Housing Choices --
Options for seniors are to move or not to move. Attachment to a home, neighborhood, friends or family nearby are reasons not to move. Life changes, retirement or the need for care are reasons to look at moving.
- Senior Retirement Communities
- Age Restricted Apartments
- Modular Homes Communities and Housing Parks
- ECHO or Accessory Unit Housing
- Shared Housing
- Continuing Care or Life Care communities
- Congregate Communities
- Assisted Living
- Board and Care Housing
- Nursing Homes
- Alzheimer's Communities
- Affinity Communities
Aging in Place
Not moving, or successfully
Aging In Place (or Staying at Home) takes a lot of planning.
- The neighborhood has deteriorated, safety is a concern.
- To be near children (70% of those 65+ live
within 1 hour of a child).
- To match home's facilities to senior's faculties.
- To avoid stairs in a home.
- Home is too large or costly to maintain.
- Home may not meet present needs, physical or other.
- Assets are tied up in the home and cash is needed.
- Don't drive and available transportation is not adequate.
- Retired and looking for new lifestyle.
Active seniors, seen as move-down buyers may be moving down, not in size, but in their home maintenance. Since 1960 the trend has been to move from cities to rural or suburban settings with warmer climate and recreational opportunities (Choi, Journal of Applied Gerontology, 1996).
Recently we see more active senior communities, apartments and complexes for the elderly, offering medical care components, "infilling" in older neighborhoods. Opportunities to move to nearby metro or suburban located senior communities offers the chance to right-size lifestyle without giving up proximity to friends and the familiar.
As seniors remain in their homes until they are in their late 70's or 80's, when they do relocate, they want to stay close totheir home of many years. Long distance moves occur when seniorswant to be closer to adult children, siblings, or other close relatives, or go back to where they grew up or once lived.
Relocating seniors find satisfaction in their new location if they have common interests with other residents or neighbors and can have friendly, helpful people around them.
Helping Elderly Parents Transition to In-Home Care by Dana Carr
When parents are elderly and begin to have difficulty caring for themselves,
one of the best gifts a concerned child can give them is the gift of a
paid, in-home caregiver. The elderly may already have a lifetime of possessions
and they may not want another new memento, technological gadget, or specialty
food gift. Instead, what they really may need is assistance coping with
health, housekeeping, or mobility issues.
How do you know when it's time to consider in-home assistance for your elderly parents? Try watching for these possible warning signs:
- Personal Hygiene Changes such as a failure to bathe on a daily basis, wearing the same clothes all the time, or sleeping in their clothes.
- Passive Responses such as, "Why should I bathe/change my clothes? I don't go anywhere!"
- A Dusty Home that was formerly very neat or the house not being cleaned on a regular basis.
- A Lack of Food in the refrigerator or placing to-go orders on a regular basis may signal difficulty driving, a fear of driving, or a physical inability to lift the groceries out of the car.
- Tiredness and constant complaints could be a possible sign of depression or loneliness.
- Forgetfulness such as leaving food cooking on the stove, leaving the faucet on, not taking mediations as prescribed, the phone left off the hook or bills left unpaid.
Once you decide to seek a caregiver, take these steps to ensure you hire the right person and manage the working relationship effectively.
Discuss Before Hiring
Your elderly parents should be part of the discussion regarding in-home care. A tremendous amount of fear may exist once they realize they are not functioning well on their own. Your parents may fear losing their freedom or their home. Always approach this topic with compassion.
Most often the elderly can't imagine how an in-home caregiver can possibly help them. To ease the transition, suggest they "try out" the caregiver by having them assign basic housekeeping chores, such as laundry, changing bed linens, and general cleaning duties. The caregiver can also run errands such as grocery shopping or accompanying your parents to doctor appointments.
In some instances, the caregiver can simply be a companion to drive the elderly to the movies or church. Often, the caregiver is a senior as well, so your parents may find much in common with their caregiver.
Manage the Caregiver Relationship
List the duties you and your elderly parent expect the caregiver to perform and clearly communicate the duties and the timing with the caregiver. Clearly explain your expectations and set boundaries for the caregiver’s personal phone calls, breaks, etc.
However personal the caregiver relationship becomes, make sure all family
members and the caregiver understand that the paid worker is not a family
member. The caregiver should NOT have access to credit or ATM cards. Nor
should the worker be paid in cash.
