"Be nice to your kids -- they'll choose your nursing home" is a popular phrase that has popped up on everything from greeting cards to bumper stickers. As it turns out, kids have a lot more choices than just which nursing home to pick; now it's a question of whether they'll turn to a nursing home at all. For aging adults, the long-term care options are so varied that it sometimes feels like you need a dictionary just to decipher the differences between them all.
Perhaps that bumper sticker sentiment should be amended to read, "Be nice to your kids -- and teach them how to shop around." Picking the right living option for an aging person involves considering the amount of medical care that is needed, whether the aging adult in question is a loner or a people person, and how much money is available. Just as we have criteria for our dream homes, like a pool, we may have criteria for how we spend our last years, like a private room.
It's never too early to start learning about your options, so whether you're one of those kids working on behalf of an aging parent or an adult starting to wonder if the house is just a little too big for you now, read on to find out about five places that cater to aging adults.
5: Home Care
Let's say you got married and bought your dream home -- the house that you raised your children in, a place where you imagined growing old. Many aging adults want to stay in their own home, though they may make a few changes that indicate their changing condition. For example, they may integrate features such as a grab bar in the shower or install an elevator for wheelchair and walker use. Aging adults may need help a few days a week with housekeeping or health care issues, and there are many home care agencies that can provide these services.
Sometimes, though, it becomes apparent that the home is not meeting the aging adult's needs. Maybe all the nearby friends have passed away or it's just too big for one or two adults living on their own. Because long-term care in a facility can be expensive, many aging adults elect to move in with their grown children. This option works out well for some, but be aware that it requires some delicate negotiation in terms of roles and responsibilities as the child assumes a caregiver role.
It's also worth nothing that people select this option thinking it will be inexpensive, but the hidden expenses for the caregiver add up. Adult children tend to pay out of pocket for their parents' needs to the tune of several hundred dollars a month [source: Gross].
4: Board and Care Homes
If seniors need more companionship and assistance in a day than living alone can provide, then the next step might be a group living arrangement. Board and care homes can be thought of as the fraternity and sorority houses of the elder care world, minus all the debauchery and hazing. These homes, run by groups or agencies, consist of several aging adults living together in a single-family home, which offers opportunities to socialize in an environment that doesn't feel sterile or institutionalized. Meals and housekeeping are provided, and staff is on hand to help a resident make it to a doctor's appointment or to provide a reminder to take medication.
This is a good option for aging adults who are still fairly independent but need just a little assistance or companionship. However, this situation might not be ideal for someone who places a high value on a private room or doesn't like to share or socialize. While these homes cost less than a nursing home would, they're usually not covered by Medicare or Medicaid.
In some states, these arrangements might fall under the category of "assisted living," a term that has come to denote many different types of arrangements. We'll take a closer look at assisted living on the next page.
3: Assisted Living
Assisted living represents the exact middle of the road as far as elder care housing is concerned. This is the halfway point between living on one's own and requiring the continuous care of a nursing home. As we mentioned on the last page, assisted living can be a very broad term these days, so aging adults will need to do some research to find a home that meets their needs.
Assisted living facilities may provide everything from a shared room to a private one-bedroom apartment that you can decorate with your favorite furnishings from home. Regardless of the set-up, though, the focus is on helping aging adults remain autonomous and active while providing assistance with daily tasks such as bathing, dressing and eating.
Assisted living facilities provide meals, light housekeeping and some social activities, but they don't offer the kind of supervision or medical services that a nursing home provides. Because of this, residents may be asked to leave assisted living facilities once their health declines. These health standards will be included in the facility's contract, so it's important to read all documents carefully to avoid unpleasant surprises. But where can you go if you need additional medical help?
2: Nursing Homes
Nursing homes provide around-the-clock medical care. We tend to think of them primarily as a long-term care option, but nursing homes are also available for short-term stays. Short-term patients may be recovering from an illness or injury and not quite ready to be on their own yet. Meals, housekeeping and social activities are all part of the package. Unfortunately, you'll pay a pretty penny for that level of care, which is why many nursing home residents receive assistance in the form of Medicare or Medicaid. While we may have the impression that nursing homes are institutionalized places that rob people of their privacy and autonomy, many facilities strive to create a homey atmosphere where the resident is valued as an individual.
If you're the kind of person that just can't make up your mind, then you might like the opportunity presented on the next page.
1: Continuing Care Retirement Communities
Can't decide which option is right for you? Are you independent now but understand that there might be a time when you're not? Are you rich? If so, then a continuing care retirement community, or CCRC, might be for you. This is the big kahuna of elder care options, if only because it encompasses all levels of housing and treatment. You could begin living in an apartment and then move to assisted living and then a nursing home as your health declines.
This option is popular because it provides peace of mind -- if you find a community you like, you'll be set for the duration of your life. However, peace of mind and long-term care are rarely cheap. CCRCs generally require one large entrance fee, which could range from $20,000 to $400,000, followed by monthly fees for the length of the stay [source: Morris]. These communities also require a good deal of advance planning, as they often only accept people who are healthy enough for some of the more independent living options. If you are looking into this option, be sure to investigate more than just that swanky apartment you'll start off in. You'll also need to investigate the nursing facilities that might be in your future as well.
For more in-depth information on these housing options and how to choose the best one, have a look at the links on the next page.
Lots More Information
Related HowStuffWorks Articles
- 5 Things to Look for in Long-term Care
- 5 Tips for Adjusting to an Empty Nest
- 5 Signs an Elderly Person Shouldn't be Living Alone
- How Assisted Living Works
- 10 Ways to Protect Your Joints
- "Alternatives to Nursing Home Care." Medicare. March 27, 2008. (March 9, 2009)http://www.medicare.gov/Nursing/Alternatives/Other.asp
- "Choosing a Long-Term Care Option." Pioneer Network. (March 9, 2009)http://www.pioneernetwork.net/Consumers/Choosing/
- Gross, Jane. "Elder-Care Costs Deplete Savings of a Generation." New York Times. Dec. 30, 2006. (March 9, 2009)http://www.nytimes.com/2006/12/30/us/30support.html?_r=1
- "Housing Options for Older Adults: A Guide to Making Housing Decisions." Eldercare Locator. (March 9, 2009)http://www.eldercare.gov/Eldercare.NET/Public/Resources/fact_sheets/pdfs/Housing%20Options%20Booklet.pdf
- Leland, John. "For Families of the Ailing, a Brief Chance to Relax." New York Times. August 19, 2008. (March 9, 2009)http://www.nytimes.com/2008/08/19/health/19aging.html
- "Living in a Nursing Home: Myths and Realities." American Health Care Association, National Center for Assisted Living. (March 9, 2009)http://www.longtermcareliving.com/family_guide/myths/myth1.htm
- Matthews, Joseph L. "Choose the Right Long-Term Care." Nolo. July 2002.
- Morris, Virginia. "How to Care for Aging Parents." Workman Publishing. 2004.