Senior Housing Options

January 5, 2014 Senior Help

WHEN IT’S TIME TO MAKE A CHOICE

Whether we want to admit it or not, as we age, we eventually all reach a point where it becomes clear that we can no longer continue a completely independent lifestyle. The daily routines of life can become thornier and difficult medical conditions may be a cause for concern.

It’s human-nature to want to be self-sufficient and carry our own weight through life. The transition to various levels of loss of dependency can be very difficult and many times goes against everything we’ve been taught by our parents and American culture as a whole. We are typically trained to go out in the world, learn, work and become a self-made person, taking full responsibility for ourselves and our families. It’s no wonder we push-off retirement planning; we simply don’t want to consider the situation of our dependence on others. After all, dependence is so foreign to us; we may never have been in a position where we relied on the assistance of others for our everyday living.

SOONER IS BETTER THAN LATER

The truth of the matter is that the sooner we start to consider our options, plan and actually make some decisions, the more choices and control we will have when the time comes. While finding the right place to transition to senior life can be challenging and lead to increased stress levels in the short term for both us and our families, accurate information, advanced planning, and the general knowledge of your senior housing options and the landscape of senior living are keys to a successful transition.

CHANGE IS NEVER EASY

As is true with much of life, getting older is a time of change and adapting to change is never easy for any of us. As you are considering senior housing options, it is important to keep in mind that your needs and living requirements may evolve and change unexpectedly over time. As each person is different, senior housing choices will vary depending on financial limitations, family preferences, the individual’s health issues, previous lifestyle, needs, likes and wants.

THE RANGE OF CHANGE

Sometimes, preparing for life as you get older may mean simply making a few changes to better accommodate your limitations (shower handles, wheelchair, walker and so forth). It may involve actually moving into a senior housing environment, community project or senior apartment building where the residents are 65 or older. The highest level of care may involve a full nursing home for those requiring constant monitoring and assistance. There are also integrated senior mega corporation facilities known as continuing care retirement communities (CCRC’s) where a complete scope of care is provided as needs change ranging from independent living all the way up to full service nursing. These mega facilities take into account the needs that future changes in your situation may dictate, allowing you to remain at the same facility through all levels of assistance.

BELOW ARE SOME CONSIDERATIONS AS YOU AGE

Financial Needs – Budgetary consideration is extremely important when figuring out your future living requirement. Remodeling your house for handicap access and better mobility is an expensive proposition. If you choose to go this route and then in a short time realize you need to move up to more extensive care options, then the money you’ve spent on your home modifications may have been better used towards a more long-term solution. Balancing your finances with the type of environment you wish to live in requires very astute evaluation of your budget.

Home maintenance – If you’re living away from supportive family members or on your own, the home you currently may own can become too difficult or costly to properly maintain. Additionally, you may have increasingly complex health problems that make it close to impossible to handle the otherwise routine tasks such as housework and yard maintenance that you were at one time able to accomplish with little or no assistance.

Physical and Medical needs – As you get older, you may need help due to physical limitations and with daily living. These may include shopping, cleaning, cooking, taking care of pets or more intensive help with bathing, moving around, and eating. If driving is no longer an option, getting to medical appointments may be a problem. These limitations could possibly come about as a result of a sudden condition, such as a stroke, heart attack, brain aneurism or from a more gradual onset condition that slowly requires higher levels of care such as Parkinson’s or Alzheimer’s disease.

Social and Emotional Needs – We all need and crave connection. Sometimes getting through the day may mean a simple call from a friend or connection with a grandchild or other relative. As you age, your social networks may become more limited or change dramatically. Long trusted and dependable friends or loving family members may move away. Your dependable and caring neighbors may move to another state or region or possibly pass-on. If you are accustomed to hopping in your car to visit your social connections, you may come to find you no longer qualify for a driver’s license, or it becomes unsafe for you to drive, or your access to public transportation may be eliminated or limited. Perhaps as you get older you would prefer a situation that exposes you to more social opportunities such as a senior community of some sort in order to avoid becoming isolated and housebound.

WE ARE ALL IN THIS TOGETHER

Accepting the reality of increased dependence on others and preparing yourself for a dramatic lifestyle change is difficult at best. In order to help your perspective, it is important to look at the big picture. Try to remember that you are not in this alone. Consider the fact that virtually everyone at some point, who is fortunate enough to have lived a long life, eventually, gets to where they need to consider these same tough choices.