Pay close attention to your parents’ feelings. If your or your parents feel uncomfortable or incompatible with the caregiver, take action immediately. Either do not hire the person or discontinue his/her use if you’ve already hired the person.
Finally, remember, in-home assistance is not the beginning of the end. Rather it’s an active step to prolong your elder parents’ ability to live in their lifelong home for as long as possible. Hiring an in-home caregiver is a proactive step that can help the elderly continue to lead healthy, active and happy lives.
Dana Carr is the owner of California-based Carr & Associates, a carebroker who helps families find the right caregiver
Safe Drinking Water
Water is the lifeblood of every community and an integral part of our lives. It does more than quench our thirst; it also enables us to stay clean, grow food, fight fires, and manufacture products. Obviously the water must be safe for use.
How do you know your water is safe?
The Safe Drinking Water Act, passed by Congress in 1974, authorizes the United States Environmental Protection Agency (USEPA) to set national standards for drinking water quality based on science that weighs potential health risks, available technology, and costs. USEPA requires large water districts to yearly submit a Consumer Confidence Report (CCR). The report outlines the compliance with the Safe Drinking Water Act and identifies the amount of various contaminants found in the water. By reviewing this data you may determine the quality of the water you are drinking. Water Quality Plus has gathered this data in one place on the web. Visit www.waterqualityplus.com to see how well your water meets national standards
A senior community can be like any other neighborhood or community except restricted to people usually 55 or over, or 62 and over. Differences in minimum age is usually established when the original community entitlement and funding is obtained. Those with a 55+ restriction require one resident to be 55+. Other residents must be over 18, but are permitted to be younger than 55. In a 62+ community all residents must meet the age requirement. HUD regulations used to require amenities, activities and services that cater to seniors to be provided or available. Although no longer required by law, to be competitive and attractive to a retirement lifestyle, age restricted communities are continuing to offer these features, and to upgrade them as the competition demands.
Retirement Communities are oriented toward an active lifestyle, or "younger thinking" seniors. They might offer golf, tennis, swimming pool and spa, exercise rooms and a variety of clubs and interest groups.
Some older seniors sell their homes of many years and move to an apartment. This frees up equity that can then supplement income through interest or dividends earned through investment of the capital. The move also frees seniors from home maintenance and grounds-keeper chores. For others living in a large complex of all seniors also affords a greater sense of security than living in a private home.
“Modular Homes Communities,“ or “Manufactured housing” refers to housing that is already on-site and ready to move into. “Manufactured housing parks” tend to serve low- to moderate-income households.
They have common areas that can be used to provide services and activities, such as pools and clubhouses. Some are subsidized by HUD, and these HUD-subsidized projects for the aging are somewhat further along in addressing aging-in-place issues. Housing prices are much lower than the average, and the parks charge low monthly or annual rents for living there. Housing park owners with more than one housing park are better positioned to help improve the extent and quality of home- and community-based services, including health care services, because of the large number of sites they control and the network that exists among such owners.
Often, parks are built fairly close to large medical facilities so that residents may take advantage of comprehensive medical services. They are generally located in moderate and warm climates, and tend to be in more suburban than urban areas. More than three million seniors already live in manufactured housing, which is the most affordable form of homeownership available. It offers the opportunity to bring services to the residents, both because there is a “critical mass” of seniors living in manufactured housing parks, and because in many cases the home is movable and could be relocated in a park providing assisted living services.
Elder Cottage Housing Opportunity, Accessory Units, Granny Flats refer to a housing opportunity where seniors occupy a second family living unit or apartment with a separate entrance, on a single family lot, with another family. Generally they are permitted by the jurisdiction to foster affordable housing, or aid families with elderly parents unable to live completely alone. The owner of the home and lot may be a senior, or the "renting" party may be seniors.
Seniors can share their home, or share the home of another. The roommate need not also be a senior. Professional organizations which specialize in these arrangements match the two parties based on needs on one side with abilities to provide on the other side. They screen before matching and follow up afterwards to help the match work out. Most organizations that do this are non-profit and supported from sources other than those seeking their help.
Seniors who share their home, are Aging In Place, and should understand the planning that will help to do it successfully.
