeping, and transportation to community health providers.
Section 202 housing works to increase the residents’ independence to help them “age in place”. These facilities also offer security, community, and continuity, which are important housing features for aging residents that other housing assistance programs may not provide.
- Low-Income Housing Tax Credit (LIHTC) program
The LIHTC is a program that offers an indirect option for low income seniors. It is a Federal subsidy used to finance the development of affordable rental housing for low-income households. The LIHTC Program offers developers financial assistance in return for new low-income housing options.
To be eligible for consideration under the LIHTC Program, a proposed project must:
- Be a residential rental property.
- Commit to one of two possible low-income occupancy threshold requirements.
- Restrict rents, including utility charges, in low-income units.
- Operate under the rent and income restrictions for 30 years or longer, pursuant to written agreements with the agency issuing the tax credits.
- Respite Care – Short Term Stay
Respite care assists the family of the senior as caregiving is a very demanding job. Respite care offers a break and helps to reduce stress and allows the caregiver a chance to unwind. There are many different options to choose from when it comes to short-term respite care. In-home respite care can be as informal as a friend stepping in for a few hours to personal support workers assisting with activities of daily life. These in home options can also vary widely in price from volunteers to agency organized support and health care. Out-of-home respite options are also available. Programs like support groups and adult day programs add stimulation and companionship. Adult day centers offer social and health services in a safe, supportive environment. They offer meals and snacks but are only open during daytime hours, Monday through Fridays. Another option is emergency respite services which are provided by some hospitals, nursing homes and specialized facilities. These can allow the caregiver up to 24 hours of respite care.
Thankfully today there are many alternative living options for seniors. Today’s seniors have more choice and more independence. Living arrangements in your senior years should be enjoyable, offer stimulation and a variety of services. Ensure to do your research to find the best option for your lifestyle and care needs.
About the Author
Amy comes to the OpenPlacement Blog with an extensive medical background, most recently, 16 years of medical experience as a serving member of the Canadian Forces. Before enlisting in the military, Amy worked in both hospital and in-home care services spending countless hours with seniors in both palliative and non-palliative care settings. Upon releasing from the Canadian Forces she continues her passion for the medical field pursuing a career in medical and technical writing. Amy is currently completing an Advanced Diploma in Business Administration-Accounting and a graduate certificate in Technical Writing.