While the majority of older adults wish to remain in their home as they age, it is sometimes necessary and safer for an older adult to relocate. There are a variety of long-term housing options for older adults. These options differ in price, degree of assistance, and amenities.
Before evaluating housing options, caregivers and older adults must consider two things. The first is finding out where the older adult would prefer to live, while the second is weighing where it is safest for the older adult to live.
Long-term Housing Options
The first option, and usually preferred option, is aging in place. Aging in place is a phrase that refers to an older adult who stays in their home as they age rather than transitioning into a facility or community. Typically, to make aging in place possible, caregivers and older adults must seek out in-home assistance or make modifications to the home. For example, home care aids may be hired to handle some daily tasks or personal care responsibilities. Home modifications may include installing grab bars, adding new lighting, or using assistive devices. It is important to consider an older adult’s physical and cognitive limitations as well as their financial and social situation before deciding on aging in place.
The alternative to aging in place is moving to a new home, which may be a smaller house, apartment, condominium, independent living community, assisted living community, nursing home, continuing care retirement community, or memory care community. The cost of each option can vary greatly, but typical price ranges are provided in the following section for reference. Notably, long-term care insurance, Medicaid, and veteran’s benefits may help cover the costs of long-term residential care. Consult a financial professional or your state Medicaid office for an explanation of what may be covered in your situation.
Independent living communities may be single-family homes, apartment buildings, or townhomes designed specifically for older adults. While services and costs vary greatly, most communities offer security, housekeeping, social events, and transportation to make independent living easier and more enjoyable. (Typical cost: $24,000-$48,000 per year)
Assisted living communities may be apartment-like buildings or shared residential houses. Generally, each resident has personal living space and is provided with meals, limited nursing care, and assistance with personal care such as bathing, dressing, toileting, and taking medications. Social activities are usually offered as well. Some facilities also offer memory care services. (Typical cost: $25,000-$50,000 per year)
Nursing homes provide meals, personal care, and social activities just like assisted living facilities but also offer 24/7 nursing care. It is common for professionals such as doctors, social workers, and therapists to work with residents of nursing homes to promote health and independence. (Typical cost: $80,000-$90,000 per year)
Continuing care retirement communities offer the options of independent living, assisted living, and nursing homes all in one community. The perk of this combination is that older adults do not have to move to a new location if their needs were to change. (Typical cost based on level of care: $24,000-$90,000 per year)
Memory care communities are designed specifically for older adults with dementia or Alzheimer’s. Generally, nursing and personal care are provided along with planned activities tailored to those with cognitive limitations. Memory care may also be offered by assisted living facilities. (Typical cost: $60,000-$72,000 per year)
How to Evaluate Communities:
Once you have evaluated the older adult’s needs, considered financial limitations, and decided on the level of care that is needed, it is important to visit and evaluate prospective communities. It is recommended that at least three different facilities are inspected for comparison. It may be helpful to schedule a formal visit with an administrator and then also make an impromptu visit on a weekend. Here is what to look for:
Cleanliness, including odors
Where do residents spend their time, are the common areas active?
Are employees friendly and engaged with residents?
Do advertised and planned daily activities actually occur?
Can residents bring their own furniture and decorations?
Is the property secure? (especially if it is a memory care community)
Are there plants and animals around that bring residents joy?
Here are some questions to consider during your visit:
Can all of the older adult’s needs be met in this facility?
What is the monthly cost for the level of care the older adult requires?
Is there a fee charged for move-in?
What activities are offered?
Are religious services offered in the facility?
What is the ratio of residents to staff? (should be no more than 15:1 for assisted living and 8:1 for memory care)
Do medical providers visit the community often?
Are residents happy living there?