America is aging and it’s important to find the right senior home. If you or your family member is one of the over 70 million Americans over the age of 55 and technically considered a “senior citizen”, it can be challenging to find the right senior citizen home. Senior homes and senior communities offer a wide range of options available to suit the senior citizen population.
There are a couple general categories of senior homes and they can be defined by the services available.
Some older adults might be senior citizens, but they might still be very active and healthy and might not require any daily assistance. These seniors can choose among senior communities, also referred to as age restricted communities that offer a low maintenance lifestyle, but otherwise offer minimal, if any, assistive services. Some senior citizens appreciate daily meals and laundry provided as a benefit, but for convenience, not necessarily required.
When most people think of senior homes, they think of assisted living and nursing homes. Residents of these types of senior homes need help to varying degrees on a daily basis. These facilities might be short-term for convalescence only or long-term. Dementia and Alzheimer’s patients are in this category due to specialized assistive and monitored care. Assisted living costs can go from $1500 to more than $10,000 per month for very luxury assisted living facilities.
There is a third tier of senior homes which is becoming more popular. These are senior communities designed to meet the lifestyle of the active older adult who doesn’t immediately need assistive services, but wants them available in the future, if needed. As seniors age and require more assistance, residents of these senior communities do not need to relocate or seek solutions. They have already considered what might be needed and services are readily available. Residents are less stressed if they aren’t forced to relocate due to deteriorating health.
There are a wide variety of senior citizen homes available. The range of senior homes runs from totally active and independent living to full care nursing homes. Many people don't realize the full range that is available. Understanding the differences can help make an informed decision.
An active adult community is a senior community of freestanding houses, condos, or mobile homes, but there are also apartment style options available. Residents typically buy their homes, but there are sometimes rentals available depending on the community. These are commonly known as 55+ or 55 Plus Communities, age restricted communities, or senior communities. These communities have a minimum age of residents of 55 years for at least 1 adult in the home. There is at least one senior citizen per home. This is typically a fully independent lifestyle with residents who require no assistance in their daily lives. These senior communities are independently developed and adhere to the Fair Housing Act and Housing for Older Persons Act.
Independent senior community homes are also referred to as retirement community homes. They can also be referred to as a senior citizen retirement home or senior community. Homes are either personally owned or rented and are most likely apartment style. Residents do not need daily assistance, but meals are often included, along with housekeeping. Residents are in closer proximity to each other. This encourages social interaction and helps to reduce loneliness. These senior communities are independently developed and adhere to the Fair Housing Act and Housing for Older Persons Act. There is no federal regulation unless Medicare or Medicaid is accepted, so individual states are responsible for oversight and monitoring.
An assisted living residence is similar to an independent living community, but offers personal care services. These services typically include bathing, dressing, and help with medication. Residents here are somewhat active, but need help with the basics of personal care. This is not round-the-clock care. In some states, assisted living residences are specifically barred from admitting residents who require round-the-clock care. These facilities are generally not licensed nationally. Each state has independent laws, regulations and licensing requirements and is responsible for monitoring compliance. Find assisted living near you and call the facility to ask everything you need to know. If a facility accepts Medicare and/or Medicaid, it is then required to adhere to the Federal Nursing Home Reform Act and is monitored for compliance. State level agencies are responsible for monitoring compliance of all regulations. Access to these records is set at a state-by-state basis.
Nursing homes are typically facility style where daily services and medical care are provided. Nurses and health professionals are available 24 hours a day. Stays at this type of senior care home can be temporary or long-term, depending on the situation. Medicare and/or Medicaid may cover some services that are provided if they are medically required. State level agencies, such as department of health or the equivalent, are responsible for monitoring compliance of all regulations, state and federal. Access to these records is set at a state-by-state basis. Finding a nursing home near you involves quite a bit of research as the facilities and their services vary.
Nursing home abuse has become a popular topic, as more senior citizens seek the services senior homes provide. Most states now provide websites with non-profit agencies that advocate for residents in care facilities. Abuse can be defined as harmful neglect, assault and battery, criminal conduct, and/or embezzlement or theft. These abuses can be monitored in health care facilities that include nursing homes and assisted living facilities.
Congress passed law in 1987 that required all assisted living facilities or skilled nursing facilities participating in Medicare and/or Medicaid to abide by Federal guidelines for the operation standards and services provided. Among other things, the Nursing Home Reform Act specifies that a nursing facility must have sufficient nursing staff, as well as specifies that the responsibility is with the nursing home to develop a comprehensive care plan per resident, as well as provide services needed to have good nutrition, personal oral hygiene and grooming. This also specifies that nursing homes must provide adequate supervision and assistive devices to prevent accidents.
