What is Independent Living?Independent Living is now a popular option for seniors who need little (or no) medicalassistance. Independent living communities provide the greatest amount of independence andfreedom of any senior living option available. Most independent living communities provideprivate apartments or houses designed for seniors.Services OfferedThese facilities generally offer commvmity services such as laimdry and cleaning services, butusually dont provide assistance with dressing, personal care, and other aspects of daily life.There may be some social events and conmiunity activities oflFered, but residents are generallyindependent in this area. Independent living facilities usually dont provide medication assistanceor nursing care, although residents can bring in outside help in this area i f they prefer.ladependent living facilities are not for everybody. To live in an independent living facility,potential residents must be able to care for themselves, as well as communicating with doctorsand caregivers without the need for trained onsite staff. Good candidates for independent livinggenerally value their independence highly and want to live in a community of other seniors, andprefer not to have to maintain a house on their own.Types of Independent Living FacilitiesSome indejiendent living facihties provide very little community space, while others offer largecommunity centers including recreational facilities, dining rooms, and other common areas.There are several different types of senior independent living. Some are comprised of apartmentcomplexes converted to be comfortable to senior citizens. Most of these complexes have an agerestriction, usually at over 55. Senior apartment complexes generally are remodeled fromexisting apartment structures and have features such as handrails and senior-friendly bathroomsadded in.Retirement communities are generally entire neighborhoods or groups of homes or condos thatare restricted to seniors only. They may be comprised of single-family or attached homes, ormanufactured housing. Some retirement communities look a lot like traditional subdivisions.Residents often have the option of renting or buying their home within these communities.Some independent Uving commimities are subsidized by the US Department of Housing andUrban Development. These housing units are often available for rent at below-market rates, anddemand for them is high. Often, they gauge individual residents rent based on a percentage ofincome. I f you get on the waiting list for one of these facilities, expect to be there for years.There are several different types of senior independent living. Some are comprised of apartmentcomplexes converted to be comfortable to senior citizens. Most of these complexes have an agerestriction, usually at over 55. Senior apartment complexes generally are remodeled from
existing apartment structures and have features such as handrails and senior-friendly bathroomsadded in.Retiremen! commimities are generally entire neighborhoods or groups of homes or condos thatare restricted to seniors only. They may be comprised of single-family or attached homes, ormanufactured housing. Some retirement communities look a lot like traditional subdivisions.Residents often have the option of rentmg or buying their home within these communities.Some independent living communities are subsidized by the US Department of Housing andUrban Development. These housing units are often available for rent at below-market rates, anddemand for them is high. Often, they gauge individual residents rent based on a percentage ofincome. I f you get on the waiting list for one of these facihties, expect to be there for years.What to Consider When Choosing an Independent LivingCommunityI f youre sure an independent living community is right for you or your loved one, there are afew things to keep in mind when choosing the right one. Here are a few questions to ask whenconsidering a community. • Is parking well Ut and close to your apartment or home? • Is there public transportation easily accessible from the apartment or home? • Does the facility offer units that occupy a single floor only? Are facihties on the first floor available? • Are buildings and parking spaces handicapp>ed-accessible? • Is the housing adaptable to the needs of seniors? Can you install grab bars in the showers, for instance? • Does the community provide group activities and common areas, and do you have opportunities to meet and socialize with other residents? • I f grandchildren come to visit, how long are they permitted to stay? • Is the security provided adequate to your needs? • Is the community near your doctor or a hospital?Paying for Independent Living HousingMedicare and Medicaid dont cover the costs of housing pajonents, since these are notconsidered health expenses—so most independent living residents pay for their housing on theirown. The exception involves subsidized independent living; i f youre lucky enough to get into asubsidized senior Uving commxmity, your costs will probably be determined as a percentage ofyour income. Veterans benefits can help; currently up to $2000 a month supplement for marriedcouple.Outside of subsidized housmg, the cost of independent living communities varies greatly. I fyoure renting your apartment or home, the rents will probably be eqmvalent to the cost ofhousing in your area. You may also pay a monthly fee for services—which may be as little as a
few hundred or as much as a few thousand dollars per month, depending on which services youneed.I f youre buying your unit within an independent living facility, expect to pay the most. The costwill probably be determined by the market in your area, but expect to pay a monthly fee on topof your housmg costs for shared amenities and community services. These fees can add up to athousand or a few thousand dollars per month.Independent living facihties are ideal for seniors who value their independence—and dont needintensive medical or daily living assistance. For seniors who qualify, independent senior livingcan combine independence with opportunities to connect with and be surrounded by otherseniors in a supportive community. Give yourself plenty of time to research, and you should beable to find an independent living community that supports your needs—^and your budget.My suggested Questions to ask about cost:How much per month? Are any extra fees added or are there optional services that can beadded? When was your last rent (purchase price increased?) Do you anticipate anyincreases in cost in the next year? How often in the past 5 years have you had a costincrease? How much was each increase? Is the current price guaranteed for any specificperiod of time? What happens if I move here and cannot continue to pay for it (applies to aunit you buy; primarily refers to maintenance fees)?