Losing your independence and having to rely on others can bring with it feelings of vulnerability, fear, shame, embarrassment, confusion, frustration, helplessness and even anger. These feelings are to be expected and are normal human feelings after living a long life of self-control and sufficiency. It may help you to consider that depending on other people at a certain point in life is just a natural progression of life.

We have the choice to look at the situation in another light. All through our lives we needed to hire and depend on others to help us. We have required the services of doctors, lawyers, accountants, contractors, mechanics, plumbers, and others in order to make it to where we are now in life. Even in our careers we called on fellow workers and bosses to assist us when we were stuck or needed a hand. Emotionally, we reach out to friends and family all the time for support and comfort when life presents its multitude of problems. As the cliché goes, “no man is an island.” We are all connected to our surroundings and each other and are dependent on each other to make it through life.

LEARNING TO ACCEPT THE CHALLENGES OF GROWING OLD

No one wants to become a burden to family or friends. As self-sufficient souls, we look for every possible way to avoid being placed in a situation where we will be someone else’s responsibility or burden. Since the negative feelings mentioned in the previous section are common to almost everyone who must transition from self-dependence to inter-dependence, it may be therapeutic to acknowledge these feelings and see them as being common to everyone who traverses this earth. Hopefully this perspective will help you to put your situation in context while keeping a cool and calm demeanor allowing you to maintain an open mind to all possible options available to you. Cool and level heads prevail and will help things go easier for all parties involved in your transition.

Communication is King – Communicating clearly is important in avoiding misunderstandings and assumptions that are unrealistic. Family and friends typically only want to help and many times come up with ideas or suggestions that are not necessarily in line with your thoughts and desires or even what is best for you in the long run. If you have a large church and close friend support network in your area that is helpful to you both physically and emotionally, your best option may not be to immediately move to the other side of the country to live with children or other family members where things are unfamiliar and strange. It’s important to communicate clearly with family for the best and most effective options to be ultimately realized. Their intentions may be sincere but their own family responsibilities may render their care not as good as that found with your existing local support network. On the other hand, you must also be realistic as to the actual ability of your local support network to fully engage in and assist with your potential increasing needs. Once again, both you and your family need to be as clear and realistic as possible when communicating in order to ensure the best outcome.

Keep Your Options Open – As your family and friends try to help by offering suggestions for your new living arrangement, it is best to listen to them and maintain an open mind in their suggestions. If you dismiss their ideas quickly and without at least discussing the possibility, you may be cheating yourself out of a great new friendship, hobby interest or adventure that you were never exposed to or even considered until you tried the new living option.

Patience can go a Long Way – Be patient in your situation and realize that you are not a failure simply because you can no longer take care of yourself independently. We all suffer losses as we age; it is a normal part of life. You should be able to allow yourself to feel sad or frustrated about a change in your independence for a period of time, but without continually beating yourself up over something that is out of your control and not your fault.

Give what you can in Return to Offset the Acceptance of Help – You may end up living with a group of other seniors in a retirement community, a private senior home or your children’s family. In any of these situations you still may have talents and abilities that can create a value to others. As a human being, you are valuable in some way and have a unique ability to help others; this in turn helps you feel better about accepting help in your situation. Giving back to others by doing sewing, knitting or something you are uniquely qualified to do may be a way to somehow compensate for the care that is extended to you. If you have expertise in certain academic areas, you may want to volunteer to teach or tutor children or students. In giving back, you will feel more comfortable and less dependent in balancing the help that is given to you by giving help back to others, all the while developing more social connections in the process.

HOW CAN RELATIVES HELP A LOVED ONE DEAL WITH CHANGE AND THE LOSS OF THEIR INDEPENDENCE

The son or daughter who arrives at their mom’s house to find a pile of dishes and an extremely messy and dangerous house is troubled as to how to approach the situation. They know from previous experience that their mom will react very strongly against moving from the home she has known and loved for decades. The mother’s children may also be torn as they don’t want their beloved mother to lose her independence. But they come to a point where they realize their mother can no longer manage her daily routine without help.

While we all suffer some occasional memory lapses, when a loved one becomes a danger to themselves or others as a result of extreme memory dysfunction, everyone’s good intentions must be trumped by responsibility. If a loved one is falling, leaving the oven on, the door unlocked or not eating properly, then these are situations that could cause harm. If the memory issues are related to dementia, Alzheimer’s or another cognitive impairment, then the situation is most likely only going to get worse.