Facilities not accepting Medicare or Medicaid are not required to meet these specifications, so it is important to check during your evaluation.
A continuing care retirement community is the most adaptive senior home option, but it is also the most expensive option. These senior citizen communities are more of a campus layout, rather than a single building. Residents have the option of independent living, assisted living, or nursing home services. The luxury of this choice is that residents choose the campus and then can add required services later if required. With flexibility comes cost. Often older adult residents pay in advance for the ability to access services that might never be used. Sometimes that cost is outweighed by having peace of mind. It can be stressful to relocate at any age and it might be worth the cost for the convenience of not having to relocate later in life when health has diminished. These senior communities may or may not accept Medicare or Medicaid.
The first step in making any decision on a senior citizen home is to assess any special requirements. Dementia, Alzheimer's, or physical restrictions can limit the choices in where to live. There might be special services or facilities that are required. A consultation with a doctor provides valuable insight.
Ask the doctor:
Doctors, nurses, or caregivers are excellent sources for referrals to reputable senior homes or senior care homes offering assistive services. Hospital staff or social services also have valuable opinions and insight into available services. Most communities have a non-profit Agency for Aging which can make informed recommendations.
Choosing a home for a senior citizen is a personal choice that must be weighed by the circumstances. A doctor should consult and offer an opinion of what medical assistance is required or will be required. Caregivers often offer valuable input as to personal needs and habits. It’s important to discuss this decision with family members so everyone understands the choices available. This provides peace of mind that the best decision has been made.
Senior citizens can often experience loneliness if they are separated or without access to social interaction. Limited mobility or accessibility often isolates and that can be detrimental to physical and mental health.
Inability to take care of themselves is a significant concern to be addressed in choosing a senior care home. This is especially important when family members are unable to provide that assistance. This requirement is a key factor in choosing a senior housing option.
Facing a relocation can be emotional for older adults, even those who are active and require no assistance. Elders want to be responsible for making good decisions when possible. It can be uncomfortable to consider the effects of aging and consider what services could be required in the future. Choosing a senior home is like estate planning or writing a will in that it is facing mortality.
Choosing a senior citizen home can also be emotional for family members. They might be helping to decide by giving opinions and helping in the selection process. In advanced cases, they might be solely responsible for making the decision.
Regardless of the type, choosing a senior home has important criteria.
Knowing the budget is key at any age, so this comes first. It’s especially key if a senior citizen is no longer working and living off retirement savings. There are solutions for every budget and different kinds of senior homes require different budgets. Some senior citizen homes are private pay (such as assisted living, adult foster care) and some can be paid via state or federal health insurance such as Medicaid or Medicare.
It seems basic, but make a list of what is needed. It can be straightforward to list medical and physical needs, so this is usually done first in this assessment. Don’t forget about emotional needs. Life is not limited to the physical body. Social interaction, mental stimulus, and personal enrichment should be available at a well-run senior home and can often be overlooked. Don't forget about pets if you own one - in such case you need to look for pet friendly senior homes.
Third, to what area do you want the senior home to be in? Cosmopolitan or suburban? Close to the heart of things or on the outskirts?
A life-long city liver might not think twice of relocating to another city, but someone from the quiet countryside might find city noise disturbing and have problems adjusting. In a country so large, we have developed colloquialisms and speech patterns that might be harder for older adults to understand, especially if they already have diminished hearing ability. Relocating a significant distance can introduce these hurdles that might not be obvious.
Finally, the contract will need to be signed before anyone moves in. A senior home or nursing home agreement will outline the services, fees, and policies that will be in effect for the new home. It is very important, especially with the requirement of specialized services, that everyone understand this agreement. It is recommended that the senior home agreement be reviewed by a family lawyer before signing and becoming bound by the contract.
Best practice for choosing a senior home is to consider any specific requirements, choose several options, then visit and evaluate multiple senior homes in a uniform way. It is not advised to sign a contract based on one visit to one option. Visit a senior home or community a couple times and sometimes unannounced so you can see things as they regularly operate. Compare what is available and choose the best senior citizen home for the situation.
Many senior homes can provide a safe and secure environment that is comfortable and meets the physical and emotional needs of the resident. A quality senior home choice should make everyone feel confident that the right choice has been made. This includes the resident senior, as well as family members, caregivers, and doctor.
Family members can be powerful advocates, but it’s important to remember it’s the senior citizen who will be living in the home. It’s good that the family feel confident in maintenance and safety, but it is the senior retiree who needs to be comfortable in the home and with the surroundings.