Senior Housing Options — Making the Best Senior Living Choices
What is senior housing?
Aging is a time of adaptation and change, and planning your future housing needs is an important part of ensuring that you continue to thrive as you get older. Of course, every older adult is different, so the senior housing choice that’s right for one person may not be suitable for you. The key to making the best choice is to match your housing with your lifestyle, health, and financial needs. This may mean modifying your own home to make it safer and more comfortable, or it could mean moving to a housing facility with more support and social options available on site. It could even involve enrolling in a network of like-minded people to share specialized services, or moving to a retirement community, an apartment building where the majority of tenants are over the age of 65, or even a nursing home.
When deciding on the senior housing plan that’s right for you, it’s important to consider not only the needs you have now but also those you may have in the future:
- Physical and medical needs. As you age, you may need some help with physical needs, includingactivities of daily living. This could range from shopping, cleaning, cooking, and looking after pets to intensive help with bathing, moving around, and eating. You or a loved one may also need increasing help with medical needs. These could arise from a sudden condition, such as a heart attack or stroke, or a more gradual condition that slowly needs more and more care, such as Alzheimer’s disease.
- Home maintenance. If you’re living alone, your current home may become too difficult or too expensive to maintain. You may have health problems that make it hard to manage tasks such as housework and yard maintenance that you once took for granted.
- Social and emotional needs. As you age, your social networks may change. Friends or family may not be as close by, or neighbors may move or pass on. You may no longer be able to continue driving or have access to public transportation in order to meet up with family and friends. Or you simply may want to expose yourself to more social opportunities and avoid becoming isolated and housebound.
- Financial needs. Modifying your home and long-term care can both be expensive, so balancing the care you need with where you want to live requires careful evaluation of your budget.
Preparing yourself for change
Whether you’re considering home care services or relocating to a retirement home, planning your future housing needs often runs hand-in-hand with facing up to some loss in your level of independence. Understandably, the prospect of losing independence can be overwhelming for many older adults. It can bring with it feelings of shame, embarrassment, fear, confusion, and anger.
But it’s important to remember that you’re not alone in this. Most of us over the age of 65 will require some type of long-term care services. And there’s nothing to be ashamed about in admitting you need more help than you used to. After all, we’ve all had to rely on others at some point during our adult lives, be it for help at work, home or vehicle repairs, professional or legal services, or simply moral support. For many of us, independence is recognizing when it’s time to ask for help.
Coming to terms with changes in your level of independence
It’s normal to feel confused, vulnerable, or even angry when you realize you can’t do the things you used to be able to do. You may feel guilty at the prospect of being a burden to family and friends, or yearn for the way things used to be. By acknowledging these feelings and keeping your mind open to new ways to make life easier, you’ll not only cope with your change in situation better but may also be able to prolong other aspects of your independence for longer.
- Communicate your needs with family and loved ones. It’s important to communicate with family members your wishes and plans, and listen to their concerns. For example, long distance family members might think it’s better for you move close by so that they can better coordinate your care. However, you might not want to uproot yourself from your community and friends. Similarly, just because you have family close by does not automatically mean they will be able to help with all your needs. They may also be balancing work, their own children, or other commitments. Clear communication from the outset can help avoid misunderstandings or unrealistic assumptions.
- Be patient with yourself. Losses are a normal part of aging and losing your independence is not a sign of weakness. Allow yourself to feel sad or frustrated about changes in your housing situation or other aspects of your life without beating yourself up or labeling yourself a failure.
- Be open to new possibilities. Your loved ones may offer suggestions about senior housing options or other ways to make your life easier. Rather than dismissing them out of hand, try to keep an open mind and discuss the possibilities. Sometimes, new experiences and situations can lead to you developing new friendships or finding new interests you’d never considered before.
- Find a way of accepting help that makes you comfortable. It can be tough to strike a balance between accepting help and maintaining as much of your independence as possible. But remember that many people will feel good about helping you. If it makes it easier, offer to trade chores. For example, you can sew on buttons in exchange for some heavy lifting or cleaning chores. Or return other people’s help by “paying it forward.” Volunteer your time to help or teach others, while at the same time expanding your own social network.
