If you are caring for an aging parent, at some point you should have a conversation about housing options for when they can no longer live on their own. Although most seniors say they want to age in place, often it isn’t practical to do so. The more you know about the options available for long-term care, the easier it will be when the need arises. And the need will arise for many.

According to the Center for Disease Control, more than 8 million people annually receive support from the 5 main long-term care services: home health agencies, nursing homes, hospices, residential care communities and adult day care service centers. Approximately 65% of persons needing long-term care are aged 65 and older, the remaining 37% are 64 years or younger.

Long-term care is defined as the support needed when individuals can no longer perform regular daily functions for themselves due to a chronic condition, trauma or illness.  These functions may range from household chores, meal preparation and money management to the more basic self-care tasks of bathing, dressing and eating (referred to as Activities of Daily Living, or ADLs). According to the U.S. Senate Special Committee on Aging, long-term care “differs from other types of health care in that the goal of long-term care is not to cure an illness, but to allow an individual to attain and maintain an optimal level of functioning.”

Long-term care housing options fall into a number of categories: home care, independent living communities, assisted living, board and care, skilled nursing and continuing care communities.

Home care. There are two main options for home care providers: full service agency and private caregiver.  Caregivers provided through a full service agency are pre-screened, and paid by the agency. This relieves you of the payroll, insurance and personnel issues encountered with a privately hired caregiver. Also, because the agency has a pool of caregivers, if your assigned caregiver is sick or doesn’t work out, the agency can quickly provide another.  Because of these services, however, you will typically pay more for a caregiver through a full service agency than when you hire someone yourself.

The cost of hiring a private caregiver will typically be lower than through an agency you often have more control over scheduling and activities. Because you are the employer, however, you must adhere to relevant, current employment and tax laws. And unless you’re able to arrange for back up, you may be left without a caregiver in the event of unplanned absences and other disruptions.

Independent living communities are targeted to seniors over 55 and may include single family homes, apartments and townhomes. These communities often have planned activities and minimal assistance with yard work or other maintenance needs. This option gives the senior independence and a sense of community while generally reducing the amount of home upkeep required.

Assisted living communities are an option for those who need assistance with their basic activities of daily living (ADLs) such as bathing, grooming, dressing, etc. These communities also have planned activities, transportation services and offer meals as part of the monthly cost. Often senior living communities will have an assisted living section where independent living residents move when they begin to need assistance with their ADLs. Assisted living communities differ from nursing homes in that they don’t offer complex medical services.

Many assisted living facilities have a special section focused on providing different levels of care for seniors with dementia. It’s important to note here that as the level of care increases, so does the cost of the facility.

Board and care homes are residences that offer housing and personal care services for from 3 to 16 residents. Board and care homes are private and residential, often in a converted or modified single-family home. Residents may share bedrooms or bathrooms, and meals and housekeeping are included. These homes are not certified by Medicaid, but are licensed and approved by the State.

Skilled nursing facilities are for older adults who require a higher level of care 24/7.
There are a number of things to consider as you determine the best housing option for your loved one. Their wishes, their health and mobility and, perhaps most importantly, their financial situation – what will their resources support and for how long?

One of the services I provide my clients is evaluating the options from a personalized financial perspective, and presenting various scenarios so they can make an informed decision in the best interests of their loved one. If you’re interested in learning more, please contact me.

Although most of us would agree that “there’s no place like home,” a housing option that’s the right fit for your senior can be the next best thing.