There are many reasons older people think about giving
up their homes. The house and yard are more than they want
to maintain. The house is just too quiet. Living alone in the old
neighborhood is isolating and inconvenient. Health problems make
independent living a struggle. Finances have grown tight.
These are just some of the reasons older people may want to re-evaluate
their housing situation and consider alternatives. While ultimately
the decision must be that of the parents, adult children can help
their parents review the options and decide what choice might work
best.
There are many housing possibilities for older adults,
and they are constantly changing. The following overview
describes the most common arrangements and provides links to more
detail about some of the options:
Home Modification. Sometimes all that is needed
to keep people in their own homes is to make some changes to the
home. Replacing doorknobs with door handles or faucet knobs with
faucet levers can greatly help arthritic hands and wrists. Removing
scatter rugs, increasing the wattage of light bulbs, and installing
grab bars in bathtubs all reduce the risk of falls. Remodeling a
bathroom can help those with mobility difficulties.
Senior Retirement Communities. Sometimes called
"senior apartments," these buildings are for residents
who are mobile and can take care of themselves in their own apartments.
A variety of social and recreational activities are usually offered.
Sometimes meals are available in a central dining room, and housekeeping
services may be offered. There is usually no entrance fee, and rents
can vary widely. Meals and other services usually cost extra.
Homesharing. At any age, two or more people can
share a home or apartment. Generally, each person has a private
bedroom and shares the kitchen and other living spaces, as well
as sharing household chores. Sometimes assistance with cooking or
cleaning can be exchanged for rent. Faith-based groups (and others)
may sponsor these homes. Some homeowners seek this arrangement to
avoid living alone or to supplement their income.
Accessory Apartments. These are constructed by
making a separate apartment within a detached home, such as a basement
apartment or one above the garage or in the attic. They allow people
to live in privacy and independently without living alone. Help
with household tasks can be exchanged for rent. Construction costs
vary widely. Creating an accessory apartment is more economical
in a two-story home than in a single-story home.
Elderly Cottage Housing Opportunities (ECHO). ECHO homes are small, portable "cottages" that can be
placed in the back or side yard of a single family home - usually
the home of an adult child. The resident lives close to family or
friends who can provide needed support, yet each keeps his/her own
living space. These units typically cost $25,000 and up.
Continuing Care Retirement Communities (CCRC). These facilities offer several housing options and services depending
upon the needs of the resident. Typically residents begin by living
independently in their own apartments. Later they may move to an
assisted living facility on the same grounds. Some may move in and
out of the CCRC nursing home, as skilled nursing care is needed.
A CCRC is out of the financial range of many older persons because
they often require a large entrance fee and have expensive monthly
charges.
Assisted Living. Assisted living facilities generally
provide housing, group meals, personal care and support services,
and social activities in a residential setting. Some health care
may be provided. Costs may be $1,000-3,000 a month or more. A few
states help pay for personal care services for those with limited
incomes; more typically, assisted living residents must pay their
own way.
Board and Care Homes. Board and care homes are
smaller in scale than assisted living facilities. They provide a
room, meals, and help with daily activities. Some states will allow
some nursing services to be provided, but these homes are not medical
facilities. These homes may be unlicensed, and even licensed homes
are infrequently monitored by the state. Costs range from $350 -
$3,000 a month. Supplemental Security Income (SSI) may help pay
for those with very limited incomes.
Foster Care. Some families will take an older
person in to their homes when the person needs some help with daily
living. The foster family provides services such as cooking meals
and doing laundry. Ideally, the older adult becomes a surrogate
family member and receives emotional support and companionship,
as well as housing. Costs range from $500 - $3,000 per month. SSI
is often used to cover the cost.
Nursing Homes. For those who need skilled nursing
care and/or substantial long-term assistance, nursing homes are
an option. These homes provide medical services, personal care,
and meals. Bedrooms and bathrooms may be shared. Costs average about
$56,000 a year but many are more expensive. Medicare provides only
short-term coverage and must follow a hospitalization. Medicaid
offers coverage for low-income, low-asset residents.
American
Association of Homes and Services for the Aging (AAHSA)
AAHSA is a national nonprofit organization representing 5,600
not-for-profit nursing homes, continuing care retirement communities,
assisted living residences and senior housing facilities and community
service organizations for the elderly. Their Website offers information
to the consumer, including a list of accredited continuing care
retirement communities, tips for choosing an assisted living facility,
a sample assisted living resident agreement, and more. The new AAHSA
resource, "The Consumers' Directory of Continuing Care Retirement
Communities," is now available. Ordering information is on
the Website.
Eldercare
Locator
To get information on how to locate the nearest agency on aging
and on a wide variety of community services to support older adults,
visit their web site or call 1-800-677-1116 weekdays, between 9AM
- 8PM Eastern Time.
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