Downsizing seniors
have more housing options today than ever before. Here’s a quick guide to
understanding industry terminology and the differences between the numerous
senior living options available.
Continuing Care Communities
Continuing Care means
forever, but at additional expense as you need more care, and not necessarily
on the same premises. The terms “pay-as-you-go” and “a la carte” are
definitions used for programs at Continuing Care Communities. There is usually
an initial entrance fee, and then the additional care you receive is priced as
it is provided. A prorated portion of the entrance fee is usually refunded
depending on the length of time a person resides in the community.
Lifecare Communities
Lifecare means care
forever on the same premises (excluding acute care) with no increase, except
for the yearly inflation increases. Lifecare is a form of Continuing Care, but
it takes it one step further. It is usually referred to as the “extensive care
plan.”
Many people think of
Lifecare as a form of long-term care insurance. You may pay a higher entrance
fee than in a Continuing Care community, but the financial security of knowing
that once you are in you won’t have an increase in your medical costs as long
as you live can be reassuring. A person must be able to live independently upon
moving in and must pass a physical exam given by a professional at the
community.
There are refundable
entrance fee packages available, but the entrance fee is usually more and is
prorated according to the time a person resides in the community. Some Lifecare
communities also offer a “continuing care” contract option for those who would
rather pay as they go.
Assisted Living Communities
Assisted living
communities are appropriate for individuals who are unable to function in an
independent environment, but who don’t require the level of supervision and
care provided in a skilled nursing community. Most residents need some
assistance with Activities of Daily Living (ADLs), such as bathing, dressing,
grooming, housekeeping, and medication monitoring. The staff oversees these
things as well as offers social activities and outings for shopping or doctor
appointments. Residents are free to come and go as they please and have access
to in-house amenities, such as salons and whirlpool tubs.
These types of
communities are private pay and vary in price. They are rented on a
month-to-month basis, although some may require a lease. Apartments are small
and sometimes include a kitchenette with a microwave and small refrigerator. Meals
are provided in a common dining area, usually three times daily.
Independent Living Communities
Independent senior
living retirement communities are not licensed and offer a variety services.
They usually have a minimum age requirement and rent from month to month. The
key here is that they are “independent” retirement communities, meaning they DO
NOT provide medical care. Most will arrange for independent home health
services to come in if needed temporarily; however, when a person is required
to have ongoing medical care, they will no longer be eligible to live in the
community.
Independent Retirement
Communities typically offer full kitchens, some meals in a common dining room,
housekeeping, paid utilities (except telephone and cable), laundry facilities,
24-hour staffing, and private areas for tenant use. Since these communities are
not licensed, they can charge whatever the market will bear and are not subject
to uniform regulations like licensed communities. Some are affiliated with
churches, schools, and other community programs.
Skilled Nursing Communities
Skilled nursing
communities are known historically as “rest homes” or “nursing homes.”
Residents at these communities are typically unable to live independently and
need more medical assistance than assisted living communities will provide.
Skilled communities
offer 24-hour nursing care, assistance with bathing, feeding, grooming,
physical therapy, occupational therapy, and other medically necessary services.
A nursing care community can be a temporary arrangement while someone is recovering
from surgery or a stroke, or it can be permanent if a person is going to need
ongoing medical care and/or supervision. Levels of care in nursing communities
can vary from unit to unit within the same community, some offering more or
less services than others. There are no age requirements for living in nursing
communities; therefore, persons of any age with chronic illnesses or injuries
may also reside there.
Memory Care
Many skilled nursing
communities have added a section designed specifically for dementia patients
and their special needs. Some Lifecare and Continuing Care Communities have
also added special Alzheimer’s care. These areas are typically secured and
require a code for access in and out for the safety of those residents who have
a tendency to wander. All specialized units are different, so it is important
to ask questions and tour the entire community to get a feel for the overall
care provided and services offered.
Planned Adult Communities
Planned Adult
Communities are characterized by clusters of apartments and condominiums or
single-family homes built around a core of services and amenities. Residents
can own their own property and must abide by the covenants, codes, and
restrictions administered by a governing body which deals with the policies of
the community facilities, property requirements, charges and assessments, and
provisions of the association of homeowners. In some parts of the country,
these types of communities are promoted as recreational and are located on golf
courses and lakes.
Condos, Townhomes, and Duplexes
If a person would
prefer to live in a multi-generational environment and not in an exclusively
senior community, but needs maintenance-free living, there is the option of a
condominium, townhouse, or duplex. Downsizing from a large home with a large
yard to a duplex with a small yard may prove to be a helpful transition for a
person who is still able to care for a household, but who may not have the
stamina or desire to care for a large home and/or acreage.
With some private
housekeeping assistance and lawn care provided, many empty nesters find that
this transition is less stressful than an immediate move to a retirement
community. It is not considered specifically a “senior” community option, but
one that certainly should be considered if a person is in good physical and
mental health.
Subsidized and Low Income Housing
There are a variety of
senior complexes throughout the country which offer subsidized rent. Most of
them are multi-level apartments, and while they do not include the lavish décor
of the Lifecare and Continuing Care communities, they are typically
well-maintained and affordable. Some are subsidized through HUD, while others
are operated by non-profit organizations and property management companies.
There are often waiting lists to get in, and once you are called with an
available opening, you must make a decision quickly. If you do not accept it in
a timely manner, your name will go back to the bottom of the list.
Advice when touring long-term care
communities
1.
Visit on different days and at various times, including
mealtimes, taking note of nursing staff levels.
2.
Talk to members of the nursing staff about how long they have
worked there.
3.
Ask the nursing community administrators about staff-to-resident
levels.
4.
Get a copy of the most recent state survey of the facility to
learn if it has been cited for
deficiencies.
5.
Ask if they have a plan of care for each resident and if it is
revised continually.
6.
Contact the local ombudsman organization and ask them about
specific long-term care facilities in the area.
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