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Choice in Housing and Policy Solutions
A wide range of housing options is necessary to support an individual’s choice to age in place, age in community or move to assisted living should be available. As such, the availability of accessible, affordable, and integrated multi-generational housing options is critical to promoting and sustaining independence and successful aging in communities.
A range of housing stock that meets the needs of older adults is a key part of creating livable communities. Many obstacles, however, stand in the way of this goal, whether discrimination by a landlord, physical barriers, or substandard housing stock. Alternatively, advances such as universal design elements and supportive services can contribute greatly to the quality of life for all, at a relatively reasonable cost. The public and private sectors must work together to increase the number of homes that work for people as they age.
“Supportive housing” refers to residential settings that offer services such as group meals, transportation, and help with housekeeping and personal care. Because the services are provided in a residential setting, there are many housing-related issues that make these settings different from institutions such as nursing homes. Supportive housing options increase an individual’s ability to live longer in a community setting and age in place. They are expanding as a result of consumers’ desire to remain outside of institutional settings, policymakers’ desire to provide fiscally responsible quality care for increasing numbers of older people, and providers’ interest in developing new settings for service delivery.
Congregate housing is typically an apartment building for people who are living independently and want common services, such as one meal a day or light housekeeping. Congregate housing does not generally provide personal care or oversight.
Continuing care retirement communities (CCRCs) provide shelter, social activities, health care, and supportive services under a variety of contractual arrangements that often include substantial up-front fees with guarantees of increasing levels of services as needed. CCRCs are usually campus-like complexes, with most residents living in private apartments, and usually include an assisted living building and a skilled-nursing home.
Assisted living residences are residential group settings providing personal care to residents who need assistance with daily activities such as bathing, dressing, taking medication, and preparing meals. The philosophy of assisted living emphasizes providing physically and cognitively impaired older people with personal and health-related services needed to age in place in a home-like environment that maximizes dignity, privacy, independence, and autonomy. At present most legislative and regulatory activity in the supportive housing arena concerns implementing the philosophy of assisted living in the daily lives of residents. Major goals include:
- Maximizing the ability to age in place
- Balancing safety and autonomy
- Maximizing privacy
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