Continuing Care Retirement Communities (CCRCs) or communities offering Life Care are designed to offer active seniors an independent lifestyle and a private home from which to enjoy it, regardless of future medical needs. They may require buy-in, or an up-front annuity purchase followed by monthly payments covering services, amenities and needed medical. The buy-in may be refundable in part, or not at all.
They provide the availability of multiple levels of care, without the uncertainty of wondering where you will live.
Congregate communities offer independent living in private separate apartments, and the opportunity to share activities of daily living with other residents as one chooses. They may offer rental or ownership units.
Assisted living is often viewed as the best of both worlds. Residents have as much independence as they want with the knowledge that personal care and support services are available if they need them. Assisted living communities are designed to provide residents with assistance with basic ADLs (activities of daily living) such as bathing, grooming, dressing, and more. Some states also allow assisted living to offer medication assistance and/or reminders.
Assisted living communities differ from nursing homes in that they don’t offer complex medical services. Assisted living communities range from a stand-alone residence to being one level of care in a CCRC (continuing care retirement community).
The physical environment of an assisted living is often more appealing to both potential residents and their families. These communities offer a more home-like atmosphere with apartment styles that typically include studio and one-bedroom models. Kitchenettes usually feature a small refrigerator and microwave.
Board and Care is usually offered in what may appear as a converted home. It provides a homelike setting with supervision and care for 4-10 residents (Foster care, available in some states is limited to 2 residents).
Skilled Nursing Facilities may be freestanding, or part of a seniors community offering any or all of the following:
Continuum of Care
It may specialize in Short Term or acute nursing care, intermediate or long term skilled nursing care.
Alzheimer's patients may be accommodated in a Congregate or Independent wing of a multi-level campus. Many Assisted Living Communities will accept and successfully house early-stage residents. As the disease progresses, patients may develop argumentative behavior, "sundowning" and wandering habits. Generally the communities best equipped to deal effectively with this middle stage patient are Alzheimer' Communities.
A relatively new concept in senior assisted-living is the “affinity community.” Like other assisted-living communities, affinity communities provide private living accommodations, and essentially function as continuing-care communities. However, they are organized around sub-groups of the aging. “Affinity communities” may consist of retired military service-members and/or their spouses (i.e., Air Force ViIlage in San Antonio TX, Air Force Village West, in Riverside CA); education-based communities (such as The Forest at Duke, in Durham NC, and The Village at Penn State); or LGBT communities, spread particularly throughout the Western United States.
Some more-specialized affinity communities exist. These include the well-known Motion Picture & Television County House and Hospital in Woodland Hills CA, the Firefighters Home in upstate New York, and the National Association of Letter Carriers, near Tampa, FL. Asians have built an affinity community in Northern California, and American Indians in Montana. Although currently fewer than one hundred sizeable affinity communities now exist (February, 2013), this specialized niche assisted-living arrangement is predicted to greatly expand as the economy improves.
Senior Day Care varies from "custodial care" with programs for stimulation and rehabilitation to day care providing medical care and procedures.
Senior Short Term Vacation Housing offers the chance to try before you buy. It allows one to take advantage of a senior community in a distant location. People too frail for the rigors of hotels and restaurants for multiple days can vacation at a slower pace with needed care available to them.
Interested in Selling a Home or Condo?
Thorough and timely services.
Compare your home's costs against what a Senior Congregate, Assisted Living or Continuing Care Retirement Community offers in convenience and services by putting the cost of each of the following items in the column for "Aging in Your Home" or the column for the alternative living choice, i.e., "Assisted Living." Then total each column and compare costs. Assisted or group retirement living may not be much more expensive than staying where you are. Or, perhaps you will find it's more expensive.
After you have a handle on cost differences, look at social, stress and medical advantages or disadvantages. Only then are you ready to visit places that are alternative possibilities.
- Mortgage and Association Fees
- Maintenance of outside, gardening
- Fire, theft and liability Insurance
- Electricity and gas
- Water, sewer and trash pickup
- Telephone and cable
- Car ownership (ownership, maintenance, repairs, insurance)
- Linen service
- Comeraderie with privacy
- Supplemental Medicare Insurance
- Long Term Care Insurance
Other Resources to Help with Your Decision
Eldercare Locator 1.800.667.1166
Offers local eldercare office numbers throughout the United States to help with location of facilities and services for seniors.