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Aging Parents and Adult Children Together (A/PACT)
ALTERNATIVE LIVING ARRANGEMENTS
(Fourth in a 10-part series)
Your mother is 78 years old and lives alone. Her eyesight is failing, she’s becoming forgetful and she’s finding it difficult to keep up with housekeeping, home repairs and maintenance. You fear that she can’t manage on her own much longer.
Many older people find it necessary or sometimes just more convenient to move to housing where housekeeping, recreational and other services are available. Fortunately, housing options abound. Among the choices these days are independent living facilities, continuing care retirement communities, supportive housing and congregate care. Some facilities are privately owned; others are government supported or sponsored by religious or other non-profit groups. The distinctions among facilities aren’t always clear cut: The way a facility describes itself may provide little or no indication of the services it offers.
Here are some general guides to help you explore housing options with someone you love. Independent living facilities offer recreational and social programs, but few services. However, an independent living facility might be found within a continuing care retirement community (CCRC), where housing options vary by need. A CCRC lets seniors enter while they’re still active and independent, knowing that if they become infirm, services are available to meet their changing needs.
Housing options that fall between independent living facilities and nursing homes include supportive housing, congregate care, board and care, personal care and assisted living facilities. All provide housing and varying levels of health or supportive services. For example, assisted living may refer to a single-family home that provides shelter and care to a small group of residents or a large complex that houses hundreds of people.
What programs are called, and the care and services they provide, vary by state — sometimes even within a state. Some facilities offer at least one meal a day and light housekeeping; others include transportation to shopping and medical appointments. Some have staff that administer medication and coordinate residents’ health care; in others, staff provide skilled nursing care. Add federally subsidized apartments to the mix. While these facilities for low-income seniors don’t provide services, they may have a service coordinator to help residents get services.
The federal government regulates nursing homes and federally subsidized housing. By contrast, state governments are responsible for regulating and licensing assisted living and other housing programs for older people, but the laws that apply and the agencies that are responsible vary by state. However, every state has a long-term care ombudsman program to investigate issues involving nursing homes, board and care homes and other long-term care facilities. Some long-term care ombudsman programs also help residents of assisted living facilities.
The state or local area agency on aging can help you explore housing options. Many agencies distribute directories or guides to housing options for older people and people with disabilities in their service areas. Area agencies on aging also can direct you to the long-term care ombudsman program, which in turn can supply information about a particular facility. In addition, your parents may have friends and relatives living in senior housing facilities who can provide suggestions and recommendations.
When you consider alternative housing arrangements, think about the older person’s needs and preferences. Start with the basics:
Before deciding on a facility, visit the premises and talk with staff, residents, and family members — theirs and yours. Before you sign a contract, read it carefully and ask a lawyer to review it.
For More Information
American Association of Retired Persons
Fulfillment
601 E Street, NW
Washington, DC 20049
AARP offers several free pamphlets about housing options for older adults. Particularly helpful is Home Away From Home: A Consumer Guide to Board and Care Homes and Assisted Living, Stock No. D12446. Refer to the stock number when ordering.
American Association of Homes and Services for
the Aging
900 E Street, NW, Suite 500
Washington, DC 20004-2937
(800) 675-9253 or (202) 783-2242
This provider organization offers consumer information about continuing care retirement communities and assisted living on its Web site and publishes Consumer’s Directory of Continuing Care Retirement Communities, which is available for $33.50, including shipping and handling.
Assisted Living Federation of America
10300 Eaton Place, Suite 400
Fairfax, VA 2030
(703) 691-8100
This provider organization offers consumer information about assisted living on its website.
Consumer Coalition on Assisted Living
2342 Oak Street
Falls Church, VA 22046
(703) 228-5243
This grassroots membership organization was founded in 1995 by consumers, providers, advocates, researchers and others to explore critical issues in assisted living.
Institute for Health
Policy
Heller School, Brandeis University
415 South Street
Waltham, MA 02254
(800) 456-9966
This university affiliated research institute on assisted living publishes a consumer guide, Finding the Assisted Living Program for You. It also offers additional information and discussion groups on its website.
American Bar Association Commission
on Legal Problems of the Elderly
740 15th Street, NW
Washington, DC 20005-1022
(202) 662-8690; fax: (202) 662-8698
The Commission publishes the ABA Legal Guide for Older Americans, containing information about consumer legal issues, including housing options. The cost is $13.00.
For the state or local area on aging, check the government listings in the telephone book or contact the Eldercare Locator (800) 677-1116.
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