Senior Housing Location Service

There are many housing options available for seniors. One of the most significant decisions an individual can make is to move from their home into a facility that provides more support and services.  It can be an even more difficult decision for an aging family member who has lived in the same home for many years. Before deciding, consider the following issues:

• Stability of the old and new neighborhood.
• Proximity to children or grandchildren.
• New facility’s compatibility to senior’s needs and/or abilities.
• Stairs and other accessibility issues.
• Cost to maintain old home versus cost of living in new facility.
• Availability and accessibility of transportation and medical care.

Types of Senior Housing

ECHO Housing

Elder Cottage Housing Opportunities (ECHO) refers to accessory units and mother-in-law flats that allow a person to share a single-family home with another person or family.  These flats are designed using universal design criteria that make them suitable for those with disabilities or age-related challenges.  These pre-fabricated units can be added to or removed from an existing structure as needs change.

Active Adult Communities

These are age-restricted housing developments created for seniors who enjoy participating in various physical and social activities.  This type of community attracts people who want to own their own homes in an environment that offers many amenities for seniors.

Independent Community Living

These are typically apartments that only accept people over a certain age – usually 55. The apartments are found in many communities.  Some are under federal housing guidelines and will only accept low-income seniors, but most are privately owned and operate much like an apartment complex. A growing trend in these apartment complexes is to provide services that typically are not found in apartment buildings – like an on-site activities program, van services, and meals in a communal dining room.

Continuing Care Retirement Communities (CCRC)

These are communities where a continuum of care levels is offered (also known as Lifecare Communities).  They are designed to provide active seniors an independent lifestyle while enjoying the privacy of their own home.  Coordinated social activities, dining, and healthcare are provided as needed.  

Some communities may require the purchase of Long Term Care Insurance as criteria for acceptance.  Typically the insurance premiums are built into the purchase price and monthly fees.  Additional fees may provide for:  meals, scheduled transportation, housekeeping, unit maintenance, linen and personal laundry, health monitoring services, utilities, coordinated social activities, emergency call monitoring, and around-the-clock security. 

Many of these types of communities require an entrance fee that may or may not be refundable, and this fee may be substantial in some cases.  Therefore, it is imperative that the financial stability of the facility be thoroughly investigated.  Although these facilities may help one “age in place,” inquire as to where a resident would be relocated if the nursing center became full or unavailable.  Many reputable CCRC’s contracts with rehabilitation centers in the event they cannot keep the resident on site.

Types of Contracts:

1. Extensive Agreement: Provides residents with lifetime healthcare without increasing the monthly fee when care is provided.
2. Modified Agreement: Offers access to health care at discounted rates that are lower than fee-for-service.
3. Fee-For-Service Agreement: Residents may initially pay a lower monthly service fee and are responsible for additional healthcare costs.

Assisted Living

These facilities provide professionally managed personal and health care services in a residential environment.  Assisted living facilities are appropriate for individuals who may no longer be safe living in their own homes but do not need the level of service provided in a nursing home.  The older adults who live in these facilities are often dealing with physical and functional disabilities.  Some assisted living facilities may offer a secure unit that provides services for people with Alzheimer’s disease or other dementias.  These facilities are generally private pay (meaning that neither Medicare nor Medicaid covers the costs).  They typically provide non-medical care and do not provide 24-hour medical supervision or nursing care.  Some facilities may offer respite care to give a break for at-home caregivers.  Respite care can also be an excellent way to introduce a senior to the assisted living environment.

It is important to compare fees and services.  An all-inclusive fee may seem expensive, but when the costs of additional services in a fee-for-service arrangement are added up, an all-inclusive agreement may be a lower-cost option.

Nursing Care Facilities

These facilities provide care for individuals who need ongoing medical care but do not need to be hospitalized. The care is directed by a physician and is administered by nursing or other related professionals. These facilities provide 24-hour medical supervision and offer rehabilitation, sub-acute, respite, and other short term needs.   

For Medicare to pay for nursing home costs, a patient needs to have stayed at least three days in a hospital and have a improving condition.  Medicare will pay for most skilled nursing care costs for up to 100 days (see Medicare chapter for details).  Other funding sources for nursing home costs include individual health insurance, Medicaid, Long Term Care Insurance, and personal funds.  The social worker and nursing home administrator can help determine what is covered, by whom, and for how long.  When looking for a nursing home, tour several facilities, and inquire about their specific costs.