Choosing an Assisted Living FacilityAssisted living facilities provide a type of long-term care that emphasizes independence,flexibility, and individualized support. While there is no official, standardized definition ofassisted Uving, most residences that fall under this title offer private apartments for residents,with staff" on call to help with some daily-living activities such as bathing, dressing, mobiUty, andrunning errands. Assisted living facilities are generally designed for those who dont need theintensive medical care provided at nursing homes.There are thousands of assisted living faciUties throughout the US. Choosing one can be acomplex process—but its important to pick the right one. Here are a few factors that should beincluded in choosing an assisted living facility for yourself and a loved one.Know your price range.For many people looking into senior housing options for the first time, the most stressful aspectis how to pay for the care. Medicare does not pay for assisted living care, and Medicaid pays avery small amount. Residents and their famiUes are expected to pay most of the costs.However, there are ways to make it work. Many people pay for ongoing assisted living with thefunds from the sale of the residents former house. The money can be invested in a CD orannuity that provides monthly interest. Its important to bear in mind that most assisted livingfacilities include meals, so you wont have to include groceries as part of monthly expenses.I f possible, choose a facility whose costs wont exceed the residents current monthly income,from retirement accotmts and other sources. Bear in mind that inflation wiU raise the cost ofliving at retirement facilities more than the average rate of inflation.Choose a location.I f you are searching for assisted living residences on behalf of a loved one, its important toinvolve them in choosing the location. This is a very individual choice and depends on theresidents preferences as well as the affordability of the residences available in that area. Thereare several criteria that may be unportant. • One is familiarity. Some residents prefer assisted living facilities in the area where they lived. You or your loved one may have a sfrong attachment to a particular region or city. • Another is proximity to family. Its crucially important to some families that the resident Uve m a place where regular visits are easy. In this case, the resident may have to choose a facility in a new area i f his or her family doesnt already live nearby. • A third involves climate. Harsh winter weather or extreme heat can be hard on the elderly, and for some, a mild climate promotes better health. States such as Florida and California, with mild and simny climates, can be more comfortable for residents than states that are either very cold or very hot and dry.
Assisted living facilities are designed to help residents maintain control over their lives for aslong as possible, and part of that involves allowing residents to choose their own location.Visit and talk to the staff.However, there are ways to make it work. Many people pay for ongoing assisted living with thefunds from the sale of the residents former house. The money can be invested in a CD orannuity that provides monthly interest. Its important to bear in mind that most assisted livingfacilities include meals, so you wont have to include groceries as part of monthly expenses.I f possible, choose a facility whose costs wont exceed the residents current monthly income,from retirement accounts and other sources. Bear in mind that inflation will raise the cost ofliving at retirement facihties more than the average rate o f inflation. • One is familiarity. Some residents prefer assisted living facihties in the area where they lived. You or your loved one may have a sfrong attachment to a particular region or city. • Another is proximity to family. Its crucially important to some families that the resident live in a place where regular visits are easy. In this case, the resident may have to choose a facility in a new area i f his or her family doesnt already live nearby. • A third involves climate. Harsh winter weather or exfreme heat can be hard on the elderly, and for some, a mild climate promotes better health. States such as Florida and Ccilifomia, with mild and sunny climates, can be more comfortable for residents than states that are either very cold or very hot and dry.Assisted living facilities are designed to help residents maintam confrol over their lives for aslong as possible, and part of that involves allowing residents to choose their own location.as public areas. Have a meal in the dining hall i f you can. And i f its possible, walk around thegrounds without a guide—this will give you an opportunity to get an impression on your own,without a sales pitch. I f you can, talk to die residents to find out what they like about thefacility—and what they dont.Choosing an assisted living facihty can be a sfressfiil experience. But i f you give yourself sometime to research many different facilities, youre more likely to find one thats a good match.Assisted living faciUties emphasize providing residents with help in daily activities that may bedifficult for them—while allowing as much independence as possible in other areas of daily life.With the help of your loved one, you should be able to choose a facility that meets his or herneeds.My comments:Visit more than once at different times of the day. Go when not expected. You should have to sign inor be admitted after explaining who you are and why you are there. Be leery of their security if noone checks you in and out.
