As our loved ones age, their needs change. Some people are able to live out their retirement years playing golf and enjoying a healthful life, while other require a degree of assistance, dictated by health and safety concerns.
The choices for senior housing can be overwhelming. From aging in place with the help of caregivers to assisted living, there are many options that enable seniors to remain as independent as possible while receiving care. Many seniors find it possible to remain in their family home with some outside help; others choose to join a community of seniors in an independent living setting. For seniors with lower levels of acuity, needing a more secure environment or simply unable to care for themselves, memory care and skilled nursing facilities may be appropriate solutions.
Since senior housing needs can vary so drastically from person to person, traditional senior housing communities are evolving to suit a more diverse population:
Image via SeniorLiving.org
As you can see, the senior housing market is changing, and in a good way. The following comprehensive senior housing guide will provide you with more information about your options in today’s senior housing market, along with the information you need to make an educated decision about the right senior living option for your loved one.
Table of Contents
- Aging in Place
- Assisted Living Facilities
- Skilled Nursing Facilities
- Memory Care Facilities
- Residential Care Homes
- Current Senior Housing Trends Infographic
For some seniors, aging in place is a reality. They’re able to live on their own, completely independent, while others require various degrees of assistance. Some people will enlist the help of family and home health agencies in order to remain in the home they love. Others may rent out rooms in their home, hoping a housemate will provide companionship as well as income. Consider this quick guide to smart home safety for seniors; for many seniors who are in good general health, these basic steps are all that’s required to make a living space more suitable for aging in place.
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There are various levels of home care available for people who wish to remain in their primary residence. For eligible seniors, visiting nurses can perform a range of essential health procedures, from wound dressing changes to administration of IV medication. For seniors who need assistance with non-medical needs, such as bathing and dressing, home care providers, also known as caregivers, may be the solution. Some seniors hire caregivers or agencies to provide companionship or help with light household chores.
Adult day care services generally accommodate nursing home eligible residents whose primary caregivers are unable to provide care during the day. Generally these services operate during traditional business hours, and many provide meals, snacks and personal care. Some programs are even able to offer nursing care and rehabilitation while the senior is in their care.
Adult day services can be independently owned, or part of a skilled nursing facility. Some services are funded through Medicare and Medicaid, while others are strictly private pay.
Home health care may be funded through Medicare, Medicaid and insurance. Non-medical home care is generally privately funded.
Additionally, there are over 67 million unpaid caregivers across the United States caring for loved ones, at a staggering price tag of more than $522 billion annually. These are spouses, children and other family or friends providing supportive services for an aging loved one, many of whom are also maintaining a full-time or part-time job. These caregivers provide a variety of services in order to ensure the health and safety of their loved one, and they come from all walks of life.
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With the burgeoning numbers of seniors choosing to age in place, it’s important that caregivers also take time to care for themselves. Respite care services and short-term stays are often available at skilled nursing and assisted living facilities. These stays typically range from a few days to a few weeks. Respite guests receive the same level of care as other residents of the respective facility, and caregivers can rest assured knowing their loved ones’ care needs are being met.
Most respite stays are privately funded; however, in some states Medicaid waiver programs will cover the cost of the respite stay.
Independent Living Communities:
For those who wish to remain as independent as possible yet find it impractical to remain in their long-term home, independent living communities may be the solution. Independent Living communities are age-based (e.g., 55+ or 62+) and offer a variety of living arrangements, including single-resident dwellings, condominiums and apartments. This can be an ideal setting for someone who is able to live independently, yet wants to downsize from their larger family home — and avoid the upkeep of regular home ownership. Most independent living communities provide a variety of services and amenities, including home maintenance and lawn care, as part of the fee. Additionally, many seniors enjoy the camaraderie of living among others of their generation, who often have similar interests.
Some independent living communities are part of a greater continuing care retirement community (CCRC). These facilities offer transitional care as a resident’s needs change, allowing the resident to remain among familiar faces as they age and their care needs escalate.
Continuing care communities can be very expensive, however. Most charge an initial, one-time entrance or buy-in fee that varies based on several factors, including accommodations and care needs. These fees can range from $100,000 for a non-purchase (rental) agreement, with buy-in fees up to $1,000,000 or more depending on the size and location of a unit, and the community. In addition to the entrance fee, most CCRCs require monthly service fees. Again, these are variable and may change as the level of care increases.
Seniors living on fixed incomes may qualify for subsidized housing programs through their county or state. Some housing communities may also have disability requirements. Most subsidized programs (also known as affordable housing) provide seniors with private apartments at lower than market rents. Many are maintenance-free and offer on-site programs in a common room for socialization and entertainment. Some may even offer assistance with transportation to and from doctors’ appointments and group outings.
As care needs increase, some seniors are no longer able to remain in an independent living setting, even with the help of full-time caregivers. At this point, care levels exceed what loved ones or even professional home-health agencies are able to provide. In some instances, safety concerns outweigh the benefits of remaining in the home.
Assisted Living Facilities
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When care at home is no longer an option, many seniors will opt for an assisted living community, the least restrictive of senior care settings. As the name implies, assisted living (AL) facilities provide independent living with assistance for activities of daily living, such as bathing, dressing and grooming. Additionally, residents often receive assistance with medication management and rehabilitation services. Some facilities even provide transportation services to and from medical appointments.
Many assisted living facilities offer premier services and amenities designed to foster independence and bolster dignity while providing care as needed. Most provide activities geared towards a variety of social and cultural interests, such as gardening and cooking classes, computer classes, trips to museums and other local points of interest, and exercise classes.
