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Staying in the family home is not always the right choice for seniors. While many of our clients tell us that their plan is to age in place, research shows that staying at home until the end of life may not be ideal or even feasible. According to a recent Medicare Survey, almost one in four seniors over the age of 85 live in housing communities with services, some of which are long term care facilities. When seniors do decide to leave the family home, they face a challenging decision: where to live next. There are many different housing options available to seniors and it is best to compare costs, features and amenities before making a final decision.

Below is an overview of the different housing options and some of the factors to consider when a move is desired or necessary.

Independent Living Communities
In basic terms, independent living is any housing arrangement designed exclusively for seniors, generally those aged 55 and over. Residences can vary widely, from apartment-style living to freestanding homes. In general, the housing is more favorable to older adults, often being more compact, easier to navigate, and with no significant maintenance or yard work.

While residents live independently, most communities offer amenities, activities, and services. Frequently, recreational centers or clubhouses are available on site to give seniors the opportunity to connect with neighbors and participate in community activities, such as holiday gatherings, classes, or movie nights. Independent living facilities may also offer amenities such as swimming pools, fitness centers, tennis courts, even a golf course or other social clubs and interest groups. Other services offered in independent living may include daily meals, basic housekeeping, laundry services, onsite spas and salons.

Since independent living facilities are aimed at older adults who need little or no assistance with activities of daily living, most do not offer medical care or nursing staff. As with regular housing, though, you can hire in-home help separately as required.

Popular examples in the Bay Area include Smith Ranch Homes, Tam House, The Broadmoor, Atria (multiple locations) and Presidio Gate Apartments.

Dependent (Assisted) Living
Assisted living is a residential option for seniors who want or need help with some of the activities of daily living—things like cooking meals, getting to the bathroom in the middle of the night, housekeeping, and transportation to appointments.

An assisted living facility may be a good choice for someone who needs more personal care services than are available at home or through an independent living retirement community, but who also does not require the continuous medical care and supervision of a nursing home.

Assisted living facilities offer the safety and security of 24-hour aides and access to care. However, privacy and independence are encouraged. Commonly, facilities will develop a plan that meets your needs and accommodates your disabilities, while giving you the freedom to do what you can for yourself. In general, assisted living is in a residential type facility, ranging from converted homes or apartment complexes to renovated schools. Some provide apartment-style living with scaled down kitchens, while others provide rooms. Unless you’re willing to pay a higher cost for a private room, you may have to share a room in some facilities. Typically facilities have a group dining area and common areas for social and recreational activities.

Popular examples in the Bay Area include Vintage Golden Gate, Alma Via, Avalon Mill Valley, Casa Fairview, Aegis (multiple locations), Cardinal Point, and The Berkshire.

Nursing Home
A nursing home is the highest level of care for older adults outside of a hospital. While they do provide assistance for daily living activities, nursing homes differ from other senior housing options in that they also administer a high level of medical care. A licensed physician supervises each resident’s care and a nurse or other medical professional is always accessible. Skilled nursing care and medical professionals such as occupational or physical therapists are also available.

A nursing home may be a smart choice if someone’s medical and personal care needs have become too overwhelming at home or in another facility. This may be due to a recent hospitalization, or a chronic illness which has gradually led to declining health. They may also be appropriate for someone in need of rehabilitation services temporarily after a hospitalization. In this case, the person may anticipate returning home or to another facility after a period of time.

Popular examples in the Bay Area include The Redwoods, Jewish Home – San Francisco, Saratoga Retirement Community, Country Villa (multiple locations), and the Fruitvale Health Care Center.

Continuing Care Retirement Communities (CCRC)
CCRCs are facilities that include independent living, assisted living, and nursing home care in one location, so seniors can stay in the same general area as their housing needs change over time. Typically, there is a fee for buying a unit in the community as well as monthly fees that may or may not increase as you require higher levels of care. A CCRC can allow spouses to be very close to one another even if one requires a higher level of care than the other.

Popular examples in the Bay Area include The Tamalpais, Villa Marin, San Francisco Towers, The Sequoias, The Terraces, Vi at Palo Alto, The Peninsula Regent, and The Forum at Rancho San Antonio.

Factors to Consider
There are a number of financial and non-financial factors to consider when choosing a retirement community including: affordability of fees, level of medical services provided, social life and recreational options, and other personal services offered. Contracts, especially for CCRCs, can also be quite complex and you will want to understand the details before making a final decision.

Fortunately, there are a number of helpful information sources available and your BOS advisory team can provide a list of questions to consider, as well as direct you to educational resources.

Filed under: Retirement Planning

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