Observe what goes on during your visit. Just take a seat and watch. How do the aides respond to theresidents? Do you observe someone calling for assistance? How long does it take before there is aresponse? How courteous is the interaction between residents and staff? How satisfied do theresidents appear to be? Picture yourself in this facility: think about it. is it a "fit" for you? Visit morethan one place, 3 or more if possible.Talk to the residents. Could you become friends with those people? What else is ttiere for you to dowhile there?Think about it a while; dont make snap decisions.Your Options for Alzheimers CareI f you have a loved one who is entering the early stages of Alzheimers disease, its never tooearly to think about your options for long-term care. There are a range of options available forpatients with varying severity of need. When deciding which is best for you, its good to start byanswering the following questions: • Does your loved one need help with personal needs such as bathing, dressing, preparing meals, and other daily activities? • Does your loved one need assistance in taking medications or managing chronic health problems? • Does your loved one need any kind of special care or roimd-the-clock assistance? If so, what expertise does a caregiver need to have to provide that care? • What level of care can you afford?At-Home OptionsMost people start out providing Alzheimers care on their own, at home. However, as the diseaseprogresses, it can be increasingly difBcult for family caregivers to provide care on their own.There are a variety of services available to lend a hand, from occasional to round-the-clockassistance. Here are a few options that may be available in your commimity. • Respite care. Respite care organizations provide short-term, temporary relief when primary caregivers need a break. Usually the temporary caregiver comes to the patients home and integrates into the family routine. You may be able to find a respite caregiver through family or friends, through a community or religious organization, or through paid agencies. • Adult day services. Also referred to as elder care programs or adult day care, these programs provide activities, opportimities to socialize, and a supervised, safe place for adults in need of it—^and a much-needed break for caregivers. Some programs are designed for those with Alzheimers disease, while others cater to a wider range of needs. Most of these programs are open only during business hours on weekdays, and may provide lunch meals and transportation.
• Home health care services. Home health aides provide assistance wdth personal care such as bathing, grooming, dressing, eating, and bathroom needs. Home health care visits may be scheduled for a set period of time every week or on a 24-hour basis, depending on the familys and the patients needs. Some home health agencies also offer help with preparing meals and completing general household chores. Some home health care agencies offer workers with medical training who can assist with woimd care, administering medications, and managing medical equipment.Residential Care OptionsAt first, you may be able to get the help you need in caring for your loved one with Alzheimersat home. As the disease progresses, however, your loved one may need more intensive help—and round-the-clock care. At this point, you may need to consider residential care options, suchas: • Assisted living. Assisted living communities provide help with daily activities—including meal preparation, housel<eeping, personal care, and other tasks. They generally dont provide the advanced medical care youd get at a nursing home. These facilities are ideal for those who are generally mobile and can care for themselves with a moderate level of assistance. • Memory-care assisted living. Some assisted living facilities are designed especially to provide for the needs of those with diseases affecting memory. These facilities typically include more specialized staff members with training in cailng for people with Alzheimers and other types of dementia. In addition, the facility itself should be designed for Alzheimers safety, with secured exits and visual signs to help residents find their way in an unfamiliar area. • Nursing homes. A nursing home provides advanced medical care on a 24-hour basis as well as meals and living quarters. Some nursing homes have wards that specialize in Alzheimers care, with specially trained staff members as well as activities and an environment designed to serve the needs of those with Alzheimers disease. • Most families of Alzheimers patients start off by providing all the care themselves at home. While this may be possible for some time, the disease usually progresses to the point where extra help is needed. If your loved one has received a diagnosis of Alzheimers, its never too early to consider options for long-term care—and if possible, involve your loved one in the planning. The earlier you consider your options, the more likely youll be able to make good decisions for your loved ones care.Is Continuing Care Right for You?A continuing care retirement community (CCRC), sometimes referred to as a life-carecommunity, provides for the needs of a very diverse range of residents as they age. Continuingcare facihties may provide independent living, assisted living, and nursing home care in a singleresidence. Continuing care faciUties are designed so that residents can move m while their needsare still light—and can provide progressively advanced care as needs increase. The benefit of