Since the loved one may be strongly opposed to any kind of change, and possibly not willing to listen to a close family member, it’s important to have meetings with other family members, friends or even the loved ones medical professional, doctor, care manager or some third party who is impartial to the situation. Sometimes a few words from your loved ones trusted professional may be all the reassurance they need to convince them that changing their living situation is in their best interest. The best advice here is not to try to take on the situation alone but rather involve as many people as necessary to help facilitate the best possible outcome.

Care can Extend the Loved One’s Independence – If your loved one sees a move to assisted living as a negative thing, then you can help modify their perspective by reinforcing the positive aspects of a change. It should be explained to them that moving into an assisted living facility sooner than later, may put-off or eliminate the need for more intensive care at some point later, such as a nursing or convalescent home.

Start with a Short Trail Period – Suggesting to your loved one a move to an assisted care facility entirely on a trial basis. This may be less of a feeling of finality in regards to the loss of their freedom. It could provide them with a sense that they still have some control and say in the situation. While in the trial period, hopefully they will be able to experience reduced stress from the struggles of managing the complexity of life and its daily needs on their own. They may develop a positive perspective of the benefits of living in an environment of help and assistance during the trial period.

If a Relative Takes in a Loved One, they May Need Assistance – Many well-intentioned relatives may decide to take on all of the care giving of an aging loved one. Many times the situations seem manageable at first, but later may develop into a much more complex and all-encompassing situation. It’s important for the family care giver to be realistic and remember current responsibilities of their own family, their work and available finances. The caregiver should become as informed as possible about all of the community assistance programs that may be of help to them in taking on this role. They should not feel embarrassed to seek help from other family members.

Help Cope with Loss of Independence – A relative can help their loved one cope with their loss of independence by encouraging them to stay active and connected with friends and family. Additionally, encouraging a loved one to stay interested in new and interesting hobbies and various activities can be helpful. Puzzles, knitting, Croce, music, painting and other focused activities can help their mental attitude. Whether at a community senior center or at an assisted living facility, maintaining connections and keeping busy can give your loved one a sense of purpose and something to look forward to each day.

SENIOR HOUSING OPTIONS FOR YOUR LOVED ONE

When dealing with the official titles or the naming conventions of senior care, different state in the U.S. will utilize varying terminology. There appears to be a rather broad scope of naming conventions and they may mean different things depending on what state or region you are located in. This many times leads to confusion and uncertainty for the unfamiliar and new senior housing seeker. You may come across the term “assisted living” that may mean full assistance with all daily functions such as bathing, eating, and medication in one state and in another, more limited assistance that provides only meals and transportation to doctor’s appointments.

In most situations the level of care a facility provides is directly proportional to the price you will pay. To a lesser degree, the quality, niceties or amenities a given facility provides will increase the price compared to another similar type of facility. It is probably best to focus on the exact level of care a specific facility will provide that will cover your particular situation and not get too bound up in the semantics. By all means make sure there is a clear understanding (in writing) between you and the care provider of the exact level of care that is included and is expected to be provided for a given monthly rate.

Aging in Place – This option is all about staying in your existing home and making the necessary modifications to your home to provide effective, safe and easy daily functioning. It may also involve hiring a caregiver to come in for a certain number of hours a day or may mean a full time care provider if your condition prescribes. Budgetary constraints will dictate the amount of hired help you will be able to afford. Optionally, if family and friends are only available in the evening hours or after work, and you are reasonably ambulatory, you can opt for day care at a facility external to your home during times when they are away. If you or your loved one has a well established network of local and trusted family and friends, then they may be able to assist and thereby limit the number of hours of hired-help or daycare required, or possibly even eliminates it altogether. There are home assisted-care coordination networks that offer contract care workers for hire. Some of the modifications to your home when choosing aging in place may include adding an easy-access bathtub and/or bathtub handrails, a wheelchair ramp, a Life Alert type of emergency response system, internet assessable security cameras and other important safety and convenience features.

It’s important to look at this option carefully and to consider the possibility that if your medical condition gets significantly worse, then you may be forced into another more intensive care situation sooner than you planned. You also need to consider many other issues such as home and yard maintenance, transportation (hired, personal, family or public), the safety of your neighborhood and even your personality (are you able to reach out for social support). Aging in place may lead to eventual isolation and loneliness if you are not with relatives or a full time care giver. If you choose this option, it is always best to have an alternate plan in place for the future, should loneliness overtake you or your situation worsens.

