Article Posted: 04/30/2008
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Housing Options for Older Adults
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Below are definitions and average costs of different housing options for older adults.  You may consider consulting the AgingPro directory to locate a housing referral agency to assist you in finding a good match.  Usually housing referral agencies are free- of- charge to families, and they get a referral fee from the facility if a client moves in. 

 

 

Independent Living / Senior Apartments / Senior Housing / Income-Qualified Housing / Congregate Care:

  • Apartment facilities with complete units (kitchen and bath)
  • Large hotel-type buildings where 50-100+ residents can live
  • Generally provide few, if any, supportive or personal care services
  • Most government-assisted housing falls in this category
  • If medical or custodial care becomes necessary, the facility is usually allowed to bring in outside help (such as home health or caregiving).  Most are licensed to provide assisted living, such as bathing, dressing, medication and escorting to meals
  • Incontinence, wheelchair dependency and mild dementia usually accepted

Independent living is for people who want to and are able to live independently but do not want to maintain a home.  Some people prefer to live in a community with others of the same age and with similar interests.  These placements meet this need by offering social activities and trips.  Many independent living facilities also offer prepared meals and provide a wide range of amenities.

Shared rooms can range from $1,200 - $3,000 per month.  Private room rates range from $2,000 - $4,000 per month.  Supplemental Security Income (SSI) will sometimes pay for these facilities for low income residents. 

 

Continuing Care Retirement Communities (CCRCs) / Life Care Community:

 

  • A community that offers several levels of assistance, including independent living, assisted living and nursing home care – residents move from one level to another as their needs change
  • Programs provide independent and assisted living, as well as nursing care
  • There is usually a significant payment (endowment) that is required upon admission along with monthly fees.  Sometimes lifetime contracts are written, which assures continuing care throughout ones lifetime.  The high costs of these programs make them generally inaccessible to low-income persons. There is no HUD financing or insurance associated with CCRC’s
  • Most of these communities admit people when they are still able to live independently.  Once admitted residents receive whatever care is needed for the rest of their lives
  • These communities can be expensive, yet offer all levels of care necessary.   Entrance fees range from $20,000 - $400,000, and often monthly fees range from $500 - $4,000+ per month.  Contracts vary widely, therefore it’s advisable to do some research before signing anything.  The entrance fee may be refundable  if the resident dies or moves, however, in other cases it is surrendered entirely upon signing the center’s contract

 

Assisted Living:

Assisted Living is a generic, universal name.  These facilities are referred to by different names around the country:

 

- Residential care
- Personal care
- Adult congregate living care
- Board and care
- Domiciliary care
- Adult living facilities
- Supported care
- Enhanced care
- Community based retirement facilities
- Adult foster care
- Adult homes
- Sheltered housing
- Retirement residences

  • It is a residential setting that provides personal care services, 24-hour supervision and assistance (scheduled and unscheduled), activities and some personal and health-related services. Services range from light housekeeping to daily assistance with personal care
  • Programs and a physical environment designed to maximize residents' dignity, autonomy, privacy and independence
  • There are limited programs that make assisted living more affordable through working with Medicaid and state-based funding.  Check with your local Area on Aging for programs in your vicinity
  • Costs range from $1,500 - $10,000 per month, averaging around $2,500 per month ($30,000 annually) nationally, depending on facility and care needs.  Private or semi-private rooms are available

 

 

Board and Care / Residential Care Facility for the Elderly (RCFE ) /

Adult Family Homes (AFH)

  • A general term for a licensed private home in a residential neighborhood
  • They provide services including:  meals, activities, transportation, administering  medication, supervision 24 hours a day 7 days a week, housekeeping, assistance with ADLs and laundry
  • They are generally licensed for under 10 residents
  • They may be run (managed?) by an individual or business partners, and they often hire other caregivers 
  • Sometimes they allow pets
  • Most provide specialized care to people living with developmental disabilities, dementia and/or mental illness
  • Some have hospice waivers, allowing hospice agencies to serve their residents.
  • Monthly fees often depend on the level of care required and are usually less than a nursing home
  • Check with your state community care licensing agency for specific state regulation, such as whether residents that are bed-bound are eligible
  • Costs range from $1500 - $4,500 per month, depending on care needs and location of the home.  The average cost in a 6-bed home is $2,500 a month for a shared bedroom and $3,500 for a shared (private?) room

 

Alzheimer’s / Dementia Care Facility

A facility specializing in the care of residents with Alzheimer’s Disease or dementia.  Either the entire facility offers Alzheimer’s care or it is designated to a specific area or floor.

 

Skilled Nursing Facility (SNFs) / Convalescent Care Home / Long-Term Care Facility

  • Provides 24-hour skilled care for acute or frail patients that do not need the level of care that a hospital would provide but need more than home care
  • Patients generally rely on assistance for most or all of their daily living activities (such as bathing, dressing and toileting)
  • Because it is skilled care, in many cases it is covered by Medicare and secondary insurance for up to 100 days. Beyond that, it must be paid for privately, by long-term care insurance or by Medicaid/Medi-Cal
  • Residents generally share a room with one or two other residents.
  • Meals are provided in a group dining area
SNFs offer 24-hour skilled nursing care, including licensed professionals such as certified nursing assistants (CNAs), registered nurses (RNs) and licensed vocational nurses (LVNs).  Other professional services such as speech, occupational and physical rehabilitation will often be offered.  Licenses vary by facility.  Some are able to accept patients with g-tubes, IVs or tracheotomies.  Prices average $76 per day (shared room) $203 for private room (averaging over $70,000 per year).   Many accept Medicare (if coming from a hospital) or Medicaid /Medi-Cal and private pay.
For detailed information about the past performance of every Medicare and Medicaid certified nursing home in the country, go to Medicare.gov   www.medicare.gov/NHCompare.

 

 

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