choosing a continuing care community is that the residents needs can be provided for in oneplace, without having to imdergo a stressfiil move or search for a new facility.Continuing care communities are designed for elderly residents to move in while they still liverelatively independently—^and to stay for the rest of life. As residents medical needs change, thelevel of service increases to provide for them. Residents are closely monitored and care levels areadjusted as needed. I f a major illness or injury requires the resident to be hospitalized, he or shecan return to the residence after treatment and receive ongoing care i f needed.Continuing care isnt right for everyone. Here are a few questions to ask yourself whenconsiaering continuing care for a loved one. Does my loved one want or need the socialization? Continuing care commimities are a good option for elderly patients who are living by themselves and who would prefer to Uve in a comfortable, friendly environment, is my loved one currently living independently? The idea behind continuing care is that residents enter while still relatively independent, and can receive more intensive services in the same place as they age. Continuing care residences are designed—and priced—for long-term stays, and can be quite expensive. If your loved one already needs advanced care, he or she might get more value for the money at a facility designed specifically to provide the level of care needed. Can you afford continuing care? Continuing care residences are costly. Many require an mitial buy-in that can be as expensive as buying a house; up-front payments upwards of $100,000 to $500,000 are not uncommon. In addition, there is usually a monthly fee that can vary depending on the level of care needed. Many potential residents sell their homes in order to come up with the cash necessary to buy into a continuing care commimity. However, in a difBcult housing market, this option has become less possible for some. Are there other options in your community? Most continuing care residents enter at the assisted living or independent hving stage. I f money is a concern, investigate assisted living and independent living options in your area. It may be that you could save money by choosing to live in an independent or assisted living community and then transferring to a nearby nursing home when the time comes. I f there are no desirable options in your loved ones desired area for assisted and independent living or nursing homes, however, a continuing care residence may be a better choice than living in a less desirable area—depending on your loved ones priorities.Choosing a Continuing Care CommunityThere are a variety of things to consider when choosing a continuing care residence. Here are afew questions you should ask:
• Does it provide the services I need? It can be im|x)ssible to predict which services your loved one will need as aging progresses. However, its important to be sure the community provides the services they need now, and that their continued service offerings are diverse enough to cover a range of scenarios in later hfe. • What amenities are available? Most continuing care communities provide activities and conmion areas. Some provide a wide range of services such as beauty salons, fitness centers and pools, golf faciUties, libraries, common dining areas, and outdoor gardens. Find out whats available and whether its enough to keep your loved one occupied on a continuing basis. • Do services and amenities cost extra? How are services and amenities paid for? Are they included in the monthly bill or paid for a-la-carte? How much can monthly biUs be expected to increase as a residents needs progress? • Can you afford it? Most continuing care facilities require a large up-front investment in addition to monthly payments. Be aware that monthly costs are likely to increase as end of life approaches, so if the facility is a financial strain now, its not likely to get better. • Is the community doing weU financially? Buying into a continuing care facility is a huge investment—and many residents can only afford one such payment after selling a house. Be sure that the continuing care commimity you choose is thriving and not likely to go under anytime soon. I f it does, your loved one and family could be placed in a difficult financial situation. • What are the living arrangements? Will your loved one be living in an apartment, separate unit or single room? Will he or she be living alone or with a roommate, family member or spouse? Is your loved one happy with the living arrangement?Choosing end-of-life care is never easy. Continuing care retirement communities are an excellentoption for those who dont want to move again later—when their medical needs may be moredire. While not everyone can afford continuing care, its an exceUent option for those who canmake it work. ***Most material copied fi-om Housing for Seniors:Helping You Find the Right Community at wvyw.housing forseniors.com. M y comments are typed in bold. This article has most of the major information about housing for seniors. I f you are seriously considering moving to senior housing, read more and visit lots of places.