America’s older population is in the midst of unprecedented growth. As the baby boomer generation continues to experience increased longevity, the 50 and over population is projected to increase about 20 percent by 2030 or to about 132 million people. In just 15 years, one in five people will be at least age 65. Ensuring that this demographic continues to experience affordable and accessible housing that offers a sense of community as well as other services and supports that enables them to remain active and productive members of society has taken on a new urgency not only for individuals and their families, but also for the nation as a whole.
For some people, staying in their current homes works. For others, there may come a time when everyone agrees that a different housing option is needed. For those individuals living with chronic conditions and/or disabilities, the availability of housing with supports and services they need determines the quality and cost of long-term care—particularly the portion paid with public funds. Every day, seniors and their caregivers ask questions such as “What if mom or dad can’t go home?” or “What are my housing options?”
Thankfully, today society offers seniors a host of choices and options with regard to alternative housing. Options include: Age-Restricted Communities; Active-Adult Communities; Senior Apartments; Cohousing; Home with Help (HWH); Assisted-Living Facilities (ALF); Continuing-Care Retirement Communities (CCRC); Board and Care Homes; and Skilled Nursing Facilities (SNF).
- Age-Restricted Communities. Age-Restricted Communities also known as “active adult” or “[age] 55+” communities cater to older adults who have a common preference to live among their peers. Age-Restricted Communities usually offer a mix of this housing type—single-family homes, townhomes, or apartments that are often connected by sidewalks or paths. Age Restricted Communities tend to focus on an active lifestyle, and many communities have well-equipped clubhouses and other amenities, such as tennis courts, gardening, and other community-based activities.
- Active-Adult Communities. Active-Adult Communities tend to be more suitable for older adults who are healthy, independent, and interested in the social benefits of living among peers. It should be noted that many age-restricted communities don’t allow multigenerational living arrangements, including children and grandchildren.
- Senior Apartments. Senior Apartments are age-restricted apartments that are typically available to people age 55 and older. While senior apartments are luxury apartments with high price tags, a lot of senior apartments are priced at market rates or below. Some are even built specifically for low-income people. Because the units are constructed for older adults, they are often designed to be accessible and include transportation services.
- Cohousing. “Cohousing” designates “a type of ‘intentional neighborhood’ in which residents actively participate in the design and operation of the community.” Residents privately own their homes and do not pool their incomes, but there are common facilities for daily use. Decisions are made cooperatively, rather than by top-down hierarchy or majority-rules voting. Cohousing communities are vibrant places where there are many opportunities for multigenerational interactions and social connections. In elder or senior cohousing communities, the “intentional community” is only for older people. Homes and facilities are designed for aging in place, and residents often share the cost of health aides or an on-site health-care provider.
- Home with Help (HWH). Home with Help assistance is available to an individual when it has been deemed that it is unsafe for that person to live at home alone. HWH services are geared towards providing care in the home. This may include individuals continuing to live in their home environment with 24 hour care. It also may include in the form of family caregivers, private paid caregivers, transportation services, and meal options such as meals on wheels. Hiring private caregivers is an out-of pocket expense; therefore one must consider the financial aspect associated with in-home care.
- Assisted-Living Facility. Assisted-living facilities (ALFs) are housing communities for those individuals who may require minimal assistance with their activities of daily living such as bathing, dressing, eating, housekeeping, shopping, and medication management, but they want to live as independently as possible. Residents living in this facility keep the sense of “home”, by having their own apartment. Medicare does not cover the cost of assisted-living facilities, but in some states, Medicaid may assist with funding.
- Continuing-Care retirement Communities (CCRC). Continuing-Care Retirement Communities are a combination of an assisted-living facility that is connected with an independent living residence and a nursing. Residents in this setting are able to take advantage of a variety of services, including meals, transportation, housekeeping, laundry, health monitoring, and social activities. Another advantage about living in a CCRC is that residents will not have to relocate to a new community as their level of care may increase. Fees often increase as services increase. A CCRC offers many different contract options including, extensive, modified, and fee-for-service. The contracts differ in the amount according to the services offered. To determine which option is best for your loved ones, visit the Continuing Care Accreditation Commission.
- Board and Care Homes. Board and Care Homes are also known as a residential care facility or group home for older adults. They are often very small and provide assistance with meals and basic Activities of Daily living (ADL’s). A board and care home offers seniors a “home” atmosphere. Often board and care homes are located in single-family homes. Government funding as well as SSI can sometimes cover the costs of such facilities.
- Skilled Nursing Facilities. Skilled Nursing Facilities provide care to those who need 24 hour care after suffering from an illness, injury, or functional disability; some nursing homes offer specialty services geared towards specific medical conditions. Nursing homes provide many skilled services including occupational therapy, physical therapy, speech therapy, and respiratory therapy. Typically, individuals stay for a short period of time to receive services to increase independence to return home. Skilled nursing facilities are often covered by Medicare, Medicaid, and private insurance carries.
Finding the appropriate senior housing can be a difficult and tedious process for everyone. Whenever possible, involving the whole family can help everyone maintain dignity and power of choice. For additional information on senior housing, visit:
The National Caucus and Center on Black Aging, Inc., Housing Management Corporation: www.ncbahmc.com
National Clearinghouse for Long-Term Care Information: http://www.longtermcare.gov/LTC/main_Site/index.aspx
Housing and Urban Development: http://www.hud.gov/groups/seniors.cfm
Continuing Care Accreditation Commission: http://www.carf.org
The opinions expressed in this article are those of the author and do not necessarily reflect those of the Diverse Elders Coalition.