Helping a loved one cope with a loss of independence
It’s painful to see a loved one struggling to maintain their home or themselves. Maybe clothes are not as clean as they used to be or the house is getting increasingly messy. Or maybe your loved one is experiencing frequent falls or memory lapses such as leaving the stove on or the door unlocked. While you can’t force a loved one to accept help or move home, unless they are a danger to themselves or others, you can provide them with information and reassurance. Don’t take it on alone. Brainstorm with other family and friends and talk with your loved one’s medical team. Sometimes a senior will listen more to a doctor, care manager, or other impartial party.
- Explain how care may prolong independence. Accepting some assistance now may help your loved one remain in his or her home for as long as possible. Or if your loved one considers an assisted living facility now, for example, it may negate the need for a nursing home later on.
- Help your loved one cope with the loss of independence. Encourage your loved one to stay active, maintain relationships with friends and family, and to keep an open mind about new interests, such as trying a day care facility.
- Suggest a trial run for home care services or other changes to give your loved one a greater sense of control over his or her situation. A trial run let’s your loved one have the chance to experience the benefits of assistance or change in living situation before having to commit to anything long-term.
- Don’t expect to handle all care yourself. There are only 24 hours in a day, and you need to be able to balance your own health, family, work, and finances. Caregiving can start with small assistance, and rapidly grow to an all-encompassing task. Getting help is not a sign of weakness. It means you care enough about your loved one’s health and safety to realize when the responsibility is too great. Educate yourself about the resources that can help your loved one, and see if other family members can also help.
What are your senior housing options?
There is a broad array of housing options available to seniors, from staying in your own home to specialized facilities that provide round-the-clock nursing care. The names of the different types of housing options can sometimes be confusing, as the terminology can vary from region to region. For example, the term “assisted living” can mean one thing in one state or country and something slightly different elsewhere. However, in general, the different types of senior housing vary according to the amount of care provided for activities of daily living and for medical care. When researching a senior housing option, make sure it covers your required level of care and that you understand exactly the facilities offered and the costs involved.
Senior housing option 1: Aging in place
Staying at home as you age has the advantage of keeping you in a familiar place where you know your neighbors and the community. There is a wide range of home care services that can help you maintain your independence within the comfort of your own home, from in-home care to day care. You may also be able to make home repairs or modifications to make your life easier and safer, such as installing a wheelchair ramp, bathtub railings, or emergency response system.
Staying at home may be a good option if:
- You have a close network of nearby family, friends, and neighbors
- Transportation is easily accessible, including alternate transportation to driving
- Your neighborhood is safe
- Your home can be modified to reflect your changing needs
- Home and yard maintenance is not overwhelming
- Your physical and medical needs do not require a high level of care
- You have a gregarious personality and are willing and able to reach out for social support
- You fall within the geographical confines of an integrated community, such as a “village” or NORC (Naturally Occurring Retirement Community)
Aging in place is a less effective senior housing option once your mobility is limited. Being unable to leave your home frequently and socialize with others can lead to isolation, loneliness, and depression. So, even if you select to age in place today, it’s important to have a plan for the future when your needs may change and staying at home may no longer be the best option.
Senior housing option 2: The Village concept
The Village solution to aging in place is a relatively new concept, enabling active seniors to remain in their own homes without having to rely on family and friends. Members of a “village” can access specialized programs and services, such as transportation to the grocery store, home health care, or help with household chores, as well as a network of social activities with other village members.
Senior housing option 3: Naturally Occurring Retirement Communities (NORC)
Like the village concept, Naturally Occurring Retirement Communities (NORC) enable seniors to stay in their own homes and access local services, volunteer programs, and social activities, but tend to exist in lower income areas. A NORC may be as small as a single urban high rise, or it may spread out over a larger suburban area. See Related Links for help finding a NORC program in the U.S.
Senior housing option 4: Independent living
Independent living is a general name for any housing arrangement designed exclusively for seniors. Other terms include retirement communities, retirement homes, senior housing, and senior apartments. These may be apartment complexes, condominiums, or even free-standing homes. In general, the housing is friendlier to older adults—it’s more compact, easier to navigate, and includes help with outside maintenance. Sometimes recreational centers or clubhouses are also available on site.
