Needing Some Help
Often the reason families are looking into different housing options is that their older family members need help on a daily basis. Depending upon the level of care needed, options include assisted-living residences and nursing homes.
Assisted Living - Assisted-living arrangements help people stay as independent as possible while offering necessary help. They provide personal care and support services or help with basic daily activities, such as bathing, dressing, and medication management. Most assisted-living residences provide apartment-style living, though there are also "board-and-care homes" and "personal care-group homes," which are single-family dwellings licensed at the state or local level to provide care. They offer meals, activities, housekeeping, transportation, and some level of security.
Nursing Homes - These facilities provide skilled nursing care for older adults who require it. While the homes have doctors on staff, nursing assistants provide most of the help with basic, daily activities, and nurses direct medical monitoring and intervention when necessary. Their work is often supported by speech, occupational, and physical therapists, who work to keep residents as strong as possible. The nursing-home decision is one of the most difficult housing choices that families have to make. Quality can vary among these facilities.
To find a certified facility, use Medicare's Nursing-Home-Compare Web portal to assess homes on a variety of measures. And if everyone decides that a home is the best option, be sure to stay involved with the facility. If there is not a "family council," start one. A council provides valuable information on services and facility management and allows caregivers to be advocates for their loved ones. For more information on advocating for your family member, see the National Citizens' Coalition for Nursing-Home Reform Web site.
Planning for the Future
It is important to remember that everyone in your loved one’s life is seeking to find the best housing fit for him or her. However, health conditions can change, and what seemed like a good fit last year may not be sufficient this year. There is, however, an alternative-housing option that adapts to accommodate people, no matter what their care needs are.
Continuing-Care Retirement Communities - These facilities feature independent-living apartments and homes and offer the various social, recreational, and cultural activities of other retirement communities. But they also have assisted-living and nursing-level care. In this "continuum-of-care" system, residents usually enter the facility at the independent-living level. Later, if their health and abilities decline, they can move to the assisted-living tier, and then, if necessary, to the nursing-home tier.