Naturally Occurring Retirement Communities (NORC) – NORCs are typically affordable senior care facilities found in lower income areas. They are usually found in more urban settings and consist of single family residences in large apartment building complexes or in several buildings spread-out over a larger campus. NORC’s were originally started by large philanthropic Jewish groups in New York as a new model to promote healthy aging-in-place. These senior housing options offer increased dignity, independence, and community building to their participants. Initially, existing large New York City apartment buildings were converted for this new senior care model. The operators of these senior communities uphold fully integrated concepts including ongoing case management, social work services, health care management and prevention programs, education programs, enhanced socialization, recreational activities and volunteer opportunities for community seniors that help to create an effective and holistic environment. Today, these programs have grown tremendously with city, state and federal participation enabling more seniors to choose this aging-in-place option.

The Village Concept Community – The Village Concept is essentially an integrated community of active seniors all living in their own residences and are typically all-inclusive, aging-in-place, senior communities. This concept began in 2001 at a Boston neighborhood called Beacon Hill. A group of residents formed a nonprofit organization that helped seniors obtain easy access to services that, lacking such, would typically cause seniors to move out of their own homes to a retirement community or other senior care solution. These communities are generally upper scale, private facilities that are unique in that they provide specialized programs and services, including but not limited to transportation services, integrated grocery stores, home health care services, networks of volunteers and other services providing help with household chores. The senior community members themselves oftentimes are able to check in on each other in order to keep tabs on their neighbor’s wellbeing. The community is designed from the ground-up for seniors, so the social activities and events are generally numerous and specific to seniors preferences. These facilities can work out rather well for the still active senior that does not require advanced assistance or medical care.

Independent Living – This can be a broad term referring to many different types of senior living environments. These are usually private projects, specifically designed for seniors and can be referred as retirement homes, senior housing, senior apartments, senior condominiums, or even individual homes. The main focus here is that these types of housing options are designed with seniors in mind and are therefore generally more ideally suited to their needs. Most of these facilities being designed from the ground-up for seniors have amenities important to seniors such as handicapped ramps, bathroom rails/handles, along with intercom systems, and alarms. They tend to incorporate more compact and functional floor plans, making them easier to navigate and include such niceties as outside lawn maintenance along with greatly appreciated communal facilities such as workout centers, clubhouses and meeting rooms. These facilities are wonderful for those requiring minimal assistance with daily living and those at a point in their lives where they need to get away from home maintenance and yard work. They are also nice for those looking to form strong social ties. Independent living facilities can be highly effective at bringing seniors together in the utilization of the community-focused design concept.

Assisted Living – This category is rather broad, but in general, assisted living provides care beyond your own personal home or independent living situation but less care than a continuously monitored, 24 hour full nursing home facility. Depending on your region or state, these facilities may be known as adult foster homes, adult care homes, board and care, residential care homes, adult group homes, alternative care facilities or sheltered housing. These could be anything from a room in a private home or large facility to an independent apartment with a small kitchenette. All of these facilities typically have common group dining and activity areas where all guests can mingle, do activities and eat. In a private adult foster home environment, these group areas may be the residential home’s living room, family room and/or dining room areas. Some assisted living facilities offer shared-room situations while others provide private rooms or even small apartments. Typically these facilities provide assistance with medication, food and other daily living needs all the way up to minor medical assistance in some cases.

Of course the more privacy you require the higher the price tends to be. Price may also be dependent on your level of care required. Some accept Medicaid while others only accept privately funded clients. Some will take privately funded individuals until their private funds are exhausted, then transition the client to a Medicare program.

Continuing Care Retirement Communities – These are full-spectrum communities in that they provide housing and care through the entire range of aging. They essentially include separate facilities all within a common campus environment where independent living, assisted living and full nursing home care all included in one integrated location. If a senior’s level of care and needs increase, they don’t need to worry about moving to a different facility or location. This is a great option for those who still have spouses requiring a more advanced level of care but wish to remain within close proximity to their loved ones. These mega senior projects are typically reserved for those who have substantial fiscal resources and/or assets. Many continuing care retirement communities require the purchase of a housing unit along with monthly payments that may increase as the person requires more advanced levels of care as they get older.

Nursing Home or Convalescent Home – At the top of the spectrum, a nursing home is typically reserved for adults needing full time monitoring and care. They are the closest thing to a hospital, but with limited doctors and no surgery rooms. Nursing homes provide high levels of medical care. They maintain highly trained nurses and staff along with facility doctors and physical and/or occupational therapists. Most nursing homes have common activity rooms and eating halls for socialization opportunities such as games, music, movies and other group activities.