Additionally, ALs encourage socialization and companionship among their residents. Many facilities will have spacious common areas where residents can gather to play a game of cards or discuss the books they’re reading.
Although AL often costs more than home health care, monthly fees are generally less than those of skilled nursing facilities. Federal programs do not cover room and board; however, facilities that are Medicaid eligible will accept Medicaid as a form of payment. The cost of assisted living varies by state and facility but the median cost is around $3628 per month, according to the Genworth 2016 Cost of Care Survey.
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When care needs exceed what independent living or assisted living facilities can provide, it may be time for a move to a nursing home, aka skilled nursing facility, for short-term or long-term care. Skilled nursing facilities are the most costly of all senior living facilities; however, some services may be covered by Medicare, Medicaid and long-term care insurance. The cost of skilled nursing care varies by state with the national average exceeding $222 per day or $6,600 per month (room and board only), which translates to upwards of $80,000 to $90,000 per year.
SNFs are no longer just for long-term care. Many facilities have begun providing short-term medical and rehabilitation care to those individuals who are capable of returning to their prior level of living. For instance, if an individual has a hip replacement and is not able to return home upon discharge from the hospital due to the need for wound care and rehabilitation, she can stay at a SNF, receive the necessary nursing care while regaining her strength, endurance and balance through occupational and physical therapy, then return home, perhaps with a part-time caregiver, once she is capable of managing more independently.
For those requiring 24-hour nursing care and supervision, skilled nursing facilities provide long-term care. This is the ideal setting for people who are no longer able to care for themselves, and their care needs exceed what is available at home or in an assisted living community. Many residents require extensive nursing services for chronic health conditions, assistance with activities of daily living such as bathing, grooming, toileting, and eating, and assistance with transporting (e.g., wheelchairs, walkers, or transfers from bed to chair).
Individuals with Alzheimer’s disease and other forms of dementia often need more specialized care than what is offered at typical assisted living communities. To meet this need, many communities provide separate memory care services. Some memory care facilities are located within senior living settings, while others are operate independently.
Image via Avalon Memory Care
Many memory care setting have daily schedules that enable those with memory impairment enjoy an organized day, which supports mental health. Staff at memory care facilities is usually specially trained in treating the physical and cognitive needs of residents with Alzheimer’s disease and other forms of dementia and memory impairment.
For more information on Alzheimer’s disease, read our Caregiver’s Guide to Alzheimer’s Disease and Dementia, featuring advice from 20 memory care experts.
Residential Care Homes
As an alternative to Assisted Living, people with chronic health conditions, including mental health issues, may find that living independently is not an option. Residential care homes, also known as Board-and-Care Homes or Residential Care Facilities for the Elderly (RCFE), can be one solution for such individuals. As the name implies, many of these residences were once single- family dwellings that have been converted to fit the care needs of several people. Care homes provide onsite supervision and assistance with activities of daily living. Many include three meals a day, and offer assistance with medication management. The cost of room and board at a residential care home is often less than that of an assisted living facility and may be covered, at least partially, by Medicaid.
Current Senior Housing Trends Infographic
As the older American population expands exponentially, the demand for quality senior housing and assisted living is ballooning as well. Senior housing trends are evolving as increased senior vitality and the growing need for specialized care reshape American senior living.
We’ve created this infographic to help illustrate the current trends in senior housing. Share this infographic on social media (using the social media icons). You can also embed it on your blog or website using the HTML code below.
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Full Transcript from the Senior Housing Trends Infographic
As more and more Americans progress past middle age, the demand for senior housing and assisted living is increasing. Senior housing trends are changing as factors such as the poor economy, increased vitality of seniors and demand for specialized care reshape American senior living.
Increased Demand for Senior Living Professionals
- The senior living industry will see increased demand for qualified professionals as more people enter senior housing and the industry cracks down on overtime regulations for care providers
- 2000-2030: The elderly population will more than double from 35 million to 72 million to represent nearly 1 in 5 Americans
- To keep up with demand, by 2030, 3.5 million additional health care professionals and direct-care workers will be added to the workforce
Higher Risk Levels
- Increased rates of risk for prospective senior living residents elevate the need for entrance and cost of providing care
- Risk is rising because:
- 7 out of 10 Americans over the age of 65 will require long-term care
- Seniors delay entrance due to economic reasons, and eventually enter care due to medical reasons instead of lifestyle change
- 1999 average age of incoming residents: 82
- 2011 average age of incoming residents: 85
- Seniors have become more accustomed to utilizing family, technology, medicine and community support to remain out of senior housing
An Evolution in Senior Housing Communities
As Senior Resident Profiles Change, So Do Senior Care Communities
- Independent living becomes more like assisted living
- As more seniors live in apartment complexes and 55+ communities, more a la carte services are being offered, providing a light assisted living feel
- Current assisted living facilities function more like skilled nursing facilities
- Current nursing homes will care for the sickest seniors in the coming years as an alternative to hospital stays
- More facilities dedicated to Alzheimers care
- As demand for Alzheimers disease and dementia care steadily increase, more specialized facilities will emerge
Senior Care Technology Goes Mainstream
- Senior care technology will become more mainstream for seniors and their caregivers
- More electronic applications will become available on a range of devices to cater to senior needs:
- First aid apps
- Drug information
- Pain management
- Personal Emergency Response Systems (PERS) and other monitoring technologies will become more prevalent in everyday senior living
- In 2016, a PERS pendant/watch with automated fall detection, call center, emergency response and family notification runs $30-60/month.
- A high-end wearable device with multiple in-home sensors, two-way communication, online reporting and multi-party notification incurs a $500-1000 startup fee, and then costs $50-100/month ongoing.