You may want to consider independent living if:
- You see needing minor assistance with activities of daily living
- You’d like a place that does not require a lot of maintenance and upkeep
- You like the idea of socializing with peers and having activity options nearby
If you don’t want to live exclusively with others your own age, there are alternatives to an independent living community. You can consider moving in with a family member, or simply moving to a more accessible apartment or condo. The key is being in an area with good access to transportation, services, and social networks.
Senior housing option 5: Assisted living
Also known as residential care, board and care, congregate care, adult care home, adult group home, alternative care facility, or sheltered housing. In general, assisted living is a housing option for those who need help with some activities of daily living, including minor help with medications. Costs tend to vary according to the level of daily help required, although staff is available 24 hours a day.
Some assisted living facilities provide apartment-style living with scaled-down kitchens, while others provide rooms. In some, you may need to share a room unless you’re willing to pay a higher cost. Most facilities have a group dining area and common areas for social and recreational activities.
An assisted living facility may be a good choice if:
- You need more personal care services than are feasible at home or in an independent living retirement community
- You don’t need the round-the-clock medical care and supervision of a nursing home
What is a Continuing Care Retirement Community ?
Continuing Care Retirement Communities (CCRCs) are facilities that include independent living, assisted living, and nursing home care in one location, so seniors can stay in the same general area as their housing needs change over time. There is normally the cost of buying a unit in the community as well as monthly fees that increase as you require higher levels of care. It also can mean spouses can still be very close to one another even if one requires a higher level of care.
Senior housing option 6: Nursing homes
A nursing home is normally the highest level of care for older adults outside of a hospital. While they do provide assistance in activities of daily living, they differ from other senior housing in that they also provide a high level of medical care. A licensed physician supervises each resident’s care and a nurse or other medical professional is almost always on the premises. Skilled nursing care and medical professionals such as occupational or physical therapists are also available.
A nursing home may be a good choice if:
- Both your medical and personal care needs have become too great to handle at home or in another facility. This may be due to a recent hospitalization, or a chronic illness which has gradually been worsening.
- You need a higher level of care temporarily after a hospitalization, but it’s anticipated you will be able to return to home or another facility after a period of time.
Assessing your senior housing needs
When evaluating your senior housing needs, consider the following issues:
- Level of Care. No one can predict the future. However, if you or a loved one has a chronic medical condition that is expected to worsen over time, it’s especially important to think about how you will handle health and mobility problems. What are common complications of your condition, and how will you handle them? Are you already at the point where you need daily help?
- Location and accessibility. Even if you are completely independent at this time, circumstances can change. It pays to think a little about your current location and accessibility of your current home. For example, how far is your home from shopping, medical facilities, or other services? If you can no longer drive, what kind of transportation access will you have? Can your home be easily modified? Does it have a lot of steps or a steep hill to navigate? Do you have a large yard that needs to be maintained?
- Social support. How easy is it for you to visit friends, neighbors, or engage in hobbies that you enjoy? If it becomes difficult or impossible for you to leave your home, you’ll become isolated and depression can rapidly set in.
- Caregiving Support. You will want to consider housing where both your current and future needs can be met. Even if family members can commit to caregiving, they might not be able to fill in all the gaps if physical and medical needs become extreme. The more thought you put into your future, the better chance your needs will be met.
- Finances. Making a budget with anticipated expenses can help you weigh the pros and cons of your situation. Senior housing options like assisted living can be expensive, but extensive in-home help can also rapidly mount in cost, especially at higher levels of care and live-in or 24-hour coverage. You may be able to purchase insurance to offset some of the costs of long-term care. In the U.S., the Department of Housing and Urban Development (HUD) provides some housing options for seniors under a certain income limit, while Medicaid covers the bulk of nursing home care for those with limited income and assets.
- Need a professional assessment? Geriatric care managers can provide an assessment as well as assistance with managing your situation, including crisis management, interviewing in-home help, or assisting with placement in an assisted living facility or nursing home. See the Resources section below to learn more about geriatric care managers.
|Comparison of Senior Housing Options in the U.S.|
|Feature or Service||Independent Living||Assisted Living||Nursing Home|
|Approx. Cost per Month||$1,500 – 3,500||$2,500 – 4,000||$4,000 – 8,000|
|Meals per Day||Meal Plan Options||3+||3+|
|Transportation||Most Yes||Most Yes||Yes|