As there is full-time medical staff on the premises, nursing and convalescent homes are expensive options and should be utilized only when advanced care is required. These are many times used as a transitory facility after hospitalization where more close and professional medical care is required prior to moving back home or to an independent care or assisted care situation. Many times chronically ill patients require close medical attention but do not need a full hospital. In these cases, nursing or convalescent homes provide the best and most applicable solution.

QUESTIONS TO ASK YOURSELF WHEN CONSIDERING SENIOR HOUSING OPTIONS

Care Level – If you have a progressive medical condition that will get worse over time, it is important to learn as much as possible about the condition and its eventual progression. For example, if your mobility is at a certain limited level of range now, will your condition grow worse with time, thereby limiting your mobility further in the not too distant future? This is just one of many important questions to ask in order to prepare as best as possible for your senior housing needs in the future.

Accessibility to Services – None of us cherish the thought of losing our driving privileges. If you are considering aging in place or living in an independent senior retirement facility, you need to ask yourself questions pertaining to your realistic ability to obtain products and services needed for basic daily survival. How far is your doctor, dentist or other medical services? How far is the supermarket and pharmacy? Can you get to these crucial locations using public transportation if you are no longer able to drive?

Home Functionality Questions – If you’re going to stay in your existing home, it’s important to ask yourself if it is setup adequately for loss of mobility and functioning. Can you reach the cabinets and cupboards? Are you safe in your existing shower or tub? Can a wheelchair or walker fit down your hallway? Are their steep hills and steps that would cause you problems or be dangerous as you age? Does your home require a lot of yard work or maintenance that is simply too much for you as you get older? Is the home in a safe and adequately maintained condition for an older person?

Social Support Network – Too many times we take for granite our social ties. Social support is crucial for our mental well being and to help us avoid getting depressed. If we forget about this important consideration as we grow older, we are possibly sabotaging our future mental health and maybe even our physical health. Isolation is difficult when we are young, but as we grow older the need for connection and friends becomes even more critical. Will you be able to maintain social connections in your current situation? Will family and friends be able to visit you regularly? Will you be able to continue doing the hobbies and play the games you enjoy? What happens to your social connections if it becomes difficult to leave your home?

Future Caregiver Needs – Even if your home is safe, the pipes and electrical system are all new and all of the safety equipment has been installed and retrofitted, you still may require the help of a caregiver in the near future as your condition changes. Even if you have an extensive social support network in place and your immediate family all have the greatest of intentions in helping you in your advanced years, things can always change. As mentioned above, your family has their own lives and a multitude of problems life naturally brings with it to content with. The reality is your family most likely will not be able to meet all of your needs if your condition gets substantially worse. Ask yourself, if I am not able to depend on my family and friends, what options are out there for a caregiver or assistance in daily life functioning. The more thought and consideration you prepare for now the better the opportunity is for your needs being met in the future. That is why it is always best to consider a housing option where your current and future needs can be adequately met.

Costs of Growing Old – It is never cheep to grow old. If you have limited assets and need to maximize them to provide for your most comfortable of golden years on a budget, then you will need to do some financial planning. Assisted living facilities can be very expensive while in-home caregiver services also add up quickly. If you require advanced levels of in home care with 24 hour support, you may run out of money very quickly. There is long-term care insurance available for those still young enough to plan ahead. These plans can pay a healthy portion of your care needs. If you have limited income under a certain defined amount, you may qualify for some U.S. Department of Housing and Urban Development (HUD) housing options. Generally, if you are limited with income and assets, Medicaid will kick-in for most assisted living, nursing home and convalescent care.

Professional Help – If all of the options and considerations of growing old in America are too much for you and your family to handle on your own, you may need a professional on your side. In many jurisdictions, there may be county and state agencies able to help. Additionally, private professional geriatric care managers are available to help you make the best decision for your future.

Disclaimer: The suggestions above are only to be considered as general ideas and concepts and are not to be considered as professional or medical advice or a replacement for the advice of a personal retirement planner. Before considering any suggestions written above, always consult an expert or governmental agency on aging first. Every individual and condition is different and specific situations and/or medical conditions may require more varied options than are presented in the above text.  Senior Home Locators and its owners are not responsible for the accuracy of the content or the results of any use of the information contained in this posting.