Seniors and their families have a wide variety of housing options to consider depending on the senior’s health status, mobility and need for care. In this article, Comfort Keepers® explores senior housing options: from staying in the comfort of their own home to moving to a skilled nursing site.
Home Care Services
If a senior’s medical needs are minimal and the senior’s primary need is assistance with activities of daily living, home is a good option. There are various types of support services needed to promote independent living.
If help is needed in assessing a family member’s care needs, a geriatrics care manager can help. Or call on Comfort Keepers. Our Client Care Coordinators will provide in-home assessments to determine care needs.
In-home service options range from offerings like home-delivered meals or transportation to personal care, companionship and homemaking care to skilled home health care.
While staying at home can be less expensive than living in a senior community, modifications may need to be made to the home to accommodate the changing needs of the senior (see “Adapting Homes to Seniors’ Changing Needs” at the end of this article).
These are apartments or condominiums exclusively for people age 55 and over who can live independently. Services vary from site to site but generally do not provide meals or personal care services. However, they often provide social activities or transportation to movies, sports events and other social opportunities.
Independent Living Communities
As the term implies, these communities, which consist of maintenance-free homes or apartments, are designed for independent, active seniors. Residents furnish the homes or apartments themselves. The communities generally offer 24-hour security, community centers, fitness centers and/or pools, and other types of services.
Independent living communities generally do not have 24-hour health care support, but such services may be purchased separately from outside sources or the community itself. Some include daily check-ins, while other communities charge for daily check-ins as an extra service.
Residents of assisted living communities do not require the skilled medical services of a nursing home yet have difficulty living independently and don’t have the support they need to live at home. Assisted living communities often provide three meals a day in a common dining room in addition to assistance with activities as housekeeping, laundry, dressing, bathing, and managing medications, and 24-hour security and staff availability.
They also provide access to health and medical services, as well as medical supervision or assistance. Transportation may be included in the fee.
Continuing Care Retirement Communities
Continuing care retirement communities (CCRC) combine independent living, assisted living and skilled nursing services. This provides residents access in one location to varying levels of service as their needs change. Services may vary, but generally include housekeeping, laundry, home and garden maintenance, and 24-hour security. These communities also often provide golf, tennis, exercise and swimming facilities, as well as art classes and other social and recreational activities.
Many CCRCs, unlike other senior housing options, offer residents a legal agreement to provide housing and services for life. They usually charge an entrance fee in addition to rental fees and payments for services not covered by rent.
Nursing homes serve seniors who require full-time care. Unlike the other housing options, a physician’s order is required for admission to a nursing home. Nursing homes offer 24-hour nursing and medical services; personal care services, such as help with dressing, bathing, eating, and toileting; physical, occupational and speech therapy; social activities; and three meals a day served in the dining room or the senior’s room.
Nursing homes are divided into two categories: intermediate care facilities (ICF) and skilled nursing facilities (SNF). ICFs provide eight or more hours of nursing supervision per day, and SNFs, 24-hour nursing supervision.
Nursing homes are regulated and licensed at the state level. In order to receive Medicare funding, the nursing home must meet Medicare certification standards.
These sites may be dedicated units in assisted living communicites, nursing homes, and continuing care retirement communities, or they may stand alone. In any case, they meet the special needs of persons with Alzheimer’s disease and other dementia-related conditions.
They are staffed and designed to provide 24-hour security and care for persons at all stages of dementia. They provide nursing care as well as therapy and activities that promote the quality of life of persons with dementia.
Some in-home care providers, such as Comfort Keepers, also provide Alzheimer’s and memory care services as well as in-home technology solutions that enable persons with dementia to continue living at home.
Hospice care for persons diagnosed with a terminal illness may be provided at home, as well as in a nursing home. Hospice includes medical and nursing care, as well as therapy, emotional, spiritual and bereavement support. Comfort Keepers works in partnership with hospice care providers to offer supportive in-home care services for persons receiving hospice care and their families.
Adapting Homes to Seniors’ Changing Needs
More Americans are choosing to “age in place”—that is, stay in their home rather than move to an alternative retirement setting. As they do, they are discovering the need to modify their homes to make them easier and safer to get around.
A new career field has risen to address this need: the Certified Aging-in-Place Specialist (CAPS), a program of the National Association of Home Builders. CAPS certified specialists assess homes to identify and recommend modifications to prevent injuries from falls and other risks.
According to the Centers for Disease Control (CDC), one third of Americans age 65 and over fall each year. The CDC adds that environmental factors lead to about half of all falls that occur at home. These include slipping and tripping hazards, poor lighting, or lack of needed modifications, such as bathroom grab bars, handicapped showers, stair railings and ramps.
For more information on home safety, read the CDC’s Check for Safety: A Home Fall Prevention Checklist for Older Adults brochure.
Home modifications help seniors maintain quality of life by preventing injuries and loss of independence from early admission to an assisted living or long-term care community.
Following are examples of commonly recommended modifications:
- Install grab bars for toilets and tubs and install a walk-in tub and/or tub seat
- Remove unnecessary throw rugs and fasten down rugs or floor runners to prevent slipping
- Move furniture to create clear walking paths
- Keep objects off the floor and coil or secure cords to the wall to prevent tripping
- Replace knobs with lever door handles
- Apply non-slip tape on uncarpeted indoor and outdoor steps
- Replace standard light switches with rocker-style switches
- Increase the width of doorways and hallways to accommodate wheelchairs, and where possible, lower sinks and countertops
- Move often used items to lower cabinets to avoid the need for step stools
- Repair or replace loose handrails and install adequate lighting in stairways
- Install an elevator or chair lift
- Install an elevated dishwasher or one with drawers for easy access
- Replace old stoves with induction cook tops to help prevent burns
- Replace ceramic tile floors with hardwood or vinyl for safe standing
Shedding Light on Home Modification
When modifying a home for a senior do not forget the importance of good lighting. Seniors need two to three times as much light to see as well as younger people.
Good lighting—in the form of natural light—provides seniors advantages besides safety:
- Sunlight produces a good dose of Vitamin D, which helps the body absorb more calcium to strengthen teeth and bones. Choose window treatments that allow in sunlight, without glare.
- Daylight also uplifts psychological health. It lessens the energy-zapping effects of Seasonal Affective Disorder (SAD) and other forms of depression.