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​​Aging in Place Guide

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Overview

A synopsis of housing options for older adults, along with products and services to make living at home (Aging in Place) easier and safer. ​
​Last update: 5.26.21


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​​Aging in Place/Independent Living

Aging in Place is defined as the ability to live in one's own home and community safely, independently and comfortably. There are three categories: people who are not experiencing immediate health/mobility issues; people with chronic or progressive conditions, such as diabetes and lung or heart disease, that will require special modifications; people who experienced an abrupt or immediate change that demands adjustments in their living environment, such as home modifications or a complete redesign.

Remaining at home offers the advantage of staying in a familiar place where you know your neighbors and the community. 90 percent of adults over the age of 65 report that they would prefer to stay in their current residence as they age.

The Village Movement is a relatively new concept that enables active seniors to remain in their own homes without having to rely on family and friends. Members of a “village” (typically operated as a non-profit organization), can access specialized programs and services such as transportation to the grocery store and medical appointments, or help with household chores. They also provide a network of social activities with other village members. Many communities also operate Senior Centers which provide similar services.

Other emerging independent options to consider:
  • Agrihood...a urban housing development centered on community farming. 
  • Co-Op Housing...where residents live in apartments or houses and share common spaces for group meals and gatherings. More on Co-Op Housing. 
  • Concierge-Style Condos...High-end condos and apartment buildings with amenities such as state-of-the art gyms, concierge services, art studio space, pet grooming, and car washing.
  • Experiential Living...Another name for Active Adult Communities in a work/play/live environment.
  • Intergenerational/Multigenerational Living...Communities that offer an active lifestyle, a connection to the outside community and avenues to share lifetime experiences and wisdom.
  • Niche Retirement Communities...Developments created for people who share a common identity such as sexual orientation, labor union membership, artistic inclination, college or religious faith.
  • Naturally Occuring Retirement Communities (NORCs)...neighborhoods or locales with a significant portion of older people who’ve aged in place.
  • ​​​Shared Housing...where two or more unrelated retirees live together for lower costs and companionship; sometimes called “The Golden Girls” housing (from the hit TV show)​. Shared Housing Services: Senior Homeshares

Related Issues:
Aging in Place, What Every Senior Should Know, Porch
Aging in Place Guide, NIH
How new communities/technologies help us live longer, Next Avenue
Community-centered housing solutions, HUD
Four Stages of Aging in Place, HomeCare.org
Home Elevators, A Rising Trend, Houzz
Homes Renewed, a coalition to support aging-in-place
Steps to Stay Independent, Harvard Medical
New Stairs Technology To Help Remain Independent, SciBlog
Elder Orphans, Single and Living Alone, Psychology Today
Learning to Live Alone with Roommates, Next Avenue
Designing a Home for Aging in Place, Architectural Digest
More on Cohousing, Kaiser

​
What Does Independent Living Really Mean, NextAve

Age-Restricted Communities
This type of community is designed for people where at least one of the inhabitants is at least age 55, but it could be age 50 and even age 60 in some cases.

Age-Restricted Communities are typically setup to accommodate older individuals who would like to live in an area without the perceived problems of having children around. They are often planned communities that offer homes and community features that might include a clubhouse with a wide range of social and recreational activities such as a swimming pool, exercise facilities, craft rooms, card room, and more.
  • ​Another Perspective, Senior Living
​
​University-Based Retirement Communities...where residents live on campus and have an opportunity to take classes.


Aging in Place Product and Service Guide
  • Creating Age-Friendly Cities and Living Environments: AARP, World Health Organization
  • Evolving role of Community Senior Centers: Louisiana State Office Study, Middle Tennessee State U.
  • Find In-home Caregivers: Care.com, Eldercare.gov, AARP
  • Find Transportation Resources: Care.com, Administration on Aging
  • Home doctor visits (Independence at Home Demonstration Program): National Law Review, AARP
  • Home Meal Delivery Services: Meals on Wheels
  • Home Modifications: HomeAdvisor​
  • Products to make living at home easier and safer: Agingcare, Taylor Gifts, Gold Violin, Wright Stuff
  • Medical Alert Systems, Reviews.com, Guide to Alert Systems
Housing Trends and Issues
  • Life On a Cruise Ship, USA Today
  • Decluttering Guide for Seniors, Redfin
  • Decluttering Guide, Online Stamp
  • Downsizing/Rent vs Buy and related issues
  • Shift to Home Care and Adult Day Care, Senior Housing
  • Average Monthly Rents Across the Senior Housing Landscape, Sr. Housing
  • Hoarding, Dopa
Transitional and Dependent Living
​

​Apartments for Life (Aging in Community)
The Apartments for Life (A4L) movement has existed for nearly two decades in the Netherlands. Individuals who range in age and competency from completely independent to extremely dependent may age in place there, in their own dwelling unit, until death. Homecare workers provide scheduled help and assistance—once a day for more independent residents, or four to eight times in 24 hours for frailer residents. Unlike continuing care retirement communities, which also provide a continuum of care, residents in A4L settings remain in the same unit and services are increased based on need.

Continuing Care Communities
Continuing Care Retirement Communities (CCRCs) are facilities that include independent living, assisted living, and nursing home care in one location, to meet the needs of residents as they require more support. People most often move into such a community when they are healthy.

This type of housing enables spouses to remain close to each other even if one requires a higher level of care. The cost of buying a unit along with monthly fees can be very expensive. Fees increase as higher levels of care are required. Most facilities have a group dining area and common areas for social and recreational activities.
  • Guides and Tools for finding CCRCs: Retirement.org, AARP, Caring.com, A Place for Mom, Seniors for Living, SeniorHousing/A Place for Mom
  • Adding a University Component to CCRCs, Sr. Housing
  • Continuing Care at Home (CCaH), CCRCs without Walls, Sr. Housing
  • When is It the Right Time to Move Out of Your Home, BostonGlobe

Assisted Living, RCFEs Including Board and Care
Also known as residential care, board and care, congregate care, adult care home, adult group home, alternative care facility, or sheltered housing. This type of housing option is best for those who need help with some daily living activities such as bathing, dressing, medication management, and toileting. Costs tend to vary according to the level of daily help required, although staff is available 24 hours a day.

Some assisted living facilities provide apartment-style living with scaled-down kitchens, while others provide private or shared rooms. Most facilities have a group dining area and common areas for social and recreational activities.

Congregate Housing is usually located within a public housing facility, and is designed for people with limited incomes. Depending on the state, Medicare and Medicaid might pay for some services.

RCFEs (Residential Care Facilities for the Elderly/Board and Care Homes) 
serve persons 60 and older. They provide room, board, housekeeping, supervision, and personal care assistance with basic activities like personal hygiene, dressing, eating, and walking. Facilities usually centrally store and distribute medications for residents to self-administer. This level of care and supervision is for people who are unable to live by themselves but who do not need 24 hour nursing care. They are considered non-medical facilities and are not required to have nurses, certified nursing assistants or doctors on staff.
​
  • Guides and Tools for finding assisted living facilities: A Place for Mom, AARP, Caring.com, About AL, Eldercare.gov., SeniorAdvice, AssistedLiving.org
  • How to Pay for Assisted Living, AL
  • More on Adult Foster Homes, NextAvenue
  • More on Board and Care Homes, A Place for Mom
  • More on paying options for Assisted Living: ALFA
  • More about PACE--Program of All Inclusive Care for the Elderly, Assisted Living Today
  • Planning Ahead for Assisted Living, NextAve
  • Priciest Assisted Living Markets in the US, Senior Housing News
  • States with Highest/Lowest Assisted Living Costs, Senior Housing News
  • Guide for Easing the Transition to Assisted Living, MoneyGeek

Group Homes
An alternative for seniors who can't age in place. A smaller home-like setting compared to assisted living or nursing home facilities. Among the benefits, Group Homes provide more personalized care, higher staff to client ratios, home-cooked/customized meals, and a smaller monthly fee.  

Nursing Homes
Typically, this is the highest level of care for older adults outside of a hospital, and is designed for individuals who require rehabilitative care or can no longer live independently due to functional or cognitive impairment.  A licensed physician supervises each resident’s care and a nurse or other medical professional is almost always on the premises.

Skilled nursing care along with medical professionals such as occupational and physical therapists are also available. Most residents share a room, but are allowed to bring personal items to encourage a more home-like atmosphere. In recent years, nursing homes have attempted to create a more home-like atmosphere. Depending on the state, Medicare and Medicaid are available to pay for this type of housing.
  • Guides and Tools for finding nursing homes: A Place for Mom, Medicare, Caring.com, U.S. News.
  • More about PACE--Program of All Inclusive Care for the Elderly, Assisted Living Today
  • Rebooting the Nursing Home, The Agenda
  • How to Choose a Nursing Home for Personal-Directed Care, Pioneer Network
  • Nursing Home Abuse, NHAC
  • Saving for a Nursing Home Stay, CRR
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​Memory Care or Dementia Care Community
Communities that provide care to individuals with Alzheimer’s or dementia are governed by regulations to ensure that appropriate care is provided to residents. Rooms can be shared or private. In addition to the security of the building, a Memory Care community must provide programs to help residents with dementia, including: gross market skills, self care, crafts and other activities.

These units/communities are more expensive than a traditional nursing home or assisted living facility due to the extra care required for the residents. Depending on the state, Medicare and Medicaid are available to pay for this type of housing.
  • Guides and Tools for finding Memory Care facilities: A Place for Mom, Senior Living, SeniorAdvisor.com.
  • A New Plan for Memory Care Communites, Senior Housing
  • How to Pay for Memory Care and Manage Finances, SimpleDollar

Transitions: Assisted Living, Nursing Home, Memory Care Facility
  • Assisted Living versus Nursing Home Care, A Place for Mom 
  • Transitioning to a Nursing Home, Care Conversations 
  • Assisted Living or Nursing Home, Caring.com 
  • Easing the Transition, Everyday Health 
  • Making the Transition to a Memory Care Facility, HealthCentral 
  • Assisted Living or a Nursing Home, NY Times 
* More information in Caring for Elderly Parent section.​

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