Housing for Older Adults - Deb Richmond, Author

As our parents grow older, they may need help with daily living tasks like making meals, running errands and shopping, cleaning and laundry, and getting to appointments. The challenge of taking the right meds every day can be a struggle even for those in mid-life. I used to think housing for older adults meant living independently in their homes or going straight to the convalescent home. But in searching for a placement for my in-laws years ago, I found many options between farmhouse and nursing home.

I am not an expert in this field, only someone who has searched through the possibilities. As you consider a placement for a parent who needs intervention, be sure to do ample research and visitation.

Each facility uses its own terms and provides unique levels of care. The following descriptions of housing for older adults are general guidelines and will vary from place to place.

Housing for Older Adults:

CCRC – Continuing Care Retirement Community – This is an all-in-one option. Residents can move to different units depending on their care needs. These include independent living apartments or cottages for adults who want independence without yard care and home upkeep. As residents require more help with personal care such as meals and housecleaning, they can move to assisted living areas where daily care is available. When mobility and healthcare concerns become a challenge, residents transition to a nursing home staffed by skilled medical workers. CCRCs tend to be expensive because they offer many options for the retirement to end-of-life journey.
Retirement communities – There is another option besides the cottage or small house located near a retirement/nursing home. Some communities are designed for people aged 55+. These housing developments often offer transportation, landscaping, and central locations for gatherings, meals, recreation, and fitness activities. Residents may rent or own housing units. This kind of living may require a major move as many of these communities are located in Arizona, California, and Florida.
Senior co-housing – This idea is similar to retirement communities but may be less expensive. Residents share housing and utility costs, and the houses are often centered around parks, pools, playgrounds (well, maybe not playgrounds), and gardens. Not every state has senior co-housing for older adults options.

Faith-based senior communities offer housing at various need levels and are supported by church, ministry, or denominational resources and values.

Subsidized senior housing – Some communities offer independent apartments, partially government-funded, that offer assistance with transportation, meals, and shopping,

Board and care homes offer no nursing or medical care. Staff members help with meals & personal care. They tend to be small, privately owned, usually 20 or fewer residents, with private or shared rooms. These are sometimes called residential care facilities or group homes.

Accessory Dwelling Units (ADUs), mother-in-law apartments, or, as my Pennsylvania Dutch relatives called it – Dawdy Haus may be an option. Caring for older parents, for many, is a matter of having extended family living in or near the family home. For example, some families convert a basement, spare room, or garage to a living unit because the older generation can live independently but with visits from family members. This is a great option if the desire is to keep family close by. However, it requires the availability of unused living space and some remodeling for walk-in/sitting showers, handrails, and one-floor maneuvering.

Assisted Living/Personal Care Homes are independent apartments or rooms where residents may find assistance with meals, cleaning, laundry, and medications. These facilities usually include full-time staff and security and usually provide recreation and social events.
Nursing homes or skilled nursing facilities provide 24-hour medical care and supervision. They may also offer long-term rehabilitation services.

Support Services:

Adult Day Care – Caring for aging parents in a multi-generational home can be much like living with toddlers. For example, toddlers can play independently but should not be left alone for long periods of time. As older adults reach a place where safety is a concern, many people turn to the services of adult daycare centers. These facilities benefit not only the older adult but the caregiving family members, too. They allow caregivers to continue with full-time jobs while the older parents enjoy socialization, supervision, and appropriate levels of activity.

Senior community centers – Many communities offer activity days that go beyond the stereotypical Bingo sessions. Some centers provide learning opportunities like classes, lectures, and continuing education courses. Some offer physical activity clubs like a walking club or a gardening group.

Adult foster care options include a small number of residents living independently but in close proximity with the support of staff. This lifestyle provides assistance with daily tasks but not round-the-clock care. At present, these facilities are only available in a few states.

In-home care – A Google search will most likely bring up a variety of organizations and services. In my rural area, I was able to find local help for meals (Meals on Wheels), managing medications, how to obtain medical equipment like wheelchairs, hospital beds, and walkers, and professional advisors on caring for older parents. In recent years, though, a shortage of personnel has made these services harder to find.

Home health services – Professionals who visit the home can help with adult care needs, such as therapy, nursing care, socialization, mental health, household chores, nutritional support, and transportation needs. These services vary from place to place.
Respite care – Being a caregiver can be exhausting. At times, the caregiver may need someone to serve as a substitute or stand-in. Professional respite care provides workers who can step in for several hours or several weeks. Before looking into professional respite care, though, call in the family reserves. Are there family, friends, church members, or neighbors who would be willing to care for an older parent for a period of time?

End-of-Life Care:

Palliative care – For those facing life-limiting conditions, palliative care professionals work to help reduce pain and make the remaining days as comfortable as possible.
Hospice – When the end of life nears, hospice teams provide medical, emotional, and spiritual care for both the dying person and their family. Hospice workers provide helpful information and advice for family members to support in understanding what is happening and what is about to happen. Both palliative and hospice care can take place in any setting, hospital or home.