I have lived in my favorite home ever since June 1988. It has everything I could want: one story, floor-to-ceiling windows throughout, beautiful views of surrounding mountains and nightly sunsets, and all the things my husband and I brought in to make it our home. It was built in 1968, is situated on a 7.10 acre lot with more than 50 trees of varying sizes and has a pool, all wonderful but requiring monitoring and maintenance. I can simply open my back door and my two best friends run around for hours in our backyard. Every time I come home, I realize what a big and happy part of my life it continues to be.
So what could the problem possibly be? I will be 80 on my next birthday and have been blessed with good health that still allows me to spend hours working in my yard and adding new gardens every year. Like most people in my age group, I have seen friends experience sudden health changes that prevented them from continuing to live independently. I have seen the difficulties they had in having to make a quick decision about where they will move and what type of care they will need.
In my heart I want to stay in my home forever but what would I do if a health change made this no longer possible? Volunteering as a Long Term Care Ombudsman for the past 14 years has shown me that seniors who move to any type of congregate living are so much happier if they were the ones who made or were included in the decision on when and where to move.
There are many options for seniors ranging from aging in place at home, as I have been doing, to full-time care in a skilled nursing home. The following is a basic summary of what may be available in your and my communities based on several articles listed and my experience. They are shown in order of seniors who want more independent living and those seniors who may want varying degrees of assistance.
AGING IN PLACE
– When a senior continues to live in their home
– Home can be modified to address mobility issues and in-home care/assistance can be hired as needed
– Can be beneficial for seniors with limited health/mobility/financial issues
– Allows senior to remain in their own community and feel more independent
– Programs like Village to Village are available in some areas to help seniors remain home as long as safely possible
– Can be isolating for seniors living alone
– Relative cost Is lower than institutional living but may require more help from family and friends
INDEPENDENT LIVING/RETIREMENT/OVER 55 COMMUNITIES
– Seniors can rent or buy homes in these communities
– Del Webb Communities and The Villages, Florida are well-known examples
– May be good option for seniors who do not need assistance but feel lonely living alone and want regularly activities available
– Some provide meals, limited transportation, housekeeping and laundry, social activities
– Cost varies greatly depending on location and range from $1000/month to $1 million to buy
CONTINUING CARE RETIREMENT COMMUNITIES (CCRCs)
– Include independent living, may also offer assisted living, memory care and skilled nursing
– Good for seniors who want to live in one location for the rest of their lives without concern for their future care needs
– Residents start out living in the independent living section and move to different parts of the community when their care needs increase; home health aides are available in most communities at hourly rates of $20 or more.
– Cost at CCRC’s usually require a significant entrance fee and continuing monthly fees. Some do not increase your monthly fee even when you move to a higher level of care. They usually require contracts, so it is very important to understand the requirements. In California, the entrance fee for CCRCs ranges from $500k to $1million and more, depending on size of the apartment and the location of the facility. Most allow a proportional refund of the entrance fee upon the death of the resident or if they move out.
ASSISTED LIVING FACILITIES
– Staff available 24-7 to help with activities of daily living such as meal preparation, bathing, dressing, laundry, housekeeping, and medication management
– Some may have limited nursing staff for medical issues
– Residents live in private or shared bedrooms or apartments
– Provide opportunities for recreational, physical and social activities, including congregate dining areas
– Designed for seniors who need help with their daily activities
– Cost is high. An article in Consumer Affairs lists the cost of an assisted living facility nationwide as about $4000/month, with state averages ranging from $3000 to $10,000. In addition to the monthly rent, residents are charged more depending on the amount of assistance they need.
– Most large assisted living facilities provide a separate unit/area for residents with memory care issues. This will add to the monthly charges. Memory care units in California cost at least $8000 or more a month.
SMALL RESIDENTIAL CARE FACILITIES/BOARD & CARE HOMES/PERSONAL CARE HOMES
– Licensed by states usually to house a limited group of seniors. In California most are licensed to house 6.
– Good for seniors who need more individual care in a home setting and more help with Activities of Daily Living (ADLs) but do not require on-site medical staff
– Good for seniors who are dealing with memory care issues/dementia
– Generally they do not provide a high level of activities/recreation
– Relative cost is medium. Daily Caring says they can be half the cost of nursing homes and in some states are more affordable than assisted living.
NURSING HOME/SKILLED NURSING FACILITY
– Intended for those needing 24-hour supervised care with meals, activities and health management, especially those with debilitating conditions and unable to care for themselves
– A licensed physician supervises residents’ care and a nurse or other medical professional is almost always on premises
– Some have physical and occupational therapists on staff
– Some have special facilities for Alzheimer’s or dementia care
– Relative cost is high. Genworth’s Cost of Care Survey shows the average cost of nursing home care is $7,756 to $8,821 a month, depending on choice of room, level of care and location. Prices range from under $200/day in Oklahoma to over $1000 in Alaska.
There are clearly many choices available if and when a senior’s needs no longer allow them to remain safely in their home. None of us knows what the future will bring. Simply having a basic knowledge of what is available in your community and the costs associated with them can make all the difference, if you or a loved one is ever faced with having to make this very important life decision.
Here are some additional resources:
https://familydoctor.org/housing-options-for-seniors/