My parents have reached the point where they are tired of keeping up their big house. They are thinking of downsizing, and are looking at other housing options. They’ve learned that in what is called the senior housing market, there are many options, some of which didn’t exist just a few years ago. The trick is to find the option that meets your needs.
The names of some types of senior housing are different in some part of the country, but the concepts are the same. Here’s a guide to what is available.
Planned communities. Some of these are specifically restricted to seniors, while others use pricing and marketing to ensure that residents primarily will be seniors. These communities tend to differ from regular subdivisions and developments only by adding amenities that are especially desirable to active retirees. Golf and other recreation facilities often are a prime feature. A community center with an active agenda usually is an important element. Housing usually is single family homes or condominiums or both, with design features that are attractive to seniors (for example, one level, door handles instead of door knobs, security). Usually there is no medical care element to these communities. They are for independent, active people who happen to be retired.
Independent living. In some places this is called congregate care. These facilities are for seniors who need a little bit of help for activities such as cooking, cleaning, and driving or anticipate needing some help in the near future. Housing usually is in apartments or condominiums. Onsite amenities usually include recreation facilities, a convenience store, dining rooms, meeting rooms, a library, social areas, and television rooms. Often there is a bus service to local shopping and medical offices, and regular outings are organized. For many, independent living is like being back at college.
The buildings usually feature extra-wide hallways and doorways to accommodate walkers, wheelchairs, and motorized scooters and other senior-friendly features. Housecleaning and other services usually are available. But, again, onsite medical facilities usually are limited. Usually you buy the housing unit and pay a monthly fee based on the services you use.
Assisted living. This often is described as an alternative to nursing homes, but it is not. Limited medical care is provided at assisted living facilities (which is one reason their basic rate is considerably less than at nursing homes.) Assisted living facilities are for someone who needs help in one or two daily living activities (dressing, bathing, eating, housekeeping, walking, etc.) but who does not need physical rehabilitation or skilled nursing care. Residents generally live in dormitory-style rooms and have common dining and social areas.
You should be aware that assisted living facilities generally have to comply with far fewer regulations than nursing homes. Many have a nurse or other licensed medical personnel on site for only part of the day and there are few or no medical facilities on site.
Group homes. These usually offer assisted living services in homes with 15 or fewer residents. These might face less regulation than larger assisted living facilities.
Nursing homes. These are for individuals who need physical therapy or skilled nursing care on a regular basis. Usually the care is provided by nurses and other medical professionals under the direction of a physician. Nurses usually are on-duty 24 hours a day.
Continuing Care Retirement Communities: The CCRC is a relatively new but fast-growing type of senior housing. CCRCs attempt to put the main types of senior housing in one community: independent living, assisted living, and a nursing home. Some CCRCs also have townhomes and detached homes in the community.
You initially move to a CCRC when you are healthy. You start in an independent living apartment, townhome, or detached home. After that, you or your spouse can move into assisted living and nursing home care as your needs require. If you never need either specialized facility, that’s fine. But as you age, you might need to move into one of the other facilities. The independent living, assisted living, and nursing home usually are in one building or are connected by walkways so that you don’t need to go outside to visit someone. The building also usually includes the types of amenities found in independent living
Financing residence in a CCRC varies. Most often, you pay a large lump sum up front to live in the CCRC. This sum usually is fully or partially refundable to your heirs, though the refund right might disappear after 10 years or so. (In some CCRCs you buy the housing unit outright.) There also is a monthly fee, which might be the same for everyone or depend on the services you are receiving. In return for these payments, you are guaranteed care in the appropriate facility for the rest of your life.
Planned communities generally are suitable for any active retiree. Most senior citizens don’t start seeking out the other facilities until they reach their mid-seventies, unless there is a medical problem. So if you move into independent living or a CCRC before 75, you might be one of the youngest residents.
If you are considering a move into a planned community or CCRC, be aware that there is a building boom among these facilities. You need to check out the financial stability of the firm that will provide the services and lifetime guarantees. In the 1980s there was some overbuilding in senior housing, and the developers of some communities went bankrupt. You’ll also want to look at the by-laws, covenants, and other regulations of the community. And be sure you know who determines what level of care is needed and when you move into assisted living or the nursing home.
To learn more about CCRCs consider these sources: “Tips on Continuing Care Retirement Communities,” available for $2 and an SASE from the Council of Better Business Bureaus, Dept. 023, Washington, D.C. 20042-2037; “The Continuing Care Retirement Community: A Guide for Consumer,” available for $10.50 from the American Association of Homes and Services for the Aging, 901 E Street, N.W., Suite 500, Washington, D.C. 20004-2037; Retirement Living Communities by Deborah Freundlich published by Macmillan for $24.95.
One final tip is to do your research before you need to. The most attractive CCRCs have waiting lists for entry. Most assisted living facilities and nursing homes find that nobody researches them until there is a problem. Then the children usually select a facility in a hurry. You might want to review the facilities in your area (or near your children) and let them know which ones you prefer, or at least draw up a